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In case of increased plasma volume but no increase in hemoglobin relative anemia leads to decreased O2 saturation.. Production of concentrated urine: is also called hyperosmotic urine, i

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FCPS Past Papers

MEDICINE & ALLIED 4

01 May2018 Morning (A) 6

01 May2018 Morning (B) 30

01 May2018 Noon (A) 52

01 May2018 Noon (B) 75

01 May2018 Evening (A) 98

01 May2018 Evening (B) 121

02 May2018 Morning (A) 143

02 May2018 Morning (B) 159

09 March 2018 Evening (A) 173

09 March 2018 Evening (B) 185

08 March 2018 Evening (A) 201

08 March 2018 Evening (B) 223

08 March 2018 Morning (A) 247

07 March 2018 Morning (A) 295

07 March 2018 Morning (B) 313

07 March 2018 Evening (A) 340

07 Sep 2017 Morning (B) 407

1st March 2017 Morning (A) 426

1st March 2017 Morning (B) 447

09 Nov 2016 Evening (A) 466

09 Nov 2016 Evening (B) 488

10 Nov 2016 Evening (A) 509

10 Nov 2016 Evening (B) 526

Parietal layer is sensitive to pain as receptors are present on it and absent on visceral layer 543

SURGERY & ALLIED 547

02 May 2018 Evening (B) 573

01 May 2018 Evening (B) 624

07 Mar 2018 Evening (A) 639

07 Mar 2018 Noon (A) 682

07 Mar 2018 Morning (A) 734

07 Mar 2018 Morning (B) 748

01 Mar 2017 Morning (A) 773

01 Mar 2017 Morning (B) 790

GYNAE 798

01 May 2018 Evening (A) 800

01 May 2018 Morning (A) 838

01 May 2018 Morning (B) 864

08 Mar 2018 Morning (A) 887

08 Mar 2018 Morning (B) 910

07 Mar 2018 Morning (A) 927

07 Mar 2018 Morning (B) 952

07 Mar 2018 Evening (A) 968

07 Mar 2018 Evening (B) 995

EYE 1020

MARCH 2018 EYE Papers 1021

MD / MS Papers MD-MS FEB 2018 1076

MD-MS January 2017 1106

MD-MS May 2016 1136

MD MS Nov 2016 1165

MD-MS October 2017 1194

MEDICINE & ALLIED

S UBJECT & C HAPTER WISE

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01 May2018 Morning (A)

Q: A Shopkeeper suddenly collapsed in his shop On exam, his pulse was thready BP was 80/60 and Pulse was 120bpm, thready and weak Most likely he suffered from?

 Cardiogenic Shock

Sustained hypotension (systolic blood pressure (BP) <90 mm Hg for more than 30 minutes) Tissue hypoperfusion (cold peripheries, or oliguria <30 ml/hour, or both Cardiogenic shock occurs if the heart suddenly can't pump enough oxygen-rich blood to the body

 Massive Pulmonary Embolism

 Gastritis/esophagitis

 Dissecting aortic aneurysm

Q: Lymphoma in AIDs pt is caused by?

 EBV

It is interesting to note that although Burkitt lymphoma is common in HIV-infected patients, immunodeficiency-related lymphomas and Epstein-Barr virus (EBV), the association of EBV infection in AIDS-related lymphoma

malignancies such as prostate cancer

 CMV

 Adenovirus

Q: Which of the following is Characteristic feature of Crohns Disease?

 Causes Cancer in Young age

 Affects small Intestine

 Tr mural Inflammation

CD is characterized by tr mural (full-thickness) inflammation, involvement of discontinuous segments of the intestine (skip areas) Crohn's disease (CD) is an autoimmune inflammatory

bowel disease characterized by chronic inflammation in the gastrointestinal tract leading to abdominal pain

Q: Female patient with uterine atony Drug you will give

Q: Traveler returned from foreign trip.Aftr 6 weeks developed generalyzed

lymphadenopathy,hepatospleenomegaly,fever and atypical lymphocytosis Diagnosis?

Q: muscle which increase AP diameter of thorax during inspiration

 intercostal

The anteroposterior diameter is increased by raising the ribs and thrusting the sternum forward through contraction of the intercostal muscles The tr verse diameter is increased byraising the ribs (like bucket handles) through contraction ofthe intercostal muscles

 Peutz Jeiger syndrome

 True hermaphrodite

 Patau syndrome

Patau syndrome (trisomy 13), 1:15,000 :Findings: severe intellectual disability, rockerbottom feet, microphthalmia, microcephaly, cleft liP/Palate, holoProsencephaly,Polydactyly,

congenital heart disease Death usually occurs within 1 year of birth

Q: 3rd heart sound is due to

Q: premalignant lesion on cheek

 actinic kertosis

Actinic keratosis: Premalignant lesions caused by sun exposure Small, rough, erythematous

or brownish papules or plaques Risk of squamous cell carcinoma is proportional to degree

Smooth endoplasmic reticulum:Site of steroid synthesis and detoxification of drugs and poisons Lacks surface ribosomes

19.O2 tension normal but O2 saturation is decreased due to

 dec plasma

 inc plasma

In case of increased plasma volume but no increase in hemoglobin (relative anemia) leads to decreased O2 saturation

In solid organ tr plant always mark CMV Its features include Congenital infection,

mononucleosis (negative Monospot), pneumonia, retinitis Infected cells have characteristic

“owl eye” inclusions Latent in mononuclear cells.Tr mitted congenitally and by tr fusion, sexual contact, saliva, urine, tr plant

 HBV

Q: hypophyseal part receiving supply from hypophyseal portal system

 adenohypophysis

Anterior pituitary (adenohypophysis):Secretes FSH, LH, ACTH, TSH, prolactin, GH,

melanotropin (MSH) Derived from oral ectoderm (Rathke pouch)

Production of concentrated urine: is also called hyperosmotic urine, in which urine

osmolarity > blood osmolarity is produced when circulating ADH levels are high (e.g., water deprivation, volume depletion, SIADH)

 dec by ADH

Q: cervical rib compresses which nerve root

 Pudendal

Q: Arthus reaction is example of which type of hypersensitivity

Collecting tubule—reabsorbs Na+ in exchange for secreting K+ and H+ (regulated by

aldosterone).Aldosterone—acts on mineralocorticoid receptor increased insertion of Na+ channel on luminal side

 ITP

Q: basement membrane containcollagen type

 type 1

 type 2

 type 3

 type 4

Type III Reticulin—skin, blood vessels, uterus, fetal tissue, granulation tissue Type IV

Basement membrane, basal lamina, lens

Q: Factory worker presented in opd with progressive peripheral motor disfunction and anemia Cause can be

Q: true about aspirin

 inhibits both COX1 and 2

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:

 inhibits COX1 only

 inhibits COX2 only

Parkinson disease Degenerative disorder of CNS associated with Lewy bodies (composed of α-synuclein—intracellular eosinophilic inclusion) and loss of dopaminergic neurons (i.e., depigmentation) of the substantia nigra pars compacta

Correct wer is Heparin which is safe in pregnancy.Warfarin is used in Chronic

anticoagulation (after STEMI, venous thromboembolism prophylaxis, and prevention of stroke in atrial fibrillation).But Not used in pregnant women (because warfarin, unlike heparin, can cross the placenta) Follow PT/INR values

The pons is located between the medulla (caudally) and the midbrain (rostrally) The

cerebellum overlies the pons It is connected to the brain stem by 3 pairs of cerebellar peduncles

Q: nerve damage in posterior triangle of neck

 spinal

 spinal acessary

The spinal root of CN XI runs downwardand laterally, and it enters the deep surface of the sternocleidomastoid muscle, which it supplies, and then crossesthe posterior triangle of the neck to supply the trapeziusmuscle

glossopharyngeal nerve (general sensation and taste)

Q: schwann cells are present in

 tendon

 ligaments

 Elastin

 PNSMyelin results in saltatory conduction of action potential between nodes of Ranvier, where there are high concentrations of Na+channels CNS—oligodendrocytes, PNS—Schwann cells

Myelin results in saltatory conduction of action potential between nodes of Ranvier, where there are high concentrations of Na+channels CNS—oligodendrocytes, PNS—Schwann cells

Q: true about warm receptors

 nociceptorExtremes of temperature and painis detected by Nociceptors

frequently of theupper lumbar arteries (L1 and L2)

 T8

 T9-10

Q: Surfactant starts to be made by which week?

Dorsal column system processes sensations of fine touch, pressure, two-point

discrimination, vibration, and proprioception consists primarily of group II fibers

Nonspecific signs common to many ToRCHeS infections include hepatosplenomegaly,

jaundice, thrombocytopenia, and growth retardation

Fractures of the femoralneck interfere with or completely interrupt the mainblood supply from medial circumflex femoral artery to the root of the femoral neck to thefemoral head Avascular necrosis of the femoral headis a common complication of femoral neck fractures

CK-MB is predominantly found in myocardium but can also be released from skeletal

muscle Useful in diagnosing reinfarction following acute MI because levels return to normal after 48 hours

Q: Substance which is freely cleared and reabsorbed

 PAH

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

Q: A patients labs show urine Osmolarity of 100 and polyuria.ADH analogue is given shows response and increase in urine osmolarity Diagnosis?

Acute respiratory distress syndrome:May be caused by trauma, sepsis, shock, gastric

aspiration, uremia, acute pancreatitis, or amniotic fluid embolism Diffuse alveolar damage and increased alveolar capillary permeability leading to protein-rich leakage into alveoli and noncardiogenic pulmonary edema (normal PCWP)

Q: A burn patient presents with bleeding profusely and shock.Total protiens 4(normal

is 5 to 8).labs will have

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

P ystolic murmur appears in MR and TR In aortic area tricuspid regurgitation is the

enucleated.Choroidal thickening was present.What abnormality at cellular level causing this?

 T cell supression

 T cell depression

 T cell supression failure

As the reconstruction was done after the RTA, the T cells should be suppressed in order to maintain and bear the reconstructed tissues

 K closure

Q: maxillary vein starts from

Danazol:MECHANISM Synthetic androgen that acts as partial agonist at androgen

receptors.CLINICAL USE Endometriosis and hereditary angioedema

Q: in 3rd trimester which vaginal infection is most common

 staph aureus

 candida

Candida albic : alba = white.Systemic or superficial fungal infection Oral and esophageal thrush in immunocompromised (neonates, steroids, pregnancy, diabetes, AIDS),

vulvovaginitis (diabetes, use of antibiotics), diaper rash, endocarditis in IV drug users,

disseminated candidiasis (to any organ), chronic mucocutaneous candidiasis

Anterior pituitary (adenohypophysis): Secretes FSH, LH, ACTH, TSH, prolactin, GH,

melanotropin (MSH) Derived from oral ectoderm (Rathke pouch) α subunit—hormone subunit common to TSH, LH, FSH, and hCG β subunit—determines hormone specificity

Kinase: Uses ATP to add high-energy phosphate group onto substrate (e.g.,

phosphofructokinase).Phosphorylase: Adds inorganic phosphate onto substrate without using ATP (e.g., glycogen phosphorylase).Phosphatase: Removes phosphate group from substrate (e.g., fructose-1,6-bisphosphatase)

Q: Heinz bodies are seen in

 Aplastic anemia

 sideroblastic anemia

 asplenia

 G6PD deficiencyHeinz bodies appear in G6PD deficiency and oxidative stress

Q: UMNL present on CT scan.There is muscle weakness.what other signs may

present?

 hypotonia

 Hypertonia

Signs and symptoms of the upper motor neuron lesion are, spasticity, hypertonia,

hypereflexia and clonus

 flaccid paralysis

 dec reflexes

Q: brachiocephalic trunk divides into

 right Subclavian

RIGHT SUBCLAVIAN ARTERYThe right subclavian artery arises from the

brachiocephalicartery, behind the right sternoclavicular joint

The anterolateral pathway carries pain and temperature sensations It contains

In a negative feedback system, the outcome or the result of the activity is opposite to

previous turn, negative feedback returns the changes towards normal

Q: Example in which Homeostatic function of autonomic nervous system is opposed is

 negative Feedback

In a negative feedback system, the outcome or the result of the activity is opposite to

previous turn, negative feedback returns the changes towards normal

Q: Patient of COPD present with breathlessness pH shows acidosis His electrolytes test will show

 RBC

 WBC

Q: receptors for temperature regulation are present on

Etiologies—alcohol (60–70%), viral hepatitis, biliary disease,

hemochromatosis.Portosystemic shunts partially alleviate portal hypertension:Esophageal varices, spider nevi, decreased production of clotting factors leading to increased bleeding Tedency.Caput medusae In this case it seems acute on chrnoic hepatits resulting CLD

Q: MOA of propylthiouracil is to inhibit peroxidase and

01 May2018 Morning (B)

Q: A Pt developed Hoarseness of voice On indirect Laryngoscopy, sluggish movement

of left vocal cord was noticed Injury to which nerve?

 Lt Recurrent L

The recurrent laryngeal nerve (RLN) carries signals to different voice box muscles

responsible for opening vocal folds (as in breathing, coughing), closing the folds for vibration during voice use, and closing them during swallowing

Adipose tissue, or fat, is an anatomical term for loose connective tissue composed of

adipocytes Its main role is to store energy in the form of fat, although it also cushions and insulates the body

Q: Staging of tumor is by?

Q: Pre-mortem Thrombi characterized by?

 Current jelly appearance

 Lines of Zahn

Lines of Zahn are a characteristic of thrombi that appear particularly when formed in the heart or aorta They have visible and microscopic alternating layers (laminations) of platelets mixed with fibrin, which appear lighter and darker layers of red blood cells

 Sideroblastic Anemia

 Anemia of Chronic Disease

 Folic acid deficiency

Q: Regarding liver of Fetus?

 Covers whole of Abdomen???

 Vit D

 Vit K

The functions of vitamin K are concerned with blood clotting process Post-tr lational (after protein biosynthesis in the cell) modification of certain blood clotting factors The clotting factors II (prothrombin) VII ,IX and X are synthesized as inactive precursors (zymogens) in the liver

 Retinal detachment

 Increase mineralocorticoid secretion

Q: Thiamine deficiency results in?

 Hyperkeratosis

 Peripheral neuritis

peripheral neuropathy due to vitamin B1 (thiamine) deficiency is a part of beriberi

syndrome Atrophic skin changes are also commonly present The neuropathic presentation

of thiamine deficiency is quite varied and may precede the systemic and cognitive

The abdominal aorta has three ventral branches (Figs 7-1 and 7-2) The celiac artery arises

at the T12-L1 level It can initially take a forward, upward, or dowward course The superior mesenteric artery (SMA) takes off at the L1-L2 level about 1 cm below the celiac axis

 IVC joined by portal

 Head of Pancreas

 Level of Adrenal Glands

Q: A female Pt with family hx of fetal abnormalities has been found with decreased Maternal AFP Dx?

 Renal Agenesis

 Down syndrome

In Down syndrome, the AFP is decreased in the mother's blood, presumably because the yolk sac and fetus are smaller than usual Estriol is a hormone produced by the placenta, using ingredients made by the fetal liver and adrenal gland Estriol is decreased in the Down syndrome pregnancy

 Ebstein Anomaly

 Neural Tube defects

Q: A Pt climbed a peak with a heavy bag on his shoulders After that he developed loss of adduction of arm with loss of flexion at elbow and loss off extension at wrist Most likely damage occurs to?

a Radial nerve

 Axillary nerve

 Musculocutaneous nerve

 Upper part of Brachial Plexus

A brachial plexus injury (BPI), also known as brachial plexus lesion, is an injury to the

brachial plexus, the network of nerves that conducts signals from the spinal cord to the shoulder, arm and hand

Q: Slowest conduction occur in which part of Conducting System?

Q: After exercise a person lost fluids by Sweating He drinks 2 liters of water What will happen?

Q: Most important mechanism in formation of Exudate

 Increase Vascular permeability the most important and most useful of our host defense mechanisms, and without an adequate inflammatory response It involves all vessels leading to increase vascular

permeability and the formation of inflammatory exudate

 Vasodilation

C Chemotaxis

Q: Regarding Internal Jugular Vein:

 Starts form ear lobule to sternal Angle

 Starts from Angle of Mandible to hyoid bone

 Starts from Ear lobule to Sternoclavicular Joint

The internal jugular vein is often the access site of choice for central venous cannulation the posterior approach, the needle is placed at the posterior border of the sternocleidomastoid muscle, at a point one-third of the way from the sternoclavicular joint to the mastoid

 Ureters

 Bladder

Q: Which of the following has an Oro-fecal route?

 Hep-E

Hepatitis E (HEV) is a viral infection causing inflammation of the liver It is primarily acquired

by ingesting water contaminated with fecal matter The virus is also tr mitted from person

to person through the fecal-oral route as a result of poor body hygiene practices

(Ag)- Antibodies

 Helper T Cells

Q: PENICILLIN works on bacteria through?

 Destruction of Cell Wall

 Inhibition of Cell Wall Synthesis

Penicillin by inhibiting cell wall synthesis would inhibit both growth and mullication Since the antibiotic is bactericidal to rapidly mullying cells, its effect on cell wall would interfere with its bactericidal action

Q: Aortic Pressure highest in which Phase of Cardiac Cycle?

 Slow Ejection Phase

ejection stage of the cardiac cycle, it is depicted (see circular diagram) as the ventricular systole–first phase followed by the ventricular systole–second phase After ventricular pressures fall below their peak(s) and below those in the trunks of the aorta and pulmonary arteries

 Rapid Ejection Phase

 Isovolumetric Contraction

 Isovolumetric relaxation

Q: In which of the following conditions PaO2 is decreased?

 Dec Atmospheric O2 concentration

 V/Q Mismatch

The A-a oxygen difference increases with age It is primarily due to age-induced decrease in the PaO2 level because of the rise in V/Q mismatch The drop in PaO2 after 70 years is about 0.43 mmHg per year

epinephrine and norepinephrine are called adrenergic receptors Epinephrine and

norepinephrine have equal affinity at both alpha1 and alpha2 receptors

The most common intestinal roundworms are those tr mitted through contact with the soil Ancylostoma duodenale and Necator americanus They are distinguished by the morphology

of the mouth parts and male bursa

 Conditioning of inspired air

dead space is the volume of air which is inhaled that does not take part in the gas exchange, either because it remains in the conducting airways

 Mildly Increases in Old Age

Q: Which of the following is characteristic in diagnosing Asthma?

 FEV

The FEV1/FVC ratio is used as a criterion for airflow obstruction, however, the test

characteristics of spirometry in the diagnosis of asthma

b Expiratory flow rate

Q: Which of the following is marker of Carcinoma?

Q: A pt who is Alcoholic and chronic smoker developed a non-healing Ulcer in oral cavity Most likely lesion?

 SCC

Upon compilation of the relevant data, oral ulcerative lesions were categorized into three major groups: acute, chronic, and recurrent ulcers According to Wood and Goaz, a lesion is most likely a SCC if the patient is male, older than 40 years, smokes or drinks heavily,

 Malignant Melanoma

 Salivary Gland Tumor

Q: A chronic smoker developed Dysphagia for solids and Wt loss Which of the

following is most likely in this Pt?

a Dec Peristalsis

The diagnosis of paraneoplastic esophageal motility disorders requires a heightened

suspicion in current or former smokers with severe dysphagia in SSc suggest that decreased esophageal clearance is a central pathophysiologic factor its development

Q: Increasing SV, while keeping TPR, Diastolic Pressure What will happen?

 Inc MAP and Pulse pressure

increase in end-diastolic volume results in a decrease in TPR and heart rate, whereas they increase to a decrease in end-diastolic

 Inc MAP and Dec Pulse P

 Dec MAP and Pulse P

Q: Anterior and Posterior Ethmoidal nerves are branches of?

 Frontal

 Lacrimal

 Nasociliary

Nasociliary nerve is a branch of the ophthalmic division of trigeminal nerve It is

intermediate in size as compared to the other two branches of the ophthalmic division

 Maxillary

Q: Which of the following is common cause of Salivary Gland Atrophy?

 Obstruction of Excretory ducts

salivary glands Sequelae of long-standing calculi include chronic sialadenitis, duct dilatation, gland atrophy,

 Sup Thyroidal Artery

artery branches from the superior thyroid artery near its bifurcation from the external carotid artery

 Occipital Artery

Q: Which of the following is Side Effect of ACEIs?

 Hyperkalemia

Hyperkalemia (high concentration of potassium in the blood) is another possible

complication of treatment with an ACE inhibitor due to its effect on aldosterone

Suppression of angiotensin II leads to a decrease in aldosterone levels

 Hypokalemia