NRE October 2026 Prediction Exam

Batch 2 of 4 - Answer Key with Reasons

Prepared for: Ahmad Zafar
Purpose: Answer key for PMDC/NRE-I style prediction exam simulation.
Provenance: Prediction-derived from May 2026 intelligence, Dec 2025 paper patterns, NRE50 rotation logic, QBank sampling, and PM&DC syllabus weighting.

Answers

Q1. B. Inferior wall supplied by RCA
Reason: ST elevation in II, III, and aVF localizes to inferior wall MI, usually RCA territory.

Q2. A. IV thrombolysis
Reason: Ischemic stroke within the thrombolysis window with no hemorrhage on CT is treated with IV thrombolysis if eligible.

Q3. B. Non-invasive ventilation
Reason: COPD exacerbation with respiratory acidosis and drowsiness needs NIV if the patient is arousable and not immediately requiring intubation.

Q4. B. IV fluids with insulin protocol
Reason: DKA management starts with aggressive IV fluids, insulin protocol, and potassium monitoring.

Q5. B. Graves disease
Reason: Hyperthyroid symptoms plus diffuse goitre and exophthalmos are classic Graves disease.

Q6. A. Active immune-complex disease
Reason: Low complement in SLE usually reflects active immune-complex consumption, especially with renal involvement.

Q7. A. Renal allograft biopsy
Reason: Gradual graft dysfunction with normal ultrasound needs biopsy to diagnose rejection or chronic allograft pathology.

Q8. A. Acute interstitial nephritis
Reason: Drug exposure plus fever, rash, eosinophilia, AKI, and white-cell casts is acute interstitial nephritis.

Q9. B. Pernicious anemia
Reason: B12 deficiency with neurologic signs and intrinsic-factor antibodies points to pernicious anemia.

Q10. A. Hodgkin lymphoma
Reason: B symptoms with Reed-Sternberg cells on excisional biopsy indicate Hodgkin lymphoma.

Q11. B. Panic disorder
Reason: Sudden recurrent episodes of intense fear with autonomic symptoms lasting minutes are panic attacks.

Q12. A. Schizophrenia
Reason: Psychotic symptoms with functional decline for more than 6 months fit schizophrenia.

Q13. B. Cluster headache
Reason: Severe unilateral orbital/temporal headache with autonomic signs and restlessness at the same nightly time is cluster headache.

Q14. A. Intraductal papilloma
Reason: Single-duct spontaneous bloody nipple discharge without a lump is classic intraductal papilloma.

Q15. A. Fibroadenoma
Reason: Young woman with painless, firm, mobile, well-circumscribed breast lump suggests fibroadenoma.

Q16. B. Carcinoma head of pancreas
Reason: Painless obstructive jaundice, weight loss, pale stools, dark urine, and palpable non-tender gallbladder suggest pancreatic head cancer.

Q17. A. Sigmoid volvulus
Reason: Coffee-bean loop arising from pelvis with obstruction symptoms is sigmoid volvulus.

Q18. A. Retrograde urethrogram
Reason: Blood at meatus and perineal bruising indicate urethral injury. Do RUG before catheterization.

Q19. A. Post-obstructive diuresis with electrolyte loss
Reason: Large urine output after relief of chronic obstruction can cause dangerous volume and electrolyte loss.

Q20. B. Varicocele
Reason: Bag-of-worms swelling worse on standing is varicocele.

Q21. A. Renal colic due to ureteric stone
Reason: Colicky flank pain radiating to groin with hematuria is ureteric stone.

Q22. A. Compartment syndrome
Reason: Severe pain, tense compartment, and pain on passive stretch are compartment syndrome; pulses can still be present early.

Q23. A. Psammoma bodies
Reason: Papillary thyroid carcinoma classically has psammoma bodies and Orphan Annie nuclei.

Q24. A. Airway with cervical spine protection
Reason: ATLS begins with airway and cervical spine protection.

Q25. A. Direct inguinal hernia
Reason: Direct inguinal hernia protrudes through Hesselbach triangle.

Q26. B. Oral glucose tolerance test
Reason: OGTT is the diagnostic test for gestational diabetes.

Q27. A. Polycystic ovarian syndrome
Reason: Obesity, hirsutism, acne, irregular cycles, infertility, and peripheral ovarian follicles indicate PCOS.

Q28. A. Betamethasone
Reason: Antenatal corticosteroids improve fetal lung maturity in threatened preterm delivery.

Q29. B. C5-C6
Reason: Waiter-tip posture is Erb palsy from upper trunk C5-C6 injury.

Q30. A. Vitamin D deficiency
Reason: Bowed legs, rachitic rosary, low calcium/phosphate, and high ALP indicate rickets from vitamin D deficiency.

Q31. B. Vitamin K
Reason: Newborn bleeding without prophylaxis is vitamin K deficiency bleeding.

Q32. B. Desferrioxamine
Reason: Desferrioxamine chelates iron in significant iron poisoning.

Q33. A. Vernal keratoconjunctivitis
Reason: Recurrent severe itching in summer with cobblestone papillae is vernal keratoconjunctivitis.

Q34. A. Amblyopia
Reason: Long-standing strabismus can suppress vision in the affected eye and cause amblyopia.

Q35. A. Otic barotrauma
Reason: Ear pain after airplane descent with retracted congested tympanic membrane indicates barotrauma.

Q36. B. Thrombotic thrombocytopenic purpura
Reason: MAHA plus thrombocytopenia with normal PT/APTT fits TTP; DIC prolongs coagulation tests.

Q37. A. Squamous cell carcinoma
Reason: Marjolin ulcer is SCC arising in a chronic scar or burn wound.

Q38. D. Type IV
Reason: TB granuloma formation is delayed-type T-cell mediated hypersensitivity.

Q39. A. Anterior interosseous nerve
Reason: Inability to make the OK sign indicates anterior interosseous nerve injury.

Q40. B. Nerve to stapedius
Reason: Hyperacusis means stapedius is paralyzed, so the lesion is proximal to the nerve to stapedius.

Q41. A. Midbrain
Reason: Ipsilateral CN III palsy with contralateral hemiplegia is a crossed brainstem syndrome, classically Weber syndrome in the midbrain.

Q42. A. Sodium influx
Reason: Rapid neuronal depolarization is caused by opening of voltage-gated sodium channels and sodium influx.

Q43. A. Total peripheral resistance
Reason: Hypovolemic shock triggers compensatory vasoconstriction, increasing TPR.

Q44. B. Oral vitamin K and hold warfarin
Reason: High INR with minor bleeding is managed by withholding warfarin and giving vitamin K; protamine reverses heparin.

Q45. A. Thiamine
Reason: Wernicke encephalopathy requires thiamine before glucose to avoid worsening neurologic injury.

Q46. A. Glucose-6-phosphate dehydrogenase
Reason: Antimalarial-triggered hemolysis with dark urine is classic G6PD deficiency.

Q47. B. Randomized controlled trial
Reason: Assigning patients to intervention groups and comparing outcomes is an RCT.

Q48. B. Median
Reason: Median best represents central tendency in skewed data.

Q49. A. Post-mortem interval
Reason: Rigor mortis progression helps estimate time since death.

Q50. A. Atropine and pralidoxime
Reason: Organophosphate poisoning causes cholinergic excess; atropine treats muscarinic effects and pralidoxime regenerates acetylcholinesterase.