Professional Documents
Culture Documents
6. A female taking alcohol is more prone to develop toxicity and cirrhosis compared with male
when the same amount of alcohol is taken due to:
a. Decreased alcohol dehydrogenase in stomach
b. Decreased absorption
c. Large body size
d. Genetic factors
19. Horner’s syndrome associated with pain shoulder and arm is suggestive of:
a. Aortic aneurysm
b. Myocardial infarction
c. Cervical spondylosis
d. Pancoast tumor
26. Sudden death can occur in all of the following cardiovascular conditions except:
a. Ventricular fibrillation
b. Massive myocardial infarction
c. Atrial fibrillation
d. Rupture of the aorta from dissecting aneurysm
TTS pg. 1
1 Best way to treat street wounds…
a) Immediate suturing b) Cleaning with Saline & Debridement
c) Oral Abx d) Leave it alone
2 Erythema Nodosum can be caused by…
a) Sarcoidosis b) Post prim. Tbc
c) Sulphonamide Therapy d) Streptococcal Pharyngitis
3 Pruritus is seen in all except…
a) Hodgkin Lymphoma b) Obstructive Jaundice
c) Prim. Biliary Cirrhosis d) Lead Poisoning
4 Acne Vulgaris is rare in/on…
a) Face b) Back
c) Leg d) Scalp
5 Basal Cell Carc. of the Skin…
a) Accounts for the majority of
cancers on the exposed skin
b) Is almost unknown in blacks
c) Is an important hazard of
radiotherapy
d) May be caused by prolonged exposure
to arsenic
6 Ecthyma is a…
a) Deep Viral Infect. b) Superficial Bacterial Infect.
c) Deep Bacterial Infect. d) Non-infect. Inflammation
TTS pg. 2
7 Which of the following methods is thee best for controlling an outbreak of
MRSA of wounds in post-operative ward
a) Use of face masks by the
personal
b) Washing hands thoroughly before &
after dressing the wounds
c) Through fumigation of the
room
d) Pre-op Vancomycin to every patient
8 “Strawberry Tongue” followed by “Raspberry Tongue” is characteristic for…
a) Mumps b) Measles
c) Scarlet Fever d) Small Pox
e) Chicken Pox
9 Erysipelas is…
a) Lymphangitis due to
Staphylococcus
b) Lymphangitis due to
Streptococcus
c) Subcut. Inflam. due to
Streptococcus
d) Anaerobic Infection
10 Extensive chr. Candidiasis should arouse suspicion of…
a) HIV b) Tbc
c) Histoplasmosis d) Leprosy
11 Langhans Giant Cells are seen in…
a) Sarcoid Granuloma b) Tuberculous Granuloma
c) Leprosy d) Syphilis
12 Which are not features of Botulism…
a) Deranged pupillary reflexes b) Spasticity
c) Akinesia d) Rigidity
TTS pg. 3
13 The following is true about Tetanus…
a) Centrally placed spasm b) Contagious
c) Local Necrosis d) Prevented by Immunisation
14 Features of Klebsiella Pneumonia is/are…
a) High mortality b) Upper lobes are involved
c) Systemic disturbances d) Chocolate coloured sputum
e) All of the above
15 Staphylococcus Aureus commonly inhabits…
a) Nose b) Throat
c) Ear d) Skin
16 TBC is exacerbated by…
a) Gastrectomy b) Alcoholism
c) Diabetes d) All of the above
17 Lyme disease is caused by…
a) Borrelia Burgdorferi b) Borrelia Dutoni
c) Borrelia Recurrentis d) Borrelia Turicate
18 Toxic Shock syndrome is caused by…
a) Pseudomonas b) Staphylococcus
c) Gonococcus d) Penumococcus
TTS pg. 4
19 Bull neck in Diphtheria is due to…
a) Cellulitis b) Lymphadenopathy
c) Retropharyngeal Abscess d) Laryngeal Edema
20 All of the following may be complications of Pulmonary Tbc, except…
a) Empyema b) Bronchopleural Fistula
c) Bronchiectasis d) Pulmonary Haemorrhage
e) CO2 Retention
21 The best single laboratory aid in Dx of Tbc
a) Skin Test b) Chest X-Ray
c) Sputum Examination d) Histology
e) Physical Examination
22 Which of the following is NOT associated with Streptococcus…
a) Rheumatic Fever b) Scarlet Fever
c) Acute Glomerulonephritis d) Scalded skin syndrome
23 In prim. Syphilis the lesion seen is…
a) Indurated Ulcer b) Multiplicity of Lesion
c) Painful Ulcer d) Bleeding Ulcer
24 Following can be used for Dx of H. Pylori except…
a) Rapid Urease Test b) Urea Breath Test
c) Gastric Biopsy & staining
with Giemsa
d) SAFA Test
TTS pg. 5
25 Which of the following Ig is characteristically elevated in a parasitic infection
with Filariasis
a) IgA b) IgE
c) IgG d) IgM
26 Which of the following is false about H. Pylori…
a) Endoscopy is best for Dx b) Urease activity becomes negative in a
chronic carrier
c) Unless treated it will remain
life long
d) Gastric Carcinoma can develop in
chronic disease
27 A farmer rearing sheep presented with complaints ofFever, Weakness and
Hepatomegaly. Biopsy of the liver showed non-caseating Granulomas. These
are most likely due to an infection with…
a) Brucella Melitensis b) Brucella Canis
c) Francisella Tularensis d) Yersinia Pestis
28 Botulinum Toxin is used in the Tx of…
a) Facial Dystonia & Tics b) Tetanus
c) Guillain-Barre Syndrome d) Botulisms
29 Method of choice to confirm H. Pylori eradication is…
a) Urea Breath Test b) Culture
c) Serology d) Microscopy
30 Most common X-Ray finding of Pulmonary Tbc in AIDS is…
a) Upper zone haziness b) Diffuse Infiltrates
c) Multiple cavities d) Pneumonic Patch
1. Most common cause of spontaneous pneumothorax is:
a. Rupture of sub pleural bleb
b. TBC
c. Trauma
d. Asthma
2. All of the following cause transudation in pleural cavity except:
a. Empyema
b. Congestive heart failure
c. Nephritis
d. Meigs syndrome
3. Pleural fluid low in glucose is seen in:
a. RA
b. TBC
c. Mesothelioma
d. Empyema
4. Causes of hemorrhagic pleural effusions are:
a. Pulmonary infarction
b. Mesothelioma
c. Bronchial adenoma
d. TBC
5. Bilateral pleural effusion are seen in:
a. Nephrotic syndrome
b. Constrictive pericarditis
c. Congestive heart failure
d. All of the above
6. Bilateral malignant pleura effusion is most often seen in:
a. Breast cancer
b. Lung cancer
c. Mesothelioma
d. Lymphoma
7. Best position to see small pleura effusions on chest X-ray is:
a. Anterior-post view
b. Posterior-ant view
c. Latero-lateral view
d. Lateral decubitus view
8. Increased amylase in pleural fluid is seen in:
a. Malignancy
b. RA
c. Pulmonary infarction
d. TBC
9. All are features of ARDS except:
a. Pulmonary hypertension
b. Normal pulmonary artery wedge pressure
c. Hypoxemia
d. Low protein pulmonary edema
10. The thing that differentiate ARDS from cardiogenic pulmonary edema is:
a. Normal PO2
b. Normal pulmonary artery wedge pressure
c. Normal arterial-alveolar gradient
d. Normal PCO2
11. ARDS is associated with:
a. Acute pancreatitis
b. Trauma
c. Severe Falciparum malaria
12. The following about Klebsiella pneumonia are true except:
a. Red jelly sputum
b. Seen in alchoholics
c. Seen in older people
d. Penicillin is the drug of choice
13. Post-influenza bacterial infection of the lung is caused by:
a. Staphylococcus
b. Streptococcus
c. Pneumococcus
d. Hemophilus
14. Primary atypical pneumonia is caused by:
a. Mycoplasma
b. Mycobacterium kansasli
c. Photochromogens
d. Pneumocystis carinii
15. A person who has high fever, tachycardia, hemoptysis and lobar consolidation on chest
X-ray has:
a. Bronchopneumonia
b. Lobar pneumonia
c. Pulmonary edema
d. Pulmonary infarction
16. Nosocomial pneumonia is caused most often by:
a. Streptococci
b. Mycoplasma
c. Gram-neg. bacteria
d. Virus
17. All of the following organisms can cause interstitial pneumonia, except:
a. Pneumocystis carinii
b. Mycoplasma pneumonia
c. Legionella pneumophilia
d. Hemophilus influenza
18. Viruses causing pneumonia are all except:
a. CMV
b. Mumps
c. Herpes
d. Measles
19. True about Legionella pneumonia include:
a. Occurs in epidemics
b. Treated with penicillin
c. Associated with splenomegaly
d. Diagnosed from sputum
e. Are more common in children
20. Common presenting symptom of pneumocystis carinii is:
a. Cavity on chest X-ray
b. Hemoptysis
c. Breathlessness
d. Purulent sputum
21. Complications of lobar pneumonia does not include:
a. Lung abscess
b. Amyloidosis
c. Suppurative arthritis
d. Infective endocarditis
22. All are seen in emphysema except:
a. Decreased vital capacity
b. Hyperinflation
c. Ronchi
d. Damage to alveoli
23. Which pulmonary function change is not seen in COPD?:
a. Decreased residual volume
b. Decreased FEV
c. Low mid expiratory flow rate
d. Decreased diffusion capacity
24. Lung involvement in chronic bronchitis is:
a. Bilateral
b. Segmental
c. Lobar
d. Unilateral
25. All are true in the definition of chronic bronchitis exept:
a. Cough for 3 months
b. Productive cough
c. Symptoms more than 2 consecutive months
d. Hemoptysis
26. Pulmonary hypertension in COPD are due to:
a. Constriction of pulmonary vessels
b. Hypoxia
c. Interstitial fibrosis
d. Bronchoconstriction
27. Lung function tests in emphysema reveals:
a. Increased vital capacity
b. Decreased diffusion capacity for carbon monoxide
c. Increased diffusion capacity for carbon monoxide
d. Decreased total lung capacity
e. Decreased FEV1
28. True statements about emphysema is:
a. Breathlessness are always there
b. Diffusion rate of carbon monoxide is reduced
c. Restrictive pattern of lung disease
d. Long-term bronchodilators is not effective
29. The earliest manifestation of pulmonary embolism are:
a. Cyanosis
b. Hemoptysis
c. Dyspnea
d. Chest pain
30. Pulmonary embolism causes:
a. Bradycardia
b. Decreased cardiac output
c. Arterial hypoxemia
d. Acute load on right ventricle
31. Pulmonary embolism is most commonly caused by which of the following:
a. Trauma
b. Atherosclerosis
c. Thrombosis of the pelvis vessels
d. None of the above
32. I acute pulmonary embolism the most frequent ECG-finding is:
a. Sinus tachycardia
b. P-pulmonale
c. Right axis deviation
a) Atherosclerosis is inversely proportional to:
a) Pain at rest
b) Uterine artery
c) SGOT d) SGPT
e) All
a) Nitrates b) Diltiazem
c) Verapamil d) Propranolol
j) Indication for coronary bypass operation include all of the following except:
a) 70% b) 60%
c) 80% d) 90%
l) Riskc factors for coronary arterial disease:
a) High HDL
b) Low LDL
e) Increased lipoproteins
b) Unstable angina
c) Aortic stenosis
b) P mitrale
c) ST segment elevation
d) ST segment depression
b) Hyperhomocysteinemia
a) STEMI b) NSTEMI
s) Which of the following is common risc factor for coronary heart disease
except:
b) Decreased homocysteinemia
d) Type 1 DM
a) Mitral stenosis
b) Aortic regurgitation
c) Aortic stenosis)
d) Mitral regurgitation
c) Pulmonary hypertension
a) Cardiomegaly b) Arrythmia
a) 6 weeks b) 6 months
c) 6 days d) 30 days
b) Systemic embolism
c) Dissection of aorta
d) Ventricular fibrillation
a) Morphine b) Fortwin
c) Diazepam d) NSAID
a) Nifedipine b) Aspirin
ab) All of the following may cause ST segment elevation on ECG, except:
b) Constrictive pericarditis
c) Ventricular aneurysm
d) Prinzmetal angina
ac) The amino acit which is associated with atherosclerosis is:
a) Lysine b) Homocystein
c) Cystein d) Alanine
ad) A patient presents with intense chest pain of 2 hrs duration. ECG
shows ST depression in leads I and V1-V5. There is associated T inversion
and the CPK-MB is elevated. Which of the following should be included in
his management:
e) i.v metoprolol
Correct :1)d 2)c,e 3)d 4)a 5)All 6)c 7)c 8)a 9)a 10)d 11)a
12)c,e 13)c 14)d 15)c 16)a 17)c 18)c 19)b 20)d 21)a,c,d
12 Which of the following antihypertensives will you not prescribe to a truck driver –
a) Clonidine
b) Hydralazine
c) Aldomet
d) Propranolol
e)
13 Which one of the following is of most serious prognostic significance in a patient of
essential hypertension –
a) Diastolic B.P. greater than 130mmHg
b) Transient ischaemic attacks
c) Left ventricular hypertrophy
d) Papilloedema and progressive renal failure
17 A young patient presented with B.P. of 190/120 mmHg without any clinical symptom
and fundus examination is normal, treatment od choice
a) Oral Nitroglycerine
b) IV Nitroglycerine
c) Oral Enalapril
d) IV Enalapril
e) Sublingual short acting Nifedine
A 40 years old male patient, is suffering from type II diabetes mellitus and hypertension.
Which of the following antihypertensive drug should not be used in such patients –
a) Lisinopril
b) Hydrochlorthiazide
c) Losartan
d) Trandolpril
A young hypertensive patient has serum K 2.8 meq/2 and increased aldesterone level with
decreased plasma renin activity. The likely is/are –
a) Renal artery stenosis
b) Ectopic ACTH syndrome
c) Diuretic therapy
d) Conns syndrome
e) Liddle’s syndrome
HeartFailure
Examination of a patient in a supine position reveals jugular veins from the base of the neck
to the angle of the jaw. This finding indicates:
Medicine is an important component of treatment for congestive heart failure. Which one of
these is NOT prescribed routinely for CHF?
a) Benzodiazepine
b) Digitalis
c) ACE-inhibitors
d) Diuretics
What is the technical term which describes the coronary arteries as being narrowed by
hardened plaque, which limits the free flow of oxygen and overworks the heart?
a) Aoritis
b) Thrombosis
c) Artherosclerosis
d) Atherosclerosis
Sometimes, people with congestive heart failure develop arrhythmias of the heart. These
irregular rhythms can be conducive to developing a blood clot. Physicians frequently treat
people with 'blood thinning' medicines which require regulation of the density of the blood.
Which of these is the name for a blood-thinner?
a) Tetracycline
b) Erythromycin
c) Warfarin
d) Amoxicillin
There are two kinds of CHF, depending on which of the heart's two ventricles are affected.
If the problem stems from the left ventricle, the prime pumping mechanism in the heart, which
symptoms tend to dominate?
a) Diarrhea
b) Enterophathy
c) shortness of breath and fatigue
d) Hepatic dysfunction
Which of the following decreases blood volume by increasing the excretion of sodium and
fluids?
a) Aspirin
b) Diuretics
c) Nitroglycerin
d) Digitalis
e) Renin
Which of the following is used to treat the symptoms of heart failure by increasing the
strength of heart contractions (positive inotropy)?
a) Diuretics
b) Digitalis
c) Nitroglycerin
d) Renin
e)
Causes of death in untreated coarctation of aorta may include all of the following except ?
a) Bacterial endocarditis and aortitis
b) Rupture of aorta
c) Myocardial infarction
d) Congestive heart failure
e) Cerebrovascular accidents
Causes of cyanosis ?
a) TOF
b) PDA
c) Tricuspid atresia
d) Eisenmengers complex
e) TGA
Clinical features of ostium secondum type of atrial septal defect are all except. ?
a) Occurrence of congestive failure in childhood
b) Atrial arrhythmias
c) Wide and fixed splitting of the second heart sound
d) Mid diastolic rumble along the left sterna border
Hemoptysis is seen in ?
a) Aortic stenosis
b) Pulmonary stenosis
c) Mitral stenosis
d) Tricuspid stenosis
A 33-year-old man has never been vaccinated for hepatitis B. Serologic tests reveal
negative hepatitis B surface antigen (HBsAg) and positive antibody to surface antigen.
Which of the following conditions does this serologic pattern best fit with?
a) previous hepatitis B infection
b) chronic active hepatitis
c) acute hepatitis B infection
d) poor prognosis
e) need for vaccine to hepatitis B
A 33-year-old woman develops mild epigastric abdominal pain with nausea and
vomiting of 2 days duration. Her abdomen is tender on palpation in the epigastric region,
and the remaining examination is normal. Her white count is 13,000/mL, and amylase is
300 U/L (25–125 U/L). Which of the following is the most common predisposing factor for
this disorder?
a) drugs
b) gallstones
c) malignancy
d) alcohol
21 .A 50-year-old female is 170 cm tall and weighs 75 kg. There is a family history of diabetes
mellitus. Fasting blood glucose is 150 mg/dL on two occasions. She is asymptomatic, and physical
exam shows no abnormalities. The treatment of choice is
a) Observation
b) Medical nutrition therapy
c) Insulin
d) Oral hypoglycemic agent
24 .Which one of the following investigations is most sensitive for early diagnosis of diabetic
nephropathy:
a) Serum creatinine level
b) Creatine clearance
c) Glucose Tolerance Test
d) Microalbuminuria
25 .Fungal lung infection commonly seen in diabetics is:
a) Actiomycosis
b) Murcomycosis
c) Aspergillosis
d) Coccidiodomycosis
26 .Which of the following statements is true regarding type 1 diabetes mellitus:
a) Family history is present in 90 % cases
b) Dependent on insulin to prevent ketoacidosis
c) Time of onset is usually predictable
d) Autoimmune destruction of beta cells occur
e) Mostly occurs in chlidren
27 .Which is the feauture of Dawn phenomenon:
a) Early morning hypoglycemia
b) Early morning hyperglycemia
c) Breakfast hypoglycemia
d) Post prandial coma
28. Somogyi phenomenon is:
a) Hypoglycemia followed by hyperglycemia
b) Hypeglycemia followed by hypoglycemia
c) Glycosuria with normal blood sugar
d) Reactive hypoglycemia
29 .All of the following are assosiated with insulin resistance except:
a) Acantosis nigricans
b) Lipodystrophy
c) Gout
d) Werner Syndrome
30. Impaired glucose tolerance can cause:
a) Neuropathy
b) Nephropathy
c) Retinopathy
d) IHD(ischemic heart disease)
Correct :18.b 19.a,c, 20.e 21.b 22a,b, 23.b 24.d 25 b 26.b,d,e 27.b 28.a 29.c 30.d
. UMF-Tgm, General medicine 6th year (topics with quastions and answers for the final exam in
familymedicine)
Topics: ENT, Ophtalmology and Nephrology.
17. in patients with acute glaucoma the prophylactic treatment for the other eye is:
a. Peripheral iridectomy
b. Anterior sclerotomy
c. Irienclesis
d. Scheie's operation
Nephrology
18. Majority of primary infection of the urinary tract are caused by:
a. E.coli
b. streptococcus fecalis
c. Pseudomonas
d. Proteus
19. polycystic kidneys kan be associated with:
a. Cysts in liver and Lungs
b. Coarctation of aorta
c. Berry aneurisms
d. a and c are correct
e) Which of the following treatments is adequate in slowing down the evolution of renal disease in
a diabetic patient with proteinurea on urinalysis?
a. Calcium chanell blockers
b. ACE-inhibitors
c. Beta blockers
d. Loop diuretics
f) Which of the following alternatives is most indicative in the screening of prostate cancer?
a. prostate ultrasound
b. DRE (digital rectal examination)
c. PSA (prostate specific antigen)
d. PSA & DRE
ae) Which of the following changes is seen in a patient with chronic kidney failure due to chronic
analgesic (NSAID) ingestion?
a.Glomerulosclerosis
b. Papillary necrosis and tubulointerstitial inflamation
c.Cortical necrosis
d. Tubular necrosis
e) In a 65 years old male patient with reccurent severe artritis in his big toes and elevated
creatinine levels. Which the most likely cause to his symtoms?
a.Glomerulonephritis
b.Vascular injury
c. Renal parenchymal uric acid cristals
d. Uric acid kidney stones
26.In which part of the normal kidney nephron is most of the water reabsobed from?
a. Ascending loop of Henle
b. Descending loop of Henle
c. Proximal convulted tubule
d. Collecting duct
e) In a young patient with renal colic, urinalysis showing hexagonal crystals and a cyanide-
nitroprusede test of urine is positive. Which of the following is the most likely diagnosis?
a. Cystineuria
b. Thalasemia
c. Sarcoidosis
d. hereditary glycinuria
e) In pasient with sepsis, hypotension and oliguria following a pneumonia infection. Despite
antibiotic treatment and i.v fluids with the evolutin of (ARF) acute renal failure. Which of the
following is the most likely cause of ARF?
a. Antibiotic treatment
b. Acute infectiouse (GN) Glomerulonephritis
c.Contrast nephropathy
d. (ATN) Acute tubular necrosis
f) A 27-year-old woman with well-controlled bipolar affective disorder, treated with lithium,
develops polyuria and polydipsia.
Which of the following statments is the correct cause of her symtoms?
a. Central diabetes insipidus (DI)
b. Nephrogenic DI
c. Primary polydipsia
d. Osmotic diuresis
'
Which of the following is true of iron deficiency anemia
1. Iron binding capacity is decreased
2. Increased number of sideroblast
3. Serum iron concentration is decreased
4. All of above
A 16 years old female presents with generalized weakness and plapitations. Her Hb is
7g/dl and peripheral smear shows microcytic hypochromic anemia, reticulocyt count is 0,8
% serum bilirubin is 1 mg%. whats is the most likely diagnosis?
1. Iron deficiency
2. Hemolytic anemia
3. Aplastic anemia
4. Folic acid deficiency
A child 5 years old presents with anemia. On examination his MVC was 70 and MCH
wa 22. Blood erythrocyt protoporphyrin was high. Whats the probably diagnosis?
1. Thalasemia
2. Iron deficiency syndrome
3. Porphyria
4. Sickle cell anemia
Viral infection in hemolysis is seen in-
Hepatitis B
Hepatitis C
Prolonged fever
Hepatitis A
CMV
Anemia in chronic renal failure (CRF) is due to-
Decreased erythropoietin production
Iron deficiency
Hypoplastic bone marrow
Decreased vitamin- B 12
Decreased folate levet
Iron absorbtion is increased in-
Iron deficiency anemia
Pregnancy
All types of anemia
Malignancy
Macrolytic anemia
Polycythemia:
Causes of secondary polycythemia may include-
1. Chronic cor pulminale
2. Renal carcinoma
3. Cerebellar haemangioblastoma
4. All of above
True about polycycthemia vera is all exept-
Bleeding
Thrombosis
Decreased ESR
infection
Lymphoma:
lymphadenopathy is seen in all of the following except-
primary syphilis
donovanosis
LGV
Chancroid
Treatment of choice for stage III a Hodgkin’s lymphoma-
Chemotherapy
Radiotherapy
Combination of chemotherapy and radiotherapy
excision
stage B symptom of Hodgkins lymphoma include-
weight loss
fever
bone marrow infiltration
pruritus
anemia
Myeloma:
multiple myeloma is characterized by all exept-
CRF (chronic renal failure)
Gum hyperplasia
Lytic bone lesions
Respiratory infections
In multiple myeloma following are seen-
Increased calcium
Sclerotic bone lesion
Bone deposition
Renal failure
Leukemia:
Regarding leukemia which of the following is correct-
ALL is common in children
ALL is seen in the fifth decade
Bone marrow transplant is done in ALL
d) Bleeding tendency in AML
Neuro–psychiatric disorders
Neurologic
2. The condition where babinski sign is positive but deep tendon jerks are absent is -
a) cerebral hemorrhage
b) cerebral palsy
c) cerebral tumor
d) Frederich's ataxia
3. Primary optic nerve atrophy is a recognized complication of:
a) glaucoma
b) disseminated sclerosis
c) Paget's disease of the skull
d) neurosyphilis
e) ethambutol therapy
15. A 40 year old female presents with a history of sudden onset of headache and nausea which passed
off with rest and analgesics. Later she developed blurring of vision for a few days. On the day of
admission she had developed third nerve palsy with neck rigidity. The temperature was 37,7°C. The
most likely diagnose is
a) acute attack of migrane
b) viral encephalitis
c) sub-arachnoid hemorrhage
d) severe hypertension
23. A35 year old male with no history of DM or hypertension presents with sudden onset bursting
headache and altered sensorium. Most prbable cause would be
a) Meningitis
b) Encephalitis
c) Intracerebral hemorrhage
d) Intracranial tumor
26. A middle aged man presents with progressive atrophy and weakness of hands and forearms. On
examination he is found to have slight spasticity of the legs, generalized hyper-reflexia and increased
signal in the cortoco-spinal tracts on MRI. The most likely diagnosis is
a) Multiple Sclerosis
b) Amyotrophic lateral sclerosis
c) Subacute combined degeneration
d) Progressive spinal muscular atrophy
Psychiatric