Decreased lymphatic flow due to?

 Shock

The lymph flow gets decreased to very low values during the hypotensive periods.

Hemorrhage causes increase in lymphatic flow due to sympathetic activity. Lymphatic flow is most commonly decreased by local obstruction which is not given in options

 CCF

 Increased oncotic pressure

 Increased venous return

1Q: A patient is presented with foot drop,which nerve is damaged?

 Sural nerve

 common peroneal

Foot drop is a gait abnormality in which the dropping of the forefoot happens due to weakness, irritation or damage to the common peroneal nerve including the sciatic nerve, or paralysis of the muscles in the anterior portion of the lower leg.

 Femoral nerve

 Obturator nerve

1Q: A patient presented with an overall increased level of plasma renin,increased aldosterone, increased left kidney renin amount, but right kidney renin size is increased, why?

 Left renal vein stenosis

Possible complications of renal artery stenosis include: High blood pressure (renovascular hypertension due to increased renin pf the respective kidney) Kidney failure, requiring treatment with dialysis or a kidney tr plant. Fluid retention (edema) in your legs, causing swollen ankles or feet.

 Right renal vein stenosis

 Defect in JG apparatus

 Defect in macula densah

07 March 2018 Evening (A)

1.what is the that anti –TB drugs are given together?

a. For enhancing the potency b. to increase the effect c. to decrease the resistance

the combination of antibiotics is used for longer times to beat M.Tuberculi as it’s notorious for resistant to antibiotics

d. combination is cheap

2.The itching is due to hypersensitivity type 1, in scabies as a. crawling of bug over the skin

Itching worsens at night and feels like crawling bugs over the body at night.

a. toxins produced by the mite b. tissue destruction

c. any of the above

3.The amount of air needed for air embolism to occur is:

a. 50ml b. 100ml

To produce a clinical effect in the pulmonary circulation, generally more than 100cc of air is necessary. During obstetric or laproscopic procedures, this volume of air can unintentionally be introduced, unless care is taken.

c. 150ml d. 200ml

4. B/L pleural effusion with Cough, Dyspnea, and reticular nodular infiltrate in CXR was found in an alcoholic patient. While 85% granulocytes, 15% lymphocytes were found in thoracocentesis, what could be other histopathological findings?

a. increase N/C ratio with light granules b. AFB staining

c. pleo-morphism with dark staining d. Fibrin deposits

interstitial and intra-alveolar edema, inflammation, fibrin deposition, diffuse alveolar damage, and lining of waxy hyaline membranes within alveolar walls were found.

5. In which part of nephron, absorption of HCO³ occurs

 collecting ducts

 Ascending Loop of Henle

 Descending Loop of Henle

 PCT

Reabsorption of filtered glucose, amino acids, and HCO3 occurs in early proximal tubule, where these are completely removed from the tubular fluid

6. At which vertebral level, the xiphoid process is present

 T4

 T7

 T9

At the level of T9 (9th thoracic vertebra) and the T6 dermatome, xiphoid process is present.

 T11

7. where does pericytes are found?

 Bones

 Heart

 small blood vessels

more than 95% of the basal lamina adjacent to the capillary endothelial cells is covered with processes (having “end feets”) of pericytes.

 ciliary bodies

8.what is altered by viruses to cause cancer?

 DNA

 RNA

 Oncogene

 Protoncogene

Mutation in tumor suppressor genes caused by viruses lead to cancer

9. What is the renin-angiotensin system’s most potent and immediate effect:

 salt retention

 Thrust

 vasoconstriction

Angiotensin-II causes vasoconstriction immediately with fast acting mechanism. It’s slow acting mechanisms are the salt & water balance that contribute to arterial blood pressure control.

 increase aldosterone secretion

10.the disease having feature of granulomatous necrosis is

 TB

 Sarcoidosis

 Crohn's disease

 syphilis

In the ulcer of chancroid, a superficial zone of neutrophilic debris and fibrin and an

underlying zone of granulation tissue containing areas of necrosis and thrombosed vessels is found, microscopically. While in TB, caseous granuloma occurs

11.which hormone causes maturation of seminiferous tubules:

 FSH

 androgen

Androgens causes seminiferous tubules' maturation.

 LH

 TSH

12.In asthma, which cells increase

 basophils

 cytotoxic t cells

 Mast cells

 eosinophils

Reversible bronchoconstriction, smooth muscle hypertrophy, and eosinophilia occurs in asthma due to bronchial hyperresponsiveness

13.what is the cause of cyanosis in a newborn baby?

 teratology of Fallot

 VSD

 ASD

 tr position of great vessels

Tr position of great vessels causes early cyanosis. Unless a shunt is present to allow mixing of blood, for example, VSD, PDA, or patent foramen ovale, it’s not compatible with life

14.the H2 receptor blockers have no role in

 uncomplicated duodenal ulcer

 uncomplicated peptic ulcer

 zollinger Ellison syndrome

Gastrinoma of ZES (zollinger Ellison syndrome) has no relation with H2 receptors. It activates Gq G-Proteins whose continuous activation causes acid secretion. So it’s not controlled by H2 blockers.

 menderson syndrome

15. Aspiration of gastric contents occurred in a patient in ICU, aspirate will go to

 Right middle segment

 Left upper segment

 Left lower segment

 Right lower apical segment

The right main stem bronchus is wider and more vertical than left one, so right lung is the more common site for the inhaled foreign bodies to go

16.what will be the duration if cardiac cycle if the heart rate is doubled?

 0.10 seconds

 0.12 seconds

 0.14 second

 0.4 seconds

Increase in heart rate causes decrease in the duration of one complete cardiac cycle. As duration of Cardiac Cycle is 60s when HR is 72 beats, so when the heart rate is doubled, cardiac cycle will become 0.4 sec/ beat

17.what is the nerve supply of Scalp?

 superficial temporal nerve

 Zygomaticotemporal & auriculotemporal nerves

Zygomaticotemporal nerve, Greater occipital nerve, Lesser occipital nerve,

Auriculotemporal nerve, Supratrochlear nerve and Supraorbital nerve (Z-GLASS: mnemonic) innervates scalp.

 zygomatic nerve

 lacrimal nerve

18.A female having cushing disease has hypertension, and micro pigmentation. What are the other features of this disease

 Increased ACTH

A tumor of the pituitary gland (pituitary adenoma) which is a noncancerous (benign) tumor of the pituitary gland, located at the base of the brain, causes excess secretion of ACTH, which causes stimulation of the adrenal glands to make more cortisol. The syndrome developed due to this is called Cushing disease.

 Decreased cortisol

 Dark complexion

 Psychic mo

19.the structure present lateral to pituitary gland is

 Pituitary fossa

 Hypothalamus

 Brocas area

 cavernous sinus

Superiorly pituatary gland is related to the diaphragma sellae and the optic chiasma.

Inferiorly, it is related to the body of the sphenoid and the sphenoid sinus. To its lateral side, cavernous sinus and its contents (the internal carotid artery and the abducent nerve) are present

20.what could occur in a pre-mature baby

 PDA

Normally in uterus, PDA is present which closes after birth. But prematurity causes ductus arteriosis to stay open.

 ASD

 VSD

 TOF

21. Which artery is involved in the bleeding from peptic ulcer?

 right gastric

 pancreaticoduodenal

 Left marginal branches

 posterior gastro-duodenal

Large, posterior duodenal ulcers which erode the gastroduodenal artery causes severe bleeding while high, lesser curve gastric ulcers involves branches of the left gastric artery 22.the control of blood flow through the exercising muscle occurs by

 sympathetic

 local metabolites

In exercising muscles, as metabolic demand is increased, sympathetic system is activated to increase blood flow to skeletal muscles proportionally to meet its demands.

 Parasympathetic

 Gluconeogenesis

23.CT in a Lady with tall height and galactorrhea showed enlarged pituitary. This shows

 astrocytoma

 granuloma

 eosinophilic granules

Staining done is acidophilic, usually. This tumor was initially called as acidophilic adenoma.

 Ependymoma

24.which of the following are the mediators of inflammation

 histamine

 prostaglandins

The prostaglandins are the most important contributors to inflammatory process as these are one of the more potent mediators. They cause blood flow to increase and chemotaxis, which are the chemical signals that summon white blood cells, and subsequent

dysfunctioning of tissues and org occurs. Prostaglandins are released by membrane phospholipids as a result of inflammation by cellular injury.

 Serotonin

 Steroids

25.A Student had hyperventilation, tachycardia, profuse sweating, in exams. But, after breathing in a bag, he became better. If a sample is taken with attack, it’ll have

 Decreased PH

 increased PH, decreasedPCO2

As, wash out of CO2 occurred as a result of hyperventilation, it’ll lead to increase in PH.

 decreased PH, increasedP02

 Increased pCO2

26. Which of the following occurs in accommodation reflex

 Decrease lens curvature

 Ciliary muscle contraction

Ciliary muscle contraction pulls itself forward and frontal region is moved towards the eye axis which releases the tension of zonular fibers (fibers that hold or flatten the lens) on lens.

Due to which the lens become more spherical causing it to adapt to short range focus. So, accommodation is a combination of three processes i.e. increase lens power, convergence, and miosis, and is referred to as the near triad, or accommodation reflex. These are

controlled by edinger-westphal nucleus.

 Ciliary muscle relaxation

 The divergence of the eyes

27.which of the following has the most important role in the thrombosis's pathogenesis

 prolonged bed rest

 increase platelet count

 hypercoagulable state

 endothelial injury

Interaction of platelets, damaged endothelial cells, and the coagulation cascade causes thrombogenisis. The other two factors involved in thrombogenisis are hypercoagulable state and turbulence

28.what will happen, if the cervical sympathetic is damaged?

 increase in salivation

 increase in heart rate

 pupillary dilation

 pupillary constriction

If sympathetic chain is damaged above T1, it’ll cause constriction of pupils. The three neurons oculosympathetic pathway projects from the hypothalamus to the

intermediolateral column of the spinal cord. From here it moves to the superior cervical sympathetic ganglion. Finally, it reaches the pupil, the smooth muscle of the eyelids, and the sweat glands of the forehead and face. If any of these is interrupted or damaged, it’ll cause Horner's syndrome

29.which unmyelinated fibers tr mits pain sensation

 Aδ fiber

 B-fibers

 C-fibers

The C group fibers are unmyelinated fibers with small diameter and low conduction velocity.

Postganglionic fibers in the autonomic nervous system and nerve fibers at the dorsal roots (IV fiber) are C-type and carry sensory information. Lesion or damage of these nerve fibers leads to neuropathic pain. One of the smallest and slowest unmyelinated C-type fibres in the nervous system are the axons of the olfactory nerves. Olfactory epithelium is also innervated by trigeminal nerve, detecting noxious or painful stimuli, such as ammonia.

 D-fibers

30.Test which excludes completely non-affected

 sensitivity

 specificity

Specificity (true negative rate)----> Proportion of all people without the disease who test negative.

 low PPV

 high PPV

31. which artery supplies AV node?

 right coronary artery

Right coronary artery supplies both SA and AV node. Nodal dysfunction can occur due to its infarction.

 right circumflex artery

 left coronary artery

 left anterior descending

32. Non Caseating granuloma will be present in which patient?

 TB

 sarcoidosis

Caseating granuloma is a feature of TB.

 Silicosis

 Asbestosis

33.which sympathetic receptor is responsible for production of unsual thick saliva production in a lady, previously having normal serum

 alpha 1

 alpha 1 & beta 1

 beta1 and alpha2

 beta 2

Beta receptor stimulation causes decrease in the production of serous salive. Therefore, thick salive is produced

34.A child having one testes in the inguinal canal has a risk of

 Malignancy

Abnormally more temperature in testes than usual leads to increased risk of dysplasia.

 Atrophy

 Hyperplasia

 Hypertrophy

35.which of the following controls proximal flexor muscles

 corticospinal

 vestibulospinal

 corticonuclear

 Rubrospinal

Modulation of muscle tone of body position & gait (proximal muscles) is controlled by Rubrospinal tract and a lesion of the red nucleus causes impairment of symptoms 36.what is the microscopic diagnosis of polyarteritis or Vasculitis

 Lymphocytic infiltrates

 Granulomatous changes

 Fibrinoid necrosis

Small microabscesses composed of neutrophils surrounded by granulomatous inflammation and collection of fibrinoid necrosis is seen in microscope, in vasculitis.

 Fat necrosis

37.CBC of a man, presented with hemorrhage with a history of RTA will show

 normocytic normochromic anemia

RBCs changes don’t occur in recent/ acute blood loss cases.

 normocytic hypochromic

 hypochromic hypocytic

 hypocytic normochromic

38.If parasympathetic supply to intestine is lost, it will lead to

 Blocks peristalsis

 no effect on primary peristalsis

As peristalsis is controlled by GIT's own enteric nervous sytem, loss of parasympathetic will have no effect on it

 block secretions of the intestine

 Hypersecretion of glands

39.Test which has true positive property

 sensitivity

Sensitivity (truepositive rate) Proportion of all people with the disease who test positive.

True +ve detected by specificity.

 specificity

 low PPV

 high PPV

40.which area of brain receives rception of Disgust

 Hypothalamus

 Insular cortex

Insular cortex perceives shame, regret & disgust. With the possibility that higher order auditory association pathways may pass via areas in the insula, it has also been involved in language functions.

 Frontal cortex

 Temporal cortex

 Occipital cortex

41.which of the following drugs have extensive first-pass effect?

 streptomycin

 insulin

 Aspirin

 nitroglycerin

The bioavailability of nitroglycerin is low, as during first pass, it is well absorbed and gets rapidly metabolized by the liver

42.Increasing stroke volume, while keeping TPR and diastolic pressure constant, would result in

 increase MAP(mean arterial pressure) & decrease Pulse pressure

 increase MAP & increase Pulse pressure

Increase in stroke volume will lead to increase in MAP and pulse pressure, provided TPR and diastolic pressure remains normal.

 Decrease MAP & Decrease Pulse pressure

 No change in MAP & pulse rate

43.which of the followinge is altered by virus to cause mutation

 DNA structure

 RNA structure

 protein synthesis

Viruses alter protein structure by either DNA or RNA resulting in defective protein sythesis, causing mutation.

 nucleus damage

44. where does the water is absorbed maximally

 Ascending loop of Henle

 Descending loop of Henle

 collecting ducts

 PCT

In PCT, about 70% of water is absorbed. Its reabsorption occurs in collecting duct until tubular fluid osmolarity becomes equal to that of the surrounding interstial fluid. The

osmolarity of final urine is 1200mOsm/L, which is equal to that at the of papilla and the end of loop of Henle

45.Digitalis cause decrease in the heart rate by decreasing

 chronotropic effect

Digoxin cause decrease in ventricular rate by decreasing conduction and increasing refractory period in AV node. It can also increase vagal activity which causes decrease in depolarization of pacemaker cells in AV node, ultimately decreasing heart rate. The patients with congestive heart failure or cardiomyopathy can be given this medicine like digoxin, a positive inotrope, increases the amount of Ca in the heart cells leading to increase in strength of force of heartbeat.

 Bathmotrophic effect

 Bromotrophic effect

 ionotropic effect

46.Which of the following determines the virulence of staph. aureus

 drug sensitivity

 coagulase production

The virulent factor of staph. aureus is coagulase (protein A), which is an enzyme converting prothrombin to thrombin which in turn causes activation of fibrinogen to fibrin forming fibrin clot.

 allergic reaction

 Both A & B

47. which of the following is differentiated from terminal bronchioles on the basis of C- Shaped cartilage

 Respiratory Bronchioles

 Alveolar sacs

 Conducting airways

C shaped catilage becomes irregular plates, after conducting airway and gradually it disappears.

 Alveoli

48.on which cell, the receptor for IgE is present

 basophils

 mast cells

Fc portion of IgE binds to the membrane of mast cells (allergic reaction mediators in local tissues, resembling basophils structurally and functionally, but different from same cell type A). Upon antigen binding, IgE cross links leading to degranulation which causes release of histamine, heparin, and eosinophil chemotactic factor.

 eosinophils

 Platelets

49.From plasma to the interstitial fluid, water goes by which process

 Primary active tr port

 secondary active tr port

 cotr port with sodium

 Filtration

Filtration of plasma into interstitial fluid occurs due to hydrostatic pressure, at capillary level 50.Pre-malignant lesion of the oral cavity is known as

 leukoplakia

 erythroplakia

Erythroplakia is red plaque, representing vascularized leukoplakia. It progresses to squamous cell carcinoma.

 candidiasis

 oral submucous fibrosis

51.which fascia covers thyroid gland?

 paravertebral fascia

 pre-vertebral fascia

 pre-tracheal fascia

Thyroid gland is invested by the pretracheal fascia which forms a sheeth around it attaching it to the larynx and trachea.

 membranous fascia

52. From the lower end of clavicle up to sternal angle, what is the dermatomal supply?

 c1-c2

 c2-c3

 c3-c4

C3 supplies this area in high turtleneck shirt. While in low-collar shirt, C4 supplies it.

 T1

53.which of the following destroys free radicals

 vit.K

 tr ferrin

Macrophages take in tr ferrin to sequester iron. It also removes the free radicals.

 albumin

 Mast cells

54.which of the following causes digitalis toxicity

 hypokalemia

Hypokalemia causes worsening of digitalis toxicity. So diuretics, which causes hypokalemia, further aggravate/worsen it.

 hyperkalemia

 Hypomagnesemia

 Hypermagnesemia

55.In microcytic hypochromic anemia, eggs of which parasite were found on microscopic examination of the stools of the affected person

 ascaris lumbricoides

 H.nana

 wuchria bancrofti

 ancylostoma dudenale

As Ancylostoma duodenale causes blood loss anemia and hence microcytic hypochromic anemia, eggs of this parasite are found in stools of the affected person

56.which of the following stabilizes the temporomandibular joint in the articular surface

 Temporomandibular ligament

Superiorly, the temporomandibular joint is attched to the articular tubercle at the root of the zygomatic arch and inferiorly it’s attached to the neck of the mandible. It stabilizes the TMJ.

 sphenomandibular ligament

 Auriculomandibular ligament

 Frontomandibular ligament

57.what’s the cause of decrease in GFR in a patient with bleeding

 A decrease in arterial volume

 a decrease in arterial blood

 a decrease in glomerular pressure

 a decrease in arterial pressure

Decrease in arterial pressure occurs as a result of bleeding. This leads to activation of sympathetic system resulting in constriction of afferent arterioles, which causes decrease in glomerular capillaries pressure. This ultimately results in decrease in GFR

58.what is the mechanism of action of benzodiazepines

 will facilitate GABA receptor

Benzodiazepines increases the frequency of opening of Cl- channels, thus facilitating GABA action.

 inhibit GABA receptor

 activate acetylcholine receptors

 Both A & C

59.what causes clasp-knife rigidity

 muscle spindle

 Refines corpuscle

 Free nerve endings

 Golgi tendon org

As a result of the disease of the corticospinal tracts (hypertonicity or spasticity), exaggeration of golgi tendon reflex occurs, which is called Clasp-knife reflex 60.lesion of which area leads to development of intention tremors

 Pons

 Medulla oblongata

 Frontal lobe

 cerebellum

Lesion in cerebellum leads to intentional tremors due to loss of coordination 61.Hepatitis D (dormant), it is the only infection that occurs in the presence of

 HAV

 HBV

HDV (defective virus) infection occurs when HBV is present.

 HCV

 HEV

62.what is the role of estrogen?

 Primary sexual characters

 the glandular proliferation of breast

 secondary sexual characteristics

Follicular growth, proliferation of endometrium, excitability of myometrium, development of genitalia and breast, female fat distribution and secondary sexual characters'

development is under control of estrogen.

 Both A & C 63.The cauda equina

 anterior n posterior roots of the spinal cord from L1 – L5

The spinal cord ends at the level near L1 and it continues on as the collection of spinal nerves ( anterior & posterior roots of spinal nerves) called cauda equina (resembling horse’s tail), in the vertebral canal.

 anterior n posterior roots from S1-S2

 Anterior roots of S1-S4

 Posterior root of S1-S4

64.we can know that patient is on warfarin, not on heparin by

 monitoring APTT

 monitoring Bleeding time

 Monitoring PT/INR only

Prothrombin time is the time required for clot formation, measured in seconds. It’s a laboratory test and is sensitive to the clotting factors affected by warfarin. So for warfarin function, PT test is used. While for heparin monitoring, APTT is used