WMC Block N 2023 Final Year MBBS Past Paper PDF

Women Medical College, Abbottabad Final Year MBBS BLOCK N 2023 1. Evidence-based medicine (EBM) is a 4. Which stage of clinical audit process systematic appr...

Women Medical College, Abbottabad Final Year MBBS BLOCK N 2023 1. Evidence-based medicine (EBM) is a 4. Which stage of clinical audit process systematic approach to identifying the follows developing criteria and most appropriate strategy for 1 standards? managing an individual patient. This approach is based on which of the a. Search for literature following? b. Data collection 2 c. Data analysis 3 a. Advice gleaned from recently d. Implement necessary changes 4 published literature e. Re-audit 5 b. Strategies effective in previous patients 5. Evidence-based medicine is "the c. Analyses of relevant medical conscientious, explicit and judicious literature use of current best evidence in making d. Advice given by mentors decisions about the care of ________. e. Advice given by colleagues a. Individual Patients 2. What is the first step in applying EBM b. Doctors (evidence based medicine) concepts to c. Pharmaceuticals answer a clinical question? d. Technicians e. Nurses a. Ask the question b. Acquire the evidence 6. Palliative care addresses the following c. Appraise the evidence issues of a serious patients: d. Apply the evidence e. Assess the whole process a. physiotherapy & spiritual therapy only 3. What is the definition of clinical audit? b. emotional aspect only c. emotional, physical & spiritual a. A structure activity which is aspect intended to provide new knowledge d. physical symptoms only which is genrealisable and intended e. to council the patient for curative for wider dissemination treatment b. A process by which protocols and guidelines are created by policy 7. In palliative care, Hospice is a program: makers and implemented at national level a. that provides only the medical c. A quantifiable method of testing a treatment to the patients new hypothesis in clinical practice b. that provides counseling &spiritual d. A quality improvement process that therapy only seeks to improve patient care and c. that has no effect on the patient outcomes through systematic management review of care against explicit d. that gives care to the people who measures and the implementation of are near the end of life & have change stopped treatment e. A quantifiable method of testing a e. that provides only the dietary new hypothesis in clinical practice support to the serious patients 1 BLOCK N FINAL YEAR MBBS-280423 Setting standards - Assess performance by data collection of existing medical redords, practices, patient outcomes etc - Analyse data and compare to the standard - Implement the changes needed - Re evaluate with another clinical audit to see if the changes have brought about an effect Clinical Audit Stages 8. A 57-year old male is in pre-surgical 11.A 40yr old female presented with O2 testing for an elective laparoscopic month history of lethargy and cholecystectomy. He has an otherwise dysphagia for solid food. There is no unremarkable medical history, and he history of weight loss or indigestion. is scheduled at 1 PM on the day of ON EXAMINATION: She has glossitis, surgery. Which of the following is and anemia. No other abnormality against the guidelines for preoperative found on examination. fasting: Her Barium Swallow showed stricture in esophagus a. Drinking orange juice at 6 AM Her peripheral blood smear showed b. Eating toast with apple juice at 6 AM microcytosis, anisocytosis, c. Coffee with cream at 10 AM poikilocytosis and hypochromia. d. An omelet with pancakes at 5 AM What is the most likely diagnosis? e. None of the above Avoid solids 6-8 hours before surgery and clear fluids 2 hours before a. Thalassemia 9. A 50 yr sold recently diagnosed as AML b. Sideroblastic anemia undergone chemotherapy which he c. Plummer -Vinson syndrome tolerated well, but on second day of d. Megaloblastic anemia chemotherapy session he developed e. Pernicious Amenia severe nausea. Biochemical results are as follows: 12.A 56yr old male was admitted with Na = 136 mmol/L (N), K= 6.5mmol/L increasing fatigue for the last 06 (High), month. Urea = 23 mmol/L (High), creatinin= On Examination: He is pale with 200 by mmol/L (High) massively enlarged spleen. What is most likely diagnosis? His HB is 7.8g/dl, WBC = 39000x109 / L, PLT = 500X109. a. Chemotherapy induced What is most likely diagnosis? hyperkalemia b. Lactic acidosis a. Polycythemia rubravera. c. TUMORlysis syndrome b. Chronic Myeloid Leukemia d. Blast crisis c. Hypersplenism due to chromic e. Delayed Type Hypersentivity malaria reaction d. Iron Deficiency anemia e. Myelodysplastic syndrome 10.A 15 yrs old boy presented withfatigue, palpitation and body aches. Hehas 05 13.A 30yr old presented with jaundice and month history of repeated attacks of anemia. On workup his Hb is 6.2g/dl upper respiratory tract infection & with Reticulocytes count of 7%.LFT’s recurrent epistaxis. revealed increase indirect ON EXAMINATION:He is Pale hyperbilirubinemia. withpurpras, Nolymph Nodepalpable, What test should be done to confirm there is no hepatosplenomegaly, No the diagnosis? bone tenderness Investigations: CBC Hb = 8g/dl, WBC = a. TIBC 2.5X 109, PLT = 50x109 b. Serum ferritin Peripheral blood smear- unremarkable c. Coomb's test What is the most probable diagnosis? d. Bonemarrow biopsy a. Acute myeloid leukemia e. S vit B12 b. Hemolyctic Anemia c. Acute lymphoid leukemia Remember Aplastic anemia will present with pancytopenia d. Aplastic Anemia without any lymphadenopathy or hepatosplenomegaly. This can e. Меgаlоblastic Anemia distinguish it from myelodysplastic syndrome in some questions where not a lot of info is given 2 BLOCK N FINAL YEAR MBBS-280423 14.A 22 yrs old is known case of the 17.A 60 years old male patient has lasemia trait. Which portion of presented to your clinic with history of hemoglobin will be the expected to be intermittent high grade fever with raised on HB electrophoresis. significant weight loss over the last one month. On examination he has multiple a. Hb A2 cervical and axillary lymph nodes. He b. Hb A has generalized scratch marks all over c. Hb F his trunk as well. Baseline investigation d. Hb S revealed Hb 10.6g/dL, White cell count e. Hb Bart and platelets within normal limits. Chemistry profile was normal. He 15.A 75 yr old male presented with 06 underwent cervical lymph node biopsy month history of skin pigmentation, that showed owl-eye shaped abnormal tingling sensations in the body and cells with cellular surface effacement. unable to maintain posturalbalance. What is the likely Diagnosis and what CBC: Hb 7.5g/dl, WBC 3.2X109, MCV are these cells called? 115, MCH26, Platelets 320 a. Classical Hodgkin's Lymphoma - Peripheral smear showed Macrocytosis Reed-sternberg cells. and Hypersegmented neutrophils. b. Non- Hodgkin's Lymphoma - Pop- Serum Ferritin: 200ng (Normal >27ng) corn cells. What is the most likely diagnosis? c. Lymphoblastic Lymphoma - Smudge cells. a. Iron deficiency Anemia d. Classical Hodgkin's Lymphoma - b. Sideroblastic Anemia Auer Rods. c. Megaloblastic Anemia e. Non-Hodgkin's Lymphoma - Reed- d. Anemia of Chronic Disease Stern berg cells. e. Aplastic Anemia 18.A 32 years old young male has been recently Diagnosed with Large B Cell 16.A 30 year old female is known case of Non-Hodgkin's Lymphoma. On Rheumatoid arthritis for last 15 years examination he had multiple bulky presented with Anemia. cervical, axillary and inguinal lymph On investigation: nodes. Before the commencement of CBC: Hb 8.4 g/dl, WBC 5.2X109, MCV chemotherapy that consisted of 86, Platelets 320 steroids aswell, his baseline Peripheral smear showed Normocytic investigations were within normal Anemia. limits. He presented to you on his 3rd What is the most likely diagnosis? day of chemotherapy administration in the Emergency department with history a. Iron deficiency Anemia of suddent onset of shortness of b. Hypersplenism breath, altered sensorium and cloudy c. Hemolytic Anemia urine. His investigations revealed Hb d. Anemia of Chronic Disease 11g/dL, WBC 9,000, Platelets 358,000. e. Marrow infiltration Chemistry profile showed Creatinine Occurs in RA and SLE 11.1g/dL, Potassium 7.2 micromol/L, uric acid 13mg/dL (markedly raised), Calcium 1.8mg/dL. What is the likely Diagnosis? a. Acute on Chronic Renal Failure. b. Metastasis to kidneys. c. Tumor Lysis Syndrome with Acute Kidney Injury. d. Diabetic Ketoacidosis. e. Steroid induced Psychosis. 3 BLOCK N FINAL YEAR MBBS-280423 19.A 45 years old male with no co- 21.A 15 years old male presented with morbidities presented to you with bilateral neck swellings and non history of left upper abdominal pain resolving fever for the last 02 months. and early satiety since one month. On He also reported weight loss of about 8 examination he had palpable spleen kg and marked fatigue which has upto the umbilicus and mild pallor. He compromised his daily life activities. has no significant past or family Clinical examination revealed non history. The rest of the examination tender enlarged palpable Lymph nodes was unremarkable. His blood work in cervical, bilateral axillary and showed Hb 9.4g/dL, WBC 26,000, inguinal region. Blood counts were Platelet count 410,000. Chemisty normal. Excisional biopsy was done profile was within normal limits. While that showed owl eye shaped abnormal further investigating, which is the less cells. likely diagnosis? What is the first line treatment regimen used in this disease? a. Chronic myeloid leukemia. a. R-CHOP b. Acute lymphoblastic leukemia. 6-8 cycles of ABVD + b. CHOP c. Leishmaniasis. Radiotherapy c. ABVD d. Myelofibrosis. d. BEACOPP e. Chronic Malaria. e. R-CVP 20.A 54 years old man presented with 22.A 17 years old young female otherwise generalized weakness , easy fatigability normal, presents to your clinic with , early satiety and left upper abdominal history of easily bruisibility and heavy heaviness for last 3 months. Physical menstruation. Physical examination examination revealed pallor and was unremarkable. You order her blood massive splenomegaly palpable 10 cm work and it revealed complete blood below left costal margin. His blood picture within normal limits. Which of workup showed white cell count of the following is the least required 54,000 with 80% neutrophils and investigation in this case? basophilia. Haemoglobin was 10.2g/dL a. Activated partial thromboplastin and Platelet count was 432000 with a time (aPTT) low LAP Score.His abdominal b. Factor VIII (FVIII) coagulant ultrasound showed massively enlarged activity spleen. c. Ristocetin cofactor (RCoF) activity What is the likely Diagnosis? d. Concentration of vWF antigen (vWF:Ag) a. Chronic lymphocytic leukaemia e. Bleeding time b. Chronic myeloid leukaemia c. Hairy cell leukaemia 23.Tumor Lysis Syndrome is best d. Non-Hodgkin’s lymphoma characterized by following serum levels e. Primary Myelofibrosis of? a. Low Calcium, high Potassium, high phosphate, high uric acid. b. High calcium, high potassium, high phosphate, high uric acid. c. High Calcium, low potassium, high phosphate, high uric acid. d. Low Calcium, high potassium, low phosphate, high uric acid. e. Calcium, high potassium, low Magnesium, high uric acid. 4 There is hyperphosphotemia which results in BLOCK N FINAL YEAR MBBS-280423 increased calcium binding leading to hypocalcemia 24.A 52 years old male initially reported 27.A 50 years old patient with chronic with history of low grade fever for the polyarthritis complains of gritty eyes last 2 months. He has significant and needs to wet her mouth weight loss. On further inquiry he repeatedly. RA factor is positive. The reveals that he has night sweats and most likely diagnosis is generalized itching. On examination he has bulky bilateral cervical and axillary a. anterior uveitis lymph nodes. Contrast enhanced CT b. drug induced anticholinergic effect scan revealed enlarged abdominal c. episcleritis lymph nodes as well. His blood workup d. psoriatic arthritis was unremarkable except for his very e. Sjogren's syndrome high levels of Serum Uric Acid. His lymph node biopsy showed Non- 28.A thirty years old female has a one- Hodgkin's Lymphoma. He received first year history of getting painful blue cycle of chemotherapy and on 4th day hands on exposure to cold, dysphagia he presented in the ER with overt and difficulty making a good hand grip TumourLysis Syndrome with Acute due to severe restriction in the ability Kidney Injury. He was oliguric to flex her fingers. The most likely ,creatinine was 8.5mg/dL, markedly diagnosis is raised serum uric acid levels. To lower his serum uric acid levels, what is the a. carcinoma oesophagus beat treatment option for this patient? b. dermatomyositis c. multiple sclerosis a. Febuxostat. d. Raynaud’s disease b. Intravenous Hydration with Sodium e. systemic sclerosis Bicarbonate. c. Allopurinol. 29.All of the following are deformities of d. Rasburicase. rheumatoid arthritis except e. Glucarpidase. a. button-hole deformity 25.Rheumatoid factor b. radial deviation of the fingers c. swan neck deformity a. if negative rules out the diagnosis of d. ulnar deviation of the hand rheumatoid arthritis e. Z thumb deformity b. indicates the presence of antibodies (either IgG or IgM) directed against 30.A 26 years male patient has a 6 months other antibodies. history of fever and recurrent c. is positive in 35% of patients with ulcerating skin nodules. His BP is psoriatic arthritis 180/100. His ESR is 100 mm in the 1st d. is positive in15% patients with hour and his urine shows microscopic adult RA haematuria. The most helpful e. when positive indicates a good investigation to reach a diagnosis will prognosis Poor prognosis if high titres of be RF present 26.The following disease is most likely to a. LE cell phenomenon be mono-articular rather than poly- b. Leucocytosis articular c. leucopenia d. micro-aneurysms on renal a. ankylosing spondylitis Polyarticular arteriography b. primary osteoarthritis Mostly Polyarticular e. neutrophil leucocytosis c. reactive arthritis Poly/mono, Asymmetric d. rheumatoid arthritis Polyarticular, symmetric e. septic arthritis 5 BLOCK N FINAL YEAR MBBS-280423 31.A 9 years old boy who had a sore throat 35.Rheumatoid arthritis is one week back, presented with 3 days a. a bacterial disease history of migratory polyarthritis, fever b. a milder disease in sero positive and acute dyspnoea. On examination patients has tachycardia, 3rd sound gallop and a c. may cause carpal tunnel syndrome diastolic murmur at the mitral area. The d. more common in males best treatment option is e. spares the cervical spine 36.A 30 years old lady has history of a. amoxicillin intravenous chronic polyarthritis predominantly of b. clopidogril 75 mg plus aspirin 75 mg the small joints of the hands and feet daily and has now come with fever for the c. corticosteroids past 10 weeks. On admission she is d. cyclophosphamide found to have a left sided pleural e. indomethacin effusion. The pleural aspirate is an exudate with high LDH and a very low 32.A patient is getting treatment for sugar content. The most helpful rheumatoid arthritis and develops investigation to reach a diagnosis will corneal deposits. The drug that has to be be stopped is a. a positive rheumatoid factor in the pleural aspirate a. hydroxychloroquine b. a positive tuberculin (Mantoux) test b. indomethacin c. blood culture for mycobacteria c. leflonamide d. cytology of the pleural fluid for d. methotrexate malignant cells e. NSAIDs e. ESR of over 80 mm in the first hour 37.A 30 years old female patient came 33.A 22 years young male has 3 years with history of swollen hands. On history of sacroiliac pain and backache examination her PIP & MCP joints are and stiffness especially in the swollen and tender bilaterally. The pain mornings. He seems to improve after is worse in the morning. Rheumatoid exercise and gets worse after rest. His factor is negative. Her anti-CCP ESR is 100 mm in the 1st hour. The antibodies are positive. Her long-term most helpful investigation to reach a treatment should be diagnosis will be a. cyclophosphamide alone a. anti CCB antibodies b. corticosteroids and NSAIDS. b. hepatitis B surface antigen c. methotrexate and corticosteroids c. HLA B27 d. methotrexate and NSAIDs d. LE cell phenomenon e. non steroidal anti-inflammatory e. rheumatoid factor drugs (NSAIDS) alone 38.A 22 years old male presented with a 34.A 26 years young lady has a 6 weeks history of lower backache for the last 2 history of severe painful weakness of years. He describes his backache to be muscles. She has a heliotrope worse in the early morning and discolouration over her eyelids. Her improves on exercise. On examination ESR is 90 mm in the 1st hour and the there is straightening of the lumbar serum CPK levels are very high. The spine. His ESR is 100 mm in the 1st most likely diagnosis is hour. The most likely diagnosis is a. ankylosing spondylitis a. dermatomyositis b. degenerative disc prolapse b. muscular dystrophy c. dengue fever c. osteomalacia d. osteomalacia d. polymyalgia rheumatica e. TB spine e. systemic lupus eryhthematosis Bamboo Spine Loss of normal 6 BLOCK N FINAL YEAR MBBS-280423 spine curvature 39.A 26 years young female has fever, 43.A 25 years old male had an episode of rash, alopecia, buccal ulcers and dysentery about 2 weeks back from splenomegaly. The most likely which he recovered. Now he has diagnosis is arthritis of both knees, red eyes, dysuria and a urethral discharge. The a. polyarteritis nodosa most likely diagnosis is b. polymyositis c. herpes stomatitis a. E coli cystitis d. scleroderma b. gonococcal urethritis e. systemic lupus erythematosus c. Reiter’s syndrome d. Schogrens syndrome 40.A 32 years old female has scaly non- e. syphilis itchy skin lesions, for over 15 years. For the past two years she is finding it 44.A 40 years old female gets repeated extremely difficult to get up in the attacks of DVT. The current attack is in mornings because she feels very stiff. both her calves and this is her 8th such There is asymmetrical arthritis of the attack. She is married for 21 years, has small joints of both hands along with had multiple abortions but has no living arthritis of both elbows. Her ESR is 70 child. The most helpful investigation to mm in the 1st hour. The most likely reach a diagnosis will be diagnosis is Treat with LMWH during pregnancy a. anti cardiolipin antibodies a. anti phospholipid syndrome b. diagnostic D & C b. Behcet's syndrome c. pelvic ultrasound c. polyarteritis nodosa d. serum LH and FSH d. polymyalgia rheumatica e. serum fibrin degradation products e. psoriatic arthritis 45.A 53 years old obese patient is on 41.A diagnosed SLE patient’s renal treatment for congestive cardiac functions have recently deteriorated failure. He gets excruciating pain in his and needs treatment. The best left big toe which wakes him from treatment option is sleep. When brought to hospital his toe is red and swollen and he is stopping a. cephalosporin antibiotics to cover you from touching it. The most likely for background renal infection diagnosis is b. corticosteroids and azathioprine c. corticosteroids and a. acute osteoarthritis cyclophosphamide b. drug induced lupus d. haemodialysis if blood urea is over c. gonococcal arthritis 110 mg/dl d. gout e. intravenous fluids and azathioprine e. haemochromatosis 46.An elderly male who is diagnosed a 42.A 40 years old man has mild case of carcinoma of prostate with polyarthritis and extensive psoriasis. painful bony metastasis admitted The best treatment option is indoor for pain management. Which of the following is more likely to help this a. corticosteroids patient? b. hydroxychloroquine c. methotrexate a. NSAIDs d. NSAIDs & corticosteroids b. Paracetamol e. penicillamine c. Tricyclic drugs DMARDS first line agent (leflunomide preferred) d. codein e. Morphine 7 BLOCK N FINAL YEAR MBBS-280423 47.Which of the following is good indicator 52.A 30 years old female had 15 % burn of tissue perfusion? involving both thighs. Examination revealed deep partial thickness burn. a. pulse How this wound will heal if no b. blood pressure intervention is done c. urine output d. CVP a. Normal healing e. GCS b. No scarring c. Hypertrophic scarring 48.A 25 years old female presented with d. Keloid formation history of flame burn 2 hrs ago. e. Atrophic scar Examination revealed burned area involving both upper arms, front of 53.A 30 years old female had 15 % burn chest, abdomen and head & neck. What involving both thighs. Examination is total body surface area involved revealed deep partial thickness burn. In how much time this wound will heal a. 35 % spontaneously b. 45 % c. 55 % a. 1-2 WEEK d. 25 % b. 2 WEEKS Superficial Partial Thickness e. 65 % c. 3-4 WEEKS Deep Partial Thickness d. 6 -8WEEKS 49.A 40 years old female having second e. >8 WEEKS degree burn brought to emergency room. Which of the following formula is 54.A 35 years old male was operated for used for fluid resuscitation incision biopsy of right axillary lymph node. The procedure was uneventful, a. Curie after 10 hours of procedure he b. Barclays 4ml x Body wieght x %TBSA developed bleeding from incision site. c. Parkland What is likely cause of this 50% in 8 hours 50% in 16 hours d. Wallace complication e. Lund & Browder a. 1˚ hemorrhage 50.How much small intestine can be safely b. 2˚ hemorrhage resected or bypass without deleterious c. Reactionary hemorrhage effects d. Non surgical hemorrhage e. Tertiary hemorrhage a. 25 % b. 50 % 55.A patient of 30 years female was c. 65 % operated for lap-Cholecystectomy in d. 75 % morning elective list. After 6 hours of e. 85 % surgery patient deteriorated vitally with pallor, pulse 130/min weak, BP- 51.Which of the following fluids contain 80 systolic. What is the next step of potassium management a. Normal saline a. Reassurance of patient b. Ringer Lactate b. FAST Scan c. Dextrose saline c. MRI d. Dextrose water d. ERCP e. None e. Blood CBC 8 BLOCK N FINAL YEAR MBBS-280423 56.Informed consent must always be 61.Mental State examination (MSE) taken by; includes all of the following except: a. Staff Nurse a. Appearance b. House Officer b. Thought c. Surgeon Operating on Patient c. Affect d. Medical Officer d. Cognition e. Anesthetist e. Diagnosis 57.The maximum pressure for 62.Which of the following is a somataform pneumoperitoneum during laparoscopic disorder? Cholecystectomy is a. Pain disorder a. 10 mmHg b. Depression b. 15 mmHg 12-15 mmHg c. Malingering c. 20 mmHg d. Munchausen's syndrome d. 25 mmHg e. All of the above e. 30 mmHg 63.Delusional disorder is: 58.During laparoscopy which of the following gas is used to create a. Unrealistic fixed beliefs that cannot pneumoperitoneum be changed b. Thought broadcasting a. Air c. Hearing of voices b. CO2 d. Crying spells c. Oxygen e. Thought withdrawal d. Nitrous oxide e. Halothane 64.A false sensory perception in the absence of external stimulus is: 59.A 30 years old female operated for Para umbilical hernia on elective list. A a. Hallucination Redivac drain was placed for any b. Illusion collection. When this drain should be c. Delusion removed d. Depression e. Stress a. After 24 hrs b. 02 Days 65.Thalassemia is inherited as c. 05 Days d. 07 Days a. Autosomal Recessive e. No use of drain b. Autosomal Dominant c. Sexlinked Recessive 60.A 20 years old female underwent d. Sexlinked Dominant excision biopsy for 2×2 cm left breast e. None of above lump. Wound is stitched with pro line O and stitch is removed on day 7. This 66.Peripheral smear of thalassemia can wound is healed by show a. 1˚ intension a. Hypochromia b. 2˚ intension b. Target cells c. Skin grafting c. Microcytosis d. Tertiary intension d. Anisocytosis e. Flap application e. All of the above 9 BLOCK N FINAL YEAR MBBS-280423 67.Hb electrophoresis in Thalassemia 73.Splerocytisis is inherited as major shows a. Autosomal Recessive 25 Hereditary b. Autosomal Dominant 75 Spherocytosis a. Absent Hb A2 c. Sex linked Recessive b. Hb A2 Decreased d. Sex linked Dominant c. Hb F les then 10% e. None of above d. Elevated Hb A1 e. Hb F more than 90% 74. Sherocytosis is presented in a. Adult life 68.Which one is not treatment of b. Neonatal life thalassemia c. Infancy d. Childhood a. Vit.C e. None of above b. Folic cid c. Oral iron supplements 75. A 4 year old child presented with fever d. Blood transfusion and epistaxis for 2 weeks. O/E he is e. Iron chelation febrile with temp 101,pale, bruises on abdomen and legs and 69.In sickle cell anemia peripheral smear splenomegaly.His cbc shows hb shows 8g/dl,Tlc 55000,PLT 40000. What is the next investigation to confirm the a. Hypochromia diagnosis? b. Microcytois a. Hb electrophoresis. c. Anisocytois b. Serum Ferritin. d. Sickle cells c. Bone Marrow biopsy e. All of above d. Blood culture e. Ct scan Abdomen. 70.Longtime manifestations of sickle cell 76. A 7 year old child is admitted with hx a. Tissue infarction of weight loss, fever and sweating for 3 b. Gallstones weeks. O/E he is pale, febrile and has c. Leg ullcers cervical and bilateral axillary d. Hemosiderosis Lymphadenopathy. He has received e. All of above oral antibiotics for 2 weeks. What is the 71.G6PD deficiency is inherited as best next step in management? a. Autosomal Recessive a. Oral antimalarial drugs b. Autosomal Dominant b. Sputum for AFB c. Sex linked Recessive c. Lymph node biopsy. d. Sex linked Dominant d. Bone marrow biopsy e. None of above e. Intravenous ceftriaxone 77. A known case of ALL is brought to you 72.In G6PD deficiency hemolytic crisis by his parents with complaints of facial shows puffiness, vomiting and pain epigastrium and hirsutism. The pt is on a. Hb less then 5g/d chemotherapy for 8 months. Which b. Peripheral smear shows Heinz drug is responsible for the symptoms? bodies c. Elevated bilirubin a. Methotrexate d. Hemoglobinurea b. Steroids e. All of above c. Vincristine. d. Septran. e. Etoposide 10 BLOCK N FINAL YEAR MBBS-280423 78. A 10 month old boy is presented with 82.Risk of having a duchenne muscular progressive pallor. He is breast fed with dystrophy child to a carrier mother is no weaning food. Blood picture reveals microcytic, hypochromic anemia. What a. 50% of sons is the diagnosis? b. 25% of sons c. 50% of daughters a. G6PD deficiency d. 25% of daughters b. Thalassemia major e. All of above c. Aplastic anaemia d. Iron deficiency anemia 83.Which investigation is diagnostic for e. Hemophilia DMD 79.Which one is the diagnostic test for a. Low Hb thalassemia major b. High creatinine kinax c. Reduced dystroplnin in muscle a. Peripheral smear biopsy b. Reticulocyte count d. Nerve conduction study c. Haemoglobin electrophoresis e. Gene analysis d. Bone marrow examination e. Coagulation profile 84.Cause of migratory polyarthcritis is 80.A 7 year old boy presented with fever, a. Sepsis anaemia and multiple bruises. There b. Trauma was no lymphadenopathy or c. JIA visceromegaly. Blood picture d. Rheumatic fever reveals:Hb 4 g/dl, TLC 1600/ e. None of above cmm,platelets 5000/cmm. What is your diagnosis 85.Monoartheris in a sick child may be a. Leukaemia a. Sepsistic artheris b. Aplastic anaemia b. Rheumatic fever c. Fanconi anaemia c. JIA d. Thalassemia d. All of above e. Thrombocytopenia e. None of above 81.A 4 year old boy presents with 86.Rickets is: epistaxis. He had URTI 10 days back. He is now a febrile, active and cheerful. a. Failure of mature bone to He has petechial rash over his mineralize. abdomen. He is having no b. Failure of mineralization of growing visceromegaly and no bone lymphadenopathy. What is the most c. A disease of elderly people. important test for diagnosis of this d. Due to excess of vitamin D. patient? e. Due to acute diarrhea. a. Complete blood count 87.Rickets can occur due to: b. Bone marrow examination c. Haemoglobin electrophoresis a. Pneumonia d. Reticulocyte count b. Acute diarrhea e. Osmolar fragility test c. Dysentery d. Celiac disease e. Acute urinary tract infection 11 BLOCK N FINAL YEAR MBBS-280423 88.Best site for x-ray for diagnosis of 94.According to WHO, Anemia in rickets is pregnancy is defined as a.Ankle joint b.Wrist joint a.Hb level decreased 12 mg/dl in ist c.Knee joint trimester d.Hip joint First trimester: Hb level less than 11.0 b.Hb level decreased 11 mg/dl in ist e.Chest g/dlSecond trimester: Hb level less than 10.5trimester g/dlThird trimester: Hb level less than 11.0 c.Hb level decreased 10.5 gm/dl in ist 89.Measles vaccine g/dlis given trimester a. I.M d. Hb level decreased 10 gm/dl in ist b. I.V trimester c. Subcutaneous e. Hb level decreased 9 gm/dl in ist d. Intra dermal trimester e. None of above 95.A 10 years old child present ED in A/E, 90.Development is almost complete by with history of limping gait, high grade a. 7 years fever. On examination temperature was b. 5 years 102˚ F. Localized tenderness just c. 9 years above knee. Most probably diagnosis d. 12 years e. None of above a. Fracture Femur 91.Which of the following is not given by b. Osteosarcoma I.M injection c. Acute osteomyelitis d. Rickets a. Pneumococcal vaccine e. Septic arthritis b. Hep B c. HIB 96.A 15 years old male come to d. Rota virus orthopedics’ OPD with pain & swelling e. IPV near the knee joint. On examination 92.All of the following imaging modalities temperature is normal; swelling is use ionizing radiation, EXCEPT: distal part of femur, some movements of knee joint possible. Blood count is a. digital radiography normal. X-rays show radio destructive b. MRI lesion distal femur c. Mammography d. CT Scan a. Septic arthritis knee e. PET Scan b. Osteosarcoma 93.A 25 years old G3 P2 Al2 at 28 wks of c. Fracture distal femur pregnancy presented with the C/O easy d. Giant cell tumor fatigability tiredness and paller. She is e. Acute osteomyelitis giving history of MUD eating as well. Investigation show 97.Two weeks old male child present to Hb 7.8 gm/dl ortho OPD with deformity of feet. Both MCHC 20 gm/dl feet were inverted and planti flexed. MCV 68 fl Most probably diagnosis MCH 26pg/dl What is the most likely diagnosis? a. Congenital tellepes calcaneo volgus a. iron deficiency anemia b. Congenital tellepes equino varus b. B12 c. Pes plamous c. Folic Acid d. Post polio paralysis of feet d. Sickle cell anemia e. Neurofibromatosis e. Thalessemi clubfoot 12 BLOCK N FINAL YEAR MBBS-280423 98. A 1 year old female child was brought 102. A 13 years old girl presented with to orthopedic OPD. Parents’ deformity of spine. On examination complaining of limping gait O/E right thoracic spine are curved latterly. X- leg is shorter then left leg. Right hip rays show scoliosis. On measurement abduction is limited. Most probably the curve is 50˚. What should be the diagnosis treatment For curves greater a. Congenital dislocation of hip a. Observation than 50 degrees b. Septic arthritis of hip b. Surgical Stabilization c. Fracture neck femur c. Braces 20 - 40 Degrees d. Post polio paralysis of right leg d. None of above e. Tuberculosis of hip e. Physiotherapy 99.A one day old female child was sent to 103. A 70 years old male presented to ortho ward from labor room for orthopedic OPD with severe knee joint orthopedic assessment of limbs. On pain. On examination, it was revealed examination Barlow’s test is positive in that he has Genue Varum; knees are both legs. What is the most probable swollen but skin colour is normal and diagnosis movements are painful. X-rays show marked reduction of joint space and a. Fracture neck of femur osteophytes formation. What will be b. D.D.H diagnosis; c. CTEV d. Proximal femoral focal defect a. Rheumatoid arthritis e. Septic arthritis of hip b. Anky losing spoudylets c. Osteoarthritis 100. A one day old female child was sent d. Fracture distal femur to ortho ward from labor room for e. ACL injury orthopedic assessment of limbs. On examination Barlow’s test is positive in 104. A 40 years old lady presented with both legs. What treatment is the best boutonniere (Buttonhole) deformity of index finger and swan neck deform of a. Surgery other fingers. Most probable diagnosis b. Pavlick Harness c. Hip Spica a. Osteoarthritis d. Traction b. Rheumatoid arthritis e. Brace c. SLE d. Osteoporosis 101. A two day old male child present in e. Gout ortho OPD. On examination his both 105. A 40 years old lady presented with feet are deformed and everted with severe back pain for last 3 months. planter flexed. What will be the best Pain worsens at night and not relieved treatment in this case with rest. On examination there is marked tenderness in lower thoracic a. Surgical correction of deformity spines slight weakness of both limbs. b. Serial casting of feet X-ray shows loss of disc space between c. Treatment should wait till child is 1 T10 & T11. Most probable diagnosis year d. Braces Clubfoot - Serial casting as part of a. Disc herniation e. Hip spica the ponsetti method b. Tuberculosis of thoracic spine c. Fracture of thoracic vertebra Braces are used after serial casting is complete d. Kyphosis and are worn till 4 years of age e. Acute phylogenic infection 13 BLOCK N FINAL YEAR MBBS-280423 106. A 40 years old lady presented with 110. A 6 years old child with a dry and severe back pain for last 3 months. xerotic skin, is having positive family Pain worsen at night and not relieved history of asthma. On examination with rest. On examination there is there is excoriations and lichenification marked tenderness in lower thoracic in cubital fossa. The condition can be spine, slight weakness of both limbs. X- best diagnosed by: ray shows loss of disc space between a. Clinical evaluation T10 & T11. Most probable treatment in b. Patch test this case c. IgE level d. Skin biopsy a. Spinal brace e. IgG levels b. Debridement 111. A 32 years old lady presents in c. ATT with debridement autumn season, with a pruritic rash all d. Surgical stabilization over the torso but remember an initial e. Analgesics and rest solitary large patch with a collarette of scales. Which of the following is the 107. A 41-year-old man develops itchy, most likely cause of the rash? polygonal, violaceous papules on the a. Secondary syphilis flexor aspect of his forearms. Some of b. Lichen planus these papules have coalesced to form c. Pityriasis rosea plaques. What is the most likely d. Psoriasis diagnosis? e. Tinea Corporis a. lichen planus 112. A 30 years old female having b. Scabies symmetrical, pruritic, purple papules on c. Lichen sclerosus the wrists, ankles, shins and umbilical d. Morphea region. The disease is found to be e. Psoriasis associated with: a. Diabetes 108. A seven year old child presenting b. Psoriasis with recurrent dry scaly macules c. Pemphigus vulgaris (white, small) on face has: d. Arsenic poisoning e. Malignant hypertension a. Post dermal leishmaniasis 113. All of the following are causes of b. Pityriasis alba erythroderma except? c. Early vitiligo a. Psoriasis d. Leprosy b. Lichen planus e. Mycosis fungoides c. Eczema d. Pityriasis versicolor 109. A 25 year old women developed e. Mycosis Fungoides small itchy wheals after physical 114. A 35 years old male with a exertion, walking in the sun, eating hot complaint of fever, enlarged inguinal spicy food and when she was angry. lymph nodes and generalized rash The most likely diagnoses is? involving palms and soles. He has a positive history of sexual contact 03 a. Chronic idiopathic urticaria months back. The causative organism b. Heat urticaria of the disease is c. Solar urticaria d. Cholinergenic ueticaria a. Entamoeba histolytica e. Aquageuic usticaria b. Nisseria gonorrhoeae c. Plasmodium d. Treponema pallidum e. Trichophyton Rubrum 14 BLOCK N FINAL YEAR MBBS-280423 Macupapular rash in second stage of syphilis 115. A 40 years old male having 118. A man presents with an area of symmetrical erythematous plaques dermatitis on his left wrist. He thinks with silvery scales has recently he may be allergic to nickel. Which one developed the following associated co of the following is the best test to morbidity: investigate this possibility? 10% patients with longstanding psoriasis a. Urticaria develop psoriatic arthritis a. Skin patch test b. Gingivitis b. Radioallergosorbent test (RAST) c. Conjunctivitis c. Nickel IgG levels d. Arthritis d. Skin prick test e. cholecystitis e. Nickel IgM levels 116. A 17 years old boy living in the 119. What is the most common causative hostel presented with a history of agent of erythema multiforme (EM)? severe itching all over. The itcing is worse at night. He has excoriated skin a. Penicillin and sulphonamides between fingers and toe webs. On b. Systemic lupus erythematosus examination there are some itchy c. HSV infection papules on his genitals. Based on d. Malignancy history and clinical examination, which e. Pregnancy of the following is the diagnosis: 120. A 42 years old male patient is a. Contact dermatitis suffering from psoriasis. The important b. Pidiculosis diagnostic feature is: c. Urticaria d. Scabies a. Crusting e. Eczema b. Silvery Scales c. Oozing 117. A 30 years old women presents with d. Erythema a fixed erythematous scaly, atrophic e. Excoriations plaque on the face and sun-exposed areas, telangiectasia , hypopigmentation and follicular plugging are apparent. Examination of the scalp shows scarring alopecia and the mouth has erythematous patches. She also suffers from Raynaud’s phenomenon. Skin biopsy shows dense , patchy , dermal lymphocyte infiltration , epidermal basal layer is damaged and hyperkeratosis is also present. What is the most likely diagnosis? a. Squamous cell carcinoma b. Scleroderma c. Discoid lupus erythmatosus d. Plaque like psoriasis e. Bowens disease. 15 BLOCK N FINAL YEAR MBBS-280423 FINAL MBBS/SECRETS OF KMU Join WhatsApp group to get all Colleges Papers, books’ PDFs, OSPE material and MUCH MORE to help you ace your PROF, in shaa Allah.We are a community of final-year medical students offering support, guidance, and sharing study 📚👩 👨 materials. It's a respectful and welcoming space for everyone. ⚕ ⚕ https://chat.whatsapp.com/Gth8bqZzdGLGDT1 wwrMWgk