Diploma - Mock 3 (Pediatrics)

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MOCK TEST 3
1) Cells are united by

T a)desmosomes.
T b) intermediate junction.
T c) tight junctions.
F d) gated junctions.
F e) terminal junctions.
Explanation
Desmosomes are small button-like areas on the cell membrane, they provide the strongest
form of anchorage.In intermediate junctions, the gap is retained but a cobweb of filaments
extends into the cytoplasm of the adjacent
cells. In tight junctions, the intercellular gap is lost; these are areas of great cellular
permeability.
2) Exocrine glands:
F a)typically discharge their contents directly into
the blood stream.
F b) usually secretes in a holocrine manner.
F с)are of mesenchymal origin.
F d) are absent in stratified squamous epithelium.
T e)may be unicellular.
Explanation
a.This is the definition of an endocrine gland. Exocrine glands have ducts opening on to a
surface.
b.Most exocrine glands secrete without damage to the cell,i.e. merocrine or epicrine
secretion, as do most endocrine
glands.
c.They are of epithelial origin.
d.Sebaceous and sweat glands are common in this form of tissue.
e. Goblet cells are unicellular.
3)Primary cartilaginous joints:

F a)unite the lower end of the tibia and fibula.
F b)occurs between the teeth and jaw.
F c)comprise the sutures of the vault of the skull.
F d) unite the two pubic bones.
T e) include the costochondral junctions.
Explanation
EXCLUSIVE EDUCATION AID
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Primary cartilaginous joints are found between the body of a long bone and its epiphyses.
The unions in a, b, and c are all examples of fibrous joints. The pubic bones are united by a
secondary cartilaginous joint (symphysis).
4)Neuroglia:
T a)exist only in the brain.
T b)are cellular neural connective tissue.
T c)have a phagocytic function.
T d)produce myelin.
T e)are concerned with the nutrition of neurons
Explanation
Neuroglia do not exist outside the brain and comprise three different types of cells:
astrocytes, oligodendroglia and microglia.
The microglia are small mobile phagocytes and
oligodendroglia produce the myelin of the central nervous system.
5)The lymph nodes:

F a)receive afferent lymph vessels at the hilus.
T b) have a fine reticular network of collagen fibres.
T c)have a peripheral subcapsular space.
F d) have an inner densely packed medulla.
F e)are surrounded by an elastic capsule
Explanation
Afferent vessels enter the convexity of the node and efferent vessels leave the hilus on the
concave side.Into which the afferent vessels open.The outer cortex is densely packed with
cells and follicles,the central medulla is loosely packed with cells.The capsule is fibrous
and from it, fibrous trabeculae pass inwards.
6)The diaphragm is pierced by the:

T a)splanchnic nerves.
F b)sympathetic trunks.
T c)left phrenic nerve.
T d)gastric nerves.
F e)the lowest intercostal nerves.
explanation
a.The splanchnic nerves pierce the crura.
b.The sympathetic trunks pass behind the medial arcuate ligaments.
c.The left phrenic nerve pierces the left dome of the diaphragm.
d.The anterior and posterior.gastric nerves are transmitted with the oesophagus through an
opening in the muscular part to the left of the midline. Muscle fibres from the right
crus of the diaphragm surround the opening.
e.These lie superficial to the diaphragmatic attachments. The subcostal nerve passes behind
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the lateral cruciate ligament.
7)The azygos vein:

T a) originates in the abdomen.
F b)leaves the abdomen by the oesophageal opening.
F c)drains into the right atrium directly.
T d) receives both right bronchial and right posterior intercostal tributaries.
F e)receives small pulmonary tributaries.
Explanation
a.Usually by the union of the right subcostal and right ascending lumbar veins. On the left
side the accessory hemiazygos is formed.
b. It leaves through the aortic opening.
c.It arches over the root of the right lung at the level of the 4th thoracic vertebra and enters
the superior vena cava.
d.The left intercostal and bronchial veins drain via the hemi-azygos and accessory
hemiazygos veins into the azygos
vein.
e.Venous blood from the lung parenchyma drains into the pulmonary veins.
8)The 'spermatic cord:

T a)has three fasciai coverings.
T b)contains three arteries.
T с)contains three nerves.
T d) contains one muscle.
T e)is less well developed in the female.
Explanation
a.The internal spermatic fascia is continuous with the transversalis fascia, the cremasteric
fascia and muscle are continuous with the internal oblique, and the external spermatic
fascia is continuous with the external oblique.
b.The testicular, cremasteric and the artery to the ductus deferens.
C.The genital branch of the genitofemoral nerve, the ilioinguinal nerve and sympathetic
nerves.
d.The cremasteric muscle which mediates the cremasteric reflex. The testis is drawn up
when the skin of the medial side of the thigh is stimulated.
e.The spermatic cord is formed as the testis descends through the inguinal canal into the
scrotum. It is absent in the female.
9)The abdominal oesophagus:

F a)enters the abdomen between the right and left crus of the diaphragm.
F b)is enveloped by peritoneum.
T c)is closely related to both the anterior and posterior gastric nerves.
T d)is closely related to the left lobe of the liver.
F e)is surrounded by an external oesophageal sphincter
Explanation
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a.The oesophageal opening of the diaphragm lies within the fibres of the right crus to the
left of the midline.
b.Peritoneum covers only its anterior surface.
C.The anterior 'gastric nerve is often within its wall and the posterior gastric nerve is
adjacent to its posterior surface.
d.It lies between the diaphragm posteriorly and the left lobe of the liver anteriorly.
e.The lower oesophageal sphincter lies within the oesophageal wall. Competence of the
sphincter is aided by the oblique angle of entry of the oesophagus into the stomach.
10)Pus contains:
T 1. lipids
T 2. fibrin
F 3. collagen
F 4. plasma cells
T 5. polymorphonuclear leucocytes
Explanation
1. True
Lipids are present in pus. They are derived from the plasma lipoproteins and from cellular
breakdown products. Cholesterol may
be found in old pus.
2. True
Pus contains fibrin because the activation of the coagulation system by the Hageman factor
converts plasma fibrinogen into fibrin.
3. False
Collagen is not a constituent of pus although its breakdown products on may be present due
to the activity of enzymes known as
collagenases.
4. False
Plasma cells are not normally found in the pus formed as a result of
acute inflammation.
5. True
The major cellular component of pus consists of living or dead polymorphonuclear
leucocytes.
11)The following belong to the mononuclear phagocyte system:

T 1. macrophages
F 2. mast cells
T 3. epithelioid cells
F 4. fibroblasts
T 5. Küpffer cells
Explanation
1. True
The macrophage is the prototype of the cells belonging to the mononuclear phagocyte
system.
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2. False
Mast cells are not a part of MPS.they are effector cells of IGE induced allergic reactions.
3. True
Epithelioid cells represent an activated form of the cells of the MPS.
4. False
Fibroblasts are not related to the mononuclear phagocyte system although they may be
found in close proximity to macrophages and
epithelioid cells in granulomas. The function of fibroblasts is to secrete collagen
5. True
Küpffer cells are derived from precursor cells in the bone marrow circulate as monocytes
and then settle in the sinuses of the liver
forming actively phagocytic cells.
12)Organised epithelioid cell granulomas develop in the following infections:

T 1. leprosy
T 2. syphilis
F 3. ankylostomiasis
F 4. ascariasis
T 5. schistosomiasis
Explanation
1. True
Epithelioid granulomas develop in the tuberculoid and not in the lepromatous form of
leprosy.
2.True
Gummas are nodular masses of syphylitic granulation tissue varying in size from scarcely
visible lesions to masses several cm in size.
3. False
Hookworm infection is not associated with granuloma formation.
4. False
Infection with the round worm, Ascaris lumbricoides, which is particularly prevalent in
tropical areas, is not associated with
granulomatous formation.
5. True
The granulomas developing around schistosome eggs in the liver,
intestines and bladder are typical immunologically induced epithelioid cell granuloma.
13)Pseudomembranous enterocolitis is caused by the following organisms:

F 1. Clostridium sporogenes
T 2. Clostridium difficile
F 3. Streptococcus faecalis
T 4. penicillin resistant staphylococci
F 5. Pseudomonas aeruginosa
explanation
1. False
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Clostridium sporogenes is one of the causative organisms of gas gangrene, it plays no part
in the development of enterocolitis.
2. True
Clostridium difficile has recently been identified as the causal agent of antibiotic associated
colitis. The organism is resistant to both
lincomycin and clindamycin and exerts its noxious effect through the production of
cytopathic toxin. The organism is sensitive to
vancomycin and metranidazole.
3. False
Streptococcus faecalis plays no part in the development of pseudomembranous
enterocolitis. This organism is an opportunistic
pathogen and can only produce a pathological lesion when tissue resistance is lowered.
4. True
Penicillin resistant staphylococci are believed to play a part in the development of one type
of pseudomembranous enterocolitis
5.False
Pseumonas aeroginosa plays no part in the development of enterocolitis.
14)Staphylococci pathogenic to man:

F 1. produce a capsular polysaccharide
T 2. grow in irregular clusters in culture
T 3. produce coagulase
F 4. are resistant to penicillin
F 5. all produce an enterotoxin
Explanation
1. False
Capsular polysaccharide is associated with the pathogenic forms pneumococci.
2. True
The growth of the staphylococci is irregular thus producing irregular clusters.
3. True
The ability to produce coagulase, an enzyme which clots citrated plasma in vitro,
differentiates the pathogenic forms of staphylococci from the nonpathogenic.
4. False
Pathogenic staphylococci are not necessarily resistant to penicillin although most strains
associated with epidemic and endemic disease
in hospitals in fact are resistant.
5. False
Only some strains of staphylococci produce an enterotoxin.
15)The common pathogenic pyogenic organisms affecting man Include:

T 1. Staphylococcus aureus
F 2. Clostridium tetani
F 3. Staphylococcus albus
T 4. bacteroides
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T 5. Pseudomonas aeruginosa
Explanation
1. True
The pathogenic varieties of this Gram-positive organism are in particularly associated with
(a) The development of localized infections such as boils,carbuncles and abscesses
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(b) Spreading infections of the skin such as impetigo
(c) Septicaemia followed by the formation of pyogenic abscesses,
2. False
Clostridium tetani is not a pyogenic organism. 3.False
Staphylococcus albus is a commensal and rarely pathogenic.
4.True
Bacteroides which are nonsporing anaerobic organisms are the commonest organisms
present in the intestines. They are frequently
associated in pyogenic infections with other organisms such as the anaerobic cocci. They
are a particularly important cause of pus
formation in surgical wounds following colo-rectal surgery and with intra-abdominal septic
complications.
5. True
Normally present in small numbers in the gastrointestinal tract these
organisms can cause severe infections in burn patients. The pus produced possesses a
characteristic greenish colour.
16)Spores are killed by exposure to:
F 1. moist heat at 110°C for 15 minutes
T 2. dry heat at 160°C for 1 hour
T 3. ethylene oxide
F 4. hydrogen peroxide
F 5. gentian violet
Explanation
1. False
Bacterial spores require exposure to moist heat at a temperature of 121°C for at least 15
minutes and preferably 30 minutes before they
are destroyed.
2. True
The majority of spores are killed by exposure to dry heat at 160°C for 1 hour.
3. True
Ethylene oxide is highly lethal to all kinds of microbes and spores. It is of particular value
for sterilizing articles liable to damage by heat,
e.g. plastic and rubber articles,
4. False
Hydrogen peroxide has been used as sn antiseptic.
5. False
Gentian violet will kill some vegetative forms of bacteria particularly Gram-positive
organisms.
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17)The following antibiotics are effective against fungi:

T 1. nystatin
F 2. bacitracin
T 3. griseofulvin
F 4. polymyxin B
T 5. amphotericin B
Explanation
1. True
Candida albicans, Cryptococcus neoformans and Histoplasma capsulatum and duboisi are
sensitive to this drug.
2. False
Bacitracin is a polypeptide antibiotic which is active against many Gram-positive bacteria
and neisseria. It is now only used locally for
skin infections.
3. True
This drug is produced by the growth of certain strains of penicillium griseofulvum. It exerts
an inhibiting effect on the growth of the
epidermophyton causing athlete's foot, the trichophyton causing ring worm and the
microsporum causing tinea.
4. False
The polymyxins are polypeptides which are derived from the soil organisms B. polymyxa.
Five have been identified of which two are in
commercial use, polymyxin B (polymyxin) and polymyxin E (coliston).
These drugs are effective against both Gram-positive and -negative organisms, particularly
Pseudomonas aeruginosa but they are inactive against proteus.
They have no antifungal action.
5.True
This drug is the most effective agent for the treatment of systemic fungal infections. It is
active against Histoplasma capsulatum and
duboisii, Cryptococcus neoformans, Coccidioides immitis,Blastomyces dermatitidis and
Candida albicans.
18)Benzyl penicillin is:

F 1. bacteriostatic
T 2. destroyed by the enzyme penicillinase
F 3. insoluble in water
F 4. damaging to the nucleus of the bacterial cel
F 5. active against some viruses
Explanation
1. False
Benzyl penicillin is bactericidal. In vitro bacteria which have been exposed to this
antibiotic die even when transferred to a drug-free
medium.
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2. True
Penicillinase destroys penicillin by hydrolysis to inactive penicilloic acid and by opening
the B-lactam ring.
3. False
Benzylpenicillin is extremely soluble in water,
4.False
Penicillin exerts its bactericidal effect by its action on the bacterial
Cell wall.
5.False
Penicillin and the semisynthetic derivative have no action on viruses.
19)Wound healing is enhanced by the administration of:

F 1. cortisol
T 2. zinc
F 3. aldosterone
T 4. oxygen
T 5. vitamin C
Explanation
1.False
Cortisol impairs the synthesis of collagen and enhances its lysis and thus inhibits wound
healing.
2. True
Zinc has been shown to accelerate the development of granulation
tissue in a wound produced by the excision of a pilonidal sinus.
3. False
Aldosterone has no effect in wound healing.
4. True
The fibroblast requires an ambient po2 of around 10 mm Hg in order to synthesize collagen
and ground substance.
5. True
Although the administration of vitamin C does not accelerate wound healing a deficiency
causes a reduction in the synthesis of collagen
and hence a lack of proper healing.
20)Secondary hypogammaglobulinaemla occurs in:

F 1. sarcoidosis
F 2. congestive heart failure
T 3. malnutrition
T 4. chronic lymphatic leukaemia
T 5. nephrotic syndrome
Explanation
1. False
Sarcoidosis is normally associated with an increase in IgG particularly in cases with active
extensive disease. It is accompanied
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by a depression of cutaneous delayed hypersensitivity.

2. False
Hypogammaglobulinaemia does not occur in association with the oedema of congestive
heart failure.
3. True
Protein-calorie malnutrition also called protein energy malnutrition PEM, is associated with
a functional defect in both the B and T
lymphocytes leading to secondary hypogammaglobulinaemia and
decreased immunoglobulin synthesis.
4. True
In at least half the cases of chronic lymphatic leukaemia there is reduction in all classes of
immunoglobulin.
5.True
Protein loss due to failure of reabsorption from the renal tubules can cause a depression of
the serum immunoglobulins as well as albumin..
21)Drugs metabolized by acetylation are

a) Hydralazine
b) Diazepam
c) Naproxen
d) Isoniazid
e) Procainamide
TFFTT
Explanation:
Acetylation occur for
Isoniazid, Histamine
Hydralazine
Procainamide
Sulfonamide
clonazepam
dapsone
mescaline
Acetylation
Amines
Sulfonamides,
isoniazid,
clonazepam,
dapsone, mescaline
22)Conjugation of drugs
a) Occurs primarily in the liver
b) Increases their water solubility
c) is brought about by enzymes present in the intestine
d) Does not occur with glycine
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e) Can occur with glucuronic acid

TTFFT
Explanation:
a) In phase 2 biotransformation liver is Primary site.
b) Less lipid soluble, more polar, easily excretable
c) occurs in liver
d) glycine conjugation occurs
el Also sulfuric acid, Acetic acid, Glycine
23)Enzyme inducing drugs are

a) allopurinol
b) phenobarbitone
c)griseofulvin
d) phenytoin
e) erythromycin
FTTTT
Explanation
Enzyme inducers:
Carbamazepine
Griseofulvin
Phenytoin
Rifampicin
Phenobarbiton
Barbiturares
Phenylbutazone
Chlorcyclizine
Macrolides
24)Enzyme inhibitors are

a) metronidazole
b) phenytoin
c) INH
d) rifampicin
e) erythromycin
TFTFT
Explanation:
Inhibitors:
- Disulfiram,
-Metronidazole,
- Allopurinol,
- Macrolide,
-Cimetidine,
- Quinolone,
- Chloramphenicol,
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- Na-valproate,
-Corticosteroids,
- Quinidine,
- INH.
- MAO inhibitor,
25)Passage of drug through cell membrane is influenced by

a) lipid solubility of the drug
b) source of the drug
c) molecular weight of the drug
d) mode of action of the drug
e) dose of the drug
TFTFT
Explanation:
Drug Transfer through membrane depends on:
• Concentration-gradient
. Lipid Solubility
. pH of local fluid
. pka of durg
. Molecular weight &
• thickness of membrane
26)Drugs having low therapeutic index are

a) methotrexate
b) paracetamol
c) digoxin
d) phenytoin
e) penicillin
TFTFF
Explanation
Low TI
Barbiturate - Phenobarbitone, Thiopental Na
Narcotic analgesic & CNS drug except BDZ
Cardiac glycoside
Anti-arrhythmic
Anticancer-cytotoxic & immunesuppressive
Anti-Coagulant,
Aminoglycosides
Anti-hypertensive
OCP
27)Drugs with a high hepatic first-pass effect. include -

a) Diazepam
b) Lidocaine
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c) Digoxin
d) Morphine
e) Phenytoin
FTFTF
Explanation:
Drug with high FPM:
Opioids.
Oxprenolol
Chlorpromazine
Aspirin,
Propoxyphene,
Nitrate,
Salbutamol
Verapamils, Hyodrocortisone
Proranolol
Terbutaline
Lidocaine
28)Following are partial agonist drugs

a) Clonidine
b) Pindolol
c) Acebutolol
d) alpha methyl-dopa
e) Reserpine
TTFFF
Explanation:
Name of partial agonist:
nalorphine
clonidine
pindolol
acebutolol
29)Concurrent use of Following drugs leads to the failure of oral contraceptive pill
therapy
a) Paracetamol
b) Phenytoin
c) Carbamazepine
d) Morphine
e) Omeprazole
FTTFF
Explanation
Phenytoi & carbamazepine are enzyme inducer,so concurrent use of these drugs with OCP
will cause therapeutic failure of OCP

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30)Confirmed teratogens are

a) Phenytoin
b) Retinoids
c) Salbutamol
d) Erythromycin
e) Folic acid
TTFFF
Explanation
Name of teratogenic drugs:
Cytotoxic drug-MTX
Thalidomide
ACE inhibitor, beta blocker, Thiazide diuretics
Tetracycline, streptomycin, Quinolone
Carbamazepine, Na-valporate, phenytoin
Vitamin-A
Chloramphenicol, aminoglycosides
Chlorquine, quinine
Warfarin

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31)Stimulation of beta-2 receptor causes -

a) bronchodilatation
b) vasoconstriction
c) glycogenolysis in liver
d) increase in blood pressure
e relaxation of gravid uterine muscle.
TFTFT
Explanation
1.Relaxation of the smooth muscles of blood
vessels- Vasodilatation
2.Smooth muscle relaxation -Bronchodilatation.
3.Relaxation of smooth muscle of GIT decreases Peristaltic movement or motility-may be
constipation
4.Relaxation of mainly gravid uterus - Delay
premature labour pain.
5.Promotes potassium uptake and Glycogenolysis.
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6.Active Glycogenolysis and gluconeogenesis

7.Release of glucagon.
8.Lipolysis
31)Eicosonoid include following substances -

a) Prostaglandin
b) Thrombaxane
c) Leukotrienes
d) Sphingomyelin
e) Gangleosides
TTTFF
Explanation
Eicosanoids are those that are derived from cell membrane phospholipid.these are -
1.prostaglandin
2.prostacycline
3.thromboxane
4.leukotriene
5.lipoxin
32)Side effects of thiazide diuretics include

a) Hyperuricemia
b) Hypocalcemia
c) Hypernatremia
d) Hyperlipidemia
e) Metabolic alkalosis
TFFTT
Explanation:
Adverse effects of thiazide diuretics
Hypercalcemia
Hyponatremia
Erectile dysfunction
Hyperuricaemia
Hyperglycaemia
Acute pancreatitis,cholecystitis
Hypokalaemia
Metabolic alkalosis
33)The following drugs prolong the QT interval

a) Quinidine
b) Disopyramide
d) Phenytoin
d) Amitryptilline
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el Magnesium
TTFTF
Explanation:
Drugs causing prolong QT interval
1.Disopyramide, ﬂecainide and other class Ia, Ic anti-arrhythmic drugs
2.Sotalol, amiodarone and other class III anti-arrhythmic drugs
3.Amitriptyline and other tricyclic antidepressants
4.Chlorpromazine and other phenothiazines 5.Erythromycin and other macrolides
34)Anti-diabetic drugs reducing body weight are

a) thiazolidinediones
b) metformin
c) SGLT-2 inhibitors
d) DPP-4 inhibitors
e) GLP-1 analogues
FFTFT
Explanation
1.Metformin & DPP-4 inhibitors are weight neutral while thiazolidinediones increases
weight.
2.GLP-1analogues & SGLT-2 inhibitors decreases body weight.
35)Drugs causing hyperglycaemia are

a) Thiazides
b) Diazoxide
c) Theophylline
d) Nitroglycerine
e) Prazosine
TTFFF
Explanation:
Drug causing Hyperglycemea:
Diazoxide,Quinolone
Antipsychotics
large dose Aspirin
steroid
cyclosporin
thiazide
diuretics
36)Followings are the colloid solution

F a) ringers lactate solution
T b) hydroxyl ethyl starch
T c) albumin
F d) one fifth normal saline
T e) gelatin derivatives
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Explanation
Colloid solutions
1.Plasma proteins, Gelofusine
2. Hydroxyethyl starch
3. polysaccharides(starch, gelatin, glycogen),
4. lipid(neutral fat, lipoproteins, chylomicron,
VLDL, LDL, HDL, phospholipid, cholesterol
ester)
5. DNA and RNA, Antibody(IgG, IgA, etc)
6. Various enzymes, Blood clotting factors.
37)Following compounds are disaccharides:

T a) laclose
T b) isomaltose
F c) galactose
T d) maltose
T e) Trehalose
Explanation
Disaccharides:
Sugar
Sucrose
Lactose
Maltose
Isomaltose
Lactulose
Trehalose
38)The reducing substances are

F a) sucrose
T b) glucose
F c) triglyceride
T d) lactose
F e) isomaltose
Explanation
Reducing substance
Sugars:
Glucose, Fructose, Pentose, Lactose, galactose, maltose, L-xylose
Non sugars:
Uric acid, urates, creatinine, glucoronides, salicylates,
phenol, PAS, ascorbic acid, levodopa, Nalidixic acid,
Tetracycline, Cysteine, Tyrosine, homogentisic acid ketone body
39)essential amino acid

T a)phenyl alanine
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F b) glutamate
T c) Threonine
T d) valine
F e) aspartate
Explanation
Essential (supplied in diet) and semi-essential amino acids(synthesize by adults but not
growing children)
PVT TIM HALL
P-Phenylalanine
V-Valine
T-Tryptophan, Threonine
I- Isoleucine
M-Metheonine
H-Histidine (Semi-essential)
A- Arginin (Semi-essential)
L-Leusine
L-Lysine
40)Omega 6 fatty acids are

T a) linoleic acid
F b) linolenic acid
F c) oleic acid
T d) arachidonic acid
F e) palmitic acid
Explanation
Essential fatty acid
1.Linoleic acid(18:2; 9,12), omega 6 fatty acid with two double bond)
2.Linolenic( 18:3; 9,12,15), 18 c omega 3 with 3 double bond)- promote brain development
in children
3.Arachidonic acid: 20 c omega 6 with double bond.
- Linoleic can be converted to arachidonic acid
- Source: Vegetable oil, fish oil, cod liver oil, egg yolk(linoleic acid)
41)Essential fatty acids are:

T a) precursor of prostaglandins
T b) structural component of biological membrane
T C) precursor of leukotriens
F d) monounsaturated fatty acid
F e) saturated fatty acid
Explanation
Essential fatty acids are those polyunsaturated fatty acids which are not synthesized in the
body but are supplied in the diet from natural sources.
Name
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1.Linoleic
2.Linolenic
3.Arachidonic acid.
Importance:
1. Precursor of eicosanoids (prostaglandin, thromboxane, leukotrienes)
2. Synthesis of structural lipid.
3. It decreases the plasma cholesterol conc. and thus it can reduce coronary artery diseases.
4. Concerned with optimum gonadal activity and it is directly related to sterility.
5. It causes prolongation of clotting time & Tthe fibrinolytic activity.
6. They cure skin lesions.
7. The deficiency of EFA in the diet of baby cause eczema.
42)Metabolic pathways occurring in mitochondria are

T a) ketogenesis
F b) cholesterol synthesis
T c) TCA cycle
F d) fatty acid synthesis
T e) B-oxidation of fatty acid
Explanation
Metabolic pathways in Mitochondria
1. Oxidative phosphorylation/respiratory
chain
2. TCA cycle
3. Oxydation of pyruvate
4. B oxidation of fatty acid
5. Ketone body formation
43)Hexose monophosphate shunt generates

T a) NADPH
F b) FADH
F c) NADH
F d) GTP
T e) ribose sugar
Explanation
Hexose monophosphate shunt:
It is an alternative pathway to glycolysis and TCA cycle for the oxidation of glucose to
CO2 & H20 without generating ATP.
Others name:
1. Pentose phosphate pathway
2. Phosphogluconate pathway
Nature: Catabolic
Substrate: Glucose-6-phosphate
Product: Ribose suger (5 C), NADPH, Glucos-6-phosphate
Possible sites: Liver, RBC, adipose tissue, adrenal cortex, testes/ovary, lactating gland.
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Compartment: Cytoplasm
44)Sources of acetyl CoA are

T a) B-oxidation of fatty acids
T b) glycolysis
F c) Krebs's cycle
F d) breakdown of cholesterol
T e) breakdown of ketone bodies
Explanation
Sources of Acetyl CoA:
Oxidation of glucose via glycolysis
Oxidation of fatty acid via beta oxidation
Oxidation of amino acid
Degradation of ketone body
Oxidation of ethanol
45) Metabolic fates of pyrovate are

T a) synthesis acetyl-CoA
T b) synthesis of lactic acid
T c) synthesis of alanine
F d) synthesis of cholesterol
F e) synthesis of ketone bodies
Explanation
Metabolic fates of pyruvate
Convertion to lactate,
synthesis of alanine,
synthesis of glucose,
convertion to oxaloacetic acid,
Convertion to acetyl COA
46)Plasmid is dissimilar with

A.is extrachromosomal DNA
B.present only in gram negative bacteria
C.can be transferred from cell to cell by transduction
D.is a double stranded structure
E.can be integrated into bacterial chromosome
FTTFF
Explanation:
Plasmids
• Extrachromosomal, double-stranded, circular DNA molecules that are capable of
replicating independently of the bacterial chromosome.
• Can be integrated into the bacterial chromosome.
22
• Present both gram-positive and gram-negative bacteria

• Different types of plasmids can exist in one cell-
(1) Transmissible plasmids
✓ Can be transferred from cell to cell by conjugation.
✓ They are large, contain genes responsible for synthesis of the sex pilus and
for the enzymes required for transfer.
✓ They are usually present in a few (1–3) copies per cell.
(2) Nontransmissible plasmids

✓ Small (MW 3–20 million) since they do not contain the transfer genes.
✓ They are frequently present in many (10–60) copies per cell.
47)Hormone-sensitive lipase is activated by

T a) TSH
T b) ACTH
F c) nicotinic acid
F d) prostaglandin E
T e) vasopressin
Explanation
Regulation of Hormone sensitive lipase (HSL)
1.Enhance the activity by
Epinephrine(most effective)
Norepinephrine
Glucagon
Growth hormone
Cortisol
Thyroxine, TSH
ACTH, Vasopressin (ADH)
Caffeine
Also in fasting and sress
2.Inactivates lipase:
insulin, prostaglandin El, and nicotinic acid
48)The factors causing dilation of blood vessels are -

T a) Nitric oxide
F b) Endothelin-1
T c) hypercapnia
F d) Neuropeptide Y
T e) Prostacyclin
49)Second heart sound-

F a)is a low frequency sound
F b) Signals the onset of ventricular systole
T c) Wide fixed splitting of it is the pathognomonic feature of atrial septal defect
23
T d) Reverse splitting of it occurs in left bundle branch block

F e) The P2 component is loud in pulmonary stenosis
50)Biologically active substances metabolized by the lungs are-

T a) Surfactant
T b) Serotonin
T c) Histamine
F d) VIP
T e) Bradykinin
Explanation:
Biologically active substances metabolized by the lung
>surfactant
>prostaglandines
>histamine
>kallikrein
>bradykinin
>serotonin
>acetylcholine,norepinephrine
51)A shift of 02-Hb dissociation curve to the right

F a) Occurs in the pulmonary capillaries
T b) Occurs if body temperature rises
T c) Favors delivery of O2 to the tissue
F d) Favors 02 uptake by lungs
T e) Increases the P50
Explanation:
Factors shifting the curve to right
> ↑H or decrease PH
> ↑ PCO2
>↑ Temperature
> ↑ 2, 3 DPG
> HbS
> ↑P 50
> ↑ PO2
>High altitude
>Hypoxia
> Exercise
> Thyrotoxicosis
> Polycythaemia
> occurs in systemic capillaries
52)Rate of gas diffusion through the respiratory membrane is directly proportional to

T a) Surface area of the membrane
T b) Solubility of gas
F c) Molecular weight of gas

24
F d) Thickness of the membrane

T e) Diffusion coefficient
Expalantion:
Factors affecting diffusion of Gas through respiratory membrane:
1. Thickness of the membrane: Inversely proportional to diffusion
2. The surface area of the membrane: Directly proportional
3. Diffusion coefficient: Directly proportional.
4. Partial pressure difference between the two sides of the membrane: Directly proportional
53)The chemical factors regulating respiration are

T a) PO2
T b) H+ concentration
T c) PCO2
F d) HCO3- concentration
F e) 2,3-diphosphoglycerate
Explanation:
Chemical factors that are involved in the control of ventilation are:
1. Partial pressure of arterial CO2 (PC02)
2. pH of arterial blood (i.e. H+ concentration)
3. Partial pressure of arterial O2 (P02)
54) A patient with carbon dioxide retention is likely to have

F a) Metabolic acidosis
F b) Alkaline urine
F c) Cool extremities
T d) Raised cerebral blood flow
T e) Raised plasma bicarbonate
Explanation:
a. Respiratory acidosis
b. Large amount of HCO3- are excreated in urine, but more HCO3- is reabsorbed
C. 13% increase of CO2 increase 1% temperature
55)Viscosity of blood rises in

T a) Acidosis
T b) Cyanosis
T c)Jaundice
F d) Anaemia
F e)Oedema
Explanation:
Cause of ↑Viscosity of blood:
Acidosis
Hypercalemia
Hyperglycemia
Polycythemia
25
Cyanosis
DM
Multiple Myeloma
Dehydration
Jaundice
56)Essential hormones for erythropoiesis are

T a)Testosterone
T b) Thyroxine
F c) Oestrogen
T d) Thyroid stimulating hormone
F e) Prolactin
Explanation:
Essential hormones for Erythropoiesis
1. Erythropoietin
2. Thyroid hormone
3.TSH
4.Adrenocortical hormone like
-Glucocorticoid
- Minarelocorticoid
- Androgens (Andosteron & testosterone)
57)Platelet activation is caused by

T a) Collagen fibers
T b) ADP
T c) Epinephrine
F d) Thromboplastin
F e) Prothrombin
Explanation:
Platelet activation is caused by
1. Collagen
2. ADP
3. Thrombin
4. Adrenaline (epinephrine)
5. Thromboxane
58)Complications of massive blood transfusion are-

F a) Febrile reaction
T b) Hypothermia
F c) Thrombophlebitis
T d) Coagulopathy
F e) Incompatible haemolytic transfusion reaction
Explanation:
Complications from massive transfusion include:
26
-coagulopathy
-hypocalcaemia
.hyperkalaemia
• hypokalaemia
.hypothermia
59)Renal vasodilation is caused by

T a) dopamine
T b) atrial natriuretic peptide
F c) cortisol
F d) endothelin
F e) angiotensin II
Explanation:
Renal vasodilation is caused by
ANP
Dopamine
PGE2
CAMP
60)Hormones acting on kidney are

F a) 1 -25 dihydroxycholecalciferol
T b) Atrial Natriuretic peptide (ANP)
T C) ADH
T d) parathormone
F e) T3& T4
Explanation:
Endocrine hormones acting on kidneys:
1.Aldosterone:
2. ADH ( antidiuretic hormone)
3. ANP:
4. Angiotensin II
5. Dopamine
6. Parathyroid hormone (PTH)
61)Substances that are freely filtered but not reabsorbed by the kidney are
T a) Creatinine
F b) Urea
F c) Glucose
F d) Bicarbonate
T e) Inulin
Explanation:
Substances not reabsorbed
Inulin, creatinine, mannitol,sucrose
27
62)ECG change(s) in hyperkalemia is(are)

T a) Tall peaked narrow based T wave
F b) Prolonged QT interval
F c) Tall P wave
T d) ST depression
F e) U wave
Explanation
ECG changes in
Hyperkalaemia :
> Loss of P wave
> Tall, Peaked T wave
> Widened QRS complex
> Prolonged PR interval
> ST depression
63)Heart rate is accelerated by

T а) Hypoxia
T b) Exercise
T c) anger
T d) bainbridge reflex
F e) Increased intracranial pressure
Explanation:
Heart rate accelerated by
> Decreased activity of baroreceptors in the arteries,
left ventricle, and pulmonary circulation.
> Increased activity of atrial stretch receptors
> Inspiration
> Excitement
> Anger
> Most painful stimuli
> Hypoxia
>Exercise
>Epinephrine
>Thyroid hormones
> Fever
>Bainbridge reflex
64)Which parasites are transmitted by penetration of skin by larvae?

F a. Trichuris
T b. Necator

28
F c. Ascaris
T d. Strongyloides
F e. Trichinella
65. Parasites causing malignancy are
T a. Schistosoma haematobium
F b. Trypanosoma
F c. Trichinella
T d. Clonorchis
F e. Toxoplasma
66. Tissue nematodes are-

T a. Wuchereria bancrofti
T b. Loa loa
T c. Trichinella
F d. Diphyllobothrium
F e. Paragonimus
67)Tetralogy of fallot consists of

F a) ASD
T b) VSD
F c) Dextroposition of the aorta
T d) Pulmonary stenosis
T e) Right ventricular hypertrophy
Explanation :
Fallots tetralogy consists of
1)pulmonary stenosis
2)overriding of the aorta
3)ventricular septal defect
4)right ventricular hypertrophy
68)Post-exposure prophylaxis by vaccination is recommended for the following

29
infections
a) Hepatitis A
b) Hepatitis B
c) Influenza
d) Rubella
e) Rabies
TTFFT
69. Viruses establishing latent infections in the human sensory ganglia are
a) Herpes simplex virus (HSV)

b) Hepatitis B virus (HBV)
c) Varicella zoster virus (VZV)
d) Rabies virus
e) Rubella virus
TFTFF

30
70)Cortisol plays a permissive role in the

T a) Lipolytic effect of catecholamines
T b) vasopressor effect of catecholamines
F c) Lipolytic effect of glucagon
T d) Calorigenic effects of glucagon
F e) Lipolytic effect of thyroxine
Explanation:
-Calorigenic effects of glucagon
-Lypolytic effects of catecholamines
-Vasopressor effects of catecholamines
-Bronchodilatation by catecholamines.
71)Microcytic anemia usually occurs in the following conditions

F a) Evan's syndrome
31
T b) thalassemia
T c) iron deficiency anemia
F d) hypothyroidism
T e) sideroblastic anemia
Explanation :
Microcytic hypochromic anaemia
→ Iron deficiency anaemia
→ Thalasemia
→ Anaemia of chronic disease
→ Sideroblastic anaemia
Lead poisoning
72)Features of haemolysis are

T a) Increased Bilirubin
T b) Increased LDH
F c) Decreased Reticulocytes
F d) Increased Haptoglobin
T e) Increased Urobilinogen
Explanation :
Hallmarks of haemolysis :
↓Haemoglobin • ↑Unconjugated bilirubin • ↑Lactate dehydrogenase •
↑Reticulocytes • ↑Urinary urobilinogen
Additional features of intravascular haemolysis •
↓Haptoglobin • ↑Methaemalbumin • Positive urinary haemosiderin •
Haemoglobinuria
73)The following enzyme deficiency lead to hemolytic anemia -

F a) Lactate dehydrogenase
T b) Pyruvate kinase
F c) Pyruvate dehydrogenase complex
T d) Glucose 6 phosphate dehydrogenase
F e) NADPH oxidase
Explanation:
Red cell enzyme deficiency:
1)PK 2) G6PD 3) Pyrimidin 5' nucleotidase
74)Iron deficiency anemia can be differentiated from anemia of chronic disease by

F a) Low serum iron level
T b) Raised serum transferrin receptor level
T c) Low serum ferritin level
F d) Low transferrin saturation
T e) Raised TIBC
32
Difference between IDA & ACD :
75)Microorganisms that do not meet the criteria of Koch's postulates are
a) Treponema pallidum
b) Mycobacterium tuberculosis
c) Mycobacterium leprae
d) Neisseria gonorrhoeae
e) Escherichia coli
TFTFF
76)Normal flora of skin are

A.Staphylococcus aureus
B.Corynebacterium (diphtheroids)
C.moraxella catarrhalis
D.Histoplasma capsulatum
E.enterococcus faecalis
TTFFF
Normal flora of Skin:

● Staphylococcus
epidermidis
Less important organisms
● Staphylococcus aureus
● Corynebacterium (diphtheroids)
● various streptococci
● Pseudomonas
Aeruginosa
● anaerobes (e.g.,
Propionibacterium), yeasts (e.g.,
Candida albicans)

33
77)Cell wall of gram positive bacteria contain

A.peptidoglycan
B.periplasmic space
C.lipopolysaccharide
D.teichoic acid
E.porin protein
TFFTF
Explanation:
Comparison of cell walls of gram positive and gram negative bacteria
Component Gram positive cells Gram negative cells
peptidoglycan thicker,multilayer Thinner,single layer
Lipopolysaccharide(e No Yes
ndotoxin)
Teichoic acids yes No
Cell Wall:
• Outermost component common to all bacteria (except Mycoplasma species, which
are bounded by a cell membrane)
• Located external to the cytoplasmic membrane and is composed of peptidoglycan.
• Peptidoglycan layer is much thicker in gram-positive than in gram-negative
bacteria.
• Many gram-positive bacteria have fibers of teichoic acid that protrude outside the
peptidoglycan.
• Gram-negative bacteria have a complex outer layer consisting of
lipopolysaccharide, lipoprotein, and phospholipid. Lying between the outer membrane
layer and the cytoplasmic membrane in gram-negative bacteria is the
periplasmic space, which is the site, in some species, of enzymes called β-
lactamases that degrade penicillins and other β-lactam drugs.
• The cell wall has several other important properties:
✓ In gram-negative bacteria, it contains endotoxin, a lipopolysaccharide.
✓ Its polysaccharides and proteins are antigens that are useful in laboratory
identification.
✓ Its porin proteins play a role in facilitating the passage of small,
34
hydrophilic molecules into the cell. Porin proteins in the outer membrane
of gram-negative bacteria act as a channel to allow the entry of essential
substances such as sugars, amino acids, vitamins, and metals as well as
many antimicrobial drugs such as penicillins.
78)Double stranded RNA viruses

a. Rabies
b. Rotavirus
c. Ebola
d. Reovirus
e. Yellow fever virus
FTFTF
Explanation:
● Double stranded RNA viruses are rotavirus and reovirus.
● All other RNA viruses are single
stranded.
● All DNA viruses are double stranded except parvovirus B 19 which is single
stranded.
79)Oncogenic DNA viruses are-

a. Human papillomavirus
b. HTLV-1
c. Epstein barr virus
d. Hepatitis B virus
e. Retrovirus
TFTTF
Explanation:
● Epstein barr virus(EBV), Human Papillomavirus ( HPV), Hepatitis B virus
(HBV),human
herpes
Virus 8 are oncogenic DNA viruses.
● EBV causes Burkitt’s lymphoma, nasopharyngeal carcinoma.
● HPV – cervical carcinoma, HBV- hepatocellular carcinoma, Human herpesvirus 8-
Kaposi
Sarcoma.
● Oncogenic RNA viruses are

● Hepatitis C virus( hepatocellular carcinoma),HTLV-1, Human T
lymphotropic virus 1-( adult T cell leukemia/lymphoma), HTLV-2 ( hairy cell leukemia).

35
80)Parasites having heart-lung passage through infection are

A.wuchereria bancrofti
B.necator americanus
C.S. stercoralis
D.paragonimus westermani
E.echinococcus granulosus
FTTFF
Explanation:
Parasites passing through lungs
● Necator americanus
● Ancylostoma duodenale
● Ascaris lumbricoides
● Strongyloides stercoralis
20 SINGLE BEST QUESTIONS
81) Capsulated organism

A.haemophilus influenzae
B.cryptosporidiosis
C.E. coli
D.staphylococcus epidermidis
E.streptococcus agalactiae
Ans a
Capsulated bacteria:
● Neisseria meningitidis
● Streptococcus pneumoniae
● Haemophilus influenzae
● Salmonella typhi
● Klebsiēlla pneumoniae
● Bordetella pertussis
● Bacillus anthracis
● Ștreptococcus pyogenes
82) Splenectomized pts are more susceptible to following pathogens except?

a. Strep. Pneumoniae
b. Neisseria. meningitidis

36
c. H. influenzae
d. H. influenzae type b
e. Chlamydiae
Ans e
Explanation :
Splenectomized pts are more susceptible to infection by encapsulated bacteria
Streptococcus
pneumoniae, Neisseria, Haemophilus influenzae.
83)Fibrocartilage is found in
a) Pubic symphysis
b) Menisci
c) Both a+b
d) Epiglottis
e) Ends of the ribs
Ans c
84)Elastic fibers are found in

a) Lung
b) Uterus
c) Epiglottis
d) Heart
e) both a + c
Ans e
85)Parasites that have intermediate host as part of their life cycle

A.taenia solium
B.both a+ e
C.ascaris lumbricoides
D.trichomonas vaginalis
E.echinococcus granulosus
Ans b
Explanation:
Man act as intermediate host for the following parasites
● S. mansoni
● T. solium
37
● M. multiceps
● E. granulosus
● E. multilocularis
● Babesia
● Toxoplasma gondii
● Plasmodium
86)Sites of undescended testis are

a) Deep inguinal ring
b) Inguinal ligament
c) Root of the penis
d) Perineum
e) both b + c
Ans a
87)Attachment of flexor retinaculum are with the following structures except

a) Pisiform
b) Trapezium
c) Capitate
d) Hook of hamate
e) Scaphoid
Ans c
88)Structures passing through lesser sciatic foramen

a) Obturator artery
b) Pudendal nerve
c) Sciatic nerve
d) both b+ e
e) Internal pudendal artery
Ans e
89)Parasites that can be diagnosed by examination of sputum

a. Wuchereria bancrofti
b. Loa loa
c. Echinococcus granulosus
d. Diphyllobothrium
e. Trichinella spiralis
Ans c
38
Explanation:
Parasites that can be diagnosed by examination of

sputum
● Entamoeba histolytica
● Echinococcus granulosus
● Paragonimus westermani
90)Arterial thrombi are usually – while venous thrombi are –

a)occlusive,non occlusive
b)not occlusive,occlusive
c)partially occlusive,not occlusive
d)atherogenic,embolic
Ans b
Explanation
Differences between arterial thrombi and venous thrombi
Feature Arterial thrombi Venous thrombi
Blood flow Formed in rapidly Formed in slow
flowing blood of moving blood in
arteries and heart. veins.
Sites Aorta, coronary, Superficial varicose
cerebral, iliac, veins, deep leg veins,
femoral, renal and popliteal, femoral and
mesenteric arteries. iliac veins.
Thrombogenesis Formed following Formed following
endothelial cell injury, venous stasis eg : In
eg : In atherosclerosis abdominal
operations,
childbirth.
Development Usually mural, not Usually occlusive
occluding
the lumen completely,

may propagate.

39
Macroscopy Gray - white, friable Red blue with fibrin

with line of Zahn on strands and lines of
surface. Zahn
Microscopy Distinct lines of Zahn Lines of Zahn with
composed of platelets, more abundant red
fibrin with entangled cells.
red and white blood
cells.
Effects Ischemia leading to Thromboembolism,
infarcts eg : In the edema, skin ulcers,
heart, brain. poor wound healing.
91)example of benign tumor is

a)seminoma
b)wilms tumor
c)immature teratoma
d)hydatidiform mole
Ans d
Explanation
Benign and Malignant tumors

Tissue of origin Benign Malignant
Connective tissue and ● Fibroma ● Fibrosarcoma
derivatives ● Lipoma ● Liposarcoma
● Chondroma ● Chondrosarcoma
● Osteoma ● Osteogenic
sarcoma
Blood vessels ● Hemangioma ● Angiosarcoma

Lymph vessels ● Lymphangioma ● Lymphangiosarcoma
Hematopoietic cell ● Leukemia
Lymphoid tissue ●Lymphoma
Smooth muscle Leiomyoma Leiomyosarcoma
Striated muscle Rhabdomyoma Rhabdomyosarcoma

40
Stratified squamous Squamous cell papilloma Squamous cell carcinoma

Basal cell of skin or Basal cell carcinoma
adnexa
Epithelial lining of ● Adenoma ● Adenocarcinoma
glands or ducts ● Papilloma ● Papillary
● Cystadenoma carcinoma
● Cystadenocarcino
ma
Respiratory passages ● Bronchial ● Bronchoge
adenoma nic
carcinoma
Renal epithelium ● Renal ● Renal cell carcinoma
tubular
adenoma
Liver cell ● Hepatic adenoma ● Hepatocell
ular
carcinoma
Transitional epithelium ● Transitional ● Transitional
cell cell
papilloma carcinoma
Placental epithelium ● Hydatidiform ● Choriocarcinoma
mole
Testicular epithelium ( ● Seminoma
germ cells) ● Embryo
nal
carcino
ma
Tumors of melanocytes ● Nevus ●Malignant melanoma
Renal angle Wilm's tumor
Totipotential cells in Mature teratoma, Immature teratoma

gonads or in embryonic dermoid cyst
rests
92) Compensated shock is characterized by

a) lactic acidosis
b) decreased urine output
c) both a + d
d) increased pulse rate
41
e) altered consciousness level

Ans c
92)Glasgow coma scale score include

a) eye opening
b) extensor plantar reflex
c)both a & e
d) tongue tremor
e) verbal response
Ans c
93)Veins used for central venous catheterization are

a) basilic vein
b) both c & e
c) internal jugular vein
d) long saphenous vein
e) subclavian vein
Ans b
94)Biochemical changes that occur following prolonged vomiting due to gastric outlet
obstruction are
a) metabolic acidosis
b) hypernatremia
c) hypokalaemia
d) hyperchloremia
e) hypoalbuminemia
Ans c
95)Hallmarks of cancer are all except
a)Self-sufficiency in growth signals.

b)Insensitivity to growth-inhibitory signals.
c)Altered cellular metabolism
d)invasion of apoptosis. Tumors are sensitive to programmed cell death.
Ans d
Explanation
Hallmark of cancers
1. Self-sufficiency in growth signals.

2. Insensitivity to growth-inhibitory signals.

42
3. Altered cellular metabolism

4. Evasion of apoptosis. Tumors are resistant to programmed cell death.
5. Limitless replicative potential (immortality)
6. Sustained angiogenesis.
7. Ability to invade and metastasize.
8. Ability to evade the host immune response
96)Osteolytic lesions are found in all except

a) hyperparathyroidism
b) metastatic bone tumor
c) polyostotic fibrous dysplasia
d) plasmacytoma
e) rickets
Ans e
97)dysplasia is characterized by the following

a)metamorphism
b)dyskeratosis
c)achromatic nuclei
d)a+b
Ans b
Explanation
Characteristics of dysplasia:
1. Dysplastic cells show considerable pleomorphism (variation in size and shape).
2. Hyperchromatic nuclei which are abnormally large
3. Mitotic figures are more abundant than usual. Although almost invariably they
conform to normal pattern.
4. Dyskeratosis and diminished cellular polarity.
5. Presence of koilocytosis, i.e. cytoplasmic vacuolation around the nucleus.
98)lesch nyhan syndrome is an example of

a)X linked recessive disease
b)autosomal dominant disease
c)autosomal recessive disease

43
d)X linked dominant disease

Ans a
Explanation
GENETIC DISORDERS
X linked recessive disease.
System Disorder
Musculoskeletal Duchenne muscular dystrophy

Blood Hemophilia A and B
Chronic granulomatous disease

Glucose 6 phosphate
dehydrogenase deficiency
Immune Agammaglobulinemi
a Wiskott-Aldrich
syndrome
Metabolic Diabetes insipidus
Lesch Nyhan
syndrome
Nervous Fragile X syndrome
99)Acute myeloid leukemia is associated with – exposure

a)asbestos
b)chromium
c)benzene
d)nickel
Ans c
Explanation
Diseases arises from occupational exposure
Agents or group of agents Human cancers for which

reasonable evidence is available
Arsenic and arsenic compounds Lung carcinoma, skin carcinoma

44
Asbestos Lung, esophageal, gastric, and

colon carcinoma, mesothelioma
Benzene Acute myeloid leukemia
Beryllium and beryllium compounds Lung carcinoma
Cadmium and cadmium compounds Prostate carcinoma
Chromium compounds Lung carcinoma
Nickel compound Lung and oropharyngeal carcinoma
Radon and its decay product Lung carcinoma

Vinyl chloride Hepatic angiosarcoma
100)Liver flukes are

a. Schistosoma.
b.Opisthorchis
c. Clonorchis
d. Fasciolopsis buski
e. Both b + c
Ans e
Pediatrics
SBA QUESTIONS
1. A 6 day baby is brought to you with complaints of yellow discoloration of

skin for 3 days .baby well alert and reflexes are good .jaundice extended upto
leg , palm and soles are spared .which of the following against your
diagnosis?
a) No sign of septicemia
b) Jaundice will persist longer than 14 days
c) Jaundice will decline by 7-10 days
d) It occur due to lysis of fetal RBC
e) It demands no treatment
ANSWER: B

45
2. In case of severe pneumonia which sign will be absent ?

a) Stridor in calm child
b) Spo2 <90%l
c) Lethargic
d) Not able to drink
e) Chest indrawing
ANSWER: E
3. MOST common organism of EONS -

a) Group b streptococcus
b) E coli
c) H influenza
d) Klebsiella
e) Listeria monocytogenes
ANSWER: B

46
4. A 1 year old baby presented with history of coryza and fever ,followed by
suddenonset of burking cough, inspiratory stridor what would be the
diagnosis?
a) Croup
b) Acute epiglotitis
c) Foreign body inhalation
d) Laryngomalacia
e) Vocal cord paralysis
ANSWER: A
5. In case of relative frequency of major congenital heart disease which one

is mostcommon ?
a) Ventricular septal defect
b) ASD
c) TOf
d) PDA
e) Pulmonary valve disease
ANS: A
6. A 3 year old male child presented with decreased albumin protinuria

(+++),hypercholesterolemia ,c3 level normal .child is massively edematous
.what is your most probable DIAGNOSIS?
a) IGA nephropathy
b) FSGS
c) AGN
d) MCNS
e) Membranoproliferative glomerulonephritis
ANSWER:D

47
7. A 15 month old child present with sgort stature ,lethargy ,constipation

.examinationreveals a plpable goiter.laboratory investigation reveals low T4
aand elevated TSH which could be the most likely underlying cause of such
condition ?
a) Dietary iodine deficiency
b) Hypogenesis of thyroid gland
c) Thyroid dishormonogenesis
d) Defect in iodine transport
e) Maternal TSH receptor blocking ab
ANSWER:C
8. A 10 month old boy is admitted because he can not sit yet .on examination
you notedh is hypotonic ,his eys are slunted upwards and have epicanthic
fold.what could be the diagnosis?
a) Down syndrome
b) Congenital hypothyroidism
c) Turner syndrome
d) Fraxile X syndrome
e) Klinefelter syndrome
ANSWER: A

48
A 10 yar old boy present with slow growth ,truncal obesity with moon face buffalo hump
muscle weakness .what would be the most common etiology of such condition
?
a) Adrenal tumor
b) Bilateral adrenal hyperplasia
c) Addisons disease
d) Pheochromocytoma
e) Growth hormone deficiency
ANSWER:
B
9. Feature of scurvey
a) Painless rachitic rosary at costochondral junction
b) Valgus and varus deformity
c) Anterior bowing of leg
d) Pigeon chest deformity
e) Sharp painful scorbutic rosary at costochondral junction
ANSWER:E
10. Which is the gold standard test for pulmonary TB –

a. X-ray
b. Gene expert
c. Mantoux test
d. Microbial culture
e. Interferon gamma release assay
ANSWER : D

49
11. In case of Crohn disease, which one is incorrect –

a. Predispose to anorectal faiure
b. Commonly affect terminal ileum
c. Cause granulomatous inflammation in intestinal mucosa
d. Can affect anorectal junction
e. May associated with pyoderma gangrenosum
ANSWER : E
12. 2 years girl presented with high grade fever for last 1 day. Give history of
convulsion once which lasted for less than 10 minutes. Most likely diagnosis –
a. Meningitis
b. Febrile convulsion
c. Cerebral malaria
d. Meningioma
e. Neural tumour
ANSWER : B
13. A 4 year old baby is brought with complaints of pooe feeding and seizures. On
examination, baby is lethargic with hypotonia and bulging anterior fontanel.
Infectiondue to which organism should be suspected -
a. E. coli
b. H. influenza
c. P.aeruginosa
d. Rota virus
e. S.typhi
14. A 20 days old male baby present with nonbilious projectile vomiting. Mother
gave H/O of prolonged jaundice. Serum electrolyte showed Hyponatremia,
Hypokalaemia, Hypochloraemia & metabolic alkalosis. What is your most
likely diagnosis ?
a. Congenital Adrenal Hyperplasia
b. Renal tubular acidosis
c. Infantile hypertrophic pyloric stenosis
d. Intussception

50
e. Congenital hypothyroidism
ANSWER : C
15. The most common presenting feature in acute rheumatic fever is –

a. Erythema marginatum
b. Migratory polyarthritis
c. Rheumatic pancarditis
d. Subcutaneous nodules
e. Sydenham chorea
ANSWER : B
16. A 15 years old boy with palpable purpuric rashes on the exterior surface of
hand andbuttock, abdominal pain, knee and ankle point tenderness. Now
what is the most likely diagnosis ?
a. vWD
b. ITP
c. HSP
d. TTP
e. HUS
ANSWER : C

51
17. A boy presented with progressive weakness, intellectual impairment,

hypertrophy of the calves and proliferation of connective tissue in muscle.
Which is the best initial test for diagnosis ?
a. Electrography
b. Muscle biology
c. Nerve conduction study
d. Polymerase chain reaction
e. Serum creatine phosphokinase
ANSWER : E
18. A 6 years old girl came to you with the complaints of epistaxis, excessive
menstrual bleeding and easy bruising, aPTT was prolonged but PT was
normal. What is your most common diagnosis ?
a. Haemophilia
b. vWD
c. ITP
d. HDN
e. DIC
ANSWER : B
19. Which is the most common subtype of Hodgkin lymphoma ?

a. Lymphocyte rich
b. Lymphocyte predominant
c. Lymphocyte depletion
d. Mixed cellularity
e. Nodular sclerosis
ANSWER : E

52
20. A 2 year old girl present with recurrent respiratory tract infection, failure to
thrive. Onexamination second heart sound is widely splitted and fixed. What is
the most probable diagnosis ?
a. ASD
b. VSD
c. PDA
d. TOF
e. Coartation of aorta
ANSWER : A
21. 7 years girl presented with moderate anaemia, HB% level 7mg/dl. MCV,
MCHreduced, PBF shows teardrop cell microcyte hypochromic
anaemia. Ferritin decreased, TIBC increased. What is the diagnosis ?
a. Thalassemia
b. Hemoglobinopathies
c. Megaloblastic anaemia
d. Iron deficiency anameia
e. Hereditary spherocytosis
ANSWER : D
22. A 3 years old child having 110 min mid upper arm circumference will be
defined as ?
a. Marasmus
b. Stunted
c. Kwashiorkor
d. Well nourished
e. SAM
ANSWER : E

53
23. Minerals are used in the initial management of PEM except ?

a. Zinc
b. Magnesium
c. Potassium
d. Sodium
e. Iron
ANSWER : E
24. Ossification center appears in child of 1 year age –

a. Head of femur
b. Lateral cuneiform
c. Epiphyses at lower end of fibule
d. Capitulum
e. Cuboid
ANSWER : B
25. Sign of good attachment during breast feeding is ?

a. Mouth wide open
b. Lower lip turned inward
c. More areola below than above the mouth
d. Facing breast, nose opposite to nipple
e. Body is fully supported
ANSWER : A

54
26. A 5 year old child admitted with progressive muscle weakness and frequent
falls. Onexamination, Gower sign was positive. What is the most probable
cause from the following ?
a. Acute poliomyelitis
b. Duchene muscular dystrophy
c. Gullian barre syndrome
d. Juvenile dermatomyositis
e. Polymyalgia rehumatica
ANSWER : B
27. According to EPI Schedule, which vaccine is not given at 10 weeks of age ?
a. Penta
b. OPV
c. PCV
d. IPV
e. PCV 2
ANSWER : D
28. Gold standard investigation of neonatal sepsis is ?

a. Sepsis screening
b. Blood for C/s
c. CSF study
d. Procalcitonin
e. Urine for R/M/E
ANSWER : B

55
29. In case of raised ICP sunsetting eyes is occurred due to paralysis of ?

a. 3rd cranial nerve
b. 4th cranial nerve
c. 6th cranial nerve
d. 2nd cranial nerve
e. 7th cranial nerve
ANSWER : B
30. Most common causes of convulsion within first 24 hours after birth is-
a. Hyponatremia
b. Hypoglycemia
c. Hypocalcaemia
d. HYPOXIC ischemic encephalopathy
e. Hypomagnesaemia
ANSWER : D
31. Confirmatory diagnosis of Thalassaemia is ?

a. CBC with PBF
b. Bone marrow study
c. Haemoglobin electrophoresis
d. Serum iron profile
e. Bone marrow stainable iron
ANSWER : C

56
32. In which of the following cases, is breast feeding contraindicated ?

a. Baby with breastmilk jaundice
b. HBsAg positive mother
c. HIV positive mother
d. Mother taking anti TB drugs
e. Mother taking cytotoxic chemotherapeutics
ANSWER : E
33. Most common pathognomic trigger for Guillain-Bare syndrome is-

a. Helicobacter pylori
b. Hemophilus influenza
c. Camplyobacter jejuni
d. Epstein-barr virus
e. Cytomegalovirus
ANSWER : C
34. CSF study shows elevated pressure, lymphocytes count 500/mm^3,

glucose < 40 mg/dl, protein 1000 mg/dl then what is the probable
diagnosis ?
a. Pyogrnic meningitis
b. Viral meningitis
c. Tubercular meningitis
d. GBS
e. Subarachnoid haemorrhage
ANSWER : C

57
35. Which one is the most infectious period of pertussis ?

a. Incubation period
b. Catarrhal Phase
c. Paroxysmalphase
d. Convalescent Phase
e. Latent phase
ANSWER : B
36. A chest X-ray shows normal size heart with concavity at pulmonary
conus andupturning of cardiac apex. Which would be diagnosis ?
a. Atrial septal defect
b. Patent ductus arteriosus
c. Coarctation of aorta
d. Tetralogy of Fallot
e. Transposition of the great arteries
ANSWER : D
37. Most specific investigation in case of NS except renal biopsy ?

a. Heat coagulation test
b. 24 hours urinary total protein
c. Serum C3 level
d. Spot urinary protein creatinine ratio
e. Serum cholesterol level
ANSWER : B

58
38. 2 years girl presented with high grade fever for last 1 day. Gives history of
convulsion once which lasted for less than 10 minutes. Most probable diagnosis
–
a. Meningitis
b. Febrile convulsion
c. Cerebral malaria
d. Meningioma
e. Neural tumour
ANSWER : B
39. Most common micro-organism responsible for infective endocarditis is-

a. Enterococci
b. Streptococci iridans
c. Staphylococcous aureus
d. Haemophilus
e. Cardiobacterium
ANSWER : B
40. Mutation of ATP 7B gene on chromosome 13, coding for a specific P-type
adenosinetriphosphatase is related to –
a. Acute stroke syndrome
b. Cerebral palsy
c. Guillain Barre syndrome
d. Poliomyelitis
e. Wilson disease
ANSWER : E

59
41. A 12 year old boy is suspected to have Wilson disease. What could be
the goldstandard investigation to establish the diagnosis ?
a. D-penicillamine challenge test
b. Liver biopsy with copper assay
c. Serum ceruloplasmin level
d. Serum copper level
e. Urinary 24 hours copper level
ANSWER : B
42. A 5 year old child admitted with progressive muscle weakness and frequent
falls. Onexamination, Gower sign was positive. What is the most probable
cause from the following ?
b. Duchenne muscular dystrophy
c. Guillain Barre syndrome
d. Juvenile dermatomyositis
e. Polymyalgia rheumatic
ANSWER : B
43. Most common type of congenital heart disease in case of Down syndrome ?
a. VSD
b. TOF
c. AV canal defect
d. PDA

60
e. ASD
ANSWER : C
44. A 7 year old boy is presented with asymmetrical paralysis in one limb. Wasting
on thigh muscles was visible. On enquiry, there was h/o diarrhea and same type
of illnessin the community. Immunization history was not complete. What is
your MOST probable diagnosis ?
b. Guillain barre syndrome
c. Spinal cord compression
d. Transverse myelitis
e. Traumatic neuritis
ANSWER : A
45. Most common type of Leukaemia in children is ?

a. AML
b. ALL
c. CML
d. CLL
e. Mixed
ANSWER : B

61
46. Most commonly involved heart valve in case of ARF is –

a. Aortic valve
b. Pulmonary valve
c. Mitral valve
d. Tricuspid valve
e. Semilunar valve
ANSWER : C
47. 3 months old baby presented with sudden onset of cough, respiratory distress
and wheeze. But affected baby seems playful and a febrile, not looking so sick.
What maybe the most common organism of such condition ?
a. Influenza virus
b. Para influenza virus
c. Respiratory syncytial virus
d. Human metapneumo virus
e. Mycoplasma
ANSWER : C
48. Confirmatory test for SLE –

a. ANA
b. Anti DSDNA
c. Anti Smith antibody (anti-Sm)
d. Anticardiolipin antibody (aCL) IgG
e. Antiphospholipid antibody
ANSWER : B

62
49. Main stay for treatment of SLE-

a. Hydroxychloroquine
b. Steroid
c. NSAID
d. Methotrexate
e. Biological agents
ANSWER : B
MCQ Clinical Paediatrics
1. Regarding mumps following are correct statements-

A. Mumps is non contagious
B. Disese is rare before 1 year of age
C. Sterility is common complication
D. Caused by virus
E. There is painless swelling of parotid gland
2. complication of measles
A. Flarring of dormant TB
B. Giant cell pneumonia
C. Unilateral deafness
D. Palatal palsy
E. Severe malnutrition
3. poliomyelitis shows following feature –
A. Bladder dysfunction
B. Involve distal muscle
C. Complete recovery of non paralytic polio can occur
D. Viral isolation from stool confirmatory
E. Autonomic involvement present
4. FATE of primary complex of TB may be devided into-
A. Silent primary complex
B. Progression of lung
C. Progression of lymphnode
D. Hypersentivity
E. Lymphohematogenous dissemination
5. CAUSE of non obstructive hydrocephalus –
A. Secondary to SAH
B. Acquedactal stenosis
C. Midline brain tumor
D. VIT A intoxication
63
E. Arnold chiari malformation

6. SITE of ectopic testis –
A. Bttom of scrotum
B. Deep inguinal ring
C. Inguinal canal
D. Femoral canal
E. Front of thigh
EXPLANATION :B+C+D site of undescended testis
7. commonest malignancy of childhood are-
A. LYMPHOMA
B. Retinoblastoma
C. Leukemia
D. Wilms tumor
E. Neuroblastoma
8. Peripheral motor disorders not include –
A. GBS
B. CP
C. Wilson disease
D. Poliomyelitis
E. Myasthenia gravis
9.Genaralized lymphadenopathy not include –
A. TB
B. Systemic JIA
C. Aplastic anemia
D. ITP
E. Leukemia
10. At birth a child with congenital hypothyroidism present with-
A. Wrinkled forehead
B. Flat nasal bridge
C. Low set ear
D. Bulged anterior and posterior frontanelle
E. Subnormal body temperature
11. Chromosomal abnormality found in down syndrome –
A. Mosaicism
B. Translocation
C. Non dysjunction
D. Inversion
E. Deletion .
12. RADIOLOGICAL finding include in vit D deficiency –
A. Widdening cupping and fraying of epiphysis
64
B. Widened growth plate

C. Epiphysesl centre are visible
D. Green stick fracture present
E. Osteopania
13. Feature of marasmus-
A. Round edematous face
B. Muscle wasting remarkable
C. Hepatomegaly
D. Diarhoea present
E. S.cortisol markedly elevated.
14.Regarding clinical feature s and examination finding of patent ductus arteriosus-
✓ Intolerance to physical activities
✓ Occasional respiratory tract infection
✓ Apex beat is heaving in nature
✓ Continuosus machinery murmur present
✓ S2 is widely splitted and fixed .
15.whenever a child present with wheeze , following condition should be considered-
A. Bronchial asthma
B. Acute bronchiolitis
C. GERD
D. Foreign body
E. Pneumonia
16. BACTERIAL cuse of pneumoni in newborn –
A. S.pneumonie
B. H influenzae
C. S.aureus
D. Virus
E. Group B streptococcus
17.Cyanotic disease with increased pulmonary flow not include –
A. Transposition of great arteries
B. Truncus arteriosus
C. Single ventricle
D. Tricuspid atresia
E. TOF
18. FEATURE of IUGR baby –
A. Lanugo hair absent
B. Limbs limp
C. Labia majora widely separated
D. Peeling of epidermis
E. Breast bud well developed.

65
19. Which of the following is a cause of prolonged unconjugated hyperbilirubinemia –

A. Hypothyroidism
B. Breast milk jaundice
C. Billiary atresia
D. Idiopathic neonatal hepatitis
E. Septicemia
20. Regarding sepsis screening not true-
A. Leukopenia
B. Absolute neutrophil count <1500/cm
C. Immature to total neutrophil ratio >0.2
D. ESR< 15 mmin 1st hour
E. Haptoglobin decreased

Diploma - Mock 3 (Pediatrics)

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1

1) Cells are united by

3)Primary cartilaginous joints:

5)The lymph nodes:

6)The diaphragm is pierced by the:

the lateral cruciate ligament.

7)The azygos vein:

8)The 'spermatic cord:

9)The abdominal oesophagus:

11)The following belong to the mononuclear phagocyte system:

12)Organised epithelioid cell granulomas develop in the following infections:

13)Pseudomembranous enterocolitis is caused by the following organisms:

14)Staphylococci pathogenic to man:

15)The common pathogenic pyogenic organisms affecting man Include:

17)The following antibiotics are effective against fungi:

18)Benzyl penicillin is:

19)Wound healing is enhanced by the administration of:

20)Secondary hypogammaglobulinaemla occurs in:

by a depression of cutaneous delayed hypersensitivity.

21)Drugs metabolized by acetylation are

e) Can occur with glucuronic acid

23)Enzyme inducing drugs are

24)Enzyme inhibitors are

25)Passage of drug through cell membrane is influenced by

26)Drugs having low therapeutic index are

27)Drugs with a high hepatic first-pass effect. include -

28)Following are partial agonist drugs

EXCLUSIVE EDUCATION AID

30)Confirmed teratogens are

EXCLUSIVE EDUCATION AID

31)Stimulation of beta-2 receptor causes -

6.Active Glycogenolysis and gluconeogenesis

31)Eicosonoid include following substances -

32)Side effects of thiazide diuretics include

33)The following drugs prolong the QT interval

34)Anti-diabetic drugs reducing body weight are

35)Drugs causing hyperglycaemia are

36)Followings are the colloid solution

37)Following compounds are disaccharides:

38)The reducing substances are

39)essential amino acid

40)Omega 6 fatty acids are

41)Essential fatty acids are:

42)Metabolic pathways occurring in mitochondria are

43)Hexose monophosphate shunt generates

44)Sources of acetyl CoA are

45) Metabolic fates of pyrovate are

46)Plasmid is dissimilar with

• Present both gram-positive and gram-negative bacteria

(2) Nontransmissible plasmids

47)Hormone-sensitive lipase is activated by

48)The factors causing dilation of blood vessels are -

49)Second heart sound-

T d) Reverse splitting of it occurs in left bundle branch block

50)Biologically active substances metabolized by the lungs are-

51)A shift of 02-Hb dissociation curve to the right

52)Rate of gas diffusion through the respiratory membrane is directly proportional to

EXCLUSIVE EDUCATION AID

F d) Thickness of the membrane

53)The chemical factors regulating respiration are

54) A patient with carbon dioxide retention is likely to have

55)Viscosity of blood rises in

56)Essential hormones for erythropoiesis are

57)Platelet activation is caused by