Q168. 15 year old male with recent sudden growth. Current height 6'4'' with widening of jaw, large hand and foot. Frequent visual disturbances and headache. On ophthalmic examination he has bitemporal hemianopia. What test is used in the diagnosis?

Q169. Binocular single vision consists of which of the following components as depicted in the image.

Q170. A patient scheduled for surgery develops preoperative bradycardia, hypotension, and facial flushing. Which of the following muscle relaxants is most likely responsible for these symptoms?

Q171. Patient administered sevoflurane and succinylcholine for abdominal surgery develops post operative muscle rigidity. Drug of choice

Q172. A 32-year-old female presents with weakness in the right arm in the form of difficult in kneading dough. On examination, there is hypotonia and sluggish deep tendon reflexes in the affected limb. Which of the following structures is most likely involved?

Q173. A patient with asthma is currently being treated with salbutamol and ipratropium bromide. He now reports frequent nocturnal symptoms. What is the most appropriate next step in management?

Q174. A 35-year-old woman with a history of migraine was initially on over the counter NSAIDs. But since there was not adequate relief, she is currently using sumatriptan for acute attacks. Her father has a history of coronary artery disease. What is the most appropriate agent to add for migraine prophylaxis?

Q175. A 70-year-old patient with a history of hypertension and atrial fibrillation presents with acute-onset right-sided weakness and aphasia, which began 2 hours ago. A non-contrast CT scan of the brain shows no evidence of hemorrhage. What is the next best step in management?

Q176. A 55-year-old patient presents with episodes of shortness of breath and palpitations. An ECG confirms paroxysmal supraventricular tachycardia. What is the most appropriate option for long-term prophylactic treatment?

Q177. Which of the following intravenous fluids when given in large volume is most likely to cause hyperchloremic metabolic acidosis?

Q178. A 45-year-old woman presents with a 6-month history of dry mouth, dry eyes, and dry cough. Laboratory investigations reveal that she is ANA positive, anti-Ro positive, and anti-La positive. Which of the following findings is most commonly associated with this condition?

Q179. A teenage girl with known type 1 diabetes mellitus, currently on insulin therapy, presents to the outpatient department with severe dehydration after skipping her last insulin dose. Her random blood glucose is markedly elevated at 720 mg/dL, and her serum sodium is 126 mEq/L and serum potassium is 4.3 mEq/l. Which of the following is NOT appropriate as part of her management?

Q180. A patient with tuberculosis and HIV (CD4 count <150) is found to be rifampicin-resistant on CBNAAT. What is the appropriate management, and what is the most likely associated complication?

Q181. A patient diagnosed with hyponatremic encephalopathy presents with a serum sodium level of 95 mEq/L. She was treated with 3% hypertonic saline, and after 24 hours, her sodium level increased to 111 mEq/L. After sodium correction, her neurological status has deteriorated. What is the next best step in management?

Q182. A critically ill patient with covid 19 is admitted into ICU and is currently on mechanical ventilation. The PaO2/FiO2 ratio is 100, indicative of ARDS. Which of the following is the Most appropriate ventilation strategy to manage the patient?

Q183. A 45-year-old female presented with a 6-month history of paroxysmal nocturnal dyspnea, palpitations, and breathlessness. JVP elevated, pulse irregularly irregular, tender hepatomegaly. A heaving apex was noted, and a mid-diastolic murmur (MDM) was heard at the apex. The patient also has a history of acute rheumatic fever. Which statement is TRUE?

Q184. A 45-year-old male presents with headache, palpitations, and sweating. Laboratory tests reveal elevated vanillylmandelic acid (VMA) and metanephrine levels. What is the drug of choice for preoperative and intraoperative management?

Q185. Which drug is used for prophylaxis of meningococcal meningitis in close contacts?