EMERGENCY MEDICINE
1 Patient p/c aspirin overdose .which of the following is most likely to suspect salicylate poisoning
A HCO3 28
B PH 7.35
C PCO2 25
D Lactate 4
E BE -5
2 FVC/FEV <80, Increased CO transfer factor seen in
A COPD
B Atelectasis
C Pulmonary hemorrhage
D Interstitial pneumonia
E Pulmonary edema
3 Patient with addiction to morphine .recognized feature is
A meiosis
B Euphoria
C constipation
D increased sweating
E
4 In BLS , O2 % OF each breath deliver to patient
A 13.7
B 14.8
C 15.4
D 16.0
E 20.0
5 Increased GFR,efferent vasoconstriction afferent vasodilatation ,reduced Na reabsorption
a
Angiotensinogen 11
b Aldosterone
c
Acetylcholine
D ANP
E
ADH
6 Ca absorption from gut manly due to action of
a Calcitonin
b Calcitriol
c PTH
d thyroxine
e insulin
7 During insertion of central venous line, needle accidentally enter into lateral side. Most likely structure
getting risk of damage is
A vagus nerve
B sympathetic trunk
C phrenic nerve
D carotid artery
E deep cervical lymph node
8 what is the best way of explanation for Combination of carvedilol, captopril, with spironolactone for
chronic heart failure
A reduce sympathetic drive to heart
B reduce afterload
C
D
E
9 when measuring plasma level of x hormone, following observations made. 42 year of women suffering
fever plasma [x] increased when her puffy died plasma[x] increased again. Fasting plasma[x] slightly
increased, 2hour later of breakfast reduced plasma level of [x]. x most likely be
A norepinephrine
B thyroxine
C Growth hormone
D melatonin
E cortisol
10 Inversion of foot mainly from
A tibialis anterior
B tibialis posterior
C external halluces longus
D peroneus longus
E peroneus tertius
11 which of the following cause cutaneous and pulmonary vasodilatation with increased gastric acidity
A Histamine
B Ach
C Noradrenaline
D Serotonin
E encephalin
12 Acclimation in 5 days, body response is
A increased erythropoietin
B increased 2.3 BPG
C Pulmonary capillary pressure
D respiratory alkalosis
13 one microne nebulized particles produced by
A gas driven nebulizer
B ultrasonic nebulizer
C
D
E
14 Order of stricter medial to lateral
A infratemporal fossa, pterygopalatine fossa, sphenopalatine fossa, nasal cavity
B sphenopalatine fossa,pterygopalatine fossa,infratemporal fossa,nasal cavity
C pterygopalatine fossa ,infratemporal fossa,sphenopalatine fossa,nasal cavity
D infratemporal fossa, pterygopalatine fossa,nasal cavity,sphenopalatine fossa
E
15 Retroperitoneal infection spread by
A pancreaticodudenal artery
B ileocolic artery
C sigmoidal artery
D inferior mesenteric artery
E Inferior rectal vein
16 fluid collection of abdomen ,most possible site
A RIF
B LIF
C hepatorenal pouch
D paracolicgutter
E behind bladder
17 following observation were made for pupillary light reflex
R-Eye-direct and consensual reflex-Both react
L-Eye- direct and consensual reflex-no reaction
Site of lesion
A L/S Oculomotor N
B R/S Oculomotor N
C L/S Retinal detachment
D L/S Opthalmic N
E pons of brain stem
18 Highest airway resistant in
A trachea
B main bronchi
C medium sized bronchi
D respiratory bronchiole
E
19 Needle accidentally inserted toward laterally when trying to insert central venous catheter to right
IJV,Possible nerve get damaged is
A Vagus N
B Phrenic N
C Sympathetic trunk
D Greter auricular N
E Accessory N
20 After injury femur move forward over tibia, likely damaged structure is
A ACL
B PCL
C Medial collateral ligament
D lateral collateral ligament
E patella
21 unit of radioactivity
A candela
B becquerel
C pared
D curay
E ampere
22case hx of L/Lower limb injury .presented with claw toe, possible site of nerve compression.?
A anterior compartment of the leg
B superficial posterior compartment of leg
C deep posterior compartment of leg
E fibular fracture
F flexor retinaculum at ankle
23 bruising colour change from golden yellow to dark brown is due to
A hemosidrine
B bilirubin
C haemoglobin
D myoglobin
E albumin
24 Anaphylactic reaction to IM injection MO decided to give IM ADRENALIN to buttock, most suitable
Site is
A anterolateral aspect of thigh
B anteromedial aspect of thigh
C lateral to greater trochanter
D
E
25 Injury to membranous urethra ,urine extravasation in to
A fascia lata
B scrotum
C superficial perineal pouch
D deep perineal pouch
E
26 patient with left sided weakness ,CT brain showed dark opacified lesion of the right side ,most likely
pathology is
A coagulative necrosis
B liquefactive necrosis
C fat necrosis
D abscess
E tumor
27 lump in left lower limb, was painful and red ,surgical debridment done,removed yellow material
Possibility is
A pus collection
B fat necrosis
C coagulative necrosis
D liquefactive necrosis
E neoplasm
28 left atrial preload best assessed by
A trans esophageal echo
B PCWP
C
D
E
29 SPO2 remain 85% despite high flow oxygen, probable reason is
A car boxy hemoglobin
B met hemoglobin
C anemia
D CNE
30 R/S genioglossus weakness, manifest as
A tongue move to right
B tongue move to left
C tongue cannot protruded
D atrophy of tongue
E
31 case hx of blood mucus diarrhea .tea color urine .low hemoglobin, urine bilirubin and increased s
bilirubin.most useful investigation to see pathology
A FBC
B LDH
C Blood picture
D retic count
E USS
32 Carbimazole required weeks before the pt euthyroid, reason is
A long t1/2 of thyroxine
B rapid metabolism of carbimazole
C stored thyroxine
D receptor down regulation
E
33 inversed agonist
A submaximal effect compared with full agonist
B effect opposite to that of the endogenous agonist
C reduced the effect of full agonist
E high affinity for receptor
D no effect on rece
34 IM Adrenalin given for anaphylaxis, best explanation regarding that
A potent vasoconstrictor effect
B physiological antagonism
C positive chronotropic effect
D rapid acting
E bronchodilator effect
34 Methyl dopa used in pregnancy.reason is
A centrally acting drug
B considering risk benefit ratio
C does not cross placenta
D smooth antihypertensive profile
E
35 In appendicitis most possible reason to get pain is
A edema of the appendix
B due to chemical mediator
C ischemia
D congestion
E
36 Drugs A& B , A 50 mg equal to B 100mg effect
A A is more potent than B
B B is more potent than A
C A has more efficacy than B
D B has more efficacy than B
37 A 76 year old bed bound pt ,Na 151, Bu 96 mg/dl ,S Cr 1.1 mg/dl,progressively deteriorate over last 3
days ,Bp 85/60.PR 110.Posible explanation is
A sepsis
B Dehydration
C acute renal failure
D meningoencepalitis
E high protein intake
38 which of the following hormone involve calcium metabolism
A PTH
B Calcitriol
C calcitonin
D cortisol
E melatonin
39 quantitavly most abundun buffer in the body is
A alanine
B HCO3
C NH4
D COHb
E citrate
40 tachyphylaxis of Nitrate expalain by
A receptor down regulation
B depletion of –SH group
C metabolite to nitrite
D rapid hepatic metabolism
E
41 structure pierce during lumbar puncture
A posterior longitudinal ligament
B ligamentum flavum
C anterior longitudinal ligament
D erector spine muscle
E
42 IN DKA Kussmal breathing explain as
A deep regular breathing
B shallow regular breathing
C shallow rapid breathing
D deep irregular breathing
E paradoxical breathing
43 Infection of lymph scrotum,enlarged lymph node seen in
A para aortic
B deep inguinal
C superficial inguinal
D external iliac
E inernal iliac
44 damaged to membranous urethra ,urine extravasation into
A superficial perineal pouch
B deep perineal pouch
C scrotum
D fascia lata
E peritoneum
45 patient with stroke experience swallowing difficulty most likelyaffected cranial nerve is
A accessory
B vagus
C facial
D glossopharyngeal
E hypoglossal
46 heparin is started with warfarin therapy ,reason is
A need augmentation
B warfarin take few days to act
C rapid metabolism of warfarin
D T1/2 IS short in heparin
E
47 wright spirometer used to measure
A vital capacity
B peak flow rate
C vane anomet
D FRC
48 patent with B/L femur # and hypotension,best possible site for venous cut down is
A greater saphenous
B cephalic
C basilic
D superficial epigastric
E median cubital
49 in the case of arrthmia drug x was given as bolus then infusion. Reason to give loading dose
A high clearance
B high lipid solubility
C high volume of distribution
D
50 deprivation of water for 2 hour, urine and plasma osmolality are
51 ADR definition
52 action of glucocorticoid receptor
53 q wrist drop
54 O2 content
55 radiation q
56 RCT objective of randomization