Q37. 6-year-old child presents with pallor, jaundice, and splenomegaly. The child has a history of intermittent anemia since infancy. Laboratory investigations reveal low hemoglobin, elevated reticulocyte count, elevated MCHC. On further questioning, it is revealed that the father had similar symptoms in childhood. Which of the following is the most likely diagnosis?

Q38. A 35-year-old patient presents with progressive vision loss, more prominent in the temporal fields. MRI brain reveals a suprasellar mass compressing the optic chiasm. Histopathological examination of the excised lesion shows 'wet keratin' and stratified squamous epithelium. Which of the following is the most likely diagnosis?

Q39. Which of the following technique is most commonly used to compare and quantify CD markers on immunophenotyping?

Q40. A 48-year-old woman presents with complaints of tightening of the skin over her fingers, difficulty swallowing, and episodes of color change in her fingers upon cold exposure. Serologic testing reveals positive anti-Scl-70 antibodies. Which of the following complications is most strongly associated with anti-Scl-70 positivity in the given condition?

Q41. A 45-year-old woman presents with complaints of fatigue, pruritus, and mild right upper quadrant discomfort. Laboratory investigations show elevated ALP. Further testing reveals positive anti-mitochondrial antibodies. A liver biopsy shows non-suppurative, granulomatous destruction of intrahepatic bile ducts. What is the most likely diagnosis?

Q42. A 32-year-old non-smoker presents with a 2-month history of dry cough and progressive dyspnea. Chest X-ray reveals bilateral hilar lymphadenopathy. Biopsy shows non-caseating granulomas composed of epithelioid histiocytes and multinucleated giant cells, with stellate inclusions. Which of the following is the most likely diagnosis?

Q44. An elderly female is found unconscious with frothy sputum and is brought to the emergency room. On evaluation, she is noted to have tachypnea, basal crepitations, and bilateral pedal edema. Chest X-ray shows pulmonary congestion, and a lung biopsy reveals hemosiderin-laden macrophages. Which of the following conditions is least likely associated with this histopathological finding?

Q47. A 55-year-old hypertensive patient on long-term hydrochlorothiazide therapy presents with flank pain. Imaging reveals the presence of a renal stone. Which of the following best explains the likely mechanism of renal stone formation in this patient?

Q48. A 14-year-old boy with chronic kidney disease is brought for follow-up. Laboratory investigations reveal normocytic, normochromic anemia with low reticulocyte count. What is the drug of choice for managing this patient's anemia?

Q50. A patient with gastroesophageal reflux disease complains of heartburn and regurgitation. Which of the following drugs increase the tone of the lower esophageal sphincter and enhances gastric emptying to reduce reflux episodes?

Q51. A 16-year-old adolescent presents with bone pain and muscle weakness. Lab investigations reveal serum calcium mildly low, decreased serum phosphate, elevated PTH, elevated ALP. A wrist X-ray shows splaying of metaphyses. Which of the following is the best next step in management?

Q52. Which of the following statements regarding Zasko phenomenon is true?

Q53. A 28-year-old female is brought dead to the emergency department. On postmortem examination, there is bruising below the angle of mandible over the front and sides of the neck, particularly over the thyroid cartilage. The neck dissection reveals subcutaneous hemorrhage, fracture of the superior horn of the thyroid cartilage. There is a laceration of the inner aspect of the lower lip and linear scratch abrasions over the upper back and shoulders. A scalp contusion is also noted on the right parietal region. Based on the injury pattern, what is the most likely cause of death?

Q54. According to the POCSO Act, 2012 (Protection of Children from Sexual Offences), who is legally considered a 'child' for the purpose of protection under this law?

Q55. Mother of a 15-year-old girl files a complaint alleging rape and kidnapping. The male admits that he was in a romantic relationship with the girl and plans to marry her, and that they had consensual sexual intercourse. The girl also confirms it was mutual and voluntary. Medical examination shows evidence of recent sexual activity without any physical injuries. Which of the following is legally correct under Indian law?

Q56. A patient is brought to the emergency department with acute onset of severe abdominal pain, throat irritation, followed by vomiting and purging that contains blood and bile. There is a history of diarrhea that initially appears bloody but later becomes colorless, odorless and rice watery. On examination a distinct garlicky odor is noted in the breath. Which of the following agents is most likely responsible for the poisoning in this patient?

Q57. 68 year old female with history of breast cancer presents with breathlessness, deteriorating health condition and is found to have multiple metastases. She is awake, alert and visibly anxious. The medical team assesses that aggressive chemotherapy, radiotherapy, ICU care and mechanical ventilation would not improve her condition. Despite this, the patients daughter insists on 'doing anything and everything' for her mother. What is the most appropriate next step in managing this case?

Q58. You hear a loud siren followed by news alerts reporting a toxic chemical gas leak from an industrial plant located a few kilometers from your area. You are currently at home with your family. What is the first and most appropriate step you should take to ensure safety?