GENESIS Anal canal below pectinate line drains into superficial

(Post Graduation Medical orientation Centre) inguinal lymph nodes

Exam : Subject Final-2: Anatomy & Pharmacology Glans penis drains into deep inguinal lymph nodes.
Exam Diploma Superficial inguinal lymph node receives lymph
Course: M.Phil / Diploma Discipline: Anaesthesiology from:
Faculty: Surgery 1. Integument of the 6. Back below the level of
Batch: Online Diploma 500 Topic Batch-2 penis iliac creast
Year: 2023 Session: March'24 M.Phil/Diploma 2. Scrotum 7. Vulva
Candidate 3. Perineum 8. Anus
(1 of 100 ) 4. Buttock 9. The thigh and medial side
Nerves that are mostly vulnerable for injury by 5. Abdominal wall of the leg
fracture of humerus at the- below umbilicus 10. Lymph from most of the
a) Upper end: Axillary nerve T lower limb cleft between
b) Upper end: Radial nerve F toes
c) Middle of shaft: Ulnar nerve F [Ref: Vishram Singh/3rd/P-295 +
d) Lower end: ulnar nerve T BD/8th/V-2/P-152, 153]
e) Middle of shaft: axillary nerve F (5 of 100 )
Three nerves directly related to humerus are, therefore, Structures related to the medial surface of left lung
liable to injury. are-
1. Axillary: at surgical neck a) Both right and left ventricle T
2. Radial: at radial groove b) Trachea F
3. Ulnar: behind medial epicondyle c) Oesophagus T
(2 of 100 ) d) Thoracic duct T
Hepatic segments- e) Arch of azygos vein F
a) Based on the distribution of the T (6 of 100 )
portal & hepatic veins Superior aperture of thorax-
b) Segments IV corresponds to the F a) The wide upper end of the thorax, F
caudate lobe which is continuous with the neck, is
c) The right lobe (segment-IV) can be T called the inlet of the thorax
transplant into an adult b) It is kidney-shaped T
d) Caudate lobe receives portal vein F c) Sibson’s fascia or suprapleural F
branches from the right lobe only membrane completetly separates the
e) Are well defined as the broncho- F thorax from the neck.
pulmonary segments d) Morphologically, Sibson’s fascia is T
b) Segment I corresponds to the caudate lobe and regarded as the flattened tendon of the
segment IV corresponds to the quadrate lobe scalenus minimus (pleuralis) muscle
d) From both right and left hepatic artery e) The inferior surface of the membrane T
e) The hepatic segments are not well defined as the is fused to the cervical pleura, beneath
broncho pulmonary segments which lies the apex of the lung
(3 of 100 ) The narrow upper end of the thorax, which is
Regarding Erb’s palsy- continuous with the neck, is called the inlet of the
a) Lesion occur in C5, C6 nerve root T thorax. Its transverse diameter is 10–12.5 cm. The
b) Paralysis of adductor muscles of F anteroposterior diameter is about 5 cm. Sibson’s fascia
shoulder or suprapleural membrane partly separates the thorax
c) Sensation lost over a small area over T from the neck
the lower part of the deltoid (7 of 100 )
d) Supination of the forearm is lost T Lymphatics of the heart-
e) Paralysis of biceps brachi T a) Lymphatics of the heart accompany T
Deltoid & Supraspinatus (abductors of shoulder) are the coronary arteries
paralysed b) Form three trunks F
[Ref: BD/8th/V-1/P-62] c) The right trunk ends in the T
(4 of 100 ) brachiocephalic nodes
Superficial inguinal lymph nodes receive lymph d) The right trunk ends in the preaortic F
from nodes
a) Upper anal canal F e) left trunk ends in the T
b) Labia minora T tracheobronchial lymph nodes at the
e) Glans penis F bifurcation of the trachea
d) Skin of the buttock T Form two trunks
e) Vagina below the hymen T (8 of 100 )
The stomatch - pelvic splanchnic nerves. From which nerve roots
a) Is completely covered by peritoneum T do these arise?
b) Is anterior to the left kidney T a) L2-4 F
c) Has a blood supply from all 3 T b) L3-5 F
branches of the celiac axis c) L4, 5-S1 F
d) Has a lymph drainage that follows T d) S1-3 F
arterial supply e) S2-4 T
e) Has area gastricae which are F The pelvic plexuses supply the viscera of the pelvic
longitudinal elevations of the mucosa cavity. They are situated at the sides of the rectum in
(9 of 100 ) men and at the sides of the rectum and vagina in
Structure that lies posterior to the 2nd part of women. The pelvic plexuses are formed on either side
duodenum is- by a continuation of the hypogastric plexus, by the
a) Transverse colon F sacral parasympathetic efferent fibers from the second,
b) Gall bladder F third and fourth sacral nerves and by a few filaments
c) Left lobe of the liver F from the first two sacral ganglia.
d) Hilum of the right kidney T (14 of 100 )
e) Superior mesenteric artery F Regarding ossification center-
(10 of 100 ) a) Epiphysis from secondary T
Structure pierce clavipectoral fascia- ossification center
a) Lateral pectoral nerve T b) Appears before the end of 4th month T
b) Medial pectoral nerve F of intrauterine life
c) Cephalic vein T c) Union of epiphysis and diaphysis T
d) Thoracoacromial vein F starts at puberty
e) Lymphatic T d) Fibular ossification centre appears F
d) Thoracoacromial artery last and fuses first
(11 of 100 ) e) Ulnar ossification centre appears last F
In human gametogenesis & early development- and fuses first
a) Maturation of spermatogonia to F • Ossification centre
spermatogonia to spermatozoa in man Ossification centre of Fibula:
takes 3-4 weeks • The fibula ossifies from one primary and tow
b) Embedding of zygote occurs on 6th T secondary centres
day after fertilization • The primary centre for the shaft appears at about
c) Meiosis II is necessary before F 8th week of intrauterine life
penetration of sperm • The secondary centre for the lower end appears
d) Embedding of zygote occurs at F earlier during 1st and 2nd years,and fuses with the
morula stage shaft earlier by about 16 years
• The secondary centre for the upper end appears lately
e) The number of germ cells present in T
at about 3rd to 4th year, and fuses with the shaft by
the ovary is greatest at about the4 fifth
month of fetal life about 18years
So ,the fibula violates the law of ossification because
* Maturation of spermatogonia spermatozoa takes
the secondary centre that appears first in the lower end
around 10 weeks
does not fuse last
* After completing meiosis II, we get spermatid
* At the stage of embedding, blastocyst is found. (15 of 100 )
Astrocytes are the components of the nervous
(12 of 100 )
tissues that-
Hepatorenal pouch-
a) Are glioblast derivatives T
a) Posteriorly bounded by left kidney F
b) Are only present in grey matter F
b) May communicates with lesser sac T
c) Are smaller than microglia F
c) Inferiorly restricted by the F
diaphragm d) Have processes that forms the blood T
brain barrier
d) Closed above by the inferior layer of T
the coronary ligament e) Play an important role in repair T
process of central nervous system
e) Intraperitoneal fluid may accumulate T
here during lying condition b) Fibrous type presents mainly in white matter
protoplasmic type mainly in grey matter
a) Right kidney
c) Microglia is the smallest glial cell. All are macroglia
c) Continuous with right paracolic gutter
[Ref: Snell’s/8th/P- 55 58]
(13 of 100 )
(16 of 100 )
A 47-year-old female undergoes low anterior
In left sided hemisection of spinal cord
resection to treat a rectal adenocarcinoma. During
the surgery, great care is taken to preserve the
a) Loss of pain in right side below the T b) The tonsillar artery enters the tonsil F
level of lesion by piercing the inferior constrictor
b) Left sided hyper aesthesia just above T muscle
the level of injury c) The intertonsillar cleft is the largest F
c) Left sided lower motor type paralysis T crypt of the tonsil
in at the level of lesion d) Main source of blood is tonsillar T
d) Left sided loss of deep tendon reflex F branch of facial artery
e) Loss of fine touch sensation in right F e) Histologically tonsil is differentiated F
side into cortex and medulla.
In brown Sequard syndrome (Hemisection of spinal b) Superior constrictor
cord) – c) Intra-tonsillar cleft
i) At the level of lesion: Ipsilateral- e) Not differentiated
a) LMN paralysis (21 of 100 )
c) Anaesthesia over the skin of the segment Which are true about facial skeleton?
ii) Above the level: Ipsilateral hyperaesthesia due to a) The maxilla are a pair of regular F
irritation of dorsal nerve roots pneumatic bone
iii) Below the level of lesion: b) The maxilla is ossified in membrane T
a) Ipsilateral: UMN paralysis & loss of conscious at 6th weeks of intrauterine life
proprioceptive sensations c) The mandible is the only moveable T
e) Contralateral loss of pair & temperature & touch bone of skull
(Anterolateral) d) The Maxilla is the largest & F
(17 of 100 ) strongest bone of the face
Motor nucleus of brain stem: e) The mandible is the second bone to T
a) Edinger west phal nucleus T start ossification after the clavicle
b) Nucleus tractus solitarius F a) Irregular pneumatic bone
c) Inferior salivatory nucleus T d) The mandible is the largest & strongest bone of the
d) Mesenuphalic nucleus F face
e) Nucleus Ambigus T (22 of 100 )
a) Sensory nucleus Which are false about carotid triangle?
d) Sensory nucleus a) Infront & below is formed by F
[Ref: Snell’s Neuroanatomy/8th/325-348] inferior belly of omohyoid muscle
(18 of 100 ) b) Behind by the posterior border of F
Postasior wall of 3rd ventricle is formed by – sternocleidomastoid muscle
a) Postesior commissure T c) Common carotid artery & internal T
b) Pineal body T jugular vein are important contents of
c) Habenalar commission T carotid triangle
d) Optic chiasma F d) Cranial nerves X, XI, XII are the T
e) Tuber cinereum F contents of carotid triangle
d) Floor form e) Floor is formed by four muscles. T
e) Floor form Boundary of carotid triangle:
(19 of 100 ) a) Anterior inferiorly: By superior
Following structure passing through the medial belly of digastric muscle
aspect of the cavernous sinus – b) Posteriorly: By anterior belly of sterrocleido-
a) Oculomotor nerve F mastoid muscle
b) Trochlear nerve F (23 of 100 )
c) Internal carotid artery T Which are the tributaries of internal jugular vein?
d) Abducent nerve T a) Subclavian vein F
e) Maxillary nerve F b) Internal thoracic vein F
Structure passing through lateral aspect – c) Superior & middle thyroid vein T
• Oculomotor nerve d) Pharyngeal vein T
• Trochlear nerve e) Inferior petrosal sinus T
• Opthalmic nerve Tributaries of internal jugular vein
• Maxillary nerve 1. Inferior petrosal sinus - 1st tributary
• Trigeminal ganglion 2. Pharyngeal vein
(20 of 100 ) 3. Common facial vein
The Tonsil – 4. Lingual vein
a) The medial surface is covered by T 5. Superior thyroid vein
stratified squamous epithelium 6. Middle thyroid vein
7. Occipital vein
(24 of 100 ) (b) Compression in the Guyon’s canal/pisohamate
Facial nerve supplies - tunnel. Characteristic clinical features in such cases
a) Stylopharyngeous muscle F will be as follows:
b) Parotid gland F • Claw-hand deformity affecting ring and little fingers
c) Muscle of styloid apparatus F (ulnar claw hand) but it is more pronounced (ulnar
d) Glands of soft palate & nose T paradox) because the FDP is not paralyzed; therefore
e) Muscle of facial expression T there is a marked flexion of DIP joints.
a) Stylopharyngeous muscle is supplied by • Atrophy and flattening of hypothenar eminence.
glossopharyngeal nerve (3rd arch) • Loss of abduction and adduction of fingers.
b) Parotid gland by otic ganglion • Foment’s sign is positive.
c) Styloid apparatus muscle is supplied by three (28 of 100 )
different nerve. Regarding the salivary glands:
• Stylohyoid muscle-by Facial nerve a) Submandibular & sublingual glands T
• Stylopharyngeal muscle- by glossopharyngeal are major salivary gland
nerve b) Fifty percent of the submandibular T
• Styloglossous muscle - by hypoglossal nerve gland tumour are mailgnants
(25 of 100 ) c) Minor salivary glands may present in T
The inversion of foot is produced by – the larynx trachea & paranasal sinuses
a) Tibialis anterior T d) Submandibular glands are F
b) Extensor digitorum longus F predominantly mucous type
c) Extensor hallucis longus F e) Ninety percent of the minor salivary T
d) Peroneus longus F gland tumour are malignant
e) Peroneus tertious F d) Predominatly serous
The inversion of foot is produced by (29 of 100 )
1. Tibialis anterior The thyroid gland is the largest endocrine gland of
2. Tibialis posterior the body Here-
3. Flexor hallucis longus a) It lies opposite to the C5,C6,C7 and T
4. Flexor digitarum longus T1 vertebrae
(26 of 100 ) b) It’s isthmus extends across the F
Nerve arising from the posterior cord of brachial midline in front of the 5th,6th tracheal
plexus are – rings
a) Medial pectoral nerve F c) Anterolateral surface is related to F
b) Ulnar nerve F carotid sheath and its contents
c) Musculocutaneous nerve F d) It is highly vascular and supplied by F
d) Axillary nerve T superior thyroid artery, branch of
e) Radial nerve T thyrocervical trunk
Nerve arising from posterior cord of brachial plexus e) It’s parasympathetic supply is T
- Upper scapular nerve derived from the vagus and recurrent
- Middle scapular nerve laryngeal nerves
- Lower scapular nerve b) The isthmus extends across the midline in front of
- Axillary nerve (C5-C6) the 2nd,3rd and 4th tracheal ring
- Radial nerve (C4 -C8 +T1) c) Posterolateral surface is related to carotid sheaths
(27 of 100 ) and it’s contents
Low variety of ulnar nerve palsy is characterized by d) Superior thyroid artery is a branch of external
- carotid artery
a) Wasting of thenar muscle F (30 of 100 )
b) Diminished sensation of little finger T Which is true about pericardium?
c) Clawing of little & ring fingers T a) Serous pericardium is thin, double T
d) Weakness of flexor carpi ulnaris F layered membrane lined by
muscle mesothelium
e) Positive Froment’s sign T b) Ascending aorta pulmonary trunk T
Wasting of thenar muscles seen in median nerve lesion. are the contents
Weaknesses of FCU occurs in ulnar nerve lesion (if c) Supplied by ascending thoracic aorta F
injury occurs at elbow) d) Fibrous & parietal pericardium are T
Injury of the ulnar nerve at wrist: The ulnar nerve at supplied by phrenic nerve
wrist is injured due to e) Serous pericardium develops from F
(a) Superficial position of ulnar nerve at this site makes septum transversum
its vulnerable to cuts and wounds, and c) Supplied by descending thoracic aorta
e) Develops from splanchnopleuric layer of lateral 5. Anal canal
plate mesoderm (36 of 100 )
(31 of 100 ) Posterior surface of the body pancreases is not
Nerve supply of Auricle by related to –
a) Upper ⅔ rd of the lateral surface by F a) Left kidney F
Great auricular Nerve b) Left suprarenal gland F
b) Lower ⅓ rd by (Lateral surface) by F c) Splenic vein F
auriculotemporal nerve d) Transeverse colon T
c) Upper ⅔ rd medial surface by lesser T e) Inferior venacova T
occipital by (37 of 100 )
d) Lower ⅓ rd medial surface by great T Sinusoids are present in the following organs –
auricular nerve a) Kidney F
e) Root of the auricule supplied by F b) Liver T
glossopharyngeal nerve c) Spleen T
a) Auriculotemporal d) Thyroid gland F
b) Great auricular nerve e) Parotid gland F
e) Vagus nerve Sinusoids are present in
(32 of 100 ) 1. Liver
According to oesophagus – 2. Spleen
a) The pharyngo-oesophageal junction T 3. Bone marrow
is the narrowest part of alimestary canal 4. Adrenal cortex
except the vermiform appendix [Ref: Janqueira/15th/P-228+A.K. Datta General
b) Anteriorly releated by thoracic duct F anatomy/7th/P-169]
c) Azygos vein lies left to the F (38 of 100 )
oesophagus Lining epithelium of different region of body-
d) Shows four constrictions at different T a) Upper half of post. surface of F
levels epiglottis® pseudostratified ciliated
e) Thoracic part is longest & supplied F columnar
by oesophageal branches of aorta b) Terminal bronchiole® F
(33 of 100 ) Pseudostratified ciliated columner
Abductors of vocal cords- c) Inner surface of tympanic F
a) Lateral cricoarytenoid F membrane® simple ciliated columnar
b) Transverse cricoarytenoid F d) Uterus ( before menarche) ® simple F
c) Posterior cricoarytenoid T columnar
d) Oblique arytenoid F e) Epididymis ® Pseudostratified T
e) Cricothyroid F columnar with sterocilia
Abductor of vocal cords: (39 of 100 )
- Posterior cricoarytenoid muscle Correctly matched statements regarding the phases
(34 of 100 ) of mitosis are-
Which are true about large intestine? a) The chromosomes condense and F
a) Taenia coli absent but sacculations F became visible in metaphase
are present b) Nuclear envelop disappears by T
b) Villi present F fragmentation in prophase
c) Peyer’s patches are present F c) Chromosomes have become aligned F
d) Greater part is freely mobile F at the equatorial plate in anaphase
e) Transverse mucosal folds are T d) Nucleoli reappear in telophase T
obliterated e) Nuclear envelop reassemble in T
(35 of 100 ) telophase
Which are the sites of portocaval anastomosis? a) The chromosomes condense and become visible in
a) Posterior abdominal wall T prophase
b) Umbilicus T c) Chromosomes have become aligned at the equatorial
c) Upper end of rectum & oesophagus F plate in metaphase
d) All area of liver F (40 of 100 )
e) Ligamentum venosum & falciform T Following are the derivatives of Ectoderm –
Sties of portocaval anastomosis - a) Anterior lobe of the hypophysis T
1. Abdominal part of esophagus cerebri (Pituitary gland)
2. Umbilicus b) Lining epithelium of the pharynx F
3. Βare area of liver c) Parotid gland T
4. Posterior abdominal wall d) Lining epithelium of thyroid gland F
e) Lining epithelium of kidney F (47 of 100 )
(41 of 100 ) Drugs causing cardiomyopathy -
Biotransformation of following drugs occurs in gut a) Beta blocker F
mucosa- b) Calcium channel blocker F
a) Suxamethonium F c) Alcohol T
b) Clonazepam T d) Doxorubicin T
c) Prostanoids F e) Cocaine T
d) Chlorpromazine T a & b causes congestive cardiac failure not
e) Cyclosporine T cardiomyopathy.
a) In plasma Also, Adriamycin Daunorubicin, lithium, emetine,
c) In lung Suphonamide, Sympathomimetic, Phenothiazine cause
(42 of 100 ) cardiomyopathy.
The respiratory effects of propofol are - (48 of 100 )
a) Increase tidal volume F The progesterone only pill
b) Decrease respiratory rate F a) Is Liable to cause amenorrhea T
c) Impaired response to hypoxia & T b) Is safe and effective in lactating T
hypercapnea women
d) Bronchoconstriction F c) Can be prescribed to a woman with a F
e) Depressed laryngeal reflex T medical history of venous
a) ↓ tidal volume thromboembolic episode
b) ↑ Respiratory rate d) Acts to suppress the F
d) Bronchodilatation adenohypophysis
(43 of 100 ) e) Increases tubal motility F
Advantages of ketamine are - Progesterone only pill prevent ovulation
a) Produce profound analgesia T By increasing cervical mucus thickness,reduction of
b) Less vomiting T tubal motility & flow of ovum & alter endometrium.
c) Minimal respiratory depression T (49 of 100 )
d) Profound muscle relaxation F Pharmacological action of diazepam is -
e) No postoperative psychic F a) Anxiolytic T
phenomenon b) Visceral muscle relaxation F
d) Ketamine produces no muscle relaxation c) Retrograde amnesia F
e) Produce postoperative psychic phenomenon d) Coronary vasodilation T
(44 of 100 ) e) Sleep induction T
Pharmacological actions of H2 receptor antagonist b) Skeletal muscle relaxation
are - c) Anterograde amnesia
a) Reduce both basal & Food T (50 of 100 )
stimulated HCl secretion Local anesthetics acts through which of the
b) Healing of ulcer T following mechanisms?
c) Gynecomastia T a) Block Ca+ channel F
d) Impotency T b) The threshold for excitation F
e) Galactorrhea T decreases
c, d, e is anti-androgenic effect c) Sensitivity is determined by fibre T
(45 of 100 ) diameter
Bioavailability of a drug may be decreased if the d) Sequence of blockade F
drug is sensory>motor>autonomic
a) Acid stable F e) Action potential amplitude decreases T
b) Lipid soluble F a) Block voltage dependent Na+ channel
c) Water soluble T b) Increases
d) Protein in nature T d) Autonomic > sensory> motor
e) Ionized T (51 of 100 )
(46 of 100 ) Drugs of choice in acute attack of migraine are
Following chemotherapeutic agent are cell-cycle a) Sumatriptan T
specific - b) Ergotamine T
a) Methotrexate T c) Pizotifen F
b) 5-Flurouracil T d) Propranolol F
c) Busulphan F e) Methysergide F
d) Vincristine T Acute attack of migraine
e) Melphalan F Includes, Triptans (Sumatriptan, Rizatriptan etc. Ergot
c & e is cell-cycle non-specific agent Alkaloids (Ergotamine)
Β-Blockers are the drugs of choice for migraine (56 of 100 )
prophylaxis. The ocular effects of atropine are -
(52 of 100 ) a) Mydriasis T
Non-neurological adverse effects of antihistamines b) Cycloplegia T
are - c) Photophobia T
a) Fatigue F d) ↓ IOP F
b) Dry cough T e) Light reflex exaggerated F
c) Tinnitus F d) ↑ IOP
d) Dermatitis T e) Light reflex lost
e) Agranulocytosis T (57 of 100 )
a & c are neurological adverse effect. Atypical neuroleptics are -
Adverse effect of antihistamines: a) Olanzapine T
CNS Sedation, drowsiness, fatigue, b) Molindone F
irritability, incoordination, c) Clopenthixol F
nervousness, tinnitus d) Quetiapine T
Ocular Disturbance of ocular e) Trifluoperazine F
accommodation b, c & e are typical neuroleptic drug.
Antimuscarinic Dry mouth, diplopia, constipation, (58 of 100 )
urinary retention Adverse effect of GTN on therapeutic dose -
Respiratory Dry cough a) Reflex tachycardia F
GIT GIT upset b) Throbbing headache T
Teratogenicity Cyclizine (teratogenic) c) Postural hypotension F
Other Dermatitis, skin rash, d) Flashing of the eye T
agranulocytosis e) Methemoglobinemia T
a) On high dose
(53 of 100 )
c) On high dose
Glycine conjugation occurs in following drugs -
(59 of 100 )
a) Nicotinic acid T
Following are true about digitalis interaction with
b) Benzoic acid T
other drugs -
c) Salicylate T
a) Digitalis + Frusemide = Increase T
d) Aspirin F
chance of digitalis toxicity
e) Adrenaline F
b) Digitalis + Spironolactone = T
d) Glucuronide conjugation Decrease chance of digitalis toxicity
e) Methylation conjugation
c) Digitalis + Quinidine = Increase T
(54 of 100 ) chance of digitalis toxicity
Antibiotic causing thrombocytopenia-
d) Digitalis + β-blocker = enhance A-V T
a) Vancomycin T blockade
b) Cephalosporin F e) Digitalis + Ca2+ = Increase chance T
c) Lecofloxacin F of digitalis toxicity
d) Quinidine T a) Frusemide causes hypokalemia like digitalis and
e) Sulphonamides T heart block occurs
Drug-associated thrombocytopenia: b) Spironolactone is a K+ sparing drugs which
1. Quinine, antagonize the effect of digitalis
2. Vancomycin c) Quinidine increase plasma concentration of digitalis
3. Heparin by displace it from PPB
4. Gold salts d) Both causes heart block by enhancing A-V blockade
5. (Cytotoxic agents) azathioprine, 6-mercaptopurine e) Ca2+ increases myocardial sensitivity to digitalis,
6. Thiazide overloading of Ca2+ store.\
(55 of 100 ) (60 of 100 )
Drug receptor which are G-protein coupled type in Toxicities of loop diuretics not related to renal
nature - action are -
a) Muscarinic acetylcholine receptor T a) Hyperglycemia T
b) 5-HT3 receptor F b) Hyperuricemia F
c) Insulin receptor F c) Photosensitivity T
d) Adrenoceptor T d) Myalgia T
e) Steroid receptor F e) Hypovolemia F
b) Direct ligand-gated channel type b) Renal action toxicity
c) Tyrosine-kinase type e) Renal action toxicity
e) Intracellular receptor (61 of 100 )
MgSO4 can be used as (67 of 100 )
a) Anticonvulsant T Antianginal drug-
b) Neuroprotector T a) Nitroglycerin acts by releasing nitric T
c) Tocolytic T oxide
d) Antiemetic F b) Propanolol is selective Beta blocker F
e) Prophylactic drug in severe pre- T c) Propanolol is used for acute angina F
eclampsia d) Verapamil reduces CO and FOC T
(62 of 100 ) e) Nitrates are highly lipid soluble T
Nonadrenal disorders where glucocorticoid is a) Nitroglycerin releases NO which causes smooth
indicated are- muscle relaxation of vessels
a) Idiopathic thrombocytopenic purpura T b) Propanolol is selective beta blocker
b) SLE T c) Propanolol is used for prophylaxis of
c) Addison’s disease F Angina.Nitrates are used in acute angina
d) Angioneurotic edema T d) Verapamil, diltiazim is Calcium channel blocker and
e) Cushing’s syndrome F blocks non selective L Type Calcium channel.
c & e are adrenal disorder [Ref: Katzung/15th/P-215]
(63 of 100 ) (68 of 100 )
Common adverse effects of heparin except Following are side effects of Spironolactone-
hemorrhage are - a) Hypokalemia F
a) Osteoporosis T b) Hyperchloremic metabolic alkalosis F
b) Alopecia T c) Kidney stone T
c) Teratogenicity F d) Ototoxicity F
d) Necrosis of skin F e) Gynaecomastia T
e) Thrombocytopenia T a) Hyperkalemia
b) Adverse effect of warfarin b) Hypochloremic meabolic acidosis
d) Adverse effect of warfarin d) Ototoxicity is side effect of Frsemide
(64 of 100 ) (69 of 100 )
Following antibiotics have beta lactam ring Factors modifying drug distribution
a) Benzathine penicillin T a) Water soluble drugs distribute F
b) Tobramycin F mainly intra-cellularly
c) Mecillinum T b) Colloid drugs→ intra- cellular F
d) Monobactam T distribution
e) Vancomycin F c) High PPB→ Extra cellular T
Penicillin, cephalosporin, Monobactam, Carbapenem distribution
(65 of 100 ) d) Only lipid soluble drugs readily T
Antipseudomonal cephalosporins are - penetrate the BBB
a) Ceftazidime T e) Chloroquine has affinity to bind with T
b) Cefoperazone T retina
c) Cefepime T a. Extracellular
b. Intra-vascular
d) Cefixime F
(70 of 100 )
e) Ceftibuten F
Pharmacological effect of epinephrine on CVS
d & e are false. Only a, b and c are antipseudomonal
a) Increase heart rate T
(66 of 100 )
Bacitracin b) Incease FOC T
a) Obtained from Bacillus subtilis. T c) Increase peripheral resistance F
b) Inhibits nuclic acid synthesis F d) Increase Systolic pressure T
e) Increase diastolic pressure F
c) Commonly associate with T
hypersensitivity c) Decrease peripheral resistance
d) Highly nephrotoxic T e) Decrease diastlic pressure due to beta2 mediated
vasodilation in skeletal muscle vascular bed.
e) Applied to wound for purpose of F
preventing infection (71 of 100 )
Levodopa
b) Inhibits cell wall synthesis
d) Highly nephrotoxic that’s why only topical use in an a) it is metabolic precursor of dopamine T
ointment base b) Cannot cross BBB F
e) Should not applied to wounds for purpose of c) Levodopa with carbidopa is an T
preventing infection as associated with hypersensitivity efficacious regimen for Parkinsonism
reaction. Uses for treatment of infection due to mixed d) Visual and auditory hallucinations T
bacterial flora in surface lesion of skin or on mucus are adverse effects
membrane.
e) Anorexia and nausea due to T a) Is excreted mainly by kidney T
stimulation of CTZ b) Cannot cross the placental barrier T
b) Can cross BBB dopamine cannot cross BBB easily
(72 of 100 ) c) Is well absorbed from the intestine F
What are the toxic effect of local anaesthetics? d) Accumulates in cellular lipids F
a) CNS toxicity T e) Can easily cross blood brain barrier F
b) Cardiotoxicity T d) Highly ionized drugs or polar drugs are more water
c) Local neurotoxicity T soluble and less lipid soluble. So, less accumulation in
d) Renal shut down F cellular lipids.
e) Liver dysfunction F (76 of 100 )
Lidocaine causes CNS excitation and local Resting membrane potential (RMP) -
neurotoxicity. Bupivacaine causes Cardiovascular a) Same as entry of K+ in resting T
Collapse Cocaine can cause CNS excitation, condition
convulsion, cardiac arrhythmia, HTN, Stroke b) Increases as Na+ enters F
(73 of 100 ) c) The voltage difference across the cell F
Following antidotes are correct membrane of a neuron is called a
a) Acetaminophen –Acetylcysteine T Resting membrane potential
b) BDZ—Fomepizole F d) There are more open K+ channels T
c) Narcotics – Naloxone T than Na+ channels at rest
d) CO—Oxygen T e) The membrane permeability to Na+ F
e) Cyanide- Ethanol F is greater
b) Flumazenil Resting membrane potential (RMP) -
e) Hydroxycobalamin The voltage difference across the cell membrane of a
(74 of 100 ) neuron is called a membrane potential. The resting
Zero - order kinetics membrane potential of neurons is usually about –70
a) Constant amount of drug will be T mV. Because there are more open K+ channels than
eliminated Na+ channels at rest, the membrane permeability to K+
b) T ½ is constant F is greater. Consequently, the intracellular and
c) Occurs when metabolizing / T extracellular K+ concentrations are the prime
eliminating system is saturated determinants of the resting membrane potential, which
d) Accounts for elimination of most F is therefore close to the equilibrium potential for K+.
drug Steady ion leaks cannot continue forever without
e) Rate of elimination dependent on F eventually dissipating the ion gradients. Na, K ATPase
drug concentration prevents this from occurring by actively moving Na+
Order of kinetics: and K+ against their electrochemical gradients.
i) First order kinetics ii) Zero order kinetics / (77 of 100 )
/ Exponential kinetics: Saturation kinetics: Remdesivir
Criteria: Criteria: a) Is a broad spectrum antiviral agent T
• Constant fraction of • Constant amount of b) Inhibits DNA dependent RNA F
drug will be drug will be polymerase
excreted excreted c) Has ability to inhibit SARS-COV-2 T
• Constant t ½ • t ½ is not constant in vitro
• Constant clearance • Occurs when drug d) Is highly efficacious in COVID-19 F
• Liver enzyme is in doses are very high e) May shorten the time to recover T
excess • It is dose dependent from COVID-19 infection
• Elimination rate is • Liver enzyme is not b) The active metabolite of Remdesivir interferes with
proportional to excess (saturated) the action of viral RNA-dependent RNA polymerase.
plasma conc of free • Elimination rate is not d & e) According to international experts from the
drugs proportional to British Medical Journal, Remdesivir “probably has no
plasma conc. important effect on the need for mechanical ventilation
- Example: Example: and may have little or no effect on the length of
* Paracetamol, * High dose of Aspirin, hospital stay.
*Diazepam, Alcohol, Phenytoin (78 of 100 )
* Atropine, *Ethanol, Cisplatin, What are the mechanism of antihypertensive action
* Low dose Aspirin, Fluoxetine, Omeprazole of ca+channel blocker?
Alcohol & phenytoin * High dose a) Decrease myocardial contraction T
methylxanthines b) Dilation of small veins F
(75 of 100 ) c) Decrease peripheral resistance T
A highly ionized drug d) Decrease heart rate T
e) Interaction with digoxin F a) Renal collecting tubule
a) As SA node action potential is Ca+dependent, Ca+ b) Ureter
channel blocker reduce Ca+channel activity thus SA c) Part of the urogenital sinus
node activity, So myocardial contraction with decrease d) Gartners duct
b) Ca+ channel blocker dialates the resistance vennele e) Fallopian tubes Correct Ans
like arterioles by blocking Ca+ channel in smooth Fallopian tube is derived from paramesonephric /
muscle in ressete wall. Mullerian duct.
c) As arterioles are main resistance extering vessels. Mesonephric duct (Wolffian duct) derivatives -
Na+ channel blocker will block arteriol and decrease Trigone of UB, prostate, part of prostatic urethra
peri- pheral resistance and thus blood presenced) By Epididymis, ductus deferens, seminal vesicles,
decreasing SA node activity ejaculatory duct
e) No interaction with digoxin Ureteric bud ureter, renal pelvis, major & minor
(79 of 100 ) calyx, collecting duct
Drugs causing iatrogenic hypertension are- Metanephros: nephron
a) Erythropoeitin T (83 of 100 )
b) Spironolactone F A 30 years old patient come to you with a history of
c) Mycophenolate mofetil T simple mastectomy with axillary lymph node
d) Steroid T dissection on left side during examination you found
e) Cyclosporine T elevation of medial & inferior border of left scapula
Other drugs causing HTN: when pushing of wall by hand) Which structure
• OCP containing oestrogens most likely injured?
• NSAIDS a) Musculocutaneous nerve
• Carbenoxolone b) Long thoracic nerve Correct Ans
• Sympathomimetic agents -Winging of Scapula
• Leflunamide -Nerve involve
(80 of 100 ) -Long thoracic nerve
What are the benefits of digoxin in treatment of -Accessory nerve
heart failure -Muscles involve
a) Increase force of cardiac contraction T -Serutus anterior
b) negative inotropic drug F -Trapezius
c) Increase cardiac out put T -Nerve root- C5-6
d) has low theraputic index F c) Axillary nerve
e) Increase level of free Ca+ T d) Supra scapular nerve
a+b+e) Digoxin inhibits Na+/K+ ATPase in cardiac e) Sub scapular nerve
myocyte → inhibit Na+ pump → ↑free Ca+in cell →↑ (84 of 100 )
Foc → ↑Co A 34-year-old lady suffers from
b) Positive inotropic drug hyperparathyroidism. The right inferior
d) Digoxin has low therapeutic index but it is not a parathyroid is identified as having an adenoma & is
beneficial effect scheduled for resection. From which of the
(81 of 100 ) following embryological structure is it derived.
A 32-year-old male is admitted in the emergency a) 2nd pharyngeal pouch
department of DMCH with groin pain. Examination b) 3rd pharyngeal pouch Correct Ans
reveals that the patient has indirect inguinal hernia. The inferior parathyroid derived from 3rd pharyngeal
Which of the following nerve is compressed by the pouch and superior parathyroid from 4th pharyngeal
hernia in the inguinal canal to produce pain? pouch
a) Iliohypogastric c) 4th pharyngeal pouch
b) Lateral femoral cutaneous d) 1st pharyngeal pouch
c) Ilioinguinal Correct Ans e) None of the above
Contents of inguinal canal is spermatic cord or round (85 of 100 )
ligament of uterus and Ilioinguinal nerve. So that Regarding sensory nerve supply of hand-
ilioinguinal nerve is compressed and produce pain. a) Lateral half of palm by ulnar nerve
d) Subcostal b) Medial one & half of palm by
e) Pudendal median nerve
(82 of 100 ) c) Lateral three & half of dorsum by
A baby with Klinefelter’s syndrome has presented median nerve
to SOPD (Surgical outpatient department) with d. Medial two & half of dorsum by
poorly developed male phenotypical characteristics. ulnar nerve
Following derivatives aren’t derived from wolffian e) First web space of dorsum by radial Correct Ans
duct- nerve
Regarding sensory nerve supply of hand-
[Ref: Vishram/3rd/V-1/P-144, 145/ Fig. 11.19, 11.20]
FMedian and ulnar nerves in hand: A, branches; B,
areas of sensory innervation of the palmar aspect of the
hand
Fig. 11.20 Dorsum of the hand: A, nerves of dorsum
of the hand; 13, areas of sensory innervation of the
dorsum of the hand.
(86 of 100 )
Which organelle sorts and packages proteins within
a cell?
a) Rough endoplasmic reticulum
b) Smooth endoplasmic reticulum
c) Lysosome
d) Golgi apparatus Correct
Ans
e) Mitochondria
(87 of 100 )
A 60-year-old patient develops third degree heart
block with Stokes-Adams syncope & is implanted
with an artificial cardiac pacemaker. Which of the
following conductive tissues of the heart had a
defective function that required the pacemaker?
a) Atrioventricular bundle
b) Sinoatrial node Correct Ans
The sinoatrial (SA) node initiates the impulse of
contraction and is known as the pacemaker of the heart.
Impulses from the SA node travel through the atrial
myocardium to the AV node and then race through the
AV bundle (bundle of His), which divides into the right
and left bundle branches. The bundle breaks up into
terminal conducting fibers (Purkinje fibers) to spread
out into the ventricular walls. The moderate band
carries the right limb of the AV bundle from the
septum to the sternocostal wall of the ventricle
c) Bundle of His
d) Purkinje fiber
e) Moderator band
(88 of 100 )
Surgical occlusion of which of these structures, will
result in the greatest reduction in hepatic blood
flow?
a) Portal vein Correct Ans
The portal vein transports 70% of the blood supply to
the liver, while the hepatic artery provides 30%. The
portal vein contains the products of digestion. The
arterial and venous blood is dispersed by sinusoids to
the central veins of the liver lobules; these drain into
the hepatic veins and then into the IVC. The caudate
lobe drains directly into the IVC rather than into other
hepatic veins.
b) Common hepatic artery
c) Right hepatic artery
d) Coeliac axis
e) Left hepatic artery
(89 of 100 )
A patient present with the abnormality of
discriminatory touch, joint position & vibration
sense of upper extremity to you. Which tract lesion
is responsible for this patient?
a) Lateral spinothalamic tract
b) Anterior spinothalamic tract
c) Tract of Gall
d) Anterior spinocerebellar
e) Dorsal column Correct Ans
• Anterior spinothalamic tract-Crude touch and
pressure
• Lateral spinothalamic tract-Pain, Temperature
• Dorsal column-Fine touch,vibration,joint position,
two point discrimination
(90 of 100 )
Pancoast syndrome is associated with cancer
involving apex of the lung. Which of the following is
not found in Pancoast syndrome?
a) Pain along the medial side of
forearm and hand
b) Wasting of small muscles of the
hand
c) Horner’s syndrome
d) Erosion of first rib.
e) Increased radial artery pulse Correct Ans
It occurs due to involvement of structures related to the
posterior aspect of the apex of lung by the cancer of the
lung apex. Cancer of lung apex may spread to involve
neighboring structures, such as subclavian or
brachiocephalic vein, subclavian artery, phrenic nerve
causing following signs and symptoms.
a) Venous engorgement and edema in neck, face, and
arm due involvement of subclavian and
bracheocephalic veins.
b) Diminished brachial and/or radial pulse due to
compression on subclavian artery
c) Paralysis of hemidiaphragm due to infiltration of
phrenic nerve
(91 of 100 )
Stem: You see a 57-year-old business man in the
hypertension clinic for review. He has been recently
started on losartan by his GP and he is referred for
further advice and investigation .Lead in: Which
mechanism of action best accounts for the blood
pressure lowering action of losartan?
a) Angiotensin-II receptor blockade Correct Ans
Angiotensin II is a powerful vasoconstrictor.
Angiotensin-II subtype-1 receptor antagonist, also
known as angiotensin receptor blockers (ARBs),
include losartan, candesartan and valsartan. The major
actions of angiotensin receptor antagonists reflect
inhibition of the classic effects of the renin–angiotensin
system mediated by the AT1 receptor on the blood
vessels, heart, adrenal gland, kidneys, brain and
sympathetic nervous system. Like ACE inhibitors,
ARBs may cause hyperkalemia and kidney disease,
especially in sodium-depleted patients and in those
with a critical reduction of renal blood flow. They are
less likely than ACE inhibitors to cause cough
b) Calcium-channel blockade
c) Fall in plasma renin concentrations
d) Increased plasma aldosterone
concentrations
e) Inhibition of angiotensin converting
enzyme
(92 of 100 )
Stem: A 60-year-old woman with a past history of
hypertension has been receiving a number of
different cardiac medications. She presents to the
Emergency Department at 2 hours after a suspected
drug overdose. She smells strongly of alcohol, and is
found to have heart rate 48 bpm and blood pressure
90/70 mmHg. There is wheeze on auscultation of the
chest. An ECG shows sinus bradycardia with first-
degree heart block and prolongation of the PR
interval. Lead in: What class of drugs is most likely
to cause these effects?
a) Beta-blockers Correct Ans
The patient’s presentation with low pulse rate (48
bpm), low systolic blood pressure (90/70 mmHg), first-
degree heart block and prolongation of the PR interval
is typical of ß-blocker toxicity.
b) Class III antiarrhythmic drugs
(amiodarone)
c) Digitalis glycosides
d) Phenothiazines
e) Tricyclic antidepressants
(93 of 100 )
Stem: A 29-year-old woman who is taking the
combined oral contraceptive pill (OCP) comes to
the Emergency Department because she has become
pregnant. On closer questioning, she has recently
received a course of rifampicin for prophylaxis after
a household member had been diagnosed with
meningitis. Lead in: What is the most likely
pharmacological explanation for this contraceptive
failure?
a) Rifampicin blocks absorption of
oestrogen
b) Rifampicin displaces oestrogen from
protein binding
c) Rifampicin increases oestrogen
excretion
d) Rifampicin is a hepatic enzyme Correct Ans
inducer
Rifampicin is a hepatic enzyme inducer. Therefore, it
increases metabolism of sex steroids, including those in
the OCP and therefore leads to reduced pill
effectiveness. It is therefore crucial that women taking
rifampicin who are users of the OCP should be warned
to use other measures for contraception.
e) Rifampicin is a hepatic enzyme
inhibitor
(94 of 100 )
Stem: A 64-year-old Asian man attends the
Emergency Department for review. He is
complaining of aching pains in his arms and leg
muscles and of lethargy; he also has minor
symptoms of a cold. He is a smoker with
hypercholesterolemia and has recently been
prescribed oral simvastatin 40 mg daily. He has
developed aches and pains around his pelvic girdle,
and his urine is dipstick-positive for blood. Lead in:
What is the most likely cause of this clinical
picture?
a) Dermatomyositis
b) Influenza
c) Polymyositis
d) Proximal myopathy
e) Rhabdomyolysis Correct Ans
Specifically, the risk of rhabdomyolysis may be
increased with the use of high-dose statin therapy.
Rhabdomyolysis is suggested by the presence of
suspected myoglobinuria and muscle pains; muscle
enzymes including creatine kinase (CK) are likely to be
abnormally elevated
(95 of 100 )
Stem: Drug distribution in the human body is
sometimes occurs in an unequal manner.Lead in:
Which is not the cause of unequal distribution of
drug?
a) Plasma protein binding
b) Half-life of drug Correct Ans
Half-life of drugs has no influence on the distribution
of drug in the body
c) Tissue binding of the drug
d) Redistribution or sequestration of
body fat
e) BBB or, BPB
(96 of 100 )
Stem: Antibiotic use during pregnancy should be
rational and need to be cautious because of
teratogenic effect. Lead in: Which of the below
mentioned antibiotic is safe to use during Lead in: Which of the following drugs has
pregnancy? predominantly peroxisome proliferator-activated
a) Cephalosporine Correct Ans receptor α (PPAR-α) activity?
Except cephalosporin the above-mentioned antibiotics a) Fenofibrate Correct Ans
are not safe to use because they are teratogenic. The fibrate class of drugs are PPAR-α agonists, their
b) Sulfonamide predominant action is in reducing serum triglyceride
c) Fluoroquinolone levels and increasing HDL-cholesterol. PPAR
d) Chloramphenicol activation results in increased gene transcription; over
e) Aminoglycoside 100 different genes are thought to be upregulated by
(97 of 100 ) glitazone therapy. This group is distinct from PPAR-γ
Stem: You are reviewing a 63-year-old man in the agonists (the glitazone), and unrelated to PPAR-δ
medical admissions unit who has been given a agonists that promote HDL-cholesterol.
diagnosis of community-acquired pneumonia. You b) Gliclazide
remember from a recent teaching session that c) Metformin
moxifloxacin is licensed for the treatment of d) Pioglitazone
community-acquired pneumonia, acute e) Simvastatin
exacerbation of chronic bronchitis and acute (100 of 100 )
bacterial sinusitis. Lead in: Which of the following Stem: A patient is currently taking quadruple
adverse effects is most strongly associated with combination therapy for tuberculosis, with
moxifloxacin? rifampicin, isoniazid, pyrazinamide and
a) Achilles tendon rupture Correct Ans ethambutol. He is also given pyridoxine. He asks
Moxifloxacin is a new generation of quinolone about potential side-effects of the treatment
antibiotics that is bactericidal by interfering with DNA regimen. Lead in: Which one of the following side-
synthesis, and is effective against Gram-positive, effects is most important to consider with this
Gram-negative and certain atypical respiratory treatment regime?
pathogens. Adverse effects of quinolones include risk a) Gastrointestinal upset
of tendonitis and tendon rupture. Other adverse effects b) Cirrhosis
include gastrointestinal disturbances, headache and c) Peripheral neuropathy
liver dysfunction. Quinolones should not be used in d) Visual impairment Correct Ans
combination with other drugs that prolong the QT Visual impairment due to optic neuritis is an important
interval (e.g. erythromycin, citalopram) because there and common adverse effect of ethambutol & isoniazid,
is an increased risk of cardiac arrhythmias. and patients need visual assessment before and during
b) Clostridium difficile associated treatment.
diarrhoea e) Urticaria
c) Neutropaenia
d) Oesophageal erosions and
perforation
e) Widening of the QRS duration
(98 of 100 )
Stem: A 65-year-old man with a history of chronic
obstructive pulmonary disease (COPD) is
prescribed a course of cefalexin for a respiratory
tract infection. Lead in: Which of the following
correctly reflects the mode of action of cefalexin?
a) Binds to bacterial dihydrofolate
reductase
b) Binds to the 30s subunit of the
ribosome
c) Binds to the 50s subunit of the
ribosome
d) Disrupts cell wall formation Correct Ans
Cephalosporins disrupt the synthesis of the
peptidoglycan layer forming the bacterial cell wall, in a
similar way to other β-lactams, including penicillin.
e) Leads to DNA fragmentation
(99 of 100 )
Stem: A 54-year-old man with type-2 diabetes and
dyslipidemia has been prescribed metformin,
pioglitazone, gliclazide, simvastatin and fenofibrate.