Sunday, May 11, 2008

SURGERY March 2008

COURTESY: DR: ALTAF GHUMRO &
PREPARED BY DR: MUHAMMAD SHEERAZ AKHTAR SOOMRO


1] A newborn child has abdominal swelling on the right side of the umbilical cord. It is not covered with amnion. The condition is

A} Gastroschisis
B} omphalocele

2] Which of the following is not related to Meckel’s Diverticulum?

A} is remnant of urachas
B} lies 60 cm proximal to illeocecal Valve

3] A boy is excreting meconium from rectum and has severe constipation. The rectal examination showed no ganglion cells. The condition is called

A} Intussusceptions
B} Hirschsprung’s disease

4] Regarding somites

A} They develop on both sides of notochord.
B} they develop from lateral plate mesoderm

5] Regarding diaphragmatic hernia the most likely is

A} Absence of septum transversum
B} Failure of pluiroperitoneal membrane

6] Which one of the following is not the derivative of 1st (mandible) pharyngeal arch?
A} Incus
B} Malleus
C} Stapes
D}
E}

7] Embrologically, Which one of the following is not the developmental remant

A} lateral umbilical ligament
B} Medial umbilical ligament
C} Median umbilical ligament
D} ligamentum teres
E} ligamentum venosum

8] The part of mouth derived from ectoderm is

A} Epithelium of parotid salivary gland
B} Epithelium of Tongue
C} Floor f mouth
D}
E}

9] A male with Gynaecomastia, small testes, diagnosed as Klienfelters syndrome. The karyotype involved is

A} 45 XO
B} 46 XX
C} 47 XXX
D} 47 XXy
E} 47 XX

10] Somites are derived from

A} Intermediate mesoderm
B} Paraxial mesoderm
C} Lateral plate mesoderm
D} Ectoderm
E} Endoderm

11] An I/V Urograph of 8 year old boy shows Excretion of dye normal I kidney but absence of shadow on left side. Instead there is a small shadow just above the bladder on the left side. Which one of the following is most likely?

A} Horse shoe kidney
B} Constricted ectopic kidney
C} Pelvis kidney
D} Non rotating kidney
E} Unilateral renal agenesis

12] Which one of the following is not formed from urogenital sinus?

A} Bartholin’s gland
B} Urethral glands
C} Para urethral glands
D} Seminal vesicle
E}

13] Virus damage the cell by

A} making the pores in cell membrane
B} Forming free radicals
C} Altering the formation of proteins
D} Nuclear damage
E} using energy for their own metabolism

14] The tissue damage by Ionization Radiation is due to
A) Damage to Golgi bodies
B} Formation of free radicals
C} Hydropic degeneration
D} Metaphase of cell
E} Swelling of cells
15] All are features of IRREVERSIBLE cell injury EXCEPT
A} Karyolysis
B} Karyorhexis
C} Autolysis
D} Shrinkage of mitochondria
E} Appearance of myelin figure
16] Which one of the following is least likely involved in increasing Osteoporosis

A} Increased wt: on bone
B} Renal cell carcinoma
C} Carcinoma prostate
D}
E}

17] Patient X-Ray shows hilar lymph nodes. Granuloma but no necrosis. What is the diagnosis?

A} Sarcoidosis
B} Silicosis
C} Tuberculosis
D}
E}

18] In women the most common form of necrosis after trauma is due to

A} Trauma to fatty tissue
B}
C}
D}
E}

19] Dystrophic calcification is present in which of the following

A} Acute pancreatitis
B} Malaria
C} Tuberculosis
D}
E}

20] Which one of the following is most likely feature of reversible injury?

A} Cell swelling
B} Karyorhexis
C} Decreased glycogen
D} Myelin figures
E}

21] A person fell on road and got an abrasion on elbow the first event likely occur would be

A} Vasoconstriction
B} Platelet adhesion
C} Platelet aggregation
D}
E}

22] Which one of the following facilitates phagocytosis in neutrophils?

A} C5a
B} C3a
C} C3b
D} C3 - C5 complex
E}

23] Which one of the following is potent antioxidant?

A} Vitamin A
B} Vitamin C
C} Vitamin E
D} Transferrin
E}

24] Which one of the following among Arachidonic acid metabolite is most likely function mediated in phagocytosis?

A} Chemo taxis
B} Diapedisis
C} Transmigration
D}
E}

25] Which one of the following is potent COX-II INHIBITOR?

A} Aspirin
B} Celocoxib
C} Indomethacin
D} Meloxicam
E} Piroxicam
26] In case of pulmonary embolism extensive infarction causes sudden death due to

A} Air embolism
B} Fat embolism
C} Thromboembolism
D}
E}

27] A patient was operated for abdominal surgery. A few days after he developed pain and swelling in his right leg. Which one of the following is most likely?

A} endothelial injury
B} hypercoagubility
C} stasis and endothelial injury
D}
E}

28] A soldier has profuse bleeding. He was admitted in the hospital. Which one of the following should be given immediately?

Fresh frozen plasma
B} 20 days old blood
C} 3 days old blood
D}
E}

29] A boy was born with the condition of polycystic kidney disease. Which one of the following is correct?

A} Autosomal Dominant disorder
B} Autosomal recessive disorder
C} X- linked disorder
D}
E}

30] In a renal transplantation, which one of the following is single most significant test to be done?

A} ABO blood grouping of donor and recipient
B} HLA typing and matching
C} Donor and recipient should be close relatives
D}
E}

31] A organ was transplanted to the patient, but within 10 mins the organ failed. Which one of the following is likely etiology?

A} Antibody mediated
B} T-Cell mediated
C} Preformed antibodies
D}
E}

32] AIDS occur in the presence of

A} Kaposi’s sarcoma
B}
C}
D}
E}

33] A 2 year old boy is suspected as HIV positive, which one of the following is the confirmatory test in the boy

A} ELISA test
B} Western Blot test
C} PCR
D} Increased levels of HIV in T lymphocytes
E}

34] A 10 year old boy was operated for gastrectomy, which one of the following type of anemia is developed postoperatively

A} Megaloblastic anemia
B} Iron deficiency anemia
C} Normocytic norm chromic anemia
D}
E}

35] Autoimmunity is not involved in which one of the following

A} Pernicious anemia
B} Grave’s disease
C} Diabetes mellitus
D} Hashimoto’s thyroiditis
E} Thymoma

36] In case of hashimoto’s thyroiditis, which one of the following is seen?

A} Anti thyroglobulin
B}
C}
D}
E}

37] To differentiate Chron’s disease from Ulcerative colitis, which one of the following is likely significant regarding Chron’s disease

A} has increased frequency to cancer
B} Involves both small and large intestine
C}
D}
E}

38] Regarding alcoholic hepatitis, following is finding

A} Mallory bodies
B}
C}
D}
E}

39] A 20 year old girl has developed Galactorrhea due to prolactinoma. Bromocriptine is given to treat it the drug causes

A} Inhibition of prolaction from pituitary gland
B} Decreased prolaction from hypothalamus
C} Inhibition of prolaction from breast
D} Stimulation of prolaction of anterior pituitary
E}

40] An unconscious patient presented in ED does not respond to Naloxone. Which of the following drug has been taken by this patient?

A} Morphine
B} Heroine
C} Pethidine
D} Phenobarbital
E}

41] Strongest layer of small intestine is

A} Mucosa
B} Sub mucosa
C} Circular layer
D} Serosa
E} Longitudinal layer

42] Regarding adrenal medulla which one of the following is true?

A} Secretes epinephrine and Norepinepinephrine in 80/20 ratio
B}
C}
D}
E}

43] R.E.R most likely

A} Synthesizes protein
B} Synthesizes lipids
C}
D}
E}

44] Half life of insulin is

A} 5 mins
B} 90 mins
C} 120 mins
D}
E}

45] Insulin

A} Converts glycogen to glucose
B} Stimulates protein synthesis
C} Stimulates lipolysis
D}
E}

46] Which one of the following most likely contains abundant cholesterol?

A} VLDL
B} LDL
C} Chylmicrons
D} HDL
E}


47] Which one of the following most likely causes Increase in GFR?

A} Constriction of afferent arteriole
B} Constriction Of efferent arteriole
C}
D}
E}

48] Gastric emptying is delayed by

A} Gastrin
B} Secretin
C} CCK
D}
E}

49] Which one of the following pancreatic enzyme is most likely involved in fat absorption

A} Amylase
B} Lipase
C}
D}
E}

50] Smooth muscle

A} Contain sarcomere
B} T-tubules are present
C} Gap junctions are present
D} Forms motor end plate
E}

51] Steady pressure on skin is perceived by

A} Pacinian’s corpuscle
B} Ruffini’s corpuscle
C} Meissener’s Corpuscle
D} Golgi tendon organs
E}

52] Which one of the following is related to pain?

A} Serotonin
B} Substance P
C}
D}
E}

53] Free nerve endings have receptor for

A} Light touch
B} Pressure
C} Pain
D} Vibration
E}

54] Which one of the following has highest pressure?

A} Pulmonary artery
B} Left atrium
C} Right atrium
D} SVC
E}

55] Flow of current through junctions in the muscle

A} Smooth muscle
B} Skeletal muscle
C} Cardiac muscle
D}
E}

56] A profusely bleeding patient develops hypotension, which one of the following would be immediate mechanism to maintain B.P

A} Baroreceptor reflex
B} Chemoreceptor reflex
C} Secretion of ADH
D} Aldosterone
E} Renin angiotensin mechanism

57] Water enters into the cell by

A} Pinocytosis
B} through pores
C} Simple diffusion
D} Facilitated diffusion
E} Active transport

58] Insulin secretion is controlled by

A} Glucagon
B} increased glucose
C} Decreased glucose
D}
E}

59] Systolic B.P is highest in

A} Pulmonary arteries
B} Cerebral arteries
C} Renal arteries
D} Brachial arteries
E}

60] End diastolic volume depends on

A} Atrial contraction
B} Distensibility of ventricles
C} Duration of diastole
D} Venous return
E}

61] Mean electrical axis of heart is deviated to left if

A} Heart is angulated on right side
B} Pulmonary stenosis
C} Right bundle branch block
D} COPD
E}

62] Pulse Oxymeter measurement gives error in the reading if

A} Pt. is dark skin
B} Increased conc: of Hb A
C} Increased Conc: of Hb F
D} Aortic stenosis
E}

63] Secretion of potassium by distal collecting tubule decrease by

A} Increase in potassium in diet
B} Hyperaldosteronism
C} Metabolic alkalosis
D} Spironalactone intake
E} Thiazide diuretic



64] Absorption of iron is markedly affected by

A} Ingestion with meal
B} Partial gastrectomy
C} Trivalent form
D}
E}

65] Patient with pancreatitis has developed steatorrhea due to deficiency of

A} Lipase
B} Pepsin
C} Amylase
D} Renin
E}

66] Absorptive surface of small intestine is

A} 50
B} 100
C} 200
D} 350
E} 500

67] Daily dietary protein for 70 kg. Man is

A} 12 gm
B} 120gm
C} 200 gm
D} 150 gm
E}

68] Source for metabolic fuel for liver in post absorptive state is

A} Glucose
B} Ketones
C} Glycerol
D} Fatty acids
E}

Saturday, May 10, 2008

ANESTHESIA MARCH' 08

FCPS I - 26th MARCH' 08
ANESTHESIA

1. If a drug is taken orally. How will u assess the drug?
a. plasma drug conc
b. blood drug conc
c. urine drug conc

2. Regarding Nitroglycerine, all are true except
a. extensive 1st pass effect
b. venodilator
c. dec venous return
d. dec HR
e. t1/2 is 3-5 min

3. Warfarin, effect inc by
a. Cimetidine

4. Why the dose of theophylline in infant is smaller than in adults
a. dec metabolism
b. dec plasma protein binding

5. Enzyme induction occurs in:
a. liver
b. kidney
c. heart
d. adrenals

6. Digoxin toxicity
a. Inc K*
b. Inc Mg*
c. dec Ca**
d. dec Na*
e. alkalosis

7. Secondary active transport occurs thru
a. glucose
b. Na*
c. K*
d. Urea

8. 2 liters of 2 different gases of diff mol wt contain
a. equal no. of molecules
b. equal no. of atoms

9. Capillary permeability is inc by
a. hypertension
b. plasma colloid osmotic pressure
c. intersitial hydrostatic press
d. altered permeability

10. PG in inflammation dec by:
a. aspirin
b. corticosteroids
c. phosphodiesterase inhibitors

11. Which is true.
a. all parasymp are cholinergic
b. all sympathetic are adrenergic
c. all post-gang parasymp are cholinergic

12. Gastric motility is inc by:
a. inc gastrin
b. ACh
c. Secterin
d. Somatostatin

13. Gastric acid is inc by
a. Gastrin
b. ACh
c. Secterin
d. Somatostatin

14. Basal level of bile

15. alpha recptors effects ?
a. inc HR
b. lipogenesis
c. midriasis
d. piloerector contraction
e. bronchodilator

16. Beta effect ?
a. Inc HR and force of contraction

17. ACh effect?
a. Inc salivation
b. inc sweating
c. constipation

18. Thirst is dec by:
a. ADH
b. aldosterone
c. Ag II
d. baroreceptor efferent
e. inc Hematocrit

19. promotes each others actions
a. atropine and reserpine
b. amytriptyline and reserpine
c. atropine and amitryptyline

20. After induction of anesthesia by 10 mg/kg thiopentone, pt is hypotonic. Cause ?
a. hypersensitivity
b. dec HR
c. dec contractility

21.In hypertonic obs cardiomyopathy, which Ca** channel blocker is used:
a. Nifedipine
b. Nicardipine

22. Loop diuretics + thiazides enhance each others effect ( Dec NaCl abs) at:
a. descending loop of Henle
b. ascending loop of Henle
c. proximal convoluted tubule
d. distal convoluted tubule
e. collecting duct

23. Pt with mild CCF. Treatment started. 1 week later pt complains of severe pain at Rt big toe. Cause:
a. thiazide
b. furosemide
c. ACEi
d. amiodarone

24. Metastatic pleural effusion. Drug to be given:
a. streptomycin
b. clindamycin
c. corticosteroids
d. bleomycin

25. Monotherapy for mild CCF:
a. digoxin
b. captopril
c. nifedipine
d. propranolol

26.Pacemaker for complete heart block. Terminals shd be in:
a. SA node
b. AV node
c. Rt atrium
d. purkinje
e. Rt ventricle ..............(correct)

27. Infant with renal abnormality (renal artery stenosis). Drug responsible:
a. ACEi
b. Ca** channel blocker
c. amiodarone

28.Lungs inactivate Bradykinin by:
a. enz involved in converting kallikrein to plasma protein

29.After loss of 1 litre of blood in 5 min:
a. diastolic press dec
b. systolic press dec
c. aldosterone inc
d. no change

30. CO = VR. Large hump on left of cardiac pacing mentions:
a. inc contractility
b. inc HR
c. inc end-diastolic vol

31. Amiodarone.........> MOA

32. Lidocaine. MOA?
a. dec abnormal tissue conduction and no effect on normal tissue
b. inc PR interval
c. dec atrial contraction
d. dec AV conduction
e. inc QRS
f. inc QT

33. Class IA antiarrythmic drugs
a. Lidocaine
b. quinidine
c. procainide
d. amiodarone

34. Lidocaine as antiarrrythmic:
a. blocks Na* channels
b. Beta blocker
c. K* channel blocker

35.Verapamil ..... as antiarrythmic ?

36.Drug that inc extracellular K* (moves K* out of the cell):
a. Angiotensin
b. H2CO3
c. Carbonic anhydrase
d. pH
e. exercise

37. Sec K* in renal cells
a. metabolic alkalosis
b. carbonic anhydrase

38. Consistent finding in hypoKalemia
a. prolong vomiting
b. diarrhea
c. ureters attached to colon

39. Metabolic alkalosis
a. renal failure

40. ARF- most effect.
a. PCT
b. DCT
c. LOH
d. CD

41. Hb 8.0, HCO3- inc (35), pH Inc, Ca++ dec. Cause
a. ARF
b. Vit D def
c. folic acid deficiency
d. PTH

42. Anesthetics differ from anelgesics in:
a. only alter A delta and C fibers
b. Anesthetics effect at cerebral level and analgesics at spinal cord level
c. affects only pain and temp and no other sensory modalities

43. High output cardiac failure
a. Thiamine
b. B2
c. B6
d. Folic acid

44. 90 yrs old lady with purplish large patch on Rt hand and arm. No itching or pain. No comorbids, Otherwise Normal. Reason?
a. Capillary abn
b. Prothrombin
c. Vit K dependent clotting factors

45. 10 yrs old girl from Baluchistan c/o fatiguw, lethargy, mild jaundice, discoloration of skin, enlarged spleen. Hb 8.0, MCV 58, S. Ferritin 1000. Appropriate treatment?
a. deferroxamine
b. blood transfusion
c. iron transfusion

46. Death d/t embolism after accident
a. Fat
b. tumor cells
c. air
d. thromboembolism

47. Warfarin, effects on:
a. Factor VIII
b. factor III
c. Prothrombin

48. Ibpratopium bromide given by nebulization:
a. dec ACh release in bronchi
b. vasodil
c. inc secretion

49. Mast cell stabilizer.
a. Na chromoglycate

50. T1/2 of desmethyl diazepam, an inactive metabolite of diazepam is:
a. 20-50 hrs
b. 50-100 hrs
c. 100-200 hrs
d. 36-200 hrs ................... (correct)

51. Post menopausal women with brease ca. DOC
a. Tamoxifen

52. Sec released from thyroid gland entering circulation is:
a. Thyroxine
b. Free T3
c. free T4
d. TSH
e. TRH

53. Cushing's triad:
a. Inc ICP, HTN, Bradycardia
b. Inc ICP, hypoTN, bradycardia
c. inc ICP, hypoTN, tachycardia
d. inc ICP, HTN. tachycardia
e. dec ICP, HTN, tachycardia

54. CSF
a. total 150 ml
b. production rate 20 ml/hr
c. produced by ependymal cells of choroid plexus
d. drained by lymphatics

55. CSF:
a. Inc K* than plasma
b. dec glucose
c. dec specific gravity

56. PTH
a. inc PO4 abs from renal tubules
b. inc Ca resorption from bones
c. CRF
d. Anemia

57. Imp buffer in interstitial fluid
a. H2CO3
b. Hb
c. plasma pr.
d. PO4

58. Cell wall synthesis inhib
a. Penicillin

59. Sulphonamides inhibit
a. tetrahydrofolate in bacteria

60. Dark urine after starting ATT.
a. Rifampin

61. 1 week after starting of ATT, pt c/o pain in big toe. Reason
a. INH
b. Rifampin
c. Ethambutol
d. PZA

62. Needle inserted at paramedian vertebral canal pierces:
a. ant spinal lig
b. post spinal lig
c. supraspinal lig
d. interspinal log
e. ligamentum flavum

63. Pseudomembrane colitis linked to:
a. clindamycin
b. penicillin
c. cephalosporins
d. erythromycin

64. Regarding chemotherapy all are true, except:
a. often multi therapy is not curative
b. req daily dosing of multiple drugs for long time

65. Flumazenil
a. onset of action 30-60 min
b. all unconscious pts must be screened by this drug
c. paradoxical tachycardia
d. max safe dose 1 mg/day

66. Isoflurane
a. MAC 1.9
b. req special vaporizer
c. dec HR

66. Sevoflurane
a. dec HR
b. req use of normal vaporizer

67. MAC of Sevoflurane with 60% NO
a. 0.66-0.68

67. Ether causes
a. autonomic stimulation

68. Enflurane
a. EEG typical of seizures
b. not concerned to dose / conc adm
c. inc ICP
d. nonevident facial spasm

69. More pungent.
a. Isoflurane
b. enflurane
c. desflurane at MAC <1

70. Halothane

71. Metabolism of halides to release fluroide levels in descending order:
a. desfurane < isoflurane < enflurane < sevoflurane < halothane < methoxyflurane
0.02 0.2 2.5 3 - 5 20

72. Blood flow regulation
a. cerebrum > cerebellum > sp. cord
b. sp. cord > cerebellum > cerebrum
c. cerebrum > sp. cord > cerebellum

73. N2O shd not be used in elderly with intestinal obs d/t:
a. risk of inc distension

74. Cylinder half filled with liquid N2O. Pressure in the cylinder?

75. Pressre of N2O cylinder is 750 psi. Pressure in the cylinder till the last drop evaporates?

76. T1/2 N2O ?
a. does not undergo metab and is exc unchanged

77. Myocardial toxicity to a L/A?
a. Bupivacaine

78. cardiovascular collapse
a. bupivacaine

79. MetHbemia
a. Prilocaine

80. Fracture 5, 6th rib. longest acting L/A to be given
a. Bupivacaine

81. MAC related to:
a. Bl / gas solubility
b. oil / gas solubility
c. alveolar air conc.

82. Hyperoxia. All true except 1.
a. retrolental fibroplasia
b. atelectasis
c. dec surfactant prod
d. CV depression
e. anemia

83. PG released in inflammation are inhibited by:
a. aspirin
b. corticosteroids
c. serotonin

84. Muscle relaxant that can be given to an asthmatic pt
a. atracurium
b. tubocurare
c. cisatracurium
d. suxa

85. Muscle relaxant, renally exc, long duration of action
a. tubocurare
b. vancuronium
c. pancuroniun
d. gellamine

86. For disinfection hands shd be washed with
a. phenol
b. alcohol with chlorhexidine
c. formaldehyde

87. The operating room shd b cleaned with the following drug, following surgery of HIV pt:
a. 10% gluteraldehyde
b. 1% phosphoenol
c. 2% gluteraldehyde
d. H2O2

88. Following is true regarding sterilization:
a. repeated heating denatures polyvenyl tubings
b. autoclaving is heating objects at 121 degC at 15 psi for 3 min
c. radiation (UV light)
d. dry heat
e. formaldehyd

89. Reason for heat generation when CO2 is passed thru soda lime
a. formation of CaCO3
b. CaO formation
c. friction b/w soda and CO2

90. Flowmeter stops working when
a. flow of N2O > O2
b. flow of O2 > N2O
c. breakage / disruption of control valve.

91. Laminar flow (MURAD QS)
a. flow directly prop pressure
b. resistance independent

92. When Rynolds no. exceeds 3000
a. viscosity dec
b. density dec
c. velocity dec

93. Flow meter
a. used towards expiration
b. kept vertical to keep the dial needle at zero
c. not affected by humidity
d. cannot be attached to the ventilator

94. Regarding transducer all are true except
a. changes signal from 1 form of energy to another
b. capacitanc transducer can be used on body

95. Movement of molecules from high conc they layer/ surface:
a. diffusion
b. osmosis
c. doppler effect

96. Critical temp is:
a. the temp at which gas must be cooled to become liquid

97. Latent heat of vaporization:
a. temp at which liquid converts to vapour / gas without the utilization of external heat
b. becomes zero with gain of energy

98. Relation of vol of a subs to its weight is:
a. density
b. viscosity
c. conc

99. To convert Celcius scale to Farenheit scale:
a. 9/5 *F- 32
b. 5/9 *F x 32
c. 5/9 *F + 32
d. Subract 32 and multiply by 5/9
e. add 32 and multiply by 9/5

100. Pt lying uncovered in operating room. Max heat is lost by:
a. Conduction
b. convection
c. radiation
d. evaporation

101. Pt with ETT tube. Heat is lost by:
a. Conduction
b. convection
c. radiation
d. evaporation

102. As the gas flows thru the vaporizer
a. gas is heated
b. outside of the container is cooled
c. surface vapour with highest energy is evaporated

103. Humidity is measured by:
a. hygrometer
b. thermometer

104. Apart frm measuring end tidal CO2 conc., capnograph can also measure
a. CO2 saturation
b. PO2
c. reduced Hb
d. oxyHb

105. Regarding Capnograph
a. rise of baseline indicate failure of valve
b. rise of height indicate valve failure

106. O2 is measured by all techniques except ......................(MURAD QS)
a. mass spectrometry

107. alpha waves with eyes closed
a. convert to beta when eyes open
b. convert to delta in REM
c. followed by slow frequency, high altitude wave

108. During diathermy when neutral plate is disturbed: ( Burn inc as current density inc, but independent of freq )
a. pt may get a burn even at ECG electrodes ( Burn can occur at all frequencies )
b. depends it is operating at cutting or coagulation mode
c. depends on current frequency

109. Strong magnetic instruments may not be used in a remote village d/t side effects. Instrument that can be used is:
a. CT scan
b. MRI
c. Angioplasty

110. Resistance in series:
a. inc as the wire is stretched
b. known as strain gauge used as pressure transducer
c. proportional to current flow

111. Wheatstone bridge
a. measures changes of resistsnce
b. no current flows when bridge is balanced

112. Pulse oxymetery
a. signals occur at 0.5 sec
b. light emitted by filtered light source

113. Variance is related to:
a. variability
b. square root of std deviation
c. range

114. Which measure of central tendency is used most frequently in clinical practise
a. mean
b. mode
c. median
d. 50th percentile
e. Wilcoxon rank sum test

115. t-test
a. shows relation of 2 paired means

116. Surgeon treats 200 pts of heamorrhoids. He randomly divides the pts into surgically treated and pharmacologically treated groups. After 1 yr he reasses the pts and finds that surgically treated pts have better outcome. This is called:
a. case - control study
b. cohort study
c. prospective cohort
d. randomized control trials

117. Treatment of strep pneumonia by sulphonamide and penicilline by random selection is called:
a. single blind
b. double blind
c. tripple blind

118. O2 carried most in fetal circ.
a. Umblical artery
b. Umblical vein
c. Superior vena cava
d. Aorta

119. Esophagus histology
a. covered by squamous ep
b. has str. sq in upper 1/3
c. has str. sq. in lower 1/3
d. has 3 layers of muscles
e. esophageal opening acting as anatomical sphincter

120. Length of larynx.
a. 15 cm average
b. cricoid to T2 cartilage

121. Esophageal opening
a. at left crus of diaphragm
b. Left phrenic nerve also passes thru this opening
c. at level of T12 vert
d. acts as anatomic sphincter to the stomach

122. Pt complains of chest pain for more than 30 min . ECG shows changes in V1- V4. It denotes:
a. anterior wall MI
b. anterolateral MI
c. Inferior wall MI
d. Lateral wall MI
e. Inferior wall MI

123. Groove for subclavian artery at
a. clavicle
b. 1st rib
c. 2nd rib
d. 6th rib

124. Structures entering thorasic inlet
a. accessory nerve
b. aorta
c. superior vena cava
d. azygous vein
e. Left recurrent laryngeal nerve

125. Diaphragm is directly not attached to:
a. T10 vertebral body
b. L1 vertebral body
c. xiphisternum
d. 10th rib

126. Fibrous pericardium and parietal layer of serous pericardium is supplied by
รค. phrenic nerve
b. cardiac plexus
c. esophageal plexus
d. intercostal nerves

127. Needle inserted at 5th intercostal space on the left of the sternum pierces:
a. internal intercostal muscle
b. internal membrane
c. left atrium
d. left ventricle
e. right ventricle

128. Which is untrue. 1st branch of ascending aorta is:
a. RCA from anterior aortic sinus
b. LCA from arch of aorta
c. left subclavian

129. 2nd heart sound is produced d/t :
a. closure of aortic and pulmonary valves

130. S2 splitting occurs d/t
a. delayed closure of pulmonic valve

131. Spinal cord ends at the level of lower border of:
a. L2 vertebra
b. L3 vertebra
c. L4 vertebra
d. L5 vertebra
e. S1 vertebra

132. Which is a branch of posterior division of sacral plexus
a. pudendal nerve
b. posterior cutaneous nerve of thigh
c. common peroneal nerve
d. nerve to quadratus femoris
e. perforating cutaneous nerve

133. Aortic pressure tracing is highest at which phase of cardiac cycle:
a. isovolumetric relaxation
b. rapid ejection phase
c. slow ejection phase
d. isovolumetric contraction

134. Muscle of quiet inspiration
a. diaphragm

135. Damage to pneumotaxic centre leads to:
a. apneusis
b. deep inspiration
c. short expiratory phase
d. irregular breathing
e. apnea

136. Thich filaments:
a. actin
b. myocin
c. tropomyocin
d. actin and myocin
e. troponin

137. Example of carrier mediated counter transport:
a. Na- glucose transport

138. Depolarization of cell is maintained by:
a. Na influx

139. Inhaled foreign body lodges in which part of lung
a. Rt apical bronchus

140. At the end of expiration:
a. intra-alveolar pressure is subatmospheric
b. intra-pleural pressure is subatmospheric

141. Action potential thru large nerve fiber:
a. 300 ms
b. 30 ms
c. 3 ms
d. 0.3 ms
e. 0.03 ms

142. Blow to the lateral surface of knee joint damages:
a. medial meniscus, medial collateral lig and anterior cruciate lig.

143. Knee joint is supplied by:
a. L3-L4

144. Vagus forms the efferent pathway of:
a. Hering- Breur reflex
b. J- receptors of pulmonary capillaries
c. Bain Bridge reflex

145. Leftwatd shift of oxy-Hb curve is called:
a. Bohr effect
b. Haldane effect
c. Chloride shift

146. Ventilation perfusion mismatch in which Ventilation > Perfusion is called as:
a. shunt
b. dead space

147. Most important buffer is interstitial fluid
a. Hb
b. H2CO3
c. H2PO4
d. Proteins

148. Damage to what part of brain will result in central cease of respiration
a. medulla

149. Pacinian corpuscles related to
a. touch
b. vibration
c. pressure
d. rapidly adapting pain
e. slowly adapting pain

150. Medullary respiratory group of neurons part of ascending reticular system
a. True
b. false

151. Anion gap increases in:
a. Uncontrolled DM

152. Bile from liver is different from that from GB in:
a. has more HCO3-
b. has more mucous and pigments
c. has more anions

153. Dry mouth increases all except
a. thrist
b. ADH
c. Ag II
d. Plsma osmolarity
e. Plasma vol

154. H* sec from nephron is inc by
a. acidosis
b. alkalosis

155. Coronary blood flow is maintained by:
a. autoregulation

156. Increased filtration thru capillary is fascilitated by:
a. Inc plasma colloid osmotic pressure
b. inc hydrostatic pressure of cap
c. inc hydrostatic pressure of ISF
d. inc oncotic pressure of ISF

157. General anesthesia influences
a. motor is affected 1st
b. pain neurons blocked 1st
c. sensory neurons blocked 1st
d. autonomic neurons blocked 1st

158. Middle cerebral artery supplies
a. leg foot area of motor and sensory cortex.......... true / false

159. Stretch reflex afferent 1a fibers .................... true/false

160. Mediators of inflammation
a. C3a
b. C5a
c. IL1
d. TNF alpha

161. Largest total cross-sectional and surface area is of:
a. artery
b. arterioles
c. capillaries
d. venules
e. veins

162. Blood flow regulation is mediated by:
a. arterioles
b. precepillary sphincter
c. capillaries
d. venules

163. If heart rate is 80 beats/min
a. duration of PR interval wld be b/w 0.12 - 0.16 sec

164. Lung function that cannot be measured by spirometry:
a. Residual vol

165. FRC = ?
a. ERV + RV

166. Hypoglycemia increases
a. SSK
b. Somatostatin
c. Gastrin
d. VIP
e. Secretin

167. Gastric acid is stimulated by:
a. Gastrin
b. CCK
c. Secterin
d. GIP
e. VIP

168. Somatostatin dec sec of which hormone
a. ADH
b. Insulin
c. Oxytocin
d. Prolactin
e. Thyroid hormone

169. A postmenopausal women suffered fracture d/t osteoporosis. Her Ca** is Inc, PO4 is dec. Reason?
a. Estrogen
b. Cortison
c. PTH
d. CRF
e. Calcitonin

170. Physics... Capacitance

Medicine March 2008

PREPARED BY: DR:MUHAMMAD SHEERAZ AKHTAR SOOMRO

1] Which one of the following is COX-II INHIBITOR?
A} Aspirin
B} Ibuprofen
C} Indomethacin
D} Meloxicam
E} Piroxicam

2] Which one of the following vitamin deficiency causes HOMOCYSTENURIA?
A} Vitamin B1
B} Vitamin B2
C} Vitamin B6
D} Vitamin B12
E} Biotin

3] Which one of the following structures is present at free edge of LESSER OMENTUM?
A} Bile duct, cystic artery, portal vein
B} Bile duct, hepatic artery, portal vein
C} Hepatic vein, hepatic artery, portal vein

4] A 16 year old boy was given CO-TRIMAXAZOLE for fever, after few hours he developed red color urine, likely abnormality is in
A} Glucose-6-Phosphate deficiency
B} Immune hemolysis
C} Paroxysmal Nocturnal Haemoglobinuria
D} Malaria
E} Sickle cell disease

5] Thiamine deficiency causes
A} Peripheral Neuropathy
B} Pellagra
C} Chelosis
D} Dermatitis

6] Milk is notoriously deficient in
A} Vitamin C
B} Iron
C} Riboflavin
D} Pantothenic acid
E} Vitamin A

7] Dry heat kills the bacteria by
A} Coagulation of proteins
B} Cell lysis
C} Free radical formation
D} Direct killing
E} Oxidation

8] Virus damage the cell by
A} Making the pores in cell membrane
B} Forming free radicals
C} Altering the formation of proteins
D} Nuclear damage
E} using energy for their own metabolism

9] Which one of the following lipoprotein has highest protein content?
A} HDL
B} LDL
C} VLDL
D} IDL
E} CHYLMICRONS

10] All are related to PLATELET FUNCTION EXCEPT
A} Capillary resilience test
B} BT
C} Clot retraction

11] ALLELLE is:
A} Fragmented genes
B} Non-identical genes
C} Structural genes
D} Regulatory gene
E} Autosomal Dominant gene

12] D.I.C is stimulated by:
A} Factor X
B} Factor XII
C} Thromboplastin
D} Factor IX
E} Fibrinogen

13] In parenchymal cells Iron is deposited in the form of
A} Tranferrin
B} Ferritin
C} Heamatin
D} Heamoglobin
E} Lipifuscin

14] a mother is having blood group A+(Ao, DD), father is having blood group B+(Bo, Dd). Which of the following blood group cannot be inherited by their children?
A} A+
B} B+
C} AB+
D} AB-
E} O+

15] The person has suffered the injury to spinal cord leading to HEMISECTION of the cord, the IPSILATERAL sign will be
A} Loss of pain
B} Loss of temperature
C} Loss of sensation of touch and vibration
D} Lower motor neuron paralysis
E} Upper motor neuron paralysis

16] Valve less vessel is
A} Aorta
B} Pulmonary artery
C} Coronary Sinus
D} Pulmonary Trunk
E} SVC

17] A lady has undergone colostomy is now on the TPN. She is prone to develop:
A} Hyperglycemia
B} Hypocalcaemia
C} Hypophosphatemia
D} Hyperviscosity
E} Hypoglycemia

18] Turner syndrome
A} XXY
B} 45XO
C} 46XY
D} XXX
E} 69XX

19] Regarding Von Willbrand disease
A} Autosomal Dominant
B} Autosomal Recessive
C} Some family members have low level of Factor IX
D} Some family members have abnormal level of Factor IX
E} has positive family history

20] Which of the following condition is related to lymphatics?
A} Angiosarcoma
B} Rhabdomyosarcoma
C} Cystic hygroma

21] The condition in which pulmonary trunk fails to divide leading to

A} PDA
B} Truncus arteriosus
C} TOF

22] Basal Cell Carcinoma is located at
A} Lower lip
B} Upper lip
C} Tongue
D} Hard palate
E} Soft palate

23] All are branches of Vagus Nerve except
A} Auricular Nerve
B} Lacrimal Nerve
C} Recurrent Larengeal Nerve
D} Internal Larengeal Nerve

24] Permanent Atrophy is caused by
A} Loss of Innervation
B} Hormonal Deficiency
C} Immobilization
D} Nutritional deficiency
E} blockage of arterial supply

25] Which of the following is not Carcinogen?
A} Alcohol
B} Benzathracine
C} Cyclophosphamide
D} Benzidine
E} Dimethylsulfate

26] The Initial step in APOPTOSIS is
A} Inhibition of P53 genes
B} Activation of BCL-2
C} Activation of Caspases
D} pores formed by lymphocytes

27] Which of the following is content of Cavernous Sinus?
A} Oculomotor
B} Trochelear
C} Abducent
D} Trigeminal (V3)

28] Which part of kidney produces ERYTROPOITEN
A} Macula Densa
B} Peritubular Capillary
C} PCT
D} DCT
E} LOH

29] A patient with signs and symptoms of megaloblasstic anemia. The likely cause is
A Decreased GIT motility
B} Deficiency of intrinsic factor
C} Malabsorption

30] Stimulation to increase Serum Calcium is
A} Hypo-phosphatemia
B} Paratharmone
C} Decreased ECF

31] Malnutrition causes all of the following EXCEPT
A} Pitting Edema.
B} Loss of subcutaneous fat.
C} Failure to thrive.
D} Skin pigmentation
E} Thrombocytopenia

32] Liver biopsy from a patient shows a lesion which comprises of central collection of structure less material surrounded by epitheliod cells and lymphocytes. One large cell with multiple nuclei arranged close to membrane is also seen. The most likely change in central area would be:
A} Caseous necrosis
B} Coagulation necrosis
C} Fatty changes
D} Hydropic changes
E} Liquefective necrosis

33] A 28 year fisherman presented with slowly developing lethargy, easy fatigue and palpitations. His diet comprises of fish and rice only. Physical examination: Pallor, Loss of touch sense in both feet and legs Hb: 7.5 gm/dl, Platelet count: 110 x 10 9/L. Reticulocyte count: 0.5%. Stool DR: Ova of Intestinal parasite. The most likely causative parasite is
A} Ankylostomata Duodenale
B} Ascris Lumbricoidis
C} Diphylobothrium Latum
D} Strangyloids Stercoralis
E} Taenia Saginata

34] A 40 year old male after road traffic accident had received massive blood transfusion. He is expected to have all EXCEPT
A} Hypocalcaemia
B} Hypokalemia
C} Hypothermia
D} Left shift of Oxyheamoglobin dissociation curve
E} Metabolic acidosis

35] The endothelial molecules ICAM-1 & VCAM-1 are responsible for
A} Direct endothelial injury
B} Endothelial cell contraction
C} Junctional retraction
D} Leukocyte adhesion
E} Leukocyte margination

36] Eating raw or under cooked meat can cause infestation by
A} Dracunculous Medinensis
B} Echinecoccus Granulosis
C} Liver Fluke
D} Schistosomiasis
E} Tape Worm

37] A pt: has sustained burn that is very painful with blisters. Healing of this burn will take place from which of the following layers of the skin
A} Basal layer of epidermis
B} Keratinized layer
C} Layer of upper dermis
D} Lower dermis
E} Subcutaneous layer

38] A 40 year old male presented with jaundice and generalized itching. His LFT shows Direct Billirubin 11 mg/100 ml, SGPT 75U/L, Alkaline Phosphate 2300 IU/L 500IU/L. The most likely cause is
A} Drug induced jaundice
B} Extra hepatic Cholestasis
C} Autoimmune Hepatitis
D} Alcoholic Hepatitis
E} Intrahepatic Cholestasis

39] The tissue damage by Ionization Radiation is due to
A} Damage to Golgi bodies
B} Formation of free radicals
C} Hydropic degeneration
D} Metaplasia of cell
E} Swelling of cells

40] Formation of free radicals cause by
A} Ionization Radiation

41] Edema of renal origin is most likely due to
Albuminuria & sodium retention
B} Decreased water excretion
C} Hypertension
D} Renal stone
E} Sodium retention by the kidney

42] Increase in Light Chain Immunoglobulins Is the characteristic feature of
A} Endocrine type Amyloidosis
B} Hereditary Amyloidosis
C} Localized type Amyloidosis
D} Reactive Amyloidosis
E} Systemic type Amyloidosis

43] Chemotaxis is caused by
A} C5a
B} C5b
C} Lymphokines
D} Leucotriene B3
E} Opsonins

44] Following are the actions of Archidonic acid metabolites in inflammation EXCEPT
A} Chemotaxis
B} Increased vascular permeability
C} Thrombosis
D} Vasoconstriction
E} Vasodilatation

45] A 65 year old male pt: presented with chest pain for last 30 mins. And has ST segment elevation in LEADS V1 to V4. He is most likely to have
A} Anterior infarction
B} Anterolateral infarction
C} Anteroseptal infarction
D} Inferior Infarction
E} True Posterior infarction

46] A female at 30 wks of gestation has Hb: 9.0 g/dl with normocytic normochromic picture. The blood condition is most likely due to
A} Iron deficiency
B} Decreased bone marrow activity
C} Folic acid deficiency
D} Increased placenta size
E} Plasma Volume Expansion

47] The Sensations of Anterior Triangle of the neck is mediated through
A} C1, C2, C3
B} C1, C2, C3, C4
C} C2, C3, C4
D} C2, C3s
E} C1, C2

48] All are features of IRREVERSIBLE cell injury EXCEPT
A} Karyolysis
B} Karyorhexis
C} Autolysis
D} Shrinkage of mitochondria
E} Appearance of myelin figure

49] A young athlete has difficulty in flexion of knee and extension of hip. Which of the following muscle is likely paralyzed
A} Rectus femoris
B} Sartorius
C} Semitendinosus
D} Vastas lateralis
E} Popliteus

50] In the Aortic opening I the Diaphragm is constricted, which of the following structure will be compressed along with Aorta
A} Azygous vein and Vagus nerve
B} Thoracic duct and Vagus nerve
C} Thoracic duct and Azygos vein
D} Azygos vein and both phrenic nerves
E} Inferior vena cava

51] When the bulbur urethra wil injure, urine will leak into
A} Deep Perineal Pouch
B} Superficial Perineal Pouch
C} Fascia lata
D} Scrotum
E} Ischiorectal fossa

52] The most common site of fertilization in humans is
A} Ovary
B} Uterus
C} Fallopian tube
D} Cervix
E} Peritoneal cavity

53] The initial event in the transfer of RBC to site of inflammation
A} Margination
B} Emigration
C} Pavementation
D} Diapedesis
E} Phagocytosis

54] A semiconscious patient is brought to the emergency room. He has history of taking some unknown drug. NaHCO3 reverses the action of the drug. Which drug the pt. has likely taken:
A} Phenobarbital
B} Phenothiazine
C} Morphine
D} Diazepam
E} Alcohol

55] Within 1 hr of the Acute M.I, which of the following enzyme will be raised?
A} CK-MB
B} LDH
C} Alkaline Phosphatase
D} AST
E} Troponin T

56] Which organelle is not present at axon hillock
A} Microtubules
B} microfilaments
C} Mitochondria
D} RER
E} SER

57] Which is not related to embolus?
A} Liquid
B} Gas
C} Thrombus
D} Amniotic fluid
E} Fat

58] Which of the following muscle compensate for supinator?
A} Biceps Brachi
B} Brachialis
C} Brachioradialis

59] A patient presented with anterior wall M.I Artery involved is

A} LAD

60] Which of the following molecule easily crosses Blood Brain Barrier?
A} CO2
B} H2O

61] Hypervitaminosis A cause

A} Ataxia
B} Anemia
C} Scaly Dermatitis

62] Hypertrophy indicates
A} Increase in size of cell
B} Increase in no. of cell
C} Decrease in no. of cell
D} Decrease in size of cell

63] Diabetic patient using Roziglitazone and metformin. Which investigation for follow up
A} Lipid profile + Renal profile
B} Renal profile + Hepatic profile
C} Renal profile + Hepatic profile + Cardiac
64] If the whole movement of Abduction of arm is lost the likely damage is in the Brachial Plexus
A} Upper trunk + Posterior cord
B} Upper trunk + Medial cord
C} Lower trunk + Posterior cord
D} Lower trunk + Medial cord

65] Cords of Brachial Plexus are named according to Relation with
A} Axillary artery
B} Subclavian artery

66] Myelination in CNS is done by
A} Schwann cells
B} Oligodendrocytes
C} Astrocytes
D} Microglia cells

67] Captopril
A} can be given in large doses in hypertensive crisis

68] Which of the nucleus is NOT related to Facial Nerve?

A} Main Dorsal Nucleus
B} Nucleus of Tractus Solitarius
C} Nucleus Ambiguas
D} Sensory nucleus

69] Platelets
A} Are formed from precursor cells in the bone marrow
B} Has no nucleus

70] Primary auditory cortex is present in
A} Occipital lobe
B} Superior Temporal Gyrus
C} Frontal lobe
D} Prefrontal lobe

71] Patient is suffering from factor VIII deficiency
A} Genetically Engineered Factor VIII is available

72] Most Common cause of Thyrotoxicosis

A} Graves disease
B} Solitary nodule
C} Toxic nodular goiter
D} Diffuse goiter

73] Which of the following is involved in maintaining RESTING MEMBRANE POTENTIAL?
A} Outward Potassium current
B} Outward Sodium current
C} Inward Sodium current
D} Inward Chlorine current
E} Sodium/potassium ATPase Pump

74] Heart sound produced by rapid ventricular filling is
A} 1st heart sound
B} 2nd heart sound
C} 3rd heart sound
D} 4th heart sound
E} 5th heart sound

75] A patient presented with vertical diplopic, head tilting, and also difficulty coming downstairs the likely nerve damaged is
A} Oculomoter nerve
B} Trochlear nerve
C} Trigeminal nerve
D} Optic nerve
E} Abducent nerve

76] Substance has to cross semi permeable membrane in simple diffusion
A} Is not saturable
B} Require carriers
C} Require energy

77] Carcinoma prostate drain into
A} Para-aortic nodes
B} External iliac nodes
C} Internal iliac nodes
D} External and internal iliac nodes

78] Pulmonary capillary wedge pressure is so
A} Catheter used is wedge shaped
B} Is direct measurement of left atrial pressure
C} Is direct measurement of Right atrial pressure