Medi Call FCPS – 1 | MAY 2023 PAPERS

Ⓐ ✪ Dopamine ☛ ∼ 2 mins ✪ Thiopental ☛ ∼ 9 hours

✪ Ketamine ☛ 2.5-3 hrs ✪ Propofol ☛ 2-24 hrs

Med 23 May 2023 7. A Patient presents with neck rigidity. He has history of
weight loss, headache and photophobia in last 3 days.
kernig sign is positive. His labs show CSF protein

(A.N)
400mg/dl. Glucose 35 mg/dl . WBCs Raised with 400
Iymphocytes. Diagnosis would be? (Med 25 May 2023 (M) +16
past) - ID: 2263

Ⓐ Tuberculous meningitis (TBM) Ⓑ Bacterial mengintits

1. Patient having liver cirrhosis with Secondary Ⓒ Viral meningitis Ⓓ Encephalitis
Hyperaldosteronism. It can occur due to? (+4 past) - ID: 253
Ⓐ ✪ TBM ☛ ◉ ↑ CSF Pressure ＞ 180 ◉ ↓ Glucose ＜ 40 ◉ ↑ Proteins ＞
Ⓐ Increased renin Ⓑ Decreased rennin
100mg ◉ ↑ WBCs ＞100 ( Lymphocytes )
Ⓒ Increased potassium Ⓓ Hypertension
8. Following drug is used in hepatic transplant without
Ⓐ ↑↑ Serum renin ➜ conversion of angiotensinogen to angiotensin I ➜ causing Bone Marrow Suppression but cause
converted by angiotensin-converting enzyme to angiotensin II ➜ Nephrotoxicity. (Med 23 May 2023 (A.N) +13 past) - ID: 2938
↑↑ aldosterone ➜ Secondary Hyperaldosteronism.
✦ BRS Pathology, Pg. 330
Ⓐ Cyclophosphamide Ⓑ Cyclosporine
Ⓒ Azathioprine Ⓓ Methotrexate
2. The process of apoptosis is loss during the carcinogenic
activity. Which of the following is a tumour supressor gene Ⓑ ✪ Cyclosporine ☛ has dose-related nephrotoxicity without causing
and Antiapoptotic factor ? (Med 23 May 2023 (A.N) +14 past) - ID: marked bone marrow suppression.
370 ✪ All other cause Bone Marrow suppression.
Ⓐ Ras Ⓑ Bcl2
9. A person at the end of the marathon race will have: (Med
Ⓒ ABL Ⓓ AFP 23 May 2023 (A.N) +26 past) - ID: 3447

Ⓑ Bcl-2 keeps the mitochondrial membrane impermeable ➜ preventing Ⓐ High insulin and low glucagon
cytochrome C release ➜ ↓ activation the caspase family of proteases ( Ⓑ High glucagon and high insulin
primary trigger leading to the onset of apoptosis ) ➜ ↓ Appoptosis Ⓒ High glucagon and low insulin
Bcl-2 normally☛ Antiapoptotic , But become proapoptotic when cell Ⓓ High cortisol
become mutated whose DNA can not be repaired
✦ First Aid, Pg. 208,224, 208,224, 208,224 ✦ Robbins, Pg. 47 ✦ Ⓒ Marathon race ☛ ↓ Blood glucose ➜ ↓ insulin and ↑ Glucagon ➜ ↑
Pathoma, Pg. 27 blood glucose levels ( provide energy ).
✦ Guyton, Pg. 993 ✦ BRS Physiology, Pg. 250
3. How does the Fatty acid from adipose tissues is
transported in blood? (Radio 23 May 2023 (A.N) +2 past) - ID: 666 10. LVF occurs due to which malfunctioning (Med 23 May 2023
(A.N) +5 past) - ID: 3782
Ⓐ Free fatty acid bound to albumin
Ⓑ Cholymicrons Ⓐ Mitral stenosis Ⓑ Aortic stenosis
Ⓒ Triglycerides bound to albumin Ⓒ Tricuspid stenosis Ⓓ Tricuspid regurgitation
Ⓓ VLDL
Ⓑ Failure of aortic valve leaflets to open fully during systole ➜ Aortic
Ⓐ Free fatty acids ☛ transported in bounded form with plasma stenosis ➜ increase in afterload ➜ left ventricular hypertrophy (
proteins ➜ mostly albumin. Concentric ) ➜ left ventricular dysfunction ( Eccentric ) ➜ eventually
congestive heart failure.
4. The patient came in ER with chest pain ECG normal ✦ Harsh Mohan, Pg. 451
cardiac enzymes normal doctor advised thoracic cage X.
RAY. Which one of these structures is a primary 11. Child presented with decreased breath sounds and
cartilaginous Amphiarthrosis joint? (Med 23 May 2023 (A.N) +14 chest movement on left side which improved on holding
past) - ID: 894 him up CXR revealed coils of intestine on left side of chest.
Cause of congenital diaphragmatic hernia is (Med 23 May 2023
Ⓐ Costochondral Ⓑ Teeth and jaw (A.N) +9 past) - ID: 4090
Ⓒ Inferior tibiofibular joint Ⓓ Sutures of skull
Ⓐ Absence of pleuropericardial membrane
Ⓔ Sutures of skull
Ⓑ Absence of septum transversum
Ⓐ Costochondral joint is a primary cartilaginous joint (The bones Ⓒ Incomplete pleruperitioneal membrane
involved are connected by hyaline cartilage . It also sometimes occur Ⓓ Absence of central tendon
between ossification centers)
Ⓒ The Diaphragm embryologically originates from pleuro-peritoneal
5. At which stage the RBC nuclei is disappeared (Radio 23 May membrane and if it is defective or incomplete, it leads to congential
2023 (A.N) +11 past) - ID: 1005 diaphragmatic hernia that is protrusion of one or more of the abdominal
organs into the chest where their lungs should be.
Ⓐ Erythroblasts Ⓑ Late Normoblast
✦ Kaplan Anatomy, Pg. 94
Ⓒ Early normoblasts Ⓓ Reticulocytes
12. A patient can survive without mechanical ventilation
Ⓑ Orthochromatic / Late normoblast ☛ Nucleus is expelled after RTA, due to respiration is working properly if the
before cell becomes reticulocyte. lesion is (Med 23 May 2023 (A.N) +5 past) - ID: 4108
✦ Wikipedia, Pg.
Ⓐ Above C2 Ⓑ At C4
6. Shortest half life of which substance which needs Ⓒ Below C5 Ⓓ At C1
continuous IV supply is following (Med 23 May 2023 (A.N) +2
past) - ID: 1015 Ⓒ Above C4 ☛ Respiratory arrest. ( Phrenic nerve root value ☛ C3, 4,
Ⓐ Dopamine Ⓑ Thiopental 5 ).
✦ Gray's Neuroanatomy, Pg. 144
Ⓒ Ketamine Ⓓ Propofol

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13. Most aggressive carcinoma is which of the following Ⓐ Microcytic Hypochromic anemia
(Gynae 24 May 2023 (M) +31 past) - ID: 4321 Ⓑ Normocytic Hypochromic Ⓒ Normocytic
Ⓐ SCC Ⓑ BCC Normochromic
Ⓓ Macrocytic anemia
Ⓒ Melanoma Ⓓ Lichen planus

Ⓐ Normal RBCs have a diameter of 6 - 8 μm. Anemia causes a reduced

Ⓒ Melanoma ☛ less common than BCC and SCC But more dangerous
red blood cell volume (hematocrit) or a reduced concentration of blood
because of its ability to spread to other organs more rapidly
✦ Skincancer.org, Pg.
hemoglobin ( Thinning ). Microcytic, Hypochromic anemia can simply be
caused by Iron Deficiency. ( Ref : Kaplan )
14. Child has hemophilia. His 2 sisters are unlikely to have
this condition because Hemophilia is: (Surg 24 May 2023 (A.N) 20. What is main determinant of coronary circulation that
+21 past) - ID: 4812 produces greater effects on circulation and causes
increase coronary blood flow during exercise? (Med 23 May
Ⓐ X linked recessive Ⓑ Autosomal dominant 2023 (A.N) +6 past) - ID: 9734
Ⓒ Autosomal recessive Ⓓ X linked dominant
Ⓐ Sympathetic stimulation
Ⓑ Local metabolites and oxygen demand
Ⓐ ✪ Hemophilia ☛ X-linked recessive
✦ Harsh Mohan, Pg. 260 Ⓒ Parasympathetic output Ⓓ All of above

15. Hering Breuer reflex is due to? (Surg 25 May 2023 (M) +6 Ⓑ When myocardial oxygen consumption is increased, as during
past) - ID: 4976 exercise, coronary vasodilation and increased oxygen delivery are
Ⓐ Stretch receptors in bronchioles critical to preventing myocardial underperfusion and ischemia. Exercise
coronary vasodilation is thought to be mediated primarily by the
Ⓑ Irritants Ⓒ Receptors
production of local metabolic vasodilators released from cardiomyocytes
Ⓓ None of above
secondary to an increase in myocardial oxygen consumption.
Ⓐ located in the muscular portions of the walls of the bronchi and 21. What happened after 1000 ml normal saline infusion?
bronchioles throughout the lungs are stretch receptors that transmit (Med 23 May 2023 (A.N) +6 past) - ID: 9894
signals
Ⓐ Blood volume increases Ⓑ Na excretion decreases
✦ Guyton, Pg. 540
Ⓒ Osmolality increases Ⓓ Renin secretion increases

Ⓐ ✪ Isotonic saline infusion ➜ No effect on osmolirity ➜ No osmosis or

diffusion across membrane ➜ Just ECF vol ↑
✦ Guyton, Pg. 312

22. Pt with history of recurrent UTI to emergency with

fever 103 ,tachycardia, bp 40/80. Which type of shock will
be present due to Gram -ve infection (Med 25 May 2023 (A.N)
+15 past) - ID: 10039

Ⓐ Septic shock Ⓑ Hypovolumic shock

Ⓒ Cardiogenic shock Ⓓ Anaphylactic shock

Ⓐ ✪ Normal flora translocation (E.coli G㊀ rod in colon) ➜ UTI ➜ Acute

pyelonephritis ➜ Urosepsis ➜ septic shock.
✪ Biliary tract ➜ communicates with small bowel ➜ No Ascending
infcetion in absence of billiary tract pathology.
✦ Davidson, Pg. 103 ✦ Levinson, Pg. 155, 155, 155

23. True about achalasia cardia ? (Med 23 May 2023 (A.N) +15
past) - ID: 10389

Ⓐ Loss of inhibitory ganglion of myenteric plexus.

Ⓑ No role of enteric nervous system
Ⓒ Upper esophageal relaxation is incomplete
18. Patient has weakness of forearm .wasting of thenar Ⓓ Occurs only at pharyngoesophagus junction
muscles and loss of sensation of lateral 2/3rd of fingers
and palm. Which nerve is likely involve in Transverse Ⓐ Achalasia ☛ caused by loss of inhibitory ganglion cells of Myenteric
carpal ligament damage ?? (Med 23 May 2023 (A.N) +8 past) - plexus in lower two thirds of Esophagus ➜ lower esophageal sphincter
ID: 7108 fails to relax during swallowing ➜ Bolus fails to pass from the
Ⓐ Radial nerve Ⓑ Musclucutenous nerve esophagus into the stomach
✦ Guyton, Pg. 843 ✦ Robbins, Pg. 591
Ⓒ Median nerve Ⓓ Ulnar nerve
24. Adductor muscles are supplied by which nerve? (Surg 24
Ⓒ Carpal Tunnel ☛ compression of Median nerve ➜ burning pain or May 2023 (M) +5 past) - ID: 11111
“pins and needles” to lateral three and a half fingers + weakness and
wasting of Thenar muscles Ⓐ Saphenous nerve Ⓑ Obturator
▶ No paresthesia over thenar eminence because this area of skin is Ⓒ Common paroneal Ⓓ Tibial nerve
supplied by the palmar cutaneous branch of the median nerve, which
passes superficially to the flexor retinaculum Ⓑ ✪ Adductor muscle ➜ ● Gracilis ● adductor brevis ● adductor longus
● obturator externus ● pectineus ● adductor magnus (adductor
✦ SNELL, Pg. 398 ✦ Netter, Pg. portion)
✪ Nerve Supply ➜ obturator nerve
19. A young Female presents with weakness and ✪ Arterial Supply ➜ profunda femoris, assisted proximally by obturator
lethargy.Her peripheral blood picture shows RBCs 5.5
artery.
diameter and very thin red line of RBCs. Likely diagnosis is ✦ RJ Last, Pg. 202 ✦ SNELL, Pg. 223
(Gynae 24 May 2023 (M) +6 past) - ID: 9658

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25. Pan systolic murmur in the aortic area, left ventricular Ⓐ ✪ FEV1/FVC ➜ % Amount of air you can forcefully exhale from
hypertrophy (LVH), and atrial fibrillation (Afib), the most your lungs
likely Diagnosis? (Med 23 May 2023 (A.N) +3 past) - ID: 12233 ✪ FEV1 ➜ volume of breath exhaled with effort in first second (
Normal value : 80% )
Ⓐ Mitral regurgitation Ⓑ Aortic regurgitation
Obstructive lung disease ( ◉ Asthma ◉ COPD ◉ Chronic Bronchitis ◉
Ⓒ Tricuspid regurgitation Ⓓ Aortic stenosis
Emphysema ◉ Bronchiectasis ) ➜ Decrease in elastic recoil ➜
Ⓐ Pansystolic murmur in the aortic area is indicative of mitral Distended Lungs ➜ Decreased Expiratory flow ➜ Both FEV1 and FVC
regurgitation are reduced, but FEV1 is reduced more than FVC thus ➜ FEV1/FVC is
decreased
26. In autosomal dominant genetic defect, if ✦ BRS Physiology, Pg. 221 ✦ Kaplan Physiology, Pg. 157
phentyphically it is not expressed, pattern is (Med 23 May
2023 (A.N) +9 past) - ID: 12537 32. Which of the following drug is Nephrotoxic and
Ototoxic and should be reduced in renal impairment: (Med
Ⓐ Pleotropy Ⓑ Reduced penetrance 23 May 2023 (A.N) +23 past) - ID: 14905
Ⓒ Variable expressivity Ⓓ Codominance
Ⓐ Gentamicin Ⓑ Rifampicin
Ⓑ ✪ Incomplete/ Reduced penetrance ☛ Some persons Ⓒ Penicillamine Ⓓ Phenytoin
inherit mutant gene but are phenotypically normal Example: BRCA1
gene mutations do not always result in breast or ovarian cancer
Ⓐ Aminoglycosides ( gentamicin ) ☛ Nephrotoxic and Ototoxic.
✦ Robbins, Pg. 246
33. Zollinger Ellison Syndrome causes increase stomach
27. Dialysis is monitored by clearance of (Med 23 May 2023 dumping and leads to which of following (Med 23 May 2023
(A.N) +5 past) - ID: 12580 (A.N) +6 past) - ID: 14995

Ⓐ Urea Ⓑ Inulin Ⓐ Dec. gastrin Ⓑ Increase Insulin

Ⓒ Creatinine Ⓓ PAH Ⓒ Peptic ulcer disease

Ⓒ ✪ Dialysis is an artificial cleansing of nitrogeneous wastes of body. Ⓒ Zollinger-Ellison syndrome ☛ Gastrinomas ➜ ↑

Its effectiveness and frequency is monitored by serum Creatinine level. Gastrin ➜ Hypersecretion of HCL ➜ severe peptic ulceration
✦ CMDT, Pg. 942 ✦ Robbins, Pg. 784

28. Phasic, Rapidly Adapting receptors that sense Pressure 34. Which drug can be given preoperatively to a patient
and vibration? (Med 23 May 2023 (A.N) +56 past) - ID: 12901 with liver decompensation? (Med 23 May 2023 (A.N) +15 past) -
ID: 15077
Ⓐ Ruffini Ⓑ Merkels
Ⓒ Paccinian Ⓓ Baroreceptors Ⓐ Oxazepam Ⓑ Diazepam
Ⓒ Lorazepam Ⓓ Fentanyl
Ⓒ Pacinian corpuscles ☛ Rapidly adapting, deep , encapsulated
Ⓒ Lorazepam ☛ safest benzodiazepine in elderly and in patients with
receptors ➜ high-frequency vibrations in the skin + gross pressure
liver disease.
changes.
✦ First Aid, Pg. 494 ✦ Duane Neurosceince, Pg. 244 ✦ Guyton, Pg. 35. A male has cholangio carcinoma. Which of the
615, 608
following organism will be responisble: (Med 23 May 2023 (A.N)
29. Effect of Digoxin may increase and cause Toxicity by +13 past) - ID: 15222
which of the following ? (Med 23 May 2023 (A.N) +11 past) - ID: Ⓐ S. mansoni Ⓑ C.sinesis
13753
Ⓒ S. hematobium Ⓓ Wuchreria
Ⓐ Hypoglycemia
Ⓑ Use of Non K+ sparing Diuretics Ⓑ Clonorchis sinensis ( Asian / Chinese liver fluke) Encysted larvae
Ⓒ Hyponatremia Ⓓ Hypermagnesemia (metacercariae) in raw or undercooked fish ➜ Excystation in
duodenum ➜ Immature flukes enter biliary ducts ➜ Differentiate into
Ⓑ ✪ Non K Sparing diuretics ☛ Hypokalemia ➜ digoxin easily binds adults ➜ Inflammatory response ➜ Hyperplasia and fibrosis of the
ATPase pump ➜ ↑ Digoxin toxicity. biliary tract.
✪ Digoxin toxicity is Worsen by HYPO-kalemia and it further causes ☛ Heavy infection ➜ Cholangitis and Cholangiohepatitis.
HYPER-kalemia. ☛ Increased risk of Cholangiocarcinoma.
✦ Oxford Microbiology, Pg. 565 ✦ Levinson, Pg. 466
30. An English businessman developed headaches,
vomiting high-grade fever, chills and rigors after coming 36. Right lung middle lobe segment names (Med 23 May 2023
back from Thailand. Clinical examination reveals massive (A.N) +6 past) - ID: 15449
splenomegaly associated to pale conjunctive. Labs show
Ⓐ Medial apical Ⓑ Medial and lateral segments
deranged RFTs and decreased Hb, WBCs and Platelets.
Ⓒ Lateral segment Ⓓ Apical segment
What will be the diagnosis? (Gynae 24 May 2023 (M) +7 past) -
ID: 13987
Ⓑ ● Rt.Upper Lobe ➜ Segments ➜ 1. Apical 2. Posterior 3.
Ⓐ Chagas disease Ⓑ UTI Anterior ● Middle Lobe ➜ 4. Lateral 5. Medial ● Lower Lobe ➜ 6.
Ⓒ Pyelonephritis Ⓓ Malaria Superior 7. Medial basal 8. Anterior basal 9. Lateral basal 10. Posterior
basal
Ⓓ Malaria causes abrupt onset of fever and chills, alongwith headache, ✦ BD Chaurasia, Pg. 240
myalgias and arthralgias. This occurs after about 2 weeks of mosquito
37. Amount of end-diastolic volume that is pumped out
bite.Southeast asia is endemic for malaria
with each beat is: (Med 23 May 2023 (A.N) +6 past) - ID: 15701
31. One of the following is related to the diagnosis of
Ⓐ Mean systemic volume Ⓑ Systemic vascular
obstructive lung disease, asthma in 20 yr. old male? (Med 23
May 2023 (A.N) +31 past) - ID: 14885 resistance
Ⓒ Cardiac output Ⓓ Ejection fraction
Ⓐ FEV1/FVC less than 65% Ⓑ PO2 =40 mmHg
Ⓒ Respiratory rate=12 Ⓓ Tidal volume 500 ml Ⓓ ✪ Ejection fraction is a measurement of the percentage of blood
leaving your heart each time it contracts.
✦ Guyton, Pg. 115

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38. A 35 years old male laborer present with acute, sudden
pain starting from the lower lumbar area and radiating
along the posterior aspect of the left lower limb. His
symptoms started after lifting a heavy container 3 days
back. On examination, straight leg raising is restricted to
only 30 degrees on the left side, decreased sensation
along lateral border of left foot,difficulty to Evert,
weakness of left flexor hallucis longus and diminished
ankle jerk. This patient has compression of? (Med 23 May 2023
(A.N) +29 past) - ID: 15823
Ⓐ S1 root Ⓑ S3 root
Ⓒ S4 root Ⓓ S5 root
Ⓐ Most common causes of pain that originate in the lumbosacral
segment ➜ L5-S1 Disc herniation as Compression ➜ S1 Root
Compression ➜ Sciatica ➜
✔ Numbness ✔ Paresthesias ✔ Weakness
✔ Pain in buttocks that radiates down behind the thigh to back of calf
and then to top of the foot
✔ Difficult plantar flexion ✔ Diminished ankle jerk
✦ SNELL, Pg. 525, 525 ✦ First Aid, Pg. 458
39. During bronchoscopy first structure visible is (Med 23
May 2023 (A.N) +17 past) - ID: 15895
Ⓐ Upper lobe Ⓑ Upper basal lobe
Ⓒ Lower basal lobe Ⓓ Middle lobe
Ⓐ Structures seen in bronchoscopy are right upper lobe bronchus
Ⓐ Prevention of disease Ⓑ Limiting disease
Ⓒ Early detection
Ⓓ Early stage tumor has better treatment outcomes
Ⓒ The primary purpose of screening tests is to detect early disease or
risk factors for disease in large numbers of apparently healthy
individuals. Higher costs associated with diagnostic tests are justified to
establish the diagnosis.
44. Sub-dural hemorrhage is due to damage to: (Med 23 May
2023 (A.N) +17 past) - ID: 16650
Ⓐ Superior cerebral vein Ⓑ Middle cerebral vein
Ⓒ Inferior cerebral vein
Ⓓ The anterior division of middle meningeal artery
Ⓐ 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
45. Bad news when delivered to patient, should ideally be
(Med 23 May 2023 (A.N) +8 past) - ID: 17776
Ⓐ At bedside
Ⓑ All the staff involved in patient's care should be present
Ⓒ In front of all family members
Ⓓ In doctor's office, in a formal session, in environment of
exclusivity

40. Child has puffy face and pedal edema. Urine shows Ⓓ Bad news should be broken following the codes of medical
proteinuria . Edema in Nephrotic syndrome occurs due to ethics.Breaking bad news to individuals who are seriously ill and have a
which of the following? (Surg 25 May 2023 (M) +14 past) - ID: poor prognosis is a complex and contentious issue. Arguments for
15954 disclosure of bad news generally appeal to basic ethical principles such
as respect for patient autonomy, doing good (beneficence) and avoiding
Ⓐ Na and water restriction Ⓑ Increased venous pressure
harm (nonmaleficence).
Ⓒ Hypoalbuminemia Ⓓ Lymphatic obstruction
Ⓔ Shock by injection 46. Primary and most important objective of Screening in
cancer is (Med 23 May 2023 (A.N) +8 past) - ID: 17853
Ⓒ If protein loss exceeds hepatic synthesis (usually with a loss of
Ⓐ Detect disease which are treatable
protein ＞ 3.5 g/24hours) ➜ hypoproteinemia/hypoalbuminemia ➜
Ⓑ Detect disease at early stage
Decreased colloid osmotic pressure ➜ edema (especially if albumin
Ⓒ Socially acceptable Ⓓ Cheap
levels ＜ 2.5 g/dl) ( Robbins )
✦ Guyton, Pg. 196
Ⓑ Detection of cancer at early stage is associated with better prognosis
41. Anterior (Sternocostal) surface of the heart is formed
47. The Taste sensations from post 1/3 of tounge is taken
by (Med 25 May 2023 (M) +41 past) - ID: 16413
by ? (Med 23 May 2023 (A.N) +18 past) - ID: 18183
Ⓐ Left atrium Ⓑ Both atria
Ⓐ Glossopharyngeal nerve Ⓑ Acessory nerve
Ⓒ Right atrium and Right ventricle
Ⓒ Optic nerve Ⓓ Occulomotor nerve
Ⓓ Both ventricles
Ⓐ Posterior 1/3 Tongue ➜ Hypoglossal Nerve ➜ Tractus Solitarius (
Ⓒ Anterior (Sternocostal) surface ➜ formed Primarily by the Right
Receives Afferent from Whole Tongue ) ➜ Cross Midline ➜ Thalamus ➜
Ventricle ( Right Atrium also contributes ). Both are separated from
Gustatory Cortex .
each other by the vertical atrioventricular groove.
✦ BD Chaurasia, Pg. 253 48. Most of the Postganglionic sympathetic fibers naturally
Release ? (Radio 23 May 2023 (A.N) +33 past) - ID: 19374
42. A severly ill female patient brought from village with
history of difficult labour 2 days back. She is bleeding from Ⓐ Acetylcholine Ⓑ Nor-epinephrine
multiple sites. On labs: inc PT, APTT, BT, Hb=4.2 g/dl, Ⓒ Lithium Ⓓ Histamine
platelets=10x10. Both PT and APTT are derranged along
with elevated levels D-dimer and FDPs due to ? (Med 23 May Ⓑ Postganglionic sympathetic neurons ➜ adrenergic ➜
2023 (A.N) +34 past) - ID: 16436
norepinephrine.
Ⓐ DIC Ⓑ Hep. E
Ⓒ Pregnancy induced thromboytopaenia ✦ Netter Nervous System Illustrations, Pg. 201
Ⓓ ITP 49. HIV patient developed reddish lesions on his skin. One
of his sex partners has similar lesions too, Most common
Ⓐ ✪ Obstructed Labour ➜ Fetal Demise and Amniotic Fluid Embolism skin cancer in HIV/AIDS patients are: ( may also be asked
➜ Risk of DIC in case of homosexuals ) (Med 25 May 2023 (M) +36 past) - ID:
DIC ☛ ◉ ↓ Clotting Factors ↓ Platelets 19477
◉ ↑ PT, aPTT, CT, FDP and D-Dimer
Ⓐ Lymphoma Ⓑ Kaposi sarcoma
✦ Harsh Mohan, Pg. 337, 338 ✦ Davidson, Pg. 408
Ⓒ Lymphogranuloma venarum Ⓓ Warts
43. Cancer Screening is done in order to: (Med 23 May 2023
(A.N) +2 past) - ID: 16628 Ⓑ Kaposi sarcoma is a neoplasm of endothelial cells. it is seen in
HIV/AIDS ( hint:homosexual male) and transplant patients. it presents

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 Medi Call FCPS – 1 | MAY 2023 PAPERS

as dark/violaceous plaques or nodeuls representing vascular

proliferations. 55. A patient is prepared for a kidney transplant what
function will best measure his Renal functions regarding
50. Lesion of parietal lobe with inferior Quadrantanopia is whether to do transplant or not? (Med 23 May 2023 (A.N) +16
due to damage to ? (Med 23 May 2023 (A.N) +5 past) - ID: 19674 past) - ID: 20496

Ⓐ Optic tract Ⓑ Optic nerve Ⓐ Serum creatinine Ⓑ Serum K

Ⓒ Optic radiation Ⓓ Optic chiasma Ⓒ Serum Mg Ⓓ Serum Ig

Ⓒ Lesions @ : Ⓐ ✪ Creatinine clearance should be considered for dialysis or

✪ Complete Optic Radiation ☛ Contraleteral homonymous transplant. Early-start dialysis based on creatinine clearance as a
hemianopia measure of kidney function.For clinical we do creatinine.
✪ Parietal Upper Radiation ☛ Contraleteral Inferior Quadrantanopia ✪ Remember, Best test to measure kidney function or gfr is insulin.
✦ CMDT, Pg. 34
✪ Temporal Lower Radiation Lesion ☛ Contraleteral Superior
Quadrantanopia 56. A 20 year old man with rheumatic valvular heart
✪ Optic Nerve ☛ Monocular Vision Loss disease has been running a low grade fever for the last of
✪ Central Chiasmal ☛ Bitemporal Hemianopia two weeks. In addition to a pansystolic murmur .He is
✪ Optic tract ☛ Contraleteral homonymous hemianopia found to have splenomegaly and clubbing. Diagnosed as
✪ Visual cortex ☛ Contraleteral homonymous hemianopia with Infective Endocarditis. DOC? (Med 23 May 2023 (A.N) +21 past) -
macular sparing ( Textbook of Neuro ) ID: 21151
✦ First Aid, Pg. 542
Ⓐ Inj. Cefotaxime + Metronidazole
51. An 8 year old girl with history of Pica presented with Ⓑ Inj Penicillin + Gentamicin Ⓒ Inj. Ceftriaxone
Pallor and Dyspnea. Labs show HB 6.8 MCV 59 MCH 18 Ⓓ Inj Ciprofloxacin
and MCHQ 27, Low serum iron, microcytic hypochromic
RBCs, Low reticulocyte count and Low serum ferritin. All Ⓑ Infective Endocarditis ☛ Low grade fever, Clubbing, Diastolic
parameters decreased but Increased TIBC is seen in ? (Med Murmers with mitral valve insufficiency ➜ 1st line Treatment ➜
25 May 2023 (M) +25 past) - ID: 19859 Combination of β Lactam Antibiotic with Gentamycin.
Ⓐ Thalassemia 57. Dead space does not change in which of the following
Ⓑ Anemia of Chronic Disease (ACD) ? (Radio 23 May 2023 (A.N) +18 past) - ID: 21266
Ⓒ Sideroblastic Anemia Ⓓ Iron Deficiency Anemia
Ⓐ Asthma Ⓑ Chronic bronchitis
Ⓓ ✪ ↓ Ferritin stores ➜ ↑ TIBC and ↑ Ferritin stores ➜ ↓ TIBC. Ⓒ Emphysema Ⓓ Shallow breathing
✪ IDA ☛ ↓ Ferritin stores ➜ ↑ TIBC.
✪ Thalassemia ☛ Normal TIBC.
Ⓓ since dead space volume is constant, Pattren of respiration cast no
effect on Dead space as there are equal increases in total and alveolar
✪ Sideroblastic Anemia ☛ Normal.
ventilation per breath
✪ ACD ☛ ↑ Ferritin stores ➜ ↓ TIBC.
✦ Kaplan Physiology, Pg. 141
✦ Harsh Mohan, Pg. 279 ✦ Goljan, Pg. 321
58. Patient got hit by a Motorbike and had damage to right
52. A child is brought to your clinic, she has an enlarged
side of linea alba. A deep wound below umbilicus 3cm
clitoris and Sex Chromatin is Positive . diagnosis ? (Med 23
lateral to it is present. Vessel leading to profuse bleeding,
May 2023 (A.N) +10 past) - ID: 20148
went into hemorrhagic shock Which of the following is
Ⓐ Androgenital syndrome Ⓑ True hermaphrodite damaged? (Med 23 May 2023 (A.N) +11 past) - ID: 21373
Ⓒ Klinefelter Ⓓ Testicular feminization
Ⓐ SVC Ⓑ Juglar vein
Ⓒ Spleen Ⓓ IVC
Ⓐ ✪ Autosomal Resessive disorder ➜ Deficiency of enzyme 21
Ⓔ Common iliac vessel
Hydroxylase ➜ Reduction in cortisol production ➜ a compensatory
increase in ACTH secretion ➜ stimulates androgen production ➜
Ⓓ Surface marking of IVC is vertical line 2.5 cm to right to midline from
virilizing effects ➜ masculinization in females (ambiguous genitalia,
intertubercular plane to sixth costal cartilage
oligomenorrhea, hirsutism) + Precocious puberty in males ✦ SNELL, Pg. 217 ✦ RJ Last, Pg. 425
✦ Robbins, Pg. 790
59. Most potent antioxidant is ? (CPSP Demo +24 past) - ID:
53. A patient has calf muscle pain after few steps of 21578
walking (Intermittent claudication) relieved on rest which
artery is involved? (Med 23 May 2023 (A.N) +9 past) - ID: 20170 Ⓐ Vitamin A Ⓑ Glutathione
Ⓒ Vitamin E Ⓓ Vitamin C
Ⓐ Popliteal Ⓑ Tibial
Ⓒ Fibular Ⓓ Illeic Ⓑ Glutathione > VitE > Vit C > Vit A. But remember if asked that which
vitamin is the most potent one choose Vit E
Ⓐ Popliteal artry branch of femoral artry which supply calf muscles so
ans is popliteal artry or femoral artry 60. Which of the following is Locally malignant tumor ?
(Med 23 May 2023 (A.N) +5 past) - ID: 22029
54. Regarding X linked disorders. Heterozygous females
rarely affected ? (Med 23 May 2023 (A.N) +8 past) - ID: 20462 Ⓐ BCC Ⓑ SCC
Ⓒ HCC Ⓓ Lymphoma
Ⓐ X-linked dominant Ⓑ Y-linked dominant
Ⓒ Z-linked dominant Ⓓ X-linked recessive Ⓐ Basal cell carcinoma ☛ type of skin cancer ➜ most often develops
on areas of skin exposed to sun.
Ⓓ ✪ X-linked recessive inheritance ☛ mutations in X chromosome
➜ male carrying such mutation will be affected, because he carries only 61. The most specific test to diagnose SLE is ? (Med 23 May
2023 (A.N) +8 past) - ID: 22127
one X chromosome ➜ female carrying mutation in one gene, with a
normal gene on other X chromosome, is generally unaffected.✪ X- Ⓐ Anti SMA Ⓑ Anti GGD
linked dominant disorders ☛ mutations in X chromosome. In females Ⓒ Anti ds DNA Ⓓ ANA
(who have two X chromosomes), a mutation in one of two copies of
gene is sufficient to cause the disorder. Ⓒ ✪ Anti Ds-DNA ➜ 60%, Anti sm ➜ 30% ☛ Both are specific for SLE
✦ Robbins, Pg. 246 ✪ ANA ➜ Sensitive ＞ 90%

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 Medi Call FCPS – 1 | MAY 2023 PAPERS

✦ CMDT, Pg. 854, 854 Ⓔ Metabolic acidosis and Respiratory acidosis (Mixed acid-base)

62. At which stage the Hb start appearing at ? (Radio 23 May

2023 (A.N) +4 past) - ID: 22516
Ⓔ ✪ pH : 6.8 ➜ Low ( Normal 7.25 to 7.45 ) ➜ Acidosis
Ⓐ Early normoblast Ⓑ Pronormoblast
✪ pCO2 : 65 ➜ High ( Normal 40 )
Ⓒ Intermediate normoblast Ⓓ None of above
✪ HCO3 : 10 ➜ Low ➤ Cause is Metabolic ( Same directions : ↓ pH +
↓ HCO3 )
Ⓒ Intermediate and late normoblast ☛ show scanty ragged rims of
So normally in case of Metabolic Acidosis ➜ PCO2 should be low after
poorly hemoglobinized cytoplasm indicating that Hb has started
hyperventilation in order to Neutralize Acidosis but in this case we see
appearing.
element of repiratory acidosis too as PCO2 is raised
✦ Sceincedirect Elsevier, Pg.
✦ Kaplan Physiology, Pg. 254
63. Which of the following is true about the familial
69. ECG shows norrnal P waves but wide QRS. Heart rate
AdenoPolyposis ? (Med 25 May 2023 (A.N) +14 past) - ID: 22792
is 25. Pace maker in? (Med 23 May 2023 (A.N) +6 past) - ID: 24707
Ⓐ X kinked dominant Ⓑ X kinked recessive
Ⓐ AV node Ⓑ SA node
Ⓒ Multifactorial Ⓓ Autosomal dominant
Ⓒ Bundle Of His Ⓓ Purkinie fibers
Ⓓ Familial AdenoPolyposis is autosomal dominant condition As the
Ⓓ ✪ P wave normal ☛ Sinus rhythm present
mutation causing FAP is autosomal dominant it can be inherited directly
✪ AV Block ☛ Poor conduction from Atria to Ventricles ➜ slower spread
from either parent to a child.
of ventricular depolarization ➜ Widening of QRS complex ➜ Ventricular
64. Newborn presented with Erythroblastosis Fetalis. escape Rhythm➤ Pacemaker is at AV node or bundle of his ➜ 40-60
Baby's blood group is A+ . Exchange transfusion should b/min
be done with? (Med 23 May 2023 (A.N) +17 past) - ID: 22909 ➤ Pacemaker in ventricles or purkinje ➜ 20-40 b/min
✦ Guyton, Pg. 157
ⒶA- ⒷA+
ⒸO Ⓓ AB + 70. A hypertensive patient, has increased urine output,
and having polyurea, this is because of? (Med 23 May 2023
Ⓐ Erythroblastosis fetalis ☛ when Rh -ve woman is impregnated by (A.N) +2 past) - ID: 27678
Rh +ve man and conceives a fetus with Rh-positive blood, sometimes
Ⓐ Afferent arteriole constriction
resulting in hemolysis due to Rh incompatibility
Ⓑ Efferent arteriole dilatation
Blood Transfusion ☛ primary objective is to replace damaged RBCs
Ⓒ Increased hydrostatic pressure in the bowman’s capsule and
and alleviate symptoms of anemia.
A+ve blood have Anti-B Ab and Rh Ag , So exchange transfusion done increased GFR
Ⓓ Increased glomerular capillary pressure + increased GFR
with A-ve
✦ First Aid, Pg. 405
Ⓓ ✪ Changes in glomerular capillary hydrostatic pressure affect GFR i.e
65. A pt came to ER with infection of 1st web space in In hypertension Increased arterial pressure tends to raise glomerular
right hand. Painful and swollen which group of lymph hydrostatic pressure and, therefore, to increase GFR
nodes will drain this area? (Med 23 May 2023 (A.N) +9 past) - ID: ✦ Guyton, Pg. 339
23137
71. Person falls on an outstretched hand and injured his
Ⓐ Supraclavicular Ⓑ Infraclavicular wrist. Which structure will get damaged while passing
Ⓒ Epitrochlear Ⓓ Lateral axillary group superficial to flexor retinaculum (transverse carpal
ligament)? (Med 23 May 2023 (A.N) +17 past) - ID: 28277
Ⓑ Infraclavicular nodes drain the upper part of the breast, and the
thumb with its web Ⓐ Ulnar artrey and nerve Ⓑ Median Nerve
✦ SNELL, Pg. 371 ✦ BD Chaurasia, Pg. 82 Ⓒ Radial Artery Ⓓ Radial Nerve

66. Which of the following test is used for the diagnosis of Ⓐ Ulnar artery and ulnar nerve, and cutaneous branches of median and
HIV ? (Med 25 May 2023 (M) +11 past) - ID: 23234 ulnar nerves, pass on top of flexor retinaculum.
✦ Kaplan Anatomy, Pg. 212
Ⓐ Western blot Ⓑ Eastern Blot
Ⓒ Both a and b Ⓓ None of above 72. Melanoma reaches orbital Cavity through (Surg 24 May
2023 (A.N) +12 past) - ID: 28395
Ⓐ Immunological test for HIV ◉ ELISA ◉ Western blot
Ⓐ Emissary vein Ⓑ Retina
(immunoblot) ◉ OraQuick Rapid screening test for HIV antibodies.
✦ Davidson, Pg. 310 ✦ Levinson, Pg. 384 Ⓒ Optic nerve Ⓓ Lymphatics

67. The Glomerulus supply is by which of the following Ⓐ Primary choroidal melanoma ☛ arises from melanocytes within
artery? (Med 23 May 2023 (A.N) +4 past) - ID: 23292 choroid.
Metastasis ☛ through emissary channels into orbit
Ⓐ Arcute Ⓑ Interlobular
Ⓒ Vesa recta Ⓓ None of above 73. What is the blood supply of pituitary gland and its
Blockage will affect the pituitary gland? (Radio 23 May 2023
Ⓑ Interlobular arteries arise from the arcuate arteries and ascend into (A.N) +4 past) - ID: 31312
the cortex, where they divide into afferent arterioles that supply blood
Ⓐ PICA Ⓑ AICA
to the glomerular capillaries. After traversing the renal corpuscle, the
glomerular capillaries reform into a second arteriolar network, the Ⓒ MCA Ⓓ Internal carotid artery
efferent arterioles. Ⓔ Posterior superior cerebellar artery

68. Patient having cardiorespiratory arrest had pH : 6.8 , Ⓓ Near Pituitary gland ☛Cavernous sinus area contains ☛ internal
Bicarb :10 and CO2 : 65. What picture ABGs are showing? carotid artery and several important nerves that control eye movement.
(Med 23 May 2023 (A.N) +12 past) - ID: 23781
74. Filtration of substance is subtracted from excretion of
Ⓐ Metabolic alkalosis Ⓑ Respiratory alkalosis substance to get: (Med 23 May 2023 (A.N) +2 past) - ID: 31319
Ⓒ Resp acidosis with compensation
Ⓓ Resp acidosis without compensatlon Ⓐ Renal filtration Ⓑ Renal reabsorption
Ⓒ Clearance Ⓓ Renal secretion

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 Medi Call FCPS – 1
Ⓑ Filtration of a substance ☛ refers to how much of it enters the
nephron through glomerular filtration
Excretion ☛ amount eliminated in urine. Renal
Reabsorption ☛ Difference between the filtration of a substance and
its excretion that has been reabsorbed by the renal tubules
(Guyton , 14th Edition, p. 330).
75. Primigravida in 2nd trimester felt sudden lower
abdomen severe cramps followed by watery foul-smelling
discharge. After 2 days delivered a still born child. On
examination chorion and placenta have neutrophilic
infiltration it is likely caused by which organism? (Med 23
May 2023 (A.N) +6 past) - ID: 31345
Ⓐ Mycobacterium Ⓑ E. coli
Ⓒ Toxoplasmosis Ⓓ Treponema
Ⓔ HSV
Ⓑ ✪ E.coli (Vaginal Flora) ➜ Acute Chorioamnionitis (Ascending
infcetion) ➜ Premature Rupture of Memberane ➜ Still Birth.
✪ TORCH infections ☛ Toxoplasma + Treponema (Syphilis) + HSV ➜
Transplacental Infections.
✦ Robbins, Pg. 732
76. Lymphatic drainage of external nose and anterior part
of nasal cavity: (Radio 23 May 2023 (A.N) +30 past) - ID: 33706
Ⓐ Submandibular Lymph Nodes Ⓑ Deep cervical lymph
nodes
Ⓒ Retropharyngeal Lymph nodes Ⓓ Occipital Lymph
Nodes
Ⓐ Lymphatic drainage ☛
●Anterior part drains ☛ submental , submandibular lymph node
● Posterior part ☛ retropharyngeal nodes.
●All of these nodes finally drain into ☛ upper deep cervical lymph
nodes.
✦ Reference, Pg.
77. A person got a stab wound 3cm vertical on lateral right
side of linea alba, below umblicus, initially he was fine but
then developed hypotension and shock . Which vessel is
most likely damaged (Med 23 May 2023 (A.N) +13 past) - ID:
33734
Ⓐ IVC Ⓑ Superior mesenteric Artery
Ⓒ Inferior Mesenteric Artery Ⓓ Abdominal Aorta
Ⓔ Ileal branch of superior mesenter ic artery
Ⓐ Stab injury ➜ Piercing rectus abdominus ➜ IVC injury ➜ Severe
bleeding ➜ Hypotension ➜ Shock
✦ SNELL, Pg. 96
78. Muscles have different classifications according to
their actions and features they are divided in different
groups and sub groups, according to one classification,
which of the following muscle is white muscle: (Radio 23 May
2023 (A.N) +20 past) - ID: 33737
Ⓐ Masseter Ⓑ Temporalis
Ⓒ Gastrocnemius Ⓓ Buccinators
Ⓒ This specialization is connected to the predominance
of white muscle fibers (type II fast twitch) present in the
gastrocnemius, as opposed to the soleus, which has more red muscle
fibers (type I slow twitch) and is the primary active muscle when
standing still, as determined by EMG studies.
✦ Wikipedia, Pg.
79. 20 years young boy presented with fever, headache
vomiting. He is having neck stifness and Alter mental
status with hallucination which among following is brain
eating parasite? (Surg 25 May 2023 (M) +8 past) - ID: 33885
Ⓐ Naegleria Fowleri Ⓑ Entamoeba Histolytica
Ⓒ Amoeba Proteus Ⓓ Chaos Carolinense
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| MAY 2023 PAPERS
Ⓐ Naegleria fowleri ☛ commonly known as brain eating amoeba ➜
free-living microscopic ameba ➜ causes amebic meningoencephalitis ➜
brain infection that leads to destruction of brain tissue.
80. A patient presents with symptoms of Horner
syndrome, unusual facial expressions, ptosis, unilateral
facial flushing and loss of sweating function. Which nerve
supply is damaged? (Radio 23 May 2023 (A.N) +20 past) - ID:
33904
Ⓐ Cervical sympathetic chain Ⓑ Lesser splanchnic
Ⓒ Greater splanchnic Ⓓ Least splanchnic
Ⓐ Horner syndrome☛ Interruption (central or peripheral) of the
sympathetic pathway through the superior cervical ganglion.
Signs and symptoms ☛ Miosis, ptosis, facial flushing and anhidrosis.
✦ Duane Neurosceince, Pg. 434
81. The glands atrophy in the stomach of a chronic
alcoholic and smoker patient, having dyspepsia would
result in: (Med 23 May 2023 (A.N) +2 past) - ID: 33992
Ⓐ Anemia Ⓑ Gastric cancer
Ⓒ Hypomobility of stomach Ⓓ Diminished blood
supply
Ⓐ Atrophic gastritis ☛ ↓ intrinsic factor ➜ ↓ vitamin B-12 absorption
➜ pernicious anemia.
82. Best way to get a urine culture ? (Radio 23 May 2023 (A.N)
+2 past) - ID: 34319
Ⓐ Flood cled agar with 1ml of urine
Ⓑ Bacterial dipstick
Ⓐ Diagnostic tests for UTIs ➤
Urine microscopy ☛ one can often find pyuria (elevated white blood
cells [WBCs] in urine) and hematuria (red blood cells in urine), and
sometimes bacteria can be seen
Urine dipstick ☛ Leukocyte esterase, Nitrite reduction , and positive
hemoglobin
Urine culture ☛ ● Midstream void ➜ ≥1 × 105 CFU/mL is consistent
with infection ● Catheterization ➜ ≥1 × 102 CFU/mL is consistent with
infection ➤ Grow on CLED or MacConkey agar
83. 55 year old Diabetic woman complaining of bloating
and indigestion especially after meals. DOC for
gastroparesis to increase her tone of lower esophageal
Sphincter and increase gastric motility for emptying ? (Med
25 May 2023 (A.N) +68 past) - ID: 34344
Ⓐ H2 receptor blocker Ⓑ Antacids
Ⓒ Prokinetic (Metoclopramide) Ⓓ Cisapride
Ⓒ Gastroparesis ☛ delayed gastric emptying, common complication of
diabetes ➜ heartburn and indigestion
Prokinetic agents (metoclopramide) ☛ enhance gastrointestinal
motility and speed up gastric emptying.
✦ Katzung, Pg. 1097, 1115
84. Nucleus of clarke lies at spinal level of ? (Med 25 May 2023
(M) +7 past) - ID: 34397
Ⓐ C8-L2 Ⓑ T1-L2
Ⓐ Clarke nucleus ☛ ● Origin of dorsal spinocerebellar tract ● Present
at level of C8-L2 ● Responsiblefor Proproception and vibration
✦ Snell Neuro, Pg. 140 ✦ High Yield Neuroanatomy, Pg. 12
85. Woman with iodine deficiency cause? (Med 23 May 2023
(A.N) +1 past) - ID: 34519
Ⓐ Lack in water and food Ⓑ Inborn error of metabolism
Ⓒ Poor dietary status
Ⓑ Metarnal iodine deficiency ➜ Cretinism ➜ impaired development
of the skeletal system and central nervous system, severe mental
retardation, short stature, coarse facial features, a protruding tongue,
and umbilical hernia.
659
 Medi Call FCPS – 1 | MAY 2023 PAPERS

✦ Robbins, Pg. 758 Ⓒ Greater thoracic splanchnic nerve

Ⓓ Sciatic nerve
86. Touch and vibration / pressure through? (Med 23 May
2023 (A.N) +3 past) - ID: 34526
Ⓒ Adrenal medulla ☛ Preganglionic sympathetic fibers derived from
Ⓐ Alpha fibers Ⓑ A Beta fibers splanchnic nerves supply glands.
Ⓒ Gamma fibers Ⓓ Autonomic fibers ✦ SNELL, Pg. 215

94. Anterior hypothalamus regulates temperature via (Med

Ⓑ A Beta ☛ Touch and pressure
23 May 2023 (A.N) +7 past) - ID: 36003
✦ Ganong, Pg. 94
Ⓐ Cutaneous vasodilation and Sweating
87. A person from Karachi who recently took membership
Ⓑ Cutaenous Vasoconstriction Ⓒ Shivering
in swimming pool classes presented with signs of
Ⓓ Thermogenesis
meningitis, microbiologist said ameboid on wet agar.
Cause? (Radio 23 May 2023 (A.N) +3 past) - ID: 34580
Ⓐ Anterior hypothalamus ☛ Causes cooling by increase sweating and
Ⓐ Naegleria fowleri Ⓑ Listeria monocytogenes Cutaneous vasodilation
Ⓒ Entamoeba histolytica Ⓓ Neisseria meningitidi ✦ First Aid, Pg. 498

95. A Patient presented with fever, Petechiae, and

Ⓐ Naegleria fowleri ☛ Swimming in warm freshwater; enters via
Bleeding Gums, Bone marrow biopsy was advised. The
cribriform plate ➜ Rapidly fatal meningoencephalitis
commonest site of Bone marrow aspiration and bone
✦ Robbins, Pg. 868
marrow biopsy is (Radio 23 May 2023 (A.N) +14 past) - ID: 36371
88. A patient suffering from generalized Edema and Frothy
Ⓐ Manubrium sterni Ⓑ Ventral Iliac crest
urine, microscopy reveals PCT basement membrane with
Ⓒ Pubis Ⓓ Ischial Tuberosities
pink cytoplasm (vacuoles) cells. This is likely due to the?
(Med 23 May 2023 (A.N) +3 past) - ID: 34759
Ⓑ Adults or Children ☛ Bone marrow aspiration and trephine biopsy
Ⓐ Reabsorption of protein Ⓑ Reabsorption of lipids are usually performed on the back of the posterior iliac crest.
Ⓒ Reabsorption of Glucose Ⓓ Reabsorption of fats ✦ Mayo Clinic, Pg. ✦ N.I.H USA, Pg. ,

96. Low Calcium, high phosphate, decrease excretion of

Ⓐ ↓ Protein reabsorption ➜ ↑ protein in urine ➜ forthy urine
phosph in urine after use of PTH but increased excretion of
✦ Davidson, Pg. 394
cyclic AMP (Med 24 May 2023 (A.N) +5 past) - ID: 36477
89. Right bronchial artery is a branch of (Med 23 May 2023
(A.N) +2 past) - ID: 34903
Ⓐ Pseudohypoparathyroidism Ⓑ Hypoparathyroidism
Ⓒ Hyperthyroidism
Ⓐ Arch of aorta Ⓑ Thoracic aorta
Ⓒ 2nd intercostal artery Ⓓ Third intercostal artery Ⓐ Pseudohypoparathyroidism ☛ ↑ PTH, ↓ Ca2+, ↑ PO4
✦ First Aid, Pg. 344
Ⓑ Right bronchial artery ☛ Usually arising from thoracic aorta as a
common trunk with right third posterior intercostal arteryClick to view 97. Restrictive lung disease (Pneumonia) (Med 23 May 2023
(A.N) +5 past) - ID: 36670
Grays reference in MediCall App
✦ GRAY'S, Pg. 968 Ⓐ Decrease lung compliance, FEV1 dec,increased FEV/FVC ratio
90. A ppd tuberculin test done to a patient After 40 hours,
15mm erythema is noticed. Cells responsible for erythema Ⓑ Decreased lung compliance, decreased FEV/FVC ratio
are (Med 25 May 2023 (M) +19 past) - ID: 34960 Ⓒ TLC increase Ⓓ FVC increase

Ⓐ Helper CD4+ T cell Ⓑ Cd8 cells

Ⓐ Restrictive lung diseases (● ARDS ● Pneumoconiosis ● sarcoidosis
Ⓒ NK cells Ⓓ Cytotoxic T cell
● Int. Fibrosis ● Pneumonia ● Pulmonary edema) ➜ Increased Tissue ➜
Stiff and Small Lung ➜ increase in elastic recoil ➜ Reduced lung
Ⓐ PPD test ☛ CD4+ T-cell mediated reaction
✦ Robbins, Pg. 143
compliance ➜
➊ Vital capacity Decreased
91. A player hiked to a mountain, having Low oxygen level ➋ All Volumes Decreased ( ● ↓ RV ● ↓ FRC ● ↓ TLC )
in blood (low PO2), and developed dyspnea the likely ➌ Both FEV1 and FVC are reduced, but FEV1 is reduced less than
etiology is: (CPSP Demo +11 past) - ID: 34979 FVC thus ➜ FEV1/FVC is increased ususally or Normal
Ⓐ Hypovolumic shock Ⓑ Anemic Hypoxia ✦ Wikipedia, Pg.

Ⓒ Hypoxic Hypoxia Ⓓ Congestive Heart Failure 98. The patient in day care is in anxious. Treatment of
hypertensive and depressed patients is (Med 23 May 2023 (A.N)
Ⓒ Hypoxic hypoxia ➜ Hypoventilation, ↑ Altitude, ↓ Atmospheric +1 past) - ID: 37146
O2 ➜ ● ↓ PO2 ● ↓ O2 Sat ● ↓ PvO2
✦ Guyton, Pg. 564
Ⓐ Haloperidol Ⓑ Diazepam
Ⓒ Phenytoin Ⓓ Propanolol
92. Marker raised 60% in colon cancer and 80% in
pancreatic cancer: (Med 23 May 2023 (A.N) +2 past) - ID: 35540 Ⓐ Haloperidol ☛ causes temporary drop in blood pressure and
rebalances dopamine ➜ improves thinking, mood and behavior.
Ⓐ CEA Ⓑ CA19-9
Ⓒ CA125 Ⓓ CA15-3 99. Right hemiparesis, pt can't speak and write but can
Ⓔ PSA understand, lesion at (Med 23 May 2023 (A.N) +6 past) - ID: 37222

Ⓑ Explanation Ⓐ Post central gyrus

Ⓑ Motor speech area in dominant hemisphere
93. Nerve supply to adrenal medulla is from? (Radio 23 May Ⓒ Frontal lobe
2023 (A.N) +13 past) - ID: 35889

Ⓐ Lesser thoracic splanchnic nerve Ⓑ Motor speech area, a.k.a Broca's area ☛ located in frontal lobe
Ⓑ Least thoracic splanchnic nerve of dominant cerebral hemisphere ( left hemisphere in about 95% of
right-handed individuals and 70% of left-handed individuals)
Damage to area ☛ Broca's aphasia ➜ partial loss of ability to produce

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 Medi Call FCPS – 1 | MAY 2023 PAPERS
language (spoken, manual, or written) ➜ comprehension generally
remains intact ➜ patient is able to understand but unable to speak or
write.
100. Positive inotropic and vasopressor that is given to
increase contractility and prevent MI ? (Med 23 May 2023 (A.N)
+1 past) - ID: 37232
Ⓐ Epinephrine Ⓑ Calcium
Ⓒ Norepinephrine Ⓓ Adenosine
Ⓐ Epinephrine ☛ potent vasopressor and inotropic properties ➜ can
rapidly increase diastolic blood pressure to facilitate coronary perfusion
➜ help restore organized myocardial contractility.
101. Cerebrospinal fluid (CSF) drains into circulation and
absorbed in (Radio 23 May 2023 (A.N) +14 past) - ID: 37759
Ⓐ Arachnoid granulation Ⓑ Ependymal cells
Ⓒ Blood Ⓓ Skin
Ⓐ Absorption of CSF ☛ occurs across arachnoid villi by valve like
mechanism ➜ arachnoid granulations show series of channel like
structures ➜ allow CSF to drain into blood, but preventing blood from
entering CSF.
102. Hematemesis for 6 hours in CLD patients which of the
following vein is involved (Med 23 May 2023 (A.N) +1 past) - ID:
37792
Ⓐ Left azygous vein Ⓑ Left gastric vein
Ⓒ Hemi azygous vein Ⓓ Right azygous
Ⓑ CLD ☛ often results in portal hypertension ➜ can lead to
development of esophageal varices (most commonly supplied by left
gastric vein) ➜ Hematemesis if varices ruptured
103. Consistent finding of hypokalemia is present in (Med 23
May 2023 (A.N) +4 past) - ID: 38070
Ⓐ Persistent vomiting Ⓑ Respiratory alkalosis
Ⓒ Dietary deficiency
Ⓐ EXPLANATION
104. A 45-year-old man has noted scleral icterus for the
past 4 days but feeling tired for a month. O/E. mild
tachycardia, his vital signs are normal. No other physical
examination findings are of noted other than scleral
icterus. Laboratory studies show a hematocrit of 25%.
Which of the following conditions is most likely to account
for these findings? (Med 23 May 2023 (A.N) +4 past) - ID: 38278
Ⓐ Intravascular hemolysis Ⓑ Systemic hypertension
Ⓒ Pulmonary squamous cell carcinoma
Ⓓ Type 1 Diabetes meilitus Ⓔ Excessive iron absorption
Ⓐ EXPLANATION
105. A male presented in ER with severe chest pain. Life-
supportive treatment was given. After 4 days, he died. On
autopsy, there is coagulative necrosis of the anterolateral
wall of the left ventricle. Microscopy will show? (Med 23 May
2023 (A.N) +1 past) - ID: 38625
Ⓐ Granulomatous inflammation
Ⓑ Neutrophils + necrotic tissue
Ⓒ Granulation tissue Ⓓ Collagen fibroblasts
Ⓑ symptoms ☛ severe chest pain and subsequent death suggest a
possible myocardial infarction (heart attack), which can result in
coagulative necrosis of the affected area.
Microscopically ☛ mixture of necrotic tissue (dead cells) and
infiltrating neutrophils (a type of white blood cell involved in the
inflammatory response).
106. In ECG u will find out 2 P wave and one QRS complex
rhythm where the pacemaker lies does (Med 23 May 2023 (A.N)
+2 past) - ID: 38715
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Ⓐ SA node Ⓑ AV node
Ⓒ Purkinje
Ⓐ In 2nd degree heart block pacemaker is still SA node
✦ Davidson, Pg. 477
107. A surgeon has to remove the right middle lobe due to
carcinoma. Which of the following lobar segments will he
remove? (Med 23 May 2023 (A.N) +2 past) - ID: 38757
Ⓐ Med and lateral segments Ⓑ Apical and basal
segments
Ⓒ Anterior and posterior segments
Ⓐ EXPLANATION
108. A 25-year-old female consulted her physician about
the swelling in the anterior part of her neck. On
examination the swelling is just below the hyoid bone and
move with the protrusion of tongue. What is the most
likely congenital anomaly in this case? (Surg 24 May 2023 (M)
+14 past) - ID: 54514
Ⓐ Brachial sinus Ⓑ Brachial fistula
Ⓒ Thyroglossal cyst Ⓓ Thyroidal agenesis
Ⓔ Ectopic thyroid
Ⓒ Thyroglossal cysts ☛ fluctuant swelling in neck midline caudal to
hyoid bone ➜ attached to thyroglossal tract which attaches to larynx by
peritracheal fascia ➜ moves upwards when patient protrudes tongue.
✦ KLM, Pg. 1041, 1041
109. A 40-year-old male with a history of frequent loose
motions presented with muscle cramps, irritability,
tingling of hands, feet, and circumoral area, carpopedal
spasm, and convulsions. A patient has bronchospasm and
brisk reflexes. Investigations reveal Calcium 7. 8 mg/dL,
magnesium 1 mg/dL , Phosphate 6 mg/dL, alkaline
phosphatase 100 IU/L and potassium 4 meq/L. What is
the most likely diagnosis? (Med 23 May 2023 (A.N)) - ID: 54710
Ⓐ Epilepsy. Ⓑ Hypoparathyroidism.
Ⓒ Malabsorption syndrome. Ⓓ Respiratory alkalosis
Ⓑ Hypoparathyroidim ☛ Hypocalcemia ,Hyperphosphatemia ➜
Carpopedalspasm, Convulsion, Bronchospasm, Dizziness, Numbness
and /or tingling in fingertips, toes and lips.
110. 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 (Surg 24 May 2023 (M) +22 past) -
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
111. A 10-year-old boy came in an OPD with complaints of
pain and swelling in the left knee, which developed
spontaneously. On inspection, the overlying skin is bruised
and tensed due to swelling. There is a history of 5 same
incidences since the age of two. Which of the following is
the most likely diagnosis? (Med 23 May 2023 (A.N) +4 past) - ID:
55104
Ⓐ DIC (disseminated intravascular coagulation)
Ⓑ Chronic liver disease Ⓒ Hemophilia
Ⓓ Von-Willebrand disease
Ⓒ Hemophilia A ☛ ↓ factor 8 ➜ spontaneous hemorrhage into joints (
hemarthrosis ) ➜ blood and fat ( Cholesterol crystals ) in joint space ➜
pain and swelling.
661
 Medi Call FCPS – 1
✔ Gum Bleeding, bruising, epistaxis
✔ X-linked recessive ✔ Only males affected
✔ Family Hx Present ✔ APTT ➜ Prolonged
✔ Heamarthrosis is hallmark
✦ Kaplan Pathology, Pg. 34 ✦ Wikipedia, Pg.
112. A 4 year old boy is brought to the emergency room
with complaints of generalized purpura and epistaxis of
sudden onset. He had an upper respiratory tract infection
10 days ago, but had been otherwise well and active. The
most suitable investigation that will guide to diagnosis is
(Med 23 May 2023 (A.N) +6 past) - ID: 55204
Ⓐ Platelet count Ⓑ RBC count
Ⓒ WBC count Ⓓ Red Cell indices
Ⓐ ITP ☛ Primary bleeding disorder ➜ Thrombocytopenia ➜ Dec PPP
formation ➜ petechiae , purpura and ecchymosis
◉ ↓ Platelets count ◉ ↑ Bleeding Time
◉ Normal PT ,aPTT and CT
✦ British Medical Journal - BMJ, Pg. ✦ Pathoma, Pg. 32
113. A 34-year-old man presented with altered
consciousness and fever for 2 days. The CSF analysis
revealed glucose 20mg, protein 150 mg, 75% neutrophils,
20% lymphocytes with predominant polymorphs. What is
the most likely diagnosis? (Med 23 May 2023 (A.N) +7 past) - ID:
55438
Ⓐ Acute Bacterial meningitis Ⓑ Subarachnoid hemorrhage
Ⓒ Tuberculous meningitis Ⓓ Viral meningitis
Ⓐ BACTERIAL Meningitis
◉ ↑ CSF Pressure ＞ 200 ◉ ↓ Glucose ＜ 40
◉ ↑ Proteins ＞ 100mg ◉ ↑ WBCs ＞100 ( 80% PMNs )
VIRALMeningitis
◉ Pressure Normal ◉ Glucose Normal
◉ Proteins ↑ / Normal ◉ ↑ WBCs ＞10 ( Lymphos)
TB Meningitis
◉ ↑ CSF Pressure ＞ 180 ◉ ↓ Glucose ＜ 40
◉ ↑ Proteins ＞ 100mg ◉ ↑ WBCs ＞100 ( Lymphocytes )
114. A group of mice was taken and injection of plastic
hydrocarbon was given this will work as initiator in
process the initiator work as: (Med 23 May 2023 (A.N) +8 past) -
ID: 57896
Ⓐ Slow process will take time
Ⓑ It is last step in ccarcinogensis
Ⓒ Memory produce Ⓓ Cause Clonal proliferation
Ⓒ Initiation of chemical carcinogenesis ☛ normal cell undergoes
irreversible change ➜ characterized by intrinsic capacity for
autonomous growth ➜ capacity remains latent for weeks, months, or
years ➜ initiated cell may be phenotypically indistinguishable from
other parenchymal cells in that tissue.
✦ Harsh Mohan, Pg. 211
115. A malnourished child , multiple extracted teeth he
had , on radiography scans were not suggestive of his Age
.As age is not known how will you calculate age? (Radio 23
May 2023 (A.N) +5 past) - ID: 57903
Ⓐ Multiple XRAYS Ⓑ Height and weight ratio
Ⓒ Nutritional status Ⓓ Height of molar teeth
Ⓑ may be wrong Answer. Confirm with EXPLANATION
116. The most common cause of ascites in patient of
chronic HCV (Med 23 May 2023 (A.N) +4 past) - ID: 57934
Ⓐ Decrease plasma oncotic pressure
Ⓑ Increase hydrostatic pressure
Ⓒ Increase colloid osmotic pressure
Ⓓ Decrease hydrostatic pressure
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Ⓐ ✪ Portal hypertension ➜ shunting of blood into systemic
circulation ➜ vasodilators (mainly nitric oxide) released ➜ Splanchnic
vasodilatation ➜ Main cause of Ascites + Varices
✪ CLD ➜ ↓ Albumin synthesis ➜ ↓ Oncotic Pressure ➜ Transudation of
Fluid ➜ Contributing factor in Ascites + Main role in Generalized
Edema ( Anasarca )
✦ Robbins, Pg. 862, 863
117. 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? (Med 23 May 2023 (A.N) +1
past) - 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
118. A 7-year-old boy with acute hepatitis has recurrent
episodes of spontaneous bleeding after a minor knee joint
and muscle injury. His PT 14 and APTT 60. After labs
investigations his factor 8 was 87% and factor 9 was 7%.
What is the SINGLE most - likely diagnosis ? (Med 25 May
2023 (A.N) +5 past) - ID: 66498
Ⓐ Haemophilia A Ⓑ Christmas disease
Ⓒ Von Willebrand's disease Ⓓ Sickle cell anaemia
Ⓔ Thalassaemia
Ⓑ Hemophilia B (Christmas disease) ☛ factor IX deficiency
Symptoms ☛ Bleeding is the main symptom :
circumcised infant, bleeding into joints, urine and stool, nosebleeds,
prolonged bleeding cuts, tooth extraction
Diagnostic LABS ☛
✪ APTT ➜ prolonged ✪ PT ➜ normal
✪ Bleeding time ➜ normal ✪ Fibrinogen ➜ normal,
✪ Factor 8 ➜ normal ✪ Factor 9 ➜ reduced
Treatment ☛ Factor IX concentrates infusion
119. A child with blue sclera and multiple fractures his
uncle suiter from same condition diagnose is: (Med 23 May
2023 (A.N) +4 past) - ID: 67543
Ⓐ Osteogenesis imperfecta (type I collagen defect)
Ⓑ Marfan Ⓒ EDS
Ⓐ Osteogenesis Imperfecta ➜ Autosomal dominant ➜ mutation in
COL1A1 or COL1A2 genes ➜ decreased synthesis of type 1 collagen ➜
Brittle bones + Multiple fractures + Growth retardation + Skeletal
deformities + Blue sclera + Progressive hearing loss
✦ Harsh Mohan, Pg. 825
120. Whose function is it to present exogenous peptides to
helper T cells (Med 23 May 2023 (A.N) +2 past) - ID: 70072
Ⓐ MHC class II Ⓑ MHC class I
Ⓐ Antigen presentation ☛ mediated by MHC class I and class II ➜
found on surface of APCs ➜ deliver short peptides to cell surface ➜
allow them to be recognized by CD8+ ( cytotoxic ) and CD4+ ( helper
cells ).
◉ Endogenous or intracellular peptides for MHC class I.
◉ Exogenous or extracellular peptides for MHC class II.
✦ Robbins
121. The hormone that causes glycogenolysis (glucagon)
release from which pancreatic cells: (Radio 23 May 2023 (A.N)
+2 past) - ID: 71001
Ⓐ Alpha cells Ⓑ Mucous cells
Ⓒ Beta cells Ⓓ D cells
Ⓔ Serous cells
662
 Medi Call FCPS – 1 | MAY 2023 PAPERS

Ⓐ Pancreas alpha cells ☛ produce glucagon ➜ raises blood sugar 2 being causes for edema what combination can cause
edema due to local lymphatic obstruction? (Radio 23 May 2023
122. Patient having Fatigue, Weight loss and lethargy. (A.N) +6 past) - ID: 72550
Upon detail investigations diagnosed as case of Cancer.
Mechanism of cancer formation (Med 25 May 2023 (M) +14 past) Ⓐ Infection and neoplasia Ⓑ Trauma and albuneminuria
- ID: 72134 Ⓒ Renal failure and hypoproteinemia
Ⓓ Cardiac failure and IHD
Ⓐ Initiator and promotor
Ⓑ Only Initiator cause carcinoma Ⓐ Chronic inflammation ( Filariasis, due to Wuchereria bancrofti ) ➜
Ⓒ Initiator followed by promotor causing carcinoma Fibrosis ➜ Lymphatic obstruction ➜ Lymphedema.
Ⓓ Multiple initiator ✦ Robbins, Pg. 100
Ⓔ Promotor followed by Initiator Causing carcinoma
128. A woman with microcytic hypochromic anemia.
Ⓒ Carcinogenesis ☛ Initiator may cause mutational activation of an Presented with had 6-month history of gastritis, target
oncogene such as RAS, subsequent application of promoters leads to cells, spoon-shaped (Koilonychia) and brittle nails, low
clonal expansion of initiated (mutated) cells. mch, low hb: (Med 23 May 2023 (A.N) +14 past) - ID: 72689
✦ Robbins, Pg. 230
Ⓐ Iron deficiency anemia Ⓑ Megaloblastic anemia
123. Patient after renal transplantation develops Ⓒ Anemia of chronic diseases Ⓓ Thalassemia
moderate. Acute cellular rejection acute moderate. Which
cell type increased in acute cellular rejection? (Med 23 May Ⓐ IDA ☛ Pica ( Eat dirty things like mud , sand) with mycrocytic
2023 (A.N) +3 past) - ID: 72158 hypochromic P/S are typical features
Koilonychia ☛ spoon nails ➜ sign of hypochromic anemia, especially
Ⓐ Neutrophils in myocardium Ⓑ T Lymphocytes in
iron-deficiency anemia.
myocardium
✦ Harsh Mohan, Pg. 275
Ⓒ Ventricular aneurysm Ⓓ Coronary stenosis
Ⓔ Coronary dilation 129. A young female diagnose with MDR Tb and taking 2nd
line and Tb drugs. After taking drugs she has developed
Ⓑ Acute cellular rejection ☛ Extensive infiltration in interstitium of enlarge thyroid and anti-thyroid antibodies. Due to which
the transplant by lymphocytes (mainly T cells), a few plasma cells, drug he has developed thyroid problem (hypothyroidism):
monocytes and a few polymorphs (Med 23 May 2023 (A.N) +6 past) - ID: 79402
✦ Harsh Mohan, Pg. 66
Ⓐ Ethionamide Ⓑ Streptomycin
124. A girl has Atelectasis, bronchial obstruction but Ⓒ Cyclosporin
alveoli are still aerated by bronchus and do not collapse
this is due to which of the following? (Surg 24 May 2023 (A.N) Ⓐ Second-line MDR-TB drugs ☛ cause hypothyroidism due to para-
+15 past) - ID: 72190 aminosalicylic acid, ethionamide and prothionamide
Ⓐ Sinusoid Ⓑ Clara cells 130. Anti aging property of cell (Radio 23 May 2023 (A.N) +7
Ⓒ Kulshitsky cells Ⓓ Alveolar pore past) - ID: 82345
Ⓔ Intracellular Canaliculi
Ⓐ Decrease cell division Ⓑ Decrease protien
Ⓒ Decrease calories intake Ⓓ Damage to cellular protein
Ⓓ Pores of Kohn (Alveolar pores) ☛ are apertures in alveolar
septum, which allow communication of two adjacent alveoli.
Ⓒ EXPLANATION
✦ N.I.H USA, Pg.

125. A women deliver a baby with cleft palate and 131. A patient is on peritoneal dialysis. His plasma K is 6.5
congenital birth defects she give history of taking drug for what will you advise him to avoid? (Med 23 May 2023 (A.N) +2
past) - ID: 82347
acne the likely risk factor is (Med 25 May 2023 (A.N) +25 past) -
ID: 72204 Ⓐ Cereal Ⓑ Mango
Ⓐ Retinoic acid Ⓑ Ascorbic acid Ⓒ Tomato Ⓓ Yogurt
Ⓒ Iron deficiency Ⓓ Cobalamine Ⓔ Carrot
Ⓔ Calcium
Ⓒ Tomatoes ☛ high in potassium
Ⓐ ✪ Vitamin A Toxicity ➤ 132. Myxoma in heart location? (Med 25 May 2023 (M) +6 past) -
◉ Acute toxicity include headache, dizziness, vomiting, stupor, and ID: 82393
blurred vision—all of which may be confused with those of a brain
tumor ( Pseudotumor cerebri ) Ⓐ RV Ⓑ LV
◉ Chronic toxicity is associated with weight loss, anorexia, nausea, Ⓒ LA Ⓓ LV
vomiting, and bone and joint pain
▶ Although synthetic retinoids used for treatment of acne are not Ⓒ Myxomas ☛ About 75% occur in left atrium of heart ➜ Most
associated with these complications, their use in pregnancy must be common 1° cardiac tumor in adults ➜ usually described as a “ball
avoided because of the well-established teratogenic effect of valve” obstruction in left atrium ( associated with multiple syncopal
retinoids. episodes ).
✦ Katzung, Pg. 1049 ✦ Robbins, Pg. 329
133. An igG2 molecule is composed of which of the
126. A patient is known case of CKD. Which drug is following (Med 23 May 2023 (A.N) +2 past) - ID: 82401
contraindicated to be used in this patient due to its
nephrotoxicity? (Med 23 May 2023 (A.N) +17 past) - ID: 72323 Ⓐ One alpha, one gamma 2 , and 2 kappa Ig chains
Ⓑ One gamma 1 chain and 2 kappa chains
Ⓐ Gentamicin Ⓑ Penicillin Ⓒ Two gamma 1 chains and two kappa Ig chains
Ⓒ Amoxicillin Ⓓ Augmentin Ⓓ Two gamma 1 chains and two kappa Ig chains
Ⓔ Two gamma 2 chains and two kappa L chains
Ⓐ Gentamicin ☛ Not for use in patients with ascites, burns covering ＞
20% of total body surface area, cystic fibrosis, end-stage renal disease, Ⓔ IgG 2 ☛ 2 κ and 2 λ chains
✦ Medscape, Pg. ✦ Levinson, Pg. 527

127. Edema can occur due to decrease oncotic pressure

and due to raised hydrostatic pressure . Apart from these

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134. In dilated cardiomyopathy why force of contraction is
increased (Med 23 May 2023 (A.N) +1 past) - ID: 82443
Ⓐ Increase interaction of actin myosin
Ⓑ Option B Ⓒ Option C
Ⓐ Dilated cardiomyopathy ☛ Mutations in certain sarcomere proteins
such as cardiac troponin-T and I, b-and a-myosin, and a-cardiac actin
have been observed.
✦ Harsh Mohan, Pg. 434
135. A female develop developed chronic otitis media
resistant to antibiotics, the organism is non. lactose and
stains turn green likely agent is (Surg 24 May 2023 (A.N) +3
past) - ID: 82465
various cellular redox reactions.
NADP is synthesized from NAD + phosphate group. Both NAD and
NADP are derived from niacin (vitamin B3)
141. A female after coming from foreign develops nodule
on the side of her face, Nasal myiasis and eye vision issue
increasing gradually. What can be the cause for this? (Med
23 May 2023 (A.N) +1 past) - ID: 83329
Ⓐ Fly Larvae Ⓑ Allergy
Ⓒ Bacterial infection Ⓓ Fungal infection
Ⓐ Myiasis symptoms, especially the nasal myiasis, suggest an
infestation by fly larvae, known as myiasis. This can occur when a
female fly lays its eggs on the skin or in the body openings of a host.

Ⓐ Pseudomonas Ⓑ Pneumonia 142. Ribosome composition (Radio 23 May 2023 (A.N) +2 past) -
Ⓒ Staph Aureus Ⓓ Streptococcus pneumonia ID: 83458

Ⓐ Protein Ⓑ DNA
Ⓐ Pseudomonas infection is a common cause of chronic otitis media.
Ⓒ Protein + RNA
Pseudomonas infections are suspected on physical examination when
there is a a greenish or blackish, fruity-smelling discharge
Ⓒ Ribosomes are composed of ribosomal proteins and ribosomal RNA
136. Through probe DNA study. Technique use to detect (rRNA) that together form the large and small subunits.
abnormality and microdeletion in chromosomes (Med 25 May
2023 (M) +4 past) - ID: 82509
143. On data Normal distribution (Radio 23 May 2023 (A.N) +2
past) - ID: 83460
Ⓐ Microarray Ⓑ FISH technique
Ⓐ Mean, median, mode are equal in normal curve
Ⓒ Sequencing Ⓓ Cytogenic abnormality
Ⓑ Median, mode in skewed curve
Ⓔ PCR
Ⓒ Mode, median in bimodal curve
Ⓓ Mean, median in kurtotic curve
Ⓑ FISH ☛ Permits localization of a gene to one chromosomal band
✦ First Aid, Pg. 55
Ⓐ Normal distribution (bell curve) ☛ mean, median, and mode are
137. Eye carcinoma that spread minimal? (Surg 24 May 2023 all the same and lie at center of distribution.
(A.N) +6 past) - ID: 82926
144. Old man collapse and his ECG show atrial rate of 75
Ⓐ Retinoblastoma Ⓑ Melanoma and ventricular rate of 35 bpm, P and QRS are dissociated
Ⓒ SCC Ⓓ BCC (Med 23 May 2023 (A.N) +1 past) - ID: 83469

Ⓐ Stokes Adams Ⓑ Atrial Fibrillation

Ⓓ Locally Malignants☛ Locally Invasive and Do Not metastize
BCC ☛ Highly Locally Invasive and rarely Metastize
✦ Harsh Mohan, Pg. 185, 517, 519 ✦ Robbins, Pg. 192, 196, 589
138. Pt has multiple opacities in lung found on general
health checkup. 15 cm mass fixed compact granuloma
without necrosis, neutrophils surrounded by epithelioid
giant cells: (Med 23 May 2023 (A.N) +6 past) - ID: 82966
Ⓒ Sinus Bradycardia Ⓓ Ventricular Tachycardia
Ⓐ Stokes-Adams syndrome ☛ sudden unconsciousness due to
decrease in blood flow (cardiac output), most often resulting from
certain forms of heart block.
Disparity between atrial and ventricular rates might suggest a form of
heart block, leading to decreased perfusion and episodes of syncope.

Ⓐ Tb Ⓑ Sarcoidosis 145. Rh -ve mother with Rh +ve baby, antibodies develop

Ⓒ Mesothelioma Ⓓ Aspergillosis (Med 23 May 2023 (A.N) +1 past) - ID: 83489

Ⓐ After 2 weeks Ⓑ 3 - 6 months

Ⓑ Sarcoidosis ☛ Non caseating Granuloma ➜ Epithelioid cells rimmed
Ⓒ Within 3 months Ⓓ Prepartum hemorrhage
by an outer zone rich in CD4+ T cells
✔ Microscopic features of Granuloma ☛ ➊ Schaumann bodies ➋ Ateroid
Ⓓ Rh alloimmunization occur if there's significant mixing of fetal and
Bodies
maternal blood during pregnancy (such as with a prepartum
✦ Robbins, Pg. 513
hemorrhage)
139. Upper 2/3rd cervix, Pap smear is done which shows
146. Right handed person with Left inferior
dysplasia, pleomorphism, loss of polarity, and active
quadrantanopia lesion in: (Med 23 May 2023 (A.N) +1 past) - ID:
mitotic figures but the basement membrane is intact what 83809
is associated with this? (Radio 23 May 2023 (A.N) +5 past) - ID:
83094 Ⓐ Right parietal lobe Ⓑ Right temporal lobe
Ⓒ Left parietal lobe Ⓓ Left temporal lobe
Ⓐ Carcinoma in situ Ⓑ Invasion of adjacent tissue
Ⓒ Invasion of basement membrane
Ⓐ Superior optic radiations passes through parietal pathway, lesion of
Ⓓ Carcinoma
the right parietal lobe will cause left inferior quadrantanopia that is loss
of lower nasal quadrant from right eye and lower temporal quadrant
Ⓐ Carcinoma in situ ☛ characteristic Dysplasia in cervix epithelial
from left eye.
layer with an intact basement membrane ➜ No invasion to deeper
tissues ➜ precancerous condition 147. A professor was talking about tumor suppressor
genes that involve in cancer of long bones due to mutation
140. Riboflavin + phosphate form (Gynae 24 May 2023 (M) +4 in single or both alleles. He gives an example of bringing
past) - ID: 83269 their child being affected by a disease with rest of children
Ⓐ NAD Ⓑ NADP being normal. The gene involved is: (Med 23 May 2023 (A.N) +3
past) - ID: 83959
Ⓒ FAD Ⓓ FAN
Ⓐ KRAK Ⓑ Myc
Ⓒ Riboflavin (vitamin B2) combines with a phosphate group to form Ⓒ RB 1 Ⓓ WT1
flavin adenine dinucleotide (FAD), an essential coenzyme involved in Ⓔ M8H

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 Medi Call FCPS – 1
Ⓒ RB1 gene, ☛ a tumor suppressor gene, common for only one allele
to be affected (loss of heterozygosity) ➜ when mutated, can lead to
osteosarcoma.
148. A patient having joint pain with rash With DsDNA
1:153 hematuria Urea 55 mechanism is: (Med 23 May 2023
(A.N) +1 past) - ID: 83963
Ⓐ AntiGBM antibodies Ⓑ Antigen-Antibody Complex
Ⓒ Complement mediated Ⓓ Autoimmune
Ⓑ Lupus ☛ body's own DNA becomes a target for immune system ➜
forming antigen-antibody complexes ➜ deposit in various organs and
tissues ➜ leading to joint pain, a rash, and testing positive for high
levels of DsDNA, with hematuria and high urea levels.
149. Hep. B High infectivity and virus active replication is
indicated by: (Med 23 May 2023 (A.N) +2 past) - ID: 83974
Ⓐ HBeAg Positive, HBeAb Negative
Ⓑ HBsAg Positive, HBsAb Positive
Ⓒ HBcAg Positive, HBsAg Negative
Ⓓ HBcAg Positive, HBcAb Negative
Ⓐ High Hep B infectivity ☛ when active virus replication
1. Hepatitis B e-antigen (HBeAg) is positive
2. Hepatitis B e-antibody (HBeAb) is negative
✦ Davidson, Pg. 874
150. Twin pregnancy with two ova. Which is correct? (Radio
23 May 2023 (A.N) +2 past) - ID: 83982
Ⓐ Same placenta Ⓑ Same amniotic sac
Ⓒ Different chorion Ⓓ Same chorion
Ⓓ Twin pregnancy with two ova ☛ dizygotic or fraternal twins,
which have separate amniotic sacs and separate placentas, but share
the same chorion. Same amniotic sac is incorrect for a twin
pregnancy with two ova because dizygotic or fraternal twins, which
develop from two separate ova, typically have separate amniotic sacs.
151. Patient has emphysema what will be the acid-base
imbalance present in him: (Radio 23 May 2023 (A.N) +3 past) - ID:
84048
Ⓐ Raised in H ion in plasma Ⓑ Raise in plasma PCO2
Ⓒ Decrease in HOC3 in plasma Ⓓ Positive base excess
Ⓔ Rise in plasma PH
Ⓑ Emphysema ☛ chronic obstruction to airflow which results in
hypoventilation ➜ primarily leads to retention of CO2 ➜ raised plasma
PCO2 ( respiratory acidosis )
152. A 65 year male develops right-tided hemiplegia and
the slight deviation of angle of mouth to left and dribbling,
while talking he is able to close his eyes on command what
other finding can be present? (Med 23 May 2023 (A.N) +3 past) -
ID: 84104
Ⓐ Lead pipe rigidity Ⓑ Clasp knife spasticity
Ⓒ Muscle fasciculation Ⓓ Atrophy
Ⓔ Low Tone
Ⓑ Left stroke ☛ right-sided hemiplegia and slight deviation of the
angle of the mouth to the left while talking + spasticity
Clasp-knife spasticity ☛ initial resistance to movement followed by a
sudden release ➜ common in stroke and MS (UMNL)
153. The most common gene alteration in pancreatic
carcinoma? (Med 23 May 2023 (A.N)) - ID: 84245
Ⓐ KRAS Ⓑ SMAD4
Ⓒ TP53 Ⓓ Brca 1
Ⓔ BRCA 2
Ⓐ KRAS mutations ☛ occur in approx 95% of pancreatic
adenocarcinomas ➜ activate signaling pathways that promote cell
proliferation and survival.
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154. Proprioception is provided by the muscle spindle due
to (Med 23 May 2023 (A.N)) - ID: 84246
Ⓐ Alpha 1a Ⓑ Type Ib afferent fibers
Ⓒ Type II afferent fibers Ⓓ Type III afferent fibers
Ⓐ Proprioception ☛ Muscle spindles have sensory endings ➜ Type
Ia afferent fibers wrap around the middle of intrafusal muscle fibers ➜
provide CNS with information about muscle length and velocity of
muscle length change.
155. Pt came with jaundice and dark-colored urine. Labs
showed HbsAg negative, AntiHbs and antiHbc positive, and
IgM negative. (Med 23 May 2023 (A.N)) - ID: 84247
Ⓐ HBV Probable Ⓑ Acute Infection
Ⓒ Chronic Ⓓ Post Immunization
Ⓔ Post Vaccination
Ⓓ HbsAg -ve ☛ indicates absence of an active Hepatitis B
AntiHbs, AntiHbc +ve ☛ denote previous exposure to virus but body
has produced antibodies
IgM -ve ☛ indicates it's not a recent infection
signs align with post-immunization status, where person has developed
antibodies against HBV.
156. Pt has fatal disease, brother asked not to tell pt the
truth because it will kill him faster. What will you do? (Med
23 May 2023 (A.N)) - ID: 84249
Ⓐ Provide clear information to the pt about his medical condition
Ⓑ Tell brother that hiding information is against ethics
Ⓐ Principle of autonomy and patient's right to know truth about his
health status overrides ➜ Therefore, doctor is obliged to provide clear
information about medical condition.
157. Dilated cardiomyopathy, Ventricular with more end
diastolic vol will compensate for it because stretch in
ventricle cause (Med 23 May 2023 (A.N)) - ID: 84250
Ⓐ Influx of calcium and efflux of k
Ⓑ Efflux of calcium
Ⓐ Dilated cardiomyopathy ➜ Ventricles have increased end-diastolic
volume ➜ This causes stretch in ventricle ➜ stretch leads to activation
of mechanosensitive ion channels ➜ This causes an influx of calcium
ions and efflux of potassium ions, leading to an increase in contractility
(Frank-Starling).
158. A boy fell from the flight stairs. blood accumulates in
the nape neck. which part is fractured? (Radio 23 May 2023
(A.N) +1 past) - ID: 84251
Ⓐ Middle cranial fossa Ⓑ Anterior cranial fossa
Ⓒ Posterior cranial fossa Ⓓ Occipital lobe
Ⓓ Boy fell from stairs ➜ Blood accumulates in nape of neck, which is
directly related to occipital region ➜ bone underlying this region is
occipital bone, and it forms posterior cranial fossa housing occipital
lobes of brain
159. Change in the cardiac event during inspiration,
decrease in (Med 23 May 2023 (A.N)) - ID: 84252
Ⓐ Right ventricle filling Ⓑ Right ventricle ejection
Ⓒ Dec heart rate Ⓓ Systemic filling
Ⓓ Inspiration ➜ decrease in intrathoracic pressure ➜ increased
venous return to right side of heart (right ventricle filling) ➜ less blood
in systemic circulation ➜ decreased systemic filling.
160. Spike and wave appearance in which type of epilepsy
(Med 23 May 2023 (A.N)) - ID: 84253
Ⓐ Petit mal epilepsy Ⓑ Tonic-clonic epilepsy
Ⓒ Partial epilepsy
Ⓓ Psychogenic non-epileptic seizures
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Ⓐ spike-and-wave discharge is a regular, symmetrical, generalized
EEG pattern seen particularly during absence epilepsy, a.ka 'petit mal'
epilepsy
161. A patient has Zollinger–Ellison syndrome (ZES) What
will happen? (Med 23 May 2023 (A.N)) - ID: 84254
Ⓐ APD Ⓑ Tropical sprue
Ⓒ Secretary diarrhea
Ⓒ Zollinger-Ellison Syndrome ☛ gastrin-secreting tumors
(gastrinomas) ➜ hypersecretion of gastric acid ➜ High acidity in
intestines can cause injury to mucosa ➜ induces a secretory state,
leading to secretory diarrhea.
162. Common nerve for Deep vein thrombosis (DVT): (Med
23 May 2023 (A.N)) - ID: 84255
Ⓐ Deep calf nerves Ⓑ Superficial femoral nerve
Ⓐ DVT ☛ primarily affects deep veins of leg ➜ nerves accompanying
these deep veins, such as tibial and peroneal nerve (calf nerves), are in
close proximity and associated.
163. A 25-year-old male who had CVA was bedridden and
suddenly complained of shortness of breath. After 2 days
he had left-sided pleuritic pain. Had another CVA and died.
On atopy wedge-shaped hemorrhagic area was seen on
the left lower lobe of the lung, Most likely diagnosis is: (Med
23 May 2023 (A.N)) - ID: 84310
Ⓐ Vasculitis Ⓑ Thromboembolism
Ⓒ Atherosclerosis
Ⓑ Bedridden Immobile due to CVA ➜ increased risk of thrombus
formation (DVT) ➜ embolization of thrombus to pulmonary vasculature
➜ shortness of breath and pleuritic chest pain due to pulmonary
embolism ➜ another CVA (potentially due to paradoxical embolism
through patent foramen ovale or from other venous clots) ➜ death ➜
autopsy revealing hemorrhagic infarct (common in pulmonary
embolism) in the left lower lobe of lung.
164. In Vitamin A deficiency complication can occur is
kidney stones (Radio 23 May 2023 (A.N) +1 past) - ID: 84318
Ⓐ Atrophy of renal epithelium
Ⓑ Hypertrophy of renal epithelium
Ⓒ Metaplasia of renal epithelium
Ⓓ Dysplasia of renal epithelium
Ⓔ Hyperplasia of renal epithelium
Ⓐ vitamin A deficiency ➜ lack of retinoids can cause reduction in
cell growth and function ➜ atrophy of renal epithelium, which is a
component of urinary system ➜ eventually lead to renal dysfunction
and increased risk of kidney stones.
165. Cochlear duct true feature (Med 23 May 2023 (A.N)) - ID:
84319
Ⓐ 1.5 rotation of duct Ⓑ Macula cells present
Ⓒ Scala vestibulae continous with scala tympani at helicotremma
Ⓓ Cochlea direct in contact with vestibular nucleus
Ⓒ Cochlear duct or scala media, is sandwiched between scala
vestibuli and scala tympani. scala vestibuli and scala tympani meet at
the apex of cochlea in an area called helicotrema.
166. Heart is not pumping . EDV increases that increases
stretch then how contractility will increase ? (Med 25 May
2023 (M) +1 past) - ID: 84321
Ⓐ Inc Ca influx Ⓑ During action potential
Ⓒ Inc Ca influx in sarcoplasmic reticulum
Ⓓ Inc potassium efflux Ⓔ Inc potassium influx
Ⓐ Heart is not pumping ➜ EDV increases ➜ Increased stretch ➜
According to Frank-Starling law, increased stretch leads to increased
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contractility ➜ This happens due to increased Ca influx which results in
stronger heart muscle contractions.
167. Females having iodine deficiency neck mass ( goiter)
what is the cause of iodine deficiency? (Med 23 May 2023 (A.N))
- ID: 84322
Ⓐ Dec intake Ⓑ Radiations
Ⓒ Dec iodine in food and water
Ⓓ Metabolic disorder and dec iodine absorption
Ⓒ Females with goiter ☛ Indicates iodine deficiency
Most common cause of iodine deficiency worldwide is decreased iodine
content in food and water.
168. Glucose facilitated diffusion is increased by : (Med 23
May 2023 (A.N)) - ID: 84323
Ⓐ Increasing the electronegativity of the cell
Ⓑ Increase activity of Na potassium ATPase
Ⓒ ATP-dependent uptake
Ⓑ Glucose facilitated diffusion ☛ Is dependent on sodium gradient
across cell membrane ➜ Increased activity of Na-K ATPase pumps more
Na out of cell ➜ Creates a more favorable gradient for sodium (and
glucose) to enter cell via co-transport.Even though facilitated diffusion
doesn't directly use ATP, the Na-K ATPase, which maintains sodium
gradient, is ATP-dependent. increasing activity of the Na-K ATPase can
indirectly increase facilitated diffusion of glucose.
Med 24 May 2023
(A.N)
1. Inhibition of transcription done by which of the
following (Med 24 May 2023 (A.N) +1 past) - ID: 424
Ⓐ Tetracycline Ⓑ Erythromycin
Ⓒ Rifampicin Ⓓ Ofloxacin
Ⓒ Rifampicin ☛ inhibits RNA polymerase ➜ inhibiting RNA synthesis (
transcription ).
2. A 23 years old girl at 5 weeks postpartum comes
requesting COCPs for contraception. She has vaginal
delivery and breastfeeding her child. Her BMI is 29 andB.P
is 130/90 mmHg. Her mother has breast cancer. She has
migraine sometimes. You refuse to give her combined oral
contraception pills because OCPs are contraindicated In
(Med 24 May 2023 (A.N) +6 past) - ID: 564
Ⓐ Migraine Ⓑ Cervical metallic
Ⓒ Vaginal epithelial Ⓓ Heavy menses
Ⓐ (Oral Contraceptive Pills are contraindicated in migraine headache
with focal neurological symptoms and above age of 35.)
3. 70 years old man presents with myalgia, rashand
arthralgia.Joints examination reveal no abnormality.Motor
power is 5/5 l.ANA is positive with speckeled appearance.
If anti-ribonucleoprotein RNP is also positive then the
diagnosis is (Med 25 May 2023 (A.N) +13 past) - ID: 1399
Ⓐ Mixed connective tissue disorder
Ⓑ Dermatomyositis Ⓒ SLE
Ⓓ Polymyositis
Ⓐ Mixed connective tissue disease ☛ Clinical features of SScl,
myositis and SLE all occur in same patient.
It commonly presents with indolent puffiness of
fingers with Raynaud’s phenomenon and myalgias.
Most patients have anti-RNP antibodies
✦ Davidson, Pg. 1038
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