FCPS Surgery 24 May 2023 (M)

Medi Call FCPS – 1 | MAY 2023 PAPERS
Ⓒ PCT kidney ☛ reabsorbs majority of glucose from filtrate by

Ⓐ Anterior tibial artery Ⓑ Dorsalis pedis
sodium-glucose cotransporters.
Ⓒ Peroneal artery Ⓓ Popliteal artery
Creatinine filtered in glomerulus but Not reabsorbed by PCT.
Ⓔ Posterior tibial artery
158. A patient develops abdominal pain, and guarding
after fever, after few day now he is severely constipated Ⓐ Anterior tibial syndrome ☛ compartment syndrome with
and abdomen is tender and distended what is the likely excessive pressure within muscles of anterior compartment of lower leg
cause: (Med 25 May 2023 (A.N) +2 past) - ID: 84051 ➜ affects nerves and anterior tibial artery (supplies blood to this
compartment) can be compromised ➜ leading to tissue ischemia and
Ⓐ Malaria Ⓑ Obstruction pain.
Ⓒ Typhoid with intestinal perforation
Ⓓ Liver CA 164. Level of education that has showed improved female
reproductive health? (Surg 25 May 2023 (M) +2 past) - ID: 84377
Ⓒ Typhoid fever ➜ Complication cause intestinal perforation ➜
Ⓐ Primary health Ⓑ Higher secondary school
Abdominal tenderness and guarding after fever
Ⓒ Lower secondary school Ⓓ Doctoral education
Obstruction ☛ can cause abdominal pain, But No fever unless a sec.
Ⓔ Post graduation
infection or ischemia.
159. Medial Surface of frontal and parietal lobe supplied Ⓑ Higher education level ➜ Enhanced knowledge and awareness
by: (Surg 24 May 2023 (A.N) +3 past) - ID: 84122 about reproductive health ➜ Better utilization of healthcare resources
➜ Improved female reproductive health.Primary level of education
Ⓐ PCA Ⓑ MCA does not provide comprehensive knowledge on reproductive health.
Ⓒ ACA Ⓓ Internal carotid artery
Ⓒ Cortical branches of Anterior cerebral artery,

✪ Orbital branches ☛ Olfactory cortex, gyrus rectus and medial orbital
gyrus.
✪ Frontal branches ☛ Corpus callosum, cingulate gyrus, medial
frontal gyrus and paracentral lobule.
✪ Parietal branches ☛ precuneus and frontal and parietal branches
both send twigs over superomedial border of hemisphere to supply
a strip of territory on superolateral surface
Surg 24 May 2023
(M)
☢ Cortical branches of anterior cerebral artery supply areas of motor
and somatosensory cortices that represent lower limb.
✦ Gray's Neuroanatomy, Pg. 93
160. Which structure passes through the left side of the

groove of the mediastinum? (Surg 24 May 2023 (A.N) +3 past) - 1. A patient presents with a slow-growing, painless mass
ID: 84123 at the junction of the soft and hard palates, infront of right
ear with pinching/picking sensation .O/E and
Ⓐ Ascending Aorta Ⓑ Esophagus
Ⓒ Trachea Ⓓ Azygous vein investigation she was found to have tumor of right parotid
gland. What is the most common Unilateral benign
Ⓑ Mediastinum ☛ space between two pleural sacs, contains all carcinoma of parotid? (Surg 24 May 2023 (M) +7 past) - ID: 230
structures within thoracic cavity except lungs. The esophagus is a Ⓐ Pleomorphic adenoma Ⓑ Monomorphic
muscular tube that carries food and liquids from the throat to the adenoma
stomach for digestion. Ⓒ Oncocytoma
Esophagus ☛ passes through left side of groove of mediastinum. Ⓓ Papillary cystadenoma lymphomatosum
Ascending aorta ☛ situated within middle mediastinum, then turns
into aortic arch rather than continuing through left side. Ⓐ Pleomorphic adenoma ☛ ◉ Most Common Salivary Tumor ◉
161. FSH is inhibited by which of the following organ / Benign ◉ Slow growing ◉ Painless ◉ Mobile single nodular mass ◉
Gland? (Surg 24 May 2023 (A.N) +1 past) - ID: 84125 may become Malignant
All other ☛ Benign and slow but much Less common
Ⓐ Seminal Vesicle Ⓑ Testes ✦ Robbins, Pg. 899 ✦ Robbins, Pg. 589
Ⓒ Ductus deference Ⓓ Ovaries
2. Which of the following show complete Ventricular
depolarization (systole) in cardiac phase (Surg 24 May 2023
Ⓑ Testes ☛ stimulated by FSH ➜ spermatogenesis + production of
(M) +24 past) - ID: 1806
Inhibin ➜ negative feedback to pituitary ➜ inhibit FSH
Ovaries ☛ stimulated by FSH ➜ growth of ovarian follicles. No Ⓐ QRS complex Ⓑ PR segment
Inhibition of FSH Ⓒ PR interval Ⓓ ST Segment
162. A patient diagnosed with kwashiorkor cause of fatty Ⓓ QRS is begining of ventricular depolarization ➜ contraction occurs
liver is? (Surg 24 May 2023 (A.N) +1 past) - ID: 84180 after QRS ➜ depolarization ends at begining of T wave ( repolarization
Ⓐ Recurrent hepatitis wave ) ➜ completion of Systole
✦ Guyton, Pg. 114, 132
Ⓑ High protein and low carbohydrate diet
Ⓒ Fulminant hepatitis A Ⓓ Aflatoxin in diet 3. A 60 years old businessman is evaluated by doctor.His
Ⓔ Antioxidants in diet blood pressure was 185/130mmHg.Lab tests reveal
increase in plasma renin activity, plasma aldosterone level
Ⓓ Kwashiorkor ☛ severe form of malnutrition due to lack of protein and left renal vein renin level is high and his right renal
➜ leads to hypoalbuminemia ➜ decreased synthesis of lipoproteins ➜ vein renin level is decreased.Most likely diagnosis is (Surg
liver accumulates fat due to poor transport ➜ leading to fatty liver. 24 May 2023 (M) +11 past) - ID: 1816
Aflatoxin, Mycotoxin in foods, a potent hepatotoxin and carcinogen ➜
can lead to fatty liver, cirrhosis and HCC Ⓐ Pheochromocytoma Ⓑ Left renal artery
stenosis
163. Anterior tibial syndrome (a form of shin splints) is Ⓒ Right renal artery stenosis Ⓓ Aldosterone secreting tumor
due primarily to compression of the arterial supply by
swelling of the muscles within this myofascial Ⓑ Renal artery stenosis is the narrowing of one of the renal arteries,
compartment. The affected vessel is: (Surg 24 May 2023 (A.N) most often caused by atherosclerosis or fibromuscular dysplasia. This
+1 past) - ID: 84218 narrowing of the renal artery can impede blood flow to the target
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kidney, resulting in renovascular hypertension – a secondary type of eyelids),

high blood pressure. ◉ Flat nasal root (portion between eyes) and small nose
◉ Low-set ears, and a small mouth
4. Gastroduodenal artery is the branch of (Surg 24 May 2023 ◉ Tongue is not completely visible, but it was large (macroglossia).
(M) +9 past) - ID: 3161
◉ Short stature of child ◉ Hand shows a palmar (simian) crease ◉
Ⓐ Hepatic artery Ⓑ Splenic artery Wide space between first and second toe,◉ Short fifth finger
Ⓒ Gastric artery Ⓓ Left gastric artery ✦ Goljan, Pg. 163
10. ODC shifts to Left and Oxygen delivery to tissues is

Ⓐ Common hepatic artery Branches ➜ ● cystic artery ● right gastric decreased by (Surg 24 May 2023 (A.N) +30 past) - ID: 4946
artery ● gastroduodenal artery ● right hepatic artery ● left hepatic
artery Ⓐ Cyanide poisoning Ⓑ CO poisoning
✦ Snell Review, Pg. 58 Ⓒ Person inhaling 100% oxygen at mount Everest
Ⓓ At sea level
5. What is true about child birth? (Surg 24 May 2023 (M) +20
past) - ID: 3516
Ⓑ CO Poisoning ➜ Binding of CO at 1 out of 4 sites on Hb ( 200 Times
Ⓐ Negative feedback mechanism Ⓑ Positive feedback more affinity than O2 ) ➜ increases the oxygen affinity of the remaining
Ⓒ Independent of feed back mechanism 3 sites ➜ hemoglobin molecule retain oxygen ➜ Curve shifts to Left (
Ⓓ Passive process haLdane effect )➜ Low O2 Supply to tissues
✦ BRS Physiology, Pg. 244
Ⓑ Stretching of the cervix ➜ contraction of uterus ➜ more
11. A 30 yrs male during a robbery got a Stab wound on
stretching of cervix ➜ ↑ oxytocin secretion by pituitary ➜ intensifies
Neck in the area of post triangle. Spinal accessory nerve
and speeds up contractions ➜ more oxytocin released and cycle goes
damaged and Trapezius muscle paralyzed. Which function
on until baby is born ( Positive Feedback ).
✦ Guyton, Pg. 1065
loss u expect? (Surg 24 May 2023 (M) +3 past) - ID: 5237
6. The ascent of horse shoe shaped kidney Is prevented by Ⓐ Elevating lateral side of scapula
which of the following (CPSP Demo +16 past) - ID: 3938 Ⓑ Moving head opposite direction
Ⓒ Elevating of med side of scapula
Ⓐ External iliac artery Ⓑ Internal iliac artery Ⓓ No functional Loss
Ⓒ Superior mesenteric artery Ⓓ Inferior mesenteric
artery Ⓐ Spinal accessory nerve ☛ When damaged in post triangle,
Trapezius muscle paralyzed.
Ⓓ Horseshoe kidney ● Inferior poles of both kidneys fuse Expected function loss ☛
abnormally ● hooks under origin of inferior mesenteric artery which in elevating arm above the head, having abducted it to a right angle by
prevents its ascend ● Kidneys function normally using the deltoid muscle. ( Snell )
✦ Kaplan Anatomy, Pg. 152 ✦ First Aid, Pg. 579
12. Thrombus formation triad is (Surg 24 May 2023 (M) +5 past)
7. Fetal Hb has which characteristics (Surg 24 May 2023 (M) +6 - ID: 5636
past) - ID: 4045
Ⓐ Blood stasis, endothelial damage, hypercoagubility
Ⓐ 2 Alpha and 2 gamma chains Ⓑ 2 Alpha and 2 beta Ⓑ Endothelial damage, high blood flow, fibrin
chains Ⓒ Endothelial damage ,haemoorhage and slow blood flo
Ⓒ 2 Beta and 2 gamma chains Ⓓ 2 Beta and 2 delta Ⓓ None of above
chains
Ⓐ BLOOD STASIS :abnormalities of haemorheology and turbulence at
Ⓐ ✪ Fetal ( HbF ) ☛ 2 Alpha+ 2 Gamma chains. vessel bifurcations and stenotic regions.
✪ Adult ( HbA1 ) ☛ 2 Alpha + 2 Beta chains. ENDOTHELIAL DAMAGE : abnormalities in the endothelium, such as
✪ Adult ( HbA2 ) ☛ 2 Alpha + 2 delta chains. atherosclerosis and associated vascular inflammation.
✪ Sickle ( HbS ) ☛ 2 Alpha + Reduced Beta chains ( mutant HbA ). HYPERCOAGUBILITY : abnormalities in coagulation and fibrinolytic
✦ First Aid, Pg. 404, 422 pathways and in platelet function associated with an increased risk of
8. In RH incompatibility which immunoglobulin agglutinins VTE and other cardiovascular diseases (including CAD and heart failure,
are present in blood against ABO antigens ? (Surg 24 May 2023 and stroke in patients with AF
(M) +9 past) - ID: 4046
13. If perineal body is injured, which muscle will be
Ⓐ Predominantly IgM Ⓑ Predominantly IgG damaged (Surg 24 May 2023 (M) +10 past) - ID: 5725
Ⓒ Also called hemolysins
Ⓐ Bulbospongiosis and superficial perineal muscles
Ⓓ Don’t cross placenta during 1st trimester
Ⓑ Superficial and deep perineal muscles
Ⓒ External anal sphincter and deep perineal muscles
Ⓑ Agglutinins ☛ antibodies that cause coagulation
Ⓓ Ischiocavernosus and sphincter urethrae
✪ Anti-D agglutinins ☛ predominantly IgG.
✪ Anti-A and Anti-B agglutinins ☛ predominantly IgM
✦ First Aid, Pg. 405
Ⓐ Bulbospongiosus and superficial perineal muscles are Inserted in
perineal body
9. Baby with small chin, flat nasal bridge, a single crease
of the palm along with mental retardation, hypotonia, 14. During esophagectomy stomach is mobilized to upper
hypermobility, protruded tongue, umbilical hernia and portion of thorax to anastomose with pharynx. Following
upward slant of lateral epicanthus. Brushfield spots are artery is mobilized for stomach supply: (Surg 24 May 2023 (M)
+4 past) - ID: 6248
also seen in the iris. baby is found Hyperthyroid. Most
likely trisomy of which chromosome (Surg 24 May 2023 (M) +58 Ⓐ Left gastric Ⓑ Right gastric
past) - ID: 4829 Ⓒ Right gastro epiploic Ⓓ Left gastroepiploic
Ⓐ Trisomy 21 Ⓑ Trisomy 22 Ⓔ Short gastric vessels
Ⓒ Trisomy 13 Ⓓ Fragile X syndrome
Ⓒ Mobilisation of the stomach ☛ tension-free, well-vascularised
Ⓐ ✪ Down syndrome ☛ stomach for transposition.
◉ Karyotype of male with trisomy 21 as seen in Down syndrome. Less Important ☛ Left gastric, short gastric and left gastroepiploic
◉ Face shows a mongoloid slant of palpebral fissures (separation arteries are all divided.
between upper and lower lids), Most Important ☛ viability of transposed stomach mainly depends on
◉ Prominent upward slanting of epicanthal folds (skin folds of upper Right gastroepiploic ＞ right gastric vessels.
✦ Bailey and Love, Pg. 1033 ✦ SNELL, Pg. 172

22. An old man playing with his grandson in garden

15. A pathologist wants to pass dye to the liver for experienced pain in his right big toe. He ate quite alot in
diagnostic purposes. In which of the following structure recent Eid-UI-adha. He is febrile with redness in the toe.
should he inject it: (Surg 24 May 2023 (M) +6 past) - ID: 6272 His C- reactive protein is positive, culture negative and
Ⓐ Ligamentum hepaticum Ⓑ Ligamentum teres negative birefringence crystal are present in synovial fluid.
Ⓒ Ligamentum ateriosum Ⓓ Hepatoduodenal Most likely diagnosis is (Surg 24 May 2023 (A.N) +5 past) - ID:
9407
ligament
Ⓐ Septic Arthritis Ⓑ Acute Gout
Ⓑ Falciform ligament ➜ ● Liver to anterior abdominal wall ● Ⓒ Chronic gout Ⓓ Pseudogout
Derivative of ventral mesentery
it contains➜ Ligamentum teres hepatis (derivative of fetal umbilical Ⓑ Animal proteins are high in purines ➜ lead to ↑ levels of uric acid
vein) ● patent paraumbilical veins ➜ Gout attacks ➜ in elderly patients are associated with fever and ↑
✦ First Aid, Pg. 261 ↑ ESR and CRP levels, often resembling a septic arthritis.
16. Patient is undergoing Surgical procedure. which Stress ▶ Synovial fluid Urate crystals ➜ ㊉ birefringent ➜ appear as needle
Hormone will be released and cause Vasoconstriction? shaped crystals ➜ specific for Gout
(Surg 24 May 2023 (M) +5 past) - ID: 8314 ✦ First Aid, Pg. 467
Ⓐ Adrenaline Ⓑ Acetylcholine 23. A 60 yrs Diabetic female had discharging sinus in jaw
Ⓒ Insulin Ⓓ Cortisol and yellow granules. Histology shows Granuloma .Most
likely causative organism will which of the following? (Surg
Ⓐ 3 Stress Hormones ☛ Cortisol, Adrenaline, Norepinephrine ➜ work 24 May 2023 (M) +9 past) - ID: 10204
for SNS. Ⓐ Tuberculosis Ⓑ Pseudomonas
➊ Adrenaline ☛ ↑ HR, BP and cause Vasoconstriction. Ⓒ Nocardia Ⓓ Actinomyces
➋ Cortisol ☛ primary stress hormone ➜ ↑ glucose for brain and body
usage and ↑ contractile responses to norepinephrine Ⓓ Discharging sinus in jaw and yellow (sulphur) granules ➜
✦ Guyton
Actinomyces
17. Supportive cells of pituitary glands: (Surg 24 May 2023 (M) ✦ Harsh Mohan, Pg. 163
+2 past) - ID: 8359
24. Thermoreceptors (Med 25 May 2023 (M) +10 past) - ID: 10375
Ⓐ Chromophobes Ⓑ Glial cells
Ⓐ Are on dendritic endings of A delta and C fibers
Ⓒ Pituicytes Ⓓ Astrocytes
Ⓑ Are subtype of nociceptors
Ⓔ Chromaffin
Ⓒ Located in superficial layer of skin
Ⓓ Large receptive field
Ⓒ Pituicytes ☛ Glial cells of posterior pituitary. Supporting role.
Ⓔ Are on dendritic endings of A delta and C fibers + subtype of
18. Ketogenic aminoacids are (Surg 24 May 2023 (M) +4 past) - nociceptors + Located in superficial layer of skin + Large
ID: 8886 receptive field
Ⓐ Lysine and leucine Ⓑ Proline and lysine Ⓔ Thermoreceptors ☛ Are free nerve endings (Nociceptors) on
Ⓒ Threonine and cystine Ⓓ Thiamine and threonine unmyelinated C fibers or lightly myelinated Aδ fibers in superficial and
deep skin having large surface area
Ⓐ Ketogenic amino acids are those amino acids that can be degraded ✦ Ganong, Pg. 174
directly into acetylcoa which is the precursor of ketone bodies
25. A Patient present with painless testicular swelling and
19. Most drugs advised to be taken after meals (Surg 24 May diagnosed as tumor, Testicular carcinoma drains into
2023 (M) +3 past) - ID: 8915 which of following group of lymph nodes? (Surg 24 May 2023
(M) +10 past) - ID: 10765
Ⓐ To increase its bioavailability
Ⓑ Reduce gastric upset Ⓒ Good compliance Ⓐ Superficial inguinal Ⓑ Deep inguinal
Ⓓ Good bioavailability Ⓒ Gastro omentum Ⓓ Retroperitoneal
Ⓑ They are mostly advised to be taken after meals to reduce its Ⓓ Cancer of the testis ➜ metastasizes initially to retroperitoneal
harmful effects on stomach lumbar lymph nodes. Subsequent spread may be to mediastinal and
supraclavicular nodes.
20. Cardiac output Increases more in (Surg 24 May 2023 (M) +6
✦ KLM, Pg. 215
past) - ID: 9172
26. After a road traffic accident the patient got his fibular
Ⓐ Exercise Ⓑ Pregnancy
neck fractured , presented with foot drop and now unable
Ⓒ Sleep Ⓓ None of above
to dorsiflex and evert foot. Damage occurred to (Surg 25 May
2023 (M) +76 past) - ID: 11044
Ⓐ ✪ During exercise, body may need three or four times of normal
cardiac output, because the muscles need more oxygen on exertion. Ⓐ Superficial peroneal nerve Ⓑ Deep peroneal nerve
Therefore, heart beats both faster and stronger to increase cardiac Ⓒ Common peroneal nerve Ⓓ Sural nerve
output during exercise.
✦ Ganong, Pg. 514 Ⓒ Common (fibular) peroneal (L4-S2 ) ➜ crosses lateral aspect
of knee at neck of fibula ➜ most frequently damaged nerve of lower
21. Most important initial step in apoptosis is which of the
limb by Trauma or compression of lateral aspect of leg, fibular neck
following (Surg 24 May 2023 (M) +34 past) - ID: 9287
fracture
Ⓐ Activation of bcl-2 Ⓑ Activation of caspases if Common Peroneal injured ➜ eversion and dorsiflexion lost
Ⓒ Suppression of p53 gene simultaneously ➜ foot dropped (steppage gait)
Ⓓ Receptor mediated phagocytosis ✦ First Aid, Pg. 453 ✦ Kaplan Anatomy, Pg. 221
27. Adductor muscles are supplied by which nerve? (Surg 24

Ⓑ ✪ Apoptosis ☛ mediated by Caspases which activate Proteases and May 2023 (M) +5 past) - ID: 11111
Endonucleases
✪ Caspases ☛ activated by multiple pathways i.e ◉ Intrinsic Ⓐ Saphenous nerve Ⓑ Obturator
Mitochondrial Pathway ◉ Extrinsic Receptor-Ligand Pathway ◉ Ⓒ Common paroneal Ⓓ Tibial nerve
Cytotoxic CD8+ T Cells-mediated Pathway
✦ Robbins, Pg. 38 Ⓑ ✪ Already Explained in Previous paper
✦ RJ Last, Pg. 202 ✦ SNELL, Pg. 223

28. Accessory cervical rib attaches to (Surg 24 May 2023 (M) +4 34. About CSF most appropriate statement is (Surg 24 May
past) - ID: 11157 2023 (M) +2 past) - ID: 14429
Ⓐ C7 Ⓑ T1 Ⓐ It is ultra-filtrate of Plasma
Ⓒ T2 Ⓓ C6 Ⓑ Has more glucose than blood Ⓒ Has cushion effect
Ⓓ Absorbed in Choroid Plexus
Ⓐ A cervical rib in humans is an extra rib which arises from the seventh
cervical vertebra Sometimes known as neck ribs Ⓒ Cerebrospinal fluid (CSF), clear, colorless liquid that fills and
surrounds the brain and the spinal cord and provides a mechanical
29. An 8 years old girl with distended abdomen was barrier against shock.
presented with H/o blood transfusions and her X Ray
shows Hair-on-end ( Crew Cut ) appearance of the skull. 35. 70 years old patient presented with left Sided
She is pale with MCV 51, MCH 17 and low Hb. Her brother Hemiplegia with Left Lower Face Paralysis,angle of mouth
died at age of 12. What is the investigation of choice to deviate to right and Left Homonymous Hemianopia.
confirm the diagnosis? (Surg 24 May 2023 (M) +21 past) - ID: Babinski sign is also positive. where is the lesion ? (Med 25
12359 May 2023 (M) +49 past) - ID: 15632
Ⓐ Ferritin Ⓑ Bone marrow biopsy Ⓐ Right Internal capsule Ⓑ Medulla

Ⓒ Hb electrophoresis Ⓓ Iron and TIBC Ⓒ Striate radiation Ⓓ Pons
Ⓔ Occipital cortex
Ⓒ ✪ ↓ MCV, MCH ➜ Microcytic Hypochromic Anemia.
✪ Hepatosplenomegaly ☛ due to extramedullary Ⓐ ✪ Same Sided Hemiplegia and Facial Weakness ☛ Uncrossed
hemotopoises ➜ favors diagnosis of thalassemia as compared to IDA. Hemiplegia ➜ Can only be Anywhere Above Brain Stem
✪ Crew Cut ☛ Hair on end appearance of skull ➜ characteristic feature ✪ Left Lower Face Paralysis ☛ UMN type ( Uncrossed is Always
of chronic haemolysis ➜ seen in thalassaemia and sickle cell anaemia . UMNL ) ➜ Upper Face/Forehead spared and Lower facial weakness (
✪ Hb electrophoresis ☛ diagnostic test ➜ uses principles of gel Because UMN for upper face project Bilaterally so it remains unaffected
electrophoresis to separate various types of hemoglobin. )
✪ β thalassemia ☛ ↓ HbA, ↑ HbA2 and ↑ HbF. ✪ Left Homonomous Hemianopia ☛ Lesion of Rt Optic Tract ➜ In
✦ Robbins, Pg. 450 ✦ Pathoma, Pg. 44, Forebrain ➜ Pass through Posterior limb of the internal capsule
✪ Babinski Positive ☛ UML ➜ can only be Above the Brainstem (
30. In which condition Baroreceptors respond Maximally
Above Midbrain , Pons , Medulla ) ➜ Anywhere in Forebrain ➜ Internal
by decreased firing frequency? (Surg 24 May 2023 (M) +18 past)
Capsule Most Likely ( If Internal Capsule option is not given then
- ID: 12816
choose Forebrain )
Ⓐ Rapidly Increasing BP Ⓑ Rapidly Decreasing BP ✦ Duane Neurosceince, Pg. 197, 234, 235, 235 ✦ Snell Neuro, Pg. 11
Ⓒ Cushing syndrome Ⓓ None of these ✦ Kaplan Neuro, Pg. 393 ✦ American Academy, Pg.
36. A child presented to OPD with 104 fever for the last 4
Ⓑ carotid sinus/aortic arch/atria/venae cavae ➜ Stretch-sensitive
days. He has been passing cola colored urine for last one
nerve endings ➜ Most sensitive for Decrease in BP
day. He has been on anti malarial medication. His LFTs are
Rapid Fall in BP ➜ Decreased firing frequency of baroreceptors ➜
deranged with increase unconjugated bilirubin. Most
Decreased signaling to brain stem (vasomotor center) ➜ Dec
probable diagnosis ? (Surg 24 May 2023 (M) +33 past) - ID: 15768
parasympathetic stimulation + Inc sympathetic innervation ➜
vasoconstriction ➜ Inc HR+ Inc SV + Inc BP Ⓐ Blackwater fever Ⓑ G6PD deficiency
✦ Guyton, Pg. 219, 219 Ⓒ Post-streptococcal glomerulonephritis
Ⓓ Rhabdomyolysis
31. A man during a roadside accident suffer injury to
cervical sympathetic chain. Most likely change in eye due
Ⓑ G6PD deficiency ☛ Intake of Certain Drugs / Infections / Food ➜
to Cervical sympathetic chain damage ? (Surg 24 May 2023
Formation of Reactive oxygen species ( ROS ) ➜ Oxidant damage
(A.N) +11 past) - ID: 12917
to Hemoglobin ➜ Formation of Small round inclusions within RBCs (
Ⓐ Sweating Ⓑ Decrease hearing Heinz Bodies ) ➜ Spleen ➜ Macrophages ➜ Damaged part of
Ⓒ Heart Failure Hemoglobin Removed ➜ Appear bitten ➜ Bite Cells ➜ Premature
Ⓓ Ipsilateral Pupillary constriction (Miosis) Hemolysis ➜ Anemia, Jaundice, Hematuria.
✦ Robbins, Pg. 450
Ⓓ Damage to the T1-T3 regions ➜ significant damage to the Superior
37. Reversible changes of shape size and polarity (Surg 24
Cervical Ganglion ➜ Oculosympathetic paresis ➜ Horner syndrome ➜
May 2023 (M) +25 past) - ID: 16272
Ipsilateral ✔ miosis ✔ anisocoria ✔ delayed pupil dilation ✔ ptosis ✔
anhidrosis ( Kaplan ) Ⓐ Metaplasia Ⓑ Hypoplasia
Ⓒ Dysplasia Ⓓ Hyperplasia
32. Which is the Best analgesia for a post operated
patient of asthma post-op? (Surg 24 May 2023 (M) +15 past) - ID: Ⓒ ◉ Metaplasia☛ Functional change in cell:
13026
◉ Dysplasia☛ Change in size,shape and orientation : , Both can be
Ⓐ Ketorolac Ⓑ Paracetamol reversible. Here ans is dysplasia
Ⓒ Naproxen Ⓓ Ibuprofen ✦ Goljan, Pg. 38 ✦ Robbins, Pg. 603
38. Nurse in ICU accidentally gave local anesthetic to

Ⓑ ✪ Paracetamol ☛ best analgesia in postop asthma.
patient in her CVP Which 10ml anesthetic is most lethal,
✪ NSAIDs ( ibuprofen, naproxen ketorolac ) ☛ cause bronchospasm.
cardio toxic/arrthymic? (Surg 24 May 2023 (M) +8 past) - ID:
19227
33. What can be the effect of a severe Increase in
extracellular potassium (Hyperkalemia) on heart? (Surg 24 Ⓐ Procaine Ⓑ Lignocaine
May 2023 (M) +7 past) - ID: 13797
Ⓒ Bupivacnlne Ⓓ Mevaacaine
Ⓐ Systolic cardiac arrest Ⓑ Tremors
Ⓒ Kussmaul breathing Ⓓ Diastolic cardiac arrest Ⓒ Bupivacaine ☛ depress cardiac conduction ➜ fast block of sodium
channels during action potential and slow recovery during diastole.
Ⓓ Hyperkalemia ☛ Membrane potential becomes less negative ➜ it is 39. Alveoli are supplied by ? (Surg 24 May 2023 (M) +17 past) -
easier to induce stimuli ➜ If Extreme hyperkalemia ➜ ventricular ID: 19520
fibrillation ➜ heart stops in Diastole (Asystole)
✪ Diastolic cardiac arrest ☛ Hyperkalemia/ Hypocalcemia Ⓐ Bronchial artery Ⓑ Alveolar ducts
✪ Systolic Arrest ☛ Hypokalemia / Hypercalcemia ( Guyton ) Ⓒ Coronary artery Ⓓ Pulmonary artery

Ⓓ Bronchi and the visceral pleura receive their blood supply from the Ⓒ Diaphragm is quiet muscle of respiration.Diaphragmatic breathing, or
bronchial arteries (branches of the descending aorta) deep breathing, is breathing that is done by contracting the diaphragm,
Alveoli receive deoxygenated blood from the terminal branches of the a muscle located horizontally between the thoracic cavity and
Pulmonary Arteries abdominal cavity. Air enters the lungs and the chest rises and the belly
expands during this type of breathing.
✦ SNELL, Pg. 73
47. A 32 years old male has a perforation in the posterior
40. Spleen involvement in Hodgkin lymphoma indicates ? stomach wall and the stomach contents have spilled into
(Surg 24 May 2023 (M) +2 past) - ID: 19700 lesser sac. The surgeon opened the gastro splenic
Ⓐ 1st stage Ⓑ 3rd stage ligament to reach lesser sac and note eroded artery, it is
Ⓒ 2nd stage Ⓓ 4th stage likely to cause bleeding by causing damage to the: (Surg 24
May 2023 (M) +5 past) - ID: 20906
Ⓑ Stage 3 ☛ Involve lymph nodes on both sides of diaphragm ( III ), Ⓐ Splenic artery Ⓑ Splenic vein
which may include spleen ( IIIS ), extralymphatic organ or site ( IIIE ), Ⓒ Left gastric artery Ⓓ Gastrodudenal artery
or both ( IIIES )
✦ Robbins, Pg. 477 Ⓐ Splenic artery ☛ passes behind the stomach ➜ Bleeds in Posterior
41. Noxious supply/ Pain receptors are ? (Surg 24 May 2023 Gastric Ulcer
(M) +10 past) - ID: 19745
48. Spore forming bacteria is ? (Surg 24 May 2023 (M) +23 past)
Ⓐ Pacinian corpuscles Ⓑ Free nerve endings - ID: 21194
Ⓒ Meissner"s corpuscles Ⓓ Merkle discs Ⓐ Clostridium botulinum Ⓑ Staph aureus
Ⓒ Pseudomonas Ⓓ N. meningitis
Ⓑ Free nerve endings ☛ Pain
Ⓐ Spore-forming bacteria ☛ B anthracis (anthrax), B cereus (food
42. The Blood supply of uterus is ? (Surg 24 May 2023 (M) +7 poisoning), C botulinum (botulism), C difficile (pseudomembranous
past) - ID: 20291 colitis), C perfringens (gas gangrene), C tetani (tetanus)
Ⓐ Ovarian + uterine artery Ⓑ Only uterine artery
Ⓒ Femoral artery Ⓓ External iliac 49. Cells in the adrenal medulla are innervated by? (Surg 24
May 2023 (M) +8 past) - ID: 21371
Ⓐ Arterial supply to the uterus ● Chiefly by two uterine arteries ● partly Ⓐ Preganglionic sympathetic nerves
by ovarian artery Ⓑ Post ganglion cells Ⓒ Parasympathetic
✦ BD Chaurasia, Pg. 389 ✦ SNELL, Pg. 287
Ⓓ None of above
43. Which of the following is acting on the anterior lobe of
the pituitary inhibitory to growth hormone? (Surg 24 May 2023 Ⓐ The adrenal medulla is considered a modified sympathetic ganglion.
(M) +26 past) - ID: 20434 Cells in the adrenal medulla are innervated by sympathetic
preganglionic neurons. . However they both bind to adrenergic
Ⓐ Somatostatin Ⓑ IGH receptors, and thus have similar physiological effects as sympathetic
Ⓒ GHRH neural stimulation
Ⓓ Prolactin inhibitory hormone.
50. Diffusion of gases is directly related to ? (Surg 24 May
Ⓐ ✪ GH secretion inhibited by ☛ ↑ blood glucose, ↑ blood free 2023 (M) +5 past) - ID: 21403
fatty acids , aging, obesity, growth hormone inhibitory hormone ,
Ⓐ Distance Ⓑ Covering
exogenous growth hormone, somatomedin.
Ⓒ Nature Ⓓ Surface area
✪ GH secretion stimulated by ☛ ↓ blood glucose, ↓ blood FFA, ↑
blood amino acids, fasting, starvation, protein deficiency, trauma,
Ⓓ The rate of diffusion is directly proportional to the available surface
stress, exercise, GHRH, estrogen, testosterone, deep sleep, ghrelin.
area
✦ Guyton, Pg. 945
51. Acute toxicity of warfarin is treated with which of the
44. A pregnant lady has mitral stenosis. To prevent atrial
following? (Surg 24 May 2023 (M) +45 past) - ID: 21521
fibrillaton which treatment should be given (Med 25 May 2023
(A.N) +21 past) - ID: 20602 Ⓐ PCV Ⓑ Vitamin K
Ⓐ Iv heparin Ⓑ Iv warafin Ⓒ Heparin Ⓓ FFP
Ⓒ Heparin and oral anticoagulant
Ⓓ Sc heparin Ⓓ FFP is effective at lowering the INR and was historically first-line
therapy for warfarin toxicity with serious or life-threatening bleeding
Ⓐ Heparin ☛ ↓ risk of thrombus and embolization. 52. The Receptors for IgE are located on ? (Surg 24 May 2023
(M) +21 past) - ID: 21981
45. Neurotransmitter for mood is ? (Surg 24 May 2023 (M) +5
past) - ID: 20713 Ⓐ Eosinophils Ⓑ Mast Cells
Ⓐ Serotonin Ⓑ Dopamine Ⓒ Basophils Ⓓ Basophils and Mast Cells
Ⓒ Acetylcholine Ⓓ Alanine
Ⓓ Crossling of Ag-Ab ➜ Fc portion binds to Mast cells and basophils ➜
Ⓐ ✪ Serotonin regulates Mood ☛ Low levels ➜ depression ➜ SSRIs Degranulation
✦ Levinson, Pg. 526
are First line of drugs in Depression.
✪ Dopamine regulates ☛ Emotions , mood and muscle movement 53. Patients with renal artery stenosis may present with
and plays a vital role in the brain's pleasure and reward systems. very high blood pressures due to increased renin
➊ Mood ➜ Serotonin ➋ Emotion + Mood ➜ Dopamine secretion. Which of the following structures in the kidney
➌ Mood + Anxiety ➜ Norepinephrine ( Guyton + American Academy) is responsible for sensing inadequate perfusion and
secreting renin? (Surg 24 May 2023 (M) +33 past) - ID: 21999
46. Which of the following is the muscle of the quiet
inspiration or deep inspiration ? (CPSP Demo +15 past) - ID: Ⓐ PCT Ⓑ JG cells
20789 Ⓒ DCT Ⓓ Collecting ducts
Ⓐ Internal intercostal Ⓑ Extetnal intercostal
Ⓒ Diaphragm Ⓓ Quadratus Lumborum

Ⓑ ✪ Renal Artery Stenosis ➜ ↓ Renal perfusion ➜ ↑ Renin release ✦ Robbins, Pg. 113
from the juxtaglomerular cells ➜ ↑ Na reabsorption (and water) + ↑
59. Which of the following is present in front of third part
BP ( Sec. Hypertension )
of duodenum? (Surg 24 May 2023 (M) +19 past) - ID: 22970
✦ Robbins, Pg. 550
Ⓐ SMA Ⓑ IMA
54. The hypersegmented neutrophils are seen due to
Ⓒ MMA Ⓓ Cystic artery
deficiency of which of the following ? (Surg 24 May 2023 (M) +5
past) - ID: 22134
Ⓐ Third Part of Duodenum ➜ Anteriorly ➜ ● Root of mesentery
Ⓐ Iron deficiency Ⓑ Folic acid/ vitamin Bl2 def of small intestine ● superior mesenteric vessels ● coils of jejunum
Ⓒ Ca deficiency Ⓓ B6 deficiency Posteriorly ➜ ● right ureter ● right psoas muscle ● inferior vena
cava ● aorta
Ⓑ Folate / vitamin Bl2 defeciency ➜ impairs synthesis of DNA Superiorly ➜ ● head of the pancreas
precursors ➜ Impaired division of granulocytic precursors Inferiorly ➜ ● Coils of jejunum
➜ hypersegmented neutrophils. ✦ SNELL, Pg. 176
✦ Pathoma, Pg. 45
60. A labourer due to excessive sweating has lost 2L water
55. Transfusion reaction within 10 minutes of whole blood developed severe dehydration due to excessive sweating
transfusion occurred leading to Heavy chest , Flank Pain, and replaced by 2 L pure water What will happen to body
Jaundice , Dyspnea and death on 3rd day This is due to ? fluids (Surg 24 May 2023 (M) +51 past) - ID: 22979
(CPSP Demo +15 past) - ID: 22327
Ⓐ Inc. ICF volume Ⓑ Dec. ICF volume
Ⓐ Type 1 HSR Ⓑ Delayed response Ⓒ Inc. ECF volume Ⓓ Dec. ECF osmolarity
Ⓒ Rh incompatibility Ⓓ ABO incompatibility
Ⓐ ↑ ICF volume ＞ ↓ ICF osmo ＞ ↑ ECF Volume
Ⓓ ✪ Acute Hemolytic Transfusion Reaction ☛ Type 2 HSR due to ✪ Sweating ➜ water loss more than electrolytes ➜ so ECF osmolarity
ABO incompatibility ➜ occur During Transfusion or within 24 hours of increases ➜ water moves out from ICF to ECF ➜ ICF osmolarity
the transfusion ➜ Dyspnea, Flank pain, Jaundice, Fever, hypotension Increases
and even death ✪ After drinking water ( Hypotonic ) ➜ Water Rush to ICF to
✦ Remember : Type 1 Anaphylaxis also occurs within 2,3 Hours of compensate ICF volume loss ➜ ICF volume increases ➜ Decrease in
Transfusion but symptoms are different ( Pruritis , Urticaria , Wheezing ICF osmolarity
, Resp Distress and shock ) ✦ Guyton, Pg. 311
61. 9 month old girl vaccinated 2 weeks back now
56. A 20 yo pop star singer complains of inability to raise develops rash over body fever. she had 1 episode of gum
the pitch of her voice. She attributes this to the Upper bleeding 3 months ago.CBC report reveal hb 13 wbc 6×10
thyroid surgery she underwent a few months back. Which and decreased platelet . peripheral smear shows large
of following nerve get damaged during Superior thyroid platelets. BT Is prolonged. PT and APTT are normal.
artery ligation? (Surg 24 May 2023 (M) +43 past) - ID: 22353 Diagnosis ? (Surg 24 May 2023 (M) +24 past) - ID: 23894
Ⓐ External Laryngeal Ⓑ Superior Laryngeal Ⓐ ITP Ⓑ TTP
Ⓒ Recurrent Laryngeal Ⓓ Internal Laryngeal Ⓒ Anemia Ⓓ Thalassemia
Ⓐ ➊ Lower lobe Thyroidectomy ☛ Unilateral RLN Damage Ⓐ ✪ ITP ☛ ↓ Platelets ➜ petechial haemorrhages, easy bruising, and
➋ Superior lobe Thyroidectomy ☛ Superior Thyroid Artery Ligation mucosal bleeding.
➜ External Laryngeal (Branch of Superior Laryngeal Nerve ) ➜ Damage ✪ MMR Vaccine ☛ reported to cause ITP in children.
➜ Loss of High Pitch sound ✦ Harsh Mohan, Pg. 311 ✦ Researchgate, Pg.
➌ Complete Thyroidectomy ☛ Bilateral RLN Damage ➜ Bilateral
vocal fold paralysis ➜ stridor and snoring sounds + severe dyspnea 62. Common variant of Basal cell carcinoma (BCC) ? (Med 25
May 2023 (M) +15 past) - ID: 24345
➍ Tracheostomy ☛ Extubation ➜ Bilateral RLN damage
➎ Overall Most common injured Nerve during Thyroidectomy ☛ Ⓐ Nodular Ⓑ Ulcerative
External Laryngeal Ⓒ Plaque Ⓓ Ulcerative Nodular
✦ SNELL, Pg. 659 ✦ KLM, Pg. 999
57. Adrenal Medulla is supplied by ? (Surg 24 May 2023 (M) +2 Ⓐ 2 Most Common pattrens of BCC seen
past) - ID: 22654 ➊ Multifocal growths originating from the epidermts (superficial
pattern).
Ⓐ Adrenergic fibers Ⓑ No Autonomic supply ➋ Nodular lesions growing downward into the dermis as cords and
Ⓒ Cholinergic fibers Ⓓ Ganglionic fibers islands of variably basophilic cells With hyperchromatic nuclei
embedded in a fibrotic or mucinous stromal matrix ( Robbins )
Ⓒ ✪ Thoracic spinal cord ➜ Preganglionic Sympathetic fibers ➜
Cholinergic stimulation ➜ Chromaffin cells of medulla ➜ secrete stored 63. Median nerve in upper arm: (Surg 24 May 2023 (A.N) +5
Catecholamines in response ( Rather than releasing a neurotransmitter past) - ID: 24461
)
Ⓐ Lateral epicondyle of humerus
➤ Adrenal Medulla ➜ Converts Tyrosine into Catecholamines (Mainly
Ⓑ Medial to Brachial Artery in cubital fossa
Epinephrine ) Ⓒ Gives rise to most of its braches in the upper arm
58. A pateint 40 weeks gestation in labor for last 25 hrs, Ⓓ Enters cubital fossa lateral to the brachial artery
presented with Acute Respiratory Distress syndrome
having dyspnea and tachypnea. she died due to? (Surg 24 Ⓑ Cubital fossa contains following structures, enumerated from medial
May 2023 (M) +40 past) - ID: 22666 to lateral side ➜ ● Median nerve ● Bifurcation of brachial artery
into ulnar and radial arteries ● Tendon of biceps muscle ● Radial nerve
Ⓐ Air embolism Ⓑ Amniotic embolism and its deep branch.
Ⓒ Obstructed labor Ⓓ Fat embolism ✦ SNELL, Pg. 377, 378
Ⓑ ✪ Labor and the Immediate postpartum period ➜ Tears in the 64. 39 year old lady complain of nausea and vomiting from
placental membranes and/or uterine vein rupture ➜ entry of amniotic last 5weeks, after endoscopic biopsy reveal plasma cell,
fluid into the maternal circulation ➜ Amniotic P.E ➜ Sudden severe macrophage and t lymphocytes (Surg 24 May 2023 (M) +2 past) -
ID: 28287
dyspnea, cyanosis, and hypotensive shock followed by seizures and
coma ➜ If survives the initial crisis, pulmonary edema typically Ⓐ H. Pylori
develops, along with DIC ➜ 80% Mortality

Ⓐ ✪ H.pylori ➜ Acute gastritis ➜ Nausea and abdominal discomfort, Ⓐ Carcinoid syndrome Ⓑ Topical sprue
with vomiting, burping and fever. Ⓒ Giardiasis Ⓓ Immunoproliferative disease
✪ Biopsy specimen Histology: Ⓔ Whipple disease
➤ Colonization ☛ Mucus layer of epithelial cells
➤ Inflammation ☛ Lamina propria ➜ Neutrophils (Cross basement Ⓔ Whipple disease ☛ Infection with Tropheryma whipplei
membrane ➜ Intraepithelial location ➜ Pit abscesses), Plasma cell (intracellular gram ⊕); PAS ⊕ foamy macrophages in intestinal lamina
(clusters or sheets), Macrophages, Lymphocytes. propria, mesenteric nodes.
➤ Lymphoid aggregates ☛ Mucosa-associated lymphoid tissue S/S ☛ Cardiac symptoms, Arthralgias, and Neurologic symptoms are
(MALT) ➜ Intestinal metaplasia (goblet cells and columnar common. Diarrhea/steatorrhea occur later in
absorptive cells) ➜ Lymphoma disease course. Most common in older men.
✦ Robbins, Pg. 600 ✦ Oxford Microbiology, Pg. 162
70. Long head of the bicep femoris is supplied by: (Surg 24
65. Meissner's corpuscles are for (Surg 24 May 2023 (M) +3 May 2023 (M) +4 past) - ID: 33888
past) - ID: 28980
Ⓐ Tibial part of sciatic nerve Ⓑ Popliteal nerve
Ⓐ Deep touch Ⓑ High frequency vibration Ⓒ Superior gluteal nerve Ⓓ Inferior gluteal nerve
Ⓒ Low frequency vibration
Ⓐ ✪ Long head of biceps femoris ☛ receives innervation from tibial
Ⓒ Pacinian corpuscles ( Higher -frequency vibration ) and division of sciatic nerve.
Meissner’s corpuscles ( lower- frequency signals ) ➜ DCML pathway. ✪ Short head of biceps femoris ☛ innervated by common fibular
✦ Guyton, Pg. 615 division.
66. Kaplan-Meier Curve indicates (Surg 24 May 2023 (M) +16 71. A patient with low level of thyroid hormones, TSH level
past) - ID: 33593 is also low but increases when TRH is administered to the
patient. The structure most likely damaged: (Surg 24 May 2023
Ⓐ Incidence of Disease Ⓑ Demography
(M) +5 past) - ID: 33987
Ⓒ Severity of Disease Ⓓ Survival
Ⓐ Thyroid gland Ⓑ Pituitary
Ⓓ The Kaplan-Meier estimator is used to estimate the survival Ⓒ Hypothalamus Ⓓ Adrenal gland
function.
Ⓒ Damage to hypothalamus ☛ ↓ TRH ➜ thyroid underactivity
67. Anti sera agglutinates with A and D and plasma has ➜ secondary or central hypothyroidism.
Anti B antibodies what’s blood group? (Surg 24 May 2023 (A.N)
+10 past) - ID: 33715 72. Ligand gated channel receptor (Surg 24 May 2023 (M) +2
past) - ID: 34308
Ⓐ A -ve Ⓑ A + Ve
Ⓒ O –ve Ⓓ B +Ve Ⓐ GABA A Ⓑ Ach
Ⓒ Dopamine b1 Ⓓ Dopamine b2
Ⓑ ✪ Blood Group A ☛ has Anti B antibodies and agglutinates with A
agglutinins. Ⓐ GABA-A receptors are GABA-gated anion channels responsible
✪ Rh +ve ☛ agglutinates with D agglutinins. (together with ligand-gated glycine receptors) for most fast inhibitory
✦ Guyton, Pg. 477,479, 477,479, 477,479 synaptic transmission in the vertebrate central nervous system
68. A baby after an obstructed delivery presented with 73. Cells present in Inter-alveolar septum? (Surg 24 May 2023
loss of whole abduction of arm, loss of flexion and loss of (M) +15 past) - ID: 34310
supination of arm at elbow joint, has got his left arm in
medial rotation, due to damage to: (Surg 24 May 2023 (M) +13 Ⓐ Clara cells Ⓑ Goblet cells
past) - ID: 33722 Ⓒ Alveolar cells Ⓓ Macrophages
Ⓐ Upper Trunk of Brachial Plexus (C5-C7) Ⓓ ✦ Large numbers of tissue macrophages are present as integral
Ⓑ Lower Trunk of Brachial Plexus components of alveolar walls.
Ⓒ Radial Nerve Ⓓ Ulnar Nerve ✦ They can phagocytize particles that become entrapped in alveoli
✦ Guyton, Pg. 459
Ⓐ Brachial Plexus Palsy Injuries
Upper Lesion ☛ Erb's Palsy 74. T cell responsible for which disease (Surg 24 May 2023 (M)
+3 past) - ID: 34352
Nerve Roots C5, C6, +/- C7 :
◉ Inability to abduct shoulder, externally rotate arm, and supinate Ⓐ Dm 1 Ⓑ Dm 2
forearm (Waiter's Hand) Ⓒ Vasculitis Ⓓ Pamphigus vulgaris
◉ Possible diaphragm paralysis
Lower Lesion ☛ Klumpke's Palsy Ⓐ Type 1 diabetes mellitus results from a T-cell mediated
Nerve Roots C8, T1 : autoimmune destruction of the pancreatic beta cells in genetically
◉ Inability to flex wrist or grasp (Claw hand ) predisposed individuals
◉ Possible Horner syndrome ✦ Robbins, Pg. 135
Arm Abduction
75. Structure immediately parallel and deep relation to
☛ 0° upto 15° by Supraspinatus ➜ Suprascapular ➜ Branch of upper
carotid sheath in the neck? (Surg 25 May 2023 (M) +10 past) - ID:
trunck
34365
☛ 15°upto 100° by Deltoid ➜ Axillary ➜ branch of posterior cord
☛ ＞ 90° by Trapezius➜ Accessory Ⓐ Internal jugular vein Ⓑ Sympathetic trunk
☛ ＞ 100° by Serratus Anterior ➜ Long Thoracic (SALT) ➜ Root C5, Ⓒ Trachea Ⓓ Vagus
C6, C7
✦ Kaplan Anatomy, Pg. Ⓑ ✪ Structure embedded with in carotid sheath ➜ ● Common Carotid
artery ● Internal carotid artery ● Internal jugular vein ● Vagus
69. A 12 years old boy presented with diarrhea not
nerve ● Deep cervical lymph nodes
responding to routine anti diarrheal treatment. Jejunal
✪ Cervical sympathetic Chain ➜ Lies directly behind internal and
biopsy showed partial villous atrophy with mansy PAS
common carotid arteries (i.e., medial to the vagus) and is embedded in
positive macrophages. Most likely diagnosis is: (Surg 24 May
deep fascia between carotid sheath and prevertebral layer of deep
2023 (M) +4 past) - ID: 33803
fascia
✦ SNELL, Pg. 619

Medi Call FCPS – 1 | May 2023 Papers
76. P53 mechanism of apoptosis (Surg 24 May 2023 (M) +9 past) through the inferior cerebellar peduncle of same side .
- ID: 34511 ✦ They are known as the posterlor external arcuate flber,
✦ Snell Neuro, Pg. 150
Ⓐ Cell shrinkage + DNA fragmentation
Ⓑ Muscle memberane rupture Ⓒ Cell memberane 83. Largest Molecular weight protein: (Surg 24 May 2023 (M) +3
rupture past) - ID: 35012
Ⓐ Globulin Ⓑ Titin
Ⓐ Cell shrinkage ☛ loss of cell volume ➜ characteristic of
Ⓒ Myosin Ⓓ Actin
programmed cell death ➜ observed in apoptosis.
77. Localized malignant tumor (Med 25 May 2023 (A.N) +24 past) Ⓑ ✪ Titin ☛ largest protein in the body, molecular mass of almost
- ID: 34640 3,000 kDa and a total length of almost 27,000 amino acids
✪ Globulins ☛ Heighviest globulins weighs around 1193 kDa.
Ⓐ Pleomorphic adenoma Ⓑ Hydatidiform Mole Click toview Reference in MediCall App
Ⓒ Ameloblastoma Ⓓ Melanoma ✦ N.I.H USA, Pg. ✦ Wikipedia, Pg.
Ⓒ Ameloblastoma ☛ is the most common benign but locally invasive 84. Nutmeg liver scenerio, alcoholic man with raised JVP
epithelial odontogenic tumour and hepatic congestion, likely cause is: (Surg 24 May 2023 (M)
✦ Harsh Mohan, Pg. 513 +11 past) - ID: 35036
78. A 4-year boy was attended in clinic and was observed Ⓐ Chronic Alcoholism Ⓑ RHF
to have a short neck, low hair line on the posterior aspect Ⓒ Passive Congestion Ⓓ Periportal congestion
of neck, and was known to be suffering from a heart
condition. X-ray neck showed fused cervical vertebrae and Ⓒ Answer
O/E limited movement of upper limb was noted. What is
85. A woman with dysphagia, on/off diarrhea, hoarseness
the most likely diagnosis? (Med 25 May 2023 (A.N) +16 past) - ID:
of voice and metastasis to cervical lymph nodes.
34718
Diagnosed as Medullary thyroid carcinoma. The tumor
Ⓐ Turner syndrome Ⓑ Klinefelter syndrome marker involved is? (Surg 24 May 2023 (M) +3 past) - ID: 35223
Ⓒ Klippel Feil syndrome Ⓓ Down syndrome
Ⓔ VACTERL syndrome Ⓐ CEA Ⓑ Calcitonin
Ⓒ HCG Ⓓ Thyroglobulin
Ⓒ Klippel-Feil syndrome ☛ is a rare bone disorder distinguished by Ⓔ AFP
the abnormal fusion of two or more bones in the neck. Children with the
disorder may have a short, webbed neck, decreased range of motion in Ⓑ MEN 2A ☛ ◉ Parathyroid hyperplasia ◉ Medullary thyroid
the head and neck area, and/or a low hairline at the back of the head.It carcinoma neoplasm of parafollicular C cells ➜ Dysphagia ➜ secretes
results in a limited ability to move the neck and shortness of the neck, calcitonin ➜ prophylactic thyroidectomy required ◉ Pheochromocytoma
(secretes catecholamines)➜ On/Off diarrhea
resulting in the appearance of a low hairline. ✦ First Aid, Pg. 351
✦ Wikipedia, Pg.
86. A 20-year-old sexually active woman with suprapubic
79. A 60 yrs male weighing 70kg has total body water of pain, frequency, urgency, and burning sensation. O/E no
42 liters, ICF = 28 liters, ECF = M liters, Plasma = 31iters ulcer were noted. Urine R/E shows numerous pus cells.
Interstitial fluid will be: (Surg 24 May 2023 (M) +16 past) - ID: Culture shows organism that is catalase positive, and
34836
coagulase-negative. organism. Which one of the following
Ⓐ3L Ⓑ6L sets of bacteria is most likely to cause this infection? (Surg
Ⓒ 11L Ⓓ 14 L 24 May 2023 (M) +13 past) - ID: 35299
Ⓐ Staphylococcus saprophyticus Ⓑ E.Coli

Ⓒ ✪ Total Fluid volume ☛ 60 % ➜ 42 liters Ⓒ Streptococcus pyogenes Ⓓ Klebsiella
✪ Intracellular ☛ 2/3rd ➜ 28 liters
✪ Extracellular ☛ 1/3rd ➜ 14 liters (Plasma 11L + Interstitial 3L) Ⓐ Staphylococcus saprophyticus ☛ Most common cause of UTI in
✦ Guyton, Pg. 306
sexually active young females and 2nd to E.Coli in community acquired
80. Head injury, Pterion damage, biconvex hemorrhage UTI ( Levinson BCQ)
caused Epidural hematoma, had blur vision and went ✦ Levinson, Pg. 115, 126
unconscious after injury, vessel ruptured is: (Med 25 May 87. Numbness of ear lobule while doing internal jugular
2023 (M) +8 past) - ID: 34849
lymph node biopsy .Which of following nerve is damaged?
Ⓐ Bridging vein Ⓑ MCA (Surg 24 May 2023 (M) +22 past) - ID: 35521
Ⓒ Anterior branch of MMA Ⓓ Superoor cerebral vein Ⓐ Posterior auricular Ⓑ Accessory

Ⓒ Vagus Ⓓ Greater Auricle
ⒸAlready Explained in Previous paper
✦ Snell Neuro, Pg. 22
Ⓓ IN cervical lyph nodes biopsy ☛ sternocleidomastoid muscle,
81. Portal of entry of Meningococcal meningitis: (Surg 24 May external jugular vein, and greater auricular nerve are important
2023 (M) +6 past) - ID: 34864 structures.
Greater auricular nerve emerges from lateral aspect of
Ⓐ Feco oral Ⓑ Respiratory droplets sternocleidomastoid at Erb’s point.Preservation to this nerve made
Ⓒ Airborn Ⓓ Blood possible to preserve sensation to ear lobule.
✦ N.I.H USA, Pg.
Ⓑ Meningococci ☛ Transmitted via respiratory and oral secretions
✦ First Aid, Pg. 142 88. True about vitamin D? (Surg 24 May 2023 (M) +11 past) - ID:
35740
82. Posterior external arcuate fibers are other name of
which of the following? (Surg 24 May 2023 (M) +14 past) - ID: Ⓐ 25 Hydroxylatlon In liver and 1,25 Hydroxylation in kidneys
34964
Ⓐ Posterior spinocerbeller Ⓑ Anterior spinocerbeller Ⓑ 25 Hydroxylatlon In Kidney and 1,25 Hydroxylatlon in Liver
Ⓒ Cunocerebller Ⓓ Ponto cerebellar
Ⓒ 25 hydroxylase in liver 1 alpha hydroxylase in kidney
Ⓒ Cuneocerebellar tract ☛ Ⓓ 1,25 Hydroxylatlon in Liver
✦ They originate in the nucleus cuneatus and enter the cerebellum

Ⓐ Vitamin D activation ☛ Liver ➜ vitamin D3 ➜ 25- Ⓒ Diaphragm + SCM + external oblique + Serratus anterior
hydroxycholecalciferol (calcidiol, 25-OHD3). The 25- muscle
hydroxycholecalciferol ➜ proximal tubules of kidneys to more active Ⓓ Abdominal muscles
metabolite ➜ 1,25 dihydroxycholecalciferol, which is also called
calcitriol or 1,25-(OH)2D3 Ⓐ ANSWER
✦ Ganong, Pg. 377 378
95. Pain of stone at pelviureteric junction arising from
89. A 3-year old, while playing outside got scared is not which segment? (Surg 24 May 2023 (M) +12 past) - ID: 36451
speaking. Mother notices the child has become cold and
has goosebumps all over and takes him to the hospital. Ⓐ T12 - L2 Ⓑ L1 - L4
The cause of Goosebumps is? (Med 25 May 2023 (M) +21 past) - Ⓒ T11 - L1 Ⓓ L4 - S1
ID: 35890
Ⓐ Kidney ☛ Pain is commonly referred along distribution of subcostal
Ⓐ Contraction of errector pili Ⓑ Relaxation of arrector pili nerve (T12) to flank and anterior abdominal wall.
Ⓒ Inc blood supply to the skin Ⓓ Dec blood supply to the skin ✦ SNELL, Pg. 210
Ⓐ Gooseflesh ☛ as a result of overactivity of sympathetic system, 96. Female Patient watching tv collapsed, Blunt trauma to
which causes vasoconstriction of dermal arterioles and contraction of posterior head and occipital lobe, resulting in fracture to
arrector pili muscles the base of the skull, B/L peripheral vision loss and
✦ SNELL, Pg. 6 weakness, artery damage (Surg 24 May 2023 (M) +15 past) - ID:
36560
90. A 12 years boy presented in OPD with posterior
cervical lymph node enlargement. Now patient can not Ⓐ Central retinal Ⓑ Posterior Cerebral Artery
extend her right hand above his head to comb hair. During Ⓒ Posterior communicating artery
biopsy from posterior triangle of neck which nerve is most Ⓓ Anterior cerebral artery
likely to be injured? (Surg 24 May 2023 (M) +30 past) - ID: 36289
Ⓑ PCA stroke:
Ⓐ Spinal part of accessory nerve ✪ Contralateral homonymous hemianopia macular sparing ( damage to
Ⓑ Long thoracic nerve Ⓒ Phrenic Nerve the calcarine cortex, macular sparing due to occipital pole receiving
Ⓓ Cranial part of accessory nerve collateral blood supply from MCA )
✪ Visual agnosla ( lschemia of left occipital lobe )
Ⓐ Spinal accessory nerve frequently encountered during neck ✪ Impairment of memory ( possible damage to medial aspect of
surgery resulting in Shoulder syndrome ➤ inability to shrug shoulders temporal Jobe )
or raise arm above head (e.g., for brushing hair), particularly due to ✦ Snell Neuro, Pg. 473 ✦ Gray's Neuroanatomy, Pg. 96 ✦ Kaplan
compromised trapezius muscle innervation. Neuro, Pg. 391
✦ SNELL, Pg. 589 ✦ N.I.H USA, Pg.
97. Rouleaux formation bone lytic lesions (Surg 24 May 2023
91. A lady accidentally cut her finger by knife in the (M) +2 past) - ID: 36600
kitchen she brought to hospital and wound is sutured Ⓐ Multiple myeloma Ⓑ Osteoprosis
doctor assured her that healing take place. Which of the
following layers will be regenrate/ healed first and Ⓐ Muliple myeloma ☛ CRAB ➜ HyperCalcemia , Renal involvement
foremost (Med 25 May 2023 (M) +11 past) - ID: 36404 ,Anemia(Roulex formation of RBC) ,Bone lyric lesion
✦ Pathoma, Pg. 63
Ⓐ Statum basale Ⓑ Stratum spongiosum
Ⓒ Stratum lucidum Ⓓ Stratum granulosum 98. Immunoglobulin involved in Rh incompatibility like
Erythroblastosis fetalis ? (Surg 24 May 2023 (M) +11 past) - ID:
Ⓐ Basal cells ☛ have a regenerative capacity (are stem cells) 36972
✦ Sceincedirect Elsevier, Pg.
Ⓐ IgM Ⓑ IgG
92. An office working lady had a feeling that her Ⓒ IgA Ⓓ IgE
colleagues had been searching her files and papers and
also her belongings. Recently she joined a group of Ⓑ ✪ IgG ☛ Rh incompatibility Ab (only Ig to cross placenta)
intellectuals and started smoking. What tests would you ✪ IgM ☛ ABO incompatibility Ab (predominantly)
order to do her psychiatric assessment? (Surg 24 May 2023 (M) ✦ Harrison, Pg. 810
+8 past) - ID: 36408
99. Helicopter pilot diagnosed with epilepsy He told he did
Ⓐ Thyroid Ⓑ Cortisol not inform higher authorities about his disease. You will
Ⓒ Urine screening Ⓓ Beta HCG (Surg 24 May 2023 (M) +3 past) - ID: 37130
Ⓒ Urine screening ☛ Done in psychiatric cases to R/O Drug absue Ⓐ Advise him to leave the job
and metabolic disorders Ⓑ Treat him and councel him to inform his authorities and if
✦ Davidson, Pg. 135 doesn't inform then u should
Ⓒ Inform his wife only Ⓓ Don't reveal it to anyone
93. Vessel containing maximum oxygenated blood (Surg 24
May 2023 (M) +12 past) - ID: 36446 Ⓑ Epileptic pt should Tell his manager, human resources
Ⓐ Umbilical vein Ⓑ Pulmonary artery representative, and workplace nurse about your condition. Let them
Ⓒ Umblical artery Ⓓ IVC know how they can help if you have a seizure.
✦ Reference, Pg.
Ⓐ Oxygenated blood returning from placenta through umbilical vein 100. A patient with Hb 9, after blood transfusion Hb raised
➜ ductus venosus, mainly bypassing the liver➜ most of blood to 10. Which test would you do to identify the cause of low
entering RA from IVC ➜ right atrium and through the foramen ovale HB (Surg 24 May 2023 (M) +2 past) - ID: 37445
directly into left atrium
✦ Guyton, Pg. 1074 Ⓐ Hb electrophoresis
94. Inspiration is vital process for oxygenation of tissues. Ⓐ ANSWER

Forceful inspiration occurs via active contraction of which
muscle (Surg 24 May 2023 (M) +15 past) - ID: 36449 101. To prevent peripheral neuropathy which vitamin is
given along with isoniazid to reduce side effects (Surg 24 May
Ⓐ Diaphragm + External intercostal+ SCM + Serratus anterior + 2023 (M) +3 past) - ID: 37678
Scalene muscle
Ⓑ Diaphragm + internal intercostal

Ⓐ Vitamin A Ⓑ Vit B6 (pyridoxine) right scrotum. What is the most likely diagnosis? (Surg 24
Ⓒ Vitamin C May 2023 (M)) - ID: 54638
Ⓐ Epidydimo-orchitis Ⓑ Obstructed hernia

Ⓑ Vitamin B6 (pyridoxine) supplementation during isoniazid (INH)
Ⓒ Strangulated hernia Ⓓ Torsion of testes
therapy is necessary to prevent peripheral neuropathy.
102. Clostridium botulinum lethal effect (Surg 24 May 2023 (M) Ⓒ Strangulated hernia ☛ Acute pain that comes on suddenly and
+18 past) - ID: 37692 may get more severe, Bloody stools,Constipation,Darkening or
reddening of the skin over the hernia,Fever,Inflammation or tenderness
Ⓐ Flaccid paralysis of respiratory muscles around the hernia,Increased heart rate,Vomiting
Ⓑ Fever Ⓒ Projectile vomiting
Ⓓ Circumoral paresthesia 108. A 37-year man presents in ER with pain, swelling, and
deformity of the right wrist. He had a history of fall on the
Ⓐ Botulism causes cranial nerve palsies and flaccid paralysis of ground with an outstretched hand. On X-ray distal
involuntary muscles and may result in respiratory failure fragment is displaced and angulated towards the dorsum
✦ Levinson, Pg. 139, 157, 158, 159 ✦ Robbins, Pg. 354, 617 and deviated towards the radial side of the wrist. What is
the most likely diagnosis? (Surg 24 May 2023 (M) +5 past) - ID:
103. A patient climbed a peak with a heavy bag on his
54692
shoulder after that he developed sensory loss of thumb
and hand, weakness of deltoid, loss of adduction of arm Ⓐ Colles' fracture Ⓑ Dorsal Barton fracture
with loss of flexion at elbow and loss of extension at wrist. Ⓒ Smith fracture Ⓓ Volar Barton fracture
Diagnosed as waiter's tip hand or Saturday night palsy.
Most likely damage occurs to which of the following? (Surg Ⓐ Colles Fracture ☛ complete fracture of radius bone of forearm
24 May 2023 (M) +2 past) - ID: 37756 close to wrist resulting in an upward (posterior) displacement of radius
and obvious deformity.
Ⓐ Upper brachial plexus damage Ⓑ Radial Nerve injury
Ⓒ Musculocutaneous nerve damage 109. A 50 year male presents with complaints of
Ⓓ Axillary Nerve injury increasing darkening of skin. On examination, he has
hepatomegaly and ankle edema. His blood report shows
Ⓐ Already Explained in Previous paper Hb 13 gm%, RBS 240 mg%, S. Iron 35 micromol/L
✦ Kaplan Anatomy, Pg. (raised), serum ferritin level ＞500 microgram/L. His ideal
104. A young man has a blood pressure of 160/110 treatment would include (Surg 24 May 2023 (M)) - ID: 54780
mmHg. His blood renin level is much higher than normal. Ⓐ Desferoxamine Ⓑ Diabetic control
The most likely stimulus for the increased renin level is Ⓒ Diuretics Ⓓ Low iron diet
(Surg 24 May 2023 (M) +1 past) - ID: 54487
Ⓐ Constriction of renal arteries Ⓐ ✪ Microcytic anemia ☛ caused by Iron deficiency or thalassemia.

Ⓑ Increased parasympathetic activity ✪ ↑ ↑ ferritin levels ➜ rules out IDA.
Ⓒ Increased sodium delivery to distal tubules ✪ Deferoxamine ☛ removes excess iron in thalassemia patients who
Ⓓ Hypertension have many blood transfusions.
✦ Harsh Mohan, Pg. 300
Ⓐ Renal artery constriction ➜ reduce renal perfusion pressure below 110. A 16-year-old male came with fever and painful
the range of autoregulation (approximately 70 mmHg) ➜ decrease GFR, swelling of the left mandibular region for 4 days. On
and sodium excretion ➜ increase Renin secretion for compensation ➜ examination, the parotid gland was enlarged and tender.
Inc BP Which of the following is the most likely diagnosis? (Surg 24
May 2023 (M) +1 past) - ID: 55064
105. During quiet inspiration, the anteroposterior and
transverse diameters of the thoracic cavity is increased by Ⓐ Bronchial cleft cyst Ⓑ Lymphoma
contraction of one of the following muscle (Surg 24 May 2023 Ⓒ Mumps Ⓓ Oral Cancer
(M) +31 past) - ID: 54510
Ⓐ Diaphragm Ⓑ External intercostal Ⓒ Mumps ( Paramyxovirus - RNA virus )

Ⓒ Pectoralis minor Ⓓ Serratus anterior ✪ Fever, Malaise and Anorexia, Bilateral swelling of Parotid gland.
✦ Davidson, Pg. 240
Ⓑ AP diameter ➜ mainly by pump-handle movements of sternum ➜ 111. A poor farmer went to the physician with complaints
contraction of external intercostal muscle ➜ elevation of second to of dry skin, dry eyes, and poor wound healing. He is
sixth ribs suspected to have vitamin A deficiency. Retinol deficiency
Transverse diameter ➜contraction of external intercostal ➜ bucket- leads to? (Surg 24 May 2023 (M) +8 past) - ID: 55086
handle movement 7th to 10th ribs
✦ SNELL, Pg. 49 ✦ BD Chaurasia, Pg. 212, 212 Ⓐ Conjunctival xerosis
Ⓑ Diffuse Pigmentation of the conjunctiva
106. A 25-year-old female consulted her physician about Ⓒ Keratomalacia Ⓓ Night blindness
the swelling in the anterior part of her neck. On
examination the swelling is just below the hyoid bone and Ⓓ ✪ Night blindness is earliest symptom of Vitamin A ( Retinol )
move with the protrusion of tongue. What is the most Defeciency
likely congenital anomaly in this case? (Surg 24 May 2023 (M) ✦ CMDT, Pg. 1285
+14 past) - ID: 54514
112. A 42 year old obese female presented with loss of
Ⓐ Brachial sinus Ⓑ Brachial fistula appetite, bradycardia, constipation, cold intolerance and
Ⓒ Thyroglossal cyst Ⓓ Thyroidal agenesis weight gain develop carpal tunnel syndrome and wear
Ⓔ Ectopic thyroid thick cloths. On further history and examination, she was
depressed with slow reflexes. The most appropriate
Ⓒ Thyroglossal cysts ☛ fluctuant swelling in neck midline caudal to investigation for her would be (Surg 24 May 2023 (M) +22 past) -
hyoid bone ➜ attached to thyroglossal tract which attaches to larynx by ID: 55090
peritracheal fascia ➜ moves upwards when patient protrudes tongue.
✦ KLM, Pg. 1041, 1041 Ⓐ Thyroid biopsy Ⓑ Thyroid Scan
Ⓒ Plasma Free T4 and TSH Ⓓ Thyroid ultrasound
107. An A65-year-old male comes to surgery OPD with
pain in the right inguinoscrotal region for 6 hours, along
with vomiting and constipation. On examination, he has
abdominal distension and a warm, tender swelling in the

Ⓒ ✪ Symptoms of Hypothyroidism ☛ Weight gain, Cold intolerance, Ⓐ Cervical ca Ⓑ Endometrial ca

Fatigue, Somnolence, Dry skin, Dry hair. Ⓒ Ovarian ca Ⓓ Breast ca
✪ Investigations ☛ ↓ T4 and ↑ ↑ TSH ➜ ＞20 mIU/L.
✦ Davidson, Pg. 637, 640 Ⓑ Endometrial thickening and in general 12 mm means hyperplasia
☛ may suggest endometrial Ca in this woman
113. A 59-year-old previously healthy woman present to
cardiac emergency with complaints of left-sided chest pain 119. Where do cervical lymph nodes drain? (Surg 24 May 2023
a few hours ago. She passed away within a few minutes of (A.N) +4 past) - ID: 58572
arrival. A section of left ventricle showed a deeply
Ⓐ Internal and external iliac lymph nodes
eosinophilic myocardium with loss of striations and nuclei
Ⓑ Superficial inguinal lymph nodes
and Collagen fibroblast necrotic tissue Which of the
Ⓒ Femoral canal
following pathological change is most likely to be noted?
Ⓓ Internal iliac lymph node only
(Surg 24 May 2023 (M) +2 past) - ID: 55091
Ⓐ Apoptosis Ⓑ Coagulative necrosis Ⓐ Cervix lympatic drainage ➜ ● Lateral ➜ External iliac nodes,
Ⓒ Fatty change Ⓓ Hypertrophy Obtorator nodes, Paracervical nodes ● Posterior ➜ Sacral nodes ●
Posterolateral ➜ Internal iliac nodes
Ⓑ Coagulative necrosis ☛ Cell death (typically caused by ischemia or ✦ Reference, Pg.
infarction) but No Proteolysis ➜ Cells become dry, hard, and white ➜
120. Collapsing pulse Is a known feature of. (Surg 24 May
Architecture preserved for at least couple of days (occur in All solid 2023 (M)) - ID: 59419
Organs except Brain)
✦ Robbins, Pg. 36 Ⓐ Aortic stenosis Ⓑ Aortic Regurgitation
Ⓒ Mitral stenosis Ⓓ Mitral regurgitation
114. A 40-year-old runner came to medical OPD with a
Ⓔ Polycythemia,
complaint of localized pain in her lower calf and cannot
perform planter flexion on her foot.having ecchymosis
Ⓑ Collapsing pulse can be thought of as a palpably widened pulse
near to calcaneum, he cannot stand on tip of toes. Which
pressure; in the context of aortic regurgitation or PDA it is often
structure is most likely involved in this patient? (Surg 24 May
possible to feel a markedly water hammer pulse on lifting the arm up
2023 (M)) - ID: 55103
121. 9 years old boy admitted for surgery complain of dry
Ⓐ Deltoid ligament Ⓑ Calcaneal tendon
mouth, examination shows white patches on mouth,
Ⓒ Tiblialis anterior Ⓓ Planter fascia
difficult to eat and swallow.Treatment of choice for oral
candidiasis is? (Surg 24 May 2023 (M) +2 past) - ID: 60834
Ⓑ Calcaneal tendon rupture ● reason is forceful push off (plantarflexion
with knee extended) followed immediately by sudden calf pain and Ⓐ Terbinafin Ⓑ Nystatin
sudden dorsiflexion of plantarflexed foot Ⓒ Griesofulvin Ⓓ Selenium sulphide
● patient cannot plantarflex against resistance (cannot raise heel
from ground or balance on affected side) Ⓑ ✪ Treatment of oral candidiasis
● Bruising appears in malleolar region ✪ Topical (ideal) nystatin suspension, clotrimazole troches, gention
✦ KLM, Pg. 607 violet, chlorhexidine, ketoocnazole, amphotericin gel.
115. After an automobile accident, a 28-year-old male was ✪ Systemic (reinfection, unresponsive and chronic cases): - oral
diagnosed as a case of splenic rupture, and the surgeon fluconazole, itraconazole or ketoconazole are needed.
planned for the emergency intervention. While performing 122. Anteversion of uterus is maintained by? (Surg 24 May
the procedure, the surgeon was keen to preserve the tail 2023 (M) +1 past) - ID: 63464
of the pancreas. This is most likely to be found in the: (Surg
24 May 2023 (M) +4 past) - ID: 55158 Ⓐ Cardinal ligament Ⓑ Uterosacral ligament
Ⓒ Pubocervical ligament Ⓓ Round ligament
Ⓐ Gastrocolic ligament Ⓑ Gastrosplenic ligament
Ⓒ Phrenicocolic ligament Ⓓ Splenorenal ligament Ⓓ Round ligament helps maintain tanteversion position of uterus
during pregnancy.
Ⓓ ✪ Tail of pancreas ☛ extends toward hilum of spleen and distal tail Cardinal ligaments support the uterus.
lies in splenorenal ligament. ✦ N.I.H USA, Pg.
✪ Neck ☛ between head and body of pancreas.
✦ First Aid, Pg. 361 123. Avascular necrosis (AVN) following transcervical neck
femur fractures occurs due to damage to which of the
116. In hypovolemic shock, the increased thirst is due to following blood vessels? (Med 25 May 2023 (A.N) +32 past) - ID:
stimulation of the hypothalamic thirst center by (Surg 24 May 63944
2023 (M) +5 past) - ID: 55357
Ⓐ Lateral retinacular branch of lateral circumflex femoral artery
Ⓐ Adrenaline Ⓑ Angiotensin II Ⓑ Lateral retinacular branch of medial circumflex femoral artery
Ⓒ Antidiuretic hormones Ⓓ Cortisol Ⓒ Medial retinacular branch of lateral circumflex femoral artery
Ⓓ Obdurator artery
Ⓑ Angiotensin ll
◉ Powerfully Constricts Only Arterioles (specially efferent) Ⓑ Neck of Femur Fx ☛ Medical Circumflex damaged ( primary blood
◉ Inhibit Renin due to Negative feedback supply of femur Head ) ➜ Head avascular necrosis.
◉ Powerful stimulus to Thirst and sodium appetite
✦ Guyton, Pg. 212 ✦ N.I.H USA, Pg.
✦ BD Chaurasia, Pg. 19
117. Cyclophosphamide side effects (Surg 24 May 2023 (M) +2
past) - ID: 55687 124. Which of the following is the mostcommon mutation
in Ewing's sarcoma (Surg 24 May 2023 (M) +11 past) - ID: 65159
Ⓐ Blindness Ⓑ Headache
Ⓒ Hematuria Ⓐ Translocation X : 18 Ⓑ Translocation 11 , 22
Ⓒ Activative mutation of G5a,p, surface protein
Ⓒ ANSWER Ⓓ Missense mutation in EXTI
118. A 36yo woman came with uterine bleeding. Vaginal Ⓑ Ewing's Sarcoma ☛ malignant, distinctive small round cell sarcoma
US reveals uterine thickness=12mm. what is the most ➜ associated with t(11:22) translocation ➜ most commonly occurs in
probable dx? (Surg 24 May 2023 (M) +1 past) - ID: 56940 the diaphysis of long bones.

125. First branch of abdominal aorta (Surg 24 May 2023 (M) +5 Ⓐ Sterilization by radiation is also used for sterilization of plastic
past) - ID: 68020 syringes, hypodermic needles, scalpels, surgical blades, adhesive
dressings and thermolabile medicaments.
Ⓐ Inferior phrenic Ⓑ Celiac trunk
Ⓒ Celiac plexus 132. A 23 year old man is Stabbed in a bar fight, the blade
of the knife enter his chest at 5th ICS, just lateral to
Ⓑ The first and often largest visceral branch of the abdominal aorta is sternum on left side, it was 4cm deep what structure is
the celiac trunk. The celiac trunk quickly bifurcates or trifurcates into most likely damage? (Surg 24 May 2023 (M) +8 past) - ID: 72372
branches.
Ⓐ Left lung hilum Ⓑ Pericardium
126. Lunate fractured, nerve damaged is (Surg 24 May 2023 Ⓒ Left pleura Ⓓ Left bronchus
(M) +1 past) - ID: 68023
Ⓐ Ulnar Ⓑ Median Ⓑ 4 cm deep wound at 5th ICS can involve Pericardium

133. Most radiosensitive tumor is which of following? (Surg
Ⓑ ANSWER 24 May 2023 (M) +16 past) - ID: 72399
127. The anatomical location of Stenson's duct is (Surg 24 Ⓐ Ependymoma Ⓑ Seminoma

May 2023 (M) +9 past) - ID: 72128
Ⓒ Glioma Ⓓ Craniopharyngioma
Ⓐ Buccal space Ⓔ Brainstem Glioma
Ⓑ Between massater and medial pterygoid
Ⓒ Inferior alveolar canal of mandible Ⓑ Radiosensitive tumor ☛ Lymphoma ＞ Seminoma ＞ Glial glioma
Ⓓ Lateral to Ramus of Mandible ＞ Craniopharyngioma
Ⓔ Between Superficial and Deep Parotid Gland ✦ Goljan, Pg. 653
134. Right bundle branch of conducting system of the

Ⓐ Parotid glands ☛ located in front and beneath the ear. heart is present in (Surg 24 May 2023 (A.N) +6 past) - ID: 72411
Stensen's duct ☛ drains saliva from parotid gland into rear of the
mouth cavity near second upper molar. Ⓐ Septomarginal trabeculae Ⓑ Chorda tendinea
Ⓒ Supraventricular crest Ⓓ Septal papillary muscles
128. Transitional epithelium characteristic is (Surg 24 May Ⓔ Chris ta terminalis
2023 (M) +11 past) - ID: 72162
Ⓐ Superficial cells Dome shape appearance Ⓐ Right bundle branch ☛ In the right ventricle, the moderator band
Ⓑ Flat Cells Ⓒ No change in cellular layer (septomarginal trabecula) contains the right bundle branch.
Ⓓ Keratinized covering ✦ Kaplan Anatomy, Pg. 92
135. A patient Presented with Chest pan radiating to left

Ⓐ Transitional epithelium ☛ type of tissue that changes shape in arm and diagnosed as MI, which type of shock will be
response to stretching (stretchable epithelium). Transitional epithelium found in this? (Surg 24 May 2023 (M) +5 past) - ID: 72436
usually appear cuboidal when relaxed and squamous when stretched.
✦ Wikipedia, Pg. Ⓐ Hypovolemic shock Ⓑ Septic shock
Ⓒ Anaphylactic shock Ⓓ Cardiogenic Shock
129. Patient presented with crushing chest pain for 3
hours O/E bp and pulse was normal but RR= 33/min
Ⓓ Acute MI ☛ MCC of cardiogenic shock ◉ Dec. stroke volume
Investigation of choice? (Surg 24 May 2023 (M) +12 past) - ID:
➜ Cardiogenic Shock ➜ systolic BP ＜ 90 mm Hg + urine output ＜ 20
72266
mL/hr
Ⓐ CK.MB Ⓑ Trop T ✦ Harsh Mohan, Pg. 436
Ⓒ Myoglobin Ⓓ LDH
136. Congenital megacolon and Chagas disease decrease
Ⓔ CPK
intestinal motality defect ? (Surg 24 May 2023 (M) +4 past) - ID:
72454
Ⓑ ◉ Within 1 hour ☛ Myoglobin
◉ After 2-4 hours ☛ Trop I ＞ Trop T ＞ CKMB Ⓐ Mucos Ⓑ Submucos
Trop-I is the most sensitive and Specific of all ! Ⓒ Serosa Ⓓ Muscularis externa
✦ Davidson, Pg. 497 ✦ Robbins, Pg. 417 ✦ Pathoma, Pg. 74 ✦ Ⓓ Hirschsprung's and Chagas ☛ primarily affect enteric nervous
Harsh Mohan, Pg. 414 system ➜ Loss of peristalsis
Myenteric (Auerbach's plexus) ☛ primarily located in "Muscularis
130. An elderly lady taking rheumatoid arthritis drugs externa" layer of the intestinal wall
presents with weakness and malaise. Her Hb was 5g/dl Submucosa ☛ also contains enteric nervous system, specifically
and decrease RBC, WBC PLT. Retic count 0.1%. Bone tap submucosal (Meissner's) plexus ➜ primarily controls function of
hypocellular bone marrow with few cells diagnose is: (Surg mucosal layer and local blood flow
24 May 2023 (M) +4 past) - ID: 72335 ✦ Guyton, Pg. 843 ✦ Robbins, Pg. 591
Ⓐ Aplastic anemia Ⓑ Myelofibrosis 137. 32 years old presented with nasal polyps microscopy
Ⓒ Leukemia Ⓓ Hemolytic anemia shows non sepstate hyphae branching (Surg 24 May 2023 (M)
Ⓔ Megaloblastic Anemia +6 past) - ID: 72490
Ⓔ Drug Induced Anemia ☛ Methotrexate used for arthritis ➜ Ⓐ Cryptocos Ⓑ Mucormycosis

Antifolate ➜ Megaloblastic anemia ➜Can present e pancytopenia Ⓒ Histoplasmosis
(Macrocytic anemia, thrombocytopenia and leukopenia ) ➜. weakness,
pallor, and dyspnea. Ⓑ Mucor ☛ Non-septate, branching hyphae forming right angle
✦ Levinson, Pg. 418 ✦ Oxford Microbiology, Pg. 489
◉ Thrombocytopenia ➜ petechiae and ecchymoses.
◉ Neutropenia ➜ serious infections. 138. Pt having anxiety about a surgical procedure, you
✦ Oxford Hematology, Pg. 60, 61
gave her diazepam it acts through (Med 25 May 2023 (M) +2
past) - ID: 72491
131. Gamma radiation sterilization use to sterilize which
instrument? (Surg 24 May 2023 (M) +10 past) - ID: 72337 Ⓐ Inc glutamate in limbic system
Ⓑ Dec glutamate in limbic system
Ⓐ Syringes needles Ⓑ Bronchoscope
Ⓒ Inc GABA in CNS
Ⓒ Cystoscope Ⓓ Laryngoscope

Ⓒ Diazepam ☛ Facilitates GABAergic transmission ➜ ↑ interneuron 145. A patient with Mitral stenosis , ECG shows (Med 25 May
Inhibition of primary motor afferent ➜ Muscle relaxation. 2023 (A.N) +3 past) - ID: 82425
✦ Katzung, Pg. 489
Ⓐ Biphasic p wave in lead 2 Ⓑ P. Pulmonale in lead 2
139. Gluconeogenesis takes place in which organ? (Surg 24 Ⓒ P Mitrale in lead 4 Ⓓ P mitrale in lead 2
May 2023 (M) +5 past) - ID: 78384
Ⓐ Mitral stenosis ➤ Pressure overload ➜ Progressive Left atrial
Ⓐ Kidney Ⓑ Liver
dilation ➜ A-fib ➜ Irregularly irregular rhythm and P-Mitrale
Ⓒ Lungs Ⓓ Spleen
P Mitrale ☛ broad, notched (bifid) P waves in lead II ➜ sign of left
atrial enlargement, classically due to mitral stenosis
Ⓑ Liver ☛ Glycogenolysis and gluconeogensis ✦ Davidson, Pg. 617 ✦ Reference, Pg.
✦ Ganong, Pg. 22
146. Follicular Thyroid carcinoma metastasize to (Surg 24
140. In sensory aphasia, there is damage to: (Surg 24 May May 2023 (M) +2 past) - ID: 82457
2023 (M)) - ID: 78772
Ⓐ Lymph nodes Ⓑ Blood
Ⓐ Arcuate fasciculus Ⓑ Broca's area
Ⓒ Lungs
Ⓒ Primary auditory area Ⓓ Visual association area
Ⓔ Wernicke's area
Ⓑ Follicular Thyroid carcinomas has a tendency to metastasize
hematogenously, primarily to the lungs and bones, and less frequently
Ⓔ Sensory aphasia (Wernicke's aphasia) ➜ caused by damage to
to regional lymph nodes.
Wernicke's area ➜ involved in understanding spoken and written
Papillary CA through Lymphatics
language. ✦ Harrison, Pg. 2443
Arcuate fasciculus ☛ is involved in language processing, But its
damage causes conduction aphasia, not sensory aphasia. 147. A female develop developed chronic otitis media
resistant to antibiotics, the organism is non. lactose and
141. Vein that is accompanied by circumflex arteryand stains turn green likely agent is (Surg 24 May 2023 (A.N) +3
taken care of at the site where LCX originates from lca past) - ID: 82465
(Surg 24 May 2023 (M) +2 past) - ID: 79337
Ⓐ Pseudomonas Ⓑ Pneumonia
Ⓐ Greater cardiac vein Ⓑ Middle cardiac vein Ⓒ Staph Aureus Ⓓ Streptococcus pneumonia
Ⓒ Ant cardiac vein
Ⓐ Pseudomonas infection is a common cause of chronic otitis media.
Ⓐ Great cardiac vein ☛ runs in anterior interventricular groove . Pseudomonas infections are suspected on physical examination when
✪ Within groove,Anterior interventricular artery passes around inferior there is a a greenish or blackish, fruity-smelling discharge
border of heart.
✪ GCV Accompanies Anterior Interventricular artery and circumflex 148. Inhibition of osmotic feedback ADH (Med 25 May 2023
arteries to enter sinus (A.N) +4 past) - ID: 82783
✦ BD Chaurasia, Pg. 267
Ⓐ Hyponatremia Ⓑ Hypernatremia
142. A patient ABGs reveal PH 7.45, PCO2 40 and HCO 38 Ⓒ Hypervolumia Ⓓ Hypovolemia.
what is acid base disorder? (Med 25 May 2023 (A.N) +10 past) -
ID: 79490 Ⓐ Plasma osmolarity ↑ ➜ detected by osmoreceptors in hypothalamus
➜ ↑ release of ADH from posterior pituitary ➜ Stimulate Aquaporin
Ⓐ Respiratory acidosis Ⓑ Respiratory alkalosis
channels of collecting ducts ➜ water osmotically pulled from collecting
Ⓒ Compensatory Respiratory Acidosis
duct into surrounding interstitial space ➜ final urine will be more
Ⓓ Metabolic acidosis
concentrated.
Ⓔ Uncompensated Metabolic alkalosis
VICE VERSA
✦ Guyton, Pg. 381
Ⓔ ✪ pH : 7.45 ☛ normal but higher side ➜ mild Alkalosis
✪ HCO3 : 38 ☛ V. High (normal 22-26) ➜ Metabolic Alkalosis 149. Clavicle fracture, separation of the shoulder joint
✪ PCO2 : 40 ☛ Nromal (normal 35-45) ➜ indicating that respiratory with the lateral end of clavicle sliding over acromion.
component is not primarily involvedConclusion ☛ Since pH is still Which ligament keeps acromioclavicular joint in place (Surg
within normal range but on high side, and PCO2 is not decreased (as it 24 May 2023 (M) +6 past) - ID: 82800
would be in a compensatory response) ➜ suggests that condition is an
Ⓐ Acromioclavicular ligament Ⓑ Coracoclavicular
uncompensated metabolic alkalosis.
ligament
Why Not Compensatory Respiratory Acidosis:
Ⓒ Sternoclavicular ligament Ⓓ Costoclavicular ligament
PCO2 isn't elevated as would be expected + high HCO3 level suggests a
metabolic rather than respiratory origin. Ⓑ Coracoclavicular ligament ☛ very strong extends from coracoid
✦ Guyton, Pg. 422 ✦ Davidson, Pg. 445
process to undersurface of the clavicle . It is largely responsible for
143. A Man smoke 20 packs per month work in factory he suspending the weight of scapula upper limb from clavicle.
develops lung cancer which carcinogen in cigrette causes ✦ Snell Review, Pg. 364
lung cancer? (Surg 24 May 2023 (M) +5 past) - ID: 79509 150. A patient is having a fever and pneumonia for 5 days.
Ⓐ Hydrocarbon Ⓑ Vinyl Chloride Most reliable test for Lobar pneumonia: (Surg 24 May 2023 (M)
+3 past) - ID: 82866
Ⓒ Nitrosamine
Ⓐ Sputum AFB Ⓑ Sputum culture
Ⓐ Tobacco smoke ☛ major source of human exposure to polycyclic Ⓒ Blood culture Ⓓ CBC
aromatic hydrocarbons ➜ associated with lung cancer
144. Avulsion of phrenic nerves (Surg 24 May 2023 (M) +4 past)

Ⓑ Pneumonia Diagnosis ☛ Patient’s history + physical examination
- ID: 79512 + imaging studies
Sputum ☛ Gram stain and culture lack sensitivity for the most
Ⓐ Ipsilateral paralysis of diaphragm common causes of pneumonia and 40% of patients cannot produce an
Ⓑ Loss of respiration reflex evaluable sputum
Ⓒ Loss of sensation at central part of diaphragm CXR ＞ Sputum Cultures
Ⓓ Loss of inspiration ✦ Levinson, Pg. 63 ✦ CMDT, Pg. 279
Ⓐ U/L phrenic nerve palsy ☛ Singal dome of diaphragm is paralyzed 151. Patient with nephrotic syndrome. Which structure in
✦ SNELL, Pg. 46 GBM plays major role in perm- selectivity for proteins (Surg
24 May 2023 (M) +2 past) - ID: 82968

Ⓐ Lamina rara interna Ⓑ Lamina rara externa

Ⓒ Lamina densa Ⓓ Visceral epithelial layer Recurrent laryngeal nerve ☛ innervates all intrinsic muscles
of larynx EXCEPT cricothyroid muscle.
Ⓓ The glomerular filtration barrier consists of fenestrated endothelium,
GBM, and podocyte foot processes, which are connected by a slit- 158. Changes in pregnancy including , Uterus size
diaphragm. enlargement due to: (Surg 24 May 2023 (M) +2 past) - ID: 84066
152. Child with frontal and occipital bossing due to Ⓐ Structural physiological
premature closure of which suture? (Surg 24 May 2023 (M) +6 Ⓑ Structural and functional physiological
past) - ID: 82992 Ⓒ Structural pathological Ⓓ Functional pathological
Ⓐ Saggital Ⓑ Coronal
Ⓑ Pregnancy ➜ physiological changes in uterus ➜ structural (size)
Ⓒ Transverse Ⓓ Occipital
and functional (capacity to hold growing fetus) changes.
Ⓐ Frontal bossing ☛ Hallmark of sagittal craniosynostosis, is an 159. Inferior phrenic artery is the branch of? (Surg 24 May
unusually prominent forehead sometimes associated with a heavier 2023 (M) +2 past) - ID: 84185
than normal brow ridge.
Ⓐ Celiac trunk Ⓑ Superior mesenteric artery
153. Virus associated with Hodgkin lymphoma with mixed Ⓒ Renal artery Ⓓ Abdominal aorta
cellularity (Surg 24 May 2023 (A.N) +6 past) - ID: 83204
Ⓐ Inferior phrenic arteries ☛ arise from celiac trunk, not directly
Ⓐ HIV Ⓑ EBV from the abdominal aorta. Celiac trunk is itself a major branch of
Ⓒ CMV Ⓓ Staph Aureus abdominal aorta
Ⓔ H. pylori
160. Lock Jaw is caused by (Surg 24 May 2023 (M)) - ID: 84346
Ⓑ ANSWER
Ⓐ Clostridium tetani Ⓑ Mycobacterium tuberculosis
154. Breast surgery needed muscle graft took from rectus Ⓒ Streptococcus pyogenes Ⓓ Staphylococcus
abdomen. Which artery also grafted from above pubic aureus
region? (Surg 24 May 2023 (A.N) +3 past) - ID: 83301
Ⓐ Clostridium tetani ➜ Tetanus toxin (neurotoxin) ➜ prevents
Ⓐ Inferior epigastric artery release of inhibitory neurotransmitter glycine ➜ excitatory neurons are
Ⓑ Superficial epigastric artery unopposed ➜ muscle spasms and a spastic paralysis
Ⓒ Inferior mesenteric artery Tetanus ➤
✦ Lock Law (trismus ) ✦ Sudden, involuntary muscle tightening
Ⓐ Breast reconstruction surgery with a muscle graft from the rectus (muscle spasms) – often in the stomach.
abdominis, the inferior epigastric artery is typically grafted, as it
✦ Risus sardonicus ✦ Trouble swallowing.
supplies the rectus abdominis muscle.
✦ Jerking or staring (seizures) ✦ Opisthotonos
155. Correct about Brown sequard syndrome: (Surg 24 May ✦ Changes in blood pressure and fast heart
2023 (M) +1 past) - ID: 83473 ✦ CMDT, Pg. 1458
Ⓐ Extensive loss of pain on same side below the level of 161. Fc (Surg 24 May 2023 (M)) - ID: 84347
hemisection
Ⓐ Mast cell Ⓑ B cell
Ⓑ Loss of fine touch and vibration on opposite side below the
Ⓒ Neutrophil Ⓓ T cell
level of lesion
Ⓒ Extensive paralysis of muscle on opposite side below the level Ⓐ Fc receptors ☛ on tsurface of mast cells ➜ bind to Fc region of
of lesion antibodies ➜ leads to a series of reactions that ultimately result in
Ⓓ Complete LMN type paralysis on same side at the level of activation of immune response.
lesion ✦ Levinson, Pg. 526
Ⓓ Brown Sequard Syndrome: 162. Whit threads in menstrual blood (Surg 24 May 2023 (M)) -
(Hemisection of spinal cord ) ID: 84348
Spinothalamic tract damage ➜ Contralateral Loss of ➜ Pain and
Ⓐ Endometrial shred Ⓑ Fungal infection
temperature, crude touch sensation ( Below the Lesion ).
Ⓒ Bacterial infection Ⓓ Parasitic infection
✦ Guyton, Pg. 629 ✦ First Aid, Pg. 531
156. Anterior to left suprarenal gland is: (Med 25 May 2023 (M) Ⓐ Menstruation ☛ shedding of endometrial lining of uterus ➜ result
+8 past) - ID: 83915 in appearance of white threads in menstrual blood, which are fragments
of endometrial tissue.
Ⓐ Liver Ⓑ Lesser sac
Ⓒ Aorta Ⓓ IVC 163. Mannitol site of action (Surg 24 May 2023 (M)) - ID: 84349
Ⓔ SVC
Ⓐ DCT Ⓑ PCT
Ⓑ Left suprarenal gland ☛ located in retroperitoneal space ➜ lesser Ⓒ Loop of Henle Ⓓ Collecting duct
sac found anteriorly to it, separated by pancreas and the stomach.
Liver ☛ is superior and slightly anterior to left suprarenal gland, but
Ⓒ Mannitol is an osmotic diuretic ➜ increases osmolarity of glomerular
not directly anterior filtrate ➜ occurs primarily in the descending limb of Loop of Henle ➜
increased osmolarity prevents water reabsorption, leading to increased
IVC ☛ lies anterior to right suprarenal gland
urine output.
157. After thyroidectomy only the cricothyroid muscle is
164. Endogenous antigen (Surg 24 May 2023 (M)) - ID: 84350
working, damage to which of die following nerves during
the procedure is anticipated: (Surg 24 May 2023 (M) +1 past) - Ⓐ MHC1 Ⓑ MHC2
ID: 84021
Ⓒ T cells Ⓓ B cells
Ⓐ Recurrent laryngeal nerve Ⓑ External laryngeal
nerve Ⓐ Antigen presentation ☛ mediated by MHC class I and class II ➜
Ⓒ Superior laryngeal nerve Ⓓ Vagus nerve found on surface of APCs ➜ deliver short peptides to cell surface ➜
allow them to be recognized by CD8+ ( cytotoxic ) and CD4+ ( helper
Ⓐ External laryngeal nerve ☛ specifically innervates cricothyroid cells ).
muscle. ◉ Endogenous or intracellular peptides for MHC class I.
◉ Exogenous or extracellular peptides for MHC class II.

✦ Robbins ✦ Ganong, Pg. 329, 109, 342 ✦ Robbins
165. Glucagon effect like (Surg 24 May 2023 (M) +1 past) - ID:
84351
Surg 25 May 2023
(M)
Ⓐ Catecholamines Ⓑ Insulin
Ⓒ Acetylcholine Ⓓ Gastrin
Ⓐ Glucagon and catecholamines ☛ similar effects on metabolism ➜

1. Patient presented with decrease BP of
Both promote glycogenolysis and formation of glucose to increase blood
90/50mmhq.lsoflurane Is contraindicated because causes
glucose levels.Same Ionotropic effects by Glucagon and (Surg 25 May 2023 (M) +3 past) - ID: 487
Catecholamines !
✦ Ganong, Pg. 329, 109, 342 Ⓐ Decrease cardiac contractility
Ⓑ Vasodilation of blood vessels
166. Brest ductal ca (Surg 24 May 2023 (M)) - ID: 84352
Ⓒ Vasoconstriction of blood vessels
Ⓐ Desmoplasia Ⓑ Necrosis Ⓓ Fluid overload
Ⓒ Inflammation Ⓓ Granulation tissue
Ⓐ Isoflurane ☛ ↓ cardiac contractility, BP and heart rate.
Ⓐ Breast ductal carcinoma ☛ induces a reaction in surrounding ✦ Sceincedirect Elsevier, Pg.
tissue, leading to fibrosis and formation of dense connective tissue, a 2. Location of superior parathyroid gland in relation to
process called desmoplasia ➜ "hard" feel inferior thyroid artery and recurrent laryngeal nerve is
(Surg 25 May 2023 (M) +4 past) - ID: 584
167. Thyrocervical cyst location (Surg 24 May 2023 (M)) - ID:
84354 Ⓐ Anterior to RLN and caudal to ITA
Ⓐ Anterior triangle Ⓑ Posterior triangle Ⓑ Anterior to RLN and cranial to ITA
Ⓒ Midline of the neck Ⓓ Lateral neck Ⓒ Posterior to RLN and cranial to ITA
Ⓓ Posterior to RLN and lateral to ITA
Ⓐ Thyrocervical cysts, a.k.a branchial cleft cysts ☛ found in lateral
part of anterior triangle of neck ➜ They are embryological remnants Ⓒ Superior parathyroid lie on ☛ posterior portion of upper half
from second branchial arch. of thyroid, cephalad to inferior thyroid artery, and posterior
to recurrent laryngeal nerve (RLN).
168. Radial nerve cut at middle shaft of humerus (Surg 24 ✦ Netter, Pg. 78
May 2023 (M)) - ID: 84355
3. Adult Pyogenic (Bacterial, Fungal and Tuberculous)
Ⓐ Axon lesions Ⓑ Axon plus dendrite Meningitis will have which of the following findings in CSF
(Med 25 May 2023 (M) +9 past) - ID: 1367
Ⓐ Radial nerve ☛ originates from brachial plexus ➜ innervates
Ⓐ Increase glucose Ⓑ Decrease proteins
extensor muscles of arm and forearm
Ⓒ Increase sodium Ⓓ Decrease Glucose
Injury especially at level of middle shaft of humerus ➜ interruption of
nerve impulse transmission along axons ➜ Axons, not dendrites, carry
Ⓓ Only Viral and Aseptic Meningitis have Normal Glucose levels ( 45-80
signals away from neuron's body, and hence axon lesions are the result
mg/dl ). Bacterial, Fungal and Tuberculous meningitis have Low glucose
of nerve injury. ➜ "Saturday night palsy" or "wrist drop"
level
169. Bainbridge reflex (Surg 24 May 2023 (M)) - ID: 84359
4. Which of the following is true Patient uses smokeless
Ⓐ Inc atrial stretch Ⓑ Decreased atrial stretch tobacco and develops submucosal fibrosis? (Med 25 May 2023
Ⓒ Decreased ventricular stretch (M) +19 past) - ID: 1942
Ⓓ Increased ventricular stretch
Ⓐ Pre malignant Ⓑ Neoplastic
Ⓒ Hyperplasia Ⓓ Metaplasia
Ⓐ Bainbridge reflex, a.k.a atrial reflex ☛ physiological process that
increases HR in response to increased venous return Ⓐ ◉ Submucous fibrosis☛ is Pre-Malignant condition
Increased venous return ➜ increased stretch of tatria ➜ stimulates ✦ Oral Pathology Textbook, Pg. 109
receptors in atria ➜ send signals via tvagus nerve to cardiac center in
medulla ➜ increased HR to pump additional blood quickly 5. Calcium in Skeletal muscle endoplasmic reticulum is
bound with (Med 25 May 2023 (M) +8 past) - ID: 2853
170. Ovary growth, clear cytoplasm? (Surg 24 May 2023 (M)) -
ID: 84364 Ⓐ Desmin Ⓑ Calmodulin
Ⓒ Myosin kinase Ⓓ Calsequestrin
Ⓐ Serious carcinoma Ⓑ Granulosa cell ca
Ⓒ Acinus carcinoma Ⓓ Calsequestrin ☛ protein inside reticulum can bind up to 40 times
more calcium
Ⓑ Granulosa cell tumors (ca) ☛ presence of granulosa cells, ➜ ✦ Guyton, Pg. 94
often appear clear or pale due to their cytoplasm Serious
carcinoma. ☛ cells resembling the epithelial lining of fallopian tubes, 6. A 63. year old man came to the emergency department
not granulosa cells. with back pain, weakness and shortness of breath. On
examination, he has an aneurysm of abdominal aorta at
171. Growth hormone is not released during (Surg 24 May the aortic hiatus of diaphragm. If aortic opening of the
2023 (M)) - ID: 84370
diaphragm is constricted due to aneurysm of aorta, which
Ⓐ Sleep Ⓑ Stress one of the following structure will be compressed along
Ⓒ Exercise Ⓓ Fasting with aorta (Surg 25 May 2023 (M) +37 past) - ID: 4222
Ⓐ Thoracic duct and vagus nerve

Ⓐ Growth hormone is primarily released during sleep, especially
Ⓑ Thoracic duct and azygos vein
during the first few hours of deep sleep
Ⓒ Azygos vein and both phrenic nerves
Stress can actually inhibit release of growth hormone, as it promotes
Ⓓ Inferior ven cava
the release of hormones like cortisol which antagoniz effects of growth
hormone.
Ⓑ Vana Caval Opening ➜ At T8 ➜ ● IVC ● right phrenic nerve
Esophageal Opening ➜ At T10 ➜ ● esophagus ● vagus (CN 10; 2
trunks)
Aortic Opening ➜ At T12 ➜ ● aorta ● thoracic duct ● azygos vein

FCPS Surgery 24 May 2023 (M)

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Medi Call FCPS – 1 | MAY 2023 PAPERS

Ⓒ PCT kidney ☛ reabsorbs majority of glucose from filtrate by

Ⓒ Cortical branches of Anterior cerebral artery,

160. Which structure passes through the left side of the

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kidney, resulting in renovascular hypertension – a secondary type of eyelids),

10. ODC shifts to Left and Oxygen delivery to tissues is

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22. An old man playing with his grandson in garden

27. Adductor muscles are supplied by which nerve? (Surg 24

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Ⓐ Ferritin Ⓑ Bone marrow biopsy Ⓐ Right Internal capsule Ⓑ Medulla

38. Nurse in ICU accidentally gave local anesthetic to

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Ⓐ Staphylococcus saprophyticus Ⓑ E.Coli

Ⓒ Anterior branch of MMA Ⓓ Superoor cerebral vein Ⓐ Posterior auricular Ⓑ Accessory

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94. Inspiration is vital process for oxygenation of tissues. Ⓐ ANSWER

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Ⓐ Epidydimo-orchitis Ⓑ Obstructed hernia

Ⓐ Constriction of renal arteries Ⓐ ✪ Microcytic anemia ☛ caused by Iron deficiency or thalassemia.

Ⓐ Diaphragm Ⓑ External intercostal Ⓒ Mumps ( Paramyxovirus - RNA virus )

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Ⓒ ✪ Symptoms of Hypothyroidism ☛ Weight gain, Cold intolerance, Ⓐ Cervical ca Ⓑ Endometrial ca

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Ⓐ Ulnar Ⓑ Median Ⓑ 4 cm deep wound at 5th ICS can involve Pericardium

127. The anatomical location of Stenson's duct is (Surg 24 Ⓐ Ependymoma Ⓑ Seminoma

134. Right bundle branch of conducting system of the

135. A patient Presented with Chest pan radiating to left

Ⓔ Drug Induced Anemia ☛ Methotrexate used for arthritis ➜ Ⓐ Cryptocos Ⓑ Mucormycosis

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144. Avulsion of phrenic nerves (Surg 24 May 2023 (M) +4 past)

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Ⓐ Lamina rara interna Ⓑ Lamina rara externa

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✦ Robbins ✦ Ganong, Pg. 329, 109, 342 ✦ Robbins

Ⓐ Glucagon and catecholamines ☛ similar effects on metabolism ➜

Ⓐ Thoracic duct and vagus nerve

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