12th February 2014 Medicine Solved Paper

Special Thanks to Dr Fahad

192 MCQs (Mixed Paper A & B)

1. High Pressure in Glomerular capillaries is due to

a. Afferent is long
b. Afferent is short
c. Efferent is low resistance
d. Efferent is down stream

2.Regarding SLE followin are true except

a. ANA is +ve
b. Fibrinoid necrosis is common histological feature
c. Glomerulonephritis is commonest cause of death
d. more common in women
e. risk is increased by inheritance of HLA B27

3.Edema in nephrotic syndrome

a. Na retention
b. Hypoproteinemia
c. Hyperlipidemia

4.Bronchopulmonary segment
a. each has its own blood supply

b. different number on both sides

5.Recently diagnosed fatal disease, most appropiate

a. tell family but nt patient
b tell patient but nt family
c. tell family and patient as soon as knwn
d. crisp, logical and evidence based accurate information to the patient and family accordin to demand

6.Young lady having anemia, MCV 78 , MCH 25, MCHC 29

a. Hypochromic
b.Hypochromic and Normocytic
c.Hypochromic and microcytic
d. normocytic and normochromic

7.WHICH OF THE FOLLOWING SHIFTS THE O2-HGB

DISSOCIATION CURVE TO RIGHT:
A.ACIDOSIS
B.ALKALOSIS
C.INCREASE pH
D. NO
E. FETAL HEMOGLOBIN

8.A 75 year old man with an acute MI suddenly dies 6 days after the infarct . At autopsy, there is a
large amount of blood in the pericardial sac . The most likely cause of death is ;
A. Cholesterol pericarditis

B. Amyloidosis
C. Cardiac tamponade
D. Codsackie B pericarditis
E. Constrictive pericarditis

9.most active gluconeogenesis results from

metabolism of ?
a.fatty acid
b.protein
c.cholesterol
d.glycogen
e. TG

10. Severe magnesium deficiency

a. Hypocalcemia
b. Hypercalcemia
c. Hypokalemia
d.Hypophosphatemia

11. Langerhans giant cells found in

a.Tuberculosis
b.Sarcoidosis
c.Wegners granulomatosis
D)Syphlis

12. parasympathetic inervation

a.sweat gland
b.salivary gland

13. A pt has multiple polyps on colonoscopy.His father died of same disease.These types of polyps are
a-Hemartomatous
b-Adenomatous polyp
c-Metaplastic

14. Dysarthria is due to a lesion in?

a.Brocas area
b.Cerebellum
c.Thalamus
d.Sensory motor cortex
e.Hypothalamus

15.Hypothyroidism
a. Increased cholesterol

16. During 2nd week which is appropriate test for

Typhoid fever ?
a) Widal+Blood culture

b) Blood culture only

c) Stool culture only
d) Bone marrow

17. A woman havin fever for few days developed chest pain which aggravated by lying down . Reason
is?
a.Costochondral junction
b.Mi
c. pericarditis
d.due to plurea

18. purpura is most likely asaociated with

a. leukemia
b. von wilbrand disease
c. hiv

19. a lady using diethylesterbestrol what should be most likely in her daughter
a. squamous cell carcinoma
b. clear cell carcinoma

20. Lady with osteoporosis,having family h/o cardiac disease and breast ca. Treated by
a. Calcium plus vit D
b. Raloxifene
c. bisphosphonates
d. HRT

21. Which disease involves a carrier stage ?

a.Measles
b.Mumps
c.Polio
d.Typhoid

22. H+ ion
secretion in proximal tubule is related with?
A. Bicarbonate reabsorption
B. Bicarbonate excretion
C. K secretion
D. Na secretion

23. Hamartoma is ;
A. A Metaplasia
B. A neoplasia
C. Has a capsule
D. Same as cholestoma
E. Totally benign

24. 40 yr old woman, middle class,3 kids ,pap smear shows cervical dysplasia..cause
A HPV
B IUCD

25. 10% Formaldehyde is used for sending Biopsy

specimens,Why?
a. Sterilisation
b.To prevent autolysis
c. TO stain cells
d. TO denature proteins
e. to cause lysis of cell

26. Metastatis occur in all except

a.Liver
b. Brain
d. Spleen
d. lung

27.Fast, sharp pain from mechanical origin is mediated by which fibers;

A. A alpha
B. A delta
C. C fiber
D. High myelinated

28. Fat necrosis occurs in ;

A. Acute pancreatitis

B. Heart
C. Liver

29. Which tumor is derived from all the 3 germ layers;

A. Adenoma
B. Teratoma
C. Rhabdomyosarcoma
D. Chancroid

30. A 20yr old male has dyspnea on lying down. The structure most likely to cause this is ;
A. Enlarged isthmus of thyroid
B. Puberty
C. Retrosternal goiter

31. A FISHER MAN PRESENTED WITH SLOWLY DEVELOPING LETHARGY, EASY FATIGUE AND
PALPITATIONS. HIS DIET COMPRISES OF FISH AND RICE MOSTLY PHYSICAL EXAM SHOWED PALLOR
AND LOSS OF TOUCH SENSATION IN BOTH FEET AND LOWER LIMB. HIS CBC SHOWED HB 7.5G/DL MCV
132, PLATELETS 110 AND WBC 3450 . MOST LIKELY CAUSATIVE PARASITE:

A.ANKYLOSTOMA DUODENALE
B.DIPHYLLOBOTHRIUM LATUM
C.STRONGYLOID STERCOLIS
D.ECHINOCOCCUS GRANULOSIS
E. TAENIA SAGINATA

32. Long term elevated BP is due to

a.cardiac output
b.renal function
c.TPR

33. The vitelline duct forms;

A. Ductus venosus
B. Duodenum
C. Meckel, s diverticum
D. Portal vein
E. Urachus

34. Which is correct Regarding Axillary artery

a-It Lies behind pectoralis minor
b-Extend upto the lower border
of pectoralis major

35. a. the components of the cell containing microtubules in there structure are;
a. cell membrane
b. centrioles
c. endoplasmic reticulum
d. lysosomes
e. mitrochondria

36. a chronic smoker from 30 years working in a tyre factory presented with painless hematuria n on
histopathology transitional cell carcinoma of bladder causative agent is ..?
a.aromatic amines
b.tobaco smoking
c.nitrites/nitrates
d.shistosomia hematobium

37. most common manifestation of autoimmune

disease ;
a. Fever
b.arthralgia
c.haematologic symptoms.
d.fatigue

38. ACTH effectively controls ?

a. Aldosterone
b. Adrenal androgens
c. Adrenal estrogen
d. Hydrocortisone

39. what defines the acute inflammation ?

1.local response of living tissue to injury

2.systemic response of living tissue to injury

3.migration of leukocytes

40. aortic pressure lowest during which phase of cardiac cycle??

a.atrial systole
b.isovolumic contraction
c.isovolumic relaxation

41. The vision lost is left temporal and right nasal field of both eyes, the visual pathway involved in
this lesion is
A. Rt optic nerve
B. Left optic tract
C. Rt optic tract
D. Left optic nerve

42. the affect of L dopa in parkinson pt dcreease gragually due to

1.antibodies develop against l dopa
2.gradual degeneration of neurons in sunstantia nigra

43. Glucose transport across a membrane is directly proportional to concentration graddient . Type of
transport is ;
A. Simple diffusion
B. Facilited

C. Active
D. Na countertaransport

44. sebacous glands are absent on

1.corner of lips
2.palms
3.glans of penis

45. Blood transfusion reaction is likely to occur when a person having blood group A+ is transfused
with blood of group;
A. A+
B. AC. ABD. O+
E. O-

46. C0mplicti0n of diabetic?

a.Wet gangren
b. dry gangren
c. ranyod phen0mena
d. thrmbroagints

47. true regarding genetic inhertance of SLE is ;

a. high incidence in monozygotic twins
b. incidence is high in females

c. if its in family, more chances to occur to all family members

48. Langhans giant cells are found in;

a.Tuberculosis
b.Sarcoidosis
c.Wegners granulomatosis
d. Leprosy

49. most active gluconeogenesis results from metabolism of ?

a.fatty acid
b.amino acids
c.cholesterol
d.glycogen/carbohydrates

50. Esophago gastric junction competence is

maintained by
A. lying supine
B. increased intra abdominal pressure
C. diaphragm paralysis
D. use of metoclopramide
E. use of morphine

51. Diminished jaw jerk due to lesion of

A. Mesencephalic nucleus of V nerve

B. Facial motor nucleus
C. Glossophyrngeal injury
D. Vagus injury

52. Co-trimoxazole action in.hiv pt on pnumocystc carini?

a.Inhibit cellwall syn
b.Inhibit folic acid synth
c. inhibit DNA synth

53. Which of the following structure doesn't pass posterior to the flexor retinacum
A. Ulnar nerve
B. Median nerve
C. Flexer digitorum superficialis
D. Flexer digitorum profundus

54. Cardiac surgeon during open heart surgery found bleeding vessel accompanying LAD in anterior
interventricular groove . Most likely involved vein is ;
A.Great cardiac vein
B. Anterior cardiac vein
C. Oblique vein
D. Small cardiac vein
E. Marginal vein

55. An upper motor lesion of facial nerve will result in ;

A. Excessive lacrimation
B. Hyperacusis
C. Loss of taste sensation in ant 2 /3 of tongue
D. Ability to wrinkle the forehead on the affected side

56. SQUAMOUS CELL CARCINOMA

a.Actinic keratosis
b. marjulian ulcer
c. Bowen Disease
57. Regarding histology of gastrointestinal tract, which is inappropriate ;
A. Peneth cells contain Eosinophilic granules in apical cytoplasm
B. Peyer's patches are present in submucous layer of duodenum
C. Parietal cells of human stomach secretes intrinsic factor
D. Striated brush border is composed of microvilli
E. The longitudinal coat of muscularis externa is arranged in 3 bands in colon

58. Which one.is.malignant

a.Glioma
b.Meningioma
c.Psedolymphoma
d.Chondroma

59. which cranial nerves r parasympathetic

A. III, VII, IX, X
B. V, VIII, II, XII

60. Severly dehydrated man comes in er what to gv

a.5percent glucose
b.Ten precent glucose
c.Hypertonic albumin
d. 0.9% nacl

61. Fibrous dysplasia commonly occurs in

a.Maxilla
b.Occipital bone
c.Frontal bone
d.Temporal bone

62. Weight of prostate

a.14 gr
b.18 gr
c.30 gr
d.40 gr

63. Edema is caused by;

A. hydrostatic pressure
B. osmotic pressure
C. Lymphatic obstruction

64. Growth hormone secretion is increased ;

A. Exercise
B. Hperglycemia

65. Drug action wont b affected bound to alpha

glycoprotein in
a. Neoplasm
b.Trauma
c. Hepatic disease
d. MI

66. Clinically GFR is measured by

a. Creatinine
B. Inulin

67. 16 yr child with cola color urine since one day , Hb 6 , high grade fever , was given antimalarial 1
day back ..

a.g6pd
b.falciparum(blackwater fever)
c. PNH

68. The cause of death in gas gangrene is due to ;

A. Bacteremia
B. Toxic shock
C. Pneumonia

69. which is not the content of mediastinum...?

a.lungs
b.heart
c.trachea
d.vagus nerve
e.large vessels

70. Diseases transferred thru vertebrate animals to

humans:
a)zoonosis
b)zonoarthosac

c)Zoncosis
d) anthropozoonosis

71. about calcitonin...?

a.must b given parenteral
b.may b used in intoxication of vid D
c.hypoparathroidism
d.a polypeptide of 32 aminoacid

72. most common conginital heart dsz?

a)asd
b)vsd

73. A man with AIDs who has no symptom with CD4 count 800 presented with suppurative otitis
media, causative organism is:
A. Mycobacterium
B. Strep pneumoniae
C. Pseudomonas aeruginosa
d)stap aureus

74. A pt can survive without mechanical ventilation, if the lesion is ;

A. Above C2
B. At C3
C. At C4
D. Below C5

75. Preganglionic sympathetic nerve fibers release ;

A. ACH
b. Norepinephrine
C. Dopamine

76. 5th Post intercostal artery

a. Thoracic aorta

77. Which one of the following is a COX II inhibitor ;

A. Aspirin
B. Indomethacin
C. Meloxicam

78. Fasting blood sugar of pt is 6.8 mmol (122 mg/dl) after 1 hr of OGTT it is 10.9 mol and later after 2
hr postprandial it was 10.7 mol ( 194 mg/ dl ) what is the diagnosis
A. DM

B. impaired glucose tolerance

C. Long lag phase

79. Not recorded on ECG normally

A. SA NODE
b.LEFT ATRIUM
c.AV NODE
d.RIGHT ATRIUM

80. After 48 hr of starvation, wht will be broken down to provide energy,;

A. Carbohydrate
B. Fat
C. Protein

81. Which of the following causes increased interstitial pressure;

A. capillary permeability
B. colloid osmotic pressure

82. Post op wound causes greenish pus discharge . Which organism is involved ;
A. Psudomonas
B. Klebseilla

C. E. Coli

83. Infection spreads retroperitoneally, which will b infected

a) Spleen
b) Jejunum
c) Transverse colon
d. Ascending colon

84. Sprain of ankle leads to eversion of ankle, which ligament is damaged .

a. Deltoid
b. Talofibular
c. peroneal
d. tendocalcaneous

85. A pt, wd DK didnt respond to treatment and died, Autopsy show inflammatory lesion in kidney
brain and lung, with some fungus. Most likely organism is ;
A. Mucormycosis
B. Candida

86. Person naked in room, temperature 21 degree centigrade, humidity present, loss of heat by ;
A. Insensible perspiration
B. Sweating

C. Conduction and radiation

87. Microscopic feature of polyarteritis nodosa is ;

A. Granuloma
B. Fibrinoid necrosis
C. Associated with hepatitis c

88. Which of the following structure damages in thyroidectomy ;

A. Recurrent laryngeal nerve damage
B. External laryngeal nerve damage
C. Laryngeal oedema
D. Sore throat
E. Vagus nerve damage

89.

ACTH effectively controls ?

a.Aldosterone
b.Adrenal androgens
c.Adrenal estrogen
d.Hydrocortisone
e.NE

90. which cannot b measured by spirometry

1.residual volume
2.expiratory reserve volume
3.inspiratory reserver vol
4.tidal vol.

91. the following diseas occur in iv abuser

1)infective endocarditis
2)llibmansack endocarditis

92. Normal FEV1/ FVC ratio is ;

A. 0.6
B. 0.8
C. 1
D. 5

93. Pt unable to void after fall which of the following section of spinal cord is affected;
A. L2, L3, L4, L5
B. L1, L2
C. S1, S2, S3
D. S2, S3, S4

94. osmotic diuretic effects on which part of nephron

a.proximal tubule
b.collecting duct

c.asc loop of henle

d.glomerular memb

95. After rapid loss of 2 liter of fluid . person drinks plain water . it ll lead to
A. Increase in interstitial fluid only
B. Increase in intracellular fluid volume
C. Plasms volume increase

96. A patient known smoker in laryngoscopy found laryngal nodule what is most unlikely
1 neoplasm
2 hyperplasia
3 keratosis
4 atrophy

97. secondary center of ossification

a.epiphysis
b.epiphyseal plate
c.diaphysis

98. .liquefactive necrosis.

a.brain

b.kidney
c.spleen

99. 1st heart sound

a.isovolumetric contraction

100. A 40 year old man has pain felt deep in the face and nose between the mouth and orbit to the
ear and temporal region . the pain may be due to the lesion of the ;
A. auricular nerve
b. facial nerve
c. hypopharyngeal nerve
d. maxillary branch of the trigeminal nerve
e. opthalmic branch of the trigeminal nerve

101. EBV
nasopharyngeal carcinoma

102. inverse stretch reflex(resulting relaxation)

golgi tendon organ

103. fast sharp pain

A delta fibers

104. 3rd ventricle

bounded laterally by 2/3 thalamus (Rabia Ali
MCQ)

105. glycogen breakdown

aerobic and anaerobic break down to pyruvate

106. fatty acids co enzyme

biotin

107. %age
units/total units X 100

108. The diagnostic lab test for the infection by streptococuss beta haemolyticus is ;
A. ASO titre
B. Blood culture
C. ESR
D. Leukocytes culture
E. Urine for bile pigment

109. disclosing pt's secret info

A. only with pt. consent
B. Insurance Claim
110. Most common cause of inc bleeding time
a.thrombocytopenia
b. Aspirin

111. opsonin

C3b

112. plasma cells produce

antibodies

113. black water fever

a.p.falciparum

114.Sulphonylurea?? Dont remember the options but question was asking about mechanism of action

115. alkalinize urine for removing

a.phenobarbitone

116. which one is true for

parasympathetic sys on Heart
a.inc the AV nodal delay
b. Decrease K ion outward current
c. Increase Ca++ inward Current
d. Decrease Inward Na+ current
117. .parasympathetic action
a. sweat glands
b.salivary glands

118.ectopic pregnancy most

common site
a. uterine tube

119. both central n peripheral chemoreceptors respond to

a..arterial pCO2
b. Increase pH
c. Decrease pO2

120. meckel's diverticulum

a.vitelline duct

121. .insulin dec by

a.beta blockers

122. most sensitive cardiac marker

a.trop T
b.Ckmb

123. Hypothyroidism
a. increased TSH

124. left adrenal vein drain into

a.left renal vein

125. fastest B.P regulation

a.baroreceptor

126. ESR inc in

a.infections
b. polycythemia

127.local factor delaying wound healing

a.foreign body
b. local infection

128.actin covered by
a.tropomyosin

129. turner
a.44xo

130.klinefilters syndrome
a.46XXY

131. S2,S3,S4 lesion

a.rectal incontinence
b.no pain in labour
c. anorgasmia

132. pain referred to shoulder

a.c2c3
b.C3,C4,C5

133. compression of S1
a.dec ankle jerk

134. not related to rt. kidney

a.descending colon

135. external carotid

a.lateral to retromandibulr vein

136.symphisis pubis
a.sec. cartilaginous joint

137.fibrous and parietal pericardium supplied by

a.phrenic

138. corona radiata

a.granulosa cells

139. .cimetidine with sucralfate

a.decrease metabolism
b. Sucralfate decreases cimetidine absorption, give it after 2 hours

140. Cimetidine may significantly prolong the prothrombin time and causes bleeding in pt who has
been treated with warfarin by ;
A. decreasing the hepatic clearance of warfarin
B. Displacing warfarin from plasma protein
C. Increasing the oral bioavailability of warfarin
D. Inhibiting renal tubular secretion of warfarin

141. .sternocleidomastoid supplied by

a.accessory nerve
142.regarding collagen
a.present in all types of connective tissue
b.unique protein
145.organ for metabolism
a.liver
b kidney

146. Regarding Portal vein following statement are correct ; Except

A. Develops partly from the cranial part of right vitelline vein
B. is connected to veins of anterior abdominal wall through paraumbilical vein
C. Is formed by union of superior and inferior mesenteric vein
D. lies in the free margin of lesser omentum

E. tributaries include left gastric and superior pancreatoduodenal vein

147. compact bone...

a.Regularly arranged lamelae

148. An initial left to right shunt before reversal is most commonly a feature of ;
A. Coarction of the aorta
B. Ebstein' s malformation
C. Eisenmenger's complex
D. Transpostion of the great arteries
E. Truncus arteriosis

149. Digoxine unlikly

1.inc Ca intracellular
2.inc K intracellular
3.inc Na intracellular
4.inc sympathetic to heart

150. u wave is associated with

A..atrial depo
B .atrial repo
C. ventricular repor
4. ventricl depo
5. slow repolarization of papillary muscles

151. A 25year old sprinter developed acute leg pain while running. the next day he noticed
ecchymosis around ankle . he can stand on his toes through it hurts . the most likely cause is ;
a. acute arterial embolism
b. deep vein thrombosis
c. herinated lumbar disc
d. ruptured Achilles tendon
e. ruptured plantaris tendon

152.A 30 year male came to a consultant clinic with history of progressive right facial numbness and
headach for 3 months, on examination, facial nerve palsy was confirmed on right side along with VIII
nerve involvement of same side, and right sided Intention tremors, the most likely site of lesion is ;
A. Cerebello pontine angle
B. Pons
C. Rt lobe of cerebellum
D. Rt side of mid brain

153. Wilsons disease

A. Ceruloplasmin

154. 16 yr old boy with diarhea,biopsy showin villous atrophy, not improved by gluten free diet, most
likely diagnosis
a. Celiac disease
b. Giardiasis
c. Whipples disease

155. IM ketorolac given in

a. Renal failure
b. Pregnancy
c. Suspected drug addicted complaining of pain

156. Water and salt reabsorption is maximum at

a. Duodenum
b. Stomach
c. jenunum
d. Ileum
e. Colon

157. wht happens in patient gettin TPN

a. Hyperglycemia
b. hyperphospatemia

158. epinephrine given slowly???

a. Decrease in TPR
b. Increase in diastolic pressure

159. Premalignant oral lesion

a. Lichen planus
b. Submucosal fibrosis

160. Question from biostatistics (Asked

about Wrong Statement)
a.statistical data is of no significance
b. Chi square

161. Nerve loops around arch of aorta

A. recurrent laryngeal nerve

162. Hemolytic anemia question?? Scenario was given and Correct Answer was Hemolytic anemia

163. Regarding atonic bladder, it is caused by

A. damage to parasympathetic efferent pathway
B. Damage to sympathetic efferent pathway
C. Cerebral cortex damage
D. Pudendal damage

164. Toxoplasmosis is inection

caused by
a. Parasite
b. Virus
C. Fungus
D. Bacteria
165. transmitted from eating undercooked meat
a. tapeworm
b. Liver fluke

166. false statement about Carbimazole

a. increases T4 to T3 conversion

167. lady with exophthalmos, thyrotoxicosis

a. Graves
b. MNG

168. Mitral stenosis, absent waves are

a. c waves
b. a waves

169. What wil decrease in hypotension

a. Carotid sinus discharge

170. RBC fragility

a. 0.35 % NaCl cause complete hemolysis
b. Hypotnonic cause swelling
c. Hypertonic causes shrinkage

171. Standing from 1 hour

a. Decrease CVP

172. something about Gamma motor neuron

a. Relaxes muscle
b. controls fiber 1a afferent
c. contract the intrafusal fibers

173. Arteriolar dilation leads to

a. increase in arterial blood volume
b. increase in venous volume

c. something about capillaries

174. Cause of Squamous Cell Carcinoma bladder

a. Shchistosoma hematobium

175.Post Commnicating artery

a. Internal carotid and Post Cerebral artery

176. Sjogrens Syndrome

a.dry mouth and eyes
b. Dry mouth only
c. Dry nasal mucosa

177. Which one is not epithelial tumour

a. Adenocarcinoma
b. Liposarcoma
c. Squamous cell Ca

178. Diphtheria toxoid given n thn aftr 2 weeks skin rashes , most likely reaction
a. Type 1
b. type 2
c. Type 3
d. Type 4

179. Cardiac output low in

a. beri beri
b. Cardiac failure
c. AV fistula
d. hyperthyroidism

180 Labetalol
a. Beta blocker
b. Alpha blockr
c. Alpha plus Beta blocker

181.Monocytes likely
A. Can transfer into large multinucleated giant cells in chronic infection
B. Increase in allergy
C. Produce IgM
D. Formed from precursor cells in lymph nodes
E. Do not migrate across capillary wall unlike granulocytes

182. not true abt surfuctant

a.increase surface tension

183.Lipid diet
a. Cholecystokinin

184. Reflex involving cerebrum

a Light reflex
b. Consensual light reflex
c.Accomodation reflex
d.Visual body reflex

185.Ocular myasthenia
a. Decreased postsynaptic receptors

186.Oral anticoagulant
a.PT
b. aPTT

187.Cushing syndrome
a.ACTH

188.Renal excretion of drugs???

a.Something about Plasma proteins

189.graft rejection
a. Acute Cellular

190.Ventilation of lungs
a.increased at base

191. Failure of aorta to separate from Pulmonary artery

a. Truncus Arteriosus
b. TOF

192. Peptic ulcer pain

a. Greater splanchnic Nerve
b. lesser splanchnic nerve

Good Luck for your Part-1 Exam