NRE-1 June 2025

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 Disclaimer
MCQs given above are recreated from Recalls
and solved by Team First Aid Made Easy. Errors
and Omissions Accepted. If you found any
Statement different/incorrect from the
statement in exam.
Please inform at 03325972869.
This is a tentative Key. Final Key will be shared
in the given group later.
https://chat.whatsapp.com/HLU08oMFY
8YLTivkC7a6dO

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 Regards

DR HAFIZ ATIF
USMLE, (FCPS, MD/MS)-1
Research Scholar at DUKE UNIVERSITY USA

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Q.1 A homeless alcoholic presents to you with fever, cough, and pleuritic chest pain. X-ray chest showed
right upper lobe consolidation. What is the most likely organism?
A. Klebsiella
B. Staphylococcus
C. Pseudomonas
D. Pneumococcus
Answer: A. Klebsiella
Explanation

Feature Key Point

Risk Group Alcoholics, homeless, diabetics
Lung Involvement Right upper lobe consolidation
Sputum Currant jelly (bloody, mucoid)
Type Necrotizing lobar pneumonia
Organism Gram-negative, encapsulated rod
Klebsiella pneumoniae is classically associated with aspiration pneumonia in alcoholics, often causing right
upper lobe consolidation and producing currant jelly sputum due to necrotizing hemorrhagic inflammation.
It is a gram-negative, encapsulated rod commonly seen in debilitated patients (e.g., homeless, alcoholic).
B. Staphylococcus aureus – Post-influenza; causes cavitations/abscesses, not typical in alcoholics.
C. Pseudomonas – Seen in nosocomial, ventilated, or structural lung disease patients.
D. Streptococcus pneumoniae – Common CAP; usually lower lobes, less necrotizing, not alcohol-specific.

Q.2 A 35-year-old female presents with bloody nipple discharge and a mobile rubbery mass, but no lump
or rash found in the breast. What is the most likely diagnosis?
A. Papilloma
B. Duct ectasia
C. Paget disease of breast
D. Fibroadenoma
Answer: A. Papilloma
Papilloma is the most common cause of bloody nipple discharge in premenopausal women. It presents with
unilateral, spontaneous, bloody or serous discharge and may have a small retroareolar mass. It is benign
and typically seen in women aged 30–50.

Feature Details
Definition Benign epithelial tumor of the lactiferous (milk) ducts
Typical Patient Women aged 30–50 years
Presentation Unilateral, spontaneous, bloody or serous nipple discharge
Mass Often no palpable mass, or small retroareolar mass
Imaging Ultrasound: intraductal solid mass in dilated duct
Diagnosis Duct excision or core needle biopsy to rule out atypia
Management Surgical excision (to relieve symptoms + confirm benign nature)

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B. Duct ectasia – Green/gray discharge, nipple inversion; common in postmenopausal women.
C. Paget disease – Eczematous nipple changes, not an isolated discharge; linked to breast cancer.
D. Fibroadenoma – Painless, mobile breast mass; no nipple discharge.

Q.3 A patient after earthquakes with minor injuries is categorized in color. What is the correct triage color
category?

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A. Red
B. Yellow
C. Green
D. Black
Answer: C. Green
A patient with minor injuries after an earthquake who is ambulatory and stable is triaged as green under
disaster triage protocols. This category, often referred to as the "walking wounded," includes individuals who
do not require immediate medical attention and whose treatment can be safely delayed without significant
risk. These patients help preserve critical resources for more urgent cases.
Color Category Meaning
Red Immediate Life-threatening injuries; require urgent intervention
Yellow Delayed Serious but not immediately life-threatening injuries
Green Minor (Walking Wounded) Minor injuries; ambulatory; treatment can be delayed
Black Expectant/Deceased Unsurvivable injuries or already dead

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A. Red – Incorrect. Red is for life-threatening but survivable conditions that require immediate intervention,
such as airway compromise or severe bleeding
B. Yellow – Incorrect. Yellow is used for serious injuries that are not immediately life-threatening but need
treatment soon (e.g., open fractures, significant wounds).
D. Black – Incorrect. Black is assigned to patients who are dead or have injuries incompatible with survival,
such as massive head trauma or cardiac arrest without response.
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Q.4 A physician diagnosed a 33-year-old man with vitamin-A deficiency. What would be the most likely
symptom in such a patient?
A. Red-eye
B. Conjunctival infection
C. Diplopia
D. Night blindness
Answer: D. Night blindness
A patient with vitamin A deficiency most likely presents with night blindness, the earliest and hallmark
symptom. Vitamin A is essential for the regeneration of rhodopsin in rod cells, which is critical for low-light
(scotopic) vision. Deficiency impairs dark adaptation, leading to difficulty seeing at night. Common in settings
of malnutrition, fat malabsorption, or liver disease, it may progress to xerophthalmia and Bitot spots if
untreated.

Key Point High-Yield Fact

Function Vision, epithelium, immunity
Cause Malnutrition, fat malabsorption
Signs Night blindness, Bitot spots, dry skin
Risk Measles complications ↑
Treatment Vitamin A supplementation

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Red-eye – Seen in infections or irritants; not related to vitamin A.
B. Conjunctival infection – Suggests conjunctivitis; unrelated to deficiency.
C. Diplopia – Indicates neurologic or ocular muscle issues; not a feature of vitamin A deficiency.

Q.5 A woman presented at 36 weeks with blood pressure 130/80 on two different occasions and 1+
proteinuria. What is the most likely diagnosis?
A. Preeclampsia

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B. Gestational Hypertension
C. Chronic Hypertension
D. Ecclampsia
Ans : . Preeclampsia
Disorder BP Criteria Timing Proteinuria Seizures Other Features
Before 20 ± (may be
Chronic HTN ≥140/90 mmHg No May persist postpartum
weeks present)
Gestational After 20 No end-organ
≥140/90 mmHg Absent No
HTN weeks dysfunction
May have severe
≥140/90 mmHg After 20 Yes (or organ
Preeclampsia No features: ↑ creatinine,
(after 20 wks) + weeks damage)
↑ LFTs, ↓ platelets
Any time
Yes or organ Seizures without other
Eclampsia Preeclampsia + (usually after Yes
damage cause
20 wks)
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Q.6 A 48-year-old woman with a known history of Rheumatoid Arthritis presents with fatigue and pallor.
Her CBC shows anemia. Iron studies reveal low serum iron, normal TIBC, and normal ferritin levels. What is
the most likely cause of her anemia?
A. Iron deficiency anemia
B. Anemia of chronic disease
C. Aplastic Anemia
D. Sideroblastic Anemia
Answer: B. Anemia of chronic disease
This patient's history of Rheumatoid Arthritis and iron study pattern (low serum iron, normal TIBC, normal
ferritin) are classic for anemia of chronic disease (ACD). In chronic inflammation, cytokines like IL-6 increase
hepcidin, which blocks iron release and reduces erythropoiesis. The result is impaired iron utilization despite
adequate stores, reflected by normal or high ferritin and low iron without increased TIBC. This is a common
cause of normocytic or mildly microcytic anemia in chronic inflammatory states.

A. Iron deficiency anemia – Typically shows low iron, high TIBC, and low ferritin; not seen here.
C. Aplastic anemia – Presents with pancytopenia, not isolated anemia; unrelated to iron studies.
D. Sideroblastic anemia – Often shows elevated serum iron and ferritin, with low TIBC; iron is not low.
Serum Transferrin
Cause TIBC Ferritin RDW Key Features
Iron Saturation
Iron Deficiency Most common; late phase =
↓ ↑ ↓ ↓ ↑
Anemia microcytic, hypochromic
Anemia of
↓ or Normal Often normocytic early; ↑
Chronic ↓ ↓ or normal Normal
normal or ↑ ferritin due to inflammation
Disease
↓ MCV with normal RDW;
Thalassemia Normal Normal
Normal Normal or ↑ Normal target cells; confirmed with
(Trait) or ↑ or ↑
Hb electrophoresis

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 Ringed sideroblasts on
Sideroblastic Normal
↑ ↑ ↑ ↑ marrow stain; associated
Anemia or ↓
with alcohol, lead
Normal Normal Basophilic stippling; ↑ free
Lead Poisoning Normal ↓ or normal ↑
or ↓ or ↑ erythrocyte protoporphyrin
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Q.7 A man with a history of working in a glass factory presents for evaluation. The patient also has renal
failure. Which of the following types of poisoning is most commonly associated with this occupational
exposure?
A. Lead
B. Mercury
C. Silica
D. Cadmium
C. Silica: Correct. Silica exposure is common in glass factories. Chronic inhalation of silica dust can lead to
silicosis, a lung disease that can also result in kidney damage, contributing to renal failure. This makes it the
most likely cause of the patient's renal issues in this occupational context.
· A. Lead: Incorrect. Lead exposure is typically linked to industries like battery manufacturing, painting, and
plumbing, rather than glass production.
· B. Mercury: Incorrect. Mercury poisoning is more common in industries such as thermometers, batteries,
and mining, not glass manufacturing.
· D. Cadmium: Incorrect. While cadmium can cause kidney damage, it is primarily associated with industries
like battery manufacturing and metalworking, not glass factories.
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Q.8 Which of the following is a clinical feature of median nerve injury?

A. Wrist drop
B. Ape hand
C. Footdrop
D. Claw hand
Answer: B. Ape hand
Explanation:

Feature Description
Cause Median nerve injury (commonly at the wrist)
Thenar atrophy Wasting of the thenar eminence
Thumb position Pulled into the same plane as fingers (adducted)
Loss of movement Inability to oppose and abduct the thumb
Functional deficit Impaired precision grip (e.g., pinching or writing)

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nerve.

A. Wrist drop – Seen with radial nerve injury, due to paralysis of wrist extensors.
D. Claw hand – Classic for ulnar nerve injury, affecting intrinsic hand muscles (lumbricals/interossei),
especially the 4th and 5th digits.

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Q9. After committing suicide, the revolver remained firmly grasped in the hand of a person. What is the
name of this phenomenon?
A. Instantaneous rigor
B. Rigor mortis
C. Secondary relaxation
D. Primary rigidity
Correct Option: A

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Q.10 What is the most sensitive test for diagnosing Rheumatoid Arthritis?
A. Anti-CCP
B. ANA
C. Rheumatoid Factor (RF)
D. Anti-ds DNA
9. Answer : C
Test Sensitivity Specificity Notes
RF 80–86% Moderate Best sensitivity; elevated in other conditions

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 Anti-CCP ~70% >90% High specificity, predicts severe disease
ANA 30–50% 85% Nonspecific; often positive in other diseases
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Q.11 Which of the following vaccines is given at 9 months of age in association with the measles vaccine?
A. Polio
B. Rubella
C. Rotavirus
D. Mumps
Answer: MR (Measles-Rubella) is the standard combination given at 9months to protect against both viral
illnesses early in life.

Q. Koplik spots are characteristic of which disease?

A. Rubella

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B. Measles
C. Scarlet fever
D. Diphtheria
Correct Answer: B

Item Key Point

Virus Paramyxovirus (RNA)
Prodrome 3 Cs: Cough, Coryza, Conjunctivitis
Spot Koplik spots (buccal mucosa)
Rash Starts at hairline, spreads down
Complications Pneumonia, encephalitis, SSPE
Treatment Supportive + Vitamin A
Prevention MMR vaccine (live attenuated)

Koplik spots are pathognomonic for measles (rubeola). They are tiny white or blue-white lesions with an
erythematous base, found on the buccal mucosa, typically 1–2 days before the skin rash appears. They are
part of the prodromal stage, along with the 3 Cs: coryza, cough, and conjunctivitis. Their presence strongly
supports a clinical diagnosis of measles.

A. Rubella – Presents with mild fever and maculopapular rash, but no Koplik spots; often associated with
postauricular and occipital lymphadenopathy.
C. Scarlet fever – Caused by group A strep; features strawberry tongue, sandpaper rash, and pharyngitis,
but no Koplik spots.

D. Diphtheria – Characterized by pseudomembrane formation in the throat and toxin-mediated

complications; not associated with buccal mucosal spots.

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Q.12 A 65-year-old patient with a history of long-term NSAID use now presents with severe anemia. What
is the most likely cause? (MCQs were not provided by the students, here are the most likely)
A. Hemolysis
B. Upper gastrointestinal bleeding
C. Nutritional deficiency
D. Bone marrow suppression
Key :: B

Pathophysiology of NSAID-induced Peptic Ulcers (Short & High-Yield)

Mechanism Details
COX Inhibition NSAIDs inhibit COX-1 and COX-2 enzymes.
↓ Prostaglandin synthesis ↓ PGE2 → ↓ mucus, ↓ bicarbonate, ↓ mucosal blood flow
Correct Choice
Long-term NSAID use disrupts gastric mucosal prostaglandins by inhibiting COX-1, leading to gastric and
duodenal ulcers, which are a major cause of chronic occult GI blood loss. Over time, this can cause iron-

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deficiency anemia or present with severe anemia in acute cases. The elderly and chronic NSAID users are at
especially high risk.

Incorrect Choices
A. Hemolysis – Typically presents with jaundice, ↑ LDH, ↑ indirect bilirubin, ↓ haptoglobin—not associated
with NSAIDs.
C. Nutritional deficiency – Usually presents gradually and without a clear bleeding source; not directly linked
to NSAID use.
D. Bone marrow suppression – NSAIDs can rarely cause aplastic anemia, but this is very uncommon; not the
most likely cause.

Key Diagnostic Clue:

Elderly + NSAIDs + anemia → think peptic ulcer with occult or overt GI bleed

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Q.13 A 12-year-old boy presents with fever, unilateral parotitis, and orchitis. What is the most likely
diagnosis?
A. Measles
B. Mumps
C. Infectious Mono
D. Epidydymitis
Answer: B. Mumps

Aspect Key Fact

Virus Paramyxovirus (−ssRNA)
Sign Parotitis (often bilateral)
Complication Orchitis, meningitis, pancreatitis
Dx Clinical ± RT-PCR (buccal swab)
Tx Supportive only
Prevention MMR vaccine (live attenuated)
Mumps is a viral illness (paramyxovirus) that classically causes parotitis (salivary gland swelling), often
initially unilateral, and may progress to orchitis, especially in postpubertal males. Orchitis typically occurs
within 7 days of parotid swelling. Fever, malaise, and localized gland tenderness are common. These findings,
especially the parotitis-orchitis combination, are strongly characteristic of mumps.
Incorrect Options
A. Measles – Causes Koplik spots, cough, coryza, conjunctivitis, and a maculopapular rash, but no parotitis
or orchitis.
C. Infectious mononucleosis – Associated with fever, pharyngitis, lymphadenopathy, ± splenomegaly; not
parotitis or orchitis.
D. Epididymitis – Causes testicular pain but no parotid gland involvement; usually bacterial and unilateral in
older teens or adults.

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Key Diagnostic Clue:
Fever + Parotitis + Orchitis in a child = strongly suggestive of Mumps
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Q.14 A lady traveling in a bus sustained a bump on her forehead just below the hairline. She consulted a
general practitioner who noted only slight bruising without any visible cut. A few weeks later, she
developed a diminished sense of smell (and, according to some reports, recurrent watery nasal discharge).
What is the most probable site where the trauma occurred?
A. Anterior cranial fossa
B. Middle cranial fossa
C. Cribriform plate of ethmoid
D. Nasal septum
Answer: C. Cribriform plate of ethmoid
A blow to the forehead just below the hairline can transmit force to the anterior cranial fossa, specifically the
cribriform plate of the ethmoid bone, which is thin and fragile. This region houses the olfactory nerves.
Fracture here can damage these nerves, leading to anosmia (loss of smell) and may also cause CSF
rhinorrhea, presenting as intermittent clear nasal discharge. These features are highly specific for cribriform
plate injury in anterior skull base fractures.

Why other options are incorrect:

A. Anterior cranial fossa – Too broad; does not specify the key structure (cribriform plate) responsible for
smell and CSF leak.

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B. Middle cranial fossa – More commonly associated with ear symptoms (e.g., CSF otorrhea,
hemotympanum), not anosmia.
D. Nasal septum – Injury here causes local nasal trauma but not anosmia or CSF leak.

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Q.15 What is the best position for performing gastric lavage in a dead person?( I wonder, is it performed in
dead persons)
A. Left lateral decubitus
B. Right lateral decubitus
C. Supine position
D. Prone position
Correct Answer: A. Left lateral decubitus

Explanation:
The left lateral decubitus position with the head slightly lowered (Trendelenburg) is considered optimal for
gastric lavage. This position helps pool gastric contents away from the pylorus, minimizing further
absorption and reducing the risk of aspiration into the lungs during the procedure.
It should be performed within 1 hour of ingestion and only if the airway is protected.

Why other options are incorrect:

B. Right lateral decubitus – Promotes gastric emptying into the duodenum, increasing absorption of toxins.
C. Supine position – Increases risk of aspiration, especially if the patient vomits during lavage.
D. Prone position – Impractical and unsafe for airway access and tube placement.
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Q16. Which one of the following is the therapeutic indication of Dextromethorphan?

A. Analgesic
B. Antihistaminic
C. Antitussive D.

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Expectorant
Correct Option: C

Q17. Which of the following is the most likely complication of kerosene oil ingestion or inhalation?
A. Bronchial pneumonia
B. Lobar pneumonia
C. Kidney injury
D. Pulmonary tuberculosis
Correct Answer: C. Pneumonitis
Kerosene ingestion or inhalation leads to chemical pneumonitis, not an infectious process. Hydrocarbons
like kerosene irritate the tracheobronchial tree and alveoli, causing inflammation and non-infectious
chemical lung injury. Clinical features include cough, tachypnea, dyspnea, wheezing, and hypoxemia. Chest
X-ray may show bilateral infiltrates, especially in the right lower lobe (common site for aspiration).

Aspect Key Point

Toxin Hydrocarbon (low viscosity, volatile)
Main Risk Aspiration → Chemical pneumonitis
Symptoms Cough, dyspnea, wheeze, tachypnea
X-ray Infiltrates, often right lower lobe
Treatment Supportive only – oxygen, fluids
Avoid Gastric lavage, emesis, charcoal
Antibiotics Only if bacterial superinfection suspected
Antidote None
WHY OTHER OPTIONS ARE INCORRECT:
A. Bronchial pneumonia – Involves infection, typically with bacterial pathogens; not the primary
complication of kerosene exposure.
B. Lobar pneumonia – Classically caused by Streptococcus pneumoniae; not chemical-related.
D. Pulmonary tuberculosis – Chronic disease with a different etiology (Mycobacterium tuberculosis);
unrelated to kerosene ingestion.
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Q18. A 3-year-old child presents after accidental ingestion of kerosene oil. He is coughing and tachypneic
but has stable vital signs. What is the most appropriate initial treatment?

A. Beta nebulization
B. Gastric lavage
C. Supportive care plus antibiotics
D. Steroids plus antibiotics
Correct Answer: C. Supportive care ± antibiotics
Kerosene poisoning primarily causes aspiration pneumonitis, a chemical lung injury. The cornerstone of
management is supportive care:
Oxygen
Monitoring respiratory status
Fluids if needed

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Antibiotics are not routinely indicated but may be added if signs of secondary bacterial infection appear
(e.g., fever, leukocytosis, worsening CXR). Most cases resolve with observation and oxygen.

Aspiration Pneumonitis – Treatment Summary

Step Management
Airway protection Suction oropharynx immediately if needed
Respiratory support Oxygen therapy; intubation if respiratory failure
Bronchodilators Use if bronchospasm present

Why other options are incorrect:

A. Beta-agonist nebulization – Only used if wheezing or bronchospasm is present; not a general treatment
for all kerosene poisoning cases.
B. Gastric lavage – Contraindicated due to high risk of aspiration.
D. Steroids plus antibiotics – No proven benefit and not routinely recommended; steroids may delay healing
and increase infection risk.

Key Point:
In kerosene ingestion, supportive care is the mainstay. Avoid gastric decontamination. Use antibiotics only if
infection develops.

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Q19. A 40-year-old man presents with sharp, pleuritic chest pain that is relieved by leaning forward. On
examination, a pericardial friction rub is heard. ECG shows diffuse ST elevation. What is the most likely
diagnosis?
A. Acute Myocardial Infarction (MI)
B. Acute Pericarditis
C. Pulmonary Embolism
D. Aortic Dissection
Correct Answer: B. Acute Pericarditis

Explanation:
Acute pericarditis presents with pleuritic chest pain that is relieved by sitting up or leaning forward, and
commonly features a pericardial friction rub on auscultation. ECG classically shows diffuse ST-segment
elevation and PR depression, which helps differentiate it from MI.

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 Aspect Key Facts
Definition Inflammation of the pericardium
Classic Symptoms Sharp, pleuritic chest pain, improves on leaning forward
Auscultation Pericardial friction rub (high-pitched, scratchy sound)
ECG Findings Diffuse ST elevation, PR depression
Common Causes Viral (most common), post-MI (Dressler), uremia, autoimmune, trauma
Diagnosis Clinical + ECG + supportive labs (↑ CRP/ESR, troponin mild ↑)
Treatment NSAIDs + colchicine; steroids if refractory or autoimmune

Why other options are incorrect:

A. Acute MI – Chest pain is pressure-like, not pleuritic; ST elevation is regional, not diffuse.
C. Pulmonary Embolism – Pleuritic pain possible, but typically with dyspnea, tachycardia, and normal ST
segments.
D. Aortic Dissection – Causes tearing pain, often radiating to the back; ECG typically normal or shows
nonspecific changes.

Key Point:
Pleuritic chest pain + friction rub + diffuse ST elevation = Acute Pericarditis
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Q20. A known diabetic patient presents with altered mental status. Arterial blood gas (ABG) shows:
pH: 7.2
pCO₂: 30 mmHg
HCO₃⁻: 12 mEq/L
What is the most likely acid-base disorder?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Correct Answer: C. Metabolic acidosis

Explanation:
Breakdown of the ABG:
Parameter Value Interpretation
pH 7.20 Acidemia → confirms acidotic state
HCO₃⁻ 12 mEq/L ↓ → Metabolic acidosis (primary)
pCO₂ 30 mmHg ↓ → Compensatory respiratory alkalosis
Correctect answer : if this option is therer
Metabolic acidosis (with compensatory respiratory alkalosis)
The low pH indicates acidemia.
The low HCO₃⁻ confirms a primary metabolic acidosis.
The low pCO₂ represents respiratory compensation (hyperventilation).

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 In a known diabetic with altered mental status, this is classic for diabetic ketoacidosis (DKA)
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Q21. Which one of the following diuretics is used as an emergency management in a patient of head injury
with increased intracranial pressure?
A. Acetazolamide
B. Furosemide
C. Mannitol
D. Torsemide
Correct Option: C

Q22. What is the most common causative organism of osteomyelitis?

A. Staphylococcus aureus
B. Salmonella
C. Streptococcus pneumoniae
D. Staphylococcus epidermidis
Correct Option: A. Staph Aureus

--Staphylococcus aureus is the most frequent pathogen responsible for both hematogenous and exogenous
osteomyelitis, especially in children and adults. It is often associated with infections in individuals with
prosthetics, diabetes, or those who use intravenous drugs.
Why the others are incorrect:
• B. Salmonella: While it can cause osteomyelitis, particularly in patients with sickle cell anemia, it is not the
most common pathogen.
• C. Streptococcus pneumoniae: This is not a primary cause of osteomyelitis. Streptococci can contribute to
osteomyelitis in some cases, but it is not the most frequent pathogen.
• D. Staphylococcus epidermidis: This organism is primarily associated with osteomyelitis in patients with
prosthetic joints, but it is less common compared to Staphylococcus aureus.
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Q23. What is the antidote for benzodiazepine overdose?

A. Flumazenil
B. Naloxone
C. Activated charcoal

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 D. Cyproheptadine
Correct Option: A. Flumazenil.
Option Explanation
Correct: Specific antidote for benzodiazepine overdose. It works by antagonizing the
A. Flumazenil
GABA receptor.
B. Naloxone Incorrect: Used for opioid overdose, not benzodiazepine overdose.
C. Activated Incorrect: Not recommended for benzodiazepine overdose; generally used for other
charcoal toxic ingestions.
D. Cyproheptadine Incorrect: Antidote for serotonin syndrome, not benzodiazepine overdose.
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Q24. A young patient is brought to the emergency department after a road traffic accident. He initially lost
consciousness, then regained it briefly, followed by rapid deterioration. What is the most likely diagnosis?
A. Subdural hematoma
B. Epidural hematoma
C. SAH
D. Scalp Hematoma
Correct Option: A. Epidural Hematoma
Epidural Hematoma
Pathogenesis Trauma to the sphenoid bone with tearing of the middle meningeal artery.
Clinical
- Brief loss of consciousness, followed by a lucid interval.
Features
- Hematoma expansion leads to:
- ↑ Intracranial pressure (impaired consciousness, headache, nausea/vomiting).
- Uncal herniation: ipsilateral pupillary dilation and contralateral hemiparesis.
CT scan of the head: biconvex (lens-shaped) hyperdensity that does not cross suture
Diagnosis
lines.
Treatment Urgent surgical evacuation for symptomatic patients.
Explanation:
• Epidural hematoma (EDH) classically presents with an initial loss of consciousness, followed by a lucid
interval (brief period of recovery) and then rapid deterioration due to expanding hematoma and increased
intracranial pressure. This is a hallmark of EDH, especially when associated with skull fractures, commonly
caused by trauma.
Why the other options are less likely:
• A. Subdural hematoma (SDH): While SDH can cause rapid deterioration, it usually progresses more gradually
compared to EDH, and the lucid interval is less common.
• C. Subarachnoid hemorrhage (SAH): Typically presents with severe headache, "thunderclap" headache, and
signs of meningeal irritation, which is not described here.
• D. Scalp Hematoma: This typically presents with swelling and bruising on the scalp, but does not cause the
rapid neurological decline seen in the described scenario.
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Q25. Which type of EEG wave is most prominent in an alert person who is sitting quietly with eyes closed?
A. Delta waves
B. Theta waves
C. Alpha waves
D. Beta waves
Correct Option: C. Alpha waves

Q26. Which antifungal agent is commonly used for the treatment of athlete’s foot (tinea pedis)?
A. Griseofulvin
B. Fluconazole
C. Clotrimazole
D. Terbinafine
D. Terbinafine
Explanation:
For the treatment of tinea pedis (athlete’s foot), topical antifungal therapy is the first-line approach in mild
cases. The most commonly used agents include:
Terbinafine (allylamine)
Clotrimazole (azole
Among these, terbinafine is generally preferred due to its fungicidal activity and superior efficacy compared
to azoles like clotrimazole.

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Q27. At what age does a child typically develop the ability to copy a circle?
A. 12 months
B. 24 months

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C. 30 months
D. 36 months
Correct Option: D.36 months
A child typically develops the ability to copy a circle at around 3 years of age (36 months). This is a fine
motor skill milestone, where children begin to develop the coordination needed to draw basic shapes.

Age Motor Social Language/Cognitive

- Rolls/sits (6 mo)
- Crawls (8 mo) - Social smile (2 mo) - Orients to voice (4 mo)
0–12 mo - Stands (10 mo) - Stranger anxiety (6 mo) - Says "mama/dada" (10 mo)
- Walks (12–18 mo) - Separation anxiety (9 mo) - Object permanence (9 mo)
- Pincer grasp (10 mo)
- Walks (12 mo)
- Climbs stairs (18 mo) - Parallel play (2–3 yrs) - 50–200 words (2 yrs)
1–3 yrs
- Kicks ball (24 mo) - Rapprochement (24 mo) - 300+ words (3 yrs)
- Stacks cubes = age × 3
- Tricycle (3 yrs)
- Cooperative play - 1000+ words (3 yrs)
3–5 yrs - Hops on one foot (4 yrs)
- Imaginary friends (4 yrs) - Tells stories (4 yrs)
- Buttons, grooms (5 yrs)

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------------------------------------------------------------------------------------------

Q28. A patient is diagnosed with an anterior wall myocardial infarction. Which coronary artery is most
likely involved?
A. Left Anterior Descending (LAD) artery
B. Left Circumflex (LCX) artery
C. Posterior Descending Artery (PDA)
D. Right Coronary Artery (RCA)
Correct Option: A. Left Anterior Descending (LAD) artery

Area Involved in Anterior Wall

Option Area Supplied
MI
A. Left Anterior Supplies the anterior wall, anterior Anterior wall, anterior septum,
Descending (LAD) artery septum, and apex of the left ventricle. apex of the left ventricle.
B. Left Circumflex (LCX) Supplies the lateral wall and posterior Lateral wall, posterior wall of
artery wall of the left ventricle. the left ventricle.
C. Posterior Descending Supplies the inferior wall and posterior
Inferior wall, posterior septum.
Artery (PDA) septum.
D. Right Coronary Artery Supplies the inferior wall, right ventricle, Inferior wall, right ventricle,
(RCA) and part of the posterior wall. posterior wall.

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------------------------------------------------------------------------------------------------------------
Q29. A 52-year-old woman underwent a hysterectomy through a midline abdominal incision. A few
months later, she presents with a bulge at the incision site, diagnosed as an incisional hernia. What is the
most appropriate treatment?
A. Laparoscopic hernia repair
B. Open mesh repair
C. Herniorrhaphy (non-mesh repair)
D. Conservative management

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 Correct Answer: B. Open mesh repair
• Open mesh repair is the gold standard for treating incisional hernias. It offers stronger reinforcement,
reduces the risk of recurrence, and is preferred for larger hernias or complex defects.
Why the other options are incorrect:
• A. Laparoscopic hernia repair: While minimally invasive, it is typically reserved for bilateral or recurrent
hernias. Open mesh repair is preferred for incisional hernias, especially when the defect is large or
complicated.
• C. Herniorrhaphy (non-mesh repair): Suture-only repairs have a higher recurrence rate compared to mesh
and are not ideal for incisional hernias, especially larger ones.
• D. Conservative management: Suitable for asymptomatic hernias, but surgical repair is recommended for
incisional hernias to prevent complications like strangulation and obstruction.
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Q30. What is the most common congenital heart defect seen in patients with Down syndrome?
A. Atrial Septal Defect (ASD)
B. Atrioventricular Septal Defect (AVSD)
C. Coarctation of Aorta (CoA)
D. Patent Ductus Arteriosus (PDA)
Correct Option: B. Atrioventricular Septal Defect (AVSD)
Explanation:
• Atrioventricular septal defect (AVSD), also known as endocardial cushion defect, is the most common
congenital heart defect seen in individuals with Down syndrome. It involves a defect in the heart's septum,
leading to a left-to-right shunt between the atria and ventricles, often requiring surgical repair.

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 Category Key Features
Cause Trisomy 21 (meiotic nondisjunction, ↑ maternal age)
Facial Features Upward slanting palpebral fissures, epicanthal folds, flat nasal bridge, macroglossia
Hands/Feet Single transverse palmar crease, clinodactyly
Neurologic Intellectual disability, hypotonia, delayed milestones, early-onset Alzheimer’s
Cardiac AVSD (most common), VSD, ASD
GI Duodenal atresia, Hirschsprung disease
Other Associations Hypothyroidism, leukemia (ALL, AML), obesity, celiac disease
🧠 Mnemonic: 5 A’s → Advanced age, AVSD, Atresia (duodenal), AML/ALL, Alzheimer’s

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Q31. A 65-year-old diabetic patient underwent foot surgery. One month later, the surgical wound has still
not healed. What is the most likely cause?
A. Old age
B. Delayed wound healing due to diabetes
C. Decreased venous supply
D. Poor hygiene
Correct Option: B. Delayed wound healing due to diabetes.
B. Delayed wound healing due to diabetes – Diabetes impairs healing through microvascular damage,
neuropathy, and immune dysfunction, making it the most common cause of chronic non-healing wounds
after foot surgery.
A. Old age – Age may slightly slow healing, but has less impact compared to diabetes.
C. Decreased venous supply – Leads to venous ulcers, usually on the lower leg, not at surgical foot sites.
D. Poor hygiene – Increases infection risk but is not a primary cause of delayed wound healing without signs
of infection.
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Q32. What is the inheritance pattern of Hemophilia?

A. X-linked dominant
B. X-linked recessive
C. Autosomal dominant
D. Autosomal recessive
Correct Option: B. X-linked recessive.
Explanation:
• Hemophilia is caused by an X-linked recessive inheritance pattern, meaning the defective gene is located on
the X chromosome. It is most commonly seen in males because they have only one X chromosome, so one
copy of the mutated gene will result in the disease. Females are typically carriers and may not show
symptoms unless they inherit two defective X chromosomes.
Type of Inheritance Affected
Cause Prevalence
Hemophilia Pattern Factor

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 Factor VIII
Hemophilia A X-linked recessive Factor VIII Most common (∼80%)
deficiency
Factor IX Second most common
Hemophilia B X-linked recessive Factor IX
deficiency (∼20%)

Option Inheritance Pattern Classic Examples

A. X-linked The disorder is expressed with one Rett syndrome, Fragile X syndrome,
dominant mutated gene on the X chromosome. Hypophosphatemic rickets
The disorder is expressed in males with Hemophilia A & B, Duchenne muscular
B. X-linked
one mutated gene on the X dystrophy, Color blindness, G6PD
recessive
chromosome. deficiency
The disorder is expressed with one Achondroplasia, Huntington disease,
C. Autosomal
mutated gene on a non-sex chromosome Neurofibromatosis type 1, Marfan
dominant
(autosome). syndrome
D. Autosomal The disorder is expressed when both Cystic fibrosis, Sickle cell anemia, Tay-
recessive alleles on autosomes are mutated. Sachs disease, Phenylketonuria (PKU)

------------------------------------------------------------------------------------------------
Q33. A young patient with a known history of H. pylori–associated peptic ulcers presents with
hematemesis. The bleeding has now stopped. What is the next appropriate step in management?
A. High-dose proton pump inhibitor (PPI)
B. H. pylori eradication therapy
C. Ranitidine
D. Endoscopy for Diagnoses and Hematemeses
Correct Answer: D. Endoscopy for Diagnosis and Hematemesis

Explanation :
D. Endoscopy for diagnosis and hematemesis – In a patient with hematemesis from a known peptic ulcer,
the next best step is endoscopy to assess the source of bleeding, apply possible endoscopic hemostasis, and
stratify risk (e.g., Forrest classification). Even if the bleeding has stopped, early endoscopy (within 24 hours)
is recommended to guide further treatment and prevent rebleeding.

Other Options:
A. High-dose PPI – Important part of therapy after endoscopy, especially if high-risk stigmata are seen. It is
not the initial diagnostic step.
B. H. pylori eradication therapy – Essential for long-term management of peptic ulcers, but only after
stabilization and diagnosis of the bleeding source.
C. Ranitidine – An H₂ blocker, now largely obsolete in ulcer management due to inferior acid suppression
and safety concerns (withdrawn in many regions).

🔑 Key point: All patients with overt GI bleeding (e.g., hematemesis) need early endoscopy for diagnosis,
risk stratification, and management—even if the bleeding appears to have resolved.

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Q34. What is the inheritance pattern of sickle cell anemia?
A. X-linked recessive
B. X-linked dominant
C. Autosomal dominant
D. Autosomal recessive
Correct Option: D. Autosomal recessive.
Sickle cell anemia follows an autosomal recessive inheritance pattern, meaning the disorder occurs when an
individual inherits two copies of the mutated gene (one from each parent). Individuals with one mutated
gene (carriers) typically do not show symptoms but can pass the mutation to their offspring.

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Q35. A patient in his 40s presents with shortness of breath. CBC shows pancytopenia (low red cells, white
cells, and platelets). What is the most likely diagnosis?
A. Thalassemia
B. Sickle Cell Disease
C. Aplastic anemia
D. Iron deficiency anemia
Correct Option: C. Aplastic anemia

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 Explanation:
• Aplastic anemia is characterized by pancytopenia caused by bone marrow failure, leading to a decrease in
all blood cell lines (red cells, white cells, and platelets).
• It can be idiopathic or caused by factors such as medications, viral infections, or exposure to toxins.
•
Aplastic anemia
Category Key Points
Definition Pancytopenia due to hypocellular bone marrow with increased fat spaces
Idiopathic (>50%), drugs (carbamazepine, chloramphenicol), toxins (benzene), viruses
Causes
(parvovirus B19, HIV), Fanconi anemia
Mnemonic Can’t Make New Blood Cells Properly
Symptoms Fatigue, pallor, bleeding (petechiae), infections
Diagnosis CBC: pancytopenia, retic↓, BM biopsy: hypocellular, fatty marrow
Treatment Supportive care, remove cause, immunosuppression, HSCT <50 yrs
•
Why the other options are incorrect:
• A. Thalassemia: Typically causes microcytic anemia and would not typically present with pancytopenia.
Thalassemia also usually involves a family history.
• B. Sickle Cell Disease: Typically leads to hemolytic anemia with pain crises and vaso-occlusive events, not
pancytopenia.
• D. Iron Deficiency Anemia: This typically causes microcytic hypochromic anemia and would not cause
pancytopenia.
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Q36. A patient presents with shifting abdominal pain, nausea, vomiting, raised temperature, tenderness in
the right iliac fossa, and a WBC count of 13,000/mm³. What is the most likely Alvarado score for this
patient?
A. 3
B. 5
C. 6
D. 7
Answer: D.7
The most likely Alvarado score for this patient presenting with shifting abdominal pain, nausea, vomiting,
raised temperature, tenderness in the right iliac fossa, and a WBC count of 13,000/mm³ is 7.
Diagnostic Approach to Appendicitis
Step Key Features
History RLQ pain (migrated from periumbilical), nausea, vomiting, fever
Exam RLQ tenderness, McBurney point, Rovsing, Psoas, rebound
Labs ↑ WBC with neutrophilia, ↑ CRP
Score Alvarado score to assess likelihood (≥7 = likely appendicitis)
Imaging US (first-line in children/pregnancy), CT (adults), MRI if needed

Alvarado Scoring

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 Parameter Score Explanation
Migration of pain to RLQ 1 The pain shifts to the right lower quadrant.
Anorexia 1 Loss of appetite commonly seen in appendicitis.
Nausea and/or vomiting 1 Often associated with appendicitis.
Tenderness in RLQ 2 Right lower quadrant tenderness on physical examination.
Rebound pain 1 Pain upon release of pressure in the RLQ (peritoneal signs).
Elevated temperature (>37.3°C) 1 Mild fever commonly seen in appendicitis.
Leukocytosis (>10,000/mm³) 2 Elevated white blood cell count is typical in infection.
Shift to the left (>75% A predominance of neutrophils (often seen in bacterial
1
neutrophils) infections).
Score Interpretation
Score Probability of Appendicitis Clinical Action
0–3 Low Discharge or observe; unlikely appendicitis
4–6 Intermediate Further investigation (e.g., imaging)
7–10 High Likely appendicitis → surgical consult

The patient has:

• RLQ tenderness (2 points)
• Migratory pain (1 point)
• Nausea/vomiting (1 point)
• Elevated temperature (1 point)
• Leukocytosis (2 points)
This gives a total of 7 points, indicating a high likelihood of appendicitis.

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Q37. A 25-year-old man is brought to the emergency department after a road traffic accident. He sustained
a fracture of the femur. Within 48 hours, he develops shortness of breath, confusion, and a petechial rash
on his chest. What is the most likely diagnosis?
A. Pulmonary embolism
B. Fat embolism syndrome
C. ARDS
D. DVT
Correct Answer: B. Fat embolism syndrome

Why B is correct:
This patient presents with the classic triad of fat embolism syndrome (FES):
Respiratory distress (dyspnea)
Neurological symptoms (confusion)
Petechial rash (on chest)

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 These symptoms developed within 48 hours after a long bone fracture (femur) — a hallmark context for FES.
Fat droplets from bone marrow enter circulation and embolize to the lungs and systemic circulation.

Why other options are incorrect:

A. Pulmonary embolism – Can cause dyspnea and confusion, but petechial rash is not seen, and it’s less
likely so soon after trauma without a clotting risk.
C. ARDS – May follow trauma but usually presents without petechial rash or neurologic signs early; often a
late complication of systemic insult.
D. DVT – May occur post-trauma, but does not cause respiratory or neurologic symptoms or rash. Also, no
leg swelling is mentioned.

🧠 Key Exam Clue:

Triad = Dyspnea + Neurologic symptoms + Petechiae in trauma patient → Fat embolism

Q38. A 5-year-old child presents with partial-thickness burns involving more than 10% of the surface area
of one arm. What should be the next step in management?
A. IV fluid resuscitation
B. Remove dressing
C. Systemic evaluation
D. Observation only
Correct Option: A. IV fluid resuscitation.
Explanation:
• Partial-thickness burns involving 10% of the body surface area in a child are significant enough to require IV
fluid resuscitation to prevent hypovolemia and maintain adequate perfusion. Fluid resuscitation helps
replace lost fluids from the burned area and ensures proper organ function.
• For burns covering >10% of the body surface area (especially in children), fluid resuscitation is crucial,
typically using formulas such as the Parkland formula to guide fluid replacement.
Why the other options are incorrect:
• B. Remove dressing: Dressing removal should only be done as part of wound care in the context of infection
prevention and wound management, but it is not the first step in management.
• C. Systemic evaluation: Systemic evaluation might be required in the case of more extensive burns or other
injuries, but IV fluid resuscitation takes priority for managing fluid loss.
• D. Observation only: Given the 10% burn area and the risk of fluid loss, observation alone is insufficient, and
IV fluid resuscitation should be initiated.
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Q39. A patient presents with pustules, a maculopapular rash, and dry, scaly skin. These findings are most
likely due to a deficiency of which of the following?
A. Essential fatty acids
B. Vitamin A
C. Vitamin E
D. Niacin
Correct Option: A. Essential fatty acids.
Explanation:

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 Essential fatty acid deficiency can present with dermatologic symptoms such as dry, scaly skin (similar to
eczema), pustules, and a maculopapular rash. This occurs because essential fatty acids play a critical role in
maintaining the integrity of the skin's barrier function.
main Essential Fatty Acids (EFAs):
Name Type Function
Linoleic acid (LA) Omega-6 Skin barrier, precursor to arachidonic acid
Alpha-linolenic acid (ALA) Omega-3 Anti-inflammatory, precursor to EPA and DHA
🧠 Both are essential because they cannot be synthesized by the human body.
•
Why the other options are incorrect:
• B. Vitamin A: Vitamin A deficiency can cause dry skin and keratinization of the skin (like Xerosis), but it
typically doesn't present with pustules.
• C. Vitamin E: Vitamin E deficiency generally presents with neurologic symptoms (like peripheral neuropathy)
and may cause hemolytic anemia in newborns, but it doesn't typically cause pustules and rash in this
manner.
• D. Niacin: Niacin deficiency (leading to pellagra) causes dermatitis, diarrhea, and dementia, but does not
typically present with pustules or dry, scaly skin as described.
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Q40. A patient presents with severe anemia (Hb: 6 g/dL), Lab investigations show:
MCV: 92 fL (normocytic)
WBC count: 12,000/mm³
Platelet count: 320,000/mm³
TIBC: High
Serum Ferritin: Normal
This mcq is not standard ,we do not know exact statement

What is the most likely diagnosis?

A. Hemolytic anemia
B. Aplastic anemia
C. Iron deficiency anemia
D. Anemia of chronic disease
Answer: C) Iron deficiency anemia
Explanation: Although MCV is normal, this can occur in the early normocytic phase of iron deficiency
anemia. High TIBC supports iron deficiency. Normal ferritin may be seen in early disease or inflammation.
Aplastic anemia is unlikely due to normal WBC and platelet counts.
Most Likely Diagnosis: Early Iron Deficiency Anemia
Although iron deficiency typically presents with microcytic anemia, it often starts as normocytic. The high
TIBC supports iron deficiency, as the body increases transferrin to bind more iron. Normal ferritin can occur
early or be falsely elevated in inflammatory states, but does not rule out iron deficiency.

❗Differential Points:
Parameter Iron Deficiency Anemia of Chronic Disease
MCV Normal → Low (later) Normal → Low (later)

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 TIBC ↑ ↓ or normal
Ferritin ↓ (can be normal early) Normal or ↑
Serum Iron ↓ ↓

🔑 Key Takeaway:
Normocytic anemia with high TIBC and normal ferritin suggests early iron deficiency, especially in the
absence of chronic inflammation.

I personally think, this is incomplete info, we are missing sth, in early normocytic stages of IDA,Hb would not
be so much low!!! question statement we think is not correct

Question 41:
Which of the following is the most common causative agent in urinary tract infection (UTI)?

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A. E. coli
B. Klebsiella pneumoniae
C. Proteus mirabilis
D. Staphylococcus
Correct Answer: A. E. coli
Why correct:
E. coli is the most common organism causing UTIs (up to 90% of community-acquired cases). Its
fimbriae enhance adhesion to the uroepithelium.
Why others are incorrect:
B. Klebsiella – Less common; associated with nosocomial UTIs.
C. Proteus – Seen in complicated UTIs; associated with stone formation.

D. Staphylococcus saprophyticus – Seen in young, sexually active women, but less frequent than
E. coli.

42. First-line treatment for stable SVT

Question:
25-year-old lady presents in emergency department with complains of palpitations and dizziness.
Her radial pulse is very fast and blood pressure is 110/70. Her ECG shows regular narrow complex
tachycardia. Which of the following is the first line treatment for this condition?
A. Defibrillation
B. Diltiazem
C. Metoprolol
D. Vagal maneuver
Correct Answer: D. Vagal maneuver
Why correct:
SVT – Key Diagnostic Approach (Short Table)
Step Key Point
1. Clinical Clue Sudden palpitations, regular rapid HR
2. Stability Assess BP, mental status (unstable = cardiovert)
3. ECG Regular narrow QRS, HR 150–250 bpm, no clear P waves
4. Response Test Vagal maneuver or adenosine → diagnostic + therap

Hemodynamically stable Hemodynamically unstable

1. Vagal maneuvers (Valsalva, carotid massage) 1. Synchronized cardioversion
2. Adenosine (if vagal fails)
3. Alternatives: Beta-blocker or CCB

Vagal maneuvers (e.g., Valsalva, carotid massage) are the first-line treatment for stable

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supraventricular tachycardia (SVT). They increase vagal tone and slow AV node conduction.

Why others are incorrect:

A. Defibrillation – Used in unstable or pulseless patients.
B. Diltiazem, C. Metoprolol – Used after vagal maneuvers fail; second-line pharmacologic options.

43. Best test to diagnose gestational diabetes

Question:
What is the most appropriate test to diagnose gestational diabetes?
A. HbA1c
B. Glucose tolerance test
C. Fasting blood sugar
D. Random blood sugar
Correct Answer: B. Glucose tolerance test

The oral glucose tolerance test (OGTT) is the gold standard for diagnosing gestational diabetes,
performed at 24–28 weeks.
Why others are incorrect:
A. HbA1c – Not reliable in pregnancy due to altered RBC turnover.
C. Fasting/Random glucose – Can be used for screening but not definitive.

44. Most common dyslipidemia pattern in T2DM

Question:
Which of the following is the most common lipid abnormality in type 2 diabetes?
A. High LDL, Low TGs, Low HDL
B. Low LDL, High TGs, Low HDL
C. High LDL, High TGs, Low HDL
D. High LDL, High TGs, High HDL
Correct Answer: C. High LDL, High TGs, Low HDL
Patients with type 2 diabetes mellitus (T2DM) often exhibit an atherogenic lipid profile,
characterized by:
↑ LDL (often small, dense particles – more atherogenic)
↑ Triglycerides (due to insulin resistance)

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↓ HDL (reduced reverse cholesterol transport
This dyslipidemia increases the risk of cardiovascular disease, a major complication of T2DM.
Why others are incorrect:
Options A, B, D – Do not reflect the classic triad of diabetic dyslipidemia.

Question:
A patient was diagnosed with acute inflammatory demyelinating neuropathy 1 week after he
recovered from an acute gastroenteritis infection. He was admitted with mild sensory symptoms
which were getting worse with progressive weakness that first began in his lower limbs. He was
finding hard to breathe and move his upper limbs as well. Which of the following treatments
would you recommend?
Correct Answer: C. IV immunoglobulin
Why correct:
IVIG is first-line therapy for Guillain-Barré syndrome (GBS) along with
plasmapheresis. Both reduce autoantibody-mediated nerve damage.
Key Diagnostic Markers

Topic High-Yield Points

Cause Autoimmune demyelination of peripheral nerves
Trigger Post-infection (especially Campylobacter jejuni)
Symptoms Ascending symmetric weakness, areflexia, paresthesias
Complications Respiratory failure, autonomic instability
Diagnosis Clinical + CSF (↑ protein, normal WBC) + NCS/EMG
CSF finding Albuminocytologic dissociation
Treatment IVIG or plasmapheresis (no steroids)
Monitoring Vital capacity → <20 mL/kg = intubation

Test Finding
CSF (LP) ↑ Protein, normal WBC
Nerve studies Demyelination (slowed conduction)
Clinical exam Ascending weakness + areflexia

Why others are incorrect:

A & D. Steroids – Not effective in GBS.
B. Antibiotics – Unnecessary unless active infection is present.

45. Best investigation for myasthenia gravis

Question:
A 32 years old woman complaining of 6 months history of dysphagia and nasal regurgitation,
which is worse during evening. She also reports intermittent drooping of her left eyelid and

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diplopia when she gets tired. Neurological examination reveals partial left ptosis and diplopia but
no ophthalmoplegia. She also has mild cough. What will be the most appropriate investigation in
this case?
A. Acetylcholine receptor antibodies
B. Barium swallow
C. CT brain
D. Tumor markers
Correct Answer: A. Acetylcholine receptor antibodies
Why correct:
These antibodies are positive in ~85% of generalized myasthenia gravis and confirm the diagnosis.

Category Key Points

Cause Autoantibodies against acetylcholine receptors at the neuromuscular junction
Fluctuating weakness (worsens with use), ptosis, diplopia, dysphagia, dysarthria,
Symptoms
normal reflexes and sensation
AChR antibodies (most sensitive), edrophonium (Tensilon) test, CT chest to rule out
Diagnosis
thymoma
Pyridostigmine (first-line), steroids, azathioprine, IVIG or , thymectomy if thymoma
Treatment
or generalized MG

Why others are incorrect:

B. Barium swallow – May assess dysphagia but doesn't confirm MG.
C. CT brain – Not helpful without CNS signs.
D. Tumor markers – Not relevant for diagnosis.

46. A woman came with collapse and vomiting preceded by occipital headache of acute onset.
After 8 hours she was conscious and alert with photophobia and mild neck stiffness, CT scan brain
was carried out which came out to be normal. Which one of the following investigations would
yield the diagnosis?
A. CT scan brain with contrast
B. MRI brain
C. CSF examination by LP after 12 hours
D. Cerebral angiography
Correct Answer: C. CSF examination by LP after 12 hours
Why correct:
If non-contrast CT is negative but suspicion of SAH remains, LP after 12 hours is done to detect
xanthochromia, confirming SAH.

Aspect Details
Cause Ruptured berry aneurysm (e.g., anterior communicating artery), trauma
Risk factors Hypertension, smoking, polycystic kidney disease, Ehlers-Danlos syndrome
Classic symptom Sudden, severe "thunderclap" headache ("worst headache of life")

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 Aspect Details
Other signs Nuchal rigidity, photophobia, vomiting, loss of consciousness
Diagnosis Approach
Step Action
1st test Non-contrast CT head – best initial test
If CT is negative Do lumbar puncture (after 12 hrs) → look for xanthochromia
Confirm aneurysm CT angiography or cerebral angiography
Treatment
Goal Management
Prevent rebleed Surgical clipping or endovascular coiling
Prevent vasospasm Nimodipine (DHP calcium channel blocker)

Why others are incorrect:

A. CT with contrast – Not sensitive for early blood.
B. MRI – May miss early SAH.
D. Angiography – Identifies aneurysm but not diagnostic in acute setting

47. Question:
Which one of the following is used in the emergency treatment of organophosphate poisoning?
A. Atropine
B. Naloxone
C. Flumazenil
D. Pralidoxime

Correct Answer: A. Atropine

Organophosphate Poisoning –High-Yield Table
Aspect Key Points
Cause Inhibits acetylcholinesterase → ↑ ACh
Source Pesticides, insecticides
DUMBBELSS: Diarrhea, Urination, Miosis, Bradycardia, Bronchorrhea, Emesis,
Symptoms
Lacrimation, Salivation, Sweating; + muscle weakness, seizures
Diagnosis Clinical; ↓ cholinesterase activity (if tested)
Atropine (muscarinic), Pralidoxime (reactivates AChE), benzodiazepines (seizures),
Treatment
airway support
Pralidoxime (2-PAM) is also used but only after atropine, to regenerate acetylcholinesterase.

Tips
Atropine treats muscarinic symptoms (e.g., bronchorrhea, bradycardia)
Pralidoxime reverses both muscarinic + nicotinic effects (must be given early)

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Miosis + bradycardia + diarrhea + muscle weakness = think organophosphate

Naloxone – opioid overdose.

Flumazenil – benzodiazepine reversal.

48. Which one of the following drugs is most appropriate to treat a patient with anaphylactic
shock?
A. Dobutamine
B. Epinephrine
C. Norepinephrine
D. Phenylephrine

Correct Answer: B. Epinephrine

First-line treatment. Acts on α1 (vasoconstriction) and β2 (bronchodilation).
Norepinephrine – preferred in septic shock.
Dobutamine – used in cardiogenic shock.
Phenylephrine – α-agonist; not adequate for anaphylaxis.

49. Question:
Which one of the following types of epinephrine receptors is responsible for bronchodilation and
is commonly targeted in the management of asthma?
A. Alpha-1 receptor
B. Alpha-2 receptor
C. Beta-1 receptor
D. Beta-2 receptor

Correct Answer: D. Beta-2 receptor

β2 stimulation = bronchodilation, key for asthma/anaphylaxis.
Beta-1 – increases heart rate and contractility.
Alpha-1 – vasoconstriction.
Alpha-2 – feedback inhibition of norepinephrine release

50. Question:
A known diabetic developed dyskinesia and akathisia after receiving an injection for
gastroenteritis. Which one of the following drugs is most likely responsible?
A. Ondansetron
B. Domperidone
C. Metoclopramide
D.

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Erythromycin

Correct Answer: C. Metoclopramide

Metoclopramide is a dopamine antagonist; can cause extrapyramidal symptoms like akathisia
and dystonia.

Extrapyramidal symptoms are drug-induced movement disorders caused by dopamine (D₂)

blockade in the nigrostriatal pathway, most commonly due to antipsychotics or antiemetics (e.g.,
metoclopramide).

Types of EPS (with timing)

EPS Type Description Onset
Sustained muscle spasms (e.g., torticollis, oculogyric
Acute dystonia Hours to days
crisis)
Akathisia Restlessness, urge to move Days to weeks
Weeks to
Parkinsonism Tremor, rigidity, bradykinesia
months
Tardive
Involuntary facial/tongue movements (chronic) Months to years
dyskinesia

Domperidone is less likely to cross the BBB.

Ondansetron – 5-HT3 blocker, not linked to movement disorders.
Erythromycin – prokinetic via motilin receptor, not dopaminergic.

Question 51:
Which one of the following diuretics is used as an emergency management in a head injury
patient with increased intracranial pressure (ICP)?
A. Acetazolamide
B. Furosemide
C. Mannitol
D. Torsemide

Correct Answer: C. Mannitol

Mannitol is an osmotic diuretic used acutely to reduce intracranial pressure.
Acetazolamide – used for chronic ICP (e.g., pseudotumor cerebri).
Furosemide – adjunct, not first-line for ICP.
Torsemide – similar to furosemide.

Question 52:
Which one of the following is the therapeutic indication of Dextromethorphan?
A. Analgesic
B.

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 Antihistaminic
C. Antitussive
D. Expectorant

Correct Answer: C. Antitussive

Dextromethorphan – Quick Facts

Aspect Key Points

Use Antitussive (cough suppressant) – NMDA receptor antagonist
Mechanism Suppresses cough reflex in medulla; structurally related to opioids
High doses → CNS effects: euphoria, hallucinations, dissociation
Side effects
("robotripping")
Toxicity Serotonin syndrome if combined with SSRIs
Abuse
Recreational use common in teens,abusive potential
potential
Dextromethorphan = antitussive + NMDA blocker → dissociation + serotonin risk at high dos

Question:
After committing suicide, the revolver remained firmly grasped in the hand of a person. What is
the name of this phenomenon?
A. Instantaneous rigor
B. Rigor mortis
C. Secondary relaxation
D. Primary rigidity

Correct Answer: A. Instantaneous rigor

• Instantaneous rigor refers to immediate stiffening of the body at the moment of death, instead of
the usual gradual onset of rigor mortis.
Also called cadaveric spasm; seen in sudden death with intense emotion or activity
(e.g., suicide with revolver in hand).
Instantaneous Rigor vs Rigor Mortis – Key Differences (USMLE Table)
Feature Instantaneous Rigor Rigor Mortis
Begins after 2–4 hours
Onset Immediately at the moment of death
postmortem
Sudden, violent death → rapid ATP
Cause Natural ATP depletion post-death
depletion
All deaths (normal postmortem
Associated with Lightning strike, seizures, electrocution
process)
Progression Generalized stiffness immediately Head → toe over 12 hours
Duration Transient Lasts up to 24–36 hours

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 Feature Instantaneous Rigor Rigor Mortis
Forensic
Suggests sudden/violent death Helps estimate time since death
relevance

Rigor mortis – generalized, sets in after 1–2 hours.

Secondary relaxation – occurs after rigor ends.
Primary rigidity – not a standard forensic term.

Q53. Which one of the following is used in the emergency treatment of organophosphate poisoning?
A. Atropine
B. Naloxone
C. Flumazenil
D. Pralidoxime

Correct Answer: A. Atropine

Organophosphate Poisoning – USMLE High-Yield Table
Aspect Key Points
Cause Inhibits acetylcholinesterase → ↑ ACh
Source Pesticides, insecticides
DUMBBELSS: Diarrhea, Urination, Miosis, Bradycardia, Bronchorrhea, Emesis, Lacrimation,
Symptoms
Salivation, Sweating; + muscle weakness, seizures
Diagnosis Clinical; ↓ cholinesterase activity (if tested)
Atropine (muscarinic), Pralidoxime (reactivates AChE), benzodiazepines (seizures), airway
Treatment
support
Pralidoxime (2-PAM) is also used but only after atropine, to regenerate acetylcholinesterase.

Tips
Atropine treats muscarinic symptoms (e.g., bronchorrhea, bradycardia)
Pralidoxime reverses both muscarinic + nicotinic effects (must be given early)
Miosis + bradycardia + diarrhea + muscle weakness = think organophosphate

Naloxone – opioid overdose.

Flumazenil – benzodiazepine reversal.

Q54. Which one of the following types of epinephrine receptors is responsible for bronchodilation and is
commonly targeted in the management of asthma?
A. Alpha-1 receptor
B. Alpha-2 receptor
C. Beta-1 receptor
D. Beta-2 receptor

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Correct Answer: D. Beta-2 receptor
β2 stimulation = bronchodilation, key for asthma/anaphylaxis.
Beta-1 – increases heart rate and contractility.
Alpha-1 – vasoconstriction.
Alpha-2 – feedback inhibition of norepinephrine release

Q55. A homeless alcoholic presents to you with fever, cough, and pleuritic chest pain. X-ray chest showed
right upper lobe consolidation. What is the most likely organism?
A. Klebsiella
B. Staphylococcus
C. Pseudomonas
D. Pneumococcus
Answer: A

Q56. A 35-year-old female presents with bloody nipple discharge and a mobile rubbery mass, but no lump
or rash found in the breast. What is the most likely diagnosis?
A. Papilloma
B. Duct ectasia
C. Paget disease of breast
D. Fibroadenoma
Answer: B

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 s
Q57. A patient after earthquakes with minor injuries is categorized in color. What is the correct triage color
category?
A. Red
B. Yellow
C. Green
D. Black
Answer: C
Q58. A physician diagnosed a 33-year-old man with vitamin-A deficiency. What would be the most likely
symptom in such a patient?
A. Red-eye
B. Conjunctival infection
C. Diplopia
D. Night blindness
Answer: D

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Q59. A woman presented at 36 weeks with blood pressure 130/80 on two different occasions and 1+
proteinuria. What is the most likely diagnosis?
A. Preeclampsia
B. Gestational Hypertension
C. Chronic Hypertension
D. Ecclampsia
Correct Option: A

Q.60 A 48-year-old woman with a known history of Rheumatoid Arthritis presents with fatigue and pallor.
Her CBC shows anemia. Iron studies reveal low serum iron, normal TIBC, and normal ferritin levels. What is
the most likely cause of her anemia?
A. Iron deficiency anemia
B. Anemia of chronic disease
C. Aplastic Anemia
D. Sideroblastic Anemia
Correct Option: B

Q61. A man with a history of working in a glass factory presents for evaluation. The patient also has renal
failure. Which of the following types of poisoning is most commonly associated with this occupational
exposure?

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A. Lead
B. Mercury
C. Silica
D. Cadmium
Correct Option: C

Q62. Which of the following is a clinical feature of median nerve injury?

A. Wrist drop
B. Ape hand
C. Monkey hand
D. Claw hand
Correct Option: B

Q63. An ECG shows findings consistent with an anterior myocardial infarction. Which coronary artery is
most likely responsible?
A. Left Anterior Descending (LAD) artery
B. Left Circumflex (LCX) artery
C. Right Coronary Artery (RCA)
D. Posterior Descending Artery (PDA)
Correct Option: A

Q64. What is the most sensitive test for diagnosing Rheumatoid Arthritis?
A. Anti-CCP
B. ANA
C. Rheumatoid Factor (RF)
D. Anti-ds DNA
Correct Option: C

Q65. Which of the following vaccines is given at 9 months of age in association with the measles vaccine?
A. Polio
B. Rubella
C. Rotavirus
D. Mumps
Answer: B

Q66. Koplik spots are characteristic of which disease?

A. Rubella
B. Measles
C. Scarlet fever
D. Diphtheria
Correct Option: B

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Q67. A 65-year-old patient with a history of long-term NSAID use now presents with severe anemia. What
is the most likely cause? (MCQs were not provided by the students, here are the most likely)
A. Hemolysis
B. Upper gastrointestinal bleeding
C. Nutritional deficiency
D. Bone marrow suppression
Correct Option: B

Q68. A 12-year-old boy presents with fever, unilateral parotitis, and orchitis. What is the most likely
diagnosis?
A. Measles
B. Mumps
C. Rubella
D. Epodydymitis
Correct Option: B

Q69. A lady traveling in a bus sustained a bump on her forehead just below the hairline. She consulted a
general practitioner who noted only slight bruising without any visible cut. A few weeks later, she
developed a diminished sense of smell (and, according to some reports, recurrent watery nasal discharge).
What is the most probable site where the trauma occurred?
A. Anterior cranial fossa
B. Middle cranial fossa
C. Cribriform plate of ethmoid
D. Nasal septum
Correct Option: C

Q70. What is the best position for performing gastric lavage in a dead person?( I wonder, is it performed in
dead persons)
A. Left lateral decubitus
B. Right lateral decubitus
C. Supine position
D. Prone position
Correct Option: A

Q71. A 5-year-old child accidentally ingested his grandmother’s diazepam tablets. He is brought to the
emergency department for gastric lavage. What is the best position for performing the procedure?
A. Supine position
B. Prone position
C. Right lateral decubitus
D. Left lateral decubitus
Correct Option: D

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Q72. Which of the following is the most likely complication of kerosene oil ingestion or inhalation?
A. Bronchial pneumonia
B. Lobar pneumonia
C. Pneumonitis
D. Pulmonary tuberculosis
Correct Option: C

Q73. What is the appropriate treatment option in a case of kerosene oil poisoning?
A. Beta nebulization
B. Gastric lavage
C. Supportive care plus antibiotics
D. Steroids plus antibiotics
Correct Option: C

Q74. A 40-year-old man presents with sharp, pleuritic chest pain that is relieved by leaning forward. On
examination, a pericardial friction rub is heard. ECG shows diffuse ST elevation. What is the most likely
diagnosis?
A. Acute Myocardial Infarction (MI)
B. Acute Pericarditis
C. Aortic Dissection
D. PE
Correct Option: B

Q75. A known diabetic patient presents with altered mental status. Arterial blood gas (ABG) shows:
pH: 7.2
pCO₂: 30 mmHg
HCO₃⁻: 12 mEq/L
What is the most likely acid-base disorder?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Correct Option: C

Q76. A patient presents with an “ape hand” deformity. Which nerve is most likely affected?
A. Median nerve
B. Ulnar nerve
C. Radial nerve
D. Peroneal nerve
Correct Option: A

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Q77. What is the most common causative organism of osteomyelitis?
A. Staphylococcus aureus
B. Salmonella
C. Streptococcus pneumoniae
D. Staphylococcus epidermidis
Correct Option: A

Q78. What is the antidote for benzodiazepine overdose?

A. Flumazenil
B. Naloxone
C. Activated charcoal
D. Cyproheptadine (Not sure if it was present, but assumed)
Correct Option: A

Q79. A young patient is brought to the emergency department after a road traffic accident. He initially lost
consciousness, then regained it briefly, followed by rapid deterioration. What is the most likely diagnosis?
A. Subdural hematoma
B. Epidural hematoma
C. SAH
D. Scalp Hematoma
Correct Option: B

Q80. Which type of EEG wave is most prominent in an alert person who is sitting quietly with eyes closed?
A. Delta waves
B. Theta waves
C. Alpha waves
D. Beta waves
Correct Option: C

Q81. Which antifungal agent is commonly used for the treatment of athlete’s foot (tinea pedis)?
A. Griseofulvin
B. Fluconazole
C. Clotrimazole
D. Terbinafine
Correct Option: D

Q82. At what age does a child typically develop the ability to copy a circle?
A. 12 months

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B. 24 months
C. 30 months
D. 36 months
Correct Option: D

Q83. A patient is diagnosed with an anterior wall myocardial infarction. Which coronary artery is most
likely involved?
A. Left Anterior Descending (LAD) artery
B. Left Circumflex (LCX) artery
C. Posterior Descending Artery (PDA)
D. Right Coronary Artery (RCA)
Correct Option: A

Q84. A 52-year-old woman underwent a hysterectomy through a midline abdominal incision. A few
months later, she presents with a bulge at the incision site, diagnosed as an incisional hernia. What is the
most appropriate treatment?
A. Laparoscopic hernia repair
B. Open mesh repair
C.Conservative
D. Herniorrhaphy
Correct Option: B

Q85. What is the most common congenital heart defect seen in patients with Down syndrome?
A. Atrial Septal Defect (ASD)
B. Atrioventricular Septal Defect (AVSD)
C. Coarctation of Aorta (CoA)
D. Patent Ductus Arteriosus (PDA)
Correct Option: B

Q86. A 65-year-old diabetic patient underwent foot surgery. One month later, the surgical wound has still
not healed. What is the most likely cause?
A. Old age
B. Delayed wound healing due to diabetes
C. Decreased venous supply
D. Poor hygiene
Correct Option: B

Q87. What is the inheritance pattern of Hemophilia?

A. X-linked dominant
B. X-linked recessive

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C. Autosomal dominant
D. Autosomal recessive
Correct Option: B

Q88. A young patient with a known history of H. pylori–associated peptic ulcers presents with
hematemesis. The bleeding has now stopped. What is the next appropriate step in management?
A. High-dose proton pump inhibitor (PPI)
B. H. pylori eradication therapy
C. Ranitidine
D. Endoscopy for Diagnosis & Hematemesis
Correct Option: D

Q.89 What is the inheritance pattern of sickle cell anemia?

A. X-linked recessive
B. X-linked dominant
C. Autosomal dominant
D. Autosomal recessive
Correct Option: D

Q90. A patient in his 40s presents with shortness of breath. CBC shows pancytopenia (low red cells, white
cells, and platelets). What is the most likely diagnosis?
A. Thalassemia
B. Sickle Cell Disease
C. Aplastic anemia
D. Iron deficiency anemia
Correct Option: C

Q91. A patient presents with shifting abdominal pain, nausea, vomiting, raised temperature, tenderness in
the right iliac fossa, and a WBC count of 13,000/mm³. What is the most likely Alvarado score for this
patient?
A. 3
B. 5
C. 6
D. 7
Answer: D

Q92. A 25-year-old man is brought to the emergency department after a road traffic accident. He sustained
a fracture of the femur. Within 48 hours, he develops shortness of breath, confusion, and a petechial rash
on his chest. What is the most likely diagnosis?
A. Pulmonary embolism
B. Fat embolism syndrome
C. DVT

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D. Tension Pneumothorax
Correct Option: B

Q93. A 5-year-old child presents with partial-thickness burns involving 10% of the surface area of one arm.
What should be the next step in management?
A. IV fluid resuscitation
B. Remove dressing

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C. Systemic evaluation
D. Observation only
Correct Option: A

Q94. A patient presents with pustules, a maculopapular rash, and dry, scaly skin. These findings are most
likely due to a deficiency of which of the following?
A. Essential fatty acids
B. Vitamin A
C. Vitamin E
D. Niacin
Correct Option: A

Q95. A 28-year-old woman presents with fatigue, dark-colored urine in the morning, and yellowing of the
eyes. On examination, she is pale and mildly jaundiced, with splenomegaly. Her labs show low hemoglobin,
elevated reticulocyte count, indirect hyperbilirubinemia, elevated lactate dehydrogenase (LDH), and low
haptoglobin. A peripheral smear reveals spherocytes. She reports a history of similar episodes in the past,
often triggered by infections.
What is the most likely diagnosis?
What is the most likely diagnosis?
A. Hemolytic anemia
B. Aplastic anemia
C. Iron deficiency anemia
D. Anemia of chronic disease
Answer: A
Disclaimer! We sincerely acknowledge and apologize that the full context of the question is not available.
However, based on the information provided, the most appropriate answer appears to be Hemolytic
anemia.

Q96. A patient presents with jaundice. Laboratory tests show the following:
HBsAg: Positive
HBeAg: Positive
anti-HBs: Positive
anti-HBc IgM: Positive
What is the most likely diagnosis?
A. Chronic Hepatitis B
B. Vaccinated against Hepatitis B
C. Acute Hepatitis B infection
D. Past resolved Hepatitis B infection
Correct Option: C

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Q.97 A 30-year-old man presents with recurrent episodes of severe, unilateral periorbital pain. The pain
lasts for about 45 minutes, occurs daily for several days, and often wakes him up from sleep at night. It is
accompanied by lacrimation and nasal congestion. What is the most likely diagnosis?
A. Migraine
B. Cluster headache
C. Tension-type headache
D. Trigeminal Neuralgia
Correct Option: B

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Q98. Which of the following is an absolute indication for surgery in a patient with Crohn’s disease?
A. Bowel obstruction
B. Fistula in ano
C. Sclerosing cholangitis
D. Pyoderma gangrenosum
Correct Option: A

Q99. What is the most common causative organism of infective endocarditis?

A. Staphylococcus aureus
B. Streptococcus viridans
C. Staphylococcus epidermidis
D. Escherichia coli
Correct Option: B

Q100. How many hours before surgery should prophylactic antibiotics be administered preoperatively for
optimal effectiveness?
A. 1 hour
B. 2 hours
C. 3 hours
D. 4 hours
Correct Option: A

Q101. Which of the following enzymes is elevated in myocardial infarction?

A. CK-MB
B. AST
C. ALT
D. LDH
Correct Option: A

Q102. Which immunoglobulin is primarily responsible for mediating allergic responses?

A. IgA
B. IgG
C. IgM
D. IgE
Correct Option: D

Q103. A patient presents with dry, itchy skin and signs of dermatitis. What is the most likely nutritional
deficiency responsible?
A. Vitamin E

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B. Essential fatty acids
C. Vitamin C
D. Vitamin D
Correct Option: B

Q104. A 55-year-old woman presents to the emergency room after a road traffic accident. She is
hemodynamically stable and is suspected to have abdominal trauma with possible internal bleeding. What
is the most appropriate initial investigation?
A. CT abdomen & pelvis
B. Doppler ultrasonography
C. FAST scan
D. Diagnostic laparotomy
Correct Option: A

Q105. A 55-year-old woman presents to the emergency room after a road traffic accident. She is
hemodynamically unstable and is suspected to have internal abdominal bleeding with signs of internal
organ injury. What is the most appropriate initial investigation?
A. CT abdomen & pelvis
B. Doppler ultrasonography
C. FAST scan
D. Diagnostic laparotomy
Correct Option: C

Q106. A 12-year-old obese boy is brought to the emergency department by his mother with complaints of a
limping gait and left-sided hip pain for several days. The pain sometimes radiates to the knee. On
examination, he is afebrile, and the left leg is externally rotated and appears slightly shortened. Internal
rotation of the hip is markedly restricted, especially on flexion.
What is the most likely diagnosis?
A. Blount’s Disease
B. Legg-Calvé-Perthes Disease
C. Slipped Capital Femoral Epiphysis (SCFE)
D. Congenital Hip Dislocation
Disclaimer! We sincerely acknowledge and apologize that the full context of the question is not available.
However, based on the information provided, the most appropriate answer appears to be: SCFE."

Q107. What is the most common tumor of the anterior mediastinum?

A. Lymphoma
B. Thymoma
C. Teratoma
D. Germ cell Tumor
Correct Option: B

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Q108. Which of the following is the most accurate investigation for TNM staging of esophageal carcinoma?
A. Intraluminal (endoscopic) ultrasonography (EUS)
B. Upper GI endoscopy
C. CT scan of the chest
D. Endoscopy
Correct Option: A

Q109. A 35-year-old woman presents with a mild, irregular thyroid swelling more prominent on the right
side, present for the past 2 years. Her labs show an elevated TSH level. What is the most appropriate next
investigation?
A. Thyroid scintigraphy
B. CT neck
C. Ultrasound neck
D. Thyroid function test
Correct Option: C

Q110. After a skin graft is taken, in how many weeks does the donor site typically heal?
A. 1 week
B. 2 weeks
C. 3 weeks
D. 4 weeks
Correct Option:

Q111. What is the most common cause of massive hemoptysis worldwide?

A. Tuberculosis
B. Lung cancer
C. Bronchiectasis
D. Esophageal varices
E. Arteriovenous malformation
Correct Option: A

Q112. A patient presents with lethargy and shows delayed skin pinch (skin goes back slowly). What is the
most appropriate treatment plan according to WHO dehydration classification?
A. Plan A
B. Plan B
C. Plan C
D. Plan D
Correct Option: C

Q113. In the presence of ADH inhibition, which part of the nephron is responsible for the maximum
reabsorption of sodium and water?

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A. Proximal Convoluted Tubule (PCT)
B. Distal Convoluted Tubule (DCT)
C. Ascending Loop of Henle
D. Descending Loop of Henle
Correct Option: A

Q114. According to international fingerprint classification rules, which of the following patterns are most
commonly used?
A. Loop
B. Whorl
C. Both A and B
D. Arch
Correct Option: A

Q115. A 22-year-old girl presents with 14 days of low mood and frequent crying spells following a recent
emotional stressor. What is the most likely diagnosis?
A. Dysthymia
B. Cyclothymia
C. Major Depressive Disorder
D. Adjustment Disorder
Answer: D

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Q116. A patient presents with intense itching, especially at night, and burrow-like lesions in the finger
webs and wrists. Scabies is diagnosed. What is the first-line treatment?
A. 1% Lindane lotion
B. 5% Permethrin cream
C. Oral Ivermectin
D. Calamine lotion
Correct Option: B

Q117. Ferrous sulfate exhibits pharmacological antagonism with which of the following?
A. Tetracycline
B. Vitamin C
C. Folic acid
D. Cyanocobalamin
Correct Option: A

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Q118. A 28-year-old woman presents with fatigue, pallor, and shortness of breath on exertion. Lab results
show:
Hemoglobin: 8 g/dL
MCV: 72 fL
Serum iron: ↓
Ferritin: ↓
TIBC: ↑
What is the most likely diagnosis?
A. Iron deficiency anemia

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B. Anemia of chronic disease
C. Aplastic anemia
D. Thalassemia minor
Correct Option: A

Q119. A 32-year-old woman presents with cyclic heavy menstrual bleeding. Which of the following is the
best contraceptive option for both managing her bleeding and providing contraception?
A. Progestin-only pill
B. Combined oral contraceptive pill (COCP)
C. Intrauterine contraceptive device (IUCD)
D. Diaphragm
Correct Option: B

Q120. Which of the following is a known complication associated with intrauterine contraceptive device
(IUCD) use?
A. Amenorrhea
B. Pelvic infection
C. Oligomenorrhea
D. Nulliparity
Correct Option: B

Q121. A patient develops rapidly progressing swelling and crepitus at a wound site with signs of tissue
necrosis and foul-smelling discharge. Gas gangrene is suspected. What is the most likely causative
organism?
A. Clostridium tetani
B. Clostridium perfringens
C. Staphylococcus aureus
D. Streptococcus pyogenes
Correct Option: B

Q122. A patient with a known history of malignancy presents with sudden onset of soft tissue swelling,
severe pain, and crepitus without any obvious trauma. Gas gangrene is suspected. What is the most likely
causative organism?
A. Clostridium perfringens
B. Clostridium tetani
C. Clostridium difficile
D. Clostridium septicum
Answer: D
Clostridium septicum is classically associated with spontaneous gas gangrene, especially in patients with
colorectal or hematologic malignancies.

Q123. Which of the following best characterizes the clinical presentation of nephritic syndrome?
A. Oliguria and hypertension

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B. Hematuria and hypertension
C. Proteinuria and hypoalbuminemia
D. Polyuria and hyperkalemia
Correct Option: B

Q124. Which viral infection has the highest likelihood of progressing to chronic liver disease?
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis E
Correct Option: C

Q125. A 52-year-old woman presents to the breast clinic with a 3 cm firm, movable mass in the upper
outer quadrant of the left breast. Axillary lymph nodes are not palpable. What is the most appropriate
next step in management?
A. Fine-needle aspiration cytology (FNAC)
B. Mammography with excisional biopsy
C. Observe and ask patient for follow-up
D. Refer to oncologist and immediately perform biopsy
Correct Option: A

Q126. A 34-year-old G3P2 woman at 8 weeks of gestation presents with vaginal bleeding and passage of
blood clots. On examination, the cervical os is open and partial products of conception are seen. What is
the most likely diagnosis?
A. Incomplete abortion
B. Complete abortion
C. Missed abortion
D. Inevitable abortion
Correct Option: A

Q127. A 34-year-old primigravida at 10 weeks gestation presents with vaginal bleeding and right lower
abdominal pain. Ultrasound reveals a 3 cm fetal mass consistent with ectopic pregnancy and no fetal
cardiac activity. What is the most appropriate treatment?
A. Methotrexate
B. Salpingectomy
C. Suction evacuation
D. Surgical laparotomy
Correct Option: A

Q128. A Double J (DJ) stent is commonly used in which of the following surgical specialties?
A. Ureteroscopy

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B. Neurology
C. Cardiology
D. Gastroenterology
Correct Option: A

Q129. What forms the posterior boundary of the epiploic (Winslow's) foramen?
A. Liver
B. Inferior vena cava (IVC)
C. Duodenum
D. Portal vein
Correct Option: B

Q130. A patient presents with an adducted and medially rotated arm after trauma. What is the most likely
diagnosis?
A. Anterior shoulder dislocation
B. Posterior shoulder dislocation
C. Medial shoulder dislocation
D. Lateral shoulder dislocation
Correct Option: B

Q131. What is the most common type of shoulder joint dislocation?

A. Anterior
B. Lateral
C. Posterior
D. Inferior
Correct Option: A

Q132. A woman in her 20s with a known history of joint pain presents with morning stiffness lasting for
hours and a rash that worsens with sun exposure. Her lab tests show a positive ANA. What is the most
likely diagnosis?
A. Rheumatoid Arthritis
B. Systemic Lupus Erythematosus (SLE)
C. Dermatomyositis
D. Sjögren’s Syndrome
Correct Option: B
Disclaimer! We sincerely apologize and acknowledge that the complete question stem is unavailable. Based
on the limited information provided, the most appropriate answer appears to be SLE.

Q133. A patient presents with an eye injury caused by acid exposure. What is the most appropriate
immediate management step?
A. Patch the eye and observe
B. Neutralize the acid with an alkaline solution

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C. Immediate copious irrigation with normal saline or water
D. Refer to ophthalmology without intervention
Correct Option: C

Q134. A football player was hit on the nose during a match. He briefly lost consciousness, then regained it,
but began feeling dizzy two hours later. What is the most likely diagnosis?
A. Subarachnoid hemorrhage (SAH)
B. Extradural (epidural) hematoma
C. Subdural hematoma
D. Scalp hematoma
Correct Option: B

Q135. The sternal angle (Angle of Louis) corresponds to which thoracic vertebral level?
A. T1
B. T2
C. T3
D. T4
Correct Option: D

Q136. Which of the following cells exhibit amoeboid locomotion in the human body?
A. B lymphocytes
B. Fibroblasts
C. Hepatocytes
D. Platelets
Correct Option: B

Q137. Maple syrup urine disease is characterized by the accumulation of which amino acid(s)?
A. Methionine
B. Phenylalanine
C. Branched-chain amino acids
D. Tryptophan
Correct Option: C

Q138. Which component predominantly proliferates in fibroadenoma of the breast?

A. Ductal epithelial hyperplasia
B. Lobular acinar growth
C. Stromal growth
D. Glandular growth
Correct Option: C

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Q139. A child presents with night sweats, low-grade fever, chronic cough, and palpable cervical
lymphadenopathy. What is the most likely diagnosis?
A. Tuberculosis
B. Infectious mononucleosis
C. Bronchitis
D. Lymphoma
Correct Option: A

Q140. A 3-year-old child presents with fever, dysuria. Urinalysis reveals numerous pus cells and red blood
cells. What is the most likely diagnosis?
A. UTI
B. PUV
C. Acute glomerulonephritis
D. Cystitis
Correct Option: A

Q141. A 29-year-old woman presents to the diabetes clinic. Her fasting blood glucose is 200 mg/dL, and
her 2-hour OGTT result is 240 mg/dL. What is the most appropriate initial treatment?
A. Insulin
B. Metformin
C. Glibenclamide
D. Pioglitazone
Correct Option: B

Q142. A 50-year-old male presents with abdominal pain, nausea, vomiting, weight loss, , ascites and a
palpable mass in the right upper quadrant. His serum alpha-fetoprotein (AFP) levels are elevated. What is
the most likely diagnosis?
A. Hepatocellular carcinoma (HCC)
B. Liver cirrhosis
C. Primary Billiary Cirrhosis
D. Metastatic carcinoma
Correct Option: A

Q143. Pericardiocentesis is used to treat which of the following conditions?

A. Cardiac tamponade
B. Tension pneumothorax
C. Pericarditis
D. Myocardial infarction
Correct Option: A

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Q144. A 26-year-old breastfeeding woman presents with drooping of the eyelids and generalized muscle
weakness that worsens throughout the day and improves with rest. What is the drug used to treat this
condition?
A. Neostigmine
B. Corticosteroids
C. Botulinum toxin
D. Diazepam
Correct Option: A

Q145. A 40-year-old man presents with a chronic cough, low-grade fever, night sweats, and weight loss for
the past 3 months. Chest X-ray reveals upper lobe infiltrates with cavitation. Sputum AFB smear is positive
for Mycobacterium tuberculosis. What type of hypersensitivity reaction is primarily involved in the
pathogenesis of tuberculosis (TB)?
A. Type I hypersensitivity
B. Type II hypersensitivity
C. Type III hypersensitivity
D. Type IV hypersensitivity
Correct Option: D

Q146. Broca’s area, also known as the motor speech area, regulates speech by interacting with the
temporal cortex. In which lobe of the brain is Broca’s area located?/Motor aphasia caused by damage to
which area of brain?
A. Temporal

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B. Parietal
C. Frontal
D. Olfactory
Correct Option: C

Q147. Damage to which area of the brain would most likely result in expressive aphasia?
A. Frontal lobe – Inferior frontal gyrus
B. Dominant parietal lobe
C. Occipital lobe
D. Temporal lobe
Correct Option: A

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Q148. A 40-year-old male presents with unilateral leg swelling, pain, and tenderness. Doppler ultrasound
confirms the presence of a deep vein thrombosis (DVT). What is the initial treatment of choice?
A. Low molecular weight heparin (LMWH)
B. Warfarin
C. Unfractionated heparin
D. Antiplatelet agents
Correct Option: A

Q149. Deficiency of which vitamin can lead to macrocytic anemia with elevated homocysteine levels?
A. Vitamin B1 (Thiamine)
B. Vitamin B6 (Pyridoxine)
C. Vitamin B9 (Folate)/Vit B12
D. Vitamin C
Correct Option: C

Q150. A patient has recently undergone thyroidectomy and now presents with dyspnea, hoarseness of
voice, and pain radiating to the tip of the right shoulder. Laryngoscopy reveals vocal cord paresis. What is
the most immediate next step in management?
A. Reopen surgical wound immediately
B. Perform tracheostomy
C. Start corticosteroids
D. Wait for spontaneous recovery
Correct Option:

Q151. Which of the following drugs is used in the treatment of gout by increasing uric acid excretion
(uricosuric effect)?
A. Allopurinol
B. Febuxostat
C. Probenecid
D. Colchicine
Correct Option: C

Q152. A patient presents with chest pain. ECG shows ST elevation in leads II, III, and aVF. What is the most
likely diagnosis?
A. Anterior wall myocardial infarction
B. Lateral wall myocardial infarction
C. Inferior wall myocardial infarction
D. Posterior wall myocardial infarction
Correct Option: C

Q153. A pregnant woman presents with vaginal bleeding, an open cervix, and no fetal heart activity on
ultrasound. The amniotic sac is empty. What is the most appropriate next step in management?

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A. Expectant management
B. Administer tocolytics
C. Evacuation of uterus
D. Start progesterone therapy
Correct Option: C

Q154. A "soap bubble" appearance on X-ray is classically seen in which of the following bone tumors?
A. Osteosarcoma
B. Ewing sarcoma
C. Giant cell tumor
D. Osteochondroma
Correct Option: C

Q155. A patient presents with jaundice. Lab shows elevated conjugated (direct) bilirubin, while ALT, AST,
and ALP are within normal limits. What is the most likely underlying cause?
A. Viral hepatitis
B. Hemolytic anemia
C. Bile duct obstruction/stone
D. Gilbert syndrome
Correct Option: C

Q156. A 3 cm firm, mobile mass is noted in the parotid region of a patient who also reports ear pain and
mild difficulty in chewing. The facial nerve is intact, and the mass appears free from underlying tissue.
What is the most appropriate surgical management?
A. Radical parotidectomy with facial nerve sacrifice
B. Enucleation only
C. Complete excision preserving the facial nerve
D. Observation and follow-up
E. Superficial parotidectomy
Correct Option:

Q157. A patient presents with resting tremor, bradykinesia, muscular rigidity, and postural instability.
What is the most likely diagnosis?
A. Essential tremor
B.Alzheimer
C. Parkinson disease
D. Huntington
Correct Option: C

Q158. Which part of the basal ganglia is primarily affected in Parkinson disease?
A. Caudate nucleus
B. Putamen

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C. Substantia nigra (pars compacta)
D. Globus pallidus
Correct Option: C

Q159. A woman with a history of pelvic inflammatory disease (PID), oligomenorrhea, and amenorrhea
wants contraception. Which of the following is an absolute contraindication to copper IUD insertion?
A. Amenorrhea
B. History of oligomenorrhea
C. History of pelvic infection
D. Nulliparity
Correct Option: C

Q160. In a patient with ascites, the serum-ascites albumin gradient (SAAG) is < 1.1 g/dL. What is the most
likely underlying cause?
A. Cirrhosis
B. Nephrotic
C. Peritoneal tuberculosis
D. Budd-Chiari syndrome
Correct Option: C

Q161. A young male presents with acute scrotal pain. On physical exam, elevation of the testis does not
relieve the pain. What is the most likely diagnosis?
A. Epididymo-orchitis
B. Testicular torsion
C. Varicocele
D. Hydrocele
Correct Option: B

Q162. Linoleic acid is an essential fatty acid important for growth and development. Deficiency of essential
fatty acids can lead to which of the following?
A. Dermatitis
B. Anemia
C. Marasmus
D. Stunted growth
Correct Option: A

Q163. Damage to the hypothalamus primarily affects which of the following functions?
A. Body temperature
B. REM sleep
C. NREM sleep
D. Short-term memory
Correct Option: A

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Q164. Which joint is primarily responsible for the eversion and inversion movements of the foot?
A. Ankle joint
B. Subtalar joint
C. Distal tibiofibular joint
D. Calcaneocuboid joint
Correct Option: B

Q165. The skin of the medial thigh is supplied by the medial cutaneous nerve, which is a branch of which
of the following nerves?
A. Femoral nerve
B. Hypogastric nerve
C. Obturator nerve
D. Deep inguinal nerve
Correct Option: A

Q166. A patient presents with severe bleeding from the lower medial part of the nasal septum. Which
artery is most likely involved?
A. Anterior ethmoidal artery
B. Superior labial artery
C. Sphenopalatine artery
D. Zygomaticotemporal artery
Correct Option: C

Q167. A patient presents with eye redness, watery discharge, and conjunctival congestion following a
recent upper respiratory tract infection. What is the most likely diagnosis?
A. Bacterial conjunctivitis
B. Adenoviral conjunctivitis
C. Fungal conjunctivitis
D. Allergic conjunctivitis
Correct Option: B

Q168. Protamine sulfate is used to reverse the effects of heparin. What type of antagonist is it?
A. Pharmacological antagonist
B. Mechanical antagonist
C. Physiological antagonist
D. Chemical antagonist
Correct Option: D

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Q169. A patient presents with acute testicular pain that relieves when the testicle is elevated. What is the
most likely diagnosis?
A. Epididymo-orchitis
B. Testicular torsion
C. Hydrocele
D. Varicocele
Correct Option: A

Q170. A granulomatous lesion is observed in a patient. What type of hypersensitivity reaction is most
likely involved?
A. Type I hypersensitivity
B. Type II hypersensitivity
C. Type III hypersensitivity
D. Type IV hypersensitivity
Correct Option: D

Q171. Which of the following clinical features is most characteristic of neurogenic shock?
A. Cold, clammy skin
B. Decreased TPR
C. Tachycardia with hypotension
D. Hypertension with cold extremities
Correct Option: B

Q172. A 40-year-old man presents with recurrent epigastric pain, multiple duodenal ulcers, and chronic
diarrhea. He has no history of NSAID use or H. pylori infection. Endoscopy reveals ulcers beyond the first
part of the duodenum. What is the most likely diagnosis?
A. Peptic ulcer disease
B. Zollinger-Ellison syndrome
C. Crohn’s disease
D. Gastric carcinoma
Correct Option: B

Q173. A 25-year-old patient presents with chronic diarrhea, weight loss, and an intensely itchy, blistering
rash on the extensor surfaces of elbows and knees. Biopsy of the rash shows granular IgA deposits in the
dermal papillae. What is the most likely underlying diagnosis?
A. Atopic dermatitis
B. Dermatitis herpetiformis
C. Psoriasis
D. Herpes simplex infection
Correct Option: B

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Q174. A 1-year-old child presents with a history of diarrhea. On examination, the child is alert, has dry
mucous membranes, and the skin pinch goes back slowly. The child drinks water eagerly when offered.
What is the appropriate management plan according to IMNCI guidelines?
A. Plan A
B. Plan B
C. Plan C
D. Reassurance
Correct Option: B

Q175. What is the greatest risk factor for developing melanoma?

A. Smoking
B. Ultraviolet (UV) light exposure
C. Chemotherapy
D. Asbestos
Correct Option: B

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Q176. A patient undergoing thyroidectomy suddenly develops a drop in end-tidal CO₂ (ETCO₂) to 20 mmHg
and a concurrent drop in oxygen saturation. What is the most likely cause?
A. Endotracheal tube (ETT) displacement
B. Bronchospasm
C. Pneumothorax
D. Atelectasis
Correct Option:

Q177. A doctor provides timely treatment to alleviate a patient’s suffering and improve health outcomes.
Which ethical principle does this action best represent?
A. Autonomy
B. Justice
C. Non-maleficence
D. Beneficence
Correct Option: D
Disclaimer! We acknowledge that the full question stem is not provided. Based on the available information,
the most appropriate answer appears to be Beneficence.

Q178. A patient presents to the emergency room with palpitations and sweating. On examination, the
pulse is irregularly irregular and the heart rate is 130 bpm. What is the most likely diagnosis?
A. Atrial fibrillation
B. Supraventricular tachycardia (SVT)
C. Ventricular tachycardia
D. Sinus tachycardia
Correct Option: A

Q179. A 4-year-old unvaccinated child presents with asymmetrical limb weakness and a limping gait. What
is the most likely diagnosis?
A. Guillain-Barré Syndrome (GBS)
B. Transverse myelitis
C. Poliomyelitis
D. Muscular dystrophy
Correct Option: C

Q180. Lytic bone lesions are classically seen in which of the following conditions?
A. Multiple Myeloma
B. Prostate carcinoma
C. Breast carcinoma
D. Osteoblastic metastases
Correct Option: A

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Q181. A patient with a known history of Chronic Myeloid Leukemia (CML) has died. What is the most likely
cause of death in patients with CML?
A. Infection
B. Blast crisis (progression to acute leukemia)
C. Repeated blood transfusion complications
D. Hemorrhage
Correct Option: B

Q182. An elderly patient with known prostate cancer presents with a chronic backache that worsens at
night and does not improve with changes in posture. Vertebral metastasis is suspected. What is the
investigation of choice?
A. Plain X-ray of the spine
B. MRI spine
C. Bone scan (99mTc)
D. CT spine
Correct Option: B

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Q183. A patient with a known case of prostate cancer presents for follow-up. On digital rectal examination
(DRE), what is the most likely finding?
A. Soft, enlarged, symmetrical prostate
B. Smooth, tender prostate
C. Firm, nodular, asymmetrical prostate
D. Fluctuant, boggy prostate
Correct Option: C

Q184. Which zone of the prostate is most commonly involved in prostate cancer?
A. Central zone
B. Transitional zone
C. Peripheral zone
D. Periurethral zone
Correct Option: C

Q185. A 35-year-old patient presents with episodic headaches, palpitations, and profuse sweating. He also
reports anxiety and tremors during these episodes. On examination, his blood pressure is 180/110 mmHg.
Laboratory tests reveal elevated plasma metanephrines. What is the most likely diagnosis?
A. Essential hypertension
B. Hyperthyroidism
C. Pheochromocytoma
D. Panic disorder
Correct Option: C

Disclaimer! We acknowledge that the full question stem is not provided. Based on the available information,
the most appropriate answer appears to be Pheochromocytoma.

Q186. A patient with chronic renal failure is planned for a renal transplant. His hemoglobin is 7.5 g/dL.
What is the next best step in management?
A. Delay surgery until hemoglobin normalizes
B. Transfuse packed red blood cells (PRBCs)
C. Administer intravenous iron
D. Administer intravenous erythropoietin
Correct Option:

Q187. A patient is diagnosed with left bundle branch block (LBBB). Which of the following findings is most
likely to be heard on cardiac auscultation?
A. Reverse splitting of S2
B. Soft S1
C. Fixed splitting of S2
D. Loud P2
Correct Option: A

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Q188. A mother brings her child to the OPD, concerned that he is the shortest in his class. On examination,
the child has proportionate short stature, is neurologically normal, and has no other abnormalities. What
is the most likely deficiency?
A. Growth hormone
B. Thyroxine
C. Vitamin D
D. Vitamin B12
Correct Option: A

Q189. A patient presents with recurrent vomiting and signs of dehydration. Arterial blood gas shows
metabolic alkalosis. Which electrolyte is most likely lost in this condition?
A. Bicarbonate
B. Potassium
C. Sodium
D. Calcium
Correct Option: B

Q189. A woman with a normal menstrual cycle visits the doctor seeking contraception. She is prescribed
combined oral contraceptive pills (OCPs). What is the primary mechanism by which OCPs prevent
pregnancy?
A. Endometrial atrophy
B. Inhibition of ovulation
C. Delayed implantation
D. Destruction of fertilized ovum
Correct Option: B

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Q190. Anti-mitochondrial antibodies (AMAs) are most strongly associated with which of the following
conditions?
A. Autoimmune hepatitis
B. Primary biliary cholangitis (cirrhosis)
C. Primary sclerosing cholangitis
D. Systemic lupus erythematosus (SLE)
Correct Option: B

Q191. A 32-year-old man presents to the emergency department with multiple episodes of forceful
vomiting followed by the sudden onset of hematemesis (vomiting blood). He has a history of heavy
alcohol intake and reports upper abdominal discomfort. What is the most likely diagnosis?
A. Esophageal varices
B. Boerhaave syndrome
C. Mallory-Weiss tear
D. Gastric ulcer

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Correct Option: C

Q192. What is the most common causative agent of urinary tract infection (UTI)?
A. Escherichia coli
B. Klebsiella pneumoniae
C. Staphylococcus saprophyticus
D. Proteus mirabilis
Correct Option: A

Q193. A 25-year-old lady presents in emergency department with complaints of palpitations and dizziness.
Her radial pulse is very fast and blood pressure is 110/70. Her ECG shows regular narrow complex
tachycardia. Which of the following is the first line treatment for this condition?
A. Defibrillation
B. Diltiazem
C. Metoprolol
D. Vagal maneuver
Correct Option: D

Q194. What is the most appropriate test to diagnose gestational diabetes?

A. HbA1C
B. Glucose tolerance test
C. Fasting blood sugar
D. Random blood sugar
Correct Option: B

. Which of the following is most prevalent pattern of dyslipidemia in patient with type 2 DM?
A. High LDL, Low TGs, Low HDL
B. Low LDL, High TGs, Low HDL
C. High LDL, High TGs, Low HDL
D. High LDL, High TGs, High HDL
Correct Option: C

Q195. A patient was diagnosed with acute inflammatory demyelinating neuropathy 1 week after he
recovered from an acute gastroenteritis infection. He was admitted with mild sensory symptoms which
were getting worse with progressive weakness that first began in his lower limbs. He was finding hard to
breathe and move his upper limbs as well. Which of the following treatments would you recommend?
A. IV methylprednisolone
B. IV antibiotics
C. IV immunoglobulin
D. Oral prednisolone
Correct Option: C

Q196. A 32-year-old woman complaining of 6 months history of dysphagia and nasal regurgitation, which
is worse during evening. She also reports intermittent drooping of her left eyelid and diplopia when she
gets tired. Neurological examination reveals partial left ptosis and diplopia but no ophthalmoplegia. She

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also has mild cough. What will be the most appropriate investigation in this case?
A. Acetylcholine receptor antibodies
B. Barium swallow
C. CT brain
D. Tumor markers
Correct Option: A

Q197. A woman came with collapse and vomiting preceded by occipital headache of acute onset. After 8
hours she was conscious and alert with photophobia and mild neck stiffness. CT scan brain was carried out
which came out to be normal. Which one of the following investigations would yield the diagnosis?
A. CT scan brain with contrast
B. MRI brain
C. CSF examination by LP after 12 hours
D. Cerebral angiography
Correct Option: C

Q198. Which of the following is most used in the Emergency Room for a patient with acute pulmonary
edema?
A. Furosemide
B. Mannitol
C. Digoxin
D. Spironolactone
Correct Option: A

Q199. Which one of the following types of angina is excluded when beta-blockers are administered to
counteract the symptoms of ischemia?
A. Stable angina
B. Prinzmetal angina
C. Unstable angina
D. Chronic exertional angina
Correct Option: B

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 Disclaimer
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Omissions Accepted. If you found any Statement
different/incorrect from the statement in exam.
Please inform at 03325972869.
This is a tentative Key. Final Key will be shared in the given
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NRE-2 CLASSES BY FIRST AID MADE EASY
ACADEMY LAHORE

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NRE-2 MOCK TEST BY FIRST AID MADE
EASY ACADEMY LAHORE

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NRE-2 MOCK TEST BY FIRST AID MADE
EASY ACADEMY LAHORE

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