Patient has respiratory acidosis cause is

 COPD

Hypoventilation in COPD involves mulle mechanisms, including the following: Decreased responsiveness to hypoxia and hypercapnia. Increased ventilation-perfusion mismatch leading to increased dead space ventilation.COPD causes respiratory failure resulting in CO2 retensionhypercapnia and respiratory acidosis.

 Uremia

 The resident of high altitude

 Drowning

37. mosquito bite is the cause of

 Plague

 Leishmaniasis

 Syphilis

 Yellow fever

The disease is caused by the yellow fever virus and is spread by the bite of an infected female mosquito. It infects only hum , other primates, and several species of mosquitoes. In cities, it is spread primarily by Aedesaegypti, a type of mosquito found throughout the tropics and subtropics.

38. structure immediately behind the medial malleolus:

 Short saphenous vein

 Extensor retinaculum

 Peroneoustertius

 Tibialis posterior

Structures that pass behind medial malleolus deep to the flexor retinaculum: Tibialis posterior tendon. Flexor digitorumlongus.Posterior tibial artery.

39. In the dorsal column of posterior cord of spinal cord, which neurotr mitter lies between dorsal root ganglion and pain inhibitory fibers

 Substance P

 Dopamine

 GABA

 Enkephalin

The pain information in the CNS is controlled by ascending and descending inhibitory systems, using endogenous opioids, or other endogenous substances like serotonin as inhibitory mediators. In addition, a powerful inhibition of pain-related information occurs in the spinal cord. Enkephalins are small peptides that can serve as neurotr mitters in the brain. Enkephalins act to attenuate substance P release in the dorsal horn of the spinal cord and inhibit afferent pain fibers

40. 6 years old boy with apathy, peripheral edema, albumin decrease, Hepatomegaly, calcium normal, anemia. Which disorder:

 Marasmus

 Kwashiorkar

Kwashiorkor is a form of severe protein malnutrition characterized by edema, and an enlarged liver with fatty infiltrates. Sufficient calorie intake, but with insufficient protein consumption, distinguishes it from marasmus.

 Vit C deficiency

 Rickets

41. Low oxygen level detector is:

 Aortic sinus

 Central chemoreceptors

 Peripheral Chemoreceptors

 Carotid body

Oxygen sensing by the carotid body chemoreceptors. Carotid bodies are sensory org that detect changes in arterial blood oxygen, and the ensuing reflexes are critical for maintaining homeostasis during hypoxemia.

42. major glucose absorption occurs in nephron region:

 PCT

Reabsorption of glucose can only occur in the proximal tubule and occurs regardless of the concentration gradient as it is completed via secondary active tr port. It is reabsorbed using a co-tr porter with sodium.If glucose is not reabsorbed by the kidney, it appears in the urine, in a condition known as glucosuria. This is associated with diabetes mellitus

 DCT

 CCT

 Ascending LOH

43. Prostatic cancer metastasizemainly to:

 Vertebrae

The most common site of metastasis is the lumbar spine.[Autopsy data reveal that spinal metastases precede lung and liver metastases in many patients with prostate cancer.in 1940, proposed that prostate carcinoma cells reach the lumbar vertebrae via the vertebral venous plexus

 pelvic bone

 Femur

 Skull

44. Muscle spindle will detect:

 Muscle contraction

 Muscle rotation

 Muscle Temperature

 Muscle length

Muscle spindles are stretch receptors within the body of a muscle that primarily detect changes in the length of the muscle. They convey length information to the central nervous system via afferent nerve fibers. The purpose of muscle spindles and the stretch reflex is to protect your body from injury caused by overstretching and to maintain muscle tone.

45. Cough reflex caused by:

 Trigeminal

 Vagus

The cough reflex has both sensory (afferent) mainly via the vagus nerve and motor

(efferent) components. Pulmonary irritant receptors (cough receptors) in the epithelium of the respiratory tract are sensitive to both mechanical and chemical stimuli.

 Phrenic

 Glossopharyngeal

46. which of following causes Metastasis:

 Loss of selectins

 Loss of integrins

 Anaplasia

 Down-regulation of E-cadherin

E-cadherin aids the assembly of epithelial cells and maintains the quiescence of cells within sheets by forming adherent junctions with adjacent epithelial cells . A number of studies have demonstrated that increased expression of E-cadherin is able to inhibit invasion and metastasis, while a reduced expression potentiates these phenotypes

47. Chromosome first becomes visible in which stage of the cell cycle:

 Prophase

 Metaphase

Metaphase is a stage of mitosis in the eukaryotic cell cycle in which chromosomes are at their second-most condensed and coiled stage (they are at their most condensed in

anaphase).[1] These chromosomes, carrying genetic information, align in the equator of the cell before being separated into each of the two daughter cells.Metaphase is the third phase of mitosis

 Anaphase

 Telophase

48. A woman feels lethargic for 5 months and has dyspnea on exertion, tingling sensation in feet and difficulty walking. Her Hb is 5.6, WBC 3500, platelets 120,000.Diagnosis?

 Iron deficiency anemia

 Aplastic anemia

 Vitamin B12 deficiency

The two most common causes of megaloblastic anemia are deficiencies of vitamin B-12 or folate. These two nutrients are necessary for producing healthy red blood cells. Also, lack of B12 damages the myelin sheath that surrounds and protect nerves. Without this protection, nerves cease to function properly and conditions such as peripheral neuropathy occur.

 Folic acid deficiency

49. Female present with fever, dysuria, pain suprapubic and increase frequency. On examination gram-negative rod organism.What is the Cause:

 Neisseria gonorrhea

 E.coli

The most common UTIs occur mainly in women and affect the bladder and urethra.

Infection of the bladder (cystitis). This type of UTI is usually caused by Escherichia coli (E.

coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are responsible.

 S. agalactaie

 N meningitis

50. A primary function of the basal ganglia is:

 Sensory integration

 Short-term memory

 Planning of voluntary movement

The basal ganglia are associated with a variety of functions including: control of voluntary motor movements, procedural learning, routine behaviors or "habits" such as teeth grinding, eye movements, cognition, and emotion.

 Neuroendocrine control

51. Asthmatic patient with pH 7.33, HCO3 25, pCO2 48. Which is the defect:

 Metabolic acidosis uncompensated

 Respiratory acidosis compensated

 Respiratory acidosis uncompensated

Respiratory alkalosis occurs when a person breathes too fast or too deep and carbon dioxide levels drop too low. This causes the pH of the blood to rise and become too alkaline. When the person inhales too much CO2 blood becomes acidic, respiratory acidosis occurs. To compensate that ,levels of H2CO3 increases or decreases. If no change in level occurs it is called uncompensated.

 Respiratory alkalosis

52. Muscarinic cholinergic postganglionic sympathetic nerve fiber supplies to:

 Lacrimal gland

 Sublingual gland

 Sweat gland

The postganglionic neuron for sweat gland innervation differs from other sympathetic postganglionic neurons in that it releases acetylcholine to act on muscarinic

receptors.Eccrine glands are innervated by the sympathetic nervous system, primarily by cholinergic fibers whose discharge is altered primarily by changes in deep body temperature (core temperature), but by adrenergic fibers as well..

 Submandibular gland 53. Factor 8 is produced by:

 Bone marrow

 Kupffer’s cells

 Lymph node follicles

 Endothelial cells

Factor VIII is produced in liver sinusoidal cells and endothelial cells outside the liver

throughout the body. This protein circulates in the bloodstream in an inactive form, bound

to another molecule called von Willebrand factor, until an injury that damages blood vessels occurs.

54. Regarding carpometacarpal joint of thumb true is:

 Saddle type of joint

The best example of a saddle joint in the body is the carpometacarpal joint of the thumb that is formed between the trapezium bone and the first metacarpal.

 typical synovial joint

 allows movement in the lateral direction only

 cant allow abduction

55. A 35-year woman have right upper quadrant pain leukocytosis and eosinophilia:

 Cholecystitis

 Amoebiasis

amebic abscess should be suspected in patients with spiking fever, weight loss, and

abdominal pain in the upper right quadrant or epigastrium and in patients with tenderness in the liver area. The presence of leukocytosis, a high alkaline phosphatase level, and an elevated right diaphragm suggest a hepatic abscess

 Appendicitis

 Pyogenic abscess

56. Sub-duralhemorrhage is due to damage to:

 Posterior division of middle meningeal artery

 Middle cerebral vein

 Inferior cerebral vein

 Superior cerebral vein

Subdural hemorrhage stems from traumatically severed “bridging veins” that connect superficial cerebral veins and the dural venous sinuses.

57. A Patient has right-sided body paralysis with speech loss with 7th cranial nerve damage.

Which artery is causing this problem:

 Anterior cerebral artery

 Middle cerebral artery

The MCA is by far the largest cerebral artery and is the vessel most commonly affected by cerebrovascular accident. The MCA supplies most of the outer convex brain surface, nearly all the basal ganglia, and the posterior and anterior internal capsules. Infarcts that occur within the vast distribution of this vessel lead to diverse neurologic sequelae. Understanding

these neurologic deficits and their correlation to specific MCA territories has long been researched.

 Posterior cerebral artery

 Middle meningeal artery 58. Low oxygen level detected by

 carotid body

The carotid body functions as a sensor: it responds to a stimulus, primarily O2 partial pressure.The carotid sinus contains numerous baroreceptors for maintaining blood

pressure. Aortic sinus is widening between the wall of the aorta.The coronary arteries arise from them. Peripheral

chemoreceptors(carotid and aortic bodies) and central chemoreceptors(medullary neurons) primarily function to regulate respiratory activity.

 aortic sinus

 central chemoreceptors

 Peripheral Chemoreceptors

59. The fibrous and parietal pericardium is supplied by:

 Phrenic nerve

phrenic nerves go down, crossing the roots of the right or left lung from the front and lying between the mediastinal pleura and the pericardium. The pericardium separates the right phrenic nerve from the right atrium, and the left phrenic nerve from the left pulmonary artery, left atrium, and left ventricle

 Vagus nerve

 musculocutaneous nerve

 Azygous vein

60. Amount of end-diastolic volume that is pumped out with each beat is:

 mean systemic volume

 systemic vascular resistance

 Cardiac output

 Ejection fraction

Ejection fraction is a measurement of the percentage of blood leaving your heart each time it contracts. During each heartbeat pumping cycle, the heart contracts and relaxes. When your heart contracts, it ejects blood from the two pumping chambers (ventricles).

61. Mycobacterium is non-spore forming, present in macrophage, does not produce endotoxin or exotoxin. How does it cause inflammation:

 Tuberculo-protease

 LPS

 Cell wall

Cell wall lipids from Mycobacterium r inflammatory in nature.Theres a proven contribution to the host-pathogen interaction of mycolic acid (MA), a major lipid component of the cell envelope of the Mycobacterium tuberculosis and other mycobacteria.

 Tuberculin

62. True about amyloidosis

 Cause non-caseating granuloma

 Strain with congo red

Congo Red is actually a dye used to stain fabric. It has been found to be a good stain for amyloid too. The amyloid deposits stain red. Congo Red will also stain connective tissue.

 common in youngsters

 Most common organ involved is kidneys

63. A patient is smoking for 20 years, which change occurs in bronchus:

 Hypotrophy

 Hyperplasia

 Anaplasia

 Metaplasia

Smoking causes the mucus-secreting ciliated pseudostratified columnar respiratory epithelial cells that line the airways to be replaced by stratified squamous epithelium, or a stone in the bile duct that causes the replacement of the secretory columnar epithelium with stratified squamous epithelium (Squamous metaplasia). Metaplasia is an adaptation that replaces one type of epithelium with another that is more likely to be able to withstand the stresses it is faced with.

64. 4 lumber arteries arise from:

 External iliac

 Internal Iliac

 Common iliac

 Aorta

The lumbar arteries are arteries located in the lower back or lumbar region. The lumbar arteries are in parallel with the intercostals. They are usually four in number on either side, and arise from the back of the aorta, opposite the bodies of the upper four lumbar

vertebrae

65. Partial resection of both recurrent laryngeal nerve occurred. What will happen to vocal cords:

 Completely adducted position

 Completely open

 In middle position

When the Superior laryngeal nerve is also paralyzed, the vocal cord will be in intermediate or cadaveric position because of loss of this adductive force. In partial or unilateral recurrent laryngeal nerve paralysis the vocal cords assumes a median or paramedian position &

doesn't move laterally on deep inspiration.

 Partially abducted

66. Brodie’s abscess is associated with:

 Osteoporosis

 Osteoarthritis

 Osteogenesis imperfect

 Pyogenic osteomyelitis

A Brodie abscess is a subacute osteomyelitis, which may persist for years before converting to a frank osteomyelitis. Classically, this may present after conversion as a draining abscess extending from the tibia out through the shin.

67. Venous return is measured by

 Preload

preload is the end diastolic volume that stretches the right or left ventricle of the heart to its greatest dimensions under variable physiologic demandVenous return (VR) is the flow of blood back to the heart. Increased pulmonary venous return to the left atrium leads to increased filling (preload) of the left ventricle, which in turn increases left ventricular stroke volume by the Frank-Starling mechanism

 Afterload

 TPR

 stroke volume

68. A Person develops mitral stenosis and pain and fever following tooth extraction. What is the most common cause of subacute bacterial endocarditis:

 S. Bovis

 S. mut

 S epidermadis

 S. viridi

Virid streptococci differ in their propensity to cause SBE, which is related to the ability to adhere to damaged heart valves and endothelium, which is a function of extracellular matrix production

69. Diabetic patient with ischemic heart disease with myxedema with B.P. 180/100mmHg.

Which antihypertensive is best for that patient:

 Verapamil

 Captopril

The angiotensin-converting-enzyme (ACE) inhibitors are able to slow the progression of diabetic nephropathy by reducing glomerular hypertension that causes it.Severe or resistant hypertension usually requires treatment with combinations of drugs, including a diuretic.

 Propranolol

 Labetalol

70. The middle esophagus has which type of condition most commonly:

 Squamous cell carcinoma

Squamous-cell carcinoma arises from the epithelial cells that line the esophagus. Mostly in upper and middle one-third of the esophagus.Causes of the squamous-cell type include tobacco, alcohol, very hot drinks, poor diet, and chewing betel nut.

 Adenocarcinoma

 Barret's esophagus

 Mallory Weis syndrome

71. Renal blood flow per minute is calculated by:

 Creatinine clearance

 800ml

 Para-amino hippuric acid clearance

Renal Plasma Flow is calculated by the clearance of para-aminohippuric acid (PAH), as at low concentrations this compound is completely cleared from the plasma by renal tubular filtration and secretion in a single pass. RPF=CPAH=UPAH×V/PPAH

 1/3rd cardiac output 72. Which is true about hip joint:

 Obturator nerve lies posterior

 Obturatorinternus lies superiorly

 Allows movement in lateral direction freely.

 Obturatorexternus muscle lies inferiorly

The fibers of obturatorexternus converge and pass posterolateral and upward, and end in a tendon which runs across the back of the neck of the femur and lower part of the capsule of the hip joint and is inserted into the trochanteric fossa of the femur. internalobturator muscle is situated partly within the lesser pelvis, and partly at the back of the hip-joint.

73. Development of anterior pituitary gland from:

 Evagination of neuroectoderm

 Rathke’s pouch from diencephalon

 Outpouching from stomodeum

The stomodeum, also called stomatodeum or stomatodaeum, is a depression between the brain and the pericardium in an embryo, and is the precursor of the mouth and the anterior lobe of the pituitary gland.

 Evagination from telencephalon

74. Injury to talus such that sole become flat. Damage to:

 Medial longitudinal arch

The medial arch isismade up by the calcaneus and higher than the lateral longitudinal arch.

Its weakest part (i.e., the part most liable to yield from overpressure) is the joint between the talus and navicular, but this portion is braced by the plantar calcaneonavicular ligament a.k.a. spring ligament, which is elastic and is thus able to quickly restore the arch to its original condition when the disturbing force is removed.

 Lateral longitudinal arch

 Tr verse arch

75. Endocervix has a squamous epithelium, the most likely cause is:

 Anaplasia

 Dysplasia

 Metaplasia

In regard to the cervix, squamous metaplasia can sometimes be found in the endocervix, as it is composed of simple columnar epithelium, whereas the ectocervix is composed of stratified squamous non-keratinized epithelium.It is a physiological condition

 Hyperplasia

76. Natural antithrombotic in blood

 Heparin

 Warfarin

 Plasminogen

Plasmin is released as a zymogen called plasminogen (PLG) from the liver into the systemic circulation. Plasmin is a serine protease that acts to dissolve fibrin blood clots. Apart from fibrinolysis, plasmin proteolyzes proteins in various other systems: It activates collagenases, some mediators of the complement system, and weakens the wall of the Graafian follicle, leading to ovulation. It cleaves fibrin, fibronectin, thrombospondin, laminin, and von Willebrand factor. Plasmin, like trypsin, belongs to the family of serine proteases.

 Vitamin K

77. A doctor while passing urinary catheter in a man noticed that part of urethra least distensible/dilatable. Which part is this:

 Prosthetic part

 Pre-prosthetic

 Bulbos part

 Membranous part

membranous portion is the least distensible. it is fibrous in character and will not stretch. In the membranous portion the support of the superficial and deep layers of the triangular ligament prevent dilatation.

78. Belladonna alkaloid effect on the child:

 Hyperthermia

 Hallucination

it stimulates the CNS. Atropine also blocks the muscarinic effects of injected cholinergic drugs, both peripherally and on the CNS. Unusual excitement, nervousness, restlessness, or irritability and unusual warmth, dryness, and flushing of skin are more likely to occur in children, who are usually more sensitive to the effects of belladonna alkaloids

 Hypertension

 Intraventricular muscle block

80. Levatorangularisoris muscle nerve supply is:

 Mandibular nerve

 Maxillary nerve

 Facial nerve

The levatorangulioris (caninus) is a facial muscle of the mouth arising from the canine fossa, immediately below the infraorbital foramen. It elevates angle of mouth medially. ...

Specifically, the levatorangulioris is innervated by the buccal branches of the facial nerve.

 Inferior alveolar nerve

79. Sympathetic nerve system will cause:

 Decrease heart rate

 Increase bronchial diameter

The bronchial branches contain smooth muscle which is under the control of the autonomic (automatic) nervous system. Stimulation from the sympathetic division of the autonomic nervous system causes these smooth muscles to relax, dilating the bronchial branches allowing more air to pass through the lungs. sympathetic nervous system is stimulated to prepare the body for immediate action. In the case of the lungs, this me allowing more air through so that more oxygen will be available for muscle contraction

 Miosis

 Lacrimation

81. Most important criteria for the diagnosis of malignancy:

 Nuclear-cytoplasmic ratio

 Pleomorphism

Pleomorphism is a term used in histology and cytopathology to describe variability in the size, shape and staining of cells and/or their nuclei. It is a feature characteristic of malignant neoplasms, and dysplasia.

 Loss of E cadherin

 Invasion

82. Abdominal organ removed then patient develop incisional hernia. Which structure first come outward with hernia:

 Tr versusabdominus muscle

 Fascia tr versalis

The tr versalis fascia (or tr verse fascia) is a thin aponeurotic membrane which lies between the inner surface of the tr verse abdominal muscle and the parietal peritoneum.

 Tr versusabdominus muscle + fascia tr versalis

 rectus sheath

83. True about epiphyseal plate:

 Present throughout our life

 Responsible for growth in adolescent

Postnatal growth of the long bones occurs through the stimulation of chondrocyte proliferation at the epiphyseal growth plates. ... The gonadal steroids (estrogen, testosterone) cause closure of the epiphyseal growth plates in late adolescence. The cartilage becomes entirely replaced with bone, and statural growth ceases.

 commonly involved in giant cell carcinoma

 source of nourishment for bone