General Medicine Questions and Answers for Medical Students

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General Medicine Questions and Answers

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MCQ General Medicine Model Question Paper

1. Rivaroxaban is an anticoagulant with mechanism of action as:
A) Factor Xa inhibition
B) Direct thrombin inhibition
C) Vitamin K antagonism
D) Low molecular weight heparin

2. Most specific symptom of temporal arteritis is:
A) Visual loss
B) Jaw claudication
C) Temporal headache
D) Polymyalgia rheumatic

3. A 30 year old female presents with fever, weight loss, cough and epistaxis since 4 months. Chest radiography reveals nodular pulmonary infiltrates with cavitation. Urine examination reveals active sediments with RBC casts. Likely diagnosis is:
A) Pulmonary tuberculosis
B) Sarcoidosis
C) Histoplasmosis
D) Granulomatosis with polyangitis

4. Culture of sputum of young girl with cystic fibrosis yields predominant bluish green mucoid colonies of oxidase positive gram negative bacilli after aerobic incubation at 37°C and 42°C the likely organism is:
A) Klebsiella Pneumoniae
B) Psedomonas aeruginosa
C) Burkholderia cepacia
D) Burkholderia Pseudomallei

5. Lipoatrophy can occur in patients treated with:
A) Abacavir
B) Tenofovir
C) Stavudine
D) Maraviroc

6. Sausage digit is seen in:
A) Rheumatoid arthritis
B) Juvenile idiopathic arthritis
C) Enteropathic arthritis
D) Psoriatic arthritis

7. All of the following are criteria for Septic shock EXCEPT:
A) Sepsis
B) Vasopressor therapy needed to elevate MAP to ≥ 65mmHg
C) Serum lactate concentration > 2mmo/L after fluid resuscitation
D) Elevated BNP levels

8. Aldosterone escape is:
A) Escape from the salt and water retaining effect of aldosterone
B) Escape of aldosterone from the stimulating effect of ACTH
C) Escape from the natriuretic effect of aldosterone
D) None of the above 4

9. Sterile pyuria is characteristic of:
A) Chronic hydronephrosis
B) Renal cell carcinoma
C) Renal tuberculosis
D) Nephroblastoma

10. A patient on Phenytoin develops rash with oral ulcers. The following antibody test would clinch the diagnosis:
A) Anti centromere antibody
B) Anti smith antibody
C) Anti histone antibody
D) Anti double stranded DNA antibody

11. All of the following are predominant motor neuropathy EXCEPT:
A) Acute inflammatory demyelinating polyradiculoneuropathy
B) Porphyric neuropathy
C) Lead intoxication
D) Arsenic intoxication

12. Treatment of Multiple sclerosis is:
A) Interferon alpha
B) Interferon beta
C) Infliximab A
D) Interferon gamma

13. All about Mediterranean diet is true EXCEPT:
A) Characterized by a high intake of plant-based foods and olive oil, a moderate intake of fish and poultry, and low intakes of dairy products
B) Reduces both LDL and HDL
C) Associated with reduction in insulin resistance and endothelial dysfunction
D) Maintains total fat at approximately 35-40%

14. GBS is mostly characterized by all EXCEPT:
A) Motor weakness
B) Facial paralysis
C) Posterior column sensory loss
D) H/0 preceding viral/bacterial infection holds an important clue

15. Vitamin B12 deficiency can give rise to all of the following, EXCEPT:
A) Myelopathy
B) Dementia
C) Peripheral neuropathy
D) Myopathy

16. Following statements about Kussmaul’s sign are true EXCEPT:
A) Observed predominantly in left ventricular failure
B) Increased CVP during inspiration
C) Caused by severe right sided heart failure
D) Frequent in constrictive pericarditis

17. All of the following statements are true about Hemolytic uremic syndrome, EXCEPT:
A) Uremia
B) Thrombocytopenia
C) Positive Direct Coomb’s test (DCT)
D) Fibrinogen normal

18. Lower Motor Neuron lesion is characterized by:
A) Flaccid paralysis.
B) Exaggerated Jaw Jerk
C) Spasticity
D) Positive Babinski sign

19. Hemibalismus is caused by lesions of the:
A) Caudate nucleus
B) Contralateral sub-thalamic nucleus
C) Putamen
D) Substantia Nigra

20. What is the initial test that is most commonly used for HCV screening?
A) HCV RNA by PCR
B) Anti-HCV (ELISA) Ab
C) Liver biopsy
D) Liver function tests

Practice Set for Medical Students

21. Which one of the following treatment for active ulcerative colitis would be preferable in male patients who are concerned about fertility?
A) 5-aminosalicylic acid
B) Sulfasalazine
C) Methotrexate
D) Lenalidomlde

22. Autoimmune hemolytic anemia is an example of which type of hypersensitivity reaction?
A) Type I Hypersensitivity reaction
B) Type II Hypersensitivity reaction
C) Type III Hypersensitivity reaction
D) Type IV Hypersensitivity reaction

23. Which of the following have shown efficacy in treating Non alcoholic fatty liver disease (NAFLD)?
A) Vitamin E
B) Thiamine
C) Pentoxifyline
D) All of the above

24. Which of these microbes is the most likely cause of nosocomial pnuemonia in a patient in the ICU?
A) Coagulase-negative staphylococci
B) B.Staphylococcus aureus
C) C.Pseudomonas aeruginosa
D) Pneumocystis jiroveci

25. All of the following are common consequences of congenital heart disease in the adult EXCEPT:
A) Eisenmenger syndrome
B) Polycythemia
C) infective enclocarditis
D) Pulmonary embolism

26. RAI uptake is increased in:
A) Subacute thyroiditis
B) Toxic Multinodulargoitre
C) On medications with Levothyroxine
D) Struma ovarii

27. Which of the following is NOT associated with the diagnostic criteria for ARDS?
A) Bilateral infiltrates on chest x—ray
B) Acute onset
C) Pulmonary capillary wedge pressure >19
D) Refractory hypoxaemia (PaO2:FiO2<200)

28. Which one of the following skin changes is NOT typically seen in patients with diabetes mellitus?
A) Necrobiosis lipoidica
B) Acanthosis nigricans
C) Lipohypertrophy
D) Livedo reticularis

29. A 65 years old male presents with Ipsilateral 3rd nerve palsy and contralateral hemiplegia the most probable diagnosis is:
A) Benedict’s syndrome
B) Millard Gubler’s syndrome
C) Weber’s syndrome
D) Wallenberg syndrome

30. Which of the following will NOT have a high reticulocyte count?
A) Autoimmune haemolytic anemia
B) Polycythemia
C) Chronic blood loss
D) Aplastic anemia

31. Massive splenomegaly is NOT a characteristic feature of:
A) Infectious mononucleosis
B) Polycythaemia rubra vera
C) Chronic myeloid leukaemia
D) Tropical splenomegaly syndrome

32. Most common opportunistic CNS infection in AIDS:
A) Neurocysticercosis
B) Toxoplasmosis
C) Cryptococcosis
D) Aspergillosis

33. Which of the following is longest acting insulin?
A) Lispro
B) Aspart
C) Glargine
D) Human Mixtard Insulin in a ratio of 50:50

34. Metabolic syndrome is characterized by all EXCEPT:
A) Fasting glucose ≥100 mg/dL
B) Serum cholesterol ≥ 200 mg/dL
C) Triglyceride >150 mg/dl
D) Waist circumference ≥102 cm (40 in) in men

35. Root value for knee jerk is:
A) L3 –L4
B) L1-L2
C) L4-L5
D) D12-L1

36. A 40 years old man presents with a 3 days history of severe chest pain , sharp and tearing in nature , radiating to the back. Patient’s vitals are heart rate -95/min, respiratory rate – 20/min, temperature – 37°C , BP- 176/96 mm Hg , with a negative Trop-T: the most likely diagnosis is:
A) Acute Myocardial infarction
B) Aortic Dissection
C) Pulmonary embolism
D) Pneumonia

37. Antibiotic stewardship includes all of the following EXCEPT:
A) Preventing antibiotic misuse in hospital
B) Performing antibiotic cost analysis
C) Reducing C. difficle rates in hospital
D) Promote intravenous antibiotics over oral therapy

38. Treatment of choice for multiple myeloma is:
A) Bortezomib with Lenalidomide
B) Busulfan
C) Oral thalidomide
D) Oral steroids with bisphosphonates

39. Following is the first drug of choice for plasmodium falciparum in a PREGNANT lady:
A) Artemesin based therapy
B) Chloroquine alone
C) Quinine plus doxycycline
D) Clindamycin

40. A nursing student has just completed her hepatitis B vaccine series. On reviewing her laboratory studies (assuming she has no prior exposure to hepatitis B), you will find:
A) Positive test for hepatitis B surface antigen
B) Antibody against hepatitis B surface antigen (anti-HBs) alone
C) Antibody against hepatitis core antigen (anti-HBc)
D) Antibody against both surface and core antigen

41. Criteria for GESTATIONAL Hypertension include all EXCEPT:
A) New onset hypertension with SBP ≥ 140mmHg and/or diastolic BP ≥ 90mmHg
B) SBP ≥ 16OmmHg and/or diastolic BP ≥ 110mmHg
C) Seen at ≥20 weeks of gestation
D) Absence of proteinuria or new signs of end organ damage

42. H pylori is associated with all of the following EXCEPT:
A) Chronic atrophic gastritis
B) Gastric carcinoma
C) Gastric lymphoma
D) Inflammatory bowel disease

43. CD 55, 59 mutation is seen in:
A) PCV
B) ALL
C) CML
D) PNH

44. Which of the following is Ea feature of chronic liver failure:
A) Bleeding manifestations including petechiae
B) Bilateral arcus senilis
C) Palmar erythema
D) Loss of axillary and pubic hair

45. Which of the following is TRUE about Celiac disease EXCEPT:
A) Classic symptoms-include diarrhea, steatorrhea, weight loss and growth retardation
B) Endoscopic mucosal biopsy of the duodenum is standard method of confirmation.
C) Recommended test is IgA tissue transglutaminase (lgA tTG) antibody.
D) Usually not associated with other autoimmune diseases

46. According to WHO 2017 criteria, the hallmark of Polycythemia vera is:
A) Hematocrit > 59 % in females and > 60 % in males
B) Hematocrit > 48 % in females and > 49 % in males
C) Hematocrit > 50 % in females and > 50 % in males
D) Hematocrit > 39 % in females and >50 % in males

47. Severe Haemophilia A is characterized by Factor VIII activity:
A) < 5%
B) <1%
C) Between 1 to 5%
D) Between 6 to 10%

48. In Chronic myeloid leukemia, Philadelphia chromosome is results from translocation of:
A) Long arm of chromosome 9 to short arm of chromosome 22
B) Long arm of chromosome 9 to long arm of chromosome 22
C) Long arm of chromosome 22 to short arm of chromosome 9
D) Short arm of chromosome 22 to short arm of chromosome 9

49. Mycobacterium—avium complex prophylaxis in HIV is indicated at CD 4 count:
A) Less than 100
B) Less than 200
C) Less than 50
D) No relationship with CD 4 count

50. An 80-year-old male complains of a 3-day history of a painful rash extending over the left half of his forehead and down to his left eyelid. There are weeping vesicular lesions on physical examination. Which of the following is the most likely diagnosis?
A) Impetigo
B) Adult chickenpox
C) Zoster ophthalmicus
D) Herpes simplex

51. The treatment of severe dengue infection is monitored by-
A) Hemoglobin
B) Platelet count
C) Hematocrit
D) WBC count

52. A patient presents with symptoms of chronic diarrhoea, cough and sputum production. He is diagnosed to be suffering from both HIV and pulmonary tuberculosis. What medical management is to be started first-
A) Anti-Tuberculosis treatment
B) ART
C) ATT and ART both simultaneously
D) Sequence of beginning ART and ATT is not important

53. Radioactive iodine (RAI) uptake is increased in all except:
A) Graves disease
B) Iodine deficiency
C) toxic adenoma
D) Subacute thyroiditis

54. A 40 year old male has prominent jaw, thick soles and palms, enlarged hands and feet along with coarsened facial features, the best diagnostic test for this patient would be:
A) IGF
B) TSH
C) GH
D) 8 AM Serum Cortisol

55. A young patient of 25 years presents with sudden onset of flaccid quadriparesis of 3 days duration, Which electrolyte is important to be checked first:-
A) Magnesium
B) Calcium
C) Potassium
D) Sodium

56. Which statement is true about Guillain Barre (LGB) syndrome:
A) It is a predominantly a motor type of demyelinating polyneuropathy
B) Bowel and bladder are usually involved
C) Deep tendon reflexes are exaggerated
D) Intravenous methyl prednisolone is the treatment of choice

57. Modified end stage liver disease (MELD) score includes all except-
A) Prothrombin time
B) Bilirubin
C) Albumin
D) Creatinine

58. Tertiary hyperparathyroidism is-
A) Autonomous state due to monoclonal outgrowth of previously hyperplastic parathyroid gland
B) Increased sensitivity to serum calcium
C) Seen in patients with parathyroid adenoma
D) dependent on hypothalamic stimulus

59. A 45 year old man gets admitted with fever, pneumonia and erythematous rash with a black centre (Eschar) on abdomen; the most likely diagnosis is
A) Ebola virus disease
B) Scrub Typhus
C) Relapsing fever
D) Leptospirosis

60. Sub-acute combined degeneration of spinal cord (SACD) is caused by deficiency of-
A) Cynacobalamin
B) Pyridoxine
C) Thiamine
D) Folic acid

61. Hypercalcemia is a feature of all of the following except
A) Primary & tertiary Hyperparathyroidism
B) DiGeorge’s syndrome
C) Vitamin D intoxication
D) Lytic skeletal lesions

62. Significant difference of blood pressure in both upper limbs is found in all except:
A) Supravalvular aortic stenosis
B) PDA
C) Aortic dissection
D) Takayasu’s arteritis

63. Regarding dengue fever the following statements are correct except:
A) There is cross immunity amongst all the 4 serotypes
B) A maculopapular rash generally appears on the trunk on 3rd to 5th day
C) Infection by type 2 serotype following a type 1 serotype infection is a risk factor for severe disease
D) Thrombocytopenia and increased hematocrit are highly suggestive of dengue

64. Procalcitonin can be a helpful marker in the following;
A) Severe sepsis
B) ARDS
C) Dyselectrolytemia
D) Immune reconstitution inflammatory syndrome (IRIS)

65. Aztreonam has a similar spectrum of efficacy to:
A) Daptomycin
B) Linezolid
C) Amikacin
D) Quinupristin/Dalfopristin

66. Dumb rabies (paralytic rabies) is characterized by all of the following except:
A) Often misdiagnosed as Guillain Barre syndrome
B) Hydrophobia/aerophobia
C) LMN type of paralysis
D) is as fatal as encephalitic form

67. Mortality in severe Falciparum malaria is directly related to all except
A) Hypothermia
B) Uncontrolled seizures
C) High parasitic index
D) Elevated ammonia level in CSF

68. Allergic bronchopulmonary Aspergillosis is characterized by all of the following except:
A) Elevated Ig E levels
B) Eosinophilia
C) Proximal bronchiectasis
D) Intravenous Fluconazole is the treatment of choice

69. The causative organisms for HUS (hemolytic uremic syndrome) are
A) CI. Difficile & Cryptosporidium
B) E.Coli & Shigella
C) Cholera & E.Coli
D) Campylobacter & Shigella

70. Which of the following is not useful in the treatment of Scrub typhus
A) Azithromycin
B) Rifampicin
C) Quinolone
D) Doxycycline

71. A patient of rheumatoid arthritis presents with acute pain in the knee and calf. The most likely diagnosis is-
A) Venulitis of the leg veins
B) Ruptured baker’s cyst
C) Superinfection with Borrelia Burgdorferi
D) Associated Inclusion Body Myositis

72. HLA-B27 association is seen in all of the following except:
A) RA
B) Reactive arthritis
C) Psoriatic arthritis
D) Ulcerative colitis with extraintestinal involvement

73. Foster Kennedy syndrome is –
A) B/L optic atrophy
B) B/L papilledema
C) Ipsilateral optic atrophy and contralateral papilledema
D) None of the above

74. Acute hyperkalemia is associated with which of the following ECG changes:
A) Widening of QRS complex
B) Prolongation of the ST segment
C) A decrease in the PR segment
D) Elevation of PR segment

75. A patient presents with recurrent pain abdomen, CBC reveals pancytopema and flow cytometery shows deficient CD 59 & 55 population of RBC and granulocytes. The diagnosis is:
A) MDS
B) PNH
C) PSN deficiency
D) HUS (Hemolytic uremic syndrome)

76. A patient with H/o DVT develops sudden onset breathlessness. in order to rule out pulmonary embolism, the first screening investigation of choice would be-
A) Pulmonary angiography
B) CT angiography
C) Echocardiography
D) Plasma D-Dimer Assay

77. A 60 year old hypertensive patient presents with acute onset dizziness, difficult in swallowing, nasal regurgitation and nystagmus, the likely site of lesion is :
A) Thalamus
B) Lateral part of medulla
C) Motor Cortex
D) Posterior column of spinal cord

78. A 22 year old patient with a history of paroxysmal wheeze, epistaxis, numbness and weakness of both legs along with pulmonary infiltrates presents to you , the most likely diagnosis is:
A) Wegner’s Granulomatosis
B) Churg Strauss syndrome
C) Rheumatoid arthritis
D) Bronchial asthma

79. A 25 yr. old patient presents with scaling, seborrhea, erythematous rash, depression and paresthesias. The probable diagnosis is deficiency of:
A) Pantothenic acid
B) Flavonoids
C) Niacin
D) B5 deficiency

80. Diarrhoea, alopecia, muscle wasting. depression and rash over extremities and face are associated with –
A) Copper
B) Selenium
C) Chromium
D) Zinc

81. Which of the following mineral deficiency causes Cardiomyopathy
A) Selenium
B) Molybdenum
C) Zinc
D) Phosphorus

82. Metabolic syndrome is characterized by all of the following except:
A) Abdominal girth of 102cm in Male
B) Serum LDL >150 mg
C) Insulin resistance
D) Hypertension

83. Wemicke’s encephalopathy is characterized by:
A) Ophthalmoplegia, ataxia, confusion
B) Megaloblastic mania
C) 25% glucose is the preferred treatment
D) Occurs due to folate deficiency

84. Contra indications for the use of ACE Inhibitors include all of the following except:
A) Acute Renal failure.
B) Bilateral Renal artery stenosis
C) Pregnancy
D) Albuminuria

85. Following statements are true except:
A) HPV (human papilloma virus) vaccination can prevent cervical neoplasia
B) Hepatitis B vaccination is useful in prevention of HCC (hepatocellular carcinoma)
C) Incidence of stomach cancer is reduced by H. pylori eradication treatment
D) Use of NSAID’s reduces the risk of developing myocardial infarction

86. A 25 years old pregnant female develops thyrotoxicosis the most appropriate treatment would be:
A) β-blockers to control sympathetic activity
B) Methimazole
C) RAI ablation
D) Propylthiouracil

87. The treatment of choice in a patient of Acute MI with V. Tachycardia is
A) lV Amiodarone
B) IV Xylocaine
C) lV Procainamide
D) Electroversion With I00 J of energy

88. Heliotrope Rash is seen is
A) Still’s disease
B) Dermatomyositis
C) Lyme disease
D) Systemic lupus erythematosus

89. In Hepatobiliary disease a rise in Serum Alkaline Phosphatase is often associated with a parallel rise in :
A) Aldolase
B) Gamma GT
C) Leucocytic Alkaline Phosphatase
D) Vasoactive intestinal peptide

90. The most distinguishing feature of PSVT versus VT is the presence of:
A) Delta waves
B) Wide QRS tachycardia
C) Typical right bundle branch block
D) Capture beats

91. Heparin is indicated in all of the following except:
A) ST elevation MI
B) Non ST elevation MI
C) Pulmonary Thromboembolism
D) Pericarditis complicating Ml

92. Pulsus paradoxus is seen in all except-
A) Aortic stenosis
B) Acute severe asthma
C) Cardiac tamponade
D) Constrictive pericarditis

93. The risk of complications of HINI influenza is more in the following groups except
A) Children & elderly
B) COPD & Bronchial asthma patients
C) Patients on steroids & HIV infection
D) The risk is more or less equal in all age groups & depends on the virulence of the virus

94. Lhermitte‘s phenomenon is seen in-
A) Radiation myelopathy
B) Pseudobulbar palsy
C) Motor neuron disease
D) Pseudotumor cerebrii

95. In acute liver failure, following are poor prognostic factors except
A) Decreasing transaminases
B) Increasing bilirubin
C) Increasing Prothrombin time
D) ↑ Globulin levels

96. HINI Influenza is best diagnosed at community level by
A) Viral culture
B) RT-PCR assay on throat swab
C) Detecting Viral neutralizing antibodies
D) Western blot assay

97. Antibiotic associated colitis is caused by
A) E. Coli
B) Shigella
C) Campylobacter jejuni
D) Clostridium difficile

98. The following statement regarding Zika virus infection is true
A) Transmitted by the bite of Culex mosquito
B) Associated with bilateral pneumonia and ARDS
C) Belongs to Filovirus group
D) Congenital transmission leads to microcephaly

99. Choose the biomarker of bacterial sepsis from the following options
A) Trop-I
B) CRP & Procalcitonin
C) Galactomannan
D) CA 19-9

100. Serum marker indicating immune status after vaccination for Hepatitis B is
A) HBeAg
B) Anti HBc lgM
C) Anti HBs Ag
D) HBV DNA