Medi Call FCPS – 1 | AUG 2023 PAPERS

Med 23 Aug 2023 (A.N)

the aortic hiatus of diaphragm. If aortic opening of the
diaphragm is constricted due to aneurysm of aorta, which
one of the following structure will be compressed along
with aorta - ID : 4222

Ⓐ Thoracic duct and vagus nerve

1. 70 years old man presents with myalgia, rashand
Ⓑ Thoracic duct and azygos vein
arthralgia.Joints examination reveal no abnormality.Motor
Ⓒ Azygos vein and both phrenic nerves
power is 5/5 l.ANA is positive with speckeled appearance.
If anti-ribonucleoprotein RNP is also positive then the Ⓓ Inferior ven cava
diagnosis is - ID : 1399
Ⓑ Vana Caval Opening ➜ At T8 ➜ ● IVC ● right phrenic nerve
Ⓐ Mixed connective tissue disorder Esophageal Opening ➜ At T10 ➜ ● esophagus ● vagus (CN 10;
Ⓑ Dermatomyositis Ⓒ SLE 2 trunks)
Ⓓ Polymyositis Aortic Opening ➜ At T12 ➜ ● aorta ● thoracic duct ● azygos vein
✦ First Aid, Pg. 663
Ⓐ Mixed connective tissue disease ☛Clinical features of SScl,
myositis and SLE all occur in same patient. 7. Most aggressive carcinoma is which of the following -
ID : 4321
It commonly presents with indolent puffiness of
fingers with Raynaud’s phenomenon and myalgias. Ⓐ SCC Ⓑ BCC
Most patients have anti-RNP antibodies Ⓒ Melanoma Ⓓ Lichen planus
✦ Davidson, Pg. 1038

2. Patient with pancreatitis has dec fat absorption,

Ⓒ Melanoma ☛ less common than BCC and SCC But more
developed steatorrhea due to deficiency of ? - ID : 2518 dangerous because of its ability to spread to other organs more
rapidly
Ⓐ Enterokinase Ⓑ Peptidase ✦ Skincancer.org, Pg.
Ⓒ Amylase Ⓓ Lipase
8. A woman presents with involuntary movements and
space occupying lesion in caudate Nucleus, which is most
Ⓓ Pancreatitis ➜ Loss of Lipase ( major enzyme for Fat digestion
common clinical feature indicating this lesion? - ID : 4526
) ➜ ↓ Fat digestion and absorption ➜ fatty, bulky, clay-colored
stools (steatorrhea) Ⓐ Chorea Ⓑ Intentional Tremor
● Amylase ➜ digests Carbs ● Trypsin ➜ digests Proteins Ⓒ Resting Tremor Ⓓ Hemiplagia
✦ Guyton, Pg. 825
Ⓐ Caudate lesion ☛ chorea.
3. A non-diabetic female undergo bone marrow transplant
after 2 years having chronic rhino sinusitis develop fungal 9. What are the Parasympathetic effects on lungs? (FCPS Old
infection that shows fungal ball branching septate hyphae Pool ID: 4903
at acute angle and producing respiratory symptoms most
Ⓐ Inc compliance Ⓑ Inc restrictive work
likely fungus is: - ID : 2675
Ⓒ Inc physiological dead space
Ⓐ Mucor Ⓑ Aspergillus Ⓓ Inc elastic work
Ⓒ Histoplasma Ⓓ Candida
Ⓑ Vagus nerves ➜ Parasympathetic nerve fibers ➜ lung
Ⓑ Invasive molds: parenchyma➜ Mild to moderate constriction of bronchioles.
✪ Aspergillus ☛ Septate, branching hyphae forming Narrow angle ✦ Guyton, Pg. 505

or V-shape ➜ Aspergillus keratitis and endophthalmitis. 10. A kidney transplant immediately turns blue and is
✪ Mucor ☛ Non-septate, branching hyphae rejected within minutes . What occurs in Hyperacute
forming right angle ➜ Orbital cellulitis or Retinal artery thrombosis Rejection? - ID : 5024
and visual impairment.
Ⓐ Type 4 HSR reaction
✦ Levinson, Pg. 418 ✦ Oxford Microbiology, Pg. 489
Ⓑ Antibody Mediated rejection
Ⓒ Cytotoxic rejection
4. On auscultation first heart sound is variable in - ID : Ⓓ Graft versus host disease
2711

Ⓐ Atrial flutter Ⓑ Atrial fibrillation Ⓑ ✪ Hyperacute rejection ➜ Within minutes ➜ Preformed Anti-
Ⓒ Ventricular tachycardia Ⓓ Ventricular flutter ABO Ab ➜ React ➜ Organ become Cynotic edematous and swollen
✦ Levinson, Pg. 538 ✦ Harsh Mohan, Pg. 66

Ⓑ ✪ First sound ☛ primarily related to the position of the AV 11. Which of following is related to great saphenous vein?
valves at the onset of ventricular systole (FCPS Old Pool ID: 5491
✪ Atrial fibrillation ☛ affects RR interval (increase or
Ⓐ Saphenous nerve Ⓑ Peroneal nerve
decrease) ➜ directly attributable to the degree of LV filling and
Ⓒ Tibial nerve Ⓓ Deep peroneal nerve
subsequent change in force of contraction ➜ causing change in
first heart sound intensity Ⓐ Great saphnous vein ascends in company with saphenous nerve
✦ Jaypee, Pg. 545
in superficial fascia over medial side of leg
✦ SNELL, Pg. 451
5. In a patient with chronic liver disease with upper Gl
bleeding, best treatment among the following is - ID : 3440 12. A patient after RTA was bedridden due to a fracture
Ⓐ Transamine Ⓑ Vit k and developed dyspnea and SOB. DVTs causing Pulmonary
embolism, most commonly arise from which of the
Ⓒ Octreotide Ⓓ Beta blocker
following vein? - ID : 5634
Ⓒ IV octreotide ☛ lower portal BP ➜ prevents bleeding. Ⓐ Femoral vein Ⓑ Popliteal Vein
Ⓒ Superficial vericosed veins of leg
6. A 63. year old man came to the emergency department
Ⓓ Azygous veins
with back pain, weakness and shortness of breath. On
examination, he has an aneurysm of abdominal aorta at

Latest Papers available on MediCall App | www.MediCall.pk/app 684

 Medi Call FCPS – 1 | AUG 2023 PAPERS

Ⓐ ✪ DVTs ( 95% of all venous thrombi )☛ from larger leg veins at

Ⓐ Mechanical stimulation Ⓑ Tissue injury
or above the knee joint ➜ Popliteal ＞ femoral, and iliac veins) Ⓒ Histamine Ⓓ Bradykinin
✪ DVT causing PE ☛ Femoral vein ( High risk DVT)
✦ Robbins, Pg. 515, 112
Ⓒ Injured tissue mast cells release histamine, causing the
13. The first arch (pharyngeal), is. - ID : 6487 surrounding blood vessels to dilate and increase in permeability ➜
Redness
Ⓐ Hyoid arch Ⓑ Mandibular arch ✦ Harsh Mohan, Pg. 123
Ⓒ Facial arch Ⓓ Occipital arch
20. After tonsillectomy patient is having bleeding,
Ⓑ 1st pharyngeal arch ☛ mandibular arch. shivering, tachypneic and BP is low. Which clinical sign
you will check initially to know the status? - ID : 9701
14. Separation of carbohyderates from proteins results in
- ID : 6863 Ⓐ Increase pulse rate Ⓑ Urine output
Ⓒ Temperature Ⓓ Blood pressure
Ⓐ Aggregation n precipitation
Ⓑ Eliminate from kidney Ⓐ ✪ Incraese pulse rate can be the only clinical sign in patient
Ⓒ Increase uptake into muscle with intial stages ( Class I and II ) ,Changes in BP and urine output
Ⓓ Store in body will become signaficant as shock progresses
✦ Robbins, Pg. 119
Ⓐ Carbohydrates would be precipitated and aggregated when
21. Ventricular contraction causes which wave in JVP - ID :
separated from protein in presence of some salts and ethanol as
10001
carbs are considered as macromolecules.
ⒶA ⒷC
15. Which one of the following is selective, potent COX-II
Ⓒ A and c ⒹP
inhibitor. - ID : 8435

Ⓐ Aspirin Ⓑ Celecoxib Ⓑ C wave ☛ corresponds to right ventricular contraction

Ⓒ Indomethacin Ⓓ Meloxicam causing tricuspid valve to bulge towards right atrium during RV
isovolumetric contraction
Ⓑ Celecoxib is a selective COX-2 inhibitor ➜ inhibits ✦ Guyton, Pg. 114

prostaglandin synthesis ➜ reduces inflammation and pain. 22. True about regarding descending thoracic aorta is? -
Meloxicam ☛ non-selective NSAID ➜ inhibits COX-1 and COX-2 ID : 11177

16. A 35 yrs old man presented to ER with sweating and Ⓐ Becomes abdominal aorta at L2
salivation. His heart rate was 45 and BP 60/40 mmhg. Ⓑ Begins at upper border of body of T4
What is the treatment of choice - ID : 8478 Ⓒ Begins at lower border of t5
Ⓓ Begins at lower border of body of T4
Ⓐ Atropine Ⓑ Lignocaine
Ⓒ Digoxin Ⓓ Scopolamine Ⓓ Descending thoracic aorta ➜ begins at lower border of body
of T4
Ⓐ Atropine ☛ antimuscarinic ➜ blocks parasympathetic supply to
Continuous as Abdominal Aorta ➜ At level of12th thoracic
exocrine glands ➜ ↓ salivation and sweating.
vertebra
✦ SNELL, Pg. 97
17. If a person inhales 500 ml of air during each breath
with respiratory rate of 10 breaths per minute. Calculate 23. Example in which Homeostatic function of autonomic
the alveolar ventilation? - ID : 9021 nervous system is opposed is - ID : 12253
Ⓐ 5000 ml/min Ⓑ 3000 ml/min Ⓐ Feedback Ⓑ Positive feedback
Ⓒ 3500 ml/min Ⓓ 4500 ml/min Ⓒ Sympathetic Ⓓ Negative Feedback

Ⓒ Alveolar ventilation = ( Tidal volume - Dead space) x Ⓓ Negative feed back:

Respiratory rate Increased value ➜ Initiates Response ➜ decrease to mean value
VA = (500-150) x 10 = 350 x 10 = 3500 ml/min ➜ establish homeostasis.
✦ Kaplan Physiology, Pg. 140
✦ Guyton, Pg. 8

18. A febrile patient presented in ER with ringing in the

24. Analgesic used in epidural anaesthesia which causes
ears having deep and rapid breathing along with vomiting,
delayed respiratory depression. - ID : 12323
epigastric pain. ABGs showing PCo2 : 25 , PO2 : 50 , Ph
:7.40 , HCO3 : 11. Most likely cause is? - ID : 9063 Ⓐ Halothane Ⓑ Fentanyl
Ⓒ Isoflurane Ⓓ Naloxone
Ⓐ Morphine overdose Ⓑ COPD
Ⓒ Aspirin toxicity Ⓓ Fever
Ⓑ Fentanyl ☛ delayed respiratory depression at 6-10 hrs.
( Morphine ＞ Fentanyl ).
Ⓒ All signs show ☛ Phase 1 salicylate toxicity
✪ Phase 1 ☛ Direct respiratory center stimulation ➜ 25. What HIV does after entering into the cell - ID : 12379
Hyperventilation ➜ Respiratory Alkalosis ➜ Compensatory
Ⓐ Acts on mitochondira Ⓑ Affects Nuclear membrane
Alkaluria ( K and NaHCO₃ excreted in urine ).
Ⓒ Converts RNA to DNA Ⓓ Affects only DNA
✪ Phase 2 ☛ sufficient K+ loss ➜ aciduria
✪ Phase 3 ☛ Dehydration, Hypokalemia and Metabolic Acidosis. Ⓒ Following entry of HIV in CD4 +ve cells reverse transcriptase
☢ Early Signs ☛ Nausea, vomiting, diaphoresis, tinnitus, vertigo, transcribes RNA Into DNA.
hyperventilation and tachycardia. Hyperthermia is an indication of
severe toxicity. ✦ Levinson, Pg.
✦ Lippincott Pharma
26. A patient presented with severe metabolic
19. Finger got hurt with the sharp nail. Acute inflammation alkalosis,B.P was 190/110 and serum potassium was 1.9,
and skin red flare is due to which of the first released Na+=150mmol/L.there is increased aldosterone level in
mediator? - ID : 9692 his blood with decreased renin - ID : 12777

Latest Papers available on MediCall App | www.MediCall.pk/app 685

Medi Call FCPS – 1 | May 2023 Papers
 Medi Call FCPS – 1
Ⓐ Conn's Syndrome Ⓑ Adrenal Hyperplasia
Ⓒ Secondary Hyperaldosteronism
Ⓐ Conn's syndome ( primary hyperaldosteronism ) ☛
↑↑ aldosterone ➜ increased sodium reabsorption + potassium
secretion ➜ retention of water along with sodium ➜ hypokalemia
+ Hypertension.
✦ Robbins, Pg. 788
27. Anesthesia is given with halothane, now patient
temperature increases to 105 and increased HR the cause
is: - ID : 12993
Ⓐ IL1 increased
Ⓑ Increased temp threshold in the hypothalamus
Ⓒ Increased heat production by skeletal muscles
Ⓓ Increased activity of the heart
Ⓒ Halothane ☛ Malignant Hyperthermia ➜ release of stored Ca2+
in muscle cells ➜ muscle fibers contract ➜ heat generation and
metabolic acidosis.
28. Stomach emptying is most importantly inhibited After
eating Fatty diet by which of the following strongest
stimulus? - ID : 13113
Ⓐ CCK Ⓑ Insulin
Ⓒ Glucagon Ⓓ Gastrin
Ⓐ CCK ☛ Mainly in response to fat and fatty acids ➜ secreted by
“I” cells in the mucosa of the duodenum and jejunumInhibitors of
Gastric Motility ☛ Delays Emptying ➜ CCK ( most potent ) ,
Secretin , GIP , Glucagon , Too much Chyme already in
intestine , Acidic or Fatty Chyme in duodenum
Stimulants of Gastric Motility ☛ Speed up Emptying ➜ Gastrin ,
GRP , Motilin , Histamine
✦ Guyton, Pg. 812,802,, 812,802,
29. Due to RTA a person got Injury Above sacral spinal
cord. this will result in - ID : 13124
Ⓐ Dilatation of bladder sphincter
Ⓑ Constriction of bladder Ⓒ Atonic bladder
Ⓓ Neurogenic bladder
Ⓓ ✪ Lesion At or Above Sacral Spinal Cord ➜ PARTIAL
Damage ➜ Loss of Inhibition By Brain BUT Intact Motor
Parasympathetic Innervation of Bladder ➜ Detrsusor Muscle un-
opposed supply ➜ Detrusor Contracts Frequently ➜ Frequent
Micturation ➜ Overactive, Neurogenic Bladder.
✪ Lesion only Above the Sacral segment ➜ Complete Damage
➜ Loss of Inhibition by Brain ➜ Overactive Spastic Bladder
✦Remember✦ Both Spastic and Neurogenic are Loss of Inhibitory
Signals by Brain . Neurogenic occur dur to Partial damage Above
or even AT the level of sacral segment BUT Spastic occurs due to
Complete Damage Above Sacral
✦ Davidson, Pg. 1094
30. What is the microscopic diagnosis of vasculitis in
polyarteritis nodosa - ID : 13938
Ⓐ Lymphocytic infiltrates Ⓑ Granulomatous changes
Ⓒ Fibrinoid necrosis Ⓓ Fat necrosis
Ⓒ Histologic features of polyarteritis nodosa ☛ fibrinoid necrosis
➜ often segmental ➜ destruction of medial wall and aneurysm
formation ➜ typically, acutely inflamed arteries seen in conjunction
with healed and healing lesions.
✦ Goljan, Pg. 41
31. Athetosis is due to defect in? - ID : 14600
Ⓐ Caudate Ⓑ Putamen
Ⓒ Corpus striatum Ⓓ Subthalamic nucleus
Ⓔ Globus pallidus
Latest Papers available on MediCall App |
| AUG 2023 PAPERS
Ⓔ Globus Pallidus:
Function ☛ Inhibitory action, balances excitatory action of
Cerebellum.
Damage ☛ Athetosis.
32. Pt diagnosed to have Thrombus In Right sided MCA .
which sign will be present? (FCPS Old Pool ID: 14625
Ⓐ Drooling of saliva Ⓑ Homonymous hemianopia
Ⓒ Paralysis of Left Arm Ⓓ Aphasia
Ⓒ ✪ Right MCA Stroke ➜ ✔ Left Arm paresis and anesthesia ✔
Left facial palsy ✔ Left homonymous hemianopia ( MCA supplies
proximal optic radiations from LGB )
Remember ➜ Aphasia is specific for Left MCA and Left side
Neglect is specific for Right MCA stroke. All other contralateral
signs are similar. so in given options Left Arm paralysis is specific
for Right MCA stroke.
✦ Kaplan Neuro, Pg. 383
33. After a road traffic accident, and massive blood loss,
patient undergoes shock, MAP less than 60mmhg. Most
potent response in massive hemorrhage? - ID : 14870
Ⓐ CNS ischemic response Ⓑ Baroreceptors
Ⓒ Peripheral chemoreceptors
Ⓓ Brain bridge reflex
Ⓐ Arterial pressure control :
✪ Most potent ☛ CNS ischemic response ( Only below 60 mmHg )
✪ Maximum feedback ☛ CNS Ischemic ＞ Baroreceptors ＞
Chemoreceptors ＞ Renin Angiotensin
✪ Fastest and Short Term ☛ baroreceptors
✪ Long term ➜ Renal / Renin angiotensin
34. A patient came in emergency with diplopia, occipital
headache describe it as "Worst headache" and
deteriorating counscious level. Examination reveals neck
stiffness. CT scan shows brain hemorrhage. CSF is blood
stained. What is the diagnosis? - ID : 15278
Ⓐ Subdural hematoma Ⓑ Arachnoid hematoma
Ⓒ Spinal hematoma Ⓓ Subarachnoid haemorrhage
Ⓓ Subarachnoid hemorrhage ☛ Bleeding due to trauma, or
rupture of an aneurysm (such as a saccular aneurys or
arteriovenous malformation. Rapid time course. Patients complain
of “worst headache of my life.” Bloody or yellow (xanthochromic)
lumbar puncture.
✦ First Aid, Pg. 513
35. A 20 years old Fisherman was presented with
shortness of breath and pins and needle sensation in his
both lower limbs.He uses to have only flsh and rice in his
diet. Labs show Hb : 7.5 , Platelet count: 110x10 ,
Reticulocyte count: :0.5% , Stool : Ova of Intestinal
parasite. which is the most likely causative parasite ? - ID :
15549
Ⓐ Necator americanus Ⓑ Ascaris Lumbricoidis
Ⓒ Ancylostoma duodenale Ⓓ Diphyllobothrium latum
Ⓓ Undercooked Fish ➜ Diphyllobothrium latum infestation ➜
competes with the host for vitamin B12 ➜ deficiency of B12 ➜
✪ Megaloblastic Pancytopenia
✪ Neurological signs (Pins and needles sensation in legs)
36. 21 years old boy with the history of recurrent upper
tract Infections and thick saliva, lung volumes increased
and shows emphysematous lesion. What is the cause? - ID
: 15626
Ⓐ IgA deficiency Ⓑ SCID
Ⓒ AIDS
Ⓓ α1 anti-trypsin deficiency
www.MediCall.pk/app 686
 Medi Call FCPS – 1 | AUG 2023 PAPERS

Ⓓ ✪ Combination of emphysema with recurrent respiratory tract
infections and in a young person strongly suggestive of
homozygous α1-antitrypsin defiCiency. In these instances the
emphysema is usually panacinar in type
✪ Prefer Cystic fibrosis
Ⓐ Subdural hematoma ➜ ● results from head trauma that tears
superficial (“bridging”) cerebral veins ● forms a crescent-shaped
hematoma ● occurs between meningeal dura and arachnoid
✦ Kaplan Anatomy, Pg. 245

✦ Goljan, Pg. 547

44. Which adhesion belongs to the CAM family responsible
37. Renal blood flow per minute is Best calculated by: - ID for Cells to cells adhesion during embryonic development ?
: 15711 - ID : 17628

Ⓐ Creatinine clearance Ⓑ Inulin Ⓐ Integrins Ⓑ Selectins

Ⓒ PAH clearance Ⓓ 1/3rd cardiac output Ⓒ Cadherin Ⓓ Laminin

Ⓒ ✪ Renal Plasma Flow is calculated by clearance of para- Ⓒ ✪ Cadherins ☛ Cell to cell attachment ➜ Desmosomes
aminohippuric acid (PAH), as at low concentrations this compound ✪ Integrins ☛ Transmembrane linkers between ECM
is completely cleared from plasma by renal tubular filtration and and Cytoskeleton ➜ hemidesmosomes
secretion in a single pass. RPF=CPAH=UPAH×V/PPAH ✦ Robbins, Pg. 12
✦ Ganong, Pg. 643 ✦ Guyton, Pg. 354
45. Stomach circular muscle become more thicker - ID :
38. Which one of following used in Congestive Cardiac 17641
Failure but is not a vasodilator? - ID : 15772
Ⓐ Fundus Ⓑ Antrum
Ⓐ Verapamil Ⓑ Nifedipine Ⓒ Cardiac Ⓓ Gastroduodenal orifice
Ⓒ Nimodipine Ⓓ Metoprolol
Ⓓ Circular muscles become thicker at the pylorus to form a
Ⓓ ✪ Metoprolol ☛ cardioselective β1 blocker ➜ not vasodilator functional sphincter.
but used in angina ➜ slows heart rate and relaxing blood vessels 46. The First Heart sound is produced due to ? - ID : 18060
➜ allowing smooth blood flow and ↓ BP.
Ⓐ Hpovolumic contraction Ⓑ Isovolumic contraction
✪ Verapamil, Nifedipine, Nimodipine ☛ Ca channel blockers ➜
Ⓒ Isovolumic relaxion Ⓓ Hypovolumic relaxation
lower blood pressure by causing vasodilation.

39. In last trimester uterus is more sensitive to which of Ⓑ Isovolemtric contraction ➜ left ventricular pressure to rise
following? - ID : 16103 above atrial pressure ➜ Closure of A-V valves ➜ S1
✦ Guyton, Pg. 116, 114
Ⓐ Oxytocin Ⓑ Progesterone
Ⓒ Beta hCG Ⓓ Prolactin 47. Male non-smoker One year cough history. X ray shows
mass in peri-hilar which was squamous muscle cell Ca.
Ⓐ Last trimester ☛ ↑ expression of OTR ( oxytocin receptor Second leading cause of Lung cancer after Smoking is ? -
ID : 18466
system ) ➜ ↑ sensitivity of the myometrium to oxytocin at term.
✦ Ten Teachers, Pg. 121
Ⓐ Asbestosis Ⓑ Silica
40. Antigravity muscles which stabilize you, when you Ⓒ Anthracosis Ⓓ Radon
stand are controlled by ? - ID : 16226
Ⓓ Smoking ＞ Radon ＞ Asbestos
Ⓐ Cerebral cortex Ⓑ Spinal cord ✪ Radon ☛ Byproduct of uranium decay ➜ Cause Lung cancer (
Ⓒ White nucles Ⓓ Tractussolitarus
2nd to Smoking )
✪ Asbestos ☛ Bronchogenic carcinoma ＞ Mesothelioma
Ⓑ Lateral vestibulospinal tract ☛ Synapse directly on alpha
✦ First Aid, Pg. 225
motor neuron ( or via interneurons ) which innervate paravertebral
extensors and proximal limb extensors ( Antigravity muscles ). 48. Patient with hoarse voice, dysphagia and difficulty in
✦ Duane Neurosceince, Pg. 353, 353 swallowing and has mass on base of skull. Nerve involved
? - ID : 19368
41. The volume which is inhaled maximum then forcefully
exhaled? - ID : 16245 Ⓐ Glossopharyngeal - IX Ⓑ Vagus - X
Ⓒ Accessory - XI Ⓓ Hypoglossal - XII
Ⓐ Vital capacity Ⓑ Force expiratory volume
Ⓒ Peak flow Ⓓ Total Lung Capacity Ⓑ Damage to CN X ➤ Hoarseness, breathing and swallowing
difficulty.
Ⓐ Vital capacity (VC) ➜ Total amount of air that can be expired ✦ Snell Neuro, Pg. 352
after fully inhaling
VC = TLC - RV OR VC = TV + IRV + ERV = 4600 ml 49. Infant passes stools after each feed rapidly due to
✦ Guyton, Pg. 502 hyperfunction of ? - ID : 19786

42. The patient developed gradual loss of peripheral vision Ⓐ Diarrhoea Ⓑ Celiac disease
in 3 years. On examination he had bitemporal hemianopia Ⓒ Release of metabolic mediators
with an increase of jaw- protrusion due to : - ID : 16425 Ⓓ Gastrocolic reflex

Ⓐ Adenoma of hypothalamus Ⓑ Pituitary adenoma

Ⓒ Section of optic tract Ⓓ Section of optic nerve
Ⓑ Pituitary adenoma ➜ Compression Damage to central
crossing fibers ➜ Bitemporal hemianopsia
43. Sub-dural hemorrhage is due to damage to: - ID : 16650
Ⓓ Gastrocolic Reflex ☛ Presence of food in stomach increases
the motility of colon and increases the frequency of Mass
movements.
✦ BRS Physiology, Pg. 203
50. Receptors which determines Steady pressure are - ID :
19849

Ⓐ Superior cerebral vein Ⓑ Middle cerebral vein Ⓐ Ruffni Ⓑ Pacinian

Ⓒ Inferior cerebral vein Ⓒ GTO Ⓓ Free nerve endings
Ⓓ The anterior division of middle meningeal artery

Latest Papers available on MediCall App | www.MediCall.pk/app 687

 Medi Call FCPS – 1
Ⓐ Ruffini ☛ Slowly adapting + encapsulated ➜ record the
sustained pressure on the skin and stretching of the skin +
Warmth
✦ Ganong, Pg. 161
51. Which of the following crosses brain and causes CNS
depression? - ID : 19864
Ⓐ Isoflurane Ⓑ Domperidone
Ⓒ Morphine Ⓓ Ipratropium
Ⓒ Morphine ☛ crosses BBB and acts directly on CNS to ↓ pain.
52. 30 year old male underwent Partial Lower Lobe
thyroidectomy for enlarged goiter. Inferior thyroid Artery
ligation done and now complains of hoarseness of voice
due to Loss of high pitched voice and difficulty in
swallowing. Which structure is intimately related to Inf.
thyroid artery and could be damaged during surgery ? - ID
: 19944
Ⓐ External Laryngeal Nerve Ⓑ Superior Laryngeal Nerve
Ⓒ Recurrent Laryngeal Nerve
Ⓓ Vagus Nerve
Ⓒ Lower lobe Thyroidectomy ☛ Inferior Thyroid Artery Ligation
➜ RLN blood supply is compromised ➜ Unilateral RLN Damaged
mostly ( Right RLN ＞ Left RLN ) ➜ Ipsilateral Cord Paralysis ➜
Hoarsness of Voise☛ Great care is taken to ligate inferior thyroid
artery closer to gland after it has given off branch to recurrent
laryngeal nerve. ( Netter + Bailey )
53. Which among the following is true about kidney ? - ID :
20048
Ⓐ Podocytes invisible layer of bowman's capsulecapsule
Ⓑ Podocytes in viseral layer of bowman's capsule
Ⓒ Bowmans has cuboidal epithelium
Ⓑ The visceral epithelium, also called the podocyte layer, is the
inner epithelium of the renal corpuscle in direct contact with the
blood capillaries of the glomerulus.
54. A 30 year old female has come to you with a neck
mass. She is diagnosed as a case of high-grade B-cell
lymphoma with c-myc translocation Virus involved is ? - ID
: 20134
Ⓐ EBV Ⓑ CMV
Ⓒ HIV Ⓓ HHV
Ⓐ EBV infection ➜ Translocation of the c-myc oncogene ➜
Increased synthesis of the c-myc protein ( potent oncoprotein ) ➜
Burkitt’s lymphoma
✦ Levinson, Pg.
55. A patient presented with pheochromocytoma the
following drugs should be given preoperatively as
preoperative control of blood pressure is needed? - ID :
20348
Ⓐ Alpha plus beta blockers Ⓑ Alpha blocker
Ⓒ Beta blockers Ⓓ None of above
Ⓐ ✪ Definitive Treatment ☛ Adrenalectomy.
✪ Preoperative Treatment ☛ Phenoxybenzamine ( irreversible
a-blocker ) followed by beta-blocker ➜ prevents hypertensive
crisis.
✦ Pathoma, Pg. 173
56. Regarding erythrocyte correct is? - ID : 20530
Ⓐ Increase viscosity Ⓑ Decrease viscosity
Ⓒ Increase hydrostatic pressure
Ⓓ None of above
Ⓐ ✪ ↑ Hematocrit ( Proportion of Blood That Is Erythrocytes ) ☛ ↑
viscosity✪ Viscosity of blood at normal hematocrit ☛ about 3
Latest Papers available on MediCall App |
| AUG 2023 PAPERS
to 4 i.e three to four times as much pressure is required to force
whole blood as to force water through same blood vessel.✪ In
Polycythemia ☛ Hematocrit rises to 60 or 70 and viscosity can
become as great as 10 times that of water and its flow through
blood vessels is greatly retarded.
✦ Guyton, Pg. 177, 177
57. Source of Progesterone and estrogen during the last
trimester? - ID : 20562
Ⓐ Placenta Ⓑ Uterus
Ⓒ Ovary Ⓓ Chorionic villus
Ⓐ ◉ In the luteal phase following ovulation, estrogen and
progesterone are secreted by ➜ corpus luteum which involutes
slowly after ➜ 13th to 17th week of gestation
◉ After that onwards, syncytial trophoblast cells of Placenta
secretes progesterone and estrogens to maintain pregnancy.
◉ Placental Estrogen is formed by ➜ DHEA and 16 -hydroxy-DHEA
➜ both formed in mother’s and Fetus' Adrenal glands
✦ Guyton, Pg.
58. Most important source of vitamin K is ? - ID : 21103
Ⓐ Liver Ⓑ Egg
Ⓒ Potatoes Ⓓ Green vegetables
Ⓓ ✪ Vitamin K 1 or phylloquinone, obtained from exogenous
dietary sources such as most green leafy vegetables
✪ Vitamin K 2 or menaquinone, produced endogenously by normal
intestinal flora. Phylloquinone can be converted into menaquinone
in some organs
✦ Harsh Mohan, Pg. 250
59. During pregnancy the most significant change in
pulmonary function and lung volume would be?? - ID :
21282
Ⓐ Decreased TLC Ⓑ Increased pCO2
Ⓒ Increased ERV Ⓓ Decreased FRC
Ⓔ Decreased Vital Capacity
Ⓓ ➊ Enlarging uterus produces upward displacement of diaphragm
(up to 4 cm cephalad)
➋ Increase in anteroposterior and transverse diameters of thoracic
cage (5-7 cm in circumferance)
➌ Anatomical dead space increases by about 445% due to
increased airway diameter late in pregnancy
● Vital capacity : No change or slight Inc. ↑
● TLC: ↓Dec. ● Expiratory capacity : ↓Dec.
● Inspiratory Capacity : ↑ Inc. (counterbalancing effects of
widening of lower rib cage)
● FRC : ↓Dec upto 20% and more pronounced in supine position
● ERV : ↓Dec. ● RV : ↓Dec.
● Tidal Volume : ↑ Inc. ( increased ventilatory drive )
● FEV1 : No Change ● FEV1/FVC : No Change
● Lung compliance remains the same
✦ Sceincedirect Elsevier, Pg. ✦ Guyton, Pg. 1063
60. Which of the following is the Paracetamol
(Acetaminophen) antidote? - ID : 21343
Ⓐ N-acetylcysteine Ⓑ Nalaxon
Ⓒ Bicarbonate Ⓓ None of above
Ⓐ NAC ☛ specific antidote for acetaminophen poisoning.
61. Anomic Aphasia is due to lesion of ? - ID : 21673
Ⓐ Wernike's Lesion Ⓑ Broca's lesion
Ⓒ Temporal lesion
Ⓓ Parietal angular gyrus (Brodmann 39)
Ⓓ ✪ Anomic aphasia ➜ Fluent type of aphasia ➜ word retrieval
failures ➜ cannot express the words they want to say (particularly
nouns and verbs) ➜ Speech is fluent and grammatically correct
www.MediCall.pk/app 688
 Medi Call FCPS – 1 | AUG 2023 PAPERS

but it is full of vague words Left Inferior Parietal ➜ Brodmann Ⓐ Corneal epithelium
Area 39 ➜ Angular Gyrus ➜ Convergence zones ➜ Fine Processing Ⓑ Ciliary epithelium and Pupillary Dilator
of SpeechDamage to Wernicke's and Broca's can also cause Ⓒ Throid Ⓓ None of above
Anomic Aphasia but Research has proven that the Epicentre of
Anomic Aphasia is the Parietal Lobe. Ⓑ Neuroectoderm derivatives
✦ Ganong, Pg. 298 ✪ All Neurons and Neuroglia ( Brain and Spinal cord )
✪ Neurohypophysis ( posterior pituitary )
62. Last to come to normal after heamorrhage ? - ID :
21806 ✪ EYE : Optic nerve , optic cup, Ciliary epithelium, iris muscles (
sphincter and Dilators )
Ⓐ RBCs Ⓑ Wbc
✪ Pineal Glands
Ⓒ Both of these
68. The most common reading in a data is ? - ID : 22558
Ⓐ The normal daily production of red blood cells (RBC) in a
Ⓐ Median Ⓑ Mode
healthy adult is about 0.25 mL/kg and the average lifespan of the
Ⓒ Mean Ⓓ SD
cells is about 120 days, whereas that of transfused RBCs is about
50–60 days and can be significantly shorter in the presence of
Ⓑ The mode is a statistical term that refers to the most frequently
factors reducing their survival.
occurring number found in a set of numbers. The mode is found by
63. The Best way to measure and estimate GFR is by ? - ID collecting and organizing data in order to count the frequency of
: 21997 each result. The result with the highest count of occurrences is the
Ⓐ PAH clearance Ⓑ Creatinine clearance mode of the set, also referred to as the modal value.
Ⓒ Urea clearance Ⓓ Inulin clearance 69. A patient with granuloma and sulphur granules these
are characteristics of: - ID : 22969
Ⓓ ✪ Urinary inulin clearance is considered the gold standard for
measuring GFR. It is freely filtered by glomerulus, is not secreted Ⓐ Actinomyces Ⓑ Candidiasis
or reabsorbed in tubules. Ⓒ Liver cancer Ⓓ Gall bladder stones
✦ Guyton, Pg. 366
Ⓐ Sulphur granules ➜ Actinomyces
64. A patient had RTA, he does not know recent events but ✦ Levinson, Pg. 194
he remembers his school events. Short-term memory loss
occurs due to lesions in which of the following areas? - ID 70. The Superior rectal artery is a branch of ? - ID : 23030
: 22207
Ⓐ Inferior mesenteric artery
Ⓐ Uncus Ⓑ Insula Ⓑ Middle rectal artery Ⓒ Superior rectal artery
Ⓒ Hippocampus Ⓓ Midbrain Ⓓ Posterior rectal artery
Ⓔ Neocortex
Ⓐ Braches of inferior mesenteric artery ● Superior rectal artery is
Ⓒ Hippocampus ☛ Roles in consolidation of information and if a continuation of the inferior mesenteric artery ● left colic artery ●
damaged, cause loss of Short term memory. sigmoid arteries ( 2-4 )
✦ SNELL, Pg. 194
65. A 65 yr. presents with jaundice. On work up Hb 4. 5,
increase bilirubin, increase Retic count 10%. Smear 71. The Activation of pancreatic enzyme Trypsinogen into
shows Polychromasia and clumps. Immune Hemolytic trypsin in Duodedum occur by? - ID : 23148
anemia is diagnosed by ? - ID : 22324 Ⓐ Enterokinase Ⓑ Ph less than 7
Ⓐ Periphral smear Ⓑ Bone marrow biopsy Ⓒ Bicarbonates Ⓓ Gastrin
Ⓒ Hb Electrophoresis Ⓓ Coombs test
Ⓐ Mucosal Lining of Duodenum secrete ➜ Enteropeptidase (
Ⓓ Positive Direct Coombs test enterokinase ) ➜ Activates Pacreatic Trypsinogen into Trypsin in
Confirms antibodies that fight against red blood cells. This can be duodenum ➜ Trypsin further activates other pacreatic enzymes
caused by a transfusion of incompatible blood. Or it may be related ✦ Ganong, Pg. 437

to conditions such as hemolytic anemia or hemolytic disease of the 72. The internal spermatic fascia is derived from ? - ID :
newborn (HDN). target. 23245
✦ Robbins, Pg. 491
Ⓐ Fascia transversalis Ⓑ External oblique
66. A women with the history of trauma to head and neck
Ⓒ Internal oblique Ⓓ None of above
region having lesion on tongue. On protrusion,the tongue
deviated to the left side. Which of the nerve is most likely Ⓐ Internal spermatic fascia ● derived from fascia transversalis
involved? - ID : 22329
● attached to the margins of deep inguinal ring
Ⓐ Right hypoglossal nerve Ⓑ Right facial nerve ✦ SNELL, Pg. 130

Ⓒ Right facial nerve Ⓓ Left hypoglossal nerve 73. RBCs are protected from oxidative stress due to? - ID :
23791
Ⓓ Hypoglossal nerve ( CN XII ) ➤ Inervates intrinsic muscles of
Ⓐ Anaerobic metabolism Ⓑ HMP shunt
toungue ( styloglossus, hyoglossus and genloglossus )
Ⓒ Ankyrin and spectrin
✪ LMN lesion ➤ Toungue atrophy ( + / - fasciculations ) and
deviated toward side of lesion. Ⓑ ✪ Oxidative stress, hypoxia or acidosis ➜ ↑ erythrocytes ➜
✪ UMN lesion ➤ no atrophy or fibrillation and deviate to side
↑ glucose metabolized through HMP shunt ( upto 10- to 20-fold ) ➜
opposite of lesion. ☢ Part of CN XII nucleus
↑ amounts of reduced glutathione.
supplying genoglossus receives cortlconuclear fibers only from the
✪ Coupling of glutathione metabolism with HMP shunt protects
opposite cerebral hemisphere.
✦ Snell Neuro, Pg. 353 ✦ First Aid, Pg. 532
RBCs from oxidative stress.
✦ Sceincedirect Elsevier, Pg.
67. Which of the following is the Neuroectoderm
derivative ? - ID : 22336

Latest Papers available on MediCall App | www.MediCall.pk/app 689

 Medi Call FCPS – 1 | AUG 2023 PAPERS

74. Women with vaginal bleeding ,examination shows Ⓐ Tapeworm infections ☛ praziquantel is DOC ➜ Niclosamide
cervical polyp in endo cervix lined by stratified squamous can also be used.
epithelium - ID : 23997
82. Metabolite of vitamin D most commonly assessed in
Ⓐ Dysplasia Ⓑ Metaplasia laboratory, to rule its deficiency: - ID : 34071
Ⓒ Hyperplasia
Ⓐ Cholecalciferol Ⓑ 25 hydroxy Vit D
Ⓑ Mucus-secreting endocervical cells ☛ encounter acid pH of Ⓒ 1,25 Dihydroxycholecalciferol
vagina ➜ undergo squamous metaplasia ➜ can progress to
Ⓑ ✪ Plasma 25-hydroxy vitamin D reflect body store ( Liver
dysplasia and cancer.
✦ Goljan, Pg. 38 and Adipose tissues ) ,Normal 25-hydroxy vitamin D level R/O
vitamin D defeciency
75. Median nerve in upper arm: - ID : 24461 ✦ Davidson, Pg. 126

Ⓐ Lateral epicondyle of humerus 83. Patient with Hyperthyroidism having tachycardia is

Ⓑ Medial to Brachial Artery in cubital fossa sensitive to which of the following - ID : 34239
Ⓒ Gives rise to most of its braches in the upper arm
Ⓐ Adrenaline Ⓑ Cortisol
Ⓓ Enters cubital fossa lateral to the brachial artery
Ⓒ Glucagon Ⓓ Insuline
Ⓑ Cubital fossa contains following structures, enumerated
Ⓐ Thyroid hormones ☛ ↑ Beta receptors ➜ Enhances activity of
from medial to lateral side ➜ ● Median nerve ● Bifurcation
of brachial artery into ulnar and radial arteries ● Tendon circulating catecholamines ➜ Increase sensitivity of tissues to
of biceps muscle ● Radial nerve and its deep branch. adrenergic drive
✦ Ganong, Pg. 346
✦ SNELL, Pg. 377, 378

76. The following method is recommended for cleaning 84. 55 year old Diabetic woman complaining of bloating
facemasks from infection control point of view in and indigestion especially after meals. DOC for
anesthesia: - ID : 26641 gastroparesis to increase her tone of lower esophageal
Sphincter (esophageal competency) and increase gastric
Ⓐ Clean with phenol motility for emptying ? - ID : 34344
Ⓑ Ethylene oxide sterilization
Ⓐ H2 receptor blocker Ⓑ Antacids
Ⓒ Pasteurization Ⓓ Steam sterilization
Ⓒ Prokinetic (Metoclopramide)
Ⓔ Washing with soap and water
Ⓓ Cisapride
Ⓑ ☛ Face mask is heat labile.
✦ Levinson, Pg. 102
Ⓒ Gastroparesis ☛ delayed gastric emptying, common
complication of diabetes ➜ heartburn and indigestion
77. Which artery supplies middle third/thoracic part of the
Prokinetic agents (metoclopramide) ☛ enhance gastrointestinal
esophagus? - ID : 27396
motility and speed up gastric emptying.
Ⓐ Descending thoracic Aorta ✦ Katzung, Pg. 1097, 1115

Ⓑ Inferior thyroid artery Ⓒ Intercostal artery 85. Old-age lady having problem in maintaining balance
Ⓓ Middle thyroid artery Ⓔ Superior thyroid artery and some CNS symptoms. Anemia and hyper-segmented
neutrophils are present on peripheral blood, MCV ＞110
Ⓐ Middle 1/3 of Esophagus ➜ supplied by branches from with Hb 8. WBC 3.5*109 - ID : 34462
descending thoracic aorta
✦ SNELL, Pg. 100 Ⓐ Aplastic anemia Ⓑ Sideroblastic anemia
Ⓒ Megaloblastic anemia Ⓓ Irondeficiency
78. A patient with osteoporosis and osteoclastic activity,
hormone involved would be: - ID : 33916
Ⓒ MCV ＞ 100 fL/cell ☛ Megaloblastic Anemia.
✦ Kaplan Pathology, Pg. 92
Ⓐ Calcitonin Ⓑ Chalciferol
Ⓒ PTH Ⓓ TSH 86. Lymphatic obstruction leads to: - ID : 34484

Ⓒ High PTH ☛ ↓ osteoBlastic and ↑ osteoClast avtivity Ⓐ Chronic inflammation with fibrosis
Ⓑ Kidney failure Ⓒ Liver failure
79. A protein that is important for the contraction of Ⓓ Acute inflammation
skeletal muscle but not smooth muscle: - ID : 33925

Ⓐ Myosin Ⓑ Actin
Ⓐ Chronic inflammation ( Filariasis, due to Wuchereria bancrofti )
Ⓒ Troponin Ⓓ Ca-ATPase ➜ Fibrosis ➜ Lymphatic obstruction ➜ Lymphedema
✦ Robbins, Pg. 100

Ⓒ Troponins are absent in smooth muscles but play major role in 87. A tailor developed TB symptoms, XRAY B/L hilar
skeletal muscle contraction lymphadenopathy. The mode of transmission of his
✦ Ganong, Pg. 115 disease is? - ID : 34494
80. Drug that increases BP: - ID : 33995 Ⓐ Inhaling aerosol droplets
Ⓐ Phenoxy benzamine Ⓑ Alpha agonist Ⓑ Direct contact Ⓒ Blood transfusion
Ⓒ Dibenzyline Ⓓ Beta blockers Ⓓ Needle sticks injury

Ⓑ α agonists ☛ stimulates α receptors on arteries ➜ arteries Ⓐ TB transmitted by airborne droplets and is preventable disease
✦ CMDT, Pg. 288
constrict ➜ ↑ BP.
88. Which of the following is associated with increased
81. The DOC for tapeworm infestation (Taenia solium) ? - risk of death in a cardiac pt with positive family positive
ID : 34011
of hyperlipidemia? - ID : 34507
Ⓐ Niclosamide Ⓑ Metronidazole
Ⓐ LDL Ⓑ HDL
Ⓒ Albendazole
Ⓒ Chylomicron Ⓓ VLDL

Latest Papers available on MediCall App | www.MediCall.pk/app 690

 Medi Call FCPS – 1 | AUG 2023 PAPERS

Ⓐ High LDL level ☛ blocks natural flow of blood ➜ severe risk for 96. A patient is brought to E.R with sudden onset of
heart attack and stroke ➜ leading cause of death. collapse after injection of penicillin, which antibody Is
involve - ID : 35704
89. Woman with iodine deficiency cause? - ID : 34519
Ⓐ IgG Ⓑ IgM
Ⓐ Lack in water and food Ⓒ IgE Ⓓ IgA
Ⓑ Inborn error of metabolism
Ⓒ Poor dietary status Ⓒ Drug allergy ➜ Type-1 hypersensitivity reaction ➜ IgE AB
✦ Levinson, Pg. 558

Ⓑ Metarnal iodine deficiency ➜ Cretinism ➜ impaired

97. Lower part of Mandible formed by? - ID : 35919
development of the skeletal system and central nervous system,
severe mental retardation, short stature, coarse facial features, a Ⓐ Pharyngeal arch 1 Ⓑ Pharyngeal arch 2
protruding tongue, and umbilical hernia. Ⓒ Pharyngeal arch 3 Ⓓ Pharyngeal arch 4
✦ Robbins, Pg. 758
Ⓐ EXPLANATION
90. Role of Macrophages in Immune Response - ID : 34563
98. Sterilization method that kills the bacteria but not the
Ⓐ Phagocytosis
spores increases the chances of infection of which of the
following organism - ID : 36000
Ⓐ Bone Marrow ☛ Precursor cell of myeloid lineage ➜ give rise to
Monocytes ➜ circulate in blood ➜ recruited into tissues in Ⓐ Clostridium Tetani Ⓑ Pseudomonas
inflammatory reactions ➜ mature into macrophages ➜ Ⓒ Staph Aureus Ⓓ Streptococcus
Phagocytosis
✦ Goljan, Pg. 68 Ⓐ Clostridia tetani ☛ sensitive to heat and oxygen ➜ but spores
are highly resistant and capable of surviving boiling as well as
91. In every type of shock, organ failure occurs due to? -
household disinfectants.
ID : 34748

Ⓐ Tissue hypoxia Ⓑ Toxic injury 99. A man after lifting heavy weight experiences sudden
pain in his arm. O/E swelling in upper forearm is noted at
Ⓒ Chemical injury Ⓓ Physical injury
the site where the muscle is attached to radial tuberosity.
The muscle likely injured is? - ID : 36287
Ⓐ Shock ➜ Hypoperfusion ➜ Tissue hypoxia ➜ Cell death ➜ Organ
failure ➜ Death Ⓐ Biceps Ⓑ Brachioradialis.
✦ Goljan, Pg. 147 Ⓒ Supinator Ⓓ Pronator
92. A pt presents with right Astereognosis. The lesion is
likely in which area of brain? - ID : 34753
Ⓐ Biceps Brachii ➜ Two heads
✪ Short head
Ⓐ Occipital lobe origin ➜ tip of the coracoid process.
Ⓑ Anterior part of frontal lobe
Insertion ➜ radial tuberosity
Ⓒ Right Internal capsule Ⓓ Left internal capsule
✪ Long head
Ⓓ Snell neuro bcq Origin ➜ supraglenoid tubercle of scapula , glenoidal labrum.
Internal capsule lesion ☛ C/L Astereognosis + Weakness Insertion ➜ Forms bicipital aponeurosis
✦ Snell Neuro, Pg. 182, 183 ✪ Nerve Supply ➜ Musculocutaneous nerve (C5, C6)
✦ BD Chaurasia, Pg. 88
93. Medial border of inguinal triangle is formed by: - ID :
35263 100. A lady accidentally cut her finger by knife in the
kitchen she brought to hospital and wound is sutured
Ⓐ Lateral boarder of rectus abdominis
doctor assured her that healing take place. Which of the
Ⓑ Inguinal ligament following layers will be regenrate/ healed first and
Ⓒ Inferior epigastric vessels foremost - ID : 36404
Ⓓ Medial boarder of rectus abdominis
Ⓐ Statum basale Ⓑ Stratum spongiosum
Ⓐ Explanation Ⓒ Stratum lucidum Ⓓ Stratum granulosum

94. Growth hormone needs which hormone for its Ⓐ Basal cells ☛ have a regenerative capacity (are stem cells)
function? - ID : 35318 ✦ Sceincedirect Elsevier, Pg.

Ⓐ Insulin Ⓑ Epinephrine 101. 55 years old female undergone hysterectomy for

Ⓒ Glucagon.
Ⓓ Insulin like growth factor
Ⓓ ✪ Effects of GH are partly direct and partly mediated via IGF-I.
✪ GH ☛ Secreted mainly by anterior pituitary ➜ Stimulates linear
growth and muscle mass through IGF-1/somatomedin secretion ➜
increases insulin resistance (diabetogenic).
✦ Ganong, Pg. 332
95. Metabolic response to trauma, skeletal muscles
respond by: - ID : 35542
Ⓐ Decreased protein loss Ⓑ Increased proteolysis
Ⓒ Decreased proteolysis Ⓓ No change
Ⓑ Metabolic response ☛ Trauma ➜ Stress ➜ ↑ Epinephrine and
Cortisol ➜ ↑ Lipolysis and Proteolysis
✦ Bailey and Love, Pg. 4
ovarian cyst. Readmitted due to pneumonia and after
complete screening, it showed gram-negative (-ve)
organism and develop Shock after 6 days. Mechanism
involved? - ID : 36466
Ⓐ Increase vascular / Capillary permeability
Ⓑ Albumin loss Ⓒ Na and water loss
Ⓓ Decrease heat contractility
Ⓔ Acute Tubular necrosis
Ⓐ ✪ Septic shock ☛ Triggered by ➜ Gram positive ＞ Gram-
negative＞ fungi
✪ Pseudomonas ☛ Encapsulated, Gram-negative Rod ➜
Endotoxin ➜ induce a cascade of cytokines (TNF, IL-1, IL-6, and
IL-8) ➜ activate complement and kinin system ➜ Vasodilation
+ increase capillary permeability ➜ Septic Shock
✦ Robbins, Pg. 116

Latest Papers available on MediCall App | www.MediCall.pk/app 691

 Medi Call FCPS – 1
102. A muscle that is attached to more than one joint and
prevents the excessive movement of the proximal joint is
called? - ID : 36468
Ⓐ Prime mover Ⓑ Fixator
Ⓒ Agonist Ⓓ Antagonist
Ⓔ Synergistic
Ⓑ Fixator ☛ to stabilize the origin of prime mover so that it can
act efficiently.
✦ SNELL, Pg. 8
103. A patient had trauma on-duty doctor is unable to find
a vein for the canula. He decides to do a Venous cutdown,
which vein is best? - ID : 36611
Ⓐ Great saphenous vein Ⓑ Small saphanous vein
Ⓒ Dorsal arch of foot Ⓓ Femoral vein
Ⓐ Greater saphenous vein ☛ Longest vein in the body and is
most common site for venous cutdown.
✦ Wikipedia, Pg. ✦ N.I.H USA, Pg.
104. A patient suffering from cervix pathology, pap smear
done. And it showed desmoplasia. Definition of
desmoplasia? - ID : 36614
Ⓐ Metastasis involvement of surrounding tissues
Ⓑ Non-neoplastic proliferation of fibrous connective tissue
Ⓒ Change of one epithelium to another
Ⓓ Increase in Cell Size
Ⓑ Excessive connective tissue stroma in epithelial tumour, it is
referred ☛ desmoplasia
✦ Harsh Mohan, Pg. 191
105. Pain at TMJ due to which unable to elevate mandible.
The muscle involved that causes elevation of jaw? - ID :
36667
Ⓐ Masseter Ⓑ Lateral pterygoid
Ⓒ Posterior fibers of temporalis muscle
Ⓓ Digastric
Ⓐ Masseter muscle with its perimysium has direct contact with
the articular disc on the front edge.
Action ☛ is to elevate the jaw.
106. Semicircular canal assist? - ID : 36716
Ⓐ Angular acceleration Ⓑ Horizontal acceleration
Ⓒ Linear acceleration Ⓓ Static position of head
Ⓐ Semicircular canals ☛ Detect angular
acceleration/deceleration of the head.
107. Patient after RTA having a sacral region of Spinal
cord damage, it will lead to - ID : 36869
Ⓐ Atonic Bladder
Ⓑ Decreased Bladder capacity
Ⓒ Autonomous Bladder Ⓓ Spastic Bladder
Ⓒ EXPLANATION
108. Patient with pulmonary edema and Left ventricular
failure (LVF) choice of Diuretic - ID : 36969
Ⓐ Loop Diuretics Ⓑ ACEI
Ⓒ BB Ⓓ CCB
Ⓐ Furosemide ☛ Loop Diuretics ➜ drug of choice in heart failure
➜ reduces salt and water retention, edema, and symptoms.
✦ Katzung, Pg. 220
109. A child with infection blood is needed for lab studies.
Venesection done. Which structure will be damage - ID :
37453
Latest Papers available on MediCall App |
| AUG 2023 PAPERS
Ⓐ Saphenous nerve Ⓑ Common peroneal nerve
Ⓒ Superficial peroneal nerve
Ⓓ Sciatic nerve
Ⓐ EXPLANATION
110. Biostatistics study is for - ID : 37793
Ⓐ Plant study Ⓑ Animal study
Ⓒ Analysis and interpretation of data
Ⓓ Autoimmune disorders
Ⓒ EXPLANATION
111. After an automobile accident splenectomy done. After
two months' patient presents to emergency with septic
shock and fever. The causative organism for this
overwhelming infection is - ID : 37903
Ⓐ Hemophilic influenza Ⓑ Streptococcus pneumonia
Ⓒ Neisseria meningitis Ⓓ Staph aureus
Ⓑ Post-Splenectomy ➜ ↑ Risk of Encapsulated Sepsis ➜ S.
Pneumoniae ＞ H. influenzae＞ N. Meningitidis
✦ Levinson, Pg. 57, 123
112. Cervical rib compression causes paralysis of short
muscles of hands, which are supplied by - ID : 38412
Ⓐ C8 Ⓑ T1
Ⓒ C6 Ⓓ C5
Ⓑ EXPLANATION
113. A painter was reported with cough for 3 months,
present on all days with some respite on Monday. The
most likely diagnosis is - ID: 55070
Ⓐ Allergic alveolitis
Ⓑ Interstitial lung disease
Ⓒ Occupational asthma Ⓓ Pharyngitis
Ⓒ Occupational asthma ☛ caused by exposure to inhaled
irritants in workplace ➜ often reversible ➜ symptoms may
disappear when irritants are avoided.
114. After thyroidectomy, a 45-year-old female presented
with carpopedal spasms for 10 days. Her blood was
analyzed, and she was treated with calcitriol, a divalent
cation and a polypeptide. Her blood would most likely
have revealed - ID : 55089
Ⓐ Decrease calcium and decrease phosphate
Ⓑ Decrease calcium and increase phosphate and tetany
Ⓒ Increase calcium and decrease phosphate
Ⓓ Increase calcium and increase phosphate
Ⓑ Thyroidectomy ☛ Inadvertent removal
of parathyroid ➜ hypoparathyroidism ➜ hypocalcaemia, tetany
and high phosphate.
✦ Robbins, Pg. 771 ✦ Pathoma, Pg. 166
115. A 42 year old obese female presented with loss of
appetite, bradycardia, constipation, cold intolerance and
weight gain develop carpal tunnel syndrome and wear
thick cloths. On further history and examination, she was
depressed with slow reflexes. The most appropriate
investigation for her would be - ID : 55090
Ⓐ Thyroid biopsy Ⓑ Thyroid Scan
Ⓒ Plasma Free T4 and TSH Ⓓ Thyroid ultrasound
Ⓒ ✪ Symptoms of Hypothyroidism ☛ Weight gain, Cold
intolerance, Fatigue, Somnolence, Dry skin, Dry hair.
✪ Investigations ☛ ↓ T4 and ↑↑ TSH ➜ ＞20 mIU/L.
✦ Davidson, Pg. 637, 640
116. A 12-year-old boy is admitted with anemia. He is
pale, icteric, and has mild splenomegaly. Blood Hb 9.1
www.MediCall.pk/app 692
 Medi Call FCPS – 1
g/dl. MCV 59/1. MCH 28 pg, MCHC 38 g/dl. What is the
most likely diagnosis? - ID : 55122
Ⓐ G-6 PD deficiency Ⓑ Hereditary spherocytosis
Ⓒ Sickle cell disease Ⓓ Thalassemia trait
Ⓑ ✪ Hereditary spherocytosis ☛ spherocytosis ➜ removed
in spleen by macrophages ➜ splenomegaly ➜ hemolytic
anemia ➜ ↑ bilirubin ➜ jaundice.Note :- Jaundice is differentiating
point of HS from Thalassemia. MCV is low, which is not typical of
thalassemia, indicating a more severe form of anemia.
Additionally, thalassemia trait typically has normal hemoglobin
levels and does not cause significant anemia.Reference: Robbins,
10th Edition, pg. 643-645.
✦ Kaplan Pathology, Pg. 98
117. A 30 year male, case of mitral stenosis presented
with haemoptysis and chest pain. On examination he has
elevated J.V.P with a prominent wave and loud pulmonary
component of 2ND heart sound pulmonary arterial
pressure is 32/18 mm hg. The most likely mechanism is -
ID : 55256
Ⓐ Arterial medial hypertrophy
Ⓑ Hypoxia
Ⓒ Increased pulmonary capillary pressure
Ⓓ Increased pulmonary blood flow
Ⓒ MS ➜ Inc Volume in LA ➜ Backward pressure ➜ Inc hydrostatic
pressure in pulmonary veins ➜ Pulmonary congestion ➜
pulmonary HTN ➜ Rise JVP ,Loud P2
✦ Harsh Mohan, Pg. 85
118. Most important prerequisite for renal transplant - ID :
55662
Ⓐ HLA compatibility Ⓑ ABO compatibility
Ⓒ CBC Ⓓ X-Ray
Ⓔ Donar matching
Ⓐ HLA matching ☛ More important in Kidney transplant)
ABO matching ☛ More important in Liver transplant)
✦ SRB Surgery, Pg. 332, 332
119. A 22yo Greek man presents with rapid anemia and
jaundice following tx of malaria. He is noted to have Heinx
bodies. Choose the single most likely cause from the given
options? - ID : 57082
Ⓐ G6PD deficiency
Ⓑ Anemia of chronic disease
Ⓒ Pernicious anemia Ⓓ IDA
Ⓐ G6PD deficiency ☛ exacerbated by administration of oxidant
drugs ( e.g., primaquine, dapsone, quinidine ) ➜ result in Heinz
bodies: clumps of damaged hb attached to RBCs
120. A pt is dx with SIADH. Choose the appropriate
biochemical change. - ID: 57201
Ⓐ Plasma Na+ decrease and urine osmolarity increase
Ⓑ Plasma Na+ decrease and urine osmolarity decrease
Ⓒ Plasma Na+ increase and urine osmolarity decrease
Ⓓ Plasma Na+ increase and urine osmolarity increase
Ⓐ The key is A - Plasma Na+ decrease and urine osmolarity
increase
121. Mental retardation, long face and jaw, enlarged
testes, everted ear - ID : 57908
Ⓐ Fragile X chromosome Ⓑ Klinefelters
Ⓒ Down Syndrome
Ⓐ Fragile X syndrome ☛ Intellectual disability post-pubertal
macroorchidism (enlarged testes), long face with a large jaw, large
everted ears, autism, mitral valve prolapse, hypermobile joints
✦ First Aid, Pg. 62
Latest Papers available on MediCall App |
| AUG 2023 PAPERS
122. A 50. year old patient has a heart murmur resulting
from the inability to maintain constant tension on the
cusps of AV valve, downward traction of her AV valves
cannot be made which structure is damaged? - ID : 58089
Ⓐ Chordae tendineae Ⓑ Trabeculae carneae
Ⓒ Purkinje fibers Ⓓ Annulus fibrosis
Ⓐ Papillary muscles ➜ pull on AV valves downward ➜ via chordae
tendineae ➜ slowing their closure and preventing trauma.
123. A 39-year-old pregnant woman in 36 week of
gestation has acute abdominal pain and is rushed for C-
section. Her BP was reported to be 110/60mmHg. Her
blood test show. ** ^ Hb= 101 g/L WBC= 9.8X 109/L
Platele ts=60X 109/L APTT=61 sec (elevated) PT=29 sec
(elevated) What is single diagnosis? - ID : 59284
Ⓐ Pre-eclampsia
Ⓑ Disseminated intravascular coagulation
Ⓒ HELLP syndrome Ⓓ Acute fatty lever
Ⓔ Obstetrics cholestasis
Ⓑ DIC ☛Triggered by underlying obstetric condition (Most
probably abruptive plancentae) ➜ ↑BT ,↑PT,↑aPTT ,↑FDPs and
D.Dimers e ↓ Platelets count
✦ First Aid, Pg. 428
124. A 22 yr old female college student with hx of sore
throat, fever rash on elbow, generalized cervical
lymphadenopathy and has splenomegaly. Lab shows
elevated WBC count, TLC of 7230 and heterophil
antibodies. With widening of interfollicular space and
mixed cellular infiltrate consisting of immunoblast,
lymphocytes. What is the most likely suffering from? - ID :
59609
Ⓐ Mumps Ⓑ Parainfluenza
Ⓒ Rubella
Ⓓ Infectious mononucleosis (EBV)
Ⓔ Lymphocytic choriomeningitis
Ⓓ IM ☛ Fever + Splenomegaly + LAN ➜ Histology ➜ Numerous
large pyroninophilic cells (immunoblasts), initially expanding
paracortical zone but later extending throughout node.
✦ Harsh Mohan, Pg. 330 ✦ Oxford Microbiology, Pg. 402 ✦ Davidson, Pg. 241
125. A 65 years old chronic smoker presents with acute
shortness of breath in medical emergency, 75% lips blue.
His chest x-ray shows a hollow barrel shaped rib cage.
What is the most likely diagnosis? - ID : 59780
Ⓐ Pneumothorax Ⓑ Emphysema
Ⓒ Bronchial asthma Ⓓ Pulmonary embolism
Ⓔ Pulmonary edema
Ⓑ Smoking ☛ affects lungs ➜ causes COPD ( emphysema ) in
lungs.
✪ COPD ☛ breathlessness, sputum, Crackles heard, cor
pulmonale, collapsed bronchial tubes in emphysema and barrel
shape of chest due to obstruction.
✦ Davidson, Pg. 574, 575
126. A person with a history of long-term smoking and
drinking has a mass in the middle third of the esophagus.
What is the most common worldwide carcinoma of the
esophagus? - ID : 60017
Ⓐ Adenocarcinoma Ⓑ Squamous cell carcinoma
Ⓒ Carcinoid Ⓓ None of above
Ⓑ Squamous cell carcinoma (SCC) is the most common type of
esophageal cancer worldwide. Both smoking and alcohol are
www.MediCall.pk/app 693
 Medi Call FCPS – 1 | AUG 2023 PAPERS

significant risk factors for this type of cancer, especially when
combined.
127. A 5-year-old boy presents with joint swelling after
minor trauma and a history of prolonged bleeding from
circumcision sites. With a platelet count of 17,000, PT of
10 seconds, and APTT of 60 seconds, what is the most
likely diagnosis? - ID : 60395
132. A woman undergoes abdominal surgery 10 years ago
now she is diagnosed with HCC thought to cause by Hep B.
It is said that DNA and RNA viruses are oncogenes which
one of the following is caused by RNA - ID : 79224
Ⓐ Human T cell leukemia causing virus
Ⓑ EBV Ⓒ HPV
Ⓓ HSV

Ⓐ Idiopahic thrombocytopenic purpura

Ⓐ HTLV-1 ☛ human retrovirus ➜ transmitted by breastfeeding,
Ⓑ Platelets function defect
sexual contact, blood transfusion and contaminated needles ➜
Ⓒ Von Willi brand defect Ⓓ Hemophilia
causes T-cell leukemia.
Ⓔ Vitamin K deficiency ✦ CMDT, Pg. 1039

Ⓓ ◉ Haemophilia ☛ there is spontaneous bleeding and easy 133. Tsst gene carried by 10-15 % by the following
bruising but a normal bleeding time, normal prothrombin time, bacteria - ID : 79310
normal thrombin time, but prolonged partial thromboplastin time. Ⓐ Streptococcus epidermidis
◉ Joint bleed is common in people with severe haemophilia. Ⓑ Staph Aureus Ⓒ Group b streptococcus
128. Large, friable irregular Vegetation seen in which Ⓓ Streptococcus pneumoniae
condition - ID : 62809
Ⓑ Tst ☛ gene for toxic shock syndrome toxin-1 (TSST-1) ➜ part
Ⓐ Libman sacks Ⓑ Infective endocarditis of genetic element in Staphylococcus aureus ➜ absent in TSST-1-
Ⓒ NBTE Ⓓ Rheumatic fever
negative strains.
✦ Davidson, Pg. 331
Ⓑ BACTERIAL (INFECTIVE) ENDOCARDITIS
Valves ➜ Mitral ＞ Aortic ＞ Mitral + Aortic 134. Aspiration pneumonia in a patient with parkinsons
disease. Food goes in to which lobe of lung while (supine)
Vegetations ➜ Large, irregular, single or multiple,
lying down. - ID : 79330
friableRHEUMATIC ENDOCARDITIS
Valves ➜ Mitral ＞ Mitral + Aortic Ⓐ Posterior segment of right upper lobe
Vegetation ➜ Small, multiple, firmly attached, generally produce Ⓑ Lateral segment of right upper lobe
permanent valvular deformityLIBMAN-SACKS ENDOCARDITIS Ⓒ Apical segment of right lower lobe
Ⓓ Right upper lobe
Valves ➜ Mitral and Aortic
Vegetation ➜ Medium-sized, multiple, generally do not produce
Ⓒ If you aspirate a FB ☛
significant valvular deformityNON-BACTERIAL THROMBOTIC
✪ Lying Supine ➜ usually enters superior segment of right lower
Valves ➜ Mitral ＞＞ Aortic and Tricuspid
lobe.
Vegetation ➜ Small but larger than rheumatic, single or multiple
✪ Upright ➜ enters right lower lobe.
✦ Harsh Mohan, Pg. 426 ✦ N.I.H USA, Pg. ✦ Oxford Cardio Handbook, Pg.
✪ Lying on right side ➜ enters right upper lobe
129. A 35 year old lady had an emergency C-section ✦ First Aid, Pg. 663
following an ultrasound labour. Three days post-op she
develops a sudden onset of left sided chest pain 135. Child with lump forehead excision done microscopy
shows vessels diagnosis? - ID : 79404
associated with breathlessness and hemoptysis, there is
no fever, ECG shows S1Q3T3 pattern. What is the best Ⓐ BCC Ⓑ Lipoma
investigation to provide a definitive diagnosis ? - ID : 66717 Ⓒ Hemangioma
Ⓐ Arterial blood gases Ⓑ Chest X-ray
Ⓒ CT pulmonary angiogram (CTPA) Ⓒ Hemangioma ☛ Benign vascular tumours or hamartomas are
Ⓓ D-dimer Ⓔ Electrocardiogram (ECG) common and include Campbell de Morgan spots, which present as
pink/ red papules on the upper half of the body
✦ Davidson, Pg. 1234
Ⓒ CTPA is the best test among the other options which provide a
definitive diagnosis of pulmonary embolism. 136. A 12 yr old boy presents with right illiac fossa pain
and fever . he is diagnosed to have acute appendictis .
130. Patient having Fatigue, Weight loss and lethargy.
Which of the following mediators is involved in causation
Upon detail investigations diagnosed as case of Cancer.
of both acute inflammation pain and fever ? - ID: 79753
Mechanism of cancer formation - ID : 72134
Ⓐ Nitric oxide Ⓑ Bradykinin
Ⓐ Initiator and promotor
Ⓒ Prostaglandins Ⓓ Histamine
Ⓑ Only Initiator cause carcinoma
Ⓒ Initiator followed by promotor causing carcinoma
Ⓒ MBBS MCQ
Ⓓ Multiple initiator
Ⓔ Promotor followed by Initiator Causing carcinoma 137. Woman patient bed ridden having dyspnea now
developed pulmonary embolism. What is the most
Ⓒ Carcinogenesis ☛ Initiator may cause mutational activation of common site of origin of thrombotic pulmonary emboli? -
ID : 81064
an oncogene such as RAS, subsequent application of promoters
leads to clonal expansion of initiated (mutated) cells. Ⓐ Lumen of tbe left ventricle
✦ Robbins, Pg. 230
Ⓑ Deep leg veins Ⓒ Mesenteric
131. 32 years old presented with nasal polyps microscopy Ⓓ Superficial leg veins
shows non sepstate hyphae branching - ID : 72490
Ⓑ EXPLANATION
Ⓐ Cryptocos Ⓑ Mucormycosis
Ⓒ Histoplasmosis 138. A patient came with swelling at preauricular
associated with otorrhea and occasional
Ⓑ Mucor ☛ Non-septate, branching hyphae forming right angle lymphadenopathy. biopsy needed. which one to prefer - ID
✦ Levinson, Pg. 418 ✦ Oxford Microbiology, Pg. 489 : 82312

Latest Papers available on MediCall App | www.MediCall.pk/app 694

 Medi Call FCPS – 1 | AUG 2023 PAPERS

Ⓐ Trucut biopsy
145. Antigravity muscle involves in Maintenance of
Ⓑ Fine needle aspiration biopsy
posture by - ID : 83270
Ⓒ Asspirational Ⓓ Excisional biopsy
Ⓐ Extensors Ⓑ Rotators
Ⓑ ◉ Fine-needle aspiration cytology (FNAC) ☛ guided by Ⓒ Flexors Ⓓ Abductors
ultrasound imaging (US) is a widely used diagnostic tool to
evaluate both neoplastic and inflammatory lesions of salivary Ⓐ Maintenance of posture ☛ by contraction of extensor muscles
glands. (primary role) ➜ oppose force of gravity and help to maintain an
upright position.
139. Diagnostic criteria for sarcoma - ID : 82387
146. A female patient Delivered a baby Bay with a tuft of
Ⓐ Increase vascularity/ mitotic figure
hair at the back mother was taking a diet rich in proteins
Ⓑ Inc mitochondria Ⓒ Pleomorphism
and carbohydrates but deficient in fruits and vegetables.
Ⓓ Metastasis
Neural tube defect like Spina bifida occurs due to a
deficiency of - ID : 83490
Ⓐ Sarcoma ☛ invade capillaries and/or venules and directly
spread to distant sites without involving the lymph nodes Ⓐ Folic acid Ⓑ Iron
✦ Goljan, Pg. 233 Ⓒ Vitamin B12 Ⓓ Vitamin K
Ⓔ Vitamin E
140. Patient with head injury, urination without any
sense. Sensory supply of bladder interrupted, will cause? -
ID : 82806 Ⓐ EXPLANATION

Ⓐ Urinary retention Ⓑ Automatic bladder 147. Transport of D. and L. glucose proceeds at the same
Ⓒ Urinary incontinence Ⓓ Uninhibited neurogenic rate down an electrochemical gradient by which of the
Ⓔ Atonic bladder following processes? - ID : 83926

Ⓐ Simple diffusion Ⓑ Facilitated diffusion

Ⓔ Tertiary Syphilis ➜ Demyelination of Ganglia in Dorsal Column Ⓒ Primary active transport Ⓓ Cotransport
➜ Loss of Sensory stretch input from Bladder BUT No motor Ⓔ Counter transport
pathology ➜ Full Bladder with Continuous Dribbling of Urine ➜
Atonic Bladder ➜ Tabes Dorsalis Ⓑ Glucose ☛ moves down its concentration gradient via facilitated
✦ First Aid, Pg. 530 ✦ Guyton, Pg. 331 diffusion, a passive process that requires a carrier protein, GLUT
141. Man is having RHD and MS and on lung heart failure (glucose transporter).
cells are seen, what is the mechanism of formation? - ID : Primary active transport ☛ movement of molecules against their
82877 concentration gradient using energy, typically from ATP but
glucose typically moves via facilitated diffusion, not active
Ⓐ Active chronic congestion
transport.
Ⓑ Passive chronic congestion
Ⓒ Hypoxic myocardial injury 148. Ventricular filling in which ECG segment: - ID : 83952
Ⓓ Constricted myopathy
Ⓐ TP Ⓑ QT
Ⓐ CHF ➜ Back pressure ➜ Pulmonary congestion ➜ Pulmpnary Ⓒ ST Ⓓ QRS

edema ➜ alveolar spaces contain numerous macrophages laden

Ⓐ Ventricular filling ☛ primarily occurs during TP segment of
with hemosiderin (“heart failure cells”) derived from phagocytosed
ECG, which represents period of diastole.
red cells.
✦ Robbins, Pg. 97
QRS ☛ represents ventricular depolarization and beginning of
ventricular contraction, not filling.
142. Sudden Acute severe injury to spinal cord - ID : 82896
149. FSH is inhibited by which of the following organ /
Ⓐ Hyperreflexia Ⓑ Spastic paralysis Gland? - ID : 84125
Ⓒ Loss of pain and temp Ⓓ Flaccid paralysis
Ⓐ Seminal Vesicle Ⓑ Testes
Ⓓ Acute severe injury to spinal cord ☛ Initially flaccid paralysis Ⓒ Ductus deference Ⓓ Ovaries
and later on hyperreflexia and spasticity
Ⓑ Testes ☛ stimulated by FSH ➜ spermatogenesis + production
143. Ondansetron Mechanism of action? - ID : 82946 of Inhibin ➜ negative feedback to pituitary ➜ inhibit FSH
Ⓐ 5-HT3 receptor antagonists Ovaries ☛ stimulated by FSH ➜ growth of ovarian follicles. No
Ⓑ H 2 antagonist Ⓒ H 1 antagonist Inhibition of FSH
Ⓓ HT3 agonist
150. Estrogen causes: - ID : 84131

Ⓐ Ondansetron and Dolasetron ☛ selective serotonin antagonists Ⓐ Soft skin Ⓑ Dark skin
➜ inhibit central and peripheral 5-HT3 receptors. Ⓒ Hairs on skin Ⓓ Decrease vascularity
✦ Katzung
Ⓐ Estrogen ☛ promotes collagen production, which contributes
144. Lymphoid organ have lobules contain basophils and
eosinophils - ID : 83102 to elasticity, hydration, and overall softness of skin.

Ⓐ Tonsils Ⓑ Palatine 151. A patient has signs of Byssinosis. It is closely related

to: - ID : 84164
Ⓒ Spleen Ⓓ Thymus
Ⓐ Coal Ⓑ Cotton
Ⓓ Thymus ☛ It has two lobes divided up into many lobules. Ⓒ Silica Ⓓ Dust
Outer, more darkly staining ( Basophalic ) ➜ cortex, and this is
highly cellular. Inner lighter staining ( Eosinophalic) ➜ medullar, Ⓑ Byssinosis is an asthma-like disorder in textile workers caused
and this region is less cellular. by inhalation of cotton dust ( organic )
✦ CMDT, Pg. 320
It has an outer connective tissue capsule and septa.
✦ RJ Last, Pg. 30

Latest Papers available on MediCall App | www.MediCall.pk/app 695

 Medi Call FCPS – 1 | AUG 2023 PAPERS

152. Familial emphysema is most closely associated with: Ⓐ Blood pressure ☛ is often the first and most crucial parameter
- ID : 84196
to assess in a trauma patient as it gives immediate insight into
Ⓐ Alpha-1 anti-trypsin deficiency circulatory status.
Ⓑ Chronic bronchitis Ⓒ Paraneoplastic syndrome
159. REM sleep Nucleus - ID: 91672
Ⓓ Silicosis Ⓔ Smoking
Ⓐ Locus coeruleus Ⓑ Raphe nuclei
Ⓐ Alpha-1 antitrypsin protects the lungs ➜ deficiency lead to Ⓒ Ventrolateral preoptic nucleus
emphysema and other lung diseases. Ⓓ Hypothalamus

153. Pt came with jaundice, icteric and dark-colored urine. Ⓐ Locus coeruleus ☛ is the primary source of noradrenergic
Labs showed HbsAg negative, AntiHbs and antiHbc
projections and is implicated in the control of REM sleep.
positive, and IgM negative. - ID : 84247
160. Esophagus constricted in thoracic region on barium
Ⓐ HBV Probable Ⓑ Acute Infection
test what is cause behind this? - ID: 91673
Ⓒ Chronic Ⓓ Post Immunization
Ⓔ Post Vaccination Ⓐ Left crus of diaphragm Ⓑ Right bronchus
Ⓒ Left broncus Ⓓ Arch of aorta
Ⓓ HbsAg -ve ☛ indicates absence of an active Hepatitis B
AntiHbs, AntiHbc +ve ☛ denote previous exposure to virus but Ⓐ Left crus of diaphragm ☛ is the primary constriction site for
body has produced antibodies the esophagus as it passes through the diaphragm. This is what
IgM -ve ☛ indicates it's not a recent infection would show up as a constriction on a barium test.
signs align with post-immunization status, where person has 161. 21 year Pt icterus bilirubin level 3.6 (2.1 indirect)
developed antibodies against HBV. with haptoglobin level 78( normal 200 ) for one week - ID:
91674
154. Which statement is true about apoptosis: - ID : 84263
Ⓐ Intravascular hemolysis Ⓑ Obstructive jaundice
Ⓐ It is unregulated cell death
Ⓒ Hepatic failure Ⓓ Gilbert's syndrome
Ⓑ It is not gene dependent
Ⓒ It is an inflammatory response
Ⓐ ✪ Dx ☛ The low haptoglobin and elevated indirect bilirubin
Ⓓ It is a non-inflammatory response
levels are suggestive of intravascular hemolysis.
Ⓓ ✪ Apoptosis 162. Ischial tuberosity damaged it will cause damage to
◉ Reduce cell Size ( Shrinkage ) ◉ Nuclear Fregmentation which muscle - ID: 91675
◉ Plasma membrane may be Intact ◉ No Inflammation
✦ Robbins, Pg. 41, 34
Ⓐ Bicep femoris Ⓑ Semitendinosus
Ⓒ Semimembranosus Ⓓ Quadriceps
155. Jvp appears when right atrial pressure - ID : 84382

Ⓐ 22 Ⓑ 15
Ⓐ Biceps femoris muscle ☛ is attached to the ischial tuberosity.
Ⓒ 10 Ⓓ5 Damage to the ischial tuberosity would thus likely affect the biceps
femoris.
Ⓐ Jugular venous pressure (JVP) is a measure of pressure 163. Lungs tissue is damaged, biopsy taken it will contain
within jugular veins ➜ An elevated JVP can be a sign of heart cells that are present at respiratory pathway with increase
failure that increase pressure in right atrium muscle and devoid of cartilage. Which cell are these? - ID:
JVP is visible when right atrial pressure ＞ 15 cm H2O, but 91676
becomes markedly prominent when exceeds 20-22 cm H2O. Ⓐ Dust cell Ⓑ Clara cell
156. A patient presents with ptosis (drooping of the Ⓒ Type I pneumocytes Ⓓ Type II pneumocytes
eyelid) and a dilated pupil. What is the diagnosis? - ID:
86135 Ⓑ Clara cells ☛ are non-ciliated, secretory bronchiolar epithelial
cells that are present in the respiratory pathway and are devoid of
Ⓐ Third nerve palsy Ⓑ Myasthenia gravis
cartilage.
Ⓒ Facial paralyse Ⓓ Sixth narve palsy
164. PTH action causes what - ID : 91677
Ⓐ Third nerve palsy: can present with ptosis and mydriasis
Ⓐ Vitamin D and ca absorption
(dilated pupil), often accompanied by other eye movement
Ⓑ Osteoclast cell activation
abnormalities.Myasthenia gravis: typically presents with
Ⓒ Calcium excretion Ⓓ Phosphate absorption
fluctuating muscle weakness.
Facial paralysis: affects facial expression, not the pupil.
Ⓐ Parathyroid hormone (PTH) ☛ stimulates the activation of
Sixth nerve palsy: affects lateral eye movement and not the
pupil or eyelid. vitamin D ➜ which in turn helps with calcium absorption in the
intestines.
157. Hemophilia is caused by - ID: 91670
165. Injection penicillin causes reaction having IgE and
Ⓐ Deficiency of antihemophilic globulin eosinophils due to - ID: 91679
Ⓑ Vitamin K deficiency Ⓒ Iron deficiency
Ⓓ Platelet dysfunction Ⓐ Mast cell Ⓑ T lymphocytes
Ⓒ B lymphocytes Ⓓ Neutrophils
Ⓐ Hemophilia ☛ is primarily caused by a deficiency in clotting
Ⓐ ✪ Mast cells ☛ release mediators like histamine upon cross-
factors, often referred to as antihemophilic globulin (Factor VIII for
Hemophilia A and Factor IX for Hemophilia B). linking of their surface IgE by allergens, which in this case is
penicillin. This leads to allergic reactions involving eosinophils.
158. Patient brought in ER due to RTA, will be assessed by
- ID: 91671 166. Most behavioral hormone in man - ID: 91680

Ⓐ B.P Ⓑ Pulse Ⓐ Progesterone Ⓑ Estrogen

Ⓒ Respiratory rate Ⓓ Oxygen saturation Ⓒ Testosterone Ⓓ Cortisol

Latest Papers available on MediCall App | www.MediCall.pk/app 696

 Medi Call FCPS – 1
Ⓒ Testosterone ☛ is the primary male sex hormone and is
responsible for a range of behavioral attributes such as aggression,
libido, and mood regulation in men.
167. Treatment for phaeochromocytoma - ID: 91683
Ⓐ Diuretics Ⓑ Calcium channel blockers
Ⓒ ACE inhibitors
Ⓓ Alpha blocker and beta blocker
Ⓓ ✪ Alpha and beta blockers ☛ are commonly used to treat the
symptoms of phaeochromocytoma ➜which is a tumor of the
adrenal gland ➜ that can secrete excessive catecholamines like
adrenaline and noradrenaline.
168. Initiator will cause - ID: 93386
Ⓐ Permanent DNA damage Ⓑ Temporary DNA damage
Ⓒ Reversible DNA damage Ⓓ No DNA damage
Ⓐ Initiator in carcinogenesis ☛ often causes permanent DNA
damage → which can lead to malignant transformation if not
repaired.
169. Preoperative for CLD patient drug - ID: 93387
Ⓐ Fentanyl Ⓑ Morphine
Ⓒ Ketamine Ⓓ Midazolam
Ⓐ Fentanyl ☛ is often used for preoperative analgesia in patients
with chronic liver disease (CLD) → because it is less likely to
accumulate and cause prolonged effects due to its short half-life.
170. Ejection fraction increased by - ID: 93388
Ⓐ Increased AV conduction Ⓑ Decreased AV conduction
Ⓒ Increased preload Ⓓ Increased afterload
Ⓐ ✪ Increased AV (atrioventricular) conduction ☛ will lead to
more synchronized and effective pumping of the heart, thereby
increasing the ejection fraction.
171. A patient having VDRL test 1:30 for his job
appointment but he denies any sexual activity and even
his examination is totally unremarkable how you will
manage the patient - ID: 93414
Ⓐ Tell him that don't worry and tests can be false positive
Ⓑ Tell him to ignore it
Ⓒ Insist on immediate antibiotic treatment
Ⓓ Refer him to a psychiatrist
Ⓐ Management ☛ VDRL test is a screening test for syphilis that
can yield false positives due to other medical conditions or even
technical issues. Therefore, it is not confirmatory. A more specific
test like the FTA-ABS is usually performed to confirm the diagnosis
of syphilis.
172. If dead space become zero it is called - ID: 93415
Ⓐ Physiological shunt Ⓑ Eupnoea
Ⓒ Apnea Ⓓ Hyperpnoea
Ⓐ ✪ Physiological shunt ☛ occurs when the dead space, the
area where no gas exchange happens, is eliminated.
✪ This condition is usually related to a pathology, and it allows for
all inspired air to participate in effective gas exchange.
173. Chronic renal failure will cause - ID: 93416
Ⓐ Anemia Ⓑ Dehydration
Ⓒ Hyperkalemia Ⓓ Hypocalcemia
Ⓐ Chronic renal failure ☛ can lead to anemia due to a lack of
erythropoietin, a hormone produced by healthy kidneys. ✪
Erythropoietin ➜ stimulates the bone marrow ➜ to produce red
blood cells, and its absence in renal failure ➜ can lead to anemia.
Latest Papers available on MediCall App |
| AUG 2023 PAPERS
174. Apert syndrome has high arch, hypertelorism; cleft
palate, craniosynostosis what else will be the feature. - ID:
93417
Ⓐ Delayed eruption of teeth
Ⓑ Syndactyly Ⓒ High arch palate
Ⓓ Macrocephaly
Ⓐ Apert syndrome ☛ often features craniofacial abnormalities
that include delayed eruption of teeth. This delay usually occurs
alongside other significant symptoms like craniosynostosis and
cleft palate, complicating oral health.
175. Patient is having cardiac problem SOB , dyspnea
mitral stenosis and damaged area on ventricle - ID: 93418
Ⓐ Rhabdomyosarcoma Ⓑ Angina pectoris
Ⓒ Myocardial infarction Ⓓ Pericarditis
Ⓐ Rhabdomyosarcoma ☛ is a rare type of cancer that can affect
the heart.
✪ It can present with symptoms like shortness of breath (SOB),
dyspnea, and mitral stenosis. In this particular case, it could be
the underlying cause of the damaged area on the ventricle.
176. Patient is mentally retarded , everted ear , large
testes ,tall hypogonadism, Dx is - ID : 93419
Ⓐ Klinefelter syndrome Ⓑ Turner Syndrome
Ⓒ Down Syndrome Ⓓ Fragile X Syndrome
Ⓐ Klinefelter syndrome ☛ characterized by an additional X
chromosome in males (47, XXY) ➜ manifests as mental
retardation, everted ears, large testes, and tall stature. These
symptoms align with the patient's clinical presentation.
177. Spinal cord damage and below the lesion pain and
temperature is intact what is seen ipsilateral - ID : 93420
Ⓐ Upper motor neuron lesion of same side
Ⓑ Lower motor neuron lesion of same side
Ⓒ Spasticity Ⓓ Loss of Warmth, Pain
Ⓑ Lower Motor Neuron lesions ☛ are localized to the peripheral
nervous system and are situated at or below the level of the spinal
cord lesion.
✪ LMN lesions ➜ typically lead to symptoms like muscle weakness,
atrophy, and fasciculations on the ipsilateral side.
✪ Upper Motor Neuron (UMN) lesions ➜ would usually affect both
motor and sensory pathways, which contradicts the intact pain and
temperature sensation described in the question. Therefore, an
LMN lesion is more likely in this scenario.
178. For emotion and motivation, limbic system works in
association with - ID: 93421
Ⓐ Basal ganglia Ⓑ Hypothalamus
Ⓒ Amagdyla Ⓓ Cerebellum
Ⓐ Basal ganglia ☛ work in conjunction with the limbic system for
processing emotions and motivations, including reinforcement
learning and forming habits.
179. Patient having multiple neurological flareups,
relapsing symptoms, is due defective protein - ID: 93422
Ⓐ Myelin Ⓑ Actin
Ⓒ Tubulin Ⓓ Keratin
Ⓐ Myelin sheath ☛ insulates nerve fibers and allows for effective
nerve transmission.
✪ Defective myelin ➜ can lead to multiple flare-ups and relapsing
symptoms ➜ often seen in conditions like Multiple Sclerosis.
180. Which medicine dose is not routinely reduced or
requiring adjustment in CKD. - ID: 93423
www.MediCall.pk/app 697
 Medi Call FCPS – 1
Ⓐ Linezolid Ⓑ Aminoglycosides
Ⓒ Vancomycin Ⓓ Metformin
Ⓐ Linezolid ☛ primarily metabolized by the liver and does not
require dose adjustments in patients with chronic kidney disease
(CKD), making it safe to use in these individuals without the need
for routine dose reduction.
181. Tremors before skilled movement is initially present
in - ID: 93424
Ⓐ Prefrontal cerebral cortex
Ⓑ Motor Cortex Ⓒ Basal Ganglia
Ⓓ Cerebellum
Ⓐ Prefrontal cerebral cortex ☛ plays a role in planning and
initiating voluntary movements. Tremors occurring before skilled
movements suggest a disruption in this area's function.
182. Isoniazid cannot be metabolized due to which
enzyme deficiency - ID: 93425
Ⓐ Cytochrome P450
Ⓑ N-acetyltransferase deficiency
Ⓒ Alcohol Dehydrogenase Ⓓ Glucuronosyltransferase
Ⓑ Isoniazid ☛ is metabolized by N-acetyltransferase. A deficiency
in this enzyme leads to poor metabolism and increased drug
toxicity.
183. Pt diagnosed as case of pancreatic adenoma his
brother told you tell nothing to the patient because he will
die after listening it, now patient family is asking you
about patient disease what will be your response - ID:
93426
Ⓐ Speak to the patient directly
Ⓑ Disclose the diagnosis openly
Ⓒ Gently refuse and tell them nothing
Ⓓ Ask for another family meeting to decide
Ⓒ Responce ☛ Ethically, the primary responsibility is to the
patient. Since the family does not want the patient to know, a
gentle refusal maintains confidentiality without violating ethical
guidelines.
184. Benzodiazepine and flumazenil have 7 membered
components which are common in both - ID: 93427
Ⓐ Diazepine ring Ⓑ Benzene ring
Ⓒ Imidazole ring Ⓓ Pyrazole ring
Ⓐ ✪ Both benzodiazepines and flumazenil ☛ have a diazepine
ring as their core structure, which accounts for their interaction at
the same receptor sites.
185. Liver tumor involving above muscle, blood supply - ID:
93428
Ⓐ Branch of internal thoracic aorta
Ⓑ Abdominal aorta + int thoracic artery
Ⓒ Hepatic artery Ⓓ Celiac trunk
Ⓒ Blood supply ☛ hepatic artery, a branch of the celiac trunk, is
the primary source of oxygenated blood to the liver, including any
liver tumors. This artery is part of the liver's dual blood supply,
along with the portal vein. Therefore, it would be the most logical
choice for the primary blood supply to a liver tumor.
186. Tumor involving mitral valve - ID: 93429
Ⓐ Lipoma Ⓑ Myxoma
Ⓒ Schwannoma Ⓓ Lipoma
Ⓑ Myxomas ☛ are the most common type of primary cardiac
tumor and often occur in the atrial chambers, commonly the left
atrium attached to the mitral valve.
Latest Papers available on MediCall App |
| AUG 2023 PAPERS
187. Neurocysticercosis scenario, drug - ID: 93430
Ⓐ Praziquantel Ⓑ Albendazole
Ⓒ Niclosamide Ⓓ Mebendazole
Ⓑ Drug ☛ for neurocysticercosis is generally Albendazole, often in
combination with corticosteroids to manage the inflammatory
response.
✪ Praziquantel ➜ is also an option but less commonly used.
✪ Niclosamide ➜is mainly used for intestinal tapeworm infestations
and is not effective in treating neurocysticercosis.
✪ Mebendazole ➜ is also not commonly used for this conditio
188. Blue bloaters related scenario - ID: 93431
Ⓐ Chronic bronchitis Ⓑ Emphysema
Ⓒ Asthma Ⓓ Pulmonary fibrosis
Ⓐ Blue Bloaters ☛ is traditionally used to describe people with
Chronic Bronchitis who have cyanosis and fluid retention,
differentiating them from "Pink Puffers,"
189. Which blood vessel supply diaphragm - ID: 93434
Ⓐ Internal thoracic artery Ⓑ Inferior phrenic artery
Ⓒ Aorta Ⓓ Superior phrenic artery
Ⓑ Blood supply ☛ to the diaphragm comes from the inferior
phrenic arteries. These arteries are direct branches off the
abdominal aorta.
✪ The internal thoracic artery is not the primary source of blood
supply to the diaphragm; it mainly supplies the anterior chest wall
190. Histamine released in circulation after infection or
hemorrhage by - ID: 93435
Ⓐ Endothelial cells Ⓑ Mast cells
Ⓒ Platelets Ⓓ Neutrophils
Ⓑ Mast cells ☛ are primarily responsible for the release of
histamine in response to infection or hemorrhage. They are part of
the innate immune system and play a key role in inflammation.
191. Scenario of anemia (MCV-110) but skin pigmentation
and ferritin 600 - ID: 93436
Ⓐ Sideroblastic anemia Ⓑ Megaloblastic anemia
Ⓒ Hemolytic anemia Ⓓ Aplastic anemia
Ⓐ Sideroblastic anemia ☛ is characterized by elevated ferritin
levels and skin pigmentation, differing it from megaloblastic
anemia which would not show these additional features.
192. Skeletal muscle contraction initiation requires - ID:
93437
Ⓐ ATP synthesis
Ⓑ Depolarization of membrane
Ⓒ Calcium release Ⓓ Acetylcholine binding
Ⓑ ✪ Initiation of skeletal muscle contraction ☛ requires the
depolarization of the muscle cell membrane, which is the initial
trigger for the cascade that leads to muscle contraction.
193. Lipids from small intestine transported as - ID: 93438
Ⓐ VLDL Ⓑ Free fatty acids
Ⓒ Chylomicrons Ⓓ Mixed micelles
Ⓓ Lipids ☛ after digestion in the small intestine, are transported
as mixed micelles for absorption.
✪ These micelles facilitate the ➜ transport of lipids ➜ through the
aqueous environment of the intestine ➜ to the enterocytes where
they are absorbed.
194. Enzyme involved in cell remodeling of tissue - ID :
93439
www.MediCall.pk/app 698
 Medi Call FCPS – 1 | AUG 2023 PAPERS

Ⓐ Cathepsin Ⓑ Elastase
Ⓒ Interstitial collagenase Ⓓ Matrix metalloproteinase

Ⓒ Interstitial collagenase ☛ is specifically involved in the

degradation of collagen during tissue remodeling, making it key in
processes like wound healing and tissue repair.

195. Infarct in ventricle postero septal area but hear beat

high and regular.this regularity of hert beat is bcz - ID:
93440

Ⓐ Infarct has only involved AV/SA

Ⓑ Some portion of ventricular myocardium
Ⓒ Bundle of His is intact Ⓓ Complete heart block

Ⓑ ✪ If the heartbeat is high and regular, it suggests that some

portion of the ventricular myocardium is still functional, allowing
for the maintenance of a regular rhythm despite the infarct.

196. Related to lateral epicondyle - ID: 93441

Ⓐ Median nerve Ⓑ Radial nerve

Ⓒ Ulnar nerve Ⓓ Axillary nerve

Ⓐ ✪ Radial nerve ☛ is the nerve most closely associated with the

lateral epicondyle of the humerus.
✪ The median, ulnar, and axillary nerves are not primarily related
to the lateral epicondyle.
197. Lateral border of rectus abdominis muscle - ID: 93443

Ⓐ Medial ramus of pubis Ⓑ Inguinal ligament

Ⓒ Linea semilunaris Ⓓ Linea alba

Ⓒ ✪ Rectus abdominis ☛ lateral border of the rectus abdominis

muscle is closest to the linea semilunaris.✪ The linea alba is medial
to the rectus abdominis, the inguinal ligament is inferior, and the
medial ramus of the pubis is not associated with its lateral border.

198. Increase duration and frequency of potential at

receptor cause increase frequency of action potential - ID:
93445

Ⓐ Increase refractory period

Ⓑ Decrease refractory period
Ⓒ Increase in threshold potential
Ⓓ Decrease in threshold potential

Ⓑ Refractory period ☛ is the time during which a new action

potential cannot be initiated. By shortening this period, the cell can
respond more quickly to incoming signals, thus increasing the
frequency of action potentials.✪ Decrease in refractory period
would allow the neuron to fire action potentials more frequently.

199. Hemophilia + coagulation profile - ID: 93446

Ⓐ APTT 11 sec Ⓑ APTT 60 sec

Ⓒ PT 11 sec Ⓓ PT 60 sec

Ⓑ Hemophilia ☛ primarily affects the intrinsic pathway of

coagulation, which is measured by the activated partial
thromboplastin time (APTT).
✪ An increased APTT is ➜ indicative of Hemophilia.

200. Increase neuronal activity before initiating motor

activity - ID: 93447

Ⓐ Cortical association area

Ⓑ Motor cortex Ⓒ Thalamus
Ⓓ Cerebellum

Ⓑ Motor cortex ☛ is responsible for initiating and planning

voluntary motor activities, and its activity increases before motor
actions are performed.

Latest Papers available on MediCall App | www.MediCall.pk/app 699

Medi Call FCPS – 1 | May 2023 Papers