YF T pe DR. RASHID MAHMOOD ea eee ed FCPS PART-1 EXAM for ALL SPECIALITIES. ROUND me ue Cs Radiology, Pathology, Psychiatry and Dentistry Ke Online order for Home Delivary: 0301-7747686 Pence et et Pheu ReContent e MEDICAL ETHIC ¢ HISTOLOGY © GENERAL ANATOMY e LYMPHATIC DRAINAGE ¢ NEUROANATOMY & NEUROPHYSIOLOGY e PHARMACOLOGY ¢ MICROBIOLOGY: © BIOCHEMISTRY ¢ IMMUNOLOGY e BIOSTAT e EMBRYO. e CONTROVERSIAL MCQs e RX NOTES. Beauty of this Book: This book consists of 170 pages and consist of high yield topics, minor subjects and controversial MCQs.Why “The Night Before Exam’ ‘This book provides you the golden chance to cover all the Important and high yield topics, Controversial BCQs and all Minor Subjects which are FCPS Part-1 exam oriented and arranged in such a way that are easy to digest and memorize. ‘= This book mainly focuses on Minor subjects which are usually neglected and might become the reason of you lagging behind the required passing percentile with the difference of mere 1 to 2 percent, which is really a great loss. This book helps you cover the ultimate minor deficiencies if present. + This book contains 550 controversial MCQs which are frequently tested and should be on your fingertips prior to appearing in exam. + The beauty of this bookis, it provides you the chance to cover allimportant topics, especially Minors, in only 8-10 hours of read. So, if you are appearing in exam without any proper preparation, at least you have to do it once before your exam.Posterior circulation ‘terior inal re dial medullary sdrome ‘orton wae Caudal medulla hypoglossal nerve ‘Contalteralpaalss—upper and ower Unb Dee convaater! popracestion Ipslatral hypogiosa!dafuncton tongue deviates Ipslaeraly) "ICA [ranch of Baar Ae eral pontine drome Tater pons Fada nes Spmotalamie vac spina wgemina nucleus Symonhetic fers {abyrinthine arte Paris of fae Dec lection, sivation ate from anterior 2 of tongue. Vomiting vertigo stigmas Dec pan and temperature sensation from conralteral body, Ipsacral face Ipslatral Horner syndrome Ipsistral sti, arse Ipslitra sensorineural demos, orto (A (Granch-of vertebral Artery Lneralmedulary (Walenberg) syndrome \vestbulr mud Spnotalamle vact spinal wigeminal nucleus Sympathetic ers Mile a inferior cereblir peduncles Teal medals NuieusAbigvous (CNH XX) Drertge Rosrenes, Der se refi crn Voming verge, ystagmus Dee pan and temperature sensation from cotaeterl body, Ipsilateral Horner syndrome. Ipsotral atl, dysmevri Sear are cn syarome ons medul ower ridbrala cule eafi nerve nucle TFRAS (Reicularactvaing stem spared, consciousness preserves ‘uaéripleea Ls hr zontl, butnat verte, eye movements Contant] Rerianopia wth mar sparing wa who? 29h (dominant hemisphereLocalization of lesion ‘+ Right Hemiplegia loss of proprioception on Left, Tounge deviated to Right = ASA. ‘+ Facial paralysis on Right, dec pain and temperature sensation from left side, and rightface, right constricted pupil, ataxia, dysmetria. right sensorineural deafness, vertigo= AICA, branchof Basilar artery ‘+ Dysphagia, Horseness, dec pain and temperature sensation from leftside, and right face, right constricted pupil, ataxia, dysmetria, vrtigo= PICA, branch of Vertebral artery, ‘+ Quadriplegia, loss of horizontal, but not vertical, eye movements = Locked in Syndrome (Basllar Artery) ‘+ Rightsided motor and sensory loss of upper limb and face + Aphasia = Left MCA (Dominant sphere) ‘+ Left sided moter and sensory loss of upper limb and face + Hemineglect = Right MCA (Nor-Dominant sphere) ‘+ Rightsided motor and sensory oss of lower limb + urinary incontinence =ACA ‘+ Rightsided body weakness upper and lower limb = MCA (Pure motor stroke due to invalvement of Anterior 2/3" of Posterior limb of internal Capsule or Striatum) ‘+ Paralysis «Facial lesion on same side of body of ->UMIN Lesion = Unerossed hemiplegia (internal capsule) ‘+ Paralysis + Facial lesion on opposite sce of body of >UMN lesion = Crossed hemiplegia (pons / brainstem) ‘+ Isolated Siath cranial nerve palsy causes Horizontal Diplopia e.g when moving eye left or right or reversing the car. ‘+ Isolated Fourth cranial nerve palsy causes vertical diplopia e.g coming downstairs or Reading newspaper. ‘© Third cranial nerve palsy leads to both horlzontal and vertical diplopia “+ Note diplopia on coming dovn-stairs is called vertical diplopia is present both in Ath and 3rd Nerve palsy but ath > 3rd ‘+ Allhorizontal movements of eye are disturbed in leison of= Pons (abducent nerve) ‘+ Allvertical movements of eye are disturbed in|eison of = Midbrain (Oculomotor nerve) ‘+ Bilateral Pinpoint pupil= Pons (always think Pons First) ‘© Lesion on ant 2/3 of tongue « lesion in facial canal (cords tympani in facial canal) ‘+ Bell’s palsy = lesion in stylomastoid foramen (muscular branches here) “+ Right hemiplegia with right facial nerve palsy = Lesion in internal capsule ‘+ Sensory losson left side face and leftside body. Level of lesion = Thalamus ‘+ Patient presents with paralysed right arm and leg right plantar up going and exaggerated reflexes lesion = Left internal capsule, ‘+ Pacinian corpuscles are nurnerous i ‘+The rate of regeneration of peripheral nerves following injury Is = 1-3 mm per day eriarticular tissuesObservational studies Sodyiype [Desir Mearurer/oxml Cross- Frequency of disease and frequency of risk _| Disease prevalence. sectional | related factors are assessed in the present. | Can show rsk factor study Asks, “What is happening?” association with disease, but ‘A population to study lik several middle aged or | Oe* not establish causality, ‘ost menauposal women fom karachi to check osteoporosis prevalence '®. Cross sectional! 8, case control Cohort D. Prospective Case-control_ | Compares a group of people with disease to | Odds ati (OF) study a group without disease. Looks to see if odds | Patients with COPD had Cf prior exposure or risk factor differ by | higher odds of a smoking disease state history than those without ‘Asks, What happened? copo ‘Group with disease and group without tested fora rk actor A. Cohort B._casecontroly ‘C"prospective cohoft Cohort study | Compares agroup with a given exposure or | Relative risk (AR). risk factor to a group without such ‘exposure. Looks to see if exposure or risk factors associated with later development of disease, (Can be prospective or retrospective ‘wo groups one with CHD and associated risk factorsis compared to another group with CHD but no associated risk factors what typeof study? Case control ohorw Prospective Retrospective ‘Smokers had a higher risk of developing COPD than ‘nonsmokers. Cohort = relative riskPathology Section Common cause of fatty liver in our country A) Malnutrition W™ B) Alcohol C) Obesity D) HTN Malnutrition LBB aj LCA +RCA of Heart muscle work as synctium Gj intercalated disc of Anterior 2/3 of interventricular septum jij LAD cf impulse travels ij Gap junctions of Posterior 1/3 af interventricular septurn gj PDA of Interclated disc made up af (aj Desrnosomes, te Epicardium blood supply jg Coronary artery sf Conducting system [sj Sub endocardium & Pericardium blood supply ux Pericardiophrenic of SA node sx Subopicardium artery fh AV node a Endocarcium of Fastest conduction = Purkinje fp Inferior wall J RMA branch of RCA ef Slowest conduction lag AV node ob Lateral wall Lag LCX branch of LCA ch Anterior wall gq LAD branch of LCA of Rt border Right atrium of Posterior well la PDA branch of RCA, of Lt border xj Left ventricle of Apex guj LAD branch oF LEA of Inferior borderiag Right ventricle of On xray Rt border a, Right atrium plus SVC of Moderator band is in li Right ventricle ob Artificial pacemaker is placed in Retintis>Pars Plants) In japan greater than 70% have eccular and in USA only 30% have accular menifestation, abliver Involvement is only seen in 20-30% of the palionts, sbincrease ACE levels in 70% of patients during Active Disease ACE levels used ta moniter the disease f0n histoPsthology Gj Non Caseating epithetoic granuloma > Asteriod bodies RxPhysiology Section 1.V/Q ratioin COPD is A. zero B, less than 1.v” Increased Dead Space: G1 = Emphysema D. physiological Dead Space Pneumonia E. infinite ARDS: Smoking 2. Dead space increases in ETT intubation A. Lung collapse Bronchitis Asthma B. Pulmunary edema C. Hypertension D. Hypotensiony” E. Atelectasis Cardiac Failure Pulmonary Embolism Neck Extension Standing Hypotension 3, Dead space decreases in Bronchodilation A. Lung collapse 8. Pulmiunary edema C. Hypertension Decreased Dead Space: D. Hypotension ® Atelectasis E.atelectasisv™ = Tracheostomy = Sleep Explanation = Maxillectomy V/Q>7 or V/Q ratio highiaj Dead space = Hyperventilation V/Q 1 or V/Q ratio low 24 Shunt = Neck Flexion V/Q=0 [oj Shunt ® Supine Position = Bronchoconstriction Pulmonary embolism jj V/Q = 0 Alveolar obstruction a4 W/Q = 0 Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Epithelial Cell Junctions 1, The ECM and the cytoskeleton communicate across the cell membrane through which of the following? A, Proteoglycans 8. Integrins v € cadherins D. Intermediate filaments E Microtubules 3, Which structure binds ICM to ECM, ‘A. Proteoglycans B. Intermediate filaments integrins 4.Cell to Cell adhesion, is due ta A. Proteoglycans B. Intermediate filaments € Integrins D.E-Cadherin v7 5, Cells of simple columnar epithelium are connected by? A, Tight junction, Adhering junctions, Gap junction B.Tight junctions, Gap junction, Desmasomes w C Tight junction anly D. Desmosomes only 6 Which structure connects two epithelial calls? AA Tight junction B. Desmosome Gap junction D.Tight junction 7. The regions between two adjacent cells that are physically attached at discrete locations along their Membrane separated by about 20 nm with a dense accumulation of protein at the cytoplasmic surface of each membrane are: A. Hemi desmosame B. Adhering junction C.Desmoscme wv" D.Fap junction E.Tight junction 8, Which intercellular Junction Is lke a spot weld between cell and the basement? A. Hemi desmosome W B. Adhering junction CDesmoscme D. ap junction E.Tight junction ‘foCell to Cell adhesion fj Cadherin, Cell to Cell [ej Desmasones oCell to Basement Membrane [aj Hemidesmosomes BeCell to ECM jay Integrin plEM to ECM intermediate Filaments which intermediate filaments present? bin Mesenchyme/muscle connective cells ij Vimentin plnmuscle fg Desmin bin Epithelial cells [ag Keratin ln Nuclear envelope jj Lamin Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#03017747686Malignancy ohChange in shape is iad Dysplasia feChange in type is [gj Metaplasia ebysplasia iy Disordered cellular growth and Reversible foDysplasialay loss of polarity prefer that over pleomorphism -bAnaplasia iMore advanced than dysplasia with loss of normal cellular structure and atypia, reversible {Premalignant lesion|sjPleomorphism foPremalignant conditionggN/C ratio foPremalignant lesion Leukoplakia sbPremalignant lesion(lethal) Erythroplakia {oPremalignant Condition : Sumucosal fibrosis fsPremalignant change : Lichen planus of Both Actinic keratosis and Bowen's disease leads to squamous cell carcinoma of skin but conversion rate of Bower's disease is greater than Actinic keratosis. Bowen is common in jj penile region. Actinic keratosis on sad face, lips area, foMalignancy giMetastasis >Invasion >Leomorphism >N/C ratio Microscopic feature in Malignancy aj Invasion Staging [oj Remember as TNM staging Tumour Size, Lymph nodes involvement and metastasis, {Grading Is Lj Degree of Differentiation or Anaplasia “Most aggressive tumor [a Melanoma fp Locally malignant tumor j3j Basal cell carcinoma Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#03017747686Pigmentations & Calcifications ‘Wear and tear pigment in the body called Lipochrome (Lipofuscin} formed as a result of Atrophy eDystrophic calcification means calcification in destroyed tissue with normal calcium level in the blood. 1, Dystrophic calcification is seen in A. Paget disease 8 Renal osteodystrophy CAtheromay” D. Milk-alkali 2 Which of the folowing is a common site for metastatic calcification? A. Gastric mucasa 5 Kidney C. Parathyroid D.Lungsw 5, Which of the following is not 2 commen site for ‘metastatic calcification? |. Gastric mucosa 5. Kidney syndrome C. Parathyroid wv 8. Lung 4, Psammoma bodies show which calerfcation A. Metastatic 8. Dystrophicw Secondary type of 5. Intracellular calcification begins in the A. Mitochondria wv” 8, Endoplasmic reticulum C.Golai bodies Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#03017747686 6. Brown atrophy fs due to an accumulation of A, Melanin B. Hemosiderin CHematin D.Lipofuscin vw” 7. Which of the following pigments are invalved in free radical injury? A.Upofusciny” 2B. Bilirubin & The following pigment is not derived from hemoglobin A. Hemarin B Hemosiderin CC Lipofusciny” D. Bilirubin 9, Lipofuscin, the golden yellow pigment is seen in heart muscle A. Hypertrophy B Atrophy C Hyperplasie D. Infarction 10 the patent wth the following shows the maximum ceposts of potuscin in Gaucher's disease Bay Sachs disease C acite enteric fever D Severe ralnut ition” RxChanges in Electrolytes ofeHy permagnesemia [5] Decreased Excitability efoMild Hy pomagnesemia 4) Increased Neuronal Excitability efHypomagnesemia J Decreased Excitability efHy perkalemia jo) Hyperexcitability of Neurons. efeHy pokalemia aj Decreased Excitability of Neurons eSeHy ponatremia 9] Small Peak of Action Potential cfHypernatremia (aj Large/Heighted Peak of Action Potential oSsHy permagnesemia causes jad Hypocalcemia (Mg Competes with Ca for absorption in nephrons) feild hy pomagesenia causes Lj Hypercalcemia {mild hypomagnesemia cause PTH to relaese) ohSevere hypomagnesemia causes (aj Hypacalcemia (severe hypomagnesemia inhibits PTH) sGAcidosis is usually associated with Hyperkalemia except in case of Renal Tubular Acidosis i.e. RTA type 1 & 2 is associated with acidois with hypokalemia. sfrAlkalosis is usually associated with Hypokalemia, (Hygrogen ions are exchanged with Intracellular K when H+ ions are increased or decresed) Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#050 17747686Urethral injuries 1 Rupture of membranous urathra urine leaks into A. Deep perineal pouch” 8, Superticial perineal pouch CScrotum DLAnt abdominal wall 2. Rupture of bulbar urethra urine leaks inta |A. Deep perineal pouch 8B. Superficial perineal pouch” C Scrotum D.Antabdominal wall 3. Rupture af penile urethra urine leaks into ‘A. Deep perineal pouch B. Superticial perineal pouch Scrotum B. Ant abdominal wall 4. A young man suffer injury to lcerate penile urethra. After perineum where else urine will be leaked ‘A. Deep perineal pouch 8, Superficial perineal pouch C.Scrotum D, Anterior abdominal wally” 5, Patient present with scrotal swelling after injury. Contents of swelling extends upto abdomen but not thigh, Most common cause of this swelling is due to A Injury to bulbar part of urethra B. Injury to penile urethaw™ Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686 6. Boy riding bleycle fall on roaé with rupture of Penile urethra extravagate of urine occurs first in ‘A, Superficial perineal pouch B. Deep perineal pouch C.Serotumw 7.Urine dass nat go to thigh due to A.Colles fascia B Scarpa fascia CFascle lata v" D. Bucks fascia 8. Injury to Penile Urethra without rupture of Bucks Fasia result in A, Penile swelling” B Scrotal swelling C. Abdominal swelling D Thigh sweling 9. Injury to penile urethra with rupture of urine may goto A. Penile swelling B Scrotal swelling € Abdominal swelling DAllof above 2 RxGolgi vs Spindle 1. Receptors in muscles which prevent their Length to go beyond limits are: A. Golgi tendon organ B, Messener's corpuscles C. Muscle spindles w” D. Pacinian corpuscles E. Ruffini's end organ 2. Discharge from muscle spindles decrease when? A. Muscle contract” B. When muscl spindle is stretched 3. In vigorous muscle contraction, damage to the muscle is protected by A:Muscle spindlew B: Merkel disc C:Golgi tendon organs D: Pacinian Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#03017747686 4, Book picked up some books in hand after adding one more book to his hand the boy's hand suddenly dropped all the baoks this is because of: a. Withdrawal reflex b. Inverse stretch reflex v7” ¢. Crossed extensor reflex 5, Clasp knife reflex is due to A. Exaggerated response of muscle spindle B. Oversensitive Golgi tendon organs Muscle spindles senses 3) Change in muscle length Muscle spindles causes [xj Muscle contraction (ie. in inverse Stretch reflex) Golg) tendon organs senses Golg) tendon organs causes, (iein Patellar reflex) Change in muscle Tension Muscle relaxation Golci "Tendon* "T'isj controls ‘Tension’ of muscle. Muscle Spind'Le iit controls "L'enath of mucle, = RxPhysiology Section 1. During exercise blood flow increases A. zone 1 B.zone 1&2 C.zone3 D.zone2&3¥ 2. During Exercise A. zone 1 & 2 converted into zone 3 B. zone 2 converted into zone 3 W C.zone 1&3 converted into zone 2 D. zone 2 & 3 converted into zone 1 3. While lying flat A. zone 1 &2 converted into zone 3 B. zone 2 converted into zone 3. W C. zone 1&3 converted into zone 2 D. zone 2 & 3 converted into zone 1 Explanation: zone 7 do not exists normally, it is found in pathological conditions. so foregt zone 7 when talking about normal physiological conditions. in normal physiological conditions two zone exists, zone 2 and zone 3 Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Bowen vs Actinic 1. Which of the following has high chances of developing into cancer ? A. Lymphocytoma B. Pseudocancerous C Intraenithelial nevus D. Bowen disease W 2, Most common predisposing factor for squamous cell carcinoma of Face ? A. Marjolin ulcer B. Actinic keratosis ¥ C. Bowen's disease D. None 3, Most common predisposing factor which predisposes to squamous cell carcinoma ‘A. Bowen disease” 8. Leukoplakia C. Lupus vulgaris D. Marjolin ulcer E, Senile keratosis Explanation: ofp Both Actinic keratosis and Bowen's disease leads to squamous cell carcinoma of skin but conversion rate of Bowen's disease is greater than Actinic keratosis Bowen is common in penile region. of Actinic keratosis on tace, lips area Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#03017747686Physiology Section |. Patient lying uncovered in GT, maximum 4, Patient in OT, dressed heat is lost by Heat Loss by. A. Conduction” B. Convection C. Radiation D. Evaporation 2.Patient in roam with optimum enviromental conditions, how HEAT loss will occur A.Conductions & Radiationsy” B.Convections C. Sweating D. Breathing E.Voiding 3. Person naked in room, Temp 21°C, humidity present, HEAT loss will occur by. A. Insensible perspirations B. Sweating C. Condutions & Radiationsw” D. Urination Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#03017747686 A. Conductians & Radiationsw” B. Convections C. Sweating D. Breathing 5. Loss of water by evaporation and insensible loss from body A. Controlled oy hypothalamus B. Thermal gradient . Remains constant D. Depends on core body temperature w~ Explanation: = Person in contact with surface = Conduction mention = Convection = Temperature mention = Radistion + Conduction = Endotracheal intubation = EvaporationForces in Membrane 1. Integral proteins in cell membrane are joined by A, Covalent B. lonic C.Covalent + Hydrophobic D. Hydrogen+Hydrophobic vw” 2. What kind of bond present between protein and lipids ina membrane ‘A. Hydrophobic only B. Hydrogen bond only C.Covalent and hydrophobic D. Hydrogen and hydrophobic bonds” 3. Integral proteins in cell membrane are joined to lipids of membrane by ? A. Covalent and Hydrophobic bonds B. Covalent bonds lonic bonds D. Hydrophobic bondsw Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Vascular Physiology 1. Venous pressure increased &mmhg, what will be the effect on capillary pressure? ‘A. Increase by 8mm vw” B Increase markedly C. Decrease by 6mm. D. No change Explanation: Till ZommHg pressure inc. in veins, capillary pressure rises equally. 2. When radius of resistance vessel is inc, which of following will increase ‘A. Capillary blood flowy” B, Central venous pressure C. Radius of resistance vessels D. Mean blaod pressure Explanation: when radius increases more blood will rush into capillaries, so blood flow increases) 3. When viscosity of aload is increased which of following will increase A. Capillary blood flow B. Central venous pressure Radius of resistance veseels D mean blood pressurey” Explanation: increased viscosity increase TPR.. resistance Increases mean arterial pressure increases) A, Pressure is dissipated at B. Arterioles to capillaries C Arteries to arterioles w D Capillaries to venules Explanation: Arterloles are main resistance vessels In the body. Main pressure drops In arterioles Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#03017747686Physiology Section 1. Highest diffusing capacity across respiratory membrane and in body fluids is A. Helium B. Carbon monooxide C. Carbon dioxidew D. Nitrogen E. Oxygen (Diffusing capacity is in this order CO2 44 02 4 CO) 2. Gas used to measure diffusing capacity A. Helium B. Carbon monooxidew C. Carbon dioxide D. Nitrogen E. Oxygen Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Physiology Section 1. 3rd space fluid loss should be replaced by A.Blood,plasma B. 10%dextrose C Ringers lactate D.Hypertonic saline E. Normal saline 2. 10-15% blood loss should be replaced by A, Whole blood B, Three times normal saline C. Ringers lactatew™ D.5%dextrose E, Normal saline Explanation: = 15 percent blood loss is tolerable and replace with ringer. = Less than 10 % no need of iv fluids as veins has reservior. Moreover, Ringer is prefered over Normal saline because constituents of ringers is similar to blood. Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Gastrectomy oh Partial Gastrectomy (4) Iron deficiency anemia oh Total Gastrectomy 5) Pernicious anemia cf If only Gastrectomy mentioned ) Perniciuous anemia oh} Gastrectomy with less than 6 months J Iron Deficiency Anemia Explanation-There us marked decrease in the production of gastric acid. This acid is necessary to convert dietary iron to a form that is more readily absorbed in the duodenum, o& Gastrectomy with greater than 6 months oj Perniciuous anemia Explanation: Vit b12 stores take time to b defficient in body Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686GFR RENAL PHYSIOLOGY 1. For asubstance X GFR 125 mg/ml, Tm 125 mg/min , plasma conc is 200mg/100mI, what will be the filtration , resroption and excretion of substance X ? A) 250 filtration, 125 reabsorption, and 125 excretion B) 125 filtration, 125 reabsorption, and 0 excretion W €)200 filtration , 125 reabsorption, and 75 excretion Explanation: GFR means Filteration aj 125 Tm means Maximum Absorption Capacity aj 125 As Filteration is equal to Absorption so Excretion .j0 Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Physiology Section 1, Best way to measure GFR? a: inulinw” b: Creatinine C: Creatinine Clearance 2. Best way to measure GFR Clinically? a: PAH b; inulin c: Creatinine Clearancey” 3. Best way to estimate GFR? a: Creatinine Clearancey” b: PAH C: Inulin 4, Best way to measure renal plasma/blood flow a: Creatinine b: PAH W ¢: inulin Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Biochemistry Section Hypoglycemia increases? A. Ssk B. Somatostatin C. Gastrin Ww D. VIP E. Secretin Explanation.. Glucagon is chief hormone of starvation or hypoglycemic state Where as insulin is hormone of feed or hyperglycemia state. Gastrin stimulate glucagon secretion where as secretin inhibits glucagon secretion. Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686insulin & Glucose 1. Insulin independent uptake of glucose in A. Smooth muscle B. Myocardium C. Hypothalamus ~ D. Skeletal muscle 2. Insulin independent uptake of glucose in A. Exercising musclew” B. Myocardium C. Adipose tissue D. Skeletal muscle 3. Insulin dependent uptake of glucose into A. Exercising muscle B. Myocardium C. Hypothalamus D. Skeletal musclew” Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Biochemistry Section 1. Insulin independent uptake in A. muscle B.myocaraium C.hypothalamus 7 Dskeletal muscle 2. Insulin dependent uptake of glucase into A exercising muscle B myocardium C hypothalamus D skeletal musclew Some important points: GLUT-4 (insulin dependent found in Skeletal Muscles and Adipose Tissues) BRICK LIPS (insulin independant glucose intake) Brain, RBCs, Intestine, Cornea, Kidney, Liver, Islets, Placenta, Spermatocytes Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Nerves Muscles Bones Extreme Repeats } Most frequently fractured bone of body: Clavicle efoMost frequently dislocated carpal bone: Lunate foMost frequently fractured carpal bone:Scaphoid efOsseous structure palpated deep to "Anatomical Snuff Box": Scaphoid ofpNerve injured with fracture of surgical neck of humerus: Axillary efNerve injured with fracture of shaft of humerus: Radial efoNerve injured that results in wrist drop: Radial efeNerve injured with fracture of medial humeral epicondyle: Ulnar efoMuscle that is the chief flexor and chief extensor at shoulder joint: Deltoid eloMuscles innervated by axillary nerve: Deltoid and Teres Minor efMost commonly torn tendon of rotator cuff: Supraspinatus ef Tendon that courses through shoulder joint: Long head of biceps efoChief supinator muscle of hand: Biceps brachii efePrimary (major) flexor of the forearm: Brachialis ofFracture of distal radius that produces "Dinner Fork" appearance: Colles’ fracture efoTwo muscles that rotate scapula for full abduction of arm: Trapezius and Serratus Anterior Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Physiology Section In right shift of oxygen dissociation curve, the most likely value of P50 would be A.20 B.18 C26 D.36W Explanation: P50 is the oxygen tension when hemoglobin is 50 % saturated with oxygen i.e. 26.7 mmHg In right sift, oxygen affinity decreases to bind with Hb, so more amount of oxygen will be required to saturate 50% of Hb (more than normal value i.e 37) While in Left shift, oxygen affinity increases with Hb so less amount of oxygen required to saturate 50% of Hb ( less than normal value i.e 17 mmHg) For remembering, i am going to approximate these values Normal value of p50 (23 26.7 = 27mmHg In left shift 2) 17mmHg In Right shi 37mmHg Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Thalacemia & Hemolysis 1. Young female with low MCV and MCH but normal Fe and TIBC, most likely test to make Diagnosis? A. bone marrow aspiration B.Hb AZ C. Retic count Explanation: Microcytic Anemia With normal Iron studies (Serum Iron, TIBC, Ferritin, etc) = Thalassemia. Hb electropheresisis the Next best Investigation. *Acute Intravascular hemolysis* Decreased Haptoglobin > Hemoglobenemia > Hemoglobinuria > Reticulocytosis. *Chronie Intravascular Hemolysis* Hemoglobinuria> Hemosidrinuria > Decreased Haptoglabin *Only intravascular hemolysis mentioned* Decreased Haptoglobin » Hemaglobenemia > Hemoglobinuria > Hemosiderinuria>Reticulocytosis Controversial MCQs of CPSP solved by Dr. Rashid Mahmood & Join us on Telegram group: Contraversial MCQs af CPSP Group link: Tme/Cpspcrash Rx +#03017747686 meeeOdds Ratio vs Relative Risk (Of 20 women with neonates getting Tetanus, 19 had not taken Tetanus Toxoid during pregnancy (01 40 women with neonates not getting Tetanus, 30had taken 2 Tetanus Toxoid during pregnancy Tetanus Pee Vaccinated women 1(a) 30 (b) NonVaccinatedwomen | __19(c)_|_—10(d) _ 20 40 Odds Ratio = ad/bc = 10/570 = 0.017 or 1.7% Relative Risk = (a/atb) / (c/c+d) = 0.049 or 4.9% Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Defecation reflex Defecation is Mainly Carried Out By? A. Mass movement B. Sacral Parasympathetic v Mainly carried out by @> Parasympathetic Initiated by ¢ Mass movement. 1, The defecation reflex starts when the muscles in the colon contract to move stool toward the rectum which is called “Mass movement.” The myenteric defecation reflex is responsible for increasing peristalsis and propelling stool toward the rectum.. This eventually signals the internal anal sphincter to relax and reduce sphincter constriction. 2. When enough stool moves to the rectum, the amount of stool causes the tissues in the rectum to stretch or distendMost important reflex is Rectoanal inhibitory reflex is an involuntary internal anal sphincter relaxation in response to rectal distention 3. Inside these tissues are special stretch receptors that signal the brain when they are stretched, The reflex triggers the two main sphincters around the anal canal. Firsts the internal anal sphincter which is involuntary. Second is the external anal sphincter which is relat ively voluntary. The defecation reflex occurs when the internal anal sphincter relaxes and the external anal sphincter contracts.. The second type of defecation reflex is the parasympathetic defecation reflex, a person can voluntarily control the parasympathetic defecation reflex, but they can't control the myentericone.. After the defecation reflex is triggered, you can either delay or defecate Controversial MCQs of CPSP solved by Dr. Rashid Mahmood 1) Join us on Telegram group: Contraversial MCQs af CPSP Group link: Tme/Cpspcrash Rx +#03017747686Physiology Section Which organ has highest arteriovenous difference a. Heart Wo b. Lungs c. Liver d. Kidney Explanation: Heart draws maximum oxygen from blood creating highest AV difference. So Heart has highest difference while Kidney has least. Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Alveolar Gas Equation ‘At sea level PaO2 is 48mmHg, P.O2 level will De ‘A. 100mmHg B 150mmHg Somme v D. 6ommHg According to Alveolar Gas Equation Fractn fraps sgn 02! nom a (PCO tee AB Paco, Pie = snes — car + (FO: x (Pramea= Prac) Ri ) Soar yon Resort cstet wich my 08 ‘craphore peta TEeety at 0 el HO pn pose nthe sas (uty Trg 3 For atmospheric pressure equation will become PaO2 = 150 PaCO2 /0.8 = 150- 48/08 =150-60 =S0mmHg Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#03017747686 ene nsBlood Transfusion BCQs r= o | o [A | A | 6 | & | AB | AB o ra a % * Or Z 7 px [x px ® ® % a v x |v = | |= x Eg a £ o>). se | * * & = «|x [>*« [v1 a * Be ra px [ww Es * AB ee ee Z x aes | a ee a a a e z 2. A younq waar ithe aber room reques ood Tsao. Hor oodampir sero the aberatry fr weup& ose mat The laboratory tend reports That ere als are setae by artbra= £0 O While er serum zing ees” Thermo ‘ial lod denerforher would be? B Bloodpoup A poste © eodqroup au posave 3. oodgroup megave E._Bloodgroaod postive leenaton ‘ABO BLGOD GROUP! he t's ods apie by ‘recie enboies ste ocala aenar means ‘hepatert’s bod contains antigen A Apersoa eng arian A \athave bee up A ‘+ R)81000 GROUP ptt’ ods paatatedby ‘oy b(n argent ears that the pert as agen (ints 0) Apu hn hartge af poste. 2 Severe transaion etn oc whet bod vento cov esinaton €> 8 1 rantaan rncon la ocurina patent wo ann th ‘oun Aweh Soup awe Sous ABwin ak Soupnenc Group Own renee Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpsperash #03017747686 ‘aod you ages are? 1 Prrent onc nace? © Gheopiotens D._ aly inmanoemv ‘lanatin led ru agen are preston Setecenyeproterrenualinranoneye ‘tran cbc aso bod grup angen cap 8 Glyapreten nature Hep rnmurogerse ._Atonoalrecerdrenbetance (6 Atoed rntacon wos rte on abe pst operse par. Within 2 ‘erateyshe besarte dere clam and ed Met bly ese of ents 7 ASOincomomity 1 Rybeonostbtey © Bloodtancicen mscton 7hepested oe anton tamed al xaie Th Focrocwematovcl er 1B typmcaerea © Hemogebinaa 5. Tranter rescion 3 Muti trssami) gy HemoowonstossEmbryology Development of Gonads ‘The iniferent gonad begins development in a column of Intermediate mesoderm called the urogenital ridge during week 4. Primordial germ els arise inthe wal ofthe yolk sac and migrate tothe indflerert gonad ‘© Gamecesie, Oocytes and Spermatozoa are descendants of primordia germ cells that originate in the walla the yolksac. + Primordial germ cells ate derived from eplblast, during the proces of gastrulation and migrate tothe wall af yolk sac. ‘© Thismigrationisin the @* week and arival tothe gonads (sat theend of 5" week ‘Infemates Oogeness begins before birth while in males the spermatogenesis bens at Puberty Inthe male, a test's develops from the nlfferent gonad cue to the presence oftests-etermining factor (TOF), which is produced by Sy gene on the short arm ofthe Y chromosome. Testosterone secreted by the Leydig cells and Millerian-inhibiting factor (MIF) secreted by the Serto cells also contribute tothe development of the genital system. Inthe female, development ofthe ovary and female reproductive system requires estrogen. Ovarian development occurs inthe absence of the Sry geneand inthe presence ofthe WNT# gone. ‘+ Mesonephrie (Wolfian) contributes to Male genital tracts + Paramesonephric(Mullerian) contributes to Female genital tracts Ocgenesis ‘At wesk primordial germ cells ative inthe indiferent ‘gonad and differentiate into oogonia, Oogonia enter meiosis to {orm primary oocytes. Al primary oocytes are formed by menth 5 of fetal life: they are arrested te fist time in prophase (diplotene) of meiosis | and remain arrested unt puberty + Primary oocytes arrested in meiosis are present at birth. ‘+ When girl reaches puberty, during each monthly cele a primary oocyte becomes urarrested and completes meloss to forma secondary oceyte and polar body. Coraroversial MOQ of CPSP solved by De Rashid Makmood Join uso Tega group: Cantroversal MEQs CPSP ‘rovp bok: Imercosperash Isat ae + The secondary oveyte becomes arrested the second time in ‘metaphase of melossItandis ovulate. ‘At fertiization within the uterine tube, the secondary ‘cyte completes meiosis Ito form a mature oocyte and polar body. Meiosis Is completed only if there i fertzation ‘= AtS month of intrauterine life there are 7 millon eggs Maximum in qumbor + Gocyte present in ovary at birth are 4 lakhs “+ Zona plloida i saon in primary folie Spermatogenesis ‘At week, primordial gorm cells arrive the indifferent {gonac and remain dormant until puberty * when a boy reaches puberty, primorsial germ cols ferertiate into type A spermatogonia, which serve as ster cos throughout adult Me, ‘Some type & spermatogonia diferentiate ito type 8 spermatogonia. ‘Type 8 spermatogonia enter melesis to form primary spermatocytes ‘Primary spermatocytes form 2 secondary spermatocytes + Secondary spermatocytes enter meioss ito form2 spermatiss. + Spermatids undergo spermiogenesis, which is series of -marphological changes resulting nthe mature spermatoroa, ‘Primordial germ cells iferentiae nto type A spermatogonia ‘© Type Aspermatogonia~ differentiate nto type 8 spermatogonia ‘+ Type Bspormatogonia~ enter molosist and undergo DNA replication to form primary spermatocytes. 4+ Primary spermatocytes complete melosist to form two secondary spermatocytes 1+ Secondary spermatocytes complete meisisil 0 form four spermatids @a" week Fertilization ‘+ During fotization the spermatoroon must penetrate 1. Corona Radiata 2. Zona pellucida (his ayer becomes impermeable to other spermatozoa; this \s Cortical Reaction) 3. Oocjte call membrane ‘©The ovum thatis released during ferization is ‘Secondary Oocyte. ‘+ Cleavage: a series of mitotic divisions ofthe zygote. “There increase in the numberof smaller cel called Blastomeres, ‘+ Blastomeres are the Totipotent upto 8-cell stage ‘Compaction: bastomeres undergoes compaction and forms a ballof cells with inner and outer cells Morula ‘© Compact ball of ces forms 2 26-cel structure called metus. ‘+ Morula on 3rd of 4 day, wil entor into the uterine eavity, ‘+ Morula is usually 32-cel stage, Blastula / Blastocyst When Morulaentersinto the uterine cavity, here two main changes occur. 41 Acavity appears when fuldscereted within the morula it forms the blastocyst eavity and the morula changes its ame to blastocyst. 2. Theinner and outer cel masses appear. ‘© Theinner cell mass produce Embryo (© The outer cell mass-produce extra-embryonic bissue ke Trophoblast Implantation ‘© Implantation mainly at day7 ‘© Thezona petucida dagenaratas and blastocyst implants ‘within the Functional Layer of the endometrium. ‘+ Embryo sat Blastoeyst stage during implantation. ‘© Theuterusat the time of implanting sin secretory phase. Cortroversal MCQs of CPSP scived by Dr. Rashid Mahmood. ‘oun uson Telorar grap: Conroversin Oso CPSP Embryology For implantation to occur, the zona pellucida must degenerate. The blastocyst usualy implants within the posterior wall ofthe uterus. The erabryonic pole of blastocyst implants ist. ‘© The blastocyst s mare deeply embedded in the lendometrum, and the penetration defect inthe surface epithelium is closed by a Fibrin Coagulum. 2nd Week Two Cal ayers 1. Embryoblast: els differentiate imo ‘= piblast= high columnar celts ‘© Hypoblast= small cuboidal eels Trophoblast cel dferentiates into ‘+ Mono:nucleated cells=Cytotrophoblasts ‘© Multinucleated cells «Syeeytiotrophoblast ‘he syeytiotrophoblast continues its growth into the endometrium to make contact with ‘endometrial blood vessels and glands, No mitosis ‘occurs inthe syneytiotrophoblast, The ceytotrophoblast is mitotically active. Two Cavities 1. Amniotic cavity: small cavity Within the epiblast 2. Exo-eoelamic cavity: Primitive yolk sac Amnlotl cavity: Cells ofthe nner cell mass or cembryobias also differentiate into two layers (1) A layer of small cuboidal cells adjacent tothe blastocyst cavity, known as the Hypeblast layer. (2) A layer of high columnar calls adjacent tothe araniotic cavity, the Epiblast layer. A small cavity appears within the epblast. This cavity cnlarges to become the Amniotic cavity. & BsEmbryology Ultrasound provide on accurate (1 10 2 days} measurement of CCRL during the 7th to 14th weeks, Measurements commonly used in the 16th to 30th weeks are biparetal diameter (BPD), head and atdominal circumference, and femur length ‘By the 12th week. external genitalia develop to such a deeree thatthe sex ofthe fetus can be 60% ‘+ Oxygen Satration in inthe umbilical Vein 70-80% (highest oxygen in fetus) Physiological Herniation ‘© start=6* wook Returne= 10° week ‘Aes salong SMA Counter lock wise “otal= 270" (90° during herviation, 180" while returning) + Coll ofthe small intestinal loops and formation af the cecum occur during the hernietion. ‘Teratogens ‘Week 3 to is eibryogenesis and ellsare lable to the effects of teratogens + Synthetic estrogen, Diethylstibestrol (DES), which was ‘ied to prevent abortion In female embryos raised the incidence of clea ell earcinomas ofthe vagina and cervix and malformation of the uterus, uterine tubes, and upper ‘vagina. Mle embryos exposed in utero increase in ‘malformations ofthe testes and abnormal sperm. In contrast to women, however, men donot demonstrate an Increased rskof developing carcinomas of the genital system. + Maternal diabetes Various malformations; heart and ‘neural tube defects mest common. ‘+ Thalidomide: Limb defects, heart malformations + Xrays: Microcephaly, spina bifida, cleft palate, mb defects + Rubella (German meases): Cataracts, glaucoma, heart defect, hearing oss tooth abnormalities SSRs @ Uthium: Heart malformations ‘Warfarin: Skeletal anormalties nasal hypoplasia, stippled epiphyses ‘+ ACE inhibitors: Growth retardation, fetal death &Ethics ‘+ Medical Ethics is study of = Moral of conduct of doctors’ professional life. ‘+ In Behavioral Sciences the Bio-Psycho-Social (BPS) mode of health care is best described as = Use of social and ‘Psychological factors alongside the biological aspects ofthe lines. ‘+ Patient sutonomy grants every competent adult patient the absolute right to do what he wishes with his own health ca. ‘+ Themoral aspect of doctor's professional fe: Ethies ‘+ The Foremost part of Hippocratic Oath is: Confidentiality ‘© Professionalism of a doctor is judged by = Punctuality ‘+A doctor can breach confidentiality only= ifthe patient allows ‘+ A-doctor can breach confidentiality only if patient has HIV or STDs because these conditions can harm a third person. ‘+ Regarding “Misconception” = to remove myths about disease ‘+ Sick's defined as= Feeling of unwell as perceived by patient ‘+ More chances of sueidal attempts seen in = Depression not psychosis ‘+ Technique used to teat phobias “Systemic desensitization ‘+ Doctor Patient relationship, first and foremost is = Mutual trust ‘© Denial isthe first stage of defense mechanism against against some bad news In our society female death apart from obstetrical death. = Domestic violence A doctor provides better management to patient= By better communication Breaking bad news = should be told to patient ina formal session oxclusively > crispy and acceptable way Breaking bad news= in doctor's office in a formal session, in environment of exclusively Best approach to the patient should be = starting the conversation by asking his mame age etc. In order to avoid complications while procedure is possible by= increasing professional competence. ‘© Adiabetic man comes to your office, saying that he is having problem in bed with his wife. Next step taken by physician is= Counsel the patient that it’s common in diabetes ‘+ Doctor is recognizes by = Politeness and good bedside manner ‘= Small gifts from the patient of nominal or modes value are acceptable but not i the patient expect an extra or different prescription for something in exchange for gifts + Ta prevert tne complain o 3 rosedur/nerveton=Daea shoul nat ss hs campeteny eve * Referral system means = Sending patient to a better higher facility {eer ojstem house r= Betermaogsment of prt 1 Wena tre art optonstos estmenegowihone he patent wan. + Ast nto retary sro tbe miedo pra doc es tt the dar Css hate tol warts asprin arose at Te dca scent th Bir apenarcntam ana ie nate ott thorn Tar acne eed Sythe phromeron ot aoe eel MOQ ot CPS sy Rasen ®) Srarohuagad guar loam ao { terme VsHypersensitivity Reactions Tweet hamenesiety ‘amigencowieks prtoras ion peumetied ras cle 1 Anapcteand tpi two pase rae rts Warne © teow Chematines Leattrenes tex Stet rand tn (ES forage spect Gamal: naphnons e fod dtr best alee Arc asta “ape geneity Ime coms artiper anny (mo Compleat co Carpe : Toran eae oe prociced nd 2-2 wats ate Serum snes ie reactions te ced wre comelexeedated hypersensitive laden of amie ite a fre sensed far resign en treme omsle forma n the ha enhanced oa reaction oa oerter vest) etd bed ocala angers Det Coombs et -dsecs tds ache ety tothe ROC surisce Inc coor tsar presen of urbound ants the seam ramplecaarderacion ranpiesintammation rampin-celia tection > Aatlnmune hemo anemia Gavdpntur syndrome > Mysithena ewe rmiraramaoetoers heumate 2 aerdaee “Traulenrencon + Wypemcietinslant econ Pemphigus ome aac he amor “elven "eThomecnnams ex ion Fees oie ee eres: CDS cyoeniT eli togetadeeis © erator recon eects cos ecg ae erasure nding ctons Bones Contac rma e, Poon iy. Nebel ere) ©. Graftverar hort este + Toes: 90 fore econ: ph est orcortc eats, Cnn eto al une. {reese Yarantlectons M8 shes, och ena er fourth ype sai aye) Conmoversial MCQs of CPSP solved by Dr. Rashid Mahmood &) Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx 403017747686 esdImmunodeficiency Disorders = raton Agammaglobulinemia Defect in TK, 2 yosine kinase gena>no cll maturation aneedrecesve high in Bos) ecuent bacterial ane entero fecons ater § ‘months (dee material 4G) + Absent 8 celsin perigheral blood, dec of alls + Absent/scanty mph odes nd tons (1 fies and germinal conters absent) ‘+ Une vaccines contraindicated Selective IgA deficiency ‘+ Most conimon 1 immunedefiency | Msority Asymetomate Away and Gt Infections + Dee eAvwth normal eG. aM lve + Inesusceatbiy to lads Can caus ase postwe NCS rest Common variable immunodeficiency ‘© Detect Bo eitoromtion | Maypresetincikhood but uel agnoced aftr + Incrak of autlomune disease bronchiectasis mahoma. Sinepulmenary infections “+ Dee plasma cals Dec immunopobuline Sevare combined immunodeficiency “© Dofoetiv 1-28 gamma chain most common, Xsinked recesshe) ‘+ Adenosine deaminase deficioncy (2 mest common, autosomal recessive) Failure to thrive, chon ren, tosh ocuront va bate nga and prtozea!wfectons ‘Absence of thymic shadow {0x8} Germinal centers [not node biopsy) Teal {lw cytometry ‘Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#03017747686 DiGeorge syndrome 22411 microdetton fale to develop 3rd 2nd. pharyges! ouces. absent thymus and parathyros ‘CATCH 22: Cardioc defects (conotruncl abnormalities fg, tev aiogy of Fatt, trncus arteriosus}, Abnormal faces, “Thymic hypopasia > Tell deficency (recurrent ve ungat Infections), Gett plate, Wypocalcemia2*to parathyroid ‘aplasia tetany Dec T cells, Dee PTH, Dec C32 “Thyme shadow absent on OF DiGeorge sytome—thyic, parathyroid, cordiac deters ‘elecarcofaci syndrome paae facil carne defects Job syndrome ‘Autosomal doninant hype syndrome eam the ABCDEF's to pet Ine aE and in eosinophils oi [noninianed taphylococa! Abscesss, retained Baby teeth Coarse aces, Dermatoioge protien (eczems) Inge, bone Facures rm mina trauma Chronic granulomatous disease Detect of NADPH oxidase “clined form mot common Inc svsceptiay to catalase @ organs ‘Aunorma dhydorhodamine (ow eytmetry) est = Dec green ftuorescence 2 RxBCQs of Immunodeficiency Disorders 1. Mostemman asl man inmnesleny) tao © mem L Gatimatecrn © cneocres 5. eivrtecne 4. eet meh ere sour neces Sean moe ‘har var hector wed aaa, ‘mane ene ih ied aprmaosinons © Lemedimmaeatny “Aeutwen sets Peunenanetenibey ie steer eNatemney 1 Bien apsemapiani © Oroneqenlonatecs coe mas inet aoe ade rept vactieans es fortwo tint rhea ag Peon ve ant ‘essowonm snrestterie fee aehos ever aes he ‘Siycenhisoscronegourrpoere neem aa ‘aes oy ‘aenmacenage ‘Sonntag Th faa caninne ceey © memes Comm moan ncn 1 canst bet impos E> Fate otamcepmete dongs pnp, Abe strony og iri narod bt deans ‘teats? Th he eA ete hott ah gern ‘cover Uhehol belong meson 3 hy tees {erat Cn ml sees serpy ee ecu aces etmenpanirs Mees ae ypc seep ng Sttrronetuim dees 12.9 eno ci three bc be se ny 2 ye me ‘aka sma gh toe egy ace aca pean encom 0. falueeltecstoecoreplee ei ‘sonra acer ose 2 phoma oem 6D Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Lme/Cpspcrash +#03017747686 2 Aiton naee cing hy fares tonal ca egy cas Sram gh 7, Wes ae? ‘Walsterasthcy cee ateraeblneda font nemo Gratton Laprter versa ey xan en regen eee rudy ‘domsetbedh hnremennnon wheimmeesetnet oa ‘cctestnaecece eek {Ar nap co it emstmioge bt ecm Tate poten 8 cenmennraiemmunteteery ‘petra coma SE higamaonsncen cre ye ogni sroneusbanctiniancmsntomenmarstugtonte Cininodetdertunee Tene Gemstar ene Cine vrai Agena © See cenecetgmapebanoms 5. tatrs Avenger 12.Anewtnn rset ety se Cum 3 ng surat penta nerearen acters eer oreo atts Feet amb threo eg A Ren anontyearoey | © NeWvaumechacet anode atesImmunodeficiency Disorders = raton Agammaglobulinemia Defect in TK, 2 yosine kinase gena>no cll maturation aneedrecesve high in Bos) ecuent bacterial ane entero fecons ater § ‘months (dee material 4G) + Absent 8 celsin perigheral blood, dec of alls + Absent/scanty mph odes nd tons (1 fies and germinal conters absent) ‘+ Une vaccines contraindicated Selective IgA deficiency ‘+ Most conimon 1 immunedefiency | Msority Asymetomate Away and Gt Infections + Dee eAvwth normal eG. aM lve + Inesusceatbiy to lads Can caus ase postwe NCS rest Common variable immunodeficiency ‘© Detect Bo eitoromtion | Maypresetincikhood but uel agnoced aftr + Incrak of autlomune disease bronchiectasis mahoma. Sinepulmenary infections “+ Dee plasma cals Dec immunopobuline Sevare combined immunodeficiency “© Dofoetiv 1-28 gamma chain most common, Xsinked recesshe) ‘+ Adenosine deaminase deficioncy (2 mest common, autosomal recessive) Failure to thrive, chon ren, tosh ocuront va bate nga and prtozea!wfectons ‘Absence of thymic shadow {0x8} Germinal centers [not node biopsy) Teal {lw cytometry ‘Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#03017747686 DiGeorge syndrome 22411 microdetton fale to develop 3rd 2nd. pharyges! ouces. absent thymus and parathyros ‘CATCH 22: Cardioc defects (conotruncl abnormalities fg, tev aiogy of Fatt, trncus arteriosus}, Abnormal faces, “Thymic hypopasia > Tell deficency (recurrent ve ungat Infections), Gett plate, Wypocalcemia2*to parathyroid ‘aplasia tetany Dec T cells, Dee PTH, Dec C32 “Thyme shadow absent on OF DiGeorge sytome—thyic, parathyroid, cordiac deters ‘elecarcofaci syndrome paae facil carne defects Job syndrome ‘Autosomal doninant hype syndrome eam the ABCDEF's to pet Ine aE and in eosinophils oi [noninianed taphylococa! Abscesss, retained Baby teeth Coarse aces, Dermatoioge protien (eczems) Inge, bone Facures rm mina trauma Chronic granulomatous disease Detect of NADPH oxidase “clined form mot common Inc svsceptiay to catalase @ organs ‘Aunorma dhydorhodamine (ow eytmetry) est = Dec green ftuorescence 2 RxPeudomonas Aeruginosa—aerobic; Motile, Catalase @, Gram © rod, Non-lactose fermenting, Oxidase ® Frequently found in water. It has a grape-like odor. PSEUDOMONAS is associated with: + Pneumonia, = Sepsis, © Eethyma gangrenosum, + UTIs, = Diabetes, * Osteomyelitis, ‘© Mucoid polysaccharide capsule, * Otitis externa (swimmer’s ear), + Nosocomial infections (eg, catheters, equipment), + Addicts (drug abusers), * Skin infections (eg, hot tub folliculitis, wound infection in burn victims), Mucoid polysaccharide capsule may contribute to chronic pnoumonia in cystic fibrosis patients due to biofilm formation. Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Produces PEEP: Phospholipase C (degrades cell membranes); Endotoxin (fever, shock) Exotoxin A (inactivates EF-2); Pigments: pyoverdine and pyocyanin (blue- green pigment ‘Treatments include “CAMPFIRE” drugs: Group link: Tme/Cpsperash #03017747686 Carbapenems Aminoglycosides Monobactams Polymyxins (eg, Polymyxin B, Colistin) Fluoroquinolones (eg, Ciprofloxacin, Levofloxacin) ‘ThIRd- and Fourth-generation cephalosporins (eg, Ceftazidime, Cefepime) Extended-spectrum Penicillins (eg, Piperacillin, Ticarcillin) RxPharmacology Frequontiy tested 8a Frequently tested BCOS Ketamine ‘© Provide profound analgesia © Choice of anesthetic in asthma for surgery because t causes bronchedlation ‘+ Anesthetic naving least respiratory depression Increases intracranial pressure so contrainctcatedin head injures. ‘+ Causing delirium (Atropine is use for delirium) ‘+ Anesthetic ofchoice in hemodynamically unstable patients fr surgery ‘+ Ketamine is used inthe repeated dressing ofthe bur patients: I's given i in burn patients to relief pan os well, ‘+ Inhemodynamically unstable patent's given as LV va central ine to achieve rapid onset and ‘maximum bioavailability in such case because it has central vagoytic and adrenergic properties so Jew Increase myocardial centrality and heart rate. Halothane "© Dissociatesinleht 1 Increase cerebral blood flow causes Bradycarda ‘+ Heat during surgery by skeletal muscle contraction ‘+ Causes Malignant hyperthermia ‘+ Malignant hyperthormia treated by Dantratone ‘upivacain "+ Bupivacaine fist sign of over dose: (Tinnitus) Ringing of eats ‘+ Bupivecsne serious adverse effects: Arrhythmias Bupivacaine biock: Voltage gated Na channels Ropivacaine prelered over bupivacaine: less toxic “+ Maximum safe dose of supivacaine: 150 mg ‘Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash #0301787 686 We action (Onset and direction of local anesthesia depends upon: Tissue ai pid solubity of LA determines potency GA with Low water solulity: Propofol Longest ating NM blocker: Pancuronium NM Blacker inpatient with pheochromocytoma: Pancuraoium Drug which reverses the hypotension caused by anesthetic / ‘epidural or sub Dural anesthesia: Ephedrine ‘More loral anesthesia concentration in blood ir: Itercastal block Succinycholine toxicity in individuals haying deficiency of pseudocholinesterase Ding general anesthesia halothane is given in combination ‘sth: Mitrous oxide In hypovolemia with hypotension Isoflurane should not be ven Because it isa potent vasodilator. Inanesthetized patient, heat wil not be produced due ta: toss ‘of muscle tone ‘Morphine reduces apneic threshold Transport of local anesthetic across placenta: imple affusion Wich of te flowing narcotic wnen given epicural eauses ‘delayed respiratory depression; Fentany! ‘Benzodiazepine couse hypotension in: Hypovolemic Pationt Flumazenil Doesnt causes poradoicatachyeardia Pewithallergy iv xvlecaine given itcauses: Mild syncope Toxicelfect of lignocaine: Prolong seizures for 7-9 hours ‘Neuromuscular blocking agent safe in Asthma: Cisatracurium [Neuromuscular agent safe in Liver disease: Atracuronium (extra hepatic metabolism) Enflurane: \sProconwalsant it causes toniecolanicselaures (Epilepsy = Enflurane) (DOC for anesthesia in pation with fits: Thlopentine ) Rx bond Ester oF Amide in LA determine Duration ofPharmacology Frequently tested BCS + Basic drug binds to: Alpha glycoproteins + Aiiectug beds to: Albumin ‘+ Asemiconscious patients brought due to some ‘drug intake, NaHCO administration reverses the ‘ffet ofthat erug the drugs: Phenobarital ‘+ Man, wth pn peint pupil not responding to Naloxone: Phenebarbitone + Lady treated for epilepsy with phenytoin now ‘wants to get pregnant which antiepileptic is afer {in pregnancy: Carbamazepine > Phenobarbitone ‘+ Asvanced stage grade V) Hepatic ‘encephalopathy with acute renal failure, by which drugs Paracetamol ‘Which drug ean lad to progression of Hepatic ‘encephalopathy: Olurties ‘+ Mechanism of setion of stered inflammation Phospholipase + Warfarin effect increased by Cimetidine + Following drags promote each ther’ action: Atropine & Amitriptyline Patient taking MAO inhibitors, given barbiturates, what wil happen: Coma ‘+ atienton MAO inhibitors, ihe takes caffe HIN + Cotrimoxazole given C/O Red urine, Disanosis: {G5PD deficiency ‘+ Drug with atropine ike action= Seopolamine + Digoxin toxicity increased by: Mydrochlorothiacide, Quinine 450 inducer: Phenobarbitone “+ Probenecid decreases renal excration of peniclin ‘+ Digoxin towiity increased by: Mypokslemia, Alkaioss + Use of Terbutaline in preventing preterm labor jel Controversial MCOs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash #03017747686 ‘Chiorpromatine adverse elec: Dystonie movement Naturally oceurting alkaloids: Morphine and Codeine Side effect of TCAs: Genera tonic colonic setures “Therapeutic index of drug indicates: Safety ant having hypertension which Aipha Blocker to be given DDoxazocin > tamsulesin {Low dose heparin act by inhibiting: Factor 103 ‘Most common drug used in nasal and sinuses fungal infection: “Amphotericin ® (Mucor) ‘Sucalfte-Cimetidine interaction; Sueralfate doesnot let Cimetidine get absorbed Mos specific manifestation of Pencilin Hypersensitivity Bronchospasm ‘Cabergoline: 0 2 agonist high affinity ‘Acetaminophen in wine is due to which mosifistion: ‘Glucuronidation Which antibiotic s present in saliva: Erythromycin Which erug does not eross blood brain barrier: Dopamine HIN female in OPD with indirect hyperblieubinemia: Methyldopa ‘Asthmatic patient underwent cholecystectomy, post-00 ‘analgesia: Paracetaml(Provas infusion) Most common side effect of dlazepam when used in labor: Neonatal Hypotonia Why the dose of theophyliine Is smaller in children as ‘compared to Adults: Decrease metabolism due to absence of ‘glucuronide Transferaseinchildren during eatly age. ‘Vancomycin: Inhisitor of proteoglycan ‘metronidazole MOA: Damages ONA Highest bieavalabitty of ancemetic: Wetociopramide First FDA approved bio engineered drug: Insulin Drug used in headache conteaindisted in peripheral vascular disease: Ergometrine Best way to manage febrile blood reaction are: Paracetamol tft of TA starts. as analgesic at: 3-8 weokPharmacology Frequoity tested 8¢OS {yeaah kr ene uneray abs becomes begins er acl Cetera Ss gst by arma ganar ne nl conaapeve coer sh ow neta rhino gener tition areaytoeee —_ 1 reed arin ee C Seredteeag ne 1. Retcedsmtet cr L_heneedamel ebwertnt tal vetainereae tn fee emg aro eet A tater trend en oman nants ‘aoe paternal etna nase Aes paien 1 Dtereetimnatine he neat, {eect adiaion ba te a dren © taectceemey nee eéineaion local epaminepecenr oy otra est ee oe Store goto patron ‘Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpsperash +#03017747686 Apuestas ons tg ort et dent 3 ew mcaine sega sht msi au a islet ve came plato ste he pee 365-7 ste yr contd natant mone pes. eet rmcuts tah wus nfteng en eretunec bau hennen Fre 1. Coane! © Gnu 1 tenet soy oetcorton abe ptertor ego 650 mp Tian ‘hoe lr verre ester et ©. seers 12 yur isn hae ape wom anti mst genes Abed onde eoumeesPharmacology ‘Anti-thyroid drugs in Preenancy © Trimester: PTU © 2683" Tmester: Methimazole ‘© Methimazole =Teratogenic: ‘© PTU= Hepatorore ‘© Thyroxine doesnot cross placenta sickness ‘Acotazolamide for Mountain Sickness Mectzine, Celine (ant Histamine) and ‘Scopolamine (anti Musearin) for Metion sickness ‘+ Pyridoxine for Morning sickness ‘+ Estrogen containing OCP “Pinereases rsh of ‘Thromboembolism > Breast CA ‘+ High Estrogen containing OCPs Increases isk of ‘enidometrial CA Estrogen contain OCP erases sk of epatte Adenoma ral Hypoglycemic agents ‘+ Safest drug in Elderly DM 2: Tolbutamide (Sulfontrea) 1+ Forobesebest drug Metformin (it doos nat ‘causes hypoglycemia) 1+ Fornomobese best drug: Slfonylurea (it may ‘cause hypoglycemia) 1+ laoy on artsiabetcs now C/O weight loss drug responsible: Metformin, Cox nnibitors ‘+ High selective Cox2 inhibitor: Celecoxib High potent Cox? inhibitor: Melaxicam Irreversible inhibit of Cox 1 and Cox2: Aspen Reversible inhibitor of CO 1 and Cox: NSAIDS Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Ime/Cpspcrash #03017747686 Ascirin ‘+ Asplrin and other NSIADs act on: Cycloonygenase tose dose aspirin inhibit: TAZ Aspiin adverse effet in normal dose: i dsturbance Aspiin overdose: Tnnltus Aspiin oerdote after 12 to 28 hours: Reparatory alalosic Aspiin overdo for days Raed anion gap metaboleaeidosie ‘Aspiin overdase ean also cause Hyperthermia Salleylote excretion inereased by: IV NaHCO3 Antacids ‘+ Auminum hydroxide causes constipation {Magnesium hyronie causes crea (My ‘Some notorious drugs SGranlocytopenia Phenytoin, Clozapine ‘Methemoglobinemia: Procaine, Serzocaine Corneal Opacity: chloroquine, phenotriatines Reflex tachycardia: Ntroglycerine, CA channel blockers, Pethidine> Morphine ‘+ Pseudo membranous colitis: Cindamycin > Amikacin + clavulanic acid> ceftriaxone, cefotaxime Syndromes ‘+ Groy baby yndrome= CHoramphenical Red man syndrome = Vancomycin + Grey man syndrome = Amiodarone ‘Drug Induced SLE by "ls Py Qoim My" + teonazid + Phenyioin Avivicine lactams iavulanic ac ‘lbactam Sulbactam “Tarobactam 2 RxPharmacology Side effects ‘Mechanisms of action ‘+ Peniciin: cell wall synthesis inhibitor + Tetracycine: nbibit protein synthesis + Rifamplcin: inhibit transcription + Azathioprine: inhibit both clair & eytotogleal Immune response ‘+ Cyclosporin: blocks T col, differentiation blocks T cell maturation, Oe host response to graft + Labetalot alpha + beta blocker + Clonidine: centrally acting antihypertensive, pre synaptic alpha 2 agonist in vasomotor center of brain, decreases sympathetic outflow to BVs + Steroids: init phospholipase 42 + Sulphonamides:ihiittetrahyérofolate in bacteria ‘+ Na-Cromoglycate: tas cal stabilizer Ipratropium: Decreases Ach rolease in bronchi Furosemide: smooth muscle relaxation, Rapid diuresis ‘+ Morphine: releases histamine Heparin: inhibits clot propagation (not clot organization) + EPO cts on stom cells (not CFU} + Digoain: inreases contacility decreases heat Drug of cholce ‘= AF Digoxin OOM: Verapamil anaphylactic hock: Epinephrine Partial absant solzures: thosuximide Status epilepticus DOC to start with: Lorazepam ‘DOC systemic fungal infection: Amphotericin Ketaine hallucination: Atropine coll UT: Ciprofloxacin HCV IFN & Ribaviin SAH : Nimodipine (0C0: clomipramine ‘Controversial MCQs of CPSP solved by Dr. Rashid Mahmood us on Telegram group: Controversial MCQs of CPSP Group link: Lme/Cpsperash +#03017747686 Streptomycin: Ototoxc hearing lass ‘Arninoglycosides: ototowic Dipyridamole: coronary steal syndrome “Thiatides: Hypokalemia (fk) and Hyper-ciuc (fl Glucose [Bl Uric acid(gout) Ca) Thiazides: Thrombocytopenia CChiorprometine: Extra pyraisal side effects (dystonia) ‘Theophylline: Nausea and voriting > Tachycardia > tremors > seizures Phonytoin:granulocytopenia, hirsutism, gingiva hyperplasia, Interstitial Preumonits, drug induced SLE, Ataxia, mogaloblastic anemia (olate depletion, painful swollen gums. (Methotrexate: Hepatotoxi, pulmonary Feross, magalobastic anemia Lithium: Hypethyroidsm, rant toxicity, cariae conduction abnormalties,nephrogene Di, gate distros, tramors ‘ACE inhibitors: Bone marrow depression, neutroperia, proteinuria ‘Sulphonamides: G6PD [J hemolysis, kernicterus, Nephrotonic Opioid polsoning: Respiratory depression “Aminoglycosides: both renal ototoncty Suplvaeaine:Cardiotoxlc “Trazodone: Priapiem “Terbutaline: Acidosis, Fine tremens ‘Azathioprine: Hepatosalenic Tell lychoma Didanosine: Peripheral neuropatiy aloperidol: Neuroleptic malignant syndrome ‘Na-Valproate: Flexing wemor ‘Adkiamycin:Cardiomegaly ‘Amiodrone: Thyroid eystuncton Pyratinamide: gout ‘Vancomycin: Red man syndrome Clindamycin: Pseudo membranous cots “TWimethapan: Urinary retention in elderly {iro-Giycerine: Throding headache ‘methyldopa: Indirect hyperblirubinemiaLymphatic Drainage of whole body ‘= Stomech, Duodenum (upper hal) + Liver, Spleen, Pancreas = Celiac ‘= Duodenum lower hal) up to Splenic flexure = Superior Mesenteric ' Splenic flere up to upper rectum = Inferior Mesenterl ‘Lower rectum to Anal cana -upper half (below the pectnate line}= Internal ae ‘+ Anal canal: lower half (below the pectinate line)» Superficial Inguinal Para aortic Genital system Kidneys ‘+ Penile skin: External tac © Ovaries ‘© Corpora + Glans: ee inguinal = Testis ‘= Scrotum: Superficial inguinal Uterus Tounge ‘© Fundus: para aortic Body External ac © Cervix: Internal iiac Vagina ‘© Upper 1/3: External lac © Midate 1/3: internal ac Lower 1/3 (outermost: Superficial Inguinal Urinary system Bladder: External iac ' Prostate and prostatic urethra: Internal tac ‘Posterior urethra: Internal iliac ‘© Anterior urethra: Superficial inguinal Miscellaneous ‘+ Head and neck = Cervical, supraclavicular + Deep cervical = Thyroid gland © Mediastinal= Trachea and Esophagus = Hllar= Cunes pailary= + Popliteal Dors ter foot, posterior calf ‘© Tip:sub mental ‘+ Anterior 2/3" Submandibular ‘© Posterior 1/3%: Deep cervical Lips ‘= Lower lp: Sub mental, submandibular ‘© Upper lip: Submancibular, Parotid, Post auriular Superficial inguinat ‘© Skin below umbilicus except Popiteal territory ‘© Lower half of anal canal, anus, perianal skin ‘© Labia, Vulva, lower half of vagina © Scrotum im, Breast, skin above umbilicus Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpsperash 1403017747686Genetics Autorama ecesive Autoromatdominogt ab boc Bob 66 ” 1 wyane tes trae pve 09 step thence, ‘Ain Oo Hey Soy Nd poet dnt de Soret ven eean Boma maton ‘hcapeear pects finan cme] MEN psc Fans heron popes Fr horestaters aatdooet gg Gado ba * NB «= re | «+ Tatrt amapra tn anni of eupte Taramtcn a supe ba ose otpotoessone 2 ete Xortone Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash #050 17747686 {Dun een ti generation 1 conmoigrore seve 5 brah neaengiesn me 4+ th tert ror}. on arg: peat cteing sce Assmoal enive ABBE tes otra {htc Poo org onl pert trot Sees ree i ts + Sipe geemtors Commoners {ineraenie Faso Gi er Boys Mer kes ore ie 2 eter seo 2 ten Acewmageanenta 1S haorephione {Dien rset yey RxNutrition Protein-energy malnutrition ‘washiorkorcesults for protein deficient MEALS: "= Maleutrition Edema Anemia vor (faty) Sth eons ca hyparaatonscipgmantaon) araimus Malnuteton not esusing edema. Dae artcon in cab hot wontons are letioly absent. Marasmus rsults in Muscle wasting ‘Child of thin built deplgmented apathic whats the likely A. Marasmus 8. Kwashiorhor :LL-monthold baby, 60% of ideal body welt, baby is sal, listless, not responding to vocals, contusion on thigh. Diagnosis? A. Marasmus 8. Kwashrkor Physical abuse? Flag sgn in hairs is characteristic of &. Kwashiothor 8. marasmus © Chroniciron deficiency D._cute muscle wasting wathlorkor i characterized by: "A. Extreme weight loss (wt. <60%) 8 Wormal Hair Flaky paint dermatitis Ditforonce feature of hwashlcrhor from Marasmus A fat loss B, Pitingedema ¥ Difference between hwashlorkor and Marasmus ‘A. Bilateral pitting edemah B. Muscle wasting (Conerdal MCQof CPSP save by Dr. Rabid Mabon nten Taageen rp. Corowa me a (Organ with ability to utilize ketone bodies during starvation? A Brain B tier © kidney Explanation: Produced by: Uver, Utilzed by Balance Diet ‘+ Carbohydrates = 45-65% energy 1+ Proteins = 25-48% energy + Upids = 15-20% energy ‘+ Minimum caloric requirement for an adult rman ina bed without any illness is =25 to -30cal/kg body weight {gram of alcohol yield? A decal 8. 9kcal © Thal D. tkeal E 49keal Explanation: 1p Carbhydrates/Protein =3.6 oF A kcal, 1 ‘Alcohol = 7 heal, fatty acid = 9.4 kal ‘Maximum energy reserve in body in term of kal A fae B. Protein . iver sycoren D. Muscle eyconen (More energy sources? ‘A Starch 8 FawMiscellaneous High Yield BCQs 1. Which nerve is most kely to be injured in General anesthesia: A Radial B. Sciatic ©. Common peraneal B.vinar v Explanation: Ulner fj Common peroneat 2. Overdose of thyroxine is associated with A. Gluconeogenesisw” B.Lipogenesis . Protein synthesis D.Atherosclerasis, Exolanation: Gluconeogenesis and Glycogenolysis 4.|n an Asthmatic and IHD patient immediate treatment of HTN during surgery is, A.Writraglycerin ¥ B.1V sodium néropriside C.Hydralazine D.Bath Exalanation: Not only decreases &P but also increases blood supply to heart by vasodilation of coronary arteries, 4, Respiratory Depression is LEAST after the induction dase of which of the following drugs? A. Etomidate B.Ketamine w Fentanyl D.Propofet Exalaination: One of the advantages of ketamine 's the minimal effect on respirations. After the intravenous induction dose of 2mg/kg, general anesthesia is induced within 30 to 60 seconds with, at most, a transient decrease in respirations (Paco2 rarely increases more than Smim Ha], ‘with unusually high doses or if opioids are also administered, apnea can eccur. Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#05017747686Miscellaneous High Yield BCQs 5, Lady presented with tremors, and problem in writingHe js also have family history of similar comalain. What you will advice A. Amitryptline B.Ropirinole Dopamine D.Propranol Exalanation:Don't mix it up with Parkinson or carebeller disorder as there is no history of CNS related complaints, Problem in wilting and Family history is positive, ts Benign Essential Tremor and we will advice Propranolol. 6 Cause of fatty liver in our country is A. Mainutition B Obesity CHIN Fxplanation: Matnutritionin {Inc fats intake Gj Obesity 7. Ovulation does not occur during lactation due ta Inhibition of GaRh by? A. Estrogen B. Progesterone .Prolectiny” 8 Lactation does not occur in pregnancy due to? A.Estrogen B. Pragesterone .Prolectin D.Both Estregen and Pragesteronew” Exalanation: Both Estrogen and Pragesterone, if have to choose one, choose Progesterone. Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#05017747686Miscellaneous High Yield BCQs 9, At bifurcation of abdominal aorta there is a nerve which passes from superior hypogastric plexus inferiorly tothe inferior hypogastric plexus, which nerve is this? A. Hypogastric nervew” B. Greater splanchnic nerve C. Lesser splanic nerve D.Least splancinicnerve 10. Man with weight gain, his collar has now became tight and when he turns his head towards the right side he faints, this is due to? A.Increased ANP B increased CO C Increased TPRY™ D.incressed Venous return 111, Most common cause of CAD is A.lschemia B.HING Cbiabetes: D.Htypoxia 12. After RTA disuse atrophy due to A.Dec number of cells B.Deccell size C.Denervationy” 13, Child with diarrhes and villous atrophy not improves with gluten free diet A Giarciasis B Whipple Shigella 114, Bronchopulmonary segments A. Sin Left 10in right B10in both” Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#05017747686Miscellaneous High Yield BCQs 15, Most effective for DVT prophylaxis?? A. Warfarin 8 Heparin CLM” ©. Direct thrombin Inhibitors 16. Beta blockers are used with caution in pregnancy because it cause? A. Dec placental perfusion 8. Fetal and neonatal Bradycard Cliypoglycemia DAllof the above” 1?Half life means? ALReaches stable dose quickiyw" 8. Rapid clearance C:Bioavailbility DFrealy filtered in glomeruli 18, Angina may be worsened by which af fallowing A.Atropine 3. Salbutamal C.Vesopressin D. Theophylline” 19. Patient unable to close mouth. Damage would be to A.Medial pterygoid” B.aterel pterygoid Explanation: Medial Plerygoidigj Closes mouth, Lateral Pterygoidisj Opens the mouth Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#05017747686Miscellaneous High Yield BCQs 20, Most common cause of dysentery ‘A, Shigella B Salmonella wv E.Coli B, Staphylococcus Explanation: Salmonella ang c.jeluni are most comimon cause of blood diarrhea. 21. Hypercalcemia results in increased levels of which one of the following? A, 24,25 cholecalciferolw” 3.1.25 vitamin D €.25 vitamin D 22, True hermaphrodites are Ry BLY CORY DLKKY Explanation: 1X09XX/KY99XX¥ 22, Receptors for 128 Hz are ‘A, Meisners 8, Paciniansy” C Merkel dies Explanation Low frequency ¢ 0to 40 Hz Sj Mesiners High frequency Le 100 to 400 ig Pacinian 23, Direct causes grade 4 Encephalopathy A.Diuretics B.PCM Explanation: Progress to grade 4 = diuretics Direct cause of grade 4 = paracetamol, as it can cause directly cause grade 4 encephalopathy without progressing through grade 1.2.5... Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#05017747686Miscellaneous High Yield BCQs 24. On which cell, the receptors for 1gE is present? A. Basophils B. Mast cells v” Explanation: present on both, out most abundant on Mast cells. 25. Which of the Following causes delayed Respiratory depression? A. Fentanyl B Morphine v7 Explanation: Morphine causes delayed Respiratory depression 19 hours after single intra thecal dase, Metabolite of morphine which has Long hat Ure Fontanyl causes early respiratory depression after single Intra thecal dose, Fentanyl Metabolites are pharmacolagically inactive... hat's why Fentanyl is safer option in renal and hepatic decompensation. 26, Primordial germ cells arise at 7? A 3rd week v7" B 3rd month 4th weak Explanation:Arise at Sj 3rd week, Migrate at eth week. 27. Loss of water by insensible perspiration through skin ‘4.200 to 400 mv B. 400 ta 600 ml C600 to 600 mt 800 to 1000 m| 28, Which has highest protein contents A. Lymph B, Plasmay” C.CSF Diperitoneal fluid Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Miscellaneous High Yield BCQs 29 Abealthy man with severe dehydration can be differentiated from SIADH by A. Plasina Osmalarity B. Urine Osmolarity Plasma ADH D. Free water clearance Exalanation: in dehydration, plasma osmolarity is high while in SIADH plasma osmolarity is low. while in oth cases urine osmolarity fs high. 30 Short transient action af Angiatension 1 A Thirst B. Vassoconstriction C.Saltretention D. Aldesterone release 31. Most common cause of congenital hypothroidism ‘A Defective embryagenesis/ thyrcid dysgenesis, B Maternal iodine deficiency” 32. Cause of infant tumor due to radiations ‘A. Leukemia B.Osteosarcomas, C Thyroid v7 35. Cause of adult tumor due to radiations A. Thyroid B Osteosarcamas CLeukemia 34, Risk factor for bladder CA ASmoking v B.Hydroxarbons ‘Smoking isa Hydrocarbons Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#05017747686Miscellaneous High Yield BCQs 55. Hypokaetaemia occurs in Crohn's disease B. Acute renal failure Water intoxication 0. Gastroenteritis” E. Treatment with bata adrenergic blockers Explanation: Gastroenteritis (diarrhea) causes hypokalemia due to loss of K+ in fecos. 36. Sodium clearance is decreased by: A. increased reabsorption y B. Decrease aldosterone C. Osmotic diuresisa . Water osmosis Explanation: When Nat reabsorption is increased, less amount of plasma will be cleared of Nav. So, Na+ clearance will decrease 537.19 urine which substance concentration is higher than plasma ALNat B. Bicarbonate C.Glucose O.Ureaw E, Albumin Explanation: Almost all Na, HCO3, and glucose are reabsorbed, so thelr conc. is higher in plasma than in urine. 38. Erythrogoetin is secreted from A. Liver call B. Peritubular interstitium of kidney C. Macula densa of kidney D. Liver Explanation: Erythropoietin is secretad by “mesangial cells of peritubular capillaries” ofthe kidneys. Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686 RxMiscellaneous High Yield BCQs 39. Diagnosis of T is confirmed by ALPCR B, Sputum for AFB wv” Explanation Microscopic diagnosis of TB is made by [aj Caseous nectosis/caseating granulomas Histological diagnosis of TB is made by fj Epithelioid cells 40.1 which argan blood is regulated early by sympathetic system and then by local metabolites A.Skin B. Exercise muscles W C Heart D. Brain E Spleen 41. In which ergan blood is regulated primarily by sympathetic system rather than by local metabolites A.Skin B. Exercise muscles C Heart D. Brain E Spleen 42. CNS gray matter repair by A. Glial cells B. Astrocytes v Explanation: Astrocytes are analogous to fibroblasts so repair gray matter in CNS. 445, Which structure has nonfunctioning valve A.coronary sinus ¥7 B.AV opening C Pulmonary artery D.Aarta Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#05017747686Miscellaneous High Yield BCQs 44, Septic shock is mainly caused by? ‘8, Gram Positive Bacteria B, Gram Negative Bacteria, 45, Endotoxin Is mainly 8, Gram Positive Bacteria B, Gram Negative Bacteriaw 46, Dncocyles are sean in any of the follawing except: A, Pituitary B. Thyroid © Pancreas D. Thymusw” 47, During exercise blood flow to which organ decreases A Skin B Splanchnie C. Skeletal muscle D.Kidney Explanation: Kidreylsj Splanchnic 48, Most Ukely histolog cal feature of compact bone is, A, Osteocytes reside in canaliculi B, Haversian canals are obliquely oriented Mostly osteans are oriented in the long axis of the bone D. Circumferential lamellae from the osteon around central canal w 49, Osteons show: A. Interstitial lamellae B, Inner circumferential lamellae C. Outer circumferential lamellae 1. Concentric lamellae containing Volksman canal E. Concentric lamellae containing Haversian canal” Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#03017747686Miscellaneous High Yield BCQs 50. Pain of Appendicitis is felt around umbilicus through A. Sensory nerve T70 B Sensory nerves T11 nT 12 C. Sympathetic through TI0y” D.Parasympathatic 51. SA node acts as a pacemaker of the heart because of the fact that it: ‘A. ls capable of generating impulses spontaneously. B Has rich sympathetic innervation C. Has poor cholinesgic innervations. D Generates impulses at the highest ratey” 52. Which of the following is not a feature of PDA ‘A, more common in females B. when associated with pulmonary stenosis its patency is advantageous to the child C. there's continuous machinary murmur in 2nd left intercostal space with thrill D ECG is #usually abnormal E. pulse is of high volume, 53. Nucleoll in active protein synthesis? A. Prominent nucleolus v” B Appear dense C,Heterochromatin D. Disappear E.None, 54, Which drug da nat cause gynaecomastia 4. Digoxin B.Griseofuluin Cimetidine D.Androgeny” E, Spironolactone Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686 RxMiscellaneous High Yield BCQs 55. Highest diffusing capacity across respiratory membrane and in bady fluids is, helium 8. carbon monooxide C.carbon dioxidey™ D. nitrogen E Oxygen 56. In anterior duodenal perforation the contents will goto A rightiliac fossa Ww” B leit iliac fossa C.anteriar sub hepatic space . posterior sub hepatic space E,small bursa 57.1n anterior duodenal perforatian the cantents will goto A.right para coli gutter wv 8 ight iliac fosse C anterior sub hepatic space D. posterior sub hepatic space E-small bursa Explanation: R para colic gutter [aj Rac fossa 58. Intestinal obstruction caused by carcinama colon most Likely involves ‘A. Cecum 8. Ascending colon C transverse colon D.Sigmoid colony” 59, Structures arranged behind the bladder from Lateral wo medial? (Mnemonic = USA) A. Uretr, seminal vesicles ampulla of vas deferencow 3 Seminal vesicles. Ureter ampulla of Vas deference C ampulla of Vas deference .Ureter Seminal vesicle 3. seminal vesicle Vas deference. Ureter E Yas deternce Seminal Vesicle. Ureter Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs af CPSP Group link: Tme/Cpspcrash #03017747686 RxMiscellaneous High Yield BCQs 60, Most common remnant of allantois A.urachal cystw” 8 urachal fistula Curachal sinus 61. Patent lumen of allantots: A.urachal cyst B. urachal fistulay” Curachal sinus 62. Patent lumen of allantois in inferior part or #superior part only. A urachal cyst B urachal fistula Curachal sinusw” 68 Patent Flocal area of allantols: A.urachal cystw" B. urachal fistula C.urachal sinus 64. The mest likely cause of hy percalcemia in malignancy A. parathormore related proteins 8. parathormone Calcitonin B. bone metastasisy” 65. Erythropoiesis occur in all except, A. Kidney B Spleen C.Long bones. D. Flat bones, Eliver Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#05017747686Miscellaneous High Yield BCQs 66, Increase in arterial hydrogen ion concentration will stimulate respiratory center through Center chemoreceptor B. peripheral chemoreceptor” Cin aortic and carotid baddies 67. Increase in CSF (interstitial fluid) hydrogen ion concentration will stimulate respiratory center through A, Center chemoreceptory” . peripheral chemoreceptor Cin aortic and carotid bodies 68. A young bay has lost about 1.5 litter blood in raad side accident. He has decreased GFR and urinary output. The part of renal tubules most involved in bringing back the GFR and urinary output tothe normal is ‘A. Descending loop of Henle , Distal convoluted tubulesy” Proximal convoluted tubules LD. Thick ascending loop of Henle E Think ascending loop of Henle 69, Renal threshold far Glucose is: A. 1BOMg/cl 3 200mgral v €.250ma/d 70. Renal threshold for Glucase in Arterial blood is A. eamg/cl B. 200mg/dl v7 C.250mg/dl 71, Renal threshold for Glucose in Venous blood is A. TBong/tly” 8, 200ma/al ©. 250ma at Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686 RxMiscellaneous High Yield BCQs 72.|nBitemporal hemianopia blockage will be seen in ‘A. Middle (central) part of optic chiasmy” B, Upper part of optic chiasrn . Lower part of optic chiasm 73, Posterior communicating artery connects ALIA with MCA above aculomator 8. ICA with MCA below aculemetar CICA with PCA above oculomotor” 74, Posterior communicating artery a branch of A, Internal caroticw” 8 External carotig Middle cerebral Posterior superior cerebellar 75. Patient in abducted hand is asked to move hand slowly and smoothly downward but he dropped hand suddenly by his side, Which muscle Is most likely torn A. Deltoid B. Suoraspinatusy” C.Subscapularis D. Teres major 76, Which of the following is correct about stored blood. A Inereased2,3 0PG Dec 02 affinity CC Increased hemolysisw” 78, Lady producing thick saliva. A. Alphal w 8. Alpha’ and bets? Beta’ and alphaz D.Beta2 Explanation; Alpha T+ Beta 2 Alpha 1» Beta 2 Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#05017747686Miscellaneous High Yield BCQs 79. Anterior cruciate ligament prevents ‘A. Ant. dislocation of tibia on femur B. Post cislacation of tibia on fernur Ant, dislocation of femur on tia D Post. dislocation of femur on tibia w™ 80 Posterior cruciate ligament prevents ‘A Ant. dislocation of tia on femur B. Post cislocation of tibia on feruur C-Ant. dislocation of femur on tibiaw™ D. Post. distocation of femur on tibia 81. Anterior cruciate ligament while knee jaint flexed prevents 4 Ant. dislocation of tbia on femury” B, Post distacation of tbl an fernur C-Ant. dislocation of femur on tsia . Post. distocation of femur on tibia 82. Posterior cruciate ligament while knee joint flexed prevents A. Ant dislocation of tibia on femur B Post dislocation of tibia on femur Ant. dislocation of femur on tibia D, Post dislocation of femur on tibia (GACL prevents gihyperextension of knee joint GPCL preventsaahyperflexion of kre jot 83, A patient with pyloric stenosis has chronic vomiting, The most Ukely biochemical abnormalities in this would be A. High serum bicarbonate B Hypakalomiay C-Hyponatremia D.Hypovolemis E,Incressed kalluresis Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686Miscellaneous High Yield BCQs 84. Internal capsule lies medial to? 4 Putamen B Cuadale nucleus . Globus pallidusw” D. Amgdaloid nucleus 85, A female had bilateral silicon breast implant placements, now she has arrived with inflammation, which cells will be demanstrated? A. Lymphocytes B Gant Celisy” Plasma cells D. Neutrophils E. Eosinophil 186, A couple with first child with down syndrome. Both are young. Father normal, Mother has Robertsonian transtacation. What is risk of down syndrame in next baby? A33% B 66% ©. 100% Dom 87, Neurotransmitter for mood ‘A, Dopamine B,Serotoninw’ Acetylcholine D Epinephrine '88.Lipamna on thigh, local anasthetic xylocaine is given which will be affected first? A.B fibres B.Cfloresy” C.Adatts D.Aalpha Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#05017747686 RxMiscellaneous High Yield BCQs 89, Bilateral plusis at the end of the day, confirmatory test A.Tensilon B, antibodies against ACh receptor CEMGvy D. Edrophonium E.cTscan 90, A young female presented in OPD with loss of light reflex but intact accommodation reflex, The lesion is at ‘A, Oculomator nerve B. Edinger Westphal nucleus CPretectal areaw v D. Frontal eye field E.Opticnerve 91. Infection of the first web space will be first drained by |, Epitrachiaar lymph nade . Pectoral group of lymph nade C.Supraciavicular lymph node D. infraciavicular (ymph nodew wv 92.Mass of hair shaft is mainly due to A. Corte vy 8, Matrix of nail C Basle plus spinosum D. Sebaceous gland 93, 48-A boy had extraction of decidous teeth ané now profusely bleeding which classic hemophilis factor is, missing? A. Factor9 B. Factor & major component C.Factor 8 minor componenty’ W D. Factor 7 Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash Rx +#05017747686Miscellaneous High Yield BCQs 94, Most abundant Astracytes in white matter of CNS are? A. Fibrous astracytesw” B. Oligodendrocytes .Protoplasmic astracy tes 95. Most abundant cells in Gray matter of CNS are? A. Fibrous astrocytes B. Oligodendrocytes C.Protoplasmic astracytesw” 96. Most abundant calls in white matter of CNS are? A. Fibrous astrocytes B. Oligodendrocytesy” CC. Protoplasmic astrocytes 77. Most abundant glial cells A, Astrocytes B. Oligodendrocytesy” C-Ependymal cells 98, Most potent and most immediate mediator of inflammation A.Histaminew” B Prostaglandin 99, Most potent mediator of pain is A. Prostaglandin B Brad ykininsy” 100, True hermaphrositism ALXKIKI BLxxY Cex Explanarion: Xo Gl XX/AY El KXY Controversial MCQs of CPSP solved by Dr. Rashid Mahmood Join us on Telegram group: Controversial MCQs of CPSP Group link: Tme/Cpspcrash +#08017747656 RxGood luck