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Combined Medical Services Exam Paper
General Medicine Paper
1.All the following drugs are known to cause pseudotumour cerebri except
(a) Gentamycin
(b) Tetracycline
(c) Vitamin A
(d) Oral contraceptive pills
2. A 35-year-old man presentswithdaily headache. He describes two attacks per day over the last 3 weeks. Each attack lasts about an hour and awakens him from sleep. The patient has noticed associated tearing and reddening of the right eye as well as nasal stuffiness. The pain is deep, excruciating, and limited to the right side of the head. The neurological examination is normal. What is
the most likely diagnosis ?
(a) Migraine headache
(b) Tension headache
(c) Cluster headache
(d) Brain tumour
3. In which of the following conditions is cardiac involvement not a usual feature ?
(a) Facio-scapulo-humeral dystrophy
(b) Duchenne's muscular dystrophy
(c) Friedreich's ataxia
(d) Myotonic dystrophy
4. Drugs associated with ischemic stroke include the following except :
(a) Cocaine
(b) Oral contraceptives
(c) Amphetamines
(d) Barbiturates
5. Which one- of the following laboratory tests differentiates leukernoid reaction from chronic myeloid leukemia ?
(a) LAP (Leukocyte alkaline phosphatase)
(b) LCA (Leukocyte common antigen)
(c) MPO (Myelo peroxidase)
(d) TRAP (Tartrate resistant alkaline phosphatase)
6. The first-line drug therapy in chronic myeloid leukemia is
(a) Hydroxycarbamide
(b) Alpha interferon
(c) Busulphan
(d) Imatinib
7. Which one of the following is not consistent with the diagnosis of aplastic anemia ?
(a) Hematopoietic cells occupying <25% of marrow space
(b) Hematopoietic cells morphology should be normal
(c) Normocytic normochromic anemia
(d) Splenomegaly
8. The agent of choice for controlling heparin induced bleeding is
(a) Protamine sulphate
(b) Injectable Vitamin K
(c) Whole blood
(d) Fresh frozen plasma
9. Thrombocytosis may be seen in the following conditions except :
(a) Idiopathic myelofibrosis
(b) Chronic myeloid leukemia
(c) Essential thrombocythemia
(d) Hypersplenism
10. Which one of the following disorders is not associated with Carpal Tunnel Syndrome ?
(a) Diabetes mellitus
(b) Hypothyroidism
(c) Acromegaly
(d) Addison's disease
11. A diabetic patient in hypoglycemia does not regain consciousness despite blood glucose restoration to normal. Which one of the following is the most likely condition or explanation ?
(a) Cerebral edema
(b) Alcohol intoxication
(c) Post-ictal state
(d) Cerebral haemorrhage
12. Which one of the following is the most appropriate treatment of hyperthyroidism due to subacute lymphocytic thyroiditis ?
(a) Propylthiouracil
(b) Radioactive iodine ablation
(c) Subtotal thyroidectomy
(d) Beta blockers
13. The following are consistent with pheochromocytoma except :
(a) Episodic diarrhea
(b) Episodic flushing of skin
(c) Episodes of hypertension
(d) Paroxysm, palpitation and sweating
14. Most specific diagnostic finding in gout is
(a) Uric acid crystals in urine
(b) Raised serum uric acid
(c) Presence of calcium pyrophosphate crystals in synovial fluid
(d) Presence of monosodium crystals in synovial fluid
15. Increased anion gap is found in the following disorders except
(a) Diabetic ketoacidosis
(b) Starvation ketosis
(c) Renal tubular acidosis
(d) Lactic acidosis
16. The following features are correct in the case of Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH) except :
(a) Low-normal plasma urea
(b) Low serum sodium
(c) High plasma osmolality
(d) Urinary sodium not minimally low
17. Regarding measles, which one of the following statements is not correct ?
(a) It is caused by paramyxo virus infection
(b) Rash is usually vesicular
(c) Infection spreads by droplets
(d) Incubation period is 14 days
18. Secondary syphilis is characterized by the 'following except
(a) Occurs 6 - 8 weeks after development of chancre
(b) Painful and itchy maculo-papular lesions
(c) Constitutional features are present
(d) Meningitis, hepatitis, glomerulonephritis and uveitis may occur
19. Which maturation stage of RBCs is infected by Plasmodium falciparum ?
(a) Reticulocyte stage only
(b) Normoblast stage
(c) Old RBC
(d) RBC of all ages
20. Giardiasis is characterized by the following except
(a) Abdominal discomfort and bloating
(b) 'Acute or chronic diarrhea
(c) Duodenum and jejunum are the. prime sites of involvement
(d) Giardia cysts are resistant to heat and desiccation
21. Sulphasalazine is not used for the treatment of
(a) Crohn's disease
(b) Rheumatoid arthritis
(c) Sarcoi dosis
(d) Ulcerative colitis
22. Imipenem is co-administered with cilastin because
(a) Cilastin aids the gastrointestinal absorption of the active moiety;imipenem
(b) Cilastin inhibits J3-lactamase that destroys imipenem
(c) Cilastin inhibits an enzyme in the kidney that destroys imipenem
(d) Cilastin prevents the hypoprothrombotic effect of imipenem
23. What is the drug of choice for CMV (Cytomegalovirus) Retinitis in patients with AIDS ?
(a) Acyclovir
(b) Gancyclovir
(c) Pentamidine
(d) Co-trimoxazole
24. A patient with HIV disease presents with fever, malaise and headache of acute onset. CSF examination reveals 20 cells with 80% lymphocytes, protein 100 mg/dl, sugar 35 mg/dl, and a positive India ink preparation. CT head is normal. What is the most appropriate therapy in this patient ?
(a) Amphotericin-B
(b) Amoxycillin
(c) Acyclovir
(d) Anti-tubercular drugs
25. In an immuno-compromised patient with local gamma like tumors and granulomatous lesions of lungs, bones, brain and meninges, the most likely diagnosis is
(a) Tuberculosis
(b) Leprosy
(c) Sarcoidosis
(d) Cryptococcosis.
26. Which one of the following is not a fungal infection ?
(a) Chromomycosis
(b) Pheohyphomycosis
(c) Actinomycosis
(d) Blastomycosis
27. Pyridoxine hypervitaminosis causes
(a) Polyneuropathy
(b) Hypercalcemia
(c) Liver damage
(d) Renal failure
28. With regard to vitiligo, which one of the following is not correct ?
(a) Generalized vitiligo is often symmetrical
(b) Trauma and sunburn may precipitate vitiligo
(c) It is a congenital condition
(d) Focal areas of melanocyte loss are observed
29. The following diseases are characterized by bullous eruptions except :
(a) Porphyria cutanea tarda
(b) Variegate porphyria
(c) Dermatitis herpetiformis
(d) Lichen planes
30. Which one of the following features differentiates ' lepromatous leprosy from tuberculoid leprosy ?
(a) Absence of infectivity of affected patients
(b) Organisms are scanty in number
(c) Blood-borne spread from the dermis throughout the body
(d) Anaesthetic hypopigmented. skin macules and plaques
31. Recurrent painful orogenital ulcers with arthritis is most likely due to
(a) Gonorrhea
(b) Syphilis
(c) Reiter's syndrome
(d) Behcet's syndrome
32. Which one of the following is a characteristic feature of drug induced lupus ?
(a) Antihistone antibodies
(b) Anti Ro antibodies
(c) Anti La antibodies
(d) Anti ds DNA antibodies
33. What is the most common histological type of nephritis seen in systemic lupus erythematosis (SLE) ?
(a) Mesangial
(b) Focal proliferative
(c) Diffuse proliferative
(d) Membranous
34. The following modes of therapy may be useful for treatment of obsessive compulsive disorder except :
(a) Fluoxetine
(b) Clomipramine
(c) Behaviour therapy
(d) Electroconvulsive therapy
35. Which one of the following conditions is not correct in case of bulimia nervosa ?
(a) Recurrent bouts of binge eating
(b) Lack of self-control over eating during binges
(c) Self-induced vomiting or dieting after binge
(d) Weight gain
