NEPALGUNJ MEDICAL COLLEGE

CHISAPANI, BANKE
I SEMESTER ONLINE EXAMINATION
Paper: II (Autonomic Nervous System, Musculoskeletal System and Integumentary System)
Time: 80 Minutes Date: 25-09-2020

1. Which of the following bacteria causes lung infection and a. Parasympathetic nerve activity affects only smooth
is the most common non-tuberculous mycobacterial muscles and glands
infection associated with AIDS patient? b. Parasympathetic nerve activity causes contraction of
a. Mycobcateriumavium the radial muscle of the eye to allow
b. Mycobacterium leprae accommodation fo the near vision
c. Mycobacterium gordonae c. Parasympathetic nerve activity causes contraction of
d. Mycobacterium gastri smooth muscle of the gastrointestinal wall and
2. Buruli ulcer is caused by relaxation of the gastrointestinal sphincter
a. Mycobacterium ulcerans d. Postganglionic parasympathetic nerves release
b. Mycobacterium gastri acetylcholine to activate muscarinic receptors on
c. Mycobacterium leprae sweat glands
d. Mycobacterium gordonae 10. Hexamethoniumblocks :
3. A swimming pool granuloma is a long-term (chronic) skin a. Receptors for postganglionic adrenergic nerve
infection. It is caused by the bacteria …………… endings
a. Mycobacterium marinum b. Neuromuscular junction in skeletal muscle
b. Mycobacterium gordonae c. cholinergic nerve endings in autonomic ganglia
c. Mycobacterium ulcerans d. Receptors for postganglionic cholinergic nerve
d. Mycobacterium gastri endings
4. All can cause pulmonary eosinophilia except- 11. Which of following is activity is brought by
a. Ankylostomaduodenale parasympathetic:
b. Ascarislumbricoides a. Copius sweating
c. Trichinellaspiralis b. Lipolysis
d. Necatoramericanus c. Erection of penis
5. The following statements are true regarding Clostridium d. Ejaculation after sexual intercourse
perfringens excepts 12. The cross-bridges of the sarcomere in skeletal muscles
a. Gas gangrene producing strains of C.perfringens are made up of
produce heat resistant spores a. Troponin
b. It is the commonest cause of gas gangrene b. Tropomyosin
c. The principal toxin of C. perfringens is the alpha c. Actin
toxin d. Myosin
d. It is normally present in human faeces 13. The functions of tropomyosin in skeletal muscle include:
6. Mycetoma cause by a. Binding to myosin during contraction
a. Virus b. Acting as a “relaxing protein” at rest by covering up
b. Bacteriophage the sites where myosin binds to actin
c. Bacteria, Fungus c. Sliding on actin to produce shorteing
d. Parasite d. Releasing Ca2+ after initiation of contraction
7. What is the most common causative agent of 14. The action potentials of skeletal muscle
osteomyelitis? a. Causes the immediate uptake of ca into the lateral
a. Staphylococcus aureus sacs of the sarcoplasmic reticulum
b. Bacillus anthracis b. Is longer than the action potential of cardiac muscle
c. Nocardiabrasiliensis c. Spreads inward to all parts of the muscle via the T-
d. Clostridium tetani tubules
8. Anthrax is caused by d. Has a prolonged plateau phase
a. Parasite 15. By which method maximum heat loss from the body
b. Virus a. Conduction to air
c. Fungus b. Conduction to objects
d. Bacteria c. Evaporation
9. A 45-year old man had a meal containing mushrooms d. Radiation
that he picked in a field earlier in the day. Within few
hours after eating, nausea. Vomiting, diarrhea, urinary
urgency, vasodilation, sweating and salivation
developed. Which of the following statement about the
parasympathetic nervous system is correct?
16. Which of the following hormone is associated with d. Indomethacin
decrease in the concentration of sodium chloride in the 27. Low doses of aspirin prolong bleeding time by selectively
sweat of acclimatized person? inhibiting synthesis of the following mediator in the
a. Norepinephrine platelets:
b. Aldosterone a. Platelet activating factor
c. Renin b. 5-Hydroxytryptamine
d. Epinephrine c. Prostacyclin
17. Synaptic transmission in the autonomic ganglion is d. Thromboxane A2
usually: 28. Choose the action for which the dose of aspirin required
a. Mediated by substance P is the lowest:
b. Adrenergic a. Analgesic
c. Peptidergic b. Antipyretic
d. Cholinergic c. Antiinflammatory
18. Cholinomimetics are not used in d. Antiplatelet aggregatory
a. Partial heart block 29. For a patient of peptic ulcer, the safest nonopioid
b. Glaucoma analgesic is:
c. Post operativeatony a. Paracetamol
d. Myasthenia gravis b. Naproxen
19. Neostigmine is preferred over physostigmine for treating c. Celecoxib
myasthenia gravis because: d. Diclofenac sodium
a. It has additional direct agonistic action onnicotinic 30. What is true of disease modifying antirheumatic drugs?
receptors at the muscle end plate a. Concurrent use of more than one disease modifying
b. It has longer duration of action drug is not recommended
c. It penetrates blood-brain barrier b. Their beneficial effect is manifest only after 1-3
d. It is better absorbed orally months of therapy
20. Drug of choice for treatment of acute organophosphate c. The disease does not recurr once they induce
poisoning is: remission
a. Atropine d. They are to be used life long
b. Pralidoxime 31. Select the first choice drug for acute gout:
c. Neostigmine a. Cochicine
d. Tubocurarine b. Dexamethasone
21. Which of the following drugs does not cross blood c. Indomethacin
placental barrier? d. Allopurinol
a. Physostigmime 32. Allopurinol is a competitive inhibitor of:
b. Glycopyrolate a. Adenosine deaminase
c. Atropine b. Guanase
d. Hyoscine hydro bromide c. Uricase
22. Betaxolol differs from timolol in that it: d. Xanthine oxidase
a. Produces less ocular side effects 33. Which of the following disease modifying anti-rheumatic
b. Is a β1 selective blocker drugs (DMARDs) is the drug of first choice?
c. Is more efficacious in glaucoma a. Gold compounds
d. Is longer acting b. Methotrexate
23. Which is not an endogenous catecholamine? c. Anakinra
a. Dobutamine d. penicillamine
b. Dopamine 34. Mechanism of action of quinolones is by?
c. Adrenaline a. Inhibiting DNA gyrase
d. Noradrenaline b. Inhibiting protein synthesis
24. Alpha I blocker without any effect on blood pressure is: c. Inhibiting cell wall synthesis
a. Prazosin d. Inhibiting DHFRase
b. Terazosin 35. Red man syndrome is due to:
c. Tamsulosin a. Vancomycin
d. Doxazosin b. Teicoplanin
25. The cyclooxygenase isoenzymes COX-1 and COX-2 differ c. Polymyxin
from each other in that: d. Rifampicin
a. COX-2 is inhibited by ibuprofen but not COX-1 36. Leprosy treatment includes following drugs except:
b. COX-1 is constitutive while COX-2 is largelyinducible a. Clofazimine
c. They catalyse different pathways in prostanoid b. Rifampicin
biosynthesis c. Dapsone
d. COX-1 is inhibited by aspirin but not COX-2 d. Penicillin
26. Which of the following is an irreversible inhibitor of 37. Antifungal drug used for systemic fungal infection is:
cyclooxygenase. a. Amphotericin B
a. Phenylbutazone b. Clotrimazole
b. Piroxicam c. Griseofulvin
c. Aspirin d. Econazole
38. Drug that inhibits cell wall synthesis is? c. Borderline lepromatous leprosy
a. Aminoglycosides d. Tuberculoid leprosy
b. Penicilins 49. Dilatorpupillae is supplied by
c. Tetracyclines a. Sympathetic nerves
d. Chloramphenicol b. Vagus nerve
39. Drug of choice in herpes simplex encephalitis is: c. Parasympathetic nerves
a. Acyclovir d. Facial nerves
b. Amantadine 50. Which of the following nucleus is involved in ciliary
c. Vidarabine ganglion?
d. Interferon a. Superior salivatory
40. Which type of melanoma is most common and has best b. Preganglionic EdingerWestphal nucleus
prognosis? c. Inferior salivatory
a. Nodular melanoma d. Superior colliculus
b. Acrallentiginous melanoma 51. Horner's Syndrome is due to compression
c. Lentigomaligna melanoma a. Spinal cord
d. Superficial spreading melanoma b. Celiac ganglion
41. Which of the following is not usually a gross feature of c. Sympathetic chain
melanoma d. Stellate ganglion
a. Diameter over 6 mm 52. Which layer of epidermis is known as homogenous
b. Color variation layer?
c. Border regular a. Stratum granulosum
d. Asymmetry b. Stratum lucidium
42. What would be the clinical staging for a melanoma which c. Stratum corneum
is 4 mm thick, ulcerated with palpable inguinal lymph d. Stratum germinativum
node with no evidence of spread to distant organs 53. Which of the following is known as malphigiarlayer?
a. Stage II C a. Stratum basale
b. Stage III A b. Stratum spinosum
c. Stage II B c. Stratum granulosum
d. Stage III B d. Stratum lucidium
43. Osteopetrosis is characterised by the following features 54. Sebaceous glands are
except: a. Eccrine in nature
a. There is hypercalcaemia b. Merocrine in nature
b. Skeleton is susceptible to fractures c. Apocrine in nature
c. Overgrowth of calcified dense bone d. Holocrine in nature
d. Hereditary defect in osteoclast function 55. Which of the following bone doesn't form proximal row
44. Osteoarthritis has the following pathologic changes of carpal bones
except: a. Lunate
a. Osteophyte formation at the joint margin b. Capitate
b. Atrophy of synovium c. Triquetral
c. Progressive loss of cartilaginous matrix d. Scaphoid
d. Increased osteoclastic activity 56. Which type of joint is wrist joint?
45. Paget’s disease of the bone has following features a. Ellipsoid
except: b. Saddle
a. Elevation of serum alkaline phosphatase c. Plane
b. There is generally hypocalcaemia d. Ball and Socket
c. Affects older age past 50 years 57. The first costrochondral joint is a
d. Role of virus in its etiology a. Synovial
46. Patients of myasthenia gravis have the following features b. Syndesmosis
except: c. Synchondrosis
a. Thymic hypoplasia has a risk in its etiology d. Fibrous joint
b. The disease has other autoimmune associations 58. The following structures pass through carpal tunnel
c. There is reduction in AChRs (acetylcholine receptors) except:
d. Majority of patients have anti-AChR antibodies in a. Ulnar artery
their serum b. Median nerve
47. Common to all forms of muscular dystrophies are all c. Flexor pollicis tendon
except: d. Flexor carpi radialis tendon
a. Muscle fibre necrosis 59. Infection of index finger spread to:
b. Replacement by interstitial fibrosis and adipose a. Radial bursa
tissue b. Thenar space
c. Muscle fibreatony c. Mid-palmar space
d. Regenerative activity d. Dorsum of hand
48. Lepromin test is always positive in:
a. Indeterminate leprosy
b. Lepromatous leprosy
60. Winging of scapula is due to the paralysis of: 71. Femoral artery is separated from profundafemoris artery
a. Romboides by:
b. Trapezius a. Pectineus
c. Serattus anterior b. Adductor magnus
d. Latissimusdorsi c. Adductor longus
61. Which nerve enters the forearm between the two heads d. Psoas major
of pronator teres: 72. Which muscle is called peripheral heart?
a. Musculo-cutaneous nerve a. Gastrocnemus
b. Radial nerve b. Soleus
c. Ulnar nerve c. Tibialis posterior
d. Median nerve d. Popliteus
62. Which among the following is a branch from the trunk of 73. Which statement is not true for Myasthniagravis:
brachial plexus? a. Caused by autoantibodies against Acetylcholine
a. Nerve to subclavius receptors
b. Long thoracic nerve b. May lead to muscle paralysis
c. Suprascapular nerve c. Caused by excessive Acetylcholine receptors
d. Anterior thoracic nerve d. May be associated with other auto-immune diseases
63. The most commonly used vein for blood sampling and 74. All statements are true for Parkinsonism except:
intravenous injection is: a. Decreased dopaminergic neurons in brain
a. Basilic vein b. L-dopa is administered for management
b. Median cubital vein c. Characterized by tremor ,bradykinesia ,rigidity and
c. Cephalic vein postural instability
d. Axillary vein d. Common in early childhood
64. First lower limb bone to ossify 75. The enzyme inhibited during Organophosphate
a. Neck of fibula poisoning:
b. Calcaneum a. Cholesterylesterage
c. Lower end of femur b. Acetyl choline esterage
d. Upper end of tibia c. Lipase
65. Deltoid ligament is attached to all except: d. Paraoxonase
a. Spring ligament 76. Immediate energy source for muscle contraction is:
b. Substanticulumtali a. ATP
c. Medial cuneiform b. Glucose
d. Medial malleolus c. Creatine phosphate
66. In femoral triangle most medial structure is: d. GTP
a. Lymphatic 77. For aerobic metabolism in muscle following are principal
b. Artery substrates except:
c. Nerve a. Endogenous glycogen
d. Vein b. Endogenous amino acids
67. Adductor canal lies beneath the c. Fatty acids derived from TAG of adipose tissue
a. Adductor longus d. Glucose from blood
b. Sartorius 78. Tetany, a condition caused by over excitability of nerve
c. Vastusmedialis and muscle cells characterized by spastic skeletal muscle
d. Adductor magnus contraction could be due to:
68. Anterior compartment of leg consists of all of the a. Increased retention of plasma phosphorus
following muscle except: b. An increase in pH of blood
a. Peroneus brevis c. Poor absorption of calcium from the intestine
b. Peroneus tertius d. All of the above
c. Extensor hallucislongus 79. When muscle contracts, calcium ion in association with
d. Tibialis anterior calmodulin increases glycogenolysis by:
69. Common peroneal nerve can be palpated at: a. Activating phosphorylase without phosphorylation
a. Tibial tuberosity b. Activatingdebranching enzyme
b. Head of fibula c. Increasing synthesis of cAMP
c. Tibial tubercle d. Activating inactive protein kinase
d. Neck of fibula 80. The largest concentration of glycogen in body is:
70. Saphenous nerve is the branch of: a. Liver
a. Femoral nerve b. Brain
b. Sciatic nerve c. Spleen
c. Tibial nerve d. Muscle
d. Obturator nerve