PYQ

#6. Which one of the following responses to intravenous adenosine is correctly matched regarding Arrhythmia – Response?
1. Atrial fibrillation – Termination
2. Atrio-ventricular nodal re-entrant tachycardia – Termination
3. Ventricular tachycardia – Termination and complete recovery.
4. Atrial flutter – Termination and complete recovery

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#11. Which of the following conditions are contraindications for non-invasive positive-pressure ventilation in patients with respiratory failure?
I. Craniofacial abnormalities
II. Significant burns
III. Respiratory failure with PaCO2 of 60 mm Hg
IV. Cardiovascular instability
Select the correct answer using the code given below:
1. I, II and III
2. I, II and IV
3. I, III and IV
4. II, III and IV

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#8. Under the Stepwise Approach to the management of Bronchial Asthma, which one of the following is the correct initial treatment at Step 1 for a patient diagnosed with Asthma?
1. Low dose inhaled corticosteroid only
2. Low dose inhaled corticosteroid plus oral corticosteroid
3. Low dose inhaled corticosteroid plus long acting anti-muscarinic agents
4. Low dose inhaled corticosteroid plus leukotriene antagonist

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#12. Which one of the following terms denotes the extensive sclerosis of the skin of the chest wall which restricts chest wall movement and is seen as a rare complication of systemic sclerosis?
1. Flail Chest
2. Hidebound Chest
3. Barrel Chest
4. Pigeon Chest

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#4. Which one of the following is correct with regard to Carey Coombs murmur?
1. Soft systolic murmur due to mitral regurgitation
2. Soft mid-diastolic murmur due to mitral valvulitis
3. Harsh early diastolic murmur due to aortic regurgitation
4. Blowing late systolic murmur due to aortic stenosis

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#5. Which of the following statements is correct regarding the Opening Snap (OS) in a patient of mitral stenosis?
1. OS is best heard with the bell of stethoscopе
2. Intensity of OS becomes louder when the valve is calcified
3. OS moves closer to the second sound (S2) as the stenosis becomes more severe
4. OS is best heard at the second left intercostal space

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#17. Which one of the following conditions is a complication of bacterial pharyn- gitis involving extension of infection into the internal jugular veins leading to thrombosis and metastatic dispersal of the organism?
1. Cystic Fibrosis
2. Chronic Pulmonary Aspergillosis
3. Lemierre syndrome
4. Wegener\'s granulomatosis

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#13. Consider the following pleural fluid analysis:
pH – 7.6
Pleural fluid protein – 0-5 g/dL
Serum total protein – 6.5 g/PL
Pleural fluid LDH – 100 U/L
Serum LDH – 300 U/L
What is the most likely diagnosis?
1. Pancreatitis
2. Myxedema
3. Sarcoidosis
4. Rheumatoid arthritis

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#19. Which one of the following is the investigation of choice for diagnosing the presence of stones in the gall- bladder?
1. Transabdominal ultrasound
2. Erect X-ray of abdomen
3. Capsule endoscopy
4. Computed Tomography

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#9. A 62-year old male chronic smoker has been diagnosed with Chronic Obstructive Pulmonary Disease (COPD). On pulmonary function testing, the ratio of Forced Expiratory Volume in 1 second (FEV1) to Forced Vital Capacity (FVC) was 0.6 and FEV1 was 70% of predicted. What is the severity of airflow obstruction in this patient as per GOLD criteria?
1. Stage I - Mild
2. Stage II - Moderate
3. Stage III - Severe
4. Stage IV - Very severe

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#14. \'Masson Bodies\' formed due to proliferation of immature collagen are a characteristic histopathological finding seen in which of the following conditions?
1. Lymphocytic Interstitial Pneumonia
2. Cryptogenic Organizing Pneumonia
3. Desquamative Interstitial Pneumonia
4. Respiratory Bronchiolitis

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#7. Consider the following steps for using a metered dose inhaler (MDI):
I. Incline the head backward to minimize oropharyngeal deposition
II. Remove the cap and shake the inhaler
III. Breathe out gently and place the mouthpiece into the mouth
IV. Hold the breath for 10 seconds
V. Simultaneously, begin a slow deep inspiration, depress the canister and continue to inhale
Which one of the following is the correct sequence of using MDI?
1. III, II, I, V, IV
2. II, I, IV, III, V
3. II, III, I, V, IV
4. III, I, II, IV, V

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#20. Which one of the following biologic agents used in the treatment of inflammatory Bowel Disease acts by inhibiting the enzyme ‘Janus Kinase\'?
1. Infliximab
2. Adalimumab
3. Vedolizumab
4. Tofacitinib

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#10. Which one of the following correctly denotes the inheritance pattern of cystic fibrosis?
1. Autosomal Dominant
2. Autosomal Recessive
3. X-linked Dominant
4. X-linked Recessive

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#3. Which one of the following statements is correct for subcutaneous nodules in Rheumatic fever?
1. They are present over flexor aspect of forearm
2. They are painful tender nodules
3. The usual size of these nodules is 3-5 cm
4. They typically appear more than 3 weeks after onset of other clinical manifestations

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#1. Which of the following heart sounds are best heard with the bell of stethoscopе?
I. Opening snap
II. Systolic click
III. Third heart sound
IV. Mid diastolic murmur

Select the correct answer using the code given below:
1. I and IV
2. II and III only
3. III and IV
4. I, II and III

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#2. Consider the following statements for diagnosing ventricular aneurysm in a patient with recent myocardial infarction:
I. Paradoxical impulse on chest wall
II. Persistent ST elevation on ECG
III. Unusual bulge from cardiac silhouette on X-ray
IV. Presence of pulsus paradoxsus

Which of the above are correct?
1. I and II only
2. I and IV
3. I, II and III
4. II, III and IV

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#18. A 42-year old man with history of alcohol dependency presents with progressive abdominal distension. Abdominal examination reveals a shifting dullness. Which one of the following is the most appropriate drug to relieve this abdominal distension?
1. Octreotide
2. Propranolol
3. Lactulose
4. Spironolactone

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#16. Which one of the following statements is correct in respect of pulmonary involvement in rheumatoid disease?
1. Rheumatoid pulmonary nodules are usually asymptomatic and detected incidentally on imaging
2. Rheumatoid pulmonary nodules are often solitary and located near hilum
3. Pleural effusion in these patients is transudative and usually bilateral
4. Combination of pleural effusion and pneumoconiosis in these patients is known as Caplan syndrome

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#15. Consider the following statements regarding respiratory function in old age:
I. There is increasing ventilation perfusion mismatch
II. There is increased ventilatory response to hypoxia and hypercapnia
III. There is a decline in maximum oxygen uptake leading to reductịon in cardiorespiratory reserve
IV. There is decline in the Forced Expiratory Volume to Forced Vital Capacity ratio (FEV1/FVC) by around 0-2% per year after the forties
Which of the statements given above are correct?
1. I, II and III
2. I, II and IV
3. II, III and IV
4. I, IIΙ and IV

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