Key NL 2005-2007 MED TU PDF

(Anatomy)
Thoracic Organs System

Part Anatomy 2005
1.
mitral valve
A. midsternum
B. 2nd intercostals space left at parasternum
C. 4th intercostals space left at parasternum

D. 4th intercostals space right at parasternum
E. 5th intercostals space right at mid clavicular line(
left)
2.
lymph node
superior
cervical ganglion
A.
B.
C.
D.
E.
Part Anatomy 2006
1.
metastasis
A. apical
B. axillary
C. supraclavicle
D. intraclavicle
E. Thoracic
2.
45
20

obstruction
A. Trachea
B. Main bronchus
C. Medium bronchus
D. respiratory bronchiole
E. alveoli
3.
25

A. Diaphragm
B. Pericardium
C. Pleura
D. Intercostal muscle
E. Pulmonary parenchymal
4.
40 4
A. Nose
B. Nasopharynx
C. Trachea
D. bronchus
E. alveoli
5.
superior lobe
A. ICS 4
B. ICS 5
C. ICS 6
D. ICS 4
E. ICS 5
6.
55 1-2 20
Bronchus
A. Simple sqaumous
B. Simple cuboidal
C. Simple columnar
D. Stratified columnar
E. Stratified squamous
7.
18 10
intercostal space 5
midclavicular line
A. Superior vena cava
B. Aortic valve ascending aorta
C. Pulmonary valve pulmonary aorta
D. Tricuspid valve Right atrium
E. Mitral valve Left ventricle
8.
axillary artery

axillary
combine metabolic and respiratory acidosis artery
A. brachial artery
B. internal thoracic artery
C. subclavian artery
D. subscapular artery
E. vertebral artery
9.
aortic arch
pharyngeal arch
10.
11.
double aortic arch
Echocardiogram Double aortic arch

arch
A. 1
B. 2
C. 3
D. 4
E. 6
Part Anatomy 2007

1.
50 pleural effusion effusion
anterior Axillary line pleural reflexion

rib
A. 7
B. 8
C. 9
D. 10
E. 11
2.
30 2 fine
crepitation
A. Alveoli
B. Trachea
C. Main bronchus
D. Lobar bronchus
E. Segmented bronchus
3.
40
2 4
A. Nose
B. nasopharynx
C. Trachea
D. bronchus
E. alveoli

- pneumonia lobe stethoscope
root of spine of scapula

rib
left lung

rib
left lung
1. upper lobe
2. lower lobe
th
(Snell RS. Clinical anatomy by regions. 8 .2008:6872.)

Abdominal Organs System
Part Anatomy 2005
1.
40
30
mildly pale,
no jaundice, palmar
erythema, spider nevi, impalpable liver , spleen 3 cm
under left costal margin,
ascites positive
A. portal vein
B. hepatic vein
C. hepatic artery
D. superior vena cava
E. inferior vena cava
2.
40 liver biopsy 10
nerve
3.
Esophageal stenosis syndactyly
A. migration
B. apoptosis
C. proliferation
D. differentiation
Part Anatomy 2006
1.
Organell drug detoxification

A. peroxisome
B. Nucleus
C. golgi complex
D. mitochondria
E. SER
2.
ultrasound small
sliding hiatal hernia

A. incarcerated hernia
B. strangulated hernia
C. esophageal reflux
3. 45

A. pancreas
B. large
intestine
C. Gall Bladder
D. Gastric parietal cell
E. Lower esophageal sphincter
4.
ascites
A. Portal vein
B. Splenic vein
C. Hepatic vein
D. IVC
5. chronic liver disease
4 cm.
ascites
A. Portal vein
B. Splenic vein
C. Hepatic vein
D. Mesenteric vein
E. Inferior venacava
6.
70

inferior mesenteric
artery 90%
Descending colon
A. Left gastroepiploic artery

B. Middle colic artery
C. Splenic artery
D. Sigmoid artery
E. Superior rectal artery
7.
laryngotracheal tube primitive
foregut
A. Laryngotracheal groove
B. Posterior esophageal fold
C. Bronchopulmonary segment
D. Tracheoesophageal septum
E. Laryngotracheal diverticulum
8.
24 wk Oligohydramnios
A. real agenesis
B. esophageal atresia
C. anenephaly
Part Anatomy 2007
1.
mediolateral episiotomy muscle

A. bulbospongiosus
B. ischiocavernosus
C. superficial transverse peroneal
D. deep transverse peroneal
E. external anal sphincter
2.
50 10 epigastric
A. stomach
B. liver
C. pancreas
D. small intestine
E. gallbladder
3.
20
transverse
abdominis
A. external abdominis muscle
B. Internal abdominis muscle
C. Rectus abdominis
D. Transversalis fascia
E. Peritoneum
4.
peristaltic sound trachea

A. later body wall
B. septum tranversum
C. costodiaphragmatic recess
D. pluroperitoneal membrane
E. dorsal mesentery of esophagus
5.
A. Urachal fistula
B. Omphalocele
C. gastrichisis
D. neuroblastoma
6.

A. 1/4 ASIS
B. 1/4 AIIS
C. 1/3 ASIS
D. 1/3 AIIS
E. 1/4 iliac crest
7. 30 3
BP
150/90 mmHg. , moon face,
central obesity, hyperpigmentation,

Fasting Blood Glucose 180 mg/dl Adrenal
gland
A. Adrenal capsule
B. Zona glomerulosa
C. Zona fasciculata
D. Zona reticularis
E. Adrenal medulla

- uterus structure
Brain and Nervous System
Part Anatomy 2005
1.
left homonymous
hemianopia
A. left optic nerve
B. optic chiasma
C. right optic tract
D. left optic radiation
E. occipital lobe
2.
axillary artery
A. brachial artery
B. internal thoracic artery

C. subclavian artery
D. suprascapular artery
E. vertebral artery
3.
sciatic
nerve
A. upper outer quadrant
B. upper inner quadrant
C. midgluteal
D. lower outer quadrant
E. lower inner quadrant
4.
femoral vein
lateral
medial
A. vein artery nerve ring
B. vein artery ring nerve

C. artery vein nerve ring
D. nerve artery vein ring
E. vein artery ring nerve
5.
35
(foot drop)
nerve
A. tibial nerve
B. femoral nerve
C. superficial peroneal nerve
D. deep peroneal nerve
E. centriole
6.
50

A. basilar artery
B. vertebral artery
C. anterior cerebral artery
D. middle cerebral artery
E. posterior cerebral artery
7.
medulla
8.
12 20 cervical spine
fracture 2

spinal cord
A. posterior column
B. Lissauer tract
C. corticospinal tract
D. spinothalamic tract
E. spinocerebellar tract
9.
25 cavernous sinus
sign
A. ptosis of right eyelid
B. loss of corneal reflex
C. engorgement of the retinol vein
D. constrictive pupils response
E. loss of all extraocular movement of right eye
10.
70 paralysis sensory deficit
perineum
thrombosis
A. right posterior cerebral artery

B. right middle cerebral artery
C. right anterior cerebral artery

D. recurrent artery of Henbner
E. basilar artery
11.
30 2
2

A. peripheral nerve
B. anterior horn cells
C. neuromuscular junction
D. sympathetic chain
E. muscle
12.
cavernous sinus
A. right ptosis
B. constricted pupil response to light

C. loss of corneal blink reflex
D. engorged retinal vein
E. loss of right external ocular movement
13.
50
corneal reflex negative

cranial nerve
A. CN II
B. CN III
C. CN IV
D. CN V
E. CN VI
14.
60 horizontal nystagmus
A. inferior olive
B. vestibular nucleus
C. medial lemniscus
D. nucleus ambiguous
E. superior cerebelar peduncle
15.
50 complete cord injury T10
sensation
A. nipple line
B. costal margin
C. xyphoid process
D. umbilicus
Part Anatomy 2006
1.
A. Broca area
B. Motor area
C. Angular gyrus
D. Hippocampus
E. Wernicke area
2.
visual field
A. optic chiasma
3.
60
3
A. Red nucleus
B. Basal ganglion
C. Dentate nucleus
D. Pontocerebellar fiber
4.
65
ptosis
deviate lateral pupil
5 mm. hyperreflexia
lesion
A. Cerebral artery
B. Midbrain
C. Pons
D. Medulla
E. Cerebellar hemisphere
5.
40 16 wk
AFP
A. cleft palate cleft lip
B. Neural Tube Defect
C. Tetralogy of fallot
D. duodenal atresia
6.
CT scan
lateral third ventricle

A. Hydrocephalus
B. Hydranencephaly
C. Meroanencephaly
D. meroencephaly
E. Holocephaly
F. haloposencephaly
g.
Meningohydroenephalocele

Part Anatomy 2007
1.
60
10
right
hemiparesis with motor aphasia
A. anterior cerebral artery right

B. anterior cerebral artery left
C. middle cerebral artery right

D. middle cerebral artery left
E. posterior cerebral artery right
2.
right hemiparesis + motor aphasia
A. right anterior Cerebral artery

B. right middle cerebral artery
C. right posterior Cerebral artery
D. left anterior Cerebral artery
E. left middle cerebral artery
3.
70
Alzheimer
A. cerebropontine
B. cerebellum
C. hippocampus
D. medulla oblongata
E. globus pulidus
4.
resting tremor
Metabolism
A. cerebellum
B. hippocampus
C. basal ganglia
D. anterior horn cell
E. mammillary body
5.
Alzheimer

A. crus cerebri
B. cerebellum
C. hippocampus
D. Globus pallidus

1.
medial CN
2.
Musculoskeletal System
Part Anatomy 2005
1.
35 full thickness of
skin lodal flap with skin
and subcutaneous tissue

A. basal layer
B. deep dermis
C. subcutaneous fat
D. stratum corneum
E. stratum lucidum
2.
16

flexor
Carpi radialis, flexor digitorum superficialis
3.
A.
extent
B.
flexion
C.
abduct adduct
D.
opponent
E.
sensory
femur

A. skin
B. muscle
C. vessel
D. nerve
E. bone
4.
60 2

A. hamstrings
B. quadriceps
C. gluteus maximus
D. biceps femoris
E. iliopsoas
5.
50 (eversion)
lesion
A. gastrocnemius, soleus
B. plantaris, quadratus plantae
C. tibialis anterior, tibialis posterior

D. peronius longus, peroneus brevis
E. extension digitorum longus,flexion digitorum longus
6.
A. axillary nerve
B. median nerve
C. musculocutaneous nerve
D. radial nerve
E. ulnar nerve
7.
40 total thyroidectomy
A. cervical nerve
B. recurrent laryngeal nerve
C. pharyngeal nerve
D. thoracic nerve
E. thyroglossal nerve
8.
A. superficial inguinal node

B. deep inguinal node
C. external iliac node
D. internal iliac node
E. lumbar node
9.
A. ulnar nerve
B. deep branch of ulnar nerve
C. superficial branch of ulnar nerve
D. recurrent branch of median nerve

E. radial nerve
10. 30 gluteal area

A. iliopsoas
B. hamstrings
C. gluteus minimus
D. gluteus maximus
E. obturator internus
11.
carpal bone radial
bone
ulnar bone humeral bone

radial
bone ulnar bone
A. annular ligament
B. flexor retinaculum
C. bicipital aponeurosis
D. intermuscular septum
E. interosseous membrane
12.
syndactyly
A. apoptosis
B. fusion
C. proliferative
D. migration
E. differentiation
13.
axillary nerve
A. medial side of forearm
B. lateral side of forearm
C. medial side of arm
D. lateral side of arm

E. all
Part Anatomy 2006
1.
Lumbar puncture 20

vertebra
A. L2
B. L3
C. L4
D. L5
E. L6
2.
50
Posterior
Translocation femur
A. Flexion, medial rotation, adduction

B. Flexion, lateral rotation, adduction
C. Flexion, lateral rotation, abduction
D. Extension, lateral rotation, abduction

E. Extension, medial rotation, abduction
3.
medial collateral
ligament
A.
B. posterior dislocation tibia
C. lock
D. passive abduction
E. lateral rotation full extension
F. abduction full extension
4.
40
3-4
nerve
A. Ulnar nerve
B. Radial nerve
C. Axillary Nerve
D. Median nerve
E. Musculocutaneous nerve
5.
hip joint
posterior
dislocation
A. Flexion + medial rotation + adduction
B. Flexion + lateral rotation + adduction
C. Flexion + medial rotation + abduction
D. Extension + lateral rotation + abduction
E. Extension + medial rotation + abduction
6.
A. tense vocal cord

B. relax vocal cord
C. adduct vocal cord
D. abduct vocal cord
E. close rami glostidis
7.
35
carpo-pedal
A. larynx
B. laryngeal nerve
C. thyroid gland
spasm
D. thymus
E. parathyroid gland
8.
bulb of penis nerve

A. Pudendal
B. Ilioinguinal
C. Genitofemoral
9.
10.
epidermis layer 5

Epidermis dermis cell junction
A. zona occludens
B. zona adherens
C. desmosome
D. gap junction
E. hemidesmosome
11.
(Blister) junction
A. Desmosome
B. Tight junction
C. Gap junction
D. Zona adheren
E. Zona occluta
12.

A. Sweat gland
B. Epidermal ridge
C. Stratum lucidum
D. Sebaceous gland
E. Stratum corneum
13.
Unilateral cleft lib

A. medial nasal and maxillar
B. median nasal and median nasal
C. maxillar and mandibular
D. median nasal and lateral nasal
E. lateral nasal and maxillar
Part Anatomy 2007
1.
20 posterior
dislocation
hip joint
A. flex, medial rotate, adduct

B. flex, medial rotate, adduct
C. flex, lateral rotate, abduct

D. extend, lateral rotate, abduct
E. extend, medial rotate, abduct
2. Bone Marrow biopsy
A. Tibial
B. Humerus
C. Radius
D. Femur
E. Iliac spine
3. 10 humorus

A. median nerve
B. radial nerve
C. Ulnar nerve
D. medial cord of branchial plexus

E. lateral cord of branchial plexus
4.
35
spasticity hyperreflexia
fasciculation
hyporeflexia
A. Peripheral nerve
B. Ventral root
C. Spinal cord
D. Brain stem
E. Alpha motor neuron
5.

A. ectoderm
B. mesoderm
C. endoderm
D. neural crest
E . neural tube
6. 15
A. epidermis
B. hair follicle
C. apocrine gland
D. sebaceous gland
E. arrector pilli muscle
7.
A. Large artery
B. Medium artery
C. Small artery
D. Capillary
E. Venule
(Anatomy)
Part Anatomy 2005
1. E. 5th intercostals space left at mid clavicular line
2. A.
Superior cervical ganglion sympathetic
ganglion Lesion Horner

syndrome
1)
2)
miosis : dilator pupilae muscle
ptosis :
3)
anhydrosis : vasodilation

Part Anatomy 2006
1. B. axillary

Axillary lymph node
2. D. respiratory bronchiole
respiratory bronchiole
Lower respiratory tract
Respiratory portion (
)

3. C. Pleura
Nerve
4. E. alveoli
particle 5
Mucociliary Escalator system

5. B. ICS 5

rib
left lung

rib
left lung
1.
upper lobe
2.
lower lobe
anterior view
Posterior view
6. E. Stratified squamous
Stratified squamous
Peudostratified
Columnar ciliated with goblet cell

7. E. Mitral valve Left ventricle
8. A. brachial artery
()
9.
Pharyngeal arch 4
10. distal part of the right dorsal aorta

11. D. 4
th
4 aortic arch
- arch of aorta
left common carotid left subclavian artery
- right subclavian artery,
right dorsal artery 7
th
intersegmental artery
- right dorsal artery dubble
aortic arch

Part Anatomy 2007
1C. 9
Rib 8

2. A. Alveoli
3. E. alveoli

- pneumonia lobe stethoscope

rib
left lung

rib
left lung
1. upper lobe
2. lower lobe
th
(Snell RS. Clinical anatomy by regions. 8 .2008:6872.)

Part Anatomy 2005
1. A. portal vein
Chronic liver disease : liver cirrhosis
fibrosis nodule

portal hypertension
palmar erythema ,spider nevi,
gynecomastia ,testicular atrophy, dilated suferficial
abdominal vein and ascites
portal hypertension
(Varices)
(rupture)
(malena)
(hematemesis)
2. phrenic nerve
(diaphragm)

phrenic nerve
Phrenic nerve
C3C5
referred pain
3. B. apoptosis
esophagus
1. esophageal
atresia esophagotracheal fistula
esophagus trachea
esophagotracheal septum
posterior
2. esophageal
stenosis
lumen esophagus
1/3 esophagus
rcanalization 8

Part Anatomy 2006
1. E. SER

enzyme P450 oxidase
drug

hydrolyze
2. C. esophageal reflux
lower
esophageal (gastroesophageal)
sphincter
esophageal
reflux
3. D. Gastric parietal cell
Peptic ulcer

(Gastric ulcer)
mucosal barrier
parietal cell
HCl
fundus body
pepsinogen pepsin
pepsin
mucosal barrier
peptic ulcer
4. B. Splenic vein
Gastric varices
vein thrombosis
Isolated splenic
left sides portal hypertension venous

hypertension
gastro splenic gastric
varices esophageal varices

5. B. Splenic vein
isolated splenic vein thrombosis
6. B. Middle colic artery
Descending colon left
colic artery (
inferior mesenteric artery ) middle colic artery (
superior mesenteric artery)
(anastomosis)
7. D. Tracheoesophageal septum
Tracheoesophageal septum membrane
forgut
-ventral : respiratory primordium

-dorsal : forgut esophagus
8. A. real agenesis
amniotic fluid abnormalities
Oligohydramnios < 0.5 L of amniotic fluid; associated with
bilateral renal agenesis or posterior urethral valves(in males)
and resultant inability to excrete urine. Can give rise to
Potters syndrome.
Polyhydramnios > 1.5 2 L of amniotic fluid; associated
with esophageal duodenal atresia, causing inability to swallow
amniotic fluid, and with ancephaly.
Part Anatomy 2007
1. E. external anal sphincter
oral canal
2. C. pancreas
3. D. Transversalis fascia
Anteolateral abdominal wall
1. skin
2.
superficial fascia
3. external abdominal oblique

4. internal abdominal obique
5. tranversus abdominis
6. transversalis fascia
7.extraperitoneal fat
8.parietal peritoneum
4. D. pluroperitoneal membrane

-septum transversum
-pleuroperitoneal membrane
2 Posterolateral septum
transversum
peritocardioperitonial
canals
pleuroperitoneal membrane
- -

diaphragmatic hernia
5. A. Urachal fistula
Keyword
urachal
fistula
Omphalocele
umbilical cord amnion
Gastrichisis
loop
amnion lateral
6. C. 1/3 ASIS
1/3
anterior
superior iliac spin (ASIS)

(Umbilicus) McBurneys point
7. C. Zona fasciculata

glucocorticoid cortisol
keyword
moon face, central obesity,
hyperpigmentation
Cushing
syndrome
Ureter

Part Anatomy 2005
1. C. right optic tract
A. left optic nerve
= total blindness
B. optic chiasma = bitemporal hemianopia

C. right optic tract
= left homonymous
hemianopia
D. left optic radiation = right homonymous
hemianopia
E. occipital lobe
= homonymous hemianopia
)
2. D. suprascapular artery
Suprascapular artery
trunk
thyrocervical
st
1 part
subclavian artery
anastomosis
dosal
subscapular artery
collateral
circulation
Suprascapular artery
scapular
scapula
ligation
axillary artery
3. A. upper outer quadrant
Sciatic
nerve
piriformis
gluteal
region
gluteal
gluteus

region
inferior gluteal nerve
maximus
superolateral
part of buttock upper
outer quadrant
4. D. nerve artery vein ring
femoral
triangle
lateral
N(nerve)
medial
A(artery)
V(vein)
5. D. deep peroneal nerve
Tibialis anterior
muscle
deep peroneal nerve
Tibialis anterior
muscle
6. A. basilar artery

lesion CN III
lesion CN
III

lesion
CN VII
nucleus CN VI,III,VII
pons
basilar artery
7. C.
8. C. corticospinal tract
Keyword
motor

Corticospinal tract

9.
A. ptosis of right eyelid: CN III (Levator
palpebrae superioris m. )
B. loss of corneal reflex:
corneal reflex
V ) CN V CN VII
C. engorgement of the retinol vein
Sinus
D. constrictive pupils response: intact CN III

E. loss of all extraocular movement of right
eye:
CN III
10. C. right anterior cerebral artery

right anterior cerebral artery
11. C. neuromuscular junction

myasthemia gravis
acetylcholine receptor
antibody
neuromuscular junction
12.
13. D. CN V
CN VII
Corneal reflex CN V
14. B. vestibular nucleus

Nystagmus

nystagmus
involuntary movement
15. D. umbilicus
Dermatome
1
T10

Part Anatomy 2006
1. A. Broca area
Motor area :
Angular gurus
: language and cognition
Hippocampus :
Wernicke area
2.
3. B. Basal ganglion
(resting tremor)
substantia nigra
basal ganglion
4. B. Midbrain
weber syndrome
1.
= light reflex
midbrain
2.hyperreflexia
= UMN lesion cerebral preduncle
midbrain
5. B. Neural Tube Defect
6. A. Hydrocephalus
Hydrocephalus
Obstruction
Blood clot , pus , tumor
fibrosis after meningial infection
Increase production
Tumor-producing ( choroid plexus papilloma )
Loss of brain tissue
post-infarction , brain atrophy

Part Anatomy 2007
1. D. middle cerebral artery left
63
keyword Right
hemiparesis() with motor

aphasia()
2. E. left middle cerebral artery

corticospinal tract
cecussation
medulla
lesion (left side)

Motor aphasia lesion Brocas area
( lateral side )
choice d e
d
medial side cerebral hemisphere

e
3.C. hippocampus
4. C. basal ganglia
Parkinson disease
- (rigidity)
- (Mask face)
- substantia nigra basal ganglia
5. C. hippocampus
1. CN IV
2. torticullis
sternocleidomastoid
muscle
(CN XI)
muscle
Part Anatomy 2005
1. B. deep dermis
Dermis
2. B. flexion
Flexor digitorum superficialis middle phalanges
5
Finger flexion
3. E. bone
2 ( Nerve
branch
Nerve )
4. B. quadriceps
Patellar ligament
5. D. peronius longus, peroneus brevis
lateral part
of leg
peronius longus, peroneus brevis
lateral
part of leg
6. A. axillary nerve
Axillary nerve surgical neck of
humerus deltoid teres minor
axillary nerve
overstretch
7. B. recurrent laryngeal nerve
8. A. Superficial inguinal lymph node
Superficial inguinal lymph node
Penis Scrotum Perianal
9. B. deep branch of ulnar nerve

deep branch of ulnar nerve Interossei
Palmar interossei m.
Dorsal interossei m.
10. D. gluteus maximus
= major hip extension muscle
11. E. interosseous membrane

Interosseous membrane
ulna radial
12. A. apoptosis
13. D. lateral side of arm
Axillary nerve upper lateral
brachial cutaneous nerve
deltoid
Part Anatomy 2006
( arm)
1. A. L2
L1
2. B. Flexion, lateral rotation, adduction
Head of femur
acetabulum
3.F. abduction full extension
4. D. Median nerve
Median nerve
median nerve
5. A. Flexion + medial rotation + adduction

6. C. adduct vocal cord

Recurrent laryngeal nerve

7. E. parathyroid gland
2+
Ca
Ca
2+
Parathyroid gland parathyroid thyroid

gland thyroid
gland
parathyroid gland
8. A. Pudendal
9.
1.Stratum corneum
2.Stratum lucidum
3. Stratum granulosum
4. Stratum sipinosum
5. Stratum basalae
10. E. hemidesmosome
A-D lateral cell
11. A. Desmosome
12.
C. Stratum lucidum
5
1.Stratum corneum
2.Stratum lucidum
3. Stratum granulosum
4. Stratum sipinosum
5. Stratum basalae
4 Stratum
lucidum
13. A. medial nasal and maxillar
Medial nasal prominence ,
philtrum
(Median portion)
Lateral nasal prominence
Maxillary prominence 2
lateral
Portion
Mandibular prominence ,
Medial nasal
prominence maxillary
Prominence
Part Anatomy 2007

1. A. flex, medial rotate, adduct
2. E. Iliac spine
3. B. radial nerve
Radial nerve radial groove
humorus radial nerve
action extensor
muscle
radial
nerve
4. E. Alpha motor neuron
Alpha motor neuron lower motor neuron
brain stem spinal
cord fasciculation hyporeflexia
Hyperreflexion upper
motor neuron
Fasciculation spasticity motor
neuron
UMN
LMN

E
5. D. neural crest

(melanocyte) f orm neural crest cell
6. C. apocrine gland
Apocrine gland
7. D. Capillary

2552
17
( .
)
2. 1 Barbinskis reflex
dorsiflexion
Frontal cortex Barbinskis reflex
dorsiflexion
upper motor neuron frontal lobe
motor upper
motor neuron
4. vertical diplopia
nerve
Left trochear nerve

9. bone marrow biopsy
hip bone (iliac crest)

(sternum
aspiration)
The types of biopsy

There are two main types of bone marrow test a bone marrow aspiration and a
bone marrow trephine biopsy.
marrow cells up into a syringe.
Aspiration means the doctor sucks some bone

A bone marrow trephine means that the doctor
removes a 1 or 2cm core of bone marrow in one piece.

You may have both of these tests done at the same time.
They give some of
the same information to the doctor, but there are differences.
The bone marrow
biopsy shows the doctor the structure of the bone marrow inside the bone,
whereas the aspiration takes just the bone marrow cells.
Having the test
Either test only takes a few minutes and you can have them done as an
outpatient.
bone.
The doctor usually takes the bone marrow sample from your hip
You can have a bone marrow aspiration from your breast bone (sternum)
but not a bone marrow biopsy.

First you have a local anaesthetic injection into the skin over the biopsy site
usually your hip bone to numb it. When this has worked, the doctor puts the
needle in through the skin, into the hip bone or sternum
http://www.cancerhelp.org.uk/help/default.asp?
page=3948
10. carpal tunnel syndrome
Palmar branch of median nerve

16. thalassemia

Spleen
white pulp red pulp

thalassemia
24.1/3 shaft of humerus bone
Extension wrist ( 1/2 shaft of humerus bone
) radial nerve
27.
Schwann cell

28.

Supraspinatus tendon

29.

ulnar nerve

ulna
33. carpal turnel

syndrome
nerve
palmar cutaneous branch of median nerve
superficial flexor retinaculum

34.

abductor pollicis longus
radial nerve
adductor pollicis ulnar nerve
abductor pollicis brevis median nerve
( ..
)
. 15 28 4
A. Apoptosis
B. Hydrolysis
C. Proteolysis
D. Aplasia
E. Necrosis
E
secretory phase ischemic phase

. gonad testis
A. Y chromosome
B. Sertoli cell
C. Leydig cell
D. Paramesonephric duct
E. Mesonephric duct
A H-Y antigen
. 2 testis scrotum
inguinal canal
testis
A. Iliac fossa
B. Pelvic cavity
C. Spermatic cord
D. Abdominal cavity
E. Processus vaginalis
B
(
.. )
.

A. Midgut volvulus
B. Esophageal atresia
C. Pyloric stenosis
D. Duodenal atresia
E. Annular pancreas
D. Duodenal atresia
(Duodenal atresia)
lumen
recanalization lumen
common bile duct

2-3

common bile duct

common bile duct
polyhydramnios
(amniotic fluid)
(amniotic sac)
.

A. hepatoduodenal ligament
B. hepatogastric ligament
A.
hepatoduodenal ligament
Cystic artery is located in which of the following

peritoneal structures?
A.Falciform Ligament
B.Gastrocolic Ligament
C.Gastrohepatic Ligament
D.Hepatoduodenal Ligament
E.Splenorenal Ligament
. duodenum

A. left gastric a.
B. right gastric a.
C. esophageal
a.
D. epigastric a.
E. gastroduodenal a.
E. gastroduodenal a.
. diaphragmatic herniation
( )
A. anterior
B. posterior lateral
C. lateral
D. central
B. posterior lateral
Congenital diaphragmatic hernia

pleuroperitoneal membrane

(left posterolateral site)

pulmonary hypoplasia
.
( )
A.pyloric stenosis
B.esophageal atresia
A.pyloric stenosis
Congenital
hypertrophic pyloric stenosis
pylorus
(pyloric muscle
hypertrophy) pyloric canal
(projectile
vomiting)
Duodenal atresia
.
stridor
A.trachea
B.bronchus
C.bronchiole
D.alveoli
A.trachea
. asthma wheezing
Rhonchi (Wheezing)
bronchi bronchioles
.
( )
A. gallbladder
B. pancreas
A. gallbladder referred pain gallbladder
( .
)
.
dermatome
A.
T12-L1
B.
L1-L2
C.
L2-L3
D.
L4-L5
E.
L5-S1
. 40 3
A. Detrusor muscle
B. Bladder trigone
C. Levator ani + pelvic fascia (Cilinically oriented anatomy

ed. 4 p. 345)
D. Pudendal nerve
E. Perineal fascia
. eversion
(
)
A. superial peroneal nerve
B. deep peroneal nerve
C. common peroneal nerve
C superficial
deep peroneal nerve
injury common peroneal
dorsiflex eversion injury
superficial peroneal eversion
injury deep peroneal dorsiflex
. dorsiflexion foot
)
A. deep peroneal nerve
B. superial peroneal nerve

A 31
nerve (
.

fundus lumbar lymph node
external iliac lymph node
round ligament of uterus superficial inguinal lymph

node
body external iliac lymph node
cervix internal iliac sacral lymph node
( . )
. folate Embryogenesis
A. Cell division
B. Gene mutation
C. DNA methylation
D. Histone acetylation
E. Neural tube folding
. Sympathetic trunk
A. Ectodermal cell
B. Mesodermal cell
C. Endodermal cell
D. Neuroectodermal cell
E.
Neural crest cell
.
A.ectoderm
B.splanchnic mesoderm
C.endoderm
D.neurocrest
.greater splanchnic
neural crest
nerve
(Physiology)
Part Physiology 2005

1.
respiratory rate 12/min tidal

volume 500 cc PaCO2 45 mmHg
PaCO2
A. cardiac output
B. lung compliance
C. dead space ventilation
D. functional residual capacity
E. FEV1
2.
36 hypertension hypokalemia
aldersteronism serum aldersterone
A. serum rennin
B. serum ACTH
C. serum prolactin
D. serum cortisol
E. urine Na
3.
25 HIV positive CD4+ count = 250 ml

protinase inhibitor nucleoside polymerase inhibitor
Hb 12.8 8.2 g/dl anemia
A. folate
B.
C. antibody RBC
D. RBC
E. RBC
4. poor skin turgor
Na 131 mEq/l ( 135-145 )

A. increased ADH
B. increased atrial natriuretic peptide
C. increased aldersterone
D. increased effective circulatory volume
E. ruine osmolarety < serum osmolarity
5.
1 rickets Ca P
1,25 ( OH )2D3. alkaline phosphatase parathyroid

hormone rickets
A. vitamin D intake
B. vitamin D absorption
C. activation of vitamin D
D. target cell receptor

E. catabolism of vitamin metabolite
6.
18

Serum:
Na
Cl
Urine:
140
85
Na
mEg/l
mEg/l
40
2.1
mEg/l
HCO3 35 mEg/l
mEg/l
140 mEg/l
A.
B.
anabolic steroid
C. aldosterone deficiency
D. diabetic ketoacidosis
E. anxiety with hyperventilation
7.
alcohol
coronary artery disease
A. HDL
B. LDL
C. triglyceride
D. thromboxane B2 platelet
E. contractile protein coronary artery
8.

prolactin hormone
A. insulin cortisol
B. thyroxine dopamine
C. estrogen progesterone
D. growth hormone oxytocin
E. HCG prostaglandin
9.
10 burn 2
nitrogen loss
A. insulin
B. cortisol
C. thyroxine
D. erythropoietin
E. parathyroid hormone
10.
cardiac output Fick O2 tension
O2 tension
venous blood
A. jugular
B. saphenous vein
C. foramen ovale
D. pulmonary artery
E. pulmonary vein
11.
A. ankyrin
B. myosin
C. tubulin
D. integrin
E. spectrin
12.
A. O2 affinity
B. O2 capacity
C. hematocrit
D. Pa O2
E. viscosity
13.
initial velocity (V) substrate
MicalisMenten kinetic enzyme

( 4 )
14.
A.
B.
C.
D.
control
70 NaCl 200 mEq 4
mineralocorticoid 4
urine NaCl
Day 1
30 mEq
Day 2
90 mEq
Day 3
180 mEq
Day 4
200 mEq
NaCl 1 l 1kg NaCl 150 mEq 4
A. 66 kg
B. 68 kg
C. 70 kg
D. 72 kg
E. 74 kg
15.
cardiac catheter 14
mmHg 26 mmHg
O2 saturation 55%
A. left atrium
B. right atrium
C. foramen ovale
D. ductus artheriosus
E. pulmonary artery
16.
4 2
oxidized

A. serum glucose
B. serum fatty acid
C. muscle glycogen
D. muscle triglyceride
E. muscle creatine phosphate
17.
35 6
gastrocnemius
A. conversion of fast fiber
B. decreased fiber
C. decreased myofibril
D. increased satellite cell
E. increased mitochondrial content
18.
30

BP 112/76 mmHg PR
88/min BP 80/60 mmHg PR 120/min

A. dopamine
B. isotonic saline
C. colloid solution
D. 5% dextrose in water
E. fresh frozen plasma
19.
40 20

, , severely restricted horizontal eye
movement and ataxia 2
vitamin
A. folate
B. retinol
C. thiamine
D. pyridoxine
E. cyanocobalamine
20.
50

A. amygdala
B. hippocampus
C. locus ceruleus
D. mammillary body
E. caudate nucleus
21.
platelet- derived growth factor cell
receptor signal transduction

A. DNA
B. GTP-coupled G protein
C. calcium
D. ion channel
E. thyroxine kinase
22.

A. -adrenergic blockage
B. -adrenergic blockage
C. muscarinic blockage
D. inhibition of acetyl cholinesterase
E. sympathetic denervation
23.
25 10
A. 2
B. 3
C. 1
D. 4
E. 6
24.
intracellular domain insulin receptor enzyme
activity
A. tyrosine kinase
B. adenylyl cyclase
C. phospholipase C
D. phosphodiesterase
E. phosphoprotien phosphatase
25.
30
BP 90/60 mmHg wheezing

vasoactive effect
A. IgE eosinophil neutrophil
B. IgA mast cell basophil
C. IgE mast cell basophil
D. IgA eosinophil neutrophil
E. active T-lymphocyte
26.
35
antivenom
100ml 2
RBC
A. hypersensitivity type I
B. hypersensitivity type II
C. hypersensitivity type III
D. hypersensitivity type IV
E. venum-antivenum reaction
27.
20 20 100ml
immediate response
A. hematocrit
B. heart rate
C. vagal activity
D. ADH
E. plasma hydrostatic pressure
28.
blood flow mean arterial pressure (MAP)

autoreguration blood flow
29.
severe atherosclerosis 10
Compliance
30.
pulse pressure
A.
B.
C.
D.
E.
50 aerobic

A. liver glucose
B. serum lactic acid
C. muscle protein
D. muscle glycogen
E. muscle phosphocreatine
31.
30 respiratory rate 20/min tidal volume 500 ml

anatomical dead space 200 ml respiratory rate
30/min tidal volume 350 ml anatomical dead space

A. PaCO2
B. PaCO2
C. PaCO2
D. pH
E. pH
32.
30
A. oxytocin
B. prolactin
C. estrogen
D. progesterone
E. HCG
33.
20 sex
physiology
A. sexual ambiguity
B. sexual immaturity
C. sexual perversion
D. sexual dysfunction
E. sexual inadequacy
34.
25 32
A.
B.
C. Hb 11
D.
E. urine protein 2+
35.
10 2
generalized edema, ascites positive

pH 6.0,
specific gravity 1.015, protein 4+, glucose negative
urine sediment
A. RBC cast
B. broad cast
C. oval fat body
D. urate crystal
E. numerous WBC
36.
30 chronicotitis
media tuning folk
A. Rene test right positive
B. Rene test right negative

C. Rene test left negative
D. Waber no lateralization
E. Waber lateralized to the left
37.
aterial blood gas pH 7.2
PaCO2 80 mmHg
Pa O2 50 mmHg
A. renal failure
B. metabolic acidosis
C. ventilatory failure
D. oxygenation failure
E. combine ventilatory and oxygenation failure
38.
18

PR 100/ min, BP 80/60 mmHg,abdominal
distention, decreased bowel sounds
A. splenic rupture
B. stomach perfotation
C. colonic perforation
D. renal pelvis rupture
E. hepatic subcapsular hemorrhage
39.
Specific gravity
1.035,Glucose negative, Protein negative
A. medullary blood flow

B. urea availability
C. solute free water
D. collecting tubule ADH
E. NaCl reabsorption thick ascending limb
40.
50 1

hormone
A. inhibin
B. estradiol
C. FSH & LH
D. progesterone
E. androstenedione
41.
25 2

A. night urine specimen
B. random urine specimen
C. midstream urine specimen
D. first- voiding morning urine specimen
E. 24 hours urine specimen
42.
30
postural hypotension poor skin
turgor
A. angiotensin II
B. ADH
C. ANP
D. aldosterone
E. sympathetic activity
43.
QRS complex
A. atrial depolarization
B. atrial repolarization
C. SA node depolarization
D. Ventricular depolarization
E. Ventricular repolarezation
44.
40 specific
gravity 1.015, sugar 2+ ,protein negative
blood sugar 100 mg/dl
A. afferent arteriole
B. glomerular basement membrane
C. proximal convoluted tubule
D. Henles loop
E. distal convoluted tubule
45.
HR 2 SV
TPR MAP ( mean arterial
pressure )
A.
B.
C.
D.
E.
46.
25
100dB 5
A.
B.
C.
D. +
E.
47.
60
A. cardiac index
B. GFR
C. renal blood flow

D. fasting blood sugar
E. maximum O2 uptake
48.

receptive relaxation
A. parietal chief cell

B. antral G cell
C. secretin
D. somatostatin
E. vagus nerve
49.
2 ( x y )
Y
X
A. isotonic
B. hypotonic
C. hypertonic
D. isosmotic
E. hyperosmotic
50.
( circadian varian )
melatonin MRI lesion
A. accessory optic nucleus

B. supraoptic nucleus
C. suprachiasmatic nucleus
D. lateral preoptic nucleus
E. preoptic nucleus
51.
35 shock BP 80/66
mmHg compensate
A. vagal activation
B. sympathetic activation
C. rennin-angiotensin-aldosterone system
D. higer center
52.
5
deleyed bone growth recombinant growth
hormone 3
A. insulin-like growth factor
B. activity PO4
C. parathyroid hormone
D. Ca
53.
2+
dehydration
sp.gr. 1.030 .protein negative, sugar 4+,
ketone-positive, Na 148 mEq/l, Cl 92 mEq/l HCO3 5
mEq/l, blood sugar 560 mg/dl
A. ADH
B. insulin
C. Hyperthyroidism
D. Cortisol
54.
18 cardiac catheterization
Blood pressure
O2 saturation (%)
(mmHg)
Right atrium
95 (75)
Right ventricle
95 (75)
Pulmonary artery
95 (75)
Left Atrium
90 (90)
Left ventricle
90 (90)
Aorta
90 (90)

A. mitral stenosis
B. aorticstenosis
C. artrial septal defect
D. tricuspid insufficiency
E. patent ductus arteriosus

55.
3
arterial blood gas
A. pH=7.5, pCO2= 55, HCO3 = 34
B. pH=7.4, pCO2 = 40, HCO3 = 24

1.
60
3

clinic

A. Glycine
B. Serotonin
C. Dopamine
D. Acetylcholine
E. Gamma aminobutyric acid
2.
10

A. c fiber
B. A beta fiber
C. transmittion cell in spinal cord
D. substance P nociceptor
E. enkepalin periaqueductal gray
3.
30
( myasthenia gravis)
A. Cholinesterase
B. Cholinesterase

C. ACh Receptor
4. 70 6

A. splanchnic arteriole
B. symphathetic activity
C. intercranial pressure
D. BP
E. coronary parasymphathetic activity
5.
100 10
6.

A. Ach
B. Ach receptor
C. AchE Synaptic cleft
D. Ach presynap
E.
turnover Ach receptor
7.

()
A. T4
B. T3
C. rT3
D. TSH
8.
40
PR 120/min Thyroid
gland PTU
PTU
A. Iodine transport
B. Thyroglobulin synthesis
C. TSH receptor synthesis
D. Thyroid peroxidase activity
E. Thyroglobulin binding activity
9.

Thyroid enlarge
,tachycardia
A. Osmotic diarrhea
B. Bacteria overgrowth
C. Increase GI motality
D. Inflammatory
E. Loose sphincter tension
10.
30 BP 150/100 Na+ = 150 K+ = 3.0
hormone
A. aldosterone
B. ACTH
C. ANP
D. ADH
E. Glucocorticoid
11.
30
negative MRI Pituitary

tumor hormone
A. Prolactin
B. Estrogen
C. Progesterone
D. LH
E. FSH
12.
45
fasting blood sugar 220
A. glycolysis
B. ketonegenesis
C. gluconeogenesis
D. lypolysis
E. glucogenolysis
13.
20
4-5 fasting blood
glucose = 250 mg/dl
A. Albumin
B. C-protein
C. Chylomicron
D. Ketone bodies
E. Triacylglyceride
14.
30

BP 150/100
FBS 180 hormone
A. GH
B. LH
C. TSH
D. ADH
E. ACTH
15.
45 BP PR

A. rennin
B. aldosterone
C. ADH
D. Epinephrine
E. ANP
16.
hormone
A. Leptin
B. Insulin
C. Thyroxin
D. Growth hormone
E. Insulin like growth factor
17.
BP
+
90/65 Na = 120, K = 5, HCO 3 = 20 , Fasting blood

glucose = 60 Hormone
A. vasopressin
B. thyroxin
C. adenocorticotrophin H.
18.
60

Hb 10 Hct 30 MCV 120
A. Gastrin
B. Secretion
C. Intrinsic factor
D. CCK
E. VIP
19.
terminal ilium 2/3 ilium valve

A. bile acid
B. transient time colon

C. transient time intestine
D. bile salt
20.
30 10

shooting star
RBC WBC
toxin

second messenger
A. cAMP
B. DAG
C. phospholipase
D. tyrosine lanase
E. IP3
21.
albumin edema
A. osmotic p
B. osmotic p
C. Increase permeability
D. increase hydrostatic pressure
22.
30
post hypertension pure
skin turgor Na+ 130 mEq
A. ADH
B. ANP
23.
pH = 7.55 HCO3 = 22 PCO2 = 25
24.
Serum osmolarity 320 mOsm/H2O

Urine osmolarity 40 mosm/H2O urine sp. Gr. = 1.002 Na+
K+
A. Na+
B.
proximal tubule
C. Na+ proximal tubule
D. Na+ distal tubule
E.
collecting
25.
60 4(multipartum)

A. Pelvic muscle contraction
B. Detrusor
C. bladder
D. micturatio center
26.

12
Yellow color,clear,specific gravity 1.035,

AlbuminGlucose negative
A. Urea renal medulla
B. Medulla blood flow

C. Solute-free water excretion

D. Collecting duct ADH
E. NaCl reabsorption loop of Henle

(Na -K
reabsorption Henles loop )

27.
60 6

A. splanchnic arteriole
B. sympathetic activity
C. cadiac pressure
D. BP
E. GFR
28.
3 HCG
hormone
A. HCG Corpus luteum
B. LH Corpus luteum
C. Estrogen Corpus luteum
D. progesterone Corpus luteum
E. Estrogen secretory endrometrium
29.
Hormone

A. LH
B. FSH
C. HCG
D. Progesterone
E. estrogen
30.
25 3
1
Hormone
A. Estrogen
B. Progesterone
C. FSH
D. LH
E. HCG
31.
1 ovulation
32.
Estrogen endometrium
A.
cAMP
B. GTP G-protein
C. gene expression
D. tyrosine kinase
E. adenylate cyclase
33.
50 6

1
Estrogen

A.
B.

C.
D. Estrogen
E.
34.
1 RR = 15 , Tidal volume = 500

, Anatomical dead space = 200 2 RR = 30
, Tidal volume = 300 , Anatomical dead space = 200

2

A. PaCO2
B. PaCO2
C. PaCO2
D. pH
E. pH
35.
pulmonary function Pa CO2 , Pa

O2 () 70 20
( 20 )
Pa O2
Pa CO2
A.
B.
C.
36.
D.
E.
25 O2
effector
A. Proton
B. CO2
C. 2, 3 - DPG
D. Erythropoietin
E. F 1-6
37.
Arterial blood gas

pH 7.55 , Pa CO2 25 mmHg , HCO3 = 22

A. hyperventilation
B. hypoventilation
+
C. H
D. HCO3
E. Titratable acid
38.
10 midbrain
pH 7.25 , Pa CO2 55 , Pa O2 60 , HCO3

= 25
A. diffusion defect
B. intrapulmonary shunt
C. alveolar hypoventilation
D. decrease perfusion
E. V/Q mismatch
39.
ARDS
A. compliance of lung
40.
10
dull percussion Breath sound
A. pleural effusion
B. pneumothorax
41.
A. cell atrophy
B. mucus
42.

Pulmonary defense mechanism
A. Cilia movement
B. Cough reflex
C. Secretory IgA
D. Alveolar fluid
E. Alveolar macrophage
F. Mucous blanket
43.
5 25 kg.
A. Chest wall muscle tone

B. Thoracic muscle tone
C. Upper respiratory muscle tone
D. Smooth muscle tone
E. Skeleton
F. Pressure upper respiratory trac
44.
45.

consolidation right lower lobe
hypoxemia
A. Hypoventilation
B. Anatomical shunt
C. Intra-alveolar shunt
D. Diffusion
E. V/Q mismatch
46.
2
Exudate Exudate
A. respiratory permeability
B. plasma oncotic pressure
C. plasma hydrostatic pressure
D. plasma oncotic pressure
E. lymphatic drainage visceral pleura
47.
50
Engorge jugular vein crepitation lower
lung field 2 2cm. costalmargin
pretibial edema
A. Oncotic Pressure
B. Oncotic Pressure
C. Hydrostatic Pressure
D. Hydrostatic Pressure
E. Vascular Permeability
48.
2 32
RDS
(Respiratory Distress syndrome)
A. surfactant
49.
murmur S1&S2 intercostal

space5 midclavicular line
A. aortic stenosis
B. aortic regurgitation
C. mitral stenosis
D. mitral regurgitation
E. tricuspid regurgitation
50.

A. ASD
B. VSD
C. tetralogy of fallot
D. PDA
E. Coarctation of Aorta
51.
60 aortic perfusion pressure 80

atherosclerosis aortic perfusion
pressure
52.
60 coronary thrombosis
dysfunction endothelial cell
A. Endothelium
B. NO
C. Angiotensin
D. Epinephrine
E. PG
53.
20 BP 90/50 PR 120
A. Cerebral
B. Coronary
C. Cutaneous muscle
D. skeleton muscle
54.

enlarge jugular vein crepitation lower lung
area 2 2 cm
pretibial myxedema
A. oncotic pressure
B. oncotic pressure
C. hydrostatic pressure
D. hydrostatic pressure
E. vascular permeability
55.
20
A. Splanchnic artery
B. Sympathetic activity
C. Increase Intracranial pressure
D. Blood pressure
E. Cardiac parasympathetic
56.
20 BP 160/100 BP 110/80
57.
36

A. stroke volume
B. venous return ( IVC )

C. respiratory rate
D. Heart rate
E.
F. Tidal volume
G. FRC
58.
55 BP 140/85 20 BP
115/80 BP
A. HR
B. SV
C. Aortic compliance
D. Vascular ..
59.
50 coronary perfusion pressure 80 mmHg

50% () coronary
perfusion pressure
A. 40
B. 160
C. 640
D. 1280
E.
60.
20 30 BP 70/50
A. Heart rate
B. Splanchnic blood flow
C. Cutaneous blood flow
D. Skeleton M.
E. Carotic baroreceptor activity
61.
EKG
A. P wave
B. PR interval
C. QRS complex
D. T wave
62.
Carotid Aortic Chemoreceptor
A. Low O2
B. High CO2
C. Severe anemia
D. CHF
E. CO poisoning
63.
Hemoglobin
O2 tissue effector
A. 2,3-DPG
B. CO2
C. Temperature
D. Fluid
E. Surface tension of alveoli
64.
5 PP BP poor skin
turgor , eye ball () pH 7.2 HCO3- 10 PCO2
60 PO2 100
A. metabolic acidosis
B. metabolic alkalosis
C. respiratory acidosis
D. respiratory alkalosis
E. combine metabolic and respiratory acidosis
65.
1
murmur intercostals
space 2
A. aortic stenosis
B. pulmonic stenosis
C. ductus arteriosus
66.
30
cardiac murmur apex
Rheumatoid heart disease
A. Aortic stenosis
B. Aortic insufficiency
C. Mitral stenosis
D. Pulmonic stenosis
E. Tricuspid stenosis
67.
50 30 10
30
45
BP 160/110 acute myocardial infarction
non modifiable risk factor coronary artery
disease
A. family history
B. hypertension
C. hyperlipidemia
D. Cigarrete smoking
E. DM
68.
26
ultrasound
1.
10 lower esophagus
sphinter manometry LES pressure

A.
B.
C.
D.
E.
2.
60 5
6 postural hypotension
poor skin turgor
A. aldosterone
B. plasma angiotensin II
C. ANP
D. Sympathetic activity
E. Efferent arteriole resistant
3.
2 10 2
serum CO2 = 12 mmol/L urine pH= 5.0

compensation nephron
A. Glomerulus
B. Proximal tubule
C. Loop of henle
D. Distal tubule
E. Collecting duct
4.
35 16 .
urine sp.gr 1.025 hormone
A. insulin
B. Oxytocin
C. Vasopressin
D. Glucocorticoid
E. ANP
5.
FEV1 (force expiration in 1 second)
FEV1(liter) = (1.052 x height) - (0.244 x age) -0.561
A. 1 ,FEV1 0.244 liter

B. 0.244 FEV1 1 liter
C. 1 FEV1 0.244 liter
D. 0.244 FEV1 1 liter
6.
25 2

A.
B.
C.
D.
E.
7.

A. FEV1/FRC
B. Elascity
C. Compliance
E. Restrictive fibers
8.

A. micelle
B. chylomicron
C. cholesterol
D. fatty acid
E. monoglyceride
9.
30 tidal volume 500 mL,anatomical dead

space 200 mL, RR15 RR 30,tidal volume 350
anatomical dead space
A. Paco2
B. Paco2
C. pH
D. pH
E. paco2
10.
70 40
2 x-ray emphysema
A. airway resistance
B. lung compliance
C. intrapleural P
D. FRV
E. FEV1
11.
bile salt
A. bilirubin
B. lecithin
C. fatty acid
D. triglyceride
E. cholesterol
12.
200 m
A. mitochondria
B. glycolytic enzyme
C. muscle blood flow
D. Fat composition
13.
35

rennin-angiotensin system BP
A. GFR
B. renal blood flow
C. Na reabsorption
D. ACE activity
14.
17
A.
Baroreceptor
B.
Low Pressure receptor
C. rennin
D.
chemoreceptor
E. Hydrostatic pressure
15.

A. Na+
B. K+
C. Renin
D. Aldosterone
E. ANP
15.
2 serum CO2 Urea pH 5.0 nephron
compensate
A. Glomerulus
B. Proximal tubule
C. Loop of Henle
D. Distal tubule
E. Collecting duct
16.
20 5-6

A. Hypoxia
B. Hyperoxia
C. Hypocapnia
D. Hypercapnia
E. Pneumothorax
17.
25 HR
66 RR 20 Pressure 210/100 CVS
A. Blood volumn
B. Preload
C. Afterload
D. Sym
E. Peripheral Vasoconstriction
18.
50 Ascites furosemide 1

Na 130 K 2.5 pH 7.58 PCO2 50
acid-base
A. uncompensated respiratory alkalosis
B. compensated respiratory alkalosis
C. uncompensated metabolic acidosis
D. compensated metabolic acidosis
E. mixed respiratory and metabolic alkalosis
19.
15 ER
10

A. Ach
B. NE
C. AchE
D. muscarinic Receptor
E. adrenergic receptor
20.
50 . New York City

hormone
A. anterior Pituitary
B. posterior pituitary
C. pineal gland
D. hypothalamus
E. adrenal gland
21.
30
thymus

A. immediate hypersensitivity
B. delay type hypersensitivity
C. immune complex hypersensitivity
D. Ab-cytotoxic hypersensitivity
E. Complement activation
22.
65 Alzheimer

A. nerve growth hormone
B. intracellular ca2+
C. glycogenolysis
D. gluconeogenesis
E. ......
23.
25
Hormone
A. Prolactin
B. Oxytocin
C. Vasopressin
D. Catecholamine
E. Corticosteroid
24.
35

A. FSH
B. testosterone
C. estrogen
D. Progesterone
E. Estrogen
25.
35 16 .
urine specific gravity = 1.025 hormone
A. insulin
B. oxytocin
C. vasopressin
D. glucocorticoid
E. atrial natriuretic peptide
26.
35 PR
110/min BP 80/50 24 . BP 70/50-80/60
A. Venous return
B. Central vasoconstriction
C. Central venous pressure
D. End diastolic pressure
E. Total peripheral resistance

26.
vagotomy
vagotomy parietal cell
A. Cl- channel
B. H+ channel
C. nicotinic receptor
D. muscarinic receptor
E. histamine receptor
27.
30

A.
B.
C.
D.
E.
28.
ECG
A. PR interval
B. RR interval
C. P wave
D. P wave
E. QRS complex
29.
35
BP
rennin angiotensin system
BP
A. Vasodilation
B. renal blood flow
C. sodium reabsorption
D. GFR
E. angiotensin
30.
20
A. Tidal volume
B. RR
C. Minute ventilation
D. Dead space ventilation
E. Inspire reserve volume(IRV)
31.
65 COPD+bronchietasis
A. FEV1/FVC
B. Airways resistance
C. Residual volumn
D. Lung compliance
E. Lung capacity
32.
10 2 Hct 25% Hb 7
WBC 5000 ( N 65% L 35% M 5% ) Plt 250000
Heinz body
A. Precipitate Ribosome
B. Precipitate Hemoglobin
C. Iron inclusion
D. Nucleus
E. Aggregation ER
33.
3 1
hormone
A. estrogen
B. progesterone
C. FSH
D. LH
E. HCG
34
.
RR (), BP 200/100 BP
A. Preload
B. afterload
C. Sympathetictone
D. vasoconstriction of peripheral vessels
35.
800
A. J-receptor
B. Irritant receptor
C. peripheral chemoreceptor
D. central chemoreceptor
36.
30
8 urine pregnancy test

A. prolactin
B. estradiol
C. progesterone
D. leutinizing hormone
E. follicular stimulating hormone
37.
A. ADP
B. Prostacycline
C. Activation COX enz
D. Activation thrombomodulin
E. Activation glycoprotein VWF
38.
20
(unconscious) 8 /
arterial blood gas : pH = 7.07 paO2 = 32paCO2 = 88
HCO=24

A. oxygen
B. minute ventilation
C. diffusing capacity
D. resistance
E. intrapulmonary shunt
39.
100 ml/min
50%
A. 6.25
B. 25
C. 50
40.
8 Ca 7.5 mg/dl,phosphate
2.8mg/dl, alkaline phosphatase 300microI/L
A. Ca
B. Vit D
C. Vit C
D. Calcitonin
E. PTH
41.
40
A. Ca
B. phosphate
C. Creatinine phosphate
D. ADP
E. ATP
42.
20 1 unit
BP 80/50 , PR 50/min
A. cardiogenic shock
B. hypovolumic shock
C. vasovagal attack
D. orthostatic hypotention
E. stroke adams
43.
5000 ml
urine graviy 1.015

A. .
B. reabsorb sugar
C. ...
D. reabsorb water collecting duct
E. reabsorb Na PCT
44.
50 2 1

hormone GI
A. Motilin
B. Gastrin
C. Secretin
D. CCK
E. VIP
45.
30 3
Hct 23% WBC
3,200 Neu 30% Lymphocyte 70%Platelet 50,000 MCV 89
A. RBC
B. RBC
C. Ab RBC
D.
E.
46.
35 peptic ulcer
Hb 8 g/dL Hct 30
Reticulocyte 8% Platelet 250,000/mm3 MCV 86 fL
A. autoimmune
B. Vit B12
C. Hb
D. enzyme
E. Post hemorrhage
47.
20
urlicaria rash generalized lymphadenopathy ,arthritis
A. Serum complement
B. Absolute white blood cell
C. Serum IgG
D. Lymphocyte
E. ESR
48.
25 alcohol
Gastroscope Gastric
mucosa Gastric biopsy Neutrophil
A. Autoimmune
B. Direct mucosal toxicity
C. Stimulate acid secretion
D. Alcohol-induced Thiamine deficiency
E. Stimulate growth of H.pylori
49.
60 2
rigid

A.
DA
Cholinergic
50.
B.
C.
D.
25 5 PCR
20
higher cortical function
A.
B.
C.
D.
E.
51.
45 Cardiac
murmur pulmonaric valve Hct 20%
Cardiac murmur
A.
B.
C.
D.
E.
52.
50 ...
TSH TRH stimulation test TSH

A. Thyroid gland
B. Thalamus
C. Hypothalamus
D. Anterior pituitary gland
E. Posterior pituitary gland
53.
Blood pressure 110/70 100/70
A. venous pooling
B. stroke volume
54.
20

A. Ca2+
B. K+
C. HCO3-
D. Na+
E. Mg
55.
30 24 ultrasonography
anencephaly
A. insulin
B. Thyroid hormone
C. TSH
D. GH
E. HCG
56.
DM Insulin-dependent Insulin
15 Insulin 10
A. insulin
B. .........
C. sensitivity insulin
D. absorb insulin
57.
20 midbrain 10 /min pH7.25

PaCO2 =55 HCO3 = 20
A. alveolar hypoventilation
B. Q-V mismatch

- p53 suppress
- Barrett esophagus adaptation
- insulin

- MI EKG
- EKG
- Hormone
- mediator
Physiology
1. c. dead space ventilation
RR tidal volume

dead space

Dead space
1.anatomical dead space: conducting zone trachea,
bronchus,bronchiole
2.alveolar dead space: alveolar
3.physiologic dead space : dead space

anatomical dead space + alveolar dead space
b. lung compliance(V/P) lung compliance
tidal volume tidal volume
b.
d. functional residual capacity
e. FEV1 : force expiratory volume in 1 second

2.
A. serum renin (activity)

aldosteronism primary secondary

aldosterone RAAS renin angiotensin

aldosterone LAB
plasma renin activity plasma aldosterone level
primary secondary primary renin

secondary renin ACTH
Aldosterone
3. D. RBC
AIDS 3
1) Nucleoside reverse transcriptase inhibitor (NRTIs)
Zidovudine(AZT) , Stavudine(d4T) , Lamivudine(3Tc)
reverse transcriptase enz. side
effect RBC
anemia granulocytopenia
, peripheral
neuropathy pancreatitis
2) Non-nucleoside reverse transcriptase inhibitor
(NNRTIs) Nevirapine , Delavirdine
reverse transcriptase enz.
HIV-1 side effect
rash
3) protenase inhibitor Ritonavir , Saquinavir ,
Indinavir protease enz. of HIV-1
enz. viral protein precursor

functional protein maturation of viral
side effect
asthenia, malaise, diarrhoea, nausea and vomiting,

abdominal pain, dizziness, insomnia, sweating , taste
abonormality
4.
A. increased ADH
: poor skin turgor
ECF volume extraction
Posm
+
ADH release
(serum
~ 285 295 mOsm/kgH2O)
urine
hypertonicity
urine
osm >
serum osm
5.
D. target cell receptor

rickets Ca P 1,25 ( OH )
D3, alkaline phosphatase parathyroid hormone

Impaired action of 1,25-dihydroxycholecalciferol on target
tissues
certain anticonvulsants
1,25-dihydroxycholecalciferol receptor defects
Uremia
Vit D metabolism
PTH vitamin D
target cell
receptor
6.
A.
Hypokalemia
Hypochloremia
Flurosemide
+
K plasma
E.
B.
C.
anabolic steroid
aldosterone deficiency
aldosterone K cell,
K plasma
D.
diabetic ketoacidosis
metabolic acidosis; HCO3 ,

+
PaCO2 insulin, insulin K cell; K

E.
anxiety with hyperventilation anxiety loss

-
CO2, PaCO2, HCO3 respiratory alkalosis

7.
8.
C. estrogen progesterone
estrogen, progesterone
hormeone
9.
B. cortisol
Cortisol stress hormone
Stress cortisol
cortisol

metabolism catabolism
Nitrogen Nitrogen loss
EPO and PTH

Insulin
10. D. Pulmonary artery

Fick C.O.
C.O.
O2 consumption
A-V O2 Difference
A-V O2 Difference [O2]

Pulmonary vein Pulmonary artery [O2]
Pulmonary vein (O2 )
Radial artery
[O2] [O2]
Pulmonary artery ( O2 Venous blood

) Pulmonary
artery
11.
E. spectrin
(peripheral protein)
spectrin, ankyrin, protein 4.1, actin and adducing

spectrin
polypeptide 2 alpha and beta chains
2
Spectrin
actin,
ankyrin
adducin
(circulatory shear force)
2 (biconcave shape)
lipid
2
12.
D. Pa O2
d. PaO2 HbF affinity O2

O2 () O2
a. O2 affinity fetus HbF

b. O2 capacity fetus HbF O2
HbA1 ()
c. Hct fetus fetus PaO2 Hb
O2 affinity fetus chronic hypoxemia
erythropoietin RBC
Hct
e. viscosity fetus Hct
fetal blood O2(Pa O2) = 25-30 mmHg Pa
CO2 = 45-50 mmHg adult
O2
cardiac output
O2 Hb
Hb(hematocrit)
O2

(viscosity)
20
15 g/dL
18 g/dL
RBC Hb HbF O2 (O2affinity)
RBC HbA Hb adult HbA
2,3-diphosphoglycerate HbF 2,3diphosphoglycerate Hb O2
RBC
2,3-diphosphoglycerate O2
RBC 2,3-diphosphoglycerate
13.
B. 2
Enzyme (Vmax)
Enzyme 1
2 (Vmax Enzyme)
Enzyme
Enzyme Substrate
Substrate Product
2 Vmax/2 2
Normal
14.
15. E. Pulmonary artery

Pulmonary
artery ( 24/9 mmHg)
** systolic diastolic
pressure ( = 120/80
mmHg) Pulmonary
circulation Right atrium , Right ventricle ,
Pulmonary artery , Pulmonary capillary Pulmonary vein
1. diastolic pressure
0 secondary pressure wave
aorta large artery (diastolic pressure
secondary pressure wave) Right atrium , Right

ventricle Foramen ovale
2. O2 saturation 55% Pulmonary

vein Ductus arteriosus ( ductus arteriosus
Left atrium O2 )
Pulmonary artery
16.
B. serum fatty acid

1-3
glucagon
free fatty acid
glucose
17. C. decreased myofibril

myofibril
disuse muscle atrophy

18. B. Isotonic saline

(Dehydrate) Electrolyte Venous
return C.O. BP drop

Isotonic Saline
electrolyte
19.
C. thiamine
Alcohol Ethanol
Thiamine Alcohol
Thiamine Thiamine
Thiamine Thiamine
diphosphate (ThDP) Coenzyme Enzyme
metabolism Pyruvate
Dehydrogenase (PDH)
Acetylcholine , Neurotransmitter myelin sheat
Ataxia
20.
D. mammillary body
Korsakoffs syndrome amnestic

confabulatory syndrome 1

(Confabulation)
mammillary bodies
dorsomedial thalamic nuclei
mammillary body
papez circuit recent memory
remote memory

cerebral cortex
recent remote memory

Limbic system
(medial margin; margin = limbus)
cerebral hemisphere limbic system

limbic lobe, fornicate
gyrus, visceral brain, vital brain emotional brain
Limbic System
. Telencephalon
. Hippocampal formation
.. Hippocampus (Ammons horn, cornu
ammonis)
.. Dentate gyrus (fascia dentate)
.. Subiculum
. Parahippocampal gyrus
. Cingulate gyrus
. Retrosplenial cortex (isthmus)
. Septal area
. Basolateral amygdaloid nucleus
. Diencephalon
. Mammillary body
. Anterior thalamic nucleus

. Habenular nucleus
http://www.colorado.edu/intphys/Class/IPHY3730/image/figure58.jpg
http://www.med.wayne.edu/diagRadiology/Limbic%20System
%20RSNA%202004/Overview.html
HIPPOCAMPAL FORMATION
Hippocampal formation temporal lobe
inferior horn lateral ventricle
Hippocampal formation archicortex
. Hippocampus: Hippocampus
temporal lobe
hippocampus inferior horn
lateral ventricle hippocampus archicortex

. Molecular layer
. Pyramidal cell layer
pyramidal fimbria-fornix
. Polymorphic cell layer
. Dentate gyrus:
hippocampus parahippocampal gyrus dentate
gyrus archicortex hippocampus
granule Dentate gyrus
hippocampus
. Subiculum: parahippocampal gyrus
hippocampus
Dissection of the left cerebral hemisphere demonstrating

structures of the limbic system. The body of the corpus
callosum has been divided sagitally. The frontal, temporal and
occipital lobes have been sectioned horizontally and their
superior parts removed. The left lentiform complex and
thalamus have been removed and the floor of the inferior
horn of the lateral ventricle opened.
http://www.neurosurvival.ca/ComputerAssistedLearning/neuroana
tomy/neuroanatomy_epilepsy/neuroanatomy_epilepsy_data.htm
Hippocampus
. entorhinal cortex olfactory association

cortex hippocampus perforant pathway
. septal area
fornix hippocampus
. parahippocampal gyrus temporal lobe
association areas parietal, occipital
temporal lobes
fimbria fornix:
Axon pyramidal hippocampus
ALVEUS floor inferior horn lateral ventricle
alveus FIMBRIA
splenium corpus callosum
FORNIX Fornix
corpus callosum anterior commissure

anterior column posterior column
http://spinwarp.ucsd.edu/NeuroWeb/Text/br-800epi.htm
Anterior column fornix septal area, preoptic

area, anterior ventromedial hypothalamic nuclei
hypothalamus
reticular formation
hypothalamotegmental tract dorsal longitudinal
fasciculus
Posterior column fornix

hypothalamus mammillary body
anterior thalamic
nucleus mammillothalamic tract (bundle of Vicq dazyr)
anterior thalamic nucleus cingulated gyrus
thalamocingular fibers anterior thalamic radiations
cingulated gyrus cingulum
entorhinal area entorhinal area
hippocampus
Papez (Papez loop)
Papez Circuit
http://commons.wikimedia.org/wiki/File:Papez_Circuit.jpg
http://www.indianjpsychiatry.org/articles/2007/49/2/images/Indian
JPsychiatry_2007_49_2_132_33264_3.jpg
mammillary body
mammillotegmental tract
CINGULATE GYRUS
Cingulate gyrus cerebral hemisphere
corpus callosum

archicortex neocortex mesocertex Cingulate gyrus

Thalamocingular thalamocortical fibers anterior
thalamic nucleus

. Corticostriate fibers caudate nucleus
putamen
. Corticothalamic fibers anterior dorsomedial
thalamic nuclei
. Corticohypothalamic fibers anterior, lateral

posterior hypothalamic nuclei
Papez circuit Limbic system
21.
E. thyroxine kinase
Critical molecular determinant of endothelial cell biology :
angiogenic endothelium expresses a number of receptor not

found on resting epithelium. These include receptor thyrosine
kinases (RTK) and integrins that bind to extracellular matrix
and mediate endothelial cells adhesion, migration and
invasion. Endothelial cells (ECs) also express RTK (i.e., the
FGF and PDGF receptors) that are found on many other cell
types. Critical function mediate by activated RTK include
proliferation, migration and enhanced survival of endothelial
cells, as well as regulation of the recruitment of perivascular
cells and bloodborne circulating endothelial precursors and
hematopoietic stem cells to the tumor. Intracellular signaling
via EC-specific RTK utilizes molecular pathway that may be

targets for future antiangiogenic therapies.
22.
E. Sympathetic denervation
.
23.
A. 2
2 hCG

24.
A. tyrosine kinase
The insulin receptor is a dimer with two different types
of subunits. It spans the membrane.

The -subunits are tyrosine kinases. When insulin binds
the subunits phosphorylase themselves at tyrosine residues.
The subunits also phosphorylate other protein kinases at
tyrosine residues. These kinase produce the cellular
responses reversal of glucagon stimulated
phosphorylation, phosphorylation of proteins, induction and
repression of specific genes, stimulation of general protein

synthesis and stimulation of glucose transport.
second messenger
cAMP
Ca -DAG
2+
Tyrosine kinase
Increase cAMP
ACTH
Acetylcholine
-adrenergic
1-adrenergic
catecholamines
catecholamines
Insulin
Calctonin
Angiotensin
Insulin-like growth
Glucagon
Cholecystokinin
LH
Gastrin
FSH
Oxytosin
TSH
ADH(V1receptor)
HCG
TRH
Parathyroid
Epidermal growth
factor
factor I
Fibroblast growth
factor I
Platelet-derived
growth factor
hormone
GnRH
Secretin
Decrease cAMP
Acetylcholine
2-adrenergic
catecholamines
Dopamine
Opiate peptides
Somatostatin

Insulin receptor family insulin
like growth factor 1
insulin IGF-I
metabolism (growth promoting effect)
IGF-1 polypeptide Insulin

Growth
hormone Androgen
insulin IGF-1 Glycoprotein
tyrosine specific protein kinase
4 (tetramer) 2
disulfide linked heterodimers ( )2
Cystein
membrain

membrane
phosphorylation Tyrosine kinase
tyrosine kinase
SH domain (Src homology domain)

SH2 domain SH3 domain
transcription factor
leucine zipper
heterodimer c-fos/c-jun AP-1 DNA response
element gene
..
25. C. IgE mast cell basophil

BP wheezing
hypersensitivity type 1
hypersensitivity type 1 allergen
IgE mast cell basophil mast cell
basophil histamine vasodilate
skin (urticaria and eczema), eyes
(conjunctivitis), nasopharynx (rhinorrhea, rhinitis),
bronchopulmonary tissues (asthma) and gastrointestinal
tract (gastroenteritis) BP ( vasodilate )
26. C. hypersensitivity type III
(-bungaro toxin ) block
nicotinic
receptor postsynaptic NMJ Ach ptosis

diaphragm paralysis ( )
serum ( antivenom )
excess Ag

Ab immune complex
complement
chemetatic factor neutrophil
, () ,
nephritis ( RBC )
Serum sickness
27. B. Heart rate

(hemorrhage)
Cardiac
output
Stretch on carotid sinus
baroreceptors
Firing rate of
carotid sinus nerve
Parasymp
Symp activity to heart
Heart
activity to heart
ana
blood rate
vessels
Hea
Contractility
rt rate
Mean arterial
Arterioles constrict
pressure
TPR
Venous return
28. D. Sigmoid curve
MAP 2
(Blood
flow )
(Central control)

central control
blood flow sigmoid
curve
29. B. Compliance
pulse pressure
severe atherosclerosis
Compliance Systolic pressure

secondary
pressure wave Diastolic pressure Pulse
pressure
30. E. muscle phosphocreatine
ATP
creatine
phosphate
Time Course of Contributions from Different Energy

Sources
Taken from Gleim, Anaerobic Testing and Evaluation,
Med Exerc Nutr Health 1993;2:27-35
31.
A. PaCO2

alveolar ventilation(VA) = RR x (VT-VD)
RR 20 / VT 500 ml VD 200 ml : VA = 20(500-
200) = 6000 ml
RR 30 / VT 350 ml VD 200 ml : VA = 30(350200) = 4500 ml
RR VT VA
PaO2
32.
PaCO2
A. oxytocin
33. .
34
35.
A. RBC cast
pH 6
PCT H
specific gravity 1.015 concentrate

urine ( concentrate urine renal
failure)
glucose -ve
pct glucose
protein 4+ glomerulus
RBC, WBC cast
RBC cast
cast : are formed in tubular lumen in kidney; they are

composed of a protein matrix(Tamm-Horsfall protein) within
which are entrapped cell, debris or protein leaking through
the glomeruli; Their presence proves a renal origin of
rd
disease.[ Rapid review pathology 3 edition, Edward F.

Goljan]
urate crystal:
oval fat body: renal tubular cell with lipid
numerous WBC(pyuria): urinary tract infection (
)
36.
B. Rene test right negative

Webers test Y

hair cell bone conduction
conductive hearing loss
(lateralizes to the affected ear)
sensory-neural hearing loss/deafness

/
Rinnes test Y
mastoid process bone conduction
air
conduction air conduction
bone conduction amplification

air conduction bone
conduction (AC BC positive)
air conduction bone

conduction (BC AC negative )
conductive hearing loss/deafness
chronic
otitis media BC AC negative

37.
C. ventilatory failure
pH 7.2 (acid) , PaCO2, PaO2
a.
renal failure reabsorp HCO3
PaCO2, PaO2
b.
metabolic acidosis HCO3

+
H CO2 PaCO2, PaO2
c.ventilatory failure PaCO2, PaO2
pH
CO2
d.oxygenation failure: CO2 exchange
O2 exchange PaCO2
PaO2
38.
C. colonic
perforation
bowel sounds
39.
c.
solute free water

a. medullary blood flow medullary blood
flow interstitial medulla
specific gravity (urine

specific gravity 1.001-1.035)
b. urea availability urea availability
concentrate urine urine specific gravity
1.035 higher normal urea availability
d. collecting tubule ADH : ADH

ADH
e. NaCl reabsorption thick ascending limb

40.
C. FSH & LH
A. inhibin
B. estradiol
D. progesterone
E. androstenedione
41.
D. first voiding morning urine specimen
42.
C. ANP
blood volume VR Stretched atrium
ANP
Intravascular volume
ANP
RAAS renin ,AII ,aldosterone ADH
AII Hypothalamus
Sympathetic activity AII

Vasomotor center
43. D. Ventricular depolarization
EKG
44.
C. proximal convoluted tubule

glomerulus
PCT
2Na-glucose cotransporter ( secondary active
transport Na-K ATPase Na
gradient Na cell lumen

Na lumen gradient cell
glucose cell
glucose electrochemical gradient

capillary GLUT1,GLUT2)
blood glucose
glucose blood
glucose 200 mg/dL glucose reab

transporter glucose
glucosuria
Textbook of Medical Physiology, 11th edition (Guyton,

2006)
45. C.

MAP =
SV x HR x TPR
MAP=
(1/2SV) x (2HR) x TPR
MAP
46. C
Bern physiology
1oo hair
cell cochlear
47. A. Cardiac index

acidosis
O2
anaerobic metabolism
Hyperventilation
O2 Cardiac index (
Maximum O2 uptake )
**Cardiac index (CI)

BSA = Body Surface Area

48.
E. vagus nerve
: receptive relaxation vagovagal reflex (

afferent efferent pathway vagus nerve)
food bolus
bolus lower esophagus esophagus
mechanoreceoptor vagus
nerve CNSCNS lower
esophageal sphincter stomach relax
a. p
arietal cell : parietal cell HCl
intrinsic factor Ach(parasymp:vagus nerve),
Histamine, gastrin
b. a
ntral G cell: G cell gastrin
small peptide, amino acid, distention of stomach and vagal
+
stimulation H secretion growth of

gastric mucosa
c. secretin : secretin S cell duodenum
+
H fatty acid duodenum

-
pancreatic HCO3 secretion , biliary HCO3 secretion ,

+
gastric H secretion inhibit trophic effect of gastrin on

gastric mucosa
d. somatostatin : endocrine cell
gastrointestinal
mucosa pH
H
( physiology 2
49.
nd
edition, Linda constanzo)
B. hypotonic
2
y
2
1. x Hypertonic
leak x
2. y Hypotonic
leak y
50.
C.suprachiasmatic nucleus
hypothalamus

Function
Afterents From
Integrating Areas
Temperature
Temperature receptors in
Anterior hypothalamus,
regulation
the skin,deep
response to heat;
tissues,spinal
posterior hypothalamus,
cord,hypothalamus,and
response to cold
other parts of the brain

Neuroendocrine
control of.
Limbic areas concerned
Dorsal and posterior
Catecholamines
wih emotion
hypothalamus
Vasopressin
Osmoreceptors, volume
Supraoptic and
receptors, others
paraventricular nuclei
Touch receptors in
Supraoptic and
breast, uterus, genitalia
paraventricular nuclei
Temperature receptors in
Paraventricular nuclei
infants,perhaps others
and neighboring areas
Oxytocin
Thyroid
stimulating hormone
(thyrotropin,TSH) via
TRH
Adrenocorticotropi
c hormone(ACTH)
and -lipotropin( LPH) via CRH
Limbic system (emotional

stimuli); reticular
formation(systemic
stimuli); hypothalamic and
Paraventricular nuclei
51. C. rennin-angiotensin aldersterone system (RAAS)

symp
(HR)
compensate
symp hemorrhage RAAS
compensate
compensate RAAS
vagal activation parasymp BP
HR
52.
- IGFs
bone
remodeling

GH

tyrosine kinase
GH IGF-I
GH

IGF
GH

metabolite
1. growth-promoting action:

GH IGF-I

epiphyseal plate
(chondrocyte,cartilage cell) long bone

collagen chondroitin matrix
2+
bone Ca
chondrocyte
osteocyte
epiphyseal plate bone shaft
GH
osteoclast osteoblast

(hyperplasia)

(hypertrophy) osteoblast
osteocalcin osteocalcin

osteocalcin
GH GH

2. metabolic action: GH

GH
(glucostatic effect) stress
GH (protein anabolic
effect)

lean body
mass nitrogen IGF insulin
GH
GH
insulin IGF
GH
IGF
GH PO4
2+
Ca
3-
GH

D Ca3(PO4)2 GH

RAAS ANP (
)
53.
B. insulin
ketoacidosis
urine ketone
positive
sp.gr.
ketone Na
complication DM type I diabetic
ketoacidosis DM type I type insulin
insulin

IDDM
insulin osmotic diuresis
polyuria polydipsia
polyphagia

hypovolemia GFR H excretion

acidosis
insulin
ketone bodies
DKA (. )
54. C. Atrial septal defect

( Left atrium)
Pulmonary artery +
Left atrium + %O2 saturation (
)
Left atrium
Right atrium
O2 Left to right shunt
ASD
55.
A. pH = 7.5,
pCO2 = 55, HCO3 = 34

-
= , = HCO3

a. pH 7.5 Pco2 55
HCO3
34 pH,
-
Pco2, HCO3
1. C. Dopamine
(Parkinsons disease)
3. C. ACh Receptor
myasthenia
gravis
antibody
autoimmune
Ach
receptor NMJ
Ach Ach receptor (
receptor block
nicotinic receptor)
action potential

muscle fatigue , weakness ,ptosis ( ),
( )
4. D. BP

Vulsava
Manuver Intrathoracic pressure
Venous return C.O.
(Phase1) Venous return

C.O. BP
( MAP = C.O. x TPR) Baroreceptor

BP drop

Syncope
ATP
5.
-
--
ATP = creatine phosphate <
glycogen < fatty acids

( )
Glycogen Ca

< 30
2+
100 (sprinter)
ATP ( 1.2 )
creatine phosphate (
9 )
creatine regenerate ATP

(ATP buffer)
Creatine phosphokinase
creatine phosphate
6. E.

turnover Ach receptor
myasthenia
antibody
NMJ
Ach
gravis
receptor
Ach Ach receptor
( receptor block nicotinic receptor)

action potential
E. turnover
Ach receptor
7.
D. TSH
Negative feedback
th
Williams Textbook of endocrinology 11 edition

Thyroid T3 T4
negative feedback Hypothalamus Anterior pituitary
gland TSH TRH
8.
D. Thyroid peroxidase activity

Deiodinase activity
Antithyroid drug Thioamides methimazole

(MMI) propylthyouracil(PTU)
Thyroid peroxidase catalyzed step
Thyroid hormone synthesis (oxidation, iodination,coupling)
PTU Extrathyroid action
T4 T3 (periperal tissue)
PTU Thyroid strom
Thioamides immunosuppressive
Gravesdisease thyroid stimulating
immunoglobulin(TSI) lymphocytic infiltration
Thyroid
9.
C. Increase GI
motility
Thyroid hormone, hyperthyroidism diarrhea

E. loose sphincter tension smooth muscle
10.
A. aldosterone
Na
K
aldosterone
- Reabsorption
Na Plasma Na
- K circulation cell Plasma K

+
- Plasma Na
ECF
volume BP
hyperaldosteronism
11.
A. prolactin
Pituitary tumor prolactinoma tumor

function prolactin Dopamine
prolactin
prolactin

prolactinoma galactolia
12.
C. gluconeogenesis
DM type II insulin
Fasting bood sugar cell resistance

insulin insulin
mild to moderate
Gluconeogenesis Gluconeogenesis
FBS () insulin
lipolysis lipolysis

ketogenesis ketoacidosis
insulin
FBS
C
13.
E. Triacylglyceride
DM lipolysis TG TG
14.
E. ACTH
ACTH dependent - Cushing Syndrome
ACTH MSH
ACTH dependent - Cushing Syndrome
ACTH MSH melanin
15.
E. ANP
volume
+
Na A C D
BP
ANP
blood volume Atrium ANP
16.
D. Growth hormone

Growth hormone

arginine (sleep stage
III,IV)
DA,NE(-adrenergic receptor), serotonin, enkephalin
GHRH GHIH
GH (REM sleep)
GH
GH
17. CAT epinephrine
cell, K
BP, metabolic
18.
21.
C. Intrinsic factor
B. osmotic pressure : oncotic pressure
osmotic pressure
PIF (interstitial
hydrostatic pressure) C (plasma oncotic pressure)
PC (capillary hydrostatic
pressure) IF (interstitial oncotic pressure)

albumin
C(plasma oncotic pressure)

edema
23.
pH
pCO2
HCO3
Resp. acid.
Resp. alk.
Met. acid.
Met alk.
pH 7.55 (base), pCO225(; normal 40),

-
HCO3 22 (; normal 22-26)
resp. alk.
compensate HCO3
24.
E. collecting
serum osm (normal: 275-300), urine
osm(normal: 50-1400), urine specific gravity :lower

normal(normal: 1.001-1.035)
e-lyte (
c.
Na proximal tubule d. Na distal

tubule )
collecting duct

ADH e.

26. E. NaCl reabsorption loop of Henle

(Na -K reabsorption Henles loop )
+
1.002-1.003
1.030-1.040 (osmolarity 50-100 1000-1400
mOsm/kg.H2O )
=
(particle)
ADH collecting duct

renal tubule

+
furosemide Na -K -Cl thick

ascending limb of Henles loop
total solute clearance osmolar clearance

(Cosm) free water clearance (CH2O)

CH2O < 0 CH2O > 0
(solute free water excretion)
1) countercurrent
multiplication system Henles loop urea recycle
hyperosmolarity medullary interstitium 2)
countercurrent exchanger vasa recta
hyperosmolarity medullary interstitium
3)
ADH

Distal tubule collecting duct
27.
D. BP
28.
A. HCG Corpus luteum

HCG corpus luteum progesterone

29.
A. LH
Ovulation predictor kits are widely avaible in pharmacies
LH LH peak
30.
E. HCG
31.
14
32.
C. gene expression
Estrogen steroid cell membrane
gene expression
33.
E.

34.
A. Pa CO2

Pt.1: RR 15 / VT 500 ml VD 200 ml : VA =
15(500-200) = 4500 ml
Pt.2: RR 30 / VT 300 ml VD 200 ml : VA =
30(300-200) = 3000 ml
Pt.2 VA Pt.1
Pt.1
Pt.2
Pt.2 PaO2
PaCO2
Pt.1
35.
A. Pa O2
Pa CO2
alveolar, elastin, lung capillary

fibrosis
gas
alveolar capillary
PaO2 20
chest diameter
diaphragm weak
pattern of breathing, lung expansion gas

exchange.
36.
C. 2, 3-DPG
37. D. HCO3
pH7.55: acid, PaCO2 25:, HCO3 22:lower

normal
Resp. alk. compensate

-
HCO3
pH
pCO2
HCO3
Resp. acid.
Resp. alk.
Met. acid.
Met alk.
38.
C. alveolar hypoventilation
pH7.25: acid, PaCO2 55:, PaO2 60 : HCO3
25: Resp. acid. compensate

-
reabsorb HCO3 HCO3
Resp. acid
midbrain
center alveolar
ventilation
39.
A. compliance of lung
surfactant
40.
A. pleural effusion
dull percussion fluid

()
b. peumotharax : gas
pleural cavity alveoli chest wall
pleural cavity

41. cough reflex
stimulant
42. C. Secretory IgA

: virus infection receptor

secretory IgA
receptor
d. alveolar fluid : alveolar fluid secretory IgA
IgG virus receptor tracheobronchial
epithelium
alveolar fluid
airway secretory IgA
43. F. Pressure upper respiratory tract

44.
IRDS(infant respiratory distress syndrome)
surfactant
45.
e. V/Q mismatches
consolidation rt. Lower lobe Lower lobe

ventilation & perfusion ( gas exchange
) consolidation gas diffuse
perfusion v entilation V/Q mismatches
a. hypoventilation
hypoven
b. anatomical shunt conducting
Zone of resp. tract
d. diffusion a.
diffuse diffuse
c onsolidation
46.
A. respiratory permeability

exudate
exudate respiratory epithelium
permeability WBC, complement

infectious agent
exudate
b. plasma oncotic pressure
c. plasma hydrostatic pressure

exudate
d. plasma oncotic pressure
e. lymphatic drainage visceral pleura

ECF circulation
47. B. oncotic pressure

Liver 2 cm below costal margin
neoplasm, cirrhosis, infection, inflammation
neoplasm
infect inflam
cirrhosis
pretibial edema
fluid leak cirrhosis
oncotic pressure
cirrhosis albumin
48.
A. surfactant
: surfactant24
RDS
RDSglucocorticoid
surfactant
49. D. Mitral regurgitation
murmur S1-S2
Systolic murmur 2 Aortic stenosis
Mitral regurgitation
intercostals space 5 midclavicular line

Mitral valve (
apex) Mitral regurgitation
50. C. tetralogy of fallot

Cyanosis
(Right to
Left shunt)

O2 Cyanosis
choice tetralogy of fallot Right
to Left shunt ( Left to Right shunt
)
**Tetralogy of Fallot (TOF)
4
1. (right ventricular
outflow tract obstruction)
2.

(Ventricular septal
defect : VSD)
3. aorta (Aorta
overrides the right ventricle) aorta 2
4. (hypertrophy
of
right ventricle)
pulmonary artery ( 1)
Right ventricle Right ventricular
pressure VSD
Left ventricle Right to Left shunt
51. choice Aortic perfusion
pressure
Aortic perfusion pressure aorta
(Aortic pressure)

aorta
aorta Aortic
perfusion pressure aortic
perfusion pressure artery

atherosclerosis
atherosclerosis Compliance
+ vasoconstriction total
peripheral resistance (TPR) mean arterial pressure
(MAP) ( MAP = C.O. x TPR)
52. E. PG ( )
Thrombosis PG
PG PGI2 (Prostacyclin)
Endothelial cell
Vasodilate platelete aggregation
PGI2 platelete
Coronary thrombosis
** Thrombosis
? NO
Thrombosis Endothelial cell function
pathway NO pathway
NO platelete aggregation

53. A. Cerebral
BP drop
Baroreceptor
Sympathetic activity BP

( Cerebral blood flow) Hypoxia
54. B. oncotic pressure
Liver 2 cm below costal margin
neoplasm, cirrhosis, infection, inflammation
neoplasm
infect inflam
cirrhosis
pretibial edema
fluid leak cirrhosis
oncotic pressure
cirrhosis albumin
55. D. Blood pressure
74
56. Bernoulli
57.
B. Venous return
(IVC )
IVC venous return

cardiac output
58. C. Aortic compliance

Aorta collagen tissue elastic
tissue compliance

BP
59. E.

Perfusion pressure
(
224 Aortic perfusion pressure) organ
perfusion pressure = organ pressure
Coronary perfusion pressure

pressure
60. A. Heart rate
Hemoorhage Stroke
volumn BP drop Baroreceptor
Sympathetic activity HR , contractility
+ Vasoconstrict internal organ
Splanchnic vessels vasodilate
61. D. T wave
T wave Ventricular repolarization
ST segment Isoelectric line MI
( MI) ST
elevation ST segment T wave
Isoelectric line
62. B. High CO2
Chemoreceptor 2
1.Central chemoreceptor Medulla Oblongata
response PCO2 blood pH
response PO2
2.Peripheral chemoreceptor Carotid body response
PO2 PCO2 response pH
Aortic body response 3
Chemoreceptor
O2 CO2
** Chemoreceptor
PCO2
63.
A. 2, 3-DPG.: hypoxemia
2,3-DPG
Rt. Shift
O2
b. CO2 Rt. Shift CO2
Bohrs
effect affinity O2 Hb
CO2
c. temperature Rt. Shift

d. fluid
e. surface tension of alveoli alveoli (
. alveoli)
O2
64.
E. combine metabolic and respiratory acidosis
pH: acid, HCO3 , pCO2, pO2

-
acidosis HCO3
-
Met. acid. pCO2 Resp. acid.

combine resp. met. acidosis
pH
pCO2
HCO3
Resp. acid.
Resp. alk.
met.
acidosis
Met alk.
65 A. Aortic stenosis
intercostals space 2 Aortic
Valve
murmur Aortic
stenosis
66. C. Mitral stenosis
S. Pyogenes
Rheumatoid heart disease
murmur
apex mitral valve
67. A. Family history
MI Risk factor 2
1.non-modified : age, sex, family history
2.modified : smoking, hypertension, DM, obesity, etc.
non-modified Risk factor Family
history
ANP
1.
2.
D. sympathetic activity

ECF volume blood volume

CO GFR renin
AII
BP
baroreflex
aldos
Symp
3. B. proximal tubule HCO3

-
HCO3
-
HCO3 proximal tubule

4.
C. Vasopressin
5. c.
1 FEV1 0.244 L
H
A1= A
A2=A +1
A1 : FEV1 = (1.052xH) (0.244xA) 0.561
A2 : FEV2 = [(1.052xH) (0.244(A+1)) 0.561
A2- A1: FEV2 - FEV1 = [(1.052xH) (0.244(A+1)) 0.561]
[(1.052xH) (0.244xA) 0.561]
= -0.244 L
1 FEV1 0.244 L
6.
C.

Heat stroke
7.
B. Elasticity
elastic fiber,
alveoli alveoli
elastic recoil gas
emphysema
a. FEV1/FRC
emphysema FRC(barrel-shape chest)
(emphysema obstructive disease
trap (
)
) FEV1 elatic
recoil obstuct
FEV1/FRC = / =
c. compliance elastic recoil
alveolar
alveolar
compliance
e. restrictive fiber : restrictive disease
fibrosis
( emphysema
obstructive disease)
8.
B. chylomicron
chylomicron (CM) apoprotein C-II
lipoprotein lipase

triglyceride chylomicron
apoprotein C-II
chylomicron remnant apoprotein apo E
apo B-48 ligand
9.
E. PaCO2


RR 15 / VT 500 ml VD 200 ml : VA =
15(500-200) = 4500 ml
RR 30 / VT 350 ml VD 200 ml : VA =
30(350-200) = 4500 ml
VA .PaCO2
10.
E. FEV1
FEV1
FRC
FVC
RV
FEV1/ FVC
TLC
Elastic recoil
VC
Lung compliance
IC
Airway resistance
Work of breathing(resistive work)
11.
E. cholesterol
12.
B. glycolytic enzyme
200
fast
fiber
fast fiber
anaerobic glycolysis
glycolytic
enzyme
13.
C.
Na reabsorption
14.
B. Low Pressure Receptor
Na + ANP, ADH + osmoreceptor, baroreceptor

H2O
15.
A. Na
15.
b. proximal tubule =
-
compensate HCO3
proximal tubule
a. glomerulus
c. loop of
Henle
d. distal tubule & e. collecting duct Na
ADH
16.
A. Hypoxia
D. hypercapnia
17. D. Sympathetic

Trauma Intracranial pressure
Cerebral perfusion pressure cerebral blood
flow CNS ischemic response
Hypothalamus Sympathetic activity
Peripheral vasoconstriction + C.O.
MAP
Cushing reflex
Cerebral perfusion pressure (CPP) = MAP Intracranial
pressure
18.
19.
A. Ach (Botox Clostridium
botulinum Snare protein End bulb Presynapse)

20.
C. pineal gland
Jet lag
pineal
21. D. Ab-cytotoxic hypersensitivity

Myasthenia gravis

40

acetylcholine

Myasthnia gravis
75%
Hypersensitivity Reactions, Immediate
The immune system is an integral part of human protection
against disease, but the normally protective immune
mechanisms can sometimes cause detrimental reactions in
the host. Such reactions are known as hypersensitivity
reactions, and the study of these is termed immunopathology.
The traditional classification for hypersensitivity reactions is
that of Gell and Coombs and is currently the most commonly
known classification system. It divides the hypersensitivity

reactions into the following 4 types:
Type I reactions (ie, immediate hypersensitivity reactions)

involve immunoglobulin E (IgE)mediated release of
histamine and other mediators from mast cells and
basophils.
Induction and effector mechanisms in typeI hypersensitivity
Type II reactions (ie, cytotoxic hypersensitivity reactions)

involve immunoglobulin G or immunoglobulin M
antibodies bound to cell surface antigens, with
subsequent complement fixation. Examples; Rh
incompatibility, myasthenia gravis, Rheumatic fever,

Graves disease
Type II hypersensitivity mechanisms
Type III reactions (ie, immune-complex reactions) involve

circulating antigen-antibody immune complexes that
deposit in postcapillary venules, with subsequent
complement fixation. Examples; Arthus reaction,SLE,
Rheumatoid arthritis
Mechanism of damage in type-III hypersensitivity
Type IV reactions (ie, delayed hypersensitivity reactions,

cell-mediated immunity) are mediated by T cells rather
than by antibodies. Examples; tuberlin (PPD) test,
chronic transplant rejection.
Mechanisms of damage in delayed

22.
hypersensitivity
B. A

glycogenolysis gluconeogenesis C D

Alzheimer
Pathophysiology of Alzhimers Disease
Alzheimers disease dementia

genetic disposition
1,12,14,19,21 19
Apolipoprotein E
21
-amyloid precursor small amyloid
peptides protein fibrils
senile plaques fibrin

-amyloid fibril

receptor for advanced glycation and products (RAGE) ,
scavenger receptor (RA)
depolarization
NMDA receptor
RAGE RA microglia cells

NO, Prostaglandins, excitotoxins, cytokines, tumor
necrosis factor (TNF-), tumor growth factor (TGF-1),
fibroblast growth factor (b-FGF) inflammation
NGF NGF
recoptor
Cholinergic neurons hippocampus entorhinal
cortex
cerebrum
neurotransmitter
Acetylcholine
cerebral cortex hippocampus
choline-acetyltransferase 90%
acetylcholine

neurotransmitter
cerebrum

(Anterograde amnesia) ,
, ,
limbic system
, lethargy, ,
2+
Ca
Ca
Exitable cell
Ca
Homeostasis
nerve growth factor

A B nerve growth
factor A B

Ca

23. A. oxytocin
Oxytocin

hypothalamus
stretch receptor

24.
D. progesterone
progesterone

ferning
25.
C. vasopressin
Stress, sp.gr.
26. E. Total peripheral resistance

Negative feedback
Baroreceptor
Vasoconstrict BP
BP drop Vasoconstrict
blood flow organ Metabolite
Local control
+
metabolite CO2 , H , K
vasodilate
metabolite
Vasodilate TPR BP drop
BP
Shock
** 2
1.Central control BP
Reflex Baroreceptor
2.Local control
constrict dilate
metabolite
27.
C.
Hemotoxic

DIC (Disseminated Intravascular Coagulation)

Fibrinogen
Nephrotoxic
28. B. RR interval
P wave , PR interval , QRS complex
Arrythmia
RR interval RR interval
HR RR interval HR
Hyperthyriodism
**- RR interval ( HR)

HR HR
Respiratory sinus arrhythmia (
Cardiac inhibitory center HR
)
29. C. Increase sodium reabsorption
RAAS
+
RAAS Aldersterone Na reabsorption

30. C. minute ventilation
minute ventilation =RR x VT
RR VT
a. tidal volume & d. inspiratory reserve volume

(inspiratory reserve volume)
(tidal volume)
a.
b.
RR a.
d. dead space ventilation

31. B. Airways resistance

COPD(Chronic obstructive
pulmonary disease)
airway
pleural cavity
pleural cavity
airway
airway pleural
cavity elastic tissue

airway air way
COPD, emphysema
airway
airway
airway trap
FRC residual volume
a. FEV1/FVC : FEV1/FVC
FEV1 airway obstruction airway resistance
1
pleural
cavity airway obstruction
c. residual volume : residual volume
airway obstruction
trap

residual volume
d. lung compliance : lung compliance
elastic recoil alveolar
alveolar
compliance
e. lung capacity : lung capacity

32. B. Precipitate Hemoglobin
Heinz bodies (unstable
hemoglobin)
1-3 m Wrights stain

()
brilliant cresyl blue Heinz bodies

phase contrast
Heinz bodies

G-6-PD
pyruvate kinase
33.
E. HCG
34. D. Vasoconstriction of peripheral vessels

55 Choice
55 choice
C. Sympathetic activity
Vasoconstriction of peripheral vessels
(Sym + Vasoconstrict)
Sympathetic activity
35.
C. peripheral chemoreceptor
36.
prolactin
amenorrhea galactorrhea
38.
A.
oxygen
:
RR
alveolar RR
alveolar O2 CO2
b. minute ventilation : minute ventilation RR x VT
RR VT

c. diffusing capacity
A : surface area
T: thickness of membrane
diffusion constant( gas)
D:
P1 P2 : gas
A, T, D
P1 P2
a. ()
d.
resistance :
39. A. 6.25
Poiseuille
2 (50%)
4
2 =

Central control
blood flow 16
blood flow 100/16 = 6.25 ml/min
40.
B. Vit D
41. E. ATP
ATP
myosin
affinity myosin
actin
actin
myosin
ATP
42. C. Vasovagal reflex
BP Drop
Baroreceptor Sympathetic activity **

Sym
Vagal tone Sym Peripheral vasodilate +

HR Vasovagal syncope
**

Stroke adams

(Heart block) HR Blood flow
(
)
** Vasovagal syncope
Blood perfusion (
) , ,
43.
( frontal lobe micturition center )

D. CCK
44.
: I cell of duodenum and ileum pancreatic

-
enzyme and HCO3 secretion, biliary secretion, growth

of exocrine pancreas and gallbladder ,delay gastric
emptying
a. motilin : upper duodenum during fasting state
gastrointestinal motility
b. gastrin : G cell of stomach gastric H
+
secretion and stimulate growth of gastric mucosa
c. secretin : S cell of duodenum pancreatic

-
HCO3 secretion,biliary HCO3 secretion, gastric H
secretion and
inhibit trophic effect of gastrin on gastric
mucosa
e. VIP : neuron of mucosa and smooth muscle
relaxation of smooth muscle, pancreatic and intestinal
secretion
45. D.
Hct, WBC Neu
lymphocytes , Platelet MCV
(The normal reference range is typically 80-97fL)
granulocyte
platelet

Hematopoietic stem cells give rise to two major progenitor

cell lineages, myeloid and lymphoid progenitors
46. . D Enzyme
Glucose-6-Phosphate
Dehydrogenase G6PD Deficiency

G6PD (Glucose-6Phosphate Dehydrogenase)
Pentose Phosphate Pathway

(PPP.) NADP NADPH
Glutathione reductase
Glutathione peroxidase
(Oxidants) H2O2
G6PD

(Oxidants)
(Hemolysis)
G6PD X-linked
recessive
Acute hemolytic anemia (
)

(Acute
renal failure)
Electrolytes ()
Hyperkalemia

Hb 8 g/dL Hct 30 Reticulocyte 8%
CBC
Hb , Hct

Reticulocyte

47. A. serum complement
hypersensititvity type 3
Type III reactions (ie, immune-complex reactions) involve

circulating antigen-antibody immune complexes that
deposit in postcapillary venules, with subsequent
complement fixation. Examples; Arthus reaction,SLE,
Rheumatoid arthritis
hypersensitivity type
complement
serum complement
48. B,C

Alcohol
Alcohol
Alcohol in large Quantities or in high concentration

damage the mucosa. While moderate drinking of wine or
beer increase
gastric secretion through their alcohol
component.
( Color Atlas of
pathophysiology)
- Excessive alcohol consumption causes damages to the
stomach or duodenum by impairing the integrity of the
mucosal barrier.
- alcohol may also cause irritation and erosion of the
mucous lining of the stomach and increase the production of
stomach acid.
- alcoholic drinks may stimulate the overproduction of

pepsin and gastric acids.
49.
A. DA
Cholinergic
( DA agonist )
C. DA Cholinergic
DA
(Parkinsons disease
Amantadine
Ach improve tremor)

50.
B C

Hypoxia oxygen
cerebral blood
flow oxygen
( )

Function
Attention
()
51. D.

anemia Hct + O2
carrying capacity metabolic demand
C.O.
( )
Aortic + pulmonic valve
Systolic murmur
** Reynolds number
Tubulance flow
52.
C. Hypothalamus
Hypothyroidism
primary secondary serum TSH
secondary hypothyroidism Hypothalamus
pituitary TRH stimulation test TSH
TRH Anterior pituitary

Hypothalamus(.
Thyroid axis )
LAB TSH
TRS stimulation test TSH
basal Hypothyroidism

Hypothalamic hypothyroidism
Diagnostic Tests for Hypothyroidism

b) Secondary
c) Hypothalamic
Hypothyroidism
Hypothyroidism
T4 low, TSH response
T4 low, No TSH
T4 low, Delayed TSH
exaggerated
response
response
a) Primary Hypothyroidism
The TRH stimulation test used to make the differential

diagnosis between primary hypopothyroidism and secondary
hypothyroidism.
TRH stimulation test

primary hypothyroidism Thyroid gland
/ negative feedback
TRH TSH
Thyroid hormone
TSH TSH
Lab secondary hypothyroidism
TRH stimulation test
TSH TSH Thyroid hormone
Hypothyroidism
TRH
TRH
TSH TSH
Thyroid hormone thyroid hormone

TSH TRH TSH Thyroid
hormone
http://www.islandnet.com/~rinfocan/thyroid.htm
53. B. Stroke volumn

Bernoulli BP
venous return SV
55.
A. insulin
Insulin
B. Thyroid hormone >>> anencephaly T

SH
C. TSH >>>
anencephaly
D. GH >>>maternal GH+fetal GH have no role in
regulation of fetal growth
E. HCG >>>
57. A. alveolar hypoventilation
midbrain
RR alveolar
hypoventilation

- gastroenteric reflex
(Biochemistry)
Part Biochemistry 2005

1.
DNA fragment GGACGG mutation GGCGG
mutation
A. silent
B. nonsense
C. transition
D. frame shift
E. transversion
2.
carnitine
A. glucose
B. glycogen
C. amino acid
D. fatty acid
E. triglyceride
3.
gene expression in RT-PCR RNA
A. transfer RNA
B. mitochondrial RNA
C. messenger RNA
D. heteronuclear RNA
E. ribosomal RNA
4.
Metabolism carbohydrate 100 g lipid 25 g protein
20 g
A. 300 kcal
B. 500 kcal
C. 700 kcal
D. 900 kcal
E. 1100 kcal
5. 5
Down
syndrome karyotype 46.XY
A. somatic mutation
B. deletion
C. translocation
D. undetected trisomy
E. mosaicism
6.
endonuclease AAUAAA
3 heterogenous nuclear RNA (hnRNA)
A. splicing
B. capping
C. transport
D. hybridization
E. polyadenylation
7.
A. riboflavin
B. biotin
C. thiamine
D. pentathonic acid
E. folate
8.
A. ketolysis
B. ketone bodies
C. gluconeogenesis
D. fatty acid
E. glycerol adipose tissue
9.
cytoplasmic organelle power house of cell
A. mitochondria
B. Golgi apparatus
C. lysosome
D. rough endoplasmic reticulum
E. centriole
10.
DNA
duplex
phosphorus 4 4 enzyme
type II restrictive endonuclease Bc/l 6 base
pair palindrome DNA duplex symmetry
DNA
11.
A. CCCGGT
GGGCCA
B. CCGGTT
GGCCAA
C. CGGTTG
GCCAAC
D. TTGATC
AACTAG
E. TGATCA
ACTAGT
55 40
chromosome abnormality
trisomy 21
A.

B.
C. endometrium
D. fallopian tube
E. non disjunction oocyte
12.
48
2
sigmoid colon biopsy neoplastic
glandular lesion invade colon
marker
monitor
A. -fetoprotein
B. CA- 125
C. alkaline phosphatase
D. lactic dehydrogenase
E. carcinoembryonic agent
13.
35 liver
function test total bilirubin 10 mg/dl,direct bilirubin 8
mg/dl, AST 700 U/L, ALT 1,000 U/L HBsAg
positive
A. viral toxicity
B. cyto
C. immune response
D. intranuclear multiplication
E. intracytoplasmic multiplication
14.
20 3
A. Cori cycle
B. beta oxidation
C. sorbital pathway
D. glucose-alanine pathway
E. hexose monophosphate shunt
15.
3
20
A. DNA cloning
B. DNA sequence
C. DNA fingerprint
D. Wentern blot
E. in situ hybridization
16.
A. sutosimal dominant
B. autosomal recessive
C. X-linked recessive
D. Non penetrance
E. Sporadic
17.
messenger RNA
uridine 135
136 amino acid
A. 134
B. 135
C. 136
D. 137
E. 138
18.
double stranded DNA nucleotide

5GGAACCATT3 nucleotide
19.
gluconeogenesis
1.
lipid

A. cholesterol
B. sphingolipid
C. phospholipids
D. fatty acyl
E. triglyceride
2.
3.
25
potassium cyanide
cyanide poisoning

A. glycolysis
B. Krebs
C. Electron transport chain
D. phosphooxidative
4.
Paraquat superoxide cell
injury

O2 free radical
A. B1 Thiamine
B. B6
C. A (Retinoic acid)
D. C (Ascorbic acid)
E. B5 Panthetoic acid
5.
Organelle steroid
6.
30 35

Downs syndrome 46 XY 45 XX
t(q14,q21) Downs
syndrome
A. 0 %
B. 25 %
C. 33.3%
D. 50 %
E. 99.9 %
7.
G6PD deficiency
1 16
chromosome 46,XX G6PD
deficiency
A. 0
B. 25
C. 50
D. 75
E. 100
8.
- - - GCSCGG - - - - - - GCCGG- - -
A. non sense
B. missense
C. frame shift
D. silence
9.
5
chromosome
A. Down syndrome
B. Turner syndrome
C. Edward syndrome
D. Klinfelter syndrome
E. Cri du chart syndrome
10.
20 DM lab
A. C-peptide
B. ketone body
C. TG
11.
Albinism
A. Tyrosinase
B. Hexokinase
C. Galactase
D. Lactase
E. Maltase
12.
60 10
Hepatic encephalopathy
A. Lipogenesis
B. Bile formation
C. Urea metabolism
D. Ketone bodies formation
E. Estrogen biotransformation
13.
1 6
2

A.
B.
C.
D.
14.
( )
A. B1
B. B2
C. B5
D. folic
E. B12
15.
30
A. DNA repair
B. cell membrane repair
C. Hb synthesis
D. free radical scavenger
E. 2,3-DPG
16.
60
Hepatic encephalopathy
A. Lipogenesis
B. Bile formation
C. Urine formation
D. Ketone formation
E. Glycolysis
17.
LFT, SGOT, SGPT ALP 3
18.
50
A. urea
B. Albumin
C. Ammonia
D. Ketone body
19. 25 5

A.
B. detergent
20.
40 56 trisomy 21
A.

B.
C. non-disjunction of ovum
D. endometrium
E. Fallopian tube
21.
25

(myocardial infarction)
A. Saturated fatty acid

B. Polyunsaturated fatty acid
C. Monounsaturated fatty acid
D. Medium chain fatty acid
E. Long chain fatty acid
1.
3
kwashiorkor amino acid
A. Threonine
B. Tryptophan
C. Methionine
D. Aspartic acid
E. Phenyl alanine
2.
5 glioma 4 cm
right frontal lobe
cell
A. inactivation of bcl2 gene
B. inactivation of p53 gene
C. inactivation of precursor of MDL-2 gene
D. activation of BCL-XL gene
E. activation of retinoblastoma gene
3.

ethanol ethanol
A. Product inhibitor
B. Allosteric inhibitor
C. Irreversible inhibitor
D. Competitive inhibitor
E. Feedback inhibitor
4.
2
Bitots spot ()
A. Retinol
B. Thiamine
C. Riboflavin
D. Pyridoxine
E. Ascorbic acid
5.
deep tendon reflex

metabolic pathway
A. glycolysis
B. Krebs cycle
C. Glucogenesis
D. Glycogenesis
E. Oxidative phosphorelation
6.
acute lymphoblastic leukemia

uric acid metabolism
A. heme
B. purine
C. pyrimidine
D. amino acid
E. glucoronide
7.
50
5 . Hb
A. sulfhemoglobin
B. methamoglobin
C. oxyhemoglobin
D. carboxyhemoglobin
E. oxidized hemoglobin
8.
50
1 lab creatinine kinase
troponin-t
A. dissociation of ribosome
B. swelling mitochondria
C. clumping nuclear chromatin
D. Fragmentation plasma membrane
9.
5
platelet 200,000/
cu.mm.
A. Deamination of alanine
B. Hydroxylation of praline
C. Phosphorylation of serine
D. Glycosylation of hemoglobin
E. Carboxylation of glutamic acid
10.
apoptosis
A. P53 protein
B. bcl-2
C. IL-6
D. tyrosine kinase
E. TNF
11.
Pathway RBC
A. Urea cycle
B. Krebs Cycle
C. Beta oxidation
D. Lactose fermentation
E. Glycolysis
12.
50 1
2

A. Retinol
B. Thiamine
C. Riboflavin
D. Cobalamine
E. Niacin
13.
45 MTP joint
uric 8.2 mg/dl
metabolism
A. purine
B. protein
C. glucose
D. cholesterol
E. pyrimidine
14.
mutation ...ATGCCAAA...
DNA probe
A. UUUGGCAU
B. UACGGUUU
C. TTTGGCAT
D. TACGGTTT
E. TTTGGUAT
15.
X telomerase

A. DNA stability
B. DNA replication
C. DNA degradation
D. Gene rearrangement
E. Spindle fiber attachment

16.
Vitamin
A. thiamine
B. folate
C. Riboflavin
D. B12
E. niacin
17.
Phagocytosis
neutrophil enzyme O2-dependent mechanism
A. Lysozyme
B. Defensin
C. Hydrolaze
D. Lactoferrin
18.
5 down syndrome
karyotype 46,XY
A. deletion
B. mosaicsm
C. translocation
D. somatic mutation
E. undetected trisomy
19.
1
hydrolytic enzyme enzyme organelle
A. acrosome
B. lysosome
C. ribosome
D. microsome
E. peroxysome

1.Western blot ...
? ()
2.alpha-fetoprotein
3.gene apoptosis
1
2552
17
1. 60 BUN 80 ml/dl
creatinine 8
transamination
nitrogen waste product
A. Leucine
B. Lysine
C. Threonine
D. Glutamate
E. Aspartate
2.
A. Oxytocin
B. prolactin
3. 45 specific gravity 1.001
A. Aldosterone
B. Antidiuretic hormone
4. 35
A. Muscle protein
B. Lipid
C. Liver glycogen
D. Muscle glycogen
E. Ketone body
5. Epigenetic inactivation X chromosome
DNA
A. Phosphorylation
B. Mutation
C. Gene rearrangement
D. Gene deletion
E. Methylation
6. autosomal recessive
PCR
Band carrier
A.A
B.B
C.
D.
7. 20
BP 130/80
of both legs
PR 110/min moist skin, muscle weakness
A. Insulin
B. Glucagon
C. Aldosterone
D. Epinephrine
E. Thyroxine
8. ketoacidosis
A. Protein metabolism
B.
Protein degradation
C. Fatty acid oxidation

D. Fatty acid synthesis
E. glycogenolysis
9. 25 3
1
A. Estrogen
B. Progeterone
C. LH
D. FSH
E. HCG
10. 25 3
blood sugar 35 mg/dL
A. lipolysis
B. gluconeogenesis
C. glycogenolysis
D. glycogenolysis
E. pentose phosphate pathway
11. 5
A. Arginine
B.
C. Tryptrophan
D. Methionine
E. Hydroxyproline
12.

A.alcohol dehydrogenase
B.acetaldehyde dehydrogenase
13. epigenetic gene
A.methylation
14.
A.transduction
B.translocation
C.conjugation
D.transposition
15. anticodon tRNA 5 - - - 3 3
codon
16.keloid
A. fibroblast
B. granulation tissue
C. collagen
17. ketone bodies (

ketone bodies
)
A. lipolysis
B. gluconeogenesis
C. fatty acid metabolism
D. fatty acid synthesis
18. xy,+21
A. translocation
B. meiosis
nondisjunction
C. deletion
19. labia majora
gamete
A. xy
20.
A. 69,xxy
B .46,xx
C. 46,xy
D.23,xx
E. 23,xy
21. ( )
A. tryptophane
B. tyrosine
22. log michealis Y
X antagonist
23. PG type
A. PGI2
B. PGF2
C. PGD2
24. posttranslation
A.ER
B.ribosome
C.nucleus
D.vesicle
(Biochemistry)
1. D. Frame shift
2.
D. fatty acid
Carnitine
Lysine Methionine
Fatty acyl CoA mitochondria
beta-oxidation cell
3
1.
Carnitine-acyl transferase 1
outer membrane of
mitochondria
Fatty acyl CoA LCarnitine O-acylcarnitine
intermembrane space of mitochondria
2.
Acylcarnitine translocase
innermembrane of
mitochondria
O-acylcarnitine
matrix mitochondria
3.
Carnitine-acyl transferase 2
innermembrane
of mitochondria
L-carnitine Fatty
acyl-CoA beta-oxidation
carnitine
Malonyl-CoA
AcetylCoA + CO2
---- MalonylCoA
enzyme
AcetylCoA Carboxylase Biotin ( Vitamin B6 )

Co-enzyme
MalonylCoA inhibit Carnitine-acyl transferase

3.
C. messenger RNA
4.
C. 700 kcal
(100
4)+( 25
9)+(20
4) = 705
5.
C. translocation
6.
E. polyadenylation
hnRNA transcript 3
AAUAAA
enzyme endonuclease
polyA
7. C. thiamine
tannic acid
tannic caffeic acid

Vit B1
Vit B1
8.
transketolase
B. ketone bodies
( Starvation ) fat adipocyte
hormone cortisol , glucagon
Triglyceride Fatty acid Glycerol

Fatty acid albumin
ketone body ketone
body
substrate

preserve RBC ,
renal medullary cell
ketone body ( Glycerol
DHAP enzyme Glycerol
kinase
9.
10.
gluconeogenesis )
A. mitochondria
E. TGATCA ACTAGT
Bc/l restriction enz.

11. E. non disjunction oocyte
35
non-disjunction meiosis
oocyte
12.
E. carcinoembryonic agent
Carcinoembryonic antigen tumor marker
follow up colorectal cancer (

non-neoplastic lesion
ulcerative colitis , pancreatitis , cirrhosis)
-fetoprotein
- fetus
adult
tumor marker Hepatocellular

carcinoma
CA-125
tumor marker ovarian tumor
lactic dehydrogenase
RBC
marker hemolysis
follow up cancer
lymphoma turn over
Dysgerminoma elevate LDH first sign

13.
C. immune response
parenchyma of liver
infected hepatocyte

14.
E. hexose monophosphate shunt

G6PD activate
oxidative stress antibiotic
sulfonamide
15.
C. DNA fingerprint
16.
C. X-linked recessive
17. E. 138
UUU
CUG
CCA
UAU
UUU AUG
UGU
UAA(stop
codon)
18.
3 CCTTGGTAA 5
19.
Ethanol metabolize
enzyme alcohol
Dehydrogenase cytoplasm acetaldehyde (
metabolize
mitochondria )
NADH NADH cytoplasm
NADH enzyme Lactate
dehydrogenase pyruvate lactate
pyruvate
substrate gluconeogenesis
NADH enzyme
gluconeogenesis (lactate
peripheral tissue skeleton muscle

lactic acidosis
)
1.
E. triglyceride
2.
Adipose tissue
3.
C. Electron transport chain

potassium cyanide
cytochrome c oxidase
Electron transport chain
tissue
oxygen anaerobic glycolysis -> lactic acidosis

,
cyanosis cardiac arrest

2
4.
D. C(ascorbic acid)
5.
D.
steroid cholesterol
cholesterol
(
acetylCoA
LDL-receptor)
mitochondria
pregnenolone
pathway
steroid substance ( SER
pregnenolone)
6.
C. 33.3%
Robertsonian Translocation
6

A.
14
21
Monosomy 21
21
B.
C.
D.
21
14
Monosomy 14
14
(spontaneous abortion)
14 21
Robertsonian
Translocation ( 21 14 )
balanced translocation
E.
Robertsonian
Translocation 21
trisomy 21
F.
(Down
syndrome)
Robertsonian
Translocation
14
trisomy 14
carrier Robertsonian Translocation

t(14q;21q)
(live birth)
Down syndrome 1: 3
7.
A. 0
G6PD deficiency X-link
recessive
2
1 allele

) 3
1
XX
XX
XY
XY
*
XX
XX
XY
XX
XX
XY
*
XY
*
XY
*
XX
XY
XX XY
XX
XY
3
X-link recessive
2
1

recessive

8.
C. frame shift
9.
D. Klinfelter Syndrome
Turner
syndrome monosomy x
Edward syndrome
trisomy 18
Klinfelter Syndrome karyotype 47,XXY or 48,XXXY

10.
A. C-peptide
DM
type1 autoimmune
beta-cell pancreas insulin deficiency

C-peptide C-peptide
exocytosis insulin marker
endogenous insulin
11.
A. Tyrosinase
Albinism
autosomal recessive Tyrosinase deficiency
Tyrosinase enzyme tyrosine melanin
melanocyte hypopigmented skin eye hair
12.
C. Urea
metabolism
Hepatic Encephalophathy
metabolize

deamination amino acid

aromatic amino acid phenylalanine
metabolize
urea urea cycle

ammonia alpha-ketogutarate
neuron alpha-ketogutarate neuron
aromatic amino acid
neuron channel tryptophan
tryptophan neuron 5-HT (
Tryptophan 5-HT )
13.
D.
CHO
14.
E. B12
Vit B12
bacteria yeast
15.
D. free radical scavenger

G6PD
deficiency NADPH G6PD
enzyme pentose phosphate pathway
NADPH free radical

Glutathione
G6PD free radical
16.
C. Urea
17.
Cholestasis
formation
ALP ( Alkaline Phosphatase ) enzyme

enzyme

clinic marker
cholestasis
18.
C. Ammonia
urea cycle urea NH3
NH3
19.
B. detergent
20.
C. non-disjunction of ovum
21.
C. Monounsaturated fatty acid
- (MUFA)
cholesterol (LDLc)
- w-6
1 LDLc
1.35 100 10
HDLc
- w-3
a linolenic triglyceride
(ADA
US RDA RDI 2007 etc.)

1.
D. Aspartic acid
Aspartic acid
oxaloacetate
enzyme AST ( Aspartate
transaminase)
kwarshiorkor

2.
D. activation of BCL-XL gene
BCL-XL Bcl-2 family
apoptosis mitochondrial
pathway
expression
gene induce
apoptosis
3.
D. Competitive
inhibitor
methanol
structure ethanol
inject ethanol
enz. Alcohol DHnase enz.

methanol toxic product
( formaldehyde formic acid toxic
)
4.
A. Retinol
= night
blindness retinol
Rod & Cone cell
Biots spot = Xerosis of epithelium conjunctiva
5.
B. Krebs cycle
1
Thiamine pyrophosphate coenzyme enzyme
metabolism
1.
Pyruvate dehydrogenase
pyruvate
acetylCoA
2.
-ketoglutarate dehydrogenase
ketoglutarate SuccinylCoA Krebs cycle
3.
Transketolase pentose phosphate pathway
(beri beri ) deep

tendon reflex neuron
6.
B. purine
purine uric acid
7.
D. carboxyhemoglobin
8.
B. swelling mitochondria
9.
B. Hydroxylation of proline
matrix protein collagen loose
connective tissue
Platelet 200,000/ cu.mm.
platelet
confirm
10.
B. bcl-2
11.
E. Glycolysis
12.
D. Cobalamine
B12
B12 ( cobalamine)
coenzyme enzyme 5-Methyltetrahydrofolatehomocysteine methyltransferase ( MTR )
5
N -methyl-tetrahydrofolate Tetrahydrofolate
coenzyme thymidine
B12

megaloblastic anemia
( pernicious
anemia)
13.
A. purine
14.
C. TTTGGCAT
15.
A. DNA stability
Telomerase enzyme DNA
telomere DNA replication
DNA
replication ( senescence )
breakdown chromosome enzyme
telomerase DNA stability
16. D. B12
17.
E 4 choice
phagocytosis
phagocyte 2
1.
O2-dependent mechanism enzyme

free radical
2.
oxidation

O2-independent mechanism enzyme

Lysozyme bacterial cell wall 1,4beta-linkages between N-acetylmuramic acid Nacetyl-D-glucosamine

peptidoglycan
Defensin
cell wall bacteria
Hydrolase

lactoferrin mucosa innate

immunity
( ETS )
18.
C. translocation
19.
B. lysosome

1. Protein
2. Neural Tube Defect
3. Bcl-2
1
2552
17
1. Ans D
glutamate dehydrogenase
ketoglutarate

glutamate dehydrogenase
-ketoglutarate
glutamate + H2O + NAD
NH4 + NADH + H
2. Oxytocin
(Hypothalamus) (Posterior
pituitary gland)

(Persistalsis)
Oviduct Oxytocin
Prolactin Lactogenic hormone (LTH)
androgen
3. (vasopressin) ADH (antidiuretic

hormone)

Antidiuretic
hormone increases the permeability of the distal portion of
the nephron allowing more water to be reabsorbed from the
nephron back into the blood stream which dilutes the blood
and concentrates the urine. Alcohol interferes with the
production of antidiuretic hormone which is why beer drinking
leads to frequent trips to the bathroom.
aldosterone mineralocorticoid
(K )
(distal renal tubules)
+
(Na )

+
(H )

-
(Cl ) (HCO3 )

4.
1
glucose-6-phosphatase
G-6-P glc
G-6-P

glc Glc
glucose-6-phosphatase Glc

5. epigenetic
5'
(CpG) (-CH3) 5'

(methylation)
6.
7. Thyroxin

metamorphosis
Hyperthyroid

Adrenalin hormone Epinephrine hormone
( )
glycogen
(adrenalin
)
Insulin cell
insulin
insulin
glycogen
insulin ( diabetes
mellitus )

(Ketone Body)

Glucagon
( insulin )

8. Protein degradation
branch chain
amino acid ketone body

ketoacidosis
Fatty acid oxidation
acetyl co A acetyl co A
oxaloacetate TCA cycle

acetyl co A
oxaloacetate
acetyl co A
ketone bodies acetoacetate, D--hydroxybutyrate

acetone
TCA cycle
renal cortex
ketone bodies
ketone bodies ketone bodies
pH acidosis
ketone bodies ketosis

9. The hormone human chorionic gonadotropin (better
known as hCG) is produced during pregnancy. It is made by

cells that form the placenta, which nourishes the egg after it
has been fertilized and becomes attached to the uterine wall.
Levels can first be detected by a blood test about 11 days
after conception and about 12 - 14 days after conception by
a urine test. In general the hCG levels will double every 72
hours. The level will reach its peak in the first 8 - 11 weeks
of pregnancy and then will decline and level off for the
remainder of the pregnancy.
10. 3

gluconeogenesis glucogenic
amino acid

Lipolysis acetyl co A
acetyl co A Glc
glycogenolysis 24
glc
gluconeogenesis
glycogenolysis
pentose phosphate pathway
NADPH
-5 -
11. Vitamin C hydroxylation

proline lysine

12. acetaldehyde dehydrogenase

acetaldehyde

Ethanol----1
acetaldehyde
-2
acetic acid
1: alcohol dehydrogenase; 2: aldehyde dehydrogenase

13. epigenetic

methylation
14. Bacterial conjugation is the transfer of genetic
material between bacteria through direct cell-to-cell contact.
[1]
Discovered in 1946 by Joshua Lederberg and Edward Tatum,

[2]
conjugation is a mechanism of horizontal gene transferas
are transformation and transductionalthough these

mechanisms do not involve cell-to-cell contact.
[3]
15.
16. collagen

keloid granulation
tissue

exuberant granulation
fibroblast
connective tissue
desmoid aggressive fibromatosis.
17. fatty acid metabolism ketogenesis
ketone bodies acetyl CoA
18. meiosis
19.
nondisjunction Down syndrome
20. hydatidiform mole 46,XX

genomic imprinting
21. tyrosine melanin pigment
22. Competitive inhibition
Lineweaver-Burk plot of competitive inhibition. Note the
complete relief of inhibition at high [S] (ie, low 1/[S]).
23.
24.
Hydrophobic signal peptide appears at the N-terminus of
protein.
Signal recognition particle (SRP) binds to signal peptide,
ribosome, GTP and stops elongation.
Ribosome-SRP cpx is bound by receptors on ER.
Newly synthesized protein is translocated into the ER

lumen.
The signal peptide is cleaved from protein by peptidase

within the lumen.
Ribosome dissociates and is recycled.
The protein is made into the ER, then folded and
packaged into a vesicle.
(Pharmacology)
Part Pharmacology 2005

1.
55 gout allopurinol
enzyme
A. xantine oxidase
B. adenine deaminase
C. guanine deaminase
D. adenine phosphoribosyltransferase
E. guanine phosphoribosyltransferase
2.
55 recurrent ventricular
arrhythmia 5
increased
ESR pulmonary function
diffuse lung capacity diffuse

interstitial pneumonia
A. atenolol
B. verapamil
C. propanolol
D. amiodarone
E. procainamide
3.
50 chronic obstructive pulmonary
disease theophline
14
2 theophyline
theophyline
A. rifampin
B. isoniazid
C. cimetidine
D. hydrothiaxide(hydrochlorothiazide?)
E. pyrazenamide
4.
mydriasis c ycloplegia
A. atropine
B. pilocarpine
C. neostigmine
D. phenylamine
E. phenylephrine
5.
38 amphetamine
BP
170/110 mmHg
amphetamine BP
A. potent -1 adrenergic agonist
B. potent -2 adrenergic agonist
C. inhibition of catecholamine metabolism
D. release of internal catecholamine
E. metabolism to false neurochemical transmitter
6.
30
BP
112/76 mmHg PR
88/min BP 80/60 mmHg
PR 120/min

A. dopamine
B. isotonic saline
C. colloid solution
D. 5% dextrose in water
E. fresh flozen plasma
7.
effect digitalis Na-K pump axon

+
A. Na
+
B. K
-
C. Cl
D. inhibit propagation of action potential
E. hyperpolarization membrane potential
8.
4 tuberculin test
positive
isonizid prophylaxis 4

isoniazid ( 4
)
A. heme
B. metabolism hepatocellular injury
C. billirubin albumin
D. lymphatic obstruction
9.
mean arterial
pressure
peptidase
A. histamine
B. bradykinin
C. serotonin
D. angiotensin ll
E. neuropeptide Y
10.
46 cholesterol
CPK
A. captopril
B. propanolol
C. nicotinic acid
D. simvastatin
E. hypochlorothiazide
11.
40 deep vein thrombosis warfarin
A. kininogen
B. prothrombin
C. Hageman factor
D. thrombomodulin
E. antihemophilia A factor
12.
39

impressed vertebral fracture (osteoporosis)

A. vitamin D
B. calcium
C. estrogen
D. progesterone
E. prednisolone
13.
antrax
spore
A.
B.
C.
D. hypochlorite 400 ppm
spore
E. Phenol 1 %
14.
bronchiolar resistance
epinephrine
x x epinephrine
x
A. nadolol
B. pindolol
C. propanolol
D. metropolol
E. isopoterenol
F.
15.
50 dyslipidemia antilipid drug
A. probucol
B. gemfibrozil
C. simvastatin
D. nicotinic acid
E. cholestyramine
16.
40
A. dimenhydrinate
B. domperidone
C. metoclopamide
D. scopolamine
E. cyclizine
17.
50 digitalis
A. adrenylate cyclase
B. Na-K ATPase
C. adrenergic receptor
D. dopamine receptor
E.
18.
30 3 thin
film RBC
trophozoit, Shuffner dot
A. quinine + primaquine
B. quinine + atezunate
C. quinine + cloroquine
D. cloroquine + atezunate
E. cloroquine + primaquine

1.
30 50 kg 20 mg/kg half- life
A. 2 .
B. 4 .
C. 8 .
D. 9 .
E. 10 .
2.
30 L/kgs
apparent of volume distribution (Vd)

A.
B. hydrophilicity
C. protein-binding
D. blood brain barrier
E.
3.
Azotimycin afferent volume of distribution [V d] = 50

l/kg
A. binding protein
B.

4.
rapid metabolism
loading dose
5.
maintain dose
A.
B.
C.
D.
E.
vaccine
1
A. multistep trial
B. pharmacokinetic activity
C. pharmacodynamic activity
D. pharmacoeconomic activity
E. none of the above
F. double blind effect
6.
glaucoma bete-blocker
A. aqueous humor
B. trabecular membrane
C. iris dilator muscle
D. papillary. Muscle
7.
antiemetic drug brain

A. cerebrum
B. midbrain
C. Pons
D. medulla
8.
diuretic
glaucoma

9.
50
prolonged muscle relax LAB Abn. Plasma
cholinesterase
A. Atracurium
B. vercuronium
C. Pancuronium
D. Suopotamia
E. Sucrinylcholine
10.

A. Ergotamine
B. ASA
C. Ibuprofen
D. Diazepam
E. Morphine
11.
35

A. Heroin
B. Alcohol
C. Gasolene
D. Morphine
E. Amphetamine
12.
Long acting relax

A. Tubocurarine
B. Pancuronium
C. Romum
D. Scopolamine
E. Succinylcholine
13.
45 type 2 2
glipizide
fasting blood glucose 110 mg/dL, HbA1C 6.5

%
A.
insulin
B. insulin receptor
C. cortisol
D. ........
14.
45 7
4 24
A. water diureis
B. solute diuresis
C. osmotic diuresis
D. ADH
E. ADH
15.
estrogen
hormone
A. Interleukin
B. interferon
C. calcitonin
D. Thromboxane A2 (TXA2)
E. TNF
16.
50
moon face Na+

+ plasma sugar
A. Estrogen
B. Progesterone
C. hydrocortisone
D. Thyroid
E. ACTH
17.

3
1
moon face lab
Na+ 120 K- 5 C l- 105
Blood glucose 60 globulin20
A. estrogen
B. hydocortisone
C. ADH
D. ACTH
E. TSH
18.
40 20
deep tendon reflex
A. B1
B. B2
C. B3
D. B6
E. B12
19.
A. B1
B. B2
C. B6
D. B12
20.
1 hyoscine
enteric nervous plexus
A. afferent fiber
B. meissner plexus
C. mucosal plexus
D. myenteric plexus
E. submucosal plexus
21.
30 Nephrotic syndrome
Prednisolone WBC
Lab : WBC 14,000 Platelet 200,000 (Neutrophil
Lymphocyte )
A.
Bone Marrow
B. Neutrophil
C. maturation Neutrophil
D.
permeability / migrate vessel
circulation
E.
granulocyte CFS
22.
congestive heart failure furosemide
digitalis
furosemide digitalis toxicity
A. hypo K+
B. hypo Na+
C. hypo Cl
D. hypo Ca2+
E. metabolic alkalosis
23.
A. free radical scavenger

24.
20

A. R..
B. tamoxifen
C. Ergonovine
D. Mifedistone(Mifepristone?)
25.
endometriosis Danazole
irreversible effect
A.
B.
C.
D.
E.
25.
50
Tamoxifen

A. Estrogen negative feedback
B. Gonadotropin
C. FSH
D. Estrogen receptor
E.
Progesterone
26.
Benign Prostate Hyperpasia finesteride
hormone
A. DHT
B. Estrogen
C. LH
D. Didydro( Dihydrotestosterone)
27.
Salbutamol
A. mucus
B. beta - agonist
28.
60
isosorbide dinitrate

A.
guanylate cyclase
B.
B2-adrenergic receptor
C. ionized calcium cell
D. B1-adrenergic receptor
E. ACE
29.
transient myocardial infarction aspirin
A. decarboxilation
B. COX enzyme
C. Hexokinase
30.
50 3 1 T 39 C BP 80/50
fluid therapy
BP 80/60
A. Dopamine
B. Vasopressin
C. Epinephrine
D. Zsopetunal
E. hydrocortisone
31.
25 30 AMI
A. Plasmin
B. Protein C
C. Antithrombin
D. Prostacyclin
E. Phospholipase
32.
acute MI ER fibrinclytic drugs

A. protein C
B. plasmin
C. antithrombin
33.
multiple myeloma Ca2+ 12 mg/dL
Ca 2+
A. Thiazide
B. Kay
33.
A. 2 nd wk
B. 4 th wk
C. 12 th wk

1.
cyclosporine cell
A. B-cell
B. T-cell
C. Macrophage
D. NK cell
E. PMN
2.
Nanosum

A. Phase IIa Clinical trial
B. Phase IIb Clinical trial
C. Phase III Clinical trial
D. Phase IV Clinical trial
3.
60 80
Number needed to
treat
A. 5
B. 20
C. 33.3
D. 50
E. 10
4.
Terbutaline sulfate

A. alpha1 antagonist
B. alpha2 agonist
C. beta1 agonist
D. beta2 agonist
E. antimuscarinic
28
respiratory distress syndrome surfactance

surfactant

A. lung compliance
B.
6.
25
discharge
intracellular gram negative
diplococci penicillin
A. Imipenam
B. Gentamicin
C. Erythromycin
D. Ciplofloxacin
E. Bactrim
7.
20 Barbiturate
1
RR 12/min arterial blood gas
A. pH 7.5
B. PaCO2 55 mmHg
C. PaO2 100 mmHg
D. Bicarbonate 18 mEq/L
E. Base excess +4 mEq/L
8.
systematic review amoxicillin

Amoxylin clavuranic acid sinusitis
causal association
A. temporalily
B. reversibility
C. consistency
D. dose-effect
E. biological plausibility
9.
X max 5 mg 1 hr
max 25
mg 2 X Y
A. 5
B. 10
C. 25
D. 40
E. 50
10.
N-acetylcystein paracetalmol toxicity

liver
A. N-acetylation
B. N-hydroxylation
C. sulfer conjugate
D. glutathione conjugate
E. glucolonide conjugate
11.
5 3 Stifness of neck
CFS Gram
Gram negative diplococci
A.
B.
C.
D.
E.
12.
60 BMI=30
A. Metformin
B. Acarbose
C. Meglitinide
D. Glitazone
E. Glipizide
13.
K= 6, Na = 135 , Cl
A. Spinoloractone
B. Priqnerene
C. Amiloride
D. Furosemide
E. Eplereone
14.
20 Haloperidol
A. inhibit dopaminergic
B. inhibit cholinergic
C. inhibit serotonin
D.
dopaminergic
E.
cholinergic
15.
25 40
A. Oxytocin
B. Ritrodine
C. Ergotarmine
D. Vasopressin
E. Bromocriptine
16.
50
acute myocardial
infarct
mechanism activity
A. plasmin
B. Protein C
C. AntiThrombin
D. Prostacyclin
E. Phospholipid
17.
27 carbamet ,muscle
fasciculation, , , PR 60 beat/min
Atropine
A.
B. Muscle fasciculation
C.
D.
E. 60 beat/min
18.
50
KOH
preparation hyaline septate hyphae
A. Fluconazole
B. Clotimazole
C. Amphotericin B
D. Bemzyl benzoate
E. Sodium thiosulfate
19.
35

single treatment
A. Ca
B. Vit D
C. Prednisolone
D. Progesterone
E. Estrogen
20.
5 Hemophilia A
coagulation
A. Aged plasma
B. Cryoprecipitate
C. Fresh frozen plasma
D. Platelet
E. Fresh whole blood
21.
Point mutation Ribosome Subunit 50 Bacteria

A. Cloxacillin
B. Ceftriaxone
C. Norfloxacin
D. Tetracycline
E. Erythromycin
22.
25

A. paraquat
B. organophosphate
C. ethylene glycol
D. arsenical compound
E. sodium hypochlorite
23.
Organophosphate
A. Ach
B. Ach
C. ACh esterase
D. reuptake Ach
E. sensitivity Ach receptor

24.
Venous thromboembolism
INR = 5

- asthma
- succinylcholine action
- organophosphate action
- first line drug of DM
- haloperidol action
- penicillin
- ciprofloxacin
- fasciculation flaccid

Pharmacology
(
)

1.
A. xanthine oxidase
Key word gout
gout uric acid
Uric acid
metabolic product purin

enzyme xanthine oxidase hypoxanthine
& xanthine
Purine bases Inosine Hypoxanthine Xanthine
Uric acid
allopurinol xanthine oxidase inhibitor
uric acid hypoxanthine & xanthine 2

2.
D. amiodarone
Key word arrhythmia, pulmonary
function, pneumonia
recall amiodarone arrhythmic
adverse
effect
atenolol

Side
-blocker 1-selective
effect
indigestion,
constipation,
fatigue,
dizziness, faintness
verapamil
Antiarrhythmic agents class IV (Ca
2+
channel blockers)
Side effect : constipation, CHF LV dysfunction,
hypotension
propanolol
-blocker Nonselective
Side effect : fatigue, bronchoconstriction
procainamide Antiarrhythmic agents class IA (Na
channel blockers)
Side effect : proarrhythmic effects (e.g., torsades de
pointes)
3.
C. cimetidine (enzyme inhibitor )

Key concept Drug Interaction
Key word theophyline
Cimetidine, ciprofloxacin, erythromycin
enzyme
inhibitor theophylline theophylline

enzyme inducer phenobarbital, phenytoin,
rifampin
4.
E. phenylephrine
Key word mydriasis cycloplegia
Key concept autonomic control of the eyes
Mydriasis 1-adrenoceptor radial muscle

muscarinic receptor circular muscle (
contract miosis)
Cycloplegia = loss of power in ciliary muscle
cycloplegia
1-adrenoceptor
ciliary muscle
phenylephrine
1-selective adrenoceptor agonist

phenylramine H1-receptor antagonist
allergic conjunctivitis
atropine
Antimuscarinic drugs
ciliary muscle
pilocarpine
Cholinomimetics M3
receptor ciliary muscle

neostigmine
Cholinesterase-inhibiting drugs
ciliary muscle
5.
D. release of internal catecholamine

Key word
amphetamine, BP 170/110
mmHg
Amphetamine
cathecholamines nerve terminals
6.
B. isotonic saline
electrolyte

isotonic saline
electrolyte colloid solution

dextrose

dextrose electrolyte dextrose
Fresh flozen plasma
factor
7.
B. K
+
Key concept mechanism of Digitalis action &

action potential
Digitalis enzyme Na+/K+ ATPase pump Na+ 3
K+ 2 K+
K+ gradient resting
membrane potential
action potential: Na+ depolarization;
K+ repolarization
hyperpolarization
K+
Na+/K+ ATPase K+
membrane potential
hyperpolarization Digitalis hyperpolarization of

membrane potential
B
membrane potential resting potential

hyperpolarization
8.
B.
metabolism hepatocellular
injury
Key concept
metabolite
of isoniazid acetylhydrazine hepatic damage
B.
9.
Key word peptidase
mean arterial pressure

peptidase
protein/peptide
peptidase peptide bond peptide/protein

Histamine = amine
bradykinin = peptide
serotonin = 5- hydroxytryptamine
angiotensin ll = octapeptide, vasoconstrictor
neuropeptide Y = vasoconstrictor
10.
A,C
D. simvastatin
Key word
CPK
D
recall
Simvastatin HMG CoA
reductase inhibitor cholesterol

first choice hypertension
nicotinic acid
triglyceride & hepatotoxicty &

common side effects: flushing & dyspepsia
11.
B. prothrombin
Key concept Coagulation Factors & Mechanism

of warfarin action
Mechanism of action warfarin enzyme
Vitamin K epoxide reductase Inactive vitamin K epoxide
Vitamin K (active hydroquinone
form) Precursors of clotting factors II, VII, IX, X
Active clotting factors II, VII, IX, X
Prothrombin Thrombin
Prothrombin Extracellular
prothrombin B. Prothrombin
. Extracellular prothrombin Intracellular
prothrombin
( : Journal of the American society of hematology)
12.
C. estrogen
Key concept Osteoporosis in menopausal
women
estrogen deficiency estrogen

bone resorption
13.
A.

disinfection
anthrax C. anthrax spore

B., D. E.
bacterial spore disinfection (
bacteria, virus )
, hypochlorite phenol
14.
A. pindolol
Key concept
Sympathetic drugs & -
adrenoceptors
heart rate & bronchiolar resistance
(= bronchodialtation)
1- adrenoceptor heart rate

2 -adrenoceptor bronchial smooth
muscle
adrenoceptors
Epinephrine 1 & 2-
X 1- adreoceptor
100 % 2- adrenoceptor
2-
adreoceptor 100 % intrinsic sympathomimetic activity

(
sympathetic nerve)
X - adreoceptor
(nonselective antagonist)
antagonist
recall
()
Propranolol, nadolol, timolol & pindolol nonselective
- adrenoceptor antagonists
pindolol
intrinsic sympathomimetic activity ( )
Metopolol
1- selective adrenoceptor antagonist intrinsic

sympathomimetic activity
Isoproterenol
adrenoceptor agonist
15.
D. nicotinic acid
Probucol Side effect : decrease HDL level (20-30%)
Gemfibrozil
Side effect : GI side effects
Simvastatin
Side effect :
Nicotinic acid Side effect : Flushing of body and face

Cholestyramine
Side effect : GI side effects
D. nicotinic acid
16.
Key concept motion sickness

- Antihistamines: Cyclizine (long duration of
action),
hydroxyzine
(antipruritic*),
promethazine,
dimenhydrinate (Dramamine, most effective OTC drug) &

diphenhydramine
-
Anticholinergic
agents:
scopolamine
(p.o.
or
transdermal patch: i.v., most effective prescription drug)

A., D. E.
B., C. B., C.
Dopaminergic antagonist GERD, vomiting,
gastroparesis
17.
18.
A. quinine + primaquine
Key concept maralial diagnosis & treatment
Key word trophozoit, Schuffner
Schuffner dot P. vivax & ovale malaria
malariae Ziemanns dot
[P.
P. falciparum Maurers dot]
hypnozoites relapse hypnozoites

Primaquine
A & E
chloroquine > quinine A

1.
half-life : Y

maximum
X
X
half-life
2.
C. protein-binding
Key concept
Drug distribution
Vd
= Amount of drug in body/ Drug concentration in
blood or plasma
Vd
tissues e.g. muscle, adipose tissue &
drug receptor
tissues
membrane
( B
)
Plasma proteins tissue
components Vd plasma volume (3 )
bound drug
C. protein-binding (
)
* protein-binding Vd
3.
4.
D.
Key concept Pharmacokinetics & Drug Dosing
Loading dose
minimal effective concentration
IV Loading dose Vd
metabolize
maintenance dose
MEC
rate of drug elimination drug metabolism &
drug excretion
D.

IV loading dose
maintain dose
prodrug
loading dose
& maintain dose
5.
C. pharmacodynamic activity
Key concept Drug development Clinical
trials (testing, study)
Phase I normal volunteers/ special population (renal and

hepatic impairment)
- biological effects, safety, metabolism, kinetics, drug
interaction
Phase II- selected patients
- therapeutic efficacy, dose range, kinetics, metabolism
Phase III- large sample of selected patients
- safety, efficacy
NDA review NDA approved marketing
Phase IV- post-marketing surveillance
- patients given drug for therapy
- adverse reaction, pattern of drug utilization, additional
indications discovered
=
. .. C. pharmacodynamic activity
Pharmacodynamics is the study of the biochemical and

physiological
effects
of
drugs
on
the
body
or
on
microorganisms or parasites within or on the body and the

mechanisms of drug action and the relationship between drug
concentration and effect
6.
A. aqueous humor
Key concept autonomic control of intraocular
pressure
(ciliary epithelium & blood vessel) receptors
( 2)
receptor
aqueous humor ( )
7.
A.
D. medulla
Emetic center medulla (lateral reticular formation)
chemoreceptor trigger zone (CTZ) base

of fourth ventricle
(in area postrema of medulla)
CTZ
receptors antiemetic
dopamine
receptor
(Metoclopramide,
Promethazine),
5HT3
receptor (Ondansetron), muscarinic receptor (Scopolamine or

hyoscine), opioid receptor
8.
D.
Key concept Mechanism of action of diuretics

acetazolamide (carbonic anhydrase inhibitor)
aqueoushumor intraocular pressure

Osmotic diuretics (Glycerin, Isosorbide, Mannitol,
Urea) plasma osmotic pressure
intraocular pressure acute attack of
glaucoma, ocular surger
9.
E. Succinylcholine
(RECALL: Succinylcholine)
Key word ,
Abn. Plasma
cholinesterase
Succinylcholine (SCh) Depolarizing drugs
2 phase
Phase I :
Depolarization of motor end-plate
Phase II :
Muscle relaxation
prolonged paralysis
Plasma ChE
(Cholinesterase) Abnormal plasma
cholinesterase
Abnormal plasma
cholinesterase
10.
A. Ergotamine
Key concept Migraine therapy
Ergotamine migraine severe
50-70%

5-HT1-receptor partial agonist, vasoconstrictor, affect adrenoceptors blocks trigeminal nerve transmission
side effect increase BP,
myocardial infarction, stroke
11.
E. Amphetamine
Key concept CNS stimulation
Amphetamine Phenethylamine derivatives
Methylphenidate
Clinical effects Amphetamine Cocaine
Amphetamine increase the
concentration of catecholamines transmitter in the synaptic
cleft (
)
alertness
fatigue insomnia
12.
A. Tubocurarine B. Pancuronium
Long-acting muscle relaxants onset of action & clinical
duration of action Tubocurarine onset 4-6
duration
80-
120 Doxacurium 4-6, 90-120

120-180
Pancuronium 4-6,
Pipercuronium 2-4, 80-100
Succinylcholine short-acting muscle relaxant: onset 1-1.5

duration 5-8

A. B. long-acting drugs
13.
A. insulin
Recall : glipizide sulfonylurea
insulin
14.
C. osmotic diuresis
Key words
Key concept : dehydration

hyperglycemia osmotic diuresis
15.
A. Interleukin
Key concept Estrogens & Bone remodeling

Estrogen

- ***number & activity of osteoclasts
osteoclast- stimulating cytokines: IL-1, IL-6, TNF-
osteoblast & stroman cell

antiresorptive
insulin-like growth factor (IGF)-1, bone
morphogenic protein (BMP)-6, & transforming growth factor

(TGF)-
- bone organic matrix type I
collage, osteocalcin, osteopontin, osteonectin markers of
differentiated osteoblast alkaline phosphatase
- osteocyte survival apoptosis
Estrogen Osteoprotegerin (OPG)

RANKL RANKL RANK
hematopoietic osteoclast precursor cells & mature osteoclast
RANK gene expression differentiation of

osteoclast precursor cells, maturation of osteoclast
Estrogen bone resorption
Cytokines differentiation of
osteoclast precursor cells, maturation, activation of osteoclasts
& apoptosis
2 Interleukin TNF
IL osteoporosis ( )
TNF in vitro bone loss in arthritis &

periodontal disease
16.
C. hydrocortisone (cortisol)
Key word moon face
glucocorticoid effect
effect
moon face key word key

word
17.
E. TSH
Key concept
[ Na+ 120 glucose 60
(?)]
. Acute hyponatremia
< 135 mEq/L;
(Hyponatremia : plasma [Na ]

+
[Na ] < 120 mEq/L
severe weakness, consciousness

the National Institute for Diabetes and Digestive
and Kidney Diseases (NIDDK)
120 mg/dL
blood sugar 60 -
60 mg/dL
shakiness, dizziness,
sweating, hunger,
headache, irritability, pale skin color,

, clumsy or jerky movement,
, tingling sensation .
[ Drugs and
Fluids
used
disorders]
to
treat
volume,
electrolyte
and
acid-base
Hypovolemic hyponatremia
, , Addisons disease,
burns, , hypotonic
fluid isotonic NaCl (0.9%)
Euvolemic hyponatremia
syndrome
of
inappropriate
hypoadrenalism,
secretion
hypothyroidism,
polydipsia
renal
of
ADH
failure,
(SIADH),
psychogenic
SIADH Lithium
Demeclocycline (
ADH)
Hypervolemic hyponatremia

CHF, hepatic cirrhosis renal failure
,

dialysis
advanced renal failure
Plasma sodium menopausal women

Estrogen
. moon face glucocorticoid
hydrocortisone
ADH hyponatremia
ACTH sodium retention
Aldosterone
cortisol
hypothyroidism hyponatremia
thyroid
hormone permissive action aldosterone

ADH
E. TSH thyroid
hormones
18.
A. B1
Key concept Thiamine deficiency
. Alcoholics
19.
A. B1
.
alcohol intoxication .
unconscious (hypoglycemia)
IV thiamine (vitamin B1) 50% Dextrose

solution hypertonic solution
. Alcoholic
malnutrition thiamine coenzyme

glucose metabolism
glucose B1
Wernickes encephalopathy
Wernickes encephalopathy time- dependent reversibility
. 40 % residual deficit
Encephalopathy
triads ocular abnormality (primarily horizontal

nystagmus or bilateral sixth nerve palsy), ataxia, and global
confusion
pyridoxine(B6) supplement .
Cirrhosis 50 .
B1
20.
D. myenteric plexus
Recall: anatomy & parasympathetic drugs
Enteric nervous system 2 plexuses:
Meissner
plexus
(submucosal)
sensing
the
environment within the lumen, regulating GI blood flow and

controlling epithelial cell function (secretion)
Auerbachs (myenteric) plexus circular
longitudinal smooth muscle layers tunica muscularis
digestive motility
plexus [myenteric
mys (Greek, ) + enteron (intestine)]

hyoscine (scopolamine)
muscarinic receptor antagonist ( plexus muscarinic
receptor)
21.
B. Neutrophil
Glucocorticoids apoptosis neutrophils
22.
A. hypo K+
Recall: Digitalis Na+/K+ ATPase
hypokalemia receptor toxicity

Furosemide Inhibit Na+,K+,2Cl- cotransport (symport)
thick ascending
limb of Henles loop Na+ tubules
late distal convoluted tubules collecting ducts
aldosterone reabsorb Na+ K+
hypokalemia
23. -
,dehydrate ,
, rifampin
24.D. mifepristone
Mifepristone progesterone and glucocorticoid receptor
antagonist (RU486) emergency contraception
PGE analog early abortion
25.A.
Danazol testosterone side effect
liver dysfunction, virilism (acne,
hirsutism, oily skin, reduced breast size), HDL
side effect irreversible deep voice , enlargement of
the clitoris, increased body hair
25.D. estrogen receptor
Tamoxifen selective estrogen receptor modulator
(SERM) D receptor ( A)
26.A.
DHT
fenasteride -Reductase inhibitors
testosterone dihydrotestosterone (DHT)

27.B.
beta-agonist
Salbutamol beta2 agonist (short acting)
28.A. gualnylate cyclase

Isosorbide dinitrate nitrate angina
NO
cGMP gualnylate cyclase
endothelial vasodilation
29.B.
COX enzyme
Aspirin antiplatelet NSAID COX

TXA2 platelet aggregation
aspirin analgesic
(),antipyretic (),antiinflammation
30.A.
dopamine
sepsis shock ()
mediator vasodilation dopamine
vasoconstriction ( epinephrine
web dopamine BP sepsis)
epinephrine anaphylactic shock steroid
sepsis antiinflam
31.A.
plasmin
Fibrinolytic plasminogen plasmin
fibrin 2 1. Tissue
plasminogen activator alteplase 2. Streptokinase
32. - furosemide ()
diuretic Na K Cl cotransport channel
lumen-positive potential --> -->
lumen -->
Ca, Mg
Thiazide Ca Na/Ca exchange
basolateral membrane Ca
Kayexalate (sodium polystyrene sulfonate)
hypokalemia
33. B. 4 th week
upper limb bud 26
Pharmacology 2007
1. B. T-cell
Cyclosporine immunosuppressant
helper T cell IL ,IFN gramma
2. D. phase IV Clinical trial
Phase IV phase
long term effect
3. A. 5
number needed to treat (NNT)
1
NNT = 1/ARR ARR absolute risk
reduction CER EER CER control group

event rate EER experimental group event rate
60 80 60% 80%
40% 20%
CER 40% 0.4 EER 20%
0.2
NNT = 1/(0.4 - 0.2) = 5
4. D. beta2 agonist
Terbutaline beta2 agonist (short acting)
5. A.
lung compliance
Surfanctant
compliance
6. D. ciplofloxacin ()
Imipemam carbapenam Gram positive
cocci,Gram neg rod ,anaerobe, etc
Gentamicin aminoglycoside Gram neg

aerobe
Erythromycin macrolide Gram + cocci
and bacilli
Ciprofloxacin fluoroquinolone Gram neg
UTI GI
Bactrim beta lactam inhibitor
choice cephalosporine
7. B. PaCO2 55 mmHg
Barbiturate sedative-hypnotic drug overdose
severe respiratory and cardiovascular depression
-
respiratory acidosis PaCO2 HCO3 side effect

liver enzyme inducer, psychomotor dysfunction, CNS
depression
8. C. consistency
epidemiology occupational health
Criteria for determining Causation

1. Temporality: Does the presumed cause precede the
effect?
2. Reversibility: Does removal of a presumed cause lead to
a reduction in the risk of ill-health?
3.
Dose response relationship (dose- effect): Is increased

exposure (dose) to the possible cause associated with
an increased response (i.e. an increased likelihood of an
effect) ?
4. Biological plausibility: Is there a reasonable postulated

biologic mechanism linking the possible cause and the
effect?
5.
Consistency: Have similar results been shown in other

studies?
Elsewhere you can learn how to critical
appraise literature. It follows that if a number of good

studies using different approaches lead to the same
interpretation of a cause-effect relationship it is more
likely to be a valid one.
c. consistency
9. A. 5
max
2 efficacy 5 (duration
)
10. D. glutathione conjugate
N-acetylcysteine
glutathione
paracetamol 98%
conjugate glucuronide sulfate nontoxic
metabolize P-450
mixed function oxidase toxic metabolites

glutathione (GSH)
toxic metabolite paracetamol
paracetamol toxic
metabolites GSH
11. A.
Neisseria meningitides A.

12. A. metformin
Metformin
hepatic gluconeogenesis
glycolysis BMI (
)
13. D. furosemide
hyperkalemia Furosemide
Na/K/Cl channel --> K --> K
( K sparing diuretic)
14. A. inhibit dopaminergic
Haloperinal dopamine neuron
extrapyramidal symptom
adrenergic (alpha)
15. A. oxytocin
Oxytocin
ergotamine

postpartum bleeding bromocriptine

dopamine agonist Parkinson
16. A. plasmin
216
17. B. muscle fasciculation
Carbamet acethylcolinesterase inhibitor

Ach muscarinic nicotinic
Atropine muscarinic receptor antagonist
muscarinic nicotinic neuron NMJ
muscle fasciculation
18. B. Clotimazole
(local) -->
Clotrimazole
19. E. estrogen
--> estrogen
and progesterone --> osteoporosis --> hormone
replacement therapy estrogen (progesterone

osteoporosis)
20. B. Cryoprecipitate
hemophilia A factor VIII
cryoprecipitate factor VIII,XIII
21. E. :Erythromycin ( macrolide)
antibiotic ribosome 50s
Chloramphenical macrolide
Tetracycline ribosome 30s
22. paraquat arsenic
paraquat arsenic herpecide paraquat
GI irritate, pulmonary impairment arsenic
RBC renal failure
Organophosphate insecticide , ethylene glycol

antifreeze , sodium hypochlorite antiseptic pesticide
23. A. Ach esterase
muscarinic parasympathetic

nicotinic NMJ

24. vit K
prothrombin time (PT), prothrombin ratio (PR)
international normalized ratio (INR)
extrinsic pathway of coagulation
warfarin, liver damage and vitamin status.

reference PT 12-15 INR 0.8
-1.2 ( = 0.9 1.3)
warfarin 2.0-3.0
INR
INR
bleeding
ISI
INR = [PT()/PT(normal)]
ISI (International Sensitivity Index) tissue

factor
sensitivity internationally
standardized sample
1.0 1.4
INR extrinsic
pathway Factor VII
half-life

vitamin K

Vitamin K

Platelet blood vessel
(Microbiology)
(Parasitology)
Part Microbiology 2005

1.
5 2 pharynx
submandibular area beta-
hemolytic colony blood agar

bacitracin
A. Haemophilus influenza
B. Coryneacterium diptheriae
C. Streptococcus pyogenes(group A)
D. Mycoplasma pneumoniae
E. Mycobacterium tuberculosis
2.
35 right upper quadrant

1 BT
38 C
A. HBV
B. CMV
C. Entamoeba histolytica
D. Mycobacterium tuberculosis
E. Salmonella typhi
3.
35
antibiotics 10
toxin
A. Salmonella typhi
B. Shigella dysenteriae
C. Escheridchia coli
D. Helicobacter jejuni
E. Clostridium difficile
4.
40 1
cavity at right upper lobe
positive acid fast bacilli
A. cell wall mycolic acid

B. cell wall protein carbohydrate

C. cell wall
D. cytoplasm , ribosome
E.
5.
antrax
spore
A.
B.
C.
D. hydrochoride 400 ppm
spore
E. Phenol 1 %
6.
16
gram positive rods
A. Chlamydia sp.
B. Clostridium sp.
C. Bacterioides sp.
D. Actinomyces sp.
E. Pseudomonas sp.
7.
CSF cell count
A. acanthosis
B. spongiosis
C. ballooning degeneration
D. cyotolysis
E. liquafactive degeneration
8.
8
2
gram positive cocci in chain

complete hemolysis blood agar
A. Staphylococcus aureus
B. Staphylococcus epidermidis
C. Streptococcus pyogenes
D. Streptococcus viridans
E. Streptococcus pneumoniae
9.
30
3-4 24
Gram positive rod spore
A. Botulium toxin
B. Clostidium enterotoxin
C. heat-labile enterotoxin
D. heat-stable enterotoxin
E. toxin c.perfingens type A
10.
specimen
A. pus
B. urine
C. sputum
D. throat swab
E. CSF
11.
30

A.
Vibrio sp.
B.
Shigella sp.
C. Salmonella sp.
D. Campyrobacter jejuni
E.
12.
Yersinia enterocolitica
25
A. Shigella sp.
B. Salmonella enteriditis
C. Clostridium difficile
D. Bacillus cereus
E. Staphylococcus aureus
13.
SLE 3 X-Ray Cavity
Upper Right Lung

modified acid fast
..
A. Norcardia sp.
B. Aspergillus sp.
C. Acitinomyces sp.
D. Streptomyces sp.
14.
antibiotics 10

A. E. coli
B. Clostridium difficile
C. Shigella
15.
3
gram
positive cocci enzyme

A. elastin
B. laminin
C. fibronectin
D. hyaluronic acid
E. collagen type 4
16.
2 alpha-
hemolytic group, diplococci, lancet shape, gram positive

A. Klebseilla pneumoniae
B. Staphylococcus aureus
C. Neisseria meningitidis
D. Streptococcus pneumoniae
E. Pseudomonas aeruginosa
17.
Salmonella typhi reservoir

A. Intestinal lymphatic tissue
B. Gall bladder
C. Liver
D. Spleen
E. Thymus
18.
10
KOH

A. Pityriasis versicolor
B. pediculosis
C. scabiasis
D. larva migrane
E.
19.
eruptive
KOH preparation septate
hyphae

A. Aspergillus sp.
B. Malassezia furfur
C. Exophiala werneckii
D. Trichosporum (Tricophyton sp.?)
E. Candida albicans
20.
Cryptococcal meningitis

A. Ionic
B. lipid solubility
C. anionic acidic
D. low MW
E. low lipid H2O coefficient
21.
20 2 ........
lymphocyte

A. CMV
B. EBV
C. Adenovirus
D. Coxsackie B virus
E. Influenza virus
22.

fecal contamination
A. Salmonella sp.
B.
E.coli
C. Staphylococcus aureus
D. Vibrio cholera
E. Clostridium perfringens
F. Streptococcus fecalis
23.

discharge

A. E.coli
B. Streptococcus group B
C. Neisseria species
D. Lactobacillus species
E. Staphylococcus sp.
24.
20 discharge
gram negative rod

A. E. coli
B. Neisseria gonorrhea
C. Chlarmydia trachomatis
D. Pseudomonas aeruginosa
25.
35 cervicitis
cervical discharge

A. Mobiluncus spp.
B. Lactobacillus spp.
C. Gardnerella vaginalis
D. Chlamydia trachomatis
E. Staphylococcus epidermidis
26. 30 5

sperm analysis

A.
B.
C.

D.
E.
27.

(
)
A.
B.
C.
D.
E.

28.

lymph node
A. Actinomyces israelii
B. Clamydia trachomatis
C. Neisseria gonorrhoeae
D. Treponema pallidum
29.
gram

A. Syphilis
30.

A.
Dientamoeba fragilis
C. Pseudomonas aeruginosa
31.
20

Respiratory epithelium
A. cell lysis
B. cell degeneration
C. mucous production
D. cell fusion and shrinkage
E. cell necrosis and exudates formation
32.
10 pneumonia
gram positive bacteria
(
)
A. Haemophilus influenzae
C
Staphylococcus epidermidis
D. Streptococcus pyogenes
33.
3 Mitral valve
vegetation

A.
Viridans streptococci
C. Staphylococcus epidermidis
34.
Cell count 10,000 (N 90 L 10)

Glucose 30 Protein 80

A. Neisseria meningitidis
B. Haemophilus influenzae
C. Listeria monocytogenes
D. Streptococcus agalactiae

35.
Urinalysis lab
14.00 .
A. 14.30 .
B. 15.00 .
C. 16.00 .
36.
D. 18.00
E. 20.00
25
polymyositis bacterial
coagulase catalase

B.
C. Staphylococcus hemolyticus
D. Staphylococcus pyogenes
E.
37.
Staphylococcus pneumoniae
red vesicle,
erythema and papule 2

histopathology intranuclear halo,
multinucleated giant cell
A. HSV
B. Gonococcal infection
C. CMV
D. Treponema pallidum
E. HPV
38.
20 8 murmur
echo 0.5 cm vegetative mitral 7

Bacteria
A. Enterococcus faecalis
C. Haemophilus aphrophilus
D. Pseudomonas aeruginosa
E. Staphylococcus epidermidis
39.
25 2
Gram +ve diplococci

Pneumonia Criteria sputum gram
strain
Epithelium (/HPF)
A. 10
WBC(/HPF)
40
40.
B. 25
30
C. 30
50
D. 50
10
E. 30
40
Squarmous cell CA cervix

A. Parvovirus
B. Herpes
C. EBV
D. CMV
E. HPV
41.
5 stiffness of
neck CSF WBC 1,200 cell/cu.mm. N 90%

MN 10% protein 150 g/dl sugar 20 g/dl(blood sugar
100)
A. Enterovirus
B. Neagleria floweli
D. Cryptococcus neoformans
42.
2
x-ray ureteral
calculi
A.
Esterichia coli
B.
Proteus mirabilis
C. Enterococus faecalis
D. Krebsiella pneumoniae
E.
43.
Staphylococcus saprophyticus
40

normal flora
A.
Clostridium difficile
B.
Shigella dysenteriae
C. Salmonella enterica
D. Yernisia enterocolitica
E.
44.
Plesiomonas shigelloides

modified acid fast
A.
Nocardia asteroides
B.
Penicillium maneffii
C. Clostidium perfringen
D. Mycobacterium chelone
E.
Streptomyces spp.
45.
30 6

A. E.coli
B.
Vibrio cholerae
C. Shigella
D. Bacillus cereus
E.
46.
Aeromonas hydrophilia
E.coli
Colony forming unit / mL

47.
17
LAB ........., Nitrite +
A. E. coli
B. Enterococcus spp.
C. Trecomonas vaginalis
D. Candida albicans
48.
peritonitis
A. Bacteriodes fragilis
49.
5 stiffness of
neck CSF WBC 1,200 cell/cu.mm. N 90%,
MN 10% protein 150 g/dl, sugar 20 g/dl (blood sugar
100)
A. Enterovirus
B. Naegleria fowleri
C. Neiseria meningitidis
D. Cryptococcus neoformans
50.

A. Erysipelothrix fhusiopathiae
B. Aeromonas hydrophila
Parasitology
Part Parasitology 2005
1.
35
2

2.
40
A. tiiasis Taeniasis
Trichinosis (
Taeniasis solium saginata
)
B. spargadiasis sparganosis
C. gnathostomiasis
D. cystececosis cysticercosis
E. fasicolopiasis fasciolopsiasis
3.
RBC,
WBC ()
A. Isopora belli
B. Giadia lambria
C. E. coli
D. E. histolitica
4.
10 occult blood positive
stool exam

A.
B.
C.
D.

E.
5.
A. praziquentel
C. metronodazol
B. albendazol
D. ivermectin
E. amphotericin B
6.
A. Opisthorchis Viverrini

- scotch tape technique

Microbiology
Parasitology

1.
C. Streptococcus pyogenes (group A)

A. Haemophilus influenza
B. Coryneacterium diptheriae
----
Gram ----
cocobacilli
Gram + bacilli ,
Chinese letter
C. Streptococcus pyogenes (group A)--- Gram + cocci
D. Mycoplasma pneumoniae
bacteria
----
Cell wall-less
----
Acid fast bacilli
-Streptococcus group A Streptococcus

pyogenes
Blood agar
( -hemolysis)
Lancefield group B
Acute (Suppurative) Streptococcus pyogenes Infection

1. Pharyngitis
anterior cervical lymph node
2. Scarlet fever skin infection

24 . sandpaper rash, circumoral pallors,
(strawberry
tongue)
3. Pyoderma/impetigo
cellulitis
Complication
infection
1. Rheumatic fever
pharyngitis autoantibody
molecular mimicry
hypersensitivity
type II (cell-mediated type) antibody

heart tissue

pericarditis , endocarditis , myocarditis erythema
marginatum (chorea later)
2. Acute glomerulonepritis (M12 serotype)
pharyngitis
skin infection
autoantibody molecular mimicry

hypersensitivity type III immune
complexes glomeruli pulmonary edema
hypertension dark urine
Streptococcus pyogenes
catalase (Staphylococcus ) lysis Blood agar
-hemolysis bacitracin ( sensitive
bacitracin) positive pyrrolidonyl

arylamidase (PYR) test
1.
M-protein
antiphagocytosis
2.
Hyaluronic capsule (polysaccharide)

antiphagocytosis non-immunogenic
3.
Erythrogenic toxin (Streptococcal pyrogenic exotoxin)

exotoxin 3
A, B C A

-
toxin phage (lysogenic phage)

phage-encoded
(scarlet fever)
(Strawberry tongue)
endotoxin
superantigen helper
T cells T cell
receptor (TCR) MHC class II markers
processes antigen
4.
Streptolysin S non-immunogenic

hemolysin cytolysin
Streptolysin S
Blood
agar
5.
Streptolysin O immunogenic
hemolysin
cytolysin toxin

Rheumatic fever
6.
Hyaluronidase hydrolyzed ground substances

connective tissue
7.
2.
Spreading factors Streptokinase, DNAse
C. Entamoeba histolytica
Salmonella sp.
Entamoeba histolytica
10 % 90
% amoebiasis
3
-
Trophozoite
Precyst
Cyst
1.
Trophozoite
Vagetative form

10-30 normal saline
pseudopodia
cytoplasm
cytoplasm
ectoplasm endoplasm
granule
NSS iron hematoxylin

2. Precyst
(chromatoidal bar)
ribonucleic acid
acid
deoxyribonucleic
and phosphate
3.
Cyst
5 -20
cyst 1-4
cytoplasm
Chromatoid body
2
1. (Intestinal amoebiasis)
2. (Extraintestinal amoebiasis)
1. (Intestinal amoebiasis)
1.1 Acute amoebiasis
Mature cyst
Excystation amoeba 4 binary

fusion
8 invade
hyalunidase mucosa
mucosa submucosa

submucosa
(Flash shape)

electrolyte
1.2 Chronic amoebiasis

acute amoebiasis
- Amoeboma
E.histolytica
cyst
E.histolytica
- Peritonitis
- (Hemorrhage)
- (Appendciitis)
- Stricture
granuloma
(Diagnosis)
- Trophozoite cyst E.histolytica
- Proctoscope sigmoidoscope
- serology ELISA,
CIEP,IHA,IFA Latex agglutination test,Precipitin test
,Complement fixation test
2. (Extraintestinal amoebiasis)
trophozoite E.histolytica
3
1. Haematogenosus portal circulation
2. Lymphatic
3. Direct extension hepatic flexure
colon
- Amoebic liver abscess

- Cutaneous and genital amoebiasis
- Pulmonary amoebiasis
- Cerebral amoebiasis
- Spleenic abscess
3.
E. Clostridium difficile
A. Salmonella typhi
(rare case)
B. Shigella dysenteriae
(rare case)
E. Clostridium difficile (most case)

Pseudomembranous colitis ()
Clostridium difficile gram-positive,
spore-forming, anaerobic bacillus
Clindamycin, lincomycin, ampicillin, or
cephalosporin Clostridium difficile

95 5 rare case
Staphylococcus aureus, Salmonella species, Clostridium
perfringens, Yersinia species, Shigella species, Campylobacter
species, cytomegalovirus, Entamoeba histolytica, Listeria
species.
pseudomembranous colitis
pseudomembrane
offensive-smelling diarrhea,
fever, abdominal pain toxic
megacolon
4.
A. cell wall mycolic acid

Mycobacterium obligate aerobe
lipids long
chain fatty acids mycolic acids
(Acid fast)
1. Mycobacterium tuberculosis complex (tubercle bacilli)

(Tuberculosis)

(droplet)
M. tuberculosis, M. africanum M.
bovis ( BCG)
facultative intracellular bacteria

serpentine cord cord
formation

1. (pulmonary tuberculosis)
85%
2. (extrapulmonary
tuberculosis) 15%

military tuberculosis

toxin exotoxin endotoxin
facultative intracellular organism
1. Sulfatides (sulfolipids cell envelope)

phagosome-lysosomal fusion
phagocyte
2. Cord factor (trehalose di-mycolate)
-
serpentine growth
-
neutrophil

- mitochondrial respiration oxidative
phosphorylation
3. Lipoarabinomannan (LAM)
-
- (free radical)

IFN-
4. Mycolic acid

5. Antigen 85 complex mycolyltransferase enzyme

TH1
**Tuberculin (purified
protein derivative, PPD) delayed
hypersensitivity (Type IV) CMI
2. Mycobacteria other than tuberculosis (MOTTS)
Non-tuberculous Mycobacteria (Atypical Mycobacteria)

Runyon grouping
2.1 M.
kansasii Photochromogen pigment
(carotenoids) pigment
2.2 M.
scrofulaceum Scotochromogens pigment
(carotenoids)
2.3 M.
avium-intracellulare Non-chromogens
pigment
3. Mycobacterium leprae
(leprosy Hansens disease) obligate intracellular
pathogen ()
3-5
M. leprae
Histiocyte
Schwan cells
5.
A.

Anthrax
Prevention & control :
1. Disposal of animal carcasses by burning or by deep

burial in lime pits
2. Decontamination of animal products (by autoclave)
3.
Protective clothing & gloves for handling potentially

infected materials
4.
Active immunization of domestic animals with

attenuated vaccine & person with high occupational
risk should be immunized
6.
B. Clostridium sp.
A. Chlamydia sp.
>>
B. Clostridium sp. >> Gram + bacilli

C. Bacterioides sp. >> Gram - bacilli
D. Actinomyces sp. >> Gram + bacilli
E. Pseudomonas sp >> Gram bacilli
Clostridium
sp. Actinomyces sp. ( actinomycosis
Granulomatous ulcer
sulfur granule )
lesion Clostridium
Clostridium perfringens anaerobic bacteria

direct smear
( subterminal
) capsule direct smear
Blood agar
swarming 2
(complete hemolysis)
theta toxin ( )
alpha toxin ()
myonecrosis phospholipase C
Clostridium perfringens
5%
7. ()
8.
C. Streptococcus pyogenes
1
9.
D. heat-stable enterotoxin
A. Botulium toxin
>>

B. Clostidium enterotoxin
>>
C. heat-labile enterotoxin
>>
toxin
D. heat-stable enterotoxin >>
B.cereus S.aereus
E. toxin c.perfingens type A >>
7-15 30
Staphylococcus
aereus
food poisoning:
2-8 .
emetic enterotoxin B. cereus

(G+ bacilli, spore)
heat stable enterotoxin ( heat 100 C, 30 min &
acid in stomach)
Bacillus cereus
Gastroenteritis (food poisoning):

2
-
Emetic form:
heat stable enterotoxin
1-6 (~2 .)
( intoxication)

8-10 . food
poisoning entrotoxin A S. aureus
-
Diarrheal form:

heat-labile enterotoxin
6 . (~9 .) 24
.
heat-labile enterotoxin E. coli
food poisoning entrotoxin Cl. perfringens

type A ()
10.
E. CSF
CSF room temperature

Neisseria meningitidis
11.
A. Vibrio sp.

7 14
2
1. Acute watery diarrhea
enterotoxigenic E. coli (ETEC),
enteropathogenic E. coli (EPEC), enteroaggregative E. coli
(EAEC), Vibrio cholerae
2. Acute invasive diarrhea

Shigella, Salmonella, Campyrobacter, enteroinvasive
E.coli (EIEC), enterohemorrhagic E.coli (EHEC), Clostridium
difficile, Yersinia enterocolitica
Vibrio cholerae
1-5
V. cholerae
(darting movement) Oxidase

: Vibrio parahaemolyticus

NaCI 0.5 - 8%
10 -10
10 12

4 96

2 5

12. B. Salmonella enteriditis

Salmonella Salmonellosis

Salmonella enteriditis

Salmonella
Regulation (EC) No 2160/2003 of the

European Parliament and of the Council of 17 November
2003 on the control of Salmonella and other specified foodborne zoonotic
12 2546
(.. 2003)

Regulation (EC) No 2160/2003 of the
European Parliament and of the Council of 17 November
2003 on the control of Salmonella and other specified food-
borne zoonotic
Salmonella
(primary production)
(zoonoses) EU
(live poultry)
(hatching eggs) (national control
programmes)
Commission Regulation (EC) No
1003/2005 30 June 2005 implementing Regulation (EC)
No 2160/2003 as regards a Community target
salmonella serotypes -
amending Regulation (EC) No
2160/2003 Salmonella

Salmonella 5
Salmonella enteritidis, Salmonella hadar, Salmonella
infantis, Salmonella typhimurium Salmonella vircho
A. Norcardia sp.
13.
A. Norcardia sp. modified acid fast
C. Acitinomyces sp. modified acid fast

D. Streptomyces sp. modified acid fast
Norcardia
sp.

Norcardia
sp.
1. Pulmonary nocardiosis: Immunocompromised

host

, necrotzing
pneumonia, lung abscess, granuloma, Cavitation
2.
Cutaneous nocardiosis:
- Mycetoma: , , sulfur granule
-
N. brasiliensis (Modified acid-fast)
Anaerobic actinomycetes: Streptomyces &
Actinomyces (Non acid-fast)

- Lymphocutaneous infection:

- Superficial cutaneous infection:

nd
- 2
cutaneous infection:

14.
B. Clostridium difficile
3
15.
D. hyaluronic acid
Staphylococcus aureus
gram positive cocci
in clusters , Coagulase-positive Catalase-positive

Virulence
factors
1. Antigens
- Capsule
- Adhesins
2. Enzymes
- Coagulase
- Catalase
- Lipase
>>
- Hyaluronidase
>>>>
Hyaluronic
connective tissue

- Staphylokinase
plasmin
>>
plasminogen
fibrin
-lactamase
>>
lactams
3. Toxin
Cytotoxin
Exfoliative toxin
Toxic shock syndrome toxin-1
Enterotoxin
Impetigo:

Folliculitis:
Furuncle:
Carbuncle:
furuncle
Wound infection:
Staphylococcal scalded skin syndrome (SSSS):

Exfoliative toxin

WBC
Bullous Impetigo:
SSSS

16.
A. Klebseilla pneumoniae
>>>>
Gram - bacilli
>>>>
Gram + cocci in
>>>>
Gram - diplococci
cluster
diplococci
>>>> Gram +
E. Pseudomonas aeruginosa
>>>> Gram - bacilli
Streptococcus pneumonia

(Gram positive diplococcic)

lancet-shaped
blood agar
(-hemolysis)

(mucoid colony)

optochin ( Viridans streptococci resistant)
bile-soluble
normal flora
5-70
(immunocompromised
host)

lobar pneumonia rusty
sputum ()

(

)

bacterial pneumonia 80-90
17.
B. Gall bladder
Salmonella typhi
Salmonella
typhi

Triple Sugar Iron Agar (TSI)

S. Paratyphi A

TSI

10

endotoxin

18.
C. scabiasis
(Scabiasis)
Sarcoptes

Scabies is a human skin infestation caused by the
penetration of the obligate human parasitic mite Sarcoptes
scabiei var. hominis into the epidermis. After the initial
exposure to the scabies mite, the pruritus and rash may take
up to 6 to 8 weeks to develop. Subsequent exposure to the
mite results in the itching and the rash developing within a
couple days, probably due to prior sensitization to the
scabies mite. The itching is severe and usually worst at
night. The lesions appear as red, scaly, sometimes
crusted
(excoriated) papules and nodules that favor the interdigital

webs sides of the fingers, volar aspects of the wrists and
lateral palms , elbows, axillae, scrotum, penis labia, and the
areolae in women. A diffuse erythematous eruption on the
trunk may be present and represents a hypersensitivity
reaction to mite antigen. The pathognomonic lesion is a
burrow, which is a thin, thread-like, linear structure that is 1
to 10 mm in length, and is a tunnel caused by the

movement of the mite in the stratum corneum. The burrow is
best seen in the interdigital webs, wrists, or elbows.
However, it can be difficult to find in early cases of the
condition, or after the patient has extensively excoriated the
lesions. Identification of a burrow can be facilitated by
rubbing a black felt-tip marker across an affected area. After
the excess ink is wiped away with an alcohol pad, the
burrow appears darker than the surrounding skin due to ink
accumulation in the burrow.
Lice

Pediculosis
Pediculus Humanus Capitis (Head Louse)
Pediculus Humanus Corporis (Body Louse)
Pthirus Pubis (Pubic Louse)
larva migrans
A larval worm, typically a nematode, that
wanders in the host tissues

but does not develop to the adult stage.
Cutaneous larva migrans may cause mild respiratory

symptoms and be associated with transient pulmonary
infiltrates and a peripheral eosinophilia (Lffler's syndrome).
Visceral larva migrans, or toxocariasis, may lead to
granulomatous involvement of the liver, lungs, heart, muscle,
brain, and eyes. Marked eosinophilia, hyperglobulinemia,
pneumonitis with wheezing, recurrent bronchitis, fever, and
tender hepatomegaly frequently occur. Skin lesions may
present as patchy urticaria or erythematous papular eruptions.
19.
C. Exophiala werneckii
septate hyphae
: Exophiala werneckii

Tinea nigra

stratum corneum

KOH preparation

(septate hyphae)

Candida albicans yeastlike fungi

cutaneous

satellite KOH
preparation budding yeast cells
pseudohyphae
epithelial cells
20.
B. lipid solubility
21.
D. Coxsackie B virus
lymphocyte
Coxsackie B virus Enterovirus, Family

Picornaviridae RNA

(Aseptic meningitis)

(Myocarditis)

(pleurodynia Bornholms disease)

22.
B. E.coli

faecal coliform
fecal contamination

Escherichia

Enterobacter, Klebsiella, Citrobacter
faecal coliform ( lactose fermenter)
facultatively-anaerobic, rod-shaped, gram-negative, non-
sporulating bacteria
bile salts oxidase negative,
lactose 48 . 44 0.5C.
23.
D. Lactobacillus species
Lactobacillus non-spore forming gram
positive bacilli ( aerobic bacteria)
pH 5.5-5.8

E. coli

enteric bacteria
24.
A. Escherichia coli
A. E. coli
>>>> Gram - bacilli
B. Neisseria gonorrhea
>>>> Gram - diplococci
C. Chlarmydia trachomatis
>>>>
D. Pseudomonas aeruginosa >>>> Gram bacilli

E. coli

(cystitis),

ascending infection E. coli

25.
D. Chlamydia trachomatis

cervicitis (, inflamed
cervix
mucopurulent discharge)
Neisseria gonorrhoeae (Gram-negative

diplococci), Chlamydia trachomatis (non-staining obligate
intracellular parasite) Herpes simplex virus

: Bacterial vaginosis (BV)
Gardnerella vaginalis ( weakly gram positive

negative thin gram variable bacilli
coccobacilli gram positive

bacilli)
anaerobes
Nonspecific vaginitis, Gardnerella vaginitis,

Amine vaginitis

BV

amine
cadaverine putrescine
BV
Gardnerella vaginalis

BV 3 4

2.
pH 4.5
1.
4.7 - 5.7

pH

10% Potassium hydroxide
3.
whiff test
whiff test
86 - 90
4.
clue cells
wet smear ( PMN)

clue cells epithelial cells Gardnerella
vaginalis gram variable coccobacilli
clue
cells 20 epithelial
cells clue cells
gram stain
clue
cells
BV
anaerobes
lactobacilli BV

1.
Metronidazole
500 2
7 Metronidazole
200
200 2
2
2.
Metronidazole gel 0.75% 5
1 - 2 5
3.
Metronidazole 2
Metronidazole
BV

anaerobes lactobacilli
Metronidazole
24

75 84
Clindamycin
1.
Clindamycin cream 2% 5
7
2.
Clindamycin 300
2 7
Metronidazole
Metronidazole
Metronidazole
3.
Clindamycin ovules 100
3

clindamycin
lactobacilli anaerobes
BV
Metronidazole
BV
- Pelvic
inflammatory disease (PID), postabortal PID, post operative
cuff infections after hysterectomy abnormal cervical
cytology

premature rupture of membranes, preterm labor and delivery,
chorioamnionitis postcesarean endometritis

BV

Gardnerella vaginalis

Gardnerella
vaginalis low grade pathogen

26.
E.
27.
D.
28.
B. Chlamydia trachomatis
Chalmydia trachomatis
oblingate intracellular bacteria

cytoplasmic inclusion

iodine

Chalmydia trachomatis

trachoma (), inclusion conjunctivitis (

), neonatal pneumonia, urethritis, epididymitis,
prostatitis, endometritis, cervicitis, salpingitis
lymphogranuloma venereum
lymphogranuloma venereum lymphogranuloma
inguinale

() 1-4

herpetiform vesicle
2-3 1 2
(inguinal lymphnodes) (venereal bubo)
perirectal lymphnodes

systemic

Treponema pallidum

(inguinal lymph node)

: 2
1. (early syphilis)

1.1 1 (primary syphilis) 9

- 90

12
.

(Chancre)

(inguinal lymph node)

3 8

2
1.2 2 (secondary syphilis)
1 6 8
2

(cervical, epitroclear, inguinal)
VDRL/RPR reactive

1.
(skin rash)

(macule)
(papule)
(pustule)
(papulosquamous)

maculopapular papulosquamous

2.

(condyloma
lata)
3.

(mucous patch)

4. (alopecia)

(moth-eaten alopecia)

(diffuse alopecia)
2

1.3 (latent syphilis)

VDRL RPR
TPHA FTA-ABS reactive 2
early latent syphilis
2 late
latent syphilis
2

VDRL non
reactive TPHA FTA-ABS reactive
2. (late syphilis)
1 3

2.1 (benign late syphilis)

gumma
tissue necrosis
granuloma

2.2
(cardiovascular syphilis)

(aorta)

2.3 (neurosyphilis)

(asymptomatic neurosyphilis)

VDRL FTA-ABS TPHA
reactive

meningovascular syphilis, tabes

dorsalis general paralysis of insane (GPI)
(congenital syphilis)

VDRL reactive VDRL reactive

2

2

30
2

1. (early congenital syphilis)
1

2 3
(prolonged jaundice)

2
(pseudo paralysis) osteochondritis
epiphyseal separation

(nephrotic syndrome)

rhagades

2. (late congenital syphilis)

2

(interstitial keratitis)

(Hutchinsons teeth)

1 3

29.
A. Syphilis
Treponema pallidum (gram negative)
Spirochaetaceae
anaerobe microaerophile
6-14

(darkfieid microscope)
contrast
phase
outer sheath
glycosaminoglycan
42
T.pallidum
subsp. Pallidum

30.
(
syphilis
28)
D. Clostridium perfringens
Clostridium perfringens anaerobic bacteia

Clostridial myonecrosis (gas gangrene)

( )

24-48 .
15-30
:
Pigmented Prevotella, Prevotella melaninogenica
Prevotella intermedia ( Bacteroides
melaninogenicus group) normal oral vaginal florae
predominant anaerobic gram-negative bacilli
(AGNB) respiratory tract infections
aspiration pneumonia, lung abscess, chronic otitis
media, chronic sinusitis, abscesses around the oral cavity,
human bites, paronychia, brain abscesses, and osteomyelitis.
Prevotella bivia Prevotella disiens (

Bacteroides) obstetric gynecologic
infections
31. E. cell
32.
necrosis and exudates formation
B. Staphylococcus aureus,
pneumoniae
E. Streptococcus
Pneumonia

Streptococcus, Staphylococcus,
Pseudomonas, Haemophilus, Chlamydia Mycoplasma,

1. Streptococcus pneumonia

(Gram positive diplococcic)
blood agar
(-hemolysis)

(mucoid colony)
optochin bile-soluble
normal flora
5-70

(immunocompromised host)

lobar pneumonia
rusty sputum ()
(

)
bacterial pneumonia
80-90
2. Staphylococcus aureus

33.
Staphylococcus aureus (catalase coagulase
positive)
acute endocarditis
(
Staphylococcus epidermidis)
heart murmur () leukocytosis
Staphylococcus epidermidis (catalase positive

coagulase negative)
novobiocin normal

acute endocarditis

prostatic device
: Viridans streptococci

C-carbohydrate capsule antigen (

optochin bile-soluble)

Streptococcus mitis, Streptococcus mutans, Streptococcus
sanguis (-
hemolysis) (non-hemolysis)
34.
A. Neisseria
meningitis
CNS
3 young adult
B. Haemophilus influenzae
CNS
6 2
CNS
renal transplant
CNS
E. Streptococcus pneumonae
CNS
2
young adult elderly
CNS 2

E. coli Streptococcus agalactiae
(gram positive cocci) Listeria monocytogenes
()
Streptococcus agalactiae gram positive cocci

blood agar
(-hemolysis) lancefield group b
bacitracin
hippurate camp test

normal flora vagina 15-20%
capsule -hemolysin
neonatal septicemia meningitis

E. coli
Listeria monocytogenes non-spore forming

gram positive coccobacilli facultative intracellular
pathogen listeriosis
1.

2.

granuloma

3.


35.
C. 16.00 .
Urinary tract specimens
Transporting the specimen within 2 hours otherwise

o
refrigerating at 4 C
36.
>>>> Gram + cocci ,
catalase coagulase positive
B.
catalase +
>>>> Gram + cocci ,
, coagulase -
C. Staphylococcus hemolyticus
D. Staphylococcus pyogenes
E.
Staphylococcus pneumoniae
C-E Streptococcus sp.
Streptococcus sp.
catalase
Staphylococcus aureus (catalase coagulase
positive)

(osteomyelitis)

metaphysic

37.
A. HSV
Herpes simplex virus (HSV)

2 Herpes simplex virus type 1
(HSV-1)
Herpes simplex virus type 2 (HSV-2)

(localized infection)
(systemic infection)

HSV gingivostomatitis, herpes
labialis, herpes genitalia, herpes keratoconjunctivitis, herpes
encephalitis, neonatal herpes infection

herpes

ganglia

20-40

80

herpes simplex

Primary Infection
Latency and Shedding
Recurring Infections
Primary Infection

2-3
24

2-3

Latency and Shedding

Recurring Infections

5

herpes simplex
herpes simplex
(HSV-1)
(HSV-2)
4-5
oral sex
type 1

HSV-2

herpes simplex
herpes simplex

Herpes Encephalitis Latency
Herpes Meningitis 4-8 primary

genital HSV-2
2-7
steroid
herpes simplex
Tzanck smear
multinucleated giant cells
38.
C. Haemophilus aphrophilus
Haemophilus aphrophilus gram negative
coccobacilli
X factor
( Haemophilus X V factors)
CO2 (
Haemophilus CO2 )
: HACEK organism Gram negative

bacteria
endocarditis
Haemophilus aphrophilus, Haemophilus parainfluenzae

Haemophilus paraphrophilus
Actinobacillus actinomycetemcomitans
Cardiobacterium hominis
Eikenella corrodens
Kingella kingae
All of these organisms are part of the normal oropharyngeal

flora which grow slowly, prefer a carbon dioxideenriched
atmosphere and share an enhanced capacity to produce
endocardial infections, especially in young children.
Collectivelly, they account for 5-10% of cases of infective
endocarditis involving native valves and are the most
common gram-negative cause of endocarditis among people
who do not use IV drugs. Because of their fastidious growth
requirements, they have been a frequent cause of culturenegative endocarditis. Culture negative refers to its inability to
produce a colony on regular agar plates, this is because they
are fastidious (require a specific nutrient).
In addition to valvular infections in the heart, they can also
produce other infections such as bacteremia, abscess,
peritonitis, otitis media, conjunctivitis, pneumonia, arthritis and
osteomyelitis, and periodontal infections.
The treatment of choice for HACEK organisms in endocarditis

is ceftriaxone, a cephalosporin antibiotic.
Enterococcus spp.
facultative anaerobe
group D streptococci ..2527

nucleic acid
Enterococcus
genus

Enterococcus faecalis Enterococcus faecium
Enterococcus spp.
Staphylococcus
spp.
(hospital acquired
community acquired
and
infection)
(infective
endocarditis)

Enterococcus spp.
cephalosporins

Enterococcus spp.

penicillin
ampicillin, aminoglycosides glycopeptides
vancomycin
Enterococcus faecalis
(endocarditis) (fatigue),
(weakness), , ,
(anorexia), (myalgias),
(murmur)
E. faecalis endocarditis
(biliary infection)
(urinary tract) genitourinary tract
manipulation ( )

E. faecalis 6.5%, ph 9.6

gamma-hemolysis (-hemolysis).

penicillin

E. faecalis non-motile microorganism

facultatively anaerobic, ferments glucose
gas, negative catalase test
reduction of litmus milk liquefy
gelatin.
39.
A. Epithelium 10 /HPF
WBC 40/HPF
Sputum specimens with > 25 leukocytes and < 10

squamous epithelial cells per low-powerfield (10x objective)
are ideal.
Adequate specimen
- Less than 10 squamous epithelial cells per low-power
field
- Present of 25 or more PMN per low-power field
Inadequate specimen
- More than 10 squamous epithelial cells per low-power
field
40.
E. HPV
human papillomavirus (HPV) dsDNA
envelope
41.
C. Neisseria meningitides
lab WBC 1200
cell/cu.mm.[] N 90% [] MN 10% Protein 150 g/dl []

Sugar 20 g/dl [] criteria
bact. bact. 2 Neisseria
meningitides S. pneumonia lab
common sense
stiffness of neck
meningitis ( - -)
42.
B.
Proteus mirabilis
Proteus urinary
tract infection ( E. coli) Non-lactose-fermenter
swarming colony
Urease
kidney stones staghorn
renal calculi ( )
43.
A.
Clostridium difficile

Normal flora Clostridium difficile
enterotoxin (toxin A) cytotoxin (toxin B)
mucosa diarrhea psudomembranous
colitis
44.
E. Streptomyces spp.
Keyword
Mycetoma
modified acid fast

modified acid fast
A.
Nocardia asteroids (modified
acid fast) B. Penicillium maneffii () D.

Mycobacterium chelone (modified acid fast)
2 C.
Clostidium
perfringen (.
gas gangrene )
Streptomyces somaliensis
anaerobic actinomycetes
modified acid fast (non-
acid fast bacteria) Nocardia asteroids

modified acid fast
Mycetoma
dermis subcutaneous tissue
granulomatous inflammation
3
1.
2.
3.
(Tumefaction)

(multiple sinus tract)
(grain)
Mycetoma chronic subcutaneous infection

actinomycetes
granulomatous inflammatory response dermis
subcutaneous tissue Mycetoma
grains
multiple sinuses
Mycetoma microaerophilic actinomycetes
actinomycetoma mycetoma true
fungi eumycetoma
45.
D. Bacillus cereus
Keyword
Bacillus cereus
46.
100 CFU/ml
105 CFU/ml in a midstream urine specimen is reliably
associated with infection.
In women with acute dysuria, 100 CFU/ml correlates

with infection (Stamm WE. et al., 1982 N Engl J Med).
Any bacteria found in a specimen from supra-pubic
aspirate may be significant.
47.
A. E. coli
(Nitrite) positive
(
E. coli )
E. coli

(cystitis),
ascending infection
E. coli

48.
A. Bacteriodes fragilis ( 55+ )

Peritonitis 3
1.
Spontaneous bacterial peritonitis E. coli
2.
Secondary bacterial peritonitis E. coli

Bacteriodes fragilis ( anaerobes)
3.
Peritonitis
Staphylococcus sp. S. aureus
49.
C. Neiseria meningitides

50. A. Erysipelothrix fhusiopathiae

Erysipelothrix fhusiopathiae
(pleomorphic)

facultative anaerobe co2 5-10%
blood agar

(-hemolysis) viridians
streptococci

neuraminidase
1. D. Gnatostoma spinigerum keyword

2. A.
Taeniasis Trichinosis
(
keyword )
A
Taeniasis solium Taenia solium

cysticercus cellulosae
Trichinosis Trichinella spiralis

( )

sparganosis
Genus spirometra
gnathostomiasis Gnathostoma
spinigerum

Cysticercosis

cysticercus cellulosae
fasciolopsiasis
(metacercaria)

3. D. Entamoeba histolitica
Keyword
RBC

4.
A.

) Necator americanus
Ancylostoma duodenale
hypochromic microcytic anemia

filariform

5.
larva
B. albendazol
Trichuris trichiura (?
) albendazole mebendazole,
albendazole
Ascariasis, Trichuriasis, Hookworm
Pinworm ( Praziquantel ,
Metronidazole Amoebiasis,
Trichomoniasis,
Ivermectin
strongyloidiasis onchocerciasis,
amphotericin B
Primary amoebic
meningoencephalitis (PAM) Naegleria fowleri
6.
A. Opisthorchis viverrini

Opisthorchis viverrini
(Metacercaria)

suckers (desquamation)
(hyperplasia)

(cholecystitis)
(cholelithiasis)
(Hepatocarcinoma)
(Cholangiocarcinoma)

-
Enterobius
vermicularis scotch tape

technique

(Immunology)
Part Immunology 2005

1.
3
vaccine antibody response chiken pox
measle
A. neutrophil
B. macrophage
C. T-lymphocyte
D. B- lymphocyte
E. eosinophil
2.
immunoglobulin immuno eletrophoresis
agar
A. adsorption
B. precipitation
C. opsonisation
D. agglutination
E. hemeagglution
3.
25
Ig
A. IgG
B. IgA
C. IgM
D. IgD
E. IgE
4.
25 2
2 Rh
2
A. Rh -
Rh
B. Rh -
Rh +
C. Rh +
Rh
D. Rh -
Rh- Rh+
E. Rh +
Rh- Rh+
5.
30 autoimmune thrombocytopenic purpura
immune complex macrophage Ab

complex
A. Fc
B. Fab
C. CH1domain
D. CH2domain
E. Ringe region
6.
T-cell organ
A. liver
B. spleen
C. lymph node
D. bone marrow
E. thymus gland
7.
renal transplant
graft rejection
A. HLA-A
B. HLA-B
C. HLA-C
D. HLA-DR
E. factor B
8.
(fetus) graft
A. isograft
B. allograft
C. autograft
D. xenograft
E. heterograft
9.
30 2
rheumatoid factor positive rheumatoid

factor antibody
A. complement
B. nuclear antigen
C. IgM
D. cartilage
E. synovial membrane
10.
10 vaccine diphtheria
tetanus- pertussis 5
tetanus toxoid

A. antigen
B. antibody
C. antibody
D.
antibody
E.
11.
antibody
vaccine
A. tetanus toxoid
B. rubella vaccine
C. hepatitis B vaccine
D. rabies vaccine
E. pneumococcal vaccine
12.
30 HIV
3
3 infiltration

Giemsa intracystic body

A. eosinophil
B. neutrophil
C. antibody
D. complement
E. T-lymphocyte
13.
19 booster
6
24 hr.

A. histamine
B. complement
C. Langerhans cell
D. mononuclear cell
E. immunoglobulin M
14.
19 tetanus antitoxoid
booster 6 .
mediator
A. histamine
B. complement
C. IgM
D. mononuclear cell
E. Langerhans cell
15.
3 measle Ab
Ab
A. matrix
B. neucleocapsid
C. hemoflutinin
D. non structural
E. polymerase
16.
17
12
A. tetanus anti-toxin
B. tetanus Ig
C. 2
D. tetaus anti-toxin and adjuvant therapy

E.
17.
20 -thalassemia-HbE disease
1 culture Streptococcus pneumoniae

A. neutrophilicfunction
B. T cell activation
C. complement
D. opsonization
18.
cocci in chain latex brad
A. IgG and fibrinogen

B. factor VII and prothrombin
C. C3b and fibrinogen
19.
A Rh+ fresh frozen plasma

1.
DPT tetanus toxoid
A.
Ag
B.
Ab
C. Ab
D. Ab
2. 30 1

chest film Lobar pneumonia
right lower lobe culture Strep pneumo

A. Opsonization
B. Complement
C. T cell activation
D. PMN function
E. Antibody production
3.
bone marrow transplantation
cyclosporine

A. Macrophage
B. B-lymphocyte
C. T-lymphocyte
D. neutrophil
4.
A. Immunogenicity
B. Viral associated antigen
C. Unique oncofetal antigen
D. Mutate oncogene product
E. Upregulation MHC class II molecule
5.
20
penicillin
BP 90/60
Wheezing
penicillin
A. hapten
B. antigen
C. adjuvant
D. Immunogen
E. Immunogen regulator
6.
antiserum
type
A. hypersensitivity type I
B. hypersensitivity type II
C. hypersensitivity type III
D. hypersensitivity type IV
7.
30 1
A. I
B. II
C. III
D. IV
8.
15

1 hr

immune
A. IgE Mast cell
B. antigen-antibody complex
C. cytokine macrophage
D. immunoglobulin B- lymphocyte
E. antibody protein dermo-epidermal junction
9.
20

1

A. Cytolysis
B. Spongiosis
C. Acantholysis
D. Ballooning degeneration
E. Liquefaction degeneration
10.
1 O ,
Rh+ A , Rh+

A. IgG
B. T-cell
C. NK-cell
D. Macrophage
E. Complement
11.
X

protein
bacteria

enz. Transpeptidyl ribosome
A. 30s
B. 40s
C. 60s
D. 70s
E. 80s
12. Spherocyte Coomb test negative

1.

antinuclear ab titer 1:512
diagnosis
A. anti ds DNA ab.
B. SER
C. CD4 T-cell
D. CBC
E. ANA
2.
30 silicone 1
A. Basophil
B. Eosinophil
C. Histiocyte
D. Neutrophil
E. Plasma cell
3.
30 erythrematous plaque,
cell mediator
A. Basophil
B. Eosinophil
C. Macrophage
D. Neutrophil
E. Lymphocyte
4.
4 tuberculin test
A. antibiotic
B. helper T cell
C. B lymphocyte
D. Innate immunity
E. Complement activation
5.
5 nephrotic syndrome
prednisolone 1
vaccine
A. tetanus toxoid
B. varizella vaccine
C. influenza vaccine
D. hepatitis B vaccine
E. Japanese encephalitis vaccine
6.
30 SLE corticosteroid
bacteria infection
A. ingestion
B. attachment
C. chemotaxis
D. degranulation
E. lysosome production
2008
. 50 MCV 120

A. Folate deficiency
B.
B12 deficiency
C. Intrinsic factor deficiency

. WBC IgM IgG IgA
A. B-Cell
B. T-Cell actiuation
C.Opsonization
. 10 Acute Viral Myocarditis
A. Mast cell
B. Neutrophil
C. Eosinophil
D.Lymphocyte
. latex 4
A. I
B. II
C. III
D.IV
. 40
promyeloblast, band 12%, plt 600,000
. 35 renal transplantation
graft rejection
A. Plasma cell
B. T cell
C. B cell
D. Antibody
E. Mast cell
. HBV 1 HBsAg
positive, anti-HBcIgM negative, anti-HBs negative
A. Phagocytosis
B. Mast cell degranulation
C. Cytotoxic T cell
D.
E. Antibody-cytotoxic T cell mediate
.

A. Monocyte
B. Neutrophil
C. Eosinophil
D. Lymphocyte
. granulomatous nonseptate hyphae
A.
Rhizopus spp.
B.Histoplasma capsulatum
. enteric fever
. macrocyte anemia
A. trancobalamin
B. ferrous
C. folic acid
D. intrinsic factor
. gram positive cocci cluster

small gram negative bacilli
. infiltative diffuse
. abscess

A. Bacteroides fragilis
B. Klebsiella pneumoniae
C. Pseudomonas aeruginosa
D.Streptococcus pneumoniae
. intracellulat fission
. giemsa
Cryptospora
stain
.
. aseptum eosiphilic infiltative
. PCR 4 lane autosomal recessive

lane carrier
. (
) (
. CSF lym glucose protein (

)
A. viral infection
B. TB infection
C. parasite infection
.
.
AB
. HLA B 27
Lumbar sacrum
. RS cell

. hydrop fetalis
( )
1. alpha chain
2. beta chain
. WBC 14,000 plt 1,000,000

1. megakaryocyte
2. myeloid cell
. basophilic stripping
. Howell
. plt
. Hb Hct WBC 60,000( N 73%
metamyeloblast 3%)
A. Metamyeloperoxidase
B. Bone marroe examination
Immunology ,
1. A
chicken pox measles
adaptive immunity (plasma cell , memory B-cell
, CTL ) vaccine antibody response
T-cell B-cell
T-cell

neutrophil
Staphylococcus
Streptococcus PMN defective
lysosomal function Chediak Higashi syndrome
pyogenic bacteria

65 (2-5)
polymorphonuclear cell PMN
azurophillic acid hydrolases,
lysozyme, myeloperoxidase, cathepsin, defensin

lysosome
secondary specific granule lactoferrin,
lysozyme, alkaline phosphatase cytochrome b558

chemoattractant

(extracellular pathogen) (intracellular pathogen)
phagosome

(receptor) IgG
IgG
2. B

hydrogen bond, hydrophobic
bond, van der Waals bond ionic bond
monovalent
affinity

precipitation
(
) (zone of equivalent)
Ouchterlony immunodiffusion, immunoelectrophoresis,
radial immudiffusion
particulate insoluble antigen
agglutination blood group typing, Widal
test, hemagglutination, hemagglutination inhibition
3. E
Systemic anaphylaxis type Ianaphylaxis hypersensitivity allergen
crosslink IgE mast cella basophils

wheal and flare

(urticaria)
preformed ( histamine,
tryptase, chymase) newly synthesized mediators (IL-4, IL13, chemokines, leukotrienes)
4. B
Hemolytic disease of the newborn- Rh Incompatibility
Rh ABO
Landsteiner
Rhesus
Rh-positive
C, c, D, d, E, e
C E
D D
Anti-D
Rh-negative
Rh-positive
Rhnegative Rh-positive
hemolytic disease of the newborn
erythroblastosis fetalis
ABO
5. A
Fab fragment of
antigen binding Fc-fragment crystallizable
Fc receptor macrophage Fc R Fc
IgG

ADCC
6 E
alpha-beta T lymphocyte thymus
maturation positive negative
selection ( central tolerance)

lymphoid follicle secondary lymphoid organ
7.
HLA-B HLA-DR polymorphism
class class I (HLA-A, B, C)
typing lymphocytes
class II (HLA-DP, DQ, DR) professional
antigen presenting cells B cells
8. B

exogenous immunosuppressive agents fetus
semi-allograft (allograft = )
isograft = syngeneic graft identical twin, autograft =
xerograft = graft
species
9. C
antiglobulin(anti-immunoglobulin) = IgM , IgG , IgA
IgM (~70%) Fc portion IgG
10.
Secondary immune response
latent
period

cross reaction
11. B rubella vaccine ()

live attenuated vaccine
12. E
(opportunistic infection)

Candida Aspergillus Cryptococcus
neoformans
phagocytes

reactive oxygen species lysozyme

TH1
TH2

Candida
albicans
13. B
Type III hypersensitivity Arthus reaction immune

complex deposit vaccine
booster ( 5 hrs) Ag Ab
vaccine
complement
14. B
Type III hypersensitivity Arthus reaction immune
complex deposit vaccine
booster ( 5 hrs) Ag Ab
vaccine
complement
15. C

HIR CMIR (CMIR infection protection
) mucosal immunity

nucleoprotein
a fourfold rise in antibody titer between acute-phase
and convalescent-phase sera
16. C
tetanus anti-toxin( tetanus Ig) tetanus toxoid
memory
cell
17. D
Streptococcus pneumoniae capsule (anti-phagocytosis)
Ab opsonization Ab
synthesis blood-borneAg
18.
19.
1.
Secondary immune response
latent
period
cross reaction
2. A
Streptococcus pneumoniae capsule (anti-phagocytosis)

Ab opsonization Ab
synthesis blood-borneAg
3. C
cyclosporine cyclophilins complex block
differentiation activation T cells

calcineurin IL-2 recepter
4. A
Immunogenicity
Tumor antigen Immunogenicity
Tumor antigen
Down regulationMHC I
immuno-suppressive protein
5. A
Hapten

conjugate
6. C

Serum sickness

Arthus
Reaction

7. D
immediate type (type I, II and III hypersensitivity)

sensitized

delayed type (type IV
hypersensitivity)

CD4 MHC
class II
CTL
Jones-Mote Hypersensitivity
24

Contact dermatitis
(chromium, nickel, mercury, atopic
drugs) 2-3
Tuberculin hypersensitivity 2-3

TB, Leishmania, Pneumocystis jiroveci
Granulomatous hypersensitivity
(2-4 )

epithelioid cells giant cells
allograft rejection
GVH reaction
8. A
Systemic anaphylaxis type I-
anaphylaxis hypersensitivity allergen


wheal and flare

(urticaria)
9.
Spongiosis prickle cells

intercellular bridge
Acantholysis keratinocyte

intercellular bridge
Ballooning keratinocyte
10. A

hemolytic disease of the fetus and
the newborn ABO-incompatibility
Rh incompatibility
AB group
(IgG
)
O
anti-A anti-B IgG

A B
IgM
11. A

1.
2. C
fibrosis Histiocyte = Macrophage tissue
3. A
Systemic anaphylaxis type Ianaphylaxis hypersensitivity allergen

wheal and flare

(urticaria)
4. B
tuberculin test CMI TB tuberculin
test positive X-ray
TB CMI T helper cell

immune response Ab
5. B
varizella vaccine live virus vaccine
6. C
Corticosteroid inflammatory cytokine production, T

cell proliferation, Chemotaxis ( adhesion
molecule), Cytokine secretion Macrophage, Phagocytosis
mononuclear phagocyte
2008
1. C
2. B IgM WBC
hyper IgM syndrome isotype
switching IgM class
T cell
express CD40L
3. D reference Eur Heart J. 2008 September; 29(17):

20732082.
To address the shortcomings, additional immunohistological
and quantitative evaluation of the EMB is required.
Immunohistochemical techniques allow quantification,
identification, and differentiation of inflammatory cells, focusing

on T-lymphocytes.
42
Criteria for immunohistological diagnosis
in the endomyocardial biopsy of inflammatory cardiomyopathy

2
is specified quantitatively as 14 infiltrating leukocytes/mm ,

preferably T-lymphocytes or activated T-cells. If foci of Tlymphocytes are present, active myocarditis can be diagnosed
due to the nature of the infiltrate even when the critical
2
number of 14 leukocytes/mm is not reached, as has been

defined by the task force of the World Heart Federation's
Council on Cardiomyopathies.
43
Infectious causes of myocarditis

Viral
Adenovirus, Arbovirus, Arenavirus, Coxsackie virus, Epstein
Barr virus, Cytomegalovirus, Echovirus, Encephalomyocarditis
virus, Hepatitis B, Human Herpes virus 6, Human
immunodeficiency virus-1, Influenza virus B, Mumps virus,
Parvovirus B19, Poliomyelitis virus, Rabies, Respiratory
syncytial virus, Rubella virus, Rubeola virus, Vaccinia virus,

Varicella virus, Variola virus
Bacterial
Brucellosis, Clostridia, Diphtheria, Francisella, Gonococcus,
Haemophilus, Legionella, Meningococcus, Mycobacterium,
Mycoplasma, Pneumococcus, Psittacosis, Salmonella,
Staphylococcus, Streptococcus, Tropheryma whippleii
Fungal
Actinomyces, Aspergillus, Blastomyces, Candida, Coccidioides,
Cryptococcus, Histoplasma, Nocardia, Sporothrix
Rickettsial
Rocky Mountain spotted fever, Q fever, Scrub typhus, Typhus
Spirochetal
Borrelia, Leptospira, Syphilis
Helminthic
Cysticercus, Echinococcus, Schistosoma, Toxocara, Trichinella
Protozoal
Entamoeba, Leishmania, Trypanosoma, Toxoplasmosis
Eur Heart J. 2008 September; 29(17): 20732082.
Published online 2008 July 9. doi: 10.1093/eurheartj/ehn296.
4. D
delayed type (type IV hypersensitivity)

CD4
MHC class II
CTL
5.
6. B
Chronic graft rejection reaction delayed type (type
IV hypersensitivity)
CD4
MHC class II

CTL
7. C
T cells
+
CD8 T cells ( cytotoxic T cells [CTL] TC)

MHC class I

perforin, granzymes Fas Ligand

carrier hepatitis B 1
anti-HBs virus
viral antigen
CTL
8. C
Eosinophils 5

IgE
IgE

()
9.... Rhizopus spp.
Granulomatous Diseases
Neutrophils usually remove agents that incite acute
inflammatory responses by phagocytosis and digestion.
However, if an agent is indigestible, yet provokes an acute
response, this would lead to a vicious cycle that would
deplete the bodys white count, and cause severe damage to
local normal tissues. The body deals with such indigestible
substances and prolonged inflammatory reactions by forming
granulomas.
The principal cells involved in granulomatous inflammation are

macrophages and lymphocytes. Macrophages are much
longer lived than neutrophils, and can phagocytose an
indigestible agent, thus keeping it from provoking an acute
immune response. Upon phagocytosis of an indigestible
substance, macrophages lose their motility and accumulate at
the site of injury, where they undergo a structural change to
become epithelioid cells. These cells are larger and have
more abundant pale cytoplasm, causing them to resemble
epithelial cells. Nodular collections of these epithelioid cells
form the heart of the granuloma. These cells often become
surrounded by collections of lymphocytes, and contain
multinucleated giant cells, formed by the fusion of up to fifty
macrophages. When the nuclei of these cells is arranged in
a horseshoe pattern, the cell is named a "Langhans Giant
cell". When a pathogen, such as a fungal spore or silica
particle, is found within the giant cell, the cell is named a
"foreign body giant cell". Other inflammatory cells may be
associated with the granuloma as well.
Infectious Etiologies Fungal
Histoplasmata capsulatum
Blastomycosis dermatitidis,
Mucor sp., Rhizopus sp., and Absidia sp. (Mucormycosis)
Aspergillus fumigatus
Candida albicans, Rhinosporidium seeberi
Coccidioides immitis
Cryptococcus neoformans
Infectious Etiologies Parasitic
Leishmaniasis (caused by Leishamania sp.)
Myiasis refers to an infection with the larvae (maggots) of the
common screw-worm fly,
Toxoplasma gondii
Infectious Etiologies Bacterial
Mycobacterium tuberculosis
Nontuberculosis mycobacterial infections (M. kansaii, M.

scrofulaceum, M.avium- intracellularis, M. gordonii, and M.
fortuitum)
Mycobacterium leprae is the organism that causes leprosy
(Hansen's disease)
Cat-Scratch Disease is caused by one of two intracellular,
gram negative bacilli, Rochalimae henselae, or Afipia felis,
which require special staining (Warthin- Starry) for detection.
Actinomycosis is an indolent suppurative infection caused by
an anaerobic or microaerophilic organism.
Syphilis, caused by the spirochete Treponema pallidum
Klebsiella rhinoscleromatis causes rhinoscleroma, which has
three distinct phases: (1) catarrhal stageprolonged purulent
rhinorrhea (honeycombed color), (2) granulomatous stage-characterized by small, nodular masses in the upper airway
which later coalesce, and (3) sclerotic stage--dense fibrosis
that causes stenosis of the nose, larynx, and tracheobronchial
tree.
Neoplastic Etiologies
Eosinophilic granuloma
Hand-Schuller-Christian disease is considered to be a chronic,
disseminated form of histiocytosis X.
Letterer-Siwe is a disease of infants that consists of
hepatosplenomegaly, lymphadenopathy, bleeding diathesis,
anemia, cutaneous lesions, and generalized hyperplasia of
macrophages in a variety of organs.
Benign fibrous histiocytoma most often develops as a
painless mass in sun-exposed and orbital tissues.
Necrotizing sialometaplasia may be found wherever salivary
tissue is present, but is most commonly found in the oral
cavity at the junction of the hard and soft palate.
Polymorphic reticulosis, lethal midline granuloma, and
lymphomatoid granulomatosis, angiocentric lymphoma, are
synonymous terms used previously to describe a condition
that is now believed to be a type of peripheral T-cell
lymphoma (angiocentric lymphoma).
Autoimmune and Vasculitic Disease
Wegener's Granulomatosis is a systemic disease, thought to be autoimmune, characterized by vasculitis
and predominantly epithelioid necrotizing granulomas in the involved tissue.
Systemic lupus erythematosus is a disease in which tissues are damaged by deposition of autoantibodies
and immune complexes.
Sjogrens syndrome afflicts mainly middle aged women (9:1 female to male predilection) and
characterized as an immunologic disorder which produces progressive destruction of the exocrine glands.
Churg-Strauss Syndrome has been described as an allergic angiitis and multi-system granulomatous
vasculitis.
Foreign Body Etiologies
The urate crystals in gout incite granulomatous lesions as they are deposited in the tissues.
Cholesterol granulomas are usually found in the pneumatized area of the temporal bone or the paranasal
sinuses.
10. CD28-dependent activation of CD4 TCR- T

+
cells.
In animals and humans exposed to live Salmonella, cellular
responses are of the Th1 type, as indicated by delayed-type
hypersensitivity (DTH) and by the predominant production of
IL-2 and IFN- upon in vitro restimulation of immune T cells
(Harrison et al., 1997; Sztein et al., 1994).
11....
12.
Gram positive cocci in cluster Staph. aureus
Staph. Coag negative
small gram negative bacilli
Hemophilus Legionella Yersinia gram

negative bacilli Klebsiella
Pseudomonas aeruginosa gram negative bacilli

Nocardia
key word partial acid fast
stain
Anaerobes, either alone or in combination with aerobes,
have been recovered from approximately 80% of lung
abscesses. The anaerobes most frequently isolated are
pigmented Prevotella & Porphyromonas (Gram negative
bacilli), Fusobacterium nucleatum (Gram negative bacilli),
Peptostreptococcus (Gram positive cocci), and
Bacteroides fragilis (Gram negative bacilli).
The major aerobic pathogens that are usually isolated mixed
with anaerobic bacteria are Staphylococcus aureus, Klebsiella
pneumoniae, and Pseudomonas aeruginosa.
gram positive cocci cluster (Staphylococcus aureus)
small gram negative bacilli (Bacteroides fragilis)
13. anti mycoplasma Ab
atypical pneumonia
atypical pneumonia virus

Influenza A, B, RSV, Adenovirus, Parainfluenza
SARS bacteria atypical pneumonia
Legionella, Francisella tularensis
Mycoplasma pneumoniae anti
mycoplasma Ab

14.... A
aspiration pneumonia anaerobes
key word anaerobes
pulmonary abscess
A anaerobes
3
15....
Penicillium marneffei
16....
17.... Candida albicans, Trichomonas vaginalis
18....
Mucormycosis
1.

(
) Woods light
short, fragmented hyphae
round to oval budding
yeast cells (Pityriasis versicolor: Malassezia furfur:

2.5% selenium sulfide shampoo, 1 - 2% zinc
pyrithione shampoo, 2% ketoconazole shampoo, 20%
sodium thiosulfate
2.
40-50% propylene glycol)

(dermatiaceous septate hyphae) ascus
(Blach piedra: Piedra hortae)
3.

yeast cell, chlamydospore branching
septate hyphae (Tinea nigra: Exophiala werneckii)
4.
(Tinea
capitis: Microsporum gypseum, Trichophyton rubrum &
Trichophyton mentagrophytes)
5.

10%KOH branching,
septate hyphae arthroconidia (Dermatophytosis
(Tinea corporis): Microsporum gypseum, Trichophyton
rubrum & Trichophyton mentagrophytes, Epidermophyton
floccosum)
6.

(Dermatophytosis (Tinea pedis): Microsporum gypseum,
Trichophyton rubrum & Trichophyton mentagrophytes,
Epidermophyton floccosum)
7.

(Dermatophytosis (Tinea unguium): Microsporum
gypseum, Trichophyton rubrum & Trichophyton
mentagrophytes, Epidermophyton floccosum)
8.
a.
:
,
, 2
b.
:
,
glans penis, prepuse
(balanitis)
c.
(satellite lesion)

d.

LAB: 10% KOH budding yeast pseudohyphae
(Candida albicans & Candida spp.: Yeast like fungi)
9.
2 cytoplasm macrophage
gian cell (Chromoblastomycosis: Fonsecaea
pedrosoi, F. compacta, Cladosporium carrionii,
Phialophora verrucosa, Rhinocladiella aquaspersa:
Dematiaceous fungi)
10.
(cyst)

(Phaeohyphomycosis: Exophiala jeanselmei, E.
dermatitidis, Cladophialophora bantiana, Alternaria sp.,
Bipolaris sp.: Dematiaceous fungi)
11.

(hyaline branching septate hyphae)
(Hyalohyphomycosis: Scedosporium apiospermum
(Pseudallescheria boydii), Fusarium sp., Penicillium sp.,
Acremonium sp.)
12.
granuloma

septum (aseptate hyphae) inflammatory cells
(Basidioboromycosis: Basidiobolus ranarum)
13.

H&E asteroid body (Lymphocutaneous
sporotrichosis:
Sporothrix schenckii (Dimorphic fungi:
mold form hyaline septate hyphae conidiophore

conidia
))
14.
()
(sinus tract) grain
grain
grain mount 10%KOH mycelium
septate hyphae 2 (Eumycotic
mycetoma: Pseudallescheria boydii, Exophiala jeanselmei,

Madurella mycetomatis, Curvularia geniculata,
Fusarium moniliforme)
Fungi that cause eumycetoma include the following:
Those with a white-to-yellow granule
a.
Acremonium species
b.
Aspergillus nidulans
c.
Aspergillus flavus
d.
Cylindrocarpon cyanescens
e.
Cylindrocarpon destructans
f.
Fusarium species
g.
Neotestudina rosatii
h.
Polycytella hominis
i.
Pseudallescheria boydii
Those with a black granule

j.
Corynespora cassicola
k.
Curvularia species
l.
Exophiala jeanselmei
m.
Leptosphaeria senegalensis
n.
Leptosphaeria tompkinsii
o.
Madurella grisea
p.
Madurella mycetomatis
q.
Phialophora verrucosa
r.
Plenodomus auramii
s.
Pyrenochaeta mackinnonii
t.
Pyrenochaeta romeroi]
15.
grain mount 10%KOH
hyphae 1
(Actinomycotic
mycetoma: Actinomyces Israelii (anaerobe), Actinomadura
madurae (grains ( < 5 .), Actinomadura
pelletieri
(grains ( < 1 .), Nocardia asteroids,
Nocardia brasiliensis
(Partially acid-fast: Grains
( ), Streptomyces somaliensis Grains

( < 2 .) )
16.
(calcification)
(chest X-ray granuloma ) H&E
intracellular yeast
( ) macrophage tissue
histiocyte (Histoplasmosis (Darlings disease):
Histoplasma capsulatum var. capsulatum (Dimorphic
fungi))
17.
(atypical
pneumonia)
(bone marrow, skin, blood and sputum
samples)
Giemsa Wright intracellular fission
yeast histiocytes
pleomorphic yeast with binary fission
(Penicillosis marneffei: Penicillium marneffei (Dimorphic
fungi))
18.
chest X-
ray granuloma

Mucicarmine (Pulmonary
cryptococcosis & cutaneous and mucocutaneous
cryptococcosis: Cryptococcus neoformans)
19.
CSF India ink preparation encapsulated

budding yeast (CNS cryptococcosis: Cryptococcus
neoformans)
20.
neutropenia) (chest X-ray granuloma )

sputum, bronchial washing H&E
(Broad and aseptate hyphae)
(Pulmonary zygomycosis Pulmonary mucormycosis:
Mucor, Rhizopus, Absidia, Cunningghamella)
21.
paranasal sinuses
( neutropenia)
thrombosis, ischemia, necrosis

(Broad and aseptate hyphae) (Rhinocerebral zygomycosis

Rhinocerebral mucormycosis: Mucor, Rhizopus,
Absidia, Cunningghamella)
22.

eosinophils (
fungal ball
, histoplasmosis)
sputum 45
(dichotomously branching septate hyphae) (Allergic
aspergillosis Pulmonary aspergillosis: Aspergillus
fumigatus)

serum LDH (a liver
23.
enzyme) ( 460 U) chest X-ray

bilateral interstitial infiltrates
Giemsa trophozoit Intracystic
bodies (cyst sporozoite 8
) cyst
methenamine silver stain cyst walls
(Pneumocystis jiroveci pneumonia (PCP): Pneumocystis
jirovecii)
Treatment Trimethoprim + sulfamethoxazole
(TMP-SMX)
()
modified acid fast (Pulmonary nocardiosis:
Nocardia asteroids)
19....
20. latex agglutination
21.
A
Pathogen
Virus
Bacteria
Open pressure
Normal
Normal, increased
Appearance
Clear
Turbid
WBC
+ (+)
+++
Lymphocyte
PMN
Protein
++
CSF sugar/ Serum sugar
Normal
Decreased
Others
Special lab
Gram stain, culture, CIE, latex

agglutination
Pathogens
Parasite
Protozoa (Naegleria)
Systemic infection
Open pressure
Normal, increased
Normal, increased
Normal
Appearance
Angio: coconut juice
Turbid
Clear
++
+++
eosinophil
PMN
Lymphocyte
++
++
Gnatho: xanthochrome
WBC
Protein
Normal
Decreased
Normal
Others
Fresh smear, culture -
Pathogen
Tuberculosis
Cryptococcosis
Open pressure
Normal, increased
Normal, increased
Appearance
Straw color
Clear
Xanthochrome
WBC
++
++
Lymphocyte
Lymphocyte
Protein
+++(+)
++
Decreased
Decreased
Others
AFB, culture, cobweb, PCR
India ink, culture, Crypto Ag
22....
23....
hypersensitivity type II
antibody AB
24.... Ankylosing spondylitis (AS) is a chronic, progressive,
connective tissue disorder that is characterized by inflammation of the
joints of the spine (vertebral joints), hipbones, and sacrum (sacroiliac

joints). The condition is one of a group of spondyloarthropathies, including
other inflammatory connective tissue disorders such as rheumatoid arthritis,
Reiter's syndrome, psoriatic arthritis, and the arthritis associated with
inflammatory bowel diseases such as Crohns disease and ulcerative
colitis.
Symptoms of ankylosing spondylitis are similar to those of the more
common rheumatoid arthritis, including pain, swelling, and stiffness in the
affected joints. The difference is that spondylitis primarily affects the
spine, forming bony outgrowths (syndesmophytes) between the vertebrae,
which may fuse vertebrae and lead to total spinal immobility (ankylosis).
Fusion of the vertebrae also can stiffen the rib cage, reducing lung
capacity and function. Constitutional symptoms may develop as the
condition progresses, including anemia, fatigue, loss of appetite, weight
loss, bowel inflammation, and eye inflammation (iritis). The presence and
severity of symptoms varies among individuals.
Diagnosis of ankylosing spondylitis is based on clinical features such as
presence of low back pain and stiffness for more than 3 months, limited
motion in the lumbar spine, and limited chest expansion. AS is termed
primary or idiopathic (of unknown origin) if the disease occurs with
radiographic evidence of inflammation of the sacrum (sacroiliitis) and

without an associated spondyloarthropathy. It is termed secondary if it
occurs in conjunction with psoriasis or chronic inflammatory bowel
disease.
The onset of ankylosing spondylitis usually occurs between ages 16 and
40. Although a single cause for the condition has not been identified,
genetic factors are known to be involved. Human leukocyte antigen B27
(HLA-B27) has been shown to be present in the tissue of a majority of
individuals with ankylosing spondylitis, but may be an association and not
part of the cause of the disease.
Risk: Individuals who test positive for HLA-B27 and are younger
than age 40 are at increased risk for developing ankylosing
spondylitis (Van der Linden). From 90% to 95% of individuals with
the disorder have the HLA-B27 gene (Schaffert). A family history of
the condition also increases risk. Ankylosing spondylitis is 10 to 20
times more common in individuals whose siblings or parents have the
disease ("Ankylosing Spondylitis").
25.... Hodgkin and Reed-Sternberg (H-RS) cells represent
the malignant cell population in classic Hodgkin's disease (HD). By
micromanipulation of single H-RS cells and subsequent amplification

of their rearranged immunoglobulin (Ig) genes, it was demonstrated
that H-RS cells clonally derive from germinal-center B cells in most
cases.
26....
27....
28. Hb aggligation
29....
30....
31....
(Hematology)
Hematology
Part Hematology 2005

1. hydrop fetalis cord blood
Hb Bart genotype
A. thal 0 / thal 0
B. thal 1 / thal 1
C. thal 1 / thal 1
D. thal 1 / thal 2
E. thal 2 / thal 2
2.
HbH disease -thal 1 trait
thalassemia
A. 0
B.
25
C.
50
D. 75
E. 100
3.
6 2
basophilic stippling basophilic stippling

A. thalassemia
B. lead poisoning
C. post splenectomy
D. iron deficiency
E. Henoch Schoenlein purpura
4.
20 2
purpura
Hb 10.5 g/dl, Hct 31 %
WBC 4,500 /cu.mm (N68%,L32% ) platelet count 20,000
/cu.mm
A. female purpura
B. aplastic anemia
C. acute leukemia
D. paroxysmal nocturnal hemolytic anemia

E. autoimmune hemolytic anemia
5.
33

platelet 200,000/cu.mm bleeding time 15 min (2-6) ,APTT
55 sec (22-35 ) ,PT 12 sec (10-13)
A. cryoprecipitate
B. platelet concentration
C. fresh frozen plasma
D. factor VII
E. factor IX
6.
20 2 jaundice
Hb 8 g/dl, Hct 29%, WBC 10,000

3
cells/mm ,PMN 80% ,L 20% ,Platelet 200,000/mm

Peripheral blood smear Heinz body RBC
Heinz body
A. iron containing gene

B. precipitating hemoglobin
C. artifactual aggregating ribosome
D. pathological precipitating ribosome
E. nuclear fragmented containing chromosome
7.
35 2

2 cm lymph node Hb 8
3
g/dl,Hc 24%, reticulocyte 10%,platelet 250,000/mm ,MCV 100

fL blood smear polychromasia,microspherocyte
A. autoimmune
B. vitamin B12
C. hemoglobin
D. RBC
E. lead poisoning
8.
50 2
Hb 7g/dl,Hct 20% MCV 7 recticulocyte 1%

3
WBC 5,000 cells/mm .L30%.PMN 70%
A. renal failure
B.
liver cirrhosis
C.
gastric carcinoma
D. chronic lung disease

9.
6 39.5 C WBC 4,000cells/mm
(PMN, L.E.M. ) atypical lymphocyte 15% ,

3
platelet 20,000/ mm Hb 16 g/dl, Hct 48%

A. acute leukemia
B. dengue hemorrhagic fever
C. immune thrombocytopenic purpura
10.
Howell-Jolly bodies blood smear

A. liver cirrhosis
B. lead poisoning
C. G-6-PD deficiency
Hematology 2006
1.
20
3
2.
30 smear normochromic
normocytic, target cell, howel jolly bodies
A. G6PD def
B. thalassemia
C. post-spleenectomy
3.
WBC, Hb, Hct
LAB ( ecochymosis )
A. coagulogram
B. aPTT
C. BT
D. VCT
4.
50 Hct 23, WBC 3,200 Plt.
70,000 ( )
A. hypersplenism
B. aplastic anemia
C. IDA
D. megaloblastic anemia
E. ATP
5.
60 1
Hb 8 Hct 24%
WBC 6,000 N 65% L 35% Plt 200,000 MCV 90
Reticulocyte1% blood smear rouleaux formation
cell
A. monocyte
B. neutrophil
C. mycloblast
D. plasma cell
E. lymphocyte
6.
20
CBC Hb 10, Hct 30, WBC 6000 , N 65% , L 35%

,platelet 200.000 , MCV 100 , reticulocyte 10%
A. Haptoglobin
B. Indirect Bilirubin
C. Bile
D. Urobilinogen
E. Hemoglobin
7.
30 1
Hemoglobin
A. O2 O2
B. O2
C. CO2
D. O2 tissue
E. CO2 tissue
8.
5 3
coagulogram
A. Heparin
B. sodium citrate
C. EDTA
9.
Hb 12
Hct 36% MCV 60 WBC Plt Hb typing; Hb A2 45%
A. alpha
B. Beta
C. gamma
10.
40
CBC: Hb 7, WBC 3,500(N 30 L 70 ) , platelet

30,000, MCV 92
A. hypersplenism
B. aplastic anemia
C. iron deficiency
D. IPT
11.
25 3
CBC; Hb 10 WBC 7,000 Plt 300,000 Reticulocyte 7%
MCV 92
A. iron def
B. B12 def
C. Hemolytic anemia
D. Hemoglobinopathy
E. Post hemorrahagic anemia

12.
Packed red cell 2 unit

unit 2 200 cc.
Urticaria Urticarial
rash
A. RBC
B. WBC
C. PLT
D. plasma protein
E.
13.
Hct.
, Hb , reticulocyte 12%, Polychromasia,
microspherocyte
A. B12
B. Hb
C. Enz. RBC
D. RBC
E. Ab RBC
14.
30 30 ml
BP
A. ABO Incompatibility
B. Rh Incompatibility
C. Citrate intoxication
D. Bacteria contaminate
E. Fabrile-non-hemolytic-trans
15.
20
2 cm right costal margin CBC: Hb 10 ,

WBC 5,000 Plt 250,000 polychromasia microspherocyte
coomb test negative
A. antibody RBC
B. globin chain
C. RBC
D. enzyme RBC
16.
18
coagulogram PTT 55 PT 12
factor
A. factorI
B. factor II
C. factor VII
D. factor VIII
E. factor X
17.
clotted blood VCT= 10 min

factor
A. II
B. XII
C. X
D. VII
E. V
F. Fibrinogen
18.
15 B thal / HbE
Ferritinl Hepatocyte Brown

Granular pigment complication
A. Hursutism
B. DM
C. Hypergonadal
D. Hypothyroid
E. Hyperpigment
19.
PTT 40 PT 40
A. Vit. K
B. Vit. C
20.
clotted blood serum
electrolyte 06.00 .
9.00. electrolyte (
)
A. Sodium
B. Calcium
C. Chloride
D. Potasium
E. Bicarbonate
21. 6 superficial ecchymosis CBC: Hb
2, WBC 5,000 , N 63%, L 20%, E 12%, M 5% Giant Plt
pale Plt 250,000 lab
a. Bleeding time
b.VCT
c.Clot retraction
d.Plt
Hematology 2007
1. 40 Hct 60% WBC 6,000
platelet 200,000
A.
B.
C.
D.
E.
2.

VDRL 2
. Hb typing
A. alpha 4
B. beta 4
C. gamma 4
D. delta 4
E. zeta 4
3.
50
2 Hb 8
g/dl Hct 24% WBC 6000 N75% L25% platelet 200000 MCV
80 fL reticulocyte 1% creatinine 5
A. Folic acid
B. Erythropoietin
C. Thyroid hormone
D. Cyanocobalamine
E. Colony stimulating factor
4.
Hb 8 HCT
24% platelet 200,000 WBC 6,000 creatinin 5 mg/dl
A. Folic acid
B. Cyanocobalamin
C. Erythropoietin
D. Thyroid hormone
E. Colony stimulating factor
5.
70 7
3 Hct 23 WBC 3200 ( N 30% L 70% ) Plt

70000
A.
B. Autoantibody
C.
D.
E. RBC
6.
B-thalassemia \ HbE disease
HbE homozygote
thalassemia
A. 1
B. 3/4
C. 1/2
D. 1/4
E. 0
7.
60
1 .

A. stercobillin
B. serum albumin
C. urine urobillinogen
D. plasma prothrombin
E. serum direct bilirubin
8.

Hb H
Genotype
A. /-B. -/C. /
D. ot
E. oo
9.
30 30 cc
BP 80/60
A. anaphylaxis
B. citrate intoxication
C. bacterial endotoxic
D. immune complex reaction
E. antibody dependent cytotoxicity

MCQ MD.316 Hematology
1.
50 CBC: Hb 8g/dl , Hct 20 %
a. Iron dextran (50%)

ferrous sulfate (50%)
2.
b. Folic acid
c. EPO
d.
e. cyanocomodulin
CBC Hct MCV RBC

a. Cytoplasm maturation defect
b. Nuclear maturation
defect
c.
. Proliferation defect
d. . Differentiation
defect
3.
10 39.4 C Pharyngitis
cytokine cell
a. Macrophage
cell
e. B- cell
b.
TH 1
c. TH 2
d. cytotoxic T
4.
Biopsy Starry Sky
5.
Aniso poikilo cytosis +3 Inclusion body
positive
a.
6.
Not found Heinz Body

Hb H disease
b. thal / Hb E
Hb typing HB A2 HB F
Genotype
7. MI Aspirin
8.
2 Neonatal jaundice
9.
BAND 3 Defect
10. frushing
a. ABO non match
b.
Rh Abnormal
c. Plasma
Bacteria
11. CBC Prolong PT,PTT,TT
clotting time
and Venous
Factor
12.
LAB

a. Hb
ring sideroblast
13.
b.
Hct
c. MCV
d. Serum ferritin
e.
( sure )
Chemotherapy Neutropenia
14. T lymphocyte
15.
CD 4 Cytoplasmic chain cell
(..B-cell CD4 - -?)

a. Blast (lymphoblast)
d. Immature B cell
b. Pro B cell
c.
Pre B cell
e. Mature B cell
16.
M PHASE
17.
Marker Hodgkin Lymphoma
18.
Sirolimus
19.
Marker Pre T Cell
20.
Hemostasis
21.
Stem Cell
22.
Enhancer Globin chain
23.
IgM
24.
Cell Active
25.
HIV
26.
T cell Bacteria
27.
Ag
Virus
B cell
Cell Cell Cell

28.
Megaloblastic Anemia
RBC
MORPHOLOGY
29.
( )
30.
Which area of lymph node is most likely to defect
Macrophage presenting antigen to T lymphocyte
a. Subcapsular
Medullary
31.
b.
Cortex
c. Paracortex
d.
e. Follicle
B-cell response is most likely to be initiated in which
area of the spleen

b. Follicle
a. PALS
Spleenic cord
e.
c. Marginal zone
d.
Red pulp
32.
33.
Bone marrow Transplantation
34.
Ring sideroblast BM
35.
Chelate
36.
Transplantation
37.
HLA
ABO 5
Solid Organ
38.
Sign
2-3 DPG
39.
Bone Marrow Transplantation
Skin Rash
GI bleeding
40.
41.
Heparin
42.
gene 2 copy
43.
44.
genotype
45.
G6PD
Heinz Body
Ghost Cell
RBC
46.
Congenital Vit K Def
47.
Follicular Hyperplasia Lymph node

a. Toxoplasmosis
Vaccination
48.
b. Dilantin
c. Viral infection
d.
e. Breast Carcinoma
TB
Macrophage
Cytokine Cell
49.
50.
APC
51.
PLT
52.
case Hereditary
Virus Present MHC I
Spherocytosis
53.
Screen test Anemia
54.
Type Thal
55.
Hemolysis
56.
Antigen Back Bone ABO Group
57.
warfarin
Cimitidine
warfarin
a.
d.
58.
Dose
b.
Dose
c. warfarin
CRF
59.
Effect Side Effect
( )
60.
Thalassemic Hemoglobinopathy
61.
factor VIII
62. bone lesion

63.
(Petichiae) small ecchymosis
64.
translocation gene
(9,22)
Philadelphia ]
Hematology
Part Hematology 2005
1. B
hydrop fetalis globin

(--/--)
thal 1 / thal 1
-thal 1(0) globin
(--)
-thal 2(+) globin
(-)
-thal 2
thal 0 (0)
globin (--)
thal 1 (+) globin
( -)
2. C
HbH (--/-)
-thal 1 trait (--/)
genotype 4
(--/--) Hb Barts hydrops fetalis
(--/) -thal 1 trait
(--/-) HbH
(/-) -thal 2 heterozygous
3. B
Thalassemia Inclusion bodies
Lead poisoning Basophilic stippling colicky
pain
Post splenectomy Howell-Jolly Bodies
Iron deficiency Basophilic stippling Lead
poisoning ?
Henoch Schoenlein purpura ?
4. B

Aplastic anemia

stem cell stem cell
5. C
coagulation
factor
lab
Platelet
Bleeding time coagulation factor
aPTT factor XII, XI, IX, VIII
PT factor VII
factor 4
fresh frozen plasma factor
6. B
Heinz body degenerated hemoglobin G6PD

deficiency
7. A
/ RBC
Hb, Hct
Reticulocyte RBC
Platelet
Polychromasia ribosome RBC
mature
Microspherocyte
Hereditary spherocyte, Autoimmune
autoimmune RBC
B12 def. megaloblastic anemia
Hb thalassemia?
RBC spherosis, elliptocytosis
lead poisoning basophilic stippling

8. colon CA
Hb, Hct
MCV RBC
Reticulocyte
WBC
iron def. chronic blood loss
colon CA
Gastric CA associated Pernicious anemia
9. B
Hb Hct plasma
Hct atypical
lymphocyte dengue
hemorrhagic fever
10. choice
?
Howell-Jolly bodies
Megaloblastic anemia, Thalassemia, Splenectomy, Asplenia
liver cirrhosis Heinz bodies
lead poisoning Basophilic stripping
G-6-PD deficiency Heinz bodies
Hematology 2006
1. : hemoglobinuria intravascular hemolysis
free plasma hemoglobin
hemoglobinuria

- Acute glomerulonephritis
- Burns
- Renal cancer
- Malaria
- Paroxysmal nocturnal hemoglobinuria
- Haemolytic uraemic syndrome (HUS)

- Pyelonephritis
- Sickle cell anemia
- Transfusion reactions
- Thrombotic thrombocytopaenic purpura (TTP)
- Tuberculosis of the urinary tract
-G-6 PD def.
2. : C
howel jolly bodies chromosome spindle
(Karyorrhexis)
howel jolly bodies blood smear

asplenia , splenectomy
3. : C
Ecchymosis primary
hemostasis
(platelet ) platelet
endothelium RBC
subcutaneous tissue
Bleeding time assess
platelet function.
partial thromboplastin time (PTT) or activated partial

thromboplastin time (aPTT or APTT) is
efficacy of both
measuring the
intrinsic (factors XII ,XI ,IX,VIII ) and
common coagulation pathway ( factors X , V , II , I )

Prothrombin time (PT) measures of the extrinsic pathway
of coagulation (factors II, V, VII, X and fibrinogen)
4. : B
>> Aplastic anemia (aplastic anemia)
(hypocellularity)
(pancytopenia)
>> Hypersplenism : (rapidly

and prematurelydestroy blood cells.)
enlarged spleen, anemia, leukopenia, or abnormally low
white blood cell counts, or thrombocytopenia, a deficiency of
circulating platelets in the blood
>> IDA Iron Deficiency Anemia
>> Autoimmune Thrombocytopenia Purpura (ATP)
Symptom
- Acute or child form symptoms usually follow a viral

infection
- No early symptoms - especially in the chronic form
- Thrombocytopenia
- Purpura
- Petechiae
5. : D
rouleaux formation
fibrinogen
sialic acid RBC
globulin Multiple
Myeloma, Chronic infection, parasitic infestation Fasciolar
hepatica
Multiple myeloma plasma cells
oncogenes cytokines
cytokine receptor genes tumor suppressor
genes myeloma cell interleukin-6 (IL-6)

2

monoclonal
immunoglobulin (M-protein) light-chain
Bence Jones protein3 Multiple
myeloma

6. B. Indirect Bilirubin
Hb Hct WBC, platelet
reticulocyte
hemolytic anemia
Jaundice extravascular hemolysis
intravascular hemolysis
hemoglobin
(Hemoglobinuria)
A.Haptoglobin alpha-beta dimer
(intravasculas hemolysis) Haptoglobin

B. Indirect Bilirubin
Direct bilirubin
C. Bile ()
D. Urobilinogen
E. Hemoglobin intravascular
hemolysis
Extravascular hemolysis
Intravascular hemolysis
7. D. O2 tissue
tissue O2 Hemoglobin
O2
tissue
The strength with which oxygen binds to hemoglobin is

affected by several factors. In effect these factors shift or
reshape the oxyhemoglobin curve ("the standard curve"). The
standard curve is shifted to the right by an increase in
temperature, 2,3-DPG, or pCO2, or a decrease in pH.
A rightward shift indicates that the hemoglobin under
study has a decreased affinity for oxygen. This makes it
more difficult for hemoglobin to bind to oxygen (requiring a
higher partial pressure of oxygen to achieve the same
oxygen saturation), but it makes it easier for the hemoglobin

to release oxygen bound to it. The effect of this rightward
shift of the curve increases the partial pressure of oxygen in
the tissues when it is most needed, such as during exercise,
or hemorrhagic shock.
In contrast, the curve is shifted to the left by the
opposite of these conditions. This leftward shift indicates that
the hemoglobin under study has an increased affinity for
oxygen so that hemoglobin binds oxygen more easily, but
unloads it more reluctantly.
8. B. sodium citrate
A. heparin
B. sodium citrate coagulogram
PT, PTT, TT, Anti thrombin III, fibrinogen, Protein C,
Protein S
coagulogram
3.8% sodium citrate

2-8
C. EDTA
CBC, . Hemoglobin typing
9. B. Beta
Adult hemoglobin HbA (22) 95-98%
HbA2 (22) 1.5-3.1% HbF (22)0-0.2%
Hb A2 -globin
-globin
10. B. aplastic anemia()
(
) (petechaie
)
lab
Hb
WBC neutrophil relative

lymphocyte increase
platelet
MCV , ,
aplastic anemia
A. hypersplenism
3
1
1.
2. (cytopenia)
1
3.
hematopoietic cells

4.
B. Aplastic anemia
Pathophysiology
Stem cell defect
BM stromal cell defect hematopoietic

growth factor
Causes
radiation, benzene, chloramphenicol, alkylating
agents, viral agents (parvovirus B19, EBV, HIV) , Fanconis

anemia etc.
Diagnosis
hypocellular BM (cellularity < 30%)
Severity
o Severe: 2 of 3 value
Absolute neutrophil count < 500/mm3

(0.5x109/L)
Plt < 20 x109/L
Reticulocyte count < 1% or absolute
reticulocyte < 40x109/L
o Very severe:
As above
Absolute neutrophil count < 200/mm3
1.
(0.2x109/L)
Hematopoietic stem cell transplantation (HPSCT)

stem cell
2.
antithymocyte and
antilymphocyte globulin (ATG/ALG)
3.
: androgen testosterone
derivative, G-CSF GM-CSF
4.
supportive care
(PRC & Platelet concentration)
hematopoietic growth factor

C.
Iron deficiency

1.
peptic ulcer, hiatal hernia, gastritis

NSAID
2.
3.
4.

(Pica)
(Koilonychia Spoon nail) (Angular
Stomatitis)
**
MCV ( Mean
corpuscular volume:MCV 79-93.3 fL) MCV
WBC, platelet
D. ITP (Idiopathic thrombocytopenia purpura)
autoantibody

Hb, WBC
MCV
1. isolated thrombocytopenia
2.
megakaryocyte
3.
4.
SLE
autoimmune
5.
antibody
11. A .Iron deficiency anemia

A .Iron deficiency anemia

( Microcytichypochromic red cells ) Anisocytosis poikilocytosis

Dimorphic picture 2 Microcytichypochromic red cells
Normocytic normochromic red cells
( nucleated red cell )

granulocytic series Megakaryocytic series
B. B 12 deficiency (pernicious anemia)
B 12
DNA

( nuclear cytoplasmic asynchronism or dissociation )

(NRC)
( MCV > 100)
( macro ovalocyte )
5 lobe
( hypersegmented neutrophil
macrocyte )
C. Hemolytic anemia

120 Jaundice
( serum
bilirubin ) reticulocyte
1.
Hereditary
- G6PD deficiency
Hereditary spherocytosis :
spherocytosis polychromasia
coombstest

- Thalassemia
2.
Acquire
-
Autoimmune hemolytic anemia ( AIHA ) :
antibody
Direct coombstest antibody

2
Warm type
37
spherocytosis reticulocytosis NRC
( agglutination )
Cold type
( 37 )

37
D. Hemoglobinopathy
Hemoglobinopathy:
Sickle cell : Hb S carrier

disease form
sickle cell anemia sickle cell
crisis
Target cell
: Hb E ,C target cell
Homozygote 100 %
E. Post hemorrhagic anemia
Post hemorrhagic anemia is a normocytic-normochromic

anemia caused by sudden blood loss in an individual with
normal iron stores. Hemorrhage may be obvious, that is, after
surgery or before a trauma, as in the cases of malignancies
or gastrointestinal disorders. It should be noted that minor
prolonged hemorrhage does not result in classic post
hemorrhagic anemia, but rather in iron deficiency anemia.
Within twenty-four hours of blood loss, there is a
reduction in the number of circulating erythrocytes, which
affects blood volume and its consistency. To compensate,
water and electrolytes from tissues and interstitial spaces are
mobilized to expand plasma volume and accelerate the
formation and development of blood cells in the bone marrow

(hematopoiesis). While this action maintains adequate blood
volume, it decreases the viscosity (thickness) of the blood.
Diluted blood flows faster and more turbulently than normal
blood and can cause heart problems (ventricular dysfunction,
cardiac dilation, and heart valve insufficiency).
12. : D. plasma protein
Pack red cell
oxygen-carrying capacity
Volume expansion
13. : D RBC
A. Vitamin B12 deficiency (pernicious anemia)
( 12 )
( macrocyte )

B. Hb

target cell
C . Enz. RBC
G6PD deficiency
G6PD (Glucose-6Phosphate Dehydrogenase)
Pentose Phosphate Pathway

(PPP.) NADP NADPH
Glutathione reductase
Glutathione peroxidase
(Oxidants) H2O2
G6PD

(Oxidants)
(Hemolysis)
G6PD X-linked
recessive
Acute hemolytic anemia (

)

(Acute
renal failure)
Electrolytes ()
Hyperkalemia ()
CBC
Heinz body

Oxidation

Heinz body

Heinz body
Bite cell Defected spherocyte
CBC

1.

(Fava beans
Broad beans) Vicine, Devicine, Convicine

Isouramil (Oxidants)
2.
(Oxidants)
3.

(Diabetic
ketoacidosis)
4.

Heinze
body
D RBC
!!!!!!!!!
D. RBC

Bilirubin
CBC Hct. , Hb
reticulocyte

E. Ab RBC
( AIHA)
Autoimmune hemolytic anemia
combs test

14. : A. ABO
Incompatibility
Hemolytic transfusion reaction
Immunologic mechanism
Non immunologic mechanism
hemoglobinemia
, hemoglobinuria
ABO Incompatibility DIC

, renal failure
allergic reaction 1 %
A
B. Rh incompatibility
C. Citrate intoxication massive blood transfusion

2,500 ml. 5,000 ml.
24 hr.
D. Bacteria contaminate

DIC shock
15. : C. RBC
13

( )

( Extra-erythropoiesis )
right costal margin
13 coombs test
negative autoimmune RBC
16. D. factor VIII

Extrinsic pathway
Prothrombin time (PT)

coagulation factor
VII , X , V , prothrombin fibrinogen
Intrinsic pathway
Activated partial thromboplastin time
(APTT) ( factor Vlll)
Whole blood clotting time (WBCT) (Venous
clotting time (VCT) )
coagulation factor
XII , XI , IX , VIII , X , V, prothrombin fibrinogen
case PTT 55 ( 30-40 )
PTT
PT 12 ( 10-14 )
PT
case PTT = Intrinsic

pathway = coagulation factor XII , XI ,
IX , VIII , X , V, prothrombin fibrinogen
17. B. XII
case VCT 10 ( 5-15 )
VCT VCT Intrinsic

pathway
coagulation factor factor XII
18. B. DM
thalassemia
(Iron overload)
cytoplasm ferritin (ferritin
hemosiderin
brown
granular pigment) reticuloendothelial
system (hemachromatosis)
-
collagen
formation (hepatic fibrosis)

-
(arrhythmia)
(heart failure)
thalassemia major
-
insulin
hypogonadism
(infertility)
-
pituitary
19. A. Vit. K
case PTT 40 ( 30-40 )
PTT
PT 40 ( 10-14 )
PT
case PT = Entrinsic
pathway = coagulation factor VII , X ,
V , prothrombin fibrinogen
case Vit.K Vit.K
coagulation factor 4 factor
II , VII , IX X
20. D.Potassium

Potassium, Magnesium
Potassium (ICF)
electrolyte serum (
) Potassium
clotted blood

(serology), Biochemistry

( Clotted )

( anticoagulant )

21. Bleeding time
Bleeding time
Ivy method

(vasoconstriction)
(Platelet aggregation)
(Platelet plug)

Venous clotting blood
(Screening test) Coagulation factor

intrinsic pathway

Surface activity

intrinsic
factor
Clot retraction

ATP
ADP
Thrombasthenin

plt 140,000
400,000 d. Bleeding time, VCT, Clot
retraction
Giant plt
plt

ecchymosis

bleeding time
Hematology 2007
1. C.

hematocrit (normal =
40%-54%) Hematocrit
Hct
-
Hct
-
-
-
-
-
-
Carbon monoxide (CO)

tissue Nicotine
(peripheral vasoconstriction)
2. C. gamma 4
Alpha globin gene located on the short arm
16 1globin gene 2globin gene
gene thalassemia1( -thal1) gene
-thalassemia2( -thal2) globin gene
Hb Bart Globin
gene Hb H disease
Thalassemia Death in utero
Hb Barts hydrops fatalis ( -thal1/ -thal1)Hb typing
gamma 4 gene express alpha
globin gene gamma globin gene
globin gene
globin
gamma 4 :
O2 tissue hypoxia

globin gene located on 11

0
globin -Thalassemia
+
globin gene -thalassemia 0
Thal/ -Thal
Preeclampsia
VDRL syphilis ( false negative)
3. B. Erythropoietin
Pathophysiologic classification of anemia
1.

1.1. Hypoproliferation
Iron deficient erythropoiesis
Iron deficiency , Anemia of chronic disorders
Erythropoietin deficiency
Renal disease, Endocrine deficiency
Hypoplastic anemia
Aplastic anemia, Pure red cell aplasia
Infiltration
Leukemia ,Metastatic carcinoma, Myelofibrosis
1.2. Ineffective
Megaloblastic anemia
Vitamin B12 deficiency , Folate deficiency
Microcytic
Sideroblastic anemia
2.
2.1 Inherited hemolytic anemia
2.1.1 Defects in erythrocyte membrane
Hereditary spherocytosis , Hereditary
elliptocytosis
2.1.2 Deficiency of erythrocyte enzymes
Pyruvate kinase defiency ,G6PD deficiency
2.1.3 Defects in globin structure and synthesis
Thalassemia, Hemoglobinopathy
2.2 Acquired hemolytic anemia
2.2.1 Immune hemolytic anemia

Autoimmue hemolytic anemia
Transfusion of incompatible blood
Hemolytic disease of the newborn
2.2.2 Microangiopathic hemolytic anemia
Thrombotic thrombocytopenia purpura
Hemolytic uremic syndrome
Disseminated intravascular coagulation
Prostatic valves and other cardiac abnormality
2.2.3 Infectious agents
Malaria , Clostridial infection
2.2.4 Chemicals, drugs and venoms
2.2.5 Paroxysmal nocturnal hemoglobinuria
2.2.6 Others
Hypersplenism
Hypophosphatemia
Spur cell anemia in liver disease
3.
3.1 External bleeding
3.2 Internal bleeding
Erythropoiesis, erythropoietin (EPO)
regulatory hormone. EPO
committed erythroid progenitor cells
programmed cell death
(apoptosis). EPO
Chronic renal failure (CRF) normocytic
anemia EPO
creatinine ( BUN
anemia CRF) anemia
Folic acid megaloblastic amemia (MCV = 80-95 =

normal)
monocyte
CSF granulocyte
thyroid hormone
4. C. Erythropoietin
C. normal Hb
13 , Hct 33 % Anemia
chronic renal failure
erythropoietin

anemia
A.& B. anemia Folic acid & Cyanocobalamin
Macrocyte (RBC) DNA
E. CSF marrow suppression or failure
3
5. A.
A.
Pancytopenia melena
(chronic blood loss)
C.
Pancytopenia marrow
suppressor e.g. benzene, chroramphenicol
6. C 1/2
Genotype
thal/ Hb E
E
Hb E homozygote = /
E
= /
( / ) >>>> Thalassemia
E
( / ) >>>>Hemoglobinopathy
7. E
serum direct bilirubin

Jaundice bilirubin
() posthepatic
lesion Jaundice direct bilirubin
(conjugated bilirubin)
function
8. A
/--
A. - thalassemia 1 trait (/--):
MCV
( < 80 fl )
Hb type A2 Hb A2
Hb H inclusion body (1:10000)
( microcyte )
B. homozygote - thalassemia 2 (-/-)

- thalassemia 1 trait
9. D. immune complex reaction
A.
anaphylaxis Ag IgE

mast cell mast cell granule

B.
citrate intoxication
(>2500
ml. 5000 ml. 24 hr.
C.
bacterial endotoxic ,
,
hypotension/shock, DIC,
renal failure, ,
,
D.
immune complex reaction
Ab recipient
Ag donor cytokine(IL-1,TNF)
hypothalamus PGE2
Plt.
antibody-dependent cell-mediated cytotoxicity (ADCC)

MCQ MD.316 Hematology

1. a. Iron dextran (50%)

Iron dextran
(ferrous sulfate )
2. a. Cytoplasm maturation defect
3. a. Macrophage
4. ANS
Burkitt Lymphoma
5. b. thal / Hb E
0
6. / Hb A 2
0
/ /

7. Protect PLT Agregation
8. Hemoglobin ( Hemoglobinuria)
9. Anion Exchanger
10. a. ABO non match
11. Factor VIII ( Hemophilia A
prolong & Family History)
12. e. ring sideroblast ( sure )
13. G-CSF (increase production of neutrophils)
14. Ran. ( T T )
15. d. Immature B cell
16. Vincistrine
( 3 )
17. CD 15,3
18. Hyperlipidemia
19. CD2, TCR (Marker Pre T Cell TdT, CD2,
CD3, pre-T receptor)
20. Blood Coagulation
21. Self Renewal

22. HS-40
Chromosome 16
23. D
24. Phagocyte ( Phagocyte
ADCC)ifferentiation (Isotype
switching)
25. Antibody
26. Polysaccharide Bacteria
B cell
27. Cytotoxic T Cell

28. Normochromic
Macrocytic
29. BT ( Bleeding Time ) [

Plt]
30. c.
Paracortex
31. b.
Follicle
32. PLT ABO typing group

33. Monocyte Appearance
34. Porphyrin
Synthesis
35. Deferiprone
( Caution
Deferoxamine )
36. Tissue Typing
37. Blood group

HLA
2
38. Oxygen Tissue
39. GVHD
( APC
Recipient )
40.
41. Anti Thrombin III
42. -thal 2 / -thal 2

43. PLT
sure
44. Bart Hydrop Fetalis genotype
_ _ / _ _
match
/_ _ / _ _
45. Enzyme Defect
46. Phytonadione
47. Toxoplasmosis
48. TH1
(M. tuberculosis Intracellular bacteria
delayed type hypersens.)

49. IgM
50. Protein/Peptide
51. VWF disease
52. Survival
53. CBC ( 80% )

54. Hemato Electrophoresis
55. Serum Hct
56. H antigen
57. b.
Dose
(cimetidine enz.inhibitor
warfarin)
58. EPO
59. ..sole
60. Hb
(+o+)
Cs
61. Cryoprecipitate
( Fresh Frozen Plasma
Cryo )
62. Plasma cell Myeloma
63. Bleeding time (Petichiae Primary
hemostasis
capillary&Plt)
64. Neutrophil
(Pathology)
Part Pathology 2005
1.
56 adenocarcinoma colon
poor
prognosis
A. polypoid growth
B. surface ulceration
C. circumferential growth
D. extention serosa
E. extention muscularis mucosae
2.
50 hypertension catecholamine
CT suprarenal mass
A. benign adrenal cortex mass
B. benign adrenal medullar mass
C. malignant adrenal cortex mass
D. malignant adrenal medullar mass
E. nodular adrenal cortex mass
3.
4 lower quadrant
right lower
quadrant mass. Hyperactive
bowel sounds
A. appendicitis
B. intussusception
C. strangulated hernia
D. Meckels diverticulum
E. Necrotizing enterocolitis
4.
75 stool occult
blood positive biopsy

A. vulvulus
B. diverticular disease
C. adenocarcinoma
D. vilous adenoma
E. polypoid adenoma
5.
25 HCG 8
HCG
A. adrenal adenoma
B. choriocarcinoma
C. pituitary insufficiency
D. ectopic pregnancy
E. second invasive mole
6.
24 upper outer
quadrant right breast

A. fibro adenoma
B. fibrocystic change
C. traumatic fat necrosis

D. breast abscess with scarring
E. infiltrative mammary carcinoma
7.
lymph
node
A. follicular carcinoma
B. papillary carcinoma
C. Hustle
D. medullary carcinoma
E. anaplastic carcinoma
8.
organ tetany
A. pancreas
B. thyroid gland
C. pituitary gland
D. adrenal gland
9.
40 thyroid gland T4, T3 TSH

antimicrosomal
antibody positive antibody TSH
A. Riedel syndrome
B. Graves disease
C. multinodular goiter
D. subacute thyroiditis
E. Hashimoto thyroiditis
10.
74 colicky
WBC

A. diverticulitis
B. ulcerative colitis
C. CA of sigmoid colon
D. familial adenomatous polyposis
E. villous adenoma of upper rectum
11.
60 40 10
crackle adventitious
sound, bronchial breath sound, dullness on percussion,
increased tactile fremitus
A. pneumothorax
B. pleural effusion
C. acute bronchitis
D. lobar pneumonia
E. pulmonary emphysema
12.
26
tubular, worm-like, freely move,

A. hydrocoele
B. vericocoele
C. spermatocoele
D. indirect hermia
E. ectasia of spermatic duct
13.
53
femeral fracture 4
autopsy petechiae white matter
petechiae
A. septicemia
B. Contracoup injury
C. fat embolization
D. deep venous thrombosis
E.
14.
subdural hematoma
malignancy
A. high mitotic activity
B. distant metastasis
C. nuclear plenomorphism
D. incomplete vacuolization
E. high NC ratio
15. 50
WBC 50,000/cu.mm
PMN 75%
A. gout
B. pseudogout
C. osteoarthritis
D. septic arthritis
E. rheumatoid arthritis
16.
irreversible cellular injury

A. karyorhesis
B. mitochondrial swelling
C. cytoplasmic vacuolization
D. detachment of ribosome
E. cytoplasmic hyaline droplets
17.
20
2 mild erythema cervix mucopurulent

discharge gram intracellular gram negative diplococi
A. endometriosis
B. ectopic pregnancy
C. cervical CA
D. endometrial hyperplasia
E. dysfunction uterine bleeding
18.
40
A. sebaceous gland
B. sweat gland
C. Focal invasive
D. suspensory ligament
E. scar contracture subcutaneous tissue
19.
9 7
2 body
temperature 37.3 C , BP 150/110 mmHg puffy eyelids,
pitting edema urine analysis specific
gravity 1.020, albumin 1+ ,RBC numerous, RBC cast 13
2/LPF, WBC 3-5 cells/mm
A. focal proliferative glomerulonephritis

B. diffuse proliferative glomerulonephritis
C. focal and segmental glomerulonephritis
D. diffuse thickening of glomerula capillary well
E. fusion of foot process of visceral epithelial cell\
20.
40 adult polycystic kidney

A. hepatic cyst
B. hepatic fibrosis
C. esophageal varices
D. renal cell carcinoma
E. cerebral artery aneurysm
21.
50

2 cm right upper lobe

A. lung abscess
B. bronchiectasis
C. pulmonary infarct
D. pulmonary tuberculosis
E. bronchogenic carcinoma
22.
chronic granulomatous disease
A. neutrophil
B. macrophage
C. NK-cell
D. T-cell
E. B-cell
23.
20

A. acanthosis
B. spongiosis
C. ballooning degeneration
D. cytosis
E. liquative degeneration
24.
50
1
markedly icteric sclera
AST 120 U/L ALT

150 U/L alkaline phosphatase 700
U/L total bilirubin
20 mg/dl, direct bilirubin
15 mg/dl
A. bile salt
B. vitamin K
C. globulin
D. cholesterol
E. gamma glutamyltransferase
25.
40 1 T4 2.3
(4.5-10.9) nmol/L, TSH 30
(0.5-4.7) mU/L antithyroglobulin antibody

antimicrosomal antibody titer

A. Graves disease
B. Hashimotos thyroiditis
C. subacute thyroiditis
D. thyroid carcinoma
E. submyxedema
26.
10 2
Kernig sign positive,

stiff neck test positive
cell 300/cu.mm. lymphocyte
100%,protein 240 ,sugar 10 mg/dl (blood sugar 90
mg/dl)
A. viral meningitis
B. bacterial meningitis
C. parasite meningitis
D. tuberculous meningitis
E. carcinomatous meningitis
27.
60
osteophyte spine knee joint 2

A. neoplasm
B. autoimmune
C. degenerative disorder
D. infection
E. crystal deposit
28.
50
sugar negative, protein trace, RBC

numerous, WBC numerous,
bacteria numerous, no cast

A. acute pyelonephritis
B. nephritic syndrome
C. acute cystitis
D. chronic glomerulonephritis
E. acute glomerulonephritis
29.
3
Staphylococcus Scalded skin syndrome
A. exfoliative
B. leukociditis
C. hemolysis
D. hyaluronidase
E. endotoxin-like syndrome
30.
30 fracture of femur
thrombophlebitis
A. splenic infarction
B. renal infarction
C. hepatic infarction
D. cerebral infarction
E. pulmonary infarction
31.
50 mitral valve stenosis
atrial fibrillation 10
600 g ( 250300g ) fibrinoid endocarditis ventricles

A. amyloidosis
B. infective endocarditis
C. rheumatic fever
D. ischemic cardiomyopathy
E. SLE
32.
50
jaundice
increased total bilirubin,
direct bilirubin, AST & ALT
100 U/L, alkaline phosphatase 600 U/L,
urine bilinogen positive
, urine urobilinogen negative
A. alcoholic hepatitis
B. alcoholic cirrhosis
C. hepatocellular carcinoma
D. obstructive jaundice
E. hemolysis
33.
40
2
smear sliding hiatal hernia

A. incarcerated
hernia
B. strangulated hernia
C. esophageal obstruction
D. esophageal perforation
E. gastroesophageal reflux
34.
25 1 UA
protein 3+ , WBC 10-15

3
cells/mm ,RBC 30-40 cells/ mm anti-dsDNA

positive

A. serum sickness
B. rheumatoid arthritis
C. Henoch-Scholein purpura
D. SLE
E. post-streptococcal glomrulonephritis
35.
28
hyaline membrane
disease

A. alveolar infiltration
B. alveolar collapse
C. pulmonary congestion
D. pulmonary artery anomaly
E. airway obstruction
36.
40 pleural effusion
cell count
50
cells/ mm ,L 100% , protein 1.5
U/L (serum protein 7 g/l, serum

LDH 350 U/L ) pleural effusion
A. metastatic cancer
B. rheumatoid arthritis
C. tuberculosis
D. congestive heart failure
E. SLE
37.
50 20
specific.gravity 1.012,sugar 3+
,protein 3+
A. acute pyelonephritis
B. cortical necrosis
C. necrotizing papillitis
D. nodular glomerulosclerosis
E. diffuse proliferative glomerulonephritis
38.
50 2 chest x-ray
apex of left lung biopsy

acidophilic amorphous necrotic
material
lymphocyte, histiocyte, multinucleated giant cell

A. tuberculosis
B. lung abscess
C. large cell carcinoma of lung

D. pneumocystic carinii pneumonia
E. cytomegalic inclusion disease

39.
osteogenic sarcoma long bone
joint
A.
B.
C.
D.

E. microenvironment joint
40.
59
respiratory failure
A. symmetrical atrophy of frontal cortex
B. decreased pigmentation at locus celureus and

substantia nigra
C. granulovascular degeneration and neuritic plaque
with neruofibrillary tangles
D. demyelation of posterior column of spinal cord
E.
degeneration of motor neuron at motor
cortex,anterior horn cell

41.
x-ray markedly dilated loop
of small and large intestine
A. aganglionosis in the rectum

B. atrophy of the colonic mucosa
C. hypertrophic pyloric stenosis
D. Meckels diverticulum
E. multiple polyps in the colon
42.
A. tetralogy of Fallot
B. ventricular septal defect
C. atrial septal defect
D. patent ductus arteriosus
E. coarctation of aorta
43.
60 1 biopsy
metastatic tumor
AFP primary tumor
A. prostatic cancer
B. renal cell carcinoma
C. colorectal adenocarcioma
D. hepatocellar carcinoma
E. aquamous cell carcinoma of lung
44.
35
2 free T4 TSH

A. colloid goiter
B. multinodular goiter
C. follicular adenoma
D. diffuse hyperplasia
E. subacute granulomatous thyroiditis
45.
60 1 biopsy
metastatic tumor -fetoprotein
primary tumor
A. prostatic carcinoma
B. renal cell carcinoma
C. adenocarcinoma of colon
D. hepatocellular carcinoma
E. squamous cell carcinoma of lung

46.
50 colonic polyps
A. retention polyps
B. lymphoid polyps
C. hyperplastic polyps
D. Pertz Jehger syndrome
E. familial adenomatous polyposis
47.
50 sliding
hernia
A. strangulated hernia
B. incarcerated hernia
C. esophageal obstruction
D. carcinoma of stomach
E. esophageal reflux
48.
50 parathyroid gland 8
parathyroid gland 2 .
parotid gland
microscopic examination neoplastic
lesion epithelium and myoepithelium

acini lobule,duct
complication
A. ipsilateral submaxillary salivary gland carcinoma
B. contralateral immune mediated parotitis
C. regional LN metastasis
D. hematogenous spreading to bone or lung
E. local recurrence
49.
50 parotid gland 8
parotid gland single mass
2cm parotid gland microscopy
neoplastic lesion epithelial & myoepithelial cell
acute tubular & duct ,myxoid &

chondroid stroma parotid lesion
A. local recurrence
B. regional lymph node metastasis
C. hematogenous metastasis to bone and lung
D. contralateral immune-mediated parotitis
E. ipsilateral submaxillary salivary gland neoplasm
50.
50 1
investigate
A.
B.
C.
D.
51.
50 3
lobar pneumonia right lower lobe

A. Streptococcus.pneumoniae
C. Mycobacterium pneumoniae
D. Staphylococcus aureus
52.
30
cumulative risk
A.
B.
mammogram
C. PAP smear
D. occult blood
53.
diverticulitis
A. malabsorption
B. carcinoma of colon
54.
acute hepatitis HBV

A. immune
55.
VDRL positive 1:128
Part Pathology 2006

1.

A. lymphatic dilate
B. vascular permeability

C. increase blood flow

D. increase hydrostatic pressure
2.
Irreversible cellular injury

A. karyorrhexis
B. mitochondrial swelling
C. cytoplasmic vacuolization
D. detachment of ribosome
E. cytoplasmic hyaline droplets
3.
liquefactive necrosis

A. brain
B. liver
C. pancreas
D. kidney
E. lung
4.
25 . CT scan
parenchyma cyst

A. hydatid encephalitis
B. Neurocysticerocosis
C. Toxoplasmotic encephalitis
D. Amoebic meningoencephalitis
E. Eosinophilic meningoencephalitis
5.

Na+ 145, Cl - 120
specific gravity 1.001
A. Hypothalamus + par distalis

B. Hypothalamus +par nervosa
C. Par distalis + thalamus
6.
A. Ankylosing
B. Hip translocation
7.
25
bacterial meningitis
A. 4
B. 37
C. lab
D. lab
E. preservative
8.
10
A. Myocarditis
B. Contractive pericarditis
C. sepsis Arthritis
D. Endocarditis fibroelastosis
9.
30 stiff neck
CSF WBC 1,000, L 90% , N 10% blood sugar 90,
protein 60, lymphocyte 60%, neutrophil 20%
A. viral meningitis
B. fungal meningitis
C. bacterial meningitis
D. TB meningitis
E. cranio tumor
10.
Cell count 10,000 N 90 % L10%
30 ( 80) 80
A. N.menigitis
B. H.infiuenza
D. Streptococcus agalicatiae
11.
12. COPD 2 .
O2
A. Pons
B. Medulla
C. Limbic system
D. Hypothalamus
E. carotid body
13.

A. neural tube
B. anterior neuropore
C. posterior neuropore
D. vertebra + spine
E. Back wall
14.
60 X-ray osteoblastic lesion
femur ,humerus metastatic tumor tumor

15.
De Quervains tenosynovitis
A.
B.
c.
C.
D.
16.
30 fine tremor,
moist skin,enlarge thyroid gland

A. colloid goitor
B. multinodular goitor
C. follicular adenoma
D. diffuse hyperplasia
17.
25 transaction
pituitary ( pituitary stalk) 1 wk

A. hyperaldosteronism
B. hypervassopressin
C. hypergonadotrophin
D. hyperthyroidism
E. hyperprolactin
18.
60 80 kg. 165 cm.

hyperuricemia CT scan Internal
capsule infarct infarct
A. Obesity
B. DM
C. Hyperuricemia
D.
E. Postmenopause
19.

marker
A. CEA
B. alpha-fetoprotein
C. AFP
D. ALT
E. CA-125
20.

A. Thyroglossal duct cyst
B. Lingual thyroid
21.
A. Urachus
B. Merkels diverticulum
22.
loop small
intestine dilate colon
A. rectal aganglion
B. Meckel diverticulum
23.
50 20 (portal
hypertension) Cell

A. regeneration and fibrosis
24.
5 hematuria urine sp.gr.= 1.035

WBC 10-20 cell/HF RBC: numerous with RBC cast sugar:
negative protein 2+
A. endothelial proliferation
B. increase mesangial matrix
C. glomerular sclerosis
D. mesangial interposition
25.
10 , BP
140/90, WBC 20-30 /HPF, protein +2, RBC numerous, red
cell cast 1-2 /HPF, , 3
26.

Lab

A.
B. 4 c
C. 37 c
D. -21 c
E. transportation
27.
50
2 BP 160 /100 BUN 80 creatinin
8 ultrasound Urine
A. RBC cast
B. WBC cast
C. Board cast
D. Uric sediment
E. Oval fat body
F. Waxy cast
28.
40 diarrhea Moderate
dehydration BP 80/60 fluid
BP 110/70 200 mL/24. BUN
50 Cr 5
A. acute tubular necrosis
B. acute interstitial nephritis
29.
35
U/A protein3+, glucose-ve,RBC
A. Lupus nephritis
B. Nodular glomerulosclerosis
C. Membranous proliferative glomerulonephritis
D. Minimal change glomerulonephritis
E. Endocapillary glomerulonephritis
30.
protein 4+, RBC 2-3

cell / HF, WBC 2-4 cell / HF
A. Focal sclerosis
B. Membranous.
31.
3 edema 2 BP 90/160,
WBC 2-4 /HPF, RBC 2-3 /HPF, fine granular
cast 0-2 /LPF, oval fat body 2-3 /HPF protein +4

32.
50 adult polycystic kidney disease
A. Hepatic fibrosis
B. Hepatic hemagioma
C. esophageal varices
D. enal cell carcinoma
E. cerebral artery aneurysm
33.
3
intravenous pyelography 3 cm

A. Wilms tumor
B. Neuroblastoma
C. Polycystic
D. Renal cell carcinoma
D. Transitional cell carcinoma
34.
50 pap
smear malignant squamous cell
A. External os
B. Endocervix
C. Ectoendocervical junction
D. Lower Ectoendocervical junction
E. Posterior part of vagina
35.
45

20
A. cervix
B. ovary
C. vagina
D. vulva
E. endometrium
36.

10 cm
A. teratoma
B. choristoma
C. chondroma
37.
2 2 cm
alfa-fetoprotein ultrasound
solid mass 2 cm neoplasm
A. teratoma
B. seminoma
C. leydig cell tumor
D. yolk salk tumor
E. gonadoblastoma
38.
60 Old
myocardial infarction slide fibrous scar
myocardium
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Coagulation necrosis
E. Cloudy swelling
39.
40.
benign malignant
A. metastasis
B. active mitotic
C. pleomorphic
D. pyknotic nucleus
E. encapsulate
41.
osteoblastic reaction X-ray

A. colonic carcinoma
B. Prostatic carcinoma
C. multiple myeloma
D. Blongcogenic carcinoma
Part Pathology 2007

1.
50 10
A. liver
B. stomach
C. pancreases
D. duodenum
E. gall bladder
2.
17
pubic hair blind
vaginal pouch labia majora
ultrasound uterus
A. Turner syndrome
B. Gonadal dysgenesis
C. Adenogenital syndrome
D. Female pseudohermaphrodite
E. Testicular feminizing syndrome
3.
55
transitional cell carcinoma

A.
B.
C.
D.
E.
4.

( NG tube )
A. midgut volvulus
B. duodenal atresia
C. annular pancrease
D. hypertrophic pyrolic stenosis
E. esophageal atresia
5.
30
stiff neck papilledema muscle

weakness
A. brain abscess
B. hydrocephalus
C. Thrombotic stroke
D. acute bacterial meningitis

E. Ruptured cerebral aneurism
6.
35 1
6 cm hard consistency bloody discharge
nipple lymph node 4 cm
A. 6 cm
B.
C. bloody discharge
D. LN
E. Hard consistency
7. resolution
A. ruptured spleen
B. skin ulcer
C. lobar pneumonia
D. bowel gangrene
E. chronic viral hepatitis
8.
35 diffuse
enlargement of thyroid gland, free T4 lab
A. thyroid scan
B. triiodothyroxine
C. thyroxine binding globulin
D. TSH
E. TRH
9.
BP buffalo
hump serum electrolyte
A. hyponatremia
B. hypokalemia
C. hypocalcemia
D. metabolic alkalosis
E. hyperuricemia
10.
acute
appendicitis inflammation
A. serous inflammation
B. organized inflammation
C. fibropurulent inflammation
D. granulomatous inflammation
11.
abscess Gram +ve cocci in
cluster Lymph node pathology

A. sinus histiocytosis
B. follicular hyperplasia
C. parafollicular hyperplasia
D. granulomatous hyperplasia
E. interfollicular hyperplasia
Pathology
Part Pathology 2005
1.
D. extention serosa, surgical staging of
colonic cancer
2. B. suprarenal /adrenal mass
catecholamine NE+E
hypertension
pheochromocytoma adrenal medulla

benign tumor malignant metastsis

3.
B. intussusception
4.
B. diverticular disease, outpouching of mucosa
5.
E. second invasive mole
see gross patho of intuss
( invasive mole 10% choriocarcinoma

2.5%)
6.
D. breast abscess with scarring

( acute
inflammation acute
mastitis breast abscess nipple fissure
bacteria
reparative process fibrosis abscess
cavity )
7.
B. thyroid carcinoma
lymphatic papillary
cancer follicular cancer

hematogeneous
8.
tetany calcium
parathyroid calcium
9.
E. Hashimoto thyroiditis
antimicrosomal antibody positive Hashimoto thyroiditis
hypothyroid
10.
inadequate data
11.
D. lobar pneumonia
( signs consolidation crackle adventitious
sound, bronchial breath sound, dullness on percussion,

increased tactile fremitus)
12.
B. Varicocele
(a non-tender, twisted mass along the spermatic cord is
felt (it feels like a bag of worms.) The mass may not be
obvious, especially when lying down, hydrocele sac
contains fluid with transillumination test +, indirect hernia

(congenital) ,
spermatocele ectasia of spermatic duct
small cystic accumulation of semen in dilated efferent ducts
or ducts of rete testis smooth soft well circumscribed)
13.
C. fat embolization
fat emboli complication fracture
fat emboli
fat marrow bone marrow
vascular injury
fat emboli blood circulation

(ischemia) petechiae
necrosis (Reference Kumar
V, Abbas AK, Fausto N. Robbins & Cotran Pathological Basis
th
of Disease. 7 Philadelphia: Elsevier Saunders; 2005)

14.
B. distant metastasis, most important
characteristic of malignancy
15.
A. Gout
(cystral) crystal-induced arthritis
urate crystal pseudogout

calcium pyrophosphate crystal rhomboid
polarized light microscopy urate crystal negative

birefingent calcium pyrophosphate positive
birefringent
Reference Kumar V, Abbas AK, Fausto N. Robbins & Cotran
th
Pathological Basis of Disease. 7
Philadelphia: Elsevier
Saunders; 2005
(synovial fluid)
inflammatory noninflammatory disorders
noninflammotory diseases
(viscous) (ampur-colored) WBC count
2000/mL mononuclear cells
inflammatory disorders
WBC count 2,000-50,000/mL
neutrophils
septic arthritis WBC count
50,000/mL neutrophils (
rheumatologist . )
Reference Harris ED, Budd RC, Firestein GS, Genovese MC,

Sergent JS, Ruddy S, et al.
Kelley's Textbook of
th
Rheumatology. 7 ed. Philadelphia: Elsevier Saunders; 2005

16.
A. karyorhexsis

necrosis
reversible cellular injury
17.
B. Ectopic pregnancy
Gonorrhea (intracellular gram negative diplococi)
ascending infection pelvic

inflammatory disease tuboovarian abscess PID
ectopic pregnancy
A. Endometriosis
1) Regurgitation theory
utrine tube
2)Metaplasic differentiation of coelomic epithelium

(endometrium coelomic epithelium )
3) Invasive/lymphatic dissemination theory
endometrium /
C. Cervical CA HPV
type16, 18(high risk)
D. Endometrium hyperplasia
estrogen
Intrinsic estrogen ( polycystic ovarian disease, functioning
granulose cell tumor of ovary)
Extrinsic estrogen (estrogen replacement therapy)
E.
Dysfunction uterine bleeding

1)Anovulatory bleeding
estrogen
2)Luteal phase defect corpus luteum

progesterone

18.
C. Focal invasive
local
lymphatic drainage lymphedema thickening

skin
19.
B. Diffuse proliferative glomerulonephritis

strep hypertension ,
nephritic syndrome , nephritic acute poststrep GN pathology

diffuse proliferative glomerulonephritis
20.
E. Cerebral artery aneurysm
Adult polycystic kidney cerebral artery aneurysm

hepatic cyst fibrosis
infantile/autosomal recessive polycystic
21.
A. Lung abscess
infection 2
acute process
x-ray cavity 2 cm right upper lobe
22.
B. macrophage
chronic
granulomatous disease
immune response
Chronic granulomatous disease

delayed type
hypersensitivity (hypersensitivity type IV)
aggregate of epithelioid cells

granuloma lymphocytes multinucleated giant cells
epithelioid cells activated macrophages
macrophages T helper1 cytokine
IFN-
Reference Kumar V, Abbas AK, Fausto N. Robbins &

Cotran
Pathological
Basis
of
Disease.
th
Philadelphia:
Elsevier Saunders; 2005

23.
B. spongiosis, underlying pathology of vesicle in
acute eczema
24.
B. Vitamin K
Obstructive jaundice fat malabsorption vit K

def ( K )
25.
B. Hashimotos thyroiditis common cause of
acquired hypothyroidism autoimmune

antibody (show positive antithyroglobulin antibody
antimicrosomal antibody ) thyroid gland thyroid
peroxidase,thyroglobulin
hyperthyroidism follicular cell
thyroid gland hypothyroidism
26.
D. tuberculous meningitis CSF protein sugar
lymphocyte
predominate
27.
C. degenerative disorder
(Symmetric) osteophyte
spine (
) Knee joint
osteoarthritis
Osteoarthritis degenerative joint disease (misnomer

itis
inflammatory disease) progressive degeneration of
articular cartilage primary (idiopathic) secondary
OA post-traumatic underlying systemic diseases
degeneration cartilage
(granular) cartilage subchondral
bone eburnation of articular
surface narrowing of joint space osteophyte
Pathological
Basis
of
Disease.
th
Philadelphia:
Elsevier
Saunders; 2005
28.
C. Acute cystitis =acute onset , pain at
bladder ,urine show infection+inflammation

no kidney lesion
29.
A. Exfoliative toxin
no cast indicate
Staphylococcus scalded skin syndrome (SSSS)

Staphylococcuc
aureus Exfoliative toxin Exotoxin

30.
E. Pulmonary infarction
Complication of Fracture
Infection
fracture healing process
Delayed union resulting from inadequate immobilization

or poor alignment
Nonunion
bone
Malunion
bone bone
Fat embolism bone marrow
circulate in blood circulation obstruct vessel

respiratory failure
31.
Nerve damage
C. Rheumatic fever
Mitral valve stenosis rheumatic

heart disease
dyspnea, congestive heart failure, arrhythmia
(especially atrial fibrillation) risk endocarditis
Amyloidosis - deposit of proteinaceous substance

between cell
Infective endocarditis - , fungal,
rickettsiae, Chlamydia subacute
fatique, weight loss,
flulike syndrome acute - rapid develop fever, chills,
weakness, glomerulonephritis, hematuria : invasion of
microbe at heart valve or mural endocardium vegetation
Diag : Duke criteria
SLE - Systemic Lupus Erythematosus Endocarditis
(Libman-Sacks Disease) mitral & tricuspid valvulitis :
small vegetation
32.
D. Obstructive jaundice, typical lab findings

Serum alkaline phosphatase Biliary obstruction,
serum aminotransferase 2-10

Jaundice type
Hyperbilirubinemi
Urine
Urine
bilirubin
urobilinogen
Hepatocellular
Conjugated/Unco
jaundice
njugated
Obstructive
Conjugated
Normal /
jaundice
Hemolytic
unconjugated
absent
jaundice
33.
E. gastroesophageal reflux (common complication
of hiatal hernia)
hiatal hernia - sliding hiatal hernia
- paraesophageal hiatal hernia
strangulated
gastroesophageal reflex sliding hiatal hernia
Hiatal hernia bleeding perforate
34.
D. Systemic lupus nephritis

autoimmune disease antibodies nuclear
antigen
anti-double stain, anti-Sm 4 11
clinical criteria
(1997
revised criteria for classification of SLE)

1. Malar rash
2. Discoid rash
3. Photosensitivity
4. Oral ulcer
5. Arthritis
6. Serositis
7.
Renal disorder proteinuria, cellular cast
8.
Neurologic disorder seizure, psychosis
9.
Hematologic disorder hemolytic anemia, leucopenia,

lymphopenia, thrombocytopenia
10. immunologic
disorder anti-ds DNA, anti-Sm and/or
antiphospholipid
11.
antinuclear antibodies

Pathological
Basis
of
Disease.
th
Philadelphia:
Elsevier
Saunders; 2005
B. alveolar collapse
35.
prematurity deficiency of surfactant

pneumocytes
type II alveolar collapse
D. Congestive heart failure
36.
transudate effusion [low cell count <2500/

3
mm , lymphocyte 100%,
Protein pleural to serum ratio < 0.5] exudate

effusion
Transudates: increased in hydrostatic pressure or
decreased plasma oncotic pressure
Congestive
heart failure
Hepatic uremia
cirrhosis
Hypoproteinemia (e.g., nephrotic syndrome)
Exudates: increased capillary permeability or decreased
lymphatic resorption
Infections
Tuberculosis
Bacterial pneumonia
Viral or mycoplasma pneumonia
Neoplasms
Bronchogenic carcinoma
Metastatic carcinoma
Lymphoma
Mesothelioma (increased hyaluronate
content of effusion fluid)
Pulmonary infarct (may be associated with
hemorrhagic effusion)
Noninfectious inflammatory disease involving
pleura
Rheumatoid disease (low pleural fluid glucose
in most cases)
Systemic lupus erythematosus (LE cells
occasionally present)
Fluid From Extrapleural sources
Pancreatitis (elevated amylase activity and low
pH)
Urinothorax (elevated creatinine and low pH)
37.
D. nodular glomerulosclerosis
pathology in DM with renal involvement(diabetic

nephropathy) are nodular glmerulosclerosis( is pathognomonic
lesion )and diffuse
38.
glmerulosclerosis
A. tuberculosis
typical caseous
granulomatous inflammation
mycobacterial infection Mycobacterial tuberculosis

apex of lung high oxygen tension

39.
B.

40.
E. degeneration of motor neuron at motor cortex,
anterior horn cell

ascending paralysis Guillian-Barre
syndrome
acute inflammatory demyelination

demyelination anterior
column of spinal cord degeneration of
motor neuron
D lesion anterior column (motor)
posterior column
(sensory)
Pathological
Basis
of
Disease.
th
Philadelphia:
Elsevier
Saunders; 2005
41.
A. aganglionosis in the rectum
most compatible
anatomical site and

clinical than other choices
42.
A. tetralogy of Fallot
congenital cyanotic heart disease right
to left shunt
noncyanotic heart
disease left to
right shunt patent ductus arteriosus, atrial and ventricular
septal defect
shunt coarctation of aorta
late cyanosis
43. D. hepatocellar carcinoma (AFP commonly relates

to HCC and nonseminoma testicular CA)
44.
D. Graves disease is primary hyperthyroid (free
T4 TSH )
+ thyrotoxicosis(
2 ) pathology= diffuse hyperplasia

45.
D. hepatocellular carcinoma (see above)
46.
E. familial adenomatous polyposis (see
pathogenesis of CA colon in any patho textbooks) Nonneoplastic polyps - hyperplastic polyps

- harmatomatous polyps PeutzJeghers syndrome,
Cronkhite-
Canada syndrome, Cowden disease

- inflammatory polyps tuberous
sclerosis
- lymphoid polyps
Adenomatous polyps -true neoplastic lesion
familial adenomatous polyposis
47.
E. esophageal reflux (?, incomplete question,
missing hiatal?)
48..
49..
50.
D.
abnormal uterine bleeding postmenopausal

woman endometrial carcinoma
51.
K. pneumoniae
lobar pneumonia Streptococcus

pneumoniae alcoholism middleaged men
52 ..
53. diverticulitis obstruction perforateion
bleeding, peridiverticulitis,
dissect into the immediately adjacent pericolic fat, extension
g pericolic abscess, pelvic and generalized
peritonitis
54. HBV Proliferative phase

HBV infect hepatocytes hepatocye express HBsAg & HBcAg
+

CD 8 T cell infected hepatocyte
Integrative phase viral DNA
Host genome risk of hepatocellualr CA
immune defect mild liver injury
55.
VDRL positve syphilis
Part Pathology 2006

1.
B. vascular permeability

inflammation
2.
injury to capillary endothelium
reversible cellular injury - generalized swelling
of cell and its organs

- blebing of plasma membrane
- detachment of ribosome
- nuclear chromatin clumping
Irreversible cellular injury - swelling & disruption of

lysosome
- large amorphous densities in swollen
of mitochondria
- disruption of cellular membrane
- pyknosis (nuclear condensation)
- karyorrhexis (nuclear fragmentation)
- karyolysis (dissolution of the nuclear)
3.
()
liver
brain ischemic
pancreas kidney lung cell
bacterial infect
ischemic
coagulative necrosis ( acute pancreatitis fat necrosis)

4.
B. Neurocysticerocosis
T. solium in raw meat ->
cysticercosis present with multiple cysts in cerebral cortex

5.
most likely central DI involve posteria
pituitary(par nervosa?) and hypothalamus

6..
7..
8.
A. Myocarditis
9.
A. viral meningitis mild increase WBC, lymphocyte
predominate, no low sugar

10.
A. N.menigitis more common than other choices
CSF show bacterial infection(marked increase wbc with n

predominate
11
12
13
14.
prostatic carcinoma lung
carcinoma
common metastatic
cancer prostatic carcinoma, breast carcinoma,
lung carcinoma carcinoma of kidney
neuroblastoma, Wilms tumor rhabdosarcoma

osteoblastic lesion prostatic carcinoma, lung
carcinoma breast carcinoma
Pathological
Basis
of
Disease.
th
Philadelphia:
Elsevier
Saunders; 2005
15.
B. De Quervains tenosynovitis
abduction policis longus extensor
policis bravis typing, gripping objects

wringing clothes ( anatomy
orthopaedics )
Reference Salter RB. 3
rd
Textbook of Disorders and Injuries
of the Musculoskeletal System; 1999

16.
D. diffuse hyperplasia , hes Graves disease
17.
B. hypervassopressin
pituitary stalk is the neural tract to post pituitary regurate

ADH(vasopressin) secretion trauma can cause both
hypo/hyper vasopressin
journal hyperprolactin
18.
19.
A. CEA (tumor marker of CA colon)
20.
A. Thyroglossal duct cyst more common than
Lingual thyroid
21
22. A. rectal aganglion ()
23..
24.
incomplete
question? History of strep infection
+nephritic+nephritic->diffuse proliferative GN
absece of history
may be minimal change GN with focal glomerulosclerosis
25.
History of strep infection,hypertension BP
140/90 +nephritic
RBC numerous, red cell cast
1-2 /HPF +nephrotic protein +2->diffuse proliferative GN

Poststrep GN
26.
27.
F. Waxy cast
chronic renal failure ( waxy
cast?)
28.
A. acute tubular necrosis
with acute renal failure BUN 50 Cr 5 (oliguric

phase 200 mL/24.)
29.
A. Lupus nephritis
malar rash
polyarthritis,
alopecia , renal involvement(nephro+nephri)

30.
Incomplete question, nephrotic syndrome in
children=minimal change , in adult = membranous GN
31.
nephrotic syndrome
3 /HPF protein +4
32.
, protienuria oval fat body 2-
in children=minimal change
E. cerebral artery aneurysm at circle of Willis

ADPKD autosomal dominant
polycystin vascular smooth muscle cerebral artery

aneurysm
33. A. Wilms tumor
This disease
is the most common renal tumor in
children b. Neuroblastoma suprarenal tumor ,d. Renal cell

carcinoma adult, e. Transitional cell carcinoma
adult
34.
D. Lower Ectoendocervical junction

squamo-columnar junction
squamous cell carcinoma

35.
A. cervix
epidemiologic factors invasive squamous

cell carcinoma (Early sexual activity, multiple sexual partners,
cigarette smoking)
36.
A. teratoma
tumor of germ cell origin
tissue elements 2-3 embryonic layers

ectoderm, mesoderm endoderm
37.
D. yolk sac tumor (endodermal sinus tumor)

alfa-fetoprotein
38.
B. hypertrophy
cellular adaptation work load
39.
40.
A. metastasis ()
41.
B. Prostatic carcinoma
osteoblastic lesion prostatic

carcinoma, lung carcinoma breast carcinoma
Part Pathology 2007
1.
C. pancreases
(chronic pancreatitis
2.
fat malbsorption steatorrhea)
E. Testicular feminizing syndrome

complete androgen insensitivity syndrome
genetic disorder xy fetuses

androgen external genitalia female
phenotype blind pouch vagina
uterus, fallopian tubes ovaries testes
abdomen inguinal canal
3.
A.
risk factor of TCC
4.
E. esophageal atresia
(most compatible with clinical of proximal obstruction)

5.
E. Ruptured cerebral aneurism

acute

ICP
subarachnoid space the worst

headache I ever had
Brain abscess headache, lethargy, fever, nuchal
rigidity blood borne
Metastasis
Hydrocephalus communicate (nonobstructive) hydrocephalus
noncomunicate (obstructive) hydrocephalus
ICP headache, papilledema
Thrombotic stroke atherosclerosis
carotid bifurcation,
origin of middle cerebral artery
acute bacterial menigitis , , , stiff neck
6.
D.
7.
C. lobar
LN
pneumonia
Lobar pneumonia
Consolidation of entire lobe
Organism:
Streptococcus pneumoniae (95%) Type 1, 2, 3, 7 or

Klebsiella pneumoniae, Haemophilus influenzae
Four classic stages

Stage of Congestion (Day 1-2)
Gross:
Heavy, boggy, and red
Microscopic:
Vascular engorgement, intra-alveolar fluid

with few neutrophils and numerous
bacteria
Stage of Red Hepatization (Day 2-4)

Gross:
Distinctly red, firm, and airless, liver-like

consistency
Microscopic:
Massive confluent with exudation (RBC,

neutrophils, and fibrin filling in alveolar
spaces)
Stage of Grey Hepatization (Day 4-8)

Gross:
Grayish brown, dry surface
Microscopic:
Disintegration of red cells
Persistence of a fibrinosuppurative exudate
Stage of Resolution (Day 8)

Gross:Brownish red, spongy cut surface
Microscopic:
Progressive enzymatic digestion to produce
a granular, semisolid debris
8.
D. TSH
This case is Graves disease =Low TSH ->primary( high
TSH -.> secondary )
9.
B. hypokalemia
buffalo hump cushings
syndrome
Glucocorticoid has mineralocorticoid-liked property->NA
retension(hypernatremia) and increase K exceretion->
hypokalemia
BP
ACTH Cortisol & Aldosterone hyponatremia
10. A. serous inflammation
Acute appendicitis supperative
purulent inflammation
Characterized by large pus Neutrophil, necrotic
cells & edema fluid
- Serous inflammation - skin blister out pouring of
thin fluid plasma mesothelial - cell secretion
peritoneal, pleural, pericardial cavities
- Fibrous inflammation - in the lining of body

cavities meninges, pericardium & pleura fibrinous
exudates vascular leakage fibrinogen
vascular barrier
- granulomatous inflammation
focal accumulation of activated
Macrophage epithelioid cells TB
11.
A. sinus histiocytosis
Sinus histiocytosis (reticular hyperplasia)
Distention and prominence of the lymphatic
sinusoids
Causes: nonspecific but may be prominent in
lymph nodes draining of cancers e.g. breast
carcinoma
Several different morphologic alterations depending on
the underlying stimuli
Follicular hyperplasia
B-cell response
Germinal center & Marginal zone hyperplasia
Causes: rheumatoid arthritis, toxoplasmosis and

early stage of HIV infection
C. parafollicular hyperplasia
Paracortical lymphoid hyperplasia
T-cell response
Paracortical expansion
Causes: drug-induced reaction (especially
Dilantin), acute viral infection (e.g. infectious
mononucleosis), vaccination
D. granulomatous hyperplasia

- lung abscess

Acute lung abscesses are not well separated from

the surrounding pulmonary parenchyma. They exhibit
abundant polymorphonuclear leukocytes and, depending on
the age of the lesion, variable numbers of macrophages.

Debris from necrotic tissue may be evident. The abscess
surrounded by hemorrhage, fibrin, and inflammatory cells. As
the abscess ages, a fibrous wall forms around the margin.
Lung abscess differ from those elsewhere in their capacity for
spontaneous drainage. The cavity thus formed air, necrotic
debris, and inflammatory exudate, creating a fluid level that is
easily seen radiographically. The lining becomes covered with
regenrating squamous epithelium. Walls of old abscesses may
be lined by ciliated respiratory epithelium, making distinction
from bronchiectasis difficult.
Rubins pathology, 5th edition, p.503.
- Aschoff body
Rheumatic heart disease
- MG thymus
Thymic epithelial cells nicotinic acetylcholine receptor

anti-acetylcholine antibodies
thymus MG
thymic hyperplasia thymoma
Reference Rubin E, editor. 5 Rubins Pathology; 2008

th
- MG Thymus
myasthenia gravis associated with thymoma
(Epidermiology and Medical

biostatistics)
Part Epidemiology and Medical biostatistics 2005

1.
60-70
linear relation
null hypothesis
A.
B.

C. inverse relation
D.
E.
< 0.05
2.
serum potassium
25 2
serum potassium
A. rapid T-test
B. chi-squae test
C. logistic regression
D. pearson correlation
E. variant analysis
3.
200
positive
negative
60
40
20
80
positive
A. 0.3
B. 0.33
C. 0.6
D. 0.67
E. 0.75
4.

cut point -
5.
cerebrovascular disease
ODD ratio
95%Cl
1.8
0.99-2.20
0.4
0.35-0.45
0.9
0.75-2.10
50
2.3
1.55
0,96-3.20
0.44-2.85
protective factor
A.
B.
C.
D.
50
E.
6.
clinical trial
( validity )
A.
B.
C.
D. ( randomization )
E.
100%

1.

cutoff
2.
infarction

A. chi-square test
B. paired t test
3.
1,000

Specificity

A. 60
B. 86
C. 71
D. 92
E. 83
4.
Ratio
A.
B.
C.
D.
E.
5.
50
(
)
type II error
A.

B.
C. p< 0.05 p< 0.01
D.
p < 0.05 p< 0.1
E.
6.
Hct% 60
normal distribution
A. median S.D.
B. mean S.D.
C. median range
D. mean range
E. mode range
7.
.
1,000 100
10
A. cluster sampling
B. simple random sampling
C. systematic random sampling

8.
60 1,000
DM 200

DM
50 incidence
A. 5%
B. 6.25%
C. 20%
D. 25%
E.
9.
50%
case-control aspirin
Odds ratio = 0.7 confident
interval 95% 0.3-1.3
2
confident interval 95%
A. 0.3-1.3
B. 0.3-0.7
C. 0.5-0.9
D. 0.1-1.1
E. 1.3-2.9
10.
4/1000 P-value =
0.9 power = 93%

A. Type I error = 0.07

B. Type II error = 0.07
C. Type I error = 0.1
D. Type II error = 0.1
E. Type I error = 0.9
11.
( )

A. chi-square test
B. unpaired t-test
C. paired t-test
D. correlative regression

1.
70 0.1/
0.08/
0.02/ life expectation 70
A. 1
B. 2
C. 5
D. 8
E. 10
2.
CA breast stage 1,2,3,4

20,40,60,80 ( 4 )
A. Ratio
B. Interval
C. Nominal
D. Ordinal
3.

4 20,35,35,10
A. Interval
B. Ordinal
C. Ratio
D. Nominal
4.
leptospirosis 2548
= 0.4 = 0.02
case fatality rate
A. 0.0002
B. 0.004
C. 0.4
D. 0.02
E. 0.4
(Epidemiology and Medical Biostatistics)

Part Epidemiology and Medical Biostatistics 2005
1.
B.
1. ratio scale
Interval scale
Quatitative data
simple regressive y = mx+c

linear relation
2. Null hypothesis
(y) (x)
2
2.
B. chi-squae test
Serum potassium ratio scale outcome
input
A. rapid T-test
B. chi-squae test +
C. logistic regression
OR(odds ratio)
D. pearson correlation ratio scale
E. variant analysis ANOVA

3.
C. 0.6
Positive predictive value
(60/100) x 100 =60%

= TP/(TP+FP)
Negative predictive value= TN/(TN+FN)
4.
C.
cut-point

2
cut-point
2
(Type 1 Type 2 Error )
5.
B.
95%CI 1
<1
odds ratio
>1 risk factor
=1
<1 protect factor
95% CI 1 95
100 1
odds ratio
=1
6.
D. (randomization)

random error
internal validity
1.
A.
2.
choice
A. chi-square
B. Paired t test
Attribute risk
3.
B. 86
specificity() = TN/
(TN+FP)=600/700=0.857 0.86
sensitivity()= TP/(TP+FN)=
250/300=0.83
4.
A.
5.
A.

6.
B. mean S.D.
7.
A. cluster sampling
8.
B. 6.25%
Incidence () =
/
= - DM = 1000-200
= 800
Incidence = (50/800) x 100 = 6.25
9.
C. 0.5-0.9
95%CI
point estimate odds ratio 0.7

B
-
95%CI
sinificant 1 D,E
10.
C. Type I error = 0.1
11.
A. chi-square test
ordinal scale
nominal scale
A. chi-square test
B. unpaired t-test
C. paired t-test
ratio scale +
D. correlative regression
1.
E. 10
life expectation
= 1/mortality = 1/0.1=1/(0.02+0.08)
=10
2.
C. Nominal
3.
C. Ratio
4.

case fatality rate
total case death / total of that case
(Professional skill and Bioethics)
Part Professional skill and Bioethics 2005

1.
10
A. paternalism
B. virtue theory
C. rights theory
D. utilitarianism
E. libertarianism
2.
A. autonomy
B. beneficence
C. confidentiality
D. non-maleficence
E. conflict of interest
3.

A. attitude
B. norm
C. belief
D. faith
E. value
4.
(Mental
health problem)
A. familial institute
B. political institute
C. religious institute
D. economic institute
E. educational institute
5.
16
20 30

A.
B.
C.
D.
E.
6.
A.
B. HIV
C.
D.

E.


1.

A. non-maleticence
B. beniticence
C. autonomy
D. justice
2.
15

20
30
A.
B.
C.

D.
E.
3.
DM insulin
. DKA .
A.

B.
C.
D.
4. 50

Cushing
A.
B.
C.
D.
E.
5.
40
20

A.
B.
C.
D.

E.

1.
15 3
B. political institute
C. religious institute
D. Economic institute
E. Education institute
2.
30 5

analysis

A.
B.
C.
D.
E.
3.
A. faith
B. value
C. norms
D. belief
E. attitude
(Professional skill and Bioethics)

Part Ethics 2005
1.
D. utilitarianism
10

Utilitarianism
Paternalism
(') n. ,
, S. . paternalist n.,adj. paternalistic adj.
Beneficence

- teleology

paternalism
Deontology [deon = duty

(
) ()

Teleology [teleo = completion]
utilitarianism

Virtue :

[5]
virtue ethics
(Kollar, Nathan R.)
[1]

3 (3,4)
1. (virtue)
2. (right) (duty)
3. (Utilitarianism)
1.
(virtue)
(3,4)

(Aristotle)
384-322
(Plato)
(Socrates)

practical wisdom

(pleasure)
(Hedonism)
Hedonist

(happiness)
(virtue)

(want)
(need)

(basic need)

temperance (
, ,), courage
()
(foolhardiness)
justice ()
(virtue)
compassion (), honesty
(), integrity (),
fortitude (), humility ()
2.
(right and duty)
(3,4)

(Immanuel Kant .. 1724-1804)
Kant
Enlightenment Kant
,

Kant

Kant
Critique of Pure Reason (3)
Kant
? Kant

(right)

(duty)

Kant
2 good will
good will

good will
good will

Kant
good will

free will

free will

Kant

Kant
Kant
( .to treat human beings as an end, no as a means..) (4)

Kant
(absolue),(unconditional),

(imperaive) categorical
imperative Kant
(happiness) good will
Kant
Titanic

Kant
3. ( Utilitarianism)
Hedonist
(pleasure)

(pain, suffering)
pleasure
Hedonism

pleasure ? pleasure ?

(Jeremy Bentham ..
1748-1832) (utility)
(happiness) (pleasure)

(pain)
(Utilitarianism Bentham

Utilitarianism (John Stuart Mill
..1806-1873) Mill

Mill

Utilitaianism
(consequence) Kant
(motive)
Utilitarianism

Bentham Mill
Utilitaianism

( Environmental ethics)
(5)
2.
A. autonomy

beneficence nonmaleficence
autonomy
Autonomy

informed consent
:Phylos
Axios = Valve
Value in Human conduct
Aestetic Value
in arts
- /,/
-
Normative ethics
Non normative
1. : Ethical
1.Descriptive ethics :
Theories
- What is good life?:
2 ,
- moral judgement :
1.
: Respect for person

- Autonomy ( Auto = self , Nomos = Governance ) =>
- Veracity : =>

- Informed
consent : ( )
- Confidentiality :
Medical
ethics
Traditional
meaning
(utilitarianism)
Mill
-

-
(Deontological
Theory)
(Duty-Based)
-()-
Kant
-
(Right-Based)
Moral problem
:

,

- 2 :

dilemma
-
Dilemma
-------------
-----------------
-------------
-------------

-----------------
-----------------
1.

Dilemma
2.
No
vote
key person
3.
( Health
Care service)
1.

-
2. ( Paradigm
-

(Engineering
Model)
(contractual
(Paternalitic Model)
-

Model)
-
-=

-

(Deliberative
-

Model)

-
-
()
)
3.
( Autonomy )
-
-
4.

- Respect for person
- Benificence
- Justice
5.
< humanized Medicine >
6.
()
-
-

-

(well-educated)

1.
2.
3.
1.
2.

1.
2.

+++
()
()
3.
3.

4. :
5. :
6.
Relation
care

Trust =
Empathy
=
Rapport =
Accountability
ReEvaluation
Professional
Healt
Empovement h
=
Belief
Insight(

Evidence
Treatment =
()
Collaboration =
Culture
Action
1. Health care service
2.

1.
3.

()
compassion
4.

2. =
5.
competence
6.
7.
( morals,mores) =

(Ethical vules)
1)
moral
()
2)
3)
(Humanity)
code ofcethics
Learning of Medicine May Be Likened Of Growth Of Plants

1.
2.
Our natural ability is the soil

The words of our teacher

3.
Learning from childhood
The seed
The prepared ground
The nutriment
4.
The place of instruction
5.
Deligence is the working of the soil
6.
Time strengthens all these things.

2
-

Hedonism
- (The sophists)
: -
Non- Hedonism
-(Epicureanism)
:

-(The Platonism)
-(The cynicism)
-(The stoicism)
(Humanism)
:
-
-
-
-
-
Ethics

:
2. :
3. :
4. :
()
1.
o
o
o

-
1.
2.
3.
Science
Fact
Ethics
What, How, Must?
/?
Should?

Pattern

Pattern

()
Anatomy of an ethical dilemma (
)
Dicision
Theory
Databas
e
Dimention
Ethical
Dilemma
Situation
Argument
Ethical theories

VS
Old Paradism
Beneficence
Paternalism
Traditional problem solving
process
Solution
New Paradism
Beneficence
Patien-autonomy
Ethical dilemma
Must
Hostitic view
Integrated
Should
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
: (
? )
:
: Should/Shouldnt
?
Ans.

(
TU 110/120 )
John Locke :
social contract()

2. Jean Jacque-Russo:

3. Thomas Hobbes:

1.
-
-
-
-
-
-
-

informed consent
Respect for person

Autonomy
3.
B. norm
Norm (
)
E.value ( ) norm
Norm
1.( 6) .
2.( 7 +8
.
4.
9
5.
B.
2005 51
2006
18
(
vital sign )
10

10.

informed consent

...

informed consent

1. Implied & Explicit Consent
implied consent

explicit consent
2. Non-Documented & Documented Consent
consent
doctor-patient communication
consent form
informed consent

informed consent autonomy

...
6.
D.
criteria 4
A C
B
1.
2.

3.

4.

5.

6.

7.
8.
9.

10.

Part Ethics 2006
1.
C. autonomy
79
2.
E.
191. 2005 51.
3.
2005
2006
D.

D.
4.
D.
5.
A.
D.
C.
Transtheoretical model of health behavior
change Prochaska JO.
Robert E. Rakel. Textbook of Family

th
Practice.6 ed.2002
chapter 16 pp.253-261.
Part Ethics 2007

1.

key
B D E
2.
E.

B. D.
3.
C. norms
B
Part Ethic Exercise for National Test Step I

1.

personality trait
A. Histrionic
B. Dependent
C. Narcissistic
D. Borderline
E. Schizotypal
2.

A. Stigma
B. Mistrusted
C. Unfamilial
D. Experience
E. Lack of privacy
3.

Kubler Ross drief stages
A. Denial
B. Despair
C. Anger
D. Depression
E. Bargain
4. 70 4
6

A.
B.
C.
D.
E.
1. A Histrionic personality disorder

Symptom: A pervasive pattern of excessive emotionality and
attention seeking, beginning by early adulthood and present
in a variety of contexts, as indicated by five (or more) of the
following:
1. in uncomfortable in situations in which he or she is
not the center of attention
2. interaction with others is often characterized by
inappropriate sexually seductive or provocative behavior
3. displays rapidly shifting and shallow expression of
emotion
4. consistently uses physical appearance to draw

attention to self
5. has a style of speech that is excessively
impressionistic and lacking in detail
6. shows self-dramatization, theatricality, and exaggerated
of emotion
7. is suggestible, i.e., easily influenced by others or
circumstances
8. considers relationships to be more intimate than they
actually are

Personality disorders
Early adulthood

Cluster
A

Paranoid, Schizoid, Schizotypal
(Mad)
B
Antisocial, Borderline, Histrionic,

Narcissistic
(Bad)
Avoidant, Dependent, Obsessive (Sad)

compulsive
Paranoid personality disorder

projection

Trust Mistrust
Schizoid personality disorder

,

(Schizoid fantasy)

Schizotypal personality disorder

Antisocial personality disorder
( )

Borderline personality disorder

(All good)
(All bad)

identity

Histrionic personality disorder

(dramatize)

(Reassurance)
Narcissistic personality disorder

Avoidant personality disorder

Dependent personality disorder

Obsessive compulsive personality disorder

(perfectionist)< Narcissistic
>
(inflexibility)

2. B. Experience

3. A. Denial
Grief reaction
Denial

Despair
Anger
Depression

The Kbler-Ross grief cycle
Background
For many years, people with terminal illnesses were an
embarrassment for doctors. Someone who could not be
cured was evidence of the doctors' fallibility, and as a result
the doctors regularly shunned the dying with the excuse that
there was nothing more that could be done (and that there
was plenty of other demand on the doctors' time).
Elizabeth Kbler-Ross was a doctor in Switzerland who railed

against this unkindness and spent a lot of time with dying
people, both comforting and studying them. She wrote a
book, called 'On Death and Dying' which included a cycle of
emotional states that is often referred to (but not exclusively
called) the Grief Cycle.
In the ensuing years, it was noticed that this emotional cycle
was not exclusive just to the terminally ill, but also other
people who were affected by bad news, such as losing their
jobs or otherwise being negatively affected by change. The
important factor is not that the change is good or bad, but
that they perceive it as a significantly negative event.
The Grief Cycle
The Grief Cycle can be shown as in the chart below,
indicating the roller-coaster ride of activity and passivity as
the person wriggles and turns in their desperate efforts to
avoid the change.
The initial state before the cycle is received is stable, at

least in terms of the subsequent reaction on hearing the bad
news. Compared with the ups and downs to come, even if
there is some variation, this is indeed a stable state.
And then, into the calm of this relative paradise, a bombshell
bursts...
Shock stage: Initial paralysis at hearing the bad
news.
Symptoms
The first reaction on hearing the bad news is one of classic
shock. This initially may appear as if there is no reaction at
all to the news. The person may nod and accept the news
without appearing to be troubled by it. Inside, they have
frozen out the news that has not really taken hold yet. To
get the news through, they may need to be told several
times.
This is followed by a more external shock, where there may
be physical reactions such as paling of the skin, shortness
of breath and physical freezing.
Treatment
When shock occurs, they may need to be sat down (to stop
them falling) and given a drink of some sort (mostly as
something to hold onto). Show them sympathy and
acceptance. If the shock is not a short-lived one, help them
get to a place where they can sit safely and let the news
sink in.
You can pre-empt shock symptoms to some extent by taking
the person to a place where they can safely hear the news.
Especially if they are likely to move swiftly into more emotive
stages, they will need to be in a private place, away from
the embarrassment of public tears, and in the company of

trusted friends or family.
Denial stage: Trying to avoid the inevitable.
Symptoms
After the initial shock has worn off, the next stage is usually
one of classic denial, where they pretend that the news has
not been given. They effectively close their eyes to any
evidence and pretend that nothing has happened.
Typically, they will continue their life as if nothing has
happened. In the workplace, they will carry on doing their
job even if that job is no longer required.
A classic behavior here is a 'flight into health', where
previously-perceived problems are suddenly seen as having
miraculously fixed themselves.
Treatment
You can move a person out of denial by deliberately
provoking them to anger. Hold up the future (sympathetically)
so they cannot avoid or deny it. Tell them that it is not fair.
Show anger yourself (thus legitimizing that they get angry).
This, to some extent, is done on daytime TV shows where
people in precarious situations are prodded into emotional
explosions that make good TV and (where sympathetically
done) may even be good for them.
Anger stage: Frustrated outpouring of bottled-up
emotion.
Symptoms
The next step after denial is a sudden swing into anger,
which often occurs in an explosion of emotion, where the
bottled-up feelings of the previous stages are expulsed in a
huge outpouring of grief. Whoever is in the way is likely to
be blamed. In a company this includes the managers, peers,
shareholders customers and suppliers. The phrase 'Why me?'
may be repeated in an endless loop in their heads. A part
of this anger thus is 'Why not you?', which fuels their anger
at the those who are not affected, or perhaps not as

seriously so.
Treatment
When they are angry, the best thing you can do is give
them space, allowing them to rail and bellow. The more the
storm blows, the sooner it will blow itself out.
Where anger becomes destructive then it must be addressed
directly. As necessary, you may need to remind people of
appropriate and inappropriate behavior. Reframe their anger
into useful channels, such as problem areas and ways to
move foreword.
Beware, when faced with anger, of it becoming an argument
where you may push them back into denial or cause later
problems. Support their anger. Accept it. Let them be angry
at you.
Bargaining stage: Seeking in vain for a way out.
Symptoms
After the fires of anger have been blow out, the next stage
is a desperate round of bargaining, seeking ways to avoid
having the bad thing happen. Bargaining is thus a vain
expression of hope that the bad news is reversible.
Bargaining in illness includes seeking alternative therapies
and experimental drugs. In organizations, it includes offering
to work for less money (or even none!), offering to do
alternative work or be demoted down the hierarchy. One's
loyalties, debts and dependants may be paraded as evidence
of the essentiality of being saved.
Treatment
When people are bargaining, you should not offer them any
false hope. Although there may be practical things they can
do which you can offer them, never offer them something
that cannot be fulfilled.
Sometimes the best you can do at this stage is point even
more at the inevitable, even though this may well tip them
into depression (which may well be a necessary move).
When they are in a bargaining mood, sometimes there are

things you can offer them, such as support for change or
new opportunities. In these cases you may be able to strike
a win-win deal, where they get an improved deal and you
get collaboration or some other contribution. In a business
setting, this may include finishing off some important work
before they leave and receiving a special bonus for doing
so.
Depression stage: Final realization of the inevitable.
Symptoms
After denial, anger and bargaining, the inevitability of the
news eventually (and not before time) sinks in and the
person reluctantly accepts that it is going to happen. From
the animation of anger and bargaining, they slump into a
slough of despond. In this deep depression, they see only a
horrible end with nothing beyond it. In turning in towards
themselves, they turn away from any solution and any help
that others can give them.
Depression may be seen in a number of passive behaviors.

In the workplace, this includes physical absenteeism, long
lunch breaks and mediocre work performance. It can also
appear in tearful and morose episodes where the person's
main concern is focused on their own world.
Treatment
The first thing you can do with people who are in
depression is to be there with them, accepting them in all
their misery. People who are depressed feel very much
alone and you company, even though it may not seem that
way, is likely to be welcome.
The second thing to do is to keep them moving. It is easy
to get stuck in depression, and the longer they stay there,
the deeper into the mud they are likely to slide. So keep up
a steady stream of support, showing them that there is light
ahead and encouraging them to reach towards it.
In the workplace, provision of professional coaching,
counselling and other support can do a lot to help people
recognize their depression and find a way to clamber out of

the pit.
Testing stage: Seeking realistic solutions.
Symptoms
Even in the pit of depressive despair, reality eventually starts
to bite and the person realizes that they cannot stay in that
deep, dark hole forever. They thus start looking for realistic
things that they can do. These may be taken on as
'experiments' to see if doing these things help the situation
in any way. As this activity starts to work, at least in some
ways, it is found to be preferred to the depression and so
the person crawls out of that dark hole.
This escape is often done with the support of friends, family
and professionals who specialize in helping people in
whatever situation this is. In medicine, hospices help the
terminally ill face their short futures with courage. In
organizations, counselors and outplacement consultants help
individuals move on to other work.
Treatment
When they reach out towards the road to acceptance, they
are at last on their way out of the mire. Help them try
different solutions and to see that they can, after all, have
an effect on their future. Hand as much control to them as
possible, as this gives them a lifeline of stability on which to
pull themselves forward.
Acceptance stage: Finally finding the way forward.
Symptoms
The final stage is back to one of stability, where the person
is ready and actively involved in moving on to the next
phase of their lives, no matter how short. The terminally ill
person will be putting their life in order, sorting out wills and
helping others to accept the inevitability that then now have
countenanced and faced.
In the workplace, people who have lost their jobs will be
actively seeking new work, whilst others who have had their
work changed will be tidying up and getting ready to move

on.
Acceptance is typically visible by people taking ownership
both for themselves and their actions. They start to do things
and take note of the results, and then changing their actions
in response. They will appear increasingly happier and more
content as they find their way forward.
Treatment
Help the person to establish themselves permanently in their
new position. Fix them there, ensuring that there is no way
back to the previous situation. Congratulate them on getting
through the change. Celebrate the completion of their
transition.
Sticking and cycling
Getting stuck
A common problem with the above cycle is that people get
stuck in one phase. Thus a person may become stuck in
denial, never moving on from the position of not accepting
the inevitable future. When it happens, they still keep on

denying it, such as the person who has lost their job still
going into the city only to sit on a park bench all day.
Getting stuck in denial is common in 'cool' cultures (such as
in Britain, particularly Southern England) where expressing
anger is not acceptable. The person may feel that anger, but
may then repress it, bottling it up inside.
Likewise, a person may be stuck in permanent anger (which
is itself a form of flight from reality) or repeated bargaining.
It is more difficult to get stuck in active states than in
passivity, and getting stuck in depression is perhaps a more
common ailment.
Going in cycles
Another trap is that when a person moves on to the next
phase, they have not completed an earlier phase and so
move backwards in cyclic loops that repeat previous emotion
and actions. Thus, for example, a person that finds
bargaining not to be working, may go back into anger or
denial.
Cycling is itself a form of avoidance of the inevitable, and

going backwards in time may seem to be a way of
extending the time before the perceived bad thing happens.
http://changingminds.org/disciplines/change_management/kubler
_ross/
. C

Informed consent
(Psychiatry)
Part Psychiatry 2005

1.
regression
A.
B.
C.

D.
E.
2.
(temper tantrums) ( 4
)
A.
B.
C.
D.
3.
50 breast cancer metastasis

liver

A. denial
B. regression
C. repression
D. sublimitation
E. displacement
4.
30 1
2

A. dysthymic disorder
B. normal rief reaction
C. schizoaffective
D. major depressive symdrome
E. obsessive compulsive disorder
5.
38

A. social phobia
B. generalized anxiety disorder
C. obcessive compulsive disorder

D. agoraphobia with Hx of panic disorder
E. prostatism
6.
A. anxiety
B. insomnia
C. regression
D. repression
E. depression
7.
25 1
A. culture lag
B. culture trait
C. culture shock
D. culture change
E. culture relativity
8.
10
A. separation anxiety disorder

B. stranger anxiety ( )
C. (maltreatment)
D.

E.
Psychiatry
Part Psychiatry 2005
1. E
Regression
...
A.
displacement
C.

isolation of affect
D.
denial
B.

suppression (
)
( )
2. B
15-24
temper
tantrum ( )

temper tantrum
3. B

choice
A. denial
C. repression

D. sublimatation
E. displacement
B. regression
4. D.
Major depressive disorder (MDD)
subset depressive disorder (depressive disorder
subset mood disorder )

psychomotor retardation (
) psychomotor agitation (
)
( 60%)
dysthymic disorder MDD
schizoaffective disorder = schizophrenia + mood disorder

~ schizophrenia (
2 ) mood disorder

obsessive-compulsive disorder =
5. D
obsessive-compulsive disorder
- generalized anxiety disorder

/

/
- phobia 1.Specific phobia
2. Social
phobia

- prostatism ... symptoms caused by an enlarged

prostate gland, including difficulty with urination (
)
- agoraphobia panic disorder subset
anxiety disorder /
panic disorder panic attack

)
/ agoraphobia
panic attack
/ 3
1. panic disorder without agoraphobia
2.
panic disorder with agoraphobia
3. agoraphobia without history of panic disorder
panic disorder
panic attack panic

panic
attack D
6. A

(?)
Anxiety =
1.
2.
3.
4.
7. C
Culture shock refers to the anxiety and feelings (of

surprise, disorientation, uncertainty, confusion, etc.) felt when
people have to operate within a different and unknown
cultural or social environment, such as a foreign country.

1. (Material Culture)

2. (Non - material Culture)

(Culture Lag)
8. B

stranger anxiety 6-9 separation
anxiety 10-18
stranger anxiety
separation anxiety

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(Anatomy)

Thoracic Organs System

C. 4th intercostals space left at parasternum

combine metabolic and respiratory acidosis artery

double aortic arch

Echocardiogram Double aortic arch

Part Anatomy 2007

50 pleural effusion effusion

anterior Axillary line pleural reflexion

Thoracic Organs System

root of spine of scapula

root of spine of scapula

(Snell RS. Clinical anatomy by regions. 8 .2008:6872.)

Esophageal stenosis syndactyly

Organell drug detoxification

A. Left gastroepiploic artery

laryngotracheal tube primitive

mediolateral episiotomy muscle

peristaltic sound trachea

150/90 mmHg. , moon face,

central obesity, hyperpigmentation,

B. internal thoracic artery

B. vein artery ring nerve

70 paralysis sensory deficit

A. right posterior cerebral artery

C. right anterior cerebral artery

B. constricted pupil response to light

corneal reflex negative

50 complete cord injury T10

Brain and Nervous System

A. anterior cerebral artery right

C. middle cerebral artery right

right hemiparesis + motor aphasia

A. right anterior Cerebral artery

skin lodal flap with skin

and subcutaneous tissue

Carpi radialis, flexor digitorum superficialis

C. tibialis anterior, tibialis posterior

A. superficial inguinal node

D. recurrent branch of median nerve

ulnar bone humeral bone

bone ulnar bone

D. lateral side of arm

A. Flexion, medial rotation, adduction

D. Extension, lateral rotation, abduction

A. tense vocal cord

bulb of penis nerve

Unilateral cleft lib

A. flex, medial rotate, adduct

C. flex, lateral rotate, abduct

D. medial cord of branchial plexus

Superior cervical ganglion sympathetic

ganglion Lesion Horner

miosis : dilator pupilae muscle

Thoracic Organs System

Lower respiratory tract

root of spine of scapula

Columnar ciliated with goblet cell

10. distal part of the right dorsal aorta

Thoracic Organs System

Thoracic Organs System

root of spine of scapula

root of spine of scapula