SMOKING

1. A 40 years old executive who smokes three packs of cigarettes a day comes to your office for
his routine health maintenance assessment. He states that he would like to quit smoking but he
is having great difficulty. He has tried three times before, but he says “pressure at work mounted
up and I just had to go back to smoking”. Of the following factors which is the most important
factor in determining the failure of smoking cessation.

a) 40 years age d) Halfhearted attempts to quit

b) Numbers of cigarettes e) Type A Personality
c) Stress at work
Key: True: d

2. A 40 years old executive who smokes three packs of cigarettes a day comes to your office for
his routine health maintenance assessment. He states that he would like to quit smoking but he
is having great difficulty. He has tried three times before, but he says “pressure at work mounted
up and I just had to go back to smoking”. He just had to go back to smoking, the content of
cigarette for this relapse is:

a) Nicotine level d) Ketone

b) Tar content of the cigarette e) Carboxylic acid
c) Aldehyde
Key: True: a

3. A 40 years old executive who smokes three packs of cigarettes a day comes to your office for
his routine health maintenance assessment. He states that he would like to quit smoking but he
is having great difficulty. He has tried three times before, but he says “pressure at work mounted
up and I just had to go back to smoking”. The most suitable method to increase long term smoking
abstinence is:

a) Nicotine chewing gum d) Pan chewing

b) Sedation e) Anxiolytic
c) Daily injection of Nicotine
Key: True: a

4. Cigarette smoking increases the risk of acquiring cancer of:

a) Liver d) Uterus
b) Bones e) Esophagus
c) Ovaries
Key: True:
NON-COMMUNICABLE DISEASES
1. 5 students of 4th year of Wah Medical College are doing research on risk factors and their
perception among patients of coronary heart disease. They have observed that risk factor which
is most significantly associated with the incidence of CHD is:

a) Hypertension d) Decreased physical activity

b) High serum cholesterol e) Cigarette smoking
c) Alcoholism
Key: True: b

2. 20 years old gentleman presented to the emergency department with history of abdominal
pain an after words loss of consciousness. His mother told that he was having polydipsia,
polyphagia for last few days. His blood sugar was 700 mg/dL & urinary ketones were positive.
The likely diagnosis is:

a) Hyperosmolar coma d) Diabetes insipidus

b) Diabetic ketoacidosis e) Vasovagal syncope
c) Diabetes Mellitus type 2
Key: True: b

3. 45 years old male morbidly obese presented with history of polyuria & polydipsia. His blood
sugar is 240 mg/dL. Most likely diagnosis is:

a) Diabetes Mellitus type 1

b) Diabetes Mellitus type 2
c) Maturity onset diabetes of young
d) Diabetes insipidus (neurogenic)
e) Diabetes insipidus (nephrogenic)

Key: True: b

4. 80 years old gentleman presented with sudden loss of consciousness. He is diabetic on oral
hypoglycemic drugs. He has skipped his breakfast today. The first laboratory investigation would
be:

a) Blood sugar level d) EEG

b) ECG e) Urinary glucose
c) Glycosylated hemoglobin
Key: True: a
5. 45 years old gentleman presents with a two week history of polydipsia, polyuria. He is found
to have a random glucose of 200 mg/dL. There are no ketones in the urine. Most suitable for this
man is that he should be:

a) On regular hypoglycomics
b) Reassured & reassessed after 2 months
c) On restricted diet & reassessed after 10 days
d) Admitted to hospital
e) Immediately on Insulin therapy

Key: True: c

6. 49 years old black African male smoker with positive family history of hypertension presented
with history of constant headache. His blood pressure was 140/90 mg hg. The modifiable risk
factor in this particular case is:

a) Male sex d) Smoking

b) African race e) Age
c) Positive family history
Key: True: d

7. An 80 kg 50 years old gentleman is found to have BP of 135/80 mm of Hg. The most important
step included in primary prevention of hypertension in this patient is to:

a) Advise lipid profile d) Take antihypertensive treatment

b) Reduce weight e) Have monthly follow up
c) Ensure patient compliance
Key: True: b

8. 45 years old hypertensive bank manager is used to high salt intake in food. Which type of salt
would be less harmful for this man?

a) Fluoride d) Manganese
b) Potassium e) Bromium
c) Chromium
Key: True: b

9. Use of oral contraceptives by women smokers over 35 years of age is associated with increased
risk of:

a) Cervical cancer c) Chronic bronchitis

b) Breast carcinoma d) Coronary heart disease
 e) Peripheral neuropathy

Key: True: d

10. A forty years old woman presents with an ovarian cyst; you want to screen her for breast
cancer before suggesting any hormonal treatment. What will you advise?

a) Chest radiograph d) Blood levels of progesterone

b) Mammography e) Tumor markers
c) Biopsy of breast
Key: True: b

11. During a health education session about non communicable diseases in a female community;
you will inform that genetics and family history make a woman more prone to have:

a) Cataract d) Oral cancer

b) Stroke e) Liver cirrhosis
c) Breast cancer
Key: True: c

12. Epidemiologist linked prevalence of carcinomas mostly related with parasitic and viral
infections, in developing countries due to bad hygienic conditions. During the research strong
linkage was proposed between carcinoma cervix and:

a) Cytomegalovirus d) Helicobacter pylori

b) Human papilloma virus e) Scistosoma Hematobium
c) Epstein bar virus
Key: True: b

13. Dietary factors have a strong influence on the development of carcinomas. A research article
was read in Marriott Islamabad regarding this fact and gastric carcinoma was linked with:

a) High fat intake d) Presence of nitrosamines

b) Beef consumption e) High dietary fiber content
c) Smoked fish
Key: True: d

14. Japan has low incidence of prostate cancer as compared to the incidence in US. The incidence
of carcinoma prostate decrease in Japanese when migrate to U.S. This support:

a) Nutritional effect d) Metabolic effect

b) Environmental effect e) Occupational effect
c) Genetic effect
Key: True: b

15. Japan has low incidence of prostate cancer as compared to the incidence in US. The incidence
of carcinoma prostate in Japanese did not change with their migration to the U.S. It supported:

a) Nutritional effect d) Metabolic effect

b) Environmental effect e) Metabolic effect
c) Genetic effect
Key: True: c

16. A 10 years old boy presented with complaints of fever, accompanied by profuse sweating for
the last 1 week. He also complained of multiple joint pains. Serum ASO titre was increase. The
likely diagnosis is:

a) Malaria d) Rheumatic fever

b) Dengue e) Ricketts
c) Hepatitis B
Key: d

17. Cancer registration is important for any cancer control program. It provides a base for
assessing the magnitude of problem and for planning the necessary action. If the size for a
population based case registry is 6 million it is considered to be:

a) Inadequate d) Very large

b) Very small e) Unusually large
c) Adequate
Key: c

18. A 35 years old man hypertensive, smoker and having positive family history of diabetes and
obesity suddenly became unconscious. CT scan was suggestive of hemorrhagic stroke. The main
risk factor of stroke in this case is:

a) Hypertension d) Smoking
b) Diabetes e) Age
c) Obesity
Key: a

19. A 40 years old woman taking oral anti-diabetics for last 5 years, with poor control of blood
sugar presented to physician for routine checkup. The test which provides a long term index of
glucose control in this case would be:

a) Standard oral glucose test

 b) Random blood sugar
c) Glycosylated hemoglobin
d) Urine sugar examination
e) Fasting blood sugar examination

Key: c

20. Cancer is the second leading cause of death in developed countries. It is regarded as a modern
slow epidemic. The most common site of cancer in men and women in the world is:

a) Lung d) Liver
b) Stomach e) Oral cavity
c) Colorectal
Key: a

21. A 45 years old man has weight of 70 kg and height of 1.6 m. His BMI is 27.3. He is:

a) Under weight d) Obese

b) Normal weight e) Severely obese
c) Over weight
Key: c

SEXUALLY TRANSMITTED DISEASES

1. A 25 years old female presented to a Gyaenacologist with complains of severe lower abdominal
pain, dyspareunia and intermenstrual bleeding. On examination cervix was inflamed with
mucopurulent discharge and contact bleeding. The most likely cause is:

a) Staphylococcus aureus d) Trichomonas

b) Gonococcus e) Treponema palidum
c) Chlamydia
Key: b

2. A 23 years old woman presented to a doctor with complaints of vaginal itching. On speculum
examination it revealed white cheesy discharge adherent to walls of vagina with vaginal
inflammation. The most likely causative organism is:

a) Candida albicans d) Condyloma accuminatum

b) Trichomonas vaginalis e) Treponema palidum
c) Gardnerella sp.
Key: a