fee aa of glans penis is likely to spread via lymphatics into? b, Internal iliac nodes ‘¢ Superficial inguinal lymph nodes 4. Deep inguinal lymph nodes ms D Lymph vessels from Glans Penis drain into DEE sfCloguet) Lymph vessels from rest of the penis ¢ Forreference Last 12/e 319/p .... Gra Inguinal Lymph Nodes (especially into E] into Superficial Inguinal LNs, | 's 39/e chapter 100..... KLM Clinically Oriente NOTE: In fernale the lymphatics from glans clitoris also drains tsk Deep apie ee i Nese passing through superior inguinal cing is > illeoinguinal ners . ; pBatalcell carcinoma causes which pacaneoplastic wenden 2 Polyeythemia Hyperthyroidism ANS A Beste fom bieycle now he is unable to pass urine which o the following struct i ihe 2 Urethra b Ureter “© Urinary bladder & Urethrovesical junction ANS: 4 EsPertant points regarding movements of temporomandibular joint > 4 Depression is done by > Diagastric muscle ,gravity , genohyoid and myelohyoid (Answes) b. Protrusion is done by > Lateral pterygoid muscle (Answer) © Elevation is done by > Temporalis muscle , Medial pterygoid and Massater muscle . (Answer) Refrence -> Grays antomy and Rj last > Muscle of mastication MCQ: , Mlich of the following muscle provide forward traction during opening Jaw? Lower fibers of lateral pterygoid muscle. : ich of the following muscle is attached to the neck of the mandible Scanned with CamScanner1h. Most powerful muscle i. ‘Temporalis muscle is attached to the rion j. Stylomandibular ligament is formed by th Person is unable to close the lips muscle in coximal end eut. Central part stimulation cause what? » Vagus nerve pt | a. Apnoea b. Inhibit cough | ¢.. Increase BP 4. Increase HR . Initiate respiration A ANS: A Ganong MCQs > Denticlae ligament is extension of Pia matter and Coccygeal ligament is extension of Dusa matter > Major contribution of phrenic nerves is from? wee CS | b < C4 4 @ ANS: C > Common manifestation of autoimmune disease is > Thermal stress occurred to a person now he is having « temperature of 99°F what event has occured to him? a. Heat stoke b._ Heat exhaustion ANS: B clammy skin and bo ® Surgical Importance of fusion fascia is? a. Position > ‘ : Highest concentration of seminal uid is formed in? Aart om seat, he eis makes only st Contbuion to semen (seinal id); most of it (0 Comes fom the seminal vices (ep, 301) and prot (30%; seep, 299), (| Scanned with CamScanner(C — Within Normal Limits Within Normal Limits a! econ na Volume — f Bae 3 flowing is anibody most mportant regarding compliment fixati A Because of Pentameric form igM is an excellent compliment fixation antibody. n¢ witness first time surgery and got collapsed before going to surgery table, Jncrease CO Bh, Decrease CO Decrease TPR nt is in shock due to intra-abdominal hemorrhage of which organ? Spleen ‘atestine Mucous cells Enzymes level Coronary angiography : A Serial ECG > Enzyme level > Exerci ear icrior most opening of diaphragm is ? erence Aortic : ‘Esophageal opening 2A crest lies lies at level off Scanned with CamScannerin a dose which will produce therapeutican, > After IV infu ee : ation after starting this infusion. Dopamy, tite, 1 steady state amin, ; ay a 15min b. Smin 25min 4. 2min se, opumine as half fe of 2 minutes and steady states achieves aie 4 05 hae e 5 x2 = 10 minutes. ee 10 minute jx chronic atrial fibrillation suddenly developed an acute abd ee to purple-red in colour. Her mesenteric veins were patent, The wel loops were dusky to purple-red : robable underlying pathological process is Mone a. Coagulative necrosis b. Dry gangrene gangrene d. Liquefactive gangrene c. Wet gangrene ; ANS: E Small-intestinal infarction following sudden and total occlusion of mesenteric artecal blood flow can involve only a short segment, but more often involves a substantial portion. The splenic flexure of the colon is at greatest risk of ischaemic injury because it is the watershed between’ distribution of the superior and inferior mesenteric arteries, but any portion of the colon can be affect With mesenteric venous occlusion, anterograde and retrograde propagation of thrombus may lead ‘extensive involvement of the splanchnic bed. Regardless of whether the arterial or venous ‘occluded, the infarction appears haemorrhagic because of blood reflow into the damaged area. In the eacly stages, the infarcted bowel appears intensely congested and dusky to purple-red, with foci of subserosal and submucosal ecchymotic discoloration. With time, the wall becomes oedematou thickened, eubbery, and haemorrhagic. The lumen commonly contains sanguinous rank blood In arterial occlusions the demarcation from normal bowel is usually sharply de Tor ial renons definition between viable and non-viable bowel. Histologically, there is haemorthage, and sloughing necrosis of the mucosa. Normal features particularly cellular nuclei, become indistinct. Within 14 days, intestinal gangrene and sometimes perforation of the bowel. There may be litle i » Xiphoid process lies at which vertebral level ? 277 1 ANS: B Vertebral level of T9 and dermatomal level of T7. » Humans most easily tolerate a lack of which of the following nutrients? a Protein b. Lipids ¢. Carbohydrates Calcium © Iodine ANS: © Chatterji MCQs Important points 10 remember in leprosy: Pattern of 1. Nerve trunks of upper limbs are most commonly in 2. Ulnar nerve is most commonly involved then 3. Amongst cranial nerve facial nerve is most 4. Initial investigation for laprosy is nasal SK-KIM ~ Last Days k Scanned with CamScannerpared to the arterial blood, the venous bloga 343 P ssolved OXYBED a b mnt Bed cell count . “¢ D eo nous blood x2 increase in venous blood so what will happenp Decrease chloride in RBC $ nexte volume of RBC Decrease HCOS in blood g° B Venous blood as compared to arter Si shift phenomenon in venous blood, aaa rire a TY seni, resulting in increased packed cell volume © the red blood it stems to remember > a. Veneous blood have more SHCO3 | _b._Invencous blood RBCS have more > ¢ Cl and PCV due Main cause of farmer lung is due to microorganism? veto chloride shift mechanism, (due to the cells, and cell brwo importa 4, Micropolyspora faeni b. Aspergillus fam nas ¢. Saccharopolyspora sectivirlgula 4. Aspergillus clavatus ANS: C Farmer's lung is associated with exposure to mouldy hay @ source of Succhacopolyspora rectivirgula, previously known as Micropohyspora faeni). + Farmers lung is type 3 hypersensitivity. (past paper BCQ), A patient with prolonged diarthea undergoes esophagogastroduodenoscopy. Biopsy of the small F intestine demonstrates numerous crescent-shaped protozoa adjacent to the epithelial brush border. Which of the following organisms is the most likely pathogen? 1. Entamoeba histolytica p. Escherichia coli Giardia lamblia d. Naegleria fowlesi ¢. Trichomonas vaginalis i ia lamb ‘ ANS: C. The probable organism is Giardia 5 ted organism has a characteistc intestine. When seen in smears from duodenal eine iar pea eught x an age and he “facelike" appearance. However, in biopsy specimens the organi in the question stem. characteristic appearance and location are as described in the qucs ‘embolism . what are suspecting pulmonary Patient presented with shortness of breath and you will be your initial investigation ? a ABGs b. CXR a © CTPA investigation is Another a ECG som is CXR and Gold standard ITSO ope i lnc initial investigation pulmonary embolism ANS: B Best ‘of CPSP Exam is > MCQ that is frequently part Silent Scanned with CamScannera. Life style modification b. Oral hypoglycemic cc. Insulin d. Usually just observation is done ANS: A a. Epinephrine b. Serotonin c Vesopresin d. Prostaglandin Al ©. Angiotensin 2 ANS: B Whict urterial blood pressure decreases ? a. Heart rate b. Venous tone ©. Neural activity at carotid sinus é ANS: C Decrease in arterial blood pressure leads to a decrease in carotid sinus pressuge leads to a decrease in carotid sinus nerve impulses to the vasomotor center, which in turn leg i enhanced sympathetic nervous activity and decreased parasympathetic nerve activity. The incre nerve activity results in pexpheral vasoconstriction and an increase in total pecphey Refrence -> Guyton Physiology ; duit between peritoneal cavity and uterus? sympathet resistan Which structure act as ¢ a. Birth canal b. Cervix c. Fallopian tube in female d. Ovaries ANS: C Some important points regarding coricospinal tract: 1. They are concerned with voluntary diserete and skilled movements of distal pacts of the limbs. 2. Fine voluntary movements are also controlled by corticospinal tract. 3. Lesion involving corticospinal tract leads to following featurs > positive babinski sign , loss of cremestesic reflex, loss of abdominal reflexes, and there is loss of fine skilled voluntary movements especially at distal extremities . Reference: Snell neuroanatomy Specific gravity of CSF is? a. 1.001-1.004 b. 1.004-1,009 ANS: B ‘losed by the age of >3 months Anterior fontanelle is closed by the aj ed by the age of 18 months Refrence > Rj last anatomy ae Bad In ovulation phase 4 Body temperature rises b. Viscosity of cervical mucous sises ©. Fem test becomes negative d._ Fern test become positive ANS: C Asim BOQ) SK-KIM — Lasi Scanned with CamScannerseaaache after LP in due to ? 545 ead Dora stretch * glx cerebri stretch Ieatation of Dural arteries None of above 800d examples ate the he: Postlumbar mien the stimulation of sensory nerve endings i Puncture hes fro caffected site for ischemic colitig? Pn 8* GA Altes removal ‘adache of meningitis, which is iat, where a headache results ei pf cerebrospinal fluid (CS) ‘Ascending Colon Caecum Splenic Flexure Rectum sigmoid Colon D_ _ Between small and large intestine , isch, cieculation. Schwartz Principles of surgery, 10/e, 1221/p mon hernia in females ? ¥ Inguinal b. Direct Inguinal ¢. Femoral 4. Diaphragmatic hernia ANS: A In females incidence of hernia : Indirect inguinal 70 % > Femoral 30 % > Direct inguinal Rare and in mlaes : Indirect 50% > Direct 40% > Femoral 10% ‘The most common incidence of Femoral is in Females (compared to males ) but Femoral is not the most common Hernia of Females. Points to remember: common cause of Death in ADPKD — CVS complicatiosn —> Most i being HTN Crisis . ee Refrence: Harrison's Principles of Internal Medicine, 19e, Page 1852 Robbin's Basic Pathology 9e page 544 ‘The Cleveland Clinic Intensive Review of Internal Medicine Se page 135 Nephrology Secrets, 3e, Page 3 and I know goljan and others say CRF 2. Lymphatic Drainage of Anal Canal: a ‘Above Pectinate Line + Internal Iliac Nodes and Below Pectinate Line — Superficial Inguinal Nodes The mos Refrence: KLM Essential Clinical Anatomy 5e page 220. Scanned with CamScanneraximum sedimentat Mainly involv Maximum carbohydrate Heat labile > igh Placental tran: cient > igM on coeffi > igh port > igG Maximum balf life > 186 Mostly extravascular > igE Most abundant in newborns > igG is > iGM. pulin synthesized in fetus pathway) in the nut shell: and extrinsic ORT a eaten elo Scanned with CamScannericons of en pu eth 2 Fo pad Seaphoid Lunate Capitate Copitate ing sinus on foot, and fed granules in smear and flameqy 6 yr old farmer, with dischargi .s,what will be diagnostic organism? a. Leptospirosis b. Actinomadura palletrie cc. Medurula mycetemia d. Nocardiasis ANS: B ‘zd many ol hefungl pees eponblepeterie, oan As eon oom Oe wih via yor gad Pancytopenia, wih hypocellular bone types Tove a cee marrow and fatty infiltrations on soft texture (Fig, 3652) tap,what is your diagnosis a. Aplastic anemia b. Myelofibrosis Lymphoma d. Hairy cell leukemia ANS: A Characteristic feature of aplastic anemia ? a. Pancytopenia b. Bicytopennia c. Bone marrow fatty infiltrate 4d. Pure red cell aplasia ANS: C What is the other name of COVID=19? a. Novel corona virus b. SARS-COV-2 ANS: B EVOLUTION OF NAME From "Waban virus" to “novel coronavics- 2017 & “COVID-19 virus and now official designation: SARS-CoV-2 (severe acute respisstory syne coronavirus 2), ie eg pre = «! ER depastment with bullet injury to neck now he suffering from respiri@? s muscle paralysed will be a Diaphram b. Rectus abdominis muscle © External intercostle muscle . Internal intercostle muscle ANS: A Scanned with CamScanner549 Whi fi i ' per trunk of brachial plexus (C5,C6. 7) Exbs palsy L, Lower trunk of brachial plexus (klumpkes palsy) ANS: A a. Facial canal b. Petrous ¢._ temporal d. Pons Supranuclear lesion ANS: E In question it is clearly mentioned that lower face is effected and upper part of face is spared which is consistant with upper motor facial pasty or supranuclear palsy. man presented with drooping of ti ning of skin fold and ght corner of mouth,fl inkle his forehead where is the lesion? ability to close the right eye and is not able tov Left facial nerve palsy Right facial nerve palsy Right maxillary nerve palsy Right supranuclear lesion of facial nerve Tic douloureux SNS: B._ In this scenario whole right side of face is involved _, Le both upper and lower face is effected and is consistent with lower motor neuron facial palsy or infra-nuclear palsy. > Infection of bulbourethralgland spreads to > deep peroneal pouch and infection of sland also known as bartholin gland spreads to superficial perineal pouch because of their location. > Gold standard and diagnostic test for DVT is > greater vestibular Cow dag OT? Asoows "+ Dale UG ie ese bo ctf ow in ee + Die ih +o cis ‘Venography. Capsule of kidney is supplied by a. Interlobar Artery b. Interlobular Artery ANS: B the base of pyramid which ? artery is Scanned with CamScannerwn a N Granuloma ee Granuloma inguinale ta a gen fn endemic foc! in certain fro UK. The causative bacterial tc oes ANS: D granuloma. Counc sdies - hepatitis, yellow fever Caannse Gandy bodies - Congestive splenomegaly Negsit Rabies 4. Lewyt Parkinson's disease Hiras Woe Alzheimer's disease F nous bodie Asbestosis teroid bodies - Sarcoidosis, sporotrichosis 8, Schaumann bodies - Sarcoidosis Jies - Schwannoma ). Verroc Granulosa cell Tumor 10. Call exner bodies 11, Schiller duval bodies - Endodemal sinus Tumor, 12. Ascoff bodies - Rheumatic fever 13. Civatte body - Lichen planus 14, Creola bodies Bronchial asthma bodies - Granuloma inguinale 5. Donovan Peterson bodies ~ Molluscum contagiosum 16. Henderson 7, Michaelis guttmann body - Malakoplakia 18, Pick bodies - Pick disease Zebra bodies - Metachromatic leucodystrophy 20. Barr body - Inactivated X chromosome Kamino bodies - spitz naevus, malignant melanoma Lafora bodies - Myoclonic epilepsy Heinz bodies - G6PD deficiency Howell jolly bodies - Post splenectomy, ineffective erythropoieisis 25. Pappenheimer bodies - Sideroblastic anemia. > Fenestration in choriocapillaires more in which region? Equatorial Orra serrata € Submacular area ANS: + Aboy suffering from S, Preumonae meningitis. On gram staining of CSF what ive diplococi Lancet shaped b. Grampositive coci in clusters will you fit? a. Gras ©. Gram positive rod d. Gram negative cocci ANS: A Scanned with CamScanner553 Liver Lung Bone Joints Eye e io Ml spree ia pw of pe ba spi en in oy pi ANS: Piet te yell oi Oitmaa c ligament is the extention Denticul: ff? Pia matter and Coccygeal ligament is Dura matter. child given 500mg of acetaminophen. Which of the following mechanism is involved in elimination of y" jlucoronidation. Bhs Dou? G 1 f the followir the most common side effect of antihyperlipidemic drug therapy? i Blevated blood pressure. Gastrointestinal disturbance. Neurologic problems. MQ. Heart palpitations ie Migraine headaches. B Gastrointestinal disturbances frequently occur as a side effect of antihyperlipidemic drug on of plasma from which a substance is removed and is excreted in urine is called: 4 Filtration fraction C Renal plasma flow: If a substance is completely cleared from plasma it will be like PAH which also almost completely cleared from plasma i.e not reabsorbed but secreted by renal tubules. + Volume of plasma Filtered per unit time is GFR + Volume of plasma cleared of a substance per unit time is Clearance . + Volume of substance filtered per unit time is Filtered load. + Subtraction of excretion rate from filtered load is called Re-absorption Volume of plasma filtered per unit time is called? Scanned with CamScanner> ee > asinity fF spin be yee 554 ehaemor tion and kallikrien system poth coagulal hind stomach which is not seen at Ty 2 Spleen is present both te . Pancreas ape sa ieee ssiae Or mae Boe lve of tan involving fracture ofleft 10 cb which organ will be damaged? and injury it > Aperson had RTA SE a Spleen b. Base of lung, c. Pancreas da. Gall bladder ANS: A See > Immediately anterior tO the hilum of right kidney 18 * 1 gecond past of duodeanm™ b. Liver <. Pancreas d. None of them ANS: A Endotoxic shock is mediated bY® a. Endothelial injury b. Peripheral vasodilatation ¢_ Increase vascular permeability d. Cytokine action Ae D Sequence of production of mediators in endotoxic shock is: oe peey > TNF? a > IL6 IL8 > NO, PAF. birth > A 28 years old pregnant lady, who is having RH negative blood grovP inh negative baby. Due to bleeding she was advised ean va iy as " positive blood 7 Peace group. Which of the following is true for her? a. Anti D antibody should be given immediately to the b. Next baby may develop hemolytic anemia ae c. No need to give anti-D antibodies tome reaction will occur : A Although baby is RH negative accidently exposed positive group and as a resu ome ure bat ae ‘ : oe ahameeaesere t a be given immediately anti-D antibodies. ae 7 > Most common - - ‘ofganism causing post splenectomy sepsis sepsis is > streptococcus pneumonae- Scanned with CamScanner2 b c 4 ANS: D 2% means > 2.gm in 100 ml, 1 gm in 50 ml so 50x5=250ml. __ mportant actions: poi ion of insulin: wi¢guucose, amino-acid and potassium into the cell fatty ediate action of insulin: ; synthesis Protein § - . vd action of insulin: sis Prey old female has HB of 9.6 gm/d. She i lethargic and ivtabe Pavionths. But still her HB is 10.6g/dL. What investigation is more sant anemia? Pr Bone marrow biopsy Hb dectrophoresis Serum fessitin a TBC. ANS: B-_ Iniron deficiency anemia Hb gets normal in 2 months of iron therapy. Volume of 1 gm lignocaine in 2% solution will be? 100ml b. 25m c. 5m d : she was given icon the useful to know the cause or | 50ml Tel ANS: D 2% solution means that there is 2 gm of lignocaine in 100 ml or 2000 mg in 100 ml «so 1 gm will be in 50 ml. | Volume of 8% of lignocaine in 2% solution will be? 50 150 200 250 Scanned with CamScanner 5559 min 25 min 2 min For a drug to achieve steady cone 5x2= 10 ~ 9 miautes of dopamine is = Always remember that Half life of dopamine is 2 rhe most likely side effect of overdose of tricyclic 4 ,. Loose motion b. Constricted pupil onic fits Generalized tonic ¢ incontinence d. Usinary it High blood pressure ANS: c ces methemoglobinemia? Following local anesthetic cau! a. Bupivacaine b. Btidocaine c._ Lidocaine 4. Prilocaine Ropivacaine ANS: D ke is presented to the likely drug uspicion of drug intal Patient with s 6/min, the most and respiratory rate O coma a. Aspirin b. Morphine c. Nalbuphine d. Pentazocine ¢. Phenobarbitone ANS: B Drug contraindicated in CLD is? a. Lorazepam b. Pentazocine cc. Aspirin d. Paracetamol ANS: B centration it requires 4 to 5 half lifes, fe, 2 minutes and steady state is re ached in 9 mt? Mate antidepressents is? emergency department. He isin responsible will be? Which of th ing i the following isan example of short acting benzodiazepines? a. Diazepam b. Lorazepam Midazolam 4. Clonazepam ANS: C Scanned with CamScanner557 Cyclopsorin sphosphamide 4 capnogram: base line demonstrates hypocarbia a Risein Rise in base line demonstrates Rebreathing, igh demonstrates expiratory obstruction ¢. Risein {Slow fall in height demonstrates expiratory obstruction |A slow rise in height demonstrates inspiratory obstruction ANS: B Pulse oximeters are 1. Based on boyle ‘s law . Can detive carbon dioxide levels c. Can differentiate Deoxyhemoglobin from oxyhemoglobin 4. Can not differentiate methemomoglobin from Oxyhemoglobin e. Usea single wavelength of red-light ANS: C » Blood Concentration of Local Anesthetics Comparison of the Blood Concentration of Local Anesthetics after various routes of administration IN ORDER OF DECREASING CONCENTRATION, Intercostal Nerve Blockade > Injection Into Caudal Epidural Space > Injection Into Lumbar Epidural Space >Injection Into Brachial Plexus > Injection Into Subcutaneous Tissue Refience > Miller's Anesthesia, 8/e, 36/chap, 1046/p. of regional anesthesia associated with greatest serum concentration of local tic? age compensatory responses were initiated by a baroreceptor reflex to keep mal level. Which one of the following is less after compensaton for before the hemorhage? Scanned with CamScannerBia Dr a jnooxidase inhibitor and the following ; action: ® Opiod hg, Fer Mor 1. Pethidi Sufent Oe nolol in anesthetic practice is? Main ad) fv st x. Noeffect onn intracranial Pressnse No rebound hypertenton <.. Reduction in plasma rennin activity d._ Selective beta blocker activity e. Short duration of action ANS: E Brachcocephalic veins are formed by the junction of ? Axillary and subclavian vein b. External jugular and subclavian vein Internal and external jugular vein 4. Internal jugular and subclavian vein fe. Superior vena cava and subelavian vein ANS: D pressure in adult, the appropriate cannulaix If radial artery is choosen to moniter intraarterial order to avoid artifact is? 2. 14 gauge b. 16 gauge c. 18 gauge d. 20 gauge e. 22 gauge ANS: D ¢ the refrence point which best correlates to the dy When measuring the central venous pressur Anterior axillary line 4 interspace b. Manubriosternal junction cc. Mid axillary line 3* interspace d. Mid axillary line 4* interspace €. Mid axillary line 5* interspace ANS: D In Ge CVP trace the right atrial filling with the closed tricuspid valve is signified by? b. Cwave «. Vwave dX decent © Ydecent ANS: C Highest risk of i " a 1 Aas yen ee let drugs Intravenous heparin gi pus heparin given ; Lawn pa one hour after needle placement Scanned with CamScanner4. S/C Heparin prophylaxis 559 Warfarin prophylaxis with normal PT and INR ANS: © Which of the following drug inhibits PG synthesis | eyclo-oxygenase 1? s by inhibiting cyclooxygenase-2 rather than a Aspirin b. Ibuprofen ¢. Meloxicam 4. Indomethacin Piroxicam ANS: The harmone which produce protein catabolism in Extraheps Stal P atabok Extrahepatic tissues and protein synthesis in a. Cortisol b. Epinephrine « GH 4. Tasulin e. Thyroxine ANS: A A 20 year old full term pregnant female is brought to a tertiary care hostpital from a distant village. She has been in labour for last 20 hours while preparation for C- section were made . she became breathless and went into shock and died. The most likely cause of death in patient is? a. Air embolism Amniotic fluid embolism Fat embolism Foreign body embolism Thromboembolism A young surgeon operated upon a middle age lady for enlage thyroid and ligated the superior and inferior thyroid arteries, as close to the poles as possible, after 2 weeks the lady presented with persisting hoarsness of voice, the most likely cause could be? External laryngeal nerve damage Laryngeal edema Recurrent laryngeal nerve damage Sore throat .¢ to vibration set up by? Closuce of aortic valve Closure of arterioventricular valve Flow of blood into aorta Opening of semilunar valves €. Rapid inflow of blood into ventsicles ANS: E a thod ridth of the in order to determine most accuestly the blood pressute 7 OEE Ty = cuff should bear what relationship to the limb atthe sts of 0.5 to 1 times the diameter : Scanned with CamScanner560 fibet surrounded by? } , Basal la a skeletal muscle ee Je fib is covered by — Endomysium a nanded by pesimysium UI gle fibers bundle # sust0! Ie is covered by Bpimysio i if le is nobile Origa of muscle} cs is more mobile Insertion of muscle Belly scl - F) Fleshy part of muscle Res? tachment are made o fibrous tissue call J part of muse Je wl led Tendons og ile others also have non contr actle Portions cay @ Ent 1 its length whi Iast and greys with a 2-di ptoms ghou' Snell, Ri anatomy lay history of right upper quadrany are worse after she eats a fatty Pe, her right oppesuadaetel aponcu @) Some muscles are fleshy throw Refrence! miting. She t€P yysician rts that her SY hormone causing tendons. A 45-year nausea, £4! which of the f Cholecystokinin Id ints t0 ollowing subst b. Gastsin c. Pepsin d. Secretin for gallstone cholecystitis. Somatostatin sree gastric acid, pepsinogen, insta gg cretion, and (as in this pation!) gallbladder contraction. Cholecystokinin is released By 7 Pills of the duodenum and jejunum sa rntraction, pancreal tion, and sphincter of Oddi relaxation vect, Gastrin is released by G © .d intcinsic factor, and pepsinogen- ig ncorrect. Pepsi is secreted y let alls ofthe stomach and facilitates protein igssioe cece is soertted By 5 calls of the Guodeno it inhibits gastric acid secret sion fom the pancreas. le secretion, which would at Somatostatia are classic ANS: E. D cells of th This patient’s symptoms ne pancreas and gastrointestinal mUCOSS- Ie inhibits pancreatic and smal intestine uid incorrect gallbladder C0 “Answer A is i tic enzyme secre! responsible for Answer B is incort secretion of gastric aci Answe Answer D is incorrec tes bicarbonate secret ai. ‘here major blood vessel are present? and stimula Ie also increases bil to potentiate the patient's p Most likely place in brain a. Deep to pia matter b. Extra-dural space Subarachnoid space 4. Subdural space ¢. Within pia matter ANS: C The ascending reticul Deemceete ‘icular activating system ist 2 toed the hypothalamus | Conse with the spinal reticulum | ©. Most discrete in the floor of Located in the cortex ee ©. Locsted in the symps 5 Jae ‘pathetic plexus A person is is presented in OPD with wwery week is working in nitroglyeet eer working 4 ‘troglycerine pharma factory from 5 on 1st day of working of years . whatis the cause’ Scanned with CamScannerallergy Sol tachyphylaxis Idiosyneracy Desnsitization If tolerance is not * in option then click tachyphyl ichyphylaxis, E pefle imulation caused by 7 FS Superior Olivary nucleus ( visual body reflexes )? p. Inferior Olivary nucleus F C._ Red nucles, D._ Superior colliculus £._ Inferior colloculus D Superior colliculus is ass: audition liculus is associated with visual and inferior o colliculus is associated with would be expected to ca 2 Death Megaloblastic anemia Severe malnutrition An increased level of ammonia in pts with circhosis of liver ¢. Decreased urinary urobilinogen ANS: E Ganong BCQ dal agents Ox, HO: are produced in neutrophils in’ B a. Lysosomes b. Peroxisome ¢. Mitochondsia 4. Golgi bodies ANS: B Sete TTP ATA A baby is dehydrated, How will you asses hydration level in him? 2. Bregma b. Pterion c. Lambda d. Nasion i ANS: A apo comers 0, res a i If anterior fontanelle is in option always click that. fontanelle. NOTE: The most characteristic fe a. Normal ferritin ature of thalasemia trait b. HbAc greater than 3.5% ¢. Slightly raised HBF Normal HbAz oa : vin salasesa sor HBE? 2 ANS: B In thalasemia nce Site of radial artery pulsation is between Scanned with CamScanner«surface of sadius in between brachioradialus fy side.(Radial tap) palpated between: AND terior medial yx radial artery icis longus tomical snuff bo aF In Ana r " tensor medial border) F aa Extensor pollicis brevistabductor pollicis Longs, natal bat ee “he question is given that where radial artery js m= Some time in pape cal snuff box ar ; anatomical sil if box: Radial nerve Radial artery (Deep branch) + cag Contents of anatomical snU! ad tween Dorsalis pedis arte jtorum longus ry is palpated be Extensor degit laterally Jon of extensor hallucis longes medially ctus 5 And ten es h intercostal nerve enters fe heath at the level Tenth 2, Xiphoid process b. Pubitubercle c. Pyrimdalis muscle 4. Umbilicus ANS: D Which is true Eye Lids have four layers ‘e skin and tarsal plate are fused together attached to the tarsus regarding the layers of the eyelid? (Choose one statement) b. Th ¢. The conjunctiva is loosely 4. The subcutaneous layer is absent in eyelids ¢. Mebomian glands are present in the musculas layer ANS: A Histologic analysis shows that the eyelids have four tissue layers: ‘The skin, the orbicularis oculi muscle, the tarsus and stromal layer, and the palpebral conjunctiva. Mebomian glands are present in tarsal plate. junctiva: tightly attached to the tarsus. ia ea 7 Nucleus of Clarke lies at spinal level of > C8-L2. TRALI is currently defined as a new epii ik within episode of acute lung injury (ALI) occurring during or hours ofa completed ansfsion b. 8 hours of a completed teans! ieee fusion. Assessment of muscle injury is done marker? a. Myoglobin Pints soe b. CK-MB © CKBB 4 CK.MM ANS: D Decre: Decrease in lym ph flow occurs: due ‘otic pressure to increase in? c -apillary hydrostg latest! oncote pee otic pr 4. Venous p ressure. S Pressure ANS: 4 & Capillary on, ue i a Scanned with CamScanneree? —— josteroid in urine is the index of > ket ne Alll androgen produced of adrenal androgen secretion. * In adult males (postpuberty), nal content 4. Lesser sac Right anterior sub-phrenic space Left lateral paracolic gutter d._ Right posterior subphrenic space ¢. Pouch of doughlas ANS: D (right iliac fossa and Scenario of azad kashmir lady mild f her distant uncle, she is in a. Family crisis ily injured in earth quake, » many People killed apart from one b. Social crisis Situational crisis 4. Developmental crisis ANS: C Situational crisis assaults fires, earthquakes, and hurricanes, } attacks, assaults and so forth, Oral contcaceptive pills and HRT potential complications; Combined oral contraceptive pills increases the tsk of breast cancer. Combined oral contraceptive pills decreases the ‘isk of endometrial cancer (Progestogen helps to decrease the tisk of endometrial cancer. Mcgs To prevent endometrial carcinoma in postmenopausal female which ofthe following should be Preferred? 363 Scanned with CamScanner564 ———— ig taking High dose of HRT (Comp, i complication of this therapy is taking woman ould be the Matin : A postmenopausal erone), what ¢ dangerous a. Thromt b. Breast cancer cc. Endometrial cancer d. None of the above .dly complication of Combined oral contraceptive pills is theomnboen ANS A ene es) cs Treast cancer as well and always remember that cony ey although Og eee eckanive agains ere of endometrial cancer. conan ire Ne ie ncreacreased risk of a8 compared 10 combing Estroger contraceptive pills? a. Breast cancer b. Endometrial cancer c. Ovarian cancer d. None of the above ANS: B There Is Increas Progestogens. ‘ed Risk of Endometrial Cancer If Estrogens Ate Not Combined is cle cells are? The slow waves in small intestinal smooth muscle cells are? a. Action potentials b. Phasic contractions c. Tonic contractions 4. Oscillating resting membrane potentials e. Oscillating CCK release ANS: D ‘The most fre quent granuloma associated with suppuration is most likely due to? a. Amoeba b. Aspergillus c. Nocardia fangus d. Rickettsia e. Virus ANS: C 1. Granuloma with suppuration > Nocardia . Granuloma with caseous necrosis > TB Granuloma with non-caseous necrosis “> sarcoidosis Granuoma with asteroid bodies > Sarcoidosis. Epitheloid cells in granuloma is derived from > Macrophages. Characteristic feature of granuloma is “> Epitheloid cells . . Granuloma with multiple discharging sinuses and yellow (sulphat) granules > Actinomyces Barr body test from cells of buccal smear is done mainly for the diagnosis of? Gonadal dysgenisis b. Klinfilter syndrome © Ovo-testis syndrome d. Super female €. Turner °s syndrome ANS: E Medial wall of ischioneetal fossa is formed. ; Ischiorectal fossa:ltis a wedge aoe Teer i Bees space situated on each side of anal canal having apex and DS Apex: Formed at line of meeting of obturator intemnus and levator ani. san aReD Scanned with CamScannerS65 {Formed by Skin iorly: Posterior border of perineal memberane anitesiorly: Gluteus maximusée sacrotuberous ligament ee wall:Lower patt of obturator internus with covering fascia Liljal wall: Sloping fibers of levator ani and anal sphinctor. weenie: Ischiorectal pad of fat, Pudental nerve & its branches, Internal Pudental vessels, ts contents. Pudental canal with if 1 invade orbital cavity M _— 7 Coxnea b. Optic nerve ¢ Em . Retina » wi the following nerve lies immediately lateral to the trachea? Vagus b. Recurrent laryngeal nerve « Phenic nerve d. Long thoracic nerve ¢. Spinal accessory nerve ANS: B Schaumann bodies are found in > Sarcoidosis. Nerve passing through foramen magnum is Spinal part of accessory nerve. Which of the following vein drains into superior vena-cava > Azygous vein. Actin protein is bound to Z-line by > Actinin, Which of the following electrolyte has profound effect on the heart > Potassium. Accessory meningeal artery passes through > Foramen Ovale. Ulnar nerve is damaged at medial epicondyle it will lead to ? a. Hypothenar wasting b. Little and ring finger claw . Little and middle finger claw 4. Cubitus varus ANS: A Always Remember Clawing Is More Significant With The Distal Lesion As Compared To Proximal Lesion. vVvVvvv re Which of the following is histologically similar to Kaposi sarcoma? 4 Dermatofibroma b. Bacilliary angiomatosis & Seborthoic keratosis 4. Actinic keratosis & Molluscum contagiosum ANS: B Scanned with CamScannerWIAY VY NIV VY v. vvvv v v. antenatal clinic at 22 weeks of gestations with pre sent 25 Year old primigeavida presents ; y tuberculosis on the bz ysed as pulmonary tu mai OF CXS Findings witty of hemopysis.she was diagnc apical cavities. How will you teat her a. Erythromycin ‘ b. Ethumbutol, si isoniazid Ethumbutol, rifampicin, No therapy during pregnancy Streptomycin and isoniazid J shoib BCQ fampicin, pyrazinamide, ¢ , isoniazid d ANS: B asim anc tic anticTh drug is > Behumbutol Pure bacteriosata dil is > Isoniazid. pacteriostatic and bacterioc Drug which is both b eTipiiuleeees ‘Antibacterial Activity of Im Major proport Athletes normally Kaplan meyer curve indicates > survival. Surgery of submandibular gland was done, which of the following nerve is most commonly injure - Marginal mandibular branch of facial nerve. Erythropoitin is secreted by > Peritubular capillaries. Puuint is on ATT and developed big Toe swelling which is the culprit drag “> pyrazinamide, Nerve passing through superficial inguinal sing is > illeoinguinal nerve: Neutrophils aso have phagocytic activity in the blood as compared to monocytes which ae oly phagocytic in the tissues. ‘Male presented with urethral discharge, on gram staining there is gram negative diplococci what is the cause > Gonorrhea. ny is having XY genotype will well developed breasts and blind vagina > testicular femini : syndrome. Part of ECG showing complete ventricular depolarization is > ST segment. Ta motile ciia the sxonemelisl poset OES 20) mierotntaslee (cena duplet is eunomadat 4 peripheral duplets). Visceral layer of serous pericardium is known Epicardium. y as> Which of the following cells provide immunity against tumor cells > natural killer cells. What is true regarding referral system > itis a two way communication between health facilities In case of susgery in HIV positive patient OT floor is cleaned wit hypochlorate and instruments are cleaned with 2% ce A patient presented wit stools investiga pecform fh eve" presente wit foul smling and fay stools what investigation wll you > seo Most potent antioxidant is > Glutathione > vitamin B. Scanned with CamScanner————<_— ~~ apatient is suspected of pancreatitis with pa 567 1 in the epigastriur faeces shows the cells Which are not nowmalh me cP Eascium. Histological exami Alpha cells he pancreas; ation of * peels Deells A calls Mucous ce = Serous cells ANS: D Most common adverse effect of using diazepam du Decreased fetal breast feeding ng labour is? p. Fetal acid base dysfunction Fetal heart rate variability 4. Neonatal hypotonia ¢. Neonatal hypothermia ANS: C Asim BCQ. , Most important component of lipid is > C, y Bronchpulmonary segment is supplied b ‘arbon, 'y “> Tertiary bronchus. Structure lying immediately lateral to trachea is > Recu urrent laryngeal nerve > vagus nerve Structure that arches over the root of le ft lung is Arch of aorta root of right lung is > Azygous vein. Structure anterior to the root of lung is > phrenic nerve Structure that lies posterior to the root of lung is > Vagus nerve Left recurrentlaryngeal nerve loops around the arch of aorta . Right recurrent laryngeal nerve loops around the tight subclavian artery. Lower respiratory sympathetic supply is > T2 to T4. ‘The only supply of mediastinal pleura is > Phrenic nerve. Diaphragmatic pleura is both supplied by > Phrenic nerve and lower six intercostle nerve. Structure that arches over the KERR ER EEE il fiction occurs due to decrease in > Alveolar PO: reat etc seen eran vasoconstriction : —s is through > Ozsensitive potassium pulmonary vasoconstriction in Guyton a Scanned with CamScanneric center that inhibits feeding? f Hypoth cular nucleus us is > satiety center ‘of fullness, anorexia, and obesity just and starvation. ypothalam' ation eauses sens xphagia » Ventromedial hy 1, Its stimul: lesion leads to hype 2. Is Like in pendes wii syadrome Lateral hypothalamus is > Feeding of hanger center: increased feeding. 1. Its stimulation causes 2. Its lesion leads to starvation. ‘Anterior hypothalamus: (Preoptic area) Set point of tredy temperature s Jocated in 480=20° hypothalamus. It activates parasympathetic Tesponse and helps in heat Joss, by the help of ilatation, and sweating. MCQ: Which of the following. jis the function of preoptic area of! hypothalamus? i. Increase musle activity b. Vasodilation Vasoconstriction decrease apetite d._ None of them. ANS: B Posterior hypotl It activates thalamus may lead 10 commonly involving VPL aiudeus), Important featos=s, of thalamic syndrome are: 1. Loss of fine senstation: 2. Exaggerated pain sensation . MCQS: Sensory ataxia is followed lesion i a. Brain stem injury a = b. Gross cerebellar lesion Lesion in the premotor cortex d. Thalamic syndrome Viral encephalitis ANS: D a MCOS: Patient ywith the history ‘sensations right the body eee en same side of the body. a ane a. Left Thalamus Sag Ph ie >. Right thalamus on the Scanned with CamScannerFERRE & & FREE & e € 569 c. Left internal capsule d. Right internal capsule ANS: A NOTE: stroke. Lesion of caps fe motor 1 of internal capsule leads to p ot Cerebellum is connected to the midbrain by > supe cerebellar peduncle. perior ebri is > substantia niagra Closest to erus e% Climbing fibers originate from > inferior olive nucleus Cerebellar lesion is associated with: Purkinje fibers receive input from climbing fibers. Dystadochok patient has tendency to fallon the left side where is the een ener site of lesion: Left cerebellum. F Hypotonia Intention tremers, ataxia and dysmetria > cerebellar lesion Pendula knee jerk Patient presented with diagnosis of Parkinson disease, site 4 of ncuron lost will be in > substantia niagra inert Substantia niagra send inhibitory signals to the thalamus, Intention tremers Folia is present in > cerebellum. Cerebellum is not the part of the brain stem. Past pointing | Fasciculation is a twitch of single motor unit. ‘A child presented with paralysis of face and inability to move his eyes >Mobins syndrome. Patent presented with right sided deviation of tongue and loss of touch and where is the site of lesion Anterior spinal artery. ‘ent with deviation of tongue to the sight side and on the left side of the body what is the site of vibration sense, Patient presented to ER departmé and motor weakness and sensory loss lesion -> Median medullary syndrome (antesior spinal atery) vomunculs is for which of the following? > Thigh. is right sided hemisphere in most of the right handed ‘Smallest are in the motor hi Representational hemisphere 4 Cytotoxic T cells b. Helper T cells © Macrophages 4 Antibodies ANS: ee bE FEEEE A sor role in allograft rejection =. tee yaa or the body for grafting is Sul nerve Graft from twin syngenic graft. Monozygotie twins. ere ciate transfer of tissue between TET aod Chronic graft rejection is Jereversible, intimal fibrosis. ‘Acute graft sejection is reversible with treatment bypass suey # The most Graft rejection graft rejection. Graft rejection reiection. Scanned with CamScanner570 Ss kidney transplant. MCQs:50 year old man devi The renal function imProw for poor function 1 transplant, 3 MCQS: Renal ‘a. Vasculitis and throm "Dense lymphocytic initsates arcuate fasci Posterior external a tract b. Posterior spinocerebellar tract c. Anterior spinocerebellar tract 4. Tectospinal tract j ANS: A Following tracts are in Inferior Scanned with CamScanneral feature of ‘ ompact bone i Most likely his a. Osteooytes reside in canaliculi b. Haversian canals are obliquely oriented ¢. Most osteon are oriented in the long axis of the bone 4, Circumferential lamellae from the osteon around central canal ANS: D » Remants of previous osteons called? a. Interstitial lamallae b. Cortex of bone c. Conceteric lamallae containing volkman canal 4. Concentric lamallae containing haversian canal ANS: A What is true about volkman's canal? a. Resembles harvesian canal b. Vascular space c. Has concentric lamella ANS: B > Which of the following is responsible for producing the majority of new bone tht reunite the two fragments of fractured bone? Cancer bone Compact bone Bone marrow Periosteum Bee cer i t €# FE FREER EES D Primary center of ossification is present in > Diaphysis. Secondary ossification is present in > epiphysis. Ossification of body of sternum occurs at 21 years of age. Most common long bone fractured is clavicle. In clavicle fracture occurs at the junction of medial 2/3+ and lateral one third. In davicle ossification takes place through intramembranous ossification. Which of the following bone has both as intrachondrial and intramembranous ossification > Mandible. Haversian system lies parallel to long axis of diaphysis. ‘Volkman canal carry neurovascular supply and they are at right angle to the central Sharprey attach periostium to the bone surface. easter Fee in peat and can cifizentte ict once Compact bone contains osteoblast in > lacunae. Osteoclasts are located in > Howship lacunae. ‘Metaphysis is the most common site of osteomyelitis in the children. Most common cause of osteomyelitis is > staph aureus. Epiphyseal growth plate remnants in adult is known as epiphyseal lines. ‘Which of the following bone is exception to the law of ossification > Fibula SS SSS SSS SSS SSS ES SSeeese cee essssSsSSsSsseaee of the following disease is associated with HLA-B27? ison °s disease Scanned with CamScanner 571RA Graves disease hypothyroidism 4. Ankylosing spondylitis ANS: D a. D1 agonist agonist cc. ML agonist d. M3 agonist Decorticate and decerebrate posture Lesion above the red nucleus leads to! a. Decerebrate posture b. Decorticate posture c. Flaccid paralysis Cessation of respiration ANS: B ‘k Red nucleus is located at the level of superior colliculus. 4 Rubrospinal tract associated with flex posture. 4& Lesion above red nucleus leads to loss of inhibition ‘on rubro-spinal tract and leading to flexed or decorticate posture 4. Spinal cord transaction below sed smucleus: Leads to extended or decerebrate posture. FOR EXAMPLE lesion at mid-collicular level (between superior and inferior colliculus ) ie below sed leads to decerebrate posture or extended as as flexor activity is lost due to (arise from red nucleus ) is nucleus posture transaction of rubrospinal tract. MCQ: A cat is denervated at mid collicular level, what will happen? a. Decerebrate posture b. Decorticate posture ¢. Flaccid posture d. Catis not able to stand ANS: A activates Scanned with CamScanner573 (Ora serrata b. Fovea Para fovea ii. Equitoreal retina Optic dise ANS: C Note: Posterior communicating artery Anterior communicating artery c Posterior cerebral artery d. Anterior cerebral artery ‘ANS: A. 3*nerve lies in close proximity to posterior “ ; ‘communicating artery, Rupture of aneurysm can lead to third ea es pays ssocted wiht nerve palsy which clinically manifest as ptosis, dilted pupil 3s meilitus in Sees is partial 3 and down and out deviation of the eye ball. nerve palsy or pupil sparing 3 nerve palsy a. Medulla b. Pons c 4 a Painful third nerve palsy is associated with posterior communicating ertery aneurysm rupture Midbrain |. Cerebrum ANS: A Climbing fibers originate from inferior olives of medulla. Reference: Guyton. Terminal brochiloles contain which type of cells that produce component of surfactant > A. Clara cells B, Pneamocytes C. Goblet cells D. Dust cells ofa called Ohmi ound withthe cited cin the ein andre paatry ronchioks, Clara celia nonlied sector cuboidal cl ht incesin umber astieoumberof cla li dramas Last Days Rev ion Notes & KIM Controvrrsial Files Scanned with CamScanner576 After performing a drenalectomy to # pat a. Epinephrine b. Cortisol Aldosterone d. Testosterone wen ANS: s 4 ‘After adrenelectomy there is increased in threshold for Destruct Uf dtr ry salty sensations. decrease th, 4k Aldosterone is is life saving harmone and cortisol is tioning of? life protecting harmone. a. Iona fasiculata 4 Adrenal gland is supplied by greater thoracic nerve. + prema b. Zona granulosa 4 Cachexia is not a feature of panhypopituitarism cheb 4 Acromegaly occurs due to increase in growth harmone level after the fasion of growth plates. Adronel moda & Gigantism occurs due to increase in growth harmone level before the closure of growth plates. heh + Growth hormone receptors are present on plasma membrane. 4 Harmone that acts through steroid pathway is > thyroxine, Angotensin 2 causes salt retention through ip3. Growth harmone secretion is no increased in Pregnancy. Most important harmone involved. in gluconeogenisis is > cortisol. Which of the following is produced only by the large amount of glucocorticoids —Antiinflamatory response. Fe costes bacon eee & & FF e + a Scanned with CamScanner_—_—— ear old obstetric patient become. a I during her first . ut her heterophil eee = saan antibod, '¥0 cats and lab teat re * Bondi. Months late, I of infection = in the neonate wor ic elisa for which me a 7 iyectious ™ ative a cal Us that the family seB"am mother is infected with toxoplasm nononucleosis like symptoms, seful history rev test was dicate Peers a full term baby with no obvious signs te the the woman vest to diagnose acute infection st be, parasite speci pe 8 : jamunogiobulin? isotype of 2 igh bp ie < igh a eG! e iG ANS: B 4 Neonate is having 5 kg weight what wil be the blood volume: 420 ml. 4 New born important points to remember for exam: 1. Upper limb well developed Lower limb less developed C shaped vertebral column Inner ear is of same size as that of adult ‘Thorax of new born is circular and adult is oval shaped Mean hematocrit of new born is 55%. In new born arterial blood sample should be taken from -> umbilical artery > radial artery. 8. Lowest HB in new born is present at 3 months. yay ae > What is true regarding polycystic ovary disease? a FSH:LH 3:1 b. LH:FSH 3:1 ANS: B LH acts on leydig cells FSH acts on sertoli cells - Ss intait togenisis. : : Bien Fit iin ma a sping O/E oe i bac oan mene wth ae, ag pea <1 aes FSH in males is inhibited tying Sertoli cells form blood testes * ‘ oi Sofiening of cervix is mediated through> peter (ue Hormonal status in post peng feet Which of the following triggers the Negative feedback control of seminiferous of sextoli cells > inhibin. ae elt Which hormone is anabolic on proteins jg under direct Which Hormone of the antedor pituitt hypothalamus: prolactin. jn > preschool 48° Lowest testosterone levels are i L a 8 t i : z \ Scanned with CamScanner———— ae 578 + ceructure development is SO ulated by testosterone begins in epididymus: f F an inhibiting factor vale genital tract for 24 to 48 hours. n uterus, place i of the semen. s main bulk s testosterone vnvsents “> total androgen production. > thickening of the larynx. Js is mediated by > FSH. in usine ref is the fur to estradiol in granulosa ce action of testosterone of the followin Conversion of testos Which hormone decreases cholesterol Jevel > Estrogen Which of the following is not the action of estroge > increase serum cholesterol level During sexual act secretions fom the vagina are under the influence of > ic nervous system. parasympathet esterone. Which of the following js thermogenic > prog Which of the following is ue regarding progesterone > when its Jeads to menstruation. Remember the sequence: harmone + Jevel decreases it & Just 2 days before ovulation LH level increases by 8 to 10 percent. 4 Menopause is diagnosed by > raised FSH. Thelarche & Viscosity of cervical mucous peaks at > 2 days after ovulation. 4 L ‘Adres 4 In ovulation phase fem test become negative. marche & Number of follicles to develop dusing each menstrual period 15 3. Manerche to 20. & Fiest pubertal change is > thelarehe. In puberty last to appear 8 menarche. Breast feeding should be started after half hour of smooth vaginal delivery. 4 Maternal child bond is lost > FOS-B gene. & At the end of pregnancy uterus i ORE Sea to which of the following harmone > oxytocin amenorthea is > Pregnancy: amenorthea is > PCOS. Most common cause of sn cause of secondary srsible cause of infertility is ovulation. Most comm Most common reve Most common cause of infertility is Amewalation: use of primary infertility idiopathie>anovulaton- Ps & + + 4& Most common c 4 Most common cause of STD in female > Chlamydia 4 Most common cause of PID > Chlamydia 4 Vagina is lined by Stratified squamous epithelium. 4 Peritoneum is present in Posterior walll OF vagina. + * Protective bacterium in vagina Lactobacillus. sion of endometrium respresents Secretory phase. Subnuclear vac Scanned with CamScanner‘ith isd fw jrug is to be given? Peet : ide ascot yof them 1 MCQS 4p Terlipcessin is the drug of choice in vaticeal bleed with mortality benefit. tnischemic heart disease terlipressin should be avoided. f Location of esophageal varices is lower one thied of esophagous and are present in submucosa. & Fsophageal varices drains into left gastric vein. 4} Most common vein that bleed in esophageal varices is left gastric vein. & Commonest cause of esophageal varices is > circhosis. A young patient presented with massive hematemesis was found to have splenomegaly. In this case the most likely cause of bleeding is esophageal varices. Patient came to ER with hematemesis and grade 3 esophageal varices. What is the best treatment option > band ligation > Sclerotherapy. £ Tumor impinges on splenic artery which of the following artery will be affected most > Short gastic arteries ( Fundus of the stomach). Right gastric artery is the branch of common hepatic artery. Fundus of the stomach is supplied by short gastric arteries which are the branches of > splenic arteries. & Cystic artery is the branch of > sight hepatic artery. * - Which of the Upper GI bleed ess then 10 percent loss No symptoms © > 10% loss postrul hypotention stachycardia, decrease urine out put © > 40% loss , resting hypatention shock Management 2 wide bore cannula Ql crystolloids ,polygelene ‘©teke blood for grouping cross matching and arrange blood QI ppis 80mg stat then 8 mg /hr continous © Incase of varices terlip 2mg stat then | mg Qid for 3 days @ Incase of ambiguity give both PPls and Terlip @IfHB'is less then 7 give packed cells IFINR is greater then LB give FFPS IF platelets less then SOk give platelets © Do diagnostic and therapeutic endascopy with in 24 hrs Right gastroepiploic artery is the branch of ‘gatroduodenal artery. Which of the following artery is most perforation > gastroduodenal artery & Left gastric artery is the branch of celiac artery likely affected in posterior duodenal Scanned with CamScanner580 —— = for one day, he is ; ceria, Narmal anion gap Mile yperclo seen in ' following is true v of the ‘Mnemonic: HARDASS i LHyperalimenatn ANS: B 5 hyperehloremic acidosis are consistant 2 Addissons disease " Hypokalemic 206 e a RAS jo normal anion gap melt polic pe & Diarhea and — «the characteristic findings are 5. Acetazolamide & In tubular inter ‘oe a sgsn in cocn in setmsotmile Saline infin & Hyper ploremic etabo a sing Prefer nial thoroughfare channels? 3. Opens on demand aia spine eof smooth masks dn capillary aI oles and preferential thoroughfare channels appeat 10 emesBe aes 1 arteriol carter” “yerounded by layer OF oe patinaous sepooth muscle cells. They erminal arteriole and venules. connec ei eng Seem i etogenisis? a. Insulin b. Glucagon ©. Consol d. Thyroxine ANS: B ature of Aplastic anemia ? Characteristic fe Pancytopenia £ Bicytopennia marrow fatty infiltrate g. Bone Pure red cell aplasia re h. ANS: C Intrinsic factor deficiency leads to? 234 ‘actions of insulin and plus epinephine. a. Megaloblastic anemia b. Pernicious anemia ANS: B That is true regarding vasculitis of different tages in same vessel and different vessels? a. Polyarteritis nodosa b. Wegner granulomatosis Giant cell arteritis d. Kawasaki disease On histopathology characteristically different stages of activity ( from early ANS: A is seen in different vessels and even with in the same vessel in case of polyarteritis to late nodosa Placenta is formed by ? 2 Deed ass and conc frondosum 2 ima bce ee 4. Straitum spongiosus ANS: A : © Fetal compe £ fetslcomponent of placenta develops from chorionic frondos »mponent of placenta develops from decidua ere s. Scanned with CamScannery hemoglobin at 100! oxygen is? S81 hours b. thours ¢. dhours hour ANS: D 4+ At room air its S hours 4+ At 100% oxygen itis 1 hour 4, At hyperbaric oxygen it is less then 30 minutes } Tragus and helical crus is derived from? a. branchial arch b. 2! branchial arch ¢ 3#branchial arch 4. 4 branchial arch ANS: A 4. Ear ossicles mature at 16 weeks. 4 Development of Pinna or auricle takes place from first and second branchil arch. + Development of air ossicles takes place from 1* and 2s! branchial arch 4 Development of external auditory meatus > 1* branchial cleft + Developemat of auditory tube,Tympanic cavity and mastoid air cells takes place from 1* branchial pouch. , ‘+ Development of tympanic membrane takes place from all three layers (ectoderm, endoderm and mesoderm) ‘+ External and internal ear develop from Ectoderm, Middle ear develops from endoderm + First part of human ear to reach adult size is Tnner ear > Inner ear in neonates is of same size as of the dult + Bar ossicles develop from meckles and richerts cartillage (mesoderm). Most common cause of Deep Venous Thrombosis is: a. Contraceptive pills >. Trauma Surgery 4 Immobility ANS: D. Most common cause of hepatic vein thrombosis 2 OCPs Order "of percentages is Rae ia vera (40%cases), while oy - OCP and antiphospholipid syadrome, and other hypercoagulable states constituc 20% cases , while HCC make less then 5%, Refrence Goljan pathology. Most — common. acquired cause of Virchow °s triad: Three factors are critically important in the development of thrombus: 1. Venous stasis 2. Activation of blood coagulation Scanned with CamScanner; —————— aa : sm its fetal surface Is covered by amni S Tshaemochorial ie placenta ¢._Istermed as chosio-all2 00" along the plane of stratum spongiosum. 3 Sepa Jue to rupture of many muscles. 1g internal jugular lymph node biopsy res Ear lobe numbness whilt doing internal jugular lym ae Greater auricular ner slotemporal nerve n of facial nerve facial nerve b. Auricu cc. Buccal branch d. Cervical branch of a hee ne head at occiput is ssory supply of back of t Sen ater OCG pital nerve 4 8 eae ‘ith swelling anterior to the vireular region which is painful. Nerv a in transmission OF pain im tia EG will be > Auriculotemporal nerve: ec a sicle ‘Ausiculotemporal weit me 1. In front of 2. Behind the auricle is > Greater Were soa capa pasa aca is 9 Ausiaotemposa ae Why is the swelling of parotid gland painful > unyielding of its capsule. Whach nerve carry pain fibers from parotid gland > Ausiculo-temporal nerve. Nerve passing through the petrous Part of temporal bone is > Fascial nerve. al bone is > Abducent nerve. Nerve lying at the apex of petrous part of tempor Geniculate ganglion is located at the junction of facial canal and internal acoustic meatus. ‘Trigeminal ganglion is located at the apex of petzous Part of temporal bone in the middle cranial fossa « sass car old male is complaining of loss of abduction of sight sys: Radiological responsible nerve . At which of the ‘examination revealed mass is pressing the following site will be the mass located? > Apex of petrous part of temporal bone. following swe is located at the apex of petrous part of the temporal bone and passes through the central part of cavernous sinus in close proximity to ICA. ean’ which is most vulnerable to damage when there is ruised intracranial pressure "> Abduceat nerve, Raised intracranial pressure leads to descent of brain Prey nerve is stretched and consequently ext by the sharp edge of petrous Part of temporal bone. 4 A patient presented with distorted face drooling of the angle of mouth and lower «Ye lid drooping. He is having history of trauma 1 year back to cranium. On CTscan pressing mass is most likely seen in which aspect of petsous part of temporal bone! > Posterior aspect + + Ree RE > Which of the following has no basement membrane a. Ependymal cells > 7 : b. Mesothelium ‘ a onal epithelium d._ Simple squamous epithelium ANS: A Refere: V ‘eference: Wheater 's Histology. GIT epithelium regenerates in 2 to days, ied squamous epithelium, Sub glotti b glottis contains sti Larynx (false vocal cords) conta 'scudo stratified columnar Lays (true vocal cont) aS il ae fe Canal above Hiltons line simple eolimnar epithel i Anal canal below Hiltons line stratified squamous epitheli ium. hehehe Scanned with CamScannersimple columnar pith. six contains simp! Pithelium, a # oes contains stratified squamous epithelium 585 4 Fe eanous and penile urethra > Pseudostratified coh 4. Memc urethra contains > Transitional epithets ™™ €Pitheing Te cells are modified columnar epithelium, é have glycolytic enzyme activity. ee ist layer of small intestine is > Submucosa, g Seonee™ vena cave is valve less vessel. St edullary rays arc present in > cortex of the kidney, Men of the following is not major basic tissue? -> Blood 4 ppihloid cells in granuloma are formed by mg, aes 4 EP pis secreted by which part of platelets > : js seoreted by 8 > alph 4 POC! Jor mocoea has extensive folds, se ars Most abundant phagocytic cells in the blood are > Neutrophils jp of the following harmone acts as a link between body weight wis and puberty? Opin patil |_eeee Progesterone i Growth hormone s. A Reference: Ganong == Most potent estrogen is > Estradiol, =e & Leptin helps in satiny. SSS Ses 4 Which of the following harmone is used to know = teens feul abnormalities -> Estriol (Gistriol is gq 90 = =n component of triple and quad screening and is also reliable index of placental function, 44 Which of the following is not synthesized in post ganclioni ile > acetylcholine. Post ganglionic neurons? -> Histamine ) 2 year old female presented with xeostomia and dryness of eyes, she is havi sss ot chronic otitis media. The neurons for the said clinival conditions ere 1 Pons b Mibrain ¢ Cerebellum ¢ Cerebrum ae re oblongata : om a result of a Tow b Gc © TST6 4 606 ANS: 4 Beech : ‘ ig With dilated pupil > occulomotor nerve palsy 4 Pog With constricted pupils > homers syndrome. 4 dag ett BOrmal pupils myasthenia gravis, yasthenge et, PY > homers syndrome, Myopathy, third nerve palsy, and a a ‘Sravis. ‘ait ecacted. with aes pin, the onl/66 Bel gl ett ate BI 4 Page that helps in diagnosis > single ber EMG. f : most herent With ptosis and diplopia, which of the following cranial nerve is 4 7 rtlely involved, -> Oceulomotor nerve trauma at which site? Scanned with CamScanner586 s and 1 ght eye Pamelor By ear resected with SH eg > Pe ne-re (Keston of sally ang 7 and eye ball move down and out) Cranial ee towards the end Se ed ia the anterior a ii a What}jis your diagnosis? myasthenia — : mass is th anoma: i a) male Spokes presented with diplopia and rete 4 «OF weakness in Ewin his pupils are pone adil = Pv size, he is having proximal muscle weaknes and oss eee f deep tendon fe exes, what is your diagnosis — eeP eaten syndrome yasthenia gravis. (old aB¢ serene , ; os Je, smoker and Joss of deep tendon refles points Seer eee te —— ad ale, sheet enc, symarome, 12 lambert eaten icome _ the deep tendon reflexes are wactersistiacally 1080) a > Garde control theory of pa 7 jodulation occurs in? a. Spine thalamic tract b, Substantia gelaunosa ANS: B <> Bradykinin ‘Potent pain mediator 4. Substantia gelatinosa © 4 Pain from loin and groin # * 7 4. Pain from Testicle and Thig The part of CNS not involve in fa PE is t Slow chronic pain is mediated Dy > Substantia to carry motor task om CO! carries > Pain fibers. tated by > illeoinguinal and illeobypogastsic ner ? ve His mediated by geniTofemoral nerve > sunbstantia gelatinosa. latinosa. mmand given with ades quate strength The inability hention is called? son coordination and compre! a. Aphasia b. Apraxia Alexia d. Aprosodia ANS: B > ‘Regarding motor apraxia lesion is in? a. Premotor cortex b. Cortical association area c. Prefrontal cortex d. Somatosensory association area €. Postcentral gyrus ANS: A >» Which of the following Ii g ligament is best palpated by per-rectal th yen by vaginal examination? a. Round ligament b. Uterosacral ligament ¢. Transverse cervical ligament d. Broad ligment. ; ANs: B 1 Complete uterine ce prolapse (Dis ervical or cardinal rect support r : Me ligament. of uterus ligament) Ligament involved is Laval -dian episiotomy ty complication prolay ns > External Re See sing through vaginal introitus a ee eee fi Pacer aati ves ie involvement, eh +e © Scanned with CamScannerF canal contain round ligament of uten,s, 4 sco pe ligament or suspensory ligament of mane + "Nang ¢ + dina ligament transmits uterine vessels , watian Vessel, and p . csi a in female give tse to round gamane of uterus ae ovates | and roung d vt common site of ureter injury during hysterecto fost 4) physi ¢ to the patient is to gay? sual problems are common in diabetes tei me what do you mean by problems in bed ; you and your wife should see a sex * doh 4 diabetes tells his "NE Problem, i in bed. The Pre ot worry therapist, B ae : liabetes polyphagia is due to > Decreased Sensitivity of sati Be seconinsoa oreo gangrene in diabetes is > Day ee center, . Diabetic foot is an example of wet . ; Life threatening fungal infection in diabetes is 4 Te most common cranial nerve involved in dich chanactristcally pupil spating or partial third 4 Diabetic patient presented with bone MUcomnycosis, tes is > 301 cranial Nerve which is Pain, parathyroid hyperplasia and ithyroidism, RET pene analysis came out to be positi is at cis a ily of thyroid gland, Posie Bele ak of deoping 4 Diabetic patent presented with hypertention the deug of choi hntestes the innermost cover; 1 Tunica is ing layer is? Scanned with CamScanner- ——— igh the posterior most diaphrag phragmatic 588 grructures passes throw Esophagows and vagus bp. Vena cava He ‘ous, esophagous and vagus . Splanic vessels Ns: E ANG Median arcuate ligament is formed by The wo crus of diaphem that arches aver aortic opening 4 Anterior to aortic opening which sqracture is present? > Median arcuate ligament & Medial arcuate ligament is fascial ‘Thickening ovet psoas muscle. Tizament is fascial 4 Lateral arcuate the quadsates thickening ove Jumborum. 4 Diaphragmatic surface of the heast is formed by the left ventricle, ne 4 Perforated peptic ulcer is demonstrated on xtay by > Gas under Diaphragm: the diaphragm. Naser bea > Between stemneh and costle attachment of vm ee diaphragm —* 90% right anterior pric ‘& Bochdelek hernia * Posterior and left side of diphragm 2 Sensory supply & Longe rons of diaphragm arises from 9 coste cartilage. party pric oa What increases lower esophageal sphincter pressure La anticholinergics E cprese 4 Vagus nerve passes through diaphragm along with > Dpenings Esophagous. = x af dro 4 Acme aneurysm at diaphragmatic hiatus wall compres > 3000 vein and thoracic duct. pees aaygous Farle er 4& A child with decrease chest sounds on left side, decrease chest avel opening in diahragnis® aoa coer inet ‘on holding him up and intestine level of T8. Structures passing a rene side of t cause > Patent pleuroperitoneal ‘vena cava, right phrenic nar, $ Moe Of quiet respiation > Diaphragm sympatenenes matraction of diaphragm I 4 4 Major inspirator a cos thorncic volume : ry muscle > Diaphragm - Diaphragmatic hernia occurs thra->Esophageal Openis Ligament of Treitz connect duodenojejt cree jj¢junal flexure to right crus of diaphragm. + Which part of liver is din contact with diaphragm ver is directly 5 a phrenic nerve nee ict gees ae Pmbryologically orign of diaphragm is > cervical somite. SussassesssssSsssessse=: ee si Scanned with CamScannery EE —— ~~ ts on which of the following? sont io pre 589 » vor : B the above Gle B Aldosterone acts on late DCT and and ¢ fe tical collecting Dy eum: atoid arthritis a Ror losing, spondylitis peoratic arthitis: 6 sthritis (osteo Be ecm te a AN] Anti-inflammatory action of diclofenic sodium in inhibitor. im in theumatoid arth is ae RA factor in cheumatoid arthritis is associated Rheumatoid factor ti ANA does not corre ih bad prognosis. Most specific for cheumatoid arthritis is > Ant-CCP. Absence of RA factor does not rule out dig ! diagnosis of rheumatoid Shrinkage or narrowing of spinal cord is due to osteophytes, HLA- B27 is associated with Ankylosing spondylitis Type of hypersensitivity in RA Is > Type 3 HSR. In rheumatoid arthritis Rheumatoid factor is IgM autoantibody portion of igG. igM autoantibody formed against Fe HERE E EEE EE yoll wrist and finger extension is known as: 4, Tinel test Fe ot epee Pee es . Phalen test lian nerve compression (carpal tunnel ¢. Reverse phalen test syndrome). It is positive f there is pain or tingling 4 Hoffman test. ‘sensations felt by the patient along the distribution ANS: C af median nerve. ‘Extension Flexion ‘Reverse Phalen's Phalen's, iagnosis of infecti beta The definitive diagnostic laboratory test for diagnosis of infection by Streptococcus is? 2 ASO titer cae iia lady brought her 6 year old child with complaint Hoint pain and pai Scanned with CamScanner590 mother who has noticed that he pe clinic by his 1 smooth cyst is identified a smal und the lesi your diagnosis? ought to # yas. On €xal 1e hyoid bone ated mass: minatio On ulte jon appears to be a What is Rhabdom! Branchial cyst e Dermoid cy st. ANS: E es tiloculated and heterogeneous. Most are located above Een from thyroglossl Css tios tangle Dermoid cysts 4 the hyoid, and on imaging ‘Most are located in the Poste of from the second branchial Cystic hy romas are Soft and trans Branchial cysts: Are ust ly located Iaterally and desive left. Unless infectior sered they will usvally have an anechoic appearance Of ultrasound Thyroglossal the hyoid (65 from remnants anechoic on om pleusipotent stem 1a has occ the midline and below 1 cyst: Located in the anterior tangle, usually i cases) Derived fi Thin walled and Derived it on location of ectopic thyrok Base of the tongue- sary gland is Mandible followed Py W Toeatioa of of ectopic sali cont and conta 4 Most com L Most commor Gingiva 4a Most common site of ectopic pregnancy t Lesst common sia aaa is 4. Investigation of voice fox ruptured ectopic Which method is used. of surgical instruments? Sporicidal 1 160 °C for 1 hour Dry heat Use temperature a 0 Dry heat a Dry heat at 160 °C for 4 hour Moist heat at 160 °C for 1 hous Moist heat:eg. Autoc cae 3enison violet for 4 hours : A °C for 15 minutes cor 134 °C for 10 minutes 4. 10 percent formaldehyde is used to send biopsy specimen is to prevent > Autolysis. Most resistant to antiseptics prions, Important way fi portant way to prevent spread of infection is ~>Frequent hand washing + ' ‘ g 4 4. For Hand washing chlorhexidine, isopropyl-alcohol. 4 Speccdal Ga Halogens. ‘8 : formaldehyde, Ethylene oxide, pores of bacteria are destroyed by autoclaving at 120C? for 15 minutes. Scanned with CamScanner