اسئلة الباطنية 2018 (1)
1 ) Diabetes insipidus is a deficiency of what hormone of the following ?
A . Atrial natriuretic peptide .
B . Vasopressin .
C . Aldosterone .
D . Insulin .
E . Progesterone .
2 ) An old lady presents with history of fever and left sided chest pain for one month . Examination of respiratory system shows decreased stony dull percussion note an absent breath sounds on left side . Her chest X_Ray is likely to reveal ?
A . Collapse
B . Consolidation
C . Fibrosis
D . Pleural effusion
E . Pneumothorax
3) Which of the following is least likely to cause symmetrical weakness of the lower limbs ?
A . Acute transverse myelitis
B . Glioblastoma multiforme
C . Guillain barre syndrome
D . Myasthenia gravis
E . Muscular dystrophy
4 ) Elderly came with sudden loss of vision in right eye with headache , investigation show high CRP and high ESR . What is the diagnosis ?
A . Temporal arteritis .
B . SAH .
C . Migraine .
D . Herpes ophthalmicus .
E . Tension headache .
5 ) Acute renal failure may be distinguished from chronic renal failure by which of the following ?
A . An increased Na excretion .
B . Left ventricular hypertrophy on ECG .
C . Hypophosphatemia .
D . Renal size on ultrasound scan .
E . Hyperkalemia .
6 ) In a patient with haematemesis . The clinical feature which suggests that peptic ulcer is underlying cause is ?
A . Ascites
B . Drowsiness
C . History of jaundice
D . Splenomegaly
E . Tender epigastrium
7 ) A 40 years old man presents with cold intolerance and weight gain . Examination reveals goiter . The most likely finding related to central nervous system in this patient ?
A . Ataxia .
B . Delayed relaxation of ankle jerk .
C . Hyperreflexia .
D . Hypotonia .
E . Loss of sensations .
8 ) Clostridium difficile is a nosocomial infection . Which of the following can be used to treat it ?
A . Broad spectrum antibiotics .
B . PPI .
C . Probiotics .
D . Vancomycin or metronidazole .
E . No treatment is required
9 ) A 15 years old girl presents with history of fever , bleeding from gums and pallor for last 15 days . Her peripheral blood films shows pancytopenia . The most important investigation is ?
A . Bone marrow examination
B . Coombs test
C . Reticulocytes count
D . Serum folic acid
E . Serum iron level
10 ) The most sensitive vaccine to heat is ?
A . IPV
B . BCG vaccine
C . Hepatitis B
D . OPV
E . Diphtheria
11) In a patient with history of shortness of breath , which of the following signs indicates left heart failure ?
A . Ascites .
B . Basal crepitations .
C . Dependent edema .
D . Engorged neck veins .
E . Fourth heart sounds .
12 ) In a patient with high grade fever , rigors and Hepatomegaly . The most likely diagnosis is ?
A . Carcinoma of liver
B . Liver abscess
C . Malaria
D . Right heart failure
E . Typhoid fever
13 ) Which one of the following is a contraindication to thrombolysis ?
A . Pregnancy
B . Age over 75 years
C . Background diabetic retinopathy
D . Asthma
E . The presence of atrial fibrillation
14 ) A young boy presents in outdoor with history of sudden painful swelling of joints after minor trauma . The most likely diagnosis is ?
A . DIC
B . ITP
C . Sickle cell disease
D . Hemophilia A
E . Glanzmann thrombasthenia
15 ) CRP may be raised in all of the following except ?
A . DM
B . Malignancy
C . Acute bacterial infection
D . Tuberculosis
E . Autoimmune disease
16 ) In a young boy with HTN , examination CVS reveals radio _ femoral delay . The most common cause of HTN in this patient is ?
A . Coarctation of aorta
B . Renal artery stenosis
C . Dissection of aorta
D . Conn syndrome
E . Diabetic nephropathy
17 ) A patient with history of jaundice , pruritus and clay coloured stool . Which of the following enzymes may be increased significantly ?
A . ALP
B . AST
C . ALT
D . LDH
18 ) A patient presents with history of intermittent fever , abdominal pain and headache . Blood culture is positive for salmonella typhi . The antibiotic of choice for this patient ?
A . Ciprofloxacin
B . Vancomycin
C . Metronidazole
D . Tetracycline
E . Gentamicin
19) A 50 years old man is admitted in emergency ward with MI . Any of the following medications are used initially ?
A . Aspirin
B . Warfarin
C . Heparin
D . Streptokinase
E . Clopidogrel
20 ) A 40 years old lady presents with history of severe constant upper abdominal pain associated with vomiting , temperature is normal , and there is marked tenderness in epigastrium . Most useful investigation for this patient is ?
A . Cardiac enzymes
B . ECG
C . Gastroscopy
D . Liver function test
E . Serum amylase
21 ) A 67 years old man presents with bilateral ankle edema and pitting . Which of the following is the most common cause ?
A . Amlodipine
B . Bisoprolol
C . Ruptured of Baker cyst
D . DVT
E . Cellulitis
22) A 50 year old smoker presents with history of cough productive of mucoid sputum every winter for last three years . The most likely diagnosis is ?
A . Bronchial asthma
B . Chronic bronchitis
C . Bronchiectasis
D . Bronchogenic carcinoma
E . Pulmonary tuberculosis
23 ) In a patient with history of muscle cramps and carpopedal spasm . Which of the following serum electrolyte level is most likely to be decreased ?
A . Calcium
B . Chloride
C . Magnesium
D . Potassium
E . Sodium
24 ) The anti diabetic agent of choice for 50 years old obese lady with mild hyperglycemia is ?
A . Chlorpropamide
B . Metformin
C . Insulin
D . Glibenclamide
E . Repaglinide
25 ) A patient of chronic diarrhea is having angular stomatitis and glossitis . The most likely cause of these signs is deficiency of ?
A . Folic acid
B . Iron
C . Proteins
D . Pyridoxine
E . Thiamine
26 ) A 40 years old woman gives history of fever for last three weeks accompanied by dry cough , night sweats and weight loss . Abdominal examination reveals hepatosplenomegaly , CXR shows symmetrically distributed line nodules . The most likely diagnosis is ?
A . Pneumonia
B . Malaria
C . Typhoid
D . Chronic liver disease
E . Miliary tuberculosis
27 ) A 40 years old diabetic man presents with history of sudden onest of pain in right loin which radiates towards the iliac fossa associated with vomiting . On examination tenderness is present in right loin . The most likely diagnosis is ?
A . Appendicitis
B . Cholycystitis
C . Diverticulitis
D . Perforated peptic ulcer
E . Pyelonephritis
28 ) A 20 year old Girl is taking anti tuberculosis treatment , she presents in eye outdoor with visual complaints . The most likely cause of her symptoms is side effects of ?
A . Isoniazid
B . Pyrazinamide
C . Rifampicin
D . Ethambutol
E . Streptomycin
29) A 40 years old man gives history of high grade fever for last one week with cough productive rusty sputum , breathing on right lower chest , CXR shows consolidation . The most likely causative organism is ?
A . Anaerobic bacteria
B . Gram negative bacilli
C . Streptococcus pneumonia
D . Staphylococcus aureus
E . Mycobacterium tuberculosi
30 ) In a patient with microscopic Hematuria , which of the following favours a glomerular source ?
A . Red cell casts and proteinuria .
B . Blood at the beginning of the urinary stream .
C . Blood at the end of the urinary stream .
D . Suprapupic pain .
E . Abnormal urine cytology .
31 ) An important physical sign of portal hypertension in a patient of cirrhosis of liver is ?
A . Gynecomastia
B . Hepatomegaly
C . Palmer Erythema
D . Spider angioma
E . Splenomegaly
32 ) An old patient presented in emergency ward with history of weakness of right side of body of rapid onest . The most helpful first line management of this patient is ?
A . Cerebral angiography
B . Cerebrospinal fluid examination
C . Computerised tomography scan brain
D . Fasting lipid profile
E . Nerve conduction study
33) A 50 years old man presents with Dysphagia . Which of the following characteristics suggests a benign strictures of esophagus ?
A . Anemia
B . Weight loss
C . Cervical lymphadenopathy
D . Hoarseness of voice
E . Dysphagia worse for solids
34 ) Which of the following is a cause of central cyanosis ?
A . Exposure to cold
B . Heart failure
C . Raynauds phenomenon
D . Right to left cardiac shunts
E . Shock
35 ) A young girl complains of nocturnal cough and shortness of breath which disturbs her sleep . It was diagnosed as bronchial asthma . Investigation to confirm this diagnosis is ?
A . CXR
B . Eosinophil count
C . Lung function test
D . Serum IgG level
E . Sputum examination
36 ) Which of the following does not form part of the initial approach to investigating a fever of unknown origin ?
A . Early CT scan of abdomen and chest
B . Serial blood cultures off antibiotics
C . Careful history and examination
D . Autoantibody screen
E . Trial of antibiotics
37 ) An epileptic girl is found to have gum hypertrophy . Anti epileptic drug which she is most likely taking is ?
A . Carbamazepine
B . Gabapentin
C . Lamotrigine
D . Phenytoin
E . Sodium valproate
38 ) A patient presents with tachycardia , wild swings in blood pressure , headache , diaphoresis , altered mental status , and a sense of panic
The most likely diagnosis is ?
A . Hyperthyroidism .
B . Generalized panic disorder .
C . Angina pectoris .
D . Panic attack .
E . Pheochromocytoma .
39 ) A 16 year old Girl presents with chronic diarrhea , which of the following features suggest that she has irritable bowel syndrome ?
A . Abdominal pain relieved by defecation .
B . Anemia .
C . Weight loss .
D . Nocturnal symptoms .
E . Blood in stools .
40 ) The most common risk factor for COPD is ?
A . Air pollution
B . Infection
C . Coal mining
D . Low socioeconomic status
E . Tobacco smoke
41) Which one of the following statements about paracetamol poisoning is not true ?
A . 15 tablets may be a fatal overdose .
B . Oral methionine may be useful in treatment .
C . Paracetamol levels should be checked at 4 hours post ingestion .
D . If liver function tests are normal at 4 hours post ingestion , the liver has not been damaged .
E . Activated charcoal should be given with laxatives .
42 ) A 35 years old man presents in a clinic with history of chronic productive cough that is worse in the morning and that occurs because changing the position of patient . Sputum is copious and yellow . The most likely diagnosis in this patient is ?
A . Bronchial asthma
B . Bronchiectasis
C . Bronchogenic carcinoma
D . Pulmonary tuberculosis
E . Chronic bronchitis
43 ) A 50 year old man presents in emergency ward with central chest pain . On examination his blood pressure 90/60 and pulse 106 , and he is pale and sweating profusely . The most likely diagnosis is ?
A . Pericarditis
B . MI
C . Esophagitis
D . Pleural effusion
E . Pneumothorax
44) The following are complication of Nephrotic syndrome with the exception of ?
A . Acute renal failure .
B . Accelerated HTN .
C . Venous thrombosis .
D . Hypocalcemia .
E . Pneumococcal infection .
45 ) Which of the following is a recognized feature of massive pulmonary embolism ?
A . Reduced plasma lactate levels .
B . Increase in serum troponin levels .
C . An arterial PH less than 7.2 .
D . Blood gases show increased PCO2 on air .
E . Normal D _ dimer levels .
46 ) A patient with embolic stroke is taking warfarin . The most useful laboratory test to monitoring effect of warfarin ?
A . PT
B . PTT
C . Bleeding time
D . Hematocrit
E . Platelet count
47 ) A 68 year old patient with COPD was admitted with a febrile exacerbation of his symptoms . Laboratory showed arterial PH 7.21 , PCO2 60 mmhg , HCO3 24 meq/L . Which is the underlying acid base disorder ?
A . Respiratory acidosis .
B . Respiratory acidosis with metabolic Alkalosis .
C . Respiratory acidosis with metabolic acidosis .
D . Metabolic acidosis with respiratory alkalosis .
E . Metabolic acidosis
48 ) 35 years old man is admitted to the hospital and is undergo brain surgery . The patient is very anxious and worried of the upcoming surgery . He begins to hyperventilate and becomes dizzy and unconscious , the ABG reveal PH 7.61 , PCO2 22 mmhg , HCO3 24 meq/L . Most likely acid base disorder is ?
A . Metabolic acidosis uncompensated .
B . Respiratory Alkalosis compensated .
C . Respiratory Alkalosis uncompensated .
D . Metabolic Alkalosis compensated .
E . Metabolic Alkalosis uncompensated
49 ) Most common cause of Wallenberg syndrome is occlusion of ?
A . Basilar artery .
B . Anterior cerebral artery .
C . Middle cerebral artery .
D . Posterior inferior cerebral artery .
E . Posterior cerebral artery
50 ) A 5 years old boy gives history of swelling of body starting from face and more on getting up in the morning . On examination pallor is absent jugular venous pressure is not raised . Signs of Ascites and bilateral pleural effusion are found , the first line of investigation is ?
A . Blood urea level .
B . CXR .
C . Echocardiography .
D . Liver function test .
E . Urine for albumin .
51 ) An 70 year old man presents with palpitations . He has history of MI in 1995 and was placed on nitroglycerin , Benzaepril , aspirin and verapamil . In 2000 he was placed on digoxin after a diagnosis of heart failure was made . Three months ago he was placed on Nebivolol and lasix ( Furosemide ) . He presents with evidence of premature ventricular contractions , ST depression , and T waves inversion on the ECG , there is no chest pain . In mean time what should you do ?
A . Stop Benzaepril and digoxin .
B . Stop verapamil and lasix .
C . Stop Nebivolol and lasix .
D . Stop lasix and digoxin .
E . Stop verapamil and aspirin .
A . Atrial natriuretic peptide .
B . Vasopressin .
C . Aldosterone .
D . Insulin .
E . Progesterone .
2 ) An old lady presents with history of fever and left sided chest pain for one month . Examination of respiratory system shows decreased stony dull percussion note an absent breath sounds on left side . Her chest X_Ray is likely to reveal ?
A . Collapse
B . Consolidation
C . Fibrosis
D . Pleural effusion
E . Pneumothorax
3) Which of the following is least likely to cause symmetrical weakness of the lower limbs ?
A . Acute transverse myelitis
B . Glioblastoma multiforme
C . Guillain barre syndrome
D . Myasthenia gravis
E . Muscular dystrophy
4 ) Elderly came with sudden loss of vision in right eye with headache , investigation show high CRP and high ESR . What is the diagnosis ?
A . Temporal arteritis .
B . SAH .
C . Migraine .
D . Herpes ophthalmicus .
E . Tension headache .
5 ) Acute renal failure may be distinguished from chronic renal failure by which of the following ?
A . An increased Na excretion .
B . Left ventricular hypertrophy on ECG .
C . Hypophosphatemia .
D . Renal size on ultrasound scan .
E . Hyperkalemia .
6 ) In a patient with haematemesis . The clinical feature which suggests that peptic ulcer is underlying cause is ?
A . Ascites
B . Drowsiness
C . History of jaundice
D . Splenomegaly
E . Tender epigastrium
7 ) A 40 years old man presents with cold intolerance and weight gain . Examination reveals goiter . The most likely finding related to central nervous system in this patient ?
A . Ataxia .
B . Delayed relaxation of ankle jerk .
C . Hyperreflexia .
D . Hypotonia .
E . Loss of sensations .
8 ) Clostridium difficile is a nosocomial infection . Which of the following can be used to treat it ?
A . Broad spectrum antibiotics .
B . PPI .
C . Probiotics .
D . Vancomycin or metronidazole .
E . No treatment is required
9 ) A 15 years old girl presents with history of fever , bleeding from gums and pallor for last 15 days . Her peripheral blood films shows pancytopenia . The most important investigation is ?
A . Bone marrow examination
B . Coombs test
C . Reticulocytes count
D . Serum folic acid
E . Serum iron level
10 ) The most sensitive vaccine to heat is ?
A . IPV
B . BCG vaccine
C . Hepatitis B
D . OPV
E . Diphtheria
11) In a patient with history of shortness of breath , which of the following signs indicates left heart failure ?
A . Ascites .
B . Basal crepitations .
C . Dependent edema .
D . Engorged neck veins .
E . Fourth heart sounds .
12 ) In a patient with high grade fever , rigors and Hepatomegaly . The most likely diagnosis is ?
A . Carcinoma of liver
B . Liver abscess
C . Malaria
D . Right heart failure
E . Typhoid fever
13 ) Which one of the following is a contraindication to thrombolysis ?
A . Pregnancy
B . Age over 75 years
C . Background diabetic retinopathy
D . Asthma
E . The presence of atrial fibrillation
14 ) A young boy presents in outdoor with history of sudden painful swelling of joints after minor trauma . The most likely diagnosis is ?
A . DIC
B . ITP
C . Sickle cell disease
D . Hemophilia A
E . Glanzmann thrombasthenia
15 ) CRP may be raised in all of the following except ?
A . DM
B . Malignancy
C . Acute bacterial infection
D . Tuberculosis
E . Autoimmune disease
16 ) In a young boy with HTN , examination CVS reveals radio _ femoral delay . The most common cause of HTN in this patient is ?
A . Coarctation of aorta
B . Renal artery stenosis
C . Dissection of aorta
D . Conn syndrome
E . Diabetic nephropathy
17 ) A patient with history of jaundice , pruritus and clay coloured stool . Which of the following enzymes may be increased significantly ?
A . ALP
B . AST
C . ALT
D . LDH
18 ) A patient presents with history of intermittent fever , abdominal pain and headache . Blood culture is positive for salmonella typhi . The antibiotic of choice for this patient ?
A . Ciprofloxacin
B . Vancomycin
C . Metronidazole
D . Tetracycline
E . Gentamicin
19) A 50 years old man is admitted in emergency ward with MI . Any of the following medications are used initially ?
A . Aspirin
B . Warfarin
C . Heparin
D . Streptokinase
E . Clopidogrel
20 ) A 40 years old lady presents with history of severe constant upper abdominal pain associated with vomiting , temperature is normal , and there is marked tenderness in epigastrium . Most useful investigation for this patient is ?
A . Cardiac enzymes
B . ECG
C . Gastroscopy
D . Liver function test
E . Serum amylase
21 ) A 67 years old man presents with bilateral ankle edema and pitting . Which of the following is the most common cause ?
A . Amlodipine
B . Bisoprolol
C . Ruptured of Baker cyst
D . DVT
E . Cellulitis
22) A 50 year old smoker presents with history of cough productive of mucoid sputum every winter for last three years . The most likely diagnosis is ?
A . Bronchial asthma
B . Chronic bronchitis
C . Bronchiectasis
D . Bronchogenic carcinoma
E . Pulmonary tuberculosis
23 ) In a patient with history of muscle cramps and carpopedal spasm . Which of the following serum electrolyte level is most likely to be decreased ?
A . Calcium
B . Chloride
C . Magnesium
D . Potassium
E . Sodium
24 ) The anti diabetic agent of choice for 50 years old obese lady with mild hyperglycemia is ?
A . Chlorpropamide
B . Metformin
C . Insulin
D . Glibenclamide
E . Repaglinide
25 ) A patient of chronic diarrhea is having angular stomatitis and glossitis . The most likely cause of these signs is deficiency of ?
A . Folic acid
B . Iron
C . Proteins
D . Pyridoxine
E . Thiamine
26 ) A 40 years old woman gives history of fever for last three weeks accompanied by dry cough , night sweats and weight loss . Abdominal examination reveals hepatosplenomegaly , CXR shows symmetrically distributed line nodules . The most likely diagnosis is ?
A . Pneumonia
B . Malaria
C . Typhoid
D . Chronic liver disease
E . Miliary tuberculosis
27 ) A 40 years old diabetic man presents with history of sudden onest of pain in right loin which radiates towards the iliac fossa associated with vomiting . On examination tenderness is present in right loin . The most likely diagnosis is ?
A . Appendicitis
B . Cholycystitis
C . Diverticulitis
D . Perforated peptic ulcer
E . Pyelonephritis
28 ) A 20 year old Girl is taking anti tuberculosis treatment , she presents in eye outdoor with visual complaints . The most likely cause of her symptoms is side effects of ?
A . Isoniazid
B . Pyrazinamide
C . Rifampicin
D . Ethambutol
E . Streptomycin
29) A 40 years old man gives history of high grade fever for last one week with cough productive rusty sputum , breathing on right lower chest , CXR shows consolidation . The most likely causative organism is ?
A . Anaerobic bacteria
B . Gram negative bacilli
C . Streptococcus pneumonia
D . Staphylococcus aureus
E . Mycobacterium tuberculosi
30 ) In a patient with microscopic Hematuria , which of the following favours a glomerular source ?
A . Red cell casts and proteinuria .
B . Blood at the beginning of the urinary stream .
C . Blood at the end of the urinary stream .
D . Suprapupic pain .
E . Abnormal urine cytology .
31 ) An important physical sign of portal hypertension in a patient of cirrhosis of liver is ?
A . Gynecomastia
B . Hepatomegaly
C . Palmer Erythema
D . Spider angioma
E . Splenomegaly
32 ) An old patient presented in emergency ward with history of weakness of right side of body of rapid onest . The most helpful first line management of this patient is ?
A . Cerebral angiography
B . Cerebrospinal fluid examination
C . Computerised tomography scan brain
D . Fasting lipid profile
E . Nerve conduction study
33) A 50 years old man presents with Dysphagia . Which of the following characteristics suggests a benign strictures of esophagus ?
A . Anemia
B . Weight loss
C . Cervical lymphadenopathy
D . Hoarseness of voice
E . Dysphagia worse for solids
34 ) Which of the following is a cause of central cyanosis ?
A . Exposure to cold
B . Heart failure
C . Raynauds phenomenon
D . Right to left cardiac shunts
E . Shock
35 ) A young girl complains of nocturnal cough and shortness of breath which disturbs her sleep . It was diagnosed as bronchial asthma . Investigation to confirm this diagnosis is ?
A . CXR
B . Eosinophil count
C . Lung function test
D . Serum IgG level
E . Sputum examination
36 ) Which of the following does not form part of the initial approach to investigating a fever of unknown origin ?
A . Early CT scan of abdomen and chest
B . Serial blood cultures off antibiotics
C . Careful history and examination
D . Autoantibody screen
E . Trial of antibiotics
37 ) An epileptic girl is found to have gum hypertrophy . Anti epileptic drug which she is most likely taking is ?
A . Carbamazepine
B . Gabapentin
C . Lamotrigine
D . Phenytoin
E . Sodium valproate
38 ) A patient presents with tachycardia , wild swings in blood pressure , headache , diaphoresis , altered mental status , and a sense of panic
The most likely diagnosis is ?
A . Hyperthyroidism .
B . Generalized panic disorder .
C . Angina pectoris .
D . Panic attack .
E . Pheochromocytoma .
39 ) A 16 year old Girl presents with chronic diarrhea , which of the following features suggest that she has irritable bowel syndrome ?
A . Abdominal pain relieved by defecation .
B . Anemia .
C . Weight loss .
D . Nocturnal symptoms .
E . Blood in stools .
40 ) The most common risk factor for COPD is ?
A . Air pollution
B . Infection
C . Coal mining
D . Low socioeconomic status
E . Tobacco smoke
41) Which one of the following statements about paracetamol poisoning is not true ?
A . 15 tablets may be a fatal overdose .
B . Oral methionine may be useful in treatment .
C . Paracetamol levels should be checked at 4 hours post ingestion .
D . If liver function tests are normal at 4 hours post ingestion , the liver has not been damaged .
E . Activated charcoal should be given with laxatives .
42 ) A 35 years old man presents in a clinic with history of chronic productive cough that is worse in the morning and that occurs because changing the position of patient . Sputum is copious and yellow . The most likely diagnosis in this patient is ?
A . Bronchial asthma
B . Bronchiectasis
C . Bronchogenic carcinoma
D . Pulmonary tuberculosis
E . Chronic bronchitis
43 ) A 50 year old man presents in emergency ward with central chest pain . On examination his blood pressure 90/60 and pulse 106 , and he is pale and sweating profusely . The most likely diagnosis is ?
A . Pericarditis
B . MI
C . Esophagitis
D . Pleural effusion
E . Pneumothorax
44) The following are complication of Nephrotic syndrome with the exception of ?
A . Acute renal failure .
B . Accelerated HTN .
C . Venous thrombosis .
D . Hypocalcemia .
E . Pneumococcal infection .
45 ) Which of the following is a recognized feature of massive pulmonary embolism ?
A . Reduced plasma lactate levels .
B . Increase in serum troponin levels .
C . An arterial PH less than 7.2 .
D . Blood gases show increased PCO2 on air .
E . Normal D _ dimer levels .
46 ) A patient with embolic stroke is taking warfarin . The most useful laboratory test to monitoring effect of warfarin ?
A . PT
B . PTT
C . Bleeding time
D . Hematocrit
E . Platelet count
47 ) A 68 year old patient with COPD was admitted with a febrile exacerbation of his symptoms . Laboratory showed arterial PH 7.21 , PCO2 60 mmhg , HCO3 24 meq/L . Which is the underlying acid base disorder ?
A . Respiratory acidosis .
B . Respiratory acidosis with metabolic Alkalosis .
C . Respiratory acidosis with metabolic acidosis .
D . Metabolic acidosis with respiratory alkalosis .
E . Metabolic acidosis
48 ) 35 years old man is admitted to the hospital and is undergo brain surgery . The patient is very anxious and worried of the upcoming surgery . He begins to hyperventilate and becomes dizzy and unconscious , the ABG reveal PH 7.61 , PCO2 22 mmhg , HCO3 24 meq/L . Most likely acid base disorder is ?
A . Metabolic acidosis uncompensated .
B . Respiratory Alkalosis compensated .
C . Respiratory Alkalosis uncompensated .
D . Metabolic Alkalosis compensated .
E . Metabolic Alkalosis uncompensated
49 ) Most common cause of Wallenberg syndrome is occlusion of ?
A . Basilar artery .
B . Anterior cerebral artery .
C . Middle cerebral artery .
D . Posterior inferior cerebral artery .
E . Posterior cerebral artery
50 ) A 5 years old boy gives history of swelling of body starting from face and more on getting up in the morning . On examination pallor is absent jugular venous pressure is not raised . Signs of Ascites and bilateral pleural effusion are found , the first line of investigation is ?
A . Blood urea level .
B . CXR .
C . Echocardiography .
D . Liver function test .
E . Urine for albumin .
51 ) An 70 year old man presents with palpitations . He has history of MI in 1995 and was placed on nitroglycerin , Benzaepril , aspirin and verapamil . In 2000 he was placed on digoxin after a diagnosis of heart failure was made . Three months ago he was placed on Nebivolol and lasix ( Furosemide ) . He presents with evidence of premature ventricular contractions , ST depression , and T waves inversion on the ECG , there is no chest pain . In mean time what should you do ?
A . Stop Benzaepril and digoxin .
B . Stop verapamil and lasix .
C . Stop Nebivolol and lasix .
D . Stop lasix and digoxin .
E . Stop verapamil and aspirin .
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