1.

Pre excitation can be seen in

a. Acute rheumatic fever
b. Familial HOCM
c. Ebstein anomaly
d. Tuberous sclerosis
e. Turners syndrome

2. Wernikes encephalopathy
a. Causes inter nuclear opthalmoplagia
b. IV Dextrose is given to prevent occurrence of this
c. It’s a recognized complication of hyperemesis Gravidarum
d. Clinical response to IV thiamine can be seen within 48 hours
e. CT Brain is useful for diagnosis

3. CEA
a. Present in normal colonic epithelium
b. Not useful in detection of recurrences of Ca Colon
c. Postoperative CEA Predict 70% accurately occurrence of hepatic
metastasis in one year
d. Elevated value is highly specific for colonic cancer
e. Express normally in early embryonic and fetal tissues

4. Low level of inorganic phosphates found in

a. Osteomalasia
b. Hyperparathyroidism
c. Chronic Renal Failure
d. Pseudo pseudo hypoparathyroidism
e. pseudo hypoparathyroidism

5. Secondary Messengers
a. DAG
b. cAMP
c. COX – 1
d. Tyrosine kinase
e. Acetylcholine

6. Gastric acid secretion increased by

a. Secretin
b. Histamine
c. Somatostatin
d. Gastrin
e. Acetylcholine

7. Kaneru poisoning
a. Does not affect SA node
b. Digifab is useful in management
c. Hyperkalaemia is recognized complication
d. Atropine is useful in management
e. Xanthopnia is known to occur
8. Metaclopramide
a. Cause increased gastric emptying opposed by atropine
b. Is a phenothiazene
c. Reduces blood glucose
d. Is a dopamine antagonist
e. Increases prolactin secretion

9. Intracerebral haemorrhage
a. Commonest cause is vascular malformation
b. Majority of patients benefits from surgery
c. Blood pressure should be reduced immediately in order to reduce
further bleeding
d. It’s difficult to differentiate old ICH from ischemic infarction
e. Amyloid angeopathy is an important cause

10. Histology of Respiratory epithelium

a. Upper respiratory tract epithelium has cilia
b. Bronchioles are made of predominantly smooth muscles
c. Macrophages are seen on alveolar epithelium
d. APUD cells are found scattered among lower respiratory tract
epithelium
e. visceral pleura has lymphatics

11. Spinal cord anatomy

a. Lateral cortico-spinal tract fibres cross within one spinal segment
b. C7 spinal segment lies anterior to C6 vertebrae
c. In spinal thalamic tract, sacral fibres lie medial to cervical fibres
d. Lateral cortico spinal tract is situated in anterior white column
e. Light touch is conducted predominantly in the posterior column than
anterior spino-thalamic tract

12. Osteoporosis due to steroids

a. Fractures occur before there is measurable bone mineral density loss
b. Bone strength get weaker before bone mineral density loss occur
c. 75% of the bone mineral density loss occur with in 3 month of
initiation of steroid therapy
d. Known to occur with inhaled steroids
e. Ca and Vitamin D dietary supplementations should be given to get
optimum bone protection

13. Toxin mediated diarrhoea

a. Giardiasis
b. Cholera
c. E. Coli
d. Shigellosis
e. E. histolitica

14. Causes for Clubbing

a. Silicosis
 b. COPD
c. Obstructive sleep apnoea with pulmonary hypertention
d. Crohns disease
e.

15. Leg ulcers can be seen in

a. Beta thalassaemia trait
b. Wegener’s granulomatosis
c. Polycythemia rubra vera
d. Ulcerative colitis
e. Primary syphilis

16. Massive spleen

a. CML
b. Myelodysplasia
c. PRV
d. Visceral Leishmaniasis
e. Aplastic anaemia

17. Obstructive sleep apnoea

a. More common in central obesity than neck obesity
b. Is diagnosed if there is simultaneous cessation of nasal passage,
abdominal movement and thoracic movement in polysomnography
c. C PAP reduce day time somnolence
d. Known to cause pulmonary hypertension
e. Can be treated effectively with methylphenidate

18. Vitamin B 12 deficiency

a. Reduces follate absorption
b. Neurological features occurs with normal haematological features
c. Causes ineffective erythropoesis
d. Metformin can cause Vitamin B 12 malabsoption
e. Can cause elevated level of bilirubin levels

19. Causes of hyperprolactinaemia

a. Pseudoseizures
b. Chronic liver cell disease
c. Varizella zoster chest wall infection
d. Hypothyroidism
e. P……………

20. Causes of RPGN

a. Cryoglobullinaemia
b. Wegener’s granulomatosis
c. Polyarteritis nodosa
d. Goodpasture syndrome
e. Chugtrows
21. 32 year old lady noticed difficulty in reading news papers for 1/12. On
examination, there is nystagmus on her right eye. Left eye was slow to
cross the nasal field. Site of lesion can be
a. Midbrain
b. Cerebellum
c. Pons
d. Semicircular canal
e. Medulla

22. CIDP
a. Can be treated effectively with corticosteroids
b. Typically associated with high protein content with normal cell count
in CSF
c. HIV is a known association
d. Commonest cause is Compylobacter jejuni
e. Sural nerve biopsy will show onion bulb appearance.

23. Opthalmic manifestation of RA

a. Scleritis
b. Episcleritis
c. Corneal deposits
d. Uveitis
e. conjunctivitis

24. Regarding OP poisoning

a. OP compounds found in households are less toxic than those found in
agriculture
b. Cause phosphorylation of acetylcholine esterase leading to irreversible
inactivation
c. Intermediate syndrome can be effectively treated with atropine
d. Pralidoxime reverse nicotinic receptors more effectively than
muscarinic receptors
e. Acetyl choline esterase level in RBC is used for diagnosis

25. Clinical trial to find out the efficacy of a new drug compared to enalapril
a. Most appropriate study design is prospective case control study
b. To find out the difference of stroke occurrence in 2 groups chi squared
test should be used
c. For outcome analysis regression analysis should be used
d. For each group n = 100 is adequate
e.

26. Regarding the findings of a normal healthy adult.

a. First component of the first heart sound is louder than second
component
b. Soft pan systolic murmur at the apex
c. Venous hum at the neck
d. In inspiration splitting will get narrowed.
e.
27. Regarding the pulmonary circulation
a. Pulmonary blood flow at rest is 3 l/min
b. Normal pulmonary artery pressure is 15 mmHg
c. With exercise pulmonary artery pressure rises to 30 mmHg
d. With exercise blood flow can rise to 30 l/min
e. In erect posture blood supply to apex is less than to base

28. Recognised causes of hepatocellular necrosis

a. Severe cardiac failure
b. HSV – 1 infection
c. Dengue
d. OP poisoning
e. Mushroom poisoning (Amantidia)

29. Diseases caused by herpes viruses

a. Bell’s palsy is known to caused by HSV
b. Varisella zoster is important cause for necrosis of the retina
c. Majority of the primary infections are subclinical
d. HHV 8 causes kaposis sarcoma
e. Disseminated herpis zoster well treated with interferone

30. Regarding the Leflunamide

a. Modify the course of RA
b. Should not be used in hypertension
c. Should not be used in males who plan to have children in near future
d. Not hepatotoxic
e. Can use for psoriatic arthritis

31. Inheritance - correctly matched

a. Wilson disease – X recessive
b. Alpha 1 AT deficiency – AR
c. Haemachromatosis – AR
d. HOCM - AR
e. Marfan syndrome - AR

32. Correctly matched hypersensitivity reaction

a. Urticaria – Type lll (antibody antigen complex)
b. Contact dermatitis – Type lV (T cell mediated)
c. Haemolytic anaemia – Type ll (antibody mediated - cytotoxic)
d. Serum sickness – type ll
e. Anaphylaxis – type l

33. Indicators of disease severity of Ulcerative colitis

a. Weight loss of more than 10%
b. Heart rate > 100
c. Low serum albumin
d. Stool occult blood
e. Haematocrit < 30%

34. Regarding Philadelphia chromosome

 a. Measures with PCR
b. Indicate poor prognosis in CML
c. With treatment, level does not go down
d. > 95% positive in CML
e. Occurs due to translocation

35. Vaccines contraindicated in pregnancy

a. MMR
b. Varizella
c. Influenza
d. Hep A
e. Meningococcal

36. Regarding Marfan syndrome

a. Lens dislocation is characteristically upwards
b. Is due to fibrillin1 gene defect
c. Pregnancy has worse prognosis
d. Aortic arch diameter has to measured annually
e. Thrombophillia is a feature

37. Causes of Hypokalaemia due to renal K+ loss

a. Malignant hypertension
b. Periodic paralysis
c. Salbutamol
d. Renal artery stenosis
e. insulin

38. Regarding IgA nephropathy

a. IgA deposits can be seen on capillaries in a skin biopsy
b. 80% have serum IgA level elevated
c. Persistent microscopic hematurea indicate poor prognosis
d. Proteinuria is commonly nephrotic range
e. Macroscopic haematuria is a presentation

39. Regarding Acute pancreatitis

a. Hypercalcaemia is a known featue.
b. Gallstone is known aetiology
c. Rising blood urea is poor prognostic indicator
d. Normal amylase exclude diagnosis
e. Reduction of haematocrit by more than 10% in 48 hours indicate worse
prognosis

40. In a patient with DM sudden increase of BP due to renal artery stenosis is

suggested by

a. USS – small kidney in one side

b. Presence of neurofibromatosis
c. Reduced renal function with Captopril renogram
d. Recurrent pulmonary oedema
 e. hypokelemia

41. SIADH
a. Thyrotoxicosis
b. Mesothelioma
c. GBS
d. SSRI
e.

42. Regarding LI
a. Has Narrow therapeutic index
b. Extensively metabolised
c. Better for unipolar depressive disorders than bipolar disorders
d. Causes hyponatraemia
e. Concurrent use of ACE inhibitors increases toxicity

43. Regarding Anorexia Nervosa

a. FSH, LH and testerone is Reduced

b. Reduced T3 with normal TSH
c. Elevated AST/ALT
d. Associated with MVP
e. Pancytopenia

44. Reduced total T3 can be due to

a. Multi nodular goitre
b. Amidarone
c. Thyroiditis
d. Sick euthyroid
e. Chronic liver disease

45. Regarding TB Pericarditis

a. 90% AFB positive in pericardiocentesis fluid
b. If ADA > 40, its useful for diagnosis
c. Pericardial constriction with effusion is pathognomic for TB
d. Majority caused by direct spread of pulmonary TB
e. Steroids improve prognosis

46. Regarding Hypopitiutarism

a. Growth hormone deficiency is the first manifestation

b. Commonest cause of short stature in children is growth hormone
deficiency
c. Growth hormone deficient short children are obese
d. Bone age is delayed
e. Commonest cause is non secretary adenoma

47. Regarding Malaria

a. Chloroquine is contraindicated in pregnancy
b. Beta lactamace is responsible for chloroquine resistance
 c. Primaquine is used to prevent P. Falciparum relapses
d. Symptoms are caused by parasites in hepatic stages
e. Infection cause lifelong immunity foe the species

48. Regarding Hepatitis B serology

a. Acute hepatitis – HbsAg + ,Anti-HBs - , HBeAg+ , Anti-HBe - , Anti-
HBc IgM +
b. Chronic hepatitis - HbsAg - ,Anti-HBs + , HBeAg+ , Anti-HBe - ,
Anti-HBc IgG +
c. Hepatitis carrier - HbsAg + ,Anti-HBs - , HBeAg - , Anti-HBe + ,
Anti-HBc IgG +
d. Vaccination - HbsAg - ,Anti-HBs + , HBeAg - , Anti-HBe - , Anti-
HBc IgG -
e. Pre core mutant - HbsAg + ,Anti-HBs - , HBeAg + , Anti-HBe - , Anti-
HBc IgG +

49. Anaemia of Chronic Disease

a. Reduced serum Iron
b. Increased serum ferittin
c. Reduced RBC portopophyrin
d. Hypoplastic bone marrow
e. macrocytosis

50. Causes of reduced HbA1c

a. Aplastic anaemia
b. Splenomegaly
c. Haemolytic anaemia
d. Chronic blood loss
e. Erythropoietin treatment

51. Regarding DM management

a. Presence of GAD antibody is diagnostic of type 1 DM
b. In renal impairement glipizide is better than glibenclamide
c. In critically ill patients RBS target is 110 – 130 mg/dl
d.
e.

52. Persistent vegetative state

a. For diagnosis patient has be in a partially arousable state for one year
b. Caused by bilateral cortical damage
c. Brain stem reflexes are positive
d. Has sleep awake cycles
e. Has higher cognitive functions

53. Causes of transudate

a. Dreslers syndromr
b. Hypothyroidm
c. Constrictive pericarditis
d. Yellow nail syndrome
 e. Sarcoidosis

54. M

BEST OF FIVE QUESTIONS

1. Following blood gas analysis were found in a 40 years old lady with difficulty
in breathing. PH- 7.2
HCO3 15
Pco2 20
Po2 110
What is the most appropriate explanation for the above condition.

1. Daiabetic ketoacidosis
2. Pulmonary embolism
3. Cardiogenic shock
4. Addisons disease
5. Carbexalanone toxicity

2. 55 years old man presented with ischemic type of chest pain with PR-40, BP
80\60, ECG showed acute inferior myocardial infarction. What is the best
treatment option

1. IV normal saline 500ml bolous

2. Immidiat trans cutaneous pasing
3. Atropine 0.6 stat IV
4. Dobutamine intravrnous infusion
5. IV adrenaline injection

3. 65 years old man presented with early fall, symmetrical bradikinesia,

dysarthria, difficulti in reading the newspapers. His upward gaze is impaired
but preserved lateral gaze. What is the most appropriate explanation ?

1. Idiopathic parkinsin disease

2. Supranuclear palsy
3. Shi Drager syndrome
4. Defect in semicircular canal
5. Ceribella disease
4. 12 years old child with large years and large testicals with mild impairment of
interlectual functions having history with same condition in one of his uncle.
What is the most appropriate clinical condition

1. Fragile X syndrome
2. Klinfelter syndrome
3. Dawn syndrome
4. Pradawilli syndrome
5. 45 XYZ

5. One of the traveles visited the Sri Lanka and after 5 days of the travel he
developed diarrohoea with blood and mucous. Stool full report showed , pus
cells – field full, mucous+ , blood++.
What is the most appropriate clinical state

1. Travelears diarrhea
2. Cholera
3. Shigella
4. Entamoeba
5. Food poisoning.

6. 70 years old male presented with chronic back pain,anorexia and loss of weight
For 6 months. He was investigated and followins were found

Serum calcium 2.8 mmol/l

Blood picture – leucoerythroblasic
FBC HB 8.6 mg/dl
Platlet 189
WBC 20
Serum criatanine 360
What is the most probable cause
1. Multiple myeloma
2. Metastatic carcinoma
3. Lymphoma
4. Renal cell carcinoma
5. Vitamin D toxicity

7. 12 years old child presented with mild central cyanosis, palpitation at rest with
a pan systolic murmur. His ECG showed delta waves. What is the most sutable
clinical condition.
1. Ebstin anomaly
2. Trans potion of grate arteries
3. Isonmengers complex with VSD
4. PDA
5. HOCM

8.Therty five years old lady presented with small joint pain and swelling with
scaling rash at the umbilicus. What drud should be avoided on this pation
 1. nitrofurointoin
2. chloroquin
3. diclofanac sodium
4. sulphasalizine
5. Methtraxate

9. A man with bipolar affective disorder, Li- Carbonate , what is the following
drug better to avoid
1. bendrofluorothiazide
2. digoxine
3. amiadarone
4. cimatadine
5. theophiline

10. 51 years old man presented with impotence, lethargy, small joint pain over
knukle and wrist swelling and effusion on the wrist. He had tritrangular ligamrnt
calcification. He was a hypertensive pation, on HCT and enalapril. He had elevated
serum ferritine and HB 12.5 mg/dl. What is the most specific test to achive the
diagnosis.
1. Joint fluid aspiration and sent for birengiference fest
2. Serum ferritine , serum iron, TIBC
3. CT brain
4. FSH/LH/ TSH
5. Rhumatiod factor.