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Medicine, SURGERY
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RECORDINGS+TESTS)
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MEDICINE MAY 2024 EXAM

➢ Agranular cerebral cortex > primary motor cortex:
o Probable Answer: The primary motor cortex is an agranular cortex, meaning it has
fewer granule cells and is involved in motor control.
➢ Anterior middle meningeal artery leakage where:

o Probable Answer: Leakage of the anterior branch of the middle meningeal artery
typically causes an epidural hematoma.
➢ Which transport has Vmax:

o Probable Answer: Facilitated diffusion and active transport both have a Vmax,
representing the maximum rate at which the transporters can move substances
across the membrane.
➢ 21-hydroxylase deficiency in congenital adrenal hyperplasia (CAH), why is there androgen

excess:
o Probable Answer: Due to the blockage in cortisol synthesis, precursors are shunted
into the androgen synthesis pathway, leading to excess androgen production.
➢ Cells are compact together, what is the surface/parenchyma of the adrenal medulla:
o Probable Answer: The adrenal medulla consists of chromaffin cells which are closely
packed and release catecholamines (epinephrine and norepinephrine).
➢ Renal GFR measured before transplant by:

RECORDINGS+TESTS)
o Probable Answer: GFR is commonly measured using creatinine clearance or inulin

clearance tests.
➢ Brain-eating bacteria was:

o Probable Answer: Naegleria fowleri.
➢ During hanging, person died due to fracture of:

o Probable Answer: Fracture of the hyoid bone or cervical vertebrae (usually C2) can
occur during hanging.
➢ Lung posterior expansion till which vertebrae:

o Probable Answer: The lungs expand posteriorly down to the level of T10 during full
inspiration.
➢ Posterior wall of the ovary contains:

o Probable Answer: The posterior wall of the broad ligament (mesovarium) attaches
to the ovary.
➢ In alveoli, diffusion-limiting transport is of which:

o Probable Answer: Oxygen, especially under conditions of exercise or disease states
like pulmonary fibrosis.
➢ Hering-Breuer reflex is:

o Probable Answer: A protective reflex that prevents over-inflation of the lungs,
mediated by stretch receptors in the lungs.
➢ Niacin causes:

RECORDINGS+TESTS)
o Probable Answer: Pellagra, which is characterized by dermatitis, diarrhea, and

dementia.
➢ Tuft of hair in the back of a woman:

o Probable Answer: This could indicate a congenital spinal abnormality like spina bifida
occulta.
➢ Lump on back with meninges and no neural tissues:

o Probable Answer: Meningocele, a type of spina bifida where there is a sac of fluid
without spinal cord involvement.
➢ ARDS in infants due to:

o Probable Answer: Deficiency of surfactant, leading to neonatal respiratory distress
syndrome.
➢ Posterior to lungs is:

o Probable Answer: The posterior thoracic wall, including the vertebral column and
associated muscles.
➢ Hemophilia scenario:
o Probable Answer: Hemophilia is a bleeding disorder due to deficiency of clotting
factors (Hemophilia A - Factor VIII, Hemophilia B - Factor IX).
➢ Person with skeletal abnormality, mental retardation, and jaw/mandible problem:

o Probable Answer: Pierre Robin sequence or syndrome, which includes micrognathia
(small jaw), glossoptosis (downward displacement of the tongue), and airway
obstruction.

RECORDINGS+TESTS)
➢ Ipsilateral corticospinal tract and Horner syndrome defect:

o Probable Answer: This combination suggests a lesion in the brainstem, possibly a
lateral medullary syndrome (Wallenberg syndrome).
➢ Comparison of saliva vs plasma:

o Saliva generally has lower concentrations of sodium and higher concentrations of
potassium compared to plasma.
➢ Marfan syndrome:
o A genetic disorder affecting connective tissue, characterized by tall stature, long
limbs, and cardiovascular abnormalities like aortic aneurysms.
➢ Epitheloid cells function in TB:

o Epithelioid cells are modified macrophages found in granulomas, which help in
walling off the TB bacteria.
➢ TB test:
o Tuberculin skin test (Mantoux test) or interferon-gamma release assays (IGRAs).
➢ Diastolic and systolic BP to find MAP:

o MAP = (Diastolic BP + 1/3(Systolic BP - Diastolic BP)).
o For BP 50 and 150: MAP = 50 + 1/3(150-50) = 50 + 1/3(100) = 50 + 33.33 = 83.33
mmHg.
o For BP 25 and 150: MAP = 25 + 1/3(150-25) = 25 + 1/3(125) = 25 + 41.67 = 66.67
mmHg.
➢ SA node pacemaker phase:

o Probable Answer: Phase 4 (spontaneous depolarization) due to the funny current
(If).

RECORDINGS+TESTS)
➢ Nystagmus and ataxia:

o Probable Answer: Flocculonodular lobe (part of the cerebellum).
➢ Hemoglobin E:
o Hemoglobin E is a variant of hemoglobin found in some populations, especially in
Southeast Asia, and can cause mild hemolytic anemia.
➢ Vmax - facilitated diffusion:

o Facilitated diffusion has a Vmax due to the finite number of transporters.
➢ Moritz type scenario:

o Probable Answer: This likely refers to a clinical scenario involving cardiac
arrhythmias or a condition described by the physician Moritz, potentially related to
pre-excitation syndromes like Wolff-Parkinson-White (WPW) syndrome.
➢ For transplant - HLA typing:

o Probable Answer: Human leukocyte antigen (HLA) typing is essential for matching
donors and recipients in organ transplantation to reduce the risk of rejection.
➢ Minimum pressure in heart:

o Probable Answer: Between right atrium and ventricle.
➢ Diphtheria hypersensitivity:
o Probable Answer: Type III hypersensitivity reaction can occur after diphtheria toxoid
vaccination.
➢ Hydrops fetalis HS:


RECORDINGS+TESTS)
o Probable Answer: Hemolytic disease of the fetus and newborn (HDFN) due to Rh
incompatibility.
➢ Cardiovascular changes during inspiration:

o Probable Answer: During inspiration, venous return to the right heart increases due
to the negative intrathoracic pressure.
➢ Gastrin secretion increased by alkalinization of the antrum:

o Probable Answer: Correct. Alkalinization of the antrum can stimulate gastrin
secretion.
➢ Agranular cerebral cortex > Primary Motor Cortex:

o Probable Answer: Correct. The primary motor cortex (Brodmann area 4) is an
agranular cortex.
➢ Anterior middle meningeal artery leakage where:

o Probable Answer: Leakage of the anterior branch of the middle meningeal artery
typically causes an epidural hematoma.
➢ Which transport has Vmax:

o Probable Answer: Facilitated diffusion and active transport both have a Vmax,
representing the maximum rate at which the transporters can move substances
across the membrane.
➢ 21-hydroxylase deficiency in congenital adrenal hyperplasia (CAH), why is there androgen

excess:
o Probable Answer: Due to the blockage in cortisol synthesis, precursors are shunted
into the androgen synthesis pathway, leading to excess androgen production.

RECORDINGS+TESTS)
➢ Cells are compact together, what is the surface/parenchyma of the adrenal medulla:
o Probable Answer: The adrenal medulla consists of chromaffin cells. The term
"mesothelium" is incorrect; mesothelium is the epithelial lining of the pleura,
peritoneum, and pericardium.
➢ Renal GFR measured before transplant by:

o Probable Answer: Serum creatinine and creatinine clearance tests are commonly
used. More accurate measurements can be done with inulin clearance or
radionuclide GFR.
➢ Brain-eating bacteria was:

o Probable Answer: Naegleria fowleri.
➢ Additional Questions and Probable Answers:
➢ Boy walks during sleep:

o Probable Answer: This condition is known as sleepwalking or somnambulism.
➢ Follicular lymphoma translocation:

o Probable Answer: t(14;18).
➢ U wave in ECG:
o Probable Answer: U waves can be seen in conditions like hypokalemia, bradycardia,
and some other electrolyte imbalances.
➢ ACE inhibitor:
o Probable Answer: Angiotensin-converting enzyme (ACE) inhibitors are medications
used primarily for treating high blood pressure and heart failure.

RECORDINGS+TESTS)
➢ Addison's disease:
o Probable Answer: Addison's disease is a condition characterized by adrenal
insufficiency, where the adrenal glands do not produce enough steroid hormones
(glucocorticoids and mineralocorticoids).
SURGERY MAY 2024 EXAM

➢ Loss of flexion nerve damage:
o Probable Answer: Ulnar or median nerve damage cause loss of flexion. The median
nerve primarily affects flexion of the thumb, index, and middle fingers, while the
ulnar nerve affects the ring and little fingers.
➢ Complicated scenario of calculation of GFR, creatinine, and urine output:

o Probable Answer: This involves using the formula for GFR (glomerular filtration rate).
If creatinine clearance (CrCl) is given, GFR = (Urine creatinine concentration x Urine
flow rate) / Plasma creatinine concentration.
➢ Sensory supply to the index finger:

o Probable Answer: Median nerve.
➢ Hyperextension injury to the anterior femur in a semiflexed knee causes damage to:
o Probable Answer: Anterior cruciate ligament (ACL).
➢ Ankle sprain damaged ligament:

RECORDINGS+TESTS)
o Probable Answer: Lateral collateral ligament (most commonly the anterior

talofibular ligament).
➢ Opening of left gastric vein:

o Probable Answer: Portal vein.
➢ Azygos vein opening:

o Probable Answer: The azygos vein receives blood from the right ascending lumbar
vein and the subcostal vein.
➢ Derivation of primordial germ cell:

o Probable Answer: Epiblast.
➢ Best time to conceive:

o Probable Answer: Around ovulation, which occurs during the late proliferative phase
and early secretory phase of the menstrual cycle.
➢ 5 mg/kg thiopental given, cause of hypotension:

o Probable Answer: Decreased venous return due to peripheral vasodilation.
➢ Woman after cast with red, hot, tender, and painful limb:
o Probable Answer: Cellulitis.
➢ Migration of WBCs:
o Probable Answer: Diapedesis.
➢ 4-year-old girl with platelets 85,000 and megakaryocytes present, bleeding tendency:

RECORDINGS+TESTS)
o Probable Answer: Bernard-Soulier syndrome.
➢ Hormone for ECF osmolarity:

o Probable Answer: Vasopressin (Antidiuretic hormone, ADH).
➢ Lateral boundary of urogenital diaphragm:

o Probable Answer: Ischium and pubis.
➢ Right shift in oxygen dissociation curve due to increased CO2:

o Probable Answer: Respiratory acidosis.
➢ Diabetic nephropathy characteristic lesion:

o Probable Answer: Kimmelstiel-Wilson nodules.
➢ Folia is a feature of:

o Probable Answer: Cerebellum.
➢ Subdural hematoma involves:

o Probable Answer: Cerebral veins (bridging veins).
➢ Contralateral pain at T9 and ipsilateral proprioception loss:

o Probable Answer: Spinothalamic tract at T9 and dorsal column at T1.
➢ Neuron in spinal ganglion:

o Probable Answer: Pseudounipolar neuron.

RECORDINGS+TESTS)
➢ GVE nucleus of vagus nerve:

o Probable Answer: Dorsal motor nucleus of the vagus.
➢ Abducent nerve damage with contralateral paralysis:

o Probable Answer: This suggests a lesion in the pons affecting the abducent nerve
and corticospinal tract.
➢ Muscle involved in yawning:

o Probable Answer: Lateral pterygoid muscle.
➢ Site of common peroneal nerve (CPN) injury:

o Probable Answer: The common peroneal nerve is most commonly injured at the
neck of the fibula.
➢ 5-year-old with meningitis caused by:

o Probable Answer: Streptococcus pneumoniae.
➢ Hormone of stress from neuroendocrine system:

o Probable Answer: Corticotropin-releasing hormone (CRH).
➢ In which form is vitamin D supplemented:

o Probable Answer: Cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2).
➢ Which substance breaks down lactose:

o Probable Answer: Lactase.
➢ Scenario of thyroid cancer with a single solitary nodule and oval shape:

RECORDINGS+TESTS)
o Probable Answer: Papillary thyroid carcinoma.
➢ cAMP-mediated hormone:
o Probable Answer: Thyroid-stimulating hormone (TSH).
➢ Chronic myeloid leukemia (CML) associated translocation:

o Probable Answer: t(9;22) (Philadelphia chromosome).
➢ Follicular lymphoma associated translocation:

o Probable Answer: t(14;18).
➢ Radiotherapy of breast axilla causes:

o Probable Answer: Angiosarcoma, a rare complication that can develop in the
irradiated area.
➢ Rete ridges are a feature of:

o Probable Answer: Squamous cell carcinoma.
➢ Marker for ovarian cancer:

o Probable Answer: CA-125.
➢ Acute osteomyelitis common causative agent:

o Probable Answer: Staphylococcus aureus.
➢ Nerve cut during hiatal hernia repair, which part of the intestine is spared:
o Probable Answer: The sigmoid colon is primarily innervated by pelvic splanchnic
nerves (parasympathetic) rather than the vagus nerve.

RECORDINGS+TESTS)
➢ BP decreased, CVP 2 cm, CO 2 L/min, likely cause:

o Probable Answer: Hypovolemia.
➢ Actinomyces infection features:

o Probable Answer: Granuloma and abscess formation.
➢ Vitelline duct remnant:

o Probable Answer: Meckel's diverticulum.
➢ Islets of Langerhans location:

o Probable Answer: Tail of the pancreas.
➢ Scenario of IVC rupture:
➢ Both arms abducted, line between scapula level:

o Probable Answer: The inferior angle of the scapula is typically at the level of T7, the
spine of the scapula is at T3, and the scapula itself extends from T2 to T7.
➢ GERD scenario, treatment option:

o Probable Answer: Vagotomy is not typically used for GERD; rather, medications like
proton pump inhibitors (PPIs) are used.
➢ Movement for mixing chyme:

o Probable Answer: Myenteric plexus (part of the enteric nervous system responsible
for gastrointestinal motility).

RECORDINGS+TESTS)
➢ RV contraction phase:
o Probable Answer: The c-wave of the jugular venous pressure tracing corresponds to
right ventricular contraction.
➢ Distal end radius fracture:

o Probable Answer: Colles' fracture.
➢ Ventricular filling phase:

o Probable Answer: TP interval (diastole).
➢ Artery supply to LBBB, RBB, and left ventricle:

o Probable Answer: Left coronary artery (LCA), specifically the left anterior descending
(LAD) artery.
➢ Rectus abdominis muscle innervation:

o Probable Answer: Lower six intercostal nerves and subcostal nerve.
➢ Injury to the anterior part of the axilla causing loss of flexion:

o Probable Answer: Musculocutaneous nerve.
➢ Increase dead space causing hypotension:

o Probable Answer: This could be due to ventilation-perfusion mismatch leading to
inefficient gas exchange and potential hypoxemia, contributing to hypotension.
➢ Ovum at the time of ovulation:

o Probable Answer: Secondary oocyte.

RECORDINGS+TESTS)
➢ Epiblast and hypoblast:

o Probable Answer: Epiblast gives rise to all three germ layers (ectoderm, mesoderm,
endoderm), while hypoblast contributes to the yolk sac.
➢ ILN opening between hyoid and thyroid:

o Probable Answer: Inferior laryngeal nerve.
➢ Phrenic nerve avulsion results in:

o Probable Answer: Ipsilateral paralysis of the diaphragm.
➢ SMA (Superior Mesenteric Artery) branch:

o Probable Answer: Middle colic artery.
➢ Damage to the ureter in the broad ligament:

o Probable Answer: The ureter runs under the uterine artery ("water under the
bridge") and can be damaged during gynecological surgeries involving the broad
ligament.
➢ Preganglionic autonomic fibers are found in:

o Probable Answer: Ventral rami.
➢ Structure likely ruptured in a stab wound to the thigh:

o Probable Answer: Femoral artery.
➢ Diuretic for hyperkalemia:

o Probable Answer: Potassium-sparing diuretics like spironolactone are not used to
treat hyperkalemia; instead, diuretics like furosemide (a loop diuretic) are used.

RECORDINGS+TESTS)
➢ Drug overdose requiring urine alkalinization:

o Probable Answer: Phenobarbital (alkalinization of urine increases the excretion of
weak acids like phenobarbital).
➢ Pellagra caused by deficiency of:

o Probable Answer: Niacin (Vitamin B3).
➢ Pregnant female has a Siamese cat, risk of infection in baby:

o Probable Answer: Toxoplasmosis, caused by Toxoplasma gondii, which can be
transmitted from cat feces.
➢ Baby born with amputated limb, cause:

o Probable Answer: Amniotic band syndrome, which occurs when fibrous amniotic
bands entangle parts of the fetus.
➢ Nystagmus due to which lobe lesion:

o Probable Answer: Flocculonodular lobe of the cerebellum.
➢ Most area of perineum supplied by which nerve:

o Probable Answer: Pudendal nerve.
➢ Bier's block drug:

o Probable Answer: Lidocaine is commonly used in Bier's block (intravenous regional
anesthesia).
➢ Renal plasma flow 600 ml and hematocrit is 40%, what will be blood flow:

RECORDINGS+TESTS)
o Probable Answer: Renal blood flow (RBF) = Renal plasma flow / (1 - Hematocrit) =
600 ml / (1 - 0.40) = 600 ml / 0.60 = 1000 ml/min.
➢ Urine creatinine 40, plasma creatinine 3, urine potassium 20, plasma potassium 5, calculate
GFR:
o Probable Answer: GFR (ml/min) = (Urine creatinine concentration x Urine flow rate)
/ Plasma creatinine concentration.
o Assuming a urine flow rate (V) of 1 ml/min: GFR = (40 x 1) / 3 = 13.33 ml/min.
➢ CD15 and CD30 positive, diagnosis:

o Probable Answer: Hodgkin lymphoma.
➢ Hepatoduodenal ligament contains:

o Probable Answer: The portal triad (hepatic artery proper, portal vein, and bile duct).
➢ Left gastric vein drains directly into:

o Probable Answer: Portal vein.
➢ Phrenic nerve avulsed near origin will cause:

o Probable Answer: Ipsilateral paralysis of the diaphragm.
➢ Anesthetic given during epidural block goes into:

o Probable Answer: Nerves in the epidural space.
➢ Neurohypophysis has hormone in:

o Probable Answer: Nerve endings (where hormones like ADH and oxytocin are stored
and released).

RECORDINGS+TESTS)
➢ Pelvic diaphragm attached laterally to:

o Probable Answer: The obturator internus muscle and fascia.
➢ Patient given anesthesia suddenly BP drops to 60/40, reason:

o Probable Answer: Anaphylactic reaction or severe vasodilation.
➢ Pulse 160 bpm, BP and CVP normal, cause:

o Probable Answer: Large AV shunt or sympathetic overactivity.
➢ Man suffered RTA and lying on road in shock and multiple soft tissue injuries, reason for
shock:
o Probable Answer: Hypovolemia due to internal bleeding.
➢ Cardiogenic shock cause:

o Probable Answer: Myocardial infarction or severe heart failure.
➢ Child with thick secretions and chloride positive, parents normal, pattern of inheritance:
o Probable Answer: Autosomal recessive (Cystic Fibrosis).
➢ Landmark for pudendal nerve block:

o Probable Answer: Ischial spine.

RECORDINGS+TESTS)
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22ND May 2024 Recalls

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Www.Fcpsworld.

com (Institute for Fcps & Md/Ms)

Register now www.fcpsworld.com/register Contact: 03129684658

FCPS -1 PAST PAPER RECALLS

TEAM IS WORKING ON COMPILING COMPLETE MCQS WITH ANSWERS AND EXPLANATION.

Click to Join whatsapp group to get Daily recalls: www.fcpsworld.com/fcps-update

Facebook page: www.facebook.com/fcpsworld

Register now www.fcpsworld.com/register Contact: 03129684658

Facebook Group: Fcps prep and guide

MEDICINE MAY 2024 EXAM

➢ Anterior middle meningeal artery leakage where:

➢ Which transport has Vmax:

➢ 21-hydroxylase deficiency in congenital adrenal hyperplasia (CAH), why is there androgen

➢ Renal GFR measured before transplant by:

Register now www.fcpsworld.com/register Contact: 03129684658

o Probable Answer: GFR is commonly measured using creatinine clearance or inulin

➢ Brain-eating bacteria was:

➢ During hanging, person died due to fracture of:

➢ Lung posterior expansion till which vertebrae:

➢ Posterior wall of the ovary contains:

➢ In alveoli, diffusion-limiting transport is of which:

➢ Hering-Breuer reflex is:

Register now www.fcpsworld.com/register Contact: 03129684658

o Probable Answer: Pellagra, which is characterized by dermatitis, diarrhea, and

➢ Tuft of hair in the back of a woman:

➢ Lump on back with meninges and no neural tissues:

➢ ARDS in infants due to:

➢ Posterior to lungs is:

➢ Person with skeletal abnormality, mental retardation, and jaw/mandible problem:

Register now www.fcpsworld.com/register Contact: 03129684658

➢ Ipsilateral corticospinal tract and Horner syndrome defect:

➢ Comparison of saliva vs plasma:

➢ Epitheloid cells function in TB:

➢ Diastolic and systolic BP to find MAP:

➢ SA node pacemaker phase:

Register now www.fcpsworld.com/register Contact: 03129684658

➢ Nystagmus and ataxia:

➢ Vmax - facilitated diffusion:

➢ Moritz type scenario:

➢ For transplant - HLA typing:

➢ Minimum pressure in heart:

➢ Hydrops fetalis HS:

Register now www.fcpsworld.com/register Contact: 03129684658

➢ Cardiovascular changes during inspiration:

➢ Gastrin secretion increased by alkalinization of the antrum:

➢ Agranular cerebral cortex > Primary Motor Cortex:

➢ Anterior middle meningeal artery leakage where:

➢ Which transport has Vmax:

➢ 21-hydroxylase deficiency in congenital adrenal hyperplasia (CAH), why is there androgen

Register now www.fcpsworld.com/register Contact: 03129684658

➢ Renal GFR measured before transplant by:

➢ Brain-eating bacteria was:

➢ Additional Questions and Probable Answers:

➢ Boy walks during sleep:

➢ Follicular lymphoma translocation:

Register now www.fcpsworld.com/register Contact: 03129684658

SURGERY MAY 2024 EXAM

➢ Complicated scenario of calculation of GFR, creatinine, and urine output:

➢ Sensory supply to the index finger:

➢ Ankle sprain damaged ligament:

Register now www.fcpsworld.com/register Contact: 03129684658

o Probable Answer: Lateral collateral ligament (most commonly the anterior

➢ Opening of left gastric vein: