Medicodrive NEET PG Test Series 2026: This is the first Grand Test in Internal Medicine based on the NEET PG and INICET patterns, featuring 50 questions on the subject. We strive to curate questions that will aid your preparation ahead of the actual exam. Take this free NEET PG mock test, apply your concepts, and assess your exam readiness. The answers and detailed explanations for this Medicine Grand Test (GT) is available now – Answer Key.
NEET PG Medicine GT-1
Q1. A 68-year-old man with hypertension and chronic kidney disease presents with progressive exertional dyspnea. Blood pressure is 158/92 mmHg. Echocardiography shows left ventricular hypertrophy, left atrial enlargement, Ejection Fraction (EF) of 58%, and grade II diastolic dysfunction. BNP is elevated. Which of the following drugs has the strongest evidence for reducing heart failure hospitalization in this patient?
A. Digoxin
B. Ivabradine
C. Empagliflozin
D. Verapamil
Q2. A 27-year-old man presents with muscle weakness. Laboratory values:
Na⁺ 140 mEq/L
K⁺ 2.5 mEq/L
HCO₃⁻ 34 mEq/L
Blood pressure 104/68 mmHg
Urine chloride 46 mEq/L
Serum magnesium is low.
Most likely diagnosis?
A. Bartter syndrome
B. Gitelman syndrome
C. Primary hyperaldosteronism
D. Liddle syndrome
Q3. A patient with Graves disease develops fever, agitation, atrial fibrillation (HR 170/min), and diarrhea after emergency surgery. Which treatment should be given immediately after propylthiouracil?
A. Methimazole
B. Lugol iodine
C. Levothyroxine
D. Radioactive iodine
Q4. A 34-year-old HIV-positive patient (CD4 = 42/µL) presents with headache and fever. CSF analysis reveals:
Opening pressure: 340 mmH₂O
India ink: Positive
What is the most important intervention in addition to antifungal therapy?
A. Immediate ART
B. Repeated therapeutic lumbar puncture
C. Mannitol infusion
D. Acetazolamide
Q5. A 65-year-old smoker with COPD presents with increasing dyspnea.
ABG:
pH = 7.29
PaCO₂ = 68 mmHg
PaO₂ = 54 mmHg
He is conscious, cooperative, and hemodynamically stable. Best initial management?
A. High-flow oxygen (15 L/min)
B. Non-invasive ventilation
C. Immediate intubation
D. Hyperbaric oxygen
Q6. A patient has:
Hb: 8.4 g/dL
MCV: 112 fL
Hypersegmented neutrophils
Most likely deficiency?
A. Iron
B. Vitamin B12
C. Copper
D. Zinc
Q7. A patient suddenly develops vertigo, ipsilateral facial numbness, contralateral body pain loss, dysphagia, and Horner syndrome. Which artery is most likely occluded?
A. Anterior cerebral artery
B. Posterior inferior cerebellar artery
C. Middle cerebral artery
D. Basilar artery
Q8. A patient with cirrhosis presents with hematemesis. Which drug should be started immediately, even before endoscopy?
A. Omeprazole
B. Octreotide
C. Sucralfate
D. Misoprostol
Q9. The investigation of choice to diagnose diabetic nephropathy at the earliest stage is:
A. Serum creatinine
B. Blood urea
C. Urine albumin-to-creatinine ratio
D. CT kidney
Q10. Which cardiac biomarker rises earliest after acute myocardial infarction?
A. Troponin I
B. CK-MB
C. Myoglobin
D. LDH
Q11. A 62-year-old man presents with crushing retrosternal chest pain for 90 minutes. ECG shows ST elevation in leads II, III, and aVF. Blood pressure is 82/54 mmHg. Jugular venous pressure is elevated, lungs are clear, and oxygen saturation is 95% on room air. Which is the most appropriate initial management?
A. Intravenous furosemide
B. Intravenous nitroglycerin
C. Intravenous normal saline bolus
D. Morphine infusion
Q12. A 34-year-old woman presents with recurrent nephrolithiasis. Laboratory findings:
- Calcium: 12.1 mg/dL
- Phosphate: Low
- PTH: Elevated
- Vitamin D: Normal
Tc-99m sestamibi scan shows a solitary parathyroid adenoma. Which investigation should be performed before surgery?
A. Serum calcitonin
B. MEN1 mutation evaluation
C. Urinary catecholamines
D. Serum ACTH
Q13. A 24-year-old man presents with hematuria two days after an upper respiratory tract infection. Serum creatinine is normal. Complement levels are normal, Most likely diagnosis?
A. Post-streptococcal glomerulonephritis
B. IgA nephropathy
C. Membranous nephropathy
D. Minimal change disease
Q14. A 29-year-old man with untreated HIV presents with fever, headache, focal neurological deficits, and seizures. MRI reveals multiple ring-enhancing lesions in the basal ganglia.
Most likely diagnosis?
A. CNS lymphoma
B. Toxoplasmosis
C. Tuberculoma
D. Progressive multifocal leukoencephalopathy
Q15. A patient with severe asthma develops sudden worsening dyspnea while on mechanical ventilation. Examination reveals absent breath sounds on the right side, hypotension, and distended neck veins. What is the next best step?
A. Increase PEEP
B. Needle decompression
C. Nebulized salbutamol
D. Increase FiO₂ to 100%
Q16. A 71-year-old patient presents with resting tremor, cogwheel rigidity, and bradykinesia. Which neurotransmitter deficiency is primarily responsible?
A. Acetylcholine
B. Dopamine
C. GABA
D. Serotonin
Q17. A 55-year-old man presents with hematemesis. Endoscopy reveals a bleeding duodenal ulcer with a visible non-bleeding vessel (Forrest IIa). The recommended management is:
A. Oral PPI alone
B. Endoscopic hemostatic therapy followed by IV PPI
C. Surgery immediately
D. Observation only
Q18. A patient has:
- Hb: 7.8 g/dL
- Reticulocyte count: Elevated
- LDH: Elevated
- Indirect bilirubin: Elevated
- Haptoglobin: Low
The laboratory findings are most consistent with:
A. Iron deficiency anemia
B. Hemolytic anemia
C. Aplastic anemia
D. Anemia of chronic disease
Q19. Which investigation is considered the gold standard for confirming pulmonary embolism in a hemodynamically stable patient?
A. Chest X-ray
B. ECG
C. CT Pulmonary Angiography
D. D-dimer
Q20. The first-line treatment for uncomplicated falciparum malaria in India is:
A. Chloroquine
B. Artesunate-based combination therapy (ACT)
C. Quinine alone
D. Primaquine alone
Q21. A 28-year-old woman presents with fatigue, arthralgia, and pedal edema. Investigations reveal:
- ANA: Positive
- Anti-dsDNA: Positive
- Serum creatinine: 2.1 mg/dL
- Urine protein: 4.2 g/day
- Urine RBC casts present
The next best investigation to guide management is:
A. Anti-Sm antibody
B. Kidney biopsy
C. Complement C3 level
D. Renal Doppler ultrasound
Q22. A 70-year-old man with atrial fibrillation develops sudden onset left-sided weakness lasting 40 minutes. MRI shows no infarction.
CHA₂DS₂-VASc score = 5.
Best long-term management?
A. Aspirin alone
B. Dual antiplatelet therapy
C. Oral anticoagulation with a DOAC
D. No treatment
Q23. A 42-year-old diabetic patient is admitted with:
- Glucose: 610 mg/dL
- pH: 7.28
- Serum bicarbonate: 15 mEq/L
- Potassium: 5.7 mEq/L
After initiating IV fluids, what should be the next step?
A. Sodium bicarbonate infusion
B. IV insulin infusion
C. Potassium infusion immediately
D. Mannitol
Q24. A 55-year-old chronic smoker has:
FEV₁/FVC = 0.55
FEV₁ = 34% predicted
Two hospital admissions for COPD exacerbation in the last year despite LABA/LAMA therapy. Best next step?
A. LABA alone
B. Add inhaled corticosteroid
C. Oral prednisolone lifelong
D. Stop bronchodilators
Q25. A 61-year-old hypertensive man develops sudden inability to look toward the left. Examination reveals:
- Left lateral gaze palsy
- Right hemiparesis
Site of lesion?
A. Midbrain
B. Left pons
C. Right medulla
D. Left occipital lobe
Q26. A cirrhotic patient develops abdominal distension and fever.
Ascitic fluid analysis:
- PMN count = 420 cells/mm³
Most likely diagnosis?
A. Secondary bacterial peritonitis
B. Spontaneous bacterial peritonitis
C. Tuberculous peritonitis
D. Malignant ascites
Q27. A patient with pulmonary tuberculosis develops blurred vision after starting anti-TB therapy. Which drug is most likely responsible?
A. Rifampicin
B. Isoniazid
C. Ethambutol
D. Pyrazinamide
Q28. A patient presents with recurrent venous thrombosis at a young age. Which inherited thrombophilia is the most common?
A. Protein C deficiency
B. Antithrombin III deficiency
C. Factor V Leiden mutation
D. Protein S deficiency
Q29. Which cardiac valve is most commonly affected in infective endocarditis among intravenous drug users?
A. Mitral valve
B. Aortic valve
C. Tricuspid valve
D. Pulmonary valve
Q30. Which electrolyte abnormality is most commonly associated with chronic kidney disease?
A. Hypercalcemia
B. Hypophosphatemia
C. Hyperkalemia
D. Hypernatremia
Q31. A 58-year-old man presents with recurrent episodes of syncope. ECG demonstrates alternating right bundle branch block and left anterior fascicular block. During admission, he develops complete heart block lasting 12 seconds. The most appropriate definitive management is:
A. Oral atropine
B. Implantable cardioverter-defibrillator (ICD)
C. Permanent pacemaker implantation
D. Catheter ablation
Q32. A 30-year-old man develops rapidly progressive renal failure.
Urine:
- RBC casts present
Serology:
- p-ANCA positive
- Anti-GBM negative
Kidney biopsy shows pauci-immune crescentic glomerulonephritis. Most likely diagnosis?
A. Goodpasture syndrome
B. Microscopic polyangiitis
C. IgA nephropathy
D. Lupus nephritis
Q33. A patient with type 2 diabetes is started on an SGLT2 inhibitor. Two weeks later, he develops nausea, abdominal pain, and metabolic acidosis.
Laboratory values:
- Blood glucose: 182 mg/dL
- Serum ketones: Positive
Most likely diagnosis?
A. Hyperosmolar hyperglycemic state
B. Lactic acidosis
C. Euglycemic diabetic ketoacidosis
D. Starvation ketosis
Q34. A 37-year-old HIV-positive patient (CD4 = 38/µL) presents with fever, weight loss, and generalized lymphadenopathy. Bone marrow aspirate shows intracellular yeast forms within macrophages. Most likely organism?
A. Cryptococcus neoformans
B. Histoplasma capsulatum
C. Candida albicans
D. Aspergillus fumigatus
Q35. ABG results:
- pH: 7.52
- PaCO₂: 24 mmHg
- HCO₃⁻: 19 mEq/L
Which acid-base disorder is present?
A. Acute respiratory alkalosis
B. Chronic respiratory alkalosis
C. Respiratory alkalosis with appropriate renal compensation
D. Mixed respiratory alkalosis and metabolic acidosis
Q36. A 69-year-old man develops sudden painless loss of vision in the right eye. Fundoscopy reveals a pale retina with a cherry-red spot. Most likely diagnosis?
A. Retinal detachment
B. Central retinal artery occlusion
C. Vitreous hemorrhage
D. Optic neuritis
Q37. A patient with ulcerative colitis presents with severe abdominal distension, fever, tachycardia, and hypotension. Abdominal X-ray shows transverse colon diameter of 7 cm. Most likely diagnosis?
A. Mechanical intestinal obstruction
B. Toxic megacolon
C. Sigmoid volvulus
D. Crohn disease flare
Q38. A 26-year-old woman presents with petechiae.
Laboratory findings:
- Platelets: 14,000/µL
- Hemoglobin: Normal
- WBC count: Normal
- Peripheral smear: Giant platelets
Most likely diagnosis?
A. Aplastic anemia
B. Immune thrombocytopenic purpura (ITP)
C. Disseminated intravascular coagulation
D. Thrombotic thrombocytopenic purpura
Q39. Which drug has been shown to reduce mortality after ST-elevation myocardial infarction when started within the first 24 hours in appropriate patients?
A. Digoxin
B. ACE inhibitor
C. Verapamil
D. Adenosine
Q40. Which of the following vaccines is contraindicated during pregnancy?
A. Tdap
B. Influenza (inactivated)
C. MMR
D. Hepatitis B
Q41. A 64-year-old man presents with progressive exertional dyspnea and recurrent syncope. On examination, he has a slow-rising carotid pulse and a harsh ejection systolic murmur radiating to the carotids. Echocardiography reveals:
- Aortic valve area = 0.7 cm²
- Mean gradient = 48 mmHg
- LVEF = 58%
What is the definitive management?
A. Balloon valvotomy
B. Medical management alone
C. Aortic valve replacement
D. Mitral valve repair
Q42. A 34-year-old woman develops acute kidney injury after taking NSAIDs for one week. She has fever, rash, and eosinophilia. Urinalysis reveals WBC casts and eosinophiluria. Most likely diagnosis?
A. Acute tubular necrosis
B. Acute interstitial nephritis
C. Rapidly progressive glomerulonephritis
D. Renal artery thrombosis
Q43. A 29-year-old woman presents with episodic headaches, sweating, and palpitations. BP is 220/120 mmHg. Plasma free metanephrines are markedly elevated. Before adrenalectomy, the appropriate pharmacological preparation is:
A. Beta-blocker followed by alpha-blocker
B. Alpha-blocker followed by beta-blocker if required
C. Calcium channel blocker alone
D. ACE inhibitor
Q44. A 68-year-old man with septic shock remains hypotensive despite receiving 30 mL/kg crystalloid. His MAP is 55 mmHg. Which vasopressor should be started first?
A. Dopamine
B. Phenylephrine
C. Norepinephrine
D. Dobutamine
Q45. A 33-year-old woman presents with fever, confusion, petechiae, and acute kidney injury.
Laboratory findings:
- Platelets: 18,000/µL
- Hb: 8.2 g/dL
- Peripheral smear: Numerous schistocytes
- PT and aPTT: Normal
Best immediate treatment?
A. Platelet transfusion
B. Fresh frozen plasma
C. Plasma exchange
D. Intravenous iron
Q46. A 48-year-old man with chronic hepatitis B is found to have a 2.5 cm liver lesion. Triple-phase CT shows arterial phase enhancement with portal venous washout. Most likely diagnosis?
A. Liver abscess
B. Hemangioma
C. Hepatocellular carcinoma
D. Metastatic liver disease
Q47. A 60-year-old woman develops severe shoulder and hip girdle pain with morning stiffness lasting more than one hour. ESR is 105 mm/hr. Most likely diagnosis?
A. Fibromyalgia
B. Polymyalgia rheumatica
C. Rheumatoid arthritis
D. Osteoarthritis
Q48. A 22-year-old man presents after a generalized tonic-clonic seizure lasting 8 minutes. He is still actively convulsing. First-line drug?
A. Phenytoin
B. Diazepam/Lorazepam
C. Sodium valproate
D. Levetiracetam
Q49. Which cardiac biomarker remains elevated for the longest duration after an acute myocardial infarction?
A. Myoglobin
B. CK-MB
C. Troponin T
D. AST
Q50. A healthcare worker sustains a needle-stick injury from a patient known to be HBsAg-positive. The worker has never been vaccinated against hepatitis B. What is the most appropriate post-exposure prophylaxis?
A. Hepatitis B vaccine alone
B. Hepatitis B immunoglobulin (HBIG) alone
C. HBIG plus initiation of hepatitis B vaccination
D. No treatment is required
“All the best for the NEET PG 2026 Exam”
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