Aspirin inhibits platelet activation by inhibiting?

 COX1

 COX2

 LTB4

 Thromboxance A2

Thromboxane A2 (TXA2) is a type of thromboxane that is produced by activated platelets and has prothrombotic properties: it stimulates activation of new platelets as well as

increases platelet aggregation. Platelet aggregation inhibitors work in different places of the clotting cascade and prevent platelet adhesion, therefore no clot formation. Aspirin, the most commonly used anlatelet drug changes the balance between prostacyclin (which inhibits platelet aggregation) and thromboxane (that promotes aggregation)

1Q: During Starvation what happens:

 Increase glucose use by brain

 Decrease urinary nitrogen secretion

 Ketone bodies formation

Starvation mode is a state in which the body responds to prolonged periods of low energy intake. During short periods of energy abstinence, the human body burns primarily free fatty acids from body fat stores, along with small amounts of muscle tissue to provide required glucose for the brain. Ketone bodies are three water-soluble molecules

(acetoacetate, beta-hydroxybutyrate, and their spontaneous breakdown product, acetone) that are produced by the liver from fatty acids during periods of low food intake (fasting), carbohydrate restrictive diets, starvation, prolonged intense exercise and alcoholism.

 Glycolysis by liver

07 Mar 2018 Evening (B)

1.Death due to food posioing by which organism?

 S, Aureus

 C, tetni

 C, difficille

 C, botulism

C botulinum Produces a preformed, heat-labile toxin that inhibits ACh release at the neuromuscular junction, causing botulism. In adults, disease is caused by ingestion of preformed toxin.

2.Nissel bodies

 granules in cytoplasm

 granules in nucleus

 granules in RER

Site of synthesis of secretory (exported) proteins and of N-linked oligosaccharide addition to many proteins.Nissl bodies (RER in neurons)—synthesize peptide neurotr mitters for

secretion

 granules in G. apparatus

3.True about brochopulmonary segment?

 collective innervation

 segmental bronchus & artery

Some common features are: It has a segmental bronchus, a segmental artery, lymphvessels, and autonomic nerves. The segmental vein lies in the connective tissue betweenadjacent bronchopulmonary segments. Because it is a structural unit, a diseased segment can beremoved surgically

 separate broncheol

 separate drainage

4.Increase in systolic blood pressure is by ?

 inc. renin

Renin secreted by JG cells in response to decreased renal arterial pressure and increased renal sympathetic discharge (β1 effect) and increases BP to normal

 dec. renin

 dec. ANP

 dec. Aldosterone 5.Uterus main support??

 Fallopian ligament

 Round ligament

The round ligament of the ovary is the remains of the upperpart of the gubernaculum, and it extends from the medialmargin of the ovary to the lateral wall of the uterus. It is the main support of the uterus.

 Cruciate ligament

 Broad ligament

6.Women has rheumatoid arthritis joint pain etc most likely disease is due to??

 inflammatory

 infectious

 drug induced

 autoimmune

Rheumatoid arthritis: Autoimmune—inflammatory destruction of synovial joints. Mediated by cytokines and type III and type IV hypersensitivity reactions.

7.A mother has previous baby with down syndrome now with present pregnancy at 12 week. she is worried and know about baby best screening test ???

 TVS

 USG

 Amniocentesis

best is to do an Invasive test – CVB or amniocentesisto screen and diagnose Down’s syndrome,Cystic fibrosis, Thalassaemia etc

 AFP

8.Uterus prolapse but anal canal intact, defect is in

 puborectalis

 pelvic diaphragm

The pelvic diaphragm is formed by the important levatores ani muscles, the small coccygeal muscles,and the pelvic fascia covering these muscles.

 perineal membrane

 perineal raphe

9.Patient have left sided weakness of limbs and left sided tongue paralysis. Which vessel is injured?

 MCA

Contralateral paralysis—upper limb and face. Contralateral loss of sensation—upper and lower limbs, and face. Aphasia if in dominant (usually left) hemisphere. Hemineglect if lesion affects nondominant (usually right) side.

 vertebral artery

 PCA

 lateral circulation

10.Which organ is important for initiation of labor

 placenta

 fetal adrenal

 maternal pituitary

 fetal pituitary

The production of corticotrophin-releasing hormone (CRH) by the placenta increases in concentration towards term and potentiates the action of prostaglandins and oxytocin on myometrial contractility. The fetal pituitary secretes oxytocin and the fetal adrenal gland produces cortisol, which stimulates the conversion of progesterone to oestrogen.

11.Diptheria toxoid hypersensitivity?

 type 1 HSR

 type 2 HSR

 type 3 HSR

Examples of Type III HSR are: SLE, Polyarteritis nodosa,Poststreptococcal

glomerulonephritis,Serum sickness, Arthus reaction (e.g., swelling and inflammation following tetanus vaccine)

 type 4 HSR

12.Metabolic acidsois causes??

 exitation

 dec. respiration

 CNS depression

 inc. respiration

Decreased HCO3− concentration causes a decrease in blood pH (acidemia).Acidemia causes hyperventilation (Kussmaul breathing), which is the respiratory compensation for metabolic acidosis.

13.Blood brain barrier impermebale to?

 Cl

 Proteins

The blood-brain barrier restricts access of micro-organisms, proteins, cells, and drugs to the nervous system.

 H

 CO2

14.Norepinephrine action increases??

 inc. CCK

 Inc. GIP

 dilate sphincter

 contract sphincter

Norepinephrine (NE): The primary tr mitter at most sympathetic postganglionic nerve endings. Effects on GIT is to relax the wall and contract the sphincter

15.Age of humerus ossification?

 16 yr

Ossification begins in the medial epicondyle in the fourth year in females, sixth in males, and in the lateralepicondyle about the 12th year. The centres for the lateral epicondyle,

capitulum and trochlea fusearound puberty and the composite epiphysis unites with the shaft of humerus in the fourteenth year in females,and sixteenth year in males.

 18 yr

 20 yr

 22 yr

16.Screening performed for cancer?

 dec. disease rate

 dec. disability

 diagnose at early stage

Level of the Disease prevention:Primary: Prevent disease occurrence (e.g., HPV

vaccination.Secondary: Screening early for disease (e.g., Pap smear)Tertiary: Treatment to reduce disability from disease (e.g., chemotherapy)

 dec. budget burden 17.Psoas insertion

 lateral condyle

 lesser trochenter

Origin: from 12th thoracic and lumber 5 verteb, Insertion: With Ileacus in the lesser trochenter of femor

 medial condyle

 patella

18.Enzyme causes secondary sexual characteristic in females? males?

 5-HT

 DHT

 aromatase

Aromatase is the key enzyme in the conversion of androgens to estrogen.

 Dehydroorotate

19.Urine output for 70kg man?

 1 L

 1.5L

Normal amount of urine output in adults is 1ml/kg/hr. So, in an adult of weight 70kg, output will be about 1.5L.

 2L

 2.5 L

20.A man working having profuse vomiting water loss which metabolite help ??

 Na

 Ca

 K

 Cl

Loss of H+ from the stomach by vomiting causes increased blood *HCO3−+ and metabolic alkalosis. Because Cl− is lost from the stomach along with H+, hypochloremia and ECF volume contraction occur that should be replaced by normal saline.

21.Lentiform nucleus

 Putamin and globus pallidus.

Basal ganglia are the Important in voluntary movements and making postural

adjustments.Striatum = putamen (motor) + caudate (cognitive).Lentiform = putamen + globus pallidus.

 putamin only

 globus pallidus

 stratum

22.Secondary cartilage joint?

 sutures

 gomphosis

 Symphysis pubis

Secondary cartilaginous joints or symphyses are largely defined by the presence of an intervening pad ordisc of fibrocartilage interposed between the articular hyaline cartilage that covers the ends of two bones

 Synchondrosis

23.Nucleus ambigus is a nucleus of which nerves?

 CNX

 CN IX & X

The nucleus ambiguus is a column of large motor neurons situated dorsal to the inferior olive. Axons arising from cells in this nucleus course in the ninth and tenth cranial nerves

 CNXI

 CN V

24.Unmarried 18 year female has abdominal pelvic mass chest shows Mets?

 β hcg

Dysgerminoma: Most common in adolescents. Equivalent to male seminoma but rarer. 1%

of all ovarian tumors 30% of germ cell tumors. Sheets of uniform “fried egg” cells D . hCG, LDH = tumor markers. While CA-125 is tumor marker for overian tumor but these are more in > 50yrs of females

 CA-125

 calcitonin

 5-HT

25.Clasp knife reflex??

 free nerve endings

 Golgi tendon reflex

Clasp-knife reflex, an exaggerated form of the Golgi tendon reflex, can occur with disease of the corticospinal tracts (hypertonicity or spasticity).

 muscle reflex

 tactile receptor

26.Referral system?

 better management

Refferal system between Primary care to the secondary healthcare level or to the tertiary/

teaching hospitals, is always for the purpose of the better management of the Patients in order to have good outcome.

 avoid load

 prevent overcrowding

 patient satisfaction 27.Most suitable for digitalis?

 chronotropic

 inotropic

MECHANISM: Direct inhibition of Na+/K+ ATPase leads to indirect inhibition of Na+/Ca2+

exchanger/anort. increases [Ca2+]i leading to positive inotropy. Stimulates vagus nerve leading to decrease HR.

 dromotropic

 Bathmotrophic

28.Acute myocardial infarction changes on ECG?

 S wave

 J wave

 U wave

 ST elevation

Myocardial infarction Most often acute thrombosis due to coronary artery atherosclerosis with complete occlusion of coronary artery and myocyte necrosis. If tr mural, ECG will show ST elevations if subendocardial, ECG may show ST depressions. Cardiac biomarkers are diagnostic.

29.Fisher man with rice and fish food, worm infestation by

 D, Latum

Diphyllobothrium latum:Ingestion of larvae from raw freshwater fish, it causes Vitamin B12 deficiency (tapeworm competes for B12in intestine) leading to anemia

 lumbericoid

 Wuchraria

 trichomonas

30.Eosophageal carcinoma caused by?

 EBV

 HIV

 nitrosamines

Causes of esophgeal Carcinoma:Achalasia, Alcohol—squamous, Barrett esophagus—adeno, Cigarettes—both, Diverticula (e.g, Zenker)—squamous, Esophageal web—squamous, smoked food (nitrosamines), Familial, Fat (obesity)—adeno, GERD—adeno, Hot liquids—

squam

 H. pylori

31.Temporalis insertion

 maxilla

 zygomatic

 body of mandible

 coronoid process of Mandible

Origin: Floor of the temporal fossa and covering fascia, Insertion: Coronoid process of themandible

32.Broad ligament is a double peritoneal membrane. What tubeless structure is in its antero superior portion?

 Broad ligament

 Ovarian ligament

 Round ligament

The broad ligaments are two-layered folds of peritoneumthat extend across the pelvic cavity from the lateral marginsof the uterus to the lateral pelvic walls (Fig. 3-9). Each

broadligament contains the following: The uterine tube in its upper free border. The round ligaments of the ovary and of the uterus..The uterine and the ovarian blood vessels, lymph vessels,and nerves.The broad ligaments provide little support to the uterus

 Fallopian ligament

33.Women with pitituary tumor having bitemporal heminopia .Affected part is?

 superior part of optic chiasma

Enlargement of the pituitary because of a tumor usually results in the gland initially expanding superiorlyand pressing on the optic chiasma through the diaphragma sellae.

Pressure on the chiasma producesbitemporal hemianopia.

 lateral part

 posterior part

 medial part

34.Heparin or histamine released by which cells?

 eosinophils

 Basophils & mast cells

Mediates allergic reaction. Densely basophilic granules A containing heparin (anticoagulant), histamine (vasodilator), and leukotrienes.

 Basophils

 mast cells only

35.Regarding amyloidosis the following statements are true except

 Can be diagnosed on rectal biopsy

 Causes splenomegaly

 Does not involve the heart

Amylodosis is deposition of misfolded proteins in tissues. Senile cardiac Amylodosis ia the type in which tr thyretin deposits in heart.

 Leads to nephrotic syndrome

36.Pt has head injury bp 165 pulse 105 shallow breathing?

 dec. Ca

 dec. CO2

Hyperventilation (decreased Pco2) helps decreased intracranial pressure in cases of acute cerebral edema (stroke, trauma) via decreased cerebral perfusion by vasoconstriction.

 dec. K

 dec. Cl

37.Obturator internus supplied by?

 sacral plexus

Supplied by Sacral plexus and functions to Lateral rotator of the femur at hip joint

 lumber plexus

 hypogastric

 inferior hypogastric

38.Obstetrician usually doesn"t give mid-line episiotomy incision due to?

 perineal body

 perineal raphi

 rectalis

 external anal sphincter

A mediolateral episiotomy is usually recommended a midline episiotomy is an incision in a comparatively avascular area and results in less bleeding, quicker healing and less pain, however, there is an increased risk of extension to involve the anal sphincter (third/fourth- degree tear).

39.Starvation can cause

 Production of ketone bodies

In prolonged starvation and diabetic ketoacidosis, oxaloacetate is depleted for gluconeogenesis.

 inc. glycogen

 dec.metabolites

 production of by products

40.Young child with unilateral hydronephrosis most likely obstruction??

 posterior urethral valve

 Uretro-pelvic junction

Embryologically, Ureteropelvic junction—last to canalize and is the most common site of obstruction (hydronephrosis usually unilateral) in fetus.

 stone

 horshoe kidney

41.Early diagnosis and prompt treatment?

 secondary

Primary: Prevent disease occurrence (e.g., HPV vaccination). Secondary: Screening early for disease (e.g., Pap smear)Tertiary: Treatment to reduce disability from disease (e.g.,

chemotherapy)

 tertiary

 Quaternary

 Screenig

42.Which of the following local anesthetic show highest protein binding

 lignocain

 bupivacain

 ropivacain

 Prilocain

Anesthetics that are more lipid soluble are generally more potent, have a longer duration of action, and take longer to achieve their clinical effect. Extensive protein binding (Prilocain

being the maximally protein bound local anesthetic) also serves to increase the duration of action.

43.HIV AIDS association?

 SCC

 Kaposi Sarcoma

Kaposi sarcoma, a neoplasm of endothelial cells. Seen in HIV/AIDS and tr plant

patients.Dark/violaceous flat and nodular skin lesions representing endothelial growths. Can also affect GI tract and lungs. Tr mitted by sexual contact.

 BCC

 Lymphoma

44.Neuromuscular bundle is passed though which part of rib ?

 Superior border

 medial border

 Inferior border

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).

 posterior border

45.A boy eating cholay from street vidor. Suffers from fever, vominting, nausea after few days fever relive but he develop yellow colour sclera?

 Hep. A

Hepatitis A is tr mitted by feco-oral route to the susceptible host by eating contaminated foods and it has a short course of illness

 Hep. B

 Hep. C

 Hep. D

46.Damage to perineal body cause damage to which muscle?

 pelvic diaphragm

 perineal membrane

 levator ani

The perineal body (a fibromuscular structure in the perineum supported by the levatores ani muscles). Injury to the perineal body causes damage to the muscle

 perineal facia 47.Interstitial cell buffer?

 Phosphate

 Protein-H

 NH4-H

 HCO3

The major extracellular buffer is HCO3- which is produced from CO2 and H2O.The pK of the CO2/HCO3 buffer pair is 6.1.Phosphate is a minor extracellular buffer.The pK of the H2PO4- /HPO4buffer pair is 6.8

48.Women Hep,C for several years on histology shows?

 portal fibrosis

 periphral fibrosis

 portal & periportal fibrosis

Cirrhosis— caused by chronic hepatitis esp. B & C. Characterized by diffuse fibrosis and nodular regeneration destroys normal architecture of liver increased risk for hepatocellular carcinoma (HCC).

 Degeneration

49.Young man having accident. femoral artey was cut down.There was delayed in treatment.Hhe is in shock.Organ least damage is?

 muscles

 kidney

 brain

 gut

All the features given in scenario are characteristics of hypovolumic shock, so vital org are at increased risk for damage that bears least anoxia. Gut is the one organ that can bear long anoxia.

50.Retropharyngeal lymph node drain all except???

 pharynx

 larynx

Retropharyngeal nodes: Lie between the pharynx and the vertebral column. They receive lymph from the nasopharynx, the auditory tube, and the vertebral column.

 auditory tube

 vertebral column

51.Quickening starts at

 16-17 week

Ultrasound can be used to assess fetal well-being by evaluating fetal movements (that usually starts in fifth month of gestation-quickening), tone and breathing in the Biophysical Profile.

 19 week

 19-20wks

 22weeks

52.Thyroidectomy performed... after 10 days.. pt presents with...Low calcium and exaggerated muscle activity

 laryngomalacia

 tracheal compression

 Iatrogenic Hypo-PTH

During the Surgery of thyroid gland, it is much important to identify and preserve the parathyroid glands, their accidental removal can cause hypoparathyroidism

 laryngeal nerve injury

53.Most effective route for antidote administration for rapid response???

 oral

 IV

Antidote is given to minimize the effect of the absorbed noxious chemical, and fast route for any drug to be active systemically is the Intravenous route.

 IM

 Sublingual

54.Cell membrane composition???

lipid bilayer

 proteins

 glycoprotein

 lipid bilayer & proteins

Cell membrane is composed of lipid bilayer and proteins. Phospholipids have a glycerol backbone, which is the hydrophilic (water soluble) head, and two fatty acid tails, which are hydrophobic (water insoluble). The hydrophobic tails face each other and form a bilayer.

 Glycolipids

55.Radiotherapy damage cells mostly in which phase

 G1

Radiation therapy causes apoptosis of tumors and surrounding tissue via free radical formation and dsDNA breakage during the Cell division (G1 phase). Rapidly dividing cells (e.g., skin, GI mucosa) are very susceptible to radiation therapy-induced apoptosis.

 G2

 G0

 S phase

56.PT is use to monitor ?

 heparin

 warfarin

MONITORING: Heparin is monitored with PTT (intrinsic pathway), while Warfarin is monitor PT/INR (extrinsic pathway)

 protamin

 aspirin

57.IL-1 and TNF mediates?

 anaphylaxis

 cough

 Fever

Fever: Pyrogens (e.g., LPS from bacteria) cause macrophages to release IL-l and TNF, which increase cyclooxygenase activity in perivascular cells of the hypothalamus. Increased PGE2 raises temperature set point

 Rash

58.Which is the cause of thrombus

 endothelial injury

Thromboembolic events are associated with class Virchow"s triad of Hypercoagulable state, endothelial injury and the Turbulance of blood flow

 asirin use

 aortic aneurysm

 renal stenosis

59.Diabetic pt. with limb necrosis, green colour discharge and fruity smell, organism

 S. aureus

 C. difficille

 P. aerogenosa

Aerobic gram-negative rod. Non-lactose fermenting, oxidase. Produces pyocyanin (blue- green pigment A) has a grape-like odor. Water source. Produces endotoxin (fever, shock) and exotoxin A (inactivates EF-2). PSEUDOmonas is associated with wound and burn infections, Pneumonia (especially in cystic fibrosis), Sepsis, External otitis (swimmer’s ear), UTI, Drug use and Diabetic Osteomyelitis, and hot tub folliculitis.

 Spirochete

60.Good looking girl with secondary sexual characteristics well developed ,came with complain of amenorhea

 no menstruation

 ambiguous genitals

Female pseudohermaphrodite (XX):Ovaries present, but external genitalia are virilized or ambiguous. Due to excessive and inappropriate exposure to androgenic steroids during early gestation (e.g., congenital adrenal hyperplasia or exogenous administration of androgens during pregnancy)

 baldness

 no breast development

61.Young boy bee sting emergency adrenaline tx given in order to prevent???

 systemic anaphylaxis

Clinical uses of Adrenaline:Anaphylaxis, open angle glaucoma, asthma, hypotension α effects predominate at high doses

 cellulitis

 swelling

 pain

62.Pt with haematuria and night sweats for three months.There is no fever.Diagnosis is

 renal cell CA

 UTI

 Renal TB

All the features given in scenario are characteristics of some chronic infection especially the night sweats are consistent with tuberculosis that also can present with hematuria while fever is not significant bcz fever low grade (not noticed) in tuberculosis.

 Cystitis

63.Temporalis insertion?

 maxilla

 mandible

Origin: Floor of the temporal fossa and covering fascia, Insertion: Coronoid process of the mandible

 zygomatic

 frontal

64.Side effect of eipdural analgesia?

 hypotension

Epidural and intrathecal (spinal) anaesthesia are ideal for some operations butmay cause vasodilatation and systemic hypotension because they also block the sympathetic nerves

 hypertension

 dec. heart rate

 inc. respiration

65.AFB is non resistance non capsulated etc due to?

 thick nuclear membrane

 Cell wall composition

Mycobacteria Contain mycolic acid. High lipid content that make them not affected by normal staining but by a special Acid Fast staining

 cell membrane composition

 cilia

66.Bladder nerve supply passes through ligament

 posterior

 lateral

 dorsolateral

Sympathetic and parasympathetic nerve fibers from the inferior hypogastric plexuses passes through dorsal aspect of puboprostatic ligament in males and pubovesical ligament in females to supply the bladder.

 Medial

67.In Hemolytic anemia, what is true

 inc. wbc

 dec. retic count

 dec. platelets

 inc. retic count

Findings: decreased haptoglobin, increased LDH, schistocytes and increased reticulocytes on peripheral blood smear and urobilinogen in urine (e.g., paroxysmal nocturnal

hemoglobinuria, mechanical destruction [aortic stenosis, prosthetic valve], microangiopathic hemolytic anemias).

68.Parallel arrangement of lymph nodes of breast?

 lateral group

 medial group

From the medial quadrant (arranged parallelly), most lymph drains to the parasternal nodes,which accompany the internal thoracic vessels. It is also through this medial route that cancer can spread to the opposite breast.

 inferior group

 posterior group

69.Female lethargic pigmented her hb 8.1 MCV 55 MCHC 35 serum ferritin 1000 tx?

 deferressirox

 B12

 ferrous sulphate

All the features given in scenario are characteristics of iron deficiency anemia, and its treatment is iron supplements as ferrous sulphate

 folic acid

70.Obturator internus nerve supply

 hypogastric nerve

 sacral plexus

Obturator internus- Origin: Obturator membrane and adjoining part of hip bone. Insertion:

Greater trochanter of femur. Nerve Supply: Sacral plexus Functions: Lateral rotator of the femur at the hip joint

 inferior hypogastric nerve

 pubic nerve

71.Skeletal system develop from?

 Mesoderm

Derivative of Mesoderm are: Smooth, Cardiac, Skeletal muscles,Connective tissue,All serous membranes, Bone and cartilage, Blood, lymph, cardiovascular org , Adrenal cortex, Gonads and internal reproductive org , Spleen, Kidney and ureter, Dura mater