Nerve supply to muscle of hip and knee

 sciatic

 femoral

The femoral nerve arises from the lumbar plexus (L2, 3, and4). Its Muscular branches to the sartorius, the pectineus, andthe quadriceps femoris muscles

 Obturator

 common peroneal

46. Dormant state of Malarial Parasite is

 merozoites

 nerozoites

 sporozoites

 hypnozoite

Malarial parasites and especially its P. vivax and P. ovale can remain dormant in billiary tract or gall bladder in the form of Hypocrites

47. Vibration and Touch is the function of

 Pacinian corpuscles

Pacinian corpuscle: are Onion-like structures in the subcutaneous skin (surrounding

unmyelinated nerve endings)Sensations mediated are Vibration, tapping. These are Rapidly adapting receptors.

 Merckal discs

 Meissner"s corpuscles

 tactile receptor

48. Infectious Mononucleosis is associated with

 EBV

EBV: Infectious Mononucleosis. Characterized by fever, hepatosplenomegaly, pharyngitis, and lymphadenopathy (especially posterior cervical nodes).

 CMV

 HHV

 RSV

49. Unique feature of Corneal Layer Bowman membrane is

 non regenerative

Bowman’s membrane—It is made up ofcollagen fibrils. It does not regenerate whendamaged. This results in the formation ofpermanent corneal opacity

 regeneration

 flexible

 Neuroma

50. Hearing is better In Noise ,due to

 chochlear damage

 osteosclerosis

Paracusis willisii:. An otosclerotic patient hears better in noisy than quiet surroundings. This is because a normal person will raise his voice in noisy surroundings.

 ossicular damage

 meniater"s disease 51. Basal Ganglia part includes

 pons

 putamen

Basal ganglia Important in voluntary movements and making postural adjustments.Receives cortical input, provides negative feedback to cortex to modulate movement.Striatum = putamen (motor) + caudate (cognitive).Lentiform = putamen + globus pallidus.

 crus cerebri

 uncus

52. evaporation gradient is monitored by

 hypothalamus

 thermal gradient

As much as the difference of temperature is there, between evaporating surface and external environment (thermal gradient), so is the evaporation rate.

 anterior pituitary

 posterior pituitary

53. Homocystenemia is caused by deficiency of

 B12

Hypersegmented neutrophils, glossitis, decreased B12, increased homocysteine, increased methylmalonic acid.Neurologic symptoms: subacute combined degeneration (due to involvement of B12 in fatty acid pathways and myelin synthesis).

 B6

 B3

 vitamin C

54. drug causes hypoglycemia in of asthma

 alpha agonists

 beta agonists

Beta agonists drugs used in acute exacerbation of asthma (status asthmaticus) also cause release of insulin and that is why cause hypoglycemia.

 beta blockers

 alpha blockers

55. Most common side effect of pyrazinamide

 myositis

 hypersensitivity

 hyperuricemia

Pyrazinamide: MECHANISM: Mechanism uncertain. Thought to acidify intracellular environment via conversion to pyrazinoic acid. Effective in acidic pH of phagolysosomes, where TB engulfed by macrophages is found.CLINICAL USE: Mycobacterium

tuberculosis.TOXICITY: Hyperuricemia, hepatotoxicity.

 vomiting

56. Complement levels are decreased in

 Hashimoto

 nephrotic syndrome

 Acute GN

 SLE

Antihistone antibodies—sensitive for drug-induced lupus.Anticardiolipin antibodies—false positive on tests for syphilis, prolonged PTT (paradoxically, decreased risk of arteriovenous thromboembolism).Decreased C3, C4, and CH50 due to immune complex formation 57. Thoracolumber nervous system is

 parasympathetic

 sympathetic

In Autonomic nervous system, cranio-sacral outflow (CN III, VII, IX & X with S2-4) form the Parasympathetic part. While ThoracoLumber outflow (T1-L2) forms the sympathetic part.

 cranial

 enteric

58. Pulmonary Embolism is closely related to all except

 ARDS

 asthma

Sudden-onset dyspnea, chest pain, tachypnea. May present as sudden death.Types: Fat, Air, Thrombus, Bacteria, Amniotic fluid, Tumor. Fat emboli—associated with long bone fractures and liposuction classic triad of hypoxemia, neurologic abnormalities, and petechial rash.

 long bones fractures

 infection

59. Sjogren syndrome is associated with

 Anti TNF

 Anti SM

 Anti ASA

 Anti SS

Anti-SSA, anti-SSB (anti-Ro, anti-La): Sjửgren syndromeAnti-TSH receptor: Graves diseaseAnti-U1 RNP (ribonucleoprotein): Mixed connective tissue diseasec-ANCA (PR3- ANCA): Granulomatosis with polyangiitis (Wegener)

60. For Tr plant, which is most important compatibility to be checked?

 ABO

 Rh

 HLA

HLA (Human Leukocyte Antigen) antigens are the antigens related to the hypersensitivity reactions. These are most important to be compatible before tr plantation.

 DR2

61. High speed of current in purkenjie is due to

 high Na chanels

Purkinje fibers have a large cross section, a cytoplasm with few contractile fibrils and a large content of glycogen. It has highest speed of conduction due to more Na chanels.

 interclated disc

 gap junctions

 desmosomes

62. Baroreceptors activity cause following change in the arterial pressure

 decrease

 maintain

 increase

Baroreceptors:Hypotension—decreased arterial pressure decreased stretch and decreased afferent baroreceptor firing leading to increased efferent sympathetic firing and decreased

efferent parasympathetic stimulation leading to vasoconstriction and increased HR,

increased contractility and increased BP. Important in the response to severe hemorrhage.

 monitor

63. Pregnant lady with mild diastolic murmur, valve involved

 pulmonary

 mitral

Due to fluid overload in pregnancy mitral valve disease become more severe.

 tricuspid

 aortic

64. Pt is Using Warfarin, what to monitor

 PT

PT is monitored for Warfarin therapy and APTT is monitored for heparin therapy.

 INR only

 Hb

 TLC

65. Spinal Branch of Accessory Nerve can be injured in

 anterior triangle

 posterior triangle

The spinal root runs downwardand laterally, and it enters the deep surface of the

sternocleidomastoid muscle, which it supplies, and then crossesthe posterior triangle of the neck to supply the trapeziusmuscle.

 carotid triangle

 digastric triangle

66. A pt. with short of breathing but no CVS or respiratory ailment, Clinician finds an anterior neck swelling, cause of SOB

 CHF

 pulmonary embolism

 fat embolism

 retrosternal goiter

Here in the scenario, the anterior neck swelling points out to the thyroid swelling (goiter) and SOB with no CVS or respiratory ailment is more in favor of Retrrosternal goiter 67. Congo Red Stain is characteristics of the

 fibroid necrosis

 Amylodosis

Amyloidosis: Abnormal aggregation of proteins (or their fragments) into b-pleated sheet structuresleading to damage and apoptosis. It is stained by congo red staining.

 Sjogren syndrome

 SLE

68. MOA Spironolactone

 Na reabsorption

 Aldosterone antagonist

MECHANISM: Spironolactone and eplerenone are competitive aldosterone receptor antagonists in the cortical collecting tubule.

 K loss

 ADH agonist

69. Globally most common cause of blindness

 HIV

 chlamydia infection

Chlamydia trachomatis serotypes:Types A, B, and C Chronic infection, cause blindness due to follicular conjunctivitis in Africa.

 HCV

 HBV

70. Concentration of Na in CSF is

 150

 160

 Isotonic to serum

Normal CSF is a clear fluid, isotonic with serum (290-295 mOsm/L). The pH of CSF is 7.33 (arterial blood pH, 7.40, venous blood pH, 7.36). Sodium ion (Na+) concentration is equal in serum and CSF (:O:l38 mEq/L).

 170

71. TMJ Joint is stabilized by

 temporal Ligament

 menisci

 temporomandibular ligament

 capsule

The temporomandibular joint is a synovial joint. The fibrocartilaginous disc divides the joint into upper and lower cavities.CAPSULEThe capsule encloses the joint. It stabilizes the joint 72. Diabetic Patient has retinopathy Due To damage to

 counjuctiva

 small vessels

Small vessel disease (diffuse thickening of basement membrane) retinopathy (hemorrhage, exudates, microaneurysms, vessel proliferation) A, glaucoma, nephropathy (nodular

sclerosis, progressive proteinuria, chronic renal failure, arteriolosclerosis leading to hypertension, Kimmelstiel-Wilson nodules)

 large vessels

 intermediate vessels

73. Duodenal ulcers can perforate which artery

 right gastric

 post. gastrodudenal

Hemorrhagic Complication of Peptic Ulcer: Gastric, duodenal (posterior > anterior).

Ruptured gastric ulcer on the lesser curvature of the stomach leading to bleeding from left gastric artery.An ulcer on the posterior wall of the duodenum leading to bleeding from gastroduodenal artery

 spleenic

 ant. Gastrodudenal

74. severity and onset of Food Poisoning manifestations is related to

 amount of poison

 virulence

Severity and onset of the manifestations of the food poisoning is more closely related with the virulence of the organism instead of amount of poison.

 dose

 frequency

75. Decrese intake of fluid or increase calcium is advised in

 CKD

Chronic kidney disease is a fluid overload state, that is why it is advisable to decrease fluid intake in CKD. While CKD is also associated with hypocalcemia, that is why Ca intake should be increased.

 CLD

 COPD

 CVA

76. Encapsulated afferent are all except

 free nerve endings

Free nerve endings are not encapsulated rest all are capsulated.

 Meissner"s corpuscles

 muscle spindles

 Pacinian corpuscles

77. significant finding after 12 hours of MI is increased

 neutrophils

At 1st 12-24 hours, Neutrophil migration starts.Reperfusion injury may cause contraction bands (due to freeradical damage).

 lymphocytes

 macrophages

 monocytes

78. free radicals are cleared by

 vitamin B2

 B3

 vitamin E

Free radicals can be eliminated by enzymes (e.g., catalase, superoxide dismutase, glutathione peroxidase), spontaneous decay, antioxidants (e.g., vitamins A, C, E).

 B6

79. CO causes Hb dissociation curve to

 right

 left

Carboxyhemoglobin: Form of Hb bound to CO in place of O2. Causes decreased oxygen- binding capacity with a left shift in the oxygen-hemoglobin dissociation curve. Decreased O2 unloading in tissues.

 upward

 downward

81. which of following is anti-Diabetic and Asthmatic Drug?

 salbutamol

Salbutamol is a short acting beta agonists that is used in severe attack of asthma. Moreover, it increases the insulin release and hence can be used in hyperglycemia.

 betametahsone

 montileukast

 beclomethasone

82. most common non bacterial opurtunistic infection in burn patient is

 blastomycosis

 giardia

 P. carinii

 candida

Candida albic : alba = white.Systemic or superficial fungal infection. Oral and esophageal thrush in immunocompromised (neonates, steroids, Burns,diabetes, AIDS),

vulvovaginitis(diabetes, use of antibiotics), diaper rash, endocarditis in IV drug users, disseminated candidiasis (to any organ), chronic mucocutaneous candidiasis

83. A baby with congenital rubella have loud S2, which can be true about it

 TGA

 PDA

Continuous machine-like murmur. Loudest at S2. Often due to congenital rubella or prematurity. Best heard at left infraclavicular area.

 ASD

 VSD

84. Ventricular Muscle take nerve Supply Directly from

 CN IX

 CN X

Innervation:The cardiac plexus is a combination of sympathetic and parasympathetic (vagal) fibers. Sympathetic stimulation increases the heart rate. Nerves that sense pain associated with coronary artery ischemia (angina) follow the sympathetic pathways back into spinal cord segments Tl-TS. Parasympathetic stimulation slows the heart rate. Sensory nerves that carry the afferent limb of cardiac reflexes travel with the vagus nerve.

 T12

 T11

85. Loss of E Cadherin is associated with

 tumors

 defective growth

 Ehlor Danlos syndrome

 malignancy

A first step in the invasion of malignant cells through an epithelium results from a loss of expression of cadherins that weakens the epithelium

86. characteristic cells in Chronic Inflammation are

 monocytes

 macrophages

 lymphocytes

Characteristic cells of the acute inflammation are the neutrophils While that of Chronic inflammation are the lymphocytes.

 fibrinocytes

87. after Severe Hemorrhage, Na is Reabsorb By

 ADH

 inhibin

 brush border

 Aldosterone

Aldosterone—acts on mineralocorticoid receptor leading to insertion of Na+ channel on luminal side.ADH—acts at V2 receptor leading to insertion of aquaporin H2O channels on luminal side.3–5% Na+ reabsorbed

88. Phrenic nerveis anterior to

 trachea

 esophagus

 root of lung

The left phrenic nerve descends along the left side ofthe left subclavian artery and crosses the left side of the aortic arch and the left vagus nerve. It passes in front of theroot of the left lung and then descends on the pericardiumto the diaphragm

 azygus vein

89. Somites are formed by

 Mesoderm

Mesoderm forms paraxial mesoderm (35 pairs of somites), intermediate mesoderm, and lateral mesoder.

 ectoderm

 Endoderm

 neuroectoderm

90. Lymphoid hyperplasia is seen in which infection

 leishmeniasis

Leishmania donovani: is tr mitted by sandfly, It causes Visceral leishmaniasis with lymphoid hyperplasia(kala-azar): spiking fevers, hepatosplenomegaly, pancytopenia

 T. vaginalis

 chronic malaria

 CML

91. stroke patient in ICU have absent bicep reflex but brisk knee and ankle jerk which involve??

 C5

 C4

 C6

Brisk reflexes given here in scenario point out to the upper motor neuron lesion, while absent bicep reflex shows the C6 level lower motor neuron lesion of the bicep reflex.

 C7

92. Pt Can"t Supinate after Knife Injury, nerve involved

 radial

Supination: Biceps and supinator muscles. Supinator is supplied by radial nerve. This movement returns the pronated hand to the anatomic positionso that the palm faces anteriorly and the thumb lies on thelateral side. (Supination is more powerful than pronation.)

 ulnar

 Musculocutaneous

 median

93. Spleen - White Pulp is associated with antigen collection from

 lymph

 blood stream

White pulp is a site for collection of antigens from the bloodstream (in contrast to lymph nodes which collect antigens from lymph) and provides an optimal environment for T and B lymphocytes and antigen-presenting cells to respond to the antigen.

 lymph nodes

 hepatic circulation 94. Confirmatory test for AIDS is

 ELIZA

 western blots

HIV diagnosis: Presumptive diagnosis made with ELISA (sensitive, high false-positive rate and low threshold, rule out test),positive results are then confirmed with Western blot assay (specific, high false-negative rate and high threshold, rule in test).

 nothern blots

 southern blots

95. Different of Alpha and Beta Chain are in?

 sideroblastic anemia

 Thalasemia

In Thalasemia, one of the Hb chain either alpha chain or the beta chain is deficient leading to mismatch proportion of the Hb chains.

 hemophilia

 CML

96. A pt with lower respiratory tract infection, presents with acute SOB and collapsed there, hyaline membranes are seen on autopsy, cause

 asthmatic attack

 ARDS

Acute respiratory distress syndrome:May be caused by trauma, sepsis, shock, gastric aspiration, uremia, acute pancreatitis, or amniotic fluid embolism. Diffuse alveolar damage leading to alveolar capillary permeability leading to protein-rich leakage into alveoli and noncardiogenic pulmonary edema (normal PCWP). Results in formation of intra-alveolar hyaline membrane.

 pulmonary edema

 pulmonary embolism

97. Hyperthyroid patients tachycardia is due to

 Dopamine

 epinephrine

 adrenaline

In hyperthyroidism, Chest pain, palpitations, arrhythmias, are due to increased number and sensitivity of β-adrenergic receptors.

 alpha receptors

98. A jaundiced pt with increaed protoporphyrin and ALA, cause

 iron deficiency

 B12 deficiency

 folate deficiency

 lead poisoning

Lead poisoning: Affected Enzymes are the Ferrochelatase and ALA dehydrataseleading to accumulation ofProtoporphyrin, δ-ALA (blood

01 May2018 Evening (B)

1Q: Number of Division of lower respiratory tract?

 21

 23

the tract continues down into the lungs where the passage divides mulle times (as much as 24 times in an adult), with each passageway growing smaller until it terminates in the miniature air sacs that make up our lungs.

Ref: Critical Care Medicine: Principles of Diagnosis and Management in the Adult. By Joseph

 17

 19

1Q: Executive malaise diagnosed in patient with HCV-RNA. Routine labs, USG and LFTS normal? What should be the treatment plan for this patient?

 Interferon only

 Ribavirin only

 Peginterferon

 Follow-up

The diagnosis of HCV infection is established with antibody screening followed by NAT for HCV RNA for confirmation as well as for follow-up of patients on treatment. Viral load assessment at baseline is also critical for determining response kinetics during therapy 1Q: Vagal parasympathetic fibers end in GIT at which level?

 At junction of mid and terminal 3rd of tr verse colon

The gastric nerves supply all abdominal org and the gastrointestinal tract ending just before the left colonic

 At distal end of sigmoid colon

1Q: Primary graft rejection is caused by?

 Preformed antibodies

 Helper T-cells

 Cytotoxic T-cells

Antigen-triggered T cell activation and the subsequent infiltration of activated CD4+, CD8+, macrophages, and natural killer (NK) cells into the graft are key events in acute allograft rejection

1Q: Ovary has pool of follicles. Number of follicles developing in each menstrual cycle?

 15-20 primordial follicles are stimulated and one is selected

Folliculogenesis describes the progression of a number of small primordial follicles into large preovulatory follicles that occurs in part during the menstrual cycle.

 4-5 are stimulated

 One follicle is thrown out of the ovary

1Q: Autoradiography in histology, uses which technique?

 Fluorescent dye

 Radioactive ions bound with antibodies

 Radioactive ions

Autoradiography is a specific biological tool used to detect radioactive materials by using X- ray photographic films

1. Meningococcal Meningitis is caused by

 H. influenza

 Strep Pneumoniae

 neisseria meningitis

Neisseria Meningitis Causes meningococcemia and meningitis, Waterhouse-Friderichsen syndrome

 staph aureus

2. An important mechanism of Regulation of Renal Blood Flow is

 CNS regulation

 metabolic control

 autoregulation

Autoregulation of Renal Blood Flow is accomplished by changing renal vascular resistance. If arterial pressure changes, a proportional change occurs in renal vascular resistance to maintain a constant RBF. RBF remains constant over the range of arterial pressures from 80 to 200 mm Hg (autoregulation).

 electrolyte balance

3. During tussue repair, collagen is produced by

 macrophages

 lymphocytes

 fibroblasts

Connective tissue helps in the repair of injuries whereby the fibroblasts lay down collagen fibres to form the scar tissue.

 eosinophil

4. Osteoid is formed but not mineralized in

 Scurvy

 Ehlar Danlos

 fibromatosis 1

 rickets

Osteoid tissue is formed normally and the cartilage cells proliferate freely, but mineralization does not take place. This results in craniotabes, rachitic rosary at the costochondral junctions, Harrison"s sulcus at the diaphragmatic attachments, enlarged epiphyses in limb bones and the spinal and pelvic deformities

5. Dysarthria is associated with lesion of

 medulla

 cerebellum

Cerebellar hemisphere: Intention tremor, limb ataxia, and loss of balance, damage to the cerebellum results in ipsilateral deficits, fall toward side of lesion Cerebellar hemispheres are laterally located—affect lateral limbs. Cerebellar vermis: Truncal ataxia, dysarthria

 pons

 Midbrain

6. Granulation tissue and amorphous substance formation is the function of

 Elastin

 macrophages

 fibroblasts

Fibroblasts: Deposition of granulation tissue and collagen, angiogenesis, epithelial cell proliferation, dissolution of clot, and wound contraction (mediated by myofibroblasts)

 lymphocytes

7. Meckels Diverticulum is associated with

 yolk sac

 mesenchyme

 vitteline sinus

 vitelline duct

True diverticulum. Persistence of the vitelline duct. May contain ectopic acid–secreting gastric mucosa and/or pancreatic tissue. Most common congenital anomaly of the GI tract 8. A pt. presents with body rash and plethora, investigation shows Inc Red Cell Mass, Dx..?

 CML

 CLL

 polycythemia

Polycythemia vera: Hematocrit > 55%, somatic (non-hereditary) mutation in JAK2 gene.

Often presents as intense itching after hot shower. Rare but classic symptom is

erythromelalgia (severe, burning pain and reddish or bluish coloration) due to episodic blood clots in vessels of the extremities

 ALL

9. which of following is the common complication of Parenteral Nutrition

 hyperglycemia

Hyperglycaemia is common complication of TPN,particularly following pancreatitis, and may necessitate infusion of insulin.

 hypoglycemia

 hypokalemia

 hypercalcemia

10. Pleurocentesis is done in which Inter costal space at midclavicular line

 6th

 7th

 8th

 9th

Passage of instruments through the 9th intercostal space is done in the lower part of the space to avoid the intercostal neurovascular structures (as during a thoracentesis) 11. Vasopressin Stored In?

 hypothalamus

 anterior pituitary

 posterior pituitary

Antidiuretic hormoneSOURCE Synthesized in hypothalamus (supraoptic nuclei), released by posterior pituitary

 middle lobe 12. PDA is closed By

 PGE2

 indomethacin

PGE is used to keep the PDA open in certain heart defects (tr position of great vessels). PGE inhibitor (e.g., indomethacin), acetylcholine, histamine, and catecholamines promote closure of the ductus arteriosus in a premature birth.

 ibuprofen

 TXA2

13. Which structure damaged in broad ligament of uterus

 Fallopian artery

 uterine artery

Uterine artery: This artery runs medially on the floor ofthe pelvis and crosses the ureter superiorly (Fig. 3-9). Itpasses above the lateral fornix of the vagina to reach theuterus, where it ascends between the layers of the broadligament along the lateral margin of the uterus

 vaginal artery

 pelvic artery

14. Characteristic RBC morphology in myelofibrosis

 burr cells

 hemlet cells

 Basophilic sling

 Tear drop cells

Myelofibrosis:Fibrotic obliteration of bone marrow . Teardrop RBCs and immature forms of the myeloid line

15. Hormone that prevents Ovulation During Lactation

 Prolactin

Prolactin inhibits ovulation during lactation.

 estrogen

 progesterone

 LH

16. Kussmul breathing is associated with

 alkalosis

 acidosis

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

 DM

 Hepatic Enceph

17. thoracolumbar outflow is related to

 autonomic

 parasympathetic

 sympathetic part

ThoracoLumber outflow give rise to the sympathetic nervous system While Cranio-sacral outflow gives rise to parasympathetic system.

 gastrointestinal

18. Vibrio Cholera is tolerant to

 high temperature

 lowest temperature

 neutral

 alkaline

Vibrio cholerae Produces profuse rice-water diarrhea via enterotoxin that permanently activates Gs, increased cAMP. Comma shaped, oxidase positive, grows in alkaline media.

Endemic to developing countries. Prompt oral rehydration is necessary 19. Which of following is fractured most commonly

 Anterior cranial fossa

 occiput

 middle cranial fossa

Fractures of the middle cranial fossa are common, because this is the weakest part of the base of the skull.This weakness is caused by the presence of numerousforamina and canals in this region.

 temple

20. Which drug depresses the SA node

 sotalol

 Digoxin

CLINICAL USE CHF (increases contractility), atrial fibrillation (decreases conduction at AV node and depression of SA node).