Internal medicine

1) Features of hypoglycaemia do not include:

4) Earliest changes observed by ophthalmoscope in background retinopathy of diabetes is:

5) Which of the following is not a part of metabolic 'syndrome X'?

7) All are features of diabetic ketoacidosis except:

15) Myxoedema coma is characterized by:

16) All of the following represent examples of hypothalamic-pituitary negative feedback except:

19) Which of the following is the most potent stimulus for hypothalamic production of arginine vasopressin?

23) Secondary hypothyroidism is not featured by:

25) All of the following would be expected to increase prolactin levels except:

30) Which of the following lung cancers is most commonly associated with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH)?

31) Cushing's syndrome does not give rise to:

32) Which of the following proteins is the primary source of bound T4 in the plasma?

34) Which cranial nerve is not involved in acromegaly?

35) All of the following are associated with increased levels of total T4 in the plasma with a normal free T4 except:

37) Sheehan's syndrome presents with:

40) Hypocalcemia is produced by all except:

41) Gynaecomastia may be produced after treatment with all except:

A 47-year-old woman is referred to the endocrine clinic complaining of a two month history of tiredness. Despite wearing several items of clothing, the patient appears intolerant to the room temperature. She has noticed an increase in weight, particularly around her waist. The most appropriate investigation is:

Vasopressin secretion is stimulated at what levels of plasma osmolality?

Which of the followings distinguishes secondary toxic goiter from Grave’s disease ?

A 68-year-old woman is noted to have Graves disease, and has a small goiter. Which of the following is the best therapy?

One of the following statements is incorrect regarding endocrine glands

A 13-year-old girl presents to accident and emergency with severe abdominal pain, nausea and vomiting. On examination, the patient is tachypneic, and she has a dry tongue. While listening to the patient’s lungs, you detect a sweet odor from her breath. The most likely diagnosis is:

One of the following statements is incorrect regarding blood glucose levels:

Patients with diabetes insipidus and inability to concentrate their urine usually present with what manifestations?

A 29-year-old woman is found unconscious by her brother and rushed to accident and emergency. She is a type 1 diabetic and has maintained excellent glucose control using insulin injections. Blood biochemistry results demonstrate normal insulin level of insulin, no detectable C-peptide and very low blood glucose. Her brother mentions she is a lawyer and has been working particularly hard in the last week, eating quick meals and occasionally missing meals. The most likely diagnosis is:

Which of the following is the most important first step in the treatment of diabetic ketoacidosis?

44) Which of the following is not associated with hypothyroidism?

45) Tetany is characterized by all of the following signs except:

47) Hyperparathyroidism is not featured by:

48) Phaeochromocytoma is not associated with:

50) Features of Addison's disease do not include:

53) Which of the following is the most important mechanism of action of propylthiouracil in the treatment of Graves’ disease?

54) Commonest cause of Addison's disease is:

56) Secondary hyperaldosteronism is associated with all except:

59) All of the following are actions of parathyroid hormone except

61) The triad of hyponatraemia, haemodilution and urine hypertonic to plasma suggest diagnosis of:

62) Which is not a part of multiple endocrine neoplasia type I ?

65) Which of the following is the most common sign of Cushing’s syndrome?

69) Commonest enzymatic defect for development of congenital adrenal hyperplasia is:

6. The earliest finding of iron deficiency anemia is:

8. A patient present with increased serum iron, decreased TIBC, increased percentage saturation and increased S. ferritin. Most likely diagnosis is:

12. Commonest cause of jaundice in thalassaemia is:

20. Extravascular hemolysis is best characterized by all except:

23. Direct Coomb’s test may be positive in:

25. Hemoglobinuria is not seen in:

29. In a patient with haemolytic anaemia, which of the following findings would be most suggestive of intravascular haemolysis?

39. Which one of the following clotting factors does notrequire vitamin K for its activation?

41. In a patient presenting with a bleeding disorder, which of the following clinical features would be most suggestive of a coagulation defect as opposed to a platelet disorder?

42. All of the following statements regarding haemophilia A are correct except one. Which is the exception?

43. Which one of the following statements regarding disseminated intravascular coagulation (DIC) is false?

50. Which of the following drug does not cause thrombocytopenia?

53. Bleeding in DIC is due to:

55. Most common cause of thrombocytopenia in children is:

57. Which of the following is not a first line therapy in ITP?

60. A 25 years old girl is brought to the emergency department in the state of altered sensorium with high grade fever. Investigation revealed anemia, thrombocytopenia with fragmented red cells on peripheral blood smear examination. CT•brain is normal and a serum creatinine is 3.0 mg/dl. PT/APTT/TT are normal. Which of the following is the most effective treatment?

The mean cell volume of the patient is 90 fl and the reticulocyte production index is low. Which of the following is the most possible cause of anemia in this patient ?

A patient shows prolonged prothrombin time and activated partial thromboplastin time. Blood test otherwise is normal. Which of the following is the most probably diagnosis for this patient’s condition ?

A patient is presented with pallor, fatigue and dyspnea. Physical examination shows koilonychias and angular cheilosis. Which of the following is not expected in the laboratory finding of this patient ?

Mr XY was found to be anaemia. During history taking, he informed his doctor that he was a strict vegetarian who did not consume any meat, fish of milk products.

23. Koilonychias is a specific features of

After seven days of treatment with sulfonamides a patient’s haemoglobin had decreased from 14.7 gm/100ml to 10gm/100ml. The most likely cause of hemolysis in this patient is

Spherocytosis is a common cause of inherited haemolytic anaemia. The most likely cause for spherocytosis is

Oral iron supplements are given for iron deficiency aneamia. Which of the statement is true regarding the absorption of oral iron supplements?

A 28-year-old woman complains of excessive bleeding from her gums and has petechiae. Here CBC shows a platelet count of 22,000/mm3 with a hemoglobin of 8.9 g/dL and a WBC count of 87,000/mm3. » Which of the following is the most likely diagnosis?

Autoantibodies specific for the following antigen are specific for SLE:

41. Psoriasis is characterized by except :

44. Urticarial wheals characteristically:

36. Histologically, lesions of psoriasis vulgaris may demonstrate all of the following except:

26. Favus infection is caused by: **e

28. A boy -6-year-old- presented with a boggy swelling covered with crust on his scalp. 3 months later healing occurs with scar and subsequently cicatricial alopecia. Your diagnosis is:

19. The following statements are true regarding herpes zoster except:

He treatment of choice of multiple plane warts on the face of a 6 year old child is:

24. A 6 year old child presented with multiple shiny white papules on the trunk and extremities, showing central umbilication, the most probable diagnosis is:

25. The primary lesion of molluscum contagiosum is:

15. Lepromatous leprosy is characterized by:

16. All are diagnostic features of tuberculoid leprosy, except:

12. Impetigo contagiosum is caused by:

. Ecthyma is:

7. Sebaceous glands are not present in:

4. Melanocytes are present among the keratinocytes of:

1- Delusion is a disorder of

2- Which of the following is not a symptom of depression?

4- Extrapyramidal symptoms are most commonly caused by which of the following classes of drugs?

6- Which of the following substances cannot cause addiction?

8- The main neurotransmitter affected in schezopherenia is

9- All are seen in mania except.

6) The temperature & pin sense loss usually develops with disease in:

17) Hemiplegia, hemianesthesia & hemianopia develop together with disease in the:

20) Regarding acute transverse myelitis, which is false?

23) The presence of ptosis suggests damage to cranial nerve:

24) The presence of dysphagia suggests damage to cranial nerves:

25) The presence of dysarthria suggests damage to cranial nerve:

28) The damage to IX, X & XII cranial nerves produce:

11. Complement C3 is characteristically low in all except:

25. Which of the following biochemical abnormalities in venous blood is least-likely to be present in a patient with untreated chronic renal failure?

27. In patients with hypertension and proteinuria, which of the following classes of drug has been shown to be most effective in retarding the progression of chronic renal failure?

36.A 25-year-old man has a renal biopsy due to worsening renal function. This reveals linear IgG deposits along the basement membrane. What is the most likely diagnosis?

1. Reactive arthritis is associated with which one of the following HLA antigens?

9. A 56-year-old lady is referred to rheumatology clinic due to severe Raynaud's phenomenon associated with arthralgia of the fingers. On examination you note shiny and tight skin of the fingers with a number of telangiectasia on the upper torso and face. She is also currently awaiting a gastroscopy to investigate heartburn. Which one of the following antibodies is most specific for the underlying condition?