12.


 50   hypertension  !"# catecholamine ()*+,- CT "#
suprarenal mass 1 !2
A. benign adrenal cortex mass
B. benign adrenal medullar mass
C. malignant adrenal cortex mass
D. malignant adrenal medullar mass
E. nodular adrenal cortex mass
# B phaeochromocytoma =neuroendocrine tumor of adrenal medulla
(chromaffin cells), rare 10% is malignancy

35.>+ organ (+ , ? @AB (CD+ tetany E+C

A. pancreas
B. thyroid gland
C. pituitary gland
D. adrenal gland
E. parathyroid gland
# E tetany is symptom of hypoCa, Parathyroidectomy is caused.

37.F

 40  thyroid gland H  !"# T4 , T3 D TSH "K?LMN)ODC

antimicrosomal antibody positive E?1"# antibody 1 TSH HQ(+ARK?RHD ,? DARK,+
A. Riedel syndrome
B. GraveUs disease
C. multinodular goiter
D. subacute thyroiditis
E. Hashimoto thyroiditis
# E Antimicrosomal Ab+ in GravesU disease(↑T3&4) & Hashimoto thyroiditis (vary in
TFT)
44.F

 74   +ACC
+C \C
]## colicky ?RELC !)*+"# WBC ,-E?1?R2 >
AC`-D*!! 21 ? D1 Q E+C>#D   !a>
1 HQ2E
A. diverticulitis
B. ulcerative colitis
C. CA of sigmoid colon
D. familial adenomatous polyposis
E. villous adenoma of upper rectum
# A

47.F

 60  ,-##R?K 40  E]Cd *K
1
? 10 >  !1 D
ARK+\C
D
+L "# crackle adventitious sound, bronchial breath sound, dullness on percussion,
increased tactile fremitus !(CD  !a>
`-Ce

RN
A. pneumothorax
B. pleural effusion
C. acute bronchitis
D. lobar pheumonia
E. pulmonary emphysema
# D

52. LC(+#D@M malignancy ? DARK,+

A. high mitotic activity
B. distant metastasis
C. nuclear plenomorphism
D. incomplete vacuolization
E. high NC ratio
# B
53. 
 30  !! 21 ] -C,DM  R
hRi2Lj2)DLMN
*  !1 D
"# BP A1
 112/76 mmHg PR 88/min BP A1
* 80/60 mmHg PR 120/min Q (C,
(+A )+
)*++B (`-Ce

RN? DAR,K +
A. dopamine
B. isotonic saline
C. colloid solution
D. 5% dextrose in water
E. fresh flozen plasma
# B

58. F

 50   +L1 LMN? D2A>>!C*KLMNL1 # ? ]+ C ! 2D +N B LC
L1 "# 1 ?R WBC 50,000/cu.mm PMN 75% "#`)MD-LO? !(CD  !a>

A. gout
B. pseudogout
C. osteoarthritis
D. septic arthritis
E. rheumatoid arthritis
# A

73. F

 40  HQ adult polycystic kidney  !"#p 2(+1 ?(`-Ce

R?N DARK,+
A. hepatic cyst
B. hepatic fibrosis
C. esophageal varices
D. renal cell carcinoma
E. cerebral artery aneurysm
# A ADPKD associated disease is hepatic cyst 50-80%,
cerebral artery aneurysm 10% , mitral valve prolapse, diverticulosis
75. F

 50  "i, *N> ?Rp 2A"HpF D  st`A>N D 1")R
])2!O#
C D? 2 ,>+ u "C?D>#?RELC E ?R,?2 D)K ?O  !p "@1
>,RA D
"#H"AR?K RL) L + 2 cm ( right upper lobe Q+ 1 `-Ce
1 !2HQ(+? DARK,+
A. lung abscess
B. bronchiectasis
C. pulmonary infarct
D. pulmonary tuberculosis
E. brochogenic carcinoma
# A

99. Lj2A1 EwxD ARK 1 !> >+ "# 1 ?RD 2# +LHQ anthrax (HQ ])2D2#* (
"*NARK>N
>?R spore DQC 
-1A1 Q AB 
1 E
A. ` "*NARK# j>N (C?+
B. "1ENB AR?K RQ ?C,-
C.
y1 ]?)DB !>+" 2
D. ,
u+C
hypochorile 400 ppm # jARKQ + 1 ?R spore
E. (FCNB
Phenol 1%  +(CA>K
# B

110. chronic granulomatous disease D+! DQ ?`+DL\))u(+

A. neutrophil
B. macrophage
C. NK-cell
D. T-cell
E. B-cell
# A or B CGD is defect of phagocytes (neutrophil & macrophage)
121. Q-])2>DR
 30 Q ?R D  +AC  !R
 ])2@1
N B )
Q>N )>DLC `>+
LHR
2? j 3-4 F>K H? ])2
E+C( 24 F>K H?  !(  "# gram positive
rod ?R spore L +(1  D A Q)D+>D)1 D+! D"i2E
A. Botulium toxin
B. Clostidium enterotoxin
C. heat-labile enterotoxin
D. heat-stable enterotoxin
E. α-toxin L c.perfingens type A
# ?E

126. F

 50  ?R D > )*  )* >#H !! 2\R+? 1 +*  !1 D

"# 1 ?R markedly icteric sclerae `)A Cz#>D "# AST 120 U/L ALT 150 U/L slkalin
phosphatase 700 U/L tolal bilirubin 20 mg/dl, direct bilirubin 15 mg/dl !2AB (C2+>#Q ?
LC?LCL,K(+()*+)+)
A. bile salt
B. vitamin K
C. globulin
D. cholesterol
E. gamma glutamyltransferase
# B or D

129. , ?R
 55  p

 40  Qpu]D !NB QKB "# chromosome abnormality 
trisomy 21 , Q*
A. ,!C

B. ,!E?1]LO]
C. endometrium E?1,?#-ju
D. fallopian tube E?1,?#-ju
E. non disjunction L oocyte
# E Down syndrome is defect in non-disjunction of chrom.21
130. F

 40  F#A ?-,D d +#d ,RK
1D 2E? DARK,+
A. tiniasis
B. spargadiasis
C. gnathostomiasis
D. cysticercosis
E. fasicolopiasis
# A or D common is Taenia solium,& Trichinosis( trichinellosis, or trichiniasis)

135. 
 40  ?RDCARKQH? 1 +*  !"# T4 2.3 (4.5-10.9) nmol/L, TSH 30 (0.5-
4.7) mU/L antithyroglobulin antibody ])2 antimicrosomal antibody ?RQ1 titer ,-1 !2
HQF+(+
A. GraveUs disease
B. HashimotoUs thyroiditis
C. subacute thyroiditis
D. thyroid carcinoma
E. submyzedema
# B

149. `-Ce

 60  ?R D  +LCL1 ])2)>! DE+C>#D  !A >,R"# 1 ?R
osteophyte ARK spine ])2 knee joint A>N 2 LC L`-Ce

RN !#DD)EDD D+HQ
A. neoplasm
B. autoimmune
C. degenerative disorder
D. infection
E. crystal deposit
# C Osteoarthritis
162. 
 50  ?R D  +# j> 1 ])2t,, 2#1
? 3 > `)D  !
t,, 2"# sugar-negative, protein-trace, RBC-numerous, WBC-numerous, bacteria-
numerous, no cast Q+ 1 `-Ce

RN 1 !2
A. acute pyelonephritis
B. nephritic syndrome
C. acute cystitis
D. chronic glomerulonephritis
E. acute glomerulonenephritis
# C suprabupic pain+ hematuria+pyruria without cast

166. 
 27  ?RELC  + ?LC ?R`?1  !O# D  !1 D
"# 1 ?R jaundice ])2>#
?C ?H (
>?R`) Lap #*NCRD) D  !A Cz#>D ARKQ ,1 !"*K  , L
 D \R+(`-C e

RNQ*LC(+
A. Hb typing
B. hemoculture
C. CoombUs test
D. liver function test
E. rheumatoid factor
# C SLE with autoimmune hemolytic anemia

177. F

 50  +*K?)C ? D ?R D > )*Q> ?*N>  !1 D
"# 1 ?R jaundice
 !A Cz#>D "# increased total bilirubin, dirext bgilirubin, AST & ALT-100 U/L,
alkaline phosphatase-600 U/L,  !t,, 2"# urine bilinogen positive, urine
urobilinogen negative Q ?`+DL`-Ce

RND+! D, (+
A. slcoholic hepatitis
B. alcoholic cirrhosis
C. hepatocellular carcinoma
D. obstructive jaundice
E. hemolysis
# D Obstructive jaundice= ALP elevation more than 3 times of normal e.g.CBD stone
180. F

 40   +AC# j)N€ d 
d ? 2 +* E+C>#D  !p ">,R
A +  ,1 C"# smear sliding hiatal hernia p 2]AD\C(+ARK !"#E+C(`-Ce


RN
A. incarcerated hernia
B. strangulated hernia
C. esophageal obstruction
D. esophageal perforation
E. gastroesophageal reflux
# E

181. `-C 25  ?RELC  +LC?R`*KARK C ? 1 +* `) ! UA "# Protein 3+, WBC 10-15
cells/mm3, RBC 30-40 cells/mm3  !)*+"# anti-dsDNA positive !(CD   !a>
HQ
A. serum sickness
B. rheumatoid arthritis
C. Henoch-Scholein purpura
D. SLE
E. post-streptococcal glomrulonephritis
# D SLE criteria = arthritis, malar rash, renal involvement, Immunologic

183. 
 40   !"# pleural effusion E+C! 2 N B (
*KC?+D?  !"# cell
count 50 cells/mm3, L 100%, protein 1.5 U/L (serum protein 7 g/µI, serum LDH 350 U/L)
, L pleural effusion (`-Ce

NB Q*LC(+
A. metastatic cancer
B. rheumatoid arthritis
C. tuberculosis
D. congesteve heart failure
E. SLE
# Exudative PF (Parapneumonic effusion, TB, cancer, RA, SLE) =
PF protein/ serum protein> 0.5, PF LDH/ serum LDH > 0.6 , PF LDH> 2/3 of upper limit
of normal serum LDH
If all negative is Transudative PF (CHF, Cirrhosis, NS)
184. EA

 50  #  ? 20  >Di E?1,?KB ,? 1? ?R D # ?  !
t,, 2"# sp.gr. 1.012, sugar 3+ , protein 3+ `-Ce
Q ?R"
„,p "(LC(+
A. acute pyelonephritis
B. cortical necrosis
C. necrotizing papillitis
D. nodular golmerulosclerosis
E. diffuse proliferative glomerulonephritis
# D Diabetic nephropathy

189. F

 50  E)*+? 2 > chest x-ray "#DC apex of left lung E+CAB biopsy
! DDC?
C? "# acidophilic amorphous necrotic material )C?#+C
lymphocyte,
histiocyte, multinucleated giant cell `-Ce
1 !2HQ(+? DARK,+
A. tuberculosis
B. lung abscess
C. large cell carcinoma of lung
D. pneumocystic carinii pneumonia
E. cytomegalic inclusion disease
# A TB

204.F

 60  ?R D *K
#  !E?1"#Q ?`+D(+d Q E+C>#D  !(+
"K??
A. cardiac index
B.GFR
C. renal blood flow
D. fasting blood sugar
E. maximum O2 uptake
# ?E
219.F

 60 ?R1?NB )*ARKQH? 1 +*`) biopsy  metastatic tumor ])2
"# 1 2+># AFP ,D 1 D Q+ 1 primary tumor 1 !22E
A. prostatic cancer
B. renal cell carcinoma
C. colorectal adenocarcioma
D. hepatocellar carcinoma
E. squamous cell carcinoma of lung
# C

227. `-C 50  !"# 1 ?R colonic polyps D)> 1 > ?2O !M? MDi A1  A1 
!2#D 1 "
„,p "]##(+ARK?RQ ?,R
K ,-1D ?2O? DARK,+
A. retention polyps
B. lymphoid polyps
C. hyperplastic polyps
D. Pertz Jehger syndrome
E. familial adenomatous polyposis
# E

233.F

 50 ?R D AC*+d
d"# 1  sliding hernia `-Ce

R?N RHD ,
HQ(LC(+? DARK,+
A. strangulated hernia
B. incarcerated hernia
C. esophageal obstruction
D. carcinoma of stomach
E. esophageal reflux
# B
248. F

 50 HQ"i, *N> ?RELC E #? 3 > !OD\
u+" lobar
pneumonia ARK right lower lobe F*N2EARKEE+C? DARK,+
A. streptococcus pneumoniae
B. klebsiella pneumoniae
C. mycobacterium pneumoniae
D.staphyolcoccus sureus
# B

254.
 30  ,-##RK>D D)># 1 !2?2O!M? MDi ]"A
u D AB (LC(+!2)+
cumulative risk LD ?2O
A. 
+,-##RK
B.  ! mammogram AD
C.  ! PAP smear AD
D.  ! occult blood
# A

267. `-Ce
 +ACd
d t diverticulitis !2,RK
1HQ(+
A. malabsorption
B. carcinoma of colon
# ?

271. acute hepatitis ! D HBV D+! DD)ED

A. immune
# ?

77. `-Ce
COPD ? 2  
(!+L>+])C ? ".?R D 
(!FC ])2LR
)>! D(C O2

DA # 1 D+! DD+D Q #Q?2##2E
A. Pons
B. medulla
C. limbic system
D. hypothalamus
E. carotid body
# ?B or E

79. F

 60   +LC `)D  ! X-ray "# osteoblastic lesion ARK femur ,humerus
,,>
1  metastatic tumor ])C tumor (+1 !2, 
Metastatic cancer to bone = ,  , !, "#$, %&' (CA breast, Renal, Thyroid,
Lung, Prostate)
94. `-Ce
F
30  (!,>K ++ D! NB >D)+ fine fremor moist skin,enlarge thyroid
gland "#"
„,p "]##(+
A.colloid goitor
B.multinodular goitor
C.follicular adenoma
D.diffuse hyperplasia
# ?B or D