Medi Call FCPS – 1 | MAY 2023 PAPERS

111. Earliest Neuroendocrine response to stress (Anesth 23 Ⓐ Air blanket Ⓑ OT temp change
May 2023 (M) +1 past) - ID: 84269
Ⓐ During surgery, temporary loss prevention is achieved by:
Ⓐ CRH release Ⓑ ACTH release
Patient pre-warming ➜ Use of air blanket to cover and warm patient ➜
Ⓒ Adrenaline release Ⓓ Cortisol release
Air blanket provides a constant, adjustable source of warm air that
reduces heat loss
Ⓐ Stress ➜ triggers hormonal changes ➜ initiated by hypothalamus
OT temp might be adjusted to a comfortable level for the staff, which
releasing corticotropin-releasing hormone (CRH) ➜ this signals pituitary
might be cooler than optimal for the patient.
gland to produce ACTH ➜ ACTH then signals adrenal glands to produce
cortisol. 119. Ach esterase genetic deficiency (Anesth 23 May 2023 (M)) -
ID: 84284
112. Low Signal to Noise ratio in fixed SPO2 split of
Oximeter (Anesth 23 May 2023 (M)) - ID: 84271 Ⓐ Succinylcholine resistance develops
Ⓑ Succinylcholine sensitivity develops
Ⓐ 75 Ⓑ 85 Ⓒ No effect on succinylcholine
Ⓒ 100 Ⓓ 90 Ⓓ Resistance to all anesthetics

Ⓑ Signal to noise ratio (SNR) in pulse oximetry refers to ratio of
pulsatile signal (due to arterial blood) to non-pulsatile signal (due to
other absorbing/non-absorbing components)
◉ Higher SNR improves accuracy of SpO2 reading
◉ SNR of 85 is acceptable for reliable SpO2 readings.
113. Ribs fracture (Anesth 23 May 2023 (M)) - ID: 84276
Ⓐ ACh esterase deficiency results in decreased breakdown of ACh in
synaptic cleft ➜ This leads to a prolonged effect of ACh ➜
Succinylcholine, a depolarizing muscle relaxant, would therefore have a
prolonged effect, not resistance
120. Interstitial lactogenic hormone released by: (Anesth 23
May 2023 (M)) - ID: 84286

Ⓐ Increase ventilation-perfusion Ⓐ Pituitary Ⓑ Pineal gland

Ⓑ Decrease ventilation-perfusion Ⓒ Adrenal gland Ⓓ Placenta
Ⓒ No effect on ventilation-perfusion
Ⓓ Only painful, no physiological effects Ⓐ Interstitial Lactogenic hormone, ☛ Prolactin, is predominantly
secreted by anterior pituitary gland
Ⓐ Fractured ribs ☛ cause painful breathing, which reduces breath Placenta secretes HCG during pregnancy, the term "Interstitial
depth and frequency, thus causing hypoventilation ➜ Hypoventilation Lactogenic hormone" specifically refers to Prolactin
reduces oxygenation, but blood flow remains constant ➜ leads to
increased V/Q mismatch. 121. Young boy swelling on forehead. On biopsy mature
adipocytes found (Anesth 23 May 2023 (M) +1 past) - ID: 84287
114. Brain total blood supply (Anesth 23 May 2023 (M)) - ID:
84277 Ⓐ Lipoma Ⓑ Fibrom a
Ⓒ Osteoma Ⓓ Chondroma
Ⓐ 150 Ⓑ 750
Ⓐ Presence of mature adipocytes in a biopsy signifies an accumulation
Ⓑ Brain receives approx 750 milliliters (mL) of blood per minute, of fat cells ➜ characteristic of a lipoma, which is a benign tumor made
which accounts for about 15% of total cardiac output. up of fat tissue.
115. Tendon jerk reflex. which receptors are present 122. Space occupying tumor of lung causes obstruction of
(Anesth 23 May 2023 (M)) - ID: 84280
(Anesth 23 May 2023 (M)) - ID: 84288
Ⓐ Merkel Ⓑ Ruffini Ⓐ Sup bronchus Ⓑ Bronchioles
Ⓒ Free nerve endings Ⓓ Golgi Ⓒ Pulmonary artery Ⓓ Pulmonary vein

Ⓓ Tendon jerk reflex a.k.a Golgi tendon reflex ➜ involves stimulation Ⓐ space-occupying tumor in lung can indeed cause obstruction of
of Golgi tendon organs located within tendons near point where they larger airways, including superior bronchus ➜ lead to cough, dyspnea,
attach to muscle. and hemoptysis.
Tension or stretching of the tendon, Golgi tendon organs are
activated, leading to reflex response.
Free nerve endings are typically associated with detection of pain,
temperature, and touch.

116. Pt has a grayish-white membrane on the tonsils. MOA

ENT 23 May 2023

of diphtheria toxin: (Anesth 23 May 2023 (M) +2 past) - ID: 84281

Ⓐ Inhibition of DNA synthesis Ⓑ Inhibition of RNA synthesis

Ⓒ Inhibition of protein synthesis

(M)
Ⓓ Inhibition of lysosomes

Ⓒ MOA of diphtheria toxin ☛ Attachment to target cell ➜ Entry into

cell via endocytosis ➜ Reduction in endosome leading to release of A 1. Which hormone increases blood levels of glucose, amino
fragment into cytosol ➜ A fragment (the active portion of toxin) acids, and fatty acids: (ENT 23 May 2023 (M) +2 past) - ID: 270
inactivates Elongation Factor 2 (EF-2) ➜ Inhibition of protein synthesis
➜ Cell death. Ⓐ Epinephrine Ⓑ Insulin
Ⓒ Growth hormone Ⓓ Cortisol
117. Steroid inhalation whitish tongue (Anesth 23 May 2023
(M)) - ID: 84282
Ⓓ ✪ CORTISOL ☛ ↑ blood glucose by gluconeogenesis, ↑ blood
Ⓐ Rinse mouth Ⓑ Use antifungal mouthwash amino acids by protein catabolism and ↑ FFAs by lipolysis.
Ⓒ Discontinue steroid use Ⓓ Use antibiotic mouthwash ✪ EPINEPHRINE ☛ ↓ amino acids, ↑ blood glucose by glycogenolysis
and ↑ FFAs by lipolysis.
Ⓐ Steroid inhalation can cause a whitish coating on tongue, a ✪ INSULIN ☛ ↓ blood glucose by storing it as glycogen, ↓ blood
symptom of oral thrush ➜ Rinse mouth after inhalation can reduce amino acids by their uptake by cells and conversion into protein and ↓
amount of residual medication FFAs by storing them in adipose tissue.
✪ GH ☛ ↑ blood glucose by ↓ uptake by cells, ↓ blood amino acids by
118. During surgery temp loss prevention by: (Anesth 23 May ↑ uptake by cells and ↑ FFAs by releasing them from adipose tissue.
2023 (M)) - ID: 84283

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 760

 Medi Call FCPS – 1 | MAY 2023 PAPERS

✦ Guyton, Pg. 972, 880, 992, 984, 987, 943, , ✦ N.I.H USA, Pg. ✦ stimulated, whereas when doing cartwheels those cells of the posterior
Pubmed USA, Pg. semicircular canals are stimulated Equal rotation along each plane
2. Toxin involved in the streptococcal toxic shock 9. Parenchymal tissue of thyroid gland derives from (ENT 23
syndrome is? (ENT 23 May 2023 (M) +2 past) - ID: 1734 May 2023 (M) +2 past) - ID: 6352

Ⓐ Pyrogenic exotoxin Ⓑ Erythrogenic toxin Ⓐ Other then pharyngeal pouches

Ⓒ Hemolysin Ⓓ M Protien Ⓑ 1st pharyngeal pouch Ⓒ 2nd pouch
Ⓓ 4th pouch
Ⓐ Pyrogenic exotoxin ☛ A is the toxin responsible for most cases of
streptococcal toxic shock syndrome. Ⓓ Ventral portion of 4th Pouch ☛ forms ultimobranchial body ➜ its
✦ Levinson, Pg. 120 cells migrate into thyroid gland ➜ differentiate into parafollicular (C)
3. Increase salivary flow occurs by (ENT 23 May 2023 (M) +4 cells of thyroid.
past) - ID: 2272
10. A young farmer while working in field became
Ⓐ Substance P Ⓑ Prosta glandins unconscious and start frothing from mouth due to
Ⓒ Sleep Ⓓ Anticholinergic organophosphorus poisoning. Which characteristic feature
will be present (ENT 23 May 2023 (M) +14 past) - ID: 8664
Ⓐ Substance P ☛ a neuropeptide ➜ acts as a neurotransmitter ➜
Ⓐ Bilateral pinpoint pupil Ⓑ Dry skin
stimulates cholinergic as well as SP specific receptors ( Tachykinin NK-1
Ⓒ Flaccid paralysis Ⓓ Bibinski sign
receptors ) ➜ ↑ Saliva flow
Acetylcholine ＞ VIP ＞ Sub P
Ⓐ Insecticides and pesticides ☛ contain organophosphorous ➜
excessive cholinergic symptoms ( e.g. pinpoint pupils ) if inhaled.
✦ N.I.H USA, Pg.
11. Most common Chronic Fungal infection with rhino
4. Mode of action of cephalosporin which of the following?
sinusitis causing medial erosion and granulomas relate to
(ENT 23 May 2023 (M) +5 past) - ID: 2710
which of following ? (Surg 24 May 2023 (A.N) +12 past) - ID:
Ⓐ Dec peptidoglycan synthesis Ⓑ Inhibit transpeptidase 10085
Ⓒ Cell membrane synthesis inhibitor
Ⓐ Cryptococcosis Ⓑ Rhinophycomycosis
Ⓓ Cox inhibitor
Ⓒ Histoplasmosis Ⓓ Aspergillus
Ⓑ Cephalosporin ☛ inhibit transpeptidation ➜ responsible for 3D
Ⓓ Aspergillosis ☛ opportunistic systemic mycosis ➜ affects
structure of cell wall.
respiratory tract predominantly ➜ most common cause of Invasive
5. Which is true regarding parotid duct (Stensen duct)? fungal sinusitis
(Gynae 24 May 2023 (M) +13 past) - ID: 3223 Chronic granulomatous and Invasive sinusitis ☛ Cuased
by Aspergillus ➜ destructive process that most commonly affects the
Ⓐ Arises from posterior surface of Parotid ethmoid and sphenoid sinuses
Ⓑ Pierces the Buccinator muscle
Phycomycosis ☛ Also causes invasive Rhino orbital granulomas but
Ⓒ Opens in the oral cavity against 2nd incisor
rarer than aspergillus
Ⓓ Is duct of submandibular gland ✦ Harrison, Pg. 1535 ✦ Oxford, Pg.

Ⓑ Stensen duct 12. Human can hear sounds best in what frequency range
● Drains saliva from parotid gland into oral cavity (ENT 23 May 2023 (M) +1 past) - ID: 10339
● Emerges from anterior border of gland near second upper molar
Ⓐ 200-500db Ⓑ 1000-2000db
● Buccinator muscle is pierced by parotid duct.
Ⓒ 2000-3000 db Ⓓ 3000-4000 db
✦ SNELL, Pg. 582, 630

6. Why the spinal nerves are called mixed nerves? (Eye 23 Ⓑ ✪ Frequency (Hz) ☛ Normal person can hear frequencies of 20–
May 2023 (M) +10 past) - ID: 3362 20,000 Hz , Frequencies of 500, 1000 and 2000 Hz are called speech
frequencies as most of human voice falls within this range
Ⓐ Sensory and motor nerves Ⓑ Dorsal and ventral
✪ Intensity (dB) ☛ Stapedial reflex is elicited with a sound of 70–100
roots
dB
Ⓒ Come through inter vertebral foramen
✦ Sound with intensity ＞ 120-130 dB will cause discomfort and pain in
Ⓓ Constitute both craniosacral and thoracolumbar outflow
ear
Ⓔ Constitute both craniosacral and thoracolumbar outflow ✦ Dhingra, Pg. 19

Ⓐ As spinal nerves contain both motor and sensory nerves they are 13. Dermatome of neck from chin to supraclavicular notch
called mixed nerves. (ENT 23 May 2023 (M) +3 past) - ID: 11010

7. Dorsum of nose is supplied by (ENT 23 May 2023 (M) +2 past) Ⓐ C3, C4 Ⓑ C1, C2
- ID: 4033 Ⓒ C2, C3 Ⓓ C5,C6

Ⓐ Ethmoidal branch of ophthalmic artery Ⓐ ✪ C2 ☛ Occipital Region , Posterior Neck , Skin over Parotid
Ⓑ Branch of facial artery Ⓒ Branch of temporal artery ✪ C3 ☛ Neck and upper shoulder regions (acromioclavicular joint)
Ⓓ Branch of maxillary artery ✪ C4 ☛ Supraclavicular fossa , Lower clavicular region , middle
clavicular line ( Netter + Last )
Ⓐ Dorsum of nose is mainly supplied by ethmoidal branches of
ophthalmic artery, which is a branch of internal carotid, sends several 14. A student was examining a slide under microscope. He
branches to nasal region, including anterior and posterior ethmoidal found mass of lymphoid tissue covered with Cuboidal
arteries. epithelium. The structure he is examining is? (ENT 23 May
2023 (M) +13 past) - ID: 12300
8. Semicircular canals in cortex of ear are maximally
stimulated by? (ENT 23 May 2023 (M) +4 past) - ID: 4499 Ⓐ Pharyngeal Tonsil Ⓑ Palatine Tonsil
Ⓒ Peyer’s Patches Ⓓ Lingual Tonsils
Ⓐ With nodding of head downwards
Ⓑ Doing cartwheel Ⓒ Vertical axis Ⓒ ✪ Peyer's patches ➜ Columnar / Low Cuboidal M cells Epithelium
Ⓓ Linear acceleration ✪ Palatine tonsil ➜ stratified squamous epithelium
✪ Pharyngeal tonsil (adenoids) ➜ ciliated pseudostratified
Ⓑ When a gymnast performs forward somersaults the hair cells located ✪ Lingual tonsils ➜ stratified squamous
in the anterior semicircular canal of the vestibular apparatus are ✪ Tubal Tonsils ➜ Ciliated pseudostratified Squamous

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 761

 Medi Call FCPS – 1 | MAY 2023 PAPERS

✦ Leeds Uk, Pg. Ⓑ G6PD deficiency ☛ Intake of Certain Drugs / Infections / Food ➜
Formation of Reactive oxygen species ( ROS ) ➜ Oxidant damage
15. Coordinated movement and posture stability is the
to Hemoglobin ➜ Formation of Small round inclusions within RBCs (
function of which part and its lesion leads to rigid posture
Heinz Bodies ) ➜ Spleen ➜ Macrophages ➜ Damaged part of
and poor coordination (ENT 23 May 2023 (M) +7 past) - ID: 12447
Hemoglobin Removed ➜ Appear bitten ➜ Bite Cells ➜ Premature
Ⓐ Cerebellum Ⓑ Pons Hemolysis ➜ Anemia, Jaundice, Hematuria.
Ⓒ Medulla Ⓓ Spinal cord ✦ Robbins, Pg. 450

22. Which gland contains Mucinous epithelial cells and

Ⓐ Cerebellum ☛ Coordination of voluntary movements i-e posture,
Acini along with Serous Demilunes? (ENT 23 May 2023 (M) +12
balance, speech. past) - ID: 16411
✦ Kaplan Neuro, Pg. 240 ✦ Snell Neuro, Pg. 241
Ⓐ Sublingual gland Ⓑ Submandibular
16. 26-year-old boy presents with pallor, weakness, fever
Ⓒ Parotid Ⓓ Minor glands
of 101 f, bruises, rash and petechia. Definitive diagnosis
be made on (ENT 23 May 2023 (M) +3 past) - ID: 12802
Ⓑ ✪ Submandibular gland ☛ secrete both serous and mucous.
Ⓐ Serology Ⓑ CBC ✪ Sublingual gland ☛ epithelial cells are all mucus-secreting.
Ⓒ Bone marrow aspiration Ⓓ Molecular biology ✪ Parotid gland ☛ produce serous, watery secretion.

23. Acute myocardial infarction changes on ECG? (ENT 23

Ⓒ ✪ Fever, weakness, petechiae and ecchymoses ➜ features May 2023 (M) +10 past) - ID: 16658
of Thrombocytopenia.
✪ Bone marrow aspiration ☛ indicated in Thrombocytopenia. Ⓐ ST segment depression Ⓑ Prolong QRS complex
✦ Robbins, Pg. 489 ✦ Harsh Mohan, Pg. 463 Ⓒ T wave depression Ⓓ ST-segment elevation
17. Phasic, Rapidly Adapting receptors that sense Pressure
Ⓓ ✪ Acute M.I ☛ First peaked T waves ➜ then ST elevation ( 25 –
and vibration? (Med 23 May 2023 (A.N) +56 past) - ID: 12901
40% ) ➜ then negative T waves ➜ finally pathologic Q waves
Ⓐ Ruffini Ⓑ Merkels ✪ Prolong QRS complex ☛ shows slower spread of ventricular
Ⓒ Paccinian Ⓓ Baroreceptors depolarization ➜ may be due to disease of His-Purkinje network
✪ Absent P wave ☛ Fine Atrial fibrillation
Ⓒ Pacinian corpuscles ☛ Rapidly adapting, deep , encapsulated ✪ T wave depression ☛ Hypokalemia
receptors ➜ high-frequency vibrations in the skin + gross pressure ✦ Davidson, Pg. 497
changes. 24. SLE main effect on (ENT 23 May 2023 (M) +3 past) - ID: 16708
✦ First Aid, Pg. 494 ✦ Duane Neurosceince, Pg. 244 ✦ Guyton, Pg.
615, 608 Ⓐ Joints Ⓑ Skin
18. A man during a roadside accident suffer injury to Ⓒ Bones Ⓓ Heart
cervical sympathetic chain. Most likely change in eye due
Ⓐ Arthralgia is main symptom occurring in 90% of SLE Patients
to Cervical sympathetic chain damage ? (Surg 24 May 2023
✦ Robbins, Pg. 154
(A.N) +11 past) - ID: 12917
25. A 6 year old child had a bout of flu and suddenly
Ⓐ Sweating Ⓑ Decrease hearing
developed widespread pinpoint skin hemorrhages,
Ⓒ Heart Failure
recurrent purplish rash on both lower limbs, ecchymosis.
Ⓓ Ipsilateral Pupillary constriction (Miosis)
Laboratory findings revealed a reduced platelet count and
Ⓓ Damage to the T1-T3 regions ➜ significant damage to the Superior no other abnormalities. The bone marrow showed an
Cervical Ganglion ➜ Oculosympathetic paresis ➜ Horner syndrome ➜ increased number of megakaryocytes, which appeared
Ipsilateral ✔ miosis ✔ anisocoria ✔ delayed pupil dilation ✔ ptosis ✔ mononuclear and had smooth cytoplasmic contours. The
anhidrosis ( Kaplan ) symptoms disappeared spontaneously. Diagnosis? (ENT 23
May 2023 (M) +15 past) - ID: 16769
19. A medical student was studying a slide under a
Ⓐ Acute ITP Ⓑ TTP
microscope. He found a tissue with st squamous
Ⓒ Henochscholeinpurpura Ⓓ Hemophilia B
epithelium with lymphatic tissue underneath and crypts.
Which can be the tissue? (ENT 23 May 2023 (M) +26 past) - ID:
Ⓐ ✪ ITP ☛ production of antibodies to receptors on platelets ➜
15497
engulfed by spleen ➜ ↓ platelets.
Ⓐ Parotid gland Ⓑ Palatine tonsil ✪ Lab Findings in ITP ☛ ↓ platelets, ↑ megakaryocytes on bone
Ⓒ Pharyngeal tonsil Ⓓ Peyer's patches marrow biopsy, Normal PT/PTT.
✪ Acute ITP ☛ in children, selflimited ➜ resolves in weeks.
Ⓑ Palatine Tonsils ☛ luminal surface is covered with stratified ✪ Chronic ITP ☛ in adults ➜ usually women of childbearing age.
squamous epithelium ➜ lymphoid follicles beneath epithelium. ✦ Pathoma, Pg. 32 ✦ Davidson, Pg. 972 ✦ Harsh Mohan, Pg. 311

20. Cough reflex caused by: (ENT 23 May 2023 (M) +12 past) -
ID: 15686
Ⓐ Trigeminal Ⓑ Vagus
Ⓒ Phrenic Ⓓ Glossopharyngeal
Ⓑ Cough reflex ➤ Afferent + Efferent ➤ CN X.
✦ Kaplan Neuro, Pg. 312
21. A child presented to OPD with 104 fever for the last 4
days. He has been passing cola colored urine for last one
day. He has been on anti malarial medication. His LFTs are
deranged with increase unconjugated bilirubin. Most
probable diagnosis ? (Surg 24 May 2023 (M) +33 past) - ID: 15768
26. A patient has bronchogenic carcinoma (nonproductive
cough, worsened over 2 yrs). Which is most commonly
causes/ contributing factor of bronchogenic carcinoma
(ENT 23 May 2023 (M) +8 past) - ID: 17912
Ⓐ Asbestosis Ⓑ Silicosis
Ⓒ Brucellosis Ⓓ Smoking tobacco
Ⓓ Tobacco is the top leading cause ( 90% of all cases ) of bronchogenic
cancer followed by Radon being second leading cause. Adenocarcinoma
is the most common FORM of lung cancer ( First Aid )
27. A Palatine Tonsils lie between which of the following
two structures? (ENT 23 May 2023 (M) +1 past) - ID: 18028

Ⓐ Blackwater fever Ⓑ G6PD deficiency Ⓐ Co-lateral sternocleidomastoid

Ⓒ Post-streptococcal glomerulonephritis Ⓑ Superior constrictors of pharynx and inferior constrictors
Ⓓ Rhabdomyolysis Ⓒ 2 Inferior constrictors of pharynx
Ⓓ Palatoglosus arch and palatopharyngeous arch

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 762

 Medi Call FCPS – 1 | MAY 2023 PAPERS

Ⓓ Palatine tonsils are located in isthmus of the fauces between 34. Type A personality. environmental factor to cause
palatoglossus and palatopharyngeous, the two arches of soft palate. coronary diseases ? (ENT 23 May 2023 (M) +6 past) - ID: 21788

28. Tensor villi palatini is supplied by the ? (ENT 23 May 2023 Ⓐ Physiological responce to stress
(M) +2 past) - ID: 19578 Ⓑ Low sensitivity to stress Ⓒ Both
Ⓓ High sensitivity to stress
Ⓐ CN III Ⓑ CN X
Ⓒ CN IV Ⓓ CN V
Ⓐ Type A behavior pattern (characterized by individuals who are
highly work-driven, time-conscious, and aggressive) is an important
Ⓓ The tensor veli palatini is supplied by the medial pterygoid nerve a
risk factor for CHD, Combined stress (psychological and physical) can
branch of mandibular nerve the third branch of the trigeminal nerve the
exacerbate cardiovascular responses, which may partially contribute to
only muscle of the palate not innervated by the pharyngeal plexus
the elevated risk of CVD
which is formed by the vagal and glossopharyngeal nerves.
35. Tumor spread from infratemporal fossa to middle
29. A lady suffering from CA breast undergoes a total
cranial fossa is by (ENT 23 May 2023 (M) +12 past) - ID: 22550
mastectomy and axillary lymph node dissection and
develops edema of the right arm which of the following Ⓐ Tegmen tympani Ⓑ Antrum tympani
can be the reason for this edema? (ENT 23 May 2023 (M) +26 Ⓒ Lesser wing of sphenoid Ⓓ Sphenoid body
past) - ID: 20661 Ⓔ Geater wing of sphenoid
Ⓐ Lymphatic obstruction
Ⓔ Infratemporal fossa bounded:
Ⓑ Increase vascular permeability
Superiorly☛ greater wing of sphenoid bone
Ⓒ Decrease oncotic pressure
Inferiorly ☛ medial pterygoid musc
Ⓓ Increase hydrostatic pressure
Medially ☛ sphenoid and palatine bones
Ⓔ Endothelial damage
Laterally ☛ ramus and coronoid process of mandible
Ⓐ Mastectomy ➜ Removal of LN ➜ Lymphatic obstruction ➜ Edema 36. ESOPHAGEAL OPENING in diaphragm is at level of ?
✦ Robbins, Pg. 98 (ENT 23 May 2023 (M) +11 past) - ID: 22616

30. A30 years old female is having to swell in front of the Ⓐ T9 Ⓑ T10
neck. She feels difficulty in breathing while in the supine Ⓒ T11 Ⓓ T8
position What can be the type of swelling in this patient ?
(CPSP Demo +36 past) - ID: 20854 Ⓑ Esophageal opening is located in the right crus at level of the tenth
Ⓐ Heart failure Ⓑ CKD thoracic vertebra (T10).
✦ First Aid, Pg. 663
Ⓒ CLD Ⓓ Retrosternal goiter
37. 19 years old patient developed diabetic ketoacidosis
Ⓓ Retrosternal goiter extends to trachea and causes difficulty in but did not respond to treatment and died. Autopsy
breathing and neck vein engorgement. showed inflammatory lesion in kidney ,brain and lung with
Fungus.Most likely cause? (CPSP Demo +16 past) - ID: 22672
31. During exercise skeletal muscle blood flow is increased
by ? (Med 25 May 2023 (A.N) +24 past) - ID: 21190 Ⓐ Aspergillosis Ⓑ Mucor
Ⓒ S. aureus Ⓓ H. influenza
Ⓐ Sympathetic supply Ⓑ Local metabolites
Ⓔ Strep Pneumoniae
Ⓒ O2 consumption Ⓓ CO2 loss

Ⓑ ✪ Metabolic byproducts ☛ adenosine, hydrogen ions and CO2 ➜

Ⓑ Mucor and Rhizopus:
Mucormycoses ☛ Hyperglycemia and Acidoses (DKA) ➜ Favour
produced by muscles ➜ Expand capillaries within muscle ➜ ↑ blood
Invasive disease ➜ Hyphae Penetrate blood vessels wall ➜ grow along
flow ➜ delivers oxygenated blood.
vessels ➜ thrombosis and necrosis.
✪ Sympathetic Activity ☛ control flow to Non Exercising Muscles.
✪ Brain ☛ Rhinocerebral disease.
32. Artery from left main stem causes infarct of left ✪ Lungs ☛ Pulmonary Mucormycosis / Pulmonary Hemorrhage.
ventricle which is sub-endocardial, is accompanied by ✪ Dissemination ☛ Spleen and Kidney.
anterior cardiac vein and also infarcted intra-ventricular ✦ Oxford Microbiology, Pg. 489, 490, 489, 490, 489, 490 ✦ Davidson,
septum most likely what is the cause (Med 25 May 2023 (A.N) Pg. 303 ✦ Harsh Mohan, Pg. 455
+19 past) - ID: 21567
38. During Submandlbular gland surgery which nerve is
Ⓐ Hypotensive shock Ⓑ Hypovolmic shock likely to be affected? (Med 24 May 2023 (A.N) +28 past) - ID:
Ⓒ Thrombotic occlusion of LCX Ⓓ Dec blood supply to 23431
the wall Ⓐ Marginal Mandibular branch of facial nerve
Ⓑ Zygomatic branch of the facial nerve
Ⓒ LCA ➜ ➊ Circumflex artery ➜ supplies blood to the left atrium, Ⓒ Mandibular division of the trigeminal nerve
side and back of the left ventricle ➋ Left Anterior Descending artery Ⓓ Inferioralveolar nerve
(LAD) ➜ supplies the front and bottom of the left ventricle and the front
of the septum ( Snell ) Ⓐ 3 nerves that can be damaged all with varying results:
✦ KLM, Pg. 147
1) Marginal mandibular branch of the facial nerve is the nerve most
33. Massive pleural effusion in old age. Which of the likely to be bruised ➜ Weakness of the lower lip
following is the safe area for paracentesis? (Anesth 23 May 2) Lingual nerve is rarely bruised ➜ Numbness of the tongue
2023 (M) +24 past) - ID: 21625 3) Hypoglossal nerve is only very rarely bruised ➜ Restricted tongue
movement ( British Society Oral surgery - Baoms.org.uk )
Ⓐ Upper part of 9th intercostal space midclavicular line
Ⓑ Lower part of 9th intercostal space midclavicular line 39. A patient had headache, neck stiffness and fever.
Ⓒ Upper part of 9th intercostal space midaxillary line Treatment of choice (DOC) for cryptococcus neoformans
Ⓓ Lower part of 9th intercostal space midaxillary line meningitis (ENT 23 May 2023 (M) +14 past) - ID: 24332

Ⓓ During Paracentesis Inserting needle into 9th intercostal space Ⓐ Amphotericin B Ⓑ Ciprofloxacin
in midaxillary line during expiration will avoid inferior border of Ⓒ Acylovir Ⓓ Azithromycin
Lung.(klm) Acc to BD Churasia its 8th intercostal space
✦ KLM, Pg. 121 ✦ BD Chaurasia, Pg. 300 Ⓐ C. neoformans meningitis ☛ Initial therapy should be
amphotericin B alone or in combination with flucytosine.

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 763

 Medi Call FCPS – 1 | MAY 2023 PAPERS

40. High frequency is detected by which part of the ear in 47. Uncinate process present in (ENT 23 May 2023 (M) +3 past) -
central nervous system: (ENT 23 May 2023 (M) +4 past) - ID: ID: 34639
27348
Ⓐ Frontal bone Ⓑ Palate
Ⓐ Base of Basilar membrane near Oval window. Ⓒ Ethmoid Ⓓ Sphenoid
Ⓑ Tympanic membrane Ⓒ Sulcus
Ⓓ Semicircular canals Ⓒ The uncinate process can be attached to either the lateral nasal wall,
on the lamina papyracea (50%), anterior cranial fossa, on ethmoidal
Ⓐ High-frequency sound waves cause maximum vibration area of ☛ roof (25%), or the middle concha (25%)
basilar membrane nearest to base of cochlea
48. The first step in formation of platelets plug is? (Anesth 23
41. Which of the following translocation is seen in May 2023 (M) +5 past) - ID: 34756
Burkitt’s Lymphoma? (Med 23 May 2023 (A.N) +16 past) - ID:
Ⓐ The shape changes from round to flat with release of enzyme
33882

Ⓐ T (8:14) Ⓑ T (8:21) Ⓑ The shape changes from flat to round with release of enzyme
Ⓒ T (9: 22) Ⓓ T (11:14)
Ⓔ T (X:18)
Ⓒ Fibrin collection
Ⓐ Burkitt Lymphoma ☛ cells have translocation between Ⓓ The shape changes with no release of enzyme
chromosomes 8 and 14 ➜ overexpression of MYC gene on chromosome
8 by juxtaposition with immunoglobulin heavy chain gene regulatory Ⓐ Primary platelet plug ☛ ➜ Disruption endothelium ➜ Expose
elements on chromosome 14. subendothelial collagen ➜ VWF ➜ Adhesion ➜ Activation ➜ Shape
✦ Robbins, Pg. 202 change ( Round to flate ) ➜ Degranulate ➜ release enzymes ➜
Aggregation ➜ PPP
42. Structure behind Ovarian Fossa (Med 23 May 2023 (A.N) +22 ✦ Robbins, Pg. 101
past) - ID: 34292
49. Afferent of Sneeze reflex in nasal cavity is by (ENT 23
Ⓐ Internal Illiac Artery Ⓑ Ureter May 2023 (M) +6 past) - ID: 34818
Ⓒ External iliac artery Ⓓ Obturator
Ⓐ Trigeminal Ⓑ Olfactory
Ⓑ B＞A Ⓒ Vagus Ⓓ Facial
Already Explained in Previous paper
✦ GRAY'S, Pg. 1106 Ⓐ Trigeminal ＞ Olfactory
Irritation of nasal mucosa ➜ Olfactory and Ethmoidal ➜ Afferent ➜
43. 55 year old Diabetic woman complaining of bloating sneezing center in medulla ➜ N.Ambigous ➜ Somatic motor nerves ➜
and indigestion especially after meals. DOC for Pharyngeal , Laryngeal and Respiratory muscles
gastroparesis to increase her tone of lower esophageal ✦ N.I.H USA, Pg.
Sphincter and increase gastric motility for emptying ? (Med
25 May 2023 (A.N) +68 past) - ID: 34344 50. Chrionic villus sampling done at which week? (Eye 23
May 2023 (M) +6 past) - ID: 34830
Ⓐ H2 receptor blocker Ⓑ Antacids
Ⓒ Prokinetic (Metoclopramide) Ⓓ Cisapride Ⓐ 11 week Ⓑ 15 week
Ⓒ 19 week Ⓓ 20 week
ⒸAlready Explained in Previous paper
✦ Katzung, Pg. 1097, 1115 Ⓐ CVS ☛ between 10 and 13wks
Amniocentesis ☛ 15wks onwards
44. Cerebral blood flow is increased by ? (ENT 23 May 2023 (M) ✦ Oxford OBG Handbook, Pg. 130
+1 past) - ID: 34371
51. A Patient has enlaged parotid gland with pain in this
Ⓐ Exercise Ⓑ Sleep region. Which nerve is carrying pain fibers from the
Ⓒ Mental stress parotid gland? (CPSP Demo +19 past) - ID: 34994

Ⓐ Exercise ➜ ↑ CO2 ↓ O2 ➜ Cerebral vasodilation ➜ ↑ Blood flow Ⓐ Anterior auricular Ⓑ Post auricular
✦ Guyton, Pg. 787 Ⓒ Facial nerve Ⓓ Auriculotemporal
Ⓔ Greater auricular nerve
45. Why ATT given in combination ? (ENT 23 May 2023 (M) +26
past) - ID: 34412
Ⓔ Greater auricular nervesupplies ☛ fascia superficial and deep
Ⓐ To avoid drug resistance to parotid gland carries pain
Ⓑ To avoid side effects of higher doses of drugs if given alone Pain caused by ☛ stretching of Capsule when acute enlargement of
gland occurs such as Mumps or any other reason
✦ GRAY'S, Pg. 505

Ⓐ ATT ☛ Rifampin, usually 600 mg/d (10 mg/kg/d) orally, must be 52. Which of the following is a component of acquired
given with isoniazid or other antiTB drugs ➜ prevent emergence of drug immunity? (Anesth 23 May 2023 (M) +4 past) - ID: 35211
resistant mycobacteria
✦ Katzung, Pg. 845 Ⓐ Complement cascade Ⓑ Antibody
Ⓒ Increase CRP Ⓓ NK cells
46. A connective tissue layer that covers a complete
muscle (Inter Muscular layer) (ENT 23 May 2023 (M) +3 past) - Ⓑ Adaptive immunity ☛ T cells, B cells, circulating antibodies
ID: 34414 ✦ First Aid, Pg. 99

Ⓐ Epimysium Ⓑ Endomysium 53. Swelling of lip, mucosal tags, oral ulceration,

Ⓒ Perimysium cobblestone appearance, perianal disease and granuloma
with few multinucleated giant cells are features of which
Ⓐ ✪ Epimysium ☛ connective tissue that surrounds Entire muscle ( disease? (ENT 23 May 2023 (M) +2 past) - ID: 35605
Inter-Muscular )
✪ Perimysium ☛ surrounds each bundle of muscle fibers (fasiculus) Ⓐ Crohn's disease Ⓑ Coeliac disease
✪ Endomysium ☛ ENDO means within - areolar connective tissue that Ⓒ Gardners syndrome Ⓓ Peutz-Jagher's syndrome
ensheaths each individual muscle fiber Ⓔ Ulcerative colitis
Click toview GRAY's Reference in MediCall App
✦ GRAY'S, Pg. Ⓐ Crohn's disease :
➊ Oral Menifestations : Lip swelling , cheilitis , ulcers

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 764

 Medi Call FCPS – 1 | MAY 2023 PAPERS

➋ Involes Terminal Ileum and Colon Ⓑ ANSWER

➋ Skip Lesions ➌ Transmural Inflammation
➍ Deep Fissures ➎ Fibrosis and Stricture 61. About clavulanic acid used with amoxicillin? (ENT 23 May
2023 (M) +1 past) - ID: 36748
➏ Fistulae ➐ Perianal Lesions (75%)
➑ Non-caseating giant cell granulomas Ⓐ To increase the microbial spectrum
Ⓑ To reduce microbial resistance to drugs
54. A 45 years old Patient presents with Conductive
Ⓒ To inhibit beta lactam resistant microbes
hearing loss, faciei pain In the temporoparietal region and
the lower Jaw area, and an Immobile soft palate on right
Ⓐ ANSWER
side. The most probable diagnosis is (ENT 23 May 2023 (M) +1
past) - ID: 36238 62. Aldosterone acts directly at (ENT 23 May 2023 (M) +2 past) -
ID: 37029
Ⓐ Coston Syndrome Ⓑ Trotters' syndrome
Ⓒ Sluder's syndrome Ⓓ Wallenberg syndrome Ⓐ Na/ CHO channels in kidney Ⓑ Na/ K channels in the
kidney
Ⓑ Trotter's syndrome ☛ clinical triad of unilateral deafness, neuralgia Ⓒ Na/ H channels in kidney Ⓓ Na/ HC03 channels in kidney
affecting branches of trigeminal nerve and defective mobility of soft
palate ➜ caused by malignant tumors involving lateral pharyngeal Ⓑ Aldosterone secretion from adrenal gland ➜ Act on principle cells in
recess ( Rosenmüller's fossa ). CCT ➜ Activate Na+/k+ ATPase at basolateral side ➜ K+ Secretion
✦ Guyton, Pg. 363
55. A 12 years boy presented in OPD with posterior
cervical lymph node enlargement. Now patient can not 63. Rotation of head to the side is the function of ? (ENT 23
extend her right hand above his head to comb hair. During May 2023 (M) +2 past) - ID: 37079
biopsy from posterior triangle of neck which nerve is most
Ⓐ Circular canal Ⓑ Left circular canal
likely to be injured? (Surg 24 May 2023 (M) +30 past) - ID: 36289
Ⓒ Right semicircular canal Ⓓ Saccule
Ⓐ Spinal part of accessory nerve
Ⓑ Long thoracic nerve Ⓒ Phrenic Nerve Ⓐ Semicircular canals ☛ detect rotational acceleration of the head.
Ⓓ Cranial part of accessory nerve
64. Most superficial structure in the parotid gland? (Radio 23
May 2023 (A.N) +5 past) - ID: 37874
Ⓐ Spinal accessory nerve frequently encountered during neck
surgery resulting in Shoulder syndrome ➤ inability to shrug shoulders Ⓐ Facial Nerve Ⓑ Retro mandibular Vein
or raise arm above head (e.g., for brushing hair), particularly due to Ⓒ External Carotid Artery Ⓓ Lymph Nodes
compromised trapezius muscle innervation.
✦ SNELL, Pg. 589 ✦ N.I.H USA, Pg. Ⓐ In Parotid gland ☛ termination of facial nerve and begining of its
terminal branches are most superficial structures.
56. First line of defense and the most immediate response
✦ The nerve enters posterior border of parotid gland after leaving
in bleeding by? (Eye 23 May 2023 (M) +4 past) - ID: 36355
stylomastoid foramen.
Ⓐ Blood vessels constriction Ⓑ Coagulation system
65. A premature baby is born with decreased surfactant.
Ⓒ Platelets Ⓓ WBCs
What would be the result when comparing to normal
neonate (ENT 23 May 2023 (M) +1 past) - ID: 38422
Ⓐ ANSWER
Ⓐ Decrease surface tension and inc compliance
57. Alcohol used by the mother during 1st trimester of
Ⓑ Increase surface tension and dec compliance
pregnancy may cause (Med 23 May 2023 (A.N) +13 past) - ID:
Ⓒ Increase surface tension and inc compliance
36363

Ⓐ Anancephaly Ⓑ Premature birth Ⓑ ANSWER

Ⓒ Microcephaly Ⓓ Spina bifida
66. A patient was really afraid of dental extraction. When
Ⓑ Alcohol use, especially in the first 3 months of pregnancy, increases he sat in the dentist's chair, his heart beat increased. What
the risk of miscarriage, Premature birth other reaction is most likely to occur in Extreme
✦ NHS.uk, Pg. sympathetic stimulation ? (Anesth 23 May 2023 (M) +44 past) -
ID: 55469
58. Related to the hilum of lung posteriorly (Anesth 23 May
2023 (M) +14 past) - ID: 36386 Ⓐ Decreased heart rate Ⓑ Decreased blood pressure
Ⓒ Decreased sweating Ⓓ Bronchodilation
Ⓐ Aorta Ⓑ Phrenic nerve
Ⓒ Vagus nerve Ⓓ Azygous Ⓓ β Adrenergic Sympathetic Stimulation
➜ Airway smooth muscle Relaxation ➜ Bronchodilation.
Ⓒ Vagus nerve ☛ Behind the root of lungs ✦ Ganong, Pg. 260 ✦ Guyton, Pg. 779
✦ SNELL, Pg. 99
67. Chlorpromazine most toxic effect? (Anesth 23 May 2023 (M)
59. A boy was talking in classroom teacher got irritated +8 past) - ID: 59144
and asked him to lower the pitch of voice. Which of the
muscle is used for this function? (Med 23 May 2023 (A.N) +8 Ⓐ Hallucinations Ⓑ Dystonia
past) - ID: 36390 Ⓒ Anxiety Ⓓ Seizure

Ⓐ Cricothyroid Ⓑ Thyroarytenoid Ⓓ Chlorpromazine ☛ Corneal deposits , Dystonia But most serious

Ⓒ Vocalis Ⓓ Posterior cricoarytenoid effect is seizure
Ⓔ Lateral cricoarytenoid ✦ Katzung, Pg. 522

Ⓑ Thyroarytenoid ☛ tilts the thyroid cartilage posteriorly and relax 68. Which of the following is the mostcommon mutation in
vocal cord ➜ Lower pitch of voice Ewing's sarcoma (Surg 24 May 2023 (M) +11 past) - ID: 65159
✦ Reference, Pg.
Ⓐ Translocation X : 18 Ⓑ Translocation 11 , 22
60. Biopsy of stomach non specialised mucosa with Ⓒ Activative mutation of G5a,p, surface protein
scattered goblet cells (Anesth 23 May 2023 (M) +10 past) - ID: Ⓓ Missense mutation in EXTI
36496
Ⓑ Ewing's Sarcoma ☛ malignant, distinctive small round cell sarcoma
Ⓐ Dysplasia Ⓑ Metaplasia ➜ associated with t(11:22) translocation ➜ most commonly occurs in
Ⓒ Atrophy Ⓓ Hyperplasia the diaphysis of long bones.

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 765

 Medi Call FCPS – 1 | MAY 2023 PAPERS

69. Regarding preferential thorough fare channel correct Ⓐ All of actin and a little of myosin
statement is (Med 23 May 2023 (A.N) +9 past) - ID: 72157 Ⓑ All of myosin and no actin Ⓒ All actin and no myosin

Ⓐ Small caliber Ⓑ Having smooth muscles Ⓐ A band is a part of sarcomere, functional unit of muscle fibers ➜ It
Ⓒ Open on demand contains entire length of a single thick filament (myosin) and includes
Ⓓ Present at origin of precapillary sphincter overlapping portions of thin filaments (actin).
Ⓔ Increase capillary valve
76. Pt has a grayish-white membrane on the tonsils. MOA
Ⓑ Thoroughfare channels ☛ Smooth muscle ＞ Have precapillary of diphtheria toxin: (Anesth 23 May 2023 (M) +2 past) - ID: 84281
sphincter ＞ open on demand
✦ Ganong, Pg. 568, 569 ✦ GRAY'S, Pg. 131
Ⓐ Inhibition of DNA synthesis Ⓑ Inhibition of RNA synthesis
Ⓒ Inhibition of protein synthesis
70. Ear pinna, helix and tragus develops from (Med 25 May Ⓓ Inhibition of lysosomes
2023 (M) +7 past) - ID: 79461
Ⓒ MOA of diphtheria toxin ☛ Attachment to target cell ➜ Entry into
Ⓐ 1 and 2 branchial arch Ⓑ 2 and 3 branchial arch
cell via endocytosis ➜ Reduction in endosome leading to release of A
Ⓒ 1 branchial cleft Ⓓ 2 branchial cleft
fragment into cytosol ➜ A fragment (the active portion of toxin)
Ⓔ 4 branchial arch
inactivates Elongation Factor 2 (EF-2) ➜ Inhibition of protein synthesis
➜ Cell death.
Ⓐ External ear ☛ develops from first two pharyngeal arches, which
begin forming six hillocks of His in the five weeks of development. The 77. Endolymph, compared to perilymph has more: (ENT 23
first three hillocks originate from the first pharyngeal arch and fuse May 2023 (M) +1 past) - ID: 84324
together to form the tragus, helix, and cymba conchae.
Ⓐ K+ Ⓑ HCO3-
71. Pt has multiple opacities in lung found on general Ⓒ Na+ Ⓓ Ca+2
health checkup. 15 cm mass fixed compact granuloma
without necrosis, neutrophils surrounded by epithelioid Ⓐ Endolymph compared to perilymph, is known for having a higher
giant cells: (Med 23 May 2023 (A.N) +6 past) - ID: 82966 concentration of potassium ions (K+).
Sodium is predominant in most bodily fluids, But potassium is actually
Ⓐ Tb Ⓑ Sarcoidosis more concentrated in endolymph.
Ⓒ Mesothelioma Ⓓ Aspergillosis
78. Which is true about cochlea: (ENT 23 May 2023 (M)) - ID:
Ⓑ Sarcoidosis ☛ Non caseating Granuloma ➜ Epithelioid cells rimmed 84325
by an outer zone rich in CD4+ T cells
Ⓐ Transverse section of cochlea is circular
✔ Microscopic features of Granuloma ☛ ➊ Schaumann bodies ➋
Ⓑ Scala media and scala tympani are separated by tectorial
Ateroid Bodies
membrane
✦ Robbins, Pg. 513
Ⓒ It has endolymph
72. Baby with erythroblastosis fetalis died. What will be Ⓓ Floor is made by stria vascularis
seen on autopsy? (Med 25 May 2023 (A.N) +4 past) - ID: 83026
Ⓒ Cochlea, ☛ a part of inner ear, contains endolymph.Scala media
Ⓐ Basal ganglia staining due to bile and scala tympani are actually separated by basilar membrane, not
Ⓑ Pulmonary hemorrhage Ⓒ Renal calcification tectorial membrane.
Ⓓ Hepatic necrosis
79. Pt presents with increased breathing in the absence of
Ⓐ Erythroblastosis fetalis ☛ Rh incompatibility between mother and any metabolic acid-base disorder. What will increase as a
fetus ➜ hemolysis of fetal RBCs ➜ resulting in high levels unconjugated compensatory response: (ENT 23 May 2023 (M)) - ID: 84326
bilirubin ➜ brain and basal ganglia affected ➜ yellow staining of basal
ganglia due to bilirubin ➜ kernicterus Ⓐ HCO3- Ⓑ Renin
Ⓒ Ca+2
73. Hospital nurse consults a microbiologist about
fumigation. It should be done when (Med 23 May 2023 (A.N) +5 Ⓐ Hyperventilation ➜ More CO2 expelled ➜ Decrease in blood CO2
past) - ID: 83462 conc. ➜ Respiratory alkalosis ➜ Compensatory increase in renal HCO3-
excretion to maintain balance.
Ⓐ In wards where a patient of plague was admitted
Ⓑ 5 confirmed cases of dengue 80. Palatine tonsil is covered by: (ENT 23 May 2023 (M)) - ID:
Ⓒ Cardiac surgery O.T where increased incidents of post Op 84327
infections reported.
Ⓐ Stratified squamous non-cornified
Ⓓ 4 cases of measles were in the room
Ⓑ Stratified squamous cornified
Ⓐ Fumigation ☛ typically done when there is risk of highly infectious Ⓒ Stratified columnar Ⓓ Simple columnar
diseases, like plague to disinfect the area and prevent further spread of
the disease.
Ⓐ Palatine tonsils ☛ in oropharynx ➜ covered by stratified
squamous non-cornified epithelium ➜ for interaction with antigens
74. A professor was talking about tumor suppressor genes without damage by desiccation.
that involve in cancer of long bones due to mutation in
81. Which antibody has potent effect: (ENT 23 May 2023 (M)) -
single or both alleles. He gives an example of bringing
ID: 84328
their child being affected by a disease with rest of children
being normal. The gene involved is: (Med 23 May 2023 (A.N) +3 Ⓐ IgA Ⓑ IgG1
past) - ID: 83959 Ⓒ IgG2 Ⓓ IgG3
Ⓔ IgG4
Ⓐ KRAK Ⓑ Myc
Ⓒ RB 1 Ⓓ WT1
Ⓑ IgG1 ☛ most abundant subtype of IgG in blood and has a wide
Ⓔ M8H
range of defense functions, including neutralization of toxins,
organisms, complement activation, and opsonization.
Ⓒ RB1 gene, ☛ a tumor suppressor gene, common for only one allele
to be affected (loss of heterozygosity) ➜ when mutated, can lead to 82. A gymnast pushes his chest above the bar. What
osteosarcoma. function of larynx is involved? (ENT 23 May 2023 (M)) - ID:
84329
75. A band consists of (Med 23 May 2023 (A.N) +4 past) - ID:
84264

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 766

Medi Call FCPS – 1 | May 2023 Papers
 Medi Call FCPS – 1 | MAY 2023 PAPERS

Ⓐ Fixation of thoracic wall Ⓑ Adduction of vocal cords glossopharyngeal nerve actually supplies stylopharyngeus ➜ this
Ⓒ Increase pressure Ⓓ Phonation proximity and related function may lead to confusion

Ⓒ Pushing chest above bar ➜ requires increased intra-abdominal 90. Larynx is made of both hyaline and elastic cartilage. A
and intrathoracic pressure ➜ larynx is involved in increasing this structure that has both types: (ENT 23 May 2023 (M)) - ID: 84338
pressure. Ⓐ Epiglottis Ⓑ Thyroid cartilage
83. What is true about inverse stretch reflex: (ENT 23 May Ⓒ Arytenoids Ⓓ Cuneiforms
2023 (M) +1 past) - ID: 84330
Ⓐ Epiglottis ☛ has both types of cartilage ➜ it to be flexible (elastic
Ⓐ Muscle spindle cells Ⓑ Regulate tension in muscle cartilage) yet maintain structure (hyaline cartilage).
Ⓒ Doesn't let muscles stretch beyond a limit other structures of larynx, like the thyroid cartilage and cricoid
Ⓓ Is monosynaptic cartilage, are primarily made of hyaline cartilage

Ⓒ Muscle stretches ➜ Inverse stretch reflex activated ( Golgi tendon 91. A diver has hearing loss: (ENT 23 May 2023 (M)) - ID: 84339
reflex) ➜ Contraction of muscle fibers decreases ➜ Prevents muscle
Ⓐ Hemotympanum due to negative middle ear pressure
from stretching beyond a safe limit.
Ⓑ Displacement of ossicles
84. Blood supply of middle ear is mostly by: (ENT 23 May 2023 Ⓒ Rupture of tympanic membrane (TM)
(M)) - ID: 84331
Ⓒ Diver descends or ascends too quickly ➜ rapid change in pressure
Ⓐ Maxillary artery Ⓑ Auricular artery can lead to barotrauma ➜ tympanic membrane (eardrum) rupture ➜
Ⓒ Facial artery Ⓓ Occipital artery lead to hearing loss

Ⓐ Middle ear Blood supply is primarily derived from maxillary 92. Post ethmoidal sinus has intimate relation with: (ENT 23
division of external carotid artery, which is complemented by branches May 2023 (M)) - ID: 84341
of the internal carotid artery.
Ⓐ Trigeminal nerve Ⓑ Ophthalmic artery
Deep auricular branch of the maxillary artery supplies lateral surface
Ⓒ Hypoglossal nerve
of the tympanic membrane

85. Main arterial supply of palatine tonsil I through: (ENT 23 Ⓑ Post ethmoidal sinus ☛ located within ethmoid bone in skull ➜
May 2023 (M)) - ID: 84332 found between orbit and upper nasal cavity ➜ in close proximity to
ophthalmic artery ➜ which travels near this region as it enters orbit
Ⓐ Facial artery Ⓑ Lingual artery through optic canal
Ⓒ Maxillary artery Ⓓ Ascending palatine artery

Ⓓ Ascending palatine artery is a branch of facial artery ➜ moves

upward between pharynx and styloglossus muscle ➜ sends several

Eye 23 May 2023

branches to palatine tonsil, which is located in pharynx, being the main
arterial supply.

86. The structure most superficial in submandibular gland:

(M)
(ENT 23 May 2023 (M)) - ID: 84333

Ⓐ Retromandibular vein Ⓑ Lingual artery

Ⓐ submandibular gland is a salivary gland situated beneath floor of 1. Patient with myasthenia gravis on neostigmine and
mouth ➜ retromandibular vein runs superficially, making it most atropine was doing well but now the response is
superficial structure to submandibular gland. decreasing. Edrophonium is given and symptoms
improved. What will you do (Eye 23 May 2023 (M) +9 past) - ID:
87. A patient had heat intolerance and exophthalmos. 23
What is mainly the cause? (ENT 23 May 2023 (M)) - ID: 84334
Ⓐ Withdraw neostigmine Ⓑ Increase neostigmine
Ⓐ TRH Ⓑ TSH Ⓒ Withdraw atropine Ⓓ Increase atropine
Ⓒ TSI Ⓓ Cortisol
Ⓑ Myasthenia ☛ complement activity increases and decreases with
Ⓒ TSI ☛ often present in Graves' disease ➜ overproduction of thyroid inc or dec in no of synaptic receptor ➜ ↑ neostigmine dose when
hormones ➜ inflammation and swelling in tissues around eyes causing patient is getting weak.
exophthalmos, eyes bulge out. Edrophoinum ☛ short acting ➜ used for diagnosis
TSH ☛ in Graves' disease, typically low due to a feedback, whereas
2. Among Following which one is most obvious sign of
TSI, mimicking TSH, keeps stimulating thyroid
malignancy (Eye 23 May 2023 (M) +1 past) - ID: 82
88. Pt had a mass in lung tissue. He had increased serum
Ⓐ Loss of differentiation
Na level and decreased urine osmolality. It is due to
Ⓑ Increased nuclear- cytoplasmic ratio
increased: (ENT 23 May 2023 (M)) - ID: 84335
Ⓒ Metastasis Ⓓ Decrease telomerase activity
Ⓐ Cortisol Ⓑ ADH
Ⓒ ACTH Ⓓ Thyroid hormones Ⓒ Cancer ☛ can also spread regionally, to nearby lymph nodes,
tissues, or organs ➜ can spread to distant parts of body ➜ it is called
Ⓑ ADH ☛ responsible for retaining water in body ➜ Increased ADH metastatic cancer.
can lead to SIADH ➜ decreased urine osmolality
3. The patient came in ER with chest pain ECG normal
SIADH can be caused by lung ca ➜ pseudo-hyponatremia.
cardiac enzymes normal doctor advised thoracic cage X.
89. Nerve that arises from nerve to mylohyoid supplies: RAY. Which one of these structures is a primary
(ENT 23 May 2023 (M)) - ID: 84337 cartilaginous Amphiarthrosis joint? (Med 23 May 2023 (A.N) +14
past) - ID: 894
Ⓐ Styloglossus Ⓑ Stylopharyngeus
Ⓒ Levator palatini Ⓓ Tensor palatini Ⓐ Costochondral Ⓑ Teeth and jaw
Ⓒ Inferior tibiofibular joint Ⓓ Sutures of skull
Ⓑ Inferior alveolar nerve (branch of trigeminal nerve) ➜ gives off a Ⓔ Sutures of skull
branch before entering mandibular canal ➜ this branch is nerve to
mylohyoid ➜ this nerve is close to glossopharyngeal nerve (CN IX) ➜

View References & Discuss MCQs in MediCall App | www.MediCall.pk/app 767