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In gouty arthritis which of the following is the most specific

diagnostic finding:

A. Family history of gout

B. The presence of sodium urate crystals in synovial fluid ****************

C. Prompt response to colchicine therapy

D. The presence of hyperuricemia

E. Involvement of the big toe



221.ALL of the following are recognized features of Parkinsonism, EXCEPT:

A. Rigidity

B. Tremor

C. Hypokinesia

D. Extensive sensory loss ****************

E. Expressionless face


222.Signs of lower motor neuron disease include ALL of the following, EXCEPT:

A. Fasciculation

B. Hypotonia

C. Hyporeflexia

D. Clonus*********

E. Muscle wasting


223.Which of the following is NOT a feature of Felty's syndrome:

A. Lymphadenopthy

B. Splenomegaly ,

C. Polycytemia**************

D. Rheumatoid arthritis

E. Leukopenia


224.Each of the following penicillins is penicillinase resistant, EXCEPT:

A. Ampicilline *************

B. Oxacilline

C. Nafacillin

D. Methicillin

E. Cloxacillin


225.ALL of the following may cause bradycardia, EXCEPT:

A. Myxedema

B. Atenolol

C. Raised intracranial pressure

D. Jaundice

E. Salbutamol*********



226.A 50-years-old male awoke in the midnight with severe pain in his left big toe. He was taking some diuretics for hypertension. His toe was swollen, hot and severely tender, and patient was unable to stand on it. The most probable diagnosis is:

A. Reiter's syndrome.

B. Acute pyogenic arthritis

C. Rheumatid arthritis

D. Osteoarthritis

E. Acute gouty arthritis**********


227.Regarding left to right cardiac shunts ALL are TRUE, EXCEPT:

A. Cyanosis is a prominent feature****************

B. Oxygenated blood is shunted from left to right

C. Systemic flow is decreased

D. Pulmonary congestion is a prominent feature

E. Left heart pressures normally exceed those on the right


228.Which of the following drugs is useful for plasmodium falciparum malaria chemoprophylaxis:

A. Emetine hydrochloride

B. Trimetoprim

C. Chloroquine**************

D. Metronidazole

E. Rifampicin

229.Rheumatoid arthritis may cause ALL of the following in the hand, EXCEPT:

A. Joint ankylosis

B. Rupture of extensor tendons

C. Int -insic contractures

D. Rupture of flexor tendons

E. Heberden's nodes*************

230.Signs of severity in an acute attacks of bronchial asthma include ALL of the following, EXCEPT:

A. Cyanosis

B. Hypercapnia

C. Loud wheezes on auscultation*************

D. Pulsus paradoxus

E. Silent chest

231.Erythema nodosum may be associated with ALL of the following, EXCEPT:

A. Sarcoidosis

B. Tuberculosis

C. Streptococcal pharyngitis

D. Crohn's disease

E. Rheumatoid arthritis************


232.The usual causes of low arterial oxygen tension (Pa02) include EACH of the following, EXCEPT:

A. Right to left shunt

B. Ventillation-perfusion mismatch

C. Impaired diffusion capacity

D. Hyperventilation **************

E. Hypoventilation


233.Aplastic anemia may occur following the administration of which of the following:

A. Penicillin

B. Prednisolone

C. Tetracycline

D. Chloramphenicol ***************

E. Erythromycin


234.Characteristic cerebrospinal fluid findings in viral meningitis include:

A. White cell count may be low

B. There may be early polymorphonuclear cell reaction

C. Normal sugar content

D. Elevated protein

E. Positive direct smear for AFB************


235.Which of the following is commonly found in the pusterior mediastinum:

A. TeratomaSubsternal thyroid ***********

B. Thymoma

C. Neurofibroma

D. Dermoid cyst



236.Benign intracranial hypertension (pseudotumor corebri) is usually associated with which of the following:

A. Hemiparesis

B. Papilloedema**********

C. Increased CSF protein and sugar

D. Convulsions

E. Severe mental retardation


237.ALL of the following manifest with indirect hyperbilirubinemia, EXCEPT:

A. Gilbert's syndrome

B. Dubin-Johnson syndrome*******************

C. Crigler-Najar syndrome

D. ABO incompatibility

E. Physiologic neonatal jaundice

238.The protein present in the greatest quantity in the urine of normal people is:

A. Albumin************

B. Tamm-Horsfall protein

C. Gamma globulin

D. Amylase

E. Bence-Jones protein

239.A 50-years old Male who was seen in the casualty complained of sudden onset severe left anterior chest pain radiating to the left arm. It was not relieved by sublingual nitrates. He was short of breath; frothy blood was coming out of his mouth. He was hypotensive, cold, cyanotic and profusely sweating, There were diffuse bilateral wheezes and basal crepitations on chest examination. The heart sounds were soft and there was third heart sound, but there were no murmurs. Patient suffering from:

A. Acute bronchial asthma

B. Angina pectoris with acute bronchial asthma

C. Acute pulmonary edema secondary to myocardial infarciion *******************

D. Acute viral pneumonia with pleuritic chest pain

E. Dissecting aneurysm

240.The Budd-Chiary syndrome is due to occlusion of the:

A. Hepatic veins******************

B. Portal veins

C. Mesenteric veins

D. Pancreatic veins

E. Splenic veins

241.The following drugs could be given safely as a treatment of hypertension to a patient with peripheral vascular disease, EXCEPT:

A. Alpha-methyldopa

B. Nifedipine

C. Captopril

D. Propranolol*******************

E. Hydrochlorthiazide

242.The following gastrointestinal manifestations can be related to diabetes mellitus, EXCEPT:

A. Constipation

B. Diarrhea

C. Fecal incontinence

D. Duodenal ulcer****************

E. Gastric atonia


243.A 20-yers-old patient presented with 5 days history of gradually increasing fever, headache and constipation. Provisional diagnosis of typhoid fever was suggested. Diagnosis can be best confirmed at this stage by which of the following:

A. Widal test

B. Blood culture***************8

C. Urine culture

D. Stool culture

E. Clinical examination

244.Subarachnoid hemorrhage occurs most commonl3 as a result of:

A. Rupture of an arteriovenous anomaly

B. Rupture of a berry aneurysm********************

C. Rupture of a mycotic aneurysm

D. Trauma

E. Rupture of a fusiform aneurysm

245.There is an association between the use of biguanide oral hypoglycemia agent metformin (Glucophage) and the development of:

A. Lactic acidosis******************

B. Respiratory acidosis '

C. Metabolic acidosis with normal anion gap

D. Metabolic alkalosis

E. Marked respiratory alkalosis

246.Gastrin is produced primarily in the:

A. Gastric fundus

B. Antrum

C. Pylorus***************

D. Liver

E. Pancreas


247.Features of the Pickwickian syndrome may include ALL of the following, EXCEPT:

A. Obesity

B. Somnolence

C. Hypocapnia***********

D. Polycythemia

E. Hypoxemia


248.Causes of secondary hypertension include ALL of t he following, EXCEPT:

A. Addison's disease ***************

B. Conn's syndrome

C. Pheochromocytoma

D. Coarctation of aorta

E. Acromegaly


249.Rigors are typical features of ALL of the following, EXCEPT:

A. Brucellosis

B. Primary pulmonary tuberculosis ***************

C. Malaria

D. Acute pyelonephritis

E. Acute cholangitis


250.Secondary polycythemia is known to occur with ALL of the following, EXCEPT:

A. Heavy smoking

B. High altitudes

C. Chronic renal failure********************

D. Hepatoma

E. Fibroma of uterus



251.Signs of mitral stenosis include ALL of the following, EXCEPT:

A. Loud first heart sound

B. Opening snap

C. Presystolic murmur

D. Wide pulse pressure**************

E. Rumbling mid-diastolic murmur


252.Hematemesis and melena in a patient with liver cirrhosis is likely to be due to ALL of the following, EXCEPT:

A. Gastric ulcer

B. Hepatoma**************

C. Bleeding esophagus varices

D. Duodenal ulcer

E. Abnormal clotting mechanism


253.Hypertension may be secondary to ALL of the following, EXCEPT:

A. Renal artery stenosis

B. Conn's syndrome

C. Pheochromocytoma

D. Addison's disease *******************

E. Acromegaly


254.Features of myxedema include ALL of the following EXCEPT:

A. Periorbital puffiness

B. Pericardial effusion

C. Brisk ankle reflex *************

D. Deafness

E. Constipation


255.Splenomegaly can occur in ALL of the following, EXCEPT:


A. Chronic granulocytic leukemia

B. Chronic malaria

C. Amyloidosis

D. Celiac disease********************

E. Polycethemia rubra vera


256.ALL of the following can cause hematuria, EXCEPT:

A. Renal stone

B. Renal tuberculosis

C. Glomerulonephritis

D. Amyloidosis ******************

E. Cystitis


257.Contraindications to the use of streptokinase therapy include ALL of the following, EXCEPT:

A. Bleeding peptic ulcer

B. Infective endocarditis

C. Surgery to eye

D. Cor pulmonale******************

E. Severe hepatic insufficiency


258.ALL of the following can cause short stature, EXCEPT:

A. Achondroplasia

B. Familial

C. Klinefelter's syndrome ***************

D. Hpothyroidism

E. Corticosteroid therapy


259.ALL of the following can cause macroglossia, EXCEPT:

A. Addison's disease*****************

B. Hypothyroidism (cretinism)

C. Down's syndrome

D. Acromegaly

E. Amiloidosis


260.The most common form of extragenital gonococcal infection is:

A. Conjunctivitis ****************

B. Arthritis

C. EndocardiLis

D. Myocarditis

E. Hepatitis



261.Hyperventilation ma be found in ALL of the following, EXCEPT:

A. Narcotic overdose*************

B. Diabetic ketoacidosis

C. Acute attack of bronchial asthma

D. Hysterical reaction

E. Pulmonary embolism


262.A lesion in the cerebellar hemisphere will cause ALL of the following, EXCEPT:

A. Muscular hypotonia

B. Dysarthria

C. Dysmetria

D. Motor aphasia ****************

E. Intention tremor


263.Which of the following. drug is useful in the treatment of angina pectoris:

A. Salbutamol

B. Propranolol**************

C. Digoxin

D. Quinidine

E. Phenytoin


264.ALL of the following are TRUE about diabetic ketoacidosis, EXCEPT:

A. May be precipitated by infection

B. May occur in type II diabetes

C. Thromboembolic pnenomenon is recognized complication

D. Total body potassium is high***************

E. Dehydration can be very severe


265.ALL of the following can cause hemoptysis, EXCEPT:

A. Pneumonia

B. Mitral prolaps ****************

C. Tuberculosis

D. Lung trauma

E. Goodparture's syndrome



266.Causes of epilepsy include ALL of the following, EXCEPT:

A. Cerebrovascular accident

B. Brain tumor

C. Head injury

D. Hypokalemia *****************

E. Brain abscess


267.ALL of the following are TRUE about brucellosis. LXCEPT:

A. Spondylitis is a feature

B. Causes huge splenomegaly*****************

C. Rifampicin is used in the management

D. Endocarditis may occur

E. Causes peripheral neuropathy


268.ALL of the following about typhoid fever are CORRECT, EXCEPT:

A. Caused by Salmonelltt typhi

B. Headache is a prominent symptom

C. Rose spots occur during the second week

D. Splenomegaly can occur

E. Leucocytosis is usually present**********************


269.Indications for the use of ß-blockers include ALL of the following, EXCEPT:

A. Hypertension

B. Ischemic heart disease

C. Migraine

D. Bronchial asthma *******************

E. Anxiety


270.ALL of the following are TRUE about AIDS, EXCEPT:

A. Can be transmitted from mother to fetus

B. Is caused by retrovirus

C. Causes dementia

D. Kaposi sarcoma is a feature

E. Carriers are not infective*******************


271.ALL of the following are causes of malabsorption,EXCEPT:

A. Celiac disease

B. Tropical sprue

C. Bacterial overgrowth

D. Meckel's diverticulum *********

E. Giardia lamblia


272.ALL of the following can cause diarrhea, EXCEPT:

A. Food poisoning

B. Viral gastroenteritis

C. Inflammatory bowel disease

D. Colonic neoplasia

E. Hypothyroidism*************


273.Hyperkalemia is known to occur in which of the following:

A. Hydrochlorthiazide therapy

B. Propranolol

C. Captopryl************

D. Digoxin

E. Nifedipine


274.Signs of pleural effusion include ALL of the following, EXCEPT:

A. Stony dullness on percussion

B. Diminished or absent breath sound

C. Deviation of trachea to opposite side

D. Increased tactile vocal fremitus ********************

E. Bronchial breathing above effusion


275.ALL of the following are indications of liver biopsy, EXCEPT:

A. Liver cirrhosis

B. Pyrexia of unknown origin

C. Hydatid cyst**********

D. Unexplained hepatomegaly

E. Hemochromatosis



276.Diabetes may be secondary to ALL of the following, EXCEPT:

A. Cushing's syndrome

B. Thiazide therapy

C. Acromegaly

D. Pancreatic carcinoma

E. Insulinoma*************


277.ALL of the following can cause obstructive jaundice, EXCEPT:

A. Common duct stones

B. Carcinoma of the head of pancreas

C. Biliary stricture

D. Sclerosing cholangitis

E. Fatty liver***********


278.ALL of the following are risk factors for cholesterol gall stones, EXCEPT:

A. Females more than males

B. Obesity

C. Contraceptive pills

D. Peptic ulcer ***************

E. Multiparity


279.Aplastic anemia can be caused by ALL of the following, EXCEPT:

A. Fanconi's anemia

B. Benzene

C. Insecticides

D. Viral hepatitis

E. Typhoid fever***********************


280.The following are TRUE about cholera, EXCEPT:

A. Individuals with achlorhydria are more susceptible to infection

B. Disease is mediated by exotoxin

C. Causes metabolic acidosis

D. Usually involves large bowels**************

E. Tetracycline is used on then treatment



281.Signs of left ventricular failure include ALL of the following, EXCEPT:

A. Orthopnoe

B. Triple rhythm

C. Pulsus alternans

D. Bilateral basal crepitation

E. Gross liver enlargement**********


282.ALL of the following can cause liver cirrhosis, EXCEPT:

A. Alcohol

B. Hepatitis B

C. Hepatitis A*******************

D. Hemochromatosis

E. Budd-Chiari syndrome


283.Leucocytosis may occur in ALL of the following, EXCEPT:

A. Brucellosis******************

B. Myocardial infarction'

C. Bacterial infection

D. Burns

E. Infancy


284.Signs of thyrotoxicosis include ALL of the following, EXCEPT:

A. Lid lag

B. Tremor of both hands

C. Carpopedal spasm *******************

D. Pretibial myxedema

E. Tachycardia


285.Differential diagnosis of oro-genital ulceration include ALL of the following, EXCEPT:


A. Reiter's syndrome

B. Pemphigus

C. Erythema multiforme

D. Herpes zoster ************************

E. Behchet's disease



286.ALL of the following are features of pernicious anemia, EXCEPT:

A. Usually over 30 years, with blue eyes

B. Microcytic and hypochromic anemia********************************

C. Subacute combined degeneration of the cord can occur

D. Dementia is a feature

E. Optic atrophy can occur


287.ALL of the following are features of ß-thalassemia major, EXCEPT:

A. Skull X-ray show "hair on end" appearance

B. Blood film shows hypochromic and microcytic picture

C. Usually is asymptomatic***********

D. Hepatosplenomegaly is a feature

E. Is inherited disease


288.ALL of the following are extra-articular manifestations of rheumatoid arthritis, EXCEPT:

A. Pericarditis

B. Mononeuritis multiplex

C. Fibrosing alveolitis

D. Pneumoconiosis***************

E. Scleritis


289.ALL of the following are features of systemic lupus erythematosus, EXCEPT:

A. Fever

B. Butterfly rash

C. Alopecia

D. Glomerulonephritis

E. Keratoderma blennoiThagica*****************


290.ALL of the following are features of polyarteritis nodosa, EXCEPT:

A. Commoner in males

B. Hypertension may occur

C. Mononeuritis multiplex

D. Death usually from anemia*************

E. Myocardial infarction can occur


291.The following are TRUE about Behchet's disease, EXCEPT:

A. Causes oro-genital ulcers

B. Thrombo-phlebitis can occur

C. Is a viral infection************

D. Steroid can be used in the treatment

E. Neurological complications may occur


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