Medical Officer (BS-17) Past Papers — FPSC & PPSC Solved MCQs — Part 1

Magnesium sulfate is the definitive first-line anticonvulsant for prevention and treatment of seizures in severe pre-eclampsia and eclampsia (Pritchard or Zuspan protocol: 4 g IV loading dose followed by maintenance infusion or IM injections).

Immediate dual antiplatelet therapy (DAPT) for acute STEMI consists of chewable non-enteric coated Aspirin (162-325 mg, typically 300 mg) combined with a P2Y12 inhibitor such as Clopidogrel (300 to 600 mg loading dose) unless contraindicated.

Acute bacterial meningitis produces turbid CSF with predominantly polymorphonuclear neutrophils (PMNs), high protein, and low glucose (hypoglycorrhachia) consumed by multiplying bacteria. Viral meningitis shows lymphocytic predominance with normal glucose.

McBurney's point lies one-third of the distance along the oblique line from the right anterior superior iliac spine (ASIS) to the umbilicus, representing the base of the inflamed vermiform appendix.

The initial priority in DKA is intravascular volume expansion with isotonic saline (0.9% NaCl) at 10-20 mL/kg/hr (approx 1-1.5 L in the first hour). Insulin infusion (0.1 units/kg/hr) is initiated after confirming adequate fluid hydration and serum potassium > 3.3 mEq/L.

Murphy's sign is an abrupt arrest in inspiratory effort when the examiner deeply palpates the right subcostal margin during deep inspiration, as the inflamed gallbladder contacts the examining fingers.

Under WHO and Pakistan National TB Control guidelines, standard Category 1 treatment for newly diagnosed pulmonary TB comprises an initial 2-month intensive phase with 4 drugs (HRZE) followed by a 4-month continuation phase with 2 drugs (HR). Total duration is 6 months (2HRZE / 4HR).

Under WHO IMNCI criteria, Severe Dehydration is diagnosed if two or more of the following signs are present: 1. Lethargy or unconsciousness, 2. Sunken eyes, 3. Inability to drink or drinking poorly, 4. Skin pinch going back very slowly (more than 2 seconds).

Cardiac troponins (cTnI and cTnT) are highly specific and sensitive structural proteins released into the bloodstream following cardiomyocyte necrosis, rising within 3-4 hours and remaining elevated for 7-14 days.

Intramuscular adrenaline (epinephrine) 1:1,000 (0.5 mg in adults) injected into the anterolateral mid-thigh is the immediate, life-saving drug of choice for anaphylaxis. Antihistamines and corticosteroids are secondary adjuncts and do not reverse airway obstruction or cardiovascular collapse promptly.

Tetracyclines chelate calcium and deposit in developing bones and deciduous/permanent teeth, causing permanent brownish-yellow enamel discoloration and hypoplasia; they are classified as pregnancy category D.

Placenta previa classically presents as painless, recurrent, bright red vaginal bleeding in late second or third trimester without uterine tetany. Abruptio placentae presents with painful, dark vaginal bleeding and a tense, tender, wooden uterus.

Serum lipase has higher sensitivity (85-100%) and specificity for pancreatic injury. Amylase normalizes within 48-72 hours, whereas lipase stays elevated for 8 to 14 days, providing wider diagnostic utility.

The Pentavalent vaccine in Pakistan's national immunization schedule protects against Diphtheria, Tetanus, Pertussis, Hepatitis B, and Haemophilus influenzae type b, administered in three doses at 6, 10, and 14 weeks of age.

The clinical triad of pinpoint pupils (miosis), central nervous system depression, and profound respiratory depression indicates acute opioid overdose. Naloxone (a pure competitive opioid receptor antagonist) must be administered immediately IV/IM/subcutaneously.