1. Threshold of a screening test is increased. How it will affect sensitivity and specificity?
a) Sensitivity increase & specificity decrease
b) Sensitivity decrease and specificity increase
2. A child has ingested overdose of iron tablets- first symptom?
a) Nausea and abdominal pain
3. Rheumatoid arthritis patient develops tinnitus. Cause?
a) Due to ASA
4. WHO conference in 1978 in Alma Mata, Russia- declaration on
5.Rheumatoid arthritis patient develops swelling left calf and ankle. Thigh normal. Cause?
b) Rupture of popliteal cyst
6. Child 3years with swelling of scrotum. Testis can be palpated through the swelling Fluctuant, painless. Observed for few months. Translucent. Definitive Management?
a) examine regularly
b) aspirate only
d) injecting sclerosant
7. Question on probability- probability of finding one disease is A and other is B. (Independent). Probability on finding the 2 diseases in one pt.
a) AX B
c) AXB- A+B ???
8. Most common occupational disease in Canada.
9. Most common cancer in Canada/
10. 23 year old lady presented with cramping abdominal pain and heavy bleeding. Pregnancy test positive. Bleeding stopped today morning. Pregnancy symptoms disappeared one week ago. USG shows empty uterus and 3 cm mass in adnexa. Diagnosis?
a) ectopic pregnancy
b) complete abortion with corpus luteal cyst
c) ves. Mole with corpus luteum
d) twin gestation- one aborted and one ectopic
11. Child with inguinal hernia. Presentation
a) scrotal swelling
b) thickening of spermatic cord
12. A mother brought to her son to your clinic with red spots around eye. You confirmed it as petechiae. What other finding is of concern to you
a) petechiae all over body
b) subconjunctival hemorrhage
c) he developed vomiting after few hours
13. A lady 50 years with swelling medial to femoral pulse. Firm and smooth. Diagnosis?
a) femoral hernia
b) inguinal hernia
c) saphena varix
14. galactorrhoea . cause?
a) pituitary infarction
d) thoracic nerve stimulation
e) dopamine agonist
15. Mechanism of action typical antipsychotics
a) + dopamine receptors
16.a patient on antipsychotics, cannot sit still……
17.best way to prevent benzodiazepine dependence
a) use the one with short half-life
b) use for short duration
c) use at nighttime only
18. Most common gynecological infection in Canada
b) bacterial vaginosis
19. Most common cause for premenstrual itching (cyclical itching)
b) bacterial vaginosis
c) non specific vaginitis
20. Most specific site to collect swab for gonococci
21. Pap smear swab collected from
a) endo cervical and recto cervix
b) endocervical and endometrial
c) endo cervical
22. A patient presented with an ulcer near medial malleolus. Cause
b) perforator incompetence
23. A patient with chronic bronchitis PaO2 60 mmHg. What advise you will give EXCEPT
a) no need for continuous O2 therapy
b) maintain healthy food hygiene
c) annual influenza vaccination
d) no need for prophylactic antibiotics
e) avoid hypnotics or sedatives
24. HIV positive patient, CD4 count 250 Presented with cold. What will you do
a) start multiple drug antiretroviral treatment
b) TMP+ Sulpha
25. Full term child. Birth weight 3000. Develops respiratory distress. Xray shows air bronchogram. Diagnosis
a) Transient tachypnoea of newborn
26. Baby 8 hours after birth, staring and severe Cyanosis. Hypotonia of muscles. What investigation you will do?
27. A child had headache, vomiting, and abdominal pain. Then he sleeps. What is your diagnosis?
b) temporal lobe epilepsy
28. A child 3 years presented with abdominal pain and Bleeding PR for 12 hours. What is your diagnosis?
a) meckel’s diverticulum
29.elderly –sensorineural hearing loss. Most common Cause
30. Occupational deafness. Usually caused by
a) high frequency loss
b) low frequency loss
31. A passenger in bus got an injury in his eye with the newspaper of the neighboring person. Diagnosis
a) corneal abrasion
32. Benzodiazepam. Cross-tolerance with which drug
33. A child has ingested 30 tablets of imipramine. What should be done mean while contacting the toxicology center.
a) forced diuresis
b) give ipecac syrup
c) drug to prevent convulsions.
34. A child has ingested an overdose of imipramine. Pt. is stable. What investigation is done to monitor sign of toxicity.
c) Blood level of drug
35. Which combination should not be used?
a) tranyl cypramine-sertraline
36. A child with tic disorder- what is the first thing in management
b) family psychotherapy
37. Behavior therapy least useful
b) depression with strong suicidal ideation
c) generalized anxiety
38. Anti depressant drugs most useful in which of the following conditions?
39. Which of the following is the most common condition in Canada?
a) cervical malignancy
b) endometrial malignancy
c) endometrial polyp
d) septulum uterus
40. Toxic shock syndrome. Not true
a) exo toxin
c) skin necrosis
41. A lady 50 years, 2 years nocturnal cough. Now develops fever sweats weight loss purulent sputum. X-ray shows consolidation apex of lower lobe. Diagnosis
42. Asian 53 years. Weight 93 kg. Arthritis. Now c/o head ache. Striae on abdomen, thinning of skin. What investigation to be done?
A) CT scan head
B) Random plasma cortisol
C) Enalapril enhanced renal angiogram
43. Commonest cause of broncheolitis
44. Which of the following diseases can be prevented by a live attenuated vaccine except?
44. If a child develops diphtheria now the mortality is almost the same as it was 50 years ago. But now the disease is not so common because
a) incidence decreased
b) prevalence decreased
c) effective antibiotics developed
45. CAD is more in men compared to women. Which of the following is true?
a) MI investigation and treatment more effective in men
b) Chest pain in women is less frequently attributed to non cardiac causes
c) Awareness about MI is same in men and women
d) Hypertension is a strong risk factor in men compared to women
46. Which of following is the most important risk factor for CVA
a) systolic hypertension
c) elevated serum cholestrol
47. A child with proptosis, swelling and redness around eye, movement of eye painful. Diagnosis
a) orbital cellulites
b) preorbital cellulitis
48. Elderly people
a) prefer to live alone and like their children to visit them
b) live alone because of geographical distribution children have to live away
c) like to live alone and don’t like visitors
49. A man 65 years labile mood, depression forgetful for 2 years. He has long standing hypertension. O/E Cognitive functions partial impairment, absent ankle jerk. Diagnosis
b) pseudo dementia
c) multiinfarct dementia
50. A man presented with injury of hand after a fight in beer parlor. Most likely injury
a) dorsal dislocation of 5th metacarpal
b) palmar dislocation of 5th metacarpal
c) radial dislocation of 5th metacarpal
d) ulnar dislocation of 5th metacarpal
51. Which of the following antipsychotic has got least extrapyramidal side effects
52. Which of the following antipsychotic produce extrapyramidal SE in therapeutic dose?
53. A lady 33 years had a pregnancy with anencephaly and undergone abortion at 15 weeks. She wants to conceive in 6 months. What advise you will give
a) start folic acid now
b) she has to do amniocentesis at 16 weeks
c) neural tube defects are unlikely to recur in subsequent pregnancies
54. Diabetic lady advice regarding risk of congenital anomalies.
a) risk is same for gestational diabetes and other diabetes
b) risk can be reduced to that of general population if strict control of sugar is maintained through out the pregnancy.
c) Sacral agenesis is the most common anomaly
d) USS for congenital anomaly is done at 32 weeks
56. Prostate cancer; most important in diagnosis
59. Soldier returning from peacekeeping force. He has nightmares anxiety. Etc. what is the initial step in management
b) benzodiazepine for 1year
c) a trial of behavior therapy for s assort period
60. A 23 year old girl develops watery diarrhea after a picnic, 2 days later she develops purpuric rashes, oliguria, what is most likely
a) 2 other picnic mates developed rashes the next day
b) they made lemonade using water from a near by pond
c) many of the picnic people developed bite marks bitten by mosquito
d) few of the picnic people were returning from usa
61. Toddler’s diarrhea what seen
a) indigested food particles
b) fecal occult blood
62. hirshsprung’s most imp. Inv
a) Barium enema
b) Colonic transit time with radio opaque markers
c) X ray
63. hirshsprung .diff from constipation
a) from birth
b) fecal soiling
64. Male pain left lower quad. Mass. Neutrophilia. Inv?
a) rigid sigmoidoscopy
b) barium. Enema
65. Child ingested cleaning liquid with Iye. Lips & mouth corroded what is least useful
b) X ray chest
66. Tension pneumothorax. All are features except
a) hyper translucent
b) mediastinal shift
c) inspiratory stridor
d) subcutaneous crunchy sound
e) decreased breath sounds
67. What is the first management of tension pneumothorax?
a) needle thoracotomy
b) needle thoracostomy
c) chest tube
68. Epiglottitis with mild stridor. all are true except
b) ABG to monitor prognosis
69. Child with sore throat red tongue lymphadenopathy. How to differentiate viral etiology
a) throat swab,
b) white cell count
70. Man with gonorrhea. Treated with cef. Still symptoms. Urine microscopy no organism, cause
a) intracellular diplococci
b) extra cellular diplococci
72. RTA- blood at urinary meatus, what to do next?
73. Child h/o fall. Pain lumbar region with ecchymoses, gross hematuria. Renal CT shows peri renal hematoma. Child stable renal pedicle normal. Management?
a) surgical repair
b) close monitoring in ICU
c) catheterize and rest for 7-10 days
d) send home
74. Man 56 years. Father died of prostate ca. o/e a small nodule right lobe. PSA 2.2. What advice
a) follow up in 6 months DRE and PSA
b) foloow up in 3 months PSA
c) uss guided Biopsy now
75. Post menopausal bleeding. What inv.
a) endometrial biopsy
76. severe premenstrual syndrome. Definitive management
a) b/l oopherectomy
77. Girl 5 years. H/o vomiting since birth. Now complaints of dysphagia for solids. Cause
c) hiatus hernia
d) duo ulcer
78. A man with tertiary syphilis. Which of the following is going to alter his management plan?
79. A man presented with contracture of PIP. He cannot flex Dip. Which s the pathology
a) flexor digitorum
b) extensor pollicis
c) extensor carpi
80. Case control study useful in
a) study of rare disease.
81. Ethics- a man suspects to be having probable gonorrhea. His wife works in lab. He doesn’t want her to know his specimen. What to do.
a) ask him to tell his wife
b) put a code no. on the sample, not his name.
c) Don’t listen to him
d) Send him to the public sexually transmitted disease clinic
82. A couple comes to you. Husband wants to end the relation what the wife thinks to be a happy marriage. She is crying. What to next?
a) spend one and a half hours to each of them to psychotherapy
b) try to find out what made the crisis
c) send to lawyer
83. For which of the following is behavior modification is best?
a) phobic anxiety
b) generalized anxiety
c) affective disorder
d) bipolar disorder
84. A man 50 years hp 156/95 sweating, palpitation, one of his relative had thyroid ca. what inv. To be done?
a) urine catecholamine
b) urine VMA
c) CT adrenal
85. A man 10 days after pancreatitis complains of abdominal pain, firm swelling
b) a/c hepatitis
86. Peptic ulcer patient complaints of pain radiating to back. Diagnosis
87. Gastric ulcer patient. Treated for12 weeks. Asymptomatic now. When gastroscopy done ulcer is still present. Negative for malignancy and H.pylori. What to do?
a) treat for 8 more weeks
b) life long H2 receptor blocker
c) follow up only
d) partial gastrectomy with excision of ulcer
88. Known MI patient now presents with palpitation. He says he is on quinide, propranolol and digoxin 0.125
mg. O/e- PR-96,irregularly irregular. What should be done to prevent any complications?
a) increase the dose of digoxin
b) anti coagulant for long time
c) give digoxin and quinide togather
89. All are true about carbamazepine except
a) starting dose 200mg
b) causes leucocytosis
90. Mitral stenosis patient goes to a dentist for some procedure. He is asking for prophylactic antibiotics. Which of the following decides which to given?
a) type of procedure
b) presence of atrial fibrillation
c) presence of cardiac failure
d) type of procedure
91. Bier block (regional IV anesthesia). Which is true?
a) bupivacaine is better
b) effect lasts longer even after the procedure , giving adequate post op analgesia
c) suitable for all procedures in hand
92. Elderly lady, pain on hand and upper arm. Wasting of thenar eminence. Severe pain at night. Cannot carry shopping bag. Diagnosis
a) carpal tunnel syndrome
b) cervical spondylosis
93. 75 year old man, sudden onset of back pain, severe pain right buttock, hamstrings, micturition problem. He was having UTI 2 weeks back Cause
a) multiple myeloma involving spinal cord
b) lung ca with metastasis
94. A baby with birth wt.3.5kg now 4 weeks weighs 3.6 kg. Mother worried not drinking enough milk. What will you advise?
a) Tell her that nothing to worry, as some kids don’t gain much weight in the first month
b) start formula feeding
c) investigate the kid
95. A lady 33 weeks of gestation, admitted with uterine cramps and moderate bleeding. Nurse started IV line and blood taken for grouping and cross matching. What to do next?
a) start another IV line
b) arrange for CS
c) start tocolysis
d) examine for cervical dialtaton
96. Triple screening done in the antenatal period. Which is true?
a) should be only offered to women who are willing for termination if any abnormality is found
b) should be offered only if proper pre test counseling is given
97. Regarding HRt, a lady ha h/o migraine and strong family history of osteoporosis what should be done/
a) offer oes-prog.HRT
b) progesterone only
c) biphosphonate only
d) oes only
98. Raloxifine, which is true
a) contraindicated in peptic ulcer
b) effective for hot flushes
c) effective for osteoporosis
d) breast ca increased risk
99. Infertility with c/c salpingitis. Which is not done?
100. Ophthalmoplegia with pupillary sparing. Cause?
b) canernous aneurysum
101.herpes simplex corneal ulcer. What is not done?
b) corticosteroids use
normal ear drum
103. A child with sinusitis and otitis media. Treated with antibiotics. Serous effusion still present in middle ear. What to do?
a) another course of antibiotics
b) myringostmy with tube
104. A lady gave birth to a cleft palate baby. You are going to send her home after counseling. For what reason she is going to come to your office more often?
a) feeding problem
b) recurrent otitis media
c) teeth problem
105. You gave a new drug to your patients with dementia. Those suffering from multi infarct dementia improved while those with Alzheimer’s not.. What should you do before prescribing this to your patient
106. What type of trial is this?
107. In the Er you are planning to do a new trial on pts with retrosternal chest pain
108. A lady for laparoscopic tubal ligation on the way to theater asks for removal of a mole on her forearm while she is under GA. What you will tell?
109. Jehovah witness signed card
110. hemophilia A
111. A carrier lady for an X linked recessive disease marries a normal man. They have 2 daughters. What is the probability of each of them to become carrier?
a) 1in 4
b) 1 in 8
c) 1 in 16
d) 1in 64
112. Which is not a cause for occupational asthma.
113. Which causes nasal sinus ca?
114. condyloma accuminata, pregnant lady what is used
c) trichloracetic acid
115. Picture of tinea cruris. Treatment.
a) topical steroids
b) amphoterecin b
116. A man presented with headache, photophobia, menigism. CSF_ cells increased, neutrophils 95% What is the most common cause
117. Viral meningitis. Which is not true?
a) sugar normal
b) protein elevated
c) chloride high
118. A man with dark skin, liver 20 cm. Cirrhosis. Diagnosis
119. What inv. In the above patient
a) transferrin saturation
120. A child with necrotizing enterocolitis. All are true except
a) air in portal vein
c) peritoneal calcification
121. a man presented with a mass right to his rectus below umbilicus while standing and straining. Disappears while lying down. Diagnosis
a) Richter’s hernia
b) spigelian hernia
c) desmoid’s tumor
122. Which of the following is toxic in overdose?
123. c/f of congenital hypertrophic pyloric stenosis.
124. A lady 50 years presented with mild hypercalcemia X-ray chest normal. Diagnosis.
125. A child had a/c sinusitis and you treated with a course of penicillin. His blood inv shows- TC increase, s.ca decrease others normal. You supplement with ca, what inv. To be done
a) s PTH
b) X-rays of hands
126. A man presented with pain in flanks radiating to groin. He had similar episodes 2 times previously. And was diagnosed to have hyper calciuria. What should be done?
c) reduce dietary calcium
127.post appendicectmy pt develop s-subphrenic abscess
128.which of the following is most likely to be a drug reaction
a) IMN patient treated with pencillin produces rash
c) patient with sore throat treated with pen. Has rash
129. Intoxication. –Which one causes oliguria?
a) ethylene glycol
130. Intoxication- dry skin. Pupil sluggish reacting. Agitated. Paranoid
131. Child electrocuted. What is the cause of death?
a) cardiac arrest
132. A child has features of meningitis. Which is poor prognostic factor?
b) generalized seizure
c) localizing sign
d) neck stiffness
134. Neonatal sepsis.a feature
135. A man complaints of severe headache for the last 12 hours. Vomiting + photophobia. Diagnosis
a) subarchnoid hemorrhage
136. A child had a fall and he was drowsy. While waiting in the ER he becomes more and more drowsy .one pupil dilated diagnosis
a) extradural hematoma
b) subdural hematoma
137. A man with a swelling in the right scrotum. O/e- tender mass above testis. skin of scrotum red and inflamed. Prostate enlarged He has pyuria. What is the diagnosis?
b) epididymitis and prostatitis
c) gonococcal urethritis
138. How to look for clue cells.
a) vaginal secretion with KOH and cover
b) vaginal secretion with saline and cover
c) cervical secretion with saline and cover
d) cervical secretion with KOH and cover
e) vaginal secretion with KOH and dry
139. Multiple pregnancy-cause of perinatal mortality
140. Tocolysis contraindicated in all except
a) twins at 33 weeks
b) cervix 4 cm
141. Persistent bradycardia in fetus due to
a) head compression
b) AV block
142. Which is true about congenital anomalies?
a) congenital anomalies rarely affect growth
b) if symmetrical IUGR is detected look for congenital anomalies
c) trisomy 13&18 will not cause growth retardation
143. A child 3 years has BP 138/95. He has a systolic murmur right 2nd space, femoral pulse not palpable. Diagnosis ?
144. apgar score
145. A pregnant lady with GCT 10.3 mmol/l, what is most imp.
Strict maintenance of euglycemia through out the pregnancy
146. A lady prepared for hysterectomy. What will you tell her regarding risk of thromboembolism
a) risk is highest after 72 hours
b) thromboembolism mostly originate from pelvic veins
147. A lady post partum develops DVT. What is the management?
a) warfarin for 3 months
b) heparin IV for 1 week and warfarin for 3 months
c) heparin IV for 1 week and low molecular wt. Heparin for 3 months
148. A pregnant lady 20 weeks. Uterus 26 weeks. Beta HCG 30000.what is the management
a) suction curettage
149. Which of the following is not poor prognosis in melanoma)
a) color change
d) tuft of hair
e) irregular surface
150. C/f of thrombosed external pile. Diagnosis?
151. Same scenario. Management
152. c/f ischirectal abscess . management
153. A girl c/o continuous pain in the vulva for the last 8 hours. O/e a red tender swelling is seen on the post 1/3 of lab minora. What is the diagnosis?
a) bartholin’s cyst
b) bartholin’s duct abscess
c) skene’s gland abscess
154. A group of people returning from Rocky Mountains developed diarrhea. Cause
a) Rocky mountain spotted fever
155.esophageal atresia with tracheo esophageal fistula at the lower end. What is true?
a) gastric aspiration common
b) gastric air shadow not seen
156. A man sustained a stab wound on the thigh anteriorly. He is bleeding profusely. What is the first thing to do?
a) apply tourniquet above the wound
b) press femoral artery
c) direct pressure
d) on wound
e) fill the wound with clothes
157. A child with 15% burns On face and chest. What is done?
a) oral midazoalm and i/v morphine
b) i/v midazolam and burn dressing
c) i/v cef.and morphine
158. 2 year old child. burns 15% calculate fluid replacement
159. A lady brings her son to you saying that he is alcoholic who denies that . what question is least relevant
a) do you need an eye opener in the morning
b) do you hate criticism
c) do you drink only on social occasions
160. Features of anaphylaxis-treatment
161. Laryngeal nodule- not a risk factor-
162. A man 64 years c/o hoarseness. What is the first thing to be done?
a) chest X ray
163. Uncomplicated intestinal obstruction. All are seen except
a) increased bowel sounds
164. Idiopathic thrombocytopenia
165. Most common cause of syncope in a young man
166. A man presented to Er after a party. Intoxicated. Blood values- HCO3 very low. All others normal. What other inv
a) urine osmolality
b) serum osmolaity
167. Mallory weis – what inv.
a) senstaken tube
b) OG scopy
168. Clinical features suggestive of intestinal ischemia
169. Crohn’s. C/f given. Diagnosis?
170. Right upper quadrant pain, fever, jaundice. Diagnosis
a) a/c cholecystitis
171. A/c cholecystis. Cause.
a) obstruction of cystic artery
b) onstruction of CBD
c) obstruction of GB by stone
172. post op 36 hours. Cause of fever,
c) Wound infection
173. Most common cause of incontinence in women
a) stress incontinence
b) urge incontinence
c) detrusor instability
174. Dementia patient. Treatment of which of the following could have prevented
b) pernicious anemia.
175. Another question on dementia.
176. What is the most imp. Thing to differentiate Alzheimer’s from pseudo dementia
a) Short duration
b) mental status examination
177. Treatment for seasonal rhinitis
a) nonsedative antihistamines
b) oral steroids
178. Picture of a child. Mouth open.
a) adenoid hypertrophy.
179. Couple comes to you. Husband hypertensive says impotence 6 months but erection occurs in the morning and while reading the magazine. What should you do?
180. Cause for recurrent UTI in child
a) VU reflux
181. Treatment of nephritic syndrome. All except
b) salt restriction
c) fluid restriction
e) protein restriction
182. Elderly lady fecal occult blood. All are true except.
183. Case of DUB.
184. All the following can be given to improve sexual function. Except
d) gonadotrophin analogues
186. A lady with previous h/o cs for footling breech is kept for trial. During labor she develops bleeding PV, fetal tachycardia. …. Diagnosis
a) rupture uterus.
187.a lady at 41 weeks of gestation likes to wait for spontaneous onset of labor. Which of the following require immediate delivery?
a) interest of public is most
189. Which of the following is the most effective way to prevent dental caries in children?
a) fluoridation of water
b) dental flossing
190. Periodic health examination not true
a) detection of chronic diseases
b) behaviour change and hygiene
c) more focused annual physical examination
b) RBBB with RAD
192. Picture of a hand with a lump on the dorsal surface MCP jt.
a) h/o renal calculi
193. A lady develops dry cough. Treated with ampicillin few days later Develops rash, elevated liver enzymes. Cause
194. Bacterial vaginosis. All true except
b) Flagellated organism
195. Malaria treated. Recurrence after 1 year
a) dormant liver schizhont
196. Features of meningitis. What inv.
a) lumbar puncture
197. Features of multiple sclerosis all except
198. Horner’s with dysphagia.
199. Paranoid schizhoprenia- features given,
201. Elderly wife abusing husband who is suffering from arthritis what is not done
a) send hem to daycare
b) support to wife
202. Status asthmaticus
a) hydration, inhaled beta agonist, IV steroid
203. Strawberry angiomas. Treatment.
a) spontaneous regression
c) injection of sclerosant.
204. Ocd treatment
205. Abruption placenta. Cause of DIC
Also available in download section of this site