Q1- A 56-year-old male presents with substernal chest pain radiating to the left arm. ECG shows ST-elevation in leads II, III, and aVF. Which artery is most likely occluded? A) LAD B) RCA C) LCX D) Diagonal branch Q2-A 30-year-old woman presents with fatigue and pallor. Labs: Hb 8.5 g/dL, MCV 70 fL, ferritin low. What is the most likely diagnosis? A) Vitamin B12 deficiency B) Anemia of chronic disease C) Iron deficiency anemia D) Thalassemia trait Q3-Which of the following is the most sensitive test for diagnosing early diabetic nephropathy? A) Serum creatinine B) 24-hour urine protein C) Spot urinary albumin-to-creatinine ratio D) Renal ultrasound Q4-A patient with chronic hypertension develops sudden-onset headache and right-sided weakness. CT scan shows an intracerebral hemorrhage. Most likely site? A) Pons B) Cerebellum C) Basal ganglia D) Occipital lobe Q5-A 22-year-old male has polyuria, polydipsia, and fasting glucose of 270 mg/dL. HbA1c is 10%. What is the best initial treatment? A) Metformin B) Insulin C) Sitagliptin D) Glipizide Q6- A patient with cirrhosis is found to have ascites. What is the first-line management? A) Albumin infusion B) Therapeutic paracentesis C) Spironolactone D) Beta-blocker Q7-A 70-year-old with atrial fibrillation presents for stroke prevention. CHA₂DS₂-VASc score is 3. What is the most appropriate management? A) Aspirin B) Clopidogrel C) Warfarin or DOAC D) No therapy Q8-A 35-year-old female presents with heat intolerance, tremor, and palpitations. Labs: TSH low, T3/T4 high. Next best step? A) TSH receptor antibody test B) MRI pituitary C) Start levothyroxine D) TPO antibody test Q9-In a COPD exacerbation, what medication improves survival long-term? A) Salbutamol B) Inhaled corticosteroids C) Antibiotics D) Long-term oxygen therapy Q10-A patient with suspected bacterial meningitis is hypotensive and febrile. What is the most appropriate immediate step? A) Lumbar puncture B) Start antibiotics C) CT head D) Wait for blood cultures Q11- A 67-year-old smoker presents with hematuria and flank pain. CT shows a solid renal mass. What is the likely diagnosis? A) Renal cyst B) Transitional cell carcinoma C) Renal cell carcinoma D) Hydronephrosis Q12-A patient has a positive PPD test (15 mm) but no symptoms or CXR findings. What is the next step? A) No treatment B) Start isoniazid for 9 months C) Start full anti-TB regimen D) Repeat test in 6 months Q13-Which of the following is a common cause of SIADH? A) Hypothyroidism B) Small cell lung cancer C) Diabetes mellitus D) Adrenal insufficiency Q14-A man with gout develops joint pain and swelling. What is the drug of choice in acute attack? A) Allopurinol B) Colchicine C) Febuxostat D) Probenecid Q15-Which electrolyte abnormality is most commonly associated with adrenal insufficiency? A) Hyperkalemia B) Hypokalemia C) Hypocalcemia D) Hypernatremia Q16-A 55-year-old male with history of alcohol use presents with confusion, ataxia, and ophthalmoplegia. What is the diagnosis? A) Korsakoff syndrome B) Delirium tremens C) Wernicke encephalopathy D) Subdural hematoma Q17-A patient on isoniazid develops numbness and tingling in the hands. What vitamin deficiency is likely? A) Vitamin B6 B) Vitamin B12 C) Vitamin C D) Vitamin D Q18-Which one of the following is a side effect of ACE inhibitors? A) Hypokalemia B) Bradycardia C) Cough D) Constipation Q19-A man presents with fatigue and skin hyperpigmentation. Labs show hyponatremia, hyperkalemia, and low cortisol. Diagnosis? A) Cushing syndrome B) Addison's disease C) SIADH D) Diabetes insipidus Q20-A diabetic patient with fever and flank pain is found to have pyelonephritis. Best initial antibiotic? A) Nitrofurantoin B) TMP-SMX C) IV ceftriaxone D) Ciprofloxacin PO Q21-A 65-year-old male with heart failure is on furosemide. He complains of hearing loss. What is the likely cause? A) Age-related loss B) Sensorineural damage C) Furosemide toxicity D) Infection Q22-A woman presents with fatigue, weight gain, and cold intolerance. TSH is high, T3/T4 low. What is the next step? A) MRI pituitary B) Start levothyroxine C) Repeat labs in 6 weeks D) Test cortisol level Q23-A 28-year-old male presents with severe sore throat, fever, and difficulty opening his mouth. Examination reveals unilateral tonsillar swelling and uvular deviation. Most likely diagnosis? A) Acute pharyngitis B) Peritonsillar abscess C) Ludwig's angina D) Infectious mononucleosis Q24-A 40-year-old woman has persistent epigastric pain relieved by meals. She uses NSAIDs regularly. What is the most likely diagnosis? A) Gastric ulcer B) Duodenal ulcer C) GERD D) Pancreatitis Q25-Which of the following is a common cause of secondary hypertension? A) Hyperaldosteronism B) Diabetes mellitus C) Obstructive sleep apnea D) Smoking Q26-A patient develops hematuria and a palpable purpuric rash after a sore throat. Labs show RBC casts. What is the likely diagnosis? A) IgA nephropathy B) Minimal change disease C) Post-streptococcal GN D) Lupus nephritis Q27-Which of the following is most suggestive of nephrotic syndrome? A) Hematuria and RBC casts B) Proteinuria >3.5g/day and edema C) Oliguria and elevated BUN D) Hypertension and pyuria Q28- A 38-year-old woman with tremors and weight loss is diagnosed with hyperthyroidism. Which medication blocks peripheral T4 to T3 conversion? A) Methimazole B) Propylthiouracil C) Radioactive iodine D) Levothyroxine Q29-A patient presents with moon face, central obesity, and striae. Serum cortisol is elevated and ACTH is low. Next step? A) MRI pituitary B) Low-dose dexamethasone test C) Abdominal CT D) High-dose dexamethasone test Q30- Which of the following findings is most consistent with Parkinson’s disease? A) Intention tremor B) Resting tremor C) Hyperreflexia D) Fasciculations Q31-A 70-year-old man presents with worsening memory, disorientation, and visual hallucinations. He has rigidity and bradykinesia. Most likely diagnosis? A) Alzheimer’s disease B) Frontotemporal dementia C) Lewy body dementia D) Vascular dementia Q32-A patient presents with RUQ pain, fever, and jaundice. What is the most likely diagnosis? A) Cholelithiasis B) Cholecystitis C) Choledocholithiasis D) Ascending cholangitis Q33- Which hepatitis virus is a DNA virus? A) HAV B) HCV C) HEV D) HBV Q34-A patient with atrial fibrillation suddenly develops right-sided weakness. CT shows no bleed. What is the most likely cause? A) Intracerebral hemorrhage B) Carotid artery dissection C) Embolic stroke D) Lacunar infarct Q35- Which of the following medications is contraindicated in pregnancy? A) Methyldopa B) Labetalol C) ACE inhibitors D) Nifedipine Q36-A 65-year-old male presents with bone pain and hypercalcemia. Labs: high ALP, low PTH, monoclonal spike on SPEP. Likely diagnosis? A) Paget’s disease B) Multiple myeloma C) Primary hyperparathyroidism D) Osteoporosis Q37-A man presents with acute vision loss in one eye, headache, and a tender temporal artery. ESR is high. Best next step? A) Temporal artery biopsy B) MRI orbit C) Start high-dose steroids D) Wait for biopsy result Q38- A 35-year-old female has episodes of palpitations, sweating, and headaches. Her BP is 190/100. What is the best initial test? A) CT abdomen B) Serum renin C) Plasma metanephrines D) ECG Q39-A 25-year-old IV drug user presents with fever, murmur, and splinter hemorrhages. Which valve is most likely involved? A) Mitral B) Aortic C) Pulmonic D) Tricuspid Q40-A 34-year-old with asthma uses salbutamol inhaler daily and has nighttime symptoms. What is the next step? A) Add LABA B) Add inhaled corticosteroid C) Oral prednisone D) Increase salbutamol Q41- A patient with hyperkalemia presents with peaked T-waves on ECG. What is the immediate management? A) Calcium gluconate B) Insulin with glucose C) Loop diuretics D) Sodium bicarbonate Q42-Which ECG change is most characteristic of hypokalemia? A) Peaked T-waves B) Prolonged QT C) U-waves D) ST elevation Q43-A young male presents with hemoptysis, hematuria, and anti-GBM antibodies. What is the likely diagnosis? A) Granulomatosis with polyangiitis B) Goodpasture’s syndrome C) IgA nephropathy D) Lupus nephritis Q44- A 58-year-old diabetic presents with foot ulcer and fever. What is the best investigation to assess for osteomyelitis? A) X-ray B) Wound swab C) MRI foot D) ESR Q45-A patient presents with fatigue, pruritus, and elevated alkaline phosphatase. Antimitochondrial antibodies are positive. What is the likely diagnosis? A) Primary sclerosing cholangitis B) Primary biliary cholangitis C) Autoimmune hepatitis D) Hepatitis C Q46-Which of the following conditions is most commonly associated with aortic regurgitation? A) Marfan syndrome B) Rheumatic fever C) Atherosclerosis D) Hypertension Q47-A young man presents with bloody diarrhea, abdominal pain, and weight loss. Colonoscopy reveals continuous inflammation starting from the rectum. Diagnosis? A) Crohn's disease B) Ulcerative colitis C) IBS D) Infectious colitis Q48-A 70-year-old presents with anemia. Labs: low serum iron, low TIBC, normal ferritin. Most likely cause? A) Iron deficiency anemia B) Anemia of chronic disease C) Thalassemia D) Sideroblastic anemia Q49-A 35-year-old woman presents with proximal muscle weakness and elevated CK. ANA is positive. Diagnosis? A) Polymyalgia rheumatica B) Polymyositis C) Myasthenia gravis D) RA Q50-A 55-year-old male has difficulty swallowing solids more than liquids and recent weight loss. Next best investigation? A) Barium swallow B) Upper GI endoscopy C) Esophageal manometry D) CT chest Q51- Which of the following vaccines is contraindicated in pregnancy? A) Influenza (inactivated) B) Hepatitis B C) MMR D) Tdap Q52-A patient presents with new-onset seizure and hyponatremia (Na+ = 115 mmol/L). What is the best initial management? A) IV normal saline B) Fluid restriction C) Hypertonic (3%) saline D) Furosemide Q53-A 29-year-old presents with joint pain, malar rash, and photosensitivity. What is the most likely diagnosis? A) RA B) SLE C) Psoriatic arthritis D) Sjögren syndrome Q54-A 65-year-old male has persistent cough and weight loss. CXR shows a hilar mass. Most likely diagnosis? A) Small cell lung cancer B) Adenocarcinoma C) Squamous cell carcinoma D) Tuberculosis Q55-Which of the following drugs is most commonly associated with drug-induced lupus? A) Methotrexate B) Hydralazine C) Hydroxychloroquine D) Ibuprofen Q56-A 34-year-old presents with palpitations and anxiety. ECG shows narrow complex tachycardia at 180 bpm. First-line treatment? A) Lidocaine B) Beta-blocker C) Adenosine D) Amiodarone Q57-A 25-year-old man with sudden severe chest pain radiating to the back. BP 180/100 in both arms. CXR shows widened mediastinum. Diagnosis? A) MI B) PE C) Aortic dissection D) Pericarditis Q58-Which of the following is NOT a feature of nephrotic syndrome? A) Hypoalbuminemia B) Hyperlipidemia C) Hematuria with RBC casts D) Edema Q59-A man returns from sub-Saharan Africa with fever, chills, and hemolytic anemia. What is the most likely diagnosis? A) Dengue B) Typhoid C) Malaria D) Leptospirosis Q60-A 68-year-old presents with worsening dyspnea and orthopnea. BNP is elevated. Most likely diagnosis? A) COPD B) Pulmonary embolism C) Heart failure D) Asthma Q61-A man with long-standing GERD presents with dysphagia. Barium swallow shows narrowing of the distal esophagus. Likely diagnosis? A) Schatzki ring B) Esophageal carcinoma C) Peptic stricture D) Achalasia Q62-Which anti-diabetic drug promotes weight loss? A) Sulfonylureas B) Metformin C) DPP-4 inhibitors D) GLP-1 agonists Q63-A 38-year-old woman presents to the emergency department with sudden onset shortness of breath and pleuritic chest pain for the past 2 hours. She reports mild hemoptysis. Her past history includes a cesarean section 3 weeks ago. On examination, pulse is 118/min, BP 98/60 mmHg, respiratory rate 26/min, oxygen saturation 88% on room air. ECG shows sinus tachycardia and is given below Which of the following is the most likely diagnosis? A) Acute myocardial infarction B) Pulmonary embolism C) Spontaneous pneumothorax D) Acute pericarditis E) Anterior wall MI Q64-A 35-year-old woman has amenorrhea, galactorrhea, and visual field defect. Most likely diagnosis? A) PCOS B) Sheehan syndrome C) Pituitary adenoma D) Hypothyroidism Q65-. A patient with suspected TB has negative sputum smear but high suspicion remains. Next step? A) Send blood culture B) Bronchoscopy with lavage C) Start antibiotics D) Chest ultrasound Q66-A 60-year-old smoker has high hematocrit and low EPO. Diagnosis? A) Polycythemia vera B) Secondary polycythemia C) Lung cancer D) Chronic hypoxia Q67-A young female has a systolic murmur that increases with Valsalva. Most likely diagnosis? A.)Aortic stenosis B) Mitral valve prolapse C) HOCM D) Tricuspid regurgitation Q68-A 23-year-old male presents after a stab wound to the chest. He is hypotensive, distended neck veins are noted, and heart sounds are muffled. What is the most likely diagnosis? A) Tension pneumothorax B) Hemothorax C) Cardiac tamponade D) Pulmonary embolism Q69-A 60-year-old man presents with painless rectal bleeding. Colonoscopy reveals a mass in the sigmoid colon. Next best step? A) CT abdomen B) Colon biopsy C) Hemicolectomy D) Laparoscopy Q70-A patient presents with sudden severe abdominal pain out of proportion to physical exam findings. Most likely diagnosis? A) Acute pancreatitis B) Mesenteric ischemia C) Perforated ulcer D) Intestinal obstruction Q71-A woman presents with a breast lump. On biopsy, it shows ductal carcinoma in situ (DCIS). What is the treatment of choice? A) Chemotherapy B) Mastectomy C) Lumpectomy with radiation D) Observation Q72-A 48-year-old man presents with a non-healing foot ulcer and fever. X-ray shows gas in soft tissue. Most likely organism? A) Streptococcus pyogenes B) Clostridium perfringens C) Pseudomonas aeruginosa D) E. coli Q73-A 65-year-old man presents with progressive dysphagia to solids then liquids. Barium swallow shows a narrowing at the gastroesophageal junction. Most likely cause? A) Achalasia B) GERD C) Esophageal carcinoma D) Schatzki ring Q74-What is the most common type of hernia in females? A) Indirect inguinal B) Direct inguinal C) Femoral D) Umbilical Q75-A 25-year-old with a history of appendectomy now presents with crampy abdominal pain and vomiting. X-ray shows multiple air-fluid levels. Likely diagnosis? A) Intussusception B) Small bowel obstruction C) Volvulus D) Paralytic ileus Q76- 65 year-old male presents to the emergency department with sudden onset of chest pain radiating to the left arm and associated diaphoresis. His blood pressure is 135/85 mmHg, pulse is 90 bpm, and he has no significant past medical history. The ECG obtained show ST-segment elevation in leads I, aVL, V5, and V6].Which of the following best describes the most likely diagnosis based on the ECG findings? A) Anterior Wall Myocardial Infarction B) Inferior Wall Myocardial Infarction C) Lateral Wall Myocardial Infarction D) Posterior Wall Myocardial Infarction Q77-Which of the following is an absolute contraindication to laparoscopic cholecystectomy? A) Pregnancy B) Acute cholecystitis C) Peritonitis D) Obesity Q78-What is the most common complication following thyroidectomy? A) Hematoma B) Hypocalcemia C) Infection D) Hoarseness Q79-A patient is diagnosed with acute pancreatitis. Which finding is most specific for diagnosis? A) Elevated serum amylase B) Elevated serum lipase C) Hypocalcemia D) Leukocytosis Q80-A patient presents with bright red blood per rectum. Which diagnostic tool is most appropriate first? A) CT scan B) Colonoscopy C) Sigmoidoscopy D) Digital rectal exam Q81-A 70-year-old man has a painless, pulsatile abdominal mass. Best initial investigation? A) MRI abdomen B) CT angiography C) Abdominal ultrasound D) Plain X-ray Q82-A young man suffers blunt abdominal trauma. FAST scan shows free fluid but no solid organ injury. What is the likely source of bleeding? A) Liver B) Spleen C) Bowel mesentery D) Kidney Q83-Which of the following is most associated with colorectal cancer? A) Ulcerative colitis B) Celiac disease C) Crohn's disease D) Diverticulosis Q84-A woman presents with a thyroid nodule. TSH is normal, and the nodule is cold on scan. Next best step? A) Repeat scan in 6 months B) Fine-needle aspiration C) Start levothyroxine D) Surgery Q85-A trauma patient has a pelvic fracture and is hypotensive. What is the initial management? A) Foley catheter B) Angiography C) Exploratory laparotomy D) Pelvic binder Q86-Which electrolyte disturbance is commonly seen post-operatively in patients with vomiting? A) Hyperkalemia B) Hypernatremia C) Hypokalemia D) Hyperchloremia Q87-A 55-year-old male smoker complains of progressive hoarseness. Laryngoscopy shows a lesion on the vocal cord. Most likely diagnosis? A) Laryngeal papilloma B) Vocal cord polyp C) Laryngeal carcinoma D) Laryngitis Q88-What is the most sensitive imaging for detecting gallstones? A) CT abdomen B) Ultrasound C) MRI D) HIDA scan Q89-A post-op patient has tachycardia and fever on day 3. Most likely cause? A) Wound infection B) DVT C) Pneumonia D) UTI Q90-What is the best initial management for an anal abscess? A) IV antibiotics B) Sitz bath C) Incision and drainage D) Colonoscopy Q91-A 45-year-old male presents with retrosternal burning pain after meals. Which test confirms GERD? A) Endoscopy B) 24-hour pH monitoring C) Barium swallow D) Manometry Q92-A patient presents with sudden severe testicular pain. Cremasteric reflex is absent. Most likely diagnosis? A) Epididymitis B) Torsion C) Orchitis D) Varicocele Q93-A young child has a soft reducible umbilical bulge that becomes prominent on crying. Next best step? A) Immediate surgery B) Observation C) CT scan D) Abdominal X-ray Q94-A patient has a tender, fluctuant mass at the tailbone. Diagnosis? A) Anal fissure B) Pilonidal cyst C) Perianal abscess D) Hemorrhoids Q95-A patient with upper GI bleeding has hypotension and tachycardia. First step? A) IV proton pump inhibitor B) Endoscopy C) Nasogastric lavage D) Fluid resuscitation Q96-A 40-year-old woman has persistent RUQ pain post-cholecystectomy. US shows no stones. Next step? A) CT scan B) MRCP C) ERCP D) LFTs Q97-Most common cause of lower GI bleeding in elderly? A) Hemorrhoids B) Polyps C) Diverticulosis D) Colitis Q98-A patient develops a wound infection 5 days after surgery. Organism most likely responsible? A) Streptococcus B) E. coli C) MRSA D) Clostridium Q99- A 65-year-old has abdominal bruit and postprandial pain. Most likely diagnosis? A) GERD B) Chronic mesenteric ischemia C) Peptic ulcer disease D) Pancreatitis Q100-A patient has a tender, erythematous swelling at the inguinal region, not reducible. What is the most likely complication? A) Bowel obstruction B) Infection C) Strangulation D) Recurrent hernia Q101-A male smoker with hematuria and flank pain is found to have a solid mass on kidney imaging. What is your Diagnosis? A) Transitional cell carcinoma B) Renal cyst C) Renal cell carcinoma D) Nephroblastoma Q102-A newborn fails to pass meconium within 48 hours. What is the most likely cause? A) Intussusception B) Meconium ileus C) Hirschsprung’s disease D) Duodenal atresia Q103-A 6-month-old presents with fever, irritability, and bulging fontanelle. What is the best next step? A) Start antibiotics immediately B) Lumbar puncture C) CT head D) Wait for blood culture Q104-What is the most common cause of viral gastroenteritis in children? A) Norovirus B) Rotavirus C) Adenovirus D) Astrovirus Q105- A 35-year-old man presents with a 6-month history of difficulty swallowing both solids and liquids, regurgitation of food, and occasional chest pain. What is the most likely diagnosis.Radiological findings are given.? A) Gastroesophageal reflux disease (GERD) B) Esophageal stricture C) Achalasia cardia D) Diffuse esophageal spasm Q106-A child with nephrotic syndrome presents with periorbital edema and frothy urine. What is the most likely complication? A) Pulmonary embolism B) Hypertension C) UTI D) Peritonitis Q107-A 10-year-old presents with joint pain and a heart murmur after a sore throat. What is the most likely diagnosis? A) Infective endocarditis B) Acute rheumatic fever C) Juvenile idiopathic arthritis D) SLE Q108- A 2-month-old is brought for immunization. Which vaccine is contraindicated in immunocompromised children? A) DTaP B) Hepatitis B C) MMR D) Hib Q109-A 3-year-old presents with a limp but no history of trauma. He had a viral illness a week ago. Most likely diagnosis? A) Septic arthritis B) Transient synovitis C) Legg-Calvé-Perthes disease D) Juvenile arthritis Q110- A newborn has a continuous machinery murmur. What is the most likely diagnosis? A) Atrial septal defect B) Ventricular septal defect C) Patent ductus arteriosus D) Tetralogy of Fallot Q111-A child has a seizure lasting 2 minutes during high fever. No postictal deficits. What is the next step? A) Start antiepileptics B) MRI brain C) Reassurance D) CT scan Q112-A 7-year-old boy has hyperactivity, impulsivity, and difficulty focusing. Most likely diagnosis? A) Autism B) Conduct disorder C) ADHD D) Learning disability Q113-A child presents with dry cough, low-grade fever, and wheezing. Chest X-ray shows hyperinflation. Most likely cause? A) RSV bronchiolitis B) Pneumococcal pneumonia C) Asthma D) Foreign body Q114-A 13-year-old girl has short stature and primary amenorrhea. She has a webbed neck. Likely diagnosis? A) Klinefelter syndrome B) Turner syndrome C) Down syndrome D) Prader-Willi syndrome Q115- A 2-year-old with congenital heart disease presents with cyanosis that improves with squatting. Likely diagnosis? A) VSD B) ASD C)Tetralogy of Fallot D) PDA Q116- A newborn with Down syndrome is at risk for which congenital heart defect? A) Tetralogy of Fallot B) Atrioventricular septal defect C) PDA D) Aortic coarctation Q117-What is the most common cause of abdominal pain in children? A) Appendicitis B) Colic C) Intussusception D) Constipation Q118-A 6-year-old has itchy rashes on flexural surfaces of arms. What is the likely diagnosis? A) Atopic dermatitis B) Psoriasis C) Tinea corporis D) Scabies Q119- A child has fever, strawberry tongue, and peeling skin. Diagnosis? A) Scarlet fever B) Kawasaki disease C) Staphylococcal scalded skin syndrome D) Measles Q120-A 5-year-old boy presents with a new systolic murmur and fever. He has a central line. Best next test? A) Chest X-ray B) Blood culture C) ESR D) ECG Q121-A child presents with colicky abdominal pain and red currant jelly stool. Most likely diagnosis? A) Volvulus B) Appendicitis C) Intussusception D) Pyloric stenosis Q122- A 4-week-old has projectile non-bilious vomiting and a palpable olive-like mass. Diagnosis? A) GERD B) Intestinal atresia C) Pyloric stenosis D) Malrotation Q123-A 4-year-old child with a barking cough is treated with racemic epinephrine. What other treatment is indicated? A) Antibiotics B) Inhaled bronchodilators C) Oral steroids D) Antihistamines Q124- A 7-year-old has poor growth, recurrent infections, and greasy stools. What is the likely diagnosis? A) Celiac disease B) Cystic fibrosis C) Lactose intolerance D) GERD Q125- A 5-month-old is not yet rolling over or laughing. What is the next best step? A) Reassure B) Refer for developmental assessment C) Order CT brain D) Hearing test Q126-A fully immunized 1-year-old develops a rash that started on the face and spread to trunk. Diagnosis? A) Measles B) Rubella C) Roseola D) Chickenpox Q127-What is the best first-line treatment for nocturnal enuresis in a 7-year-old? A) Desmopressin B) Counseling only C) Oxybutynin D) Alarm therapy Q128-A child with a cochlear implant is at high risk for which infection? A) Otitis externa B) Meningitis C) Sinusitis D) Labyrinthitis Q129-A newborn has scalp swelling that crosses suture lines. Most likely diagnosis? A) Cephalohematoma B) Subgaleal hemorrhage C) Caput succedaneum D) Epidural hematoma Q130-What is the most common cause of stridor in an infant? A) Vocal cord paralysis B) Epiglottitis C) Laryngomalacia D) Croup Q131-A child has pallor, lethargy, and hemoglobin of 6 g/dL. MCV is low. What is the most likely cause? A) Vitamin B12 deficiency B) Iron deficiency C) Thalassemia major D) Aplastic anemia Q132-A child with Sickle Cell Disease presents with acute chest pain and hypoxia. Most likely diagnosis? A) Pulmonary embolism B) Asthma attack C) Acute chest syndrome D) Pneumonia Q133-A 10-year-old girl has facial swelling and cola-colored urine after a sore throat. What is the most likely diagnosis? A) IgA nephropathy B) Minimal change disease C) Post-streptococcal glomerulonephritis D) SLE nephritis Q134- A 28-year-old woman presents at 10 weeks of gestation with vaginal bleeding and a closed cervical os. Ultrasound shows a viable fetus. Most likely diagnosis? A) Inevitable abortion B) Missed abortion C) Threatened abortion D) Complete abortion Q135-Which hormone is responsible for maintaining the corpus luteum in early pregnancy? A) Estrogen B) Progesterone C) hCG D) LH Q136-A woman at 36 weeks gestation presents with painless vaginal bleeding. Most likely cause? A) Placental abruption B) Placenta previa C) Vasa previa D) Cervical polyp Q137-A patient presents with a blood pressure of 160/100 mmHg and +2 proteinuria at 34 weeks gestation. Diagnosis? A) Chronic hypertension B) Eclampsia C) Gestational hypertension D) Preeclampsia Q138-A 22-year-old woman presents with lower abdominal pain and cervical motion tenderness. Most likely diagnosis? A) Ectopic pregnancy B) Ovarian torsion C) PID D) Endometriosis Q139-A pregnant woman has painless cervical dilation at 20 weeks with no contractions. Diagnosis? A) Preterm labor B) Incompetent cervix C) Inevitable abortion D)Placenta previa Q140-What is the most accurate method for dating a pregnancy in the first trimester? A) LMP B) Abdominal exam C) Fundal height D) Crown-rump length on ultrasound Q141-A woman with regular 28-day cycles reports her last menstrual period was 8 weeks ago. Expected gestational age is? A) 6 weeks B) 8 weeks C) 10 weeks D) 12 weeks Q142- A 30-year-old G2P1 woman at 32 weeks has painless contractions without cervical dilation. Next best step? A) Tocolysis B) Bed rest C) Reassure D) Steroids Q143-A 25-year-old presents with lower abdominal pain and positive pregnancy test. Ultrasound shows empty uterus. Next best step? A) Repeat beta-hCG in 48 hours B) Methotrexate C) D&C D) Laparoscopy Q144-What is the most common cause of postpartum hemorrhage? A) Cervical laceration B) Uterine rupture C) Uterine atony D) Retained placenta Q145-A woman complains of pain and swelling of the breast during lactation. Most likely cause? A) Mastitis B) Fibroadenoma C) Galactocele D) Ductal carcinoma Q146-Which of the following is a contraindication to combined oral contraceptives? A) Nulliparity B) Age >35 and smoking C) Family history of breast cancer D) History of PID Q147-A woman presents with postmenopausal bleeding. Best next step? A) Pap smear B) Pelvic ultrasound C) Endometrial biopsy D) Hormonal therapy Q148-Which of the following is most likely in a woman with secondary amenorrhea and a history of D&C? A) PCOS B) Asherman’s syndrome C) Hyperprolactinemia D) Menopause Q149-What is the most common site of ectopic pregnancy? A) Ovary B) Cervix C) Ampulla of fallopian tube D) Isthmus of fallopian tube Q150- A woman has a pap smear report of ASC-US. Next step? A) HPV testing B) Repeat Pap in 3 months C) Colposcopy D) Endometrial biopsy Q151-A 32-year-old woman has hirsutism, irregular periods, and obesity. Most likely diagnosis? A) Hypothyroidism B) PCOS C) Cushing’s syndrome D) Prolactinoma Q152-A woman at 37 weeks gestation presents with sudden painful bleeding and uterine tenderness. Diagnosis? A) Placenta previa B) Vasa previa C) Placental abruption D) Preterm labor Q153-What is the most common cause of female infertility? A) Endometriosis B) Tubal factor C) Anovulation D) PCOS Q154-A postpartum woman develops fever and foul-smelling lochia. Most likely cause? A) Endometritis B) Mastitis C) UTI D) Wound infection Q155-A woman presents with severe lower abdominal pain during menstruation. Diagnosis? A) Endometriosis B) Adenomyosis C) Fibroids D) PID Q156-A 45-year-old has heavy, regular periods and an enlarged uterus. Most likely diagnosis? A) Endometrial cancer B) Uterine fibroids C) Endometriosis D) Cervical polyp Q157-A woman presents with cyclical pelvic pain and infertility. Most likely diagnosis? A) PID B) Endometriosis C) PCOS D) Fibroid Q158-What is the treatment for eclampsia? A) Diazepam B) Phenytoin C) Magnesium sulfate D) Lorazepam Q159- A woman has a positive pregnancy test and hCG level of 12,000. Transvaginal ultrasound shows no intrauterine sac. Next step? A) Repeat hCG in 48 hours B) Laparoscopy C) Methotrexate D) D&C Q160-A woman with menorrhagia and anemia has normal pelvic ultrasound. Next best test? A) Endometrial biopsy B) Pap smear C) Hormonal therapy D) Hysterectomy Q161-A 25-year-old with malodorous, frothy vaginal discharge and strawberry cervix. Likely organism? A) Candida albicans B) Gardnerella vaginalis C) Trichomonas vaginalis D) Chlamydia trachomatis Q162-A 33-year-old woman has a firm, non-tender, mobile breast mass. Most likely diagnosis? A) Fibrocystic change B) Fibroadenoma C) Breast cancer D) Abscess Q163-What is the most effective emergency contraception? A) Copper IUD B) Levonorgestrel C) Ulipristal acetate D) Condoms Q164-A woman with abnormal uterine bleeding is found to have a thickened endometrium on ultrasound. Best next step? A) Repeat scan B) Pap smear C) Endometrial sampling D) Laparoscopy Q165-A patient presents with secondary amenorrhea and elevated prolactin. First investigation? A) FSH B) TSH C) MRI brain D) Serum estradiol Q166-A pregnant woman at 28 weeks has Rh-negative blood. What is the next step? A) Give anti-D at delivery B) Do nothing unless bleeding C) Give anti-D now D) Monitor antibody titers only Q167-A 35-year-old man presents with depressed mood, anhedonia, and insomnia for 3 weeks. He has difficulty concentrating but denies suicidal ideation. Most likely diagnosis? A) Major depressive disorder B) Adjustment disorder C) Dysthymia D) Generalized anxiety disorder Q168-A patient believes their neighbor is spying on them and controlling their thoughts through the television. This is an example of ? A) Illusion B) Hallucination C) Delusion D) Obsession Q169-A 25-year-old woman has frequent hand washing due to fear of contamination. She knows it is irrational but can't stop. Likely diagnosis? A) OCD B) Phobia C) Schizophrenia D) GAD Q170-A patient with schizophrenia has been stable on haloperidol but now has neck stiffness and upward eye deviation. Most likely cause? A) Seizure B) Serotonin syndrome C) Acute dystonia D) Parkinsonism Q171-A patient presents with low mood every winter that resolves in spring. Most likely diagnosis? A) Cyclothymia B) Atypical depression C) Seasonal affective disorder D) Dysthymia Q172- First-line treatment for panic disorder is? A) Diazepam B) SSRIs C) Beta-blockers D) Psychotherapy only Q173-A child has impaired social interaction, delayed speech, and repetitive behaviors. Diagnosis? A) Intellectual disability B) Autism spectrum disorder C) ADHD D) Conduct disorder Q174-A 24-year-old female presents with binge eating followed by vomiting. Likely diagnosis? A) Bulimia nervosa B) Anorexia nervosa C) Binge-eating disorder D) Depression Q175-A 70-year-old man has memory loss, difficulty performing daily tasks, and confabulation. Diagnosis? A) Vascular dementia B) Alzheimer’s disease C) Wernicke–Korsakoff syndrome D) Delirium Q176-A patient on lithium therapy presents with tremors, nausea, and confusion. What should be done? A) Increase dose B) Check serum lithium level C) Stop lithium and start antidepressant D) Add beta-blocker Q177-A 45-year-old man presents with tremors, anxiety, and palpitations 24 hours after stopping alcohol. Likely diagnosis? A) Panic attack B) Alcohol withdrawal C) Generalized anxiety disorder D) Bipolar disorder Q178-A 25-year-old male arrives unconscious after a motorbike accident. No family is present. What is the appropriate next step? A) Wait for family consent B) Initiate emergency treatment C) Call the police D) Do nothing until consent Q179-A patient presents with chest pain radiating to the left arm and diaphoresis. First investigation? A) Chest X-ray B) Cardiac enzymes C) ECG D) Echocardiography Q180- A 50-year-old man is brought to ER with suspected stroke symptoms. What is the first imaging test? A) MRI brain B) CT brain without contrast C) CT angiogram D) PET scan Q181- A known asthmatic presents with severe shortness of breath, silent chest, and drowsiness. Next step? A) Nebulized salbutamol B) Intravenous hydrocortisone C) Chest X-ray D) Intubation and ventilation Q182-A 30-year-old woman overdosed on paracetamol 4 hours ago. What is the antidote? A) Flumazenil B) Naloxone C) N-acetylcysteine D) Activated charcoal Q183-A trauma patient has hypotension, distended neck veins, and absent breath sounds on the right. Diagnosis? A) Cardiac tamponade B) Tension pneumothorax C) Hemothorax D) Pulmonary embolism Q184-A patient with severe hyperkalemia (K+ 7.8) and ECG showing peaked T waves. First medication to give? A) Calcium gluconate B) Salbutamol C) Insulin + dextrose D) Sodium bicarbonate Q185- A 60-year-old man with history of diabetes and ESRD presents with confusion. What metabolic abnormality should you suspect? A) Hypoglycemia B) Hypernatremia C) Hyponatremia D) Uremic encephalopathy Q186-In the ER, a patient is verbally abusing a nurse. What is the best ethical approach? A) Ignore the behavior B) Report and document professionally C) Yell back to maintain control D) Discharge the patient Q187-A patient collapses after being given penicillin. What is the first step in management? A) IV fluids B) Adrenaline IM C) Hydrocortisone IV D) Oxygen Q188-A 22-year-old woman presents with vaginal bleeding and positive pregnancy test. She is pale, hypotensive, and tachycardic. Next step? A) Transvaginal ultrasound B) Methotrexate C) Stabilize with fluids D) D&C Q189-A patient refuses a life-saving blood transfusion due to religious beliefs. What is the appropriate action? A) Force transfusion B) Respect the patient’s decision C) Get family to consent D) Court order Q190-A child is brought to ER with signs of abuse. What is your obligation as a physician? A) Reprimand the parents B) Document and report to authorities C) Ignore unless confirmed D) Counsel the family Q191-A 55-year-old man presents with sudden severe headache and neck stiffness. Suspected SAH. Next step? A) CT brain without contrast B) MRI brain C) Lumbar puncture D) EEG Q192-A patient is brought in with DKA. What is the first treatment priority? A) IV insulin B) Potassium replacement C) IV fluids D) Bicarbonate Q193-An unconscious trauma patient with no ID is bleeding profusely. What is the best action? A) Wait for family B) Proceed with emergency care C) Call police D) Obtain court order Q194-What is the first priority in managing a polytrauma patient? A) Airway B) Breathing C) Circulation D) Disability Q195-A patient with chest trauma has muffled heart sounds, hypotension, and JVD. Diagnosis? A) Tension pneumothorax B) Cardiac tamponade C) Hemothorax D) Pulmonary embolism Q196-What is the best predictor of survival in cardiac arrest? A) Defibrillation time B) Age of patient C) Intubation time D) Bystander CPR Q197-A newborn was brought by her mother in OPd with complain of cyanosis,shortness of breath ,poor feeding.Radiographic findings are given below.Most probably the diagnosis will be ? A) Tetrology of Fallot B) Transposition of great arteries C) Left heart failure D) VSD Q198-A patient on warfarin develops major bleeding. What is the best immediate treatment? A) Vitamin K B) Platelets C) Fresh frozen plasma D) Protamine sulfate Q199-A patient’s condition deteriorates due to a physician’s negligence. What ethical principle is violated? A) Autonomy B) Beneficence C) Non-maleficence D) Justice Q200- What is the primary method of transmission of hepatitis A? A) Blood transfusion B) Sexual contact C) Fecal-oral D) Respiratory droplets Q201- The most cost-effective strategy to reduce neonatal mortality is? A) NICU care B) Caesarean section C) Skilled birth attendance D) Routine ultrasound Q202-Which of the following is a measure of central tendency? A) Standard deviation B) Variance C) Mean D) Range Q203- The incubation period of measles is approximately ? A) 2–4 days B) 7–10 days C) 10–14 days D) 21 days Q204-What does sensitivity of a test refer to? A) Ability to detect true negatives B) Ability to detect true positives C) Ability to detect both true and false positives D) The likelihood of false negatives Q205- A screening test is used in ? A) Diagnosis B) Treatment C) Early detection of disease D) Prevention Q206- In a normal distribution, what percentage of values fall within ±2 SD? A) 68% B) 95% C) 99% Q207- Herd immunity protects ? A) Infected individuals B) Non-immunized individuals C) Health workers D) Vaccinated people only Q208- A population has a high birth rate and high death rate. This is characteristic of ? A) Early expanding stage B) Late expanding stage C) Low stationary stage D) High stationary stage Q210-The most appropriate way to display categorical data is ? A) Line graph B) Pie chart C) Scatter plot D) Histogram Q211-In public health, primary prevention includes which ? A) Chemotherapy B) Screening tests C) Vaccination D) Rehabilitation Q212-A relative risk (RR) of 1 indicates ? A) Strong association B) No association C) Protective effect D) High risk Q213- The numerator in the infant mortality rate includes ? A) Stillbirths B) Neonatal deaths C) Infant deaths under 1 year D) Perinatal deaths Q214- The gold standard for assessing a new treatment's effectiveness is ? A) Case series B) Cohort study C) RCT D) Cross-sectional study Q215- Which vaccine is contraindicated in pregnancy? A) Hepatitis B B) Tetanus C) MMR D) Influenza (inactivated) Q216- The prevalence of a disease is affected by ? A) Incidence and duration B) Mortality only C) Birth rate D) Exposure rate only Q217- What is the correct definition of incidence? A) Total number of cases B) New cases per population at risk C) Deaths per 1000 people D) Total number of exposures Q218- What is the best method to reduce the prevalence of a chronic disease? A) Reduce mortality B) Prevent new cases C) Improve diagnosis D) Increase treatment duration Q219-A study that looks at data from a population at one specific point in time is called ? A) Case-control B) Cohort C) Cross-sectional D) Experimental Q220- Which of the following is an example of secondary prevention? A) Vaccination B) Health education C) Mammography screening D) Rehabilitation after stroke 5/5 - (1 vote)
