GENERAL MEDICINE

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GENERAL MEDICINE MCQs

1. A patient with small cell lung carcinoma has symptomatic hyponatraemia (serum sodium 127 mmol/ L). The most likely etiology is:
(a) Fanconi Syndrome
(b) Cushing’s Syndrome
(c) Metabolic Syndrome
(d) Syndrome of inappropriate ADH
Ans: D

2. A patient with cirrhosis develops oliguria and worsening azotemia. Urinary sediment is normal. Urinary sodium concentration is 5 meq/ L. The most likely cause could be:
(a) Acute cortical necrosis
(b) Acute tubular necrosis
(c) Acute glomerulonephritis
(d) Hepatorenal syndrome
Ans: D

3. A 6 week old infant presents with recurrent nonbilious vomiting with some dehydration. A mass is palpable in right upper quadrant of abdomen with visible peristalsis. The most likely diagnosis is :
(a) Intussusception
(b) Congenital hypertrophic pyloric stenosis
(c) Small intestine obstruction
(d) Duodenal atresia
Ans: B

4. A 2 year old previously healthy child develops abrupt onset high grade fever, drooling of saliva and respiratory distress. He has a toxic look and becomes severely ill within few hours. What is the most likely clinical diagnosis?
(a) Acute tonsilopharyngitis
(b) Tracheo-oesophageal fistula
(c) Acute Epiglottitis
(d) Laryngeal web
Ans: C

5. A 6 year old child presents with oliguria, haematuria, puffiness of face. He has a convulsion and blood pressure is found to be 200/100 mm of Hg. Laboratory tests reveal hemoglobin: 12g/dl, total leucocyte count: 7200/mm3, platelet count: 3.1 lakhs/mm3, blood urea: 80 mg/dl and serum creatinine: 1.1 mg/dl. What is the most likely diagnosis?
(a) Haemolytic uraemic syndrome
(b) Urinary tract infection
(c) Acute glomerulonephritis with hypertensive encephalopathy
(d) Obstructive uropathy
Ans: C

6. A two year old child with acute watery diarrhea and severe dehydration presents to the emergency. Which of the following is the most appropriate initial treatment?
(a) Ringer lactate at 30ml/kg given intravenously in 30 minutes
(b) Oral rehydration solution through nasogastric tube
(c) Ringer lactate at 10ml/kg given intravenously in 2 hours
(d) Normal saline at 10ml/kg given intravenously in 2 hours
Ans: A

7. A diagnosis of steroid dependent nephrotic syndrome is made in a 5 year old male child and he is initiated on a drug. After 6 weeks of therapy, he develops nausea, vomiting, neutropenia and gross hematuria. Which of the following is the most likely drug used?
(a) Cyclophosphamide
(b) Levamisole
(c) Cyclosporine
(d) Prednisolone
Ans: A

8. Consider the following statements regarding distal renal tubular acidosis:
1. Blood biochemistry reveals normal anion gap metabolic acidosis
2. There is defective secretion of H+ in the distal tubule.
3. There may be associated muscle weakness and rickets.
4. Children may present with polydipsia and polyuria.
Which of the above statements are correct?
(a) 1 only
(b) 2 and 3 only
(c) 2 and 4 only
(d) 1, 2, 3 and 4
Ans: D

9. A one year old male child presents with poor urinary stream and dribbling of urine since birth. A mass is palpable mass just above the symphysis pubis. The most likely diagnosis is:
(a) Tumor of the urinary bladder
(b) Posterior urethral valve
(c) Ureterocele
(d) Neuroblastoma
Ans: B

10. A 4 years old child presents with rash on lower limbs, arthritis, and abdominal pain. Urine examination reveals microscopic hematuria. The most likely diagnosis is:
(a) Thrombaesthenia
(b) Idiopathic thrombocytopenic purpura
(c) Systemic lupus erythematosus
(d) Henoch Schonlein purpura
Ans: D

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