See the paper before you sit it. INI‑CET previous year questions.

Q1. Which of the following is not a boundary of the hepatocystic triangle?

• A. Cystic duct
• B. Common hepatic duct
• C. Cystic artery
• D. Inferior border of the liver

Correct answer: C. Cystic artery

Q2. Which nerve is most commonly injured in a fracture of the surgical neck of the humerus?

High-yield addition

• A. Axillary nerve
• B. Radial nerve
• C. Median nerve
• D. Ulnar nerve

Correct answer: A. Axillary nerve

Q1. The contraction phase of a single muscle twitch lasts 40 milliseconds. What tetanisation frequency is required to produce a sustained contraction in this muscle?

• A. 10 Hz
• B. 20 Hz
• C. 25 Hz
• D. 40 Hz

Correct answer: C. 25 Hz

Q2. Tight junctions are primarily located at which part of the cell?

• A. Apical
• B. Apicolateral
• C. Basal
• D. Basolateral

Correct answer: B. Apicolateral

Q1. A child presents with fatigue and hepatomegaly. ALT and AST are elevated and ketosis is significant. Liver biopsy shows excess glycogen accumulation. Blood glucose rises after feeding but not after an overnight fast. Which enzyme deficiency is most likely responsible?

• A. Glucose-6-phosphatase
• B. Liver phosphorylase
• C. Muscle phosphorylase
• D. Phosphofructokinase

Correct answer: A. Glucose-6-phosphatase

Q2. Cancer cells take up excess glucose because:

• A. Lactate is produced even in the presence of oxygen
• B. High NADH/NAD ratio
• C. High GLUT2
• D. Absence of oxygen

Correct answer: A. Lactate is produced even in the presence of oxygen

Q1. Which of the following is the most common inherited bleeding disorder?

• A. Von Willebrand disease
• B. Disseminated intravascular coagulation
• C. Factor V deficiency
• D. Haemophilia

Correct answer: A. Von Willebrand disease

Q2. Which of the following is an incorrect gene–disease association?

• A. STK11 — breast cancer
• B. PTEN — thyroid carcinoma
• C. TP53 — mucosal neuroma
• D. BRCA2 — prostate carcinoma

Correct answer: C. TP53 — mucosal neuroma

Q3. A patient presents with ascites and omental caking. Imaging reveals solid components in an adnexal mass, with a long-standing history of symptoms. CA-125 is positive. What is the most probable diagnosis?

• A. Serous ovarian tumour
• B. Mucinous ovarian tumour
• C. Endometrioid tumour
• D. Granulosa cell tumour

Correct answer: A. Serous ovarian tumour

Q1. Which of the following statements regarding thalidomide are correct? (a) It acts as an antimetabolite and is useful as an immunosuppressant. (b) It is used in the treatment of multiple myeloma. (c) It is used in the management of type 2 lepra reaction (ENL). (d) It is teratogenic.

• A. a, b, c
• B. b, c, d
• C. a, c, d
• D. a, b, d

Correct answer: B. b, c, d

Q2. Which of the following statements regarding bempedoic acid are correct? (a) It is a non-competitive inhibitor of ATP citrate lyase. (b) It is used along with diet and statins for hypercholesterolaemia. (c) It is a dicarboxylic acid. (d) It inhibits cholesterol biosynthesis.

• A. a, b, c
• B. b, c, d
• C. a, c, d
• D. a, b, d

Correct answer: B. b, c, d

Q3. Under the Drugs and Cosmetics Rules, match each medication with its schedule — (1) Insulin, (2) Hepatitis B vaccine, (3) Morphine, (4) Veterinary drugs, against (A) Schedule H, (B) Schedule Z, (C) Schedule G, (D) Schedule X.

• A. 1-C, 2-D, 3-B, 4-A
• B. 1-C, 2-A, 3-D, 4-B
• C. 1-B, 2-A, 3-D, 4-C
• D. 1-D, 2-B, 3-A, 4-C

Correct answer: B. 1-C, 2-A, 3-D, 4-B

Q1. The Kanagawa phenomenon observed on Wagatsuma agar is characteristic of which organism?

• A. Vibrio cholerae
• B. Vibrio parahaemolyticus
• C. Staphylococcus aureus
• D. Burkholderia pseudomallei

Correct answer: B. Vibrio parahaemolyticus

Q2. A male presents with lesions and a history of unprotected sexual intercourse a few months earlier. What is the most appropriate investigation to confirm the diagnosis?

• A. Serology
• B. Tzanck smear
• C. KOH mount
• D. Biopsy

Correct answer: A. Serology

Q1. What is the minimum age at which a woman can give valid consent for medical termination of pregnancy (MTP) in India?

• A. 18 years
• B. 16 years
• C. 25 years
• D. 20 years

Correct answer: A. 18 years

Q2. Under the MTP (Amendment) Act 2021, the opinion of two registered medical practitioners is required for termination of pregnancy at which gestational age?

• A. 16–20 weeks
• B. 20–24 weeks
• C. Up to 12 weeks
• D. 12–16 weeks

Correct answer: B. 20–24 weeks

Q1. In a village of 100 children, 10 have a past history of measles and are no longer at risk. 20 new cases were reported this year. What is the incidence of measles in this population for the year?

• A. 20%
• B. 22.22%
• C. 10%
• D. 30%

Correct answer: B. 22.22%

Q2. Match each vector or agent with the disease it causes — (1) Louse, (2) Tick, (3) Mite, (4) Poxvirus, against (A) Epidemic typhus, (B) Rocky Mountain spotted fever, (C) Scrub typhus, (D) Molluscum contagiosum.

• A. 1-A, 2-B, 3-C, 4-D
• B. 1-B, 2-A, 3-C, 4-D
• C. 1-D, 2-B, 3-C, 4-A
• D. 1-C, 2-B, 3-A, 4-D

Correct answer: A. 1-A, 2-B, 3-C, 4-D

Q1. Which of the following is one of the earliest presenting symptoms in a patient with multiple sclerosis?

• A. Sensory disturbances
• B. Ataxia
• C. Vertigo
• D. Facial palsy

Correct answer: A. Sensory disturbances

Q2. Which of the following is the most common clinical feature observed during the progression of systemic lupus erythematosus (SLE)?

• A. Photosensitivity
• B. Nephrotic syndrome
• C. Arthralgia and myalgia
• D. Anaemia and thrombocytopenia

Correct answer: C. Arthralgia and myalgia

Q1. A 65-year-old patient is on mechanical ventilation for acute respiratory distress syndrome. The patient suddenly becomes hypotensive and tachycardic, with absent breath sounds on the left and tracheal deviation to the right. What is the most common cause of this in patients receiving mechanical ventilation?

• A. High tidal volume
• B. Barotrauma due to high airway pressure
• C. Endotracheal tube malposition
• D. Oxygen toxicity

Correct answer: B. Barotrauma due to high airway pressure

Q2. A 40-year-old male presents with severe respiratory distress, BP 70/59 mmHg, tracheal deviation to the right, distended neck veins and absent breath sounds on the left, suggesting tension pneumothorax. What is the most appropriate immediate next step?

• A. Perform needle thoracostomy immediately
• B. CT chest
• C. Airway, breathing and circulation (ABC) assessment
• D. Chest tube insertion

Correct answer: C. Airway, breathing and circulation (ABC) assessment

Q3. Which of the following is not a recognised cause of recurrent renal stone formation?

• A. Hyperoxaluria
• B. Hypercalciuria
• C. Hypercitraturia
• D. Hyperuricosuria

Correct answer: C. Hypercitraturia

Q1. For medical termination of pregnancy, the opinion of two doctors is required at which gestational age?

• A. 20–24 weeks
• B. 9–12 weeks
• C. 12–16 weeks
• D. 16–20 weeks

Correct answer: A. 20–24 weeks

Q2. Which of the following is not used in the treatment of postpartum haemorrhage?

• A. Misoprostol
• B. Carboprost
• C. Dinoprostone
• D. Oxytocin

Correct answer: C. Dinoprostone

Q1. A 12-year-old child with systemic lupus erythematosus presents with nephrotic-range proteinuria. Renal biopsy reveals wire-loop lesions. Which of the following is the drug of choice?

• A. IV steroids only
• B. IV steroids plus cyclophosphamide
• C. Mycophenolate mofetil
• D. Cyclophosphamide only

Correct answer: B. IV steroids plus cyclophosphamide

Q2. A 6-week-old infant presents with non-bilious, non-projectile vomiting that began at 3 weeks of age. Abdominal examination is normal. What is the most likely diagnosis?

• A. Pyloric stenosis
• B. Gastro-oesophageal reflux disease
• C. Cow milk protein allergy
• D. Intestinal obstruction

Correct answer: B. Gastro-oesophageal reflux disease

Q3. A 3-year-old child is brought with a history of cyanosis since infancy. Which of the following is a component of tetralogy of Fallot?

• A. Interatrial septal defect
• B. Infundibular pulmonary stenosis
• C. Left ventricular hypertrophy
• D. Transposition of the great arteries

Correct answer: B. Infundibular pulmonary stenosis

Q1. According to WHO, which of the following is the recommended diagnostic test for spinal tuberculosis?

• A. X-ray
• B. CT scan
• C. CB-NAAT
• D. Culture and sensitivity

Correct answer: D. Culture and sensitivity

The recalled answer conflicts with current WHO guidance, which recommends CB-NAAT. Confirm with faculty before relying on it.

Q2. A 17-year-old boy presents with a progressively increasing swelling over the tibia along with fever. Radiology reveals a Codman triangle and sunburst appearance. What is the most likely diagnosis?

• A. Osteosarcoma
• B. Ewing sarcoma
• C. Giant cell tumour
• D. Chondrosarcoma

Correct answer: A. Osteosarcoma

Q1. Which of the following nerves gives sensory supply to the orbit?

• A. Vagus nerve
• B. Trigeminal nerve
• C. Hypoglossal nerve
• D. Oculomotor nerve

Correct answer: B. Trigeminal nerve

Q2. Which of the following best defines blindness?

• A. Visual acuity less than 6/60 in the better eye
• B. Visual acuity less than 3/60 in the better eye after best possible correction
• C. Visual field less than 10 degrees from fixation in the better eye
• D. Inability to perceive light in both eyes

Correct answer: B. Visual acuity less than 3/60 in the better eye after best possible correction

Q1. Which of the following is not seen in juvenile nasopharyngeal angiofibroma?

• A. Recurrent epistaxis
• B. Unilateral nasal obstruction
• C. Occurs exclusively in adolescent boys
• D. Biopsy under anaesthesia to diagnose

Correct answer: D. Biopsy under anaesthesia to diagnose

Q2. A middle-aged woman choked while eating fish and has coughing, hoarseness and a foreign body sensation in the throat. On examination the pyriform fossa is inflamed. Which nerve supplies this region?

• A. Internal laryngeal nerve
• B. External laryngeal nerve
• C. Glossopharyngeal nerve
• D. Recurrent laryngeal nerve

Correct answer: A. Internal laryngeal nerve

Q1. Which of the following are recognised side effects of topical corticosteroid use? (a) Hypertrichosis. (b) Acneiform eruptions. (c) Skin atrophy. (d) Blue pigmentation of the skin.

• A. a, b, c
• B. a, b, d
• C. a, c, d
• D. b, c, d

Correct answer: A. a, b, c

Q2. Which of the following statements are correct? (1) Epidermis can regenerate from hair bulbs and sebaceous glands. (2) Stratum corneum is the outermost cellular layer. (3) Epidermis originates from the ectoderm. (4) Dermis and hypodermis originate from the endoderm.

• A. 1, 2
• B. 2, 3
• C. 3, 4
• D. 1, 3

Correct answer: D. 1, 3

Q1. Which of the following psychoactive substances is a new, rapidly acting antidepressant?

• A. Ketamine
• B. Bupropion
• C. Haloperidol
• D. Cannabinoids

Correct answer: A. Ketamine

Q2. Imipramine and diphenhydramine are given together to a patient. Why is this combination considered irrational?

• A. Both have anticholinergic action
• B. Both cause serotonin syndrome
• C. Both cause hypotension
• D. Both cause increased sedation

Correct answer: A. Both have anticholinergic action

Q1. Which investigation is contraindicated in pregnancy?

• A. CT scan
• B. MRI
• C. Ultrasound
• D. Doppler

Correct answer: A. CT scan

Q2. Which of the following is the investigation of choice for spinal tuberculosis?

• A. Ultrasound
• B. MRI
• C. CT scan
• D. CB-NAAT

Correct answer: B. MRI

Q1. A 50-year-old male underwent lower abdominal surgery under general anaesthesia, with vecuronium as the muscle relaxant. At the end of surgery, which is the most appropriate agent to reverse the effects of vecuronium?

• A. Neostigmine
• B. Baclofen
• C. Atropine
• D. Drotaverine

Correct answer: A. Neostigmine

Q2. Sodium thiopentone is regarded as an ultrashort-acting drug because of:

• A. Rapid redistribution
• B. Metabolism
• C. Excretion
• D. Short elimination half-life

Correct answer: A. Rapid redistribution

Q1. Which mineral is important for fertility in males?

• A. Zinc
• B. Selenium
• C. Nickel
• D. Copper

Correct answer: A. Zinc

Q1. Oestrogen receptor and progesterone receptor status are what type of markers?

• A. Diagnostic
• B. Prognostic
• C. Predictive
• D. Surrogate molecular marker

Correct answer: A. Diagnostic

The recalled answer says diagnostic, but ER/PR status is conventionally taught as a predictive marker — it predicts response to endocrine therapy. Confirm with faculty before relying on it.

Q1. The Declaration of Oslo, 1970 is primarily concerned with:

• A. Torture
• B. Abortion
• C. Environmental protection
• D. Nuclear disarmament

Correct answer: A. Torture

The recalled answer says torture, but the Declaration of Oslo (1970) concerns therapeutic abortion — torture is the Declaration of Tokyo (1975). This one looks wrong; check before revising from it.

Q1. A patient presents with weight loss, dysphagia and halitosis. Which condition do these symptoms indicate?

• A. Achalasia
• B. Oesophageal cancer
• C. Gastro-oesophageal reflux disease
• D. Zenker's diverticulum

Correct answer: A. Achalasia

The recalled answer says achalasia, but halitosis with dysphagia and weight loss is the classic triad for Zenker's diverticulum. Worth confirming.

Q2. Which of the following is not a risk factor for cholangiocarcinoma?

• A. Hepatitis B virus infection
• B. Primary sclerosing cholangitis
• C. Caroli disease
• D. Opisthorchis viverrini infection

Correct answer: A. Hepatitis B virus infection

Q3. What is the most common type of hernia in females?

• A. Direct inguinal hernia
• B. Indirect inguinal hernia
• C. Femoral hernia
• D. Incisional hernia

Correct answer: C. Femoral hernia

Q1. A 30-year-old woman with chronic hypertension develops postpartum haemorrhage. Which of the following agents is contraindicated?

• A. Oxytocin
• B. Methylergometrine
• C. Prostaglandin F2α
• D. Misoprostol

Correct answer: B. Methylergometrine

Q2. A woman at 36 weeks presents with hypertension, visual disturbance, headache and 3+ proteinuria. What is the appropriate management?

• A. IV labetalol, magnesium sulphate and delivery
• B. IV labetalol and corticosteroids
• C. IV labetalol and corticosteroids only
• D. IV labetalol and magnesium sulphate

Correct answer: D. IV labetalol and magnesium sulphate

The recalled answer omits delivery. At 36 weeks with severe features, delivery is generally indicated alongside labetalol and magnesium sulphate, which is option A. Confirm before relying on it.

Q3. A mother is O negative and the father is B positive. Which of the following is the expected finding in their baby?

• A. O positive blood group with antibodies negative
• B. O positive blood group with antibodies positive
• C. O positive blood group with a positive direct Coombs test
• D. AB positive blood group with a negative direct Coombs test

Correct answer: A. O positive blood group with antibodies negative

Q4. What is the correct dose regimen for antenatal corticosteroids?

• A. Dexamethasone 6 mg every 12 hours, 4 doses
• B. Dexamethasone 12 mg every 12 hours, 2 doses
• C. Betamethasone 12 mg every 12 hours, 4 doses
• D. Betamethasone 6 mg every 12 hours, 2 doses

Correct answer: A. Dexamethasone 6 mg every 12 hours, 4 doses

Q5. An 18-week fetus is suspected to have a neural tube defect and Down syndrome on the quadruple marker test. What is the next investigation?

• A. Chorionic villus sampling
• B. Amniocentesis
• C. Non-invasive prenatal testing
• D. Anomaly scan

Correct answer: D. Anomaly scan

The recalled answer says anomaly scan. Amniocentesis is the confirmatory test for aneuploidy at this gestation, so this one is worth settling with faculty.

Q6. A 28-year-old woman presents with abdominal pain and vaginal bleeding for the past two days. What is the most likely diagnosis?

• A. Abruptio placentae
• B. Ruptured ectopic pregnancy
• C. Placenta praevia
• D. Missed abortion

Correct answer: B. Ruptured ectopic pregnancy

Q1. What is the purpose of the Downes criteria in neonatal assessment?

• A. To assess respiratory distress syndrome
• B. To evaluate Downey cells in blood samples
• C. To measure the Silverman-Anderson score for respiratory distress
• D. To calculate the Vidyasagar scoring system for neonatal assessment

Correct answer: A. To assess respiratory distress syndrome

Q2. What is the fluid of choice for resuscitation in children?

• A. 5% dextrose with normal saline
• B. 5% dextrose with N/4 saline
• C. 10% dextrose with normal saline
• D. 5% dextrose with N/2 saline

Correct answer: A. 5% dextrose with normal saline

Q1. Which of the following is not typically seen in allergic rhinitis?

• A. Otto Veraguth folds
• B. Allergic salute
• C. Allergic shiner
• D. Dennie-Morgan lines

Correct answer: A. Otto Veraguth folds

Q2. What is the most likely diagnosis for a 13-year-old boy presenting with right-sided nasal obstruction and recurrent epistaxis for the past six months?

• A. Juvenile nasopharyngeal angiofibroma
• B. Allergic rhinitis
• C. Coagulation disorder
• D. Antrochoanal polyp

Correct answer: D. Antrochoanal polyp

The recalled answer says antrochoanal polyp, but an adolescent boy with unilateral obstruction and recurrent epistaxis is the classic presentation of juvenile nasopharyngeal angiofibroma. Confirm before relying on it.

Q3. Which procedure should not be performed in an 8-year-old with bilateral sensorineural hearing loss?

• A. Tonsillectomy
• B. Adenoidectomy with grommet insertion
• C. Myringotomy
• D. Cochlear implantation

Correct answer: B. Adenoidectomy with grommet insertion

Q1. Which is the non-spreading variety of vitiligo?

• A. Focal
• B. Acrofacial
• C. Segmental
• D. None of the above

Correct answer: A. Focal

Q1. Which of the following is not included in the criteria to diagnose autism?

• A. Cognitive delays
• B. Failure to communicate effectively
• C. Repetitive behaviours or restricted interests
• D. Impaired social interactions

Correct answer: A. Cognitive delays

Q1. The Mount Fuji sign is seen in:

• A. Tension pneumothorax
• B. Tension pneumomediastinum
• C. Tension pneumocephalus
• D. Tension pneumoperitoneum

Correct answer: C. Tension pneumocephalus

Q2. Which of the following is true about CT?

• A. Water has a Hounsfield unit of 0
• B. An unfiltered X-ray beam is used
• C. CT head dose is 20 mSv
• D. It is the first investigation for gallstones

Correct answer: A. Water has a Hounsfield unit of 0

Q3. Which contrast agent can be given to patients with chronic kidney disease?

• A. Ionic iodinated contrast
• B. Non-ionic iodinated contrast
• C. Ultrasound contrast
• D. Gadolinium

Correct answer: C. Ultrasound contrast

Q1. Which of the following structures is supplied by the superior gluteal nerve?

• A. Gluteus maximus
• B. Gluteus minimus
• C. Piriformis
• D. All of the above

Correct answer: B. Gluteus minimus

Q2. The SRY gene is present on:

• A. Y chromosome short arm
• B. Y chromosome long arm
• C. X chromosome short arm
• D. X chromosome long arm

Correct answer: A. Y chromosome short arm

Q1. The bitter taste of toxic substances prevents us from consuming them. Which of the following elicits bitterness?

• A. Aldehydes
• B. Amino acids
• C. Alkaloids
• D. Hydrogen ions

Correct answer: C. Alkaloids

Q2. Which of the following is responsible for fetal heart rate acceleration?

• A. Carotid baroreceptor
• B. Aortic baroreceptor
• C. Autonomic function of the brainstem
• D. Chemoreceptor

Correct answer: C. Autonomic function of the brainstem

Q1. Pompe disease is caused by a deficiency of:

• A. Lysosomal acid alpha-glucosidase
• B. β-hexosaminidase A
• C. β-galactocerebrosidase
• D. β-glucocerebrosidase

Correct answer: A. Lysosomal acid alpha-glucosidase

Q2. Xanthurenic aciduria is seen in deficiency of which vitamin?

• A. Vitamin B6
• B. Vitamin B12
• C. Vitamin B5
• D. Vitamin B7

Correct answer: A. Vitamin B6

Q1. The JAK-STAT pathway is used by which of the following?

• A. Vasopressin
• B. Calcitonin
• C. Leptin
• D. Aldosterone

Correct answer: C. Leptin

Q2. Which of the following is an anti-apoptotic gene?

• A. BAK
• B. MCL-1
• C. BIM
• D. NOXA

Correct answer: B. MCL-1

Q1. A woman with diabetes was given an oral drug which reduced her HbA1c from 7.6 to 6.7. She had high GIP and GLP-1 levels with low glucagon. Which drug was given?

• A. Liraglutide
• B. Pramlintide
• C. Voglibose
• D. Sitagliptin

Correct answer: D. Sitagliptin

Q2. A woman presents with vulvovaginal pruritus. History reveals she is on an antidiabetic drug. Which antidiabetic drug causes this side effect?

• A. Canagliflozin
• B. Metformin
• C. Linagliptin
• D. Liraglutide

Correct answer: A. Canagliflozin

Q1. Which of the following is the infective stage of the organism transmitted through cat faeces?

• A. Tachyzoite
• B. Bradyzoite
• C. Oocyst
• D. Gametocyte

Correct answer: C. Oocyst

Q2. A man on immunosuppressants after a renal transplant has a biopsy showing budding cells with pseudohyphae. Identify the organism.

• A. Invasive candidiasis
• B. Invasive aspergillosis
• C. Pneumocystis
• D. Histoplasmosis

Correct answer: A. Invasive candidiasis

Q1. A girl was found dead in a lake and the case is one of ante-mortem drowning. All of the following are true of this case except:

• A. Water in the stomach
• B. Froth at the nose and mouth
• C. Washerwoman's hands and fingers
• D. Positive diatom test
• E. Cadaveric spasm in the hand muscles

Correct answer: C. Washerwoman's hands and fingers

Q2. A man presents smelling of alcohol with congested conjunctivae but normal motor function and a normal gait. Which of the following is correct?

• A. Drunk but not under the influence of alcohol
• B. Drunk and under the influence of alcohol
• C. Drunk
• D. Not drunk

Correct answer: A. Drunk but not under the influence of alcohol

Q1. A 40-year-old man presents with daytime sleepiness and impaired concentration and memory. BMI is 41 kg/m², BP 160/100 mmHg. Awake ABG shows PaO₂ 66 mmHg and PaCO₂ 50 mmHg. What is the most likely diagnosis?

• A. Obstructive sleep apnoea
• B. Narcolepsy
• C. Obesity hypoventilation syndrome
• D. Central sleep apnoea

Correct answer: C. Obesity hypoventilation syndrome

Q2. A 35-year-old woman presents with skin thickening and muscle weakness, with peripheries turning pale on cold exposure. ANA is positive, creatine kinase is raised, Scl-70 is positive and biopsy shows perifascicular infiltration. Which antibody is associated with this condition?

• A. Anti-PM-Scl antibody
• B. Anti-Jo-1 antibody
• C. Anti-centromere antibody
• D. Antinuclear antibody

Correct answer: A. Anti-PM-Scl antibody

Q1. A 30-year-old man undergoes surgery for a left-sided varicocele. Through which route does venous drainage primarily occur after the procedure?

• A. Cremasteric veins
• B. Penile veins
• C. Ectopic drainage in the iliac fossa
• D. At the usual location

Correct answer: A. Cremasteric veins

Q2. A patient presents with dull aching pain and tortuous veins in both lower limbs. Which test evaluates saphenofemoral junction incompetence?

• A. Fegan's test
• B. Morrissey test
• C. Modified Perthes test
• D. Brodie-Trendelenburg test

Correct answer: D. Brodie-Trendelenburg test

Q1. What is the most common cause of menorrhagia at puberty?

• A. Endometriosis
• B. Anovulation
• C. Malignancy
• D. Primary amenorrhoea

Correct answer: B. Anovulation

Q2. A 30-year-old pregnant woman with a known fibroid presents at 28 weeks with fever, mild leucocytosis and pain. What is the likely cause?

• A. Red degeneration of the fibroid
• B. Fibroid torsion
• C. Fibroid infection
• D. Labour pain

Correct answer: A. Red degeneration of the fibroid

Q1. A child has fever for six days, strawberry tongue, conjunctival congestion and peeling of the skin. What is the treatment of choice?

• A. IVIG
• B. Aspirin plus clopidogrel
• C. LMWH
• D. Warfarin

Correct answer: A. IVIG

Q2. Which is the most common cyanotic congenital heart disease presenting beyond infancy?

High-yield addition

• A. Tetralogy of Fallot
• B. Transposition of the great arteries
• C. Total anomalous pulmonary venous connection
• D. Truncus arteriosus

Correct answer: A. Tetralogy of Fallot

Q1. A patient has a nodular red eye in which the vascularity blanches after instillation of phenylephrine. What is the likely diagnosis?

• A. Nodular episcleritis
• B. Nodular scleritis
• C. Nodular phlycten
• D. Conjunctivitis

Correct answer: A. Nodular episcleritis

Q2. Which of the following lenses is used in direct gonioscopy?

• A. Goldmann
• B. Koeppe
• C. Zeiss
• D. Richardson

Correct answer: B. Koeppe

Q1. A South Indian male farmer presents to the ENT clinic with a reddish mass protruding from the nose. What is the likely diagnosis?

• A. Rhinosporidiosis
• B. Rhinoscleroma
• C. Rhinophyma
• D. Nasal polyp

Correct answer: A. Rhinosporidiosis

Q2. A 27-year-old woman presents with a thyroid swelling compressing nearby structures. Which of the following symptoms is not seen in this patient?

• A. Hoarseness of voice from recurrent laryngeal nerve compression
• B. Dysphagia from oesophageal compression
• C. Superior vena cava syndrome
• D. None of the above

Correct answer: C. Superior vena cava syndrome

Q1. A man presents with an itchy rash on his flank for two weeks. It has not improved with over-the-counter clotrimazole or hydrocortisone. On examination the rash is also present on his palms and the sole of one foot, with no oral lesions. What is the likely diagnosis?

• A. Urticaria
• B. Viral exanthem
• C. Erythema multiforme
• D. Tinea corporis

Correct answer: C. Erythema multiforme

Q2. A patient on anti-PD-1 immunotherapy (nivolumab) presents with pruritus, eczema and urticarial rashes. Histopathology reveals a subepidermal blister and direct immunofluorescence shows linear C3 and IgG along the basement membrane. What is the diagnosis?

• A. Dermatitis herpetiformis
• B. Pemphigus vulgaris
• C. Pemphigus foliaceus
• D. Bullous pemphigoid

Correct answer: D. Bullous pemphigoid

Q1. La belle indifférence is seen in:

• A. Conversion disorder
• B. Cotard syndrome
• C. Schizophrenia
• D. Depression

Correct answer: A. Conversion disorder

Q2. The SCOFF questionnaire is used as a screening tool for which disorder?

• A. Eating disorder
• B. Sexual disorder
• C. Alcohol use disorder
• D. Schizophrenia

Correct answer: A. Eating disorder

Q1. The banana sign on ultrasound is seen in which of the following conditions?

• A. Omphalocele
• B. Spina bifida
• C. Anencephaly
• D. Encephalocele

Correct answer: B. Spina bifida

Q2. Which of the following is not an advantage of ultrasound over mammography?

• A. It detects mammographically undetectable tumours that are palpable
• B. It can be used for guided biopsy
• C. It is useful in young women with dense breasts
• D. It differentiates solid from cystic lesions

Correct answer: A. It detects mammographically undetectable tumours that are palpable

This one is recalled poorly — all four options read as advantages of ultrasound, so the intended answer is unclear. Worth checking against the original paper before relying on it.

Q1. Which of the following statements is incorrect regarding CPR?

• A. Depth of chest compression up to 5-6 cm
• B. Allow adequate chest recoil
• C. Ventilation 22-25 per minute
• D. Chest compression rate 100-120 per minute

Correct answer: C. Ventilation 22-25 per minute

Q2. A 50 kg patient with pneumonia is on a ventilator: RR 14/min, bicarbonate 18, pH 7.3, pCO₂ 48 mmHg, pO₂ 110 mmHg, PEEP 12 cm H₂O, tidal volume 420 mL, SpO₂ 100% on FiO₂ 90%. What is the next step in management?

• A. Increase PEEP
• B. Decrease FiO₂
• C. Decrease respiratory rate
• D. Increase tidal volume

Correct answer: B. Decrease FiO₂

Q1. Rupture of the penile urethra does not cause extravasation of blood into which of the following spaces?

• A. Superficial perineal pouch
• B. Deep perineal pouch
• C. Ischiorectal fossa
• D. Skin around the scrotum

Correct answer: C. Ischiorectal fossa

Q2. Arrange in sequence the structures involved in the direct pathway — (1) Striatum, (2) Globus pallidus, (3) Substantia nigra, (4) Thalamus, (5) Cortex.

• A. 1, 2, 3, 4, 5
• B. 5, 4, 2, 3, 1
• C. 5, 1, 2, 3, 4
• D. 1, 3, 4, 2, 5

Correct answer: C. 5, 1, 2, 3, 4

Q1. Match each substance with its plasma carrier — (1) Thyroxine, (2) Fatty acid, (3) Haemoglobin, (4) Haem, against (A) Haemopexin, (B) Prealbumin, (C) Albumin, (D) Haptoglobin.

• A. 1-B, 2-C, 3-D, 4-A
• B. 1-A, 2-B, 3-C, 4-D
• C. 1-A, 2-D, 3-B, 4-C
• D. 1-B, 2-C, 3-A, 4-D

Correct answer: A. 1-B, 2-C, 3-D, 4-A

Q2. Which physiological adaptation does not happen at high altitude?

• A. Pulmonary vasoconstriction
• B. Polycythaemia
• C. Respiratory acidosis
• D. Hypoxia

Correct answer: C. Respiratory acidosis

Q1. Which is the correct sequence of steps in isolating a desirable protein using recombinant DNA technology — (1) Expression of protein and lysis of the bacterial cell, (2) Incorporation of genes into bacteria, (3) SDS-PAGE, (4) Protein elution, (5) Hybridisation?

• A. 2, 1, 3, 5, 4
• B. 1, 2, 4, 3, 5
• C. 1, 5, 2, 4, 3
• D. 2, 4, 5, 3, 1

Correct answer: A. 2, 1, 3, 5, 4

Q2. In a patient with maple syrup urine disease, all of the following amino acids should be restricted in the diet except:

• A. Methionine
• B. Valine
• C. Leucine
• D. Isoleucine

Correct answer: A. Methionine

Q1. A child presents with multiple lesions over the inner thigh and genital area, which began as macules and became nodules, some with central umbilication. What would be found on biopsy?

• A. Multinucleate giant cells (Tzanck cells)
• B. Donovan bodies
• C. Henderson-Paterson bodies
• D. Koilocytes

Correct answer: C. Henderson-Paterson bodies

Q2. Reed-Sternberg cells are characteristic of which condition?

High-yield addition

• A. Hodgkin lymphoma
• B. Non-Hodgkin lymphoma
• C. Chronic lymphocytic leukaemia
• D. Multiple myeloma

Correct answer: A. Hodgkin lymphoma

Q1. The extent of drug absorption is represented by:

• A. Tmax
• B. Area under the curve
• C. Cmax
• D. t½

Correct answer: B. Area under the curve

Q2. Which of the following is the newly FDA-approved immune checkpoint inhibitor for carcinoma of the endometrium?

• A. Nivolumab
• B. Pembrolizumab
• C. Trastuzumab
• D. Ipilimumab

Correct answer: B. Pembrolizumab

Q1. Modes of transmission of abdominal tuberculosis include all of the following except:

• A. Direct spread from mesenteric lymph nodes
• B. Haematogenous spread
• C. Faeco-oral route
• D. Direct contact with an infected animal

Correct answer: C. Faeco-oral route

The recalled answer excludes the faeco-oral route, but swallowing infected sputum is a recognised route for abdominal TB, which makes direct contact with an infected animal the likelier exception. Worth confirming.

Q2. Antigen binding to MHC class I activates which of the following cells?

• A. Cytotoxic T cells
• B. B cells
• C. NK cells
• D. Helper T cells

Correct answer: A. Cytotoxic T cells

Q1. Fingerprints first develop at how many weeks of intrauterine life?

• A. 12-16 weeks
• B. 20-24 weeks
• C. 28-32 weeks
• D. 32-36 weeks

Correct answer: A. 12-16 weeks

Q2. Rigor mortis first appears in which muscle group?

High-yield addition

• A. Eyelids
• B. Lower limb muscles
• C. Upper limb muscles
• D. Diaphragm

Correct answer: A. Eyelids

Q1. Which of the following criteria should be satisfied to start multidrug therapy for leprosy — (1) Hypopigmented patch with sensory loss, (2) Peripheral nerve thickening, (3) Peripheral nerve thickening with sensory loss, (4) Skin biopsy demonstrating bacilli?

• A. 1, 4
• B. 1, 3
• C. 1, 3, 4
• D. 1, 2, 3, 4

Correct answer: B. 1, 3

Q2. Match each scientist with their discovery — (1) Walter Reed, (2) Edward Jenner, (3) James Lind, against (A) Prevention of scurvy by citrus fruits, (B) Yellow fever, (C) Smallpox vaccination.

• A. 1-A, 2-B, 3-A
• B. 1-B, 2-A, 3-C
• C. 1-C, 2-B, 3-A
• D. 1-B, 2-C, 3-A

Correct answer: D. 1-B, 2-C, 3-A

Q1. A diabetic patient's fasting blood glucose is 160 mg/dL. What non-pharmacological advice would you give?

• A. At least 80 g of dietary fibre
• B. Less than 5 g sodium intake every day
• C. Less than 30% of calories should come from fat
• D. Cholesterol less than 100 mg

Correct answer: C. Less than 30% of calories should come from fat

Q2. A chronic cigarette smoker who has joined a construction company has FEV1 0.9 L, FVC 1.9 L and FEV1/FVC 0.4, rising to FEV1 1.9 L and FVC 3.9 L after bronchodilation with FEV1/FVC still 0.4. What is the most likely diagnosis?

• A. Vascular disease with bronchodilator reversibility
• B. Restrictive lung disease with bronchodilator reversibility
• C. Restrictive lung disease without bronchodilator reversibility
• D. Obstructive disease with bronchodilator reversibility

Correct answer: D. Obstructive disease with bronchodilator reversibility

Q1. Neurogenic shock is associated with:

• A. Hypertension and tachycardia
• B. Hypotension and tachycardia
• C. Hypotension and bradycardia
• D. Hypertension and bradycardia

Correct answer: C. Hypotension and bradycardia

Q2. All of the following are criteria for SIRS except:

• A. Systolic blood pressure below 90 mmHg
• B. Temperature above 38°C or below 36°C
• C. Respiratory rate above 20 per minute
• D. Heart rate above 90 per minute

Correct answer: A. Systolic blood pressure below 90 mmHg

Q1. What is the age group distribution of vulvar cancer?

• A. Not age specific
• B. 35-55 years
• C. 55-85 years
• D. Both of the above

Correct answer: C. 55-85 years

Q2. Which of the following is not true about lupus nephritis in pregnancy?

• A. Immunosuppression can be continued during pregnancy
• B. Pregnancy should be planned once the disease has been quiescent for at least 6 months with no renal dysfunction
• C. High-dose corticosteroids for a lupus flare in pregnancy are safe
• D. Ecosprin, methotrexate, cyclophosphamide, corticosteroids and azathioprine are all safe in pregnancy

Correct answer: D. Ecosprin, methotrexate, cyclophosphamide, corticosteroids and azathioprine are all safe in pregnancy

Q1. In neonatal resuscitation, which is the most effective indicator of successful ventilatory effort?

• A. Colour change
• B. Rise in heart rate
• C. Air entry
• D. Chest rise

Correct answer: B. Rise in heart rate

Q2. A child presents with fever, rash, body ache and sore throat, with a history of a thorn prick injury a week earlier. Which antibiotic would you give empirically?

• A. Ceftriaxone
• B. Amoxicillin with clavulanate
• C. Vancomycin
• D. Meropenem

Correct answer: B. Amoxicillin with clavulanate

Q1. The most common pattern of involvement in Pott's spine is:

• A. Paradiscal
• B. Central
• C. Anterior
• D. Posterior

Correct answer: A. Paradiscal

Q2. Which combination of deformities is seen in congenital talipes equinovarus?

• A. Equinus, eversion, forefoot adduction, cavus
• B. Equinus, inversion, forefoot adduction, cavus
• C. Equinus, eversion, forefoot abduction, cavus
• D. Equinus, inversion, forefoot adduction, planus

Correct answer: B. Equinus, inversion, forefoot adduction, cavus

Q1. What is the action of the superior oblique muscle?

• A. Intorsion, abduction, depression
• B. Intorsion, adduction, elevation
• C. Extorsion, abduction, depression
• D. Extorsion, adduction, elevation

Correct answer: A. Intorsion, abduction, depression

Q2. Which triad is seen after an acute attack of angle-closure glaucoma?

• A. Vogt's triad
• B. Virchow's triad
• C. Hutchinson's triad
• D. Gaucher's triad

Correct answer: A. Vogt's triad

Q1. A man presents with saddle nose deformity and a history of cough, intermittent fever and haemoptysis. Septal perforation with pale granuloma is present, chest X-ray shows multiple cavitatory lesions, and biopsy shows granuloma with multinucleated giant cells and caseous necrosis. What is the probable cause?

• A. Wegener's granulomatosis
• B. Tuberculosis
• C. Syphilis
• D. Sarcoidosis

Correct answer: B. Tuberculosis

Q2. Which is the most common site of epistaxis in children?

High-yield addition

• A. Little's area
• B. Woodruff's plexus
• C. Sphenopalatine artery
• D. Anterior ethmoidal artery

Correct answer: A. Little's area

Q1. A woman who is 12 weeks pregnant and on multidrug therapy for leprosy presents with a type 2 lepra reaction. What is the treatment of choice?

• A. Stop MDT and start oral steroids
• B. Antibiotics
• C. Thalidomide
• D. Continue MDT and add oral steroids

Correct answer: D. Continue MDT and add oral steroids

Q2. Which of the following cause non-scarring alopecia — (1) Alopecia areata, (2) Telogen effluvium, (3) Androgenic alopecia, (4) Frontal fibrosing alopecia?

• A. 3 and 4
• B. 1, 2 and 3
• C. 2, 3 and 4
• D. Only 4

Correct answer: B. 1, 2 and 3

Q1. Which of the following is false about bipolar disorder?

• A. It most commonly affects ages 35-45 years
• B. Type 1 is common in both sexes
• C. Prevalence in the general population is 1-2%
• D. A suicide attempt is seen in around 15% of people

Correct answer: A. It most commonly affects ages 35-45 years

Q2. What is the first-line pharmacological treatment for obsessive-compulsive disorder?

High-yield addition

• A. SSRIs
• B. Haloperidol
• C. Lithium
• D. Benzodiazepines

Correct answer: A. SSRIs

Q1. Which of the following findings are seen on high-resolution CT in fungal pneumonia — (1) Interlobular septations, (2) Peripheral wedge-shaped consolidation, (3) Pleural effusion, (4) Cavitatory lesions with surrounding ground-glass opacity?

• A. 1, 2, 4
• B. 1, 3, 4
• C. 1, 2, 3
• D. 2, 3, 4

Correct answer: C. 1, 2, 3

The recalled answer excludes cavitatory lesions with surrounding ground-glass opacity — the halo sign, which is the classic HRCT finding in angioinvasive fungal pneumonia. Option A looks likelier; confirm before relying on it.

Q2. A patient presents after blunt chest trauma. In which of the following would you evaluate further before inserting a chest tube — (1) Diaphragmatic hernia, (2) Haemothorax, (3) Pneumothorax, (4) Flail chest?

• A. 4
• B. 1
• C. 2
• D. 3

Correct answer: B. 1

Q1. Arrange the following anaesthetic agents in order of potency: nitrous oxide, halothane, isoflurane, methoxyflurane.

• A. Methoxyflurane > halothane > isoflurane > nitrous oxide
• B. Methoxyflurane > isoflurane > halothane > nitrous oxide
• C. Methoxyflurane > nitrous oxide > halothane > isoflurane
• D. Halothane > isoflurane > nitrous oxide > methoxyflurane

Correct answer: A. Methoxyflurane > halothane > isoflurane > nitrous oxide

Q2. What is the drug of choice for malignant hyperthermia?

High-yield addition

• A. Dantrolene
• B. Succinylcholine
• C. Neostigmine
• D. Atropine

Correct answer: A. Dantrolene

Q1. Which of the following is not a branch of the facial artery in the face?

• A. Lateral nasal
• B. Mental
• C. Superior labial
• D. Inferior labial

Correct answer: B. Mental

Q2. The superior gluteal nerve supplies all of the following structures except:

• A. Gluteus medius
• B. Gluteus minimus
• C. Piriformis
• D. Tensor fasciae latae

Correct answer: C. Piriformis

Q1. Myosin ceases to be in contact with actin filaments as a result of:

• A. Attachment of ATP to the myosin head
• B. Cessation of calcium release from the sarcoplasm
• C. Conformational change in troponin T
• D. Dissociation of ADP and Pi

Correct answer: A. Attachment of ATP to the myosin head

Q2. Transport of iron into enterocytes is carried out by which protein?

• A. Transferrin
• B. Ferroportin
• C. Hepcidin
• D. Divalent metal transporter-1

Correct answer: D. Divalent metal transporter-1

Q1. Which technique is used to detect DNA-protein interactions?

• A. DNA footprinting
• B. DNA fingerprinting
• C. ELISA
• D. Northern blotting

Correct answer: A. DNA footprinting

Q2. The banding technique used for dicentric chromosomes is:

• A. G banding
• B. C banding
• C. NOR staining
• D. R banding

Correct answer: B. C banding

Q1. All of the following are seen in anaemia of chronic disease except:

• A. High serum hepcidin
• B. Low serum ferritin
• C. Chronic infection
• D. Normal iron stores

Correct answer: B. Low serum ferritin

Q2. Neurosecretory bodies are seen in all except:

• A. Medullary thyroid carcinoma
• B. Pituitary adenoma
• C. Paraganglioma
• D. Adrenal cortical tumour

Correct answer: D. Adrenal cortical tumour

Q1. Which of the following statements is correct regarding clinical trials?

• A. New drug application is done after phase 4
• B. Phase 4 is also called post-marketing surveillance
• C. Phase 3 is always double blinded
• D. Phase 2 is done on healthy individuals

Correct answer: B. Phase 4 is also called post-marketing surveillance

Q2. Dorzolamide is a:

• A. Topically applied sulfonamide antibacterial
• B. Topical ocular carbonic anhydrase inhibitor
• C. Second-generation sulfonylurea
• D. Opioid receptor agonist

Correct answer: B. Topical ocular carbonic anhydrase inhibitor

Q1. Which agent can be used as a disinfectant but not a sanitiser?

• A. Hydrogen peroxide
• B. Penicillin
• C. Methyl paraben
• D. Bleaching powder

Correct answer: A. Hydrogen peroxide

Q2. Vaccination against which of the following is recommended in the elderly — (1) Varicella zoster virus, (2) Rotavirus, (3) Measles, (4) Pneumococcus?

• A. 1, 2, 3, 4
• B. 1, 3
• C. 1, 4
• D. 2, 3

Correct answer: C. 1, 4

Q1. A man is tried for murder. A witness testifies that he saw the accused carrying a knife in the park. What is this evidence known as?

• A. Direct
• B. Indirect
• C. Hostile
• D. Hearsay

Correct answer: B. Indirect

Q2. A man presents after consuming an unknown substance, with increased sweating, lacrimation, diarrhoea, muscle weakness and tachycardia. What is the management?

• A. Atropine
• B. Calcium gluconate
• C. Pralidoxime
• D. Obidoxime

Correct answer: A. Atropine

Q1. A point-of-care diagnostic test with a sensitivity of 98% returns a negative result in a patient. What does this imply?

• A. The patient would need another point-of-care test for the same condition
• B. The prevalence of the disease is 2%
• C. The patient is less likely to have the disease
• D. The patient has been wrongly ruled out due to false negatives

Correct answer: C. The patient is less likely to have the disease

Q2. The attributable risk for the relation between smoking and lung cancer is 90%. Which of the following is true?

• A. 10% of lung cancers in smokers is not associated with smoking
• B. 90% of lung cancer cases in the population could be eliminated if smoking were eliminated
• C. 90% of lung cancer cases in smokers could be eliminated if smoking were eliminated
• D. 10% of lung cancer cases in the population could be eliminated if smoking were eliminated

Correct answer: C. 90% of lung cancer cases in smokers could be eliminated if smoking were eliminated

Q1. A young man presents with high-grade fever, altered consciousness and neck rigidity. Lumbar puncture shows 45 cells/µL with neutrophil predominance, elevated pressure, protein 120 mg/dL and glucose 70 mg/dL. How will you manage this case?

• A. Piperacillin with tazobactam
• B. Vancomycin with ceftriaxone
• C. Amphotericin B with flucytosine
• D. Antitubercular therapy

Correct answer: C. Amphotericin B with flucytosine

The recalled answer points to fungal meningitis, but a neutrophil-predominant pleocytosis with normal CSF glucose does not fit that picture cleanly. The CSF values in this recall may be incomplete — check the original before relying on it.

Q2. A patient with heart disease is breathless on walking to the bathroom. Which grade does he belong to?

• A. NYHA 3
• B. NYHA 4
• C. mMRC 4
• D. mMRC 5

Correct answer: A. NYHA 3

Q1. Identify the true statements regarding split-skin and full-thickness skin grafts — (1) Primary contractures are more in split-skin grafts, (2) Secondary contractures are more in split-skin grafts, (3) Primary contractures are more in full-thickness grafts, (4) Secondary contractures are more in full-thickness grafts.

• A. 2, 3
• B. 2, 4
• C. 1, 3
• D. 1, 4

Correct answer: A. 2, 3

Q2. Which of the following causes maximum malnutrition?

• A. Pancreatic fistula
• B. Duodenal fistula
• C. Distal ileal fistula
• D. Colonic fistula

Correct answer: B. Duodenal fistula

Q1. A 25-year-old woman had an uneventful vaginal delivery. On postpartum day 1 she has postpartum haemorrhage with visual changes and severe headache, then becomes unresponsive and is ventilated. BP is 60/40 mmHg with tachycardia and blood sugar 48 mg/dL; haematocrit and white cell count are normal. Which drug would help reverse this state?

• A. Injection dobutamine
• B. Steroids
• C. Thyroxine
• D. Activated protein C

Correct answer: B. Steroids

Q2. Which of the following statements regarding magnesium sulphate is false?

• A. It causes uterine relaxation, but this is dose dependent
• B. It is continued up to 24 hours after delivery or the last seizure
• C. It has an inhibitory effect on the cerebral cortex, preventing seizures and lowering blood pressure
• D. In renal failure the loading dose can be given, but the maintenance dose should be adjusted to renal function

Correct answer: C. It has an inhibitory effect on the cerebral cortex, preventing seizures and lowering blood pressure

Q1. Which alternative to breast milk can be used in low birth weight children?

• A. Cow's milk
• B. Preterm formula
• C. Term formula
• D. Human donor milk

Correct answer: D. Human donor milk

Q2. A 4-year-old boy weighing 15 kg with a height of 100 cm is admitted with renal failure. Blood urea is 100 mg/dL and serum creatinine 1 mg/dL. What is the closest calculated eGFR?

• A. 33 mL/min/1.73 m²
• B. 40 mL/min/1.73 m²
• C. 55 mL/min/1.73 m²
• D. 80 mL/min/1.73 m²

Correct answer: B. 40 mL/min/1.73 m²

Q1. Anterior dislocation of the shoulder is likely to damage which nerve?

• A. Axillary nerve
• B. Median nerve
• C. Radial nerve
• D. Suprascapular nerve

Correct answer: A. Axillary nerve

Q2. You notice that a newborn has congenital talipes equinovarus. When would you advise the parents to come in for casting?

• A. At 1 month
• B. In 6 months
• C. In a few days
• D. When the child starts walking

Correct answer: C. In a few days

Q1. What is the most common cause of moderate to severe visual impairment according to the National Blindness and Visual Impairment Survey 2015-19?

• A. Refractive error
• B. Untreated cataract
• C. Glaucoma
• D. Diabetic retinopathy

Correct answer: B. Untreated cataract

Q2. Which of the following statements is true about optic neuritis?

• A. A relative afferent pupillary defect is seen
• B. There is no pain on ocular movement
• C. Multiple myeloma is a common cause
• D. Oral corticosteroids are the mainstay of treatment

Correct answer: A. A relative afferent pupillary defect is seen

Q1. A patient presents with vertigo and horizontal nystagmus whose slow component is towards the left. What is the most likely diagnosis?

• A. Posterior canal BPPV
• B. Superior canal BPPV
• C. Right hypoactive labyrinth
• D. Left hypoactive labyrinth

Correct answer: D. Left hypoactive labyrinth

Q2. Entry of a foreign body into the laryngeal inlet is prevented by the cough reflex, which is sluggish after alcohol ingestion. Which nerve is likely injured when this reflex is lost?

• A. Internal laryngeal nerve
• B. Glossopharyngeal nerve
• C. External laryngeal nerve
• D. Recurrent laryngeal nerve

Correct answer: A. Internal laryngeal nerve

Q1. A patient with schizophrenia started on risperidone presents the next day with upward rolling of the eyes. What is the management?

• A. Lorazepam
• B. Promethazine
• C. Olanzapine
• D. Stop the antipsychotic

Correct answer: B. Promethazine

Q2. Which of the following is exclusively seen in females?

• A. Rett syndrome
• B. Asperger syndrome
• C. Selective mutism
• D. Atypical autism

Correct answer: A. Rett syndrome

Q1. The whole-body CT protocol for a trauma patient includes all of the following except:

• A. CT head
• B. CT cervical spine
• C. CT limbs
• D. CT abdomen

Correct answer: C. CT limbs

Q2. Eggshell calcification is seen in all of the following except:

• A. Silicosis
• B. Sarcoidosis
• C. Post-radiotherapy lymph nodes
• D. Metastatic lymph nodes

Correct answer: D. Metastatic lymph nodes

Q1. Which of the following local anaesthetics causes hypertension?

• A. Cocaine
• B. Lignocaine
• C. Bupivacaine
• D. Prilocaine

Correct answer: A. Cocaine

Q2. Which of the following is required for cannulation of a newborn — (1) 22G needle, (2) 24G needle, (3) 5 mL syringe, (4) Adhesive tape, (5) Normal saline?

• A. 1, 3, 4, 5
• B. 2, 3, 4, 5
• C. 2, 4
• D. 1, 4

Correct answer: B. 2, 3, 4, 5

Q1. The Auspitz sign is characteristically seen in:

High-yield addition

• A. Psoriasis
• B. Lichen planus
• C. Pemphigus vulgaris
• D. Atopic eczema

Correct answer: A. Psoriasis

Q2. What is the treatment of choice for pemphigus vulgaris?

High-yield addition

• A. Systemic corticosteroids
• B. Topical corticosteroids
• C. Dapsone
• D. Antihistamines

Correct answer: A. Systemic corticosteroids

Q1. In the formula for urea clearance, U × V / P, what does U represent?

• A. Urine volume
• B. Serum urea in mg/100 mL
• C. Urine urea in g/24 h
• D. Urine urea in mg/100 mL

Correct answer: D. Urine urea in mg/100 mL

Q2. Beta hCG is structurally similar to which hormone?

• A. LH
• B. FSH
• C. ACTH
• D. Oxytocin

Correct answer: A. LH

Q1. miRNA binds to which part of the mRNA to inhibit translation?

• A. Gene body
• B. Gene promoter
• C. 3' UTR
• D. 5' UTR

Correct answer: C. 3' UTR

Q2. Methyl-tetrahydrofolic acid accumulates in deficiency of which vitamin?

• A. B2
• B. B12
• C. B1
• D. B6

Correct answer: B. B12

Q1. Which is the cell of origin of chronic lymphocytic leukaemia / small lymphocytic lymphoma?

• A. Mature B cells
• B. Mature T cells
• C. Progenitor T cells
• D. Naïve B cells

Correct answer: D. Naïve B cells

The recalled answer says naïve B cells, but CLL/SLL is conventionally taught as arising from mature B cells, which is option A. Confirm before relying on it.

Q2. A 5-year-old child presents with proptosis of one eye and is found to have a desmin-positive tumour. What is the probable diagnosis?

• A. Ewing's sarcoma
• B. Embryonal rhabdomyosarcoma
• C. Leukaemia
• D. Retinoblastoma

Correct answer: B. Embryonal rhabdomyosarcoma

Q1. Which of the following is false about the selection of essential drugs?

• A. An adequate safety profile needs to be established
• B. Cost to benefit has to be considered
• C. Fixed drug combinations are preferred over single drugs
• D. Disease prevalence is considered

Correct answer: C. Fixed drug combinations are preferred over single drugs

Q2. A patient with a history of ischaemic stroke was started on clopidogrel but had another stroke six months later. What is likely responsible for the failure of clopidogrel?

• A. Downregulation of CYP2C19
• B. Downregulation of CYP2D6
• C. Upregulation of CYP1A1
• D. Downregulation of CYP2E1

Correct answer: A. Downregulation of CYP2C19

Q1. Which of the following causes aplastic crisis in hereditary spherocytosis?

• A. Poxvirus
• B. Epstein-Barr virus
• C. Adenovirus
• D. Parvovirus

Correct answer: D. Parvovirus

Q2. Which cell is involved in type IV (delayed type) hypersensitivity?

• A. Cytotoxic T cell
• B. Macrophage
• C. Dendritic cell
• D. Neutrophil

Correct answer: A. Cytotoxic T cell

Q1. A skull is recovered from a forest and sent to the forensic laboratory. Which of the following would identify it as a female skull — (1) Large frontal and parietal eminence, (2) Heavy cheek bones, (3) Smooth glabella, (4) Square orbits, (5) Narrow mastoid?

• A. 1 and 4 only
• B. 2, 3 and 4
• C. 1, 3 and 5
• D. 3, 4 and 5

Correct answer: C. 1, 3 and 5

Q2. Two men had been drinking and argued. One kills the other by sitting on his chest and covering his nose and mouth. This is an example of:

• A. Burking
• B. Smothering
• C. Traumatic asphyxia
• D. Overlaying

Correct answer: A. Burking

Q1. A new drug is introduced which decreases mortality but does not cure the disease. Which of the following is true regarding prevalence and incidence?

• A. Decrease in incidence
• B. Decrease in prevalence
• C. Increase in incidence
• D. Increase in prevalence

Correct answer: D. Increase in prevalence

Q2. Compared to a pregnant woman, a lactating woman requires a higher level of supplementation of which nutrient?

• A. Vitamin A
• B. Calcium
• C. Iron
• D. Folic acid

Correct answer: B. Calcium

The recalled answer says calcium, but ICMR requirements for calcium are the same in pregnancy and lactation, while vitamin A is higher during lactation. Worth checking.

Q1. For a diagnosis of resistant hypertension, the patient should have uncontrolled hypertension despite three antihypertensive drugs. This should include at least one:

• A. Calcium channel blocker
• B. Beta-blocker
• C. Alpha blocker
• D. Diuretic

Correct answer: D. Diuretic

Q2. What is the treatment of choice for an acute attack of cluster headache?

• A. Oral sumatriptan
• B. Subcutaneous sumatriptan
• C. 100% oxygen at 6 L/minute
• D. 100% oxygen at 8 L/minute

Correct answer: B. Subcutaneous sumatriptan

Q1. A surgeon performing an appendicectomy through a gridiron incision converts it to a Rutherford Morison incision. Which of the following are cut — (1) External oblique, (2) Internal oblique, (3) Transversus abdominis, (4) Rectus abdominis?

• A. 1, 3, 4
• B. 2, 3, 4
• C. 1, 2, 3
• D. 1, 2, 4

Correct answer: C. 1, 2, 3

Q2. What is triage for?

• A. To prepare for a disaster
• B. To assess the impact of a disaster
• C. To classify the priority of treatment
• D. To rehabilitate following a disaster

Correct answer: C. To classify the priority of treatment

Q1. Which of the following is not a long-acting reversible contraceptive method?

• A. Copper T
• B. Implanon
• C. Laparoscopic tubal ligation
• D. Combined oral contraceptives

Correct answer: C. Laparoscopic tubal ligation

Q2. A teenage girl presents with irregular cycles, increased facial hair and enlarged ovaries. Which of the following are used first line — (1) Laparoscopic ovarian drilling, (2) Anti-androgens, (3) Lifestyle modification, (4) Combined oral contraceptive pills?

• A. 1, 2, 3
• B. 2, 3, 4
• C. 1, 3, 4
• D. 1, 2, 4

Correct answer: B. 2, 3, 4

Q1. Which of the following is a true statement about congenital CMV infection?

• A. About 20-30% of infections are symptomatic
• B. The triad is sensorineural hearing loss, periventricular calcification and enamel hypoplasia
• C. Most children asymptomatic at birth can develop conductive hearing loss later in life
• D. If the mother is IgG positive for CMV, the child is unlikely to develop an infection

Correct answer: D. If the mother is IgG positive for CMV, the child is unlikely to develop an infection

All four options in this recall are questionable — around 10% of congenital CMV is symptomatic, the classic triad includes chorioretinitis rather than enamel hypoplasia, later hearing loss is sensorineural, and maternal IgG does not prevent congenital infection. The recall is probably garbled; check the original.

Q2. Which congenital heart disease has equal oxygen saturation in all heart chambers?

• A. Tetralogy of Fallot
• B. Total anomalous pulmonary venous connection
• C. Tricuspid atresia
• D. Transposition of the great arteries

Correct answer: B. Total anomalous pulmonary venous connection

Q1. Which of the following is seen in osteoporosis?

• A. Normal calcium and increased ALP
• B. Normal calcium and normal ALP
• C. Decreased calcium and normal ALP
• D. Increased calcium and increased ALP

Correct answer: B. Normal calcium and normal ALP

Q2. An elderly woman slips at home and is diagnosed with a Colles fracture, managed with a POP cast. What is the correct sequence of reduction?

• A. Traction, POP, palmar flexion, ulnar deviation
• B. Traction, palmar flexion, ulnar deviation, POP
• C. Traction, ulnar deviation, palmar flexion, POP
• D. Palmar flexion, ulnar deviation, traction, POP

Correct answer: B. Traction, palmar flexion, ulnar deviation, POP

Q1. A 30-year-old woman presents with redness and pain in the eye. Examination reveals an IOP of 38 mmHg, aqueous flare and keratic precipitates. Which drug must be avoided?

• A. Beta-blockers
• B. Mannitol
• C. Carbonic anhydrase inhibitors
• D. Prostaglandin analogues

Correct answer: D. Prostaglandin analogues

Q2. The SAFE strategy for trachoma includes all except:

• A. Surgery for trichiasis
• B. Antibiotics
• C. Facial cleanliness
• D. Evaluation of the control programme

Correct answer: D. Evaluation of the control programme

Q1. A patient presents with vertigo, tinnitus and head tilt, six months after myringoplasty for safe-type chronic suppurative otitis media. What is your diagnosis?

• A. Perilymphatic fistula
• B. Labyrinthitis
• C. Paget disease
• D. Vestibular schwannoma

Correct answer: A. Perilymphatic fistula

Q2. Which of the following is not used in post-laryngectomy rehabilitation?

• A. Tracheo-oesophageal prosthesis
• B. Oesophageal speech
• C. Polite yawning
• D. Super-supraglottic swallow

Correct answer: D. Super-supraglottic swallow

Q1. A man feels his hands are contaminated and is compelled to wash them repeatedly, and this is now affecting his performance. What is the best treatment option?

• A. Dialectical behaviour therapy
• B. Exposure and response prevention
• C. Systematic desensitisation
• D. Cognitive behavioural therapy

Correct answer: B. Exposure and response prevention

Q2. Which of the following is not classified under obsessive-compulsive and related disorders in ICD-11?

• A. Trichotillomania
• B. Body dysmorphic disorder
• C. Hypochondriacal disorder
• D. PTSD

Correct answer: D. PTSD

Q1. In conventional oxygen therapy, which device delivers the highest FiO₂?

• A. Venturi mask
• B. Hudson mask
• C. Non-rebreathing mask
• D. Nasal cannula

Correct answer: C. Non-rebreathing mask

Q2. During laparoscopic cholecystectomy in a 60-year-old man, EtCO₂ suddenly drops to 8 mmHg, SpO₂ falls to 90%, BP drops to 80/50 mmHg and peak airway pressure is 18 cm H₂O. What is the diagnosis — (1) CO₂ embolism, (2) Severe bronchospasm, (3) Pneumothorax, (4) Single bronchus intubation?

• A. Both 1 and 2
• B. Both 3 and 4
• C. 1 only
• D. 2 only

Correct answer: C. 1 only

Q1. Which structure passes through the foramen ovale?

High-yield addition

• A. Mandibular nerve
• B. Maxillary nerve
• C. Middle meningeal artery
• D. Internal carotid artery

Correct answer: A. Mandibular nerve

Q2. The femoral nerve is a branch of which plexus?

High-yield addition

• A. Lumbar plexus
• B. Sacral plexus
• C. Brachial plexus
• D. Cervical plexus

Correct answer: A. Lumbar plexus

Q1. Nikolsky's sign is positive in all of the following except:

High-yield addition

• A. Pemphigus vulgaris
• B. Toxic epidermal necrolysis
• C. Staphylococcal scalded skin syndrome
• D. Bullous pemphigoid

Correct answer: D. Bullous pemphigoid

Q2. What is the drug of choice for scabies in an adult?

High-yield addition

• A. Permethrin 5% cream
• B. Permethrin 1% lotion
• C. Benzyl benzoate 10%
• D. Oral griseofulvin

Correct answer: A. Permethrin 5% cream

Q1. Which is the investigation of choice in acute stroke to rule out haemorrhage?

High-yield addition

• A. Non-contrast CT
• B. MRI brain
• C. Carotid Doppler
• D. PET scan

Correct answer: A. Non-contrast CT

Q2. The double bubble sign on a neonatal abdominal radiograph suggests:

High-yield addition

• A. Duodenal atresia
• B. Hypertrophic pyloric stenosis
• C. Hirschsprung disease
• D. Malrotation

Correct answer: A. Duodenal atresia

Q1. The medial lemniscus is a continuation of which structure?

• A. Spinothalamic tract
• B. Spinocerebellar tract
• C. Spinotectal tract
• D. Fasciculus gracilis

Correct answer: D. Fasciculus gracilis

Q2. Decussation of the superior cerebellar peduncle occurs at which level?

• A. Pons
• B. Midbrain
• C. Diencephalon
• D. Medulla

Correct answer: B. Midbrain

Q1. The Gibbs-Donnan equilibrium is mainly due to:

• A. Phosphate
• B. Bicarbonate in the intracellular compartment
• C. Calcium in the extracellular compartment
• D. Intracellular proteins

Correct answer: D. Intracellular proteins

Q2. A 65-year-old man has a BP of 190/100 mmHg with a pulse pressure of 90 mmHg. A decrease in which of the following would produce this rise in pulse pressure?

• A. Myocardial contractility
• B. Stroke volume
• C. Arterial wall compliance
• D. Cardiac output

Correct answer: C. Arterial wall compliance

Q1. What is true about the Hayflick limit?

• A. Human cells can divide a finite number of times only
• B. Free radical oxidation level is unrestricted
• C. Telomerase activity is unrestricted
• D. RNA polymerase can function a finite number of times only

Correct answer: A. Human cells can divide a finite number of times only

Q2. DNA methylation is not related to:

• A. Mismatch repair
• B. Chromatin remodelling
• C. DNA replication
• D. Gene silencing

Correct answer: C. DNA replication

Q1. Deficiency of which clotting factor will not affect clotting in vivo?

• A. Factor VII
• B. Factor V
• C. Factor XII
• D. Factor IX

Correct answer: C. Factor XII

Q2. Which is the most common histological type of renal cell carcinoma?

High-yield addition

• A. Clear cell
• B. Papillary
• C. Chromophobe
• D. Collecting duct

Correct answer: A. Clear cell

Q1. If a patient on metoprolol is started on verapamil, which side effect would be seen?

• A. Bradycardia with AV block
• B. Torsades de pointes
• C. Tachycardia
• D. Ventricular fibrillation

Correct answer: A. Bradycardia with AV block

Q2. Rosuvastatin should not be combined with which of the following drugs?

• A. Oxycodone
• B. Clarithromycin
• C. Adalimumab
• D. Rivaroxaban

Correct answer: B. Clarithromycin

Q1. Which organism is transmitted transplacentally and causes microcephaly?

• A. Nipah virus
• B. Zika virus
• C. CMV
• D. Rubella

Correct answer: B. Zika virus

Q2. Affinity maturation is due to:

• A. Isotype switching
• B. Somatic hypermutation
• C. mRNA splicing
• D. VDJ rearrangement

Correct answer: B. Somatic hypermutation

Q1. A patient arrives with life-threatening injuries and there is no time to take consent. The doctor performs life-saving procedures with all precautions and the patient dies despite best efforts. The doctor is not responsible under which doctrine?

• A. Res ipsa loquitur
• B. Doctrine of anticipation
• C. Doctrine of extended consent
• D. Doctrine of conjugated consent

Correct answer: B. Doctrine of anticipation

Q2. A 14-year-old girl attends with her mother giving a history of penovaginal penetration by a neighbour, and says she does not want to be examined. As the medical officer, which should you do — (1) Document informed refusal, (2) Do not inform the police, (3) Counsel the mother and daughter, (4) Examine with necessary force, (5) Inform the police?

• A. 1, 2, 3 are true
• B. 2, 3, 4 are true
• C. 1, 3, 5 are true
• D. 3, 4, 5 are true

Correct answer: C. 1, 3, 5 are true

Q1. A resident doctor is pricked with a needle while attending an HIV-positive patient. Which regimen should be given?

• A. Zidovudine and lamivudine
• B. Zidovudine, lamivudine and nevirapine
• C. Zidovudine, lamivudine and indinavir
• D. Zidovudine and nevirapine

Correct answer: C. Zidovudine, lamivudine and indinavir

Q2. The maternal mortality ratio is defined as:

• A. Maternal deaths per 10,000 live births
• B. Maternal deaths per 100,000 live births
• C. Maternal deaths per 10,000 women of reproductive age
• D. Maternal deaths per 100,000 women of reproductive age

Correct answer: B. Maternal deaths per 100,000 live births

Q1. Which of the following is the drug of choice for hairy cell leukaemia?

• A. Rituximab
• B. Vemurafenib
• C. Cladribine
• D. Interferon-alpha

Correct answer: C. Cladribine

Q2. A patient with diabetic nephropathy is an ideal candidate for renal transplantation. Which statement is true?

• A. The graft survival rate is 95% in the first year
• B. Transplantation becomes cost-effective after the second year
• C. Life expectancy is doubled in a diabetic patient with a renal transplant
• D. Treatment of chronic rejection has improved over the last 10 years

Correct answer: B. Transplantation becomes cost-effective after the second year

Q1. Which statements are correct regarding Peutz-Jeghers syndrome — (A) Arborising pattern of smooth muscle, (B) Loss of heterozygosity in the STK11 gene, (C) Multiple GI polyps, (D) Autosomal recessive inheritance, (E) Congenital hypertrophy of the retinal pigment epithelium?

• A. B, D and E
• B. A, B and C
• C. A, C and D
• D. B, C and E

Correct answer: B. A, B and C

Q2. ERCP is least useful in the diagnosis of:

• A. Recurrent pancreatitis
• B. Unexplained jaundice
• C. Periampullary mass
• D. Acute pancreatitis without choledocholithiasis

Correct answer: D. Acute pancreatitis without choledocholithiasis

Q1. A patient with 12 weeks of amenorrhoea presents with vaginal bleeding. The cervical os is open, the uterus is 14 weeks in size, and ultrasound shows a snowstorm appearance. What is the next best step in management?

• A. Medical management
• B. Follow up with beta-hCG
• C. Suction and evacuation
• D. Hysterectomy

Correct answer: C. Suction and evacuation

Q2. Which group should be screened for carcinoma of the cervix?

• A. More than 65 years old
• B. Less than 21 years old
• C. Women aged 21 to 65 years
• D. Teenagers

Correct answer: C. Women aged 21 to 65 years

Q1. Which of the following is least likely in Rh incompatibility in a newborn?

• A. Increased unconjugated bilirubin
• B. Increased faecal urobilinogen
• C. Increased urine bilirubin
• D. Increased stercobilinogen

Correct answer: C. Increased urine bilirubin

Q2. A child transfers an object from one hand to the other. What does this signify?

• A. Visual-motor coordination
• B. Ability to compare objects
• C. Ability to handle small objects
• D. Voluntary release

Correct answer: B. Ability to compare objects

Q1. All of the following are indications for surgery in Pott's spine except:

• A. Cold abscess without neurological complication
• B. Doubtful diagnosis
• C. Drug-resistant TB
• D. Progressive cauda equina or conus medullaris syndrome

Correct answer: A. Cold abscess without neurological complication

Q2. In meniscal tear repair, which zone heals best?

• A. Red zone
• B. White zone
• C. Grey zone
• D. Red-white zone

Correct answer: D. Red-white zone

The recalled answer says the red-white zone, but the red zone is the vascular periphery and is conventionally taught as the one that heals best. Worth confirming.

Q1. Which laser is used for laser iridotomy?

• A. Argon laser
• B. Nd:YAG laser
• C. Excimer laser
• D. CO₂ laser

Correct answer: B. Nd:YAG laser

Q2. In dacryocystorhinostomy, the lacrimal sac is opened into which meatus?

• A. Inferior meatus
• B. Middle meatus
• C. Supreme meatus
• D. Superior meatus

Correct answer: B. Middle meatus

Q1. A patient with vertigo but no hearing loss is assessed by an ENT surgeon, who performs a diagnostic manoeuvre followed cautiously by a therapeutic one. What is the diagnostic manoeuvre?

• A. Hampton's manoeuvre
• B. Dix-Hallpike manoeuvre
• C. Epley's manoeuvre
• D. Simon's manoeuvre

Correct answer: B. Dix-Hallpike manoeuvre

Q2. Which is the most common benign tumour of the parotid gland?

High-yield addition

• A. Pleomorphic adenoma
• B. Warthin tumour
• C. Oncocytoma
• D. Basal cell adenoma

Correct answer: A. Pleomorphic adenoma

Q1. A woman presents with active genital warts and a history of recurrence, but her husband is unaffected. What advice would you give to prevent transmission?

• A. Give continuous prophylaxis to the patient
• B. Give prophylactic antivirals to the husband
• C. Give antivirals whenever active lesions are present
• D. Avoid intercourse when active lesions are present

Correct answer: D. Avoid intercourse when active lesions are present

Q2. A rose gardener with a history of a thorn prick presents with nodular lesions along a lymphatic tract. What is the likely causative agent?

• A. Streptococcus pyogenes
• B. Sporothrix schenckii
• C. Strongyloides stercoralis
• D. Staphylococcus aureus

Correct answer: B. Sporothrix schenckii

Q1. A drug that selectively reduces the reuptake of serotonin would likely cause which side effect?

• A. Constipation
• B. Sexual dysfunction
• C. Sialorrhoea
• D. Visual disturbance

Correct answer: B. Sexual dysfunction

Q2. A young man is shy, prefers social isolation, appears emotionally cold and lives alone, with no history of hallucinations or delusions. What is the most likely diagnosis?

• A. Paranoid personality disorder
• B. Schizoid personality disorder
• C. Antisocial personality disorder
• D. Emotionally unstable personality disorder

Correct answer: B. Schizoid personality disorder

Q1. Which statement is false regarding acute radiation syndrome?

• A. GI manifestations occur at a lower radiation dose than bone marrow depression
• B. Bone marrow suppression appears at doses greater than 1 Gy
• C. Bone marrow suppression occurs earlier than neurovascular effects
• D. GI manifestations occur at a lower radiation dose than neurovascular effects

Correct answer: A. GI manifestations occur at a lower radiation dose than bone marrow depression

Q2. A 25-year-old man with Marfanoid features presents with sudden onset breathlessness. What is the diagnosis?

• A. Pneumothorax
• B. Pleural effusion
• C. Consolidation
• D. Fibrosis

Correct answer: A. Pneumothorax

Q1. A patient with blunt chest trauma has been started on mechanical ventilation. Which of the following is not correct about the initial settings?

• A. Respiratory rate 12 breaths per minute
• B. PEEP 5 cm H₂O
• C. FiO₂ 100%
• D. Tidal volume 12 mL/kg of actual body weight

Correct answer: D. Tidal volume 12 mL/kg of actual body weight

Q2. You notice an unconscious man lying on the ground in a park. Which is the next best step?

• A. Check carotid pulse, start CPR and call for help, defibrillate if no pulse
• B. Call for help, check pulse, do CPR, defibrillate if no pulse
• C. Observe
• D. Ignore and continue walking

Correct answer: B. Call for help, check pulse, do CPR, defibrillate if no pulse