Medi Call FCPS – 1 | AUG 2023 PAPERS

unloading to tissue
Med 24 Aug 2023 (A.N) ✦ Left ODC = haLdane effect = Low O2 unloading
✦ Guyton, Pg. 536

6. A kidney transplant immediately turns blue and is

rejected within minutes . What occurs in Hyperacute
1. Young tall man with longer than usual Arms and fingers, Rejection? - ID : 5024
hypermobile joints, presents with sudden excruciating
chest pain and his is bp 90/50 mmHg. There is also finding Ⓐ Type 4 HSR reaction
dislocation of crystalline lens. Which of the following Ⓑ Antibody Mediated rejection
disease cause this complication - ID : 282 Ⓒ Cytotoxic rejection
Ⓓ Graft versus host disease
Ⓐ Marfan syndrome Ⓑ Osteogenesis Imperfecta
Ⓒ Ehler Denlos Ⓓ Achondroplasia Ⓑ ✪ Hyperacute rejection ➜ Within minutes ➜ Preformed Anti-
ABO Ab ➜ React ➜ Organ become Cynotic edematous and swollen
Ⓐ Marfan's ☛ Autosomal Dominant ➜ mutation of fibrillin-1 gene
✦ Levinson, Pg. 538 ✦ Harsh Mohan, Pg. 66
➜ Defective fibrillin ➜ defective elastin ➜ defective connective
7. What is increased in asthma (COPD) - ID : 6566
tissue throughout the body :✪ CVS ☛ ◉ Aortic necrosis (medial
degeneration) ◉ Aortic Dissecting aneurysm ◉ mitral valve Ⓐ Vital capacity Ⓑ FEV1
prolapse Ⓒ FRC Ⓓ FEV1/FVC
✪ Eyes ☛ ◉ Ectopia lentis ➜ lens subluxation superiorly and
temporally ◉ Severe myopia Ⓒ Asthma ➜ Obstructive lung disease ➜ ↓↓ Recoil ➜ Distended
✪ Musculoskeletal ☛ ◉Tall stature with rapid linear growth ◉ Lungs
long extremities ◉ Joint hypermobility ◉ High-arched palate ◉ ➊ All Volumes Increases ( ● ↑ RV ● ↑ FRC ● ↑ TLC )
long fingers and toes ◉ Pectus deformity ◉ flat foot ◉ scoliosis ◉ ➋ Vital capacity Normal or Decreased
hyperkyphosis ➌ Decreased Expiratory flow due to low lung recoil ( ● ↓↓ FEV ● ↓
✪ Skin ☛ ◉ Loss of skin elasticity/striae (stretch marks) FVC ● ↓ FEV1/ FVC )
✦ Robbins, Pg. 247 ✦ BRS Physiology, Pg. 221

2. Organelle that binds carbohydrates with protein 8. Morphine toxicity sign is - ID : 8602
forming glycoproteins, enclose them in Secretory vesicles,
and release is? - ID : 593 Ⓐ Bradycardia and miosis Ⓑ Bradycardia and mydriasis
Ⓒ Tachyapnea and mydriasis Ⓓ Tachyapnea and meiosis
Ⓐ RER Ⓑ SER
Ⓒ Golgi complex Ⓓ Mitochondria
Ⓐ Morphine ☛ pupil constriction, slurred speech,
Ⓒ Proteins formed by Ribosomes ➜ sent to adjacent RER matrix ➜ bradycardia.
Vesicles budd off from E.R having formed proteins ➜ E.R Vesicles 9. Ketogenic aminoacids are - ID : 8886
fuse with Golgi Apparatus ➜ proteins further processed into
Ⓐ Lysine and leucine Ⓑ Proline and lysine
glycoproteins and packaged in vesicles ➜ Lysosomes and
Ⓒ Threonine and cystine Ⓓ Thiamine and threonine
Secretory vesicles then pinches off from Golgi ➜ transported inside
and out of Cell Ⓐ Ketogenic amino acids are those amino acids that can be
✦ Guyton, Pg. 22
degraded directly into acetylcoa which is the precursor of ketone
3. A patient with Paraneoplastic syndrome. Most common bodies
hormone secreted by SCC (oat cell carcinoma) leading to
cushingoid appearance of patient is - ID : 3185 10. Which of the following steroid synthesis step reduce
prostate hypertrophy and responsible for decrease in
Ⓐ TSH Ⓑ ACTH prostrate size? - ID : 8993
Ⓒ Prolactin Ⓓ FSH
Ⓐ Contains testosterone 17,20 hydrolase deficiency
Ⓑ Small Cell Carcinoma of lung ☛ ectopic production of ACTH or Ⓑ Increase cholesterol desmolase
Ⓒ Inhibition of 5 alpha-reductase
ACTH-like polypeptides ➜ Cushing syndrome.
✦ Robbins, Pg. 236 Ⓓ All of these

4. 35 years female developed pericardial effusion and Ⓒ 5d-reductase inhibitor drug finasteride inhibits the conversion of
pleural effusion. Effusion fluid was examined and it turned testosterone to DHT which causes prostatic enlargement leading
out to be Transudative. Anti-DS titer was 1:560. Urine
to BPH.
nitrogen was ＞ 55. Renal biopsy will show: - ID : 3466
11. Pannus is a feature of which of the following - ID : 9396
Ⓐ Amyloidosis Ⓑ Anti-GBM antibodies
Ⓒ Glomerular deposits Ⓐ RA Ⓑ SLE
Ⓓ Immune complex deposition Ⓒ Ssystemic sclerosis Ⓓ Polymyositis

Ⓓ ✪ Lupus nephritis ☛ Deposition of immune complex are Ⓐ Rheumatoid arthritis ☛ Activation of macrophages releases
microscopic findings more cytokines which cause damage to joint tissues and
✦ Robbins, Pg. 154 vascularisation of cartilage termed pannus formation
✦ Harsh Mohan, Pg. 843
5. What does the curve Shift to left is called? - ID : 4904
12. A 20 years old boy presented with profuse bleeding
Ⓐ Bohr effect Ⓑ Haldane effect after tooth extraction. his brother also has history, his two
Ⓒ Fick’s law Ⓓ Chloride shift sisters are completely alright, his labs showed deranged
APTT, deficiency of which factor is most likely to cause
Ⓑ Haldane Effect ➜ ODC shifts to Left ➜ ↑ O2 affinity of Hb ➜ ↑ this - ID : 9623
Saturation of HbO ➜ ↑ Displacement of CO2 from blood and ↓ O2
Ⓐ Vit K deficiency Ⓑ Factor 5 deficiency
Ⓒ Vonwiliband disease Ⓓ Factor 8 deficieny

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Ⓓ Factor VIII deficiency ➜ Hemophilia A ➜ genetic disorder Ⓑ N-MYC oncogene ☛ Mutation due to amplification cause
caused by missing or defective factor 8 , 9 , a clotting protein ➜ Neuroblastoma (most common extracranial solid tumor of
Defecetive Coagulation childhood that secretes catecholamines)
✦ Harsh Mohan, Pg. 210
✔ Bleeding from gums/circumcision/stump/trauma/epistaxis
✔ X-linked recessive ✔ Only males affected 20. Posterior 1/3 of interventricular septum is supplied
✔ Family Hx Present ✔ APTT ➜ Prolonged by: - ID : 15534
✔ Heamarthrosis is hallmark Ⓐ LCA Ⓑ RCA
✦ BRS Pathology, Pg. 195 ✦ Robbins, Pg. 491 ✦ Kaplan Pathology, Pg. 34
Ⓒ Right marginal branch Ⓓ Left marginal branch
13. Hyperlipidemias side effects - ID : 12212
Ⓑ ✪ Right Coronary Artery ➜ Posterior interventricular artery ➜
Ⓐ Derranged RFTs Ⓑ Derranged PT
supplies Posterior 1/3 of the interventricular septum. ✪ Left
Ⓒ Derranged PFTs Ⓓ Derranged LFTs
coronary artery ➜ left anterior descending artery ➜ Supplies
Ⓓ Hyperlipidemias leads to hepatotoxicity Anterior 2/3 of IVS ( Snell )

14. Only inherited from mother to the child is - ID : 13146 21. A 20 years old Fisherman was presented with
shortness of breath and pins and needle sensation in his
Ⓐ Nucleus Ⓑ Mitochondrial DNA both lower limbs.He uses to have only flsh and rice in his
Ⓒ Cillia Ⓓ G.appratus diet. Labs show Hb : 7.5 , Platelet count: 110x10 ,
Reticulocyte count: :0.5% , Stool : Ova of Intestinal
Ⓑ Mitochondrial DNA ☛ Inherited exclusively from mother parasite. which is the most likely causative parasite ? - ID :
because mitochondria in mammalian sperm are usually destroyed 15549

by egg cell after fertilization Ⓐ Necator americanus Ⓑ Ascaris Lumbricoidis

✦ Ganong, Pg. 36
Ⓒ Ancylostoma duodenale Ⓓ Diphyllobothrium latum
15. AV conduction is slowed down due to Vagal
stimulation of heart. it is reflected as - ID : 14824 Ⓓ Undercooked Fish ➜ Diphyllobothrium latum infestation ➜
competes with the host for vitamin B12 ➜ deficiency of B12 ➜
Ⓐ Increased heart rate Ⓑ Increase PR interval
✪ Megaloblastic Pancytopenia
Ⓒ Increase contraction Ⓓ Increased cardiac output
✪ Neurological signs (Pins and needles sensation in legs)
Ⓑ Parasympathetic Stimulation of Heart
22. Sympathetic supply of jejunum is from: - ID : 15733
➊ SA node stimulation ☛ Lengthens depolarization ➜ ↓ H.R
➋ AV node stimulation ☛ ↑↑ AV Nodal delay ➜ ↑ PR interval Ⓐ Vagus nerve Ⓑ L1-L2 nerve
✦ Ganong, Pg. 521, 494 ✦ Guyton, Pg. 157 Ⓒ Greater and Lesser splanchnic nerve
Ⓓ Pelvic splanchnic nerve
16. Histamine is most imp mediator of inflammation. Cells
that contain histamine and serotonin and respond to IgE -
Ⓒ ✪ Sympathetic innervation of
ID : 15143
jejunum ➜ Preganglionics ☛ thoracic splanchnic nerves, T9-T12
Ⓐ Plasma cells Ⓑ Macrophages Postganglionic ☛ cell bodies superior mesenteric ganglion
Ⓒ Lymphocytes Ⓓ Mast cells
✪ Parasympathetic innervation ➜ vagus nerves
●Greater splanchnic nerve arises from ganglia 5 to 9
Ⓓ ✪ IgE-primed mast cell releases granules and powerful
●Lesser splanchnic nerve from ganglia 10 and 11
chemical mediators, ➜ ◉ histamine,◉ cytokines,◉ granulocyte
●lowest splanchnic nerve from last thoracic ganglion
macrophage colony-stimulating factor (GM-CSF),◉ leukotrienes,◉ ✦ Kaplan Anatomy, Pg. 111 ✦ Snell Review, Pg. 28
heparin,◉ and many proteases into the environment.◉ These
23. Patient with massive blood loss, B.P. 50 mm Hg. Which
chemical mediators cause the characteristic symptoms of allergy.
✦ Robbins, Pg. 84
response will be most active , important and Potent below
60 mm hg? - ID : 15738
17. Oral drugs are usually given after meal because: - ID :
15163 Ⓐ Renin-angiotensin reflex Ⓑ Bain-bridge reflex
Ⓒ CNS ischemic response Ⓓ Barorecptors mechanism
Ⓐ Dec GI acidity and disturbance
Ⓑ Dec. vol Ⓒ Slowed absorption Ⓒ Most potent ( below 60) ☛ CNS ischemic response
Ⓓ Dec. metabolic disturbance
Severe Drop in BP (below 60) ➜ Decreased Blood to medulla ➜
Ⓐ Oral medication ☛ taken after meals ➜ slow absorption ➜ ↓ GI Cerebral Hypoxia ➜ CNS ischemic response ➜ Vasomotor centre
activated ➜ Powerful Vasoconstriction ➜ BP MaintainedBP ＞ 60
acidity and disturbance ➜ helps patient tolerate larger total daily
doses. mmHg ☛ Baroreceptor Reflex most active
✦ Guyton, Pg. 223
18. Compression between L4 and L5 vertebrae in man
24. A child presented to OPD with 104 fever for the last 4
lifting weight results in radicular pain at which nerve root?
days. He has been passing cola colored urine for last one
- ID : 15443
day. He has been on anti malarial medication. His LFTs are
Ⓐ L3 Ⓑ S1 deranged with increase unconjugated bilirubin, having
Ⓒ L4 Ⓓ L5 heinz bodies and bite cells . Most probable diagnosis ? - ID
: 15768
Ⓓ 5 nerve ☛ Anatomically related to disc between L4 and L5 even Ⓐ Blackwater fever Ⓑ G6PD deficiency
though it arises from L5-S1. Ⓒ Post-streptococcal glomerulonephritis
✦ Snell Neuro, Pg. 18 ✦ Gray's Neuroanatomy, Pg. 122 ✦ SNELL, Pg. 702
Ⓓ Rhabdomyolysis
19. A Child having tumor with blue cells secretes
catecholamines and caused by gene amplification and N - Ⓑ G6PD deficiency ☛ Intake of Certain Drugs / Infections / Food
MYC gene mutation in children? - ID : 15528 ➜ Formation of Reactive oxygen species ( ROS ) ➜ Oxidant
Ⓐ Retinoblastoma Ⓑ Neuroblastoma damage to Hemoglobin ➜ Formation of Small round inclusions
Ⓒ Glial glioma Ⓓ Wilms tumor within RBCs ( Heinz Bodies ) ➜ Spleen ➜ Macrophages ➜

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Damaged part of Hemoglobin Removed ➜ Appear bitten ➜ Bite
Cells ➜ Premature Hemolysis ➜ Anemia, Jaundice, Hematuria.
✦ Robbins, Pg. 450
25. During bronchoscopy first structure visible is - ID :
15895
Ⓐ Upper lobe Ⓑ Upper basal lobe
Ⓒ Lower basal lobe Ⓓ Middle lobe
Ⓐ Structures seen in bronchoscopy are right upper lobe bronchus
26. Reversible changes of shape size and polarity - ID :
16272
Ⓐ Metaplasia Ⓑ Hypoplasia
Ⓒ Dysplasia Ⓓ Hyperplasia
Ⓒ ◉Metaplasia☛Functional change in cell:
◉Dysplasia☛ Change in size,shape and orientation : , Both can be
reversible. Here ans is dysplasia
✦ Goljan, Pg. 38 ✦ Robbins, Pg. 603
27. Man is an intermediate host in - ID : 16275
Ⓐ Malaria Ⓑ Amebiasis
Ⓒ Hydated disease Ⓓ Onchocercasis
Ⓒ Echinococcus granulosus ( hydatid worm / hyper tape-worm /
dog tapeworm ) ➜ a cestode that dwells in the small intestine of
canids ➜ shed Eggs ➜ transfer to Aberrant intermediate hosts ➜
Humans and Livestock ➜ hosts become infected by ingesting eggs
➜ where it causes cystic echinococcosis ( hydatid disease ) (
Lange )
✦ Levinson, Pg. 459
28. The patient developed gradual loss of peripheral vision
in 3 years. On examination he had bitemporal hemianopia
with an increase of jaw- protrusion due to : - ID : 16425
Ⓐ Adenoma of hypothalamus Ⓑ Pituitary adenoma
Ⓒ Section of optic tract Ⓓ Section of optic nerve
Ⓑ Pituitary adenoma ➜ Compression Damage to central
crossing fibers ➜ Bitemporal hemianopsia
29. Atypcal lymphocytosis in infectious mono neucleosis is
due to which virus? - ID : 16568
Ⓐ HHV Ⓑ HIV
Ⓒ HBV Ⓓ EBV
Ⓓ Atypical lymphocytosis ☛ Infectious mononucleosis (Ebstein bar
Virus) and Cytomegalovirus.
✦ Davidson, Pg. 241
30. With regard to counseling, the best statementis: - ID :
17880
Ⓐ It is done by trainedcounsellors.
Ⓑ It is about giving the best possibleadvice.
Ⓒ It is not an ordinary everydayconversation.
Ⓓ It is a technique to help people help themselves by increasing self
understanding
Ⓓ Counselling is the provision of professional assistance in
resolving personal or psychological problems.
31. Which anatomical structure forms the brush border in
the Proximal Convoluted Tubule (PCT)? - ID : 18052
Ⓐ Cilia Ⓑ Microvilli
Ⓒ Steriocillia Ⓓ Flagella
Ⓑ Brush border of the Proximal Convoluted Tubule (PCT) in the
kidney is made up of microvilli. These tiny projections increase the
surface area for reabsorption and secretion, which are key
functions of the PCT in nephron physiology.Cilia: not responsible
for forming the brush border in the PCT.
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Stereocilia: found in the inner ear and male reproductive tract,
not in the PCT.
Flagella structures used for locomotion and are not found in the
PCT.
32. Male non-smoker One year cough history. X ray shows
mass in peri-hilar which was squamous muscle cell Ca.
Second leading cause of Lung cancer after Smoking is ? -
ID : 18466
Ⓐ Asbestosis Ⓑ Silica
Ⓒ Anthracosis Ⓓ Radon
Ⓓ Smoking ＞ Radon ＞ Asbestos
✪ Radon ☛ Byproduct of uranium decay ➜ Cause Lung cancer (
2nd to Smoking )
✪ Asbestos ☛ Bronchogenic carcinoma ＞ Mesothelioma
✦ First Aid, Pg. 225
33. Patient with hoarse voice, dysphagia and difficulty in
swallowing and has mass on base of skull. Nerve involved
? - ID : 19368
Ⓐ Glossopharyngeal - IX Ⓑ Vagus - X
Ⓒ Accessory - XI Ⓓ Hypoglossal - XII
Ⓑ Damage to CN X ➤ Hoarseness, breathing and swallowing
difficulty.
✦ Snell Neuro, Pg. 352
34. 10 year boy come to emergency with fracture of ulna.
X-rays reveal several other fractures in various stages of
healing On examination sclera is blue and difficulty
hearing. Which of the following u suspect? - ID : 19667
Ⓐ Ehler Danlos Ⓑ Marfan
Ⓒ Osteogenesis Imperfecta
Ⓒ Osteogenesis Imperfecta ➜ Autosomal dominant ➜ mutation
in COL1A1 or COL1A2 genes ➜ decreased synthesis of type 1
collagen ➜ Brittle bones + Multiple fractures + Growth retardation
+ Skeletal deformities + Blue sclera + Progressive hearing loss
✦ Harsh Mohan, Pg. 825
35. Pt is Gravida 2 first pregnancy normal , 2nd boy
delivered at 32 weeks with hydrops fetalis , icteric phase
with complication of Autoimmune Hemolysis due to Rh
incompatibility .which type of cytotoxic reaction by blood
transfusion Is this ? - ID : 19833
Ⓐ Type 3 - Immune Complex Reaction
Ⓑ Type 4 - Delayed HSR Ⓒ Type 1 - Immediate HSR
Ⓓ Type 2 - Complement Mediated
Ⓓ ✪ During First Pregnancy / Delivery ☛ IF Mother is Rh ㊀
but carry Rh ㊉ Fetus ➜ Mixing of blood during trauma/delivery ➜
fetal RBCs stimulate maternal antibody production against the Rh
antigens.
✪ During Second Pregnancy ☛ Mother's preformed antibodies ➜
Cross placenta ➜ will react more strongly to Rh ㊉ Fetus ➜ By
complement activation ( Type 2 HSR ) ➜ cause cell destruction ➜
Blood Cell Lysis ➜ Erythroblastosis Fetalis
✦ Harsh Mohan, Pg. 72
36. 55 years old person is a a chronic alcoholic for 20
years. His lab shows megaloblastic anemia. what should
be the treatment ? - ID : 20367
Ⓐ Stop Alcohol Ⓑ Give IV Cobalamine
Ⓒ Give Methyl Alcohol Ⓓ Give Oral Vit B12
Ⓑ ✪ Alcohol ➜ Atrophic Gastritis ➜ ↓ intrinsic factor ➜ ↓ vitamin
B12 Absorption ➜ Megaloblastic Anemia.
✪ IV B12 supplementation ➜ Immediate effect.
✪ Stopping alcohol ➜ take longer to correct problem.
✦ First Aid, Pg. 379
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37. Regarding Opsonins which of the following is true ? -
ID : 20588
Ⓐ Fc portion of igG and C3b
Ⓑ Fb portion of igG and C3b
Ⓒ Fe portion of igG and C2b
Ⓓ Fm portion of igG and C2b
Ⓐ ✪ Opsonization ☛ refers to the antibody molecules (IgG and
IgE) complement proteins (C3b and C4b) and other opsonins
attaching antigens to phagocytes, Fc portion of secretory IgA can
also bind to macrophages and neutrophils for opsonization.
✦ Harsh Mohan, Pg. 135
38. First line of defense against microbial agents is
provided by? - ID : 21782
Ⓐ Skin and its mucus membrane
Ⓑ Muscle Ⓒ Bones
Ⓓ Blood
Ⓐ First line of defense microbial agents is skin. The first line of
defence (or outside defence system) includes physical and
chemical barriers that are always ready and prepared to defend
the body from infection
39. A 20 years old girl presented with erythematous rash
over nose and cheeks and joint pains from 2 months. What
is the intial test for investigation? - ID : 22249
Ⓐ ESR Ⓑ ANA
Ⓒ Serology Ⓓ DsDNA
Ⓑ ✪ SLE ☛ chronic systemic autoimmune disease ➜ loss of self-
tolerance and production of autoantibodies.
✪ Important autoantibodies in SLE ☛ antinuclear antibody
ANA ( ＞95% ), anti-dsDNA ( 40–60% ); anti-Sm ( 20–30% );
antihistone antibodies; nonhistone nuclear RNA proteins; and
blood cells.
✪ Skeletal manifestations ☛ arthritis characterized by
polyarthralgia and synovitis without joint deformity.
✪ Skin manifestations ☛ malar “butterfly” rash; maculopapular
rash; and ulcerations and bullae formation.
✦ Kaplan Pathology, Pg. 58
40. Young Patient presented with Sudden high fever,
Severe persistent headache, Neck stiffness along with
vomiting and joint pains. He hates bright lights. Kernig's
sign positive. CSF shows Pus Cells, Inc Proteins and Dec
glucose. Pyogenic Bacterial Meningitis Diagnosed. what
would be the Drug of choice ? - ID : 22334
Ⓐ First Gen Cephalosporins Ⓑ Ceftriaxone
Ⓒ Penicillin G Ⓓ Gentamicin
Ⓑ Bacterial Meningitis ☛ 3rd Generation Cephalosporins (
ceftriaxone or cefotaxime ) are DOC ➜ better BBB Penetration.
41. Girl from poor family presented with frontal
bossing,leg bowing,wide wrist angle ,pigeon chest. which
deficiency you expect ? - ID : 22527
Ⓐ Vit D Ⓑ Vit A
Ⓒ VIt B Ⓓ Vit C
Ⓐ Rickets ☛ Due to vitamin D deficiency.
Skeletal deformities : Bow legs, Forward projection of the
breastbone (pigeon chest or pectus carinatum), Funnel chest
(pectus excavatum), "Bumps" in the rib cage (rachitic rosary) and
Asymmetrical or odd-shaped skull , frontal bossing
✦ First Aid, Pg. 633
42. Our Internal jugular and Subclavian join to form which
structure Behind the sternoclavicular joint? - ID : 22731
Ⓐ Brachiocephalic veins Ⓑ Aorta
Ⓒ Carotids Ⓓ None of above
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Ⓐ After the subclavian vein passes over anterior part of the first
rib behind the clavicle ➜ joins internal jugular vein as it descends
from the neck ➜ forms the innominate ( brachiocephalic) vein
behind the sternoclavicular joint. ( KLM )
43. A soldier returning from siachin glaciers after 6
months, presented to CMH with headache and blue
discoloration of fingertips. His BP is 150/90 mmhg also
have moderate splenomegaly. On investigation, RBC : 6.4
million. PCV : 60 % . arterial PCO2 : 20, Bicarbonate : 25.
He is likely suffering from: - ID : 23048
Ⓐ Polycythemia vera Ⓑ Secondary polycythemia
Ⓒ Methemoglobinemia Ⓓ Essential hypertension
Ⓑ Living at Height / COPD / Obstructive Sleep Apnea ➜ Chronic
Hypoxia ➜ Stimulus for Renal EPO production ➜ Inc.
Erythropoeisis ➜ Inc. volume percentage of RBCs in blood ( HCT or
PCV ) ➜ Secondary Polycythemia
✪ High BP ☛ Due to Raised Viscosity
✪ Spleenomegaly ☛ Due to increased RBC destruction
✪ Low PCO2 ☛ may be due to result of Hyperventilation to
compensate Hypoxia.
✪ Cyanosis ☛ Due to overall decreased oxygen saturation
of blood.
✦ Guyton, Pg. 453, 453
44. A woman presents with Perforated gastric ulcer and
pain on xiphisternum, which nerves carry pain gastric
ulcer pain to xiphisternam - ID : 23178
Ⓐ Greater splanchnic nerve Ⓑ Accessory nerve
Ⓒ T10 spinal nerves Ⓓ T9 spinal nerves
Ⓔ Lesser splanchnic nerves
Ⓐ The sensation of pain in the stomach is caused by the stretching
or spasmodic contraction of the smooth muscle in its walls and is
referred to the epigastrium via the greater splanchnic nerves
45. Patient presented with weakness, constipation,
Palpitations and sinking heart. His ECG shows narrow
depressed T wave, with prominent U wave and prolonged
PR interval. What could be the reason ? - ID : 23206
Ⓐ Hypokolemia Ⓑ Hyponatremia
Ⓒ Hypernatremia Ⓓ Hyperphosphatemia
Ⓐ Hypokalemia ＜ 3 mEq/L cause :
✪ Sagging of ST segment
✪ Depression / Inversion of T wave
✪ U wave (after T wave) ➜ shows purkinje repolarizarion
✪ Slightly prolonged PR interval.
▶ Clinical signs ➜ Palpitations , Muscular Weakness , Cramping ,
Constipation , Hypoventilation , Hypotension
✦ Ganong, Pg. 535
46. SIADH causes - ID : 23743
Ⓐ Hypernatremia and dec thirst
Ⓑ Hyponatremia and inc thirst
Ⓒ Hypokalemia and inc thirst
Ⓓ Hypercalcemia and dec thirst
Ⓑ ✪ ↑ ADH secretion ➜ ↑↑ Water reabsorption ➜ concentrated
urine ➜ ↑ urine osmolality ( Normal 100–900 mOsm )
➤ Due to Water retention ➜ ↓ serum osmolality ( Normal 285-
295 mOsm ) ➜ Euvolemic hyponatremia
✦ CMDT, Pg. 902
47. A woman living at a hill station has had an
uncomplicated pregnancy. She is brought to the hospital
at the onset of labour. An ultrasound scan is performed
which shows no fetal abnormality. The baby can still have
which of the following conditions? - ID : 24275
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Ⓐ Transposition of great vessles Ⓐ Naegleria Fowleri Ⓑ Entamoeba Histolytica

Ⓑ Patent ductus arteriosis Ⓒ Limb defects Ⓒ Amoeba Proteus Ⓓ Chaos Carolinense
Ⓓ Tetrology of Fallot
Ⓐ Naegleria fowleri ☛ commonly known as brain eating amoeba
Ⓑ ✪ Normally As the baby is born ➜ increase oxygen tension due ➜ free-living microscopic ameba ➜ causes amebic
to breathing ➜ decrease prostaglandin (PG) synthesis ➜ Closure of meningoencephalitis ➜ brain infection that leads to destruction of
the ductus arteriosus. brain tissue.
✪ At hill stations ➜ atmospheric oxygen pressure is low ➜ chances
55. Structure behind Ovarian Fossa - ID : 34292
to face decrease in oxygen tension ➜ failure of ductus arteriosus
to close Ⓐ Internal Illiac Artery Ⓑ Ureter
✦ Guyton, Pg. 288 Ⓒ External iliac artery Ⓓ Obturator
48. Most common cause of cell injury world wide ? - ID :
24300 Ⓑ B＞A
Ovarian fossa boundaries ➤
Ⓐ Alcohol Ⓑ Hypoxia
✦ Superiorly ➜ External iliac artery and vein.
Ⓒ Ischemia
✦ Anteriorly and inferiorly ➜ Broad ligament of uterus.
Ⓓ Radiation E: malnutrition
✦ Posteriorly ➜ by the ureter, internal iliac artery and vein.
✦ GRAY'S, Pg. 1106
Ⓑ ✪ Hypoxia ☛ Hypoxia is inadequate oxygenation of tissue ◉
It is most common cause of cell injury 56. Endotoxin is present in bacteria. Where is it found ? -
✦ Harsh Mohan, Pg. 27 ID : 34340

49. Agranular cerebral cortex: - ID : 25062 Ⓐ Outer membrane of cell wall

Ⓑ Periplasmic space Ⓒ Cytoplasmic space
Ⓐ Gustatory Ⓑ Primary motor area
Ⓓ Cell Membrane
Ⓒ Sensory Ⓓ Visual
Ⓐ ✪ Endotoxin ☛ Lipopolysaccharide (LPS) of outer membrane of
Ⓑ ✪ Primary sensory areas ☛ Granular cortex
cell wall of gram-negative bacteria
✪ Primary motor areas ☛ Agranular cortex.
✦ Snell Neuro, Pg. 287
✪ It is called endotoxin because it is an integral part of cell wall, in
contrast to exotoxins, which are actively secreted from bacteria
50. Marathon runner in July sweats profusely, dizziness ✦ Levinson, Pg. 9
weakness and headache then faint, cause? - ID : 25079
57. What change does the configuration of hemoglobin
Ⓐ Hyponatremia Ⓑ Dehydration have? - ID : 34400
Ⓒ Hypokalemia Ⓓ Heat stroke
Ⓐ Decreased affinity for O2
Ⓑ Increased affinity for O2
Ⓑ ✪ Marathon Runner ➜ ➊ July ( Hyperthermia ) ➋ Exc
sweating ➜ Dehydration ➜ ◉ Weakness ◉ Fatigue ◉ Ⓐ Decreased affinity for oxygen: In some pathological
Tachycardia ◉ Syncope ◉ Headache conditions or states like the Bohr effect, the hemoglobin may
✦ Davidson, Pg. 104 ✦ Harsh Mohan, Pg. 102
demonstrate decreased affinity for oxygen. This allows for more
51. The extra systolic beat would produce: - ID : 31277 efficient off-loading of O2 to the tissues that need it, especially
during conditions like exercise or stress.Increased affinity for
Ⓐ Increase pulse pressure because contractility is increased.
O2: increased affinity would make it more difficult for tissues to
Ⓑ Increase pulse pressure because HR is increased
get the oxygen they need.
Ⓒ Decrease pulse pressure because SV is decreased
Ⓓ Decrease pulse pressure because the PR interval is increased 58. Transfusion related acute lung injury (TRALI) within? -
ID : 35340
Ⓒ When heart contracts ahead of schedule ➜ ventricles will not
Ⓐ Almost Immediately Ⓑ Within 4hrs
have filled with blood normally ➜ stroke volume output during
Ⓒ Within 24hrs Ⓓ Within 48hrs
that contraction is ↓ or almost absent ➜ ↓ CO ➜ ↓Pulse pressure Ⓔ Within 6 hrs
✦ Guyton, Pg. 158

52. Most common fungal opportunistic infection in HIV: - Ⓑ TRALI ☛ severe reaction to blood transfusion ➜ usually occurs
ID : 33673 within 1-4 hours of transfusion, not immediately.
Ⓐ Pneumonia Ⓑ Candida 59. After giving blood transfusion pt develops
Ⓒ Pseudomonas Ⓓ Cryptococcus hypersensitivity reaction. Which type of hypersensitivity
reaction? - ID : 35848
Ⓑ Oral candidiasis ☛ commonly known as thrush ➜ most
Ⓐ Type 1 Ⓑ Typ2
common fungal infection among AIDS and AIDS Related Complex
Ⓒ Typ3 Ⓓ Typ4
patients ➜ in 80-90% of cases.

53. MOA of cabergoline: - ID : 33772 Ⓑ Type II HSR involve antibody-mediated destruction of cells.
This type of reaction is best seen by blood-transfusion reactions, in
Ⓐ D1 Agonist Ⓑ D2 Agonist
which host antibodies react with foreign antigens on the
Ⓒ D1 Antagonist Ⓓ D2 Antagonist
incompatible transfused blood cells and mediate destruction of
these cells.
Ⓑ Cabergoline ☛ long-acting dopamine receptor agonist ➜ high
affinity for D2 receptors. 60. Which best characterizes a postmortem clot - ID : 36326

54. 20 years young boy presented with fever, headache Ⓐ Lines of Zahn
vomiting. He is having neck stifness and Alter mental Ⓑ Attachment to vessel wall
status with hallucination which among following is brain Ⓒ Friability Ⓓ Variegated coloration
eating parasite? - ID : 33885 Ⓔ Chicken fat appearance like fibrin clots

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Ⓔ EXPLANATION 69. Which of the following causes secretory diarrhea when

reaches colon in large quantities - ID : 37988
61. Inspiration is vital process for oxygenation of tissues.
Forceful inspiration occurs via active contraction of which Ⓐ Sucrose Ⓑ Lactose
muscle - ID : 36449 Ⓒ Fructose Ⓓ Dipeptides

Ⓐ Diaphragm + External intercostal+ SCM + Serratus anterior + Ⓑ EXPLANATION

Scalene muscle
Ⓑ Diaphragm + internal intercostal 70. Neuron hypokalemia causes - ID : 38370
Ⓒ Diaphragm + SCM + external oblique + Serratus anterior muscle
Ⓐ Decrease amplitude of action potential
Ⓓ Abdominal muscles
Ⓑ Hyperreflexia Ⓒ Increase automaticity
Ⓓ Decrease excitiability
Ⓐ EXPLANATION

62. O negative blood transfused with AB positive. What is Ⓓ EXPLANATION

a secondary blood transfusion reaction? - ID : 36452
71. A young man has a blood pressure of 160/110 mmHg.
Ⓐ Anaphylaxis Ⓑ Hemoglobinuria His blood renin level is much higher than normal. The most
Ⓒ Billirubinuria Ⓓ Febrile reaction likely stimulus for the increased renin level is - ID : 54487

Ⓐ Constriction of renal arteries

Ⓑ EXPLANATION
Ⓑ Increased parasympathetic activity
63. Most common of megaloblastic anemia - ID : 36601 Ⓒ Increased sodium delivery to distal tubules
Ⓓ Hypertension
Ⓐ Folate deficiency anemia Ⓑ B12 deficency
Ⓒ Pernicious
Ⓐ Renal artery constriction ➜ reduce renal perfusion pressure
below the range of autoregulation (approximately 70 mmHg) ➜
Ⓐ Megaloblastic anemia ☛ Folate deficiency is more common
decrease GFR, and sodium excretion ➜ increase Renin secretion
than B12 due to limited store
✦ First Aid, Pg. 420 for compensation ➜ Inc BP

64. A female patient has chronic hypertension, started ace
inhibitor, bp controlled but dizzy cause of decreased blood
supply to brain - ID : 36976
Ⓐ Decrease sympathetic Ⓑ Increase parasympathetic
Ⓒ Increase angiotensin 2 in brain
72. A 28 year old male was prescribed Nicotinic acid for
his hypercholesterolemia. He noticed yellow discoloration
of the sclera after a few days. Laboratory investigation
shows Hb: 11. 0 gm/dl, serum Bilirubin total 3. 0 mg/dl,
direct Bilirubin 0. 8 mg/dl, ALT 35 iu/L. The most likely
cause of his jaundice is - ID: 54600

Ⓐ EXPLANATION Ⓐ Drug-induced hepatitis. Ⓑ Dubin Johnson syndrome

Ⓒ Gilbert syndrome Ⓓ Hemolysis
65. A patient came with complain of fever, night sweats,
and weight loss. On investigation, you will find a disease Ⓐ Explanation
that is caused by mycobacterium. What is the best initial
test to diagnose T.B? - ID : 37061 73. A 50-year-old smoker male presented to the
Emergency OPD in severe abdominal pain, he had a past
Ⓐ CXR Ⓑ AFB smear
medical history of gastric pain on and off for the last 3
Ⓒ CT scan Ⓓ CBC years. Endoscopy revealed a bleeding ulcer of the lesser
curvature of the stomach. Which of the following artery is
Ⓑ If CXR Chest is suggestive of TB then next step is Direct most probably responsible for this bleeding? - ID : 55322
Microscopy of the Sputum ( Sputum AFB with ZN staining )
✪ Presumptive Diagnosis ☛ CXR and AFB Ⓐ Gastroduodenal Ⓑ Left gastric
Ⓒ Right gastric Ⓓ Short gastric
✪ Histopathological ☛ Caseous Necrosis.
✪ Definitive Diagnosis ☛ Culture for Pulmonary and Biopsy for
Ⓑ ✪ Ruptured gastric ulcer on the lesser curvature of stomach ➜
Extrapulmonary
✦ Davidson, Pg. 592
bleeding from left gastric artery.
✪ An ulcer on the posterior wall of duodenum ➜ bleeding from
66. Mode of action of adenosine in management of cardiac gastroduodenal artery
arrhythmia - ID : 37474 ✦ First Aid, Pg. 380

Ⓐ Stop AV conduction Ⓑ Fast AV conduction 74. Transport of CO2 from tissue to lungs mechanism - ID :
Ⓒ Slows AV conduction 55508

Ⓐ CO2 + H2O converted into HCO3- and H+ in RBCs

Ⓒ SVT Management : I/V Adenosine ➜ slows cardiac conduction
Ⓑ Uptake of HCO3- in exchange of CI
through AV node
Ⓒ Carbonic acid formation like that
67. The tertiary segmental bronchus is differentiated from
following in not having cartilage - ID : 37660 Ⓐ CO2 generated in the tissues ➜ diffuses freely into venous
plasma ➜ then into RBCs ➜ combines with H2O ☟
Ⓐ Segmental bronchus Ⓑ Alveoli
Inside RBCs ☛ CO2 + H2O (Carbonic anhydrase)➜ H2CO3 ➜
Ⓒ Terminal Bronchiloes
dissociates into HCO3 and H+.➜ ↑ HCO3 leaves RBCs in exchange
Ⓒ EXPLANATION for Cl- ( chloride shift ) ➜ HCO3 then transported to lungs
in plasma ( Major CO2 transport route 70% )
68. Most intense psychological mental stress - ID : 37846 ✦ BRS Physiology, Pg. 250, 251

Ⓐ Financial problems Disease 75. Cimetidine may significantly prolong the prothrombin
Ⓑ Noise environment Ⓒ Hunger time and causes bleeding in patient who has been treated
with warfarin. How does this happen by? - ID : 55526
Ⓑ EXPLANATION

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Ⓐ Decrease hepatic clearance of warfarin Ⓐ Pneumothorax Ⓑ MI

Ⓑ Displacing warfarin from plasma protein
Ⓒ Increasing the oral bioavailability of warfarin
Ⓓ Inhibiting renal tubular secretion of warfarin
Ⓔ Inhibiting the conversion of prothrombin to thrombin
Ⓐ EXPLANATION
76. An 70 year old patient brought to ER, in critical
condition, his arterial rate was ＞350b/m and ventricular
rate was 135-150 b/min, QRS was widely displaced and p
dissociation. What is the most probable dx? - ID : 55794
Ⓐ Atrial fibrillation Ⓑ Ventricular tachycardia
Ⓒ SVT
Ⓓ Mobitz type1 2nd degree heart block
Ⓒ Pulmonary embolism Ⓓ Aortic dissection
Ⓔ Musculoskeletal pain
Ⓓ Aortic dissection ☛ Longitudinal intimal tear forming a false
lumen. Associated e hypertension, bicuspid aortic valve, inherited
connective tissue disorders (eg, Marfan syndrome).
✪ Can present e tearing, sudden-onset chest pain radiating to the
back +/- markedly unequal BP in arms.
✪ CXR can show mediastinal widening. Can result in organ
ischemia, aortic rupture, death
✪ The investigations of choice are CT or MR angiograph both of
which are highly specific and sensitive.
✦ Davidson, Pg. 507

Ⓑ ✪ VT ☛ Wide QR complex tachy. 80. Hormones act locally through which mechanism ? - ID :
✪ SVT ☛ Narrow complex Tachy. 58109

✪ A-fib ☛ P-wave absent. Ⓐ Endocrine Ⓑ Paracrine

✪ Mobitz 1, 2nd-degree heart block ☛ Progressive prolongation of Ⓒ Autocrine Ⓓ Exocrine
P-R interval.
Ⓑ ✪ Paracrine action ☛ hormone acts locally by diffusing from
77. A man who rides camels has suffered a kick to the
its source to target cells in the neighborhood.
lateral side of his right leg just below the knee. He has a
bruise and tenderness at the site and is unable to either ✪ Endocrine action ☛ hormone is distributed in blood and binds
dorsiflex or evert his foot. He also reports a loss of to distant target cells.
sensation over certain parts of his leg and dorsum of foot. ✪ Autocrine action ☛ hormone acts on same cell that produced
Which nerve bundle is most likely damaged? - ID : 57263 it.

Ⓐ Lateral popliteal Ⓑ Peroneal 81. In Parasitic infestation, e.g hookworm infestation,

Ⓒ Tibia Ⓓ Sural blood will most likely show raised: - ID : 60615

Ⓐ Lymphocytes Ⓑ Neutrophils
Ⓑ Dx: The symptoms described are consistent with damage to the
Ⓒ Basophils Ⓓ Eosinophils
peroneal nerve. The peroneal nerve is responsible for dorsiflexion
Ⓔ None of above
of the foot and eversion, as well as sensation over the front and
outer half of the leg and dorsum of the foot. This presentation fits
Ⓓ Eosinophilia occurs in:
the clinical signs of peroneal nerve injury.Peroneal nerve is
✪ Allergy ☛ Hay fever, asthma, eczema
responsible for dorsiflexion and eversion. It also provides sensation
✪ Infection ☛ parasitic.
to the specified areas.
Lateral popliteal: This is another name for the common fibular ✪ Vasculitis ☛ e.g. eosinophilic granulomatosis, granulomatosis
nerve, which could be a possible answer, but it's less specific than with polyangiitis.
"peroneal." ✪ Malignancy ☛ solid tumours, lymphomas.
Tibia: Tibial nerve controls plantar flexion and inversion, not ✪ Bone marrow disorders ☛ myeloproliferative disorders, acute
dorsiflexion and eversion. myeloid leukaemia.
✦ Robbins, Pg. 74 ✦ Davidson, Pg. 926
Sural: Primarily a sensory nerve for the calf, not associated with
movement of the foot 82. In AIDS most common opportunistic infection? - ID:
✦ First Aid, Pg. 453 ✦ Kaplan Anatomy, Pg. 221 67872

78. A group of mice was taken and injection of plastic Ⓐ Herpes Ⓑ PCP pneumonia
hydrocarbon was given this will work as initiator in Ⓒ Cryptococcal meningitis
process the initiator work as: - ID : 57896
Ⓓ Mycobacterium avium complex
Ⓐ Slow process will take time
Ⓑ It is last step in ccarcinogensis Ⓐ EXPLANATION
Ⓒ Memory produce 83. In Alzheimer disease brain finding will be - ID : 72125
Ⓓ Cause Clonal proliferation
Ⓐ Loss of Sulci Ⓑ Hyperplasia of brain
Ⓒ Initiation of chemical carcinogenesis ☛ normal cell Ⓒ Hypertrophy of brain Ⓓ Atrophy of brain
undergoes irreversible change ➜ characterized by intrinsic capacity
for autonomous growth ➜ capacity remains latent for weeks, Ⓓ Alzheimer's disease ☛ usually first damages hippocampus,
Widespraed cortical atrophy leading to memory loss and
months, or years ➜ initiated cell may be phenotypically
disorientation. Hippocampus is the most medial portion of the
indistinguishable from other parenchymal cells in that tissue.
✦ Harsh Mohan, Pg. 211 Temporal Lobe cortex
✦ Guyton, Pg. 749 ✦ First Aid, Pg. 520
79. A 46-year-old man develops sudden severe central
84. A girl has Atelectasis, bronchial obstruction but alveoli
chest pain after lifting heavy boxes during a move. He
are still aerated by bronchus and do not collapse this is
describes the pain as "tearing" and it radiates to the back
due to which of the following? - ID : 72190
and both shoulders, but not to either arm. His blood
pressure is 155/90 mmHg, pulse rate is 92 beats per Ⓐ Sinusoid Ⓑ Clara cells
minute, and the ECG is normal. He is distressed, sweaty, Ⓒ Kulshitsky cells Ⓓ Alveolar pore
and feels lightheaded, but is not nauseous. What would Ⓔ Intracellular Canaliculi
you consider the most likely diagnosis? - ID : 57967
Ⓓ Pores of Kohn (Alveolar pores) ☛ are apertures in alveolar
septum, which allow communication of two adjacent alveoli.

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✦ N.I.H USA, Pg. directly with the superior colliculus

85. Patient presented with crushing chest pain for 3 hours Auditory reflexes more related to the inferior colliculus
O/E bp and pulse was normal but RR= 33/min Control of eye movements also involves structures like the
Investigation of choice? - ID : 72266 frontal eye fields and the cranial nerves that innervate the eye
muscles, but the primary role of the superior colliculus is reflexive
Ⓐ CK.MB Ⓑ Trop T
visual orientation.
Ⓒ Myoglobin Ⓓ LDH
Ⓔ CPK 91. A woman undergoes abdominal surgery 10 years ago
now she is diagnosed with HCC thought to cause by Hep B.
Ⓑ ◉ Within 1 hour ☛ Myoglobin It is said that DNA and RNA viruses are oncogenes which
◉ After 2-4 hours ☛ Trop I ＞ Trop T ＞ CKMB one of the following is caused by RNA - ID : 79224
Trop-I is the most sensitive and Specific of all ! Ⓐ Human T cell leukemia causing virus
Ⓑ EBV Ⓒ HPV
Ⓓ HSV
✦ Davidson, Pg. 497 ✦ Robbins, Pg. 417 ✦ Pathoma, Pg. 74 ✦ Harsh Mohan, Pg. 414
Ⓐ HTLV-1 ☛ human retrovirus ➜ transmitted by breastfeeding,
86. A man Crossing road he look right then left side this sexual contact, blood transfusion and contaminated needles ➜
movement caused by vertebrae having which type joint? -
ID : 72299
causes T-cell leukemia.
✦ CMDT, Pg. 1039

Ⓐ Pivot joint Ⓑ Condyloid joint

92. Rash after taking a drug - ID : 79312
Ⓒ Synovial joints Ⓓ Biaxial ellipsoid
Ⓔ Uniaxial ellipsoid Ⓐ Hypersensitivity Type 1 Ⓑ Hypersensitivity Type 2
Ⓒ Hypersensitivity Type 3
Ⓐ AtlantoAxial ☛ Pivot Joint ➜ between first and second cervical
vertebrae ➜ rotational motion Ⓐ Drug allergy ➜ Type-1 hypersensitivity reaction ➜ IgE AB
✦ SNELL, Pg. 13 ✦ Levinson, Pg. 558

87. Lady after total abdominal hysterectomy done bilateral 93. What is the primary cause of ovulation? - ID: 81883
oophorectomy done now present on examination with
Ⓐ Estrogen Ⓑ Progesterone
adnexal mass is present following tumor marker is
Ⓒ Testosterone Ⓓ LH surge
important for recurrence of disease - ID : 72404

Ⓐ CA 125 Ⓑ CA 19-9 Ⓓ Ovulation is primarily triggered by a surge in the luteinizing

Ⓒ Alpha fetoprotein Ⓓ CEA hormone (LH). This surge usually occurs in the middle of the
Ⓔ CA 15-7 menstrual cycle and results in the release of a mature egg from
the ovarian follicle.Estrogen estrogen levels rise in the first half of
Ⓐ EXPLANATION the menstrual cycle and play a key role in preparing the
endometrium and maturing the follicle, it's the LH surge that
88. A patient Presented with Chest pan radiating to left
directly triggers ovulation.
arm and diagnosed as MI, after 4 days died due to
uncontrolled BP, which type of shock will be found in this?
Progesterone predominates in the second half of the menstrual
- ID : 72436 cycle, after ovulation has occurred, and prepares the endometrium
for a potential pregnancy.
Ⓐ Hypovolemic shock Ⓑ Septic shock Testosterone - male hormone is present in females in small
Ⓒ Anaphylactic shock Ⓓ Cardiogenic Shock amounts but does not play a direct role in ovulation.

Ⓓ Acute MI ☛ MCC of cardiogenic shock ◉ Dec. stroke volume 94. Neostigmine Mechanism of action ? - ID : 82133
➜ Cardiogenic Shock ➜ systolic BP ＜ 90 mm Hg + urine output ＜ Ⓐ Block Acetylcholine receptors
20 mL/hr Ⓑ Deactivate Acetylcholinesterase
✦ Harsh Mohan, Pg. 436

89. 32 years old presented with nasal polyps microscopy Ⓑ Inhibits the hydrolysis of acetylcholine by inhibiting the
shows non sepstate hyphae branching - ID : 72490 acetylcholinesterase at sites of cholinergic transmission.

Ⓐ Cryptocos Ⓑ Mucormycosis 95. A patient presented with crohn disease for her
Ⓒ Histoplasmosis treatment of remission corticosteroids are given what is
best for maintenance of remission of her disease? - ID :
Ⓑ Mucor ☛ Non-septate, branching hyphae forming right angle 82520
✦ Levinson, Pg. 418 ✦ Oxford Microbiology, Pg. 489
Ⓐ Azathioprine Ⓑ Mesalamine
90. What is the primary function of the superior colliculus? Ⓒ Cyclosporin Ⓓ Ciprofloxacin
- ID: 78998
Ⓐ Azathioprine and mercaptopurine can help maintain remission
Ⓐ Visual perception. Ⓑ Auditory perception.
in active Crohn's, and reduce the need to use steroids
Ⓒ Visual reflexes Ⓓ Auditory reflexes.
Ⓔ Control of eye movements. 96. Patient with nephrotic syndrome. Which structure in
GBM plays major role in perm- selectivity for proteins - ID
Ⓒ Superior colliculus is a paired structure located in the : 82968
midbrain, and it is primarily involved in visual reflexes and
Ⓐ Lamina rara interna Ⓑ Lamina rara externa
orienting movements of the eyes and head toward something
Ⓒ Lamina densa
seen. It helps to coordinate rapid movements of the eyes to
Ⓓ Visceral epithelial layer
sudden visual stimuli, for instance, if a flash of light appears in the
peripheral vision.Visual perception primarily a function of the Ⓓ The glomerular filtration barrier consists of fenestrated
primary visual cortex located in the occipital lobe of the cerebral endothelium, GBM, and podocyte foot processes, which are
cortex connected by a slit-diaphragm.
Auditory perception associated with the auditory cortex and not

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97. Which one is the DNA repair gene? - ID : 83056

Ⓐ Spherical diameter of the lense increases
Ⓐ P53 Ⓑ Brca 1 Ⓑ Ciliary muscle contracts
Ⓒ Myc Ⓓ Cea Ⓒ Vertical diameter increase
Ⓓ Lense dislocation
Ⓐ Damage to DNA ➜ sensed by intracellular sentinel proteins ➜
accumulation of p53 protein ➜ p53 first arrests the cell cycle (at Ⓑ During Accommodation ☛ ciliary muscle contracts
the G1 phase) to allow the DNA to be repaired ➜ But if the ➜ reducing tension on zonular fibers that connect ciliary muscle to
damage is too great ➜ P53 triggers apoptosis lens ➜ lens become more convex ➜ its refractive power ➜
✦ Harsh Mohan, Pg. 213 ✦ Robbins, Pg. enabling eye to focus near
98. Pleasure and elation - ID : 83148 105. FSH is inhibited by which of the following organ /
Gland? - ID : 84125
Ⓐ Hipocampus Ⓑ Amygdala
Ⓒ Cingulate gyrus Ⓐ Seminal Vesicle Ⓑ Testes
Ⓓ Septal region for nucleus accumbens Ⓒ Ductus deference Ⓓ Ovaries

Ⓑ C＞B Ⓑ Testes ☛ stimulated by FSH ➜ spermatogenesis + production

Limbic system☛ Pleasure ,Feeding, Fleeing, Fighting, Feeling, and of Inhibin ➜ negative feedback to pituitary ➜ inhibit FSH
Sex. Ovaries ☛ stimulated by FSH ➜ growth of ovarian follicles. No
✦ First Aid, Pg. 499
Inhibition of FSH
99. Vein along anterior interventricular artery / Left
Anterior Descending (LAD) artery - ID : 83221 106. A HTN pt was started on Captopril ACE Inhibitor. ACE
Inhibitors Increases renin mo bradykinln. By which
Ⓐ Greater cardiac vein Ⓑ Middle cardiac vein mechanism does this drug Increase bradykinin levels? - ID
Ⓒ Ant cardiac vein Ⓓ Smallest cardiac vein : 84202

Ⓐ Inhibit conversion of angiotensin 1 to angiotensin 2

Ⓐ Great cardiac vein accompanies ☛ Anterior interventricular
Ⓑ Inhibit Kallikrein mechanism
artery Ⓒ Stimulate Kallikrein mechanism
✦ BD Chaurasia, Pg. 267
Ⓓ Decrease cardiac output
100. On data Normal distribution - ID : 83460
Ⓐ Captopril ☛ is ACE Inhibitor ➜ inhibits conversion of
Ⓐ Mean, median, mode are equal in normal curve
angiotensin I to II ➜ Vasodilation and reduction of blood volume ➜
Ⓑ Median, mode in skewed curve
Ⓒ Mode, median in bimodal curve
lower BP
Ⓓ Mean, median in kurtotic curve Angiotensin II ☛ degrades bradykinin, so inhibiting conversion
to Angiotensin II results in increased levels of bradykinin ➜ further
Ⓐ Normal distribution (bell curve) ☛ mean, median, and mode Vasodilation
are all the same and lie at center of distribution. 107. A young man with aplastic anemia was given anti-
101. Old man collapse and his ECG show atrial rate of 75 lymphocyte globulin (ALG). He had no immediate
and ventricular rate of 35 bpm, P and QRS are dissociated complications. However, one week later, he developed
- ID : 83469 fever, urticaria, arthralgia, and generalized
lymphadenopathy. What type of hypersensitivity reaction
Ⓐ Stokes Adams Ⓑ Atrial Fibrillation best explains these symptoms? - ID: 86683
Ⓒ Sinus Bradycardia Ⓓ Ventricular Tachycardia
Ⓐ Arthus reaction
Ⓐ Stokes-Adams syndrome ☛ sudden unconsciousness due to Ⓑ Type I hypersensitivity reaction
decrease in blood flow (cardiac output), most often resulting from Ⓒ Type II hypersensitivity reaction
certain forms of heart block. Ⓓ Type III hypersensitivity reaction
Disparity between atrial and ventricular rates might suggest a Ⓔ Type IV hypersensitivity reaction
form of heart block, leading to decreased perfusion and episodes
of syncope. Ⓓ Type III hypersensitivity reaction:In a type III
hypersensitivity reaction, immune complexes (antigen-antibody
102. A child has a history of pica now having pallor, pairs) are formed in large quantities and deposit in tissues,
fatigue diagnosed as iron deficiency anemia what should causing inflammation and damage. The symptoms described,
be given? - ID : 83892 appearing after a period of time following ALG administration, are
Ⓐ Supplemental iron Ⓑ Vitamin B12 consistent with this type of reaction.Arthus reaction: localized
Ⓒ Vitamin B6 Ⓓ Folate type III hypersensitivity reaction, which doesn't align with the
systemic symptoms described.
Ⓐ EXPLANATION Type I hypersensitivity reaction: is immediate and involves
IgE antibodies, which isn't the case here.
103. Twin pregnancy with two ova. Which is correct? - ID : Type II hypersensitivity reaction: involves antibodies directed
83982
against the body's own cells, which isn't consistent with the
Ⓐ Same placenta Ⓑ Same amniotic sac presentation.
Ⓒ Different chorion Ⓓ Same chorion Type IV hypersensitivity reaction: is a delayed-type reaction
involving T cells, which doesn't fit the clinical scenario.
Ⓓ Twin pregnancy with two ova ☛ dizygotic or fraternal twins,
108. 3rd time malaria in 6 months, with Plasmodium
which have separate amniotic sacs and separate placentas, but
vivax, despite using mosquito nets and repellents.
share the same chorion. Same amniotic sac is incorrect for a
Treatment - ID : 91628
twin pregnancy with two ova because dizygotic or fraternal twins,
which develop from two separate ova, typically have separate Ⓐ Primaquine Ⓑ Chloroquine
amniotic sacs. Ⓒ Mefloquine Ⓓ Doxycycline

104. During near vision what happens? - ID : 84101

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Ⓐ ✪ Management ☛ Primaquine is effective against the latent Ⓓ ✪ In an individual acclimatized to a desert environment with
liver stage of Plasmodium vivax and can prevent relapses, which is high water intake → water reabsorption predominantly occurs in
essential in this case given the multiple occurrences. the collecting duct, regulated by antidiuretic hormone (ADH).
109. The blood supply of the fronto-parietal-temporal- 116. Energy required - ID: 95036
inferior regions - ID: 95027
Ⓐ 3500 joule Ⓑ 2000 joule
Ⓐ MCA Ⓑ PCA Ⓒ 5000 joule Ⓓ 1000 joule
Ⓒ ACA Ⓓ Maxillary
Ⓐ Energy ☛ 3500 joules is often cited as the energy equivalent of
Ⓐ ✪ Middle Cerebral Artery (MCA) ☛ is the major artery that one pound of body weight, commonly used in weight management
supplies large portions of the frontal, parietal, and temporal lobes. guidelines.
✪ The MCA is the primary artery supplying the lateral convexity of
117. Shattered fracture of scapula which muscle spared? -
the cerebral hemisphere, including most of the sensory, motor, ID: 95037
and speech areas
Ⓐ Rhomboid major Ⓑ Rhomboid minor
110. Rectum is rich in all layers, it forms - ID: 95028 Ⓒ Supraspinatus Ⓓ Infraspinatus
Ⓐ Medial border of ischiorectal fossa Ⓔ Levator scapulae f Teres minor
Ⓑ Lateral border of ischiorectal fossa
Ⓒ Inferior border of the pelvic diaphragm Ⓔ Levator scapulae ☛ more likely to be spared in a shattered
Ⓓ Superior border of the anal canal scapula fracture as it attaches to the superior part of the medial
border of the scapula, an area less likely to be involved in such
Ⓐ Rectum ☛ forms the medial border of the ischiorectal fossa. fractures.
The ischiorectal fossa is a fat-filled space on either side of the anal 118. Sympathetic nerve come from? - ID: 95038
canal, and the rectum sits medially to it.
Ⓐ Raphe nucleus Ⓑ Nucleus Ceruleus
111. Patient with hyperthyroidism may have : - ID: 95029 Ⓒ Nucleus basalis Ⓓ Substantia nigra
Ⓐ Increase cholesterol Ⓑ Increase HDL ans
Ⓒ Increase LDL Ⓑ Nucleus Ceruleus ☛ major site for the synthesis of
Ⓓ Increase free fatty acids norepinephrine and plays a key role in the sympathetic nervous
system.
Ⓓ Hyperthyroidism ☛ typically leads to an increase in metabolic
119. Korotkoff muffled sound - ID: 95040
rate, which can result → the breakdown of fatty acids. Therefore,
levels of free fatty acids may be elevated. It usually doesn't result Ⓐ Old age Ⓑ Child
in increased cholesterol or LDL levels. Ⓒ Mitral stenosis Ⓓ Hypertension

112. Fiber parallel and post of internal capsule - ID: 95031 Ⓒ ✪ Muffled Korotkoff sound ☛ may be indicative of mitral
Ⓐ Corticospinal for lower limb stenosis, which can influence the quality of the sounds heard
Ⓑ Corticobulbar fibers Ⓒ Spinothalamic tract during blood pressure measurement
Ⓓ Auditory radiation 120. Centrioles / Microtubule in cell division - ID: 95052

Ⓐ ✪ Fibers that are parallel and posterior within the internal Ⓐ Assist in cytokinesis Ⓑ Synthesize RNA
capsule are the corticospinal fibers for the lower limb.✪ These Ⓒ Function in cell membrane repair
fibers are part of the motor pathway that controls voluntary Ⓓ Involved in the formation of the spindle fibers
movements.
Ⓓ ✪ Centrioles and Microtubules ☛ crucial in the formation of
113. Female hyperemesis - ID: 95033 spindle fibers, which help separate chromosomes during cell
Ⓐ Metoclopramide Ⓑ Acetaminophen division.
Ⓒ Ibuprofen Ⓓ Aspirin 121. Artery palpated between sternocleidomastoid (SCM)
and submandibular gland - ID: 95063
Ⓐ Metoclopramide ☛ commonly used to treat nausea and
vomiting, including in cases of hyperemesis gravidarum in Ⓐ External carotid Ⓑ Common carotid
Ⓒ Internal carotid Ⓓ Facial artery
pregnant females.✪ It acts as an antiemetic.

114. PCT histology related question - ID: 95034 Ⓑ Common carotid artery ☛ can be palpated between the
sternocleidomastoid muscle and the submandibular gland.✪ It is a
Ⓐ Dense on staining Ⓑ Lacks microvilli
major artery supplying blood to the head and neck.
Ⓒ Cuboidal epithelium without brush border
Ⓓ Simple squamous epithelium 122. Wound after suturing - ID: 95064

Ⓐ Proximal convoluted tubule (PCT) ☛ In the context of renal
histology → PCT cell are dense on staining, largely due to the
presence of a brush border of microvilli → that increases surface
area and is involved in reabsorption.
115. Man living in desert previously has a history of
drinking lots of water . where water absorption occur in
this patient. - ID: 95035
Ⓐ Collagen formation Ⓑ Muscle regrowth
Ⓒ Epithelialization only Ⓓ Bone regeneration
Ⓐ ✪ After a wound is sutured ☛ the most immediate response is
the formation of collagen to build the framework for tissue repair
and healing.
123. Pregnant with Hypothyroidism - ID: 95065

Ⓐ Medullary collecting tube Ⓐ Hashimoto Ⓑ Graves' disease

Ⓑ PCT Ⓒ CCT Ⓒ Iodine deficiency Ⓓ Hyperparathyroidism
Ⓓ Collecting duct

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Ⓐ Hashimoto's thyroiditis ☛ is the most common cause of

hypothyroidism and can affect pregnant women, leading to
potential risks for both mother and child.
124. Head of the index finger nerve supply: - ID: 95067

Ⓐ Median nerve Ⓑ Ulnar nerve

Ⓒ Radial nerve Ⓓ Axillary nerve

Ⓐ Median nerve ☛ supplies the palmar side of the thumb, index,

middle, and part of the ring finger, including the head of the index
finger.

125. Righting reflex - ID: 95068

Ⓐ Body over head Ⓑ Head over body

Ⓒ Limbs under body Ⓓ Tail over head

Ⓐ ✪ Righting reflex ☛ is the instinct to correct the orientation of

the body when taken out of its normal upright position.✪ "Body
over head" → implies that the body adjusts itself to maintain its
head in an upright position, which is a core aspect of the righting
reflex
126. Release from Raphe magnus to pain - ID: 95069

Ⓐ Enkephalin Ⓑ Serotonin
Ⓒ Dopamine Ⓓ Acetylcholine

Ⓐ ✪ Release of Enkephalin from the Raphe Magnus nucleus →

acts as an inhibitory substance to decrease the perception of pain.

127. Theta wave - ID: 95070

Ⓐ Hypoglycemia Ⓑ Deep sleep

Ⓒ Alertness Ⓓ REM sleep

Ⓐ ✪ Theta waves ☛ are generally seen in lighter stages of sleep

but can appear during hypoglycemic states, signaling metabolic
stress in the brain.

128. Organophosphorus poisoning - ID: 95071

Ⓐ Muscle weakness Ⓑ Muscle stiffness

Ⓒ Hyperactivity Ⓓ Paralysis

Ⓐ ✪ Organophosphorus compounds ☛ inhibit

acetylcholinesterase, → leading to an accumulation of acetylcholine
→ resulting in muscle weakness among other symptoms.

129. Calcium re-entry after AP by - ID: 95072

Ⓐ Voltage-gated channels Ⓑ Ligand-gated channels

Ⓒ Calcium-pump Ⓓ Sarcoplasmic reticulum

Ⓓ ✪ After an action potential ☛ calcium ions are actively taken

back into the sarcoplasmic reticulum, which helps to relax the
muscle.

130. Aspiration during fits can be prevented by - ID: 95073

Ⓐ False vocal cord Ⓑ True vocal cord

Ⓒ Epiglottis Ⓓ Diaphragm

Ⓐ ✪ False vocal cords ☛ can help prevent aspiration during fits

by closing off the airway, thus preventing material from entering
the lungs.

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