Recurrent Laryngeal nerve
Vocal cord paresis or paralysis due to iatrogenic injury of the recurrent laryngeal nerve (RLNI) is one of the main problems in thyroid surgery.
External Laryngeal Nerve
Superior Laryngeal Nerve
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.
Rt Recurrent L
External L
Internal L
Q: Which of the following decreases O2 affinity of Hb?
Metabolic Acidosis
Metabolism, and Regulation of Organic Phosphates in Erythrocytes. 2,3-DPG, ATP, inositol hexaphosphate (IHP), and other organic phosphates bind to hemoglobin and decrease its affinity for oxygen.
Metabolic Alkalosis
CO Poisoning
Q: Highest energy reserve in terms of Kcal/mole in the body is?
Muscle Glycogen
Liver Glycogen
Adipose Tissue
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.
Blood Glucose
Q: A young Pt reported Greenish, malodorous vaginal discharge. On microscopy, a motile pear shaped organism was identified. Dx?
Candida albic
Neisseria gonorrhea
Trichomonas
Trichomonas infection produces a frothy, yellow-green vaginal discharge with a strong odor Q: Staging of tumor is by?
Lymphovascular Invasion
Extent of Invasion
Cancer staging is the process of determining the extent to which a cancer has developed by growing and spreading. Contemporary practice is to assign a number from I to IV to a cancer.
C. a and b
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.
All of above
Q: 50yr old Female developed Microcytic Hypochromic Anemia. What is most likely cause of her Anemia?
Iron Def
Hypochromic me that the red blood cells have less hemoglobin than normal. Low levels of hemoglobin in your red blood cells leads to appear paler in color. Iron deficiency anemia:
The most common cause of microcytic anemia is an iron deficiency in the blood.
Sideroblastic Anemia
Anemia of Chronic Disease
Folic acid deficiency
Q: Regarding liver of Fetus?
Covers whole of Abdomen???
5% of Body Weight
At 8–12 weeks of gestation, liver is a relatively bigger organ which forms 4-5-5.5% of the total body weight and protrudes through the abdominal wall.
Nodular
At 8–12 weeks of gestation, liver is a relatively bigger organ which forms 4-5-5.5% of the total body weight and protrudes through the abdominal wall
Q: Which Vitamin is responsible for Prothrombin synthesis?
Vit C
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.
Vit A
Q: Conducting System of Heart lies in?
Sub-endocardium
The cardiac conduction system is a highly specialized network of cardiomyocytes within the heart that generate and tr mit electrical impulses, The left bundle branch ends up
descending as a sheet of cells within the septal subendocardium.
Sub-Epicardium
Endocardium
Q: Hyper-vitaminosis-A results in?
Jaundice
High intake of beta-carotene (hypercarotenaemia) can colour the skin yellow, sparing the eyes (in contrast to jaundice where the sclera are also yellow). Although hypervitaminosis A can be due to excessive dietary intakes, the condition is usually a result of consuming too much preformed vitamin A
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
symptoms.
Pellagra
Q: On a Radiograph at L-1
SMA arises from aorta
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?
AV node
o Speed of conduction—Purkinje > atria > ventricles > AV node
Inter-nodal pathway
Purkinje Fibers
SA Node
Q: After exercise a person lost fluids by Sweating. He drinks 2 liters of water. What will happen?
a. Inc ECF
(In sweating more water is lost than solutes so Inc ECF osmolarity as a result water will move from ICF TO ECF- than after drinking pure water also –Inc ECF volume)
Inc ICF????
Hyper-osmolality of ECF
Hyper-osmolality of ICF
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 process
Q: Urine D/R shows RBC casts. Which part is involved?
Glomeruli
Urine casts are cylindrical, cigar-shaped structures produced by the kidney and present in the urine in certain disease conditions.Such casts are indicative of glomerulonephritis, with leakage of RBC's from glomeruli.
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.
Typhoid Fever
Q: BCG vaccine>>It infers immunity through?
Cytotoxic T cells
BCG is primarily believed to mediate immunity through the development of antigen (Ag)- specific memory T cells BCG also induces cytotoxic T cells, whose main function is to lyse infected cells through osmotic disruption.
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.
Protein Synthesis
Q: Which of the following suggest UTI on Urine D/R?
Proteins
Nitrites
The presence of nitrites in urine most commonly me there's a bacterial infection in your urinary tract.
Casts
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.
Hyperventilation
Q: Which of the following has both Alpha and Beta adrenergic properties?
a. Isoproterenol
Albuterol
Epinephrine
epinephrine and norepinephrine are called adrenergic receptors. Epinephrine and norepinephrine have equal affinity at both alpha1 and alpha2 receptors.
Metpretrenol
Q: Which group of muscles is involved in Eversion of foot?
Peroneus Longus
The peroneus muscles are a group of muscles in the leg. While the muscle group exists in many variations, it is normally composed of three muscles: peroneus longus, brevis and tertius.
Tibialis Anterior
Tibialis Posterior
Q: Which of the following is involved in eliciting DIC?
Factor 10
Factor 11
Factor 5
Tissue Thromboplastin
The role of tissue thromboplastin in the development of DIC accompanying neoplastic diseases
Q: A pt developed Microcytic hypochromic anemia. On microscopy of Stools, Eggs were noticed. Which of the following is most likely responsible for this condition?
Ancylostoma duodenale
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.
Diphyllobothrium Latum
Ascaris lumbricoides
Q: An elderly pt has history of high grade fever of 105F and dark urine, from last 3-4 days, then he suddenly collapsed. On labs, his Hb was 5g/dl. What is the diagnosis?
a. Meningitis
Severe anaemia, Normocytic anaemia with haemoglobin <5 g dl−1 (haematocrit<15%) in presence of parasitaemia >10 000 ml−1 diagnosis of meningitis
Encephalitis
Cerebral malaria
Q: Prominent pre-potential in action potential is noticed in?
SA node
HCN2 and HCN4 are expressed in the heart, with HCN4 being the predominant isoform in the SA node.
AV node
Purkinje D. Nerves
Q: Importance of dead space?
Increases on standing
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?
Desmin
Vementin
Keratin
cytokeratin protein fragments in body fluids lies in the early detection of recurrence and the fast assessment of the efficacy of therapy response in epithelial cell carcinomas. In cancer, keratins are extensively used as diagnostic tumor markers
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.
Dec Saliva
Nerve Injured
Q: A student was examining a slide under microscope. He found mass of lymphoid tissue covered with simple cuboidal epithelium. The structure he is examining is?
a. Pharyngeal Tonsil
Tubal Tonsil
Palatine Tonsil
Payer’s Patches
Endothelium lining the high endothelial venules in payers patches is simple cuboidal rather than simple squamous
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,
Viral Infection
Chronic Inflammation
Mumps
Q: First Branch of External Carotid Artery is?
Lingual Artery
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
Q: First structural change in Reversible Injury?
Swelling of ER
This swelling results in swelling at mitochondria and ER (endoplasmic reticulum). If
reperfusion at this stage, changes can be reverse otherwise results in irreversible cell injury.
Membrane Blebbing
Q: Thyroid swelling moving on deglutination because it’s attached to?
Prevertebral Fascia
Pre-tracheal Fascia
The Pretracheal fascia of the cervical fascia runs from the investing layers in both sides of the lateral neck and splits to enclose the thyroid gland. Superiorly, it attaches to the laryngeal cartilages inferiorly, it fuses with the pericardium
Q: External Carotid artery ligated above lingual artery. Blood flow to which of the following structure will be affected?
Tongue
Temporalis muscle
External carotid artery is the chief artery which supplies to structures in the front of the neck and in the face temporal muscles confirmed acute ischemic myopathy.
Thyroid
Q: Cytoplasm of the cells demonstrate Basophilia due to presence of which structure?
a. Golgi apparatus
RER
(A & D are eosinophilic and C is negative)
SER
Mitochondria
Q: Antigen-Antibody reaction will be depressed in which of the following condition?
a. Liver Disease
ACTH
(Inc cortisol > Lymphocytopenia > Corticosteroids are immunosuppressants)
Anemia
Neutropenia
89. Anti-D antibody is clinically important because?
Present in all Rh-Neg Individuals
Doesn’t pass Placenta
Causes Hemolytic Disease
Maternal anti-D antibodies produced cross placental barrier and destroy fetal RBCs Ref bedside clinics in obstetrics
Q: Which drug is used in Pulmonary Edema because it decreases Preload?
a. Hydralazine
GTN
Isosorbide Dinitrate
isosorbide-dinitrate (ISDN) in the treatment of severe pulmonary edema improves control of respiratory failure, and reduces the need for mechanical ventilation and the rate of
myocardial infarction (MI)
Nifedipine