Medcoffee 2 Flashcards
Cervical sympathetic chain damage will cause?
sweating
decrease hearing
shoulder drop
increased papillary constriction
dec. pupil response
D) Reason
Miosis (pupil constriction)Associated with lesion of spinal cord above T1 (e.g., Pancoast tumor, Brown-Séquard syndrome [cord hemisection], late-stage syringomyelia).
maximum oxygen concentration in fetal blood is in?
umblical artery
umblical vein
umbilical cord
umbilical vesicle
pulmonary artery
B) Reason
During fetal circulation, oxygenated blood from the placenta to the fetus passes through the umbilical vein. Three vascular shunts develop in the fetal circulation to bypass blood flow around the liver and lungs.
unmyelinated pain receptors?
C fibers
A fibers
B fibers
delta fiber
D fibers
A) Reason
■ Fast pain is carried by group III fibers. It has a rapid onset and offset, and is localized.■ Slow pain is carried by C fibers (unmylenated). It is characterized as aching, burning, or throbbing that is poorly localized.
bronchopulmonary segment is supplied by?
primay bronchioles
secondary broncheoles
tertiary bronchioles
main bronchus
Quaternary bronchioles
C) Reason
Bronchopulmonary segments are the anatomic, functional,and surgical units of the lungs. Each lobar (secondary)bronchus, which passes to a lobe of the lung, gives offbranches called segmental (tertiary) bronchi
immediate action of angiotensin2?
vasoconstrition
Vasodilation
dec. renin
dec. Sympathetic flow
dec. BP
A) Reason
There are 4 effects of Angiotensin-II: 1) Increases Aldosterone 2) Increases Na-H exchange at PCTs (3) It increases thirst and therefore water intake.(4) It causes vasoconstriction of the arterioles, thereby increasing TPR and arterial pressure.
vitamin required for ALT?
B1
B3
B2
B9
B6
E) Reason
FUNCTION: Converted to pyridoxal phosphate, a cofactor used in transamination (e.g., ALT and AST), decarboxylation reactions, glycogen phosphorylase.
danger area of scalp containing vessels connecting emissary vein?
calvaria
loose conective tissue layer
pia matter
dura matter
Arachnoid
B) Reason
• Emissary veins are valveless channels that course through the bones of the skull and allow dural sinuses to communicate with extracranial veins. They can spread infection to dural sinuses when loose connective tissue layer is damaged
cortisol decreases ?
gluconeogenesis
peripheral utilization of glucose
glycogenolysis
pigmentation
pain threshold
B) Reason
Funtions: Increases Insulin resistance (diabetogenic)leading to decreased glucose use in periphral tissue.Increases Gluconeogenesis, lipolysis, and proteolysisDecreases ibroblast activity (causes striae) Decreases Inflammatory and Immune responses:
posterior cervical lymph node biopsy,nerve most likely to damage is?
CN XI
CN IX
CN X
spinal part of CN IX
CN XII
D) Reason
The spinal root of the accessory nerve arises from the nervecells in the anterior gray column of the upper five segmentsof the cervical part of the spinal cord .
About immunodeficiency conditions
The AIDS is secondary to HIV
The swiss type agammaglobulinemia is hereditary and deficient in both humoral as well as in cellular immunity
The bruton”s disease is an aplasia of T lymohocytes.
The multiple myloma is associatd with hypegammaglobulinemia
They may be primary to anemia, malnutrition, and metastases of bone
B) Reason
This is severe combined immunodeficiency deficiency that affects both B & T-cells.
A diabetic patient with ketoacidosis is being treated ,which will potentiate hypokalemia?
insulin
epinephrine
ampicillin
glucagon
cortisol
A) Reason
intracellular K+ comes out in exchange for H+ moving into the cells. Hence care should be taken while correcting acidosis which may lead to sudden hypokalemia. This is more likely to happen in treating diabetic ketoacidosis by giving glucose and insulin together.
Afebrile young patient presents with signs and symptoms of increased intracranial pressure ,what is probable cause?
miningitis
encephalitis
hydrocephalus
alzehmer disease
Parkinson”s
C) Reason
decreased CSF absorption or increased production by arachnoid granulations, which can lead to increased intracranial pressure, papilledema, and herniation .
scabies itching due to HSR of mice
proteins
lipids
feaces
polysacchride coat
wings
C) Reason
The pruritic lesions result from a delayed hypersensitivity reaction to the feaces of the mite. The mite is located within the stratum corneum of the epidermis.
scenario of RTA,maximum blood loss from?
heart
arterioles
arteries
kidneys
vein and venules
E) Reason
Veins and venules have more calibre and capacitance than that of arteries and accumulate more blood, and hence blood loss will be max from these vessels.
connected to desmosome are?
Tubulin
Intermediate filaments
Microfilaments
microtubules
cillia
B) Reason
Cadherins span between the cell membranes of desmosomes and internally desmosomes are anchored to intermediate filaments in large bundles called tonofilarnent
Most commonly associated with smoking among these?
CA bladder
CA esophagus
thromboangitis obilitarans
CA stomach
Churg Strauss
C) Reason
Thromboangiitis obliterans ( Buerger disease) is an acute inflammation involving small- to medium-sized a rteries of the extremities, extending to adjacent veins and nerves.1. This disease results in painful ischemic disease. often leading to gangrene. 2. It is clearly exacerbated by heavy cigarette smoking.
HCO3 is absorbed from?
DCT
collecting ducts
loop of henle
PCT
PCT & DCT
D) Reason
Early proximal convoluted tubule (PCT)—contains brush border. Reabsorbs all of the glucose and amino acids and most of the HCO3–, Na+, Cl–, PO4–, K+, and H2O.
injury to foramen ovale,which part of face is affected?
forehead
upper 1/3rd
middle 1/3rd
scalp
lower 1/3rd
E) Reason
The foramen ovale lies posterolateral to the foramen rotundum . It perforates the greater wing of the sphenoid, and it transmits the sensory and the motor roots of themandibular division (supplies the lower 1/3 rd of face) of the trigeminal nerve. It also transmitsthe lesser petrosal nerve .
a man running on a tread mill heart rate is doubled,effect on cardiac cycle?
0.2sec
- 1 sec
- 4 sec
- 6 sec
- 8 sec
C) Reason
Cardiac Cycle= 1mint/ number of beats that 60 sec/72= 0.82 sec. As the heart rate becomes double, the cardiac cycle duration will become half that is 0.4sec.
TM joint stability ligament?
articular surfaces
joint capsule
stylomandibular
stylomastoid
lateral temporomandibular
E) Reason
The lateral temporomandibular ligament is attached aboveto the articular tubercle at the root of the zygomatic archand below to the neck of the mandible. The fibers extenddownward and backward. This ligament limits the posteriormovement of the mandible.
An old man presents with history of bone pains, serum alkaline phosphatase is high and serum calcium is normal .most likely is is
Metastatic bone disease
Multiple myeloma
Osteomalacia
Paget”s disease of bones
Renal osteodystrohy
D) Reason
Paget Disease is the localized lesion of the bones in which there is imbalance b/w the osteoblasts and osteoclasts activity but serum Ca remains normal.
maximum feedback for blood pressure?
baroreceptor
brain bridge reflex
CNS Ischemic response
renin
chemoreceptor
A) Reason
■ The most important mechanisms for regulating arterial pressure are a fast, neurally mediated baroreceptor mechanism and a slower, hormonally regulated renin–angiotensin–aldosterone mechanism
Textile factory worker,which disease?
bysinosis
asbestosis
silicosis
asthma
pneumoconeosis
A) Reason
Organic Dusts include: Cotton, flax, hemp present in Textile manufacturing cuase ByssinosisRed cedar dust present in Lumbering, carpentry cause Asthma.
markers on B-cell?
CD3
CD 8,9
CD 19,20
CD 10,11
CD 22,28
C) Reason
B cells Ig (binds antigen)CD19, CD20, CD21 (receptor for EBV), CD40MHC II, B7
least mediated by local metabolites?
brain
blood vessels
kidney
skin
heart
D) Reason
Skin is richly supplied by the extensive distribution of the sympathetic nerve fibers. Its blood flow is least affected hy local metabolites rather is mediated by sympathetic stimulation or inhibition.
knee jerk?
L1-2
L2-3
L5-S1
L4-5
L3-4
E) Reason
Route Values of the different Deep Tendon reflexes are as: Bicep C5-6, Tricep: C3-4, Supinator C6-7, Knee Jerk L3-4, Ankle S1 and Jaw jerk V5 (CN V).
HIV patient is sero positive,what first step you would do?
isolate the patient for 1-2 months then test
treat immidiately
divorce spouse
leave home
admit in HIV clinic
A) Reason
ELISA/Western blot tests look for antibodies to viral proteins; these tests often are falsely negative in the first 1–2 months of HIV infection till you isolate the patient. It is falsely positive initially in babies born to infected mothers (anti-gp120 crosses placenta).
at FRC?
chest wall recoil
chest wall expand and lung recoils
lung expand
chest wall expand
lungs recoil
B) Reason
At FRC, inward pull of lung is balanced by outward pull of chest wall, and system pressure is atmospheric
Right sided weakness and left sided eye deviation,lesion is in?
right cortex
left cerebral cortex
corpus callosum
corona radiata
midbrain
B) Reason
In our brain, right side of body is controlled by left hemisphere and vice versa. So right side of body weakness is the feature of left sided lesion in brain and vice versa.
blood transfusion reaction?
O to A
O to B
O to AB
O+ to O-
A to AB
E) Reason
When A blood group is donated to a patient with blood group AB, Anti-B Antibodies of A blood group will damage the B antigens of AB blood group laeding to mismatch reaction.
virulence of staph aureus?
membrane lipids
cell membrane
polysacchride coat
coagulase +ve
cell wall
D) Reason
Staph make catalase because they have more “staff.” Bad staph (aureus) make coagulase and toxins. Forms fibrin clot around self leading to abscess.
minimum amount of urine reqired for draining wastes from body in
100ml
200-300ml
300-400ml
1200ml
500-600ml
E) Reason
Minimum amount (volume) of urine output that can prevwnt the adverse level of nitrogeneous wastes is 0.5ml/kg/hr that comes to be about 500-800ml in a person of 50-70kg.
In a patient with COPD which will inc
ERV
FVC
FEV
FRC
None of these
D) Reason
Obstructive lung volumes > normal (inc. TLC, inc. FRC, inc.RV); restrictive lung volumes < normal. In both obstructive and restrictive, FEV1 and FVC are reduced. In obstructive, however, FEV1 is more dramatically reduced compared to FVC, resulting in a decreased FEV1/FVC ratio.
Pterygoplatine fossa is also called
retropharyngeal
hypopharyngeal
parapharyngeal
deep vertebral
deep cervical
C) Reason
The pterygopalatine ganglion is a parasympathetic ganglion, which is suspended from the maxillary nerve in thepterygopalatine fossa (parapharyngeal fossa). It is secretomotor to the lacrimal andthe nasal glands .
which factor stabilize fibrinogen
factor X
Factor XI
factor XII
factor IX
factor 13
E) Reason
Factor X: Stuart factor; Stuart-Prower factorFactor XI: Plasma thromboplastin antecedent (PTA); antihemophilic factor CFactor XII: Hageman factorFactor XIII: Fibrin-stabilizing factorPrekallikrein: Fletcher factorHigh-molecular-weight Fitzgerald factor; HMWK.
Sudden loss of vision in one eye in an old man, what can be the cause
hypertension
Diabetes meillitis
retinal detachment
SLE
giant cell arteritis
E) Reason
Giant cell Arteritis: Clinical manifestations include: (1) Malaise and fatigue (2) Headache or claudication of the jaw (3) Tenderness, absent pulse, and palpable nodules along the course of the involved artery (4) Visual impairment, especially with involvement of the ophthalmic artery (5) Polymyalgia rheumatica, a complex of symptoms.
Muscle involved in dorsiflexion at ankle joint
tibialis longus
peroneus brevis
peroneus longus
tibialis posterior
tibialis anterior
E) Reason
• Dorsiflexion (toes pointing upward): Tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius muscles
In Hypertensive retinopathy, which vessels will be affected
Capillaries
arterioles
arteries
venules
veins
A) Reason
- Non-proliferative: Manifestations include micro aneurysms, dilation of veins, hemorrhages, soft (cottonwool) exudates (microinfarcts), and hard exudates (deposits of protein that have leaked from damaged capillaries) , all of which can be viewed with the ophthalmoscope. b. The retinopathy also includes increased capillary permeability, edema, and diffuse thickening of basement membranes (microangiopathy) . c. The disorder is related to the duration of the disease, occurring in most patients with diabetes mellitus after 10 years. 2. Proliferative retinopathy:. New retinal vessel formation (neovascularization) and fibrosis, both extending into the vitreous, is characteristic.
Free nerve endings are the receptors for
touch
pressure
deep touch
tactile
Pain
E) Reason
The receptors for pain are free nerve endings in the skin, muscle, and viscera.■ Neurotransmitters for nociceptors include substance P. Inhibition of the release of substance P is the basis of pain relief by opioids.
Upper fibers of external oblique interdigitate with
serratus posterior
external oblique
tranversus abdominis
quadratus lumborum
serratus anterior
E) Reason
External oblique aponeurosis, reinforced laterally by origin of the internal oblique from the inguinalligament. Posteriorly, its upper fibers interdigitate with serratus anterior
Major Primary fetal adrenal cortex hormone is
estrogen
LH
Testosterone
DHEA
Aldosterone
D) Reason
Estrogens are produced by the interplay of the fetal adrenal gland and the placenta. The fetal adrenal gland synthesizes dehydroepiandrosterone-sulfate (DHEA-S), which is then hydroxylated in the fetal liver.
Bone marrow is present in
metaphysis
epiphysis
diaphysis
prophysis
compact bone
C) Reason
The central most portion of the diaphysis of larger long bones is filled with bone marrow, either hematopoietically active or fatty, without intervening bony trabeculae.
Cause of Atheroma can be
inc. HDL
dec. chylomicron
increased LDL
dec. LDL
inc. glycogen
C) Reason
Inflammation important in pathogenesis. Endothelial cell dysfunction causes macrophage and LDL accumulation leads to foam cell formation- fatty streaks- smooth muscle cell migration (involves PDGF and FGF), proliferation, and extracellular matrix deposition lead to fibrous plaque leads to complex atheromas
Athelet at rest, what will be changed in comparison to non-athlete
dec. stroke vol.
increased stroke vol.
dec. Cardiac output
inc. cardiac output
no effect in stroke vol.
B) Reason
In Athletes, there is physiological polycythemia that causes dec. heart rate. But at rest heart rate decreases more and hence stroke volume increases in order to maintain the cardiac output. (Cardiac Output= stroke volume x heart rate).
Satiety center is present in which part of hypothalamus
anterior
medial
anterolateral
anteromedial
ventmedial
E) Reason
Ventromedial area: It contains Satiety. Destruction (e.g.craniopharyngioma) leada to hyperphagia. Stimulated by leptin.
Increased time for ventricular filling, cause is
AV nodal delay
SA node
Purkingi fibers
bundle of his
AV fibers
A) Reason
SA node “pacemaker” inherent dominance with slow phase of upstroke.AV node—100-msec delay—atrioventricular delay; allows time for ventricular filling
Warfarin quick reversal by
vit. K
ffp
vit. K & FFP
Protamin
protein C
B) Reason
In an acute setting, Warfarin toxicity is treated with FFP and in prolong management, it is treated with vit. K.
Patient pleural effusion sample is exudative, what is in it
inc. fibroelasts
dec. proteins
increased protein
inc. eosinophils
inc. specific gravity
C) Reason
Increased protein content, cloudy. Due to malignancy, pneumonia, collagen vascular disease, trauma (occurs in states of increased vascular permeability). Must be drained in light of risk of infection.
A graft from same specie is
isograft
xenograft
synergic graft
allograft
autograft
D) Reason
Autograft From self.Syngeneic graft From identical twin or clone.Allograft From nonidentical individual of same species.Xenograft From different species.
A patient with chest pain was given aspirin, its MAO
Inhibit platelet synthesis
Inhibit coagulation factors
inhibit TXA2
inhibit prostacyclin
Inhibits prostagladin synthesis
E) Reason
MECHANISM: Irreversibly inhibits cyclooxygenase (both COX-1 and COX-2) enzyme by covalent acetylation. Platelets cannot synthesize new enzyme, so effect lasts until new platelets are produced: inc. bleeding time, dec. TXA2 and prostaglandins. No effect on PT or PTT
Old age women with hx of IHD with irregular heart beat
sotalol
proparanolol
amoidarone
cardioversion
Digoxin
E) Reason
CLINICAL USE: CHF (increases contractility); atrial fibrillation (decreases conduction at AV node and depression of SA node). Patient in this scenario is a case of atrial fibrillation.
End stage renal disease, what will be the finding
hypokalemia
hypernatremia
dec. Creatinine
increased creatinine
dec. urea
D) Reason
Consequences (MAD HUNGER):Metabolic Acidosis, Dyslipidemia (especially increased triglycerides), HyperkalemiaUremia—clinical syndrome marked by inc. BUN and inc. creatinineNausea and anorexia
Ligamentum teres of liver is derived from
left umbilical vein
right umbilical vein
colon remnant
fossa ovalis
none of these
A) Reason
After birth, the umbilical veins are closed, and the remnant in adults is the Ligamentum teres of the liver
Right homonomous heminopia, lesion in
left occipital lobe
left temoral lobe
left optic tract
right optic radiation
upper optic chiasma
A) Reason
Homonemous hemianopia is contralatral half eye vision vision and is due to the lesion of occipital lobe.
Aortic pressure is maximum during
isovolumic contraction
isovolumic relaxation
end of ventriclular ejection
atrial filling
ventricular filling
C) Reason
Systolic ejection—period between aortic valve opening and closing, at end of this phase, the aortic pressure becomes maximum
On an anomaly scan, anencehaly is suspected, what is serum marker
Alpha fetoprotein
β hcg
sudan red
dec. vimentin
inc. keratin
A) Reason
Anencephaly Malformation of anterior neural tube resulting in no forebrain, open calvarium (“frog-like appearance”). Clinical findings: increased AFP; polyhydramnios (no swallowing center in brain). Associated with maternal diabetes (type I). Maternal folate supplementation inc. risk.
Structure post to medial mellulous
tibialis anterior
tibialis posterior
peroneus longus
sural nerve
tibial artet
B) Reason
The tuberosity lies infront of and below the medial malleolus, and it attaches tothe main part of the tibialis posterior tendon (posterior to medial maleolus).
Hunger centre is located in which part of hypothalamus
inferior
superior
posterior
lateral
anterior
D) Reason
Lateral area: Hunger. Destruction causes anorexia, failure to thrive (infants). Inhibited by leptin.
Submandibular gland stone result in
hypertrophy
hypoplasis
dysplasia
Apoptosis
necrosis
D) Reason
Obstruction to secretion of any body fluid is trigger Factor for inflammation, in glandular organs, obstruction to secretions can lead to self digestion or Autophagy of the cell- Apoptosis
Retrorbital swelling is due to
lymphocytes
fibroelastic tissue
fat deposits
thyroid stimulating Igs
SM Igs
D) Reason
Striking exophthalmos (protrusion of the eyes), possibly due to autoimmune (Thyroid Stimulating Igs) mechanisms and independent of thyroid hyperfunction, is characteristic. Manifestations include the signs and symptoms of hyperthyroidism.
blood will accumulate in epidural space due to trauma to which artry
MMA
AMA
cerebral artery
spinal artery
posterior cerebral artery
A) Reason
Lucid interval after traumatic brain injury are the features of Epidural hematoma (middle meningeal artery rupture)
lupus nephritis is associated with
nephrotic syndrome
nephritic syndrome
drug induced
allergic
SLE
E) Reason
Classic presentation of SLE: rash, joint pain, and fever, most commonly in a female of reproductive age and African descent.Libman-Sacks endocarditis—wart-like vegetations on both sides of valve.Lupus nephritis (type III hypersensitivity reaction
cervical vertebra is closely associated with
cilliary ganglion
ophthalmic ganlion
sympathetic ganglion
stellate ganglion
salivary ganglion
D) Reason
In most people, the inferior cervical ganglion is fused to thefirst thoracic ganglion to form the stellate ganglion. It is located between the transverse process of the seventh cervical vertebra and the neck of the first rib.
Notochord derivative is
spinal cord
spinal nerves
nucleus pulposus
CSF
miningies
C) Reason
Nucleus pulposus is an inner soft, elastic, compressible material thatfunctions as a shock absorber for external forces placed on the vertebral column. The nucleus pulposus is the postnatal remnant of the notochord.
Calcitonin released from
thyroid gland
parathyroid
adrenal cortex
pituitary
hypothalamus
A) Reason
SOURCE: Parafollicular cells (C cells) of thyroid. FUNCTION: bone resorption of Ca2+. It opposes the effect of PTH
There is infection in between deep layers of cervical fascia and pre tracheal fascia , pus will go to
posterior to pericardium
in pericardium
anterior to pericardium
anterior mediastinum
posterior mediastinum
D) Reason
The pretracheal layer is a thin layer that is attached above tothe laryngeal cartilages . Infection between deep cervical fascia and pre tracheal fascia can affect the anterior mediastinum.
IgE bound to which of following
Basophils & mast cells
Basophils only
mast cell only
eosinophils
lymphocytes
A) Reason
Anaphylactic and atopic—free antigen cross links IgE on presensitized mast cells and basophils, triggering immediate release of vasoactive amines that act at postcapillary venules (i.e., histamine). Reaction develops rapidly after antigen exposure because of preformed antibody
Patient has pneumonia , now he has chest pain radiating to back and rustle sound on left side of chest even when breathing is held , which is affected
pleura
pericardium
anterior mediastinum
lateral mediastinum
posterior mediastinum
B) Reason
Acute pericarditis: Commonly presents with sharp pain aggravated by inspiration, and relieved by sitting up and leaning forward. Presents with friction rub. ECG changes include widespread ST-segment elevation and/or PR depression. Suppurative/purulent Type: usually caused by bacterial infections (e.g Pneumococcus, Streptococcus). Rare now with antibiotics.
Bronchopulmonary segment is
functional unit
structural unit
respiratory unit
lymphatic unit
broncheal unit
A) Reason
Bronchopulmonary segments are the anatomic, functional, and surgical units of the lungs. Each lobar (secondary) bronchus, which passes to a lobe of the lung, gives offbranches called segmental (tertiary) bronchi
Host versus graft reaction can be due to what
kidney transplant
blood transfusion
liver transplant
FFP transfusion
lung transplant
B) Reason
In rest of all conditions (except FFP) GVHD occurs Graft-versus-host Reaction/disease:Onset Varies. Grafted immunocompetent T cells proliferate in the immunocompromised host and reject host cells with “foreign” proteins leading to severe organ dysfunction.
Emphysema can be due to deficiency of
lipase
phospholipase A2
α1 anti-trypsin
ALP
fibroelastic growth factor
C) Reason
Enlargement of air spaces, decreased recoil,increased compliance, decreased DLCO resulting from destruction of alveolar walls.Two types:1. Centriacinar—associated with smoking B.2. Panacinar—associated with α1-antitrypsin deficiency
Source of creatinine is by breakdown of
heart
muscle
kidneys
blood
liver
B) Reason
Creatinine is the end product of the muscle metabolism that is the reason that Creatinine increases in myositis and other cases of muscle breakdown
Glucokinese is present in
muscle
Liver
heart
lungs
pancreas
B) Reason
Glucokinese is an enzyme that phosphorylates glucose to glucose-6-P, it present in liver β cells unlike that of hexokinase that is present in muscles but not in liver or pancreas
Leimyoma with glands and stroma covering
Metaplasia
dysplasia
hypertrophy
dystrophy
hyperplasia
E) Reason
Leiomyoma (fibroid):A Most common tumor in females. Often presents with multiple discrete tumors A. Increased incidence in blacks. Benign smooth muscle tumor; malignant transformation is rare. Estrogen sensitive—tumor size increased with pregnancy and decreased with menopause.
which of the following doesn’t have basement membrane
clara cell
Ependymal cells
peumocytes
osteoclasts
transitional epithelium
E) Reason
Transitional epithelium is a stratified epithelium in which the shape of the surface cells changes (undergoes transitions) depending on the degree of stretch. This epithelium has no basement membrane.When a transitional epithelium is not stretched (for example in an empty bladder) the cells of the surface layers are large and rounded.
A patient is diagnosed to have Hepatitis A, labs could be
inc. ALP
inc. bilurubin
inc bilirubin and ALT
dec. ALT
decreased heptoglobins
C) Reason
Acute viral hepatitis is characterized by jaundice and extremely high elevations of serum aspartate and alanine aminotransferases. Hyperbilirubinemia is also there
In an RTA Pelvis avulsion, muscle involved
rectus femoris
quadricep femoris
adductor longus
adductor brevis
sartorius
A) Reason
• Among the muscles of the anterior compartment, Iliopsoas, rectus femoris, sartorius, and adductormuscles, most prominent and superficial muscle is rectus femoris that is injured first in avulsion injury.
1/3rd of posterior Interventricular septum blood supply of heart is
LAD
RCA
LCA
LXA
posterior artery
B) Reason
Posterior interventricular artery: It is the terminal distribution of the right coronary artery and courses in the posterior interventricular sulcus to supply parts of the right and left ventricles and, importantly, the posterior third of the interventricular septum.
In Myasthenia gravis, what is responsible for pathogenesis
IgA
IgD
IgG
IgM
IgE
C) Reason
M. gravis is the most common NMJ disorder, PATHOPHYSIOLOGY: Autoantibodies (IgGs) to postsynaptic ACh receptors. CLINICAL Manifestations are Ptosis, diplopia, weakness.Worsens with muscle use
A female presented with some growth in vulvar region, it can be
atrophy
dysplasia
hyperplasia
dystrophy
hypertrophy
B) Reason
Dysplasia and carcinoma in situ:Disordered epithelial growth; begins at basal layer of squamocolumnar junction (transition zone) and extends outward
lesion in left somatosensory area will affect
agraphesthesia
asteriagnosis
right lower limb
left lower limb
paraplegia
C) Reason
Lesions in somatosensory cortex result in impairment of all somatic sensations on the opposite side of the body, including the face and scalp.
Congenital Toxoplamosis can be diagnosed by
IgA
IgD
IgE
IgM
IgG
D) Reason
For the diagnosis of acute and congenital infections, an immunofluorescence assayfor IgM antibody is used. IgM is used to diagnose congenital infection, because IgG can be maternal in origin.
Clara cells are present in
primary bronchiole
secondary bronchiole
tertiary bronchiole
terminal bronchioles
alveolar sacs
D) Reason
The epithelial lining of the airway is composed of ciliated cells (goblet and basal cells are absent in the terminal bronchioles) and an additional type called the Clara cell.
A patient presents with features of dysphagia and horner syndrome ,artrey involved is
AICA
MCA
PICA
ACA
vertebral artery
A) Reason
Features of obstruction of anterior communicatin Artery: Vomiting, vertigo, nystagmus; decreased pain and temperature sensation from ipsilateral face and contralateral body; dysphagia,hoarseness, decreased gag reflexipsilateral Horner syndrome; ataxia, dysmetria.
Spinal cord artery supply is by
vertebral artery
spinal artery
posterior cerebral artery
posterior cervical artey
occipital artery
A) Reason
There is only one anterior spinal artery formed bythe union of branches from each vertebral artery. Vertebral artery is the main supply of the spinal cord.
Anterior surface of heart is supplied by
posterior Interventricular artery
RCA
LCA
LXA
LAD
E) Reason
Left anterior descending artery (LAD)—supplies anterior 2/3 of interventricular septum, anterior papillarymuscle and anterior surface of left ventricle. LAD is the most common cardiac artery to be occluded.
ECG findings of hypoglycemia
ST depression
No P wave
short QT
tall T wave
prolong QT interval
E) Reason
Long QT interval:1. Bradycardia2. Hypocalcemia3. Acute MI4. Acute myocarditis5. Cerebrovascular accident6. Hypertrophic cardiomyopathy7. Hypothermia
Mediastinal pleura is supplied by
C1-2
Phrenic nerve
C4
pleural nerve
vagus nerve
B) Reason
The phrenic nerve is the only motor nerve supply to thediaphragm. It also sends sensory branches to the pericardium, the mediastinal parietal pleura, and the pleura and peritoneum covering the upper m and lower surfaces of thecentral part of the diaphragm.
Lady with pregnancy malnurished now present with anemia, what is cause..?
sideroblastic anemia
Megaloblastic anemia
Thalasemia
pernicous anemia
iron deficiency
E) Reason
Causes are: Decreased iron due to chronic bleeding (GI loss, menorrhagia), malnutrition/absorption disorders or increased demand (e.g., pregnancy)decreased final step in heme synthesis.
Progressive PR prolongation followed by missing a beat on ECG is diagnostic of
atrial flutter
2nd degree block
mobitz type2
mobitz type 1
3rd degree block
D) Reason
Mobitz type I (Wenckebach):Progressive lengthening of the PR interval until a beat is “dropped” (a P wave not followed by a QRS complex). Usually asymptomatic.
sulpha drug Mechanism of action
activate B6
activate B3
block DNA gyrase
block RNA synthesis
Inhibit dihydropteroate synthetase
E) Reason
Sulfonamides interfere with folic acid synthesis by preventing addition of para-aminobenzoic acid (PABA) into the folic acid molecule through competing for the enzyme dihydropteroate synthetase. Sulfonamides are therefore bacteriostatic and inhibit growth and multiplication of bacteria, but do not kill them. Humans, in contrast to bacteria, acquire folate (vitamin B9) through the diet.
Patient doctor relationship is based on
informed working
mutual benefit
mutual respect
mutual trust
long relation
D) Reason
Doctor and Patient relationship is very special and based on absolute privacy and mutual trust
Retinal art occlusion in previously healthy man, can be due to
rupture
Amylodosis
emboli
aneurysm rupture
silent hypertension
C) Reason
Sudden loss of vision commonly occurs in central retinal artery occlusion and central retinalvein occlusion, retinal detachment, papillitis, acute congestive glaucoma, emboli, vitreous haemorrhage,etc.
Skin malignancy with most malignant potentail
melanoma
SCC
BCC
lymphoma
juvenile nevus
A) Reason
MELANOMA:A. Malignant neoplasm of melanocytes; most common cause of death from skin cancer B. Risk factors are based on UVB-induced DNA damage and include prolonged exposure to sunlight, albinism, and xeroderma pigmentosum
Scapula is firmly attached to chest wall through
teres major
serratus posterior
external oblique
serratus anterior
teres minor
D) Reason
Serratus anterior Insertion is to the Medial border and inferiorangle of the scapula where it stabilizes the bone
Tunica albogenia gives rise to which of following
processus vaginalis
tunica vaginalis
umbilical cord
inguinal canal
inguinal ligament
A) Reason
Processus vaginalis(evagination of peritoneum):Forms tunica vaginalis as its remnant in male
Pt is on hormone replacement therapy for 10 yr , sister died due to breast ca, she has high risk of
CA endometrium
Ovarian cancer
Fallopian tube CA
Lung cancer
CA breast
E) Reason
Risk factors: inc. estrogen exposure, inc. total number of menstrual cycles, older age at 1st live birth, obesity (inc. estrogen exposure as adipose tissue converts androstenedione to estrone), BRCA1 and BRCA2 gene mutations, African American ethnicity (inc. risk for triple inc. breast cancer).
Kidney in relationship with lower ribs by
facia covers glands
garota facia
psoas muscle
quadratus lumborum
perinehric fat
A) Reason
Renal fascia: This is a condensation of areolar tissue outside the perirenal fat. It encloses the kidneys and thesuprarenal glands
Face sensation is carried by which nerve
facial
mandibular
ophthalmic
maxillary
Trigeminal
D) Reason
he maxillary nerve is purely sensory. It leaves the skull through the foramen rotundum and crosses thepterygopalatine fossa to enter the orbit through the inferiororbital fissure. It then continues as the infraorbital nerve in the infraorbital groove, and it emerges on the facethrough the infraorbital foramen. It gives sensory fibers tothe skin of the face and the side of the nose.
In asthma, which is involved
small bronchioles
terminal bronchioles
alveolar ducts
main bronchus
medial bronchioles
E) Reason
Asthma: Bronchial hyperresponsiveness causes reversible bronchoconstriction. Smooth muscle hypertrophy, Curschmann spirals (shed epithelium forms mucus plugs), and Charcot Leyden crystals (formed from breakdown of eosinophils in sputum).
Most common involved in carcinoma
vimentin
keratin
cadherin
fibrin
kertinocytes
B) Reason
A first step in the invasion of malignant cells through an epithelium results from a loss of expression of cadherins and loss of keratin that weakens the epithelium.
lesion at L1 , there was loss of pain and temp on right side, which path is affected
spinobulbar
medial leminiscus
lateral spinothalamic
anterior horn
lateral horn
C) Spinothalamic and dorsal columns/medial lemniscus:Take Pain and temperature; pressure, touch, vibration, and proprioceptionDestination to 1° somatose nsory cortex
Max calcium influx at cardiac cycle, in
R wave
ST segment
P wave
Q wave
T wave
B) Reason
Phase 2 = plateau (corresponds to ST Segment): Ca2+ influx through voltage-gated Ca2+ channels balances K+ efflux. Ca2+influx triggers Ca2+ release from sarcoplasmic reticulum and myocyte contraction.
Medial rotation of arm is by
teres minor
deltoid
triceps
serratus posterior
teres major
E) Reason
• Lateral rotation:Infraspinatus, teres minor, and posteriorfibers of deltoid muscles.• Medial rotation: Subscapularis, latissimus dorsi, teresmajor, and anterior fibers of deltoid muscles
What lies in the floor of the Lateral ventricle
thalamus
hypothalamus
uncus
amydala
hippocampus
E) Reason
The hippocampal formation extends along the floor of the inferior horn of the lateral ventricle in the temporal lobe and includes the hippocampus, the dentate gyrus, the subiculum, and adjacent entorhinal cortex.
Muscles of forceful expiration
diaphragm
rectus abdominis
scalenae anterior
scalenae posterior
intercostal muscle
B) Reason
Function: Compresses abdominal contents and flexes vertebral column, is also an accessory muscle of expiration especially forceful expiration
In aspirin overdose, which drug will increase its renal excretion
Cl
K
HCO3
Na
Ca
C) Reason
Overdose:causes respiratory alkalosis initially, which is then superimposed by metabolic acidosis (by increased urinary excretion).
ALT and AST require which cofactor
B1
B2
B6
B12
vit.D
C) Reason
FUNCTION: Converted to pyridoxal phosphate, a cofactor used in transamination (e.g., ALT and AST), decarboxylation reactions, glycogen phosphorylase.
How to prevent tetanus in population
toxoid
antitoxin
vaccination
clean instruments
proper care
A) Reason
Tetanus can be prevented by Toxoid.
type of hypersensitivity in post streptococcal GN
delayed response
type 1 HSR
type 2 HSR
type 4 HSR
type 3 HSR
E) Reason
Type III: SLEPolyarteritis nodosaPoststreptococcal glomerulonephritisSerum sicknessArthus reaction (e.g., swelling and inflammation following tetanus vaccine).
Pain from the mininges of middle cranial fossa
Trigeminal ganglion
Cilliary ganglion
ophthalmic ganglion
cerebellum
basal ganglia
A) Reason
The trigeminal ganglion lies in middle cranial fossa within a pouchof dura mater called the trigeminal cave. Middle cranial fossa pain is due to pressure of this ganglion on minininges.
common carotid artery has lateral relation with
recurrent laryngeal nerve
parathyroid
external carotid
internal jugular vein
common carotid
D) Reason
In the carotid sheath, the artery is related laterally to the internal jugular vein; the vagus nerve lies between these two structures.
A young Patient with Dx of Aplastic anemia was given Anti-thymocyte Igs, developed reaction at 10 days..cause..?
type 1 HSR
type 2 HSR
type 3 HSR
type 4 HSR
delayed response
C) Reason
Type III: SLEPolyarteritis nodosaPoststreptococcal glomerulonephritis, Serum sicknessArthus reaction (e.g., swelling and inflammation following tetanus vaccine)
A 7 year old boy has unilateral blindness, gene affected
RET
BRCA1
Rb
p53
neu1
C) Reason
The prototype is retinoblastoma, an intraocular childhood tumor (causing unilateral blindness) caused by inactivation of the Rb gene. The “two-hit” hypothesis of Knudson holds that two mutagenic events are required to induce alterations on both chromosomes.
splitting of s2 is because of
early mitral closure
early pulmonary close
early aortic closure
late aortic closure
late mitral closure
C) Reason
Normal splitting is due to delayed closure of pulmonic valve than aortic valve.decreased pulmonary impedance ( increased capacity of the pulmonary circulation) also occurs during inspiration, which contributes to delayed closure of pulmonic valve.
what is true regarding Crohn”s disease
transmural lesions
continuous lesion
only colon involved
only mucosa involved
female predominant
A) Reason
GROSS MORPHOLOGY: Transmural inflammation, fistulas. Cobblestone mucosa, creeping fat, bowel wall thickening (“string sign” on barium swallow x-ray), linear ulcers, fissures.
A middle age patient with chest pain and raised CK but normal troponin and ECG, cause is
MI
angina
musculosketal pain
stable angina
gastric pain
C) Reason
In this scenario, the most specific marker that is cardioselective (troponin and ECG ) are normal while CK can be raiswd in muscular pain.
If sodium absorption is increased at DCT it will result in?
inc. plasma vol.
dec. plasma vol.
inc. interstitial cells
inc. urine vol.
dec. urine vol.
A) Reason
When the Na is reabsorbed in DCTs, it causes fluid retention in the body and thus leading to increased plasma volume.
Connexins are part of
RER
SER
ribosomes
Golgi complex
nucleus
D) Reason
Each connexon consists of 6 connexin molecules. Unlike other intercellular junctions, gap junctions are not associated with any cytoskeletal filament and Golgi complex.
Regarding Hemostasis, Most common risk factor for thrombosis is
OCPs
endothelial injury
trauma
aspirin
Clopidogrel
A) Reason
Most common is OCP . Most initial is endothelial injury.
which sign differentiate ganglionic or muscrinic blockers
selectivity
postural hypotension
dosing
quantity
specificity
B) Reason
Unlike the muscrinic blockers, the ganglion blockers interrupt sympathetic control of venous tone, they cause marked venouspooling; postural hypotension is a major manifestation of this effect.
side effect of documerol
delayed coagulation
early coagulation
acidosis
dec. RBC
dec. WBC
A) Reason
TOXICITY: Nausea, headache, facial flushing, coagulopathy, hypotension, abdominal pain.
Regarding the vectors, which virus is transmitted by mosquitoes
HHV
RSV
gray fever
yellow fever
hey fever
D) Reason
Yellow fever virus: A flavivirus (also an arbovirus) transmitted by Aedes mosquitoes. Virus has a monkey or human reservoir
In patient with previous case of Vasculitis, hepatitis associated with Vasculitis is
EBV
hep. D
hep. A
hep. C
Hepatitis B
E) Reason
Polyarteritis nodosa: Young adults.Hepatitis B seropositivity in 30% of patients.Fever, weight loss, malaise, headache.
CSF has what difference as compared to plasma
low pH
high pH
low Na
low Ca
low Cl
A) Reason
A total of 400-500 cc of CSF is produced per day; ventricles and subarachnoid space contain 90-150 cc, so all of CSF is turned over 2-3 times per day. In comparison with plasma, it has less glucose, more proteins, less cells and low pH.
nuclei of cells producing proteins
eosinophilic
dark staining
basic stippling
light staining
purple staining
B) Reason
Hematoxylin is a blue dye which stains basophilic substrates that are the acidic cellular components such as DNA and RNA. Hematoxylin stains nuclei blue, and may tint the cytoplasm of cells with extensive mRNA (proteins synthesis) in their cytoplasm.
hypovolumic shock & anaphylaxis differ in ?
BP
cardiac output
heart rate
aetiology
manifestations
B) Reason
Difference between the Anaphylactic shock and hypovolumic shock is the cardiac output, it is decreased in hypovolumic shock and increased in anaphylactic shock.
Acrosome is formed from
RER
SER
nucleus
ribosomes
golgi complex
E) Reason
The acrosome, which is located over the anterior half of the nucleus, is derived from the Golgi complex of the spermatid and contains several hydrolytic enzymes.
Patient with Ptosis, dilated pupils and downward outward eye, nerve affected
CN I
CN-II
CN III
CN IV
CNVVII
C) Reason
The oculomotor nerve, therefore, is entirely motor. It isresponsible for lifting the upper eyelid; turning the eye upward, downward, and medially; constricting the pupil; andaccommodating the eye.
In a 49 year old man with chronic Hx of HCV positive, inflamation of portal triads and adjacent lobules with necrotic foci, diagnosis
cirrhosis
hep. A
hep. E
chronic hep. C
chronic hep. D
D) Reason
Chronic hepatitis is characterized by symptoms that last > 6 months. l. Inflammation predominantly involves portal tract and adjacent lobules and necrotic foci 2. Risk of progression to cirrhosis
gunshot injury to neck, patient is in respiratory distress, what affected
C1
C2
S1-2
L3-4
diaphragm
E) Reason
Respiratory distress is due to diaphragm paralysis caused by Phrenic nerve injury at cervical C3-C4 spinal segments.
Hemisection of spinal cord causes complete sensation loss at
at level of lesion
bellow lesion
above lesion
ipsilatrally
contralatrally
A) Reason
Hemisection: Ipsilateral loss of all sensation at the level of the lesion Ipsilateral LMN signs (e.g., flaccid paralysis) at the level of the lesionIf lesion occurs above T1, patient may present with Horner syndrome due to damage of oculosympathetic pathway
receptors responsible for total periphral resistance
alpha 1
alpha 2
beta 2
beta 1
muscrinic
A) Reason
Alpha 1 receptors are Present at blood vessels and they maintain the total periphral resistance due the state of vasoconstriction or Vasodilation.
majority of growth factors have their receptors on
cell wall
SER
RER
membrane
nucleus
D) Reason
Growth factor Receptors: ■ Hormone binds to the extracellular side of the receptor. As many of the growth factor receptors are located in cell membrane.
In Barrett esophagus, pathogenesis is
hypertrophy
hyperplasia
dysplasia
columnar Metaplasia
anaplasia
D) Reason
Barrett esophagus: Glandular metaplasia—replacement of nonkeratinized (stratified) squamous epithelium with intestinal epithelium (nonciliated columnar with goblets cells) in the distal esophagus
which of following is associated with decreased risk of cancer
banana
apple
guava
orange
strawberry
D) Reason
It is a normal notation the antioxidants are regarded as protective against the carcinogenesis. Orange contains vit. C that is a strong antioxidant.
Dicyclomine acts on which receptors
sympathetic
nicotinic
muscrinic
alpha 1
alpha 2
C) Reason
The anticholinergicdrugs dicyclomine (antimuscrinic) and hyoscyamine are used as antispasmodics to relieve abdominal pain; however,their efficacy has not been convincingly demonstrated
during exercise resp. rate increases because of?
tactile reflex
inc. K
inc. O2
inc. K
inc. CO2
E) Reason
■ Sensory information (Pco2, lung stretch, irritants, muscle spindles, tendons, and joints) is coordinated in the brain stem.■ The output of the brain stem controls the respiratory muscles and the breathing cycle.
which will prevent wound contraction
vit. C
vit. D
GH
glucagon
corticosteroids
E) Reason
Functions of Corticosteroids: Increases Insulin resistance (diabetogenic)Increases Gluconeogenesis, lipolysis, and proteolysisDecreases Fibroblast activity (causes striae)Decreases Inflammatory and Immune responses:
fracture of neck of fibula will cause injury to which artery?
fibular
peroneal
posterior tibial
anterior tibial
dorsalis pedis
D) Reason
Neurovascular Structures related to the head of the fibula are anterior tibial artry and common peroneal nerve that can be damaged during the fractures
Patient with CABG 10 days back is with C/O purpra, sec. platelets, diagnosis
ITP
drug induced TTP
DIC
HUS
Thrombocytopenia
B) Reason
Thrombotic thrombocytopenic purpura (TIP) (1) Characteristics include platelet-derived hyaline microaggregates in small vessels, thrombocytopenia, and microangiopathic hemolytic anemia.
If superior mesenteric artery is damaged, which structure is likely to be spared?
spleen
liver
pancreas
dudenum
descending colon
E) Reason
Forgut Derivatives Esophagus, Stomach, Duodenum (first and second parts), Liver, Pancreas, Biliary apparatus, Gallbladder are supplied by the Superior mesenteric artery.
An 8 months baby was born to HIV positive mother, how to confirm infection
WBCs
CBC
ELISA
PCR RNA
western blots
D) Reason
HIV PCR/viral load tests determine the amount of viral RNA in the plasma. High viral load associated with poor prognosis. Also use viral load to monitor effect of drug therapy. It also determines the viral load in new born uptill age of 18 months
Which is bounded by inner and outer membrane and continued with nuclear membrane
cristae
cisternae
F1 particles
fibrils
Perinuclear cisteria
E) Reason
RER is a single, lipid bilayer continuous with the outer nuclear membrane. It is organized into stacks of large flattened sacs called cisternae, nuclear cisternae to the nuclear membrane.
drug for angina that cause no vasodilation
Captopril
hydralazine
Methyldopa
Hydraline
metoprolol
E) Reason
Metoprolol is a cardiac selective beta blockers that acts centrally on heart and least on blood vessels and hence has no Vasodilation property.
2nd vertebra has characteristic feature of?
atlas
spinous process
odontoid process
lateral body
spine
B) Reason
The axis (C2) is the point of articulation where the head turns on the neck, providing an “axis of rotation” through the odontoid.
A young boy with long term history of dirrohea, biopsy show villous atrophy, no improvement with gluten free diet, diagnosis is
giardiasis
celiec disease
amebiasis
intestinal TB
whipples sprue
A) Reason
Giardia lamblia:Giardiasis: bloating, flatulence, foul-smelling, fatty diarrhea (often seen in campers/hikers)—think fat-rich Ghirardellichocolates for fatty stools of Giardia. Villous atrophy on microscopy. Treated with metronidazole.
As an SHO, which sample would you send for blood gases analysis
heart
coagulated
serum sample
Arterial
veinous
D) Reason
Arterial blood gases are examined in the fresh sample of an arterial blood with a heparanized syringe.
Patient presents with long term memory loss, lesion is at
amygdala
cerebellum
basal ganglia
limbic system
uncus
D) Reason
Limbic system Collection of neural structures involved in emotion, long-term memory, olfaction, behavior modulation, and autonomic nervous system function.
What prevent complications in procedures
proper care
regard
profeciency
Professional competence
informed consent
D) Reason
In an any medical, the chances of complications are reduced by better management as well as high level of professional competence.
Among the following, most common method to detect tumor in blood
RFTs
LFTs
CBC
grading
tumor marker
E) Reason
Tumor markers Tumor markers should not be used as the 1° tool for cancer diagnosis. They may be used to monitor tumor recurrence and response to therapy, but definitive diagnosis can be made only via biopsy
hormone which brings about protein anabolism and fat catabolism
LH
FSH
Cortisol
glucagon
GH
E) Reason
Direct actions of growth hormone(a) ↓ glucose uptake into cells (diabetogenic)(b) ↑ lipolysis(c) ↑ protein synthesis in muscle and ↑ lean body mass(d) ↑ production of IGF.
5g protein is lost in pt. what is probable cause of edema.
inc. capillary pressure
dec. capillary pressure
increased vascular pressure
dec. vascular pressure
colloid osmotic pressure
E) Reason
Decreased Colloid osmotic pressure: Decreased plasma protein concentrationSevere liver disease (failure to synthesize proteins)Protein malnutritionNephrotic syndrome (loss of protein in urine).
which post-Op analgesia given in an asthmatic patient
spinal
sub dural
epidural
morphine
ketorolac
E) Reason
Ketorolac is only contraindicated in asthmatic if patient also has known aspirin allergy, otherwise is best post-Op analgesia.
what changes hb dissociation curve to extreme left
CO2
CO
SO2
NO3
N2O
B) Reason
In addition, binding of CO to hemoglobin increases the affinity of remaining sites for O2, causing a shift of the curve to the left
which nerve damage will lead to supination loss
radial
radial & muskulocutaneus
muskulosketal
ulnar
axillary
B) Reason
Supination: Biceps (radial nerve) and supinator (muskulosketal nerve) muscles. This movement returns the pronated hand to the anatomic positionso that the palm faces anteriorly and the thumb lies on thelateral side.
Role of parathyroid hormone
stimulate adenylate cyclase
inhibit adenylate cyclase
increase IP3
increase guanulate
increase DAG
A) Reason
Adenylate cyclase mechanism 1. Hormone binds to a receptor in the cell membrane (step 1).2. GDP is released from the G protein and replaced by GTP (step 2), which activates the G protein. The G protein then activates or inhibits adenylate cyclase. If the G protein is stimulatory (Gs), then adenylate cyclase will be activated
which receptor cause secretion of epinephrine from adrenal medulla
nicotinic
parasympathetic
sympathetic
nicotinic ganglionic
muscrinic
D) Reason
Epinephrine is stress hormone that is secreted by the adrenal medulla in case of stressful conditions by the activation of sympathetic nicotinic ganglionic receptors.
Bile salts cause
Proteins absorption
absorption of fat
Carbohydrates absorption
Vitamins absorption
minerals absorption
B) Reason
Functions of Bile salts: Digestion and absorption of lipids and fat-soluble vitaminsCholesterol excretion (body’s only means of eliminating cholesterol) Antimicrobial activity (via membrane disruption)
CSF is present in
sub arachnoid space
sub dural
sub pia
spinal canal
epidural
A) Reason
• Subarachnoid space lies between the arachnoid and pia mater containing CSF: site of subarachnoid hemorrhage (described later).
shortest acting hypnotic
dorzolamide
fentinyl
midazolam
ketamine
halothane
C) Reason
Midazolam is widely used adjunctively with inhaled anesthetics and intravenous opioids. Theonset of its CNS effects is slower than that of thiopental, and has shortest duration of action.
Diagnostic test for TB
Pleural Biopsy
AFB
Chest X-ray
Gram staining
wall polysacchride
A) Reason
Diagnostic test of T.B. is Pleural Biopsy
A pt. is diagnosed with bilateral S2-S4 lesion. Consequences?
urinary incontinence
dribbling
UV prolapse
atonic bladder
rectal incontinence
D) Reason
Lesion at S2-S4 causes atonic bladder
milk production is result of which hormone activity?
Dopamine
oxytoxin
5 HT
Prolactin
LH
D) Reason
Prolactin—induces and maintains lactation and decreases reproductive function. Oxytocin—assists in milk letdown; also promotes uterine contractions.
Why to prefer Troponin over CK-MB
fast to detect
low price
fear
tissue specific
sensitive
D) Reason
CK-MB is is non-specific enzyme that can also be increased in stress, muscle and other tissue disorder, but troponin is cardiac specific enzyme.
what cell layers are present at 2nd week of development
epiblast
hypoblast
epiblast & hypoblast
meroblast
xenoblast
C) Reason
In 2nd week: • The embryoblast differentiates into the epiblast and hypoblast, forming a bilaminar embryonic disk. • The epiblast forms the amniotic cavity and hypoblast cells migrate to form the primary yolk sac.
A patient taking carbonic anhydrase for 4 Week, what change will occur
dec. K
dec. Cl
dec. HCO3
inc. HCO3
no change in HCO3
C) Reason
TOXICITY Hyperchloremic metabolic acidosis, inc. plasma HCO3, paresthesias, NH3 toxicity, sulfa allergy
Dicrotic notch in aortic pressure is due to
aortic closure
pulmonary closure
mitral closure
tricuspid closure
bicuspid closure
A) Reason
Isovolumic ventricular relaxation, Ventricular volume is constant (isovolumetric) because all of the valves are closed.■ The “blip” in the aortic pressure tracing occurs after closure of the aortic valve and is called the dicrotic notch, or incisura.
what will be cardiac cycle in sec if H/R varies from 75 to 225/min
0.1 sec.
- 26 sec
- 22 sec
- 29 sec
- 3 sec
B) Reason
Cardiac cycle = 60 sec/number of beats = 60/225 = 0.26 sec
short term effect of angiotensin 2?
Vasodilation
inc. renin
vasoconstriction
dec. K absorption
onc. Cl absorption
C) Reason
(1) It increases thirst and therefore water intake.(2) It causes vasoconstriction of the arterioles, thereby increasing TPR and arterial pressure
Purkinje fibers have higher velocity. reason?
fast fibers
more Na channel
less K channel
less Cl channel
less number of myofibrils
E) Reason
■ reflects the time required for excitation to spread throughout cardiac tissue.■ depends on the size of the inward current during the upstroke of the action potential. The larger the inward current, the higher the conduction velocity.■ is fastest in the Purkinje system due to less number of myofibrils.
Which among the following is the most superficial structure in parotid gland
nerve
lymph nodes
vein
artery
gland
B) Reason
• Parotid nodes: Situated on usually superficially or within the parotid salivarygland. They receive lymph from the scalp above theparotid gland, the eyelids, the auricle, and the external auditory meatus.
A person on oral anticoagulant with controlled INR (2-2.5), developed pulmonary edema and INR of 5, what drug caused this change
vancomycin
metronidazole
Clopidogrel
aspirin
ciprofloxacin
E) Reason
TOXICITY:Bleeding, teratogenic, skin/tissue necrosis A, drug-drug interactions ( Pulmonary edema with quinolones).
Gunshot to the radial groove will cause
loss extension of wrist
loss of Flexion of wrist
loss of supination
loss of pronation
loss of reversion
A) Reason
Behind and below the deltoid tuberosity isa spiral groove, in which the radial nerve lies. As it supplies extensors of wrist that is why loss of wrist extension due to radial nerve injury.
An 18 year old boy from remote area, with Hx of high grade fever for 5 days, is now presented with toxic look and dec. platelets and RBC and derranged coagulation, diagnosis
DIC
CML
sepsis
Thrombocytopenia
anemia
A) Reason
Widespread activation of clotting leads to a deficiency in clotting factors, which creates a bleeding state.Causes: Sepsis (gram-negative), Trauma, Obstetric complications, acute Pancreatitis, Malignancy, Nephrotic syndrome,
A foreign body will lodge into which segment?
right bronchus
left bronchi
laft upper
right middle
right upper
A) Reason
Right lung is more common site for inhaled foreign body because the right main stem bronchus is wider and more vertical than the left.
In last trimester what changes are mostly found regarding respiration.
dec. CO
dec. CO2
dec. HCO3
dec. K
dec. O2
E) Reason
In 3rd trimester of pregnancy, gravid utrus pushes causes upward push of the diaphragm and decreases tidal volume and hence increases respiratory rate and dec. O2 saturation.
What extends into sulci and fissures of brain tissue
dura matter
pia mater
Arachnoid
sub Arachnoid
ventricles
B) Reason
Pia mater tightly invests the surfaces of the brain and cannot be dissected away, having the same relationship with the brain extends into sulci as well as spinal pia mater.
Rise in blood flow is seen in a stroke pt. cause?
inc. O2
inc. pCO2
dec. pCO2
dec. K
dec. Na
B) Reason
The Cushing reaction is an example of the response to cerebral ischemia. Increases in intracranial pressure cause compression of the cerebral blood vessels, leading to cerebral ischemia and increased cerebral Pco2. The vasomotor center directs an increase in sympathetic outflow to the heart and blood vessels, which causes a profound increase in arterial pressure.
thrombus of which artery will lead to Infarct of 1/3 of posterior Interventricular septum
LCA
RCA
LAD
LXA
posterior coronary artery
B) Reason
Posterior descending/interventricular artery (PDA)— a branch of RCA supplies posterior 1/3 of interventricular septum and posterior walls of ventricles
Iron absorbed from which part of GIT plays role in iron absorption
ileum
jejunum
duodenum
Colon
stomach
C) Reason
Iron is Absorbed as Fe2+ in duodenum.Folate is Absorbed in jejunum and ileum.B12 is Absorbed in terminal ileum along with bile acids, requires intrinsic factor.
A new born developed hemolysis of severe form, type of hypersensitivity in Erythroblastosis fetalis
type 1 HSR
type 2
type 3 HSR
type 4 HSR
delayed response
B) Reason
Type II: Autoimmune hemolytic anemiaPernicious anemiaIdiopathic thrombocytopenic purpuraErythroblastosis fetalisAcute hemolytic transfusion reactions, Rheumatic fever
Lumber puncture should be done where
above L4
above L3
at L3
above L3
bellow L3
A) Reason
A lumbar puncture is used to inject anesthetic material in the epidural space or to withdraw CSF from the subarachnoid space. • A spinal tap is typically performed at the L4-L5 or above L4 interspace.
Free radicals mainly removed by
transferrin
ferritin
transferrtin
iron
Phosphatase
A) Reason
Free radicals can be eliminated by enzymes (e.g., catalase, superoxide dismutase, transferrin, glutathione peroxidase), spontaneous decay, antioxidants (e.g., vitamins A, C, E).
After an accident an old lady can’t understand spoken words but canunderstand written words lesion in ?
broca
wernicke
temporal lobe lesion
primary auditory
secondary auditory
D) Reason
Patient can understand the written words indicating that his visual and the frontal cortex are intact but only problem is the primary auditory cortex lesion
Regarding neoplasm, best way to detect spreading tumors
grading
tumor marker
staging
HIDA scan
bone scan
C) Reason
Staging of the tumors is the best way to detect the spread and extent of the tumors, one important system is the TNM staginh system.
What is the span of the isthmus of the thyroid
2nd tracheal ring
2nd to 4th tracheal ring
3rd-4th tracheal
3-5th tracheal ring
5th-6th tracheal ring
B) Reason
The thyroid gland (from 2nd-6th tracheal rings) consists of right and left lobes connectedby a narrow isthmus from 2nd-4th tracheal rings. It is surrounded by a sheathformed of pretracheal fascia, and this sheath attaches thegland to the larynx and the trachea. I
patient has Tedency to fall on left, lesion is on
basal ganglia lesion
flocular lobe
cerebellar peduncle
left cerebellum
right cerebellum
D) Reason
Cerebellum Modulates movement; aids in coordination and balance.Input:Contralateral cortex via middle cerebellar peduncle. Ipsilateral proprioceptive information via inferior cerebellar peduncle from the spinal cord (input nerves = climbing and mossy fibers). Lesion causes ipsilatral ataxia.
No x wave is found on EEG in a pt. Dx?
REM
Non REM
wake
deep sleep
opened eyes
A) Reason
REM sleep (25%) beta waves: Loss of motor tone, brain O2 use, and variable pulse and blood pressure; when dreaming and penile/clitoral tumescence occur; may serve a memory processing function
An 11 year boy developed carpopedal spam after radius fracture, serum Ca 6.8 urinary Ca is normal, cause..?
rickets
hypokalemia
secondary hypoparathyroid
tertiary hypoparathyroid
primary hypoparathyroid
A) Reason
Rickets is the most appropriate answer.
vertical nystagmus is due to?
occipital lobe lesion
basal ganglia lesion
tippling up and down
cerebellar lesion
tipping head sideways
E) Reason
Lesions of the vestibular nuclei and pathways may produce nystagmus, vertigo, nausea, and vomiting. It can be horizontal by up & down tippling or vertical by side by side tippling of head.
Gram negative UTI,culture gives foul smelling greenish colonies treatment .
clindanycin
metronidazole
vancomycin
gentamicin
ampicillin
E) Reason
E.Coli is the causative agent here.
Tumor involved superior bronchus of lung, which segment is likely to collapse?
apical
middle
lower
superior
7th segment
A) Reason
Superior Bronchus of the lungs is closely related with the apical segment and it contains superior apical segment that can be involved in carcinoma of superior bronchus.
Regarding carcinogenesis of CA stomach, which cause CA stomach
alcohol
hydrocarbon
phenacetin
aniline
H. pylori
E) Reason
Stomach cancer:Almost always adenocarcinoma. Early aggressive local spread and node/liver metastases. Often presents with acanthosis nigricans. Intestinal—associated with H. pyloriinfection, dietary nitrosamines (smoked foods), tobacco smoking, achlorhydria, chronic gastritis.
A 50 year old man with factory worker exposed to hydrocarbons is at risk of
pancreatic cancer
HCC
CA stomach
CA urinary bladder
CA lung
D) Reason
Risk Factors of CA Urinary bladder are: Associated with problems in your Pee SAC: Phenacetin, Hydrocarbons, Smoking, Aniline dyes, and Cyclophosphamide.
reflex system of ANS is directly controlled by?
medulla
pons
Midbrain
cerebrum
cerebellum
D) Reason
A large part of the frontal cortex rostral to the central sulcus is related to the control of movements, reflex action, primarily on the opposite side of the body
A boy ARF now has fever with pancystolic murmur and speelomegaly, treatment
gentamicin
Penicillin
metronidazole
clarythromycin
azithromycin
B) Reason
IE: Mitral valve is most frequently involved. Tricuspid valve endocarditis is associated with IV drug abuse (don’t “tri” drugs). Associated with S. aureus, Pseudomonas, and Candida.Complications: chordae rupture, glomerulonephritis, suppurative pericarditis, emboli. Treated with with IV penicillin.
A 14 year old boy with Spleenomegaly and all cell line dec. what investigation
CBC
USG
CT
periphral smear
bone marrow biopsy
E) Reason
Characteristics include decreased platelet count and prolonged bleeding time; bone marrow aspiration reveals decreased megakaryocytes when caused by decreased platelet production and increased megakaryocytes when caused by increased platelet destruction.
Regarding carcinogenesis, which cancer is related to oncogene
CA uterus
CA ovary
CA breast
Cervical cancer
HCC
C) Reason
Risk factors: inc. estrogen exposure, inc. total number of menstrual cycles, older age at 1st live birth, obesity (inc. estrogen exposure as adipose tissue converts androstenedione to estrone), BRCA1and BRCA2 gene mutations, African American ethnicity (inc. risk for triple breast cancer)
sesamoid cartilage is found in
elbow
vertebral disc
ear lobule
knee
ala of nose
E) Reason
NASAL CAVITY: The nasal cavity is divided into right and left halves by thenasal septum. Ala of nose contain a small suspended cartilage, sesamoid cartilage. The septum is made up of the septal cartilage, the vertical plate of the ethmoid, and the vomer.
19 years old girl history of repeated infections , CBC done Hb=>5, WBC=>3.5 , plt40,000 , neutrophils18%, lymphosytes 80%, next to do ?
marrow biopsy
CBC
periphral smear
Electrophoresis
USG abdomen
A) Reason
All cell line are decreased RBCs, WBCs and Platelets (Pancytopenia) in a case of Aplastic anemia manifests as anemia, repeated infections and dec. platelets, can be diagnosed by bone marrow biopsy (shows pancytopenia)
Skilled motor activity is carried via
corticobulbar
spinothalamic
corticospinal tract
medial leminiscus
faciculus cuneatus
C) Reason
Corticospinal tract: UMNcell body in 1° motor cortex then descends ipsilaterally (through internal capsule), most fibers decussate at caudal medulla (pyramidal decussation) then descends contralaterally. Associated with skilled motor actions.
part of ECG from end of P wave to start of R wave is known as
PR interval
PR wave
PR segment
QR wave
QR segment
C) Reason
PR segment is the part of ECG from end of P wave to start of R wave and it represents the atrial depolarization.
Chief parameter for plasma blood flow measurment?
Urea
Creatinine
Inulin
PABA
PAH
E) Reason
Measurement of renal plasma flow (RPF)—clearance of para-aminohippuric acid (PAH)■ PAH is filtered and secreted by the renal tubules.■ Clearance of PAH is used to measure RPF.
patient with RHC pain now developed lung abscess, route of spread?
Hematogenous
lymphatic
direct spread
veinous
peritoneal
C) Reason
In the hiven scenario, the patient was fisrt having liver abscess that later on directly invaded into the chest causing right lung abscess.
All are rick Factors for CA stomach except
H. pylori
blood type O
smoking
nitrites
smoked food
B) Reason
associated with H. pyloriinfection, dietary nitrosamines (smoked foods), tobacco smoking, achlorhydria, chronic gastritis. Commonly on lesser curvature; looks like ulcer with raised margins.
right sided relation of trachea as it descends into Superior mediastinum
hemi azygus vein
Phrenic nerve
sympathetic chain
vagus nerve
azygus vein
E) Reason
Relations of Trachea in Superior Mediastinum are Right side: Azygos vein, right vagus nerve, and pleura.• Left side: Arch of the aorta, left common carotid, left subclavian arteries, left vagus nerve, left phrenic nerve, andpleura.
single gene autosomal dominant
Achondroplasia
Fredreck ataxia
Cri du chat syndrome
PCOD
meatal atresia
A) Reason
Achondroplasia: Is a single gene autosomal dominant trait. Failure of longitudinal bone growth (endochondral ossification) leading to short limbs. Membranous ossification is not affected and cause large head relative to limbs.
how to differentiate leukocytes from other cells on bone marrow
golgi complex
RER
cell membrane
staining
presence of nuclei
E) Reason
Leukocyte: Are the nucleated cell developed in marrow.Divided into granulocytes (neutrophil, eosinophil, basophil) and mononuclear cells (monocytes, lymphocytes). Responsible for defense against infections.
anterior mediastinum consists of?
thymus
heart
Phrenic nerve
azygus vein
trachea
A) Reason
ANTERIOR MEDIASTINUMThe contents of the anterior mediastinum include thesternopericardial ligaments, lymph nodes, and remains ofthymus.
A pt. has cardiac pacemaker. on ECG p wave absent & QRS present. location on pacemaker?
bundle of His
ventricle
Atria
AV node
SA node
D) Reason
Normal pacemaker of the heart is the SA node, but in case of any ectopic pacemaker especially the AV node, the P wave will be absent but the QRS complexes will be present.
alongwith thermo receptors, pain receptors also carry sensation of
cold
tactile
pressure
touch
vibration
A) Reason
Nociceptors: ■ are associated with the detection and perception of noxious stimuli (nociception).■ The receptors for pain are free nerve endings in the skin, muscle, and viscera. They also sense for extreme of temperature (heat and cold)
Regarding fibrocartilage truth is
elbow
knee
intervertebral disc
hip joint
sutures
C) Reason
Fibrocartilage has type I collagen in addition to type II, giving it greater resistance to being stretched (tensile strength), and is the type of cartilage found in intervertebral disks of the vertebral column and the menisci of the knee, and may form the attachment of ligaments and tendons to bone
A 54 yr lady concerned with her family history, with positive family H/O CA breast and IHD, what to take to avoid fracture
Ca supplements
complete HRT
vit. D
estrogen
tamoxifen
B) Reason
Hormone replacement therapy: Used for relief or prevention of menopausal symptoms (e.g., hot flashes, vaginal atrophy) and osteoporosis (decrease estrogen, decrease osteoclast activity).
In pseudostratified epithelium, nuclei lies
at lower pole
at different level
upper pole
lateral border
at top
B) Reason
The epithelial lining of the trachea and bronchi is pseudostratified columnar in which all cells lie on the same basal membrane with their nuclei at different levels but only some reach the luminal surface.
How does K enters in cells of hypokalemic pt?
K gates
Na/K ATPase
K/Cl chanel
H-K exchange
K/HCO3 chanel
B) Reason
Na+/K+ATPase (or Na–K+ pump) in cell membranes transports Na+ from intracellular to extracellular fluid and K+ from extracellular to intracellular fluid; it maintains low intracellular [Na+] and high intracellular [K+].
Inc. neuronal activity before skilled action occurs in
cortical association area
motor cortex
prefrontal
temporal lobe
uncus
A) Reason
Lesions, usually in the dominant hemisphere and which include areas 5 and 7 of the posterior parietal association areas, often result in apraxia (also seen with lesions to the premotor cortex). Apraxia is a disruption of the patterning and execution of learned motor movements
most early sign of vit. A deficiency
keratitis
keratosis
dry skin
Bitot spot
night blindness
E) Reason
DEFICIENCY: Night blindness (nyctalopia); dry, scaly skin (xerosis cutis); alopecia; corneal degeneration (keratomalacia); immune suppression.
viscosity of blood is mainly due to?
WBCs
platelets
lymphocytes
RBCs
plasma proteins
D) Reason
Erythrocyte: Carries O2 to tissues and CO2 to lungs. Anucleate and biconcave A, with large surface area-to-volume ratio for rapid gas exchange. It is the main contributer of blood viscosity.
Which bone forms glenoid fossa?
temporal
mandible
maxilla
zygomatic
vomer
A) Reason
The temporomandibular joint articulates above with themandibular fossa (glenoid fossa) and the articular tubercle of the temporalbone. It articulates below with the head of the mandible.
A 42 year old patient has chronic cough and right lung upper lobe consolidation and fatty liver with inc. AST and ALT, cause
hepatitis C
chronic hepatitis B
acute hepatitis A
chronic alcoholism
acute hepatitis D
D) Reason
Alcoholic cirrhosis: Final and irreversible form. Micronodular, irregularly shrunken liver with “hobnail” appearance. Sclerosis around central vein (zone III). Has manifestations CLD, derranged coagulation, raised AST and ALT and sometimes Pnemonia.
In left suprarenal surgery what is likely to be damaged?
renal vein
IVC
aorta
sympathetic chain
renal artery
B) Reason
VEINS:There is a single vein on each side. The right suprarenal veindrains into the inferior vena cava; the left suprarenal veindrains into the left renal vein.
newly laid uncalcified bone matrix is called
osteoblast
osteoid
spongy material
costeod
immature bone
B) Reason
Osteoblasts and osteocytes produce the type I collagen in bone, along with other components of bone ECM (osteoid). That is ossified later on.
After cerebral hemorrhage pt. lacks motivation. site of involvment?
frontal lobe
temporal lobe
parietal lobe
basal ganglia
uncus
B) Reason
Temporal lobe lesion causes depression and loss of motivation along with auditory impairment. Patients with unilateral damage to the primary auditory cortex show little loss of auditory sensitivity but have some difficulty in localizing sounds in the contralateral sound field.
A man got stab wound on right chest, consequences?
contralatral collapse
open pneumothorax
ipsilatral collapse
right consolidation
left consolidation
C) Reason
During the chest stab wound, ipsilatral lung is developed into an opened valve pneumothorax leading to ipsilatral lung collapse.
progesterone has a vital role which is
dec. uterus contraction
inc. utrus contraction
ripen cervix
mature the follicle
prevent leakage
A) Reason
FUNCTION: Stimulation of endometrial glandular secretions and spiral artery developmentMaintenance of pregnancydec. myometrial excitability
Amoebic liver abscess, treatment
tinidazole
ampicillin
gentamicin
ciprofloxacin
neomycin
A) Reason
Entamoeba hisrolytica:Amebiasis: bloody diarrhea (dysentery), liver abscess (“anchovy paste” exudate), RUQ pain (histology shows flask-shaped ulcer if submucosal abscess of colon ruptures). Treated with metronidazole and tinidazole.
basal ganglia has avital neurotransmitter which is?
glutamate
Aspartate
glycine
GABA
Ach
D) Reason
Excitatory pathway—cortical inputs stimulate the striatum, stimulating the release of GABA, which disinhibits the thalamus via the GPi/SNr (inc. motion).Inhibitory pathway—cortical inputs stimulate the striatum, which disinhibits STN via GPe, and STN stimulates GPi/SNr to inhibit the thalamus (dec. motion).
cause of fatty liver in our society
smoking
alcohlism
fast food
obesity
diabetes
D) Reason
In Western society, most common cause of fatty liver is alcohlism and in our society where alcohlism is not common, here cause is obesity.
Time from atrial depolarization to start of ventriclar depolarization
P wave
ST wave
PR wave
PR segment
PR interval
E) Reason
P wave—atrial depolarization. Atrial repolarization is masked by QRS complex.PR interval is the time from atrial depolarization to start of ventriclar depolarization—represents conduction delay through AV node (normally < 200 msec).
ICF & ECF differ by
has no cations
has inorganic anions
has more Na
has less K
has more K
E) Reason
Intracellular fluid (ICF)■ is two-thirds of TBW.■ The major cations of ICF are K+ and Mg2+
Bronchoconstriction on taking penicillin, now drug of choice
Norepinephrine
epinephrine
glutamine
acetylcholine
ranitidine
B) Reason
Epinephrine: Affects β > α Clinical uses: Anaphylaxis, open angle glaucoma, asthma, hypotension; α effects predominate at high doses.
a person lost hearing in a bomb blast, type of deafness
conductive
sensory
mixed
central
destructive
C) Reason
As in case of blast injury, both the eardrum and choclea are affected, so mixed type of hearing loss it is
A rock crusher developed lymphadenopathy and bireferengence on biopsy, Dx..?
asbestosis
pneumoconiosis
anthracosis
byssinosis
silicosis
E) Reason
Rock crush is associated with silicosis exposure
Patient after an RTA has pH of 7.5, CO2 as 20mmHg and HCO3 as 20meq. Dx…?
respiratory acidosis
metabolic acidosis
respiratory alkalosis
metabolic alkalosis
ARDS
C) Reason
Patient given in this scenario is having high pH (alkalosis) and dec. CO2 shows it to be respiratory alkalosis. Respiratory alkalosis■ is caused by increased alveolar ventilation and loss of CO2.a. Decreased arterial Pco2, which is the primary disturbance, causes a decrease in [H] and [HCO3] by mass action.
Patient after an RTA has pH of 7.5, CO2 as 20mmHg and HCO3 as 20meq. Dx…?
respiratory acidosis
metabolic acidosis
respiratory alkalosis
metabolic alkalosis
ARDS
C) Reason
Patient given in this scenario is having high pH (alkalosis) and dec. CO2 shows it to be respiratory alkalosis. Respiratory alkalosis■ is caused by increased alveolar ventilation and loss of CO2.a. Decreased arterial Pco2, which is the primary disturbance, causes a decrease in [H] and [HCO3] by mass action.
Bicarb absorb in nephron at?
PCT and DCT
thick limb
loop of henle
only DCT
PCT only
E) Reason
a. Early proximal tubule—special features■ reabsorbs Na+ and H2O with HCO3 glucose, amino acids, phosphate, and lactate.
patient with CRF has productive cough, drug of choice
gentamicin
vancomycin
methotrexate
Cisplatin
ciprofloxacin
E) Reason
As the patient is having compromised renal functions, and quinolones are relatively safe in CRF than Aminoglycosides and penicillin.
A lady with HTN, hirsuitism and inc. ACTH, cause
paraneoplastic syndrome
Wilms tumors
pheochromocytoma
Cushing syndrome
histiocytoma
D) Reason
FINDINGS: Hypertension, weight gain, moon facies, truncal obesity, buffalo hump, hyperglycemia (insulin resistance), skin changes (thinning, striae), osteoporosis, amenorrhea, and immune suppression.
Patient presents with hypoventilation and pin point pupil, cause
morphine poisoning
atropine poisoning
organophosphate
CCl4 poisoning
alcohlism
A) Reason
TOXICITY: Addiction, respiratory depression, constipation, miosis (pinpoint pupils), additive CNS depression with other drugs.
final diagnosis of COPD is by
V/Q= 0
V/Q= 0.1
V/Q= infinite
V/Q= 2
V/Q= 1
B) Reason
V/Q approaches 0 = airway obstruction (shunt) and in COPD. In shunt, 100% O2 does not improve Po2.V/Q approaches ∞ = blood flow obstruction (physiologic dead space). Assuming < 100% dead space, 100% O2 improves Po2
lesion in non-dominant Broca”s area
global aphasia
sensory aphsia
anomic aphasia
agraphesthesia
combined aphasia
C) Reason
Broca area Lesion: Nonfluent/Anomic aphasia with intact comprehension.Broca area—inferior frontal gyrus of frontal lobe.
sulphar containing amino acid
glutamate
glycine
aspartate
methionine
tryptophan
D) Reason
• Sulphur containing amino acids: Cysteine,Methionine • Amino acids with amide group: Asparagine, Glutamine
Blunt trauma immediately below and lateral to knee will injure
common peroneal
tibial
sural
anterior tibial
posterior tibial
A) Reason
The common peroneal nerve descends through thepopliteal fossa. It then passes laterally aroundthe neck of the fibula, pierces the peroneus longus muscle,and divides into the superficial and the deep peroneal nerves.
RR 18/min, tidal volume 350ml and dead space is 100ml, alveolar ventilation would be?
2.5 L
3 L
4 L
4.5L
5L
D) Reason
TV-D space x RR = 350-100 x 18 = 250 x 18= 4500ml/min = 4.5L/ min
At which level does 10th intercostal nerve enter rectus sheet?
hypochondrium
lumber region
hypogastrium
umblicus
iliac fossa
D) Reason
T 10 vertebra is located at the level of umblicus, and its nerve root enters the rectus sheet at its level
Premalignant lesion of SCC is
lichen planus
actinic keratitis
dermatitis
leukoplakia
keratosis
B) Reason
Actinic keratosis:1. This premalignant epidermal lesion is caused by chronic excessive exposure to sunlight. 2. Characteristics include rough, scaling, poorly demarcated plaques on the face, neck, upper trunk, or extremities
Patient with recurrent infections and hypocalemia since birth, what is the defect
inc. cell in paracortex
dec. cell in paracortex
abnormal T cells
IgA deficiency
abmormal B cells
B) Reason
Paracortex Houses T cells. Region of cortex between follicles and medulla. Contains high endothelial venules through which T and B cells enter from blood. Not well developed in patients with DiGeorge syndrome.
In SLE, biopsy shows immune complexes deposits on renal biopsy, mechanism is?
thick basement membrane
Antigen-Ig complexes
effaced membrane
Villous atrophy
dec. connective tissue
B) Reason
Systemic lupus erythematosus (SLE) 1. SLE, the prototype connective tissue disease, most often affects women (80% of patients), usually those of childbearing age. 2. SLE is marked by the presence of a spectrum of ANAs and by extensive deposits of antigen-antibody complexes mediated inflammatory lesions involving multiple organ systems.
Pt. is undergoing EEG with eyes closed but fully awake. which waves will be seen?
gamma wave
delta wave
theta wave
alpha waves
beta wave
D) Reason
Awake (eyes open) Alert, active mental concentration Beta (highest frequency, lowest amplitude)Awake (eyes closed) Alpha waves.
most common aquired thrombotic disorder
OCP induced thrombosis
Bud chiari syndrome
pulmonary embolism
SLE
anti phospholipid syndrome
E) Reason
Antiphospholipid Antibody Syndrome: This syndrome (previously called the lupus anticoagulant syndrome) is the most common aquired thrombotic disorder, it has protean clinical manifestations, including recurrent thromboses, repeated miscarriages, cardiac valve vegetations, and thrombocytopenia.
Graft between genetically identical twins
need HLA matching
lab. limitation
ethically not done
not rejected
sometime rejected
D) Reason
Identical twins are the genetically same to each other in all the antigenic and cellular proteins, so their no tissue rejection reaction occur in transplant of identical twins.
Drug that dec. LES and inc. emptying
domperidone
5HT3 inhibitor
Metoclopramide
ampicillin
eryhromycin
C) Reason
MECHANISM: D2 receptor antagonist. decrease resting tone, contractility, LES tone, motility. Does not influence colon transport time.
A young boy has a soft to firm mass below hyoid from past a few months.What is the diagnosis?
adenoma
thyroglossal sinus
thyroglossal fistula
MNG
thyroglossal duct cyst
E) Reason
Thyroglossal duct cyst presents as an anterior midline neck mass that moves with swallowing or protrusion of the tongue (vs. persistent cervical sinus leading to branchial cleft cyst in lateral neck).
drug to avoid in CRF
ampicillin
cisplatin
ciprofloxacin
metronidazole
6-MP
B) Reason
TOXICITY of Cisplatin and Carboplatin: Nephrotoxicity and acoustic nerve damage. Prevent nephrotoxicity with amifostine (free radical scavenger) and chloride diuresis.
failure of ant. neuropore to close
myelocele
miningeocele
miningomyelocele
acraniotomy
anencephaly
E) Reason
Anencephaly: Malformation of anterior neural tube resulting in no forebrain, open calvarium (“frog-like appearance”). Clinical findings: inc. AFP; polyhydramnios (no swallowing center in brain). Associated with maternal diabetes (type I). Maternal folate supplementation dec. risk.
Propylthiouracil oxidizes what
monoiodide
iodide
thyroglobulin
thyroid binding globulin
thyroxine
B) Reason
MECHANISM: Block thyroid peroxidase, inhibiting the oxidation of iodide and the organification (coupling) of iodine leading to inhibition of thyroid hormone synthesis. Propylthiouracil also blocks 5′-deiodinase, which dec. peripheral conversion of T4 to T3
blood antigen secreted in
urine
marrow
feaces
saliva
csf
D) Reason
Crosses epithelial cells by transcytosis. Most produced antibody overall, but released into secretions (tears, saliva, mucus) and early breast milk (known as colostrum).
pain of appendicitis is referred to?
T8
T9
T10
T11
T12
C) Reason
PAIN OF APPENDICITISVisceral pain in the appendix is produced by distention of its lumen or spasm of its muscle. The afferentpain fibers enter the spinal cord at the level of thetenth thoracic segment, and a vague referred pain isfelt in the region of the umbilicus (T10). Later, the pain shiftsto where the inflamed appendix irritates the parietalperitoneum, and then the pain is precise, severe, and localized.
Gastric ulcer is most commonly found at
antrum
pylorus
body
fundus
cardia
A) Reason
Disruption of mucosal barrier leads inflammation. Antrum is the most common site of ulceration.Can be caused by stress, NSAIDs (dec. PGE2and hence dec. gastric mucosa protection), alcohol, uremia.
while inspiring s2 splits as a result of?
late aortic closure
early closure of aortic
early pulmonary close
late tricuapid closure
late bicuspid closure
B) Reason
Normal splitting: Inspiration, drop in intrathoracic pressure inc. venous return to the RV increased RV stroke volume leading to decreased RV ejection time causing delayed closure of pulmonic valve. decreased pulmonary impedance (increased capacity of the pulmonary circulation) also occurs during inspiration, which contributes to delayed closure of pulmonic valve.
which phase of sleep has theeta waves?
REM sleep
wake
non REM stage 1
colsed eyes
frightened
C) Reason
Non-REM sleep:Stage N1: (5%) Light sleep Thetawaves.Stage N2: (45%) Deeper sleep; when bruxism occurs Sleep spindles and K complexesStage N3: (25%) Deepest non-REM sleep (slow-wave sleep); when sleepwalking, night terrors, and bedwetting occur.Delta waves: (lowest frequency, highest amplitude)
what is the Origin of systemic arterial thrombi
pulmonary embolism
veinous thrombi
mural thrombi
periphral fibrosis
MI
C) Reason
Arterial thrombi a. These thrombi are formed inside the vessels in the areas of active blood flow. b. When mature, they demonstrate alternate dark gray layers of platelets interspersed with lighter layers of fibrin. This layering results in the lines of Zahn.
right sided hemiplegia with no sensory loss, lesion is in
Right cerebral cortex
cerebellam
medulla oblongata
internal capsule
mid brain
D) Reason
Most commonly caused by systemic hypertension D . Also seen with amyloid angiopathy, vasculitis, and neoplasm. Typically occurs in basal ganglia and internal capsule (Charcot-Bouchard aneurysm of lenticulostriate vessels), but can be lobar. Presents with crossed hemiplegia.
right sided hemiplegia with no sensory loss, lesion is in
Right cerebral cortex
cerebellam
medulla oblongata
internal capsule
mid brain
D) Reason
Most commonly caused by systemic hypertension D . Also seen with amyloid angiopathy, vasculitis, and neoplasm. Typically occurs in basal ganglia and internal capsule (Charcot-Bouchard aneurysm of lenticulostriate vessels), but can be lobar. Presents with crossed hemiplegia.
Regarding kidney what is right?
separate fascia for gland
left relates to aorta
right is little bellow
covered with fat
covered with fascial sheath
E) Reason
• Renal fascia: This is a condensation of areolar tissue outside the perirenal fat. It encloses the kidneys and thesuprarenal glands.
1 alpha hydroxilation of vit. D takes place in
liver
kidney
lungs
suprarenal
spleen
B) Reason
SOURCE: D3 from sun exposure in skin. D2 ingested from plants. Both converted to 25-OH in liver and to 1,25-(OH)2 (active form) in kidney
Patient presents with parotid swelling & pain that exaggerate on chewing, nerve responsible is?
facial
ophthalmic nerve
auriculotemporal
mandibular nerve
maxillary nerve
C) Reason
• The auriculotemporal nerve, which supplies the skin ofthe auricle, the external auditory meatus, the temporomandibular joint, and the scalp. This nerve also conveys postganglionic parasympathetic secretomotor fibers fromthe otic ganglion to the parotid salivary gland .
How will ECG represent ventricular depolarization?
PR wave
Q wave
QRS complex
T wave
P wave
C) Reason
QRS complex—ventricular depolarization (normally < 120 msec).QT interval—mechanical contraction of the ventricles.
patient with fever, fits, dark urine and shivering, Dx..?
epilepsy
minigitis
cerebral malaria
encephalitis
hydrocephalus
C) Reason
All the features given in scenario are characteristics of black water fever ( dark colored urine is the clue), while CNS involvement is the point to the Dx of Cerebral Malaria.
Which of the following vessels does NOT supply the retina?
anterior cilliary
lateral Cilliary
superior Cilliary
posterior Cilliary artey
upper Cilliary
D) Reason
Blood Supply1. The choriocapillaris of the choroid supplies the pigment epithelium, the layers of rods and conesand the outer nuclear layers.2. Central retinal artery supplies rest of the layers of the retina. It is a branch of the ophthalmicartery and is an end artery
which phase of cardiac cycle posseses maximum aortic pressure?
rapid ejection
slow ejection phase
slow relaxation
rapid filling
slow contraction
B) Reason
Durig the slow ejection phase, Ventricular volume is constant (isovolumetric) because all of the valves are closed.■ The “blip” in the aortic pressure tracing occurs after closure of the aortic valve and increased pressure.
testosterone plays a role in puberty that is
thinning of laryngeal cartilage
thickening of laryngeal cartilage
edema of larynx
edema of pharynx
thinning of bones
B) Reason
FUNCTION of Testosterone: Differentiation of epididymis, vas deferens, seminal vesicles (genitalia, except prostate)Growth spurt: penis, seminal vesicles, sperm, muscle, RBCsDeepening of voice(thickens laryngeal cartilage) Closing of epiphyseal plates (via estrogen converted from testosterone) Libido
fetal part of placenta is formed by
amnion
chorion frundosum
amnion frundosum
allantois
allantois frundosum
B) Reason
Fetal componentof Placenta: Cytotrophoblast Inner layer of chorionic villi (the frundosum). Cytotrophoblast makes Cells.Syncytiotrophoblast Outer layer of chorionic villi; secretes hCG (structurally similar to LH; stimulates corpus luteum to secrete progesterone during first trimester).
Pregnant lady advised to eat green vegetables, because it contains
B12
B5
B6
B1
folate
E) Reason
FUNCTION: Converted to tetrahydrofolate (THF), a coenzyme for 1-carbon transfer/methylation reactions.Important for the synthesis of nitrogenous bases in DNA and RNA.Found in leafy green vegetables. Absorbed in jejunum. Folate from green vegetables and foliage.
Patient with raised bilirubin, direct is 9 and indirect bilurubin is 1, cause
Criglar najjar
hepatitis
HCC
bile deficiency
pancreatic enzymes deficiency
B) Reason
Conjugated or the direct bilurubin is raised in hepatitis in which conjugating system of enzymes is intact while unconjugated or the indirect bilurubin is increased in enzyme defects.
Olfactory pathway is/has
direct pathway
trochlear pathway
mitral cells to cortex
olfactory cells to cortex
mucosal cells to cortex
C) Reason
• The respiratory area is lined by pseudostratified, ciliated columnar epithelium. Goblet cells are present as well. The olfactory area is in the posterosuperior area and contains bipolar neurons and mitral cells. Olfactory neurons are constantly replenished.
Patient took antibiotics for 2 months post-Op develops dirrohea, what would be changes seen on microscopy
Villous atrophy
hyperkeratosis
Lymphocytic infiltrate
pseudomembrane
edematous villi
D) Reason
C. difficile: Produces 2 toxins. Toxin A, enterotoxin, binds to the brush border of the gut. Toxin B, cytotoxin, causes cytoskeletal disruption via actin depolymerization causing pseudomembranous colitis leading to diarrhea. Often 2° to antibiotic use, especially clindamycin or ampicillin
CHF can best be diagnosed by which of following
ANP
Chest X-ray
BNP
ECG
angiography
C) Reason
B-type (brain) natriuretic peptide(BNP): Released from ventricular myocytes in response to tension. Similar physiologic action to ANP, with longer half-life. BNP blood test used for diagnosing heart failure (very good negative predictive value). Available in recombinant form (nesiritide) for treatment of heart failure.
kidneys get how much %age of C/O?
25
27
29
30
45
A) Reason
The blood flow through the renal system circulation (25% of cardiac output) can be subdivided into the hepatic arterial flow (7% of cardiac output) and the mesenteric-portal circulation (18% of cardiac output
what struture is injured superficial to flexor retinaculum in wrist injury?
ulnar nerve & artey
ulnar nerve only
ulnar artery only
radial nerve
median nerve
A) Reason
Ulnar nerve and artery pass over the Flexor Retinaculum, and this bridge and the carpal bones form the carpaltunnel for the passage of the median nerve and the longflexor tendons of the fingers
single best drug for mild CHF
ACE Inhibitor
beta blockers
nephedipine
verapamil
furosemide
A) Reason
Treatment of CHF: ACE inhibitors, β-blockers (except in acute decompensated HF), angiotensin II receptor blockers, and spironolactone dec. mortality. Thiazide or loop diuretics are used mainly for symptomatic relief. Hydralazine with nitrate therapy improves both symptoms and mortality in select patients.
Which Structure is of same size in new born & adults?
retina
heart valves
uncus
middle ear
inner ear
E) Reason
Inner ear size remains same in child and adult.
HLA matching is important because it prevents
anaphylactic
urticaria
graft vs host reaction
arthus reaction
lupus reaction
C) Reason
HLA matching is necessary to prevent the transplant rejection reactions. Host antibodies against donor HLA antigens and leukocytes can cause type 2 HSR.
flexor reflex is carried out by which receptors
tactile
nociceptors
free nerve endings
meisssner
pacinian
B) Reason
Flexor withdrawal reflex■ is polysynaptic.■ results in flexion on the ipsilateral side and extension on the contralateral side.Somatosensory and pain afferent fibers elicit withdrawal of the stimulated body part from the noxious stimulus.
Venous supply of heart is through
left cardiac vein
coronary sinus
right cardiac vein
coronary hilum
SVC
B) Reason
• Coronary sinus The coronary sinus is the main vein of the coronary circulation; it lies in the posterior coronary sulcus. It drains to an opening in the right atrium. It develops from the left sinus venosus.
Patient ECG shows 3:1 ratio of P to QRS complexes, Diagnosis.?
3rd degree block
1st degree block
mobitz type 2
mobitz type 2
atrial fibrillation
D) Reason
Mobitz type II: Dropped beats that are not preceded by a change in the length of the PR interval (as in type I). It is often found as 2:1 block, where there are 2 or more P waves to 1 QRS response. May progress to 3rd-degree block. Often treated with pacemaker.
Virulent strain of staph are identified by
coagulase test
gram staining
ZN staining
lipase
Hemolytic reaction
A) Reason
The enzyme is coagulase.Coagulase, by clotting plasma, serves to wall off the infectedsite, thereby retarding the migration of neutrophils into the site. It is positive in virulent strains of Staphylococci.
How the patient of HIV is monitored
PCR
Elisa
CD4 count
CD8 count
Western blot
C) Reason
Also use viral load to monitor effect of drug therapy.AIDS diagnosis ≤ 200 CD4+ cells mm3(normal: 500–1500 cells/mm3).HIV-positive with AIDS-defining condition (e.g., Pneumocystis pneumonia) or CD4 percentage < 14%.
why people fear of hospitals
rude behavior
uncooperative staff
fear of microbes
fear of infection
fear of being handicap
E) Reason
people fear hospitals because they think they will become handicapped and dependent on the medications.
Structure close to crus cerebri
homocullus
uncus
striatum
substantia nigra
globus pallidus
D) Reason
The midbrain comprises two lateral halves called the cerebral peduncles; each of these is divided into an anterior part, the crus cerebri; and a posterior part, the tegmentum, by a pigmented band of gray matter, the substantia nigra.
V/Q is seen increased in a pt. reason?
pulmonary embolism
sleep
coma
ARDS
exercise
A) Reason
In pulmonary embolism V/Q become infinity.
left cercumflex artery occlusion causes infarct of
left atrium
posterior surface
right ventricle
left atrium & ventricle
left ventricle only
E) Reason
Left circumflex coronary artery (LCX)— a branch of LCA supplies lateral and posterior walls of left ventricle
A runner iinjured his foot dueing practice and now he has pain when he tries to stand on his toes.This is due to
plantaris tendon
achilles tendon
posterior retinaculum
dorsal interossi
plantaris muscle
A) Reason
Plantar flexion (toes pointing downward): Gastrocnemius, soleus, plantaris, peroneus longus, peroneus brevis,tibialis posterior, flexor digitorum longus, planteris tendon and flexor hallucis longus muscles.
A multigravid female has C/O something coming out of vagina.Upon examination, cervix is coming out of external os.This is caused by damage of
vaginal vault
utrosacral ligament
uterine ligament
cervical ligament
pelvic diaphragm
B) Reason
PROLAPSE OF THE UTERUS:The levatores ani muscles and the transverse cervical,pubocervical, uterosacral and sacrocervical ligaments are of verygreat importance in supporting and positioning the uterus. Damage to these structures during childbirthor as a result of general poor body muscular tone mayresult in downward displacement of the uterus, cal led uterine prolapse
trypsinogen is activated by
enterokinase
CCK
bile
lipase
secretin
A) Reason
Trypsinogen: is Converted to trypsin by enterokinase/enteropeptidase, a brush-border enzyme on the duodenal and jejunal mucosa
centrilobular congestion is due to
fatty liver
fatty hepatosis
cirrhosis
nutmeg liver
HCC
D) Reason
Nutmeg liver Due to backup of blood into liver. Commonly caused by right-sided heart failure and Budd-Chiari syndrome. The liver appears mottled like a nutmeg. If the condition persists, centrilobular congestion and necrosis can result in cardiac cirrhosis.
Bilateral loss of pain and temperature at T4-T8, lesion is..?
Hemisection
complete section
central spinal lesion
disc prolapse
pulposus rupture
C) Reason
Syringomyelia: Cystic cavity (syrinx) within the spinal cord A(if central canal leading to hydromyelia). Crossing anterior spinal commissural fibers are typically damaged first. Results in a “cape-like,” bilateral loss of pain and temperature sensation in upper extremities (fine touch sensation is preserved).
Which vein is formed by the union of subclavian vein with internal jigular vein?
bracheocephalic trunk
jugular vein
thoracic duct
sterna chylli
left thoracic duct
A) Reason
Subclavian veing alongwith internal jugulat vein forms the brachiocephalic trunk.
Pancreas is affected by secretin by?
HCl inhibition
thick secretion
inc. Cl secretion
dec. HCO3 secretion
inc. HCO3 secretion
E) Reason
Secretin S cells (duodenum):Functions: Increases pancreatic HCO3 secretion gastric acid secretionbile secretion.
a lady with dec. IgA, IgD, IgM and chronic dirrohea as well as recurrent cough, Diagnosis..?
IgG deficiency
IgE deficiency
IgM deficiency
IgD deficiency
IgA deficiency
E) Reason
Selective IgAdeficiency:Unknown. Most common 1° immunodeficiency.Majority Asymptomatic. Can see Airway and GI infections, Autoimmune disease, Atopy, Anaphylaxis to IgA-containing products.
true about paraneoplastic syndromes is
large cell CA
squamous cell CA
adeno CA
small cell CA lung
NeuroEndocrine tumor
D) Reason
Small Cell CA: Undifferentiated , very aggressive.Paraneoplastic Syndrome: May produce ACTH, ADH, or Antibodies against presynaptic Ca2+ channels (Lambert-Eaton myasthenic syndrome). Amplification of myconcogenes common. Inoperable; treat with chemotherapy
oxytocin is stimulated& released by
adrenaline
Dopamine
LH
prolactin
suckling
E) Reason
Lactation After labor, the dec. in progesterone and estrogen disinhibits lactation. Suckling is required to maintain milk production, since inc. nerve stimulation inc. oxytocin and prolactin.
L1 vertebra fractured, injury to which structure
conus medularis
filum terminale
sacral plexus
lumber plexus
S1
A) Reason
The spinal cord is tapered below to formthe conus medullaris (L1-L2). The filum terminale is aprolongation of the pia mater that extends from the conus tothe back of the coccyx
It tells distribution of value in a data
confidence interval
frequency distribution
Hazards ratio
p-value
none of these
B) Reason
Distribution of frequency is the number of values repetition that a specified quantity appears in the given data. Here the most frequently appeared quantity is known as mode.
what brings about stimulation of thirst
inc. Cl conc.
dec. Na conc.
renin directly
Angiotensin-II
Angiotensin-I
D) Reason
Functions of Angiotensin-II are: (1) It increases thirst and therefore water intake.(2) It causes vasoconstriction of the arterioles, thereby increasing TPR and arterial pressure.
what kind of receptors are Messner”s receptors ?
low frequency
high frequency
low adapting
free nerve endings
least distributed
A) Reason
Meissner corpuscle are low frequency receptors, Present in nonhairy skin sense the Velocity and are Rapidly adapting receptors.
Tumor marker for CA colon is
CEA
PPD
CA-19-9
RET
Rb
A) Reason
CA Colon: Screen patients > 50 years old with colonoscopy or stool occult blood test.“Apple core” lesion seen on barium enema x-ray.CEA tumor marker: good for monitoring recurrence, not useful for screening.
clot retraction is brought about via
lymphocytes
Basophils
platelets
RBCs
leukocytosis
C) Reason
Platelet (thrombocyte) Involved in 1° hemostasis. Small cytoplasmic fragment derived from megakaryocytes. Life span of 8–10 days. When activated by endothelial injury, aggregates with other platelets and interacts with fibrinogen to form platelet plug and clot retraction.
movement of larynx while swallowing
downward
upward
lateral
anterior
pushed back
B) Reason
The main part of the larynx is thus elevated to the posterior surface of the epiglottis, and the entrance into the larynx is now closed.
What kind of lesion results in pure sensory loss due to damage to nerve when it enters spinal cord
tabes dorsalis
Hemisection
complete section
canal lesion
motor lesion
A) Reason
Tabes dorsalis Caused by 3° syphilis. Results from degeneration (demyelination) of dorsal columns and roots leading to impaired sensation and proprioception and progressive sensory ataxia (inability to sense or feel the legs causes poor coordination)
Which artery gives rise to Right bronchial artery
right post-intercostal artery
left post. intercostal artery
descending aorta
arch of aorta
axillary artery
A) Reason
The bronchi, connective tissue, and visceral pleura are supplied by the bronchial arteries, which are branches of the descending thoracic aorta. Right broncheal artery is the branch of the right posterior intercostal artery.
Characteristic finding of Transudate is
high protein
high cells ratio
high specific gravity
low specific gravity
high lipids
D) Reason
Transudate: Decreased protein content, blood cells as well as low specific gravity. Causes are CHF, nephrotic syndrome, or hepatic cirrhosis.
in temperature regulation how does post. hypothalamus plays role
piloerection
thirst
vasoconstriction
Vasodilation
shivering
E) Reason
Shivering is the most potent mechanism for increasing heat production. ■ Cold temperatures activate the shivering response, which is orchestrated by the posterior hypothalamus
while performing surgery rise in TPR is due to?
epinephrine
ACTH
Cortisol
GH
Dopamine
B) Reason
Surgery is one of the stressful conditions, and releases stress hormones via activation the hypothalamus secretion of ACTH.
Triglycerides in plasma are hydrolized by
pancreatic lipase
protease
hydroxylase
lipase
lipoprotein lipase
E) Reason
Lipoprotein lipase (LPL)—degradation of TG circulating in chylomicrons and VLDLs. Found on vascular endothelial surface.
Blood flow to kidneys is maintained by?
tubuloglumerlar feedback
renin Angiotensin system
local metabolism
sympathetic
parasympathetic
A) Reason
Tubuloglomerular feedback:, in which increased renal arterial pressure leads to increased delivery of fluid to the macula densa. The macula densa senses the increased load and causes constriction of the nearby afferent arteriole, increasing resistance to maintain constant blood flow.
slowest growing organism in artificial media
S aureus
Pseudomonas
M. tuberculosis
N. miningitis
M. bovis
C) Reason
Mycobacterium Tuberculosis is one of the slow growing organism on the culture media, that is the reason that its culture is waited till 6-8 weeks at least.
A patient with liomyoma, has dec. endometrial glands embedded in stroma
atrophy
dystrophy
hypertrophy
anaplasia
dysplasia
B) Reason
Leiomyoma (fibroid):Most common tumor in females. Often presents with multiple discrete tumors with decreased glandular tissue and increased stroma by glandular dystrophy. Increased incidence in blacks. Benign smooth muscle tumor; malignant transformation is rare.
outer layer of nerve is called
epimysium
epineuron
epineurium
perimysium
perinureum
C) Reason
The whole nerve trunk is ensheathed by epineurium, each fasciculus by perineurium, and each nerve fibre by a delicate endoneurium. The toughness of a nerve is due to its fibrous sheaths, otherwise the nerve tissue itself is very delicate and friable
effect of drug in old age
more dose required
can cause toxicity at therapeutic dose
less dose required
more safe window
more side effects
B) Reason
In old age, drug elimination system of body (liver as well as kidneys) become senile and their clearing capacity become less than in adulthood. That”s why therapeutic dose can cause toxicity.
Body is caught in bacterial infection. what will be 1st line of defence?
eosinophils
basophils
neutrophils
mucous membranes
skin
E) Reason
Innate defenses can be classified into three major categories: (1)physical barriers, such as intact skin and mucous membranes; (2) phagocytic cells,such as neutrophils, macrophages, and natural killer cells; and (3) proteins, such ascomplement, lysozyme, and interferon
Hypoxic pulmonary vasoconstriction is through
Na-H antiport
Ca channels
Cl chanel
ATP sensing K chanel
ATP sensing Na chanel
D) Reason
■ In the lungs, hypoxia causes vasoconstriction.■ This response is the opposite of that in other organs, where hypoxia causes vasodilation by opening hyoxia induced K chanel.■ Physiologically, this effect is important because local vasoconstriction redirects blood away from poorly ventilated, hypoxic regions of the lung and toward well-ventilated regions.
blood flow to muscle during exercise is regulated by
sympathetic
parasympathetic
O2 level
local metabolites
working level
D) Reason
Local metabolic control■ Blood flow in skeletal muscle exhibits autoregulation and active and reactive hyperemia.■ Demand for O2 in skeletal muscle varies with metabolic activity level, and blood flow is regulated to meet demand.■ During exercise, when demand is high, these local metabolic mechanisms are dominant.■ The local vasodilator substances are lactate, adenosine, and K+.
Vasodilation by sympathetic system is through
muscrinic
alpha 2 agonist
alpha 1 agonist
beta 2 agonists
beta 1 agonist
D) Reason
β2 Activation: Vasodilation, bronchodilation, inc. heart rate, inc. contractility, inc. lipolysis, inc. insulin release, dec. uterine tone (tocolysis), ciliary muscle relaxation, inc. queous humor production
patient with gram -ve sepsis and bleeding diathesis
DIC
ITP
TTP
HUS
hemophilia
A) Reason
Widespread activation of clotting leads to a deficiency in clotting factors, which creates a bleeding state.Causes: Sepsis (gram-negative), Trauma, Obstetric complications, acute Pancreatitis, Malignancy, Nephrotic syndrome,
hyperpolarization is result of?
efflux of Ca
eflux of K
efflux of Na
influx of Cl
efflux of Cl
B) Reason
Hyperpolarization makes the membrane potential more negative (the cell interior becomes more negative).
What triggers RBCs production in marrow?
GH
testosterone
erythropoitin
Aldosterone
Cortisol
C) Reason
Erythropoietin Released by interstitial cells in the peritubular capillary bed in response to hypoxia. It is induces the production of RBCs.
low voltage QRS complex are characteristic of
recent MI
old MI
atrial fibrillation
atrial flutter
ventricular fibrillation
B) Reason
Delayed complications are Dressler syndrome, HF, arrhythmias, true ventricular aneurysm (outward bulge during contraction, “dyskinesia”).
connections of pons
substantia nigra
striatum
globus pallidus
ipsilatral cerebellum
contralatral cerebellum
D) Reason
- The telencephalon forms the cerebral hemispheres - The diencephalon forms 4 thalamic derivatives - The mesencephalon forms the midbrain - The metencephalon forms the pons and cerebellum that are closely related to wach other.- The myelencephalon forms the medulla
At site of injury which chemotactic factor appears 1st
IL2
IL3
IL4
IL8
TNF
D) Reason
IL-6: An endogenous pyrogen. Also secreted by Th2cells. Causes fever and stimulates production of acute-phase proteins.IL-8: Major chemotactic factor for neutrophils.
true hermaphrodite genotype
XO
XXY
XYY
XXXY
OY
B) Reason
True hermaphroditism (46,XX or 47,XXY):Also called ovotesticular disorder of sex development. Both ovary and testicular tissue present (ovotestis); ambiguous genitalia. Very rare.
commonest heart dominance circulation is
left side
codominance
ipsilatral
contralatral
right sided
E) Reason
Right-dominant circulation = 85% = PDA arises from RCA.Left-dominant circulation = 8% = PDA arises from LCX.Codominant circulation = 7% = PDA arises from both LCX and RCA.
In which phase of cell cycle, cell has double chromatid
prophase
metaphase
telophase
anaphase
interphase
C) Reason
Towards the end of the cell division, the telephase, chromatids reach to the corresponding opposite poles in form of double chromatids around which new membrane formed to give daughter cell nuclei.
Micronodular cirrhosis is best diagnosed by
serum Copper level
serum bilurubin
AST
serum cerulloplamin
ALT
D) Reason
Characterized by:Decreased Ceruloplasmin, Cirrhosis, Corneal deposits (Kayser-Fleischer rings). Copper accumulation, Carcinoma (hepatocellular)Hemolytic anemiaBasal ganglia degeneration (parkinsonian symptoms).
left renal vein is related to
posterior to aorta
anterior to aorta
lateral to aorta
superior to aorta
inferior to aorta
B) Reason
The renal vein emerges from the hilum of the kidney in front of the aorta and drains into theinferior vena cava.
which of following is the most common indication of mitral valve replacement
atheromatous
stenosis
rupture of papillary muscles
regurgitation
senile
C) Reason
Ventricular free wall rupture laeding to cardiac tamponade; papillary muscle rupture causes severe mitral Regurgitation; that is a one of the important indication of mitral valve replacement.
which drug at therapeutic dose causes tachycardia
captopril
Norepinephrine
isosorbide dinitrane
Methyldopa
hydralazine
C) Reason
TOXICITY Reflex tachycardia (treat with β-blockers), hypotension, flushing, headache, “Monday disease” in industrial exposure: development of tolerance for the vasodilating action during the work week and loss of tolerance over the weekend results in tachycardia, dizziness, and headache upon reexposure.
core temperature 99F but pt. is calm & cold, reason?
drowning
cardiogenic shock
hypovolumic shock
heat exhaustion
heat stroke
D) Reason
Heat exhaustion is caused by excessive sweating. As a result, blood volume and arterial blood pressure decrease laeding to cold clamy extrimities and syncope (fainting) occurs.
Which reaction occur in mitochondria
lipolysis
glycogesis
glycogenolysis
glycolysis
TCA
E) Reason
Reactions in Mitochondria: Fatty acid oxidation (β-oxidation), acetylCoA production, TCA cycle, oxidative phosphorylation.
Which reaction occur in mitochondria
lipolysis
glycogesis
glycogenolysis
glycolysis
TCA
E) Reason
Reactions in Mitochondria: Fatty acid oxidation (β-oxidation), acetylCoA production, TCA cycle, oxidative phosphorylation.
blood vessels are part of which ligament?
gastrospleenic
gastrodudenal
gastrohepatic
quadrate ligament
round ligament
A) Reason
Gastrosplenic Ligament: It connects Greater curvature and spleen. It contains Short gastrics, left gastroepiploic vesselsIt separates greater and lesser sacs on the left side.
initial sign of resuscitation after compensated shock is?
dec. BP
inc. pulse rate
dec. pulse rate
inc. BP
cold skin
C) Reason
Hypovolumia (blood loss aftr hemmorhage) causes hypoglycemic shock (low BP and high pulse rate). Fluid resuscitation causes heart rate to decrease to normal and than increase BP towards normal value.
hypothalmo-hypophysial portal system is
adrenal cortex
adrenal medulla
hypothalamus
posterior pituitary
adenohypophysis
E) Reason
Anterior pituitary (adenohypophysis):Secretes FSH, LH, ACTH, TSH, prolactin, GH, melanotropin (MSH). Derived from oral ectoderm (Rathke pouch).
How hormonal therapy dec. tumor size
necrosis
hypotrophy
hypertrophy
atrophy
Apoptosis
E) Reason
Hormones act by inhibiting the growth factors and dec. cancer growth. Tamoxifen is the typical example, Tamoxifenmoxifen, a selective estrogen receptor modulator (see Chapter 40), blocks the binding ofestrogen to receptors of estrogen-sensitive cancer cells in breast tissue.
Neurovascular bundle of rib lies in
superior border
lateral border
posterior border
internal border
inferior border
E) Reason
• The costal groove is located along the inferior border of each rib (upper aspect of the intercostal space) and provides protection for the intercostal nerve, artery, and vein which are located in the groove. The vein is most superior and the nerve is inferior in the groove (VAN).
Sympathetic neurotransmitter
epinephrine
Norepinephrine
Dopamine
phenylephrine
Ach.
B) Reason
Release of sympathetic neurotransmitter norepinephrine from a sympathetic nerve ending is modulated by norepinephrine itself, acting on presynaptic α2-autoreceptors, angiotensin II, and other substances.
BCG acts via
CD8 delayed response
CD4 delayed HSR
type 2 HSR
type 1 HSR
type e HSR
B) Reason
Type IV: Multiple sclerosisGuillain-Barré syndromeGraft-versus-host diseasePPD (test for M. tuberculosis)and BCG.Contact dermatitis (e.g., poison ivy, nickel allergy).
A patient with loss of appetite, HBc-Ab reactive, IgM unreactive, HBsAg unreactive
chronic infection
acute infection
carrier state
past HBV exposure
heavy infection
D) Reason
Here the markers of HBV given in this scenario show that no recent infection (absent IgM) and furthermore presence of antibodies indicates a previous infection.
regarding drug receptors
lipoprotein
glycoprotein
glycolipids
protein in nature
lipoploysacchride
D) Reason
Proteins:1. Integral proteins■ are anchored to, and imbedded in, the cell membrane through hydrophobic interactions.■ may span the cell membrane.■ include ion channels, transport proteins, receptors, and guanosine 5′-triphosphate (GTP)–binding proteins (G proteins).
A male loses 8% blood after RTA in half hr. most likely site of loss?
arterioles
arteries
veins
heart
spleen
C) Reason
Veins have more distensibility and calibre than that of arteries and accumulate more blood than that of arteries. Hence blood loss is mainly from veins.
hormone responsible for inc. pancreatic secretion and intracellular Ca
lipase
enterokinase
gastrin
secretin
CCK
E) Reason
Cholecystokinin (CCK): secreted from I cells (duodenum, jejunum)Increases pancreatic secretionIncreases gallbladder contractionDecreases gastric emptyingIncreases sphincter of Oddi relaxation
A pt. is on steroid therapy for a long time. sudden extraction is ill advised. why?
withdrawl effect
dec. Cortisol
inc. Cortisol
inc. ACTH
dec. ACTH
E) Reason
TOXICITY Iatrogenic Cushing syndrome—buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, easy bruisability, osteoporosis (treat with bisphosphonates), adrenocortical atrophy, peptic ulcers, diabetes (if chronic).Adrenal insufficiency (dec. ACTHg when drug stopped abruptly after chronic use.
CHF pt has developed edema. mechanism?
dec. hydrostatic pressure
inc. hydrostatic pressure
sec. oncotic pressure
inc. oncotic pressure
dec. plasma
B) Reason
Causes of Edema by Increased capillary hydrostatic pressure: Arteriolar dilationVenous constrictionIncreased venous pressureHeart failureExtracellular volume expansionStanding (edema in the dependent limbs)
histological feature of PCT
less mucosa
more mucosa
less muscles
villi
microvilli
E) Reason
The lateral borders of adjacent cells are extensively interdigitated. These characteristics are typical of cells involved in active transport. The lumen of the PCT is frequently clouded by microvilli which do not preserve well during the histologic preparation process.
Which of following cell has variable life
RBC
osteoblast
osteoclast
macrophages
lymphocytes
C) Reason
Osteoclasts are derived from cells of blood monocyte lineage, which ultimately come from hematopoietic stem cells. They have variable life span depending body Ca and PO4 levels.
Refractory period of cardiac Myocytes
0.8 sec
- 7 sec
- 5 sec
- 3 sec
- 1 sec
D) Reason
Absolute refractory period■ is the period during which another action potential cannot be elicited, no matter how large the stimulus, eg: 0.3 sec in cardiac cycle.■ coincides with almost the entire duration of the action potential.
SA node is pacemaker, reason
higher rate of firing
superior location
intrinsic property
less myofibrils
more myofibrils
A) Reason
Sinoatrial (SA) node ■ is normally the pacemaker of the heart due to its fast rate and automaticity■ has an unstable resting potential.■ exhibits phase 4 depolarization, or automaticity
prosopagnosia is inability to
recoganize color
recoganize face
recoganize objects
recoganize shapes
recoganize location
B) Reason
Among the higher mental functions of the cortex, the cerebrum, lesion manifestations are agraphesthesia (inability to recognize the shape of objects) and prosopagnosia is inability to recognize the face.
Regarding diabetes insipidus truth is?
dec. urine vol.
dec. serum Na
inc. serun K
inc. urinary Osmolarity
dec. urine Osmolarity
E) Reason
Diabetes insipidus Characterized by intense thirst and polyuria with inability to concentrate urine (decreased urine Osmolarity) due to lack of ADH. Has a central or nephrogenic cause.
A young lady took 10 tablets of paracetamol, what changes on liver on 3rd day
fibrosis
extensive hepatic necrosis
periportal fibrosis
periportal congestion
sinus congestion
B) Reason
Findings: mitochondrial abnormalities, extensive hepatic necrosis, fatty liver (microvascular fatty change), hypoglycemia, vomiting, hepatomegaly, coma.
A patient has chronic H/O gastric ulcer.Now he presented to SEW with severe epigastric pain and hypostension.Surgeon suspects gastric perfortion.Pain is carried in this situation by
lumber plexus
lumber splanchnic
great splanchnic
thoracic splanchnic
vagus
C) Reason
Great splanchnic nerve supply to the abdomenal viscera. Foregut and midgut (thoracic splanchnic nerves: T5-T12) and to the hindgut and pelvic viscera (lumbar splanchnic nerves: L1-L2) synapse in collateral ganglia.
block of artery supplying medulla will cause
deltoid paralysis
tongue paralysis
serratus anterior
serratus posterior
latismus dorsi
B) Reason
Caudal medulla—origin of hypoglossal nerve.Lesion causes Ipsilatral hypoglossal dysfunction (tongue deviates ipsilaterally
A patient can”t feel pain or touch sensation over third and fourth fingers.Which nerve is damaged in this case?
cutaneous nerve
axillary nerve
radial nerve
ulnar nerve
median nerve
D) Reason
Ulnar (C8-T1) Fracture of medial epicondyle of humerus “funny bone”.“Ulnar claw” on digit extension and loss of sensation of 3rd and 4th fingers.
A patient sustained injury to chest with a knife.How.many layers of chest wall will be damaged?
2
4
8
10
14
C) Reason
layers to be penetrted are skin, subcutaneous tissue, fat, muscle layers (2 layers), pleural ligament, pleural layers (2 layers) to lungs.
reason of decline in PaO2?
high altitude
deap sea
low drowning
sea level
Hypoxia
A) Reason
Adaptation to high altitude (Table 4.9) Alveolar Po2 is decreased at high altitude because the barometric pressure is decreased. As a result, arterial Po2 is also decreased (hypoxemia).
true about ABO blood group antigen
autosomal dominant
autosomal recessive
X-linked recessive
X-linked dominant
Y-linked
B) Reason
Autosomal recessive Traits:Albinism, ARPKD (formerly known as infantile polycystic kidney disease), cystic fibrosis, glycogen storage diseases, ABO blood group antigen, hemochromatosis, Kartagener syndrome.
which factor dec. in pregnancy
antithrombin 3
anti-trypsin
heparin
thrombin
fibrin
A) Reason
Pregnancy is an hypercoagulative state due to loss of antithrombin 3. Acquired deficiency of the Anti-thrombin III is related to the loss of factor in urine.
which is same Marker in pancreatic cancer, colon cancer and colangitis
CA 19-9
C-myc
CA 19
CA 125
CEA
E) Reason
CEA: CarcinoEmbryonic Antigen. Very nonspecific but produced by ∼ 70% of colorectal and pancreatic cancers; also produced by gastric, breast, and medullary thyroid carcinomas.
left shift in Hb-O2 curve is result of?
dec. K
dec. Na
dec. O2
increased pH
dec. pH
D) Reason
An increased in all factors (including H+) causes a shift of the curve to the right.A decreased in all factors (including H+) causes a shift of the curve to the left.
sphincter of gall bladder and intestine are relaxed by
sympathetic
autonomic
parasympathetic
lumber plexus
ascral plexus
C) Reason
Parasympathetic system is the system of rest and digest. Its activation causes increased GI motility, relaxed GI sphincters and increased GI secretions.
1st approved gene therapy was introduced through
plasmid
insulin
mice
doli sheep
horse
A) Reason
Plasmid Contains a variety of genes for antibiotic resistance, enzymes, toxins. It was used in recombinant technology for the first time in history.
A patient suddenly lifted heavy weight and subsequently developed sciatica.On examination,ankle jerk is absent.This is caused by damage of
L4
L3
S1
L5
L2
C) Reason
Heavy weight lifting is most of the time associated with damage to the Lumbosacral spine and its roots. Loss of ankle jerk (root value S1) mean lesion at S1 level.
which is not enzyme of pancrease?
glactase
lipase
amylase
mucous
protease
D) Reason
The acinar cells of the exocrine pancreas make up most of its weight.Secretion (serous) are secreted by the pancreatic acini.a. Acinar cells■ produce a small volume of initial pancreatic secretion, which is mainly Na+ and Cl
AV node delay is shortened by
parasympathetic
Ach
lidocain
autonomic
sympathetic
E) Reason
sympathetic stimulation causes increased in heart rate and hence cardiac cycle is decreased and sympathetic activity causes increased firing of nodal fibers and shortens the AV nodal delay.
in hemorrhagic shock urine output is decreased. reason?
low heart rate
high heart rate
dec. oncotic pressure
low arterial pressure
high arterial pressure
D) Reason
In hemmorhage, plasma volume decreases laeding to decreased arterial pressure and hence decreased GFR and low urine output.
ALT and AST are raised in hepatitis by which mechanism
their increase synthesis
decreased absorption
released from bile accumulation
none of these
released from destruction of hepatocytes
E) Reason
ALT and AST are the enzymes of the liver cells. In inflamation of the liver cells membrane is damaged leading to release of these enzymes. Hence their level increased in serum.
MOst active transport of sodium takes place at?
jejunum
dudenum
ileum
cecum
Colon
A) Reason
■ Examples are Na+-glucose cotransport in the small intestine (jejunum) and renal early proximal tubule and Na+K/2Cl cotransport in the renal thick ascending limb.
A patient with previous Compylobacter infection now developed paraplegia, cause.?
UMNL
LMNL
NM junction disorder
flaccid paralysis
GBS
E) Reason
Campylobacter infection can result in reactive arthritis, primarily in patients with HLA-B27. Other extraintestinal complications, including erythema nodosum and GuillainBarré syndrome, a flaccid paralysis caused by immunologically mediated inflammation of peripheral nerves, are not HLA-linked.
Which of the following structure is related medially and posteriorly to parotid and might be damaged during parotidectomy?
azygus vein
hemi azygus vein
internal jugular
carotid sheath
external jugular
D) Reason
• Posterolateral relation of the parotid gland are: The carotid sheath and its contents
which bone make floor of cranial fossa
maxillary sinus
mndibular bone
cervical spine
greater wing of sphenoid
lesser wing of sphenoid
D) Reason
Sphenoid Complex bone composed of a central body, and greater and lesser wings. Its greater wing forms the floor of the middle cranial fossa.
AB+ lady need blood postpartum. which group is apropriate?
O-
O+
AB+
B+
all of above
E) Reason
AB positive blood group is an universal accepter, moreover all groups given here all are compatible with AB positive blood group.
Which hormone causes smooth muscle contraction via IP3 ?
cortisol
Aldosterone
Prolactin
renin
ADH
E) Reason
Vasopressin [antidiuretic hormone (ADH)], IP3 and DAG■ is involved in the regulation of blood pressure in response to hemorrhage, but not in minute-to-minute regulation of normal blood pressure.■ Atrial receptors respond to a decrease in blood volume (or blood pressure) and cause the release of vasopressin from the posterior pituitary.■ Vasopressin has two effects that tend to increase blood pressure toward normal.
right hemiplegia with left sided mouth deviation, lesion is at..?
crona radiata
Midbrain
medulla
pons
internal capsule
E) Reason
internal capsule lesion: Contralateral hemiparesis/Crossed hemiplegia (contralatral mouth deviation)Common location of lacunar infarcts, 2° to unmanaged hypertension.
taste sensation from tractus solitarius goes to cortex via
hypothalamus
pons
thalamus
Midbrain
medulla
C) Reason
Solitarius Visceral Sensory information (e.g., taste, baroreceptors, gut distention). Sensations are Transmitted through thalamus to the cortex.
inhibitor of prostaglandins are
GH
insulin
corticosteroids
glucagon
naltrisone
C) Reason
orticosteroids cause neutrophilia, but eosinopenia and lymphopenia. Corticosteroids decrease the formation of prostagladins and decrease the activation of neutrophil adhesion molecules, impairing migration out of the vasculature to sites of inflammation.
All or none action potential is feature of
dendrites
axon
astrocytes
oligodendrocyte
Schwann cells
B) Reason
During the action potential of the neurons, it follows the all or none principle. All the fibers are excited or no one is excited during the action potential.
lidocaine is given in treatment of
WPS syndrome
ventricular tachycardia
atrial fibrillation
atrial flutter
ventriclar fibrillation
B) Reason
CLINICAL USE of Lidocain : Acute ventricular arrhythmias (especially postMI), digitalis-induced arrhythmias especially post-MI.
A female with recurrent UTI, Pseudomonas on culture, drug of choice
Ciprofloxacin
metronidazole
ampicillin
gentamicin
clavulunate
A) Reason
Treatment: aminoglycoside plus extended spectrum penicillin (e.g., piperacillin, ticarcillin, cefepime, imipenem, meropenem) and quinolones (UTI and pylonephritis).
Hyperextension of tibia anteriorly over knee joint will damage
patella
anterior cruciate ligament
lateral ligament
tibial condyl
fibular head
B) Reason
The anterior cruciate ligament is attached below tothe anterior intercondylar area of the tibia, most commonly injured in excessive anterior movementa of the knee joint.
squamocolumnar junction of esophagus is associated with
achlasia
squamous metaplasia
cuboidal Metaplasia
Barrett esophagus
CA esophagus
D) Reason
Barrett esophagus Glandular metaplasia—replacement of nonkeratinized (stratified) squamous epithelium with intestinal epithelium (nonciliated columnar with goblets cells) in the distal esophagus at squamocolumnar junction. Due to chronic acid reflux (GERD).
myelination of periphral nervous system
astrocyte
dendrites
axons
schwann cells
oligodendrite
D) Reason
Schwarm cells are glial cells that make myelin for PNS axons. Unlike oligodendrocytes, which make C S myelin, individual Schwann cells myelinate only a small part of a single axon.
Complete loss of arm abduction rsults from damage to
supraspinatus
axillary
supraspinatus and axillary
radial
median
C) Reason
Abduction of arm is the combined function if the Supraspinatus muscle and deltoid, supplied by supraspinatus and axillary nerve respectively.
serum Ca and phosphate are regulated by?
PTH
renal function
liver function
lung function
bone function
B) Reason
Level of serum calcium and serum Phosphate are regulated by renal function. Ca is decreased and phosphate is increased in impaired renal functions.
Quiet inspiration is carried out by
diaphragm
pleura
intercostal
thoracic splanchnic
Trapezius
A) Reason
The phrenic nerve (C3–5).Action• Muscle of inspiration: On contraction, the diaphragmpulls its central tendon down and increases the vertical diameter of the thorax
true about vibrio cholera
survive in alkaline
survive in acidic
susceptible to alkaline
live in high temperature
live in high pH
A) Reason
Vibrio cholerae Produces profuse rice-water diarrhea via enterotoxin that permanently activates Gs, inc. cAMP. Comma shaped, oxidase positive, grows in alkaline media. Endemic to developing countries. Prompt oral rehydration is necessary
Injury to the phrenic nerve at its root will lead to loss of
respiratory reflex
gastric reflex
sneezing reflex
cough reflex
pharyngeal reflex
A) Reason
Diaphragm is innervated by C3, 4, and 5 (phrenic nerve). Lesion of the nerve leads to respiratory distress and loss of respiratory reflex.
Thrombocytopenia is side effect of
loop diuretics
osmotic diuretics
thiazide
spironolactone
amiloride
C) Reason
TOXICITY Hypokalemic metabolic alkalosis, Thrombocytopenia, hyponatremia, hyperGlycemia, hyperLipidemia, hyperUricemia, and hyperCalcemia. Sulfa allergy
true about SLE
type 1 HSR
type 3 HSR
tyep 2 HSR
type 4 HSR
Delayed response
B) Reason
Type III:Polyarteritis nodosaPoststreptococcal glomerulonephritisSerum sickness, SLEArthus reaction (e.g., swelling and inflammation following tetanus vaccine)
a pt with pacemaker comes for ecg, finding shows absent P wave, normal qrs complex & T wave. location of pacemaker?
bundle of His
SA node
AV node
atria
ventricle
C) Reason
Pacemaker action:Occurs in the SA and AV nodes. Key differences from the ventricular action potential. Normally in SA node. When in AV node, there is no P wave, rest is normal.
fatty acids combines with glycerol to form fat in..?
RER
SER
golgi complex
nucleus
cell membrane
C) Reason
In golgi apparatus, Glyceraldehyde-3-phosphate to glycerol-3-phosphate (combines with fatty acids to make triglycerides
A boy had injury to knee, 8 month later he had hematoma and bone trabeculi, Dx..?
dysplasia
metaplasia
anaplasia
neoplasia
dystrophy
B) Reason
Metaplasia mean transformation of the one type of cells into another type of cells. Here in this scenario, injury caused soft tissue to develop bony (metaplstic) tissue.
in mitral stenosis which jvp is not found?
a wave
x wave
y desent
d wave
V wave
E) Reason
v wave—inc. right atrial pressure due to filling against closed tricuspid valve. It is absent in mitral stenosis.
cells responsible for maintenance and integrity of bone
fibroblasts
osteiod
osteocytes
osteoclasts
osteoblasts
E) Reason
Osteoblasts are specialized to synthesize and secrete the components of osteoid, type I collagen, and GA Gs. The unique structure of the osteoid, in particular the ordering of the collagen, promotes the formation of a crystalline structure.
Which structure will be damaged in case of penetrating injury to posterior triangle of the neck?
deltoid
trapezius
supraspinatus
teres major
seratus posterior
B) Reason
The posterior triangle is bounded posteriorly by the trapezius muscle, anteriorly by the sternocleidomastoid muscle,and inferiorly by the clavicle
Cause of amenorhea in married female with pregnancy test negative
ectopic pregnancy
molar pregnancy
no pregnancy
twin pregnancy
anovulation
E) Reason
Most common causes of anovulationPregnancy, polycystic ovarian syndrome, obesity, HPO axis abnormalities, premature ovarian failure, Anovulatory cycles, hyperprolactinemia, thyroid disorders, eating disorders, female athletes, Cushing syndrome, adrenal insufficiency.
When fibrinogen changes to fibrin what will be seen in blood
lipase
fibrinolase
Fibrinopeptidase A
Fibrinopeptidase B
Fibrinopeptide
C) Reason
Fibrinogen: It is Coagulation factor; converts to fibrin by FibrinopeptidaseA, promotes endothelial repair; correlates with ESR
A middle age man is suspected of lymphoma, it is diagnosed by
Electrophoresis
bone marrow biopsy
CBC
Peripheral smear
immuno-histochemistry
E) Reason
Lymphoma Discrete tumor masses arising from lymph nodes. Presentations often blur definitions. Diagnosed witn immunohistochemistry.
Patient has no cough, but diffuse fibrosis on chest X-ray, cause
silicon
hydrocarbon
asbestos
inorganic dust
berrylium
D) Reason
Keeping types of joints in mind, wrist joint is a
hing type
sesamoid
fixed joint
condyloid
Ellipsoid
E) Reason
Wrist joint is an example of Ellipsoid type. Reference B.D.
A 70kg male will have a urinary output of?
0.5 L
1 L
2 L
3 L
1.5 L
E) Reason
Normal urine output is about 1ml/kg per hour. So, in a person of 70kg it would be, Urine output= 1ml x 70 x 24 = 1680ml, app = 1.5L.
IV drug abuser with cough not responding to ATT, bilateral infiltrates on CXR, cause..n
M. tuberculosis
P. aerogenosa
Candida
P. jirovecii
M. bovis
D) Reason
Pneumocystis jirovecii:Causes Pneumocystis pneumonia (PCP), a diffuse interstitial pneumonia. Yeast (originally classified as protozoan). Inhaled. Most infections are asymptomatic. Immunosuppression (e.g., AIDS) predisposes to disease. Diffuse, bilateral CXR appearance. Diagnosed by lung biopsy or lavage. Disc-shaped yeast forms on methenamine silver stain of lung tissue .
primordial germ cells are formed at
2nd month
8th day
2nd week
3rd week
4th week
E) Reason
Primordial germ cells arise from the lining cells in the wall of the yolk sac. At week 4, primordial germ cells migrate into the indifferent gonad.
temp maintenance of skeleto-motor system is via?
vasoconstriction
shivering
vasodilation
piloerction
sheltering
B) Reason
Shivering is the most potent mechanism for increasing heat production. ■ Cold temperatures activate the shivering response, which is orchestrated by the posterior hypothalamus.
loop diuretic cause what
no effect on medularry osmolarity
inc. reabsorption
inc. secretion
inc. medullary interstitial osmolarity
dec. Medullary Osmolarity
E) Reason
It causes decreased osmolarity.
which structure is responsible for keeping flexor tone of muscles?
fasiculus gracilis
fasiculus cuneatus
stratum
uncus
red nucleus
E) Reason
Rubrospinal tract■ originates in the red nucleus and projects to interneurons in the lateral spinal cord.■ Stimulation of the red nucleus produces stimulation of flexors and inhibition of extensors.
which has role in tissue remodeling
macrophages
metalloproteins
fibroelasts
collagenase
lipase
D) Reason
Collegenase is protein enzyme that functions to remodeling if the repaired tissues. Its defects leads to abnormal shape of the repaired tissues like abnormal scars.
There is a triangle in neck which is formed by mandible, sternocledomastoid and midline.This traingle is called
posterior
lateral
anterior
inferior
superior
C) Reason
The anterior triangle is bounded above by the body of themandible, posteriorly by the sternocleidomastoid muscle,and anteriorly by the midline
Epithelium of urinary bladder is dervied in embryological life from
urogenital sinus
urogenital ridge
urogenital diaphragm
urogenital membrane
urachus
A) Reason
In the 3rd week the yolk sac forms the allantois, which extends into the urogenital sinus. Later on, urogenital sinus forms the epithelium of the Urinary bladder.
brain gets what %age of total cardiac output?
5
7
10
15
20
D) Reason
These are the well perfused organs. 25% of the cardiac output goes to the liver; 4-5% (225 ml/min) to the heart; 15% to the brain; 20% to the kidneys; and 100% to the lungs.
a pt experiences conduction aphasia. site of lesion is?
Arcuate faciculus
gracilis
faciculus cuneatus
red nucleus
pons
A) Reason
Conduction Aphasia There is a large fiber bundle connecting areas 22, 39, and 40 with Broca area in the frontal lobe, known as the superior longitudinal fasciculus (or the arcuate fasciculus). A lesion affecting this fiber bundle results in a conduction aphasia.
frontal lobe tumor with optic tract affected will cause
Homonemous hemianopia
Heteronymous hemianopia
ipsilatral loss
contralatral loss
upper quadrant loss
A) Reason
Bitemporal hemianopia (pituitary lesion, chiasm) Left homonymous hemianopia(lesion of ipsilatral optic tract). Left upper quadrantic anopia (right temporal lesion, MCA)
what leads to osmotic diarrhea?
fructose
galactose
sucrose
dextran
lactose
E) Reason
Lactose intolerance results from the absence of brush border lactase and, thus, the inability to hydrolyze lactose to glucose and galactose for absorption. Nonabsorbed lactose and H2O remain in the lumen of the GI tract and cause osmotic diarrhea.
Pt. can”t diff. between red and green having red color blindness, condition is called
deutronopia
tritononopia
protanopia
gluconopia
rubronopia
C) Reason
Color blindness are named as Protonopia as red blindness, Deutronopia as green blindness and tritononopia is blue color blindness.
A lady with fasting sugar 98 and random 122, post meal is 190, Dx..?
diabetes
Impaired glucose tolerance
pre-diabetes
no diabetes
type 2 diabetes
B) Reason
Diagnosis: fasting sugar greater than 110mg/dl, random level greater than 126mg/dl or post glucose greater than 200mg/dl are diagnostic ojf diabetes mellitus.
Dermatome for cholecystitis pain
C5
C6
C6-C8
C4
C7-9
D) Reason
dermatome is same as of shoulder tip.
which carry impulses away from cell body
dendrites
axon
oligodendrite
astrocytes
schwann cells
B) Reason
Signal-relaying cells with dendrites (receive input), cell bodies, and axons (send output). Cell bodies and dendrites can be stained via the Nissl substance (stains RER).
fatty meal leading to bloating at night. work of which hormone?
GIP
CCK
VIP
secretin
gastrin
B) Reason
Can also lead to biliary colic—neurohormonal activation (e.g., by CCK after a fatty meal) triggers contraction of the gallbladder, forcing a stone into the cystic duct. May present with bloating and with or without pain (e.g., in diabetics).
after shock managment what will be corected first?
BP
temperature
Hb
leukocytes
Heart rate
E) Reason
In hypovolumic shock, Blood volume decreases that causes decreased BP and increased heart rate. As the fluid therapy is started, heart rate slow down to normal and then BP also goes up to normal.
A lady going to Saudi Arabia has clear fluid filled lesion in mouth, Dx..?
HSV1
HHV
HHV-8
HIV
HCV
A) Reason
HSV-1: Gingivostomatitis, keratoconjunctivitis, temporal lobe encephalitis (most common cause of sporadic encephalitis in the United States), herpes labialis. Latent in trigeminal ganglia.Transmitted by respiratory secretions, saliva.
which NSAID is contraindicated in CLD
Clopidogrel
aspirin
ampicillin
gentamycin
metronidazole
B) Reason
TOXICITY Gastric ulceration, tinnitus (CN VIII). Chronic use can lead to acute renal failure, interstitial nephritis (contraindicated in CRF), and upper GI bleeding. Risk of Reye syndrome in children treated with aspirin for viral infection.
In thrombus formation, 1st step is
clot retraction
platelets adhesion
clot formation
endothelial injury
tissue reaction
B) Reason
In thrombus formation, platelets adhesion takes place over the injured endothelium making platelet plug that is site for thrombus formation.
A female is declared infertile yet prolactin is increased. reason?
adenoma
hyperplasia
hypertrophy
macroprolactinoma
microprolectinoma
E) Reason
Functional tumor (microprolactinoma) presentation is based on the hormone produced (e.g., prolactinoma: amenorrhea, galactorrhea, low libido, infertility; somatotropic adenoma: acromegaly).
heart contractility is affected by all except?
Ach
epinephrine
Norepinephrine
Cortisol
GH
A) Reason
Sympathetic system stimulation or secretion of any stress hormone causes increased contratility of the heart . Ach. is a parasympathetic hormone.
Cost effective way of judging vit.A deficiency in community
clinical
diet
pharmacological
supplements
Screenig
B) Reason
It is easy to assess and manage the nuitrional deficiencies in the in diet rather to do it with clinical or the pharmacological interventions that would be expensive and complicated as well.
which is type 2 hypersensitivity reaction
SLE
Polyarteritis nodosa
serum sickness
arthus reaction
ITP
E) Reason
Type II: Autoimmune hemolytic anemiaPernicious anemiaIdiopathic thrombocytopenic purpuraErythroblastosis fetalisAcute hemolytic transfusion reactionsRheumatic feverGoodpasture syndromeBullous pemphigoidPemphigus vulgaris.
staging is defined as
extent of severity
extent of lesion
differentiation
anaplasia
prognosis
B) Reason
Staging of tumor: Degree of localization/spread based on site and size of 1° lesion, spread to regional lymph nodes, presence of metastases. Based on clinical (c) or pathology (p) findings. Example: cT3N1M0
Hepatic gulconeogenesis is done by
glucagon
insulin
GH
LH
Cortisol
A) Reason
FUNCTION of Glucagon are: Catabolic effects of glucagon:Increases Glycogenolysis, gluconeogenesis(in liver)Inc. Lipolysis and ketone production
A patient was injured in RTA and sustained fracture of hip joint.Now when he stands up,his pelvis and left leg sinks down.This is caused by a lesion of
rectus femoris
quadricep femoris
adductor longus
left maximus
Right minimus
E) Reason
If gluteus minimus then the pelviswill sink downward on the opposite, unsupportedside. The patient is then said to exhibit a positiveTrendelenburg’s sign.
parameter responsible for preload calculation?
stroke volume
heart rate
plasma flow
Left ventricle EDV
viscosity
D) Reason
Preload: Preload approximated by ventricular EDV; depends on venous tone and circulating blood volume.
Damage to which of the following will lead to loss of ankle jerk?
S1
L4
L5
S2
L1
A) Reason
Heavy weight lifting is most of the time associated with damage to the spinal nerve roots. Here ankle jerk (root value of S1) loss mean lesion is at S1 level.
reason of TPR
smooth muscle
sphincters
arterioles
vasomotor tone
capillaries
D) Reason
Total peripheral resistance: maintained by vasomotor tone.Changes in TPR leads to altered CO at a given RA pressure; however, mean systemic pressure (x-intercept) is unchanged.
Which of the following vessels starts at the level of ear lobule and ends at sternoclavicular joint?
external jugular vein
internal jugular vein
internal carotid
external carotid
common carotid
B) Reason
The internal jugular vein is a large vein that drains bloodfrom the brain, face, scalp, and neck . It starts as acontinuation of the sigmoid venous sinus and leaves theskull through the jugular foramen and ends at the medial border of clavicle by forming bracheocephalic vein.
fibrocartilage is present in
knee
elbow
Intervertebral disc
sutures
TM joint
C) Reason
Fibrocartilage has type I collagen in addition to type II, giving it greater resistance to being stretched (tensile strength), and is the type of cartilage found in intervertebral disks of the vertebral column and the menisci of the knee.
most common cause of Hyperbilirubinemia in neonates
hepatitis
hemolysis
maternal alcohlism
conjugated Hyperbilirubinemia
Gilbert syndrome
B) Reason
Most common cause of unconjugated /indirect hyperbilirubinemia are: Hemolytic, physiologic (newborns), Crigler-Najjar, Gilbert syndrome
Virulence of Staph aureus is determined by
protease
plasmin
coagulase
cell wall
capsule
C) Reason
Coagulase is an enzyme that causes plasma to clot byactivating prothrombin to form thrombin. It is the main virulent factor of staph. aureus. Thrombin then catalyzes the activation offibrinogen to form the fibrin clot.
which of following is Hypertonic solution
10% dextrose
- 9% NaCl
- 2% NaCl
5% Dextrose
0.1% NaCl
A) Reason
All the fluids given in the list are either hypotonic to the body (0.1, 0.2 percent NaCl) or Isotonic such as (0.9 percent NaCl or 5 percent dextrose) except 10 percent Dextrous that is Hypertonic.
Recently married female with lower abdominal pain. Urine gives pus cells, Dx..?
E. coli
Pseudomonas
staph. aureus
N. miningitis
Shagilla
A) Reason
E. coli is the leading cause of community-acquired urinary tract infections.These infections occur primarily in women; causing frequent burning Micturation and suprapubic tenderness.
what change will be seen in lung compliance if surface tension is decreased?
decrease
increase
shift to left
shift to right
become zero
B) Reason
Compliance—change in lung volume for a given change in pressure; maintained by surfactant decreased in pulmonary fibrosis, pneumonia, and pulmonary edema and increased surfactant; increased in emphysema, low or none surfactantand normal aging
what replicates itself
mitochondria
RER
SER
Golgi complex
nuclei
A) Reason
They synthesize adenosine triphosphate (ATP ), contain their own double-stranded circular DNA, and make some of their own proteins and replicate themselves by virtue of their own genetic material.
Patient presents with constipation, muscle weakness and short T-wave, Dx..?
hyperkalemia
hypokalemia
hypernatremia
atrial flutter
atrial fibrillation
B) Reason
T wave—ventricular repolarization. T-wave inversion may indicate recent MI. While short T wave in hypokalemia and tall T wave in hyperkalemia.
which connects laminae in vertebral column
Ligamentum teres
Ligamentum flavum
round ligament
introssious ligament
transverse ligament
B) Reason
LIGAMENTSbetween 2 Vertebra:• Supraspinous ligament: Connects adjacent spines.• Interspinous ligament: Connects adjacent spines.• Ligamentum flavum: Connects adjacent laminae
In a young pt. high levels of GH are seen it will lead to deficiency of what?
amino acids
carbohydrates
protein
vitamins
fatty acids
E) Reason
FUNCTION Stimulates linear growth and muscle mass through IGF-1/somatomedin secretion. Increases lipolysis and insulin resistance (diabetogenic).
Trypsinogen changes to trypsin ?
gastrin
secretin
bile
enterokinase
protease
D) Reason
Trypsinogen: Converted to active enzyme trypsin by enterokinaseto activation of other proenzymes and cleaving of additional trypsinogen molecules into active trypsin (positive feedback loop)
Pt has mild jaundice that is recurrent and has unconjugated Hyperbilirubinemia, Dx..?
Hepatitis
Wilson disease
Criglar naggar
Dubin johnson
Gilbert
E) Reason
Gilbert syndrome: Mildly dec. UDP-glucuronosyltransferase conjugation activity dec. bilirubin uptake by hepatocytes. Asymptomatic or mild off and on jaundice. Elevated unconjugated bilirubin without overt hemolysis.
which one has highest conductance rate
SA node
AV node
bundle of His
left atrium
Purkingi fibers
E) Reason
Speed of conduction—Purkinje > atria > ventricles > AV node.Pacemakers—SA > AV > bundle of His/Purkinje/ventricles.
Ends of long bones are supplied by
nutrient artery
periosteal artery
metaphyseal artery
periphyseal artery
epiphyseal artery
E) Reason
Epiphysial arteries • These are derived from periarticular vascular arcades (circulus vasculosus) found on the nonarticular bony surface. These supply the metaohysis and epiohysis.
drug of choice for tape worm
metronidazole
ciprofloxacin
albendazole
ampicillin
gentamicin
C) Reason
Ingestion of larvae encysted in undercooked pork.Ingestion of eggs. Treated with Albendazole or ivermectin.
Difference between plasma and serum
clotting factors
proteins
cells
ions
RBCs
A) Reason
Plasma is part of blood minus blood cells while serum is the part of plasma minus clotting factors.
Receptors which adjust swiftly?
Pacinian
Meissner”s
tactile receptor
Murcel discs
GTO
A) Reason
Rapidly adapting, or phasic, receptors (pacinian corpuscle; light touch)■ show a decline in action potential frequency with time in response to a constant stimulus.■ primarily detect onset and offset of a stimulus
Choose the correct narrayive about renal fascia
sheet of muscle
encloses vessels
encloses aorta
encloses IVC
encloses suprarenal
E) Reason
Renal fascia: This is a condensation of areolar tissue outside the perirenal fat. It encloses the kidneys and thesuprarenal glands
which cells of intestine may carry antigens?
M cells
G cells
goblet cells
enterocytes
villi
A) Reason
Peyer patches: Unencapsulated lymphoid tissue found in lamina propria and submucosa of ileum. Contain specialized M cells that sample and present antigens to immune cells
most commonly raised enzyme in liver disease
AST
ALP
pseudocholinestrase
ALT
enterokinase
D) Reason
Aminotransferases (AST and ALT) (often called “liver enzymes”)Viral hepatitis (ALT > AST), viral hepatitis is more common than alcoholic one.Alcoholic hepatitis (AST > ALT)
Outer covering of single muscle is called as
epimysium
perimysium
neuromysium
exomysium
endomysium
E) Reason
Endomysium surrounds each muscle fibre separately. Perimysium surrounds bundles (fasciculi or myonemes) of muscle fibres of various sizes. Epimysium surrounds the entire muscle.
Diabetic with HLA1, undergone transplant 1 month ago, which cells involved in rejection
CD4 cell
Th1 cells
HLA 4
CD4 with MHC1
CD8 with MHC1
E) Reason
Febrile nonhemolytic transfusion reaction:Type II hypersensitivity reaction. Host antibodies against donor HLA antigens and leukocytes. through MHC.
substantia gelatinosa is related to
temperature
tactile
pressure
pain
vibration
D) Reason
This is particularly important in relation to thespinothalamic and spinoreticular pathways and the perception of pain.Presynaptic inhibition influences many, possibly all, primary afferent terminals. Amuch-investigated site ofpresynaptic effects is the substantia gelatinosa.
which phase of action potential leads to rise in pulse pressure?
phase 1
phase 2
phase 0
phase 3
phase 4
E) Reason
Positive chronotropic effect■ increases heart rate by increasing the rate of phase 4 depolarization.■ More action potentials occur per unit time because the threshold potential is reached more quickly and, therefore, more frequently.
difference between plasma and interstitial fluid
less lipids
more proteins
less proteins
less cells
less clotting factors
C) Reason
Interstitial fluid is three-fourths of the ECF. Thus, it is one-fourth of TBW (3/4 × 1/3).■ The composition of interstitial fluid is the same as that of plasma except that it has little protein. Thus, interstitial fluid is an ultrafiltrate of plasma.
Anticoagulant which is present naturally?
plasminogen
thrombin
plasmin
factor 4
Hagmann factor
A) Reason
Thrombolytics Directly or indirectly conversion of plasminogen (a natural Thrombolytic) to plasmin, which cleaves thrombin and fibrin clots. inc. PT, inc. PTT, no change in platelet count.
Fibers of the cilliary ganglion are carried through which branch
nasocilliary
optic
maxillary
labial
nasal
A) Reason
Some fibers from the nasocilliary branch go and synapse in the ciliary ganglionand reach the eyeball in the short ciliary nerves.
Doctor can develop better communication by
informed consent
non malficence
compitence
active listening
knowledge
D) Reason
A better communication skill is one of the important step of the relationship between a Doctor and a patient, it can be best developed by active listening and respect the views and ideas of the patients at their level.
Percentage of fat in normal diet
5 to 10
10 to 15
15-20
20-25
52-30
C) Reason
Normal contribution of the major nutrients in diet are as: Carbohydrates 45-65 percent, proteins 25-40 percent and fats 15-20 percent.
38 years male with fever, and chills, now presented with Hb of 8 and spleenomegaly, Dx..?
CML
ALL
malaria
CLL
lymphoma
C) Reason
Here in this scenario, all the features given are in favour of malarial diagnosis. While decreased Hb is the feature of hemolysis by the RBC burst and leading to spleenomegaly.
secondary center of ossification is associated with
epiphysis
diaphysis
metaphysis
shaft
metaphyseal plate
A) Reason
Epiphysis The ends and tips of a bone which ossify from secondary centres are called epiphyses.
clorpromazine toxicity
hypokalemia
hyponatremia
hyperkalemia
dystonia
CRF
D) Reason
TOXICITY: Highly lipid soluble and stored in body fat; thus, very slow to be removed from body.Extrapyramidal system side effects (e.g., dystonia and dyskinesias). Treatment: benztropine or diphenhydramine.
nerve damaged in Erb”s paralysis
C1-2
C2-3
C5-6
C4-5
C6
C) Reason
UPPER TRUNK LESIONS OF THE BRACHIALPLEXUS (ERB-DUCHENNE PALSY)Upper trunk (C5-6) lesions of the brachial plexus result fromdisplacement of the head to the opposite side and depression of the shoulder on the same side, as during fallson the shoulder or in infants during a difficult delivery
what is true about Antibodies in Hashimoto thyroiditis
anti mitochondrial
anti SM Igs
anti globulin
anti thyroxin
antithyroglobulin
E) Reason
Hashimoto thyroiditis: Most common cause of hypothyroidism in iodine-sufficient regions; an autoimmune disorder (anti-thyroid peroxidase, antithyroglobulin antibodies).
quatran malaria is by which specie
P. malarie
P. falciparum
P. vivax
P. ovale
P. hilus
A) Reason
Plasmodium Malarie is a specie of the Malaria causing parasites. P.Malarie fever spikes are there after every 3 days (Qurtran malaria).
