NRE Non-Negotiable 100 MCQs

Answer these fast. These are the questions you must know cold.

Q1. A 62-year-old man has sudden tearing chest pain radiating to the back with a BP difference between arms. Best immediate test? A. ECG B. CT angiography of the aorta C. Troponin I D. Chest X-ray

Q2. A Rh-negative mother delivers an Rh-positive baby 2 hours ago. Best prophylaxis? A. Anti-D within 72 hours B. Anti-D after 1 week C. IVIG D. No prophylaxis needed

Q3. A woman has symmetric MCP/PIP pain and morning stiffness lasting more than 1 hour. Best confirmatory test? A. ANA B. Anti-CCP C. ASO titre D. CRP only

Q4. An elderly patient has DIP pain and Heberden nodes, worse with activity. Diagnosis? A. Rheumatoid arthritis B. Osteoarthritis C. Gout D. Psoriatic arthritis

Q5. A child has cola-coloured urine and periorbital edema 2 weeks after a sore throat. Diagnosis? A. IgA nephropathy B. Post-streptococcal GN C. Minimal change disease D. Henoch-Schonlein purpura

Q6. Hematuria occurs during an upper respiratory infection, not weeks later. Most likely diagnosis? A. IgA nephropathy B. Post-streptococcal GN C. Membranous nephropathy D. Alport syndrome

Q7. A toxic child has drooling, stridor, tripod posture, and a thumb sign. First step? A. Examine throat with tongue depressor B. Secure airway in controlled setting C. Send home with antibiotics D. Give oral fluids only

Q8. A child has unilateral foul-smelling nasal discharge. Most likely cause? A. Sinusitis B. Foreign body in nostril C. Allergic rhinitis D. Nasal polyps

Q9. Sudden severe testicular pain, high-riding testis, absent cremasteric reflex. Best action? A. Doppler tomorrow B. Urgent surgical exploration C. Antibiotics D. Scrotal support

Q10. Sudden severe abdominal pain, board-like rigidity, and free air under diaphragm. Best management? A. PPI therapy B. Urgent laparotomy C. Observe and repeat exam D. Barium swallow

Q11. Progressive dysphagia starts with solids then liquids and there is weight loss. Diagnosis? A. Achalasia B. Esophageal carcinoma C. GERD D. Peptic ulcer disease

Q12. Dysphagia to both liquids and solids with bird-beak appearance. Diagnosis? A. Achalasia B. Esophageal carcinoma C. Stricture from reflux D. Esophagitis

Q13. A cirrhotic patient vomits blood. Best endoscopic control? A. Band ligation B. Appendectomy C. Nissen fundoplication D. Gastrectomy

Q14. After triple therapy for peptic ulcer disease, which test best confirms H. pylori eradication? A. Serology B. Urea breath test C. Repeat endoscopy in all D. Stool microscopy

Q15. Chronic abdominal pain is relieved by defecation and workup is normal. Diagnosis? A. IBD B. IBS C. Crohn disease D. Ulcerative colitis

Q16. Smoker with productive cough for 2 years. Diagnosis? A. Asthma B. Chronic bronchitis C. Bronchiectasis D. Pneumonia

Q17. Dullness on one side of chest with trachea pushed away from that side. Likely diagnosis? A. Atelectasis B. Pleural effusion C. Pulmonary fibrosis D. Lobar collapse

Q18. Hemoptysis with hematuria and RBC casts. Diagnosis? A. Goodpasture syndrome B. Bronchial asthma C. Sarcoidosis D. Polyarteritis nodosa

Q19. Purple striae, proximal weakness, HTN, eosinopenia, lymphocytopenia. Diagnosis? A. Cushing syndrome B. Addison disease C. Hypothyroidism D. Pheochromocytoma

Q20. Tetany with positive Chvostek sign suggests deficiency of which electrolyte? A. Sodium B. Potassium C. Calcium D. Chloride

Q21. The earliest biochemical change in primary hyperparathyroidism is often: A. Hypercalcemia B. Hypophosphatemia C. Hypomagnesemia D. Hyponatremia

Q22. Resting tremor, rigidity, bradykinesia, shuffling gait. Diagnosis? A. Essential tremor B. Parkinson disease C. Huntington disease D. Cerebellar lesion

Q23. Ptosis and diplopia worsen through the day and improve with rest. Best symptomatic treatment? A. Pyridostigmine B. Haloperidol C. Phenytoin D. Atropine

Q24. Ascending weakness after a recent infection with absent reflexes. Diagnosis? A. Multiple sclerosis B. Guillain-Barre syndrome C. Myasthenia gravis D. Muscular dystrophy

Q25. Transient monocular blindness. Most accurate label? A. Optic neuritis B. Amaurosis fugax C. Retinal detachment D. Glaucoma

Q26. Auer rods and MPO positivity on smear indicate: A. ALL B. AML C. CML D. CLL

Q27. Massive splenomegaly with myeloid left shift and BCR-ABL. Diagnosis? A. CML B. CLL C. AML D. Myeloma

Q28. Microcytic anemia with low ferritin and high TIBC. Diagnosis? A. Thalassemia trait B. Iron deficiency anemia C. Anemia of chronic disease D. Sideroblastic anemia

Q29. Macrocytosis, glossitis, posterior column signs, and low B12. Cause? A. Folate deficiency B. Pernicious anemia C. Iron deficiency D. Hemolysis

Q30. Sudden painful red first MTP joint. Diagnosis? A. Rheumatoid arthritis B. Gout C. Osteoarthritis D. Septic arthritis

Q31. Most common cause of community-acquired pneumonia? A. Klebsiella pneumoniae B. Streptococcus pneumoniae C. Mycoplasma pneumoniae D. Pseudomonas aeruginosa

Q32. Fever, neck stiffness, and bulging fontanelle in an infant. Best confirmatory test? A. Blood culture only B. Lumbar puncture C. CT chest D. EEG

Q33. ATT commonly causes hyperuricemia and joint pains due to which drug? A. Isoniazid B. Rifampicin C. Pyrazinamide D. Ethambutol

Q34. Fever, cough, coryza, conjunctivitis, and Koplik spots. Diagnosis? A. Rubella B. Measles C. Scarlet fever D. Varicella

Q35. Warfarin with high INR and minor gum bleeding. Best reversal? A. Protamine sulfate B. Oral vitamin K C. Naloxone D. Fresh frozen plasma immediately

Q36. A child accidentally takes a toxic paracetamol dose. Best antidote? A. Flumazenil B. N-acetylcysteine C. Atropine D. Vitamin K

Q37. Sedated patient with normal pupils and ataxia suggests benzodiazepine overdose. Antidote? A. Naloxone B. Flumazenil C. Physostigmine D. Protamine

Q38. Gingival hyperplasia and hirsutism in an epileptic patient. Drug? A. Carbamazepine B. Phenytoin C. Valproate D. Lamotrigine

Q39. Alcoholic patient with confusion, ataxia, and ophthalmoplegia. Immediate vitamin? A. Vitamin B12 B. Thiamine C. Niacin D. Riboflavin

Q40. Diabetic patient with HTN and microalbuminuria. Best BP drug class? A. ACE inhibitor B. Beta blocker C. Loop diuretic only D. Alpha blocker

Q41. Groin swelling below and lateral to the pubic tubercle. Hernia type? A. Direct inguinal B. Femoral C. Indirect inguinal D. Obturator

Q42. Hernia through Hesselbach triangle is: A. Indirect inguinal B. Direct inguinal C. Femoral D. Umbilical

Q43. Midline neck swelling moves with tongue protrusion. Diagnosis? A. Branchial cyst B. Thyroglossal duct cyst C. Thyroid carcinoma D. Dermoid cyst

Q44. Hard irregular breast lump with skin dimpling and nodes. Best first principle? A. Triple assessment B. Reassure C. Antibiotics D. Lumpectomy without workup

Q45. Young woman with a painless mobile breast lump. Most likely diagnosis? A. Fibroadenoma B. Breast abscess C. Cancer D. Mastitis

Q46. Bloody nipple discharge from a single duct with no palpable lump. Likely diagnosis? A. Intraductal papilloma B. Paget disease C. Fibrocystic change D. Mastitis

Q47. Periumbilical pain migrates to the right iliac fossa with rebound tenderness. Diagnosis? A. Cholecystitis B. Appendicitis C. Gastritis D. Mesenteric ischemia

Q48. Tension pneumothorax with hypotension and absent breath sounds. Immediate management? A. CXR first B. Needle decompression C. Bronchoscopy D. Diuretics

Q49. Circumferential burn with weak pulses and paresthesia. Next step? A. Escharotomy B. Fasciotomy only C. Observation D. Skin graft

Q50. Pelvic fracture with shock is most likely due to: A. Fat embolism B. Blood loss C. Neurogenic shock D. Sepsis

Q51. RUQ pain, fever, jaundice, and CBD stone with sepsis. Urgent intervention? A. Elective cholecystectomy B. ERCP with stone extraction C. Observation D. HIDA scan

Q52. Epigastric mass 4-6 weeks after pancreatitis. Diagnosis? A. Pancreatic cancer B. Pancreatic pseudocyst C. Abscess D. Splenic rupture

Q53. Painless bright red bleeding in late pregnancy with soft uterus. Diagnosis? A. Placenta previa B. Placental abruption C. Ectopic pregnancy D. Threatened miscarriage

Q54. Painful bleeding in pregnancy with tender rigid uterus. Diagnosis? A. Placenta previa B. Placental abruption C. Molar pregnancy D. Cervical polyp

Q55. Amenorrhea, abdominal pain, bleeding, and shock in a reproductive-age woman. First diagnosis to rule out? A. Ovarian cyst B. Ectopic pregnancy C. Fibroid D. Endometriosis

Q56. Severe pre-eclampsia with headache and low platelets. Best seizure prophylaxis? A. Magnesium sulfate B. Phenytoin C. Diazepam D. Calcium gluconate

Q57. Pregnant woman at 24-28 weeks needs confirmation of gestational diabetes. Best test? A. Random glucose B. OGTT C. Urine glucose D. HbA1c only

Q58. Preterm labor where fetal lung maturity is the priority. Best drug? A. Betamethasone B. Methyldopa C. Oxytocin D. Misoprostol

Q59. Infertility, obesity, hirsutism, irregular cycles, polycystic ovaries. Diagnosis? A. Endometriosis B. PCOS C. Hyperprolactinemia D. Asherman syndrome

Q60. Primary amenorrhea with absent uterus, 46XY karyotype, normal breasts, and blind vagina. Diagnosis? A. Mullerian agenesis B. Androgen insensitivity syndrome C. Turner syndrome D. Patau syndrome

Q61. Heavy menstrual bleeding since menarche, pregnancy test negative, coagulation normal. Most common cause? A. Fibroid uterus B. Anovulatory cycles C. Endometrial cancer D. Cervical cancer

Q62. Markedly raised beta-hCG after pregnancy-related bleeding. Important next step in surveillance? A. Stop follow-up after curettage B. Serial beta-hCG monitoring C. No follow-up needed D. Immediate hysterectomy always

Q63. Child with upslanting eyes, single palmar crease, and intellectual disability. Diagnosis? A. Turner syndrome B. Down syndrome C. Trisomy 13 D. Fragile X syndrome

Q64. Newborn after difficult delivery has waiter’s tip posture. Injury? A. Klumpke palsy B. Erb palsy C. Radial nerve palsy D. Median nerve palsy

Q65. Drowsy child cannot drink and has profuse vomiting/diarrhea. Best fluid? A. ORS B. IV Ringer lactate C. No fluids D. Dextrose only

Q66. Newborn resuscitation compression-to-ventilation ratio? A. 15:2 B. 3:1 C. 30:2 D. 5:1

Q67. Bleeding from umbilical stump in a newborn who did not receive prophylaxis. Deficiency? A. Vitamin A B. Vitamin K C. Vitamin C D. Vitamin D

Q68. Bowed legs, rachitic rosary, low Ca/phosphate, high ALP. Cause? A. Vitamin D deficiency B. Vitamin C deficiency C. Vitamin K deficiency D. Iron deficiency

Q69. Barking cough, steeple sign, non-toxic child. Diagnosis? A. Epiglottitis B. Croup C. Bronchiolitis D. Diphtheria

Q70. Poor eye contact, hand flapping, delayed speech. Diagnosis? A. ADHD B. Autism spectrum disorder C. Cerebral palsy D. Hearing loss

Q71. Painful red eye with halos and fixed mid-dilated pupil. Diagnosis? A. Conjunctivitis B. Acute angle-closure glaucoma C. Cataract D. Keratoconus

Q72. Child with severe eye itching in summer and cobblestone papillae. Diagnosis? A. Bacterial conjunctivitis B. Vernal keratoconjunctivitis C. Acute uveitis D. Dry eye

Q73. Severe pain/redness/hypopyon one day after cataract surgery. Diagnosis? A. Lens reaction B. Endophthalmitis C. Glaucoma D. Corneal abrasion

Q74. Child with long-standing squint and reduced vision despite normal ocular structures. Complication? A. Cataract B. Amblyopia C. Retinal detachment D. Glaucoma

Q75. Fibular neck injury causes foot drop. Nerve? A. Sciatic nerve B. Common peroneal nerve C. Tibial nerve D. Femoral nerve

Q76. Midshaft humerus fracture with wrist drop. Nerve? A. Axillary nerve B. Radial nerve C. Median nerve D. Ulnar nerve

Q77. Surgical neck humerus fracture with deltoid weakness and regimental badge numbness. Nerve? A. Radial nerve B. Axillary nerve C. Musculocutaneous nerve D. Ulnar nerve

Q78. Unable to make OK sign after supracondylar fracture. Nerve injured? A. Ulnar nerve B. Anterior interosseous nerve C. Posterior interosseous nerve D. Radial nerve

Q79. Facial palsy with hyperacusis indicates a lesion: A. At stylomastoid foramen only B. Proximal to nerve to stapedius C. In the external auditory canal D. In the occipital cortex

Q80. Ipsilateral cranial nerve palsy with contralateral hemiplegia. Lesion site? A. Cerebellum B. Brainstem C. Temporal lobe D. Spinal cord

Q81. TB, PSGN, AIHA, and contact dermatitis are examples used to test: A. Types of anemia B. Hypersensitivity types C. Complement pathways D. Coagulation factors

Q82. Long-standing GERD leading to squamous to columnar metaplasia is: A. Dysplasia B. Barrett esophagus C. Esophageal varices D. Achalasia

Q83. Immediate increase in vascular permeability in acute inflammation is mediated by: A. Histamine B. IL-2 C. Interferon-gamma D. Thromboxane A2

Q84. A chronic burn scar turns into a non-healing raised ulcer. Diagnosis? A. Basal cell carcinoma B. Marjolin ulcer C. Venous ulcer D. Pyoderma gangrenosum

Q85. Distinguish TTP from DIC in a lab question. Which is typical of TTP? A. Prolonged PT and APTT B. Normal coagulation profile C. Low fibrinogen D. Very high D-dimer

Q86. Vomiting with high pH, high HCO3, low chloride. Acid-base disorder? A. Respiratory alkalosis B. Metabolic alkalosis C. Metabolic acidosis D. Respiratory acidosis

Q87. At high altitude, the early blood gas change is: A. Low pCO2 B. High pCO2 C. Low pH only D. Hyperkalemia

Q88. High-flow pancreatic secretion is rich in: A. Chloride B. Bicarbonate C. Potassium D. Ammonia

Q89. At rest, the membrane potential is mainly determined by: A. Sodium B. Potassium C. Calcium D. Magnesium

Q90. In anaphylactic shock compared with cardiogenic shock, the most expected change is: A. Higher SVR B. Higher CO C. Lower heart rate D. Lower cardiac output

Q91. A population grows at 2% yearly. Approximate doubling time? A. 20 years B. 35 years C. 50 years D. 70 years

Q92. Which study design best fits division of patients into surgery and diet groups? A. Case-control study B. Randomized controlled trial C. Cross-sectional study D. Case series

Q93. Data presented as parts of a whole in percentages is best shown by: A. Histogram B. Pie chart C. Scatter plot D. Box plot

Q94. When data are skewed, the best central tendency is: A. Mean B. Median C. Mode always D. Range

Q95. Child ingests kerosene. Most important complication? A. Hepatitis B. Aspiration pneumonitis C. Renal stones D. Bleeding disorder

Q96. Rigor mortis timing is used to estimate: A. Cause of death B. Post-mortem interval C. Toxicology only D. Time of embalming

Q97. Salivation, lacrimation, bronchorrhea, and miosis after pesticide exposure suggest: A. Opioid overdose B. Organophosphate poisoning C. Benzodiazepine overdose D. Anticholinergic poisoning

Q98. Ear pain and fullness after a flight with retracted congested tympanic membrane. Diagnosis? A. Otitis externa B. Otic barotrauma C. Meniere disease D. Cholesteatoma

Q99. Child with fever, neck stiffness, and pharyngeal abscess on exam. Anatomic space? A. Submandibular space B. Retropharyngeal space C. Parotid space D. Mastoid air cells

Q100. Well-demarcated erythematous plaques with silvery scales and nail pitting. Diagnosis? A. Eczema B. Psoriasis C. Tinea corporis D. Vitiligo