Q.1 Which of the following is the most common cause of iron deficiency anemia in adults?
Dietary deficiency
Chronic blood loss
Malabsorption
Increased requirement
Explanation - In adults, chronic blood loss (often from the gastrointestinal tract) is the most common cause of iron deficiency anemia.
Correct answer is: Chronic blood loss
Q.2 Which clinical finding is most characteristic of hyperthyroidism?
Weight gain
Bradycardia
Heat intolerance
Cold intolerance
Explanation - Hyperthyroidism increases basal metabolic rate leading to symptoms like heat intolerance, weight loss, and tachycardia.
Correct answer is: Heat intolerance
Q.3 A 55-year-old smoker presents with a chronic cough. Which is the most important next step in evaluation?
Start antibiotics immediately
Perform chest X-ray
Advise smoking cessation only
Prescribe cough suppressants
Explanation - A chest X-ray is essential to evaluate chronic cough in smokers to rule out malignancy and other lung pathologies.
Correct answer is: Perform chest X-ray
Q.4 Which antihypertensive is contraindicated in pregnancy?
Methyldopa
Labetalol
ACE inhibitors
Hydralazine
Explanation - ACE inhibitors are contraindicated in pregnancy due to teratogenic effects, particularly on fetal renal development.
Correct answer is: ACE inhibitors
Q.5 The most common cause of community-acquired pneumonia is:
Mycoplasma pneumoniae
Streptococcus pneumoniae
Haemophilus influenzae
Klebsiella pneumoniae
Explanation - Streptococcus pneumoniae is the leading cause of community-acquired pneumonia worldwide.
Correct answer is: Streptococcus pneumoniae
Q.6 What is the first-line treatment for Type 2 Diabetes Mellitus in most patients?
Insulin therapy
Metformin
Sulfonylureas
Thiazolidinediones
Explanation - Metformin is the first-line therapy for type 2 diabetes due to efficacy, safety, and weight neutrality.
Correct answer is: Metformin
Q.7 Which electrolyte disturbance is most commonly associated with chronic kidney disease?
Hypokalemia
Hyperkalemia
Hyponatremia
Hypercalcemia
Explanation - Hyperkalemia occurs due to reduced renal excretion of potassium in chronic kidney disease.
Correct answer is: Hyperkalemia
Q.8 Which of the following is a common complication of uncontrolled hypertension?
Hypothyroidism
Stroke
Peptic ulcer disease
Asthma
Explanation - Uncontrolled hypertension can lead to complications such as stroke, myocardial infarction, and renal failure.
Correct answer is: Stroke
Q.9 Which test is most specific for the diagnosis of systemic lupus erythematosus (SLE)?
ANA
Anti-dsDNA antibody
ESR
Rheumatoid factor
Explanation - Anti-dsDNA antibodies are highly specific for SLE, while ANA is sensitive but not specific.
Correct answer is: Anti-dsDNA antibody
Q.10 Which of the following is NOT a risk factor for atherosclerosis?
Smoking
Hypertension
Hyperlipidemia
Hypothyroidism
Explanation - Hypothyroidism is not a classic risk factor for atherosclerosis, though it can affect lipid metabolism.
Correct answer is: Hypothyroidism
Q.11 Which vitamin deficiency leads to megaloblastic anemia?
Vitamin B1
Vitamin B6
Vitamin B12
Vitamin C
Explanation - Vitamin B12 deficiency impairs DNA synthesis, leading to megaloblastic anemia.
Correct answer is: Vitamin B12
Q.12 A patient with COPD is at increased risk of which acid-base disturbance?
Respiratory alkalosis
Respiratory acidosis
Metabolic alkalosis
Metabolic acidosis
Explanation - COPD leads to hypoventilation and CO₂ retention, causing respiratory acidosis.
Correct answer is: Respiratory acidosis
Q.13 The most common cause of upper gastrointestinal bleeding is:
Esophageal varices
Peptic ulcer disease
Gastric cancer
Mallory-Weiss tear
Explanation - Peptic ulcer disease is the leading cause of upper GI bleeding, although varices are also common in cirrhotics.
Correct answer is: Peptic ulcer disease
Q.14 Which hormone is primarily responsible for water reabsorption in the kidney?
Aldosterone
Cortisol
ADH
PTH
Explanation - ADH increases water reabsorption in the collecting ducts by inserting aquaporins.
Correct answer is: ADH
Q.15 Which investigation is best for confirming pulmonary embolism?
Chest X-ray
D-dimer
CT pulmonary angiography
ECG
Explanation - CT pulmonary angiography is the gold standard imaging modality for diagnosing pulmonary embolism.
Correct answer is: CT pulmonary angiography
Q.16 Which of the following is a hallmark feature of nephrotic syndrome?
Hematuria
Proteinuria >3.5 g/day
Oliguria
Hypertension
Explanation - Massive proteinuria (>3.5 g/day) is the defining feature of nephrotic syndrome.
Correct answer is: Proteinuria >3.5 g/day
Q.17 What is the most common cause of secondary hypertension?
Cushing’s syndrome
Renal artery stenosis
Hyperthyroidism
Pheochromocytoma
Explanation - Renal artery stenosis is the leading cause of secondary hypertension, especially in younger patients.
Correct answer is: Renal artery stenosis
Q.18 A patient with cirrhosis presents with confusion. Which complication is most likely?
Hepatic encephalopathy
Portal vein thrombosis
Variceal bleeding
Ascites
Explanation - Accumulation of ammonia in cirrhosis can lead to hepatic encephalopathy, presenting as confusion.
Correct answer is: Hepatic encephalopathy
Q.19 Which lipid-lowering drug can cause flushing as a side effect?
Statins
Niacin
Ezetimibe
Fibrates
Explanation - Niacin (Vitamin B3) commonly causes cutaneous flushing due to prostaglandin-mediated vasodilation.
Correct answer is: Niacin
Q.20 What is the most common cause of death in patients with diabetes mellitus?
Renal failure
Myocardial infarction
Stroke
Infections
Explanation - Cardiovascular complications, especially myocardial infarction, are the leading cause of death in diabetics.
Correct answer is: Myocardial infarction
Q.21 Which electrolyte abnormality is typically seen in Addison’s disease?
Hyponatremia and hyperkalemia
Hypernatremia and hypokalemia
Hypernatremia and hyperkalemia
Hyponatremia and hypokalemia
Explanation - Addison’s disease (adrenal insufficiency) causes aldosterone deficiency, leading to sodium loss and potassium retention.
Correct answer is: Hyponatremia and hyperkalemia
Q.22 Which of the following is the best initial treatment for acute gout?
Allopurinol
Colchicine
Probenecid
Febuxostat
Explanation - Acute gout attacks are treated with NSAIDs or colchicine. Allopurinol is not used acutely.
Correct answer is: Colchicine
Q.23 Which condition is most commonly associated with microcytic hypochromic anemia?
Iron deficiency anemia
Vitamin B12 deficiency
Folate deficiency
Aplastic anemia
Explanation - Iron deficiency anemia is the prototype of microcytic hypochromic anemia.
Correct answer is: Iron deficiency anemia
Q.24 Which vaccine is recommended annually for patients with chronic lung disease?
Hepatitis B
Influenza vaccine
MMR vaccine
Varicella vaccine
Explanation - Annual influenza vaccination is strongly recommended for patients with chronic lung disease like COPD and asthma.
Correct answer is: Influenza vaccine
Q.25 Which clinical triad is characteristic of meningitis?
Fever, neck stiffness, altered sensorium
Fever, cough, dyspnea
Headache, dizziness, palpitations
Seizure, rash, lymphadenopathy
Explanation - The classic triad of meningitis is fever, neck stiffness, and altered mental status.
Correct answer is: Fever, neck stiffness, altered sensorium