In the state of de-hydration hypotonic fluid will be present in which part of

 Proximal convoluted tubule

 Distal convoluted tubule

At the Distal Convoluted tubules of nephron Urine osmolality is lowest

 Loop of Henle

 Collecting duct

48.A known diabetic is presented to you with erectile dysfunction which of following can help the patient?

 Adrenaline

 Energy drinks

 Sildenafil

Sildenafil is treatment of erectile dysfunction Its use is now one of the standard treatments for erectile dysfunction including for men with diabetes mellitus. Sildenafil acts by inhibiting cGMP-specific phosphodiesterase 5 an enzyme that promotes degradation of cGMP which regulates blood flow in the penis

 Calcium channel blockers

50. RBC shape is maintained by which protein?

 Keratin

 Spectrin

Spectrin is a cytoskeletal protein that lines the intracellular side of the plasma membrane in eukaryotic cells In the light microscope the basic shape of the red blood cell is seen as the spectrin containing submembranous cytoskeleton preserved the shape of the cell

 Cytokeratin

 Vimentin

51. Pernicious anemia is most likely to occur in which condition?

 Atrophic gastritis

 After Gasterectomy

Vitamin B12 malabsorption occurs when a protein known as an intrinsic factor is either not produced by the stomach this is a condition called pernicious anemia or when the proximal stomach is resected that is the portion of the stomach that produces intrinsic factor

 After esophagectomy

 After colon resection

52. In air embolism how much air is need for initial symptoms to appear?

 500 cc

 100 cc

Minimum of 100 cc of air is needed to produced symptoms of embolism.

 1000 cc

 1500 cc

53. The most important extracellular buffer is?

 HCO3

The major buffer system in the ECF is the CO2-bicarbonate buffer system that is responsible for about 80% of extracellular buffering

 proteins

 H+

 OH-

54.Phrenic nerve has most of its contribution from?

 C3

 C4

The phrenic nerve originates mainly from the 4th cervical nerve but also receives

contributions from the 5th and 3rd cervical nerves (C3-C5) in hum thus the phrenic nerve receives innervation from parts of both the cervical plexus and the brachial plexus of nerves

 C5

 C6

55. Submandibular surgery can results in damage of?

 Marginal mandibular branch of facial nerve

The marginal mandibular branch is the nerve most likely to be bruised in the removal of a submandibular gland leading to Weakness of the lower lip Numbness of the tongue is due to

the lingual nerve if rarely bruised and restricted tongue movement is due to demage of hypoglossal nerve

 Hypoglossal nerve

 Trigeminal nerve

 Recurrent laryngeal nerve

56. What delays wound healing in the sutured wound?

 Presence of suture

 Corticosteroid

Glucocorticoids -corticosteroids cause dehiscence of surgical incisions and increase the risk of wound infection and delayed healing

 Bandage

 High O2 therapy

57. All of following do phagocytosis except ?

 Macrophage

 Neutrophis

 Kupffer cells

 Lymphocytes

All Except Lymphocytes performs phagocytic function 58.P wave is absent in which of following condition?

 Congestive heart failure

 Massive pulmonary embolism

 Atrial fibrillation

Cardinal features of atrial fibrillation are an absence of coordinated depolarization of the atria exhibited as absence of P waves on the ECG and unpredictable depolarization of the ventricles shows no pattern to R wave occurrence on the ECG

 Third degree heart block

59. Difference between cortisol and growth hormone?

 Growth hormone is exogenous

 Cortisol is exogenous

 Cortisol is called stress hormone

Cortisol is a steroid hormone in the glucocorticoid class of hormones It is produced in hum by the zona fasciculata of the adrenal cortex within the adrenal gland It is released in response to stress and low blood-glucose concentration

 Growth hormone is called stress hormone 60. Regulation of K+ in body is by which of following ?

 Most of the K+ is absorbed through P.C.T.

 Through aldosterone

The main regulator of K+ level in body is aldosterone altogether insulin also shifts the K inside the cells

 Insulin regulates

 Renin

61. Proton pump inhibitor inhibits which pump?

 Na/K atpase

 Ca/K ATPase

 H/K ATPase

Proton pump inhibitors act by irreversibly blocking the hydrogen-potassium adenosine triphosphatase enzyme system the H+-K+ATPase or more commonly the gastric proton pump of the gastric parietal cells

 H2 secretion

62. Which statement is true about the kidney?

 Drains into para-aortic lymph nodes

 Is covered by fascia along with adrenals

Gerota's fascia is a layer of connective tissue that encapsulate the kidneys and the adrenal glands the renal fascia separates the adipose capsule of the kidney from the overlying pararenal fat the only right kidney is related posteriorly to 12th rib resting on the diaphragm.

 It is related posteriorly to lower ribs

 Both kidneys full function is necessary for urine output 63. After ovulation primordial follicle rupture and become?

 An embryo

 Corpus luteum

Several follicles begin to develop in each cycle normally only one will ovulate an egg After ovulation the follicle turns into a corpus luteum The follicles that do not release a mature egg disintegrate by a process known as atresia that can happen at any stage of follicular development

 Mole

 Menstrual fluid

64. Patient in on warfarin due to atrial fibrillation which of the following factors can increase the INR?

 St. John warts

 Carbamazepine

 Barbiturates

 Cimetidine

Cimetidine may increase INR by inhibiting hepatic microsomal activity which may cause reduced metabolic clearance of warfarin and augment its anticoagulant effect

65. Which of following is example of carrier-mediated diffusion?

 Passive diffusion

 Active diffusion

 facilitated diffusion

Facilitated diffusion is also called carrier-mediated diffusion it is the movement of molecules across the cell membrane via special tr port proteins that are embedded within the cellular membrane. Facilitated diffusion may be achieved as a consequence of charge gradients in addition to concentration gradients

 forced diffusion

66. A patient presents to you with severe pain in right leg cordotomy is planned by the surgeon It will relieve pain by cutting which of following?

 Right Spinothalamic tract

 Right posterior column

 Left posterior column

 Left spinothalamic tract

The anterior spinothalamic tract carries information about crude touch whereas the lateral spinothalamic tract conveys pain and temperature. The pathway decussates at the level of the spinal cord rather than in the brainstem like the posterior column-medial lemniscus pathway and lateral corticospinal tract

67. Percentage of end-diastolic volume ejected with each heartbeat is called:

 Stroke volume

 Ejection fraction

Ejection fraction is the volumetric fraction of blood ejected from a ventricle of the heart with each heartbeat it is a measure of the pumping efficiency of the heart it is usually calculated by dividing the volume of blood pumped from the left ventricle per beat also

known as stroke volume by the end-diastolic volume which is the volume of blood collected in the left ventricle at end of diastolic filling

c.Pre-load

d.Blood pressure

68. Chlamydia infection can causes?

 Lymphogranuloma venereum

Lymphogranuloma venereum is a chronic infection of the lymphatic system It is caused by any of 3 different types of the bacteria Chlamydia trachomatis. The bacteria are spread by sexual contact and the infection is not caused by the same bacteria that cause genital chlamydia

 Pneumonia

 Liver abscess

 Splenic infection

69. One of the features that differentiate sarcoma from benign lesion is?

 Position of lesion

 Increased vascularity

high vascularity is a feature of malignant cancer and sarcoma is a cancer that arises from tr formed cells of mesenchymal origin. Thus, malignant tumors made of cancellous bone, cartilage, fat, muscle, vascular or hematopoietic tissues are, by definition, considered sarcomas.

 Localized disease

 Movement dysfunction

70. In Portosystemic anastomosis of lower end of Esophagus which of the following vein represents the tributary of portal system?

 Right gastric vein

 Esophageal tributaries of azygos vein

 Left gastric vein

Lower end of esophagus is important site of this anastomosis where left gastric vein tributary of portal vein anastomose with esophageal tributaries of azygos vein

 Phrenic vein

71. Which of the following is the therapeutic effect of atropine on CNS?

 Vagal stimulation

 Restlessness

As atropine easily crosses blood brain barrier so even at low doses it can cause excitation and restlessness.

 Flushing

 Mydriasis

72. A patient is suffering from chronic intractable pain not controlled by morphine what is best next adjuvant treatment?

 Psycho-cognitive therapy

Cognitive behavioral therapy teaches relaxation techniques, stress management and other ways to help you cope with pain

b.Further increase dose of morphine c.Add paracetamol

d.Acupuncture

73. In-effective erythropoiesis occurs in which of following disease?

 HUS

 TTP

 ITP

 Thalassemia

In thalassemia defective beta chains are produced in response to anemia continuous erythropoiesis occurs but that is ineffective as HB produced is not functional

74.Vit B 12 is absorbed in which part of Gut?

 Duodenum

 Jejunum

 Ilium

Normally vitamin B12 is readily absorbed in the last part of the small intestine that is ileum which leads to the large intestine However to absorbed the vitamin it must combine with intrinsic factor a protein produced in the stomach.

 Large Colon

75. Pleural plaque formation occurs due to exposure of?

a.Cadmium b.Radiu c.Smoke

d.Asbestos

Pleural plaques are deposits of hyaline collagen fibers in the parietal pleura they are

indicative of asbestos exposure and typically become visible twenty or more years after the inhalation of asbestos fibers although latency periods of less than 10 years have been observe

76. Which of following causes horner syndrome?

 Breast cancer

 Axillary lymph nodes enlargement

 Carotid artery dissection

Sympathetic chain lies in close proximation to the internal carotid artery when it gets damaged during Internal carotid artery dissection it may lead to Horner's syndrome includes miosis, ptosis, anhydrosis and endophthalmos

 Internal jugular vein dilatation

77. True regarding acetylcholine at motor end plate?

 Form by acetylcholine esterase

 Activate sensory stimulation

 Acetyl choline channels function by K channels

 voltage sensitive acetylcholine receptors are present at motor end plate

The acetylcholine receptors are found at the edges of junctional folds at the neuromuscular junction on the postsynaptic side it is activated by acetylcholine release across the synapse.

The diffusion of Na+ and K+ across the receptor causes depolarization the end-plate potential, that opens voltage-gated sodium channels which allows for firing of the action potential and potentially muscular contraction

78. Cervical spine is widest at which level?

 At C1 to C5

At C1 level cervical spine is widest and then narrows down at C5 level

 At C5 to C1

 At C4 to C2

 At C2 to C1

79. Major part of facial skin is supplied by?

 9th nerve

 10th Nerve

 12th nerve

 5th nerve

All 3 nerves including Ophthalmic, maxillary and mandibular divisions of trigeminal nerve supply major portion of our facial skin

80. Highest protein content is found in which of the following lipoproteins?

 L.D.L

 H.D.L

Highest protein content is found in H.D.L

 V.L.D.L

 Chylomicron

81. IgE is associated with which of the following?

 Eosinophil

IgE and eosinophils both are associated with each other and increase in an allergic reaction and parasitic infections

 Basophil

 Bacterial Infection

 Fungal infection

82. Heteronymous hemianopia occurs in?

 Cerebral cortex lesion

 Midbrain tumor

 Facial nerve lesion

 Prolactinoma

Bitemporal heteronymous hemianopsia is the medical description of a type of partial

blindness where vision is missing in the outer half of both the right and left the visual field It is usually associated with lesions of the optic chiasm the area where the optic nerves from the right and left eyes cross near the pituitary gland Prolactinoma is a tumor of the posterior pituitary that compresses optic chiasm and produces these symptoms

83. Basic differentiating point between a benign neoplasm and hyperplasia is that Resembles original tissue?

 Capsule

The presence of capsule is the basic differentiating point between a benign neoplasm and hyperplasia.

 Size of cells

 No. of cells

 Difference from original tissue

84. In human lung surfactant deficiency results in?

 Pneumonitis

 Fibrosis

 Patchy atelectasis

The function of surfactant is to decrease surface tension within alveoli and prevent them from collapsing Deficiency of surfactants leads to collapsing of alveoli and hence causes patchy atelectasis

 Lung cancer

85. Principal action of Muscarinic agonist is ?

 Decreases cardiac output

The primary effect of parasympathetic stimulation is to decrease cardiac output by

inhibiting heart rate. However, pharmacologically, muscarinic agonists are actually capable of producing both inhibitory and stimulatory effects on the heart as well as vasculature

 Increase blood pressure

 Increase appetite

 Consation

86. Contents of the cavernous sinus does not include?

 VI-nerve

 IV-nerve

 Mandibular division of V

Rest of all are contents of cavernous sinus

 Maxillary division of V

87. In a chronic smoker what histological finding you will observe in the lung?

a.neutrophilia b.decrease elastase

Cigarette smoke causes inflammation and subsequent release of proteolytic enzymes into the lung in excess of their natural inhibitors. In the absence of normal repair proteolysis leads to tissue elastase destruction and airspace enlargement

c.increased collagen d.eosinophilia

88.Active glucose absorption in kidney occurs in?

 PCT

In the proximal tubule reabsorption of glucose can 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

 DCT

 Collecting ducts

 Glomerulus

89. A patient is given Local anesthesia deep at the level of Greater palatine foramen later on the patient developed dry nasal mucosa which is due to?

 Xero-ophthalmia due to decrease lacrimal secretions

Greater palatine foramen communicates with Pterygopalatine fossa which contains Pterygopalatine ganglion which provides secretomotor fibers to lacrimal gland, Local anesthesia has blocked this ganglion that is why patient got dry nasal mucosa.

 Decreased Parotid secretions

 Decreased Submandibular gland secretion

 Decreased Sublingual secretions

90. 2 days after blood tr fusion patient presented with hemolysis and diarrhea What is your diagnosis?

a.acute GVHD

Acute graft-versus-host disease occurs after allogeneic hematopoietic stem cell tr plant and is a reaction of donor immune cells against host tissues. Activated donor T cells damage host epithelial cells after an inflammatory cascade that begins with the preparative regimen.

b.chronic GVHD

c.Bacterial contamination d.Hypermotility of gut

91. Nerve supply to all the short muscles of hand:

 C3 and C4

 C8

 Ulnar nerve

 T1

T1 nerves supplies all short muscles of hand via ulnar and median nerves

92. A patient took some anti-aging vitamin whose deficiency cause the similar neurologic effect like b12 except pernicious anemia?

 Vit A

 Vit C

 Vit B1

 Vit E

With a continued deficiency, neurologic symptoms progress and patients can develop truncal and limb ataxia as well as diffuse muscle weakness early findings include

hyporeflexia, decreased proprioception, decreased vibratory sense, distal muscle weakness, night blindness and normal cognition

93. A patient is presented with UTI infection Gonorrhea comes positive in the report what is the drug of choice?

 Clarithromycin

 metronidazole

 Acyclovir

 Ofloxacin

Drug of choice in uncomplicated gonorrhea and chlamydia genital infections is Ofloxacin 94. What is true about phospholipid membrane?

 Polar

 Non-polar

 Insoluble in water

 Both polar and non-polar

In phospholipid membrane each lipid molecule contains a hydrophilic region also called a polar head region and a hydrophobic or nonpolar tail region

95. Cricoid cartilage lies at?

 Level of C5

 Junction of pharynx and esophagus

Cricoid cartilage lies at the level of C6 vertebra which in this is junction of pharynx and esophagus.

 Level of T1

 Level of T2

96. Stenson duct pierces which of following muscle?

 Masseter

 Buccinator

The parotid duct is a duct and the route that saliva takes from the major salivary gland the parotid gland into the mouth It pierces is buccinator

c.temporalis d.Lateral pterygoid

97. A patient is admitted in hospital with hypotensive shock CVP line was passed After 10 days he develops fever culture shows gram-positive bacteria The drug of choice should be?

 Cefipime

 Augmentin

 Vancomycin

Vancomycin is the drug of choice for cellulitis skin infection and infection associated with cannula or CVP line

 Amphotericin

98. Stomach emptying is most importantly inhibited by which of the following?

 CCK

It causes both relaxation of the proximal stomach and contract the pyloric sphincter and either one or both of these actions could mediate inhibition of gastric emptying hence Cholecystokinin is a strong inhibitor of gastric emptying

 Insulin

 Glucagon

 Gastrin

08 March 2018 Morning (A)

Q: Synthesis of testosterone occur in ?

 Leydig cells

Leydig cells release a class of hormones called androgens (19-carbon steroids). They secrete testosterone, androstenedione and dehydroepiandrosterone (DHEA), when stimulated by the pituitary hormone luteinizing hormone (LH). LH increases cholesterol desmolase activity, leading to testosterone synthesis and secretion by Leydig cells.

 sertoli cells

 spermazoa

 adrenal cortex

2. Immobile joint only ligament or membrane is present ?

 gomphosis

 Synchondrosis

Synchondrosis is a type of Cartilagenous joint that contains fibrocartilage in between the joint surfaces and is associated with least or no movements around the joint surfaces.

 syndemosis

 semarthrosis

Q: difference between Ulcerative colitis from Chrons disease ?

 colon involvement

The differences between ulcerative colitis and Crohn"s disease are: Ulcerative colitis is limited to the colon while Crohn"s disease can occur anywhere between the mouth and the anus. In Crohn"s disease, there are healthy parts of the intestine mixed in between inflamed areas. Ulcerative colitis, on the other hand, is continuous inflammation of the colon.

Ulcerative colitis only affects the inner most lining of the colon while Crohn"s disease can occur in all the layers of the bowel walls

 perineal lesion

 dirrahea

 Skip leisions in ulcerative colitis Q: Asbestos causes ?

 SCC

 malignant mesothelioma

Mesothelioma Malignancy of the pleura associated with asbestosis. Results in hemorrhagic pleural effusions and pleural thickening

 BCC

 HCC

5. Function of sertoli cell?

 spermatogonia

 testosterone

 androgen

 androgen binding protein

Androgen-binding protein (ABP) is a glycoprotein (beta-globulin) produced by the Sertoli cells in the seminiferous tubules of the testis that binds specifically to testosterone,

dihydrotestosterone (DHT), and 17-beta-estradiol. Sertoli cells secrete Müllerian inhibitory actor (MIF) that suppresses development of paramesonephric ducts

6. A patient with increased BP and increased catecholamines.The problem is in ?

 adrenal cortex

 adrenal adenoma

 Adrenal medulla

Signs and symptoms of the patient are consistant with pheochromocytoma, that is a benign tumor of the adrenal medulla associated with increased secretion of catecholamines.

 pituitary tumor

7. Rapidly adapting receptor ?

 Pacinian

Rapidly adapting, or phasic, receptors (pacinian corpuscle, light touch) show a decline in action potential frequency with time in response to a constant stimulus. primarily detect onset and offset of a stimulus

 meissner

 GTO

 tactile

8. Cell with increase telomerase activity ?

 germ cells

Telomerase is the enzyme present in cells and it prevents chromosome shortening and prevents tumor formation. Its activity is maximum in germ cells as these grow continuously

 somatic cells

 squamous cells

 epithelial cells

9. Heart has decreased oxygen supply and increased oxygen demand in ?

 asthma

 emphysema

 heart failure

HF is defined as inadequate cardiac output resulting into inability of heart to fulfill the O2 demand, Clinical syndrome of cardiac pump dysfunction. Symptoms include dyspnea, orthopnea, and fatigue,signs include rales, Jugular vein distention or JVD, and pitting edema.

 interstitial fibrosis 10. Mucinus Acini?

 minor glands

 sublingual

Parotid gland secretion are serous, Submandibular secretion are mixed while that of Sublingual glands secretion are mucinous in nature

 parotid

 pancreas 11. Variance of mean

 variance

 PPV

 Standard deviation

Measures of dispersion or Standard deviation = how much variability exists from the mean in a set of values.

 Standard error

12. Which tumor is Radiosensitive ?

 Lymphoma

Lymphoma is a Radiosensitive tumor, other examples are Seminoma, squamous cell Carcinoma and choreoCarcinoma.

 BCC

 HCC

 cervical

13. Anti depressant drug causes ?

 Parkinson

Amoxapine is sometimes associated with a parkinsonian syndrome due to its D 2 -blocking action. Mirtazapine has significant sedative effect. Maprotiline has a moderately high affinity for NET and may cause TCA-like adverse effects and, rarely, seizures.

 chorea

 athetosis

 hemibalismus

14. Tr plant in Patient always need a single investigation, that is ?

 rh compatibility

 tissue matching

 ABO compatibility

 HLA compatibility

HLA matching is most important investigation for tr plant.

15. A man with increased BP , right sided heart failure, smoking for 30 years.The cause of this condition is?

 dec. lung complience

 inc lung complience

Compliance—change in lung volume for a given change in pressure, decreases in pulmonary fibrosis, pneumonia, and pulmonary edema, increases in emphysema and normal aging. This can be in response to abnormally low oxygen levels in the vessels inside the lungs as a result of COPD. The excess strain from pulmonary hypertension on the right ventricle can result in heart failure. Right-sided heart failure causes fluid to accumulate in the legs, ankles and abdomen as well as the lungs.

 inc. V/Q ratio

 sec. respiratory rate 16. Cell against tumor cell

 lymphocytes

 mast cells

 NK cell

Natural killer cells Use perforin and granzymes to induce apoptosis of virally infected cells and tumor cells. Only lymphocyte member of innate immune system. Activity enhanced by IL-2, IL-12, IFN-β, and IFN-α

 monocytes