Question 1

What could be the diagnosis if the electrocardiogram shows no sinus origin rhythm associated with 'P' waves presenting as F waves with a characteristic saw-tooth pattern, and a T wave dominated by an atrial wave?

A)Atrial fibrillation
B)Atrial flutter
C)Sinu atrial exit block
D)Sinus arrest

Accepted Answer

In Atrial flutter, the electrocardiogram shows no sinus origin rhythm, P' waves are present as 'F' waves with a characteristic saw-tooth pattern, and the T wave is dominated by an atrial wave.
In sinus arrest, the ECG shows the sinus rhythm, long pauses, 3 or more beats missing, P waves followed by a QRS complex.
In Sinu atrial exit block, the ECG shows sinus rhythm, occasional pause, one whole complex missing, P waves usually followed by QRS complex.
In atrial fibrillation, the ECG shows no sinus rhythm, P waves absent, F waves absent or replaced by wavy /flat baseline. There will be an irregular rhythm present.

Question 2

Based on the blood gas analysis, which group of values in the choices below may indicate that the patient has a chronic carbon dioxide retention?&#10;A)Pco2 55 mmHg , pH 7.25&#10;B)Pco2 55 mmHg , pH 7.32, Base excess +3&#10;C)Pco2 55 mmHg , pH 7.35&#10;D)None of the above

Accepted Answer

Blood gas values Pco2 55 mmHg, pH 7.35 may indicate that the patient has chronic carbon dioxide retention.
The pH level is key in determining the stage as acute or chronic. If the pH is not in the normal range of 7.35 - 7.45, then the patient is in an acute stage. Option A is an acute stage.
As the pH progresses back to normal with the base excess, then the patient is partially compensating as given in option B.
If the pH falls within the normal level as in option C, i.e., Pco2 55 mmHg, pH 7.35, which indicates that the patient is in the chronic stage.

Question 3

Which is the most definitive test used to detect pulmonary embolism?&#10;A)Ultrasound&#10;B)Pulmonary angiogram&#10;C)Ventilation perfusion scan&#10;D)Positive emission tomography

Accepted Answer

Pulmonary angiogram is the most definitive test used to detect pulmonary embolism.
Pulmonary angiogram is an invasive test that involves injection of dye into the arterial vasculature. It must be carried out in the catheterization laboratory under a sterile environment.
Ultrasound is commonly used to find the pockets of fluid during thoracocentesis. The ultrasound waves are bounced off by the bones of the thoracic cavity so it is not very useful in the thoracic region.
Ventilation perfusion scan is the primary test used to detect pulmonary embolism. However, research has found that this scan can give indeterminate results.
Positron emission tomography also shows the function of the organs rather than just their structure. It is commonly used to detect the viable cardiac muscle.

Question 4

Which cardiac injury enzyme is a more sensitive indicator of myocardial infarction?&#10;A)Creatine kinase&#10;B)Aspertate aminotransferase&#10;C)LDH1&#10;D)Total LDH

Accepted Answer

LDH1 is the more sensitive indicator of myocardial infarction.
LDH1 is an isoenzyme of LDH which is the more sensitive indicator than the total LDH.
Creatine kinase starts rising at 4 - 6 hours and peaks at 12 hours and then falls back normal within 48 to 72 hours.
Aspertateaminotransferate rises at 12 hours and peaks at the first and the second day.
Total LDH rises after 12 hours and peaks after 2 -3 days, and remains elevated for a week.

Question 5

In an acute asthmatic attack, which one of the following results is NOT expected in the lung function test?&#10;A)Increased total lung capacity&#10;B)Increased peak expiratory flow rate&#10;C)Reduced vital capacity&#10;D)Reduced FEV1/VC

Accepted Answer

Increased peak expiratory flow rate cannot be expected in lung function test of an acute asthma attack.
In acute asthma there is narrowing of airways with bronchospasm, mucosal edema, inflammation and mucous plugging of small airways. These changes results in reduced peak expiratory flow-rate, reduced FEV1 / VC and MEFV. Airway resistance increases. The tendency of the narrowed airways to close even during tidal expiration results in increase in FRC and RV. Total lung capacity is increased due to air being trapped behind closed airways.

Question 6

Of the following, what is the common cause of primary lymphedema?&#10;A)Infection&#10;B)Inflammation&#10;C)Trauma&#10;D)None of the above

Accepted Answer

None of the above. The common cause of primary lymphedema is none of the above.
Primary lymphedema is not associated with any underlying disease process or intrinsic abnormalities.
Secondary lymphedema is associated with infection, inflammation, trauma, malignancy, and underlying venous disease.

Question 7

In aortic regurgitation, what does the Hill's sign refer to?&#10;A)Prominent carotid pulsation in neck&#10;B)Popliteal cuff systolic pressure exceeding the brachial cuff systolic pressure&#10;C)To and from movement of head synchronized with cardiac cycle&#10;D)Booming systolic and diastolic sounds heard over the femoral artery

Accepted Answer

In aortic regurgitation the Hill's sign refers to popliteal cuff systolic pressure exceeding the brachial cuff systolic pressure.
Hill's sign is a peripheral sign of aortic regurgitation. The other options are also peripheral signs of aortic regurgitation.
Prominent carotid pulsations are known as Corrigan's neck sign.
To and fro movement of head synchronized with cardiac cycle is referred as De - Musset's sign.
Booming systolic and diastolic sounds heard over the femoral artery is Traube's sign.

Question 8

A 35-year-old male presents with fever, and cough which is chronic and worse in the mornings. He expectorates copious, purulent, foul- smelling sputum which is three layered. The chest X-ray shows a honey-comb appearance. What can be the diagnosis?

A)Asthma
B)Chronic bronchitis
C)Tuberculosis
D)Bronchiectasis

Accepted Answer

Bronchiectasis can be the diagnosis for the 35-year-old male having fever, cough which is chronic and worse in mornings, and expectorating copious , purulent, foul-smelling sputum which is three layered along with an X-ray showing honey-comb appearance.
Bronchiectasis is defined as a permanent abnormal dilatation of one or more bronchi, due to elastic and muscular components of bronchial wall. The hall mark of brochiectasis is chronic cough with sputum production. Cough is worse in the mornings and brought on by postural changes. Sputum is characteristically copious, purulent, and foul-smelling. Honey comb appearance in the chest x ray occurs in saccular bronchiectasis.
The other options of bronchitis and tuberculosis are also characterized by cough but the expectoration is not usually purulent and foul-smelling. Asthma is characterized by the presence of a wheeze. In addition, the chest X ray findings do not show honey-comb appearance in other conditions.
Chronic bronchitis (blue bloaters) is the inflammation of the bronchial tree secreting excessive mucous.
Asthma is the chronic inflammatory respiratory disease in which there is constriction of the airways and production of extra mucus.
Tuberculosis is bacterial infection of the lungs caused by bacteria known as mycobacterium tuberculosis. The bacteria spread through airborne particles, which are inhaled deep into the lungs.

Question 9

Which is a differentiating feature between pleural effusion and hydropneumothorax?&#10;A)Pain&#10;B)Dyspnea&#10;C)Percussion note&#10;D)Chest expansion reduction

Accepted Answer

Percussion note is a differentiating feature between pleural effusion and hydropneumothorax.
In the case of pleural effusion, there will be a stony, dull percussion note. Whereas in hydropneumothorax, the upper will be hyperresonant and lower part of lung will show a stony, dull note.
Pain, dyspnea, and reduced chest expansion are common for both conditions.

Question 10

A 30-year-old female has a history of repeated attacks of spontaneous pneumothorax on the right side. It occurs 48-hours after the onset of menstruation. What can be the diagnosis?&#10;A)Recurrent spontaneous pneumothorax&#10;B)Catamenial pneumothorax&#10;C)Valvular pneumothorax&#10;D)Clicking pneumothorax

Accepted Answer

Catamenial pneumothorax
Catamenial pneumothorax is a rare condition occurring in women over 25 - 30 years old. Usually spontaneous pneumothorax occurs repeatedly on the right side. Attacks usually occur within 48-hours of the onset of menstruation. It may be due to endometrial cysts attached to thoracic region which releases blood and collapses the lung.
Recurrent spontaneous pneumothorax occurs commonly in patients with emphysematous bullae.
Valvular pneumothorax occurs due to persistence of communication between pleura and lung. It acts as a valve and allows air to enter only in pleura but does not allow it to escape.
Clicking pneumothorax occurs on the left side and may be localized in front of the pericardium. This may make the heart sound louder.

Question 11

Which of the following is NOT the usual side effect of salbutamol?&#10;A)Anxiety&#10;B)Nervousness&#10;C)Insomnia&#10;D)Dysrhythmias

Accepted Answer

The answer of Which of the following is NOT the...

Question 12

Which is the drug of choice for acute asthma?&#10;A)Fluticasone&#10;B)Salmeterol&#10;C)Albuterol&#10;D)Omeprazole

Accepted Answer

The answer of Which is the drug of choice for...

Question 13

Which one of the following oxygen delivery systems is a high-flow system?&#10;A)Nasal prongs&#10;B)Transtracheal oxygen catheter&#10;C)Venturi mask&#10;D)Partial rebreathing mask

Accepted Answer

The answer of Which one of the following oxygen delivery...

Question 14

Which muscle is affected in the vertical approach of median sternotomy?&#10;A)External intercostals&#10;B)Internal intercostals&#10;C)Pectoralis major&#10;D)Trapezius

Accepted Answer

The answer of Which muscle is affected in the vertical...

Question 15

In which congenital condition does the scapula fail to descend from its embryological position in the neck?&#10;A)Sprengel's shoulder&#10;B)Madelung's deformity&#10;C)Syndactilism&#10;D)Polydactylism

Accepted Answer

The answer of In which congenital condition does the scapula...

Question 16

What is the infection at the hip joint that is spread by a septic umbilicus called?&#10;A)Tom Smith's arthritis&#10;B)Osteomyelitis&#10;C)Small pox arthritis&#10;D)Cultton's joint

Accepted Answer

The answer of What is the infection at the hip...

Question 17

What is the cause of primary osteoporosis?&#10;A)Prolonged use of corticosteroids&#10;B)Hypercorticism&#10;C)Aging&#10;D)Malignancy

Accepted Answer

The answer of What is the cause of primary osteoporosis?&#10;A)Prolonged...

Question 18

What is rickety rosary?&#10;A)Persistent fontenellae, even after 2 years of age&#10;B)Beading at the costochondral junction&#10;C)Groove-like deformity in the lower chest&#10;D)Protuberant abdomen

Accepted Answer

The answer of What is rickety rosary?&#10;A)Persistent fontenellae, even after...

Question 19

According to the American Rheumatism Association, which of the following is NOT the essential criteria in the diagnosis of rheumatoid arthritis>&#10;A)Morning stiffness&#10;B)Pain in one joint&#10;C)Swelling in one joint for 6 weeks&#10;D)Asymmetrical joint involvement

Accepted Answer

The answer of According to the American Rheumatism Association, which...

Question 20

Which factor is responsible for ankylosing spondylitis?&#10;A)IgM&#10;B)HLA- B27&#10;C)Both A. and B.

Accepted Answer

The answer of Which factor is responsible for ankylosing spondylitis?&#10;A)IgM&#10;B)HLA-...

Question 21

In an anteroposterior X-ray, which of the following shows a characteristic &#34;bamboo spine &#34;?&#10;A)Ankylosing spondylitis&#10;B)Rheumatoid arthritis&#10;C)Osteoarthritis&#10;D)Chorcot's joints

Accepted Answer

The answer of In an anteroposterior X-ray, which of the...

Question 22

What is a muscle strain?&#10;A)Complete rupture occurring through the tendon&#10;B)Tearing of some muscle fibers&#10;C)Superficial injury

Accepted Answer

The answer of What is a muscle strain?&#10;A)Complete rupture occurring...

Question 23

What is Chauffeur's fracture?&#10;A)Fracture of distal end of the radius&#10;B)Fracture of distal end of radius with palmar displacement&#10;C)Fracture of radial styloid process&#10;D)Intra articular fracture of base of the first metacarpal bone

Accepted Answer

The answer of What is Chauffeur's fracture?&#10;A)Fracture of distal end...

Question 24

What is the name of the fracture that occurs as a transverse fracture of the cortex which extends into the mid portion of the bone and runs along the long axis of the bone in children?&#10;A)Buckle fracture&#10;B)Epiphyseal fracture&#10;C)Greenstick fracture&#10;D)Displaced fracture

Accepted Answer

The answer of What is the name of the fracture...

Question 25

What is the term for the complete removal of the lamina?&#10;A)Laminotomy&#10;B)Hemilaminectomy&#10;C)Laminectomy&#10;D)Fenestration

Accepted Answer

The answer of What is the term for the complete...

Question 26

Of the following, which one is NOT a skin traction?&#10;A)K - wire&#10;B)Dunlop's&#10;C)Gallow's&#10;D)Buck's extension

Accepted Answer

The answer of Of the following, which one is NOT...

Question 27

Which one of the following is a bone cement?&#10;A)Polyethylene&#10;B)Polymethylmethacrylate (PMMA)&#10;C)Silicone&#10;D)Titanium

Accepted Answer

The answer of Which one of the following is a...

Question 28

Which surgical procedure is performed to tighten the subscapularis tendon and shoulder capsule in a dislocated shoulder?&#10;A)Bankart's operation&#10;B)Putti-Platt's operation&#10;C)Bristow's operation

Accepted Answer

The answer of Which surgical procedure is performed to tighten...

Question 29

A 40-year-old male met with a road traffic accident. He was in the driver's seat when the accident occurred. While he was brought to the hospital, there was limb shortening along with hip flexion, adduction and internal rotation deformity. What is the type of dislocation expected in this patient?

A)Posterior dislocation of hip
B)Posterior fracture dislocation of hip
C)Anterior dislocation of hip
D)Central dislocation of hip

Accepted Answer

The answer of A 40-year-old male met with a road...

Question 30

Which of the following statements is NOT true about medial meniscus?&#10;A)Semicircular in shape&#10;B)More mobile&#10;C)More commonly injured than lateral meniscus&#10;D)Injury of medial meniscus is commonly among young athletes

Accepted Answer

The answer of Which of the following statements is NOT...

Question 31

Hitch-hiker's sign is seen in what injury?&#10;A)Ulnar nerve injury&#10;B)Median nerve injury&#10;C)Radial nerve injury&#10;D)Brachial plexus injury

Accepted Answer

The answer of Hitch-hiker's sign is seen in what injury?&#10;A)Ulnar...

Question 32

If the radial nerve is injured between the spiral groove and lateral epicondyle, what muscle group will NOT be affected?&#10;A)Wrist extensors&#10;B)Thumb extensors&#10;C)Elbow extensors&#10;D)Finger extension

Accepted Answer

The answer of If the radial nerve is injured between...

Question 33

What could be the posture adapted by the patient when there is disc herniation lateral to the nerve root?&#10;A)Incline to the same side of compression&#10;B)Incline to the opposite side of compression&#10;C)No inclination

Accepted Answer

The answer of What could be the posture adapted by...

Question 34

What is a chorea?&#10;A)Irregular, repetitive, writhing movements&#10;B)Slow, sustained, abnormal movements&#10;C)Irregular, repetitive, jerky movements&#10;D)Explosive violent movements

Accepted Answer

The answer of What is a chorea?&#10;A)Irregular, repetitive, writhing movements&#10;B)Slow,...

Question 35

What is the clinical use of positron emission tomography?&#10;A)Examines the spontaneous electrical activity of the brain&#10;B)Detects the relationship between cerebral blood flow, oxygen utilization and extraction in focal areas of ischemia&#10;C)Detection of early ischemia in occlusive and hemorrhagic CVA&#10;D)Embolization

Accepted Answer

The answer of What is the clinical use of positron...

Question 36

Which type of electrode is commonly used in nerve conduction studies?&#10;A)Disc&#10;B)Cup&#10;C)Ring&#10;D)B and C&#10;E)All of the above

Accepted Answer

The answer of Which type of electrode is commonly used...

Question 37

In a median somatosensory evoked potential, what generates an N9 wave form?&#10;A)Brachial plexus&#10;B)Dorsal cervical roots&#10;C)Rostral cervical cord&#10;D)Primary sensory cortex

Accepted Answer

The answer of In a median somatosensory evoked potential, what...

Question 38

Which disc space is contraindicated for lumbar puncture?&#10;A)T12 - L1&#10;B)L2 - L3&#10;C)L3 - L4&#10;D)L5 - S1

Accepted Answer

The answer of Which disc space is contraindicated for lumbar...

Question 39

In which condition is a &#34;festinating&#34; gait present?&#10;A)Cerebellar ataxia&#10;B)Hemiplegia&#10;C)Parkinson's disease&#10;D)Lower motor neuron weakness

Accepted Answer

The answer of In which condition is a &#34;festinating&#34; gait...

Question 40

Which is the most common primary brain tumor?&#10;A)Astrocytoma&#10;B)Oligodendroglioma&#10;C)Meningioma&#10;D)Ependymoma

Accepted Answer

The answer of Which is the most common primary brain...

Question 41

Where is the common source of microorganism that causes a cerebral abscess?&#10;A)Middle ear&#10;B)Sinus&#10;C)Blood&#10;D)All of the above

Accepted Answer

The answer of Where is the common source of microorganism...

Question 42

In which condition is the &#34;Kernig's sign&#34; usually positive?&#10;A)Subarachnoid hemorrhage&#10;B)Meningitis&#10;C)Intracranial hemorrhage&#10;D)Both A and B&#10;E)Both B and C

Accepted Answer

The answer of In which condition is the &#34;Kernig's sign&#34;...

Question 43

Which is NOT a clinical feature of Brown-Sequard syndrome?&#10;A)Ipsilateral pyramidal weakness&#10;B)Contralateral pain and temperature sensation impairment&#10;C)Contralateral impaired joint position sense&#10;D)Ipsilateral impaired touch localization

Accepted Answer

The answer of Which is NOT a clinical feature of...

Question 44

In which of the following conditions is &#34;Gower's sign&#34; usually present?&#10;A)Duchenne dystrophy&#10;B)Polymyositis&#10;C)Myasthenia gravis

Accepted Answer

The answer of In which of the following conditions is...

Question 45

Which of the following is NOT a feature of cholinergic crisis?&#10;A)Worsening of weakness&#10;B)Increased sweating&#10;C)Large pupils&#10;D)Respiratory failure

Accepted Answer

The answer of Which of the following is NOT a...

Question 46

What is Uhthoff's phenomenon?&#10;A)Return of the multiple sclerosis symptoms following a hot bath&#10;B)Sudden neck flexion will evoke a shock like sensation in the limbs&#10;C)Prolonged latency in visual evoked potential&#10;D)Presence of discrete bands in CSF electrophoresis

Accepted Answer

The answer of What is Uhthoff's phenomenon?&#10;A)Return of the multiple...

Question 47

In which condition does jaw claudication occur?&#10;A)Giant cell arteritis&#10;B)Peripheral vascular disease&#10;C)Migraine&#10;D)Cluster headache

Accepted Answer

The answer of In which condition does jaw claudication occur?&#10;A)Giant...

Question 48

What is the amount of cerebrospinal fluid (CSF) secreted in a day?&#10;A)100 ml&#10;B)200 ml&#10;C)500 ml&#10;D)1000 ml

Accepted Answer

The answer of What is the amount of cerebrospinal fluid...

Question 49

When there is presence of subtentorial mass, what is the complication following a misguided lumbar puncture?&#10;A)Lateral tentorial herniation&#10;B)Tonsillar herniation&#10;C)Midline shift&#10;D)Central tentorial herniation

Accepted Answer

The answer of When there is presence of subtentorial mass,...

Question 50

What is a prodrome?&#10;A)Symptoms that occur before a seizure attack&#10;B)Attack of seizure&#10;C)Mood changes before the seizure attack&#10;D)The time period immediately after the seizure attack

Accepted Answer

The answer of What is a prodrome?&#10;A)Symptoms that occur before...

Question 51

Which drug is used to treat the raised intracranial pressure?&#10;A)Levadopa&#10;B)Mannitol&#10;C)Calcium channel blockers&#10;D)Phenytoin

Accepted Answer

The answer of Which drug is used to treat the...

Question 52

What is status epilepticus?&#10;A)Repeated tonic/clonic convulsions with a gap between them&#10;B)Does not regain consciousness between the seizure attacks&#10;C)The weakness for a few hours of the affected limb after a motor seizure&#10;D)Feeling of unfamiliarity

Accepted Answer

The answer of What is status epilepticus?&#10;A)Repeated tonic/clonic convulsions with...

Question 53

Which condition is contraindicated for surgical treatment of epilepsy?&#10;A)Tumor&#10;B)Hemartoma&#10;C)Severe mental retardation&#10;D)Ateriovenous malformation

Accepted Answer

The answer of Which condition is contraindicated for surgical treatment...

Question 54

Which of the following statements is NOT true about the closed technique of wound care?&#10;A)Holds the topical antimicrobial agent&#10;B)Reduces fluid loss&#10;C)Allows ongoing inspection of wound and healing process&#10;D)Protects the wound

Accepted Answer

The answer of Which of the following statements is NOT...

Question 55

Which antibiotic is used against gram negative organisms in the treatment of burns?&#10;A)Gentamycin&#10;B)Collagenase&#10;C)Bacitracin&#10;D)Silver nitrate

Accepted Answer

The answer of Which antibiotic is used against gram negative...

Question 56

What is a sheet graft?&#10;A)Cultured autologous skin&#10;B)Skin taken from cadaver&#10;C)Skin taken from different species&#10;D)Skin is applied without any alteration after harvesting

Accepted Answer

The answer of What is a sheet graft?&#10;A)Cultured autologous skin&#10;B)Skin...

Question 57

What is NOT a criterion for admission to a designated burn center according to The American Burn Association?&#10;A)Chemical burns&#10;B)Inhalation injury&#10;C)Partial thickness burn less than 10% of total body surface in under 10 years of age&#10;D)Full thickness burn >5% of total body surface in any age

Accepted Answer

The answer of What is NOT a criterion for admission...

Question 58

What is the action of beta blockers?&#10;A)Help your body eliminate sodium and water, reducing blood volume.&#10;B)Keep calcium from the muscle cells and constricting blood vessels&#10;C)Decrease nerve impulses to the heart and blood vessels.&#10;D)Keep the hormone from interacting with blood vessels.

Accepted Answer

The answer of What is the action of beta blockers?&#10;A)Help...

Question 59

Which medication keeps hormones from interacting with blood vessels, dilates vessels and hence reduces the blood pressure?&#10;A)Angiotensin II receptor blockers (ARBS)&#10;B)Calcium channel blockers&#10;C)Beta blockers&#10;D)Angiotensin converting enzyme (ACE) inhibitors

Accepted Answer

The answer of Which medication keeps hormones from interacting with...

Question 60

Which of the following is NOT a calcium channel blockers?&#10;A)Nifedipine&#10;B)Verapramil&#10;C)Diltiazem&#10;D)Analapril

Accepted Answer

The answer of Which of the following is NOT a...

Question 61

If the congestive cardiac failure patient presents with breathing difficulty, which is the preferred position to aid in better breathing?&#10;A)Seat patient upright at 45 degree angle&#10;B)Put the patient in a supine position&#10;C)Move the patient to a wheelchair&#10;D)Lying prone

Accepted Answer

The answer of If the congestive cardiac failure patient presents...

Question 62

Which progressive disease destroys memory and other important mental functions?&#10;A)Alzheimer's disease&#10;B)ADHD&#10;C)Parkinson's disease&#10;D)Stroke

Accepted Answer

The answer of Which progressive disease destroys memory and other...

Question 63

In which disorder does a patient get unreasonable thoughts and obsessions that lead to do repetitive behaviors?&#10;A)Depression&#10;B)Epilepsy&#10;C)Schizophrenia&#10;D)Obsessive compulsive disorder

Accepted Answer

The answer of In which disorder does a patient get...

Question 64

Which one of the following options is associated with type II diabetes?&#10;A)Fast healing process&#10;B)Ketoacidosis&#10;C)Obesity&#10;D)Peaks at age 20

Accepted Answer

The answer of Which one of the following options is...

Deck 2: Diseases and Conditions