Q1352. vomiting, or vaginal discharge. Her vitals are stable, and there is no history of recent antibiotic use or urinary tract abnormalities. Empirical therapy is being considered. Which of the following drugs should NOT be preferred as first-line empirical treatment in this case?

Q1353. recurrent abdominal pain, and episodes of venous thrombosis. Blood investigations show anemia, elevated LDH, low haptoglobin, and flow cytometry reveals deficiency of CD55 and CD59 on RBC, confirming paroxysmal nocturnal hemoglobinuria (PNH). Which of the following is the drug of choice for this condition?

Q1354. and telmisartan. She has an HbA1c level of 8.5. Her blood pressure is normal, and recent investigations show eGFR to be < 50 mL/min/1.73 m², but serum potassium is normal, and she is asymptomatic. What should be done to decrease the risk of further decrease in GFR?

Q1355. confused, febrile (39.5°C), with a positive Kernig’s sign and neck rigidity. On CSF analysis show low glucose. Fundoscopy shows no papilledema. The physician decides to start empirical antibiotics immediately. Which of the following is the most appropriate empirical therapy?

Q1356. 22-year-old man diagnosed with enteric fever (typhoid) was started on ciprofloxacin. After 5 days of therapy, he continues to have high-grade fever and toxic symptoms. Blood culture later confirms Salmonella typhi. What is the most appropriate next drug of choice?

Q1358. A patient with bronchial asthma is prescribed a salbutamol metered dose inhaler (MDI). He has difficulty coordinating actuation with inspiration, so his physician advises the use of a spacer device with the MDI. Which of the following statements is true regarding the use of a spacer with an MDI?

Q1360. presents on day 7 of his treatment cycle with dysuria, suprapubic pain, and frank hematuria.Urine examination shows numerous red blood cells without infection. It is diagnosed as hemorrhagic cystitis. His current chemotherapy regimen includes the following agents. Which drug is most likely responsible for his symptoms?

Q1361. A 48-hour culture on the PPLO agar shows small colonies showing fried egg colonies. Which organism is most likely?

Q1362. A patient from an endemic area presents with chronic respiratory symptoms. Microscopy shows small oval yeast forms with narrow-based budding, seen inside macrophages. Which of the following organisms is most likely responsible?

Q1363. An electron micrograph/image shows a bacteriophage attached to a bacterial cell. Which of the following processes of genetic transfer is being demonstrated?

Q1364. An HIV-positive patient presents with curdy white vaginal discharge. Microscopic examination of the discharge on KOH mount shows oval, narrow-based budding yeast cells measuring 4–6 μm. The organism causing this infection is an opportunistic pathogen. Which of the following is the correct characteristic of this organism?

Q1365. 20-year-old college student presents with fever, sore throat, and cervical lymphadenopathy. Peripheral blood smear shows atypical lymphocytes. The Paul–Bunnell heterophile antibody test is positive. What is the most likely causative organism?

Q1366. A 4-year-old child presents with fever, cough, and signs of lower respiratory tract infection. Sputum culture shows no growth on blood agar but grows on chocolate agar. The organism is a fastidious gram-negative bacillus requiring Factor X and Factor V for growth. The most likely causative organism is:

Q1367. A young man gives a history of bathing in pond water. He develops a rapidly moving, serpiginous, pruritic rash over the body. A stool examination shows no ova and no cysts, but larvae are identified. Routine bacterial culture is negative. What is the most likely causative organism?

Q1369. A 30-year-old foreign traveler presents with acute onset profuse watery diarrhea for 12 hours. The stools are colorless and rice-water–like, with no blood or pus. He has signs of severe dehydration. Which toxin is responsible for this illness?

Q1370. Patient with history of consuming home-canned vegetables at a family gathering presents with acute flaccid paralysis. The clinical picture is attributed to botulinum toxin produced by Clostridium botulinum. What is the most likely mode of transmission in this case?

Q1371. swelling with fever and tenderness. On examination, there are fluctuant inguinal lymph nodes with overlying erythema suggestive of buboes. What are the strains of Chlamydia trachomatis responsible for this condition?

Q1372. d) Toxoplasma gondii A 32-year-old unmarried man is brought reporting recurrent sexual arousal by wearing women’s clothes. The behavior has been present since adolescence and is associated with sexual gratification. The most appropriate diagnosis is

Q1373. Male presents to the casualty within 24 h with an alleged history of sodomy by co-worker. On examination, there is perianal tenderness and abrasions. He is sent for medico-legal examination. Which of the following is the MOST appropriate sample to be collected to establish the offence?