DFM Examination 2023 - July

01. Life threatening astma features.

a.) difficulty to complete sentence by one breath.
b.) Inaudible wheezing
c.) Respiratory rate 25 breaths /minute
d.) Heart rate 55 bpm
e.) Spo2 95%

02. 60yr old female presented with backache after doing household work, no previous
history of any diseases, no tenderness over spine, difficulty to move due to pain
Management options,
a.) Strict bedrest
b.) Movements as for as possible
c.) Analgesics
d.) Lumbosacral spine xray
e.) Lumbar corsets.

03. Regarding Rheumatoid factor,

a.) High titre in rheumatoid vasculitis
b.) Sensitivity is low
c.) Positive Predictive value is low
d.) Positive in sarcoidosis
e.) Gold standard in diagnosis of Rheumatoid arthritis.

04. Regarding cervical Spondylosis

a.) Occipital headache is a presenting complain.
b.) Cervical myelopathy is a complication.
c.) Dysphagia in advanced disease
d.) Neck pan is inflammatory.
e.) Sensory impairrment.
05. Regarding Ankylosing spondy litis.
a.) Type of inflammatory arthritis.
b.) Age of onset more than 40 yrs.
c.) Uveitis is a feature.
d.) Reduces lumbar lordosis.
e.) Dactilitis is characteristic.

06. Features of Parkinson's disease

a.) Pill rolling tremor.
b.) Brady kinesia.
c.) Postural instability
d.) Rigidity
e.) Dementia.

07. As teatotic eczema risk factors.

a.) Diuretics.
b.) Old age.
c.) Dry climate.
d.) Poor hygiene.
e.) Hyperthyroidism.
08.
09. 2yr old child should be able to
a.) name few colurs.
b.) Talk in complete sentences.
c.) Walk independently.
d.) Stand on one foot.
e.) Ride a tricycle.

10. 35yr old female with frequent hand washing through the day as she get dirty hands,
thought it is distressing, she can't stop on her own, Initial Management Options,
a.) Sertraline.
b.) Mind fulness meditation.
c.) Exposure and respose prevention therapy.
d.) Olanzapine
e.) Psycho analysis.
11. Regarding acute pancreatitis,
a.) CRP is useful to assess the severity of the disease.
b.) Early entral feeding is preferred.
c.) Morphine is contra indicated in managing the pain.
d.) Age more than 55y is associated with poor prognosis.
e.) Complication of ERCP.

12. Regarding Fibroadenoma of the breast,

a.) It's a Mobile lump.
b.) Presented at >40y old.
c.) In few it will spontaneously resolved.
d.) May lead to breast CA.
e.) Excision is the Management of option.

13. Causes of dyspepsia

a.) Cholelithiasis
b.) Crohn's disease
c.) H.pylori infection
d.) Oral iron treatment
e.) Pancreatitis

14. Regarding epidydimo orchitis.

a.) Chlamydia urethritis can cause
b.) Complication of Prostatectomy
c.) Cause for infertility
d.) Semnal fluid should be culture before treatment with antibiotics.
e.) Cause by UTI

15. Male presenting with Sudden onset of hemiplegia which lasted only short duration,
What can be the cause,
a.) Migrain
b.) Epilepsy.
c.) TIA
d.) SDH
e.) Cerebral abcess.
16. Regarding causes for seizure in adult,
a.) Alzheimer's disease
b.) Binge drinking
c.) Cerebral hemorrhage
d.) Hyperglycemia.
e.) Hypokalemia.

17. Regarding thyroid disorders

a.) Calcitonin is used as a tumor marker.
b.) Iodine - 131 is used in treating medullary thyroid cancers.
c.) Adenocarcinoma is the commonest type.
d.) Riedel thyroiditis mimic anaplastic CA.
e.) T3 is the primary hormone produced by thyroid gland.

18. DVT can be presented with

a.) Abdominal pain.
b.) Hemoptysis.
c.) Pitting edema.
d.) Superficial vein dilation.
e.) Chest pain.

19. Regarding Hernias,

a.) femoral hernias are more likely to get strangulated.
b.) Indirect hernias are more likely to get strangulated than direct hernias.
c.) Paraumbilical hernias more likely to present with if divarication of recti present.
d.) Epigastric hernias present with dyspeptic symptoms.

20. What are the complications of Crohn's disease,

a.) Intestinal obstruction.
b.) Sacroiliitis.
c.) Arthritis.
d.) Osteoporosis.
e.) Uveitis.
21. In red eye,
a.) Antibiotic eye drop prophylaxis needed to prevent secondary bacterial infections.
b.) If Circum corneal redness present have; to suspect likely glucoma.
c.) B/L Mostly cause by allergic conjunctivitis.
d.) Anterior uveitis can mimic viral conjuntivitis.
e.) Corneal abrasion cause pain.

22. Sudden onset sensory neural hearing loss,

a.) Aminoglycosides are recognized cause.
b.) Sterieds are a management option.
c.) It's managed as medical emergency.
d.) Predisposing factors can be identified in majority of patients.
e.) Tinnitus is a associated symptom.
23.
24. Newely diagnosed DM patient with high BMI what will be treatment options.
a.) Metformin
b.) lifestyle
c.) Pioglitazone
d.) Sulfonylurea
e.) DPP-4 inhibitors

25. Congenital heart diseases can be acquired form,

a.) Maternal rubella
b.) GDM
c.) PIH
d.) Maternal warfarin therapy.

26. Conditions that can presents with loos stools in a infant,

a.) Acute otitis Media.
b.) Pneumonia.
c.) Dental eruption.
d.) UTI
e.) Constipation.
27. 20yr old woman presented with RIF pain with nausea for one day duration, On
examination there is Right iliac fossa tenderness with guarding Diffential diagnosis are
a.) Diverticulitis.
b.) Urinary tract infection.
c.) Appendicitis.
d.) Diabetic Ketoacidosis.
e.) Ectopic pregnancy.

28. Changes in old age

a.) Decrease adaption in dark.
b.) prone to vitamin D deficiency.
c.) Decrease proprioception.
d.) Increases elasticity of bladder wall .

29. Thyroxine absorption can be reduced with the use of,

a.) Iron preparations.
b.) PPI
c.) Calcium lactate
d.) Propranolol
e.) Metformin.

30. Contraindications for HRT includes,

a.) Untreated HTN
b.) Active liver disease
c.) Arterial thromboembolic state
d.) Vaginal discharge
e.) Osteoporosis.

31. Generalized lymphadenopathy seen in,

a.) HIV
b.) Lymphoma
c.) IMN
d.) Bacterial endocarditis
e.) Sarcoidosis
32. Screening for hypothyroidism should be done,
a.) Patient on amiodarone.
b.) Propanlol
c.) Depression
d.) Pretibial Myxedema.
e.) Turners Syndrom.

33. T/F regarding CKD,

a.) unknown origin is the most common cause in Sri Lanka.
b.) eGFR of 25 is known as stage 4 kidney disease
c.) Metformin is contraindicated when e GFR becomes 50
d.) BP should be maintained below 130/80 mmltg.
e.) Hyperparathyroidism is a known feature.

34. Regarding hemolytic anemias,

a.) Can occur with G6PD deficiency
b.) Bilirubin gall stones can form
c.) Microcytic red cells is a feature
d.) Hemoglobinurea can occur in crisis.
e.) Hemosiderin deposition is a complication.

35. Osteoporosis risk factors,

a.) Late Menopause
b.) Alchol
c.) Smoking
d.) COCP Use
e.) Prolong use of PPI

36. Regarding Depo-Provera,

a.) Should be repeated every 8/52.
b.) cause weigh gain.
c.) Can cause Amanorrhea
d.) Should not be used while breast feeding
 e.) If patient on Depo-Provera presented >14wk of last injection and no history of UPSI
no need of additional contraception.

37. 29 year University student presents to a GP with high grade fever with sore threat what
other signs and o symptoms will you be expecting him to suspect having IMN.
a.) Severe Myalgia.
b.) Splenomegaly
c.) Tonsillitis with exudate
d.) Generalized lymphadenopathy.
e.) Night sweats.

38. Regarding Tinea corporis.

a.) Treatment can be stopped after rash disappears.
b.) To test scraping are taken from middle of the lesion.
c.) Dermatophyte found in basal epidermal layer.
d.) Oral antifungal are first line on treatment
e.) Should prescribe steroid local applications if complaining sever itching.
39.

40. Regarding peripheral vascular disease.

a.) ABPI 0.7 is diagnostic of PVD.
b.) Indicated for use of antiplatlels as prophylaxis
c.) failures of exercises in management need surgical referral.
d.) Spinal stenosis should be consider as a differential diagnosis.
e.) Postmenopausal status is a risk factor.