1
INTERNAL MEDICINE PAST PAPER 1 WITH
QUESTIONS AND ANSWERS
(RELATABLE TO REAL EXAM SAT @ 2025/26)
1. Untreated atrial septal defect can be complicated by the
following EXCEPT; a.Atrial arrhythmia
b. Pulmonary HTN
c. HFrEF
d. RSHF
e. Recurrent pulmonary infection
2. What is the best Rx option for tetralogy of fallot?
a. Surgical correction in the early life
b. Transcatheter pulmonary valve replacement
c. Catheter ablation
d. Endovascular device closure
e. Close regular follow up
3. Mr. John is a 60 years old banker, who is known diabetic and hypertensive
on medications. He had Hx of chest pain few months ago but didn't sought
any medical attention. Now he presented to JIH with Hx of worsening
dyspnea with mild exertion, he requires 3 pillows for him to sleep. He has leg
swelling and nocturnal cough. O/E he is dysphonic, bilateral pitting edema
and displaced apex, Ve left parasternal heave, systolic murmur at the apex
and bilateral basal crepitations. Which of the following medications isn't
recommended for his Rx in the acute phase?
a. Uperio
b. Dapagliflozin
c. Bisoprolol
d. Furosemide
e. Enalapril
4. The following are non-pharmacological management of HF EXCEPT?
a. Increase potassium intake
b. Reduce salt intake
c. Daily weight measurement
d. Input and output monitoring
e. Fluid restriction
,2
5. A 62 years old man is admitted to hospital following a myocardial
infarction, Four flours after admision a further episode of central chest pain,
Which of the following is the best cardiac marker to investigate his chest
pain?
a. LDAH
b. Troponin I
c. Troponin T
d. CK-MB
e. AST
6. Indications for anticoagulants in mitral stenosis include all of the following
EXCEPT?
a. Atrial fibrillation
b. Severe left atrial enlargement
c. Severe mitral stenosis
d. Severe mitral regurgitation
, 3
e. Spontaneous echo contrast on echocardiography
7. A 55 years old lady presented with a headache, blurry vision and confusion.
She is hypertensive but her husband reported that she didn't take her
medication for some weeks. Examinations revealed elevated blood pressure
of 220/140 mmHg on both arms.
PR: 112 bpm. Which of the following medications is the option for her
management?
a. Labetalol infusion
b. Furosemide
c. Hydralazine
d. Metoprolol
e. Amlodipine
8. Which of the following is an indication for vaccination of an Enteric fever?
a. Food venders
b. Travellers to endemic areas
c. Microbiology lab technicians
d. Person with intimate exposure to person with documented S Typhi carrier
e. All of the above
9. Which of the following drugs is the best in Rx of enteric fever?
a. Third generation cephalosporin
b. Carbapenems
c. Macrolides
d. Aminoglycosides
e.fluroquinolones
10. Glomerulonephritis is a known complication of malarial infection, which
of the following species is most likely to cause it?
a. P. vivax
b. P. falciparum
c. P. knowlesi
d. P. malariae
e. P. ovale
11. The following are features of severe malaria EXCEPT?
a. Non cardiogenic pulmonary edema
INTERNAL MEDICINE PAST PAPER 1 WITH
QUESTIONS AND ANSWERS
(RELATABLE TO REAL EXAM SAT @ 2025/26)
1. Untreated atrial septal defect can be complicated by the
following EXCEPT; a.Atrial arrhythmia
b. Pulmonary HTN
c. HFrEF
d. RSHF
e. Recurrent pulmonary infection
2. What is the best Rx option for tetralogy of fallot?
a. Surgical correction in the early life
b. Transcatheter pulmonary valve replacement
c. Catheter ablation
d. Endovascular device closure
e. Close regular follow up
3. Mr. John is a 60 years old banker, who is known diabetic and hypertensive
on medications. He had Hx of chest pain few months ago but didn't sought
any medical attention. Now he presented to JIH with Hx of worsening
dyspnea with mild exertion, he requires 3 pillows for him to sleep. He has leg
swelling and nocturnal cough. O/E he is dysphonic, bilateral pitting edema
and displaced apex, Ve left parasternal heave, systolic murmur at the apex
and bilateral basal crepitations. Which of the following medications isn't
recommended for his Rx in the acute phase?
a. Uperio
b. Dapagliflozin
c. Bisoprolol
d. Furosemide
e. Enalapril
4. The following are non-pharmacological management of HF EXCEPT?
a. Increase potassium intake
b. Reduce salt intake
c. Daily weight measurement
d. Input and output monitoring
e. Fluid restriction
,2
5. A 62 years old man is admitted to hospital following a myocardial
infarction, Four flours after admision a further episode of central chest pain,
Which of the following is the best cardiac marker to investigate his chest
pain?
a. LDAH
b. Troponin I
c. Troponin T
d. CK-MB
e. AST
6. Indications for anticoagulants in mitral stenosis include all of the following
EXCEPT?
a. Atrial fibrillation
b. Severe left atrial enlargement
c. Severe mitral stenosis
d. Severe mitral regurgitation
, 3
e. Spontaneous echo contrast on echocardiography
7. A 55 years old lady presented with a headache, blurry vision and confusion.
She is hypertensive but her husband reported that she didn't take her
medication for some weeks. Examinations revealed elevated blood pressure
of 220/140 mmHg on both arms.
PR: 112 bpm. Which of the following medications is the option for her
management?
a. Labetalol infusion
b. Furosemide
c. Hydralazine
d. Metoprolol
e. Amlodipine
8. Which of the following is an indication for vaccination of an Enteric fever?
a. Food venders
b. Travellers to endemic areas
c. Microbiology lab technicians
d. Person with intimate exposure to person with documented S Typhi carrier
e. All of the above
9. Which of the following drugs is the best in Rx of enteric fever?
a. Third generation cephalosporin
b. Carbapenems
c. Macrolides
d. Aminoglycosides
e.fluroquinolones
10. Glomerulonephritis is a known complication of malarial infection, which
of the following species is most likely to cause it?
a. P. vivax
b. P. falciparum
c. P. knowlesi
d. P. malariae
e. P. ovale
11. The following are features of severe malaria EXCEPT?
a. Non cardiogenic pulmonary edema
