Year 5 Medicine End-Of-Year sample MCQs


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MEDICINE YEAR 5 END OF YEAR MCQ (2000/2001)
(Courtesy of Lee Jan Hau and friends)

1. The following drugs causes hirsutism except
A. Minocycline
B. Phenytoin

2. The following are causes of proteinuria of more than 2g/day except
A. diabetic nephropathy
B. postural proteinuria
C. renal vein trombosis

3. The following is the LEAST likely area in adult scabies
A. the neck
B. the waist
C. the male genitalia
D. the finger web spaces
E. the anterior axillary space

4. Neuropathic ulcers in the foot can be due to the following except
A. Subacute degeneration of the cord
B. Syringomyelia
C. Diabetes
D. Peripheral vascular disease

5. Idiopathic thrombocytopenic purpura is:
A. uncommon under age of 40 years old
B. usually associated with a palpable spleen
C. not usually influenced by treatment of corticosteroids
D. associated with a reduction of megakaryocytes in the bone marrow
E. accompanied by a prolonged bleeding time

6. The MOST appropriate initial management of febrile neutropenia in a patient
 on cytotoxic chemotherapy should be:
A. observe for spontaneous recovery of white cell count
B. leukocyte tranfusion
C. carry out cultures of blood and urine and wait for results before commencing specific antibiotics
D. immediate empirical antibiotics after obtaining specimens for culture
E. administration of growth factors

7. Warfarin may interact in clinically important ways with all the following EXCEPT
A. alcohol
B. co-trimoxazole
C. oestrogen-progestogen contraceptive pills
D. phenobarbitone
E. frusemide

8. In a patient with spinal cord compression caused by metastases,
 the immediate management should be:
A. decompression lamniectomy
B. high dose dexamethasone
C. radiotherapy
D. chemotherapy
E. observation for spontaneous recovery

9. The MOST common causative organism in nosocomial pneumonia is:
A. gram negative aerobic rods
B. gram positive rods
C. gram positive cocci
D. Legionella pneumophilia
E. Mycobacterium tuberculosis

10. The following features concerning Addison's disease in women are correct EXCEPT:
A. postural hypotension
B. hyponatraemia
C. increased pigmentation of the areolae areolae
D. hypoglycaemia
E. hypokalaemia

11. An attack of periodic paralysis in thyrotoxicosis may be preceded by:
A. excess carbohydrate intake
B. excessive carbimazole dosage
C. propranolol
D. prolonged inactivity
E. alcohol

12. Hyperkalaemia may occur in all of following EXCEPT
A. Addison's disease
B. Cushing's disease
C. Chronic renal failure
D. Use of spironolactone
E. Acidosis

13. In a patient with diarrhoea, the featur which suggests a small bowel rather than
 a large bowel cause is:
A. fresh blood mixed with stools
B. fresh blood separate from the stools
C. positive occult blood
D. stool volume > 2 litres/day
E. mucus

14. The following are true of hepatitis A infection EXCEPT:
A. it may have a cholestatic phase
B. it may present as an influenza-like illness
C. about 10% of patients with acute hepatitis A infection become carries
D. seldom causes fulminant hepatitis
E. IgM anti-HAV titre is used for the serological diagnosis of acute hepatitis A infection

15. The drugs used in the management of atrial fibrillation are EXCEPT:
A. digoxin
B. poropanolo
C. lignociane
D. direct cardioversion
E. quinine

16. The management of symptomatic heart block after an acute myocardial infraction is:
A. digitalization
B. external cardiac massage
C. electrical pacing
D. intravenous adrenaline

17. Pneumocystis carinni pneumonia can be diagnosed by EXCEPT:
A. open biopsy
B. sputum culture
C. endotracheal brushing
D. complement fixation test
E. immuofluorescene antibody testing

18. The following causes opportunistic diarrhoea in AIDS EXCEPT:
A. Candida albicans
B. Salmonella enteriditis
C. Crytosporidium
D. Isospora belli

19. The following cast is found in the normal urine:
A. hyaline
B. red blood cell
C. white blood cell
D. fatty
E. granular

20. Multifocal atrial tachycardia is seen in
A. thyrotoxicosis
B. COPD
C. AMI
D. Pericarditis

21. The prothrombin time is normal in
A. von Willebrand disease
B. Warfarin ingestion

22. The management of chloroquine-resistant malaria includes the following EXCEPT:
A. dapsone
B. mefloquine
C. quinine
D. pyrimethaime
E. Al quine (?)

23. The following drugs should not be given intrathecally:
A. methotrexate
B. vincristine
C. cytarabine
D. benzylpenicillin
E. amphotericin B

24. Spntaneous bacterial peritonitis is especially common in
A. Hepatitis B
B. Hepatitis C
C. Alcholic liver disases
D. Wilson disease
E. Chronic active hepatitis

25. Digitalis toxicity is aggravated by:
A. Potassium
B. Lignocane
C. Calcium
D. Propranolol

26. Rapid bolus of frusemide 120mg results in the following side effect:
A. Heart failure
B. Acute renal failure
C. Deafness

27. Iron therapy is indicated in the following except in:
A. thalassaemia minor
B. chronic iron deficiency anaemia
C. chronic intestinal malabsorption 
D. bleeding GIT
E. pregnancy-induced anaemia

28. Whole blood should NOT be given in the following patient:
A. Multiple trauma
B. Bleeding GIT
C. Disseminated Intravascular Coagulation
D. Chronic iron deficiency

29. The following is correct management in severe asthma except
A. inhaled beclomethasone
B. nebulised terbutaline
C. inhaled oxygen
D. intravenous hydrocortisone
E. intravenous theophylline

30. The patiet has a past history of complex generalize epilepsy and has neutropenia.
 Which of the following drug is most likely to be the cause?
A. Carbamazepine
B. Sodium Valproate
C. Clonazepam

31. The following are symptoms of organophosphate poisoning except:
A. fasciculations
B. miosis
C. anhidrosis
D. increased salivation
E. bronchospasm

32. Systemic corticosteroid is indicated in the following:
A. PAN
B. Ankylosing  Spondylitis
C. Osteoarthrosis
D. Gout
E. Pseudogout

33. Treatment of acute gouty arthritis is:
A. colchine
B. aspirin
C. probenecid
D. allopurinol

34. Salmonella infection. The most likely duration when fecal culture will be positive.
A. 1st 24 hours
B. 1st 3 days
C. 1st week
D. 2nd week
E. 3rd  - 5th week

35. Hyponatraemia is found in the follosing EXCEPT
A. small cell carcinoma
B. meningitis
C. hypocortisolism
D. thyrotoxicosis
E. hypopituitarism

36. A 60-year old man presents with orthopnoea, blood prssure of 220/140 mmHg,
 basal crepitations and bilateral oedema. Which is the correct management?
A. i/v frusemide, oral digoxin, oral ISDN
B. i/v frusemid, oral digoxin and i/v nitroprusside
C. i/v frusemide, i.m digoxin, oral propranolol
D. i/v diazozide, oral methyldopa
E. i/v frusemide, oral propranolol, oral digoxin and i/v hydralazine

37. In chronic renal failure which was long-standing, the biochemical changes include:
A. increased Ca, decreased phosphate
B. increased Ca, increase phosphate
C. decreased Ca, decrease phosphate
D. increase Ca, normal phosphate
E. decreased Ca, increase phosphate

38. In diabetic nephropathy resulting in CRF with Hb of 9 g/dL and creatinine clearance
 of 30 ml/min, which of the following is contraindicated?
A. BP control
B. Captopril
C. Glucose control
D. Moderate diet protein restriction
E. Erythropoietin for anaemia

39. In acute liver failure, the following is correct management.
A. benefit from neomycin
B. stomach washout
C. high protein diet
D. high dose diuretics

40. In patient with low BP, pulsus paradoxus and ascites, the most likely diagnosis is
A. constrictive pericarditis
B. liver cirrhosis
C. portal vein thrombosis
D. cor pulmonale

41. A patient with past history of rheumatic fever 10 years ago has fever and increased ESR.
 Which of the following clues support diagnosis of infective endocarditis EXCEPT.
A. acute onset of clubbing
B. painful nodules on hands
C. microscopic haematuria
D. erythema nodosum
E. leucocytosis

42. A 45-year old sailor had fever and jaundice for 2 weeks with tender hepatomegaly and
 injected conjuctiva. Which of the following should be performed?
A. serology
B. liver biopsy
C. white blood count
D. blood culture
E. ultrasound liver and gallbladder

43. The following is the management of status asthmaticus EXCEPT:
A. 40 % oxygen if pCO2 raised
B. intravenous aminophylline

44. The following condition causes increase pCo2 and decrease pO2 except:
A. severe asthma
B. COPD
C. Myasthenic crisis
D. Pickwickian syndrome
E. Eisenmenger syndrome

45. Hypoperfusion is manifested by the following EXCEPT:
A. respiratory acidosis
B. hypoxemia
C. oliguria
D. decreased mental function
E. lactic acidosis


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