1. Which of the following is the most common cause of community-acquired pneumonia?
(A) Mycoplasma pneumoniae
(B) Streptococcus pneumoniae
(C) Haemophilus influenzae
(D) Legionella pneumophila
2. The hallmark clinical feature of myocardial infarction is:
(A) Sudden abdominal pain
(B) Central chest pain radiating to left arm
(C) Sudden headache
(D) Back stiffness
3. Which electrolyte abnormality is commonly seen in Addison’s disease?
(A) Hypernatremia
(B) Hyponatremia
(C) Hypercalcemia
(D) Hypokalemia
4. Which of the following is the most common cause of peptic ulcer disease?
(A) Alcohol
(B) Helicobacter pylori infection
(C) Stress
(D) Spicy food
5. Which valve is most commonly affected in rheumatic heart disease?
(A) Aortic valve
(B) Mitral valve
(C) Tricuspid valve
(D) Pulmonary valve
6. Which drug is considered first-line therapy in chronic stable angina?
(A) Nitrates
(B) Beta-blockers
(C) Calcium channel blockers
(D) ACE inhibitors
7. The “butterfly rash” is characteristic of:
(A) Rheumatoid arthritis
(B) Systemic lupus erythematosus
(C) Dermatomyositis
(D) Psoriasis
8. Which test is most specific for diagnosis of myocardial infarction?
(A) CK-MB
(B) Troponin I/T
(C) Myoglobin
(D) ECG only
9. Which is the most common cause of chronic liver disease worldwide?
(A) Alcohol
(B) Viral hepatitis
(C) Non-alcoholic fatty liver disease
(D) Autoimmune hepatitis
10. The “classic triad” of diabetes mellitus includes:
(A) Polyuria, polydipsia, polyphagia
(B) Weight gain, polyuria, rash
(C) Fatigue, nausea, vomiting
(D) Tremor, sweating, hunger
11. Which antihypertensive drug is contraindicated in pregnancy?
(A) Methyldopa
(B) Labetalol
(C) ACE inhibitors
(D) Hydralazine
12. The most common cause of acute pancreatitis is:
(A) Hypercalcemia
(B) Alcohol abuse
(C) Gallstones
(D) Hyperlipidemia
13. The most common arrhythmia seen in thyrotoxicosis is:
(A) Atrial fibrillation
(B) Ventricular tachycardia
(C) Sinus bradycardia
(D) AV block
14. Which vitamin deficiency causes night blindness?
(A) Vitamin A
(B) Vitamin D
(C) Vitamin K
(D) Vitamin E
15. A “barrel-shaped chest” is commonly seen in:
(A) Asthma
(B) COPD (emphysema)
(C) Pulmonary fibrosis
(D) Tuberculosis
16. Which of the following is a diagnostic feature of nephrotic syndrome?
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3.5 g/day” onclick=”checkAnswer(‘q16’, ‘Proteinuria > 3.5 g/day’)”> (B) Proteinuria > 3.5 g/day
3.5 g/day’)”> (C) Oliguria
3.5 g/day’)”> (D) Hypertension only
17. The drug of choice for acute gout attack is:
(A) Allopurinol
(B) Colchicine
(C) Febuxostat
(D) Probenecid
18. Which of the following is NOT a risk factor for atherosclerosis?
(A) Hypertension
(B) Smoking
(C) High HDL cholesterol
(D) Diabetes mellitus
19. Which condition is associated with “moon face” and “buffalo hump”?
(A) Addison’s disease
(B) Cushing’s syndrome
(C) Hypothyroidism
(D) Diabetes insipidus
20. Which electrolyte abnormality is most common in chronic kidney disease?
(A) Hypokalemia
(B) Hyperkalemia
(C) Hypernatremia
(D) Hypocalcemia
21. Which drug is first-line for heart failure with reduced ejection fraction?
(A) Digoxin
(B) ACE inhibitors
(C) Calcium channel blockers
(D) Nitrates
22. The Bence-Jones proteins are associated with:
(A) Multiple myeloma
(B) Lymphoma
(C) Leukemia
(D) Aplastic anemia
23. Which of the following is the most common cause of iron deficiency anemia?
(A) Chronic blood loss
(B) Hemolysis
(C) Poor diet
(D) Vitamin C deficiency
24. Which lung condition presents with “pink frothy sputum”?
(A) Pulmonary edema
(B) Pneumonia
(C) Tuberculosis
(D) Asthma
25. Which of the following is NOT a feature of nephritic syndrome?
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3.5 g/day’)”> (B) Hypertension
3.5 g/day” onclick=”checkAnswer(‘q25’, ‘Proteinuria > 3.5 g/day’)”> (C) Proteinuria > 3.5 g/day
3.5 g/day’)”> (D) Oliguria
26. Which test is most sensitive for early diabetic nephropathy?
(A) Microalbuminuria
(B) Serum creatinine
(C) BUN
(D) Urine dipstick
27. Which condition is classically associated with Kayser-Fleischer rings?
(A) Wilson’s disease
(B) Hemochromatosis
(C) Cirrhosis
(D) Hepatitis C
28. Which drug is first-line in treatment of tuberculosis?
(A) Isoniazid
(B) Rifampicin
(C) Pyrazinamide
(D) All of the above
29. Which ECG change is classically seen in hyperkalemia?
(A) U waves
(B) Peaked T waves
(C) ST elevation
(D) QT prolongation
30. Which is the most common cause of secondary hypertension?
(A) Pheochromocytoma
(B) Chronic kidney disease
(C) Hyperthyroidism
(D) Cushing’s syndrome
31. Which of the following is a major risk factor for stroke?
(A) Hypertension
(B) Hypotension
(C) Low cholesterol
(D) Low BMI
32. The classical triad of meningitis is:
(A) Headache, fever, neck stiffness
(B) Chest pain, dyspnea, cough
(C) Confusion, tremor, rigidity
(D) Rash, diarrhea, vomiting
33. Which autoantibody is specific for rheumatoid arthritis?
(A) Anti-dsDNA
(B) Anti-CCP
(C) ANA
(D) Rheumatoid factor only
34. Which thyroid disorder is associated with exophthalmos?
(A) Hypothyroidism
(B) Graves’ disease
(C) Hashimoto’s thyroiditis
(D) Thyroid cancer
35. Which deficiency leads to megaloblastic anemia?
(A) Iron
(B) Vitamin B12 or folate
(C) Vitamin C
(D) Vitamin K
36. Which of the following is the most common cause of cirrhosis worldwide?
(A) Hepatitis B
(B) Hepatitis C
(C) Alcohol
(D) NAFLD
37. Which of the following is the gold standard for diagnosis of pulmonary embolism?
(A) CT pulmonary angiography
(B) Chest X-ray
(C) ECG
(D) V/Q scan
38. Which vitamin deficiency causes scurvy?
(A) Vitamin A
(B) Vitamin C
(C) Vitamin D
(D) Vitamin K
39. Which investigation confirms diagnosis of diabetes mellitus?
(A) Fasting plasma glucose ≥ 126 mg/dl
(B) Random glucose ≥ 100 mg/dl
(C) HbA1c < 5.5%
(D) Urine dipstick
40. Which is the commonest cause of infective endocarditis?
(A) Staphylococcus aureus
(B) Streptococcus viridans
(C) Enterococcus faecalis
(D) Pseudomonas aeruginosa
41. Which of the following is the most common site for gout attacks?
(A) Knee
(B) Big toe (first metatarsophalangeal joint)
(C) Wrist
(D) Elbow
42. Which of the following is an example of restrictive lung disease?
(A) COPD
(B) Pulmonary fibrosis
(C) Asthma
(D) Bronchiectasis
43. Which electrolyte imbalance is caused by thiazide diuretics?
(A) Hyperkalemia
(B) Hypokalemia
(C) Hypernatremia
(D) Hypercalcemia
44. The most common cause of subarachnoid hemorrhage is:
(A) Hypertension
(B) Trauma
(C) Ruptured berry aneurysm
(D) Stroke
45. Which condition is associated with “bronze diabetes”?
(A) Wilson’s disease
(B) Hemochromatosis
(C) Addison’s disease
(D) Cushing’s syndrome
46. Which infection is most common in HIV patients with CD4 < 200?
(A) Pneumocystis jirovecii pneumonia
(B) Tuberculosis
(C) Toxoplasmosis
(D) CMV infection
47. Which is the most common cause of upper GI bleeding?
(A) Gastric cancer
(B) Peptic ulcer disease
(C) Esophageal varices
(D) Mallory-Weiss tear
48. Which drug is contraindicated in asthma patients?
(A) Beta-blockers
(B) Corticosteroids
(C) Leukotriene inhibitors
(D) Inhaled bronchodilators
49. Which of the following is a feature of Horner’s syndrome?
(A) Ptosis, miosis, anhidrosis
(B) Ptosis, mydriasis, sweating
(C) Tremor, rigidity, bradykinesia
(D) Headache, vomiting, photophobia
50. Which electrolyte abnormality is seen in SIADH?
(A) Hyponatremia
(B) Hypernatremia
(C) Hypokalemia
(D) Hyperkalemia