Medi Call FCPS – 1 | AUG 2023 PAPERS

Ⓐ Bladder exstrophy (also known as ectopia vesicae) is a

Surg 25 Aug 2023 (M) congenital anomaly that exists along the spectrum of the
exstrophy-epispadias complex

6. Calcium in Skeletal muscle endoplasmic reticulum is

1. Patient presented with abnormal posture, wide gait, bound with - ID : 2853
cannot perform rapidly alternating tasks and past Ⓐ Desmin Ⓑ Calmodulin
pointing. Likely diagnosis is - ID : 714
Ⓒ Myosin kinase Ⓓ Calsequestrin
Ⓐ Parkinsonism Ⓑ Cerebellar lesion
Ⓒ Wilson's disease Ⓓ Calsequestrin ☛ protein inside reticulum can bind up to 40
Ⓓ Subthalamic nucleus lesion times more calcium
✦ Guyton, Pg. 94

Ⓑ Abnormal posture + wide gait ( ataxic gait ) + rapidly 7. Fetal Hb has which characteristics - ID : 4045
alternating task ( Dystdiadochkinesia ) + past pointing ☛
Ⓐ 2 Alpha and 2 gamma chains
Cerebellar lesion.
Ⓑ 2 Alpha and 2 beta chains
2. Retromandibular vein is formed by junction of maxillary Ⓒ 2 Beta and 2 gamma chains
vein with which other vein - ID : 1479 Ⓓ 2 Beta and 2 delta chains
Ⓐ Facial Ⓑ Lingual
Ⓐ ✪ Fetal ( HbF ) ☛ 2 Alpha+ 2 Gamma chains.
Ⓒ Transverse Facial Ⓓ Superficial temporal
✪ Adult ( HbA1 ) ☛ 2 Alpha + 2 Beta chains.
Ⓓ Retromandibular vein is formed by ☛union of ✪ Adult ( HbA2 ) ☛ 2 Alpha + 2 delta chains.
● superficial temporal ✪ Sickle ( HbS ) ☛ 2 Alpha + Reduced Beta chains ( mutant HbA
● maxillary veins ).
✦ SNELL, Pg. 600 ✦ First Aid, Pg. 404, 422

3. A boy fear from snakes, he saw cobra. Most potent
response in shock as a whole which Preserve organism ? -
ID : 1672
Ⓐ Baroreceptor Ⓑ Heart
Ⓒ CNS ischemic response Ⓓ Sympatho-Adrenal system
Ⓓ Sympathoadrenal system ☛ physiological connection between
SNS and adrenal medulla ➜ stimulation of β-adrenergic receptors
by Adrenaline and Noradrenaline ➜ crucial in response in
emergency or shock ➜ saves life by maintaining Vital functions of
Heart and Brain ➜ raising Blood and energy supply.
✦ Guyton, Pg. 295
4. A plumber comes to emergency center with shortness of
breath.His blood testing reveals PO2 62 mmHg, PCO2 31
mmHg, HCO3 19 mEq/l . Ph 7.4 what is most likely
diagnosis. - ID : 2267
Ⓐ Compensated respiratory alkalosis
Ⓑ Compensated metabolic alkalosis
Ⓒ Metabolic alkalosis Ⓓ Respiratory alkalosis
Ⓐ ✪ pH : 7.4 ➜ Normal ( shows full compensation )
✪ pCO2 : 31 ➜ Low ( Normal 40 )
✪ HCO3 : 19 ➜ Low ➤ Either a metabolic acidosis or respiratory
alkalosis
Compensated Metabolic Acidosis ➜ PCO2 should be low after
hyperventilation in order to Neutralize Acidosis ➜ pH Normal
Compensated Respiratory Alkalosis ➜ HCO3 must be
decreased by renal compensation to Neutralize Alkalosis ➜ pH
Normal
So this scenario fits for both, choose given
✦ Kaplan Physiology, Pg. 252
5. Mother brought her Baby with complaints of some red
structure coming out above pubic svmphasis and
frequently getting wet Examination reveal epispadiasis
and incomplete closure of pubic svmphsis.Most likely
condition is - ID : 2296
Ⓐ Bladder exstrophy
Ⓑ Incomplete cephalocaudal folding
Ⓒ Incomplete lateral folding
Ⓓ Failed reinforcement of the cloacal membrane by underlying
mesenchyme
8. Naming of the cords of the Brachial Plexus is done on
the basis of relation with: (FCPS Old Pool ID: 4271
Ⓐ Brachial artery Ⓑ Subclavian artery
Ⓒ Internal thoracic artery Ⓓ Axillary artery
Ⓓ Second part of axillary artery is reference for naming of cords
in brachial plexus. For example, posterior cord is so named
because it lies posterior to second part of artery.
✦ BD Chaurasia, Pg. ,
9. Amniocentesis should not be done before - ID : 6336
Ⓐ Week 4-5 Ⓑ Weeks before 10
Ⓒ 14 weeks Ⓓ First 8 weeks
Ⓒ Amniocentesis ☛ performed between 15th and 20th week of
pregnancy ➜ used for diagnosis of chromosomal and other fetal
problems.
10. Urorectal septum seperates - ID : 6407
Ⓐ Separate rectum and urinary bladder
Ⓑ Separate rectum and urogenital sinus
Ⓒ Separate rectum and sigmoid colon
Ⓓ Separate rectum and urethra
Ⓑ Urorectal septum divides cloaca into:
✪ Dorsal part ☛ forms rectum and anus.
✪ Ventral part ☛ forms urogenital sinus.
11. What is increased in asthma (COPD) - ID : 6566
Ⓐ Vital capacity Ⓑ FEV1
Ⓒ FRC Ⓓ FEV1/FVC
Ⓒ Asthma ➜ Obstructive lung disease ➜ ↓↓ Recoil ➜ Distended
Lungs
➊ All Volumes Increases ( ● ↑ RV ● ↑ FRC ● ↑ TLC )
➋ Vital capacity Normal or Decreased
➌ Decreased Expiratory flow due to low lung recoil ( ● ↓↓ FEV ● ↓
FVC ● ↓ FEV1/ FVC )
✦ BRS Physiology, Pg. 221
12. A child had posterior fracture to elbow and lost
sensation on little finger. Which ligament tendon was
ruptured - ID : 7016

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Ⓐ Ulnar collateral Ⓑ Radial collateral Ⓑ Branches of Superior mesenteric artery ➜ ● jejunal and ileal
Ⓒ Flexor carpi ulnaris tendon arteries ● inferior pancreaticoduodenal artery ● middle colic artery
Ⓓ All of above ● right colic artery ● ileocolic artery
✦ Kaplan Anatomy, Pg. 144
Ⓐ Medial, triangular ulnar collateral ligament extends from
19. A female Pt with family hx of fetal abnormalities has
medial epicondyle of the humerus to coronoid process and
been found with low AFP , decreased Maternal estriol and
olecranon of ulna. as ulnar nerve passes behind medial
Elevated HCG what would be likely diagnosis ? - ID : 12276
epicondyle and crosses medial ligament of joint. it get damaged
there resulting in loss of sensation of little finger Ⓐ Renal Agenesis Ⓑ Down syndrome
✦ KLM, Pg. 816 Ⓒ Ebstein Anomaly Ⓓ Neural Tube defects
13. Steroids taken for three months and stopped suddenly
Ⓑ ✪ Down syndrome, ☛ AFP is ↓ in mother's blood, presumably
what will happen - ID : 8485
because yolk sac and fetus are smaller than usual.
Ⓐ Cushing's syndrome ✪ Estriol is a hormone produced by the placenta, using ingredients
Ⓑ Suppression of adrenal cortex made by the fetal liver and adrenal gland. Estriol is ↓ in Down
Ⓒ Hyperglycemia Ⓓ Hyperkalemia syndrome pregnancy.
✦ Oxford OBG Handbook, Pg. 114 ✦ Oxford OBG Handbook, Pg. 236
Ⓑ Steroids taken for ＞ 1 wk ➜ ↓ production by adrenal glands.
20. A patient presented with clasp knife spasicity,
14. Electrical potential change in ECG is due to: - ID : 9144 Hyperreflexia and positive babinski sign due to - ID : 12707

Ⓐ Completely depolarization Ⓐ UMNL (extrapyramidal tract lesion

Ⓑ Partial depolarized state Ⓑ LMNL Ⓒ Pons lesion
Ⓒ Hyperpolarized state Ⓓ Simple polarized state Ⓓ Cerebellar lesion

Ⓑ ECG records changes in voltage and partial depolarization Ⓐ Clasp-knife rigidity ☛ Upper motor neuron lesion, (
when the heart is fully repolarized or depolarized ➜ ECG records Extrapyramidal tract lesion ).
✦ Snell Neuro, Pg. 166
zero voltage (isoelectric baseline).
✦ Guyton, Pg. 132
21. A boy presented with Duchene muscular dystrophy
15. A 45 year old female having retrosternal chest pain and +ve Gower's sign, it is - ID : 12861
and nausea is under yearly surveillance, Above 3 cm of
Ⓐ X-linked dominant Ⓑ Autosomal recessive
gastroesophageal junction, endoscopy for changes in the
Ⓒ X-linked recessive
esophagus with velvety esophagus and columnar
epithelium due to chronic GERD. the biopsy reveals a
Ⓒ ✪ Muscular dystrophies ➜ X-linked recessive ➜ Proximal
moderately differentiated adenocarcinoma. What is the
major risk factor in this patient? - ID : 9423 muscle weakness ➜ positive Gower's sign
✦ Robbins, Pg. 842
Ⓐ Barrett's esophagus Ⓑ Long standing achalasia
22. Bronchopulmonary segment is supplied by? - ID : 12919
Ⓒ Corrosive stricture Ⓓ Alcohol abuse
Ⓐ Primay bronchioles Ⓑ Secondary broncheoles
Ⓐ Adenocarcinoma ☛ Caused by GERD Ⓒ Tertiary bronchioles Ⓓ Main bronchus
Squamous Carcinoma ☛ Caused by Alcohol, tobacco, caustic
injury, achalasia, Plummer-Vinson syndrome, very hot beverages Ⓒ Bronchopulmonary segments are aerated by tertiary or
✦ Robbins, Pg. 595, 596 segmental bronchus
✦ BD Chaurasia, Pg. 239
16. Liver Cirrhosis in an adults is most commonly caused
by? - ID : 9466 23. Where does the absorption of Cerebrospinal Fluid
(CSF) occur into the venous circulation? - ID : 13704
Ⓐ Alcoholism Ⓑ Hepatitis B
Ⓒ Hepatitis C Ⓓ Hepatitis A Ⓐ 3rd ventricle Ⓑ Lateral ventricle
Ⓒ Arachnoid Villi
Ⓐ Alcoholic Hepatitis ☛ Most common cause of Cirrhosis
✦ CMDT, Pg. 708 Ⓒ Arachnoid villi, or arachnoid granulations, are specialized
17. 10 yrs old from Balochistan c/o fatigue,mild jaundice.
projections where the cerebrospinal fluid (CSF) is absorbed into
discoloration of skin and enlarged spleen Hb is 8.0 MCV 58 the venous circulation. They act as one-way valves between the
and Serum Ferritin 1000. Appropriate treatment is - ID : subarachnoid space and the dural venous sinuses.3rd ventricle a
9476 chamber in the brain where CSF flows but is not primarily
absorbed.
Ⓐ Deferoxamine Ⓑ Blood transfusion
Lateral ventricle: serve as chambers for CSF but are not sites of
Ⓒ Iron transfusion
CSF absorption.
Ⓓ Folic acid supplementation
Ⓔ Oral iron 24. Epinephrine (adrenaline) causes which of these ? - ID
: 14274
Ⓐ ✪ Microcytic anemia ☛ caused by Iron deficiency or
Ⓐ Dec heart rate
thalassemia. Ⓑ Inc peripheral resistance (TPR)
✪ ↑↑ ferritin levels ➜ rules out IDA. Ⓒ Mental alertness Ⓓ All above
✪ Deferoxamine ☛ removes excess iron in thalassemia patients
who have many blood transfusions. Ⓑ Adrenaline ☛ α1 receptor-dependent vasoconstriction ➜ ↑
peripheral resistance but dilates blood vessels in skeletal muscles
18. Which is branch of superior mesenteric artery - ID :
10742 and liver.

Ⓐ Superior rectal artery Ⓑ Middle colic artery 25. Patient presents with loss of fine touch, proprioception
Ⓒ Hepatic artery and vibration. Which part of spinal cord has injured? - ID :
14563
Ⓓ Superior pancreaticoduodenal artery

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Ⓐ Fasiculus gracilis Ⓑ Fasiculus cuneatus
Ⓒ Posterior white column Ⓓ Lateral white column
Ⓒ Posterior white column ( Fasiculus gracillis and cuneatus ) ☛
Fine touch, proprioception and vibration.
✦ Duane Neurosceince, Pg. 151
26. The following nucleus is included in the limbic system?
- ID : 14602
Ⓐ Amygdala Ⓑ VPL nucleus of thalamus
Ⓒ Ventral dorsal nucleus of thalamus
Ⓓ Splenium
Ⓐ Limbic system ☛ Formed by hypothalamus + hippocampus +
amygdala + several other nearby areas.
27. A patient after accident talks excessively but talk
senseless , irrelevant and purpose less. patient face
difficulty in comprehension and intellectual brain function.
which area damaged? - ID : 15070
Ⓐ Broca’s area Ⓑ Wernicke's Area
Ⓒ Motor sensory Ⓓ Cerebellum
Ⓑ Paragraphic speech ☛ Werninck`s aphasia: Clear, fluent,
melodic speech but unintelligible because of frequent errors of
word choice e.g “we went to drive in the bridge for red pymarids
were crooking the lawn browsers.”
✦ Duane Neurosceince, Pg. 477
28. Which of the following in an AD disorder? - ID : 15212
Ⓐ Familial Adenomatous polyposis
Ⓑ Tay Sach disease Ⓒ Multiple sclerosis
Ⓓ SLE
Ⓐ Autosomal Dominant ☛ ◉ Adenomatous polyposis ◉
Hamatomatous
Autosomal Recessive ☛ ◉ Tay Sachs ◉ S.L.E ◉ M.S
✦ Davidson, Pg. 829
29. 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
30. A neutropenic, hypotensive patient was admitted in
oncology ward with history of dysuria and high grade
fever. His blood culture yielded growth of pseudomonas
aeruginosa. The disease as a result of excessive release of
the most likely. Bacterial product in the blood that can
worsen this kind of infection? - ID : 15489
Ⓐ IgA protease Ⓑ Interferon-gamma
Ⓒ IL 10 Ⓓ TNF
Ⓔ Reticulocyte macrophage stimulating factor
Ⓓ ✪ Excessive inflammatory response that characterizes septic
shock is driven primarily by the cytokines tumor necrosis factor
alpha (TNF-α) and interleukin-1 (IL-1), which are produced by
monocytes in response to an infection.
✦ Robbins, Pg. 74
31. A patient on ATT is having pain in big toe. Labs showed
hyperuricemia. What drug is causing this pain? - ID : 15580
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Ⓐ Isoniazid Ⓑ Ethambutol
Ⓒ Pyrazinamide Ⓓ Rifampicin
Ⓒ Pyrazinamide ☛ strong urate retention agent ➜ ↓ renal
clearance of uric acid ➜ pain in joints. and Gout
32. Patient is known case of peptic ulcer disease.he is
having pain in epigastrium. What nerve is involved in
conduction of stomach pain? - ID : 15636
Ⓐ Vagus Ⓑ Left gastric
Ⓒ Right gastric Ⓓ Great splanchnic nerve
Ⓓ Visceral referred pain from a gastric ulcer, for example, is
referred to epigastric region because stomach is supplied by pain
afferents that reach T7 and T8 spinal sensory ganglia and spinal
cord segments through greater splanchnic nerve
✦ KLM, Pg. 257
33. Ability of a test to rule out disease (true positive
cases with positive culture) is called? - ID : 16024
Ⓐ Specificity Ⓑ Standard deviation
Ⓒ Sensitivity Ⓓ Variance
Ⓔ Accuracy
Ⓒ Test sensitivity is the ability of a test to correctly identify those
with the disease (true positive rate) whereas test specificity is the
ability of the test to correctly identify those without the disease
(true negative rate). Very sensitive tests are therefore used for
screening or for ruling out disease. if the result of a highly
sensitive test is negative, it allows the disease to be ruled out with
confidence. A mnemonic for this is "SNOUT "— reminding us that a
SeNsitive test with a Negative result rules OUT the disease.
34. Serous gland which shows microscopic features of
serous acini with striated duct? - ID : 16050
Ⓐ Pancreas Ⓑ Submandibular
Ⓒ Sublingual Ⓓ Parotid Gland
Ⓓ Parotid gland ☛ has serous acini ➜ each intercalated duct
empties into larger striated duct.
35. Following l/V administration of single dose of
thiopentone sodium to 30 year pt. General Anesthesia
lasted for 15 min. Reason for short duration of
thiopentone is its rapid - ID : 16170
Ⓐ Redistribution in body Ⓑ 100% bioavalability
Ⓒ Both a and b Ⓓ None of the above
Ⓐ Sodium thiopental ☛ distributes to rest of body in 5-10min ➜
short duration of action.
36. Where are the the Clara cells present? - ID : 16195
Ⓐ Distal bronchioles
Ⓑ At bifurcation of trachea
Ⓒ Both a and b Ⓓ Terminal bronchioles
Ⓓ Clara cells are most abundant in the terminal bronchioles,
where they make up about 80 % of the epithelial cell lining ➜
secrete several distinctive proteins important for Surfactant
✦ Kaplan Anatomy, Pg. 62
37. During hysterectomy, ureter gets damaged near ischial
spine pelvic brim while ligating: - ID : 16492
Ⓐ Pudendal artery Ⓑ Obturator artery
Ⓒ Inferior mesenteric artery
Ⓓ Uterine artery
Ⓓ Ureter passes immediately inferior to uterine artery
near lateral part of fornix of vagina is clinically important. The
ureter is in danger of being inadvertently clamped (crushed),
ligated, or transected during a hysterectomy. The point at
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which uterine artery and ureter cross lies approximately 2 cm

superior to ischial spine
✦ KLM, Pg. 361
38. A patient had a lump in her axilla. On the doctor's
further examination, she had a tumor at the outer lateral
quadrant of her breast. Lymph node involved is? - ID :
16516
Ⓐ Anterior (pectoral) lymph nodes
Ⓑ Inferior axillary lymph nodes
Ⓒ Internal mammary nodes Ⓓ Infraclavicular Nodes
Ⓐ Lateral breast quadrants ➜ drains to axillary lymph
nodes ➜ anterior or pectoral nodes for the most part.
Medial breast quadrants ➜ parasternal/interna thoracic/Mammary
lymph nodes
Ⓐ Pleomorphic adenoma Ⓑ Warthin tumor
Ⓒ Adenocarcinoma Ⓓ Adenoid cystic carcinoma
Ⓑ Warthin ☛ Benign Tumor ( 8% of parotid Tumors )
Pleomorphic Adenoma ☛ Benign but can transform into Highly
malignant so here Warthin to be Preferred
All Other mentioned ☛ Malignant
✦ Harsh Mohan, Pg. 516, 517
44. A 65-year-old lady had a UTI which was treated with
broad spectrum antibiotics. A few days later she
developed bloody diarrhea and severe abdominal pain. She
has temp of 38.6 C and a pulse of 90 bpm. Her blood tests
show Hb= 119g/L WBO 10X10VL CRP= 180 mg/1
Physician is suspecting Pseudomembranous colitis. What
is the causative organism of Pseudo-membranous colitis?
- ID : 19334

Inferior quadrants ➜ inferior phrenic lymph nodes Ⓐ Clostridium dlfficile Ⓑ Clostridium botilinum
Deep surface of the breast ➜ apical node Ⓒ Salmonella typhoid Ⓓ E-coli
Ⓔ C. perferinges
✦ SNELL, Pg. 336

39. Levodopa taken by a Parkinson patient will decrease : Ⓐ ✪ C.difficile ➜ toxins A and B ➜ damage enterocytes
- ID : 16647 ➜ pseudomembranous colitis ➜ watery diarrhea.
✦ First Aid, Pg. 138 ✦ Levinson, Pg. 141
Ⓐ Thyroxine Ⓑ Prolactin
Ⓒ Progesterone Ⓓ Testosterone 45. Most of the Postganglionic sympathetic fibers naturally
Release ? - ID : 19374
Ⓑ Levodopa ☛ ↑ Dopamine ( prolactin-inhibitory factor ) ➜ ↓ Ⓐ Acetylcholine Ⓑ Nor-epinephrine
Prolactin. Ⓒ Lithium Ⓓ Histamine
✦ First Aid, Pg. 549 ✦ BRS Pathology, Pg. 320

40. Microscopic slide of liver shows portal vein hepatic
artery and bile duct at periphery and central vein in the
centre.Most slikely structure is - ID : 17626
Ⓐ Hepatic lobule Ⓑ Portal acinus
Ⓒ Hepatic acinus (liver acinus)
Ⓓ None of above
Ⓐ Hepatic lobule ☛ Central vein and triad at periphery i.e Bile
duct , Hepatic artery and portal vein
Hepatic acinus ☛ centered around terminal branches of hepatic
artery and portal vein, and terminal bile duct. Click to view
Reference in MediCall App
✦ Harsh Mohan, Pg. 578
41. What ethical principle is most emphasized in the
Hippocratic Oath? - ID : 17883
Ⓐ Confidentiality Ⓑ Sexualboundaries
Ⓒ Advertising Ⓓ Bribery
Ⓐ Confidentiality: The principle is deeply rooted in the
Hippocratic Oath, which underscores the ethical obligation for
physicians to protect patient information. This creates a foundation
of trust between healthcare providers and patients, which is critical
for effective healthcare delivery.Sexual boundaries: Important
but not the primary focus of the Hippocratic Oath.
Advertising: Not directly addressed in the Hippocratic Oath.
Ⓑ Postganglionic sympathetic neurons ➜ adrenergic ➜
norepinephrine.
✦ Netter Nervous System Illustrations, Pg. 201
46. Trephine bone marrow biopsy is done to examine bone
marrow aspirate for ? - ID : 19430
Ⓐ Sideroblastic anemia Ⓑ Hemolytic anemia
Ⓒ Thalasemia Ⓓ Aplastic pancytopenia
Ⓓ Aplastic Anemia ☛ ↓ multiple blood cell lineages and CBC
reveals pancytopenia (anemia, thrombocytopenia, and
neutropenia) ➜ bone marrow biopsy required for diagnosis ➜
reveals marked hypocellularity.
✦ CMDT, Pg. 556
47. The Follicular CA of thyroid is associated with ? - ID :
19602
Ⓐ Lymphatic invasion Ⓑ Vascular invasion
Ⓒ Skeleton invasion
Ⓓ Vertebral column invasion
Ⓑ ✪ Follicular carcinomas ☛ well-differentiated follicular
epithelial cells WITH capsular and/or vascular invasion.
✪ Follicular adenomas ☛ well-differentiated follicular epithelial
cells WITHOUT capsular/vascular invasion.
✦ Robbins, Pg. 768

Bribery: Also important but not the cornerstone principle

48. The patient was brought to ER unconscious there is a
emphasized in the Oath. breathing problem. An empty bottle of Aspirin was found.
42. The descendens (Ansa) cervicalis supply which Aspirin poisoning immediate treatment should be? - ID :
19943
muscle? - ID : 18805
Ⓐ Hydration to remove through kidney
Ⓐ Diagastric Ⓑ Genohyoid
Ⓑ Bicarbonate iv Ⓒ None of above
Ⓒ Superior belly of omohyoid

Ⓒ Descendens cervicalis, the inferior root of ansa cervicalis is
formed by fibers from spinal nerves C2 and C3.
Ansa cervicalis send off branches ☛
superior belly of omohyoid , upper parts of sternothyroid and
sternohyoid muscles.
43. Which one of following is benign tumor? - ID : 19270
Ⓑ Salicylate toxicity ☛ alterations of acid-base homeostasis ➜
reversed by Na bicarbonate.
49. 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.

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thyroid artery and could be damaged during surgery ? - ID Ⓐ Skull sutures Ⓑ Vertebral joint
: 19944 Ⓒ Hip joint Ⓓ Syndesmosis
Ⓐ External Laryngeal Nerve Ⓑ Superior Laryngeal Nerve Ⓔ Ghomphosis
Ⓒ Recurrent Laryngeal Nerve
Ⓓ Syndesmosis is a fibrous joint held together by ligaments. It's
Ⓓ Vagus Nerve
located near the ankle joint, between the tibia, or shinbone, and
Ⓒ Lower lobe Thyroidectomy ☛ Inferior Thyroid Artery Ligation the distal fibula, or outside leg bone.Bones are strongly held by
anterior and posterior ligaments ( RJ Last )
➜ RLN blood supply is compromised ➜ Unilateral RLN Damaged
mostly ( Right RLN ＞ Left RLN ) ➜ Ipsilateral Cord Paralysis ➜ 56. A Patient presented in emergency with the complaint
Hoarsness of Voise☛ Great care is taken to ligate inferior thyroid of pain in epigastrium radiating to the back. In labs, there
artery closer to gland after it has given off branch to recurrent was increased serum amylase. Diagnosis of acute
laryngeal nerve. ( Netter + Bailey ) pancreatitis superimposed on chronic pancreatitis was
made in this condition. Type of necrosis in pancreatitis? -
50. A patient with atrophy of thenar muscles and 1st ID : 20860
lumbrical muscle affected, nerve involved is ? - ID : 19945
Ⓐ Fibrinoid necrosis Ⓑ Coagulative necrosis
Ⓐ Median Ⓑ Radial Ⓒ Fat necrosis Ⓓ Liquifactive necrosis
Ⓒ Ulnar Ⓓ None of above
Ⓒ ✪ Acute pancreatitis ➜ Damage to Pancreatic Cells ➜ Release
Ⓐ Median nerve (C8-Th1) ☛ innervates muscles of thenar enzymes ➜ Liquefactive Necrosis of Parenchyma and Fat necrosis
eminence (abductor pollicis brevis, flexor pollicis brevis, opponens of Peripancreatic Fats + Mesentery
pollicis) and 1st lumbrical muscle ✦ Robbins, Pg. 36

➤ Injury to Median Nerve @ Wrist ➜ muscles of thenar eminence 57. Which of the following is the most common cause of
are paralyzed and wasted ➜ eminence flattened hospital acquired pneumonia/ infection ? - ID : 20863

✦ SNELL, Pg. 432 ✦ Netter, Pg. 446 Ⓐ Strep Pneumoniae Ⓑ Staph aureus
Ⓒ Pseudomonas Ⓓ N. meningitis
51. A child, while playing football fractured neck of fibula Ⓔ Actinomycetes
Which artery would be damaged? - ID : 20107

Ⓐ Anterior tibial artery Ⓑ Posterior tibial artery Ⓑ E.coli and S. Aureus are the most common cause of Hospital
Ⓒ Peroneal artery Ⓓ None of above acquired infections.
✦ First Aid, Pg. 185

Ⓐ Anterior tibial artery ➜ ● smaller terminal branch of popliteal 58. Pain and bilateral ankylosed joints and lumber lordosis
artery ● arises at level of lower border of popliteus muscle just were lost. Ankylosing spondylitis is related to which type
lateral to the neck of fibula ● If asked Structure prefer common of HLA ? - ID : 20990
peroneal Nerve
Ⓐ B12 Ⓑ B15
✦ SNELL, Pg. 485, 477 ✦ BD Chaurasia, Pg. 94
Ⓒ B17 Ⓓ B27
52. The enzyme deficiency in Von gierke disease is
following ? - ID : 20230 Ⓓ HLA=B27 ☛ 90% patients with Ankylosingspondylitis are
Ⓐ G 1 Phosphatase Ⓑ G 3 Phosphatase ✪ HLA-DR B27 positive.HLA B27 is commonly associated with
Ⓒ G6 Phosphatase Ⓓ Insulinase P.A.I.R ( psoriatic arthritis, ankylosing spondylitis, IBD,Reactive
arthritis)
✦ Goljan, Pg. 72
Ⓒ In von Gierke's disease, the body's metabolism of glycogen is
blocked by the absence of the enzyme glucose-6-phosphatase, 59. Following a severe automobile accident, a 29-year-old
which regulates the release of the simple sugar glucose from woman was found unstable hip joint. During the
glycogen stored in the liver. examination, when asked to stand on right off the ground,
her pelvis sank downward on the left side. The muse
53. 55 years old person is a a chronic alcoholic for 20 muscles most likely injured is - ID : 21173
years. His lab shows megaloblastic anemia. what should
be the treatment ? - ID : 20367 Ⓐ Left Gluteus medius / left Gluteus minimum
Ⓑ Right Gluteus medius / Right Gluteus minimum
Ⓐ Stop Alcohol Ⓑ Give IV Cobalamine
Ⓒ Left Gluteus medius Ⓓ Right Gluteus medius
Ⓒ Give Methyl Alcohol Ⓓ Give Oral Vit B12
Ⓑ Tendlenberg sign ➜ injury to superior gluteal nerve ➜ gluteus
Ⓑ ✪ Alcohol ➜ Atrophic Gastritis ➜ ↓ intrinsic factor ➜ ↓ vitamin
medius and minimus are weak ➜ when a person is asked to stand
B12 Absorption ➜ Megaloblastic Anemia.
on affected leg, pelvis on unaffected side descends
✪ IV B12 supplementation ➜ Immediate effect.
Sinking will be on opposite side ( Normal ) when standing on
✪ Stopping alcohol ➜ take longer to correct problem. affected side
✦ First Aid, Pg. 379 ✦ KLM, Pg. 581 ✦ First Aid, Pg. 453

54. Spinal cord ends at which level in infants? - ID : 20558 60. Patient of old age had tumor in abdomen removed It
Ⓐ L3 Ⓑ L4 was sent for histopathology and report shows having
blood vessels, vascular genesis is due to ? - ID : 21176
Ⓒ L5 Ⓓ S3
Ⓐ VEGF Ⓑ AGF
Ⓐ Spinal cord ☛ terminates at more caudad level in neonates and Ⓒ Toxin Ⓓ Receptors
infants compared to adults.
✪ Neonates ➜ Upper border of L3. Ⓐ ◉ In Pathogenesis of the tumors the angiogenesis or the blood
✪ Adults ➜ lower border of L1. vessels production is due to VEGF
✦ Harsh Mohan, Pg. 133
55. Type of immovable joint where the bones are held
together by ligaments? - ID : 20563 61. Principal 1st line anti tumor cell and Covid-19 cells are
? - ID : 21644

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Ⓐ CD8+ T Lymphocytes Ⓑ Basophils in chains. He has suddenly developed a bleeding daithesis

Ⓒ NK cells Ⓓ CD4 + T Lymphocytes What is the cause? - ID : 22948

Ⓐ DIC Ⓑ TIP
Ⓒ ✪ NK Cells ➜ earliest Innate immune defense against Microbes
Ⓒ Thrombocytopenia Ⓓ Haemophilia
and Tumor Cells using granzymes and perforin and they dont need
prior activation like T cells. Ⓐ ✪ Disseminated intravascular coagulation is a condition in which
✪ CD8+ cells that recognize class I MHC are destined to become
small blood clots develop throughout the bloodstream, blocking
cytotoxic T lymphocytes (CTLs) ➜ Most effective Anti Tumor small blood vessels.
Adaptve immune response ✪ Increased clotting depletes the platelets and clotting factors
NK ＞ CD8+ needed to control bleeding, causing excessive bleeding DIC is
✦ Kaplan Immunology, Pg. 46 ✦ Levinson, Pg. 518
triggered by gram -ve sepsis in burn patients.
62. Last to come to normal after heamorrhage ? - ID : ✦ Harsh Mohan, Pg. 337
21806
68. The Superior rectal artery is a branch of ? - ID : 23030
Ⓐ RBCs Ⓑ Wbc
Ⓐ Inferior mesenteric artery
Ⓒ Both of these
Ⓑ Middle rectal artery Ⓒ Superior rectal artery
Ⓓ Posterior rectal artery
Ⓐ The normal daily production of red blood cells (RBC) in a
healthy adult is about 0.25 mL/kg and the average lifespan of the
Ⓐ Braches of inferior mesenteric artery ● Superior rectal artery is
cells is about 120 days, whereas that of transfused RBCs is about
a continuation of the inferior mesenteric artery ● left colic artery ●
50–60 days and can be significantly shorter in the presence of
sigmoid arteries ( 2-4 )
factors reducing their survival. ✦ SNELL, Pg. 194

63. The Most lethal complication of the undescended 69. 24-hour urine shows increase V mandelic acid and
testes is ? - ID : 22053 metanephrines . Which of the following could be the
diagnosis ? - ID : 23190
Ⓐ Benign stricture Ⓑ Malignancy
Ⓒ Hydrocele Ⓓ Infertility Ⓐ Pheochromocytoma Ⓑ Pitutary tumor
Ⓔ Erectile dysfunction Ⓒ Osteoma Ⓓ None of above

Ⓑ If a testicle does not descend, its temperature can rise high Ⓐ Pheochromocytoma ☛ ↑ urinary excretion of free
enough to cause a low sperm count or poor sperm quality. catecholamines and their metabolites ( Vanillylmandelic acid and
Testicular cancer is another complication of an undescended metanephrines ).
testicle, though the risk is lower than 1 percent. ✦ Robbins, Pg. 794

64. Superior Mesenteric Vein and Splenic vein coincide at 70. During Submandlbular gland surgery which nerve is
which site to form portal vein? - ID : 22075 likely to be affected? - ID : 23431

Ⓐ Neck of pancreas Ⓑ Body of pancreas Ⓐ Marginal Mandibular branch of facial nerve

Ⓒ Tail of pancreas Ⓓ At right colic flexure Ⓑ Zygomatic branch of the facial nerve
Ⓒ Mandibular division of the trigeminal nerve
Ⓐ Posterior to neck of pancreas portal vein is formed by union of Ⓓ Inferioralveolar nerve
splenic vein and superior mesenteric vein (SMV), at the level
of L2. Ⓐ 3 nerves that can be damaged all with varying results:
✦ SNELL, Pg. 194 1) Marginal mandibular branch of the facial nerve is the nerve
65. Boy had fever palpitations and sore throat along with most likely to be bruised ➜ Weakness of the lower lip
Painful swallowing. O/E there is edematous tonsil with 2) Lingual nerve is rarely bruised ➜ Numbness of the tongue
yellow colored abscess. which organism you suspect ? - ID 3) Hypoglossal nerve is only very rarely bruised ➜ Restricted
: 22515 tongue movement ( British Society Oral surgery - Baoms.org.uk )
Ⓐ Group B streptococci Ⓑ S. Aureus 71. SIADH causes - ID : 23743
Ⓒ H.influenza Ⓓ E.coli
Ⓐ Hypernatremia and dec thirst
Ⓐ The typical signs and symptoms of streptococcal pharyngitis are Ⓑ Hyponatremia and inc thirst
a sore throat, fever of greater than 38 °C (100 °F), tonsillar Ⓒ Hypokalemia and inc thirst
exudates (pus on the tonsils), and large cervical lymph nodes. ( Ⓓ Hypercalcemia and dec thirst
??? : Davidson )
Ⓑ ✪ ↑ ADH secretion ➜ ↑↑ Water reabsorption ➜ concentrated
66. A patient after sciatic nerve injury is having difficulty
urine ➜ ↑ urine osmolality ( Normal 100–900 mOsm )
from sitting to standing position what muscle will be likely
➤ Due to Water retention ➜ ↓ serum osmolality ( Normal 285-
injured? - ID : 22619
295 mOsm ) ➜ Euvolemic hyponatremia
Ⓐ Gluteus medius Ⓑ Gluteus minimus ✦ CMDT, Pg. 902
Ⓒ Sartorius Ⓓ Quadriceps femoris
72. Face masks are sterilized by? - ID : 24193
Ⓔ Gluteus maximus
Ⓐ Lukewarm water Ⓑ Ethylene oxide
Ⓔ Principal function of the Gluteus maximus ➜ extend and Ⓒ Chlorhexidine Ⓓ Simple water
externally rotate the thigh ➜ Rising from sitting, straightening
from a bending position, walking up stairs or on a hill, and Ⓑ ✪ Cleaning with lukewarm water
running. ✔ inferior gluteal nerve is the main nerve to gluteus ✪ Sterlization with ethylene oxide
✦ Sceincedirect Elsevier, Pg.
maximus muscle.
✦ First Aid, Pg. 453
73. Left atrium and left ventricle (posterolateral Heart)
67. Patient, after a few days of severe burns, developed are supplied by - ID : 24202
high grade fever Blood culture yielded gram negative rods

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Ⓐ Left circumflex artery (LCX) Ⓓ The Kaplan-Meier estimator is used to estimate the survival
Ⓑ RCA Ⓒ LCA function.
Ⓓ Marginal
79. A 50 years old male known case of renal failure GFR
Ⓐ LCX Artery ☛ Supplies Posterior Surface of Left Ventricle and less than 50%, which of the following dearrangement is
most alarming for the doctor in this patient: - ID : 33732
Left Atrium and also Lateral surface of Left Ventricle
✦ SNELL, Pg. 89
Ⓐ Hyponatremia Ⓑ Hyperkalemia
74. A 14 years old boy who only eats fast-food presents to Ⓒ Hypokalemia Ⓓ Hypermagnesemia
you with fatigability, MCV = 112, Hb = 9.1mg/dl, what
would you suspect - ID : 25078 Ⓑ ✪ C/F of ARF ☛ ↑ BUN and Cr , Hyperkalemia and Metabolic
acidosis
Ⓐ Folic acid deficiency Ⓑ IDA
✪ Hyperkalemia causes cardiac arrthymia and can be fatal
Ⓒ Vitamin B12 Deficiency Ⓓ Sideroblastic anemia ✦ Guyton, Pg. 432

Ⓐ ✪ Megaloblastic Anaemia ☛ ↓ intrinsic factor or nutritional 80. A patient with striae, weight gain, acne, hyperglycemia
def. of folic acid or vit B12 ➜ ↑ MCV. and excessive facial hair has high ACTH.What is the cause?
- ID : 33762
✪ IDA ☛ ↓ MCV.
✦ Harsh Mohan, Pg. 280, 271 Ⓐ Primary increased ACTH production
Ⓑ Exogenous steroids Ⓒ Thyroid problem
75. Cancer of Head of pancreases will compress which
Ⓓ Decreased ACTH
structure: - ID : 25780

Ⓐ SMA Ⓑ CBD Ⓐ ✪ ↑ ACTH ➜ ↑ androgens and ↑ glucocorticoids ➜ Cushing

Ⓒ Portal vein syndrome.
✪ Cushing syndrome ☛ striae, weight gain, acne, and excessive
Ⓑ Tumors that arise in head of pancreas (usually ductal facial hair .
adenocarcinoma) can cause obstruction of common bile duct ➜ ✦ Ganong, Pg. 351

enlarged gallbladder with painless jaundice (Courvoisier sign).

81. 20 years young boy presented with fever, headache
✦ First Aid, Pg. 368
vomiting. He is having neck stifness and Alter mental
76. A 16-year-old girl who is a known case of diabetes status with hallucination which among following is brain
mellitus, presented to the ER with confusion and eating parasite? - ID : 33885
drowsiness for 2 hours. Her mother reports that she had
fever, abdominal pain and vomiting for last 4 days with Ⓐ Naegleria Fowleri Ⓑ Entamoeba Histolytica
increased urination, increased thirst. Examination shows Ⓒ Amoeba Proteus Ⓓ Chaos Carolinense
rapid breathing with fruity breath odor and severe
dehydration. Her random blood glucose is 476 mg/dl. Ⓐ Naegleria fowleri ☛ commonly known as brain eating amoeba
Arterial blood gases reveal shows metabolic acidosis : pH ➜ free-living microscopic ameba ➜ causes amebic
7.29, PaC02 33 mmHg, HC03 12 mmol/L, urine ketones meningoencephalitis ➜ brain infection that leads to destruction of
+ve. What is the most likely diagnosis? - ID : 27696 brain tissue.
Ⓐ Diabetic ketoacidosis 82. A patient presents with symptoms of Horner
Ⓑ Hyperglycemic hyperosmolar nonketotic coma syndrome, unusual facial expressions, ptosis, unilateral
Ⓒ Hypoglycemia Ⓓ Lacticacidosis facial flushing and loss of sweating function. Which nerve
supply is damaged? - ID : 33904
Ⓐ ✪ Uncontrolled DM ( Mostly Type 1 ) ☛ ↑ Lipolysis ➜ ↑ FFA ➜
Ⓐ Cervical sympathetic chain
↑ Acidic Ketone Bodies synthesis ( acetone, acetoacetate, beta-
Ⓑ Lesser splanchnic Ⓒ Greater splanchnic
hydroxybutyrate ) ➜ DKA
Ⓓ Least splanchnic
✪ DKA ☛ Rate of ketogenesis ＞ Rate of ketolysis ➜ ketonemia (↑
KB in Blood ) ➜ ketonuria Ⓐ Horner syndrome☛ Interruption (central or peripheral) of the
◉ Fruity odor on the breath ☛ Due to Acetone sympathetic pathway through the superior cervical ganglion.
◉ ↓ Bicarb and pCO2 ☛ Due to Metabolic acidosis Signs and symptoms ☛ Miosis, ptosis, facial flushing and
◉ Hyperventilation ( Kussmaul's ) ☛ Due to Partial respiratory anhidrosis.
compensation
◉ ↑ Anion Gap + ↓ pH ☛ Due to ↑ Ketone bodies
◉ Dehydration ☛ Due to Glucosuria ➜ ↑ Urea creatinine ✦ Duane Neurosceince, Pg. 434

◉ Abdominal Pain ☛ Due to Metabolic Acidosis✪ HHS ☛ serum 83. The salivary secretions from parotid gland are
glucose ( ＞ 600 mg/dL ), polyuria, polydipsia, lethargy. controlled by the following nerve: - ID : 33958
✦ Robbins, Pg. 788 ✦ Davidson, Pg. 737
Ⓐ Facial nerve Ⓑ Auriculo-temporal nerve
77. Melanoma reaches orbital Cavity through - ID : 28395 Ⓒ Hypoglossal nerve Ⓓ Glossopharyngeal nerve
Ⓐ Emissary vein Ⓑ Retina
Ⓓ Glossopharyngeal nerve ☛ provides parasympathetic
Ⓒ Optic nerve Ⓓ Lymphatics
innervation of parotid gland ➜ produces secretion of saliva.
Ⓐ Primary choroidal melanoma ☛ arises from melanocytes 84. A Young man had a road side accident in which he
within choroid. suffered from Spinal cord Injury with herniation and
Metastasis ☛ through emissary channels into orbit damage to some soft filling at center of the disc of spinal
cord known as nucleus pulposus. It is derived from which
78. Kaplan-Meier Curve indicates - ID : 33593
embryological structure? - ID : 34030
Ⓐ Incidence of Disease Ⓑ Demography
Ⓐ Mesonephric Duct Ⓑ Neural Tube
Ⓒ Severity of Disease Ⓓ Survival
Ⓒ Notochord Ⓓ Mullerian Duct

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Ⓒ Nucleus pulposus ☛ inner soft, elastic material ➜ shock

92. A patient comes to you in ill condition. His blood pH is
absorber for external forces ➜ is postnatal remnant of notochord. 7.3 PCO2 is 44 mmHg and HCO3 is 17 meq/L. What
diagnosis you are thinking of this patient? - ID : 34997
85. Tricep reflex lost, lesion at ? - ID : 34375
Ⓐ Metabolic alkalosis Ⓑ Metabolic acidosis
Ⓐ Lower cervical segment Ⓑ Upper thoracic
Ⓒ Upper cervical Ⓒ Respiratory acidosis Ⓓ Compensatory acidosis
Ⓔ Compensatory alkalosis
Ⓐ EXPLANATION
Ⓑ ✪ pH : 7.3 ☛ low( Acidic)
86. Pain of appendicitis shifts to: - ID : 34445 ✪ pCO2 : 44 ☛ Normal ➜ this indicates Acidosis can not be due to
Ⓐ Hypochondrium Ⓑ Umbilical region respiratory cause
Ⓒ Epigastrium ✪ HCO3 : 17 ☛ Low ➜ So Metabolic origin for this Acidosis caused
by decreased HCO3 in body ( may be because of severe Diarrhea )
Ⓑ Appendicitis ☛ Periumbilical pain can be an early sign ➤ This is Unompensated Metabolic Acidosis
☢ pCO2 should be low in case of Respiratory compensation (
87. ESR will deccrease with increase in? - ID : 34524
hyperventilation )
Ⓐ Albumin Ⓑ Cholesterol ☢ pH must be Almost Normal in compensation
Ⓒ Temp Ⓓ Fibrinogen ✦ Davidson, Pg. 46

93. Which of the following is the cell of atopic asthma? -

Ⓐ ESR ☛ Albumin is related inversly ESR ID : 35050
✦ N.I.H USA, Pg.
Ⓐ Mast Cells Ⓑ Eosinophils
88. Patient underwent abdominal surgery, after which he
Ⓒ Basophils Ⓓ Lymphocytes
repeatedly required fluid resuscitation due to water and
electrolyte loss. He does not remember which part of the
Ⓐ Mast cells ☛ associated with asthma, drug reactions,
intestine was operated. The - ID : 34705
anaphylaxis, mastocytosis and urticarial.
Ⓐ Jejunum Ⓑ Rectum
94. Small cell carcinoma of lung causes? - ID : 35196
Ⓒ Ileum Ⓓ Colon
Ⓔ Duodenum Ⓐ Cushing disease Ⓑ Myasthenia gravis
Ⓒ Hypocalcemia Ⓓ Cushing syndrome
Ⓒ ✪ Jejunum Resection ➜ ileum compensates Major function Ⓔ Hyperthyroidism
✪ Ileal Resection ➜
➊ ↑↑ Motility ➋ ↑↑ Intestinal transit ➌ Malabsorption Ⓓ ANS : B
✦ Robbins, Pg. 543, 236
➤ Colon receives ↑↑ Fluid + ↑↑ Electrolytes + ↑↑ Bile salts ➜
Unable to absorb all ➜ Large Volume Secretory Diarrhea☢ ↑↑ Bile 95. To see long-term compliance to insulin or control of
Salts ➜ Stimulates Colon ➜ cause Secretory Diarrhea ( but its diabetes Mellitus which investigation Is performed? - ID :
35594
One of the reasons along with others )
☢ Osmotic Diarrhea ➜ Only due to presence of Ⓐ Urea clearance Ⓑ Fasting blood sugar
Malabsorbed osmotically active agents e.g Carbohydrates Ⓒ Urea and creatinine
(esp Lactose) Ⓓ Glycosylated hemoglobin (HBA1c)
✦ Bailey and Love, Pg. 283 ✦ CMDT, Pg. 600 Ⓔ GTT
89. Plasma clearance of PAH is used to measure the renal
plasma flow because it? - ID : 34720 Ⓓ ✪ HBA1c ☛ best monitor for long term glycaemic control.
✪ Advantage ☛ no fasting is required.
Ⓐ Can be measured in plasma easily ✦ Harsh Mohan, Pg. 818
Ⓑ Is excreted in urine
Ⓒ Is filtered and secreted but not reabsorbed 96. A patient presented after RTA, you are advised to
make a histology slide containing muscle fasciculus
Ⓓ Is only filtered Ⓔ Is only secreted
surrounded by connective tissue. The bundle (fascicle. of
skeletal muscle) are surrounded by - ID : 35851
Ⓒ ✪ Para-aminohippuric acid (PAH) has the greatest clearance of
all of substances because it is both filtered and secreted. Inulin is Ⓐ Epimysium Ⓑ Endomysiun
only filtered Ⓒ Perimysium Ⓓ Myofibril
✦ Guyton, Pg. 354

90. Face mask can be washed / cleaned by: - ID : 34861

Ⓒ ✪ Epimysium ☛ connective tissue that surrounds Entire muscle
( Inter-Muscular )
Ⓐ Simple water Ⓑ Luke warm water ✪ Perimysium ☛ surrounds each bundle of muscle fibers
Ⓒ Chlorhexidine ✪ Endomysium ☛ covers each single muscle fiber.
✦ Sceincedirect Elsevier, Pg.
Ⓑ ✪ Cleaning with lukewarm water
97. A 3-year old, while playing outside got scared is not
✪ Sterlization with ethylene oxide
✦ Sceincedirect Elsevier, Pg.
speaking. Mother notices the child has become cold and
has goosebumps all over and takes him to the hospital.
91. A player hiked to a mountain, having Low oxygen level The cause of Goosebumps is? - ID : 35890
in blood (low PO2), and developed dyspnea the likely
etiology is: - ID : 34979 Ⓐ Contraction of errector pili
Ⓑ Relaxation of arrector pili
Ⓐ Hypovolumic shock Ⓑ Anemic Hypoxia Ⓒ Inc blood supply to the skin
Ⓒ Hypoxic Hypoxia Ⓓ Congestive Heart Failure Ⓓ Dec blood supply to the skin

Ⓒ Hypoxic hypoxia ➜ Hypoventilation, ↑ Altitude, ↓ Atmospheric Ⓐ Gooseflesh ☛ as a result of overactivity of sympathetic system,
O2 ➜ ● ↓ PO2 ● ↓ O2 Sat ● ↓ PvO2 which causes vasoconstriction of dermal arterioles and contraction
✦ Guyton, Pg. 564
of arrector pili muscles

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✦ SNELL, Pg. 6 Ⓐ IgM Ⓑ IgG

98. Artery present at the base of renal pyramid - ID : 36005 Ⓒ IgA Ⓓ IgE

Ⓐ Arcuate artery Ⓑ Interlobular artery Ⓑ ✪ IgG ☛ Rh incompatibility Ab (only Ig to cross placenta)

Ⓒ Inerrlobar artery Ⓓ Segmental artery ✪ IgM ☛ ABO incompatibility Ab (predominantly)
✦ Harrison, Pg. 810
Ⓐ Interlobar arteries ➜ arcuate arteries, which arch over the
106. Vitamin D is regulated by - ID : 37515
bases of the pyramids
✦ SNELL, Pg. 208 Ⓐ Ca in serum Ⓑ PTH
99. End diastolic volume (EDV) depends mainly on - ID : Ⓒ 25 Vitamin
36414
Ⓑ EXPLANATION
Ⓐ Venous return Ⓑ Atrial contraction
Ⓒ Ventricle relaxation Ⓓ Heart rate 107. A patient climbed a peak with a heavy bag on his
shoulder after that he developed sensory loss of thumb
Ⓐ EXPLANATION and hand, weakness of deltoid, loss of adduction of arm
with loss of flexion at elbow and loss of extension at wrist.
100. Soleus nerve supply - ID : 36415 Diagnosed as waiter's tip hand or Saturday night palsy.
Most likely damage occurs to which of the following? - ID :
Ⓐ Tibial nerve Ⓑ Obturater nerve
37756
Ⓒ Femoral Cutaneous Ⓓ Common peroneal nerve
Ⓐ Upper brachial plexus damage
Ⓐ EXPLANATION Ⓑ Radial Nerve injury
Ⓒ Musculocutaneous nerve damage
101. A female with sign and symptoms of hyper
Ⓓ Axillary Nerve injury
prolactinoma was diagnosed with pituitary adenoma.
Pituitary adenoma compress which structure anteriorly? -
ID : 36443
Ⓐ Brachial Plexus Palsy Injuries
Upper Lesion ☛ Erb's Palsy
Ⓐ Optic nerve Ⓑ Optic Chaisma Nerve Roots C5, C6, +/- C7 :
Ⓒ Cavernous sinus Ⓓ Optic Track ◉ Inability to abduct shoulder, externally rotate arm, and supinate
forearm (Waiter's Hand)
Ⓐ Large pituitary tumor growing superiorly may compress the
◉ Possible diaphragm paralysis
optic nerve anterior to the optic chiasm
✦ American Academy, Pg.
Lower Lesion ☛ Klumpke's Palsy
Nerve Roots C8, T1 :
102. In school children had party. Fried rice, Chinese food ◉ Inability to flex wrist or grasp (Claw hand )
intake by a children. After 6 hours many of them ◉ Possible Horner syndromeArm Abduction
developed nausea vomiting, abdominal cramps. Which
☛ 0° upto 15° by Supraspinatus ➜ Suprascapular ➜ Branch of
organism is causative agent of food poisoning after eating
upper trunck
reheated rice. - ID : 36596
☛ 15°upto 100° by Deltoid ➜ Axillary ➜ branch of posterior cord
Ⓐ Bacillus cereus Ⓑ E Coli ☛ ＞ 90° by Trapezius➜ Accessory
Ⓒ Staph aureus Ⓓ Clostridia ☛ ＞ 100° by Serratus Anterior ➜ Long Thoracic (SALT) ➜ Root
C5, C6, C7
Ⓐ Bacillus cereus ☛ Gram ⊕ rod. Causes food poisoning. Spores ✦ Kaplan Anatomy, Pg. ✦ KLM, Pg. 710
survive cooking rice (reheated rice syndrome).
✦ First Aid, Pg. 138 108. Action of Prostaglandins on stomach - ID : 37875

103. After a hysterectomy, the patient is facing a problem Ⓐ Inhibit HCO3 Secretion
with the distended abdomen. Which artery is involved - ID Ⓑ Inhibit HCL Secretion from Parietal Cells
: 36768 Ⓒ Increase permeability when Aspirindamages Mucosal Barrier to
Ⓐ Ovarian artery Ⓑ Middle sacral Ions
Ⓓ Blocks Ca from entering Parietal Cell
Ⓒ Uterine artery Ⓓ Internal iliac artery
Ⓔ Blocks Ach from binding to Parietal Cell
Ⓒ Ureter passes immediately inferior to uterine artery
Ⓑ EXPLANATION
near lateral part of fornix of vagina is clinically important. The
ureter is in danger of being inadvertently clamped (crushed), 109. Iron absorption increased by - ID : 38056
ligated, or transected during a hysterectomy. The point at
which uterine artery and ureter cross lies approximately 2 cm Ⓐ Acetic acid form Ⓑ Ferrous form
Ⓒ Oxalate intake
superior to ischial spine

✦ KLM, Pg. 361

Ⓑ Iron absorption is increased in the ferrous form.
(Ganong , 26th Edition, p. 490 )
104. The main variable controlled by Baroreceptor reflex
is? - ID : 36891 110. Which of the following is closely related with the
pharmacokinetics of the drug? - ID : 38127
Ⓐ Mean Arterial Pressure Ⓑ Pulse Pressure
Ⓒ Blood Pressure Ⓓ Stroke Volume Ⓐ Adverse effects Ⓑ Dose of the drug
Ⓒ Therapeutic index Ⓓ Mechanism of action
Ⓐ Baroreceptors ☛ sensitive to change in mean pressure Ⓔ Excretion of drug
Blood Loss ☛ ↓ MAP ➜ ↓ Firing of Baroreceptors ➜ Immediate and
Ⓑ EXPLANATION
Short term increase in ➜ HR, SV, and BP
✦ Guyton, Pg. 7
111. Activation of (extrinsic pathway) coagulation and
105. Immunoglobulin involved in Rh incompatibility like bradykinin system via - ID : 38188
Erythroblastosis fetalis ? - ID : 36972

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Ⓐ Hageman factor Ⓑ Factor 7
Ⓒ Factor 10
Ⓐ EXPLANATION
112. An old man residing near a fast-flowing river has
developed blindness over the last 2 years. The
ophthalmologist has made a diagnosis of a nematode
infection as the cause of blindness. Which one of the
following nematodes is the cause? - ID : 38405
Ⓐ Onchocerca volvulus Ⓑ Dipetalonema perstans
Ⓒ Dracunculus medinensis Ⓓ Mansonella ozzardi
Ⓔ Wuchereria bancrofti
Ⓐ EXPLANATION
113. The following arterial blood gases were taken from
an unconscious 45 year old man in the accident and
emergency department. pH 7.35, P02 96 mmHg, PC02 26
mmHg, HC03 15 mmol/L. What is the correct
interpretation of this ABG result? - ID : 54528
Ⓐ Compensated metabolic acidosis
Ⓑ Compensated metabolic alkalosis
Ⓒ Compensated respiratory acidosis
Ⓓ Compensated respiratory alkalosis
Ⓐ Compensated Metabolic Acidosis ➜ PCO2 should be low
after hyperventilation in order to Neutralize Acidosis ➜ pH Normal
◉ pH : 7.35 ☛ almost Normal but at lower Acidic border
◉ pCO2 : 26 ☛ Low ➜ this indicates Acidosis can not be due to
respiratory cause
◉ HCO3 : 15 ☛ Low ➜ So Metabolic origin for this Acidosis caused
by decreased HCO3 in body ( may be because of severe Diarrhea )
➤ This is a Fully Compensated Metabolic Acidosis
☢ pCO2 is Low because of Respiratory compensation (
hyperventilation )
☢ pH is Almost Normal which shows Full compensation
✦ Davidson, Pg. 46
114. A 3-year-old boy is brought to the OPD with
developmental delay. On examination, he has a wide-open
fontanelle, a small umbilical hernia, and short stature. No
bony abnormalities are seen. The most appropriate
investigation in this boy would be - ID: 54653
Ⓐ Liver biopsy
Ⓑ Serum TSH and free T4 levels
Ⓒ Urine detailed report (D/R)
Ⓓ X-Ray wrist
Ⓑ ✪ Congenital hypothyroidism/cretinism ☛ lack of weight
gain, stunted growth, fatigue, lethargy, poor feeding, thickened
facial features, abnormal bone growth, mental retardation, very
little crying.
✪ Investigation ☛ ↓ T4 and ↑↑ TSH
✦ Pubmed USA, Pg.
115. On physical examination of a child, you find
mediastinum deviated to the opposite side, reduced chest
movements over that area, no vocal fremitus, and
resonant percussion note with no breath sounds. The one
best disease process that can explain above mentioned
findings will be - ID : 54787
Ⓐ Consolidation Ⓑ Bronchospasm
Ⓒ Atelectasis Ⓓ Pneumothorax
Ⓓ Pneumothorax☛ Air or other gas in the pleural sac.
Tension pneumothorax ☛ ● Mediastinal or Tracheal shift to
opposite side ● ↓ Breath sounds ● ↓ Fremitus ● ↓ Chest movements
● Tachycardia ● Hypotension
✦ CMDT, Pg. 326
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116. A 16 year old girl presented with butterfly rash on
her face, oral ulcers, high grade fever, hair loss, muscle
and joint pains and Raynaud's phenomenon for last 3
weeks. She has temperature 103 degree F, erythema of
knuckles, spindling of fingers, proximal weakness of
muscles and facial telangiectasias. Investigations showed
thrombocytopenia, leucopenia, raised ESR, normal CRP.
ANA and anti-ds DNA were positive. Most likely diagnosis
is - ID : 55433
Ⓐ Mixed connective tissue disease
Ⓑ Pyrexia of unknown origin
Ⓒ Rheumatoid arthritis
Ⓓ Systemic Lupus Erythmatosis
Ⓓ ✪ SLE ☛ appear as extreme fatigue, discomfort, malaise, fever,
loss of appetite and weight loss ➜ typically affecting same joints
on both sides of body ➜ muscle pain and weakness. Skin problems
are common in SLE.
✪ Raynaud's phenomenon ☛ spasm of arteries cause episodes
of reduced blood flow ➜ nonspecific cutaneous lesions ➜
associated with SLE.
117. Lymph node biopsy of HIV finding - ID : 55719
Ⓐ Follicular Hyperplasia Ⓑ Cell depletion
Ⓑ EXPLANATION
118. A man who rides camels has suffered a kick to the
lateral side of his right leg just below the knee. He has a
bruise and tenderness at the site and is unable to either
dorsiflex or evert his foot. He also reports a loss of
sensation over certain parts of his leg and dorsum of foot.
Which nerve bundle is most likely damaged? - ID : 57263
Ⓐ Lateral popliteal Ⓑ Peroneal
Ⓒ Tibia Ⓓ Sural
Ⓑ Dx: The symptoms described are consistent with damage to the
peroneal nerve. The peroneal nerve is responsible for dorsiflexion
of the foot and eversion, as well as sensation over the front and
outer half of the leg and dorsum of the foot. This presentation fits
the clinical signs of peroneal nerve injury.Peroneal nerve is
responsible for dorsiflexion and eversion. It also provides sensation
to the specified areas.
Lateral popliteal: This is another name for the common fibular
nerve, which could be a possible answer, but it's less specific than
"peroneal."
Tibia: Tibial nerve controls plantar flexion and inversion, not
dorsiflexion and eversion.
Sural: Primarily a sensory nerve for the calf, not associated with
movement of the foot
✦ First Aid, Pg. 453 ✦ Kaplan Anatomy, Pg. 221
119. Most prone to develop Skin cancer - ID : 57881
Ⓐ Li-Fraumeni syndrome Ⓑ Xeroderma pigmentosum
Ⓑ Xeroderma pigmentosum ☛ AR inheretence ➜ Expose to
sun ➜ DNA damage ➜ Defective DNA repair ➜ Cancer
✦ Robbins, Pg. 227
120. 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.
121. A pregnant lady presents with jaundice, deranged
AST, and ALT. In a community endemic of hepatitis virus
which is typically lethal for pregnant lady? - ID : 58141
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Melanoma - type of skin cancer that arises from pigment-

Ⓐ Hep A Ⓑ Hep C
producing cells in skin called melanocytes.
Ⓒ Hep E Ⓓ Hep B
Bruise on the skin - bruise or contusion appears on skin due to
trauma and resolves
Ⓒ Hepatitis E in pregnancy ☛ ↑ risk of acute liver failure, fetal
loss and mortality. 127. Dorsal peroneal nerve Web space between: - ID: 68914

122. What primarily causes hypocalcemia? - ID: 59739 Ⓐ 1st and 2nd toe Ⓑ 2nd and 3rd toe
Ⓒ 3rd and 4th toe Ⓓ 4th and 5th toe
Ⓐ Vitamin D deficiency Ⓑ Hypoalbuminemia
Ⓒ Alkalosis Ⓓ Chronic renal failure Ⓐ EXPLANATION
Ⓔ Acute pancreatitis
128. What cell type recognizes MHC class I - ID : 70009
Ⓐ Vitamin D plays a crucial role in calcium homeostasis,
Ⓐ Cytotoxic T cell (CD8) Ⓑ NK cells
promoting intestinal calcium absorption. A deficiency can therefore
Ⓒ CD4 T Cells
lead to hypocalcemia.Hypoalbuminemia: can cause a decrease in
total serum calcium, the ionized (biologically active) calcium level
Ⓐ MHC ll ➜ CD4
typically remains normal.
MHC l ➜ CD8
Alkalosis: Can cause transient reduction in ionized calcium, but is
✦ First Aid, Pg. 100
not the primary cause.
Chronic renal failure: Can cause hypocalcemia, but more 129. Ligament pierce at last during epidural is - ID : 72197
indirectly through effects on vitamin D and phosphate.
Ⓐ Posterior spinal ligament
Acute pancreatitis: Hypocalcemia can occur in severe cases, but
Ⓑ Anterior spinal ligament Ⓒ Supraspinous ligament
it is not the primary cause.
Ⓓ Interspinal ligament Ⓔ Iigamentum flavum
123. A person with a history of long-term smoking and
drinking has a mass in the middle third of the esophagus. Ⓔ Structures Pierced during Lumbar Puncture ➤ Skin ➜
What is the most common worldwide carcinoma of the Subcutaneous tissue ➜ Supraspinous ligament ➜ Interspinous
esophagus? - ID : 60017 ligament ➜ Internal Laminar Space ➜ Ligamentum Flavum ➜
Ⓐ Adenocarcinoma Ⓑ Squamous cell carcinoma Epidural space ➜ Dura ➜ Arachnoid ➜ Subarachnoid space
✦ First Aid, Pg. 507
Ⓒ Carcinoid Ⓓ None of above
130. Patient is suffering from Dysphagia dysarthria
Ⓑ Squamous cell carcinoma (SCC) is the most common type of analgesia and thermoanesthesia on the ipsilateral side of
esophageal cancer worldwide. Both smoking and alcohol are face and ipsilateral hornet's syndrome (Miosis, ptosis and
significant risk factors for this type of cancer, especially when anhidrosis) Occlusion of which artery would produce these
combined. signs and symptoms? - ID : 72207

124. Leukocyte migration through endothelium is induced Ⓐ Posterior inferior cerebellar artery
by ? - ID : 65197 Ⓑ Superior cerebellar artery
Ⓒ Ant inferior cerebellar artery
Ⓐ Selectin Ⓑ N CAM
Ⓓ Ant spinal artery Ⓔ Basilar artery
Ⓒ C CAM Ⓓ PECAM
Ⓐ Ipsilateral Homer syndrome ( left side of face) ➜ Miosis, ptosis
Ⓓ Leukocyte migration through the endothelium is induced by
and anhidrosis ☛ Lateral medullary syndrome ( Left side ).
PECAM (Platelet Endothelial Cell Adhesion Molecule) ✦ Snell Neuro, Pg. 215
Selectin, mediates initial adhesion and rolling of leukocytes on
endothelium, but not the actual migration 131. Lymphoid organ which has paracrine action? - ID :
72388
125. Neonate with arm paralysis following difficult birth,
arm in “waiter’s tip” position - ID: 67628 Ⓐ Lymph node Ⓑ Spleen
Ⓒ Thymus Ⓓ Tonsil
Ⓐ Erb-Duchenne palsy (superior trunk [C5–C6] brachial plexus Ⓔ Palatine tonsil
injury)
Ⓑ Spleen ☛ Secondary lymphoid organ can produce antibodies
Ⓐ EXPLANATION
132. In sub mandibular triangle which structure along
126. What is the diagnosis for an 8-year-old child who has with lingual nerve? - ID : 72395
a reddish blue lesion on the forearm from childhood that
has not increased in size, and the histological examination Ⓐ Sub mandibular duct Ⓑ Maxillary artery
of the resected lesion shows dilated endothelial cells, Ⓒ Facial nerve Ⓓ Glossopharyngeal nerve
consistent with a diagnosis of port wine strain? - ID : 68154
Ⓐ Submandibular duct carries saliva from the submandibular
Ⓐ Hemangioma Ⓑ Telangiectasia
gland to the floor of the mouth, running alongside the lingual
Ⓒ Melanoma Ⓓ Bruise on the skin
nerve.
(Reference: Gray's Anatomy, 41st Edition, page 563)
Ⓐ Hemangioma type of benign tumor consisting of an abnormal
proliferation of blood vessels, often appears at birth or in the first 133. Right bundle branch of conducting system of the
or second week of life. It looks like a rubbery bump and is often heart is present in - ID : 72411
red or reddish-purple. In this case, the child's condition of a
Ⓐ Septomarginal trabeculae Ⓑ Chorda tendinea
reddish lesion from childhood, not increasing in size, and
Ⓒ Supraventricular crest Ⓓ Septal papillary muscles
histologically showing dilated endothelial cells, is indicative of a
Ⓔ Chris ta terminalis
hemangioma, also commonly known as a 'strawberry mark' in
layman's terms.Telangiectasia are dilated superficial blood
Ⓐ Right bundle branch ☛ In the right ventricle, the moderator
vessels, but they typically appear later in life and can have
band (septomarginal trabecula) contains the right bundle branch.
different underlying causes like chronic liver disease, certain ✦ Kaplan Anatomy, Pg. 92
genetic disorders, or even as part of the normal aging process.

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134. A patient has a penetrating ulcer of the posterior wall 140. A child presented with the complain of on and off
of the first part of Duodenum. Which blood vessel is bruises with episodes of epistaxis his bleeding time is
subject to erosion? - ID : 79177 prolonged with normal PT and APTT. what is the most
likely diagnosis - ID : 82474
Ⓐ Common Hepatic Artery Ⓑ Proper Hepatic Artery
Ⓒ Gastroduodenal Artery Ⓐ Christmas disease Ⓑ Hemophilia
Ⓓ Anterior Superior Pancreaticoduodenal Artery Ⓒ ITP Ⓓ VWB
Ⓔ Posterior Superior Pancreaticoduodenal Artery
Ⓒ ITP Diagnostic LABS
Ⓒ Gastroduodenal artery is more directly in contact with the ✪ APTT ➜ normal ✪ PT ➜ normal
posterior wall of the first part of the duodenum and thus more ✪ Bleeding time ➜ Increased ✪ Plts ➜ ＜1 lac
prone to erosion from a penetrating ulcer in this location. VWB also affect factor 8 ➜ APTT wil increase
135. Tsst gene carried by 10-15 % by the following 141. The cell wall of gram-positive cause septic shock
bacteria - ID : 79310 which component of cell wall cause shock? - ID : 82779
Ⓐ Streptococcus epidermidis Ⓐ Lipopolysaccharide Ⓑ Endotoxin
Ⓑ Staph Aureus Ⓒ Group b streptococcus Ⓒ Capsuler antigen
Ⓓ Streptococcus pneumoniae Ⓓ Teichoic acid and Peptidoglycan

Ⓑ Tst ☛ gene for toxic shock syndrome toxin-1 (TSST-1) ➜ part
of genetic element in Staphylococcus aureus ➜ absent in TSST-1-
negative strains.
✦ Davidson, Pg. 331
136. Aspiration pneumonia in a patient with parkinsons
disease. Food goes in to which lobe of lung while (supine)
lying down. - ID : 79330
Ⓐ Posterior segment of right upper lobe
Ⓑ Lateral segment of right upper lobe
Ⓒ Apical segment of right lower lobe
Ⓓ Right upper lobe
Ⓓ Gram positive shock ☛ Teichoic acid
Gram negative shock ☛ LPS / Endotoxin
✦ Levinson, Pg. 46
142. Type of anastomosis that occur when two vertebral
arteries join to form basilar artery - ID : 82862
Ⓐ Convergence Ⓑ Divergence
Ⓒ End to end anastomosis Ⓓ Homocladic
Ⓔ Heterocladic
Ⓐ The basilar artery is formed by the convergence of the
vertebral arteries at the junction of the pons and medulla

Ⓒ If you aspirate a FB ☛ 143. Female with multiple sexual partners developed

✪ Lying Supine ➜ usually enters superior segment of right lower
lobe.
✪ Upright ➜ enters right lower lobe.
✪ Lying on right side ➜ enters right upper lobe
✦ First Aid, Pg. 663
137. A patient was stabbed in the upper chest cause
damage to lateral chest wall, having an inferior axillary
injury, after which the vertebral column of scapula
becomes prominent and move posteriorly he has difficulty
in climbing and swimming which nerve is damaged? - ID :
79430
Ⓐ Upper suprascapular Ⓑ Thoracodorsal
Ⓒ Long thoracic nerve Ⓓ Accessory nerve
vaginal irritation and pus, organism found with jerky
movements cause is: - ID : 82882
Ⓐ Trichomonas vaginalis Ⓑ Vibrio cholera
Ⓒ Chlamydia Ⓓ Toxoplasma
Ⓐ Trichomonas vaginalis ☛ Phase-contrast, dark-ground
microscopy of a drop of vaginal discharge ➜ shows TV swimming
with a characteristic motion in 40–80% of female patients.
✪ Culture techniques are good and confirm diagnosis.
✦ Kumar and Clark, Pg. 182
144. Genetic causes are associated with tumors. Which of
the following conditions associated with shin tumors - ID :
82961

Ⓐ Fanconi anemia Ⓑ Xeroderma pigmentosum

Ⓒ inferior axillary injury ➜ Long thoracic nerve damaged Ⓒ Li-fraumani Ⓓ Von-hippel lindau
➜ serratus anterior muscle paralysed ➜ Winging of scapula ➜
difficulty in climbing and swimming Ⓓ Von Hippel-Lindau disease ☛ Numerous tumors, benign and
138. Prime mover muscle of head / neck flexion - ID :
malignant.
✦ First Aid, Pg. 525
82323
145. Hypotension, Syncope with change in posture - ID :
Ⓐ SCM Ⓑ Platysma
82995
Ⓒ Trapezius
Ⓐ Aortic stenosis
Ⓐ Sternocleidomastoid muscle is one of largest and superficial Ⓑ Subclavian steal syndrome
cervical muscles. Ⓒ HOCM.
Action☛ of the muscle are rotation of the head to the opposite
side and flexion of the neck. Ⓑ Subclavian steal syndrome ☛ When arm is used, blood is
‘stolen’ from brain via the vertebral artery. Leads to vertebro-
139. The patient came with hemolytic anemia, recurrent basilar ischaemia, which is characterised by dizziness, cortical
bleeding, increase rectic count, vitamin deficient - ID :
blindness and/ or collapse
82357
✦ Davidson, Pg. 602

Ⓐ Ascorbic acid Ⓑ Vitamin D 146. In ZN staining acid fast bacilli is stained because of?
Ⓒ Vitamin A Ⓓ Hydroquinone Deficiency - ID : 83038
Ⓔ B1 Deficiency
Ⓐ Peptidoglycan Ⓑ Mycolic acid
Ⓐ Oral vitamin C, if consumed in large doses for a prolonged Ⓒ Teichoic acid
period, may also cause hemolysis. Males are generally affected,
with higher incidence of G6PD deficiency. Ⓑ ZN stain ☛ Stains mycolic acid in cell wall
✦ First Aid, Pg. 125

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Ⓐ Increased urine osmolarity

147. Edema fluid due to acute inflammation is? - ID : 83143
Ⓑ Decreased urine Osmolarity
Ⓐ Exudate Ⓑ Purulent Ⓒ Plasma osmolarity Ⓓ Increaed ICF osmolarity
Ⓒ Fibrinous Ⓓ Transudate
Ⓐ Intense physical activity (marathon) ☛ body loses water
Ⓐ ✪ Features of Exudate primarily through sweat ➜ overall decrease in total body water
◉ ↑ vascular permeability ◉ Inflammatory edema (dehydration) ➜ body compensates by conserving water at
◉ ↑ protein ( 2.5-3.5 mg/dl) ◉ ↑ Sp.gravity ◉ ↑ LDH kidneys ➜ leading to increased urine osmolarity as more solutes
◉ Low PH ◉ Low Glucose conten ( ＜ 60 mg/dl) are excreted with less water.
✦ Harsh Mohan, Pg. 96
ICF osmolarity☛ can be affected by dehydration to some extent,
148. The patient presented with non-healing painful leg it's not the primary or most direct effect.
ulcer and chest pain having multiple blood transfusion on
155. Right heart failure with dilated Right atrium and
smear what will be found? - ID : 83214
ventricle, which would dilate?? - ID : 83483
Ⓐ Sickle cells Ⓑ Schistocytes
Ⓐ Coronary sinus Ⓑ Superior vena cava
Ⓒ Tear drop cells Ⓓ Hereditary spherocytosis
Ⓒ Pulmonary veins Ⓓ Inferior vena cava
Ⓐ Sickle cell anemia ➜ sickling ➜ Vaso-oclusive crises ➜ ulcer,
Ⓐ Right heart failure ➜ causes Right atrial enlargement or
Hemolysis ➜ anemia ➜ Transfusion
✦ Kaplan Pathology, Pg. 97
dilation ➜ can lead to dilation of coronary sinus because coronary
sinus drains into right atrium
149. Deep palmar arch bleed after the trauma of a child,
what should be done as first aid to stop bleeding? - ID : 156. A female patient Delivered a baby Bay with a tuft of
83226 hair at the back mother was taking a diet rich in proteins
and carbohydrates but deficient in fruits and vegetables.
Ⓐ Pinch brachial artery Ⓑ Pinch ulnar artery Neural tube defect like Spina bifida occurs due to a
Ⓒ Pinch radial and ulnar artery deficiency of - ID : 83490
Ⓓ Pinch radial artery against humerus
Ⓐ Folic acid Ⓑ Iron
Ⓓ Supericial palmar arch (continuation of the ulanr artery and Ⓒ Vitamin B12 Ⓓ Vitamin K
often completed by the superior palmar branch of radial artery on Ⓔ Vitamin E
the lateral side) lies on the long flexor tendons just beneath the
palmar aponeurosis. Ⓐ EXPLANATION
✦ SNELL, Pg. 402
157. A 16. year. old female presents with hypertension
150. In granulopoiesis, 1st cell that appears having and increasing weight. Which of the following features
granule - ID : 83395 would be most suggestive of Cushing's syndrome rather
than simple obesity? - ID : 83923
Ⓐ Promyelocyte Ⓑ Myelocytes
Ⓒ Metamyelocyte Ⓓ Band cells Ⓐ Abdominal striae Ⓑ Acanthosis nigricans
Ⓒ Buffalo hump (interscapular fat pad)
Ⓐ Granulopoiesis : first cell that appears having granules is Ⓓ Pot belly Ⓔ Amenorrhea
promyelocyte
Ⓐ ✪ Cushing syndrome ☛ ↑ protein breakdown ➜ wasting and
151. Promotor cause carcinogenesis by - ID : 83405
thinning of skeletal muscles ➜ atrophy of skin and subcutaneous
Ⓐ Enhancing DNA Proliferation tissue with formation of purple striae on abdominal wall.
Ⓑ Inhibit DNA proliferation ✪ Other features ☛ Truncal obesity with relatively thin arms and
Ⓒ Enhancing DNA synthesis Ⓓ Inhibiting apoptosis legs, buffalo hump, rounded oedematous moon-face, Systemic
hypertension, Impaired glucose tolerance, diabetes mellitus,
Ⓐ Promoters encourage growth of cells that have already amenorrhoea, hirsutism, Insomnia, depression, confusion and
undergone some degree of mutation due to the action of psychosis.
carcinogens. They enhance DNA proliferation, promoting rapid ✦ Harsh Mohan, Pg. 788
division and growth of these already altered cells, which could lead
158. A middle age known ESRD lists for hemodialysis
to tumor formation.
multiple transfusions done Normocytic normochromic
152. Altered nuclear-cytoplasmic N/C ratio in dysplasia - anemia which is more appropriate therapy: - ID : 84011
ID : 83411
Ⓐ S/C erythropoietin Ⓑ S/C CGF
Ⓐ Abnormal DNA production Ⓑ DNA damage Ⓒ Iron supplements Ⓓ Inj Vitamin B 12IM
Ⓔ Inj Folate IV
Ⓐ EXPLANATION
Ⓐ Erythropoietin ☛ stimulates the production of RBCs in bone
153. Cerebrospinal fluid (Csf) is: - ID : 83430
marrow.
Ⓐ Ecf Ⓑ Plasma In ESRD ☛ kidneys don't produce sufficient erythropoietin ➜
Ⓒ Interstitial fluid Ⓓ Transcellular fluid decreased production of RBCs ➜ Anemia.Iron supplements, ☛
Ⓔ ICF might be expected to help with anemia. However, in this case, the
anemia is most likely due to decreased erythropoietin production
Ⓓ Transcellular fluid is the portion of total body water contained
within epithelial-lined spaces. It is the smallest component of 159. A 35-year-old HIV-positive man presents with
extracellular fluid, which also includes interstitial fluid and plasma. diarrhea of 4 weeks' duration accompanied by tenesmus.
Examples of this fluid are cerebrospinal fluid, ocular fluid, and joint Blood and mucus are present in the stool. He is not on
antiretroviral therapy. Which of the following is the most
fluid.
likely diagnosis? - ID : 86495
154. Athlete after marathon drink distilled water, before
this what is the body condition - ID : 83480

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Ⓐ Cryptosporidiosis Ⓐ ✪ In a pregnant lady ➜ bacterial contamination of transfused

Ⓑ Cytomegalovirus (CMV) colitis blood ➜ would be an immediate and serious concern ➜ as it can
Ⓒ Giardiasis Ⓓ Microsporidiosis lead to sepsis, endangering both the mother and fetus.

Ⓑ Cytomegalovirus (CMV) colitis: The clinical presentation of 163. Elder patient has head injury due to fall there loss of
chronic diarrhea with blood and mucus in the stool in an HIV- memory. - ID: 94791
positive patient is suggestive of CMV colitis. Cytomegalovirus Ⓐ Parietal lobe Ⓑ Temporal lobe
(CMV) is an opportunistic virus that can cause gastrointestinal Ⓒ Occipital lobe Ⓓ Frontal lobe
infections in individuals with weakened immune systems, including
those with HIV/AIDS.Cryptosporidiosis: is another parasitic Ⓑ Temporal lobe ☛ crucial for memory functions.✪ A head injury
infection that can cause diarrhea in HIV-positive patients, but it affecting this region could result in memory loss
typically presents with watery diarrhea, not blood and mucus.
Giardiasis: caused by the protozoan parasite Giardia lamblia and 164. 24 year old woman pregnant in second trimester
can lead to diarrhea, but it does not usually cause blood and pregnancy terminate, spontaneous abortion something
mucus in the stool. like that how man chromosome??? - ID: 94792
Microsporidiosis: can cause gastrointestinal infections in Ⓐ 69 Ⓑ 47
immunocompromised individuals, but it is not a common cause of Ⓒ 46 Ⓓ 23
chronic diarrhea with blood and mucus in HIV-positive patients.
Ⓒ ✪ The number of chromosomes remains the same (46) →
160. What is the most sensitive test to evaluate the
synthetic function of the liver? - ID: 87212 regardless of pregnancy status or spontaneous abortion.

Ⓐ PT Ⓑ APTT 165. Glucocorticoids suddenly stop, Cause - ID: 94793

Ⓒ Albumin Ⓓ Bilirubin
Ⓐ Prothrombin time (PT): The liver produces factors necessary
for blood coagulation, and an elongated PT suggests impaired liver
synthetic function.APTT (Activated Partial Thromboplastin
Time): is less specific for liver function as it measures factors from
both intrinsic and common coagulation pathways.
Albumin level: can reflect liver synthetic function, but it's less
sensitive due to the long half-life of albumin.
Bilirubin: is more reflective of liver's excretory function rather
than its synthetic function.
161. A 57-year-old female presents with headache and
fever to the Emergency Department. On examination neck
stiffness is noted along with a positive Kernig's sign. A
lumbar puncture is performed and reported as follows:
CSF culture Gram positive bacilli What is the most likely
causative organism? - ID: 94504
Ⓐ Cryptococcus Ⓑ Haemophilus influenzae
Ⓒ Streptococcus pneumoniae Ⓓ Cryptosporidium
Ⓔ Listeria monocytogenes f Naegleria
Ⓐ Reflex hyperglycemia Ⓑ Hypoglycemia
Ⓒ Adrenal crisis Ⓓ Hyperkalemia
Ⓐ ✪ Sudden cessation of glucocorticoids → can lead to reflex
hyperglycemia → as the body responds to the lack of this hormone
that normally raises blood sugar levels.
166. American woman of African origin, with anemia,
abdominal pain. which is other finding present in it???? -
ID: 94794
Ⓐ Jaundice Ⓑ Hemolysis
Ⓒ Splenomegaly Ⓓ Sickle cells on blood smear
Ⓓ Findings ☛ presentation of anemia and abdominal pain in an
American woman of African origin suggests the possibility of sickle
cell disease, a condition that is more prevalent among people of
African descent.
✪ A characteristic finding in sickle cell disease would be the
presence of sickle-shaped cells on a blood smear.
167. Axillary nerve location on humerus: - ID: 94795

Ⓐ Surgical neck Ⓑ Anatomical neck

Ⓔ Causative organism ☛ Patient presents with signs of
Ⓒ Greater tubercle Ⓓ Medial epicondyle
meningitis (headache, fever, neck stiffness, positive Kernig's sign)
and the CSF culture shows Gram-positive bacilli. In a 57-year-old,
Ⓐ Axillary nerve ☛ passes through the surgical neck of the
Listeria monocytogenes is a prime suspect. This organism tends to
humerus, making it vulnerable to injury in fractures at this
affect older adults, the immunocompromised, and neonates. It
location.
shows up as Gram-positive bacilli on a CSF culture, making it the
most likely culprit.Cryptococcus: is a fungus, not a Gram-positive 168. Deep peroneal artery skin supply - ID: 94796
bacillus. It is more commonly seen in immunocompromised
Ⓐ Anterior leg Ⓑ Medial thigh
individuals and would not present as Gram-positive bacilli in a
Ⓒ Lateral thigh Ⓓ None
culture.
Haemophilus influenzae: is a Gram-negative coccobacillus and
Ⓓ Deep peroneal artery ☛ doesn't typically supply the skin; it
would not present as Gram-positive bacilli in a culture.
primarily supplies the deep structures of the anterior compartment
Streptococcus pneumoniae: is a Gram-positive coccus and also
of the leg.
a common cause of bacterial meningitis, but it would not present
as Gram-positive bacilli. 169. Neurophysiologist trying to generate impulse but
Cryptosporidium: is a protozoan parasite and would not present unable to do so due to - ID: 94824
in a bacterial culture. It causes gastrointestinal symptoms, not
Ⓐ Hypercalcemia Ⓑ Hypocalcemia
meningitis.
Ⓒ Hyperkalemia Ⓓ Hypokalemia
Naegleria: is an amoeba that primarily causes primary amoebic
meningoencephalitis. It is not a bacterium and would not present
Ⓐ Hypercalcemia ☛ can cause decreased neuromuscular
as Gram-positive bacilli on a CSF culture.
excitability, making it difficult to generate a nerve impulse.
162. Reaction after blood transfusion in pregnant lady - ID:
94790 170. Lumbar artery branches of - ID: 94825

Ⓐ Bacterial contaminated blood Ⓐ Aorta Ⓑ Iliac artery

Ⓑ Host vs graft reaction Ⓒ Cold blood transfuse Ⓒ Femoral artery Ⓓ Renal artery
Ⓓ Hemolytic reaction

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Ⓐ Lumbar arteries ☛ are direct branches from the aorta and

Ⓐ Great saphenous vein Ⓑ Radial artery
supply the lumbar region of the back.
Ⓒ Internal mammary artery Ⓓ Femoral artery
171. PH 7.47 analgesics toxicity. of - ID: 94826
Ⓐ Great saphenous vein ☛ commonly used in coronary artery
Ⓐ Brufen Ⓑ Ibuprofen bypass graft (CABG) surgeries as it can be easily harvested and is
Ⓒ Mefenamic acid Ⓓ Paracetamol long enough for multiple grafts.

Ⓒ ✪ pH of 7.47 ☛ indicates alkalosis, which could be seen in 180. Triploidy in meiosis - ID: 95020
cases of Mefenamic acid overdose → causing metabolic changes
Ⓐ 69 Ⓑ 46
that lead to alkalosis.
Ⓒ 47 Ⓓ 23
172. Right ovarian artery drain into - ID: 94827
Ⓐ Triploidy ☛ refers to having an extra complete set of
Ⓐ IVC Ⓑ Right renal
chromosomes.✪ In humans, who normally have 46 chromosomes,
Ⓒ Left renal Ⓓ Gonadal vein
this means having 69 chromosomes in total.
Ⓐ ✪ Right ovarian vein ☛ typically drains into the inferior vena 181. Echinocandin - ID: 95021
cava (IVC), whereas the left ovarian vein generally drains into the
Ⓐ C. krusei Ⓑ Aspergillus fumigatus
left renal vein.
Ⓒ Candida albicans Ⓓ Cryptococcus neoformans
✪ Therefore, the right ovarian artery → after supplying the
ovary → would have its venous counterpart drain into the IVC. Ⓐ Echinocandins ☛ like caspofungin, micafungin, and
173. Gram positive rods lactose fermenting which cause anidulafungin are particularly effective against Candida species,
UTI high pus cells in urine R/E? - ID: 94828 including C. krusei which may be resistant to other antifungals.

Ⓐ Enterococcus faecalis Ⓑ Staphylococcus aureus 182. Neck condyloma scenario - ID: 95022
Ⓒ Streptococcus pyogenes Ⓓ E. Coli
Ⓐ Acute / liquefactive Ⓑ Chronic / caseous
Ⓒ Acute / coagulative Ⓓ Chronic / fibrous
Ⓐ ✪ Enterococcus faecalis ☛ is a Gram-positive rod (or more
accurately, coccus in most classifications) → that can ferment Ⓐ ✪ Condyloma (a wart-like growth, often related to HPV
lactose and is one of the causative agents of urinary tract
infection) → is in an acute phase and displays liquefactive necrosis.
infections (UTIs) → that may present with high pus cells in urine
✪ Liquefactive necrosis is a type of tissue death where the affected
R/E.
cells are liquefied, commonly seen in abscess formation.
174. In early sage of HIV lymph node histological changes
183. Optic disc edema - ID: 95023
? - ID: 94829
Ⓐ Acute hypertension Ⓑ Chronic hypertension
Ⓐ Follicular hyperplasia Ⓑ Paracortical expansion
Ⓒ Diabetes mellitus Ⓓ Glaucoma
Ⓒ Granulomas Ⓓ Follicular lysis

Ⓓ ✪ In the early stages of HIV infection ☛ there is often follicular Ⓐ ✪ Optic disc edema ☛ commonly seen in conditions of acute
hypertension.
lysis within lymph nodes as part of the body's immune response.
✪ Elevated blood pressure → can lead to vascular compromise and
175. Trisomy occurs - ID: 94830 fluid leakage → causing edema at the optic disc.
Ⓐ Down syndrome Ⓑ Turner syndrome 184. Antibodies in thyroid disease - ID: 95024
Ⓒ Klinefelter syndrome Ⓓ Edwards syndrome
Ⓐ Thyroid stimulating receptors antibodies
Ⓐ ✪ Trisomy 21 ☛ commonly known as Down syndrome Ⓑ Thyroglobulin antibodies
→ characterized by an extra copy of chromosome 21. Ⓒ Thyroid peroxidase antibodies
Ⓓ Anti-TSH antibodies
176. Headache - ID: 95015
Ⓐ ✪ Thyroid-stimulating receptor antibodies ☛ are often
Ⓐ Rhinosinusitis Ⓑ Tension headache
Ⓒ Migraine Ⓓ Cluster headache
present in conditions like Graves' disease → where they activate
the thyroid-stimulating hormone receptor → leading to
Ⓐ Rhinosinusitis ☛ can cause headaches due to the inflammation overproduction of thyroid hormones.
and pressure in the sinus cavities. 185. Interwoven bodies - ID: 95025
177. Same age group vasculitis - ID: 95016 Ⓐ Intermediate filament Ⓑ Microfilament
Ⓐ Microscopic polyangiitis Ⓑ Giant cell arteritis Ⓒ Microtubule Ⓓ Nuclear lamina
Ⓒ Takayasu arteritis Ⓓ Kawasaki disease
Ⓐ ✪ Intermediate filaments ☛ provide structural stability to
Ⓐ ✪ Microscopic polyangiitis ☛ often affects people of the same cells and are one of the three main components of the
age group and involves inflammation of small- and medium-sized cytoskeleton.They are interwoven and more stable compared to
blood vessels. microfilaments and microtubules.

178. Uremia scenario - ID: 95018

Ⓐ Platelet function defect Ⓑ Hyperkalemia

Ⓒ Metabolic alkalosis Ⓓ Hyponatremia

Ⓐ ✪ In Uremia ☛ platelet function can be impaired → leading to a

bleeding tendency.
This is due to a variety of factors including platelet dysfunction.

179. Heart surgery - ID: 95019

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