FCPS Part 1 Psychiatry March 2013

Questions from FCPS Part-I Exam PSYCHIATRY (Paper 1 + 2 ) March 7, 2013  (Dr. Mubarra Sikander)

Q1. What is the blood supply of the derivatives of foregut? a. Coeliac artery b. Inferior mesenteric artery c. Superior mesenteric artery Q2. Folllowing is the derivative of second pharyngeal arch: a. Ramus of Mandible b. Body of thyroid cartilage c. Stylomandiblular ligament d. Stylohyoid ligament Q3. The following occurs due to neural tube defect: a. meningocoele b. cystocoele


Q4. The following structure arches over root of right lung: a. azygous vein b. hemiazygous vein c. oesophagus d. thoracic duct Q5. The back is supplied by: a. Dorsal rami of intercostal nerves b. ventral rami of intercostal nerves c. lateral cutaneous nerve Q6. Aminoglycosides should be given cautiously in the elderly because of its clearance from the body through: a. Renal excretion b. Hepatic metabolism Q7. (scenario given) Visual acouity decreases because of the following drug used in treatment of tuberculosis: a. ethambutol b. isoniazid c. rifampicin Q8. In our population, the cause of fatty liver in majority of population is: a. increased fat intake b. excessive alcohol consumption c. hepatitis B d. hepatitis C Q9. A person has history of recurrent lung infection, his chloride sweat test was done which was positive, he had steatorrhea, which of the following nutrient deficiency can occur in the patient? a. vitamin D b. vitamin B12 c. vitamin C Q10. Important prognostic factor in the prognosis of Carcinoma of colon a. CAE b. AFP c. hCG Q11. (scenario given) a patient has undergone resection of distal ileum. the deficiency of the following can occur: a. vitamin B 12 b. folic acid c. iron d. intinsic factor Q12. Vitamin B12 is absorbed in the following part of GIT a. stomach b. duodenum c. jejunum d. ileum Q13. unnamed salivary glands of soft palate are supplied by: a. pterigopalatine ganglion b. otic ganglion c. submandibular ganglion d. ciliary ganglion Q14. The following nerve contains the postganglionic parasympathatic fibers: a. greater petrosal nerve b. nerve of pterigoid canal c. lingual nerve Q15. the cells in medulla of the adrenal gland, mediating the release of norepinephrine have the following receptors: a. muscarinic b. nicotinic c. alpha 1 d. beta 1 e. beta 2 Q16. motor end plate contains a. acetylcholinestrase b. acetylecholine Q17. Baroreceptor reflex is most sensitive to a. hypotention b. hypertention c. rapid increase in arterial pressure d. rapid decrease in arterial pressure Q18. histologic characteristic of tuberculous lesion a. epitheloid cells b. multinuclear giant cells c. caseous necrosis Q19. the factor which contributes in production of extracellular fluid a. decreased hydrostatic pressure b. decreased oncotic pressure c. increased hydrostatic pressure Q20. the best way to start conversation with a patient is a. ask his name, age, address etc. b. ask directly about presenting complaint c. ask open ended questions d. ask leading questions c. ask closed ended questions Q21. regarding midbrain: a. its cavity is called aqueduct of sylvius b. substantia nigra separates tectum from cerebral peduncle c. it contains 2 colliculi d. red nucleus is situated in superior colliculus e. trochlear nerve emerges from anterior aspect Q22. ( scenario given) a patient has disease having following features, less aggression, increased hunger, hypersexuality. a. kluver bucy syndrome Q23. The motor cortex is required for a. initiation of voluntary movements Q24. the following nucleus is included in the limbic system a. amygdala b. VPL nucleus of thalamus c. ventral dorsal nucleus of thalamus Q25. superior cerebellar peduncle contains a. dorsal spinocerebellar tract b. ventral spinocerebellar tract Q26. a section of medulla oblongata taken a small distance above the decussation of pyramids is least likely to contain a. accessory dorsal olivary nucleus b. accessory ventral olivary nucleus c. decussation of pyramids Q27. neutrophilia occurs in a. myocardial infarction b. chronic infection (I do not remember all of the options but I do remember that there was no option of acute infection) Q28. respiratory alkalosis differs from metabolic alkalosis : a. pCO2 is decreased b. urine is more alkaline c. respiratory depression Q29. pitting edema is the feature of a. albumin less than 2.5g/dl b. SIADH Q30. myxoid degeneration is associated with a. libmann sack endocarditis Q31. Metabolic alkalosis causes a. hyperkalemia b. hypokalemia c. hypernatremia d. hyponatremia e. hypercalcemia Q32. the following drug should not be used in young adults because of its adverse effect of priapism a. trazodone b. amitryptaline Q33. hypokalemia is invariably caused by a. persistant vomiting b. dietry deficiency of potassium c. respiratory alkalosis Q34. the following are the main efferent tracts of hypothalamus, except a. medial forebrain bundle b. stria terminalis c. hypothalamohypophyseal tract d. mamillotegmental tract e. mamillothalamic tract Q35. oxazepam is active metabolite of a. diazepam b. flurazepam Q36. the following drug do not induce hepatic enzymes a. isoniazid b. barbiturates c. benzodiazipines Q37. a study was conducted on 500 smokers to determine the smoking as a risk factor, 500 healthy individuals were also included in the study a. cohort study b. cross sectional study c. case control study Q38. heart failure is associated with a. fibrinoid pericarditis b. cardiac temponade c. pericardial effusion Q39. a 10 year old child wakes up late in the evening, he has also started bed wetting a. narcolepsy b. somnembulence Q40. flouxetine combined with clomipramine results in a. improved depression b. serotonin syndrome c. neuromuscular syndrome Q41. theory of learned helplessness best explains the features of a. chronic depression b. psychosis c. schizophrenia Q42. during an RTA a man’s head struck to the windshield. he had a contusion on the forehead, otherwise he was alright, he developed headache after one month which was worsening gradually.he is most likely suffering from a. chronic subdural hemorrhage b. sub arachnoid hemorrhage c. extradural hemorrhage d. acute subdural hemorrhage e. brain tumor Q43. a person got fracture of femur after an RTA. he was vitally stable, but died suddenly after 5 days. on autopsy, petechia were found on the surface of cerebrum. the most likely cause of death was: a. fat embolism b. contusion c. multiple brain infarcts d. sepsis e. myocardial infarction Q44. lithium may cause a. hypothyroidism with increase TSH b. hyperthyroidism in susceptible individuals c. transient hyperthyroidism in start of treatment Q45. following is an example of hypersensitivity reaction type 2 a. erythroblastosis foetalis b. serum sickness c. anaphylaxis Q46. regarding stored blood a. all clotting factors remain stable b. hemolysis occurs c. platelets remain functional d. O2 affinity is decreased Q47. in case of lesion of right optic tract a. binasal heminopia b. bitemporal heminopia c. left nasal and right temporal loss of vision d. left nasal and right temporal loss of vision with sparing of macula e. right eye blindness Q48. after RTA, patient is not able to speak more than few words, where is the lesion a. Broca’s area b. Wernicke’s area c. cerebellum Q49. daily dose of lithium should be started from a. 400mg b. 18oomg c. 2000mg Q50. oliguria is the term used when urine output is a. less than 100ml b. less than 500ml c. 500-1000ml d. 1500-2000ml e. 1000-1500ml Q51. on a student, experimental study was going on, each time the student sleeps, during REM sleep, his sleep was interrupted. this will cause most likely a. decrement in intellect b. irritability and anxiety whole day Q52. a patient is started on lithium, after few weeks treatment, he notices fasciculation in hand muscles, blood lithium level was tested, it most likely is a. greater than 2 b. 1.5-2 c. 1-1.5 d. 0.5- 1 Q53. the following drug causes fasciculation after muscle relaxation a. succinyl choline b. tubocurarine c. atracurium Q54. in case of lithium, its excretion depends upon a. renal excretion b. hepatic metabolism Q55. aspirin has its anticoagulant action through inhibition of formation of a. prostacyclin b. TXA2 c. thrombin Q56. the following component of complement system is strongly chemotactic a. C5a b. C3a c. C3b Q57. the barbiturate metabolism involves all of the following enzyme systems except a. glucoronidation in liver Q58. The motor cortex least influences the movement of the digit through a. afferents from VPL of thalamus b. position of the digit, not the force or direction of movement (i coud not understand the statement of the question though I read it at least 20 times ) Q59. the sensory cortex differs from the motor cortex in that a. granular layer predominates in it Q60. long term memory involves a. structural changes in synapses Q61. consolidation of memory requires a. hippocampus Q62. regarding non-REM sleep, incorrect statement is a. it contains beta waves Q63. a person has seizures in day time, he has no previous history of seizures, advice regarding driving his car would be a. driving is allowed if EEG is required b. driving is allowed if brain is normal c. driving is not allowed for 1 year d. driving is not allowed for 3 months e. driving is not allowed for 3 years Q64. prepotential occurs in a. SA node b. purkunje fibers c. bundle of HIS Q65. after-hyper-polarization occurs a. during absolute refractory period b. during relative refractory period c. increasing threshold stimulus can cause inpulse near to EMP than resting phase Q66. the circadian rythm requires a. exposure to daylight +night rhythm b. regular routine of sleeping Q67. regarding barbiturates a. are all anti-seizures b. don’t affect the level of anticoagulant drugs Q68. insuline is required for entry of glucose in a. skeletal muscle b. brain c. liver Q69. growth hormone is a a. polypeptide b. mediates the somatomedins Q70. the articulation between the 2 pubic bones a. distend during parturition b. syphysis c. syndesmosis Q71. most carcinomas contain the following intermediate fillaments a. keratin b. vimentin c. desmin Q72. following is the benign lesion a. adenoma b. sarcoma c. melanoma Q73. metaplasia least likely a. can occur in mesenchymal cells b. involves change of one adult cell type to another c. occurs in smokers d. caused by substance that interferes with DNA methyhlation e. irreversible Q74. in case of bronchogenic carcinoma, the following risk factors may be involved a. smoke b. nickel fumes c. asbestos d. silica Q75. the junction that inhibits a substance to pass between adjacent epithelial cells a. tight junction b. gap junction c. desmosome d. zona adherens Q76. QRS complex initiates just before a. atrial systole b. ventricular systole c. filling phase Q77. formation of cancer in humans most likely follows a. increased expression of proto oncogenes b. mutations in gene Q78. klinefelter’s syndrome karyptype a. 47+XXY b. 46+XX c. 45+XO d. 46+XY e. 47+XXX Q79. anemia diagnosed as iron deficiency, most likely cause can be a. decreased globin synthesis b. most of the time occurs because of chronic blood loss Q80. Active transport: a. always means Na/K pump b. uphill movement of substance c. mediated by carrier proteins Q81. major extracellular fluid buffer is a. Hemoglobin b. bicarbonate c. phosphate Q82. Calcitonin a. increase calcium absorption from gut Q83. the following neurotransmitter is not an amino acid a. histamine b. GABA c. aspartate d. glutamate e. glycine Q84. least likely adverse effect of bromocriptine is a. Parkinson”s syndrome Q85. What is a positive predictive value a. proportion of true positives among all the positives b. same as sensitivity c. same as specificity d. proportion of true negatives in all the positives e. proportion of true negatives in all the negatives Q86. a doctor has to break bad news to a patient: a. all staff should be present there b. family of the patient should be present c. psychologist should be called to break the news d. by the health care provider in formal setting in exclusion Q87. hormones of anterior pituitry: a. TSH b. TRH c. GHRH d. oxytocin Q88. the underlying most likely pathophysiology of migraine a. increased level of serotonin level in the brain Q89. biochemically, the imidiate precursor of epinephrine is a. norepinephrine b. dopamine c. tyrosine d. L-dopa Q90. carbidopa decreases the adverse effects of dopamine by a. inhibiting the peripheral activation of L-DOPA by dopadecarboxylase Q91. in case of conductive deafness, bone conduction is unaffected, so a. ABC is normal b. Rennie’s test is false positive c. Rennie’s test is false negative d. Webers test is lateralised to affected side e. relative conduction is shortened Q92. tractus solitarius is formed by call bodies of a. taste receptors b. 1st order neurons c. 2nd order neurons d. 3rd order neurons Q93. regarding impairment of smell, the most likely statement is a. it involves all types of odours b. it may be a symptom of frontal lobe tumor c. may affect the sens of taste Q94. the following lipids are negative risk factors for heart diseases a. HDL b. IDL c. LDL d. VLDL c. cholesterol Q95. (scenario given) sign of amphetamine least likely is a. pupil constriction Q96. (scenario given) the sign of morphine toxicity most likely is a. pupil constriction Q97. enzyme oxidases are present in a. peroxisomes b. lysosomes c. smooth ER d. ribosomes Q98. bleeding time is prolonged in a. von-wilibrand disease b. liver failure c. factor VIII deficieancy d. vitamin K deficiency Q99. blood group of person is A. his serum contains a. no antibody b. antibody B c. antibody AB d. antibody A Q100. After 2 weeks of typhoid infection, the following test is diagnostic a. blood culture + widal test b. widal test only c. blood culture only Q101. Antibody in serum is diagnostic for a. gonococcus Q102. cause of Hypertension most commonly is a. idiopathic b. renal artery stenosis c. pheochromocytoma d. coarctation of aorta Q103. the common symptom among the following syndromes ( Conn’s syndrome, pheochromocytoma, renal artery stenosis) is a. hypertension Q104. visual pathway include all of the following except a. medial geniculate body b. lateral geniculate body c. optic tract d. occipital gyrus Q105. afferent sensory nerve fibers of the trigeminal nerve terminate at a. VPL nucleus of thalamus b. VPM nucleus of thalamus Q106. spinocerebellum is concerned with a. planning of voluntary activity b. initiation of voluntry activity c. regulation of tone and position of ongoing voluntary activity Q107. (scenario given) spinal tap should be done a. above L1 b. above L2 c. below L5 d. above L4 Q108. sodium regulation in body is acheived by a. osmoreceptors b. chemoreceptors c. water reabsorption from proximal tubule d. baroreceptor Q109. (scenario given) site of pleural tap should be a. lower border of 5th rib in mid-axillary line b. upper border of rib at the point of maximum dullness c. lower border of 4th rib in mid-axillary line d. middle of the 2 ribs in midclavicular line Q110. respiratory zone of lungs extend from a. alveoli to left atrium b. alveolar duct to alveolar sac c. terminal bronchi to alveoli d. main bronchus to alveoli Q111. regarding body equilibrium while standing a. vestibular nucleus b. red nucleus c. corticospinal tract d. tectospinal tract Q112. oncotic pressure of a solution depends upon a. number of solutes present in solution b. gram weight of solute Q113. (scenario given) in nephrotic syndrome, the cause of edema is a. low plasma albumin b. increased capillary permeability c. increased hydrostatic pressure in vessels Q114. most important local cause of delayed wound healing is a. ischemia b. infection c. incisional hernia d. dehiscence Q115. loss of sensation over nose, extending from upper lip to the eye, angle of mouth to ear over temporal region, nerve involved is a. ophthalmic division of trigeminal nerve b. mandibular division of trigeminal nerve c. maxillary division of trigeminal nerve d. auriculotemporal nerve Q116. the area called the feeding center is a. lateral hypothalamus b. medial hypothalamus c. para ventricular nucleus Q117. cortisol causes a. breakdown of free fattyacids b. mobilization of free fattyacids from lipid tissue c. breakdown of glucose d. increase cholesterol absorption Q118. characteristic of temporal lobe auditory center a. tonotopic presentation b. highest frequency projected anteriorly Q119. A patient after RTA was alright, but after few days, started symptoms of sexuality, appetite loss, altered behaviour, which of the following region is most likely involved? a. hypothalamus b. thalamus c. corpus callosum Q120. All of the following are bacteria, except a. histoplasma Q121. a 65 yr old bedridden patient of COPD suddenly became breathless(no comment on BP) the most likely condition is a. myocardial infarction b. air embolism c. pulmonary embolism Q122. After resection of the pituitry gland a. thyroxine should be given to prevent hypothyroidism b. There is decreased ADH secretion Q123. the following is true for thyroxine, except a. increase plasma cholesterol level b. requires phenylalanine for its synthesis c. maintains body temperature and basal metabolic rate Q124. the most important mechanism for temperature regulation by heat generation in body is a. shivering b. vasoconstriction of skin vessels c. piloerection Q125. In case of total parenteral nutrition, a. whole of the calories requirement can be accomplished by glucose administration b. aminoacids are given in the dextro-form c. decreased chance of infection if enteral feeding is given Q126. A patient who is resistant to traditional anti-psychotics, the most appropriate drug that can be given a. clozapine b. quetiapine c. olanzapine d. aripiprazole Q127. (scenario given) a patient has hirsuitism, obesity, muscle wasting, and serum ACTH is v.v.high. the cause most likely is a. exogenous administration of steroids b. addison’s disease c. cushing’s syndrome Q128. dissociative loss of temperature and pain sensation with preservation of touch sensation a. syringomylia b. tabes dorsalis c. poliomylitis Q129. regarding thyroid gland, all is true, except a. isthmus lies on thyroid cartilage b. is related to recurrent laryngeal nerve c. is included in pretracheal fascia along with parathyroid gland Q130. scalenous anterior muscle a. superiorly attached to bodies of C3-C6 vertebrae b. inferiorly attached to the outer border of 1st rib c. lies anterior to the brachial plexus nerve roots Q131. Carotid sheath is related to following nerves except a. auditory nerve b. cranial nerve IX c. cranial nerve X d. cranial nerve XI e. cranial nerve XII Q132. hemartoma is a. collection of mature but dis-organized cell at a place Q133. protein synthesis in muscle is mainly increased by a. DHT b. testosterone c. estradiol Q134. testosterone synthesis is a. controlled by FSH b. mediated by leydig cells Q135. differentiate between left and right kidney a. size and shape b. poles c. structures in hilum Q136. fundoscopy of a diabetic patient, soft wooly spots are found, the cause is a. diabetes b. hypertension c. arterial disease d. venous disease Q137. hairy leukoplakia is the feature of a. leukemia b. HIV Q138. difference between Alzheimer’s disease and multi infarct dementia is determined by a. CT scan b. physical features c. clinical course Q139. the mediators of graft rejection most likely is a. HLA system Q140. A patient receiving antipsychotic therapy develops sore throat, fever, leukopenia, the most likely drug he is taking a. clozapine Q141. baroreceptor reflex is important in case of a. hypovolemic shock b. septic shock c. cardiogenic shock d. neurogenic shock Q142. liver pedicle includes a. hepatic artery, portal vein and common bile duct b. hepatic artery, hepatic vein, and hepatic bile duct Q143. CVP is 2cm of H2O, cardiac output is 2 liters, and raised blood lactate level, the diagnosis is a. CCF b. cardiac temponade c. hypovolemia d. myocardial infarction Q144. the drug least likely to cause Parkinson-like syndrome a. hydralazine Q145. anterolateral incision of spinal cord relieves pain in right side of leg, this is achieved by a. resection of right posterior tract b. resection of right lateral spinothalamic tract c. resection of right anterior spinothalamic tract d. resection of left lateral spinothalamic tract Q146. a patient treated of meningitis. after one month, he started having headache. fundoscopy shows bilateral papilledema, cause is a. hydrocephalus b. venus sinus occlusion 147. the following is true regarding the vertebrae a. foramena are present in the thoracic vertebrae b. C7 has large spine c. lumber vertebra has heart shaped vertebral bodies d. centrum and the vertebral body is the same 148. The following microbe cannot be transmitted orally a. Clostridium botulinum b. clostridium perfringens c. staph. aureus d. M. avium intracellulare Q149. in the ovaries, corona radiata is derived from a. theca externa b. theca interna c. stroma of ovary Q150. Digastric triangle is bound by a. anterior belly of digastric + poterior belly of ddigastric muscle + mandible Q151. septum pellucidum lies between a. fornix + anterior commisure + thalamus Q152. regarding hypothalamus a. supraoptic nucleus + paraventricular nucleus send neurons to hypothalamus b. oxytocin is released from paraventricular nucleus Q153. Right sided hemiplagia + right sided facial palsy. lesion most likely a. medulla b. cortex c. pons d. cerebellum e. midbrain Q154. following is true regarding fibrous cartilage a. collagen type II fibers b. present in intervertebral disc c. present in perichondrium d. stains blue with H&E stain Q155. a lymphoid structure in which lymphatics are receieved in the subcapsular sinus a. lymph node b. thymus c. peyer’s patches d. tonsils e. spleen Q156. regarding coronary circulation following is correct a. corresponding corresponding veins and arteries have same names b. the main branches have same names c. anastomose at arteriolar level d. run in corresponding atrio-ventricular grooves e. left coronary artery supplies SA- node as a rule Q157. there is maximum chance of transmission of HBV from a patient if lab test report a. HBsAg +ve, HBsAb +ve b. HBsAg +ve, HBsAb -ve c. HBcAg +ve d. HBeAg +ve Q158. mean arterial pressure equals to a. one third of the sum of systolic blood pressure and double of the diastolic blood pressure (Dr. Mubarra Sikander)

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