Medi Call FCPS – 1 | MAY 2023 PAPERS

49. A pregnant hyperthyroid lady, during her 5th month of 55. A wound left open for secondary wound healing which
pregnancy, which antithyroid drug shoud be given? (Med 25 cell play a key role in wound contraction of secondary
May 2023 (A.N) +8 past) - ID: 16438 wound healing? (Surg 24 May 2023 (A.N) +9 past) - ID: 20585
Ⓐ Propylthiouracil Ⓑ Methimazole Ⓐ Myofibroblasts Ⓑ Fibroblasts
Ⓒ Radioiodine Ⓓ None Ⓒ Condroblasts Ⓓ Osteoblasts

Ⓑ ✪ In 1st trimester ➜ PTU Ⓐ ◉ Healing by secondary intention ☛ Myofibroblasts play a key role in
✪ In Thyroid storm ➜ PTU wound contraction.
✪ From 2nd trimester Onwards ➜ Methimazole ( Harrison + Davidson ) ✦ Goljan, Pg. 61

50. Patient brought in ER with redioulnar and femoral 56. Metastasis of malignancy is because of which of the
fractures. BP90/60 mm of Hg, Pulse = 120 bpm. What is following ? (Surg 24 May 2023 (A.N) +39 past) - ID: 20777
the best initial management? (Surg 24 May 2023 (A.N) +20 past)
- ID: 16499 Ⓐ Loss of vemintin
Ⓑ Down-regulation of E-cadherin
Ⓐ Fracture fixation Ⓑ Volume replacement Ⓒ Loss of cachexin
Ⓒ Radiography of limbs Ⓓ Refer to ortopaedic surgeon Ⓓ Loss of Basement membrane integrity

Ⓑ ✪ initial management of multiple-trauma patient includes following
steps in sequence
● Aims of the initial evaluation of trauma patients: -
● Stabilise the patient
● Identify life-threatening conditions in order of risk and initiate
supportive treatment
● Organise definitive treatments or organise transfer for definitive
treatments. Since this patient is hemodynamically unstable so the best
initial step is fluid replacement.
✦ CMDT, Pg. 506
51. Which of the following features differentiates invasive
carcinoma from carcinoma in situ (Surg 24 May 2023 (A.N) +11
past) - ID: 16518
Ⓑ ◉ Loss of E-cadherin function ☛ loosening of intercellular
junctions ➜ metalloproteinases degrade basement membrane and ECM
➜ cells attach to ECM proteins (eg, laminin, fibronectin) ➜ cells migrate
through degraded ECM (“locomotion”) ➜ vascular dissemination ➜
Metastasis
✦ Robbins, Pg. 221
57. A young boy is brought to the hospital after a bicycle
accident and possible pelvic fracture. While awaiting a
computed tomography (CT) scan of his pelvis, a physician
proceeds with a focal neurologic examination. In testing
the child's reflexes, which of the following nerves involved
in afferent of cremasteric reflex? (Surg 24 May 2023 (A.N) +27
past) - ID: 21265

Ⓐ Anaplasia Ⓑ Number of mitosis Ⓐ Ilioinguinal nerve Ⓑ Hypoepigastric nerve

Ⓒ Basement membrane invasion Ⓓ Pleomorphism Ⓒ Iliohypogastric Ⓓ Genitofemoral nerve

Ⓒ ◉ Tumor cells attach to each other by E.cadherin ➜ Down regulation Ⓐ Cremastaric reflex
of E.cadherin ➜ Dissociation of attached cells ➜ Cells attach to When inner thigh is stroked ➜ sensory (Afferent) fibers of ilioinguinal
laminin ➜ Destroy BM via Collagenese ➜ Attach to fibronectin in ECM nerve are stimulated ➜ These activate the motor (Efferent) fibers of
and spread locally genital branch of the genitofemoral nerve ➜ cremaster muscle contract
✦ Robbins, Pg. 221, 194 ➜ elevate testis
52. Which of the following ethical issues form the 58. At which level SMA supply converted to IMA supply in
foremost part of Hippocratic oath : (Surg 24 May 2023 (A.N) +5 regard of colon ? (Surg 24 May 2023 (A.N) +6 past) - ID: 21306
past) - ID: 17883
Ⓐ Transversecolon Ⓑ Ascending colon
Ⓐ Confidentiality Ⓑ Sexualboundaries
Ⓒ Decending colon Ⓓ None of above
Ⓒ Advertising Ⓓ Bribery
Ⓐ Transeverse colon ✪ Proximal two thirds ➜ supplied by middle
Ⓐ Correct answer A. confidentiality is the provision of keeping the
colic artery, a branch of superior mesenteric artery
patient information private.
✪ Distal third ➜ supplied by left colic artery, a branch of inferior
53. A lab boy giving demonstration on pulmonary function mesenteric artery
test He inspire and then forcefull expired. Strong ✦ SNELL, Pg. 183
expiratory muscle for Forced Expiration are ? (Surg 24 May 59. The Superior layer of superficial perineal pouch is ?
2023 (A.N) +19 past) - ID: 19383 (Surg 24 May 2023 (A.N) +9 past) - ID: 21329
Ⓐ Diaphragm Ⓑ Quadratus Lumborum Ⓐ Perineal membrane Ⓑ Superficial perineal fascia
Ⓒ External intercostal Ⓓ Abdominal recti Ⓒ Perineal body Ⓓ None of above

Ⓓ Forced Expiration Ⓐ Superficial perineal pouch a potential space between perineal

✪ Active process ➜ ● forcible contraction of the musculature
of anterior abdominal wall(External oblique, internal oblique, Rectus
Abdominis) ● quadratus lumborum(pulls down the 12th rib) ●
Depression of ribs by contraction of internal inter costal
✪ Minor role ➜ serratus posterior inferior + latissimus dorsi
✦ SNELL, Pg. ✦ Guyton, Pg. 497
membrane (superiorly) and the superficial perineal fascia (inferiorly)
✦ Kaplan Anatomy, Pg. 178
60. A female took 100 tablets of the paracetamol what
would be seen on biopsy ? (Surg 24 May 2023 (A.N) +4 past) - ID:
21537

54. Splenic vessels are contained in ? (Surg 24 May 2023 (A.N) Ⓐ Apoptosis Ⓑ Necrosis
+9 past) - ID: 19654 Ⓒ Infection Ⓓ Extensive liver necrosis

Ⓐ Splenic hilum Ⓑ Linorenal ligament Ⓓ Acute acetaminophen poisoning ☛ acute/ fulminat liver failure
Ⓒ Pancreatic Ligament Ⓓ Lesser sac with extensive necrosis.

Ⓑ The splenorenal ligament (or lienorenal ligament), is derived from 61. Why heart doesnt undergo tetanization (Surg 24 May 2023
the peritoneum, where the wall of the general peritoneal cavity comes (A.N) +13 past) - ID: 21641
into contact with the omental bursa between the left kidney and the
Ⓐ Long refractory period Ⓑ Short refectory period
spleen the lienal vessels (splenic artery and vein) pass between its two
Ⓒ Half refractory period Ⓓ No refractory period
layers
✦ First Aid, Pg. 361

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