Medicine PYQ 2017 AIIMS 2017 Solve Medicine INICET 2017 Total Questions: 42 1. What is the window period for thrombolysis in case of stroke? 2½ hours 1 ½ hours 3½ hours 4½ hours None 2. A patient comes to ED with fever and headache. On examination he has neck stiffness. CSF analysis was done and it shows the following findings. Most likely diagnosis is: Opening pressure - IncreasedProteins- Mildly increasedGlucose-NormalLymphocytes - Increased. Neisseria Gonorrhoea TB Coxsackie Cryptococcus None 3. Management of hyperkalaemia includes all except Insulin drip Calcium gluconate Salbutamol nebulisation Magnesium sulphate None 4. A 53-year-old man was admitted with a history of a cerebrovascular accident. On the second day, he becomes drowsy with minimal response. CT finding is shown in the image below. What will be your next line of management? Mannitol Decompressive surgery Aspirin and clopidogrel Mechanical thrombectomy None 5. Which of the following is not seen in tumor lysis syndrome? Hyperuricemia Hyperphosphatemia Hyperkalemia Hypercalcemia None 6. Metabolic acidosis with a normal anion gap is seen in all except Pancreatitis Proximal RTA Salicylate poisoning Severe diarrhoea None 7. Disappearance of loud S1 in mitral stenosis occurs in all except: Mild MS Calcified valve AR First degree heart block None 8. What is the drug of choice for scrub typhus? Ciprofloxacin Chloramphenicol Azithromycin Doxycycline None 9. The given ECG depicts which of the following conditions: Ventricular bigeminy Paroxysmal supraventricular tachycardia P pulmonale Re-entrant atrial fibrillation None 10. A patient came with sudden onset palpitations. ECG showed a narrow complex, regular tachycardia without P waves, and a rate of 160 BPM. His blood pressure is 96/68 mmHg. What is the next step in management? Defibrillator Beta-blocker Adenosine Carotid sinus massage None 11. Which of the following is a negative acute phase reactant? Haptoglobin Albumin C reactive protein Ferritin None 12. An 18-year-old girl with the diagnosis of acute promyelocytic leukemia was treated medically. She developed fever and tachypnea and a chest X-ray showed pulmonary infiltrates. What drug should she be given next? Methotrexate Dexamethasone Cytarabine Doxorubicin None 13. A 3-month-old male child was brought with a history of fever and respiratory distress. Suspecting pneumonia, a chest X-ray was ordered. Which of the following is the most likely causative organism? Streptococcus pneumoniae Staphylococcus aureus Mycoplasma pneumoniae Klebsiella pneumoniae None 14. What does the red cell distribution width deal with? Hypochromia Anisocytosis Anisochromia Poikilocytosis None 15. The definition of fever of unknown origin (FUO) includes all of the following, except: Temperature more than 38.3 C Undiagnosed after one week of investigation Immuno compromised status should be ruled out Fever persisting for more than 3 weeks None 16. A 25-year-old woman came to the OPD one year after the birth of her last child. She had been treated for iron deficiency anemia while pregnant. On examination, she is pale and investigations show a Hb of 5g/dl and a reticulocyte count of 9%. What is her corrected reticulocyte count? (Take normal Hb as 15g/dl) 4.5 1 6 3 None 17. As an intern in the emergency ward, which of the following method would you consider as correct regarding nasogastric tube length estimation? Tip of nose to angle of ear to umbilicus Mouth to ear to umbilicus Mouth to ear to midway between xiphisternum and umbilicus Tip of nose to ear to xiphisternum None 18. A 44-year-old man is referred to your center for management of severe hyperglycemia. During examination, you note that the patient has enlarged feet, coarse facial features and prognathism. You suspect acromegaly. Which of the following tests can you use as a screening method for this condition? Insulin like growth factor-1 levels Oral glucose challenge test with GH level Insulin-like growth factor-1 binding protein-3 (IGFBP-3) level Random growth hormone levels None 19. What is not a feature of myasthenia gravis among the following? Normal pupillary reflex Absent deep tendon reflexes Muscle fatigue Ptosis None 20. A 43-year-old patient presented with spikes of fever and difficulty in breathing. Transesophageal echo revealed vegetations in the heart. The culture was positive for Burkholderia cepacia. Which of the following is the first line of management? Cotrimoxazole with 3rd generation cephalosporin Cefepime and tigecycline Aminoglycosides and colistin Carbepenams and 3rd generation cephalosporins None 21. Regarding the procedure done with the needle shown below, which of the following is false? Breath holding is not necessary Coagulopathy is not a contraindication The bevel should face upwards while inserting the needle To be done in lateral recumbent position None 22. A morbidly obese diabetic woman is not responsive to metformin therapy. She has a history of pancreatitis and family history of bladder cancer. She does not want to take injections. Which of the following would be suitable to reduce her glucose levels? Liraglutide Sitagliptin Canagliflozin Pioglitazone None 23. Pancreatic cancer has the highest association with Hereditary pancreatitis Peutz-Jeghers syndrome FAMMM syndrome FAP None 24. The radio-iodine uptake scan of a patient evaluated for swelling of the thyroid is shown below. Which of the following is the most likely diagnosis? Graves disease Papillary Carcinoma thyroid Lateral aberrant thyroid Hypersecreting adenoma None 25. A patient has a right upper limb BP of 180/95 mm Hg and a left upper limb BP of 130/90 mm Hg. He also has an early diastolic murmur in right 2nd intercostal space. Which of the following is least likely to be associated with these findings? Coarctation of aorta Supravalvular aortic stenosis Takayasu arteritis Aortic dissection None 26. A 45-year-old female patient has NYHA class III heart failure with dyspnea, pedal edema and K+ levels of 5.5 mg% and creatinine 1.1 mg%. Which of the following drugs can be used in this patient? Enalapril Digoxin Furosemide Spironolactone None 27. Which of the following diseases primarily involves the marked structure? Depression Huntington chorea Alzheimers Paralysis agitans None 28. Which of the following features of stroke need not be treated? Dysphagia Spasticity Neglect Fever None 29. A young donor came to the blood bank for the first time for platelet apheresis with platelet count of 1.9L. During the course he developed paresthesias and circumoral numbness during donation. His vitals remained stable though. ECG showed tachycardia with ST-T changes. What is the reason for his symptoms? Hypocalcemia Hypovolemic shock Allergic reaction Seizures None 30. All are components of CURB65 except Systolic blood pressure less than 100 mm Hg Blood urea nitrogen value greater than 7 mmol/L Confused state Respiratory rate of > 30 /min None 31. Which of the following anti-diabetic drugs should be stopped in a patient with a creatinine of 5.6 mg/dL? Metformin Metoprolol Linagliptin Insulin None 32. A 50-year-old man is brought to the emergency following an episode of syncope during his morning walk. His blood pressure is 80/60 mm Hg. He has a history of myocardial infarction 5 yrs back. His present ECG is given below. Which is the most appropriate treatment for the patient? DC cardioversion Lidocaine Lignocaine Diazoxine None 33. A 22-year-old female patient came with complaints of vomiting and a decrease in movement of the right leg. In the past, she has had episodes of violent and aggressive behavior and abdominal pain. Which of the following is the most probable diagnosis? Acute intermittent porphyria Right side paralysis Conversion disorder AIDP with migraine None 34. A patient came with complaints of high-grade fever and altered sensorium. He was diagnosed to be suffering from meningococcal meningitis. Which of the following is the most appropriate empirical treatment option? Cefotetan Ceftriaxone Penicillin G Cefoxitin None 35. A 53-year-old patient was admitted complains of dyspnea. On examination he has puffy face with engorged veins over the chest. SVC obstruction is suspected. Chest X-ray shows mediastinal enlargement. What is the next step? Total blood count with peripheral smear Start cyclophosphamide CT thorax Urgent referral to RT None 36. A 36 year old male came with complaints of ascending weakness in both lower limbs and upper body. There was no history of trauma. Which of the following investigations is done in the evaluation of this patient? Serum magnesium Serum potassium Serum calcium Serum sodium None 37. A patient with ascites is found to have SAAG ≥1.1. All the following can be the causes except Cirrhosis Metastasis to liver Liver failure TB peritonitis None 38. A 60-year-old man post-MI had the following lab values. Which of the following must be his treatment plan? LDL - 125mg/dlHDL-33 mg/dlTGL-270mg/dl Rosuvastatin 10 mg Atorvastatin 80 mg Rosuvastatin + fenofibrate Fenofibrate None 39. On thyroid function test analysis, TSH value was much higher than normal with a low free T4. What is the diagnosis? Subclinical hypothyroidism Secondary hypothyroidism Primary hypothyroidism Hyperthyroidism None 40. A 40-year-old smoker who is a known case of hypertension was on enalapril and hydrochlorothiazide. He had an episode of hemoptysis and on evaluation he was found to have bronchogenic carcinoma with brain metastasis. His lab values were Na -124 mg/ dl, creatinine 2.8 mg%, blood sugar 112 mg/dl, blood urea - 24 mg/dl, serum osmolality 255mosm, urine osmolality-350mosm, 24 hour urinary sodium 110 and BP-150/90 mmHg. Which of the following is the most probable diagnosis of the low sodium values in him Diuretic induced hyponatremia SIADH Cerebral salt wasting syndrome Pseudohyponatremia None 41. Which of the following is responsible for the elevated levels of TG and VLDL in diabetes mellitus? Increased activity of hormone sensitive lipase and decreased lipoprotein lipase activity Increased activity of lipoprotein lipase and decreased activity of hormone sensitive lipase Increased in activity of hepatic lipase Increase in peripheral function of LDL receptors None 42. A patient on anti-tubercular therapy develops tingling sensation in the limbs. Which of the following when substituted can result in improvement of symptoms? Thiamine Folic acid Methylcobalamine Pyridoxine None 1 out of 42 Time's up
