Final 2014 Flashcards
(201 cards)
1
Q
What’s the diagnosis?
A
atrial flutter
2
Q
In radioimmunoassay, which tube has the lowest T4 concentration?
a) Tube 1
b) Tube 2
c) Tube 3
d) Tube 4
A
a) Tube 1
3
Q
Which of the following accurately describes type II hypersensitivity?
A
a) An antibody is bound to an Ag on the cell surface
4
Q
Which substance upon binding leads to ATP -> cAMP “graph of Gs activation” in muscle tissue?
a) insulin
b) Glucagon
c) Epinephrine
A
c) Epinephrine
5
Q
This graph represents the polysomnography of a 75-year-old male who complained of snoring that disrupts his sleep, what is the most likely diagnosis
a) obstructive sleep apnea
b) Central sleep apnea
c) Upper airway resistance syndrome
d) Normal sleep pattern
A
a) obstructive sleep apnea
6
Q
The above graph represents the rhythm of which of the following hormones?
A
a) Growth hormone
7
Q
study was conducted to investigate the survival rate of patients with microglobulinuria and those with normoglobulinuria. Two samples of people with micro and normoglobulinuria were selected and followed up till death occurred, and we got the following Kaplan meier curve. What is the median survival time of people with normoglobulinuria?
a) 17
b) 60
c) 72
d) Non-defined
A
d) Non-defined
8
Q
This graph shows blood flow after a period of blood vessel occlusion. What is the reason behind this increased blood flow?
A
a) Hypoxia
9
Q
Why does the Hemoglobin structure shifts from A to B conformation in the figure above?
a) 2,3BPG binding
b) Low pH
c) O2 binding
A
c) O2 binding
10
Q
A study was conducted to find the prevalence of oropharyngeal cancer in a population and the exposure state was also determined. From the following table, what is the odds ratio of cancer in smokers compared to non-smokers? a) 0.234 b) 4.2 c) 2.2 d) Cant calculate it
A
b) 4.2
11
Q
A cohort study was done to examine the association between obesity and type 2 DM. Two groups were selected one of which was obese and the other was normal weight. The participants were followed for different periods of time. What is the RR?
a) 1.4
b) 0.7
c) 2.5
A
a) 1.4
12
Q
What is the percentage of Kuwaiti people who are unaware of being hypertensive?
a) 10%
b) 25%
c) 35%
d) 65%
A
c) 35%
13
Q
- A 35-year-old woman is known for having SLE and she is taking estrogen supplements, what is your recommendation for her regarding her estrogen supplements and what is your rational behind it?
a) Continue, because it will help in reducing SLE symptoms
b) stop, because it is responsible for the flares
c) continue, because ERT helps improve fertility
A
b) stop, because it is responsible for the flares
14
Q
What is the function of aggrecan?
A
a) Retention of water
15
Q
Which of these drug regimens is the most appropriate one to treat multi-bacillary lepromatous leprosy?
a) Dapsone and ethambutol for 2 years.
b) Dapsone, rifampicin, and clofazimine for at least 2 years
c) Isoniazid, rifampicin, and ethambutol for 6 months.
d) Dapsone and rifampicin for 6 months.
A
b) Dapsone, rifampicin, and clofazimine for at least 2 years
16
Q
Which muscle is not affected by carpal tunnel syndrome? (question got cancelled)
a) Abductor policis
b) Adductor policis
c) Abductor digiti minimi
d) Flexor digiti minimi
e) Opponens digiti
A
-
17
Q
Which of the following nerves is responsible for hiccups?
a) Vagus
b) Glossopharyngeal
c) Phrenic
A
c) Phrenic
18
Q
What is the most important risk factor for non-cystic fibrosis bronchiectasis?
a) Acute bronchiolitis
b) Lung abscess
c) asthma
d) chronic bronchitis
A
d) chronic bronchitis
19
Q
Which of the following would cause an apparent decrease in the DLCO?
a) chronic bronchitis
b) emphysema
c) compression of pulmonary artery
d) left to right shunt
A
c) compression of pulmonary artery
20
Q
Which type of blood vessels has thin tunica intima and adventitia but thick tunica media with 7-8 smooth muscle cell layers?
a) muscular artery
b) small arteriole
c) muscular vein
d) elastic artery
e) small artery
A
e) small artery
21
Q
What is the rationale behind giving G-CSF for a stem cell donor?
a) To make the stem cells proliferate and differentiate into mature blood cells
b) To mobilize stem cells from bone marrow to the periphery circulation
A
b) To mobilize stem cells from bone marrow to the periphery circulation
22
Q
A patient with heart failure with reduced ejection fraction (HF-REF). What should we give him?
a) Diltiazem
b) Nitrates
c) Bisolol (beta blocker)
d) Amlodipine
A
c) Bisolol (beta blocker)
23
Q
Which of the following receptors can inhibit the cough reflex sensitivity?
a) TRPA1
b) TRPV1
c) TRPV4
d) TRPM8
A
d) TRPM8
24
Q
What is the stage of lung tissue development, during which the mesenchymal tissue between the epithelium of the lung and the endothelium of capillaries is the thinnest?
a) pseudo glandular
b) canalicular
c) terminal sac
d) alveolar
A
c) terminal sac
25
a 45-year-old male presents with progressive dyspnea, lung biopsy reveals chronic interstitial inflammation(infiltration) with eosinophils, what is the most probable diagnosis?
a) hypersensitivity pneumonitis
b) good pasture syndrome
c) sarcoidosis
d) amyloidosis
e) adult respiratory distress syndrome
a) hypersensitivity pneumonitis
26
Which of the following muscles contract during expiration?
a) Sternocleidomastoid
b) Scalene
c) Abdominal external oblique
d) External intercostal
c) Abdominal external oblique
27
how does phenylephrine decrease congestion?
a) Agonist of beta 2 adrenergic receptor
b) Agonist of alpha 1 adrenergic receptor
c) Activates histamine receptor
d) Degrades mucous by acting as a mucolytic
b) Agonist of alpha 1 adrenergic receptor
28
```
which of the following is used in the management of a patient with chronic stable angina?
(check answer)
a) Diuretic
b) Amlodipine
c) correcting the patient’s anemia
```
?
29
A 43-year-old male presented to the outpatient clinic, upon examination he was anxious with fast heart rate and forceful heartbeat he was also sweating with cold hands, his pupils were dilated. what is the most likely diagnosis?
a) Adrenomedullay tumor
b) Enlargement of the adenohypophysis
a) Adrenomedullay tumor
30
what is the body compensatory mechanism for congestive heart failure?
a) Decreased catecholamine
b) tachycardia
c) myocardial atrophy
b) tachycardia
31
what’s the first structure to receive factors coming from hypothalamus into adenohypophysis?
a) Pars distalis
b) Pars nervosa
c) Median eminence
d) Pars tuberalis
c) Median eminence
32
A patient with history of upper respiratory tract infection complains of enlargement in the neck and tenderness, a biopsy was done. Which of the following is most likely to be found in the biopsy?
a) Excessive lymphocytic infiltration
b) Granulomas
c) Hurthle cell metaplasia
b) Granulomas
33
A patient with high blood thyroxin and low TSH presented with small/atrophic thyroid gland, what is the most likely cause?
a) The patient is taking thyroid extract
b) The patient is positive for graves’ disease
c) excessive iodine intake
a) The patient is taking thyroid extract
34
What stimulates the release of both insulin and glucagon?
a) Amino acids
b) Carbohydrates
c) Fatty acids
d) Ketones
a) Amino acids
35
A female with a normal 28-days menstrual cycle presented to the clinic. 12-hours earlier she had her peak estradiol levels without any significant progesterone. What do you expect after 3 days?
a) Menses
b) Corpus luteum will degenerate
c) Ovulation
c) Ovulation
36
A 58-year-old Kuwaiti male died from heart attack, how many years of potential life lost (YPLL)?
a) 1
b) 20
c) 40
d) 78
b) 20
37
Which of the following accumulate in patients with lipoid CAH?
a) ACTH receptor
b) Cholesterol ester
b) Cholesterol ester
38
To investigate a hemolytic anemia of newborn, what sample do we use in Indirect coombs test?
a) Baby’s serum
b) Baby’s RBC
c) Mother’s RBC
d) Mother's serum
d) Mother's serum
39
Which of the following is a natural anti-inflammatory substance?
a) LTC4
b) LTB4
c) LXA4
d) LTA4
c) LXA4
40
Which of the following is a powerful chemo-attractant lipid mediator of inflammation?
a) LTA4
b) LTB4
c) LTC4
d) LXA4
e) PGI2
b) LTB4
41
Which Immune cell is deficient in a patient with recurrent bacterial infections or Patient with repeated (pulmonary) infections and primary immunodeficiency, which of the following immune cell lineages is most likely deficient?
a) T cell
b) B cell
c) Phagocyte
d) Eosinophil
b) B cell
42
What is the effect of smoking on bone healing?
a) Vasoconstriction which diminishes blood flow to the fractured area
b) Increase the efficiency of bone healing by producing some cytokines
a) Vasoconstriction which diminishes blood flow to the fractured area
43
Which of the following lies anterior to the transverse sinus?
a) Pulmonary trunk
b) Arch of aorta
c) Left atrium
d) Right atrium
e) Inferior vena cavae
a) Pulmonary trunk
44
What is true regarding right sided heart failure?
a) Distended painful liver and Lower limb edema
45
Which of the following choices in the table below indicate the effect of controlling glucose levels on micro and macro diseases?
a. Microvascular not affected, Macrovascular reduced slightly
b. Microvascular reduced significantly, Macrovascular not affected
c. Microvascular reduced significantly, Macrovascular reduced slightly
d. Microvascular reduced slightly, Macrovascular reduced significantly
c. Microvascular reduced significantly, Macrovascular reduced slightly
46
Which of the following cells work as protective cells in the airway epithelium?
a) Basal cells
b) Brush cells
c) Goblet cells
c) Goblet cells
47
which of the following decreases hemoglobin affinity to O2?
a) Bisphosphoglycerate mutase
b) Methemoglobin reductase
a) Bisphosphoglycerate mutase
48
which of the following describes the action of the antirheumatic drug infliximab?
a) blocks DHFR
b) blocks the action of TNF-a
c) inhibits JAK
b) blocks the action of TNF-a
49
A 45-year-old male come with bradycardia and have first degree heart block. What abnormality can be seen in ECG?
a) ST elevation
b) prolonged PR interval
c) prolonged RR interval
d) ST segment prolonged
b) prolonged PR interval
50
a 60-year-old man presented with hyponatremia because of overconsumption of water and not because of sodium excretion. he was given tolvaptan and improved. What is the mechanism of action of tolvaptan?
a) Acts as an agonist to ADH v2 receptor
b) Decrease the sensitivity of ADH v2 receptor
c) Blocks ADH v2 receptor
c) Blocks ADH v2 receptor
51
Which steroid hormone plays a key role in adrenarche?
a) DHT
b) DHEA
c) cortisone
b) DHEA
52
A Girl had a neck pain which radiates into right shoulder/arm and little finger, what should be the immediate investigation? Check answer
a) Physical examination
b) MRI
c) X-ray
?
53
what is the origin of the cervical sympathetic nerve supply of the heart?
a) C3-5 cervical
b) T1-5 spinal thoracic
c) T6-10 spinal thoracic
d) Vagus
b) T1-5 spinal thoracic
54
Removal of the adenohypophysis will result in the atrophy of?
a) Zona glomerulosa
b) Zona fasiculata
c) Zona reticularis
b) Zona fasiculata
55
A 55-year-old man with milliary TB has suffered from a severe acute adrenal insufficiency. What is the best treatment that should be administered?
a) Cortisol & 9-flurocortisol
b) 9-Flurocortisol & metyrapone
c) Aldosterone & metyrapone
a) Cortisol & 9-flurocortisol
56
Persistence of which of the following structures leads to the mixture of blood of the pulmonary trunk with the aorta?
a) Ductus venosus
b) Foramen ovale
c) Ductus arteriosus
a) Ductus venosus
57
A study was conducted to find negative effects of radon gas exposure on the lungs. They gave all the workers radon monitors and masks, and followed them for 5 years. What is the study design?
a) Case control
b) RCT
c) Cross sectional
d) Cohort
d) Cohort
58
What cell expresses CD34+ on their surfaces?
a) T lymphocytes
b) Multipotent stem cells
c) Pluripotent stem cells
c) Pluripotent stem cells
59
Familial cardiomyopathies are considered 50% of all cardiomyopathies. What is the mode of inheritance of familial cardiomyopathies?
a) Autosomal recessive
b) X- linked recessive
c) X- linked dominant
d) Autosomal dominant
d) Autosomal dominant
60
Which of the following accurately describes the anti-inflammatory action of aspirin?
Check answer
a) Irreversible inhibition of COX-1
b) Irreversible inhibition of COX-1 and COX-2
c) Reversible inhibition of COX-1 and COX-2
d) Irreversible inhibition of COX-2
?
61
A man presented with low WBCs, RBCs, platelets after being treated for his colon cancer. What abnormality could you find?
a) Hypercellular bone marrow
b) Inflammatory cells infiltration in the BM
c) Bone marrow hypoplasia
c) Bone marrow hypoplasia
62
It has been proven that massaging the carotid artery is helpful in terminating reentry tachycardia, what is the mechanism behind that?
a) Decreases the upstroke of action potential
63
In which of the following cases is dilution helium test not recommended to be used to estimate the lung volume?
a) COPD
b) Emphysema
b) Emphysema
64
Which of the following has a positive ionotropic effect?
a) Decrease afterload
65
Which of the following mechanisms do Th1 cells use to kill intracellular pathogens?
a) activate infected macrophages
b) release TNF-a which activates cytotoxic t-cells
a) activate infected macrophages
66
Why does warfarin act more efficiently in vivo but not in vitro?
a) Because there are pre-formed coagulation factors in vivo
67
Damage of which nerve root is responsible for loss of patellar reflex and sensation in the medial part of the leg?
a) L3
b) L4
c) L5
d) S1
b) L4
68
A young man was playing basketball when his neck was accidentally hyperflexed. Upon physical examination, the lateral part of forearm was numb. Which intervertebral disc is involved?
a) C3/C4
b) C4/C5
c) C5/C6
d) C7/C8
c) C5/C6
69
Quinidine is a drug that is used to terminate different types of tachyarrhythmias; however, it can lead to increased heart rate, what is the mechanism behind that?
a) Anti-vagal activity
70
A young female patient presented with symmetrical joints pain of the hand and hip. She also complains of morning stiffness. She told the doctor that she had suffered from an injury to her right elbow few years ago. Upon examination, her hand showed hyperextension of MCP and hyperflexion of both PIP and DIP of the 4th and 5th fingers, what is the deformity called?
a) Mallet finger
b) Swan neck deformity
c) Claw hand
d) Boutonniere’s deformity
c) Claw hand
71
Which of the following anti- neoplastic drugs is used to inhibit ribonucleotide reductase?
a) 5-Flurouracil
b) 6-Mercapotopurine
c) Methotrexate
d) Hydroxyurea
d) Hydroxyurea
72
Why is Eplerenone considered an effective drug to use in patients with heart failure?
a) It decreases salt and fluid absorption
73
What can you conclude form the lung compliance graph?
a) Surface tension reduces lung compliance
74
Which of these are not characteristic of osteoarthritis?
a) Subchondral cyst
b) Subchondral sclerosis
c) Osteophyte formation
d) Joint space narrowing
e) Erosion of the bone
e) Erosion of the bone
75
Which of the following lymph nodes drain most lymph from lymphatics that are associated with the cephalic vein?
a) Pectoral
b) Subscapular
c) Humeral
d) Central
e) Apical
e) Apical
76
What's the most common risk factor for TB in Africa?
a) Malnutrition
b) Lack of BCG
c) HIV
d) Lack of awareness
c) HIV
77
What gives the extended structure of proteoglycans?
a) Polysaccharide charges
b) Polysaccharide branches
c) Protein double helix
d) Protein triple helix
a) Polysaccharide charges
78
A 65-year-old male with recently fractured tibia, bone biopsy shows thickened bone lamella and mosaic pattern, with increase in alkaline phosphatase, what’s the underlying mechanism?
a) Hyperparathyroidism
b) Osteoclast dysfunction
c) Disorder of growth palate
d) Increased vitamin D intake
b) Osteoclast dysfunction
79
Epistaxis is nose bleeding that is usually associated with low platelet count. Where does the bleeding most commonly occur in the nasal cavity?
a) posteriolateral
b) posterior inferior
c) anterior inferior
c) anterior inferior
80
A patient with low back pain that radiates to the posterior of the thighs, the pain gets worse with standing and walking and relieved by rest and bending. On examination, the patient has normal sensation and reflexes and no weakness, and 2+ peripheral pulses, straight leg test was negative, the patient didn’t complain of any bowel problems. Which of the following is most likely the diagnosis?
a) Disc herniation
b) Vascular claudication
c) Spinal stenosis
d) cauda equine syndrome
c) Spinal stenosis
81
A patient is having palpitations and heartburn and she admitted that she drinks 4 cups of coffee daily, which of the following enzymes determines the patient’s risk of having a myocardial infarction?
a) CYP2C9
b) CYP1A2
c) CYP2B1
d) CYP1B2
b) CYP1A2
82
Which of the following modalities is best used to detect spinal haemorrhage? (check answer)
a) CT
b) MRI
c) X-ray
d) Ultrasound
?
83
An old female patient with a history of steroid therapy presented with recent severe right hip pain, which of the following methods is used to assess her condition? (check answer)
a) CT
b) Bone scan
c) MRI
d) Plane X-ray
?
84
Which of the following is considered as a secondary prevention? (check)
a) Aspirin for patients with atrial fibrillation
b) Clopidogrel for patients with atrial fibrillation to prevent thromboembolic events
c) ICD for patients with EF<30% to prevent sudden death
a) Aspirin for patients with atrial fibrillation
85
What role does SH domain play in signalling proteins?
a) Recruits cytosolic kinases for RTK.
b) Initiates proteolytic degradation of RTK.
c) Recognizes phosphorylated tyrosine residues of RTK.
d) Prevents interactions of TFs with unstimulated RTKs.
c) Recognizes phosphorylated tyrosine residues of RTK.
86
A patient presented with a recent nausea, vomiting, weight loss, hypotension and hyperpigmentation. Upon investigation, the patient was found to have anti-microsomal and anti-insulin antibodies. What is the diagnosis?
a) Pituitary adenoma
b) Multiple Endocrine Neoplasia II (MEN II)
c) Polyendocrine Autoimmune Syndrome II (PAS II)
c) Polyendocrine Autoimmune Syndrome II (PAS II)
87
Which of the following is a product of selenium containing/based enzyme?
a) Cortisol
b) T3
b) T3
88
Cellular response to hypoxia is essential for increasing oxygen delivery to tissues. HIF-1 a is a very important factor for blood vessels to develop. Which of the following is true regarding HIF-1 a during hypoxia?
a) HIF-1 beta synthesis is stimulated
b) HIF-1 alpha is not degraded by proteasomes, and it binds HRE to induce expression of target enzymes
c) HIF-1 alpha is hydroxylated
d) HIF-alpha is degraded by proteasomes
b) HIF-1 alpha is not degraded by proteasomes, and it binds HRE to induce expression of target enzymes
89
A 9-year-old girl who is known to be diabetic was rapidly hydrated after suffering from diabetic ketoacidosis, what is the most feared complication?
a) Cerebral edema
90
How many alpha genes are defected in HbH constant spring disease?
a) 1 alpha gene
b) 2 alpha genes
c) 3 alpha genes
d) 4 alpha genes
c) 3 alpha genes
91
What property does Aminolevulinic acid have that makes it possible to be used in photodynamic therapy?
a) It’s a photosensitizer that has the ability to produce ROS and singlet oxygen
92
A patient had dyspnea and cyanosis. His chest x-ray showed tracheal deviation towards the right side and upon examination there was a stony dullness on the right side of the chest. What is the diagnosis?
a) Pleural effusion on the right side and collapse of the right lung
93
In acute myeloid leukemia, point mutation in nucleophosmin gene causes the activation of which of the following oncogenes?
a) ARF
b) ABL
c) MYC
c) MYC
94
Which of following is positively correlated with BMI?
a) Resistin
b) Adiponectin
c) Cortisol
a) Resistin
95
Which of the following is a characteristic finding of pheochromocytoma under electron microscope?
a) Neurosecretory granules
96
Which structure of the humerus is most painful in a young man who lifts weight and known to have tennis elbow?
a) Medial epicondyle
b) Lateral supracondylar ridge
c) Medial supracondylar ridge
d) lateral epicondyle
d) lateral epicondyle
97
A patient comes to the ER complaining of central chest pain with shortness of breath. You suspect that he is experiencing an acute MI, what next step you should do?
a) Cardiac angiography
b) ECG
c) Cardiac troponin
b) ECG
98
In the first beat, the ejection fraction and stroke volume were reduced and the afterload was increased, what do you expect to happen in the 2nd beat?
a) Increased End diastolic volume
99
What is the mechanism of action of statins?
a) Inhibit HMG-CoA reductase
100
What is Framingham 10-year risk score?
a) The risk of developing CVD in the following 10 years
101
Why is the net fluid movement directed inwards in the pulmonary circulation compared to systemic circulation? (i.e. Why there’s no fluid in alveoli?)
a) Less hydrostatic pressure of pulmonary circulation
b) Less oncotic pressure in the pulmonary vessels
a) Less hydrostatic pressure of pulmonary circulation
102
Ventilation and perfusion are not equally distributed in the lungs. The V/Q ratio in the base is less than the apex, what is the reason?
a) Gravitational force increases blood flow to the base significantly/ Because of the gravity, the
apex is hypoperfused
b) The base of the lung is well ventilated compared to the apex
a) Gravitational force increases blood flow to the base significantly/ Because of the gravity, the
apex is hypoperfused
103
A boy complains of failure to develop secondary sexual characteristics and delayed puberty. What is the best test you will do to investigate his condition?
a) Chromosomal analysis
b) Testicular biopsy
a) Chromosomal analysis
104
Which of the following structures guides the surgeon to the inferior parathyroid gland?
a) Superior thyroid artery
b) Thyroid ima artery
c) Inferior thyroid vein
d) Inferior thyroid artery
d) Inferior thyroid artery
105
Which nerve damage is responsible for loss of sensation in the posterior part of arm?
a) Musculocutaneous
b) Medial
c) Radial
d) Axillary
c) Radial
106
How do inflammatory cytokines increase glucose output from the liver, promoting the development of diabetes mellitus type II?
a) increase glycogen degradation
b) increase gluconeogenesis
c) Increase glycogenesis
b) increase gluconeogenesis
107
Which of the following values indicate osteoporosis in a post-menopausal woman?
a) T value of -2.6
b) Z value of -2.1
c) T value of -1.9
d) Z value of -2.6
a) T value of -2.6
108
Which of the following is sensed by central chemoreceptors?
a) HCO3-
b) PaO2
c) H+
d) PaCO2
d) PaCO2
109
A patient was diagnosed with crohn’s disease a few years ago. Now he is presenting with central obesity, high blood pressure, and easy bruising. What is the diagnosis?
a) Iatrogenic Cushing
110
A patient with type II diabetes was prescribed metformin. what is the mechanism of action?
a) Decrease amino acids transformation into glucose in the liver.
111
A smoker patient comes with lung mass, from which a biopsy was taken. The biopsy showed keratinized pearls & intercellular bridges, what is the diagnosis?
a) Squamous cell carcinoma
b) Adenocarcinoma
c) Small cell carcinoma
d) Large cell carcinoma
a) Squamous cell carcinoma
112
A patient presented with muscular twitches, numbness and paraesthesia. The electrolyte lab test showed low calcium and high phosphate. What is the diagnosis?
a) Hypoparathyroidism
b) Osteomalacia
c) Vitamin D deficiency
a) Hypoparathyroidism
113
What is the effect of AAT deficiency?
a) Increased protease activity
114
A 26-year-old man with visual disturbances, sexual dysfunction, and severe headaches. On x-ray, a calcified suprasellar mass was seen and removed. What do you expect to see in a histological section of the mass?
a) Squamous cells surrounded by a layer of cuboidal cells
b) Islands of squamous epithelial cells with cuboidal cells on the margin
c) Monomorphic eosinophilic sheets of cells with loss of reticulin fibers
b) Islands of squamous epithelial cells with cuboidal cells on the margin
115
A space occupying lesion in the hypothalamus of a 1-year-old child was detected. On biopsy, it was found to contain clusters of small neurons amongst a background of neuropil-like stroma and scattered fibrillary astrocytes. What is the diagnosis?
a) Hamartoma
116
A patient had a mass in the middle lobe of his right lung. Upon further examination, it was found that it’s a lung cancer. Which nerve can be affected by the direct invasion of the cancer?
a) Vagus
b) Phrenic
c) glossophrarangeal
b) Phrenic
117
```
A patient with a history of recurrent infections presented with fever & sore throat, what would you find in his blood smear?
A. Eosinophilia
B. Basophilia
C. Toxic granulation Leukocytosis
D. Thrombocytosis
```
C. Toxic granulation Leukocytosis
118
A patient comes with vaso-occlusive crisis and had several infections in the past?
```
A. HbA2
B. HbF
C. HbA
D. HbH
E. HbS
F. Hb barts
```
E. HbS
119
Which Hemoglobin is found in a newborn with alpha thalassemia trait?
```
A. HbA2
B. HbF
C. HbA
D. HbH
E. HbS
F. Hb barts
```
F. Hb barts
120
A patient had hepatic encephalopathy, long PT, APTT.
```
A. Whole blood
B. Packed RBCs
C. Cryoprecipitate
D. Platelet component
E. Neutrophils
F. Fresh frozen plasma
```
F. Fresh frozen plasma
121
A patient comes to the ER with significant bleeding after a car accident.
```
A. Whole blood
B. Packed RBCs
C. Cryoprecipitate
D. Platelet component
E. Neutrophils
F. Fresh frozen plasma
```
B. Packed RBCs
122
A patient with AML has been treated and now presenting with bleeding from her nose.
```
A. Whole blood
B. Packed RBCs
C. Cryoprecipitate
D. Platelet component
E. Neutrophils
F. Fresh frozen plasma
```
D. Platelet component
123
Exchanging parts of DNA between 2 non-homologous chromosomes?
```
A. Transposition
B. Duplication
C. Deletion
D. Karyotype
E. Translocation
F. Inversion
G. PCR
```
E. Translocation
124
Used to examine the structure/arrangement of chromosomes?
```
A. Transposition
B. Duplication
C. Deletion
D. Karyotype
E. Translocation
F. Inversion
G. PCR
```
D. Karyotype
125
A patient with splenomegaly. PBS shows increased mature lymphocytes and smudge cells. What is the diagnosis?
```
A. primary myelofibrosis
B. chronic myeloid leukemia
C. chronic lymphocytic leukemia
D. polycythemia vera
E. acute myeloid leukemia
F. acute lymphocytic leukemia
G. Essential thrombocythemia
```
C. chronic lymphocytic leukemia
126
A patient presented with unexplained weight loss and lymphadenopathy. He was found to have the t(14:18) translocation. What’s the diagnosis?
A. Hodgkin’s lymphoma
B. Follicular lymphoma
C. Chronic lymphocytic leukemia
D. Acute lymphocytic leukemia
B. Follicular lymphoma
127
A patient is being treated for lymphoma has severe neutropenia, what is the treatment to increase neutrophil count?
```
A. Erythropoietin
B. Thrombopoietin
C. IL-1
D. IL-4
E. IL-6
F. G-CSF
```
F. G-CSF
128
Rate limiting enzyme that is inhibited in heme synthesis?
```
A. Delta ALA synthase
B. Delta ALA dehydratase
C. Porphobilinogen deaminase
D. Uroporphyrinogen III synthase
E. Ferrocheletase
```
A. Delta ALA synthase
129
Deficiency in what enzyme causes x linked sideroblastic anemia?
```
A. Delta ALA synthase
B. Delta ALA dehydratase
C. Porphobilinogen deaminase
D. Uroporphyrinogen III synthase
E. Ferrocheletase
```
A. Delta ALA synthase
130
What is characterized by Philadelphia chromosome?
```
A. primary myelofibrosis
B. chronic myeloid leukemia
C. chronic lymphocytic leukemia
D. polycythemia vera
E. acute myeloid leukemia
F. acute lymphocytic leukemia
G. Essential thrombocythemia
```
B. chronic myeloid leukemia
131
16) Which of the following is affected when lusitropy decreases?
```
A. Stroke volume
B. End diastolic volume
C. Stroke work
D. End systolic volume
E. Cardiac output
F. Ejection fraction
G. Cardiac efficiency
```
C. Stroke work
132
Decreases when O2 consumption increases?
```
A. Stroke volume
B. End diastolic volume
C. Stroke work
D. End systolic volume
E. Cardiac output
F. Ejection fraction
G. Cardiac efficiency
```
G. Cardiac efficiency
133
What ECG finding would you possibly find in severe aortic stenosis?
```
A. Sinus tachycardia
B. Sinus bradycardia
C. Atrial flutter
D. Atrial fibrillation
E. High voltage QRS complex
F. Ventricular fibrillation
G. ST elevation
```
E. High voltage QRS
134
What ECG finding is common in pregnancy?
```
A. Sinus tachycardia
B. Sinus bradycardia
C. Atrial flutter
D. Atrial fibrillation
E. High voltage QRS complex
F. Ventricular fibrillation
G. ST elevation
```
A. Sinus tachycardia
135
Which drug is contraindicated in asthma?
```
A. Calcium channel blocker
B. Beta blocker
C. ACE inhibitor
D. Temporary pacemaker
E. Digoxin
F. Cardioversion
G. ARBs
H. Carotid sinus massage
```
B. posterior descending artery
B. Beta blocker
136
What do you use to treat ventricular tachycardia?
```
A. Calcium channel blocker
B. Beta blocker
C. ACE inhibitor
D. Temporary pacemaker
E. Digoxin
F. Cardioversion
G. ARBs
H. Carotid sinus massage
```
F. Cardioversion
137
Artery which supplies the pacemaker of the heart
```
A. right marginal artery
B. posterior descending artery
C. left anterior descending artery
D. diagonal artery
E. circumflex artery
F. right coronary artery
G. nodal artery
```
G. nodal artery
138
Originates from the ascending aorta
```
A. right marginal artery
B. posterior descending artery
C. left anterior descending artery
D. diagonal artery
E. circumflex artery
F. right coronary artery
G. nodal artery
```
F. right coronary artery
139
what ECG finding do you expect in unstable angina?
A. ST segment elevation in leads I, II, and AVF
B. ST segment elevation in leads V2 to V5
C. ST segment depression in leads V3 to V5
D. Irregular QRS complexes
E. Low Voltage in all chest leads
F. ST segment elevation in all leads
C. ST segment depression in leads V3 to V5
140
What ECG finding do you expect in acute pericarditis?
A. ST segment elevation in leads I, II, and AVF
B. ST segment elevation in leads V2 to V5
C. ST segment depression in leads V3 to V5
D. Irregular QRS complexes
E. Low Voltage in all chest leads
F. ST segment elevation in all leads
F. ST segment elevation in all leads
141
Which of the following drugs is used in a patient with both hypertension and benign prostatic hyperplasia?
```
A. Captopril
B. Metoprolol
C. Carvedilol
D. Eplerenone
E. Spironolactone
F. Hydralazine
G. Alpha-methyldopa
H. Doxazosin
```
H. Doxazosin
142
A 45-year-old female with granulomatous inflammation of the subclavian artery?
```
A. giant cell arteritis
B. takayasu arteritis
C. polyarteritis nodosa
D. kawasaki disease
E. Wegener Granulomatosis
F. Churg Strauss Syndrome
G. Leukocytoclastic Vasculitis
H. thromboangiitis obliterans
```
B. takayasu arteritis
143
A woman with palpable purpura?
```
A. giant cell arteritis
B. takayasu arteritis
C. polyarteritis nodosa
D. kawasaki disease
E. Wegener Granulomatosis
F. Churg Strauss Syndrome
G. Leukocytoclastic Vasculitis
H. thromboangiitis obliterans
```
G. Leukocytoclastic Vasculitis
144
When blood leaks from the vessel and forms a false lumen beside the true one?
A. Aortic stenosis
B. Abdominal aortic aneurysm
C. Dissecting aneurysm
D. atherosclerosis
C. Dissecting aneurysm
145
Palpable mass that is likely to undergo rupture, embolism?
A. Aortic stenosis
B. Abdominal aortic aneurysm
C. Dissecting aneurysm
D. atherosclerosis
B. Abdominal aortic aneurysm
146
Represents the septum primum in a fetus?
A. Limbus fossa ovalis
B. Fossa ovalis
C. Valvulae fossa ovalis
D. Foramen ovale
B. Fossa ovalis
147
What is the response to the increase in HR?
A. decrease in cardiac output
B. Increase SVR
C. Increase velocity of flow
D. Increase stroke volume
D. Increase stroke volume
148
First line bactericidal anti TB drug?
```
A. Rifampicin
B. Capreomycin
C. Cycloserine
D. Ethionamide
E. Dapsone
F. Isoniazid
```
F. Isoniazid
149
First line sterilizing anti TB drug?
```
A. Rifampicin
B. Capreomycin
C. Cycloserine
D. Ethionamide
E. Dapsone
F. Isoniazid
```
A. Rifampicin
150
Used to treat both TB and leprosy?
```
A. Pyrazineamide
B. Ethambutol
C. Clofazimine
D. Rifampicin
E. Capreomycin
F. Cycloserine
G. Ethionamide
H. Dapsone
I. Isoniazid
```
D. Rifampicin
151
a patient with s. pneumoniae pneumonia?
```
A. Gram positive in clusters
B. Bacitracin sensitive
C. Gram negative diplococci
D. Bile soluble
E. Gram positive in chains
F. Fried egg appearance
```
D. Bile soluble
152
a patient with mycoplasma pneumoniae pneumonia?
```
A. Gram positive in clusters
B. Bacitracin sensitive
C. Gram negative diplococci
D. Bile soluble
E. Gram positive in chains
F. Fried egg appearance
```
F. Fried egg appearance
153
Which substance activates TRPV4?
```
A. Menthol
B. Capsaicin
C. Smoking cigarettes
D. Citric acid
E. Cold temperature
```
D. Citric acid
154
Which substance activates TRPV1?
```
A. Menthol
B. Capsaicin
C. Smoking cigarettes
D. Citric acid
E. Cold temperature
```
B. Capsaicin
155
A man with consolidation and cavity formation in the apex of the lung, he was treated for TB in the past?
A. Primary TB
B. Secondary TB
C. Lung abscess
D. Milliary TB
B. Secondary TB
156
Tiny consolidations in the lung because of lymphohematogenous spread?
A. Primary TB
B. Secondary TB
C. Lung abscess
D. Milliary TB
D. Milliary TB
157
This bone has a foramen that transmits several nerves and vessels?
```
A. Vomer
B. Ethmoid
C. Nasal bone
D. Inferior nasal concha
E. Medial pterygoid plate
F. Perpendicular plate of the palatine bone
G. Lacrimal bone
```
F. Perpendicular plate of the palatine bone
158
The middle concha is part of this bone?
```
A. Vomer
B. Ethmoid
C. Nasal bone
D. Inferior nasal concha
E. Medial pterygoid plate
F. Perpendicular plate of the palatine bone
G. Lacrimal bone
```
B. Ethmoid
159
Which muscle is used to tense and tighten the vocal cords?
```
A. Thyroarytenoid
B. Cricothyroid
C. Vocalis
D. Posterior crico-arytenoids
E. Lateral crico-arytenoids
F. Transverse arytenoids
G. Oblique arytenoids
H. Ary-epiglottic
```
B. Cricothyroid
160
Which muscle helps in adduction of the interligamentous part of the rima glottidis?
```
A. Thyroarytenoid
B. Cricothyroid
C. Vocalis
D. Posterior crico-arytenoids
E. Lateral crico-arytenoids
F. Transverse arytenoids
G. Oblique arytenoids
H. Ary-epiglottic
```
E. Lateral crico-arytenoids
161
Which of the following increases when the amount of shunt increases significantly?
```
A. Alveolar partial pressure of oxygen
B. Arterial partial pressure of oxygen
C. Arterial partial pressure of CO2
D. Hemoglobin saturation
E. Alveolar-arterial gradient (AaDO2)
F. Arterial oxygen content CaO2
```
E. Alveolar-arterial gradient (AaDO2)
162
Which value is always associated with hypo/hyperventilation?
```
A. Alveolar partial pressure of oxygen
B. Arterial partial pressure of oxygen
C. Arterial partial pressure of CO2
D. Hemoglobin saturation
E. Alveolar-arterial gradient (AaDO2)
F. Arterial oxygen content CaO2
```
C. Arterial partial pressure of CO2
163
Non-necrotic granulomatous inflammation along the lymph nodes and bronchi.
```
A. Sarcoidosis
B. Wagner granulomatosis
C. Rheumatoid arthritis
D. TB
E. Histoplasmosis infection
F. Acute respiratory distress syndrome
```
A. Sarcoidosis
164
Diffuse alveolar and endothelium damage with severe hypoxia.
```
A. Sarcoidosis
B. Wagner granulomatosis
C. Rheumatoid arthritis
D. TB
E. Histoplasmosis infection
F. Acute respiratory distress syndrome
```
F. Acute respiratory distress syndrome
165
What is the Mechanism of action of streptomycin?
A. Inhibit DNA gyrase and topoisomerase IV
B. Inhibit the synthesis of tetrahydrofolic acid
C. Inhibits protein synthesis by irreversible inhibition of the 30S ribosomal subunit
D. Inhibits protein synthesis by irreversible inhibition of the 50S ribosomal subunit
E. Inhibiting peptidoglycan cross-link formation in bacterial cell wall
C. Inhibits protein synthesis by irreversible inhibition of the 30S ribosomal subunit
166
Which enzyme is activated when cortisol concentration is high?
A. Tyrosine hydroxylase
B. Phenylethanolamine-N-methyl-transferase
C. Dopamine-beta-hydroxylase
D. Monoamine oxidase
B. Phenylethanolamine-N-methyl-transferase
167
Which enzyme shouldn't be there during epinephrine synthesis
A. Tyrosine hydroxylase
B. Phenylethanolamine-N-methyl-transferase
C. Dopamine-beta-hydroxylase
D. Monoamine oxidase
D. Monoamine oxidase
168
A 54 years old professor, smoker for 30 years presents with productive cough. She noticed recent hair growth over her upper lip and chest. Upon examination, you also found bruises?
```
A. Pheochromocytoma
B. Addison’s disease
C. Cushing syndrome
D. Conn’s syndrome
E. Macroprolactinoma
F. Congenital adrenal hyperplasia
G. Cushing disease
H. Acromegaly
```
C. Cushing syndrome
169
A bus driver complains of erectile dysfunction. His driving license has been suspended by the authorities since he couldn't see the pedestrians crossing the road on several occasions, what is the diagnosis?
```
A. Pheochromocytoma
B. Addison’s disease
C. Cushing syndrome
D. Conn’s syndrome
E. Macroprolactinoma
F. Congenital adrenal hyperplasia
G. Cushing disease
H. Acromegaly
```
E. Macroprolactinoma
170
A study was done to investigate if there's association between diabetic foot and myocardial infarction. Two groups of diabetic patients one with diabetic foot and the other without were followed up to see if they develop MI. If we want to represent the data based on the time of developing MI graphically, what should we use?
```
A. Kaplan Meier
B. Scatter plot
C. Bar chart
D. Relative risk
E. Odds ratio
F. Box plot
```
A. Kaplan Meier
171
A patient is not responding to oral Ca and calcitriol?
A. Vitamin D receptor mutation
B. 1 alpha hydroxylase deficiency in the kidney
C. 25-hydroxylase deficiency in the liver
A. Vitamin D receptor mutation
172
Low level of 25-hydroxy vitamin D3?
A. Vitamin D receptor mutation
B. 1 alpha hydroxylase deficiency in the kidney
C. 25-hydroxylase deficiency in the liver
A. Vitamin D receptor mutation
173
A 50 years old patient with type 2 diabetes since she was 20 presented with diarrhea for a long period of time?
A. Type 1 diabetes
B. Type 2 diabetes
C. Autonomic neuropathy
C. Autonomic neuropathy
174
61) Which of the following drug is a phosphate analogue that is used to decrease bone resorption in osteoporosis?
```
A. Glucocorticoids
B. Raloxifene
C. Alendronate
D. Calcimer
E. Fluoride
F. Teriparatide
G. Sevelamer
H. Calcitriol
```
C. Alendronate
175
Inhibits calcium absorption form the GI and stimulates bone resorption.
```
A. Glucocorticoids
B. Raloxifene
C. Alendronate
D. Calcimer
E. Fluoride
F. Teriparatide
G. Sevelamer
H. Calcitriol
```
A. Glucocorticoids
176
A 56-year-old male presented to the outpatient clinic, upon further examination he was found to be hypertensive and had metabolic alkalosis. An MRI was done and it showed pituitary tumor what is the most likely diagnosis?
```
A. Addison’s disease
B. Pheochromocytoma
C. Cushing disease
D. Cushing syndrome
E. Conn’s syndrome
```
C. Cushing disease
177
What causes the release of PTH?
```
A. Increased alimentary Ca absorption
B. Increased alimentary Phosphate absorption
C. Decreased Ca plasma concentration
D. Increased Ca plasma concentration
E. Decreased phosphate excretion
F. Increased phosphate excretion
```
C. Decreased Ca plasma concentration
178
Which of the following is a direct effect of PTH deficiency?
```
A. Increased alimentary Ca absorption
B. Increased alimentary Phosphate absorption
C. Decreased Ca plasma concentration
D. Increased Ca plasma concentration
E. Decreased phosphate excretion
F. Increased phosphate excretion
```
E. Decreased phosphate excretion
179
Inhibits Ca absorption in GI and collagen formation, and activate osteoclasts.
```
A. Transforming growth factor (TGF)
B. Bone morphogenetic proteins (BMP)
C. Platelet-derived growth factors (PDGF)
D. Prednisolone
E. Fibroblast growth factors (FGF)
F. Insulin-like growth factors (IGF)
```
D. Prednisolone
| E. Fibroblast growth factors (FGF)
180
A patient complains of a nodule in the neck. It was found that it was a cold nodule, with nearby lymph node swellings (nodules).
```
A. Hashimoto’s thyroiditis
B. Subacute thyroiditis
C. Grave’s disease
D. Hypoparathyroidism
E. Papillary carcinoma
F. Medullary carcinoma
G. Parathyroid adenoma
H. Thyroid nodule
```
E. Papillary carcinoma
181
An anxious woman complains of weight loss and intolerance to heat despite no change in exercise or eating pattern.
```
A. Hashimoto’s thyroiditis
B. Subacute thyroiditis
C. Grave’s disease
D. Hypoparathyroidism
E. Papillary carcinoma
F. Medullary carcinoma
G. Parathyroid adenoma
H. Thyroid nodule
```
C. Grave’s disease
182
A patient comes with recurrent calcium oxalate calculi and a long-standing non-healing gastric ulcer.
```
A. Hashimoto’s thyroiditis
B. Subacute thyroiditis
C. Grave’s disease
D. Hypoparathyroidism
E. Papillary carcinoma
F. Medullary carcinoma
G. Parathyroid adenoma
H. Thyroid nodule
```
G. Parathyroid adenoma
183
A patient comes with a supra-sellar mass, which was resected surgically. Upon gross examination, it was found to have some hair, thyroid tissue (cells), hair, and teeth. What is the diagnosis?
```
A. Glioma
B. Null cell adenoma
C. Hamartoma
D. Rathke’s cleft cyst
E. Craniopharyngioma
F. Acromegaly
G. Teratoma
```
G. Teratoma
184
A very tall female with a recent headache mentioned that her ring doesn’t fit her anymore.
```
A. Glioma
B. Null cell adenoma
C. Hamartoma
D. Rathke’s cleft cyst
E. Craniopharyngioma
F. Acromegaly
G. Teratoma
```
F. Acromegaly
185
Uricoslytic drug administered IV weekly?
```
A. Allopurinol
B. Colchicine
C. Indomethacin
D. Probenecid
E. Pegloticase
F. Febuxostat
```
E. Pegloticase
186
Uricosuric drug?
```
A. Allopurinol
B. Colchicine
C. Indomethacin
D. Probenecid
E. Pegloticase
F. Febuxostat
```
D. Probenecid
187
Inhibits IL-2 formation?
```
A. Leflunomide
B. Chloroquine
C. tofacitinib
D. Cyclosporin A
E. Azathioprine
F. Sulfasalazine
G. Anankira
H. Penicillamide
```
D. Cyclosporin A
188
Not used with gold compounds as it chelates metals?
```
A. Leflunomide
B. Chloroquine
C. tofacitinib
D. Cyclosporin A
E. Azathioprine
F. Sulfasalazine
G. Anankira
H. Penicillamide
```
H. Penicillamide
189
What happens when tyrosine kinase is inhibited by Staurosporine?
```
A. Activate kiss and run endocytosis
B. Permanent blocker of Ach Receptor
C. Cleaves presynaptic docking proteins
D. Hyperpolarization
E. Action potential
F. Depolarization
G. Na+ over shoot
H. K conductance
```
A. Activate kiss and run endocytosis
190
Increase frequency of which is used to increase muscle strength (inotropy)?
```
A. Activate kiss and run endocytosis
B. Permanent blocker of Ach Receptor
C. Cleaves presynaptic docking proteins
D. Hyperpolarization
E. Action potential
F. Depolarization
G. Na+ over shoot
H. K conductance
```
E. Action potential
191
The increase in K+ conductance in membrane & termination of the action potential?
```
A. Activate kiss and run endocytosis
B. Permanent blocker of Ach Receptor
C. Cleaves presynaptic docking proteins
D. Hyperpolarization
E. Action potential
F. Depolarization
G. Na+ over shoot
H. K conductance
```
D. Hyperpolarization
192
Which cytokine is a target for inhibition in Rheumatoid arthritis?
```
A. IL-1
B. IL-2
C. IL-4
D. IL-10
E. INF-gamma
F. TNF-Alpha
```
F. TNF-Alpha
193
This nerve is damaged in a patient whose foot is everted.
```
A. Lateral sural nerve
B. Femoral nerve
C. Tibial nerve
D. Common peroneal nerve
E. Saphenous nerve
F. Obturator nerve
```
C. Tibial nerve
194
This nerve supplies sensation for the anteromedial side of the leg
```
A. Lateral sural nerve
B. Femoral nerve
C. Tibial nerve
D. Common peroneal nerve
E. Saphenous nerve
F. Obturator nerve
```
E. Saphenous nerve
195
What is the mechanism of action of Bungarotoxin?
```
A. stimulates massive exocytosis
B. temporary blocker of Ach Receptor
C. No postsynaptic AP even if Ach concentration is increased
D. cleaves presynaptic docking proteins
E. Activate kiss and run endocytosis
```
C. No postsynaptic AP even if Ach concentration is increased
196
Which muscle marks the beginning of the brachial artery?
```
A. Teres minor
B. Pectoralis minor
C. Subscapularis
D. Serratus anterior
E. Coracobrachialis
F. Pectoralis major
G. Teres major
```
G. Teres major
197
A patient has a skin rash with multiple joints swelling, upon examination of the synovial fluid, silver stain showed a spirochete.
```
A. Rheumatoid arthritis
B. Osteoarthritis
C. Lyme disease
D. Onchorosis
E. Septic arthritis
F. Gouty arthritis
```
C. Lyme disease
198
A biopsy of a nodule from the ear lobe of a patient was examined under microscope. There was a granulomatous reaction surrounding a clear space?
```
A. Rheumatoid arthritis
B. Osteoarthritis
C. Lyme disease
D. Onchorosis
E. Septic arthritis
F. Gouty arthritis
```
F. Gouty arthritis
199
Which artery supplies the lateral leg compartment?
```
A. Femoral artery
B. Superior gluteal artery
C. Posterior tibial artery
D. Fibular artery
E. Anterior tibial artery
F. Deep femoral artery
```
A. Femoral artery
200
Which artery passes in the adductor canal?
```
A. Femoral artery
B. Superior gluteal artery
C. Posterior tibial artery
D. Fibular artery
E. Anterior tibial artery
F. Deep femoral artery
```
D. Fibular artery
201
Which promotes/induce cell differentiation and endochondral ossification?
```
A. Transforming growth factor (TGF)
B. Bone morphogenetic proteins (BMP)
C. Platelet-derived growth factors (PDGF)
D. Prednisolone
E. Fibroblast growth factors (FGF)
F. Insulin-like growth factors (IGF)
```
B. Bone morphogenetic proteins (BMP)
