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?

Q66. A neonate is diagnosed with congenital hypothyroidism. Investigations reveal decreased T3 and T4 levels with elevated TSH. Neck ultrasound shows a normally located thyroid gland. A radioactive iodine uptake scan shows decreased uptake. What is the most likely underlying cause?

Q67. Which of the following neural column is not carried by the vagus nerve?

Q72. A patient undergoes emergency laparotomy for a perforated duodenal ulcer. During the procedure, the surgeon performs a maneuver near the epiploic foramen to control bleeding and prevent vascular injury to structures located posterior to the foramen. Which of the following vessel is most likely at risk?

Q73. The interval between a host receiving an infection and the period of attaining maximum infectivity is known as:

Q74. In a population of 7,000,000 (70 lakh), with 30% living in slums and 70 lakh total urban residents, how many Urban Primary Health Centres (UPHCs) should be established for slums according to NUHM guidelines?