| Post Name | Assistant Professor in Emergency Medicine |
|---|---|
| Department | Medical Education |
| Question Paper Code | 104/2026/OL |
| Category Code | 813/2025, 814/2025 |
| Date of Test | 19 May 2026 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
Which electrolyte abnormality is commonly monitored and corrected in patients with delirium tremens ?
Answer
B. Hypomagnesemia
2
Which endocrine disorder can cause hyponatremia ?
Answer
B. Addisonās disease
3
The most dangerous complication of rapid correction of chronic hyponatremia is
Answer
C. Osmotic demyelination syndrome
4
Mortality in myxedema coma remains approximately
Answer
C. 20-60%
5
The arterial pH in Hyperosmolar Hyperglycemic State (HHS) is usually
Answer
D. >7.3
6
Which statement correctly compares alteplase and tenecteplase in acute ischemic stroke ?
Answer
C. Alteplase requires bolus plus infusion; tenecteplase is a single bolus
7
Which third-line drug is commonly preferred in status epilepticus initially because of its rapid onset and ease of titration ?
Answer
C. Midazolam
8
Which statement about CURB-65 is correct ?
Answer
B. It predicts mortality risk in pneumonia
9
A patient with sudden chest pain and pulse deļ¬cit between the arms should raise suspicion for
Answer
C. Aortic dissection
10
Which of the following best diļ¬erentiates unstable angina from NSTEMI ?
Answer
B. Presence of elevated troponin
11
Which investigation is most commonly used to conļ¬rm suspected aortic dissection in a stable patient ?
Answer
C. CT angiography
12
What is the most important intervention that improves survival in refractory VF ?
Answer
B. High-quality CPR with minimal interruptions
13
Refractory Ventricular Fibrillation (VF) is usually deļ¬ned as VF that persists after
Answer
C. 3 shocks
14
If amiodarone is unavailable, which alternative antiarrhythmic may be used in refractory VF ?
Answer
A. Lidocaine
15
Which statement regarding synchronized cardioversion in refractory Ventricular Fibrillation (VF) is correct ?
Answer
C. It is not used because VF requires unsynchronized shocks
16
The initial drug of choice to reduce heart rate and blood pressure in aortic dissection is
Answer
C. Beta-blockers
17
The ā65ā in CURB-65 indicates age
Answer
B. ā„65 years
18
The main goal of third-line drug therapy in refractory status epilepticus is to
Answer
B. Suppress epileptic activity on EEG
19
Eļ¬ective serum osmolality in Hyperosmaolar Hyperglycemic State (HHS) is usually
Answer
C. >320 mOsm/kg
20
Which of the following medications may precipitate myxedema coma in a patient with hypothyroidism ?
Answer
A. Amiodarone
21
The following statements regarding lower gastrointestinal (GI) bleeding are true except
Answer
D. Bleed as slow as 0.01mL/min can be detected by technetium-99m RBC scan, with 70% sensitivity
22
41 years gentleman presented to emergency department with severe upper abdominal pain for 3 days. He was a known alcoholic since 3 yrs. His pulse rate was 103/min, BP-110/80 mm of Hg, SpO2-98% in room air. Per abdominal examination showed epigastric tenderness, no guarding or rigidity. Laboratory results showed amylase 780 U/L, lipase 1070 U/L, total counts was elevated. All of the following statements in management of patient are true except
Answer
C. APACHE 2 scoring includes 3 organ based health points, 10 physiological variables and age
23
62 yrs. old lady, a known diabetic and hypertensive presented to emergency department with right lower abdominal pain, fever and vomiting for four days. Abdominal examination showed a tender, ļ¬rm lump in right iliac fossa of size 4Ć3 cm. During treatment of this patient following statement is false.
Answer
A. Surgery may be attempted and complications rates are low
24
16 yrs. old boy presented with right sided testicular pain since 3 hours. He was diagnosed with testicular torsion. The following statements are true except
Answer
B. Prehnās sign negative means lifting the aļ¬ected testis there is no pain relief is more conclusive of torsion than Doppler study
25
67 years old lady, a known diabetic and hypertensive presented with severe back pain since 1 hour. On examination she looked pale, pulse rate-110/min, BP-70/50 mm of Hg. Abdominal examination revealed pulsatile abdominal swelling. Which of the following statement is false ?
Answer
A. Type 3 endoleak in endovascular aneurysm repair (EVAR) is persistent ļ¬lling of the aneurysm sac owing to retrograde ļ¬ow of blood from aortic collaterals, e.g. IMA, lumbar arteries
26
Skin grafting in patients with extensive full thickness burns, all are true except
Answer
A. Cadaveric skin graft which is recently popular can provide excellent granulation and improves the wound bed
27
Electrical burns can cause all the following except
Answer
D. Electrical burns causes signiļ¬cant direct myocardial damage by pacing interruption and leads to cardiac arrest
28
Abdominal Aortic aneurysm following statements is true except
Answer
B. 95% of these aneurysm occurs above insertion of the renal arteries
29
In patients with burns presenting involving > 20% TBSA (Total Body Surface Area). All the statements are true except
Answer
C. Acute phase of burns are anabolic process
30
35 yrs. old gentleman presented with left testicular pain, fever for 2 days. On examination left testis was enlarged and tender, scrotal wall was red and shiny. While managing this patient, correct statement is
Answer
C. Younger men are prone for epididymo-orchitis due to urinary tract infection
31
Which of the following statements regarding āairway assessment and managementā techniques/devices is/are correct ? a. High-ļ¬ow oxygenation delivered through a high-ļ¬ow nasal cannula provides humidiļ¬ed, heated oxygen at ļ¬ow rates up to 60 L/min, providing positive pressure while decreasing the work of breathing. b. The mnemonic āMOANSā is used for prediction of diļ¬cult non-invasive airway management technique where āSā stands for secretions from oral cavity. c. Oro-pharyngeal (oral) airways should be used only in comatose or deeply obtunded patient without a gag reļ¬ex. d. A non-rebreather mask has an oxygen ļ¬ow of around 10-15 L/min. and the FiO2 delivered is nearly about 100%.
Answer
B. a, c, d
32
Which of the following is/are āHigh-quality CPR performanceā metrics/metrices ? a. Chest compression fraction > 80% b. Chest compression rate of 120-140/min c. Not excessive ventilation d. Chest compression depth of at least 50-60 mm in adults and at least 1/3 the AP dimension of the chest in infants and children
Answer
D. a, b, c, d
33
Which of the following statements regarding management of āTension pneumothoraxā is incorrect?
Answer
D. Tube thoracostomy can be avoided after needle decompression, provided the patient is hemodynamically stable with normal movements of the chest wall.
34
Which of the following statements is incorrect regarding āFASTā (Focused Assessment with Sonography for Trauma) and āe-FASTā examination?
Answer
B. It has been recently emphasized to search for organ lesions by FAST because solid organ injuries can be easily detected by FAST which helps in early decision- making.
35
Which of the following category of trauma patients should be Triaged as āGREENā on arrival to the emergency department ?
Answer
D. Injuries are localized without immediate systemic implications
36
Which of the following statements regarding āSupra-Glottic Airwaysā (SGA) is incorrect ?
Answer
B. SGA are very useful in patients needing high inspiratory pressures (e.g. chronic obstructive pulmonary disease).
37
āEpinephrineā (Adrenaline) has an important role to play in management of cardiac arrest. Which of the following statements regarding Epinephrine is correct ? a. Epinephrine may provide the most beneļ¬t within the ļ¬rst 15 to 20 minutes of cardiac arrest, based on its alpha eļ¬ects. b. The standard dose in cardiac arrest is 1.0 milligram diluted to 10 mL (10mL of 1:10,000) given intravenous or intraosseously. c. Potential adverse eļ¬ects of Epinephrine include an increase in myocardial oxygen consumption and an increase in pulmonary shunting. d. As per the 2020 American Heart Association adult cardiac arrest algorithm, the ļ¬rst dose of Epinephrine should be given before shock/deļ¬brillation in patients with ventricular ļ¬brillation.
Answer
D. a, b, c
38
As per the āLEMONā assessment for diļ¬cult airway, which of the following would classify as a āMallampattiā score/class of III ?
Answer
B. Soft palate and base of uvula visible
39
Which of the following is not a component of āNEXUSā (National Emergency X- Radiography Utilization Study) criteria for omitting cervical spinal imaging in patients of trauma ?
Answer
D. No major organ injury
40
Which of the following should be considered a āDangerous mechanismā of injury in a case of Motor Vehicle Crash (MVC) and the patient should be ideally triaged as āREDā initially ?
Answer
D. All of the above
41
Misoprostol is recommended in following situations for the prevention of postpartum haemorrhage (PPH), except:
Answer
D. Along with Controlled Cord Traction (CCT) for removal of the placenta in cesarean delivery
42
Correct recommendation for the management of retained placenta
Answer
A. lf placenta is not expelled spontaneously, use oxytocin in combination with CCT
43
For tubal ectopic pregnancy, which of the following statements is correct ?
Answer
A. Transvaginal ultrasound is the diagnostic tool of choice for tubal ectopic pregnancy.
44
Match the oxytocic with its recommended dose for prevention of ppH Oxytocic Dose a. Oxytocin IU i. 200 b. Misoprostol mg ii. 600 c. Methylergometrine mg iii. 100 d. Carbetocin mg iv. 10
Answer
D. a-iv b-ii c-i d-iii
45
Diagnostic criteria for HELLP syndrome are 1. Lactate dehydrogenase is elevated to 600 lU/L or more 2. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) elevated more than four times the upper limit of normal 3. The platelets count is less than 4,50,000 cells/microL 4. An increase in bilirubin is signiļ¬cant and develops only in the early stages of the disease
Answer
A. Only 1 is correct
46
For the treatment of PPH
Answer
C. The use of uterine packing is not recommended for atonic PPH after vaginal birth
47
Perimortem caesarean section (PMCS) 1. Should be done only in women over 20 weeks of gestation, if the fetus is alive. 2. ldeally, this should be done if there is no response to resuscitation within 4 minutes of collapse. 3. PMCS should preferably be performed under general anaesthesia. 4. Should be performed where maternal collapse has occurred and resuscitation is taking place.
Answer
C. Only 2 and 4 are correct
48
Choose the incorrect option for cardiopulmonary resuscitation in a woman who is at ā„20 weeks of gestation
Answer
B. Pillows or blankets are eļ¬ective in providing the required tilt for eļ¬ective chest compressions
49
The diagnostic criteria described for diagnosing caesarean scar pregnancy on ultrasound include all, except
Answer
B. Barrel-shaped cervix with evidence of prominent trophoblastic/placental circulation on Doppler examination
50
Incorrect statement for placental abruption
Answer
D. In case of Couvelaire uterus, hysterectomy should be performed.
51
2-year-old child presented to the casualty with acute onset of stridor. She was having mild fever and running nose for the past 2 days. On examination respiratory rate 40/minute and inspiratory stridor present. Which drug can be used orally for the treatment of this condition?
Answer
B. Dexamethasone
52
Jaundice in a newborn can be pathological in all of the following conditions except
Answer
B. Total serum bilirubin more than 10 mg/dl
53
lnclusion of ampicillin in neonatal sepsis treatment regimen is targeted against which organism ?
Answer
C. Listeria
54
A newborn has not cried immediately after birth. After initial steps of resuscitation, the baby has not started breathing and was given Positive Pressure Ventilation (PPV) with bag and mask. After 30 seconds of PPV the heart rate is 80/ minute. What is the next step?
Answer
B. To continue PPV at the same rate and monitor HR
55
As a part of investigation of a child with meningomyelocele, MRI brain showed displacement of cerebellar vermis, pons, medulla and elongation of fourth ventricle. The most probable diagnosis is
Answer
A. Arnold Chiari Malformation Type 2
56
A 4-year-old is having painful swelling of both knees for the last 6 months. She has been on treatment with NSAlDs on and oļ¬. She was investigated and a diagnosis of oligoarticular arthritis was made and is now on treatment with intraarticular corticosteroids. The most likely complication for which she has to be on regular follow up is
Answer
D. Anterior Uveitis
57
2-year-old child was having continuous fever of 1 week duration. She is irritable with red eyes without eye discharge or eye pain. Her oropharyngeal mucosa congested. She is also having diļ¬use maculopapular rashes over the body and non-tender cervical lymphadenopathy on the right side of neck. The most likely diagnosis will be
Answer
C. Kawasaki Disease
58
3-week-old newborn is having repeated vomiting and failure to thrive. On examination jaundice and hepatomegaly present. Urine for reducing substance positive. The most possible diagnosis is
Answer
A. Galactosemia
59
6-year-old girl child with short stature is having webbed neck, wide carrying angle, widely spaced nipple and shielded chest. What is the most probable diagnosis based on this phenotypic feature?
Answer
D. Turner syndrome
60
The criteria for Severe Acute Malnutrition as per WHO criteria in a 3- year-old child does not include
Answer
D. Skin changes
61
Which of the following statements regarding āNeostigmineā is incorrect ?
Answer
D. The recommended anti-muscarinic in cases of neostigmine toxicity is atropine with the added advantage that it does not cross blood brain barrier.
62
Which of the following statements is incorrect regarding 'pacing' in Digoxin poisoning/ toxicity?
Answer
A. Transvenous pacing is the ļ¬rst treatment of choice in acute cases, if clinically indicated.
63
Which of the following statements is correct regarding management of 'Organophosphorus-Induced Delayed Neuropathy (OPIDN)'?
Answer
B. Amitryptline and/or Capsaicin are eļ¬ective in managing hyperaesthesia associated with OPIDN.
64
Which of the following parameters is not a component of the āPeradeniya scaleā used in patients with organophosphorus poisoning ?
Answer
C. Blood pressure
65
With regard to Polyvalent Anti-snake Venom Serum I.P. (lndian pharmacopoeia), each ml of anti-snake venom antiserum can neutralize which of the following quantities of standard venoms ?
Answer
B. Cobra 0.60 mg, Common Krait 0.45 mg, Russellās Viper 0.60 mg, Saw-Scaled Viper 0.45 mg
66
A 38-year-old male on āLithiumā therapy for the past three years for the management of bipolar aļ¬ective disorder is brought to emergency department with the chief complaints of loose stools and restlessness. Which of the following statements regarding Lithium toxicity is incorrect ?
Answer
D. The most prevalent endocrine manifestation of chronic Lithium therapy is hyperthyroidism which may be protective in some patients by increasing the renal excretion of Lithium.
67
A 46-year-old chronic alcoholic male is brought to the emergency with a history of ingestion of 20 tablets (500 mg each) of paracetamol (acetaminophen) with suicidal intent. Which of the following statements regarding the āRumack-Matthew nomogramā is/are correct ? a. The nomogram only directly applies to an acetaminophen concentration obtained after a single oral exposure and during the window between 4 hours and 24 hours after ingestion. b.The nomogram predicts the risk of hepatotoxicity on a single acetaminophen concentration, measured at one time. lt is not a prognostic tool and hence does not predict fulminant liver failure or death. c. The upper line of the nomogram is the āprobableā line, also known as the Rumack- Matthew line. About 60% of patients with values above this line develop hepatotoxicity. d. The lower line on the nomogram is the āpossible/treatmentā line, which incorporates a 25% margin of error in measurement variations or uncertainty regarding the time of ingestion.
Answer
D. a, b, c, d
68
Which of the following statements regarding āPsilocybinā is incorrect ?
Answer
B. Psilocybin and psilocin indoles produce central nervous system eļ¬ects usually after 4-6 hours of ingestion with a return to normalcy usually within 24-48 hours.
69
Which of the following statements regarding management of Lithium toxicity is incorrect ?
Answer
B. Diuretic-induced diuresis enhances lithium elimination.
70
Which of the following statements is incorrect regarding āOrganophosphate poisoningā ?
Answer
C. Latex gloves should be used instead of Neoprene or nitrile gloves to prevent secondary poisoning of healthcare workers.
71
Crush syndrome is characterised by
Answer
A. Metabolic acidosis with hyperkalemia and hypocalcemia
72
An adult male is brought to the casualty with history of road traļ¬c accident and injury to his Right lower limb. Examination of right lower limb shows diļ¬use swelling and deformity of the thigh with 2 cm wound over the swelling. Xray shows comminuted fracture shaft of femur. Right posterior tibial and dorsalis pedis pulse is absent .The classiļ¬cation of the fracture is
Answer
D. Type III C open fracture
73
Medial compartment syndrome of the thigh is clinically diagnosed by
Answer
A. Pain during passive hip abduction with knee in extension and sensory deļ¬cit over proximal medial thigh
74
Boxerās fracture is
Answer
B. Fracture neck of Vth metacarpal
75
March fracture is
Answer
B. Stress fracture of one or more metacarpals
76
False statement regarding CHANCE FRACTURE is
Answer
C. lt is a stable spinal injury
77
Which one of the following is termed as cotton fracture ?
Answer
A. Trimalleolar fracture of the ankle
78
Which one of the following is true regarding Fromentās sign ?
Answer
D. Tests the strength of adductor pollicis
79
āPen testā is done for
Answer
C. Median nerve
80
Correct statement regarding PEN TEST is
Answer
C. lt checks the power of abductor pollicis brevis
81
All are true statement about Lateral canthotomy except
Answer
C. Usually superior crus of lateral canthus is cut
82
All are precipitating events of acute glaucoma except
Answer
D. topical timolol
83
Statement about Glaucoma i. Acute angle closure glaucoma is precipitated by nebulized ipratropium/albuterol. ii. Hypermetropia is a risk factor for acute angle closure glaucoma.
Answer
A. Both i and ii correct
84
All are correct statement about managing acute glaucoma except
Answer
B. Pilocarpine is recommended as ļ¬rst line treatment.
85
AII are contraindication to surgical cricothyrotomy except
Answer
D. Age > 12 years
86
Statements about Cricothyrotom. i. Brofeldt technique of cricothyrotomy does not include step to dilate the stoma with Trousseau dilator. ii. Melkers technique involve Seldingerās technique. iii.When making the horizontal incision in cricothyroid membrane, avoid the cricoid artery by incising the membrane at its superior border. Comment about above three statement
Answer
B. i and ii are correct
87
True statement about malignant otitis externa are all except
Answer
C. Cranial nerve involvement is rare.
88
Which test conļ¬rm CSF rhinorrhea ?
Answer
A. Beta transferrin assay in Fluid
89
Common complications of posterior packing are all except
Answer
D. Nasolacrimal bleed
90
AII are risk factor for recurrent epistaxis except
Answer
C. Use of nasal ļ¬uticasone
91
Which of the following is not recommended for emergency department record documentation of intimate partner violence and abuse ?
Answer
B. Description of any stated violence or abuse as āallegedā since the actual details are not yet known
92
A 36-year-old woman, who is 36 weeks pregnant presents after she was involved in a rollover motor vehicle collision. Another passenger in the compartment was killed. The patient is brought in on a backboard. EMS has established IV access and has administered 1L of normal saline. Her vital signs are BP 75/63, HR 130, SpO2 93% on RA, RR 20 and Glasgow Coma Scale (GCS) of 15. She has bilateral breath sounds. What is the Next best step in management ?
Answer
D. Place towel rolls under the right hip to tilt the patient 30 degrees to the left
93
The Maastricht classiļ¬cation is used to
Answer
A. Categorize non-hear beating donors (NHBD) based on the circumstances of their death
94
A 23-year old female presents to the ED requesting a "rape exam." She states that she was at a party then remembers waking up in a strangerās bed. She has no recollection of the events between the party and waking up. Which of the following queries are irrelevant with respect to the evidentiary exam ?
Answer
B. Describe your sexual activity for the last year.
95
A 28-year-old man is ejected from a car and is brought to the emergency department by EMS intubated with a Glasgow Coma Scale (GCS) of 3. A cervical collar is in place and the patient has bilateral breath sounds. What is your goal Mean Arterial Pressure (MAP) for this patient ?
Answer
C. 80 mm Hg
96
SPIKES is a clinical protocol used by healthcare professionals to deliver bad news to patients and families. In this, P stands for
Answer
B. Perception
97
Depth of vein (in cm) in anterior approach to internal jugular vein catheterization is
Answer
C. 3-5
98
Tube thoracostomy is performed at ___________ site in newborns infants.
Answer
C. 5th intercostal space, anterior axillary line
99
A 34-year-old woman is the restrained driver in a motor vehicle collision. She arrives complaining of chest pain. She has normal vital signs and has a negative radiographic workup as well as a normal ECG. What is the most appropriate next course of action ?
Answer
C. Monitor for 4 to 6 hours, discharge if no new complaints and EKG remains normal
100
Which of the following correctly describes the land mark for blocking deep peroneal nerve in ankle block ?
Answer
C. Between the tibialis anterior tendon and extensor hallucis longus at the level of medial malleolus
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