Q. 1
Medical Sciences
Difficulty: Easy
(1 Mark)
In adult Basic Life Support (BLS), what is the correct compression-to-ventilation ratio for a single rescuer in cardiopulmonary resuscitation (CPR)?
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Step-by-Step Explanation & Concept Rationale
The standard universal chest compression-to-ventilation ratio for adult CPR by a single rescuer is 30 compressions followed by 2 rescue breaths at a rate of 100-120 compressions per minute.
Q. 2
Medical Sciences
Difficulty: Medium
(1 Mark)
A 55-year-old diabetic male presents with crushing retrosternal chest pain radiating to the left arm. ECG demonstrates ST-segment elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?
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Step-by-Step Explanation & Concept Rationale
Leads II, III, and aVF reflect the inferior wall of the left ventricle, which in approximately 85-90% of individuals (right-dominant circulation) is supplied by the Right Coronary Artery.
Q. 3
Medical Sciences
Difficulty: Hard
(1 Mark)
Which of the following triad of clinical features is classic for normal pressure hydrocephalus (NPH)?
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Step-by-Step Explanation & Concept Rationale
The classic Hakim-Adams triad of Normal Pressure Hydrocephalus consists of abnormal apraxic gait ('feet glued to the floor'), urinary incontinence, and progressive cognitive impairment.
Q. 4
Medical Sciences
Difficulty: Medium
(1 Mark)
What is the hallmark diagnostic finding on bone marrow biopsy in aplastic anemia?
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Step-by-Step Explanation & Concept Rationale
Aplastic anemia results in profound pancytopenia and a hypocellular 'empty' bone marrow with prominent fatty replacement and absence of neoplastic infiltration.
Q. 5
Medical Sciences
Difficulty: Easy
(1 Mark)
According to WHO growth standards and IMNCI guidelines, which physical measurement is used for community screening of severe acute malnutrition (SAM) in children aged 6-59 months?
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Step-by-Step Explanation & Concept Rationale
A MUAC of less than 11.5 cm (red zone on tri-colored tape) or the presence of bilateral pitting pedal edema diagnostic criteria for Severe Acute Malnutrition (SAM).
Q. 6
Medical Sciences
Difficulty: Easy
(1 Mark)
Koplik spots on the buccal mucosa opposite the lower molars are pathognomonic early physical signs of:
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Step-by-Step Explanation & Concept Rationale
Koplik spots—tiny bluish-white spots on an erythematous base on the buccal mucosa—appear 1-2 days before the generalized maculopapular rash of Measles.
Q. 7
Medical Sciences
Difficulty: Medium
(1 Mark)
In a patient presenting with Diabetic Ketoacidosis (DKA), what is the initial, most critical therapeutic step prior to insulin administration?
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Step-by-Step Explanation & Concept Rationale
Immediate fluid restoration (typically 1000-1500 mL of 0.9% isotonic saline over the first hour) restores intravascular volume, reduces counter-regulatory hormones, and enhances tissue perfusion.
Q. 8
Medical Sciences
Difficulty: Easy
(1 Mark)
What is the primary etiology of Kwashiorkor in young children?
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Step-by-Step Explanation & Concept Rationale
Kwashiorkor is characterized by severe protein malnutrition with bilateral pitting edema, distended abdomen, hepatomegaly ('flaky paint' dermatosis), contrasted with Marasmus (generalized calorie deprivation).
Q. 9
Medical Sciences
Difficulty: Easy
(1 Mark)
Which of the following clinical signs is elicited by passive flexion of the patient's neck resulting in involuntary flexion of the hips and knees in meningitis?
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Step-by-Step Explanation & Concept Rationale
Brudzinski's neck sign is positive when passive neck flexion elicits involuntary flexion of the lower extremities due to meningeal irritation.
Q. 10
Medical Sciences
Difficulty: Medium
(1 Mark)
A 6-year-old child presents with periorbital edema, dark cola-colored urine, hypertension, and mild proteinuria 2 weeks following a streptococcal pharyngitis. What is the most likely diagnosis?
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Step-by-Step Explanation & Concept Rationale
Acute PSGN typically manifests 1-3 weeks post-streptococcal throat infection with the nephritic syndrome: hematuria (cola-colored), edema, hypertension, and low serum C3 complement.
Q. 11
Medical Sciences
Difficulty: Hard
(1 Mark)
What is the typical arterial blood gas (ABG) pattern seen in an acute exacerbation of severe asthma with respiratory muscle fatigue?
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Step-by-Step Explanation & Concept Rationale
While early asthma manifests with tachypnea and respiratory alkalosis (low PaCO2), a normal or rising PaCO2 with respiratory acidosis indicates impending respiratory failure.
Q. 12
Medical Sciences
Difficulty: Medium
(1 Mark)
Which cardiac enzyme or marker remains elevated the longest (up to 10-14 days) following acute myocardial infarction?
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Step-by-Step Explanation & Concept Rationale
Cardiac troponins rise within 3-6 hours, peak at 24 hours, and can remain detectable in serum for up to 10-14 days post-infarct.
Q. 13
Medical Sciences
Difficulty: Easy
(1 Mark)
The drug of choice for the treatment of severe Plasmodium falciparum malaria in hospitalized adults and children according to WHO guidelines is:
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Step-by-Step Explanation & Concept Rationale
Intravenous artesunate is superior to intravenous quinine in reducing mortality from severe falciparum malaria.
Q. 14
Medical Sciences
Difficulty: Easy
(1 Mark)
Which diagnostic sign in a pediatric patient with suspected intussusception describes stool mixed with blood and mucus?
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Step-by-Step Explanation & Concept Rationale
'Red currant jelly' stool (sloughed mucosa, blood, and mucus) is classical of advanced ileocolic intussusception in infants.
Q. 15
Medical Sciences
Difficulty: Easy
(1 Mark)
Which endocrine disorder is characterized by central obesity, moon facies, buffalo hump, purple abdominal striae, and arterial hypertension?
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Step-by-Step Explanation & Concept Rationale
Excessive glucocorticoid action produces the classic constellation of Cushingoid body habitus, protein catabolism, hyperglycemia, and hypertension.
Q. 16
Medical Sciences
Difficulty: Easy
(1 Mark)
A 65-year-old female presents with resting tremor, rigidity ('lead-pipe' and 'cogwheel'), bradykinesia, and postural instability. What is the fundamental neuropathological deficit?
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Step-by-Step Explanation & Concept Rationale
Parkinson's disease is characterized by progressive loss of dopaminergic projection neurons in the substantia nigra pars compacta and presence of Lewy bodies.
Q. 17
Medical Sciences
Difficulty: Easy
(1 Mark)
Which autoimmune disease is associated with antibodies against the nicotinic acetylcholine receptor (AChR) at the neuromuscular junction, presenting with fluctuating muscle weakness and ptosis?
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Step-by-Step Explanation & Concept Rationale
Myasthenia gravis is mediated by autoantibodies against post-synaptic ACh receptors, producing fatigable muscle weakness that characteristically worsens towards the end of the day.
Q. 18
Medical Sciences
Difficulty: Medium
(1 Mark)
In acute rheumatic fever, which diagnostic criteria are grouped as Jones Major Criteria?
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Step-by-Step Explanation & Concept Rationale
The five major Jones criteria for acute rheumatic fever are: Carditis, migratory Polyarthritis, Sydenham Chorea, Erythema marginatum, and Subcutaneous nodules.
Q. 19
Medical Sciences
Difficulty: Hard
(1 Mark)
The definitive diagnostic confirmation of Hirschsprung disease in a neonate presenting with failure to pass meconium within 48 hours is:
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Step-by-Step Explanation & Concept Rationale
Rectal biopsy showing lack of ganglion cells in Meissner and Auerbach plexuses and hypertrophied nerve fibers confirms aganglionic megacolon.
Q. 20
Medical Sciences
Difficulty: Easy
(1 Mark)
A 30-year-old female presents with heat intolerance, weight loss despite increased appetite, fine hand tremors, palpitation, and diffuse goiter with exophthalmos. What is the most likely diagnosis?
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Step-by-Step Explanation & Concept Rationale
Graves disease, caused by thyroid-stimulating immunoglobulin (TSI) activating TSH receptors, is the most common cause of hyperthyroidism with characteristic ophthalmopathy.
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