Past Paper of FCPS Part 1 Gynae and Obs 17 August Online 2015

17TH AUG,2015 ( total 173 BCQs) PAPER-I & PAPER-II OBS & GYNE Paper 1 by DR. SAIQA & DR. AMMARA 17th August, 2015

1. scenaro: Klinefilter syndrome ,genotype: 47xx
2. which of the following cranial nerves have parasympathetic nuclei : III, VII, IX, X
3. What is hamartoma : totaly benign, always malignant, dysplastic growth,focal malformation that resembles a neoplasm in the tissue of its origin ,ectopic but normal tissue 4. Adrenergic Receptors of Adrenal medulla : alpha-1, beta-1, alpha-2, beta-2, cholinergic 5. Serology can be performed for : amoebic liver abcess/cyst, hydatid Cyst 6. Stylohyoid ligament : 2nd arch

7. 70 years old bed ridden male patient of COPD developed sudden shortness of breath and chest pain , Dx ? MI, pulmonary embolism , pneumothorax 8. Positive Predictive value : same as sensitivity, same as specificity, indicates true positives from all positives, indicates true negatives from all negatives 9. Scenario of case control study,, somewhat 500 smokers with Copd and 500 non-smokers or so 10.Coronary Arteries : essentialy branches of both right and left have same names , always run in the respective AV septal depression, anastomes with each other at arteriolar level 11.Scalenus Anterior Muscle : arises from c3-c6 vertebral bodies, inserted at anterior border of first rib, phrenic nerve passes anterior to it, subclavian artery/vein passes anterior to it. 12.Man with deviated angle of mouth, drooling, can not tightly close his eyes …….. facial nerve palsy 13.loss of sensation of nose, cheek, maxilla, zygoma : maxillary division of trigeminal nerve 14.Which of the following have subcapsular afferent sinuses : thymus, spleen, tonsills, submucosal pyer’s patches , lymph nodes 15.which of the following hormone increases content of skeletal muscle proteins : testosterone , growth hormone, progesterone, cortisole, dihyrotestosterone 16.An Ovum is surrounded by corona radiata which is formed by : granulosa cells, theca cells, germinal epithelium 17.Oxidases are present in : mitochondria , lysosomes , cell membrane, Peroxysomes 18.Scenario of Metaplasia 19.Patient underwent colostomy after colon resesction for colonic cancer, best way to monitor for recurrence : alpha-feto protein levels, B- HCG, colonoscopy, CEA levels

20.Growth harmone : acts through somatomedians on skeletal muscles and bones to cause growth , is a polypeptide 21.Insuline dependant uptake of Glucose into : brain, skeletal muscles, kidneys, intestines 22.which of the following mantain sodium concentartion in the body : osmoreceptors , barorecptors, carotid sinus 23.Man with hx of repeated URTI, hx of passage of fowl smelling stools for 10 years , he would have deficiency of which of following : vit B, vit B12, folic acid , vit D ( passage of fowl smelling stools indicate loss of digestion and absorption of bowel fats resulting in defi of fat soluble vitamins, vit D is fat soluble, rest in options were water soluble) 24.Barorecptors will respond intensly by increased rate of firing impulses in which of the following: rapidly increasing b.p, rapidly decreasing b.p (senior said so), hypovolumia (i marked) 25.neurogenic shock is different from other types of shock because of : loss of vasomotor tone 26.bleeding time increased : VWbrand’s disease 27. Mean arterial pressure : difference of systolic and diastolic b.p., sum of pulse pressue plus one third of diastolic pressure, roughly 80mm Hg correct ans. rest of the options are totaly wrong 28.left kidney grossly identified from right kidney by : arrangment of structures in hilum 29.which of the following have highest incidence of bronchogenic carcinoma : asbestosis , smoking 30.A positive blood group have antibodies in serum : anti B antibodies 31.Difference of osmolarity b/w interstial fluid and plasma : 0 milliosmol, -5 milliosmole, 1 milliosmol 32.Plasma colloid osmotic pressure is mantained by : plasma albumin , plasma globulins, water 33.65% of Na is absorbed in : PCT, dct, collecting ducts 34.A man with third degree burns have increased risk of developing : keloid , contracture 35.Scenario of active transport 36.Which of the following arches ovar root of right lung : hemiazygous vein, azygous vein , thoracic duct 37.Tractus Solitarius : contains 2nd order neurons from taste pathway, contain first order neurons from taste pathway, wrong option related to is location 38.Stored blood has following charcteristics : platlets will degenrate after 5 days, deficient in factor V, VIII, dec. affinity for O2, dec. factor II, IV, VI, X, increased hemolysis 39.Fibrocartillage : contains type II collagen, Basophilic, present in Pinna of Ear, present b/w intervertebral discs 40.Regarding vertebrae : lumbar are heart shaped , thoracic vertebrae have formin thoracis, spine of C7 vertebrae is longest 41.Vitamin B12 is primarily absorbed in : distal ileum 42.scenario of Iron def anemia 43.scenario of breaking bad news : should be told to patient in a formal session exclusivly… 44.for efficient patient doctor relationship best way to start conversation with the patient is : asking abt complains, asking abt his name, age, adress 45.regarding thyroid : active follicles are filled with colloid 46.regarding oxytocin and ADH : produced by ant. pituitary, produced by post. pituitary, produced by hypothalamus 47.QRS complex is slightly prior to : ventricular systole 48.which of the following predispose to malignancy : proto-oncogenes 49.Myxoid degeneration will occur in which : mitral valve prolapse, libman sacs, mitral valve stenosis 50.Cancer cells predominantly have Increased conc. of : vimentin, desmin, glial, keratin 51.which of the follow prevents flow of substances in intercellular space : tight junctions 52.most common cause of fatty liver in our country : Hep B & C , alcohol 53.Infective stage of Hep B : HBs antigen + and hbs antibody+,HBs antigen + and hbs antibody+,HBs antigen + and hbs antibody-,HBe antigen + and hbe antibody+,HBe antigen + and hbe antibody-, confirm it urself 54.9months pregnant lady fainted, liad down in left lateral position to prevent compression of : IVC 55.Aspirin prevents formation of : PGI2, PGE2, thromboxin A2 56.Strongest chemotactic agent : C5a way to diagnose thyphoid fever at 2nd week of presentation : blood culture , stool culture, serology, blood culture and serology 58.Antharax is 90 % associated with : cutaneous lesions 59.scenario of DIC 60.Hairy Leukoplakia is associated with : AIDS 61.Strongest prepotential is in : SA node 62.LevoDOPA is given in combination with Carbidopa : to increase its diffusion through BBB , to dec. its peripheral degenration parenteral nutrition : aminoacids are given in isomer form, all caloric requirment can be fullfilled by glucose only ,dec. chances of infection via enteral nutrition 64.boundaries of Digastric Triangle : anterior and posterior bellies of diagstric muscle and ramus of mandible 65.TB can be confirmed by : Presence of caseous necrosis , presence of epitheloid cells, presence of multinucleated giant cells 66.To tap pleural effusion best site to insert needle is : lower border of upper rib , upper border of lower rib, upper border of lower rib at maximum area of dullness 67.blood supply of foregut is primarily derived from : celiac trunck encountered fracture of femure in RTA, died after 5 days, cause of death : pulmonary embolism , sudden MI, Fat embolism 69.Neutrophillia will be seen in : chronic infection, viral infection, after an acute attack of MI 70.Hepatic pedicle is formed by : portal vein only, portal vein, common hepatic duct, hepatic artery (yes common hepatic duct was written in this option) 71.scenario regarding development of tunnal vision while taking ATT , caused by : Isoniazid , rifampicin, streptomycin, pyrezinamide, ethambutal 72.scenario of patient with b.p. 80/60, dec. CVP, inc. serum lactate dehydrogenase, tachycardia : septicemia , cardiac temponade, stroke , hypovolumia , CCF ( i marked) male of long hight, well developed , presented with complain of infertility what could be the cause : klinefilter syndrome 74.Nor-Epinephrine and Serotonin are degraded by : MAO, COMT 75.Most potent Response in massive haemorrhage is : CNS ischemic Response 76.regarding metaplasia wrong is : irreversible 77.In nephrotic syndrome oncotic pressure decreases due to : hypoalbuminemia 78.joint b/w pubic bones : symphysis 79.Isthmus of thyroid gland is present in front of : 2nd,3rd, 4th tracheal rings PAPER-II O&G BY DR.SAIQA 1. Alternative of schwan cells in CNS : oligodandrocytes 2. A surgeon has to operate a patient of ureteric stone located where ureter enter bony pelvis , best approach reagarding surface anatomy through which he can easily reach at this level of ureter is : at the level of bifurcation of aorta, at the level of formation of IVC, at the level of umbilicus , at the apex of sigmoid mesocolon (i marked) 3. transpyloric plane is located at : upper border of L1 vertebral body, middle of L1 vertebral body , lower border of L1 vertebral body ,upper border of L2 vertebral body, lower border of L2 vertebral body 4. Regarding Rectus sheeth tendoneous intersections : are 10 in no. , anterior and posterior rectus sheaths completly meet here, upper most is located near xyphoid process 5. Regarding Hymen : richly innervated , lined by stratified squamous epithelium 6. Histology of Vagina : str. squamous epithelium with abundant elastic tissue in submucosa, highly vascular, smooth muscles around 7. Histology of Ureter : small lumen tubular str. lined by transitional epithelium, with complete muscular coat 8. Mother contracted german measles during pregnancy , fetus is on risk of developing : congenital Catract, congental deafness 9. Risk of Congenital catract by Rubella virus can be prevented by : vaccination of girls of child bearing age 10.Which of the following can be palpated via lateral fornix of Vagina : ureter 11.tapping of patellar tendon causes : contraction of quadriceps muscle ( only quadriceps muscle was written , and this one was the correct one) 12.Which of the following is true regarding ureter : crosses superiorly to uterine artery (crosses posteriorly is right) , enters bladder at 90 degree ( always enter bladdder diagonaly ), located away from uterus 13.A statistical constant R is used to show relationship b/w two variables, best relationship can be demonstrated if the value of R is : +1, -1, 0 (i marked) , 0.5, -0.5 14.Pts of different races are coming at emergency , 50% are whites, 20% blacks, 20 % asians, best way to depict there percentages is : pie chart 15.Scenario of Randomised control trial 16.A diabetic asthmatic patient on Sulfonylurea developed acute attack of asthma, treatment was given, next morning she woke up drowsy with blood glucose of 40%, which of the following is responsible : STERIODS ( rest of the drugs given in options are not used for asthma, think reasonably :p ) 17.A Diabetic Patient on Biguanides can complain of : diarrhea and flatulence 18.Mechanism of action of MgSo4 : on NMDA receptors act via : glycine, GABA ( i marked), glutamate? 19.During later stages of pregnancy , Ripening of Cervix is caused by : Hydration of Collagen 20.Simple columnar Epithelium with Goblet Cells and submucosal lumphoid tissue : Ileum 21.Complication of Sepsis showing adverse prognosis : development of DIC 22.Patient presented with coagulopathy with dead fetus in uterus most imp. step of initial managment : Evacuation of Uterus 23.Diphosphoglycerate in stored blood : Inc. affinity of HB for O2, con. inccreases ovar time , shifts oxy-heamoglobin curve to left, product of glycolsis 24.Cytokine which causes damage to vascular endothelium : TNF-alpha 25.Most Common cause of hospital acquired infection is : Staph. aureus 26.IF factor IX is not available best replacement could be done by : Fresh frozen plasma 27.QUESTION RELATED TO DENTATE LIGAMENT AND FILUM TERMINALE , STATMENT WAS TOOO CONFUSING MENTIONING BOTH END OF SPINAL CORD AS WELL AS SUB-ARACHNOID SPACE 28.Most common injury encountered to pelvic diaphargm after difficult labour : levator ani ? sphincter urethrae ? 29.A pregnant lady presented to mobile medical team with high grade fevr, chills and rigors and black urine : Falciparum Malaria 30.Regarding autosomal Dominant disease : requires mutation of both genes , Often pleiotropic, expression and transmission is variable ( I marked ) 31.Halothane is a weak analgesic anaesthetic, it is always given in combination with which of following to increase efficacy : Nitrous oxide 32.Rapidity of action/potency of anaesthetic agents is affected by : lipid solubility ( lignocaine and another drug was given for comparison, ) 33.Blood supply to which of the following is reduced during intense exercise : brain, kidney, skeletal muscles , Skin 34.A lady is receiving radiotherapy for CA-Cervix, which of the following will be seen on histology : karyorehexis and karyolysis ( chemo and radio both cause apoptosis) 35.Acute effect of high dose Radiation : desquamation of skin , anemia, leukemia, endarteritis obliterans (confirmed from net) 36.Blockade of Sympathetics will cause acute onset of shock b/c of : loss of vasomotor tone 37.Oliguria is production of urine in 24 hours : less than 500ml, less than 100 ml, more than 1500 ml 38.Question related to aqueduct of syalvius : lateraly formed by mid brain , bad recall mcq 39.which of the following is benign : adenoma , hepatoma, carccinoma, sarcoma 40.which of the following cranial nerves have parasympathetic nuclei : III, VII, IX, X (PAPER I QUESTION) 41.Derivative of 2nd branchial arch : stylohyoid ligament ( repeated both in paperI and II) 42.muscles of the back are supplied by : dorsal rami of spinal nerves 43.wound healing impaired/delayed by local factor : infection 44.labour is initiated by : fetal ACTH ( no option of cortisol ) 45.Patient with normal amount of semen production but azospermia : defect in sertoli cells 46.GnRH regulates secretion of : FSH and LH 47.Transport of glucose across placenta is carried out by : na-glucose antiport, na-k-glucose cotransport, simple diffusion, biport( co-transport) yes these were options, since it is Na-glucose cotransport, i marked it , as co transport was given in brackets too 48.IN preganancy mother feels respiratory distress b/c of : effect of progesterone , inc. mint. ventilation , dec. in TLC ( asim shoib mcq) 49.young female with hx of multiple recurrent abortions : LUPUS/anti-phopholipid antibody levels 50.In females neck of bladder rests on : upper part/surface of urogenital diaphragm 51.Hypophysectomy will effect primarily : principle cells of thyroid, beta cells of pancrease, aplha cells of pancreas, cells of adrenal medulla, C-cells of parathyroid gland 52.Tricuspid valve can be best auscultated at : around right lower half of body of sternum 53.Fast pain is carried by : A-Delta fibers 54.A young female patient presented with pain RIF with hx of amenhorrea for 6 weeks, pregnancy test is positive : ectopic pregnancy, acute appendicitis ( if leucocyte count, nausea and fever mentioned) 55.Urogenital diaphragm lateraly attaches to : ischiopubic rami 56.Pregnant patient presented at 3rd month of pregnancy with Hb 12.5 g/dl, later on presented on 9th month with HB 10 g/dl normocytic, normochromic, cause of anemia : iron def anemia, normal physiological change 57.Pregnant patient presented with complain of easy fatiguiblity, HB 7.5 g/dl, MCV 58, MCH 15 cause of anemia : iron deficiency anemia , thalassemia trait 58.In patients with Thalassemia major diagnosis can be made by : increased levels of HBA2 and HBF 59.local anaesthetic MOA of ionized substances : cause blockade of Na-channels 60.Neuromuscular junction motor end plate : contains acetylcholinestrase 61.Female patient presented with hx of cough for 1 week, CXR showed diffuse patchy infiltrates of both lungs, gram stain of sputum showed normal flora few neutrophills and recovered in 2 weeks : H-influenzae 62.OLd male patient on immunusuppresive therapy psented with s/s of meningitis, Gram stain of CSF showed no bacteria but gram positve cells having halos around them : Cryptococcus Neoformens , Histoplasmosis, CMV 63.Patient presented with Hx dyspepsia, anemia, pale hands, spooning of nails, stool test showed OVA : Ancylostoma Duodenale , Ascaris 64.Sphincter Urethrae is content of : deep perineal pouch 65.34 weeks pregnant lady died in RTA type of death is : Fortitious death, direct obstetrical death , indirect obstetrical death (i marked), perinatal death, antenatal death 66.While doing appendectomy via incision at Mc’burney’s point structure damaged is : deep circumflex Iliac artery ( i marked) 67.superior boundary of inguinal canal is formed by : conjoined tendon 68.Primigravida presented with excessive bleeding after delivery drug of choice is : ergometrine , oxytocin 69.Which of the following acts through cAMP ,: Nor Epinephrine, GH 70.Elderly patients are prone to develop drug toxicities b/c of : dec. renal excretion 71.45 years old lady complain of weight gain , T3: 4, T4: 15 , TSH :8 , cause of weight gain : hypothyroidism, parahypothyroidism, hyperthyroidism, parahyperthyroidism, excessive eating ( i marked consider these values as normal, no range/normal value was given in statment, confirm it) 72.type-II hypersensitivity disorder : erythroblastosis fetalis 73.Graft rejection is caused by : HLA-mismatch 74.Withdrawal reflex is caused by : nociceptors 75.falling of ovaries into abdomen is prevented by : broad pelvis (i marked) cant recall correct statment and options 76.Uterus remains in position by : Cardinal Ligament , broad ligament, round ligament 77.Prolactin secretion is controled primarily by : prolactin release inhibiting harmone 78.Patient presented in ER with PCO2 30 %, PO2 : 95% , Ph 7.35, bicarbonate : 15, PCO2 40 % ( pco2 value was given two times) : compensted respiratory alkalosis, compensated metabolic acidosis, uncompensated respiratory acidosis 79.Patient having menstrual cycle of 32 days will ovulate on : 18th day, 16th day, 10th day, 14th day 80.Which of the following will cause bradycardia : occulocardiac reflex, rest options were wrong 81.Neoplasm having rete ridges , malignant infilterating epithelial cells : Verrocous carcinoma 82.In pregnancy there is : hypoalbuminemia 83.Lymphatic drainage of skin around anus : medial group of superficial horizontal lymph nodes 84.Toxiod used for vaccination purpose is : tetnus 85.Bite cells will be seen in : G6PD def, thalassemia , sickle cell anemia 86.Mst lethal toxin produced by streptococcus pneumoniae is : streptolysin( i marked) , fibrinolysin 87.patient presented with enlarged pectoral group of lymph nodes , maliganat tissue will be present in which lobe of breast most likely : upper,outer quadrant 88.Inferior layer of urogenital Diaphragm : perineal membrane 89.Breast lobes surgicaly are : discrete entity with in breast tissue, separated by interlobar stroma (yes it was written as stroma, not septa, i marked) 90.which of the following is benign tumour: wilm’s tumor, warthin tumor 91.septum primum and septum secundum fuse to form septum which separtes : common atria into right and left atria 92.testies drain into : para-aortic lymph nodes 93.Best way to diagnose intraamniotic infection is by : detection IL-6, Gram stain of amniotic fluid ( i marked) 94.Full term pregnant lady presented with high grade fever of 103F and complain of clear water discharge from vagina : chorioamnionitis ? , UTI ( i marked) ( medsacpe said in chorioamnionitis there would be foul smelling vaginal or amniotic fluid discharge, with high grade fever, maternal and fetal tachycardia, abd.tenderness) 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