Pathophysiology 4th semester:-

Topic Genetics:

Mid term:

1: Which one of following is the set of observable characteristics and is the sum of genetic and
environment effect.

(a) Genotype
(b) Phenotype
(c) Haplotype
(d) Both genotype and phenotype

2: The normal human chromosomes diploid number is:

(a) 23
(b) 46
(c) 47
(d) 69

3: What is the relationship among DNA, a gene, and chromosome?

(a) A chromosome contains hundreds of genes, which are composed of DNA

(b) A chromosome contains hundreds of genes, which are composed of protein
(c) A genes composed hundreds of chromosomes, which are composed of protein
(d) A genes composed of DNA, but there is no relationship to a chromosome

4: Any change in the nucleotide sequence of the DNA of a gene is called

(a) Mutation
(b) Advantage
(c) A codon
(d) An anticodon

5: Genetic disorders such as alkaptonuria and albinism are

(a) Recessive inheritance has

(b) Dominant genes have
(c) X-chromosome
(d) Y-chromosome

6: Which of the following statements is correct about Turner syndrome?

(a) Male with extra X-chromosome

(b) Female with an extra X-chromosome.
(c) Male with a missing X-chromosome
(d) Female with a missing X-chromosome

7: Phenotype(s) of a patient with Turner syndrome include:

 (a) Male characters
(b) Taller hight than the average of a healthy person
(c) Webbed neck
(d) Epicanthic fold in eyes

8: Another name for down syndrome is

(a) Trisomy 21
(b) Trisomy 13
(c) Trisomy 9
(d) Trisomy 18

9: A chromosomal abnormality that causes a woman to be usually short in stature (average 4'7), to have
a webbed neck, and to generally lack feminine secondary sexual characteristics is:

(a) Triple X syndrome

(b) Turner syndrome
(c) XYZ syndrome
(d) Klinefelter syndrome

10: The karyotype of Klinefelter’s syndrome is?

(a) 47+ XXY

(b) 46+XXY
(c) 47+XYY
(d) 7+XXYY

Thyroid:
1: The main hormone secreted by the Thyroid gland

(a) T4
(b) T3
(c) Both (a) & (b)
(d) TSH

2: Iodine deficiency can cause

(a) Goitre
(b) Thyroid cancer nodules
(c) Solitary thyroid nodules
(d) Thyroiditis

3: Grave's disease is due to

(a) Hyperactivity of adrenal cortex

(b) Hypoactivity of the thyroid gland
(c) Hyperactivity of thyroid gland
 (d) Hypoactivity of islets Langerhans

4: The four small glands in the Thyroid gland are known as:

(a) Adrenal gland

(b) Pineal gland
(c) Parathyroid gland
(d) Endocrine and exocrine gland

5: In chronically deficiency patients, this abnormality is directly related to the enlargement of the
thyroid gland

(a) Imparied conversion of T3 and T4

(b) Reduced activity of thyroperoxide
(c) Elevated levels of TSH
(d) An antibody that to binds to the TSH receptor in the thyroid gland

6: This condition of chronic inflammation of the thyroid leading to under activity is:

(a) Thyroiditis
(b) Goitre
(c) Hypothyroidism
(d) Hypothyroidism

7: Medications for hypothyroidism include treatment that:

(a) Replaces insulin

(b) Replaces ADH
(c) Replaces TH
(d) Replaces Surfactant

8: An autoimmune disease where bod's own antibodies attack cells of thyroid is called_______

(a) Hoshimoto's disease

(b) Grave's disease
(c) Turner syndrome
(d) Hyperthyroidism

9: Which type of epithelium is found in thyroid follicles?

(a) Squamous
(b) Cuboidal
(c) Transitional
(d) Columnar

10: The hormone that controls the level of calcium and phosphorus in blood is secreted by_______

(a) Thyroid gland

(b) Parathyroid gland
(c) pituitary gland
(d) Thymus
11: What hormone does the parathyroid?

(a) Calcitonin
(b) PTH
(c) PFH
(d) Insulin

12: Hypothyroidism in adults causes________

(a) Myxoedema
(b) Cretinism
(c) Diabetes
(d) Obesity

Topic: Alteration in Muscloskeletal support and movement (Trauma & injury)

• Rheumatoid arthritis and osteoporosis
• Osteomylitis
• Oosteoporosis
• Rheumatoid arthritis and osteoporosis (2 recall)

1: The muscle teaching a class about the joint commonly affected by osteoarthritis (OA). Which joint
should the nurse include?

(a) Ankle, feet, and spine

(b) Knees, feet and spine
(c) Hands, knees, and hips
(d) Neck, shoulders, and ankles

2: The nurse is teaching an older adult recently diagnosed with osteoporosis (OA) about interventions to
help maintain mobility of the joints. Which should the nurse include?

(a) Jogging three times a week

(b) Routine nonsteroidal anti-inflammatory drug (NSAID) use
(c) Glucosamine and chondroitin supplement
(d) Physical therapy

3: A 25 Year old female complaints of increasing symmetrical joint pairs which are worse in the morning.
She discribes puffy hands and feet and a painful neck. Her concentration is very poor examination
reveals an increase body temperature and restriction of movement due to pain. Which of the following
investigation Would be useful in this case?

(a) Anti-cyclic Citrulinated peptide antibody

(b) Ultrasound Scan hands and feet
(c) Anti-JO-I antibody
(d) Rheumatoid factor R
Osteomylitis 1 recall and
1: The most common cause of osteomylitis is:

(a) Staphylococcus aureus

(b) Streptococcus pyrogens
(c) E.coli
(d) Pneumococcus pneumonia

2: The infection of the bone is known as:

(a) Osteomylitis
(b) Osteoarthritis
(c) Myocarditis
(d) Thyroiditis

3: A patient is being discharged after 2 weeks of IV antibiotics therapy for acute osteomylitis in the left
leg. Which information will be included in the discharge teaching?

(a) The reason for taking oral antibiotics for 7 to 10 days after discharge
(b) The need for daily aerobic exercise to help maintain muscle strength
(c) How to monitor and care for the long term IV catheter site
(d) How to apply warm packs safely to the leg to reduce pain

Osteoporosis
1: Identify methods to specially prevent osteoporosis in postmenopausal women (select all that apply)?

(a) Eating more beef

(b) Performing weight bearing exercises
(c) Spending 15 minutes in the sun each day
(d) Talking postmenopausal estrogen replacement

2: A patient is diagnosed with osteoporosis. You are going to counsel the patient, which statements
should the nurse include when teaching the patient about the disease?

(a) It’s a degenerative disease characterized by a decrease in bone density.

(b) It’s congenital disease caused by poor dietary intake of milk products.
(c) Weight bearing exercise should be avoided.
(d) Can be life threatening

Topic:2 Endocrine disorders (Dr Tazeen)

1: Gigantism results when?

(a) Growth hormone is inexcerss and epiphyseal cartilage is growing

 (b) Renal tubules are unable to respond to ADH
(c) Low stimulation of larger glands
(d) Excess of prolactin hormone

2: If pituitary gland stops producing growth hormone after body growth is completed it result in

(a) Gigantism
(b) Tetany
(c) Kidney failure
(d) Acromegaly

3: Androgens are produced by the

(a) Ovaries
(b) Testes
(c) hypothalamus
(d) islets of Langerhans.

4: The growth hormone produced by the pituitary gland is known as:

(a) Somatotropin
(b) Prolactin
(c) Luteinizing hormone
(d) Follicle stimulating hormone

5: The posterior pituitary gland stores secretes

(a) Oxytocin and antidiuretic hormone

(b) Human growth hormone and thyroid stimulating hormone
(c) Prolactin and follicle stimulating hormone
(d) Glucocorticoids and androgens

6: The release of cortical is stimulated by hormone

(a) Aldosterone
(b) Anglotensin
(c) Antidiuretic hormone (ADH)
(d) Adrenocorticotropin hormone (ACTH)

7: The hormone is responsible for" fight or flight" response

(a) Thyroxine and melatonin

(b) Insulin and glucagon
(c) Epinephrine and norepinephrine
(d) Estrogen and progesterone

8: Enlargement of the bone and hand and feet along with face is due to over production of growth
hormone is called

(a) Acromegaly
(b) Cushing syndrome
 (c) Polydactyly
(d) Addison disease

9: The endocrine gland(s) that sits top of the kidneys and secretes both metabolic stabilizers and stress
regulators

(a) Pancreas
(b) Adrenal gland
(c) Thyroid gland
(d) Pituitary gland

10: Insulin is a natural hormone secreted by

(a) Kidney
(b) Liver
(c) Pancreas
(d) Spleen

11: Hypoglycemia is said to accur when the blood glucose is:

(a) Less than 5.0mmols/L

(b) Less than 4.5mmols/L
(c) Less than 2.0mmols/L
(d) Less than 4.0mmols/L

12: The target of glucose control is an HbA1c blood level of should be:

(a) 6.0% (42 mol/mol)

(b) 7.5% (59 mmol/mol)
(c) 8.0% (53 mmol/mol)
(d) 6.5% (48 mmol/mol)

13: The newly diagnosed diabetic patient was advised by a nurse to daily check his feet for:

(a) To prevent leg amputation

(b) To check for any cut sore and to prevent infection and gangrene
(c) To see it hurts
(d) To dry cracked skin

14: Hypoglycemia is related to:

(a) Reduced insulin and increase glucose

(b) Increased insulin and decreased glucose
(c) High glucose falls too rapidly
(d) Failure to eat

15: What will be the nurse first action upon finding patient with mild hypoglycemia

(a) Call the emergency doctor

(b) Give I/M of glucagon
(c) Give 25% dextrose of orange juice
 (d) Give insulin

16: A normal fasting blood glucose in non-diabetic should be:

(a) 80-100mg%
(b) 40-80mg%
(c) 120-150mg%
(d) 150-200mg%

17: The nurse enters a diabetic patient room and noticed that patient is diaphoretic, tachycardia,
anxious, hungry and doesn't remember where she shows the sign of:

(a) Hyperglycemia
(b) Hypoglycemia
(c) Diabetic ketoacidosis
(d) Hyperosmolar hyperglycemia nonketotic coma

18: The most common cause of Cushing syndrome is:

(a) Adrenal adenoma

(b) Pituitary edenoma
(c) Ectopic ACTH production
(d) Latrogenic

19: which age group does acromegaly most commonly effect?

(a) 50-60 years

(b) 30-35 years
(c) 25-40 years
(d) 10-20 years

20: What is tinnitus:

(a) Auditory hallucination

(b) Ringing in ears
(c) A rare type of infection
(d) Damaged eardrum

21: What is the main features of glaucoma:

(a) Raised intraocular pressure

(b) Raised blood pressure
(c) Clouding of the eye lens
(d) weakness of eye muscle

Endocrine disorders ( Sub topic diabetes mellitus)

1: Which of the following is the most important stimulus for insulin synthesis and release?

(a) Glucose
(b) Fatty acids
 (c) Amino acids
(d) Glucose and fatty acids

2: Which of the following statement regarding Type 1 biabetes is correct?

(a) Alloimmune disease

(b) More common in the older age group
(c) Autoimmune disease
(d) The important environmental risk factor is obesity

3: According to WHO diagnostic criteria for Diabetes, which of the following statement is correct?

(a) fasting plasma glucose>170mg/dl

(b) A fasting plasma glucose>126mg/dl
(c) A glycated hemoglobin (HbA1C) level>9.5%
(d) A glycated hemoglobin (HbA1C)level>6.5%

4: Which of the following confirmed values meet the diagnostic threshold for Diabetes?

(a) Fasting blood glucose>140mg/dl

(b) Fasting blood glucose>126mg/dl
(c) Random glucose >160mg/dl
(d) 2 hour postprandial glucose > to 126mg/dl

5: Which of the following is 3 macrovascular complication of diabetes mellitus?

(a) Myocardial infarction

(b) Nephropathy
(c) Neuropathy
(d) Retinopathy

6: Hyperlipidemia is one of the major risk factor for atherosclerosis which lipid has maximum association
with atherosclerosis?

(a) Cholesterol
(b) Triglyceride
(c) Low density lipoprotein
(d) High density lipoprotein

7: The ideal enzymes marker for the laboratory diagnosis of myocardial infarction is?

(a) CKMB
(b) Toporin-1
(c) LDH
(d) SGOT

8: Fatty streaks are the earliest lesion of Which of the following disease?

(a) Atherosclerosis
(b) Diabetes mellitus
(c) Pulmonary hypertension
 (d) Hepatitis

9: 75 years old female was diagnosed as a osteoporosis after investigation. What is the most common
cause of osteoporosis among all these conditions

(a) CA nutritional state

(b) Genetic factor’s
(c) Reduced physical activity
(d) Senile and post menopausal type

10: The test for checking mean plasma glucose concentration over the previous 8-10 weeks is:

(a) Fasting plasma glucose concentration

(b) Random blood glucose test
(c) Hemoglobin A1c
(d) Oral glucose tolerance test (OGTT)

1: Which hormone released from adrenal gland cortex?

(a) Aldosterone
(b) Insulin
(c) Glucagon
(d) Thyroxine

2: Which hormone is responsible for glucose metabolism?

(a) Aldosterone
(b) Insulin
(c) Glucagon
(d) Thyroxine

3: Which hormone is released from thyroid?

(a) Aldosterone
(b) Insulin
(c) Glucagon
(d) Thyroxine

4: Insulin is released from which of the following organ.

(a) Pancreas
(b) Liver
(c) Thyroid
(d) Adrenal

Unit 3: Disorders of Neurological system

1: Neuropathic pain is:
 (a) Crying psychological response to pain
(b) Sharp, shooting pain
(c) Produced by visceral organ
(d) Produced at a site other than actual injury

2: Acute pain is:

(a) Less than 3 months duration

(b) More than 3 months
(c) Is no treated usually
(d) Is prolonged pain

3: Mr X suffers from a chronic pain in left sciatic nerve distribution. He has tried many pain control
methods. His doctor recommended him a latest method of pain relief which involves application of
electric current from a battery powered machine to skin via the attached electrodes, this method is
known as:

(a) Acupuncture
(b) TENS
(c) Yoga
(d) Electric massage

4: A doctor touches the patient's abdomen this sensation is detected by:

(a) Thermal nociceptors

(b) Mechanical nociceptors
(c) Chemical nociceptors
(d) Special nociceptors

Disorders of Neurological function

1: The common risk factor associated with stroke is

(a) Diabetes
(b) Lack of sleep
(c) Increased intake of meat
(d) Old age

2: A 65 year old female cause of diabetes and hypertension develop left arm weakness, his symptoms
subsided after 03 hours, this type of pattern is called as:

(a) Transient ischemic attacks (TIAs).

(b) Degenerative myopathy.
(c) Intracerebral hemorrhage.
(d) Sub arachnid hemorrhage

3: A 69 year male smoker, postman by profession and fruit lover develop acute stroke ( paralysis) during
his treatment the most important step is:

(a) Stop doing his profession.

 (b) Stop eating fruits.
(c) Take medicines on time.
(d) Stop smoking

Topic: Eye and Ear (Recall):

1: The labyrinth of the inner ear is responsible for maintaining the body’s.

(a) Binaural interaction

(b) Air conduction
(c) Equilibrium
(d) Pressure equalization

2: Why might hearing loss occur during an ear infection?

(a) Inching in ear dulls the ability to hear well

(b) The ear tubes are off balance.
(c) An ear tube has been lost.
(a) Pus buil

5:

(d) ding dampens the ear drum vibration

3: Which of the following nursing diagnoses is the priority diagnosis for a patient with Menjere's
disease?

(a) Disturbed sensory perception Auditory.

(b) Disturbed sleep pattern.
(c) Risk of Trauma.
(d) Social isolation

Ear (Application):
4: The public health nurse is preparing to teach the members of local swim club about care of the ears.
Which of the following statements would be appropriate for the nurse to include?

(a) to clean cotton swab to dry the ear canal after swimming.
(b) A tight-fitting swim cap is preferred to earplugs for keeping water out of the ear.
(c) If there is debris in the ear canal, irritate the ear with cold water.
(d) After an episode of acute inflammation, the swimmer should wait 7-10 days before returning to
the water.
(a) 5: The nurse is caring for a patient who has a hearing defect. Which of the following techniques
should be implemented by the nurse to improve communica tion?
(a) Keep the patient's face full light
(b) Use a low voice pitch with normal loudness
(c) Speak at a slower rate than usual.
(d) Use long sentence
Eye (Application)
6: The 77 year old male smoker has developed cataracts on both eyes, and is awaiting surgery The
characts have prevented the patient from driving reading and seeing television. Which of the following
statements would be appropriate for the nurse in the preoperative holding area to communicate to the
patient's?

(a) Did your eye doctor explain to you could choose to use eye drops six times a day to dissolve the
cataract.
(b) You are wise to have both eyes done at the same time.
(c) If you were non-smoker you would never have developed cataracts.
(d) Most parents undergoing cataract surgery do well and enjoy the improved vision

7: When the visiting nurse is teaching the family of a patient with acute conjunctivitis regarding the
disease process, the nurse emphasizes which of the following statements as most important?

(A) Wash hands before and after installing eye drops

(B) Cleanse the patient's contact lenses twice each day
(C) Ask patient to gently rub eyes to circulate the eye drops after installation
(D) Use a cotton-tipped swab to cleanse the right eye and then the Left eye

8: Which of the following aspects for health teaching regarding acute and chronic conjunctivitis is the
most important information to be emphasized to a group of preschool parents?

(a) Preventable cause of blindness.

(b) Important of early medical diagnosis.
(c) Mode of transmission.
(d) Pain management

9: The nurse's first action for a patient who present to the emergency department with manifestation of
corneal perforation is to:

(a) Contact the patient’s opthalmologist.

(b) Place the patient’s in a supine position.
(c) Cover the eye with gauze.
(d) Administer tears for dry eye

Topic: Rheumatoid Arthritis:

Osteoarthritis
Osteomylitis
Osteoporosis
1: 20 year old lady presents in OPD complaining about symmetrical pain in both wrist, morning stiffness
and having butterfly rash on her face. Her RBS was normal and blood pressure with normal range. ESR
was elevated. What is the most likely diagnosis?
 (a) Rheumatoid arthritis.
(b) Osteoporosis.
(c) Osteoarthritis.
(d) Osteomylitis

2: 65 year old patient complain of the pain in hip and hand joints. On examination the bony swelling
(Heberden's nodule) found on proximal and distal interphalangeal joint. N.o any color change noticed in
nails. What is the most likely diagnosis?

(a) Rheumatoid arthritis.

(b) Osteoporosis
(c) Osteoarthritis
(d) Osteomylitis

3: old patient diagnosed with osteomyelitis

What is the most likely causative organism?

(a) Staph. Aureus (bacterial)

(b) Candidiasis
(c) Viral organism
(d) Parasitic infestation

4: Malar rash is the butterfly shaped rash crossing a nasolabial fold, in which of the following condition
you may Find it?

(a) Rheumatoid arthritis

(b) Osteoporosis
(c) Osteoarthritis
(d) Osteomyelitis

Special senses
5: A young child suffering from fever and sore throat began to complain of lacrimation. On examination,
follicles were found in the lower palpebral conjunctiva with tender preauricular lymph nodes. The most
probable diagnosis?

(a) Trachoma
(b) Conjunctivitis
(c) Glaucoma
(d) Cataract

6: A female patient 18 years old, who is contact lens wearer since two years, is complaining of redness,
Lacrimation and foreign body sensation of both eyes. On examination, visual acuity was 6/. The
expected diagnosis can be:

(a) Uveitis
(b) Conjunctivitis.
(c) Bacterial corneal ulcer.
 (d) Acute congestive glaucoma

7: glaucoma is mainly characterized by

(a) Raised intraocular pressure

(b) Raised blood pressure
(c) Clouding of the eye lens
(d) Weakness of eye muscle

8: The commonest organism responsible for corneal ulcer is:

(a) Staphylococci
(b) Pneumococci
(c) Pseudomonas
(d) Candida