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A 26-year-old man from Dhaka presents on day 5 of dengue fever. He has persistent vomiting, abdominal pain, a platelet count of 58,000/mm³, and his hematocrit has increased from 39% to 46%. What is the most appropriate management?

Immediate platelet transfusion

Start IV crystalloid with close monitoring

High-dose dexamethasone

Empirical ceftriaxone

None

A 62-year-old man with type 2 diabetes and established chronic kidney disease has an eGFR of 48 mL/min/1.73 m². Which investigation should be performed at least annually to monitor progression of diabetic kidney disease?

Serum amylase

Urine albumin-creatinine ratio (UACR)

Serum calcium

Serum bilirubin

None

A diabetic patient has persistent blood pressure of 150/92 mmHg and a urine albumin-creatinine ratio of 120 mg/g. Which antihypertensive should be preferred?

Atenolol

Ramipril

Hydrochlorothiazide

Verapamil

None

According to current lipid management guidelines, what is the recommended LDL-cholesterol target for a patient with previous myocardial infarction?

<100 mg/dL

<70 mg/dL

<55 mg/dL

<130 mg/dL

None

A 45-year-old woman presents with central obesity, hypertension, dyslipidaemia, and ultrasound evidence of hepatic steatosis. According to current nomenclature, what is the most appropriate diagnosis?

Alcoholic fatty liver disease

Metabolic dysfunction-associated steatotic liver disease (MASLD)

Viral hepatitis

Autoimmune hepatitis

None

Which scoring system is commonly used to determine the need for hospitalization in adults with community-acquired pneumonia?

CHA₂DS₂-VASc Score

MELD Score

CURB-65 Score

Wells Score

None

Before initiating antibiotics in a patient with suspected complicated urinary tract infection, which investigation is most appropriate?

Blood glucose

Urine culture and sensitivity

ESR

CRP

None

A 55-year-old man presents with sudden onset central chest pain radiating to the left arm for 2 hours. Which investigation should be performed immediately to confirm the diagnosis?

Echocardiography

Chest X-ray

12-lead Electrocardiogram (ECG)

CT Coronary Angiography

None

A 70-year-old patient with diabetes, chronic kidney disease (eGFR 42 mL/min/1.73 m²), and heart failure has an HbA1c of 6.9%. Which therapy provides cardiovascular and renal protection independent of glycemic control?

Linagliptin

Empagliflozin

Gliclazide

Pioglitazone

None

Which acid-base disturbance is classically seen during the early phase of salicylate poisoning?

Respiratory acidosis

Metabolic alkalosis

Respiratory alkalosis

High anion-gap metabolic acidosis

None

Faropenem is most appropriately considered in which of the following clinical situations?

Suspected viral upper respiratory tract infection

Mild uncomplicated dengue fever

Suspected bacterial infection where an oral broad-spectrum β-lactam antibiotic is clinically appropriate

Monobactam

None

Which statement regarding Faropenem is correct?

It inhibits bacterial DNA gyrase.

It acts by inhibiting bacterial cell wall synthesis.

It is active only against Gram-positive bacteria.

It is ineffective against β-lactamase-producing organisms.

None

Mirogabalin produces its analgesic effect primarily by binding to:

μ-opioid receptors

Voltage-gated sodium channels

α2δ subunit of voltage-gated calcium channels

NMDA receptors

None

Which of the following best describes the mechanism of action of Dexlansoprazole?

Blocks histamine H₂ receptors on parietal cells

Irreversibly inhibits the gastric H⁺/K⁺-ATPase (proton pump) in parietal cells

Neutralizes gastric acid in the stomach lumen

Forms a protective barrier over gastric ulcers

None

A 45-year-old businessman has GERD symptoms but is unable to take his medication before meals regularly because of his work schedule. Which characteristic of Dexlansoprazole makes it particularly suitable for this patient?

It should only be taken before breakfast.

It has dual delayed-release technology, allowing administration regardless of meal timing.

It provides acid suppression for only 8 hours

It has antibacterial activity against Helicobacter pylori.

None

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Rank	User	Correct Score %	Time Taken
1	Md masud rana	100	00:03:48
2	Mahmudur Rahman	100	00:05:30
3	Shahin Akhteruzzaman	100	00:05:44
4	Dr Hafez Md Mominur Rahman	100	00:08:13
5	Mahmud	93	00:00:32
6	Dr Mahmudur Rahman	93	00:00:32
7	Dr Mahmudur Rahman	93	00:02:59
8	Aditi Rani Das	93	00:03:11
9	Dr MD Moshiur Rahman	93	00:07:20
10	S	93	00:07:29
11	Sajuti Humaira	86	00:00:48
12	Abdullah Al Azad	86	00:04:53
13	Md.Mojammel Haque	86	00:06:02
14	Farhana Anowar Supti	86	00:07:54
15	Pranto Roy	86	00:08:19
16	Nazimul Islam	86	00:09:53
17	Anon Afsan	80	00:00:42
18	Anon Afsan	80	00:00:55
19	Mukta Sarawar	80	00:03:28
20	Ramim Islam Ibne Noor	80	00:04:11
21	F M F AFROZ	80	00:04:20
22	Dr. Shamiul Hossain	80	00:05:27
23	Rayhan	80	00:06:15
24	Mashfik Rupam	80	00:06:37
25	Mahabuba Mim	80	00:07:39
26	Md. Afsan	73	00:00:39
27	Anon Afsan	73	00:01:04
28	Dr Monjur	73	00:04:47
29	Arkan	73	00:05:17
30	Piyas	73	00:05:50
31	Raisul Shubha	73	00:06:02
32	Nisha	73	00:08:58
33	Jarin	73	00:09:08
34	Anon Afsan	66	00:02:54
35	Fairuz Anika	66	00:06:28
36	Dr. Suhel Ahmed	66	00:07:15
37	Sabikun Nahar Srabony	66	00:07:53
38	Ibtida Nujhat	66	00:09:24
39	Nafisa Tabassum	66	00:09:30
40	Susmita Das	66	00:10:41
41	Zahid ali khan	60	00:04:08
42	Amit Chowdhury	60	00:04:58
43	Rashed	60	00:05:12
44	azizul hoque rifat	60	00:05:42
45	Mostakim Mahin	60	00:06:53
46	Nabab sirazouddoulla	60	00:06:53
47	Tasnim-E-Jannat	60	00:07:14
48	Borna	60	00:07:51
49	Musa Al-amin	53	00:00:30
50	Musa Al-amin	53	00:00:34
51	Trisha	53	00:04:07
52	R	53	00:05:32
53	Ananya	53	00:08:19
54	Sagori khatun	53	00:08:45
55	Afsana	53	00:09:32
56	Motakabbirul	53	00:09:37
57	Foysal	46	00:07:31
58	Sams e Sadeya	46	00:07:57
59	Md Musa Al Amin	40	00:00:29
60	Xyz	6	00:00:39
61	MD AMIRUL ISLAM	0	00:07:13

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