201.

Which drug inhibits uric acid synthesis by inhibiting xanthine oxidase:

A. Probenecid
B. Phenylbutazone
C. Colchicine
D. Allopurinol ************
E. Indometacin

202. ALL of the following are usual manifestations of Cushing's syndrome,

EXCEPT:
A. Amenorrhea
B. Hypertension
C. Ecchymosis
D. Hyperkalemia ****************
E. Weakness

203. Which of the following is TRUE about ulcerative colitis:

A. D-penicillamine is an effective treatment
B. The rectum is involved in most cases ************
C. Fistula formation is a common problem@@@@@@
D. Skin lesion is characteristic
E. Inflammation involves all the layers of the colon ever in early
        stages

204. Hyperpigmentation of the skin may be caused by ANY of the following,

EXCEPT:
A. Addison's disease
B. Nelson's syndrome
C. Hemochromatosis
D. Chronic renal failure
E. Panhypopituitarism*********

205. The following conditions cause transudate type of pleural effusion,

EXCEPT:
A. Nephrotic syndrome
B. Meig's syndrome
C. Liver cirrhosis
D. Congestive cardiac failure
E. Empyema********
206. ALL of the following drugs may be used to treat ventricular tachycardia,
EXCEPT:
A. Lignocain
B. Amiodarone
C. Verapamil **********
D. Phenytoin
E. Procainamide

207. In chronic renal failure the serum concentration of the following

substances is increased, EXCEPT:
A. Uric acid
B. Calcium **********
C. Urea
D. Creatinine
E. Phosphorus

208. EACH of the following diuretics can cause hypok;nlemia, EXCEPT:

A. Furosemide
B. Hydrochlorothiazide
C. Spironolactone ********
D. Ethacrynic acid
E. Bumetanide

209. ALL of the following can cause proteinuria in excess of 3 grams per 24
hours, EXCEPT:
A. Membranous glomerulonephritis
B. Malignant hyperte~ision
C. Diabetic nephropathy
D. Obstructive uropathy*************
E. Renal amyloidosis

210. ALL of the following are TRUE about brucellosis, I1,XCEPT:

A. Is a recognized cause of splenomegaly
B. May present with backache
C. Infective endocarditis may occur
D. Man to man transmission is common*****************
E. Rifampicin may be used in the treatment
211. Hepatic encephalopathy may be precipitated by ALL of the following,
EXCEPT:
A. High protein diet
B. Infection
C. Sedation
D. Administration of lactulose **********
E. Use of diuretics

212. In myocardial infarction the following serum enzyme rises latest and
remains elevated for the longest period:
A. SGOT
B. LDH************
C. Alkaline phosphatase
D. CPK
E. Acid phosphatase

213. In acute renal tubular necrosis ALL of the following are TRUE, EXCEPT:
A. Proteinuria may be present
B. BUN is usually increased
C. Creatinine is usually dricreased
D. The urine is usually hyperosmotic********
E. With prompt treatment recovery is expected in most cases with           
      no underlying illness

214. The treatment of digitalis-induced arrhythmia ma3 include EACH of the

following, EXCEPT:
A. Withdrawal of digitalis
B. Phenytoin administration
C. Calcium glucon -ite administration @@@@@@@
D. Potassium supplements
E. Xylocaine administration***********

215. The majority of hemoglobin in erythrocytes from the normal adults is

termed:
A. Hemoglobin F
B. Hemoglobin A**************
C. Hemoglobin A2
 D. Hemoglobin C
E. Hemoglobin Bart's
216. The commonest causative organism in osteomyelitis is:
A. Pseudomonas
B. Tubercle bacillus
C. Streptococcus
D. Treponema pallida
E. Staphylococcus************

217. The following are characteristic of hemolytic type of jaundice, EXCEPT:

A. Increased serum unconjugated bilirubin
B. Bilirubin does not appear in the urine
C. Abnormal liver function tests *************
D. Increased urinary urobilinogen
E. Anemia

218. ALL of the following predispose to venous thrombosis, EXCEPT:

A. Congestive cardiac failure
B. Behchet's disease
C. Iron deficiency anemia*****************
D. Paroxysmal nocturnal hemoglobinuria
E. Malignancy

219. ALL of the following are signs of chronic liver disease, EXCEPT:
A. Parotid gland enlargement
B. Increase of body hair ****************
C. Spider Naeria
D. Gynaecomastia
E. Palmar erythema

220. In gouty arthritis which of the following is the most specific

                  diagnostic finding:
A. Family history of gout
B. The presence of sodium urate crystals in synovial fluid ****************
C. Prompt response to colchicine therapy
D. The presence of hyperuricemia
E. Involvement of the big toe
221. ALL of the following are recognized features of Parkinsonism, EXCEPT:
A. Rigidity
B. Tremor
C. Hypokinesia
D. Extensive sensory loss ****************
E. Expressionless face

222. Signs of lower motor neuron disease include ALL of the following,
EXCEPT:
A. Fasciculation
B. Hypotonia
C. Hyporeflexia
D. Clonus*********
E. Muscle wasting

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

A. Lymphadenopthy
B. Splenomegaly ,
C. Polycytemia**************
D. Rheumatoid arthritis
E. Leukopenia

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

A. Ampicilline *************
B. Oxacilline
C. Nafacillin
D. Methicillin
E. Cloxacillin

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

A. Myxedema
B. Atenolol
C. Raised intracranial pressure
D. Jaundice
E. Salbutamol*********
226. A 50-years-old male awoke in the midnight with severe pain in his left big
toe. He was taking some diuretics for hypertension. His toe was swollen, hot and
severely tender, and patient was unable to stand on it. The most probable diagnosis
is:
A. Reiter's syndrome.
B. Acute pyogenic arthritis
C. Rheumatid arthritis
D. Osteoarthritis
E. Acute gouty arthritis**********

227. Regarding left to right cardiac shunts ALL are TRUE, EXCEPT:
A. Cyanosis is a prominent feature****************
B. Oxygenated blood is shunted from left to right
C. Systemic flow is decreased
D. Pulmonary congestion is a prominent feature
E. Left heart pressures normally exceed those on the right

228. Which of the following drugs is useful for plasmodium falciparum malaria
chemoprophylaxis:
A. Emetine hydrochloride
B. Trimetoprim
C. Chloroquine**************
D. Metronidazole
E. Rifampicin
229. Rheumatoid arthritis may cause ALL of the following in the hand,
EXCEPT:
A. Joint ankylosis
B. Rupture of extensor tendons
C. Int -insic contractures
D. Rupture of flexor tendons
E. Heberden's nodes*************
230. Signs of severity in an acute attacks of bronchial asthma include ALL of
the following, EXCEPT:
A. Cyanosis
B. Hypercapnia
C. Loud wheezes on auscultation*************
D. Pulsus paradoxus
E. Silent chest
231. Erythema nodosum may be associated with ALL of the following,
EXCEPT:
A. Sarcoidosis
B. Tuberculosis
C. Streptococcal pharyngitis
D. Crohn's disease
E. Rheumatoid arthritis************

232. The usual causes of low arterial oxygen tension (Pa02) include EACH of
the following, EXCEPT:
A. Right to left shunt
B. Ventillation-perfusion mismatch
C. Impaired diffusion capacity
D. Hyperventilation **************
E. Hypoventilation

233. Aplastic anemia may occur following the administration of which of the
following:
A. Penicillin
B. Prednisolone
C. Tetracycline
D. Chloramphenicol ***************
E. Erythromycin

234. Characteristic cerebrospinal fluid findings in viral meningitis include:

A. White cell count may be low
B. There may be early polymorphonuclear cell reaction
C. Normal sugar content
D. Elevated protein
E. Positive direct smear for AFB************

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

                                  A. TeratomaSubsternal thyroid ***********
                                    B. Thymoma
                                    C. Neurofibroma
                                    D. Dermoid cyst
236. Benign intracranial hypertension (pseudotumor corebri) is usually
associated with which of the following:
A. Hemiparesis
B. Papilloedema**********
C. Increased CSF protein and sugar
D. Convulsions
E. Severe mental retardation

237. ALL of the following manifest with indirect hyperbilirubinemia,

EXCEPT:
A. Gilbert's syndrome
B. Dubin-Johnson syndrome*******************
C. Crigler-Najar syndrome
D. ABO incompatibility
E. Physiologic neonatal jaundice
238. The protein present in the greatest quantity in the urine of normal people
is:
A. Albumin************
B. Tamm-Horsfall protein
C. Gamma globulin
D. Amylase
E. Bence-Jones protein
239. A 50-years old Male who was seen in the casualty complained of sudden onset severe
left anterior chest pain radiating to the left arm. It was not relieved by sublingual nitrates. He
was short of breath; frothy blood was coming out of his mouth. He was hypotensive, cold,
cyanotic and profusely sweating, There were diffuse bilateral wheezes and basal crepitations on
chest examination. The heart sounds were soft and there was third heart sound, but there were
no murmurs. Patient suffering from:
A. Acute bronchial asthma
B. Angina pectoris with acute bronchial asthma
C. Acute pulmonary edema secondary to myocardial infarciion
*******************
D. Acute viral pneumonia with pleuritic chest pain
E. Dissecting aneurysm
240. The Budd-Chiary syndrome is due to occlusion of the:
A. Hepatic veins******************
B. Portal veins
C. Mesenteric veins
D. Pancreatic veins
 E. Splenic veins
241. The following drugs could be given safely as a treatment of hypertension
to a patient with peripheral vascular disease, EXCEPT:
A. Alpha-methyldopa
B. Nifedipine
C. Captopril
D. Propranolol*******************
E. Hydrochlorthiazide
242. The following gastrointestinal manifestations can be related to diabetes
mellitus, EXCEPT:
A. Constipation
B. Diarrhea
C. Fecal incontinence
D. Duodenal ulcer****************
E. Gastric atonia

243. A 20-yers-old patient presented with 5 days history of gradually increasing

fever, headache and constipation. Provisional diagnosis of typhoid fever was
suggested. Diagnosis can be best confirmed at this stage by which of the following:
A. Widal test
B. Blood culture***************8
C. Urine culture
D. Stool culture
E. Clinical examination
244. Subarachnoid hemorrhage occurs most commonl3 as a result of:
A. Rupture of an arteriovenous anomaly
B. Rupture of a berry aneurysm********************
C. Rupture of a mycotic aneurysm
D. Trauma
E. Rupture of a fusiform aneurysm
245. There is an association between the use of biguanide oral hypoglycemia
agent metformin (Glucophage) and the development of:
A. Lactic acidosis******************
B. Respiratory acidosis '
C. Metabolic acidosis with normal anion gap
D. Metabolic alkalosis
E. Marked respiratory alkalosis
246. Gastrin is produced primarily in the:
 A. Gastric fundus
B. Antrum
C. Pylorus***************
D. Liver
E. Pancreas

247. Features of the Pickwickian syndrome may include ALL of the following,
EXCEPT:
A. Obesity
B. Somnolence
C. Hypocapnia***********
D. Polycythemia
E. Hypoxemia

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

EXCEPT:
A. Addison's disease ***************
B. Conn's syndrome
C. Pheochromocytoma
D. Coarctation of aorta
E. Acromegaly

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

A. Brucellosis
B. Primary pulmonary tuberculosis ***************
C. Malaria
D. Acute pyelonephritis
E. Acute cholangitis

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

EXCEPT:
A. Heavy smoking
B. High altitudes
C. Chronic renal failure********************
D. Hepatoma
E. Fibroma of uterus
251. Signs of mitral stenosis include ALL of the following, EXCEPT:
A. Loud first heart sound
B. Opening snap
C. Presystolic murmur
D. Wide pulse pressure**************
E. Rumbling mid-diastolic murmur

252. Hematemesis and melena in a patient with liver cirrhosis is likely to be

due to ALL of the following, EXCEPT:
A. Gastric ulcer
B. Hepatoma**************
C. Bleeding esophagus varices
D. Duodenal ulcer
E. Abnormal clotting mechanism

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

A. Renal artery stenosis
B. Conn's syndrome
C. Pheochromocytoma
D. Addison's disease *******************
E. Acromegaly

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

A. Periorbital puffiness
B. Pericardial effusion
C. Brisk ankle reflex *************
D. Deafness
E. Constipation

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

A. Chronic granulocytic leukemia

B. Chronic malaria
C. Amyloidosis
D. Celiac disease********************
E. Polycethemia rubra vera

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

 A. Renal stone
B. Renal tuberculosis
C. Glomerulonephritis
D. Amyloidosis ******************
E. Cystitis

257. Contraindications to the use of streptokinase therapy include ALL of the

following, EXCEPT:
A. Bleeding peptic ulcer
B. Infective endocarditis
C. Surgery to eye
D. Cor pulmonale******************
E. Severe hepatic insufficiency

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

A. Achondroplasia
B. Familial
C. Klinefelter's syndrome ***************
D. Hpothyroidism
E. Corticosteroid therapy

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

A. Addison's disease*****************
B. Hypothyroidism (cretinism)
C. Down's syndrome
D. Acromegaly
E. Amiloidosis

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

A. Conjunctivitis ****************
B. Arthritis
C. EndocardiLis
D. Myocarditis
E. Hepatitis
261. Hyperventilation ma be found in ALL of the following, EXCEPT:
A. Narcotic overdose*************
B. Diabetic ketoacidosis
C. Acute attack of bronchial asthma
D. Hysterical reaction
E. Pulmonary embolism

262. A lesion in the cerebellar hemisphere will cause ALL of the following,
EXCEPT:
A. Muscular hypotonia
B. Dysarthria
C. Dysmetria
D. Motor aphasia ****************
E. Intention tremor

263. Which of the following. drug is useful in the treatment of angina pectoris:
A. Salbutamol
B. Propranolol**************
C. Digoxin
D. Quinidine
E. Phenytoin

264. ALL of the following are TRUE about diabetic ketoacidosis, EXCEPT:
A. May be precipitated by infection
B. May occur in type II diabetes
C. Thromboembolic pnenomenon is recognized complication
D. Total body potassium is high***************
E. Dehydration can be very severe

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

A. Pneumonia
B. Mitral prolaps ****************
C. Tuberculosis
D. Lung trauma
E. Goodparture's syndrome

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

 A. Cerebrovascular accident
B. Brain tumor
C. Head injury
D. Hypokalemia *****************
E. Brain abscess

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

A. Spondylitis is a feature
B. Causes huge splenomegaly*****************
C. Rifampicin is used in the management
D. Endocarditis may occur
E. Causes peripheral neuropathy

268. ALL of the following about typhoid fever are CORRECT, EXCEPT:
A. Caused by Salmonelltt typhi
B. Headache is a prominent symptom
C. Rose spots occur during the second week
D. Splenomegaly can occur
E. Leucocytosis is usually present**********************

269. Indications for the use of ß-blockers include ALL of the following,
EXCEPT:
A. Hypertension
B. Ischemic heart disease
C. Migraine
D. Bronchial asthma *******************
E. Anxiety

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

A. Can be transmitted from mother to fetus
B. Is caused by retrovirus
C. Causes dementia
D. Kaposi sarcoma is a feature
E. Carriers are not infective*******************

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

 A. Celiac disease
B. Tropical sprue
C. Bacterial overgrowth
D. Meckel's diverticulum *********
E. Giardia lamblia

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

A. Food poisoning
B. Viral gastroenteritis
C. Inflammatory bowel disease     
D. Colonic neoplasia
E. Hypothyroidism*************

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

A. Hydrochlorthiazide therapy
B. Propranolol
C. Captopryl************
D. Digoxin
E. Nifedipine

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

A. Stony dullness on percussion
B. Diminished or absent breath sound
C. Deviation of trachea to opposite side
D. Increased tactile vocal fremitus ********************
E. Bronchial breathing above effusion

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

A. Liver cirrhosis
B. Pyrexia of unknown origin
C. Hydatid cyst**********
D. Unexplained hepatomegaly
E. Hemochromatosis

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

 A. Cushing's syndrome
B. Thiazide therapy
C. Acromegaly
D. Pancreatic carcinoma
E. Insulinoma*************

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

A. Common duct stones
B. Carcinoma of the head of pancreas
C. Biliary stricture
D. Sclerosing cholangitis
E. Fatty liver***********

278. ALL of the following are risk factors for cholesterol gall stones, EXCEPT:
A. Females more than males
B. Obesity
C. Contraceptive pills
D. Peptic ulcer ***************
E. Multiparity

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

A. Fanconi's anemia
B. Benzene
C. Insecticides
D. Viral hepatitis
E. Typhoid fever***********************

280. The following are TRUE about cholera, EXCEPT:

A. Individuals with achlorhydria are more susceptible to infection
B. Disease is mediated by exotoxin
C. Causes metabolic acidosis
D. Usually involves large bowels**************
E. Tetracycline is used on then treatment

281. Signs of left ventricular failure include ALL of the following, EXCEPT:
A. Orthopnoe
B. Triple rhythm
 C. Pulsus alternans
D. Bilateral basal crepitation
E. Gross liver enlargement**********

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

A. Alcohol
B. Hepatitis B
C. Hepatitis A*******************
D. Hemochromatosis
E. Budd-Chiari syndrome

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

A. Brucellosis******************
B. Myocardial infarction'
C. Bacterial infection
D. Burns
E. Infancy

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

A. Lid lag
B. Tremor of both hands
C. Carpopedal spasm *******************
D. Pretibial myxedema
E. Tachycardia

285. Differential diagnosis of oro-genital ulceration include ALL of the

following, EXCEPT:

A. Reiter's syndrome
B. Pemphigus
C. Erythema multiforme
D. Herpes zoster ************************
E. Behchet's disease

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

A. Usually over 30 years, with blue eyes
B. Microcytic and hypochromic
anemia********************************
C. Subacute combined degeneration of the cord can occur
D. Dementia is a feature
E. Optic atrophy can occur

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

A. Skull X-ray show "hair on end" appearance
B. Blood film shows hypochromic and microcytic picture
C. Usually is asymptomatic***********
D. Hepatosplenomegaly is a feature
E. Is inherited disease

288. ALL of the following are extra-articular manifestations of rheumatoid

arthritis, EXCEPT:
A. Pericarditis
B. Mononeuritis multiplex
C. Fibrosing alveolitis
D. Pneumoconiosis***************
E. Scleritis

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

EXCEPT:
A. Fever
B. Butterfly rash
C. Alopecia
D. Glomerulonephritis
E. Keratoderma blennoiThagica*****************

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

A. Commoner in males
B. Hypertension may occur
C. Mononeuritis multiplex
D. Death usually from anemia*************
E. Myocardial infarction can occur

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

A. Causes oro-genital ulcers
B. Thrombo-phlebitis can occur
 C. Is a viral infection************
D. Steroid can be used in the treatment
E. Neurological complications may occur

292. Signs of severe bronchial asthma include ALL of the following, EXCEPT;
A. Tachycardia more than 130
B. Pulse paradoxicus *************
C. Silent chest
D. Cyanosis
E. Pulse alternans

293. ?Tremor may be seen in ALL of the following conditions. EXCEP:

A. Hyperthyroidism
B. Respiratory failure
C. Hepatic failure*************
D. Parkinson's disease
E. Depression

294. 524. Diabetes    mellitus may be secondary to ALL of the following,

EXCEPT:
A. Chronic pancreatitis
B. Acromegaly
C. Pheochrc:-mocytoma
D. Insulinoma **************
E. Glucagonoma

295. 525. Signs of aortic regurgitation include ALL of the following, EXCEPT
A. Capillary pulsation in the nail beds
B. Head nodding
C. High-p-itched early diastolic murmur
D. Pistol shot femorals*************
E. Small volume pulse (slow-rising pulse)

296. ALL of the following are contraindications for exercise

electrocardiography test, EXCEPT:
A. Recent myocardial infarction
B. Diagnosis of chest pain ************?
 C. Angines
D. Uncompensated heart failure
E. Malignant hypertension

297. The most common symptom of bronchial carcinoma is:

A. Cough**********************
B. Chest pain
C. Cough and pain
D. Coughing blood
E. No symptoms

298. ALL of the following are causes of chock, EXCEPT:

A. Myocardial infarction
B. Cardiac tamponade'
C. Respiratory failure ***************
D. Burns
E. Sepsis

299. ALL of the following are causes of gynecomastia,XCEPT:

A. Old age
B. Hyperparathyroidism ***************
C. Liver disease
D. Hyperthyroidism
E. Digitalis

300. Hypochlorhydria is caused by ALL of the following, EXCEPT:

A. Carcinoma of stomach
B. Pregnancy
C. Pernicious anemia
D. Atrophic gastritis
E. Duodenal ulcer***************