Tanveer Notes for FCPS Part 1

Tanveer Notes for FCPS Part 1

All The Important CPSP

Points[2015-2016]

Session # one ; in case of mistakes, if any, feel free to ask at my e-mail ..

1- Patient with bone pains having normal Calcium,Inc Alkaline phosphatase most likely suffering from = Pagets Disease (note ;

Osteoporosis = Labs are normalPagets disease = only ALP is raisedOsteopetrosis = Only Ca is dec

Osteomalacia = Vit D dec dec Ca & phosphates inc PTH & ALP )2-.Erythropoises occurs in middle trimester mainly from = liver

(Regarding Fetal erythropoiesis ●3 to 6 weeks = Yolk sac

●6 weeks till birth = Liver ●10 to 28 weeks= Spleen

●18 weeks to adult = Bone Marrow)3-Vertebrae is derived from = Sclerotome,

4-Memory center is located in = Temporal lobe ( note ; for Dejavu = temporal lobe)5-The most common type of salivary gland tumor is = Parotids

6-Distruction of Ant.pituatary gland causes dec.functioning of = Glom.fasiculata

( Remember the Mnemonic GFR ie

●Glomerulosa aldosterone and this one is under the control of Angiotensin not ●Fasiculata Cortisol and this one is under the control of pituitary ●ReticularisSex steroids )

7- A normal looking Girl came to you with primary amenorrhea, on examination she was having short blind vagina wid normal vulva, scanty pubic n axillary hairs, normal breasts, absent uterus, her karyotype is = 46XY ( blind vagina and absent uterus always mean XY until proved otherwise )

8-Nerve supply to extensors of arm is supplied by = Post cord (Radial nerve is from posterior cord )

9-Nerve injured in Ant dislocation of Shoulder joint is = Axillary10-Damage to scaphoid bone causes injury to = Radial Artery11-Common site of fracture at rib is = Angle

12-Following is not a tumor marker = Acid Phospatase

13-Most common histology found in lung tumors is = Adenocarcinoma

14-Patients comes with Rt. deviation of tongue, Dec.sense of touch and vibartions,the artery commonly involved in brain is = Ant.Spinal artery ( whenever u see deviation of tongue in such a scenario, look for ant spinal artery in options )

15-Soldier comes with heavy bleeding,the ideal fluid replacement would be = Whole blood for 3 days ( same for same, ie for heavy blood loss, prefer blood )

16-Maxillary sinus opens into = Middle meatus

17-Patient having increased levels of IgE,most probably suffering from = Parasitic infection

18-Autospy done on the patient having CRF,most prabable finding would be =Hypertrophied PTH gland

19-Excitation of hypothalamus would cause = Shivering

(note for hypothalamus remember that

ANTERIOR is for cooling and POSTERIOR is for heating

ANTERIOR is parasympathetic center while POSTERIOR is sympathetic) 20-Foetal period starts after which week =8th

(3-8 weeks = Embryonic period, this is most sensitive to teratogens, while fetal period starts after week 8)

21-Patient having dec levels of factorII,VII,IX,X,most likely have = Dec Vit.K

( memorize vit K DEPENDENT FACTORS by 1972 ie factor 2,7 .9 ,and 10 consider 1 as = Factor 10 )

22-Young pt having Hb:6.0,TLC:3.5/ul,Plts:1lac is suffering from = Aplastic anemia23-Nucleus ambigus supplies = Larynx

(Nucleus ambigus is for IX,X,XI ie cranial nerves 9, 10, 11 also remember that the parasympathic nucleus for vagus nerve is DORSAL NECLEUS, ASKED REPEATEDLY IN PAST PAPERS)

24-Olfactory area is present in = temporal gyrus ( this the only sensation that doesnt pass through thalamus )

25-Patient with injury to left 8th cervical segment of spinal cord will not show following sign = Dec sense of pain and temperature below the lesion on same side (pain and temp loss are contralateral ie opposite to the lesion , while position and vibrations senses are ipsilateral)

26-Feature of Rickets and Osteomalacia is = Decreased bone density 27-Mostcommon site of malignancy in pts suffering from nuclear outbreak =

Hematopoietic (dont confuse it with head and neck radiations that causes papillary thyroid cancer)

28-Virus acts on cells by = Involving protein synthesis29-Most sensitive cells to hypoxia are = Neurons30-Myelin in CNS is formed by = Oligodendrocytes

31-Feature not associated with irreversible cell injury is = Myelin figures(For cpsp always remember Myelin figure = Reversible injury)

32-Ureter is not constricted at = Psoas muscle

33-Common relation of ureter is = Ant.to gonadal vessels and post.to iliac Artery 34-Patientfeels pain after she underwent surgery for fibroids, structure injured would be = Ureters

35-Least common site for ectopic pregnancy would be at = Ovaries

36-Gall bladder is supplied by = Only Cystic Artery

37-Venous drainage of urinary bladder is into = Internal Iliac Vein

(those who appear in Gynea exam, should cram the whole anatomy of urinary bladder)

38. Patient with fluid loss now show metabolic acidosis e hypokalemia. most fluid loss will be through = Colon ( colon is reservoir of HCO3 & POTASSIUM, and in diarrhea both are lost resulting in acidosis and hypokalemia

39-Patient having hyperplastic bone marrow, anaemia, Increase Platelets is probably suffering from = Leaukemia

40-Stimulus for Erythropoietin secretion is = Hypoxia

41-Erytropoiten is always raised in = Sec.polycythemia

(Polycythemia vera is only type of polycythemia in which there is Dec. EPO)43-Patient after gastrectomy is on VitB12,the cells lost in the gastrectomy = parietal

44-Fat tags attached to the walls of large intestine are known as = Appendeces epiplocea

45-Bile salts are reabsorbed from the = Ileum

46-Following is an autosomal dominant disease is = Hereditary spherocytosis47-Type of defect in Hereditary spherocytosis = Structural defect

48-Patient with jaundice, anaemia,high reticulocyte count is having = Hemolytic anaemia

49-Ejaculatory duct opens into = Prostatic urethra

50-Terminal part of CBD in relation to pancreas is = Embedded into pancreas51-Following would cause massive infarction and destruction leading to patient death = Thromboembolism

52- A 22yrs female pt.with 13th week of pregnancy after having crush fractures in RSA dies after 3 days, most likely cause of death is = Fat embolism

(Note that if fracture and 3 days duration are not mentioned then better option will be amniotic fluid embolism ie it causes immediate deaths)

53-Patient with old history of adenoCA of colon is operated for polypectomy,on histologic evaluation pathologist labelled it as benign growth with no chances into malignant transformation,it would be = Tubular adenoma

54-Tyrosine derivative doesnt include = Prolactin55-Precursor of steriod hormone is = Cholesterol

58-Wasting of thenar eminence,loss of sensation over thumb and index finger,nerve involved is = Median ( Regarding wasting of the thenar eminence always click median nerve)

59-The base of urinary bladder is made by = Post surface

60-Shock without having vasodilation is likely associated with = Burns61-Following doesnt form the layer of inguinal canal = rectus abdominus62-Femoral sheath is formed by = Fasica transersalis and Fasica iliaca63- The muscle involved in unlocking of knee joint is = Poplitus,64-External spermatic fascia is formed by: = External oblique

65-In Turner syndrome, the genotype would be = XO66-Organ having least chances of infarction = Liver67-Type of necrosis in brain infarction = Liquefactive

68-Pt.with cervical lymphadenopaty,+ve AFB sputum,sign to look for TB on microscopy is = caseous necrosis

69-Thyroid gland moves with swallowing because it is enclosed in = Pretracheal fasica70-Neurovascular bundle in chest wall lies between = Internal and Innermost layers71-Fibrous pericardium and mediastinal pleura is supplied by = Phrenic Nerve

( Remember the Mnemonic i-e

●Fibrous pericardium = Phrenic (frenic) nerve ● Visceral pericardium = Vagus nerve)

72-Man is suffering from testicular ca,the lympahtic drainage of testis is into = Para aorticLymph nodes

73-In exercise,the venous blood returns to the heart by = Muscle pump in calves74-Circulation in heart is maintained by = Local metabolites

75-Fisherman is presented with gingival bleeding and ecchymosis,he is suffering from = Vit C deficiency

( NOTE ; In vit B12 def due to Diphylobotram Latum among the fishermen, they wont mention points like gingival bleed and ecchymosis)

76-Factor affecting collagen synthesis during healing is = Vit C

77-Mesothelioma is associated with = Asbestos

78-Child having meckels diverticulum is having bleeding per rectum,it is due to = Ectopic gastric tissue

79-During lactation,Amenorrhea is due to = Inhibition of LH and FSH80-Presence of pancratic tissue in gastric mucosa is termed as = Choristoma( The other site for choristoma is Brain tissue in Nasal cavity )

81-Main difference between primary and secondary intention wound healing is = Wound contraction

82-Child with sore throat after 3 weeks developed oedema,haemturia,cause would be = post streptococcal GN

83-Microscopic feature of polyarterites nodusa is = Fibrinoid necrosis (for any vasculitis remember fibrnoid nerosis, for brains liqufactive and for solid organs remember coagulative necrosis , TB also has a type of coagluative necrosis)

84-Angiotension II exerts its effects by activating = Aldosterone

85-Tumor compressing optic chiasma would cause = Bitemporal haemianopia86-Growth hormone is maximally rasies in = Exercise

( ●For max growth hormone sec NREM sleep > Exercise > REM

● if only sleep is mentioned then prefer Exercise and if NREM sleep is mentioned then click it)

87.Lymph drainage of perianal skin is from one of the following = medial group of horizontal superficail nodes

88.Lesser omentum = .connects with deudenum

89.Which of the following is not a feature of shock = increased urine output90.Which is most imp indicator of muscle protein loss = urinary nitrogen

91.what is true about DNA = .Double stranded in which two strands are antiparallel to each other

92.Least chances of renal stones is associated with = Hyperlipidemia

93.A pt came to you with primary amenorrhea, webbed neck, short stature diagnosed as Turner syndrome, what is her karyotype = A.45XO

94.supply of sphincter urethra comes from = .Pudendal nerves

95.Thymus develops from = endoderm of 3rd brachial pouch

96.A pt presented with an opening in the ant wall of sternocledomastoid muscle with pussy discharge coming out of it.this problem occurred due to abnormality in one of the following = 2nd pharyngeal cleft

97.Diaphragmatic hernia occurs due to = absence of pleuro-peritoneal membrane

98. Adult derivative of notochord is: = Nucleus pulposis99.Superior parathyroid gland develops from = .4th brachial pouch

100.In cervical carcinoma,what is the lymph drainage = both internal & external iliac

01. Cervical rib attached to transverse process will compress = T1(though it can Compresses both C8 and T1 )

02. Aortic aneurysm which structure not compressed = Phrenic nerve

03. Resting membrane potential achieved by =Diffusion of potassium outside the cell

(Achieved by K efflux, maintained by N-K ATPase Pump while depolarization is maintained by Na influx)

04. Liver weight = 1.5 kg (1.44-1.66 kg is Range)

05. What is median if values are 20 20 25 30 35 40 25 30 = 27.5

(Arrange in Ascending order 20 20 25 25 30 30 35 40 than take middle two values 25+30/2=27.5)

06.. Dead organisms in vaccine = Pertussis

(Pertusis, Cholera, Influenza ,Inj Polio & Rabies all Killed vaccines while Tetanus is Toxoid and MMR is Live attenuated)

07.Esophagectomy done , stomach is mobilized to upper portion of thorax, To anastomosis with pharynx Which artery is responsible for stomach supply = Right gastroepiploic

08. Patient is pregnant and suddenly faints. She’ll be positioned in left lateral and not right lateral to avoid compression to which abdominal structure = IVC

09.Post op wound having greenish pus discharge organism involved = Pseudomonas

10.Prevalence is = All cases

(Prevalence: All current cases (old & new) while incidence is just new cases)11. Common carcinogen of CA Cervix = HPV

12.Apex of the heart = 8 cm from median plane

13.After normal delivery in primigravida the alive n healthy new born is given feed = After half hour ( Nelsons states 1 hour, but prefer half hour if in options )

14.Diagnostic tumor marker for ovarian CA = CA 125

15.Which of the following prolong use of drug will cause persistent increase in Gastrin secretion = PPI

16.A pt presented to his dentist due to inability to put his dentures, dentist referred back to physician saying there is no dental problem, where is the lesion = Substantia nigra

17.Chronic Myeloid Leukemia = Chromosome 9 & 22

18.Steroids drug action on cells = Act on Genes (all steroids & thyroxin act on genes)

19.ADH is inhibited by = Alcohol

20.A tumor with all germ layers = Teratoma

21.Following has high clearance value = . PAH

22.Scanty bar bodies = . Turner (REMEBER IF ASKED

Bar body diagnostic of then = klienfilter

scanty bar body or no bar body then = turner

bar body TEST is diagnostic for = turner)

23.Which parasite is not transmitted thru orofecal route = Trichenella Spiralis(Humans get it when they eat infected meat/pork )

24.Organelle having microtubules in its structure = Centriole

25.S1 nerve root lesion = . Loss of Ankle jerk

26.Mucus not secreted by = Terminal bronchioles

27.Which of the following increases lower esophageal tone n speeds up gastric emptying time = Metoclopramide

28.Diphtheria vaccine reaction = :type 3 ( remember any serum will cause serum sickness ie type 3 hypersensitivity )

29.Femoral nerve drived from which section of spinal cord = . L2 L3 L4

30.Deep coma is caused by lesion of which nucleus = . Nucleus cerelous

(REMEMBER IF ASKED

Deep coma then nucleus cerelous

Prolonged coma then Periq aquiductal gray matter ( p for prolonged & p for periquiductal &

●permanent coma = thalamus )

32. A man of 70 has recurrent UTI cause = Outflow Obstruction

(old age chances of BPH lead to outflow obstructionleading to recurrent UTI)33. Normal FEV/FVC1 Ratio = 0.8

34. Compression effects on esophagus by which organ enlargement = Left Atrium35. Plasma Protein Binds With All Except = Oxygen

36. Patient presented in emergency, deeply comatosed,not responding to nalaxone: =

Phenobarbital

37. Cause of Mental retardation = Fragile X Syndrome ( if down syndrome is mentioned then click it, because Fragile X syndrome is the 2nd most common cause)

38. In IV drugs abusers = Bacterial Endocarditis ( STAPH ARUEUS)39. Highest bioavailability of anti-emetics = Metacloprmide

40. X.ray of elbow of 12 yr girl, which Secondary ossification center will appear last on x.ray = Lateral Epicondyle

(capitellum > radial head > medial epicondyle > trochlea > olecranon > lateral epicondyle 1 , 3 , 5 , 7 , 9 , 11 (ODD Numbers so 11 is lateral epicondyle)

41.Baby born on 4th day most common cause of Meningitis = E.Coli(REMEBER : in newborns, GROUP B STREP GROUP ie strep agalactea IS ON THE TOP)

42.A tall man with normal external genitalia married but had no kids he had normal ejaculation period but semen analysis showed azospermia cause may be=Sertoli cell

43.Pregnant lady anaemic, Best lab investigation = CBC

(IF ASKED IRON DEF ANEMIA THEN SERUM FERRITIN, TIBC may give false value, cz its affected by pregnancy)

44. Highest percentage of protein in = HDL (NOTE THE POINT; IF ASKED HIGHEST THEN

●PROTEIN = HDL

●TGs = CHYLOMICRON > VLDL

●CHOLESTEROL = LDL)

45.Soft Keratin with no nucleus found in = Stratum corneum

46.A newly married female came with pain in rt illiac fossa her TlC 12000 she has fever n vomiting her lmp was 3 weeks back what is diagnosis = Acute Appendicitis

47.Open wound healing includes = Contraction of myofibroblast

48.Patient aged 65 years, is diagnosed to have severe aplastic anemia. HLA compatible sibling is available. The best option of treatment is: = Anti thymocyte globulin followed by cyclosporine

(REMEMBER ;

●ATG & CYCLOSPORIN = 1st line for non-severe aplastic anemia , or severe aplstics >

40years og age or sever aplastic who have no HLA identicl sibling donor ….

●HSCT (transplant ) = 1st line for the patients who have sever aplatic and have HLA MATCHED sibling donor)

49.Most common S/E of use of histamine 1 blocker = Sedation

50.Decrease Insulin will = Ketogenesis in Liver

51.An obese man with h/o atherosclerosis underwent laparotomy due bleeding in abdomen and during surgery his small gut was purple n sup mesenteric vein was ok so what is dx =

Wet gangrene

52.First heard sound is produced during = Isovlumic contraction

53.A patient came with c/o bitmep hemianopia so a blockage was seen at = Upper part of optic chiasma ( best ans is optic chiasma, but if both upper and lower part are in options, prefer the upper part of optic chiasma )

54.30 yr male newly diagnosed wth HTN, on ECG lt ventricular hypertrophy, serum cholesterol 200, FBS 88 mg%, urinary sugar ++ RFTs were normal, K 2.5 , Na 140, what is cause of his HTN = Primary hyperaldosteronism

55.Man With Weakness And Dysphagia, Blood Profile With Target Cells = Iron Deficiency Anemia

56.Which of the following in maternal serum for rubella should b an indication for termination of pregnancy = Ig M

57.Epithelium of Conjunctiva = Stratified Columnar Epithelium ( non-keratinized )

58. Antioxidant Vitamin = vit E (REMEMBER IF ASKED ●Potent one then = Glutathion > vit E

●among vitamins then = vit E > vit C)

59.Which of the following does not increase in stress for surgery = Insulin

60.Monitoring of HEP B virus can be done via = . SGPT (or ALT)

61.Diseased ovary pain radiating to medial thigh of body due to nearby presence of = Obturator Nerve

62.Biguanides side affects = Diarrhea and flatulence

63.Patient with Gastrectomy presents with Anemia after One and half year, what will you give = Vit B12

64.Data is collected for some clinical trial based on presence or absence of Vomiting. What type of data it is = Nominal (whenever asked about nominal remember = its the data type where u have to ans between the two variables like YES OR NO, RIGHT OR WRONG , PRESENCE OR ABSCENCE etc while ordinal gives u order like PRIMARY > SECONDARY > TIRTIARY)

65.Aphasia (Non-fluent) after stroke or Trauma which area of Brain is involved = Brocas(fluent aphasia is due to wernickes area involvement)

66.What cytoskeletal structure connects Extracellular matrix to Intracellular =intermediate filaments (Also remember that C for Cadherin and C for cell; so it mediates cell to cell attachments and is important in case of metastasis)

68.Cardiac defects in fetus of mother suffering from rubella infection will occur if = 5 th to 10th week

69.Dorsal Column Medial Leminsical carries = Proprioception

70.Contralateral loss of pain and temp at T9 and ipsilateral loss of proprioception below T8, bilateral normal reflexes = Lesion of spinothalamic tract at T8

( In these scenarios always decide the level of lesion by the level at which there is loss of peropioception like in this case T8 is given so lesion should be at T8 )

71.Downs Syndrome = Increase incidence with increasing mother age

72.Pulmonary vasoconstriction occurs due to = Reduced systemic PO2 ( this concept is repeatedly asked in many ways but the basic concept remains the same ie HYPOXIA CAUSES VASOCONSTRICTION IN PULMONARY VESSELS, )

73.Most imp buffer in blood = HCO3

74.Gastrin secretion is inhibited by = Somatostatin

75.Which vitamin act as cofactor in oxidation of fatty acids = Biotin

76.Oxytocin and vasopressin originated from = Hypothalamus

77.If FACTOR IX not available = FFP

(cyropreciptate is for factor 8, so to memorize pronounce it as CRYOPRICEPIT-8)

78.All of the following will cause lesion at genital tract except = Gonorrhoea

79.Vagus decreases HR by which mechanism = Na (permeability) ( the mechanism is , parasymp system decreases Na CHANNELS INWARD CURRENT THAT IS RESPONSIBLE FOR PHASE 4 DEPOLARIZATION IN SA NODE )

80.Maximum absorption of water = Jejunum

81.Patient with beta blocker ECG show increase PR = Drug induced block

82.Drug causing peripheral neuro and pancreatits = Diadenosine

83.Left Kidney is not related to = Diaphragm

84.What age the head of fetus become exactly half the length at CRL = 3rd month

85.Prostatic carcinoma spread to skull bones through = Vertebral plexus

86.First heart sound = Isovlumic contraction

87. Pregnant women 1st trimester develops Atrial fibrillation what would u give = IV Heparin

88. The tumor which is the ovarian counter part of seminoma of the testis is =

Dysgerminoma

89.Patient came in with sore throat, fever and lymphadenopathy. His monspot test was positive. His blood shows atypical leukocytosis. What is the type of cell that is affected =B- cell (REGARDING INFECTIOUS MONONUCLEOSIS IF ASKED

●Type of cell affected then = B CELLS

●Atypical cells that proliferate in response then = T CELLS)

90.Pt was brought into the Emergency Department and his family wanted to accompany him. What is the most appropriate response = Only pt should be allowed in the ER

91.A pregnant full term patient came into the ER with pre-eclampsia. Her Blood pressure was 190/110. She was admitted for emergency ceserean section. What is the best medicine to bring down the blood pressure = Hydralazine

92.Patient was admitted in the ICU. HE had a central venous catheter for 10 days. HE started having fevers. Blood cultures were sent. It came back positive for Gram positive cocci in clusters. What medication will you start = Vancomycin

(Always mark Vancomycin if CVP line,Indwelling catheter or double lumen site Infection especially in hospitalized patient and that too in ICU or dialysis units. High prevalence of MRSA.)

93.Pt comes in to the emergency department with seizures. His BP is 90/60. His serum calcium level is 6, serum cortical level is 6 microg/dl , blood sugar level is 80 mg/dl. What is the diagnosis = Tetany

94.About Lignocaine what is true = Prevents influx of Na ions across membrane

95.INR is for = Oral anticoagulation therapy:

( For warfarin monitering INR >>> PT )

96.A Person wid malignant melanoma. Risk factor = Xeroderma pigmentosum

97.Diabetic patient with DKA died due to = Mucormycosis

98.Urethra is narrowest at = External meatus

99.Married man had no children for few years and was diagnosd as sterile with azoospermia wat is investigatn of choice = Serum FSH and LH

200.A man goes to a high altitude 02 delivery to tissues is maintained by = Hb conc is increased

01. Regarding indication of furosemide = Acute pulmonary edema

02. A patient was brought to the hospital after a roadside accident. On examination he was pale with low blood pressure and fracture of left 10th rib. Which organ is most likely to be injured = Spleen

03. Most common cause of premalignant change in mouth in adult = Lichen planus ( some colleagues saying chronic ulcer, none of the authentic books support that , and one more question often asked, thats , what will beetle nut chewing cause and ans is submucosal fibrosis,)

05. Tumor in children with blue cells and high levels of catecholamines = Neuroblastoma06. Ligament that prevents anterior dislocation of femur on tibia = Posterior cruciate

(NOTE; if anterior dislocation of tibia on femure is mentioned then anterior cruciate ligament)

07. Cholangiocarcinoma caused by = Cholonorchis Sinensis08. Trauma to left 10 rib causes damage to = Spleen

09.Farmer wid migratory lesion on foot = Cutaneous Larva migrans

10.Washed RBCs are used for prevention of = Hypersensitive Reaction

11.Eating raw or undercooked meat can cause infection by = Tapeworm

12.Man comes 1st time to Pakistan develops fever than coma, on investigation retics10%..Platelets wbcs = Falciparum

13.Correct about Aorta =. Gives renal arteries at L2

14.Scrotum drains to = Superficial Inguinal Nodes

15.Small muscles of hand are supplied by = T1

16.Pancreatitis(acute) will cause fluid accumulation in = Lesser sac

17.Deep ring present in = Fascia transversalis

18.Eversion is done by = Peroneus longus

19.True about Thoracic duct, drains into = At Confluence of left Subclavian and left Jugular

20.Gustatory sweating is caused by = Superficial Parotidectomy

(Freys Syndrome produces flushing and sweating instead of salivation in response to taste of food after injury of AURICULOTEMPORAL which carries Parasympathetic secretomotor fibers to PAROTID gland and Sympathetic fibers to SWEAT gland. When the nerve is severed the fibers can regenerate along each pathway and innervate the wrong gland. It can occur after Parotid surgery and may be treated by cutting the tympanic plexus in middle ear- Ref BRS Anatomy)

21.Analgesic causing tachycardia in therapeutic dose = Pethidine

22.Following is a good analgesic but weak anaesthetic = NO

23.About Posterior Triangle of Neck what is true: = Contains subclavian , three trunks of brachial plexus

24.Herpez simplex virus transmitted by = .droplet

25.Pt came in with abdominal pain, his amylase was high, he was diagnosed with Pancreatitis. What is his omentum going to show = Fatty necrosis

27.Which carcinoma doesnt show distant metastasis = Basal cell Carcinoma

28.Orofecal transmission = HEV

29.When tension in muscle increases near to rupture which does the relaxation = Golgi tendon organs

30.Golgi tendon organs respond to = Tension ( FOR BOTH 129 AND 130 QUES

REMMEBER = TENSION AND TENDON i.e when tension on a muscle increases golgi tendon organs starts firing and relaxes it )

31.Pacemaker of Heart = SA Node ( reason for being master is, SA node generates impulses at faster rate, if asked , never be confused by points like automaticity etc)

32.Parasympathetic stimulation = Decreases HR

33.Sacral hiatus is formed due to = Failure of fusion of laminae of 4th and 5th sacral vertebrae (Sacral Hiatus is used to administer Caudal (Epidural) anesthesias)

34.Effect of drug on a body = Pharmodynamics

( MNEMONIC = D FOR DRUG & D FOR DYNAMICS ie drug on the body is dynamic )

35.Which is not blood supply of scalp = Maxillary artey

36.Hydroxyindol-acetic acid in urine = Carcinoid syndrome

37.Pt came with testicular mass. It was diagnosed as a yolk sac tumor. What is the follow up marker for this patient = Alpha-Fetoprotein

38.In the hospitals most common cause of wound infection = Staph aureus (Ecoli 2nd most common)

39.Nerve loss in urogenital triangle which nerve involved = Pudendal Nerve

40.Neck of femur supplied by = Medial and lateral circumflex arteries

41.A man having recurrent bacterial infections with streptococci also having diarrhea which on examination showed giardiasis, urther exam revealed normal T cells but B cells levels of igM,igG and igA were given = Bruton’s agammaglobulinemia

42.True about Pituitary = Drains to dural sinuses

43.About Quadrate lobe, true is = Drains by left hepatic duct

45.Barr body is found in the following phase of the cell cycle = Interphase ( both DNA and choromsomes replicate (Karyotyping is done in metaphase stage to study for chromosomes )

46.Old woman with swelling on external ear she also had gout wd -ve bifringent type crystals scenario was given = Monosodium urate

47.After Cholecystectomy surgeon places drains into = . Right Subhepatic Region

48.Pt having H/o cough cloudy yellow colour effusion fluid containing 98 % neutrophil nd 2% lymphocyte the fluid was dull to percussion = Purulent exudate

49.Isoniazid causes side effects which can be prevented by taking which vitamin =Pyridoxine

50.Gas gangrene. Cause of death = Toxemia

51.Not a feature of malnutrition in adults = Thrombocytopenia

53. A tumor with all germ layers = Teratoma54.Downs syndrome = Trisomy 21

55. Ankylosing spondylitis is associated with = HLA B27 ( PAIR ie

PSORIASIS , ANKYLOSING SPONDELYTIS , INFLAMATORY BOWL DISEASE RELATED ARTHIRTIS AND RIETER SYNDROME)

56. Female with fever for 10 days and chest pain that aggravates on lying down. Pain is originated at = Pericardium

57.6 years old patient presents with rhinitis, edema and urticaria on external surfaces =Type I hypersensitivity

58.Immediate effects of severe hypotension = Oliguria

59.Transfusion reaction will occur if we transfuse a person with A+ve blood group, the following group = AB-ve

60.Epidural space is widest at =. L2 (5mm)

61.Commonest cause of hepatocellular carcinoma in developing countries = Both Hepatitis B & C (IF B plus C COLLECTIVELY not MENTIONED THEN CLICK ONLY Hep B)

62.Connections that connect cells; with movement of ions across =. Gap junctions

63.HLA B27 associated disease = Reiters Syndrome ( if ankylosing spond present in

options prefer that )

64.Pregnant lady with bile duct obstruction. Diagnostic investigation = GGT (FOR NON PREG = CLICK ALP )

65.About Trichomonas vaginalis what is correct = Is sexually transmitted

66.Anion gap = Diff between measured cation and measured anion

67.Occulomotor nerve supplies = ciliary ganglion

68.Infective endocarditis diagnostic investigation = Blood culture (blood culture for diagnosis & ASO titre FOR THE EVIDENCE OF INFECTION )

69.Essential fatty acid = Linoliec acid (Also Linolenic Acid is among essentials)

70.Patient was brought to the ER unconscious. The doctor gave Naloxone but it was not

working. What is the likely cause of toxicity = Phenobarbital

71. Patient lacerated the dorsal part of his wrist accidentally. He came in with difficulty to adduct the fingers and difficulty abducting the thumb. Which nerve was paralysed = Ulnar Nerve

80.Pain from lower inferior segment of Diaphrgam = Subcostal Nerves ( Phrenic supplies central tendon of diaphrgam)

81.Cingulate gyrus blood supply = Anterior cerebral Artery

82.Dorsal Vein of penis drains into = Greater Saphenous Vein

83.Internal carotid bleeding stopped by compressing = C6

84.A patient has nodule on vocal cord. The most unlikely mechanism = Atrophy

( Hyperplasia = click it if asked the most likely )

85.Edema of acute infection. Feature = Proteins >3gm (EXUDATE)

86.Vein not draining to great cerebral vein = Occipital

87.Extent to which a tissue gets disturbed by occlusion of its blood supply depends on =Rate of development of thrombosis

88.A 15 years old girl with fixed dilated pupils. Lesion is at = Oculomotor nerve

89.Axon arise from conical shape part of neuron cell body called = Axon hillocks

90.Peptic ulcer profusely bleeding from posterior wall of duodenum which artery involed = Gastroduodenal Artery

91.Proteins that escape into tissues from blood vessels = Reabsorbed by lymphatic system

92.Epithelium of kidney = endoderm + mesoderm

93.8 mnth Baby boy with repeated rhinitis 2episodes of pneumonia in less then 2 mnth.low plasma B cells n decreased immunoglobulins = IgA deficency

94.Which is not a ‘basic tissue of body = . Blood

95.A 30 years old man had a road traffic accident and sustained fracture of femur. Two days later he developed sudden breathlessness. The most probable cause can be = Fat Embolism

96.Carpal Tunnel Syndrome = Wasting of thenar muscles

97.Which of the following statements about carcinogenesis is false = Papilloma virusesproduce tumors in animals but not in humans

98.Max potassium absorption occurs in = PCT

99.Lung capacity increased in inspiration by 2/3 by = Diaphragm

300. Pitutary Gland Causng Bitmemporal Hemianopia .Where is the lesion = Optic Chiasma

1.Hypermagnesemia = Neuromuscular depression ( hypo-Mg causes depressed deep tendon reflexes, muscle weakness, if dec acetyl choline release is present in options , click that)

2.Brain blood flow is regulated by = PCO2

3.Confidentiality can be breached = if patient authorize you

4.H202 in which organelle = peroxisomes

5.Cannot regenerate = Lens

6.2nd arch derivative = Stylohyoid

7.Liquefactive necrosis = in brain

8.Golgi muscle tendon = causes muscles relaxation

9.interstitial lung disease with non-caseating granuloma & hilar nodes = Sarcoidosis

10.Most common genetic disorder = Multifactorial11.Muscle of fright and Sadness = Platysma

12.Throid lymph Drainage = deep cervical lymph nodes13.Temporal artery is related to = Auriculotemporal nerve 14.Acute Renal failure part affected = PCT

15.Shoulder pain referred from pleura =C345 16.Lt suprarenal drain = Lt renal vein17.Councilman bodies seen = Apoptosis

18.Basic drug binds = alphaglycoprotein ( while acidic drugs bind albumin )

19.Case control typical scenario = disease and not diseased 20.ICAM and VCAM = adhesion molecules

21.Symphysis pubis joint = Secondary cartilaginous joint ( all midline joints are secondary cartilaginous joints like symphisis menti, joint between vertebrae, symphysis pubic etc )

22.Pyogenic peritonitis Bacteroids

23.Dif f Malignant and Benign tumors = metastasis24.Microscopic feature Malignant tumor = invasion25.Goblet cells covert to Clara = Terminal bronchioles 26.No lymph nodules = Thymus

27.Megalobalstic anemia invest = Intrinsic factor antibodies28.Scenario Achondroplasia = Autosomal dominant

29.Pt lying on bed at room temp = Conduction

30.Decrease Gentamicin clearance in old age = Decrease renal func

31.Congenital cataract = Rubella

32.Virus act by =altering proteins synthesis 33.No valves seen in = SVC

34.Pt support in our culture =family 35.Fast pain fiber = A delta

36.Preganglionic nerve fiber = B fiber ( while post ganglionic are C fibers, and if aksed pure autonomic fibers, then prefer B fibers, and dont confuse B fibers with A beta fibers)

37. Definitive diagnosis of TB = sputum AFB38.Extraembryonic coelomic membrane = endoderm 39.Not isotonic to plasma = 5% dextrose water 40.Ventricular filling-= 3rd heart sound ( S1 = isovolumic contraction, S2 = isovol relaxation & S4 = atrial kick )

41.Organ which utilizes glucose brain ( if asked cell then click Rbcs) 42.Lower motor neuron lesion = flaccid paralysis

43.CNS myelination = Oligodendrocytes

44.Flight or fright Stimulation = Decrease release of bronchial secretions

45.Atrial fibrillation = Pulse deficit

46.Hot sunny day, sudden collapse = Excessive sweating47.C1 vertebra feature = lacks vertebral body

48.Dec plasma proteins = Inc GFR

49.Cardiac reserve = Max % by which CO can be inc above normal 50.Osmosis depends = no of particles

51.5% dextrose in large amount given = ADH inhibition 52.Betel nut chewing causes = sub mucosal fibrosis 53.TB antibodies are = Cell bound

54.Regarding HIV = decreases helper T cells

55.Most imp response in shock as a whole = CNS ischemic response 56.In Iron def anemia in pregnacy, Increased = TIBC

57.Acute glomerunephritis proteinuria = Basement membrane defect 58.Motor unit = single motor nerve fiber innervates multiple muscle fibers

59. Extension of Hip and Flexion of Leg is by = Semitendinous60.Long Thoraccic Nerve Supply = Serratus Anterior

61. Correct Sequence of Protien Synthesis is =mRNA Cytoplasm,Ribosome,tRna,AminoAcids

62.All true regarding Breast Peau de orange appearance Except = Orange Brown Appearance is because of the Necrosis

63.Lady with leg Swelling from last 5 months with no history of fever

and coug hbut cxr show bilateral peural effusion Derranged Lfts and Rt Heart Enlargement = Recurrent Thromboembolism 64.Estrogen, Progesteron and Testosteron acts Via = Transcription (

All steroid hormones act on Genes as they can easily cross membrane and need no cell surface receptors )

65.Complication Associated with Trochanteric Fracture is = Pulmonary Emolism

66.GVE to palate Muscle is via = Dorsal Vagal Nucleus (G= Gen sensation ie not special like smell taste etc , V= Visceral ie Stomach ,Gut etc, E= Efferent ie nerves Exiting from CNS)

67.Max increase in ECF Volume due to = Infusion of Hypertonic Solution.

68.internal carotid a damage, bleeding, at what vertebral tubercle u will press to stop bleed = 6th cervical

69.Cysticercosis caused by = ingesting eggs of tenia solium

70.Which drug has more effect on cox2 than cox1 = celexocib ( if asked more selective cox2 , prefer celecoxib, if asked potent cax2 , prefer Meloxicam then )

71.Suboccipital n supply which muscle = rectus capitis posterior 72.Regarding intercostobrchial nerve true is = 2nd intercostal sensory

73.Normal resonance are = right 2nd to 4th midclvicular line

74.In asian population most common cause of macrocytosis =alchol (if asked in our country then prefer liver disease)

75.RCA after giving marginal branch obstruction affect = AV node(BRS BCQ)

76.Penile urethra rupture = scrotum under colles fascia ( note the MNEMONIC

PUS = Penile Urethra Scrotum/ Superficial perinial pouch BUS = Bulbar Urethra Superficial perinial pouch

MUD = membranous urethra Deep pouch )77.Middle rectal artery branch of, = .internal iliac

78.Chlamydial infection causing chlamydia psittacosis is,, =.obligate intracellular

79.Scenario of granuloma with yellow pigment = Actinomyeces80.Painful papule at labia = hsv II(HSV I is on lips Face , but now a days the rule is not followed strickly)

81.most perinium and pelvis nerve supplied by, = pudendal

82.Which of the following Maintain flexor tone of arm mainly =rubro spinal( note that rubroSpinal is for flexor tone while vestibulospinal tract is for extensor tone )

83.Lower motor neuron lesion. = muscle wasting

84.Hemisetion with total spinal section differentaiad by =spinal shock

85.Which one is most common exocrine pancreas tumor =ductal adenocarcinoma

86.Delayed action of insulin = stimulate mRNA transcription for lipogenesis

87.Gas having maximum diffusion capacity in body fluids =CO2 (Max affinity is of Co and Maximum Diffusion capacity is of Co2) 88.Dec PO2 in blood. = Hypoventiltion

89.A person living on river side since 2yrs, having blindness, opthalmologist indentify which larva = .onchcerosis

90.Antrum of stomach removed what will happen = dec compliance 91.Margins of TB ulcer = .undermined

92.Ulcer due to Hypertension, = Martorell

93.What is the Mechanism of action of PTU = Inhibits synthesis of thyroid hormones

94.Right optic tract lesion causes = left homonymous hemianopia 95.Internal laryngeal nerve passes through = Thyroid n hyoid 96.Which is used for screening congenital abnormality = Estriol 97.Phenyl over alcohol anaesthesia = less painful (Alcohol is Very Potent and Excruciatingly Painful)

98.Patient developed hemolysis due toG6PdD deficiency,,What will happen Next = Self limiting

99.Liver Develops from = ventral mesentry proximal foregut100.Saphenous nerve is terminal branch of = femoral

1.Adductor muscle hamstring muscle supplied by which nerve = tibial

2.Gracillis is supplied by the nerve = obturator nerve3.Adductor brevis supplied by = ant branch of obturator nerve 4.Fracture of surgical neck of humerus, artery damaged, = post.circumflex humeral

5.Common bile duct parts = omental, retroduodenal, paraduodenal (Bile Duct has 3 parts only)

6.Inion is a landmark of, = external occipital prominence

7.Gastroduodenal artery branch of, = right hepatic artery ( actually its branch of common hepatic artery, but if its not in option the click right hepatic artery Ref RJ LAST)

8.Regarding tramadol true is = weak meu agonist9.Ketorolac analgesia most preferable = Non diabetic female undergoing cholecystectomy

10.Radiotherapy most sensitive to = craniopharyngioma(Seminoma >> Glial Glioma >> Craniopharyngioma)

11.Bilateral exopthlmos, antithyroid antibody present = .graves12.Which one drain into left brachiocephalic vein = .inf thyroid (while superior and middle thyroid veins drain into internal jagular veins)

13.A 64 year Old man with posterior cervical lympadenopathy which is firm andmobile. Hb 13-14 hct = 40 wbc 7230 plateletes 250000 no hepato splenomegaly seen biopsy showed numerous small monomophic lyphocytes, ,= .hodgkin lymphcyte predominant(cervical lymph nodes in the Neck is the most Common Site of HL)14.Girl with h/o of gum bleeding, giant platelets , plt count 85k, =bernaud solier ( note, B for Bernaud souleir and B for Big platlets )15.Terminal ileum removed what happens = large amount of water in feces

16.Protein content less in glomerular filtrate occur due to = pore size and negative charge

17A 35 year old man bilateral crepts, on xray chest heart fills completely, mass in rt ventricle , what will b the main cause =

.myxoma

18.True regarding the Flexor Hallucis longus, = tendion can be felt immediately post to medial malleolus

19.Superficial parotid painless tumor, psudopoid growth, contain no capsule on histopatho = pleomorphic adenoma

20.A Very Fat Boy was eating burger & a very Large Bolus stuck after eating ..what will happen next, = secondary persiatlisis will be generated by intrinsic nervous system to remove it

21.When will u do dialysis with GFR Decreases to = 5 %

22.All drugs transported from Placenta by this mechanism = involves carriers ( also note that amino acids and fatty acids uses facilitated diffusion)

23.Regarding pituitary gland true is = .vein drain directly in dural Venous sinuses

24.Patient with fluid loss now show metabolic acidosis e hypokalemia.

most fluid loss will be through: = Colon

25.Anemia wid Blast Cells ins peripheral blood = .Erythroblastosis fetalis

26.Closure of lips involve: or unable to close lips which muscle involved = Orbicularis oris

27.Superior Thyroid artery arise from = External Carotid Artery 28.Incubation period of which disease is longest =Infectious Mononucleosis

29.Age estimation at 5th to 12th week is done through: = crown rump length

30.Shivering center is located in = Posterior hypothalamus

31.A 30 year old woman in azad kashmir was injured mildly in an earthquake that killed many people apart from her distant uncle. She would most probably be in = Situational crisis

32.Which ligament supports odontoid process of axis on atlas = Tranverse ligament

33.Vertebrae has = Longest spine

34.Conversion of fibrinogen into fibrin what will b detected in blood = Fibrinopeptides are detected in Blood

35.Percentage of Plasma out of ECF = 30%

36.Newborn with a Erythroblastosis Fetalis having Blood group B positive what is best for management = B Negative

37.If a person is taking Protein in his diet which will be necessary = Riboflavin (also note that , Thiamine for Carbohydrates in Diet and biotin for fats metabolism)

38.Group of young men bathing n beech next day develop blisters on back shoulder limbs region cause is = Mast cell destruction39.Regarding Renal Column contains= Interlobar artery ( though some friends states, that its collecting duct, not interlobar artery, I am with interlobar artery #respect)

40.Deep to post digastric and near palatoglossus a structure runs obliquely upwards, = Lingual artery

41.H2O2 found in = peroxisome

42.ICAM and VCAM are for = Leucocyte adhesion43.Breast atrophy in young female is due to = Estrogen and Progesterone

44.Virus in Human causes cancer via = Oncogen (Radiations via Protooncogens)

45.Essential amino acid = Phenylalanine

46.Spread of renal tumor will be through = Renal Vein

47.Retention of C02 = Respiratory failure

48.Regarding Gray matter foot processes = Protoplasmic Astrocytes 49.Cause of global blindness =Chlamydia Trochamatis

50.Which is normal HB = HbA

51.Thalassemia carrier percentage in Pakistan = 5%

52.Surgery for removal of ovary done which is damaged =Internal Iliac Artery

53.In respiratory Alkalosis renal compensation is =NaHC03 excretion

54.During mitosis chromosomes double in which phase = Interphase55. Pain of ovarian tumor is refered to thigh by = Obturator nerve56.Deep inguinal ring is present in = Transversalis fascia

57.17 Ketosteroid in urine seen maximally in =Normal male58.What is the relation of terminal CBD with head of pancreas= Embedded in it

59. After RTA patient becomes unconscious & on CT scan there is a hematoma which is compressing post central gyrus,s which area will be most affected = Sensory area

60.Lutenizing Hormone in males acts on = Leyding cells61.True statement regarding Bone = Circumferential lamella arranged around central canal

62.Regarding Pneumotaxic Centre which statement is true = Inhibits Respiration

63.During exercise increased blood supply to muscles is via = Local metabolites

64.Spindle fibers will decrease discharge of impulses when = Muscle contracts

65.What is the Difference between systemic and pulmonary circulation = Low resistance in pulmonary circulation

67.MOA of steroids in Inflammation is = Inhibiting phospholipase. 68.there is a Trauma to upper limb and pt cant feel sensation in little finger and paralysis of dorsal interossei which nerve is damaged = Ulner Nerve

69.which hormone causes extrahepatic protein catabolism and hepatic protein anabolism = Cortisol

70.Fragile x syndrome. = trinucleotide disorder

71.central chemoreceptors = change in PH of surrounding CSF72.INTERnal carotid relation to external at beginning = Lateral73.HIV female. Which one of the following carcinoma do occure =

cervicaL carcinoma

74.post MI peripheral cyanosis scenerio cause = decrease cardia output

75.type 3 collagen (ehler danlos syndrome) = hypermobility of joints 76.pregnant lady ferrous sulphate taking. Decrease absorption of = Calcium

78.pertusis. = nasopharyngeal and bronchial secretion spread79.allergic reaction with hypotension ( a big scenario is always there, but focus main points and ans is )= .i/m adrenaline

80.transport maximum not saturated scenario = Urate81.carbon laden macrophages = .pneumoconiosis 82.not natural immunity = plasminogen 83.REGARDING CSF= less proteins than plasma.

85.medical ethis. = moral code of conduct of doctr professional life 86.in portal HTN increases pressur in = inf mesenteric vein87.pain transmitted from tip of finger = A delta fibers(sensations

from the tips and lips are transmitted by A beta fibers, but those are not for pain, so dont be confused)

88.defect of neural tube ,which marker increase. =alpha feto protein89.durng c section structure damage causing cramps in lumbar region = ureter

90.true about ureter = cross bifurcation of common carotid

91.aftr paralysis sensitive to pain damage in = thalamus (the so called thalamic pain syndrome, the person becomes sensitive even to normal stimuli)

92.in our society female death apart from obstertical death. = domestic violence

93. obstretical death comon coz in our country = hemorrage 94.true relatd bladdr separatd frm rectum by = donovillier fascia 95.sperm stored aftr ejaculation in … EPIDYDEMUS ( BRS

ANATOMY STATES; Seminal vesicles do not store spermatozoa as once thought ; this is done by Epididymus , the ductus deference and its ampulla , if only one is asked prefer epidydemus)

96.a boy with testiculs swelling nd fever viral infection = mumps

97.hemophilia a gen located on = X chromosome

98.middle meningeal artery = passes thru foramin spinosum

99.labia majora vesicles lymph node = medial superficial inguinal node

200.true about ivc = comenses at L5

01.boy age 4 yr 4 days of fever,genraliz lyphadenopahy nd purpuric raash = infectious mononucleosis

02.G6pd deficiency = bite cell

03.suply of midgut form sympathetic = t5 t12 ( sympathetic innervation , preganglionic from thoracic splachnic nerves t5 to t12 while postganglionic cell bodies ; superior mesenteric ganglion ref;kaplan anatomy)

04.infant with absense of limb cause is = amniotc bands 05.thyroid hormon. increas = Free fatty acids

06.which cozs decres productn of prostaglandin. = corticosteriods07.about metaplasia = one epithelial changes into anothr normal epithelial 08.wafarin toxicityimediately treatd by = FFP ( if FFP andVit-K both are given in one option, click that)

09.mifepriston through = progesteron antagonist ( Miferpristone stimulate uterine contractility antiprogestinalso increases prostaglandins by inhinhibiting prostaglandin dehydrogenase)

10.goblet cell absent in = terminal bronchiole 11. preterm delivry = bactrial vaginosis12.hydrocarbon cozs = bronchogenic carcinoma13.adh and oxytocin arise in = hypothalamus

14.Alkaline phosphatase(obstructive jaundice)due to = stone 15.drug causng to inhibit breast ca metastsis to liver = .tamoxiphen 16.patient havng pain on flexng thigh = pelvic appendix

17.viruses causea chang = of protien alteration 18.radiaton caus change of = protooncogen19.Premalignant lesion = Compound nevus.

20.Regarding middle meningeal artery most appropriate….Enters middle cranial fossa through foramen spinosum…

21.Minerals not found in or minerals with low bioavalibility = tubers 22.Medial boundary of ischiorectal fossa. = External anal sphincter (External anal sphincter and sloping fibers of levator ani forms medial border)

23.Boy with h/o trauma to perineal region, swelling in scrotum and ant. Abd wall but didnt go to thigh. Rupture of =Bulbar urethra

24.Turner syndrome = Short stature

25.Pseudo hermaphrodite With 46xy = Adrenogenital synd. 26.Abdominal aorta.= Gives renal arteries at L2

27.Stab to chest…air in pleural space will cause .= Lung to collapse and chest wall to sprung out.

28.Lateral thenar muscles spared but other short muscles of hand paralysed.

Injury = Ulnar

29.axillary artery.relations = Post to pect minor

30.Infection ant. To pretracheal fascia spread to = Ant. Mediastinum 31. Primitve streak mesoderm migrates to anterior abdominal wall and

around cloaca. A rupture of this mesoderm cranially will produce=.ectopic anal opening

32.Systemic fungal infection .drug given. =Amphotericin 33.Vitamin A =. Rhodopsin

34.S2 in comparison to s1 sound = Inc. Frequency ( S1 has inc dullness and duration than S2 )

35.B/l recurrent laryngeal nerve cut. Muscle spared. =Cricothyroids. 36.Superficial cardiac plexus. = Contain both symp n parasympath 37.Gastric ulcer pain. = Greater splanchnic

38.Appendicitis pain radiates to umblicus thru = T10

39. H/o fall bladder incontinence unable to void urine. Spinal segment involved. =. S2s3s4.

40.Neck of fibula fracture. Dorsiflexion n eversion gone. =Common peroneal nerve

41.excessive eversion lig. Ruptured. = Deltoid.

42.Person standing. Venous return from legs mainly facilitated thru. = Contraction of sk. Muscles

43.Mediolateral episiotomy. Structure cut = Bulbospongiosus muscle 44.Regarding withdrawal reflex = Multisynaptic

45.Tension in the muscle is limited by = .golgi tendon organ 46.Alpha adrenergic causes.= Mydriasis

47.Due to stress of surgery inc = ACTH ( ACTH is stress hormone, but if cortisol is there in options, prefer that )

48.In crf unlikely = Hypophosphatemia49.Tcell receptor complex bind with. = MHC

50.Gluteus medius n minimus. = Abduct n medially rotate. ( whenever u see medial rotation of lower limb, close eye and click minmus and medius if there

)

51.Ciliary body = Pigment epi of retina is cont. With pigment epi of ciliary body.

52.Isthmus of thyroid lies in front of. = Rings 2 3 4

53.St elevation v4. Artery involved = LAD ( NOTE, that its the most commonly involved artery in CAD)

54.Lt.circumflex artery involved in mi. Old mi with new mi. Area involved.= Lt. Atrium n lt. Ventricle. ( left circumflex artery supplies both left atrium and ventricle)

55.Most commonly involved heart valve = Mitral valve56.Dka pt. Died. Which fungal inf. = Mucurmycosis57.Stroke death. Autopsy brain. Necrosis. = Liquefactive58.Abdominal angina. Artery involved = SMA

59.50 yrs old. Hypertensive. Severe chest pain radiating to back. Died. On autopsy findings. = Medial necrosis of aorta

60.Median umblical lig is remnant of = Urachus. 61.Premature baby born most common finding is =PDA 62.Pulmonary arteries supply. = Alveoli

63.In adult head of femus blood supply. = Med n lat circumflex femoral art. 64.During lumbar puncture the structure punctured = Lig.flavum

65. Return of blood during exercise from =. Calf muscles67.Testosterone main function = Inc muscle and bone growth 68.Sertoli cells function = androgen binding protein

69.Carb protein fat synthesis hormone = Insulin

70.Most common salivary gland tumor is of which salivary gland =Parotid 71.Cervical ca. Lymph nodes involved = Internal iliac ( if the option <> both internal and external iliac is present, prefer that)

72.Regarding rectum. = Also supplied by median sacral artery.(arises from posterior aspect of abdominal aorta just before bifurcation , descending in the front of sacrum and supply the posterior portion of rectum .Ref; BRS ANATOMY)

73.Regarding anal canal = supplied by both sup n inf rectal arteries. 74.Coumadin (warfarin) question = inc coagulation time

75.Vit k not absorbed. Coagulation factor decreased .= Prothrombin

76. Vit k def. First n foremost coagulation factor depleted. = Protein c ( if protein C is not in options, prefer factor seven )

77.Female presents with dvts . Says she has been taking some kind of pills. = Ocps.

78.10 days fever. Chest pain unrelated to respiration. =Myocardium 79.Breast outer quadrant = Pectoral (anterior ) group

80.Pregnant with jaudice. Went to remote village. To see her parents. Cause = Hep e ( note that ● commenset hpatitis is hepA anywhere, but if ● asked remote area, or epidemic or deadly in pregnancy prefer hep E then )81.Which ca rarely metastasizes = Basal cell carcinoma

82.BCC features. Most likely = Locally malignant

83.which ca spreads to large vessels = Clear cell ca of kidney ( even this carcinoma can reach the heart through inferior vena cava)

84. Cholangicarcinoma is caused by = Clonorchis sinensis.

85.Most common ca of epiphysis = Osteoblastoma ( if Giant cell tumor is

present in options click that )

86.limb growth will be affected if fracture passes thru = Epiphyseal plate 87. Acoustic neuroma. = Vestibular component of CN 8

88.Hypoglossal nerve injured. = Tongue deviated to same side89.Intraarticular disc of tmj involved.. Muscle paralyzed. = Lat.pterygoid 90.Gastric lymphoma ass with = H pylori gastritis

91.Femoral arterial pulse = Mid inguinal point92.Inguinal canal. = Roof Formed by conjoined tendon 93.In. Old age =. Vc decreases

94.Decrease in ESR is due increase in = . Albumin.95.Glycocalyx contains = Carbohydrate moiety.

96. in juxta glomerular nephron, sodium is actively reabsorbed electrically neutral from lumen of nephron in which segment of nephron = Proximal convoluted tubules ie PCT

97.Greatest clearance is of = PAH ( the order is PAH > Dietry potassium > inulin).

98.Rt. Testicular vein enter = Ivc.

99.Tibial nerve severed. Which muscle will still flex the knee joint =Short head of biceps

300.oraganelle with double membrane = Nucleus

Session # three; Light can only shine through a broken vessel.Bear Grylls

1.Sacral plexus anterior division branch = obturator nerve(●Ant division nerves = tibial nerve L4-S3, obturator L2-L4 ,

●Post division nerves = femoral L3-L4 ,common peroneal nerve L-S2 ,superior and inferior gluteal nerves Ref;KAPLAN anatomy)

2.In embryo lung is covered by mesothelium form which layer = Parietal pleura3.Anterior to pancreas is = Lesser sac (note that; head of pancreas lies anterior to inferior vena cava and the neck/ body of pancreas lies anterior to aorta, while superior mesenteric artery is anterior to the uncinate process of pancreas )

4.Most common dislocation of TMJ = Anterior (TM-Joint can dislocate only anteriorly)

5.A 60 years old man develops pain in calf muscles after walking hundred (100) yards pain is due to = Popliteal artery

6.Ulcer 2nd part of duodenum which artery will u ligate = Gastroduodenal artery7.Extraembryonic coelomic membrane = Hypoblast ( Hi yield says epiblast and langman states hypoblast, I follow langman ,#respect)

8- For transfer of radicals from one group to another = transferase ( Note that ; oxidoreductases catalyze oxidation reduction reactions, ie electrons are transferred, while transferase transfers moieties from donor to recipient )

9- For conversion of glucose-1-phosphate to glucose-6-phosphate require = isomerase ( its actually phosphoGlucomutase , but if not present in options, click isomerase )

10.Somatostatin act on beta cells by = paracrine action ( the GI Paracrines are, somatostatin and histamine, they defuse over a short distance to act on target cells ) 11.Gram negative bacteria causes infection of which system = Urinary tract

12.Per mint perfusion of 100g brain tissue per minute = 50-55ml (while brain glucose consumption is 5mg/100gm/min while oxygen consumption is 40ml/min)

13..Drug used to treat Endometriosis = medroxypregesteron acetate (click leuprolide if medroxy is not in options)

14.Toxoplasmosis is = A parasite

15.L1-L2 ends at = Inferior hypogastric plexus

16.detrusor nerve supply = Parasympathetic pelvic nerves ( while pudendal nerve supplies external sphincter )

17.which bronchus of lung is supplied by eparterial artery = right superior ( Right superior lobar bronchus is eparterial bronchus i-e branch of right main bronchus, it arises above the pulmonary artery due to this reason its name EParterial bronchus and all others arise below the pulmonary artery and are called HYParterial )

18.correlation of two things by which test = student T test ( T for two, first aid )

19.Sarcoma is differentiated from carcinoma = tissue of origin ( if this option is not present, prefer aggressiveness)

20.Narrowest point in pediatric airway = cricoid

21. If thalamus gets damaged, which is not affected = sense of olfaction 22.Superior colliculus receives which sensation = visual (Memorize as , the superior

colliculus is above and eyes are above , while inferior colliculus is for auditory system and ear are lower to eyes)

23.Posterior communicating artery = passes above the occulomotor & connects ICA and PCA

24.Which muscle gets paralyzed/damaged in temporomandibular joint dislocation =lateral pterygoid

25.1st branch of abdominal aorta = inferior phrenic artery

26.dilatation of aortic arch will compress = left bronchus

27.axillary vein is formed by = basilic vein and vena commitantes of brachial artery (these form axillary vein at the lower border of teres major muscle)

28.injury to lateral hypothalamus will = decreases hunger

29.in open laparotomy, surgeon recognizes left kidney by = anterior relation with stomach,pancrease,descending colon,spleen,jejunum

30.linear growth pf bone is affected if following structure is fractured = epiphyseal plate

40.beta endorphins = hypothalamus

41.typical scenario of sickel cell anemia with abdominal pain jaundice = HbSS

42.a tall young girl(child) with history of secretion from breast.on microscospy of anterior pituitary, which cells are abundant = eosinophilic (GH and Prolactin are acidophiles ie chromophils and take eosinophilic dye ; Rest are basophils i-e cells other than these two varieties )

43.which toxin is responsible for scarlet fever = erythrogenic toxin

44.highest sodium channel concentration = node of ranveir

45.Antibody receptors are = hypervariable regions of H and L chains

46.Dicumarol side effect = inc bleeding time

47.mode of action of cephalosporin = inhibit transpeptidase

48.lithium is a toxic antipsychotic. when should it be stopped = coarse tremors ( katzung states ; lithium causes Fine tremors in therapeutic dose and coarse tremors in toxic dose)49.Thyroid follicles that release hormone are derived from = Endoderm

50.steady pressure is detected by = ruffinis receptors

51.Best indicator of venous return = end diastolic volume

52.erythropoietin secretion is inhibited by = theophylline

53. Primigravida taking iron tablets, lots of fresh vegetables and juices .what deficiency she is at risk of developing = calcium ( iron reduces the absorption of calcium and hence may cause its deficiency, if Ca is not in options click vit B12, but the deficiency of vit B12 takes time as its stores lasts longer ; note that if a person is taking both calcium and iron tablets he/she is advised to take iron at night and calcium in the morning to avoid nutrients

combat)

54.child brought by mother,suffering from diarrhea.on examination,rectal prolapsed was found =. trichuria trichuris ( A hint is most of the time given that worm with small anterior end )

55.what is more/high in venous blood as compare to arterial blood = PCV ( due to the chloride shift phenomenon in venous blood, water enters into the red blood cells, and cell swells, resulting in increased packed cell volume )

56.in which condition atrial repolarization is shown on ECG = third degree complete heart block

57.child with hypocalcemia(or tetany),having some cardiac problems and viral infections =22q-11 microdeletion (this is a scenario of DIGEORGE SYNDROME a Developmental failure of the third and fourth pharyngeal pouches, due to 22q11 microdeletion . Presents with T-cell deficiency due to lack of thymus and hypocalcemia due to lack of parathyroids anda abnormalities of heart ,great vessels, and face)

58.which valves are most commonly involved in rheumatic heart disease = mitral and aortic valves

59.which is more in dialyzing fluid as compare to plasma = glucose (composition of dialyzing fluid;

●Glucose & HCO3 are more than plasma, if both asked prefer glucose ●Na , K & Cl less than plasma

●Mg & Ca equal to plasma

●urea , creatinine, sulphate and zero,)

60.Hematocrit = rbcs+wbcs+platelets ( this ans is from Ganong BCQs while according to many others and even Dorland, hematocrit is just RBC,s and the buffy coat is formed by platlets and wbcs, I follow ganong BCQ #respect)

61.which antiemetic is preffered in pts of chemotherapy = odansterone

62.ranitidine is different from cemitidine as = it has less CNS toxicity

63.Lower limit of subarachnoid = S2

64.In spermiogenesis acrosome reaction by = lysosomes ( if asked , acrosome is formed by

??? then click Golgi )

65.Receptor action via Phospholipase C = Vasopressin induced smooth muscle contraction66.intertesticular temp less than rectal temp = 1-2c

67.Hb is 10, O2 saturation 90% ( convert 90% to 0.9 ), PaO2 = 60 , calculate O2 content = 13 ans (see solution below)

Formula for oxygen content =(Hb g/dL ×1.34) × SaO2 + PaO2×0.003 oxygen content = (10 × 1.34) × 90% + 60 × 0.003

oxygen content = 13.4 × 0.9 + 0.18 oxygen content = 12.06 + 0.18 oxygen content = 12.24 i.e 13

68.Buccopharyngeal Membrane = Stomodium from Foregut (note that ; if asked Buccopharyngeal fascia then pharynx from foregut )

69.Absolute contraindication of Propofol is = Hypersensitivity

70. Lung carcinoma fungiform growth. = Squamous cell carcinoma

71.sugar in urine will be detected if its concentration in blood becomes = 180mg (at plasma concentration less than 250 mg /dl all the filtered glucose is reabsorbed and excretion is zero, the plasma concentration at which glucose first appears in urine is approximately 250mg/dl Ref;BRS Physiology, while chatterje states, Renal threshold for glucose is 180, I follow 180 #respect)

72.Esophagus = Passes through right crus of diaphragm

73.Aneurysm of aorta at diaphragmatic hiatus compresses = azygous vein and thoracic duct

74.Antacid decreasing gastric motility = Aluminum hydroxide(note that, aluminium causes constipation while Mg causes diarrhea )

75.Vessel lying close to LAD , prone to injury during surgery is = great cardiac vein

76.Ascending reticular formation located in = floor of aqueduct of sylvius

77.Patient taking propranolol develops increased PR interval . what is the cause = Drug induced 1st degree heart block

78.Osmolarity of Human plasma = Similar to 0.9 % N/S

79.post ganglionic sympathetic fibers are present in = all spinal nerves ( sympathetic outflow is from thoracolambar region, but post ganglionic fibers in all spinal nerves )

80.For sodium neutralization = Cl ( while HCO3 for K neutraliztion)

81.That melatonin = secretion inc in dark (Pineal gland has a midline location above the quadrigeminal plate in the midbrain and is Site for melatonin production . Superior cervical sympathetic ganglia stimulates receptors on pinealocytes causes release of melatonin into spinal fluid and blood . Melatonin is Important in sleep/moods and circadian rhythms Released at night. Ref Goljan, plz dont cofuse it with melanin)

82.Smoking is associated with = thromboangiitis obliterans ( it is also called BUERGER disease)

83.which of these is not synthesized by post ganglionic sympathetic fibers = L.Dopa

84.Bromocriptine reversed amenorrhea mechanism of action is = it acts as dopamine agonist

85.not a part of natural immunity = plasminogen

86.Factor 8 is synthesized by = Endothelial cells

87.what is the landmark for pudendal nerve block = ischial spine

88.Pt with HTN , LVH , Creatinine 0.8 , Urea inc, BSF 88mg% with urinary sugar ++ , Na 140 , K 2.5. Cause of HTN = Hyperaldosteronism ( the function of aldosterone is to reabsorb sodium and excrete hydrogen and potassium, thats why in hyperaldosteronism, K is depleted and there is alkalosis, and Sodium level won,t fall because water is absorbed along with Na)

89.Which structure is embeded in temporal lobe = insula90.Ureteric bud is formed as a part of = Mesonephric duct91.Coccygeal ligament start at = L1

92. 40 years Old man from Sibi Baluchistan with fever and Lymphadenopathy with the H/O of sleeping on floor and often bite by flies. On Peripheral blood film Unicellular structure can be seen. Diagnosis is = Kalazar

93.Irreversible step in Glycolysis = Glucose to Fructose-6-Phosphate94.Intracranial and extracranial veins are joined by = Emissary Veins

95.Situation of SA node = Upper portion of Sulcus terminalis ( but BRS anatomy states ; SA node is a small mass of specialized cardiac muscle fibers that lies in the myocardium at the upper end of the crista terminalis near the opening of the svc in the right atrium.)96.Thromocytopenia in Children due to Acute Viral infection is becausw of = Antibodies against platelets

97.Esophagous narrowest at = Cricopharyngus

98.Upper and lower limits of cerebral blood flow autoregulation = 50-150ml/min (The ranges mentioned by Francis physiology is 60 to 160 which is almost near to 50 to 150) 99.In some children Dorsalis pedis Artery is missing congenitally. Then dorsum of foot will be supplied by which artery = Peroneal artery

100.Itching will stimulate .= C fibers

01.A Child got blow at elbow and elbow joint displaced. And loss of sensation over little finger. Structure involved = Ulnar collateral ligament

02.-A 35 years old man die suddenly. Autopsy finding nill. Toxicology shows cocaine and its metabolite in blood. Cause of death = Contraction band

03.Ganglion found at T7 vertebra = Thoracocervical04.Edrophonium most common adverse effect = Nausea

05.Damage to first lumbar vertebra will lead to = . Conus Medullaris Syndrome06.In feamle neck of bladder lie = Lie above urogenital diaphragm

07. Mechanoreceptors of Warm = Long receptive field08.Cuneatus and Gracillis damage will result in = Asterognosia09.Articular surface has which cartilage = Hyaline

10.Elastic cartilage is found at = Epiglottis

11.Preganglionic Presympathetic fibers = B type ( note that post ganglionic are C fiber and if asked what are pure autonomic fibers again click B fibers, plz dont confuse B fibers with Beta fibers )

12.PICA damage, blood supply of which part will be affected = dorslateral of medulla13.Chromatid align at equatorial plate = Metaphase( also chromosal study is carried out in metaphase, and if asked replication of any organelle click interphase)

14.Which Cells have telomerase = Germ cells

15.Perineal area innervation was asked = S2-416.Most drugs are metablized in = Liver

17.Death due Clostridium botilinum = Paralysis of respiratory muscle

18. True about Supernumary cervical Rib = Compress brachial plexus and subclavian vessels

19.A female with blurred vision etc case of Multiple Sclerosis = Demyelination of neurons20.Node of Ranvier = Lack of Myelin sheath

21. tuberculin test (Negative) = Taking immunosuppressive drugs

22.Bupivacain first sign of over doze = ringingin ears (if asked about serious adverse effect, prefer arrythmias)

23.A child suffering from 104F fever, and has been on anti malarials .His lfts are deranged wd inc unconjugated bilirubin.What is the most probable diagnosis = blackwaterfever ( if in the ques , high temperature is not mentioned then prefer G6PD deficiency )

24.about sertoli cells = release androgen inhibiting factor( so called inhibin)

25.Baby Diper gets yellow due to = biliary atreasia (if biliary atreasia is not in options , prefer Gilbert then)

26.Medial quadrant of breast drain into = Internal thoracic nodes

27.Superior sagittal sinus pressure in standing position = 10 i-e minus ten (Ganong physiology)

28.Aspiration of hydrocele,needle does not pierce = tunica albugenia29.shoulder pain reffered from pleura = c3,c4,c5

30.which stucture passes through esophageal hiatus = Vagus trunk (right vagus)

31.adrenocortical deficiency causes = Hyponatremia ( the job of mineralocorticoids is to reabsorb sodium, thas how the deficiency of mineralocorticoids may result in hyponatremia )

32.malarial parasite transfer in which form in man = Sporozite

33. Most common congenital anomaly of head and neck = Cleft plate34.most commonly fructure of bone after 60 yrs = Neck of femure35.Most common Inheritance pattern = Multifactorial

36.fructure humate bone = Ulnar nerve (A fall on the outstretched hand may fracture the hook of hemate which may damage the ulnar nerve as it passes into the hand)

37. ivu kidney more prominent = Calyces38.spinal cord ends at = lower border of L1

39.epidural space contains. = Venous plexues

40.Regarding cephalic vein = Lie between deltoid and pectoralis major muscle

41. A 10 yrx boy repeated visits to opd with pallor frontal bossy = thalasemia major42.renal vein lies posterior to = Superior mesenteric vein

43..lumber triangle anteriorly bound by posterior border of = Serratus anterior

44.Mononucleosis. Stucture most likely to be damaged even on minor trauma = spleen45.Barium swallow Feathery appearance in left abdomen = Jejunum

46.Damage to middle cranial fossa. No lacrimation. Damage to = Ciliary ganglion47.Which of the following is not isotonic to plasma = 5% D/w( 5% dextrose water is almost same as pure water)

48.Highest Pco2 in = Pulmonary artery49.Somatostatin acts on beta islet cells = Paracrine50.Rabbit disease = tularemia

51.Nerve asked, loss of sensation in lower teeth, chin and lower lip = Inferior Alveolar nerve

52.Retromandibular vein is formed by junction of Maxillary vein and = Superficial temporal vein

53.Alpha-2-agonist used in ICU for sedation = Dexmedetomidine ( Dexmedetomidine isalpha-2-agonist like clonidine and is most often used in ICU setting for light to moderate sedation, the reason to prefer is , it has analgesic and hypnotic properties and is not associated with significant respiratory depression )

54.1st lumbrical = attaches to radial side of index finger ( Details; The first lumbrical of the hand arises from the anteriolateral surface( ie radial side ) of the tendon of flexor digotrum profundus to the index finger)

55.Chondrocyte change into osteocyte = thyroxin

56.Muscle damage in difficult delivery = levator ani Muscle

57.Sperm will called abnormal <20 million,,30% motile = Less than 20 million per ml is oligospermia

58.bulbourethral gland content of = deep perineal pouch ( Cowper,s glands also called the bulbourethral glands (in the male only) are the content of deep perineal pouch while the greater vestibular also called bartholin glands are located in superfascial perinial pouch in females)

59.Which step z common in glycolysis and gluconeogenesis = Fructose-1,6-bisphosphate tofructose-6-phosphate

60.Deep part of parotid fascia forms = Stylomandibular ligament ( the thin deep lamina of parotid capsule ie the investing layer of deep cervical fascia , thickens to form stylomandibular ligament )

61.whiplash injury, c5 c6 injury = flexion of elbow ( flexion of fore-arm )

62.medical ethics = conduct of doctor profession63.burkit lymphoma in aids = EBV

64.GABA destroyed n substantia nigra = Parkinson65..EDV=160. Heart rate= 70, CO2 = 5.6L solution;

Ejection Fraction = SV/EDV & CO = HR × SV

SV = CO/HR

first convert 5.6 L to ml ie ( 5.6 × 1000 = 5600 ml) then calculate SV = 5600/70 = 80

now

EJECTION FRACTION = 80/160 = 0.5 ans

67.4ml of 4% Lidocaine solution contains how much lidocaine ? Solution ;

4% means 4 gram in 100 ml convert 4 grams into miligrams 4 ×1000 = 4000 mg

if 100 ml contains 4000 mg then 1 ml contains X mg X =4000/100 = 40 mg

and 4% contains = 40 ×4 = 160 ans

68.Question = 0.85% Nacl Solution contains how much NaCl ??Solution ;

0.85 % means 0.85 gram in 100ml

now convert gram into mg ie 0.85 × 1000 = 850 mg so 0.85% NaCl solution contains = 850 mg /100 ml

69.Regarding Pseudoypoparathyroidism = Hypocalcemia ( Pseudohypoparathyroidism Autosomal dominant disease ; End-organ resistance to PTH (includes its ability to synthesize 1-α-hydroxylase in the proximal tubule) Mental retardation, basal ganglia

calcification, short fourth and fifth metacarpals (knuckle-knuckle-dimple-dimple sign). Hypocalcemia, normal to PTH, normal 25-(OH)D, 1,25-(OH)2D; serum calcium,serumphosphorus.)

70.Cholangiocarcinoma caused by = Cholonorchis Sinensis

71.Farmer with migratory lesion on foot = Cutaneous Larva migran ( look at , both the ques ie migratory lesion and ans ie larva migrans , share the same word ie migran )

72.Ligament that prevents ant dislocation of femure on tibia = Post cruciate

72.Scrotum drains to = Superficial Inguinal Nodes

73.True about Thoracic duct, drains into = At Confluence of left Subclavian and left Jugular

74.About Posterior Triangle of Neck what is true = Contains subclavian , three trunks of brachial plexus

75.Nerve loss in urogenital triangle which nerve involved = Pudendal Nerve

76.About Quadrate lobe, true is = Drains by left hepatic duct ( quadrate lobe though structurally part of right lobe, but functionally part of left lobe even arterial and venous etc are with left )

77.Isoniazid causes side effects which can be prevented by taking which vitamin =Pyridoxine

78.About Trichomonas vaginalis what is correct = Is sexually transmitted

79.Athetosis is due to defect in = Globus pallidus

80.Main class associated wid antigen presenting cells = MHC2

81.Diabetic pt came to ER insulin given what change will happen in blood = increased pH( as its Ketoacidosis so u have to change acidosis ie PH )

82.If circumflex branch of left coronary artery is blocked which area will be effected = Posterior surface of left ventricle

83.Potassium will be lost mostly fr0m which segment following dietary irregularities = distal tubule

84.Main diagnostic feature of DIC = presence of D dimers (D for DIC, D for D-dimers)

85.CO poisoning,methemoglobulinemia,anemia dont result in hyperpnoea = this is because Po2 remains normal

(Anemia- Pa02, Sa02 Normal ;MethHB and CO Poisoning – Pa02 – Normal, Sa02 DECREASED- Ref Edward F Goljan)

86.Burkitt lymphoma cause is = EBV ( EBV = it also causes infectious monoNucleosus, in which B CELLS are affected, but the ABNORMAL LARGE CELLS ARE T-CELLS , so if asked affected click B- CELLS )

87.Bitemporal hemiopnea = Pituitary Adenoma

88.Subdural hematoma due to = leakage of cerebral vein (while extradural is due to Middle meningeal Artery )

89.Penetrating injury in 4th left intercostal space just lateral to sternum will damage which of following structure first = intercostal membrane damage (this is an imp question, but if 5th space is asked, then CLICK intercostal MUSCLE)

90.young patient with history of taking some drug with anemia, HB is 8 ,WBC 90000 and platelet is 240000 and PERIPHERAL blood shows IMMUTURE CELLS = ALL

91.NON LETHAL MI what happen within first day = Cardiac arrhythmias92.pnemothorax – lung collapse inwards and chest outward ( remember that naturally the LUNG wants to be collapsed and chest wall want to sprang outward, so if pneumothorax occurs, lung follows its natural tendency, ie it collapses and wall sprang outward)

93.Hx of chest infection 10 days back. otherwise she is fine presented with petechie and ecchymosis. Investigation= platelets count

94.posterior relation of left kidney is = diaphragm

95.Malignant tumour mesenchymal in origin = Sarcoma

96 .during inspiration = greater decrease in intrapleral pressure than alvelor pressure97.young girl HB 5,MCV LOW ,MHCH LOW,and abnormal morphology of RBCS

,investigition = Hb electrophoresis

98. Most suitable NSAID during Lactation = Ibuprofen

99- pt with Diabetic ketoacidosis pt managed Bt died. Most likely infection is = mucur200Dead organisms in vaccine = WHOOPING COUGH

01. Dysphagia due to liquids only = Neuromuscular blockade02. Post 1/3 of the tongue supplied by = Cranial nerve 9

03. H2O2 found in = Peroxisome

04.. Fecal incontinence after trauma damge to = External anal sphincter05. Poliomyelitis = Anterior horn cell defect

06. Regarding P Value = Checks probability ( P for P VALUE and P for Probability ) 07. Retention of C02 = Respiratory failure type 2 ( Type 1 faliure is due to oxygenation problem , and any pathology that fills lung with fluid causes type 1 eg, pleural effusion, pneumonia etc, type2 is due to co2 retension and any pathology that causes hypoventellation causes type 2 failure eg, morphine over dose, muscles paralysis etc )08. Lymph drainage of Testes = Paraaortic LN

09.Surgery for removal of ovary done which is damaged = Internal Iliac Artery

10.In respiratory Alkalosis renal compensation is = NaHC03 excretion

11.Gardner working in garden. developed chest pain, x\ray showed mass in rt lower lob = Aspergillosus

12.Rheumatic fever (scenario) type of hypersensitivity = Type II

13.In Scarlet fever toxin type = Erythrogenic

14.A male sexually active without fever and urethral discharge organism found =Chlamydia trachomatis

15.The drug that causes hyperurecemia = Pyrazinamide

16.Surgeons injects dye during surgery of the liver through =Ligamentum Teres

17.Polycythemia characteristic feature; increase in = Red cell mass

18.. A female patient with low Hb and increased reticulocytes + Coombs test positive =Autoimmune hemolytic anemia

19.Patient with miosis and cannot gets his pupils widened even in dark, lesion of = Sympathetic trunk

20.Patient with dry eyes which ganglion involved Pterygopalatine

21.A tall man in a circus started with chest pain. Has also dislocated lens in history, chest pain due to = Dissecting aorta( another question frequently asked about dissecting aortic aneurysm and the ans is CYSTIC MEDIAL NECROSIS)

22.Damage to dorsal column medial leminiscus pathway causes = Sensory ataxia

23.Nucleus gracilis and nucleus cuneatus damage cause = Astereognosia

24.A patient with FEV1/FVC decreased with FEV1 decreased more, dyspnea (emphysema case). The activity of neutrophil elastase is due to = Nicotine

25.A child with arthritis, mucosal ulcers, uveitis and genital lesions = Behcets disease

26.Low complement system seen in = SLE

27.Pulmonary flow of blood in liters/min = 5 liters

28.In SIADH = Hyponatremia (decreased osmolarity)

29.Alpha motor neurons = Myelinated

30.Potassium secretion decreased via = Aldosteron antagonistsv(Spironolactone)

31.Costocervical trunk = 2nd part of subclavian artery

32.A man goes to a high altitude 02 delivery to tissues is maintained by = Hb conc is increased

33.A 52 year old man underwent coronary artery bypass graft two weeks ago and now presents with purpuric patches on skin. On labs his PT and aPTT were normal. Following Is true = Drug induced thrombocytopenia

34.Regarding normal heart = Right ventricle pressure 25/10 mmHg

35.Maximum absorption by renal tubules = Glucose

36.Regarding Bain Bridge Reflex = Increases HR

37.Ectopic thyroid hormone is produced by = Squ carcinoma larynx

38.Lesion above the sacral region; effect on bladder = spastic bladder, ( if spastic bladder not in option , click neurogenic bladder, note that neurogenic bladder is the term used for both spastic and atonic bladder )

39.Sickle cell anemia defect in = Beta globin

40.Deep to post digastric and near palatoglossus a structure runs obliquely upwards = Lingual artery

41.Loss of abduction and adduction of fingers and adduction of thumb with intact skin sensations involves = Deep branch of ulnar

42.A patient on MAO inhibitors, in order to avoid hypertension you would advise not to take = Coffee

43.Middle 1/3rd of oesophagus supplied by = Descending thoracic aorta

44.Follicular cells of thyroid derived from = Endoderm

45.Organophosphates = Irreversibly binds to organophosphates

46.A tumor of pituitary gland compressing anteriorly to a structure will cause problem in= Optic nerve

47.A postpartum lady with heavy bleeding due to uterine atony, drug you would use = Ergometrine

48.Parietal cells = Copious eosinophilic cytoplasm and central nucleus

49.Patient with prolonged PR interval and on beta blocker from long time cause = Drug induced 1st degree heart block

50.Lymphatic vessels related to = Cystic hygroma

51.IgA nephropathy on histology = Mesangeal deposit

52.Increased in resistance to flow = Viscosity

53.Chorea and athetosis are the features of = Basal ganglia complex

54.Femoral artery position to femoral vein below the inguinal ligament, femoral artery is = Lateral

55.About spermiogenesis = Spermatids are converted to spermatozoa

56.Family history positive, patient with recurrent respiratory infections, sinusitis investigation for diagnosis = Sweat Chloride test.

57.Myxomas most common location = Left Atrium

58.diabetic patient present with gangrenous foot cause is = angiopathy+neuropathy59.in late pregnancy placenta consist of = Synctiotrophoblast+fetal endothelium60.Person not able to open mouth = Lateral pterygoid ( speak lateral pterygoid and ur mouth remains open all the way along, thats how its memorzed ie its function is to keep mouth open)

61.Estrogen will not inc the risk ov following = carcinoma ovary62.Recurrent infections, sinusitis, situs inversus = Kartegnars syndrome.

63.Fracture of surgical neck of Humerus damage to = Axillary Nerve

64.Inversion of foot by which muscle = Tibialis Posterior

65.Lateral foot dermatome = S1

66.Giant Cell Tumors histo finding = Soap Bubble appearance

67.Young adult with raised ALP, jaundice and decreased Hb Scenario = Pigment Stones

68.Regarding Lymph drainage of breast except = Inferior Phrenic Nodes

69.Closure of lips involve: or unable to close lips which muscle involved = Orbicularis oris

70.Superior Thyroid artery arise from = External Carotid Artery

71.Incubation period of which disease is longest = Infectious mononucleosis ( look at its lengthy name , so associate with long incubation period)

72.Chronic Fungal infection with rhinosinusitis causing medial erosion and granulomas = Aspergillus

73.Which of following has highest chances of dev eloping endometrial cancer = Complex hyperplasia with atypai

74.Regarding CSF = Formed 500ml/day ( another question is sometimes there in paper regarding CSF and the answer is Cushion effect)

75.Age estimation at fifth to 12th week is done through = Crown rump length

76.Otic ganglion is between mandibular nerve and tensor tympani. It’s superior border is formed by = Foramen ovale

77.A young boy with inc appetite weight gain and sleep problems. On examination he is having genitals hypoplasia = Craniopharyngioma

78.Sensory supply of uterus passes through which ligamen = Broad ligament

79.Highest number of alpha resceptors are present in = proximal urethra followed by prostati urethra

80.A needle when inserted 2cm below and lateral to pubic tubercle will be closely related to on = Obturator nerve

81.Most common position of appendix = Retrocecal

82. Sensations from tip of fingers by = beta fibers (from the tips and lips Sensations are by BETA fibers)

83.Shivering center is located in = Posterior hypothalamus ( note that posterior hypothalamus is origin of sympathetic nervous system and that cause shivering )

84.Which tumor involves extension to nerve sheath = Carcinoma expleomorphic adenoma( associate the word EX, in both EXtension and EXpleomorphic)

85.While a surgery on submandibular gland which has more chances of injury = Facial nerve (Actually its the marginal mandibular branch of facial nerve, so any one of them may be asked in options)

86.Which one combination is correct = Morphine reduces apnoeic threshold

87.year old young man has heaviness in his scrotum for six months. On examination a solid 5cm mass is palpated. On labs his alpha feto protein level was 81ng/ml while bHCG level was 15 IU/l. Same side orchiectomy was done and Which of following could be the cause = Embryonal carcinoma

89.Which ligament supports odontoid process of axis on atlas = Tranverse ligament

90.Medial geniculate body = Fibers ascend to thalamocortical areas

91.C7 Vertebrae has = Longest spine

92.Direct Inguinal Hernia = Medial to epigastric Artery ( ie in kaselaabch triangle)

93.A man during fasting his urine become concentrated because of = ADH secretion

94. If a person is taking Protein in his diet which will be necessary = Riboflavin

95.Scenario bif on Marfans wid mitral valve prolapse died and on autopsy is prolapse this was due to defect in = Fibrillin ( F for Fibrillin and F for marFan)

96.Obstruction to RCA after giving Marginal branch will affect = AV Node (high repeat)

97.Aortic valve closure outsets = Isovlumic Relaxation ( Remember that during isovol relaxations S2 is produced while during isoVol contraction S1 is produced)

98.High Cardiac Output failure in= Beri Beri

99.Regarding indication of furosemide = Acute pulmonary edema

300. A patient was brought to the hospital after a roadside accident. On examination he was pale with low blood pressure and fracture of left 10th rib. Which organ is most likely to be Injured = Spleen ( in the scenarios of RTA and viscera damage, look for 10th rib and click the spleen )

Session # four; Too much information coming to my brain, too much information driving me insane. Conrad Fischer

01. Bupivacaine. Overdose, adverse effect = Ventricular arrhythmia. ( while initial symptom of bupivacaine toxicity is ringing in the ears, as arrhythmia isn’t symptom)

02. Pt. Anesthetized heat will not produce due to = Loss of muscle tone

03. 60 percent ventricle fill during = Rapid inflow ( there is another stem and don’t confuse that with this one, which asks, in which stage ventricals are filled maximally and ans is atrial systole, bcz during atrial systeole ventricles are already filled and atrial systole just add small amount of blood)

04. Regarding post. Comm artery. = Connects PCA to ICA ABOVE occulomotor nerve05. Dorsal vagal nuclei present in. = Medulla

06. Which hormone causes uncoupling of oxidative phosphorylation with increase heat production = Thyroid hormones

07. Patient had previous episodes of diplopia and dizziness now acutely comatose reason = Basilar artery thrombosis

08. Child has episodes of bleeding and ecchymosis i guess since birth hb 9.8 mg/dl nd platelets count was normal 180 x 10^3 BT prolong = .,platelet functional defect

09.Patient given warfarin on second day had large ecchymosis on thigh = Protein cdef ( warfarin not only dec synthesis of factors 2 , 7, 9 and 10 but also dec protein c and s, and protien C AND S are antithrombotics/anticoagulants, that’s why initially warfarin can show procoaglant effect )

10.Csf has low conc of which of the following than plasma… = .proteins

11.Corona radiata forms from. = Granulosa

12.Surgery grade 3 tumor = 50 to 75 % cells undifferentiated

13.Muscle attached to bone by = Tendon

14.treponyma pallidum for initial Diagnosis sample can be taken form.= Genital sore scrapping

15.Pt with jaundice hepatosplenomegaly which test to be Performed. =Antimitochondrial antibodies

16.1 litre blood loss quest =. Inc venous tone

17.While playing cricket got abrasions. Immediate mechanism = Vasoconstriction

18.Tumor suppressor gene = P53

19.Mc cause of fatty liver in our population = protein malnutrition ( if this is not present in options, prefer Fat intake/obesity , note that hep B&C don’t cause fatty liver, and don’t confuse NASH ie non-alcohlic-steato-hepatatis with fatty liver as it’s a condition associated with hepC not caused by Hep C )

20.Ecf volume can be increased by = Hypertonic saline (hypertonic saline inc ECF volume and osmo , and also sucks the fluid from ICF compartment futher increasing ECF volume )

21.Most radiosensitive tumor = Seminoma (after seminoma the most radiosensitive tumors are Glial glioma and followed by craniopharyngioma)

22.Alveolar surface dry due to = Negative interstitial pressure

23.Pseudomonas aureginosa. = Endotoxin

24.Corynebacterium diphtheria lethal effect on = Heart

25.Benign tumor = Leiomyoma

26.Histoplasmosis effect on = Reticuloendothelial sys.

27..Bioavailability is not affected by = Sex/gender

28..Regarding morphine use = Terminal cancer patient

29..Heparin prevent which stage of coagulation = Propagation of thrombus

30..upper motor neuron lesion = Increase muscle tone ( as a rule, in umn lesions everything goes up , so as the muscle tone )

31..passes through cavernous sinus =. Abducence nerve ie CN6

32..young girl, used a drug for back ache, platelets were in normal range,wbc 70000,neutropenia, hb was 9, small immature cell in peripheral film =.acute leukemia

33..in juxta glomerular nephron, sodium is actively reabsorbed electrically neutral from lumen of nephron in which segment of nephron = Proximal convoluted tubules ie PCT

34..about follicular ca of thyroid = Vascular invasion35..transplanted auto graft survives most in = Agamaglobinemia36..increase in creatinine,,source = Skeletal muscle

37..chronic hepatitis histology = Fibrosis38..strongest layer of bowl is = Sub mucosa

39..Weight bearing line in pelvis pass thru = .ischial tuberosity

40..Which of the following is ectoparasite.= Lice

41..Farmer organophosphate poisoning what should be given = Pralidoxime ( if pralidoxime is not in options , prefer atropine then )

42..All preganglionic neurotransmitter =. Acetylcholine (note that all preganglionic autonomic fibers are B-FIBERS, neurotransmitter is ACETYL CHOLINE & receptors are NICOTINC receptors )

43..Sweat gland by = .sympathetic ( sweat glands are supplied by sympathetic fibers but the neurotransmitter is acetyl choline not nor epinephrine)

44.Rt upper n lower limb paralysis. Angle of mouth deviates to left while talking. =Internal capsule ( if the limb paralysis & facial paralysis are on the same side ie right , then lesion is in internal capsule as in this case, note that don’t confuse the left deviation of mouth as left sided paralysis, cz it still indicates right side paralysis of facial muscles as right are weak and left muscles pull mouth towards them, avoid this tricky point; secondly if limbs paralysis on one side ie right and face on other ie

left then lesion will be in pons, third point is, if the scenario qualifies for pons and there is ATAXIA mentioned in stem then click Ponto-cerebellar junction)45..sulfur containing aminoacid = Cystine

46.. Truncal vagotomy = Dec acid secretion and pepsin

47.Insulin is inhibited by = B.blockers

48.Nonbacterial thrombotic endocarditis = Terminal cancer ( it may also be caused by conditions like SLE, but prefer neoplasm if present in options )

49..Chloride shift in rbc is due to which protein = Band 3

50.PPD is false negative in = Immunosuppressant

51.Following lymphoid organ receive lymph from subscapular sinus = . Lymph node

52.Adrenalecctomy taste preferences = Nacl (Salt)

53.patient with lung abscess develops meningitis, causative organism. =Staphylococcus ( any abscess in the lung is due to staph aurius until proved otherwise, according to oxford medicine, and after lung abscess meningitis is due to staph aurius , according to kaplan medicine )

54.Low dose estrogen pill causes. = Hepatic adenoma (look at the tricky point low dose, if its not there, click thromboembolism)

55.Human is an intermediate host of = Hydatid cyst

56.How can doctor provide better management to patient =. By better communication

57.EEG of a patient shows = Increase frequency of waves in active mind than in deep sleep

58...sodium regulation is through = osmoreceptors

59..Teratogen effect in which embryonic age =. 2 to 8 wks ( the most susceptible period to teratogens is 3 to 8 weeks when there is organogenesis, but if this is not in options, click the one near to it)

60..Which form of thyroxin is an active form = Unbound form

61..Beta receptor stimulation causes =. Increase heart rate

62..Drug interaction occur = Pharmacodynamic and Pharmacokindetic Both

63..Parasympathetic effect on Heart =. Increase PR interval

64..DIC activated by = Tissue thromboplastin

65..which of the following augment the effect of immune system = Complement System

66.Regarding occupational diseases increase risk of problems with exposure to =asbestos

67.Regarding biceps brachi = Arises from supraglenoid tubercle

68.Inf wall MI =.Right marginal artery

69.A person had an accident and there was severe bleeding from his body. He got multiple transfusions but Ecg showed Changes after transfusion due to =hyperkalemia

70.Commonest cause of hydrocephalus = Obstruction of sylvus71.BMR n resting condition maintained by = liver

72.And that conversion of chondrocytes to osteoblast type = Thyroxine73.howship lacunae contain = Osteocytes

74.EF increase will cause = dec in ESV

75.true about vertebral column. = Inter vertebral disc forms 1/4 of total

76.thalasemia in fetus how to diagnose = cvs >>>mother hb electrphoreis

77.an old man with mi suddenly develop peripheral cyanosis. =V/Q mismatch

78..Metastasis is the result of. = Loss of e cadherin

79.extra systole will cause = dec in contractility

80.true abt allele = non identical chromosomes at same locus

81.septic shock mostly due to = gram negative

82.which present in post mediastinum. = descending thoracic aorta

83.standing form sitting heart rate will increase due to =. dec discharge form Baroreceptor

84.Travellers’ diarrhea = Diaphenoxylate

85.Common support for uterus = transverse cervical ligament

86.Infusion of hypertonic saline will cause = inc ECF vol

87. Aggregation of L.Node surrounded by stratified squamous epithelium. = palatine tonsil

88.which increase obstructive lung disease. = FRC89..carbon laden macrophages = Pneumoconiosis90.lobar pneumonia Ix. =sputum culture for bacteria91.pannus formation = RA

92.1st bone to ossify = clavicle

93.most common fractured bone = clavicle (if asked in lower limb , click tibia and if asked in hand prefer scapoid and if asked face , then nasal fracture )

94…polio affects = ant horn cell of spinal cord

95….selective Cox2>> cox1 = meloxicam ( if asked highly selective prefer Celecoxib over meloxicam if in options, while if asked potent cox2 inhibitor prefer meloxicam)96..primary brain vesicle = mesencephalon

97…128 Hz tuning fork frequency what will stimulate = Pacinian

(pacinian will detect low frequency vibration while for high frequency click messiner)

98.Lft hand tremor dystonia = left cerebellar lesion

99..temporal bone fracture will cause = memory loss100.reticular activating center = Brain stem

01.ECA differs frm ICA. = ECA gives branches in neck02.down syndrome = rebertsonian translocation

03.a pt taking fruits and vegetables. = will cause vit B12 def04.a thin lean lady will low Ca after fracture = vit D defcncy

05..a man is told by his dr that he has trnd out to be positive serology becx of sex History 3 weeks back = Penile chancre

06.. Measles will cause = pan sclerosing encephalitis07. echo virus will cause = meningitis

08.HIV will cause = kaposi sarcoma >> squmous09.always associated with HIV = Cervical CA10.meningitis with rashes. = penicillin

11.not a component of innate immunity……… 4 type of Ig >> plasminogen12.myeloperoxidase specific for = Neutrophil

13.RBCs have = glycolytic activity

14. Red blood cell antigens = secreted in saliva15.temporalis is supplied by =trigeminal

16.unable to close eye = Facial nerve lesion ( the job of Cranial nerve 3 is to keep the eye open and the job of cranial nerve seven is to keep the eye closed)

17.not related with HLA = systemic sclerosis

18.langerhan giant cell seen in which type of hypersensitivity reaction = type419.in PPD what seen = T cell and macrophage

20.cell swelling is due to = entry of water

21.in black most common complication of wound healing = keloid22.Aggresive Ca = melanoma

23.tumor with metastasis what should be most commonly seen = Cachexia24.gene amplification = neuroblstoma

25.main resistance for albumin =.GB

26. Hb 10, O2 saturation 90% ( convert 90% to 0.9 ), PaO2 60 , ask about to calculate O2 contents = 13 ans (see solution below)

*Formula for oxygen content =(Hb g/dL ×1.34)×SaO2 + PaO2×0.003 oxy content = (10× 1.34) × 90% + 60 × 0.003

oxy content = 13.4 × 0.9 + 0.18

oxy content = 12.06 + 0.18 = 12.24 = 13 approximately27.RBC antigens are = glycoproteins ( Ref ;Edward F Goljan )

28.Cranial nerves 7, 9 , 10 taking taste sensations converge on = nucleus of tactus solitarus (how to memorize; remind yourself that these are the nerves carrying taste sensations, so call this nucleus tastus saltarus instead of tactus solitarus )

29.GFR and Blood flow increases = due to dilation of afferent arterioles

30.Most common CNS tumor in children is = astrocytoma (primary brain tumors in children :

Cystic cerebellar astrocytoma > medulloblastoma > brainstem glioma while in adults in order:

Glioblastoma multiforme (GBM > meningioma, >ependymoma)

31.Which nerve branch of cervical plexus supply posterior auricular area =lesser occipital nerve (lesser occipital nerve , ie the anterior ramus of C2 supplies the area behind the ear )

32.Hogdkin lymphoma cervical lymph nodes and spleen involved = stage 3 ( as both sides of diaphragm are involved )

stages of Hodgkin lymphoma are;

stage 1 = only one group of lymph nodes/organ involved

stage 2 = more than one groups/organ but on same side of diaphragm stage 3 = lymph nodes/organ on both sides of diaphragm

stage 4 = wide spread lymphoma

33.Clot retraction is medicated by = thrombosthenin ( note that clot retraction is the function exclusively specific to platets)

34.Most common brain tumor = Astrocytoma (Accounts for about 70% of all neurogical tumors)

35.Regarding malignant melanoma arrange cell in chronologic order which will present earlier = melanocytes > lymphocytes

36.Hemophilia , joint pain six months now presents , which substance will be present= cholesterol (ans from senior, I couldn’t find any authentic ref)

37.Post HIV operation theater will be cleaned by = 2% gluteraldehyde 38.Flourecent and resistant to antibiotics = teponema ( though treponema is treated with penicillin G, but still its one of the infection hard to treat by antibiotics ) 39.Sciatic nerve damaged, and dorsal surface of foot still has sensation , nerve supply is = saphenous,(saphenous nerve supplies medial side of leg and also foot extending to its dorsum up to lesser extent, and it’s the branch of Femoral nerve, while all others are the branches of sciatic nerve, so saphenous holds true as per exclusion ) The other options were sural , tibial and common peroneal

40..Whole wheat contains which vitamin = Thiamine

(vitamin-B1 Sources; Liver, eggs, whole grain cereal, rice, and wheat note that Removal of the outer layer of grain in the refining process eg white bread significantly lowers thiamine content)

41.Pulmonary symptoms are by = ascarisais

42.17-ketosetoids in urine and ambiguous genitalia = adrnalectomized female(Increase in 17-KS, testosterone, and DHT; causes Ambiguous genitalia in females primarily due to the increase in DHT and it effect on the external genitalia. First step when identifying ambiguous genitalia is to check the genetic sex of the newborn with a chromosome analysis)

43.Median nerve damaged which action of median nerve will be impaired ,=opposition

(explanation along with other options,

Flexion (flexor pollicis brevis has dual supply i.e both from ulnar and medial so flexion is least affected in case of median nerve injury)

Extension (extensor are supplied by Radial nerve not median)

Abduction ( abduction is not lost because, abduction is carried out by two muscles, ie abductor pollicis brevis and abductor pollicis longus, so if brevis is lost, longus can compensate for it)

Adduction, ( adductor pollicis is supplied by ulnar nerve)

Opposition (while opposition of the thumb is only and only the function of median nerve so its ans)

35.Lymph from the testes drains into = para-aortic lymph nodes (lymph nodes of testes drains into para-aortic lymph nodes , at the level of L2 (while lymph drainage form scrotum is into superficial inguinal lymph nodes )

36.Ventral surface of the foot is supplied by which nerve = Medial planter nerve ( tibial nerve divides into medial and lateral planter nerves that supplies foot)37.Desending thoracic aorta = supplies, pericardium, esophagus, and brochus38.Thyroid gland drains into = deep cervical lymph nodes

39.Superficial epigastric artery is a branch of = Femoral artery ( this artery is one of the superficial branches of femoral artery and should not be confused with superior epigastric artery )

40.Artery that arise in the substance of parotid gland and lies at posterior border of digastric muscles = posterior auricular artery ( external carotid artery in the substance of gland divides and give posterior auricular artery)

41.Which one is involved in portal hypertension = esophageal artery ( a branch of the left gastric artery, that forms port-systemic shunt with azygous vein, and is the artery responsible for esophageal varices and hematemesis)|

42.Mass of the hair is because of = keratin (up to 95% of the hair mass is because of keratin)

43.Spleencectomy vessels present in which ligament = spleenorenal ligament(splenic artery enters into the hilum of spleen in spleenorenal ligament , splenic vein lies below the splenic artery in the spleenorenal ligament ( while six short gastric arteries passes to the fundus of stomach in gastrosplenic ligament)

44.Neck of bladder and proximal urethra are supplied by =, symphathetic by hypogastric ( sympathetic fibers from L1 & L2 segment of the cord via superior and inferior hypogastric plexus)

45.Surgical neck of humerus which artery damaged = posterior circumflex (Surgical neck is a narrow area distal to tubercle, that’s, the common site for fracture and is in contact with axillary nerve and posterior circumflex humeral artery )

46.Which muscle is flexor of forearm and supplied by radial =brachioradialis

47. Circumflex branch is damaged which area will be affected = left ventricle and left atrium

48.Artery involved in inferior wall MI = posterior inter-ventricular artery49..Sinus in jaw plus yellow granules = actinomyces

50.Abduction up to 40 degree is lost = supraspinatus

51.Fracture of surgical neck of Humerus damage to = Axillary Nerve ( note that deltoid is supplied by axillary and damage to it result in loss of abduction,supraspinatus – by suprascapular nerve = 15 to 30 degree abduction Deltoid – by axillary nerve = upto 90 degree abduction

trapezius – by accessory nerve = above 90 degree abduction52.Inversion of foot by which muscle = Tibialis Posterior53.Lateral foot dermatome = S1

54.Most appropriate about Clavipectroral Fascia =Covers Pectoralis Minor55.The specific feature of Apoptosis = cell shrinking ( if councelman body is mentioned in options then click that )

56. Open wound healing includes = myofibroblast

57.An obese man with h/o atherosclerosis underwent laparotomy due to bleeding in abdomen n during surgery, his small gut was purple n sup mesenteric artry was blocked , so what is dx =wet gangrene

58.Cervical rib attached to trverse process of cevical rib will compress = T1

59.Aortic aneurysm which structure not compressed: Phrenic nerve

60.Mucus not secreted by = terminal bronchioles

61.nerve supply of extensor digiti minimi = deep radial nerve ( all the extensors of hand are supplied by Deep branch of radial nerve )

62. Pregnant lady anaemic, Best lab Investigation = CBC63.The muscle that causes eversion of foot = peroneus longus

64.Anion gap = difference b/w measured cation and unmeasurd anion65.regarding cimitidine intake what effect causes =.inibition of hepatic enzymes66.which of the following is premalignant lesion = lichen planus

67.ewing sarcoma occurs which site of bone = diaphysis68.spermatogenesis is stimulated by = FSH and testosterone69.epididymis drain into = vasdeferens

70.regarding lesser sac = double peritonal layer

71.basic scavengers = macrophages

72.K in diet is excreted in which part of nephron = distal tubules (Note that, 67% of the filtered K is reabsorbed along proximal tubule , but Distal tubules and collecting ducts either reabsorb or secrete K , depending on dietary K intake, the excretion ranges from 1% to 110% . if both DCT and collecting duct are present in options prefer, distal convoluted tubules)

73.narrowest part of urethra = external meautis74. ca prostate spread by = vertebral plexus

75.A patient using INH for TB prophylaxis, which vitamin he should use to avoid adverse effect = pyridoxine

76.after non-lethal MI in 4 minutes = arrhythmias77.opsonization occurs = help of c3b

78.fracture of 9th and 10th ribs will cause injury of which organ = spleen79.Saphenous nerve terminal br of = femoral

80.Adductor muscle hamstring muscle supplied by which nerve = tibial

81.loss of small muscle of one hand damaged = C8,T1 ( if u have to prefer one, then click T1)

82.gracillis nerve supplied by = obturator nerve

83.Adductor brevis supplied by = ant branch of obturator nerve

84.regarding tramadol true is, = weak meu agonist

85.epitheial changes in endocervix in squamous tissue due to = metaplasia86.ketorolac analgesia most preferable = Non diabetic cholecyctectomy87.middle rectal artery branch of = internal iliac

88.hemisetion with total spinal section differentaiad by = spinal shock89.gas having mximum diffusion capacity in body fluids = CO290.margins of TB ulcer = undermined

91.Internal laryngeal nerve passes through = thyroid and hyoid92.liver development = from ventral mesentry proximal Foregut

93.patient developed hemolysis due toG6PdD deificiency nxt happen = self limiting94. required for transport of B12 in blood = TC2

95.protein content less in glomerular filtrate occur due to = pore size and negative charge

96.superficial parotid painless tumor, pseudopoid growth, contain no capsule on histopathology = pleomorphic adenoma

97.Hypertensive ulcer = Martorel

98.regarding pituitary gland true is = vein drain directly in dural sinuses99.Anemia with Blast Cells in peripheral blood = Erythroblastosis fetalis ( note the point ie BLAST in the question and BLAST in the answer )

200.Which ligament supports odontoid process of axis on atlas = transvers ligament

01. Shivering center is located in = post hypotahlmus

02. Group of young men bathing n beech next day develop blisters on back shoulder limbs region cause is = Mast cell destruction

03.Deep to post digastric and near palatoglossus a structure runs obliquely upwards = Lingual artery

04.Surgery for removal of ovary done which is damaged = Internal Iliac Artery05.man in hot sunny environment fell…finding na 122 due to = excessive sweating06.hip extension and leg flexion by = semitendonosis

07.long thoracic nerve supply to = serratus anterior

08.how much amount of air is required for pulmonary embolism = 100cc09.Facial nerve exits through = stylomastoid foramen

10.Damage to capsule and articular capsule of temporomandibular joint causes damage to which muscle = lateral pterygoid

11.Universal donor = O negative ( while universal recipient is AB positive12.Side effects of chlorpromazine = Dystonia

13.Which structure is formed by the end of first week = blastocyst14.girl cannot comb her hairs Nerve damage = accessory nerve

15.regarding heart sounds = audible on area of heart valves more precisely16.aldosteron major action on = collecting duct

17.injury above sacral spinal cord result in = Spastic bladder (note that UMN lesion ie the lesion above sacral spine is = spastic bladder while due to lesion of the sacral spinal cord segments or sacral spinal nerve roots , means LMN lesion result in so called Atonic bladder. Neurogenic bladder is the term used for both spastic and atonic, so if clear-cut point is not asked then , prefer neurogenic bladder)

18.Cell membrane structure primarily maintained by = Cholesterol bilayer19.Enzyme may fall in liver injury = Pseudocholinesterases [decrease in liver disease(hepatitis and cirrhosis)]

20. which part of liver with poor supply = poor oxygenation of zone 3 ( note that zone 1 is richly supplied with blood and is mainly effected by VIRUSES & INGESTED TOXINS, while zone 3 is poorly perfused and mainly affected by metabolic toxins )21.trachea is = has 16-20 incomplete rings

22.what nerve loops around arch of aorta = left reccurrent laryngeal nerve23.hyper eosinophilia occurs in = hodgkin ( due to IL5, that stimulates the esinophills production )

24.corticopsinal track ends at which level = spinal cord (if asked anterior corticospinal tract or anterior spinothalamic tract ends at ?? the ans for both is = midthoracic region )

25.warthin starry stain used for = spirochete

26.phrenic nerve runs on left side with = pericardicophrenic artery

27.hypovolaemia with hypotension isoflurane shud not be given,why? b/c it is =Potent vasodilator

28.Otic ganglion location foramen was asked = inferior border of foramen ovale29.Epitheluim of preterminal bronchiole/ conducting zone = Pseudostratified columnar cilliated…with goblets in larger bronchiole (in resp bronchioles> cuboidal, then simple squamous upto the alveoli] {clara cells in terminal bronchioles} )

30.muscle which causes flexion of elbow and supplied by radial nerve =Brachioradialis

31.hormones during sleep = GH increases (During sleep Inc level than awake = cortisol)

32.chest pain and fever not related to respiration = Myocarduim

33.in later stage of pregnancy oestrogen and progesterone produce by = placenta34.A patient has hypercouagable state having def of = factor v(facror V Leiden)35.difference BTW skeletal and smooth muscle = ca calmodulin

36.Valve involved in Limb sack endocarditis = Mitral & aortic37.Abdominal angina cause by obstruction to = Sup mesenteric38.middle colic is the branch of = Superior mesenteric artery39.geniculate ganglion is located in = facial canal

40.taste sensation is carried to the cortex through = thalamus

41.two point discrimination = merkel disc (If asked ,Maximim 2 point discrimination then = Lips( TIP OF TONGUE BEST IF THERE ) while if the stem is

“Maximim distance of 2 point discrimination at” then = BACK OR scapula)42..oesophageal atresia = drooping of saliva (indicating factor)43.Aluminium hydroxide in = delays gastric emptying (causes constipation) 44.sternum ossification = 21 years

45.mandible = symphsis menti join at midline by joint. 46.broca’s area = area 44 Non Fluent aphasia

47.long refractory period = heart

48.defeciency of glucose 6 Phosphatase causes = hypoglycemia.. 49.Increase GFR causes inc absorption of salt and water from = PCT50.infection in cavournes sinus = inferior opthamic vein

51.cause of damage to lateral rectus = 6th CN

52.During hysterctomy ureters can be damaged while ligating which artery = uterine artery

53.which one is the DNA virus = Infectious mononucleosis

54.injury to surgical neck of humurus damage to which nerve = Axillary nerve55.Axillary nerve damage will cause what = Dec abduction

56. statistical test observed differences b/w 2 means been by chance = variance57.max pressure in aorta during which phase = max during slow ejection phase (

while lowest in isovolumetric contraction)

58.remant of geburnaculum,= Ovarian ligament and round ligament of uterus59-left renal vein relation to aorta = LRV is anterior

60-cause of thromboembolism = prolonged immobilization (most common)61. commonest cause of shift of K from intracellular to extracellular = strenous exercise (releases potassium from skeletal muscle)

62- regarding trachea = commence at lower end of cricoid cartilage63- damage to medulla oblongata during hanging = odontoid

64. sternocleidomastoid causes = movement of head in opposite direction against force(resistance)

65-platelets life span of = 10 days

(note that platlets Count increases after spleenectomy ,the 1st effect we see after spleenectomy is Increased Platelet count ie thrombocytosis as the sequestered RBCs are put into circulation, and the HOWEL JOLLY BODIES are after that, )66.lymphocytes = immunity against cancer cells (NK most potent)

67.multiple bone fractures history,blue sclera which products enzyme is defiecient =Collagen (the scenario is osteogenesis imperfecta)

68.Most common cause of Hepatocellular CA in developing countries = HEP B, C69.Regarding jerks corresponding with spinal segments = Biceps- C6 70.MELAS syndrome histological finding = Red ragged fibers

71.Giant Cell Tumors histo finding = Soap Bubble appearance

72.Young adult with raised ALP, jaundice and decreased Hb Scenario = Pigment stone

73.clostridium = spore producing

74.few weeks after delivery regression of uterus and breast = lysosomes75.inc stroke volume is due To = large blood volume

76.transport of glucose across placenta:-facilitated ( though both simple diffusion and facilitated are involved in glucose transport, while amino acids and fatty acids are only by facilitated diffusion; note that electrolytes use counter transport mechanism)

77.transport of local anesthetic across placenta – simple diffusion

78.Most common injured artery during difficult c- section = uterine artery ( while surgery for ovary damages interna iliac)

79.cutting of parasympathetic nervous system most likely = affects git muscles80.vaginal lymphatic drainage below hymen = Medial group of superficial inguinal lymph nodes

81.alpha amino group of non essential amino acids is derived from = glutamate

82. micturation controlled by = Mechanoreceptors in bladder wall…. ( another question is frequently asked about micturition and the answer will be SELF GENERATIVE )

83.pelvic splanchnic nerve = parasympathetic

84. years old pregnant lady,, suggested for chorionic villous sampling.What you suspect = trisomy 21

85.pt with moon facies excessive fat deposition at chest and abdominal areas,, ACTH raised,, diagnosis = cushing disease ( ITS disease not syndrome as in syndrome ACTH, will not be raised )

86.A patient presented on 18th day of menstrual cycle.Her normal cycke is such that she ovulates on 14th day.Which phase will she be in = secretory

87.standard deviation shows = variability among individuals88.Best test for diabetic nephropathy = urinary albumin

89.child with yellow sclera and colored urine best investigation = ALT & bilirubin90.Uterus remains in position by : Cardinal Ligament ,

91.A girl with primary amenorrhea ,, height 5. 4,, weight 60 kg.well developed breasts , small vagina,, no uterus on u/s,, genotype xy ( no bar body) = testicular feminization

92. Ureteric bud not reaching mesenchyme leads to – Renal Agenesis93.Longest pre erthrocyte stage is longer in = Plasmodium Malariae

94.No agglutinin is present in blood group = AB+ (Right answer is AB+ coz agglutinin means antibodies so in AB +ve blood group no antibodies that’s why no reaction with donor blood hence AB+ve iz universal recipient)

95.Platelets transfusion is contraindicated in = ITP ( if the question asks must not be given then answer is Splenomegaly)

96.4th heart sound is produced by = Atrial Systole

97.Patient is unable to open the mouth due to paralysis of = Lateral pterygoid98.What is correct about broncho pulmonary segment = Aerated byTertiary bronchi99.Characteristic of actinomyces = Abscess and granuloma

300. A carcinoma of vagina below hymen( vaginal orifice) is likely spread via the lymphatics into the = Medial group of horizantal superficial inguinal nodes

Regards; Tan Veer Ahmad

Good luck for exam …………

SESSION # FIVE ; Sometimes the chains that prevent us from being free are more mental than physical.

1. Councilman bodies seen in – Apoptosis.

( Remember ; if u see word MALLORY BODY = alcoholic liver disease

Myleine figure = Reversible cell injury and councelman body = apoptosis , never click any other option then )

2.Thorn prick in left lower limb caused abscess – Staph aureus

3.Oblique fissure of the lung at level – T3 to T6 Costochondral.

4.Stress hormone of our body – ACTH ( IF cortisole is not given in options prefer ACTH )

5.Superficial temporal artery relation with which nerve – Auriculotemporal nerve.

6.Correct about Thyroid gland – lymph drainage to deep cervical lymph nodes.

7.Anemic hypoxia occur in – Methemoglobulenemia.

8.In cerebral circulation brain arteries – Do not anastomose once entered in the brain (Don’t confuse it with circle of villus that is anastomosis in the sub arachnoid space not in the brain substance).

9.Phase 1 of transformation of drug metabolism – Oxidation.

10.Standard deviation shows – Variability of individual observation.

11.Counseling in patients is – To help themselves.

12.A young girl who is going to die and asks you “Am I going to die?” Doctor response should be – “What your parents have told you?”

13.In whole wheat – Thiamine.

14.Cholesterol enriched diet – Egg

15.Origin of peroxisomes – SER.

16.Organelle where protein combines with carbohydrates, packed and released –Golgi complex.

17.Correct about DNA – Euchromatin is transcriptionally active.

18.ADPKD associated with – CEREBRAL HEAMORRHAGE ( If asked the most common cuase of death/complication in ADPKD then = Renal failure ….. but if asked association then Sub-arachnoid heamorrhage (50%) >> cerebral heamorrhage)

19.Cause of delay in healing – Infections ( infection is the most common cause of delayed wound healing )

20.PaO2 decreased, PCO2 increased, hydrogen ion increased; manifestation –Hypoventilation.( look at CO2 which is increased that means person is not ventellating properly to remove it out that is HYPOVENTELLAION)

22.Person with tachycardia, and heat intolerance with low level of TSH, on giving TRH; level of TSH and thyroid hormones increases. Diagnosis – Hyperthyroidism with thyroid problem.

23.Origin of oxytocin and ADH – Hypothalamus.

24.Difference between systemic and pulmonary circulation – Low resistance in pulmonary circulation.

25.Mean systemic filling pressure is regulated by – Venous return.

26.Systolic pressure is directly related to which one of the following – Renin.

27.ADH responds to – Osmolarity.

28.Osmoreceptors are receptors for – ADH.

29.Right border of heart on X-ray also visible a part of –SVC.

30.In MI sensitive cardio marker – Tropinin T. ( IF asked in 1st hour or Enzyme in stem then prefer CKMB)

31.Diabetic nephropathy investigation – Urine albumin.

32.Young boy with generalized edema and proteinuria – Lesion of basement membrane.

33.Lesion of parasympathetic system affects mostly – GI muscles.

34.Decussating of medial lemniscuses – Internal Arcuate Fibers

35.S2 sound heard on – Closure of aortic and pulmonary valve.

36.A patient with history hemorrhage (trauma) receives a bag stored for 2 weeks mainly contains – RBCs.

37.Due to inspiration what decreases – Volume of atrial pulse. ( as during inspiration there is minimal blood in the left ventricle that dec blood pressure)

38.Important buffer of blood – HCO3-.

39.Max increase in ECF due to infusion of – Hypertonic NaCl.

40.Auscultation of tricuspid valve best heard at – Right lower end of the body of sternum. ( this is CPSP favorite most question )

41.GVE vagus nerve for preganglionic fiber arises from – Dorsal nucleus. ( it’s the parasympathetic nucleus of vagus to the viscera that why its supply is so called , GENERAL VISCERAL EFFERENT )

42.Tip of scapula at level – T7.

43.Diabetic female after abdominal surgery; dyspnea and cough – Pulmonary embolism.

44.MCC of pulmonary embolism – DVT. ( NOTE ; if asked the most common site of DVT then Popletial vein if asked most common source for pulmonary embolism then FEMORAL)

45.Typhoid fever 1st week test – Blood culture

46.Typhoid fever 2nd week test – Blood culture and Widal test.

47.Typical feature of falciparum – Black water fever.

48.Alcoholic patient with deranged LFTs; on biopsy – Mallory bodies.

49.Potassium is mainly regulated by – Aldosterone.

50.Natural self-defense against tumors – Apoptosis.

51.P53 gene absent results in – cell survival.

52.Pain mediator – Bradykinins.

53.Metaplasia – Functional change in cells. ( metaplasia is replacement of one adult cell to type by other , and is mostly due to CHRONIC IRRITATION , it’s a REVERSIBLE condition and most common examples are BARRET ESOPHAGUS AND SQUAMOUS METAPLASIA OF LUNG DUE TO SMOKING)

54.Female with infection of HPV, comes after 2 years, Pap smear shows prominent nucleoli and increased nucleus size – Dysplasia. (Whenever in scenario u see word , change ins SHAPE, SIZE , ORIENTATION, ARCHITECTURE, OR INC NUCLES ISZE, always pick Dysplasia , its also a reversible condition)

55.Gas exchange occur – Simple squamous epithelial layer.

56.Patient with granulomatous disease, biopsy done. Microscopic finding that suggests TB – Caseous necrosis ( if asked the feature of granuloma then click epithloid cells, not otherwise, if asked what will u do next after u see caseous necrosis then click AFB STAINING , if no clue is given the click AFB STAIN)

57.The spindle fibers will decrease in discharge of impulses when – Muscle contracts

(NOTE; the job of spindle is to contract muscle, it means when the muscle contracts , its job is done and it DEC FIRING )

58.Diagnosis for leprosy, initial investigation – Nasal scrapping.

59.Benign neoplasm – Adenoma.

60.3 germ layers tumor – Teratoma.

61.When adrenalin release from medulla, causes vasodilation by acting on – Beta 2 adrenergic receptors. ( ALPHA 1 = contraction , Beta 2= dilation )

62.Increased GFR and increased plasma flow occur due to – Dilation of afferent arteriole.

63.Charateristic of cerebellar lesion – Dysmetria

64.Emax (maximum effect) of a drug depends on – Efficacy ( crame it, is highly repeated)

65.Study in which every person of a population has equal chances of being selected

– Random sampling.

66.Amniocenthesis is done – After 14th weeks.

67.1st response against acute inflammation in tissue – Macrophages.

68.In dark granules containing cells; IgE attaches to – Basophils.

69.Opsonization – C3b. ( also Fc portion of IgG is opsonin, BUT C3b is more potent)

70.Exudate – more than 3g of proteins.

71.About active transport of drug all are true except – All drugs pass via active transport.

72.Pulmonary artery supply to – Alveoli. ( this is the evergreen question among repeated ones)

73.Muscles of back innervated by – Dorsal rami.

74.In young boy dyspnea produced on lying – Retrosternal goiter.

75.Most important cause of bronchogenic cancer – Smoking.

76.Edema caused by – Increased hydrostatic pressure.

77.Edema caused by – Lymphatic blockage.

78.BP 210/180mmHg and creatinine 8% damaged part – Juxtaglomerular apparatus. ( this ques is mostly repated In same way, so remember if very high BP an raised creatinine and in options there is JG APPARATUS. Don’t click anything else)

79.Female with blood group A, have 2 children; one with O and other with AB, blood group of father is – B.

80.Genetically true hermaphrodite XXY ( This is one of the most controversial MCQ, and according to Goljan xx is correct ans that’s in 50% of cases while other combinations make only little percentage, but cpsp key makes XXY a better option)

81.DNA replication occur in – Interphase. ( DNA & CHROMOSOMES replication occur in interphase)

82.Glycogenolysis caused by deficiency of which hormone – Insulin

83.Investigation for liver amoebic abscess – Serology.

84.Surgery of submandibular gland; nerve damaged – marginal mandibular branch of facial. ( this branch of fascial nerve runs superfascialy and is mostly damaged during surgery)

85.On posterior surface of oblique and transversalis fascia – Arcuate line.

86.Aspirin overdose causes – tennitus. ( aspirin ….. if asked GI disturbances = click normal dose, if tinnitus then= OVERDOSE)

87.Cardiac output measurement via thermodilution – Temperature change downstream with CO. ( NOTE ; if thermodilution not mentioned then Ficks method)

88.Father with defective gene on one autosomal chromosome, develops disease later in his life; chances of getting disease in children – Half of the children will be affected.

89.If left circumflex artery occluded – Infarction of left atrium and left ventricle.

90.MCC of multiple fractures in adult – Osteoporosis.

91.Patient with fracture of many bones and low BP immediate treatment – Volume replacement.

92.Most common fracture of long bone – Tibia.

93.Collagen fibers – Eosin stain

94.Gamma efferent supply to – Intrafusal muscle spindles. ( memorize by heart, its highly repeated)

95.Micturition – Self generating.

96.Hallmark of HIV – Proliferation of virus in T cell ( if asked about AIDS, THEN progressive immune deficiency).

97.1g protein gives energy – 4 kcalories.

98.Isotonic and isometric contraction difference is that isotonic contraction –comsumes more phosphate bond. ( memorize as such , highly repeated)

99.Autonomic nervous system – parasympathetic increase salivary secretion.

100.Protrusion of mandible – Lateral pterygoid.

01. After feeding the baby, diarrhea develops – Gastrocolic reflex.

02. Both sides of 5th posterior intercostal spaces is supplied by – Thoracic aorta.03. 2 years old child with medially rotated arm lesion in – Upper trunk.

04. Female with uterus cancer which travels to labia majora following which route –Round ligament.

05. Pain in epigastrium due to ulcer, transmitted by – Greater splanchnic nerve. 06. Vesicular lesion on the tip of nose and eyelid – Ophthalmic nerve.

07. Patient can’t abduct till 30 degree, which muscle is responsible – Supraspinatus. 08. Nerve supply to plantar surface of foot – Posterior tibial.

09.Medial arcute ligament – Psoas major muscle.

10.Bitemporal hemianopia due to lesion of – Central part of optic chiasm.

11.Ventral spinothalamic tract – Coarse touch and pressure.

12.Dorsal column – Proprioception.

13.Vibration and touch via – White matter of posterior spinal cord.

14.Function of notochord – Induction of ectodermal neural plate to produce neural tube.

15.Midbrain reticular system – Unusual stimulus causes arousal.

16.Most radiosensitive tumor – Glioma.

17.Hormone increased during sleep as compare to at day wakefulness – Cortisol.

18.In Trigeminal neuralgia anesthesia given to block trigeminal ganglion at which site – Middle cranial fossa.

19.Patient with intentional tremors and facial paralysis lesion at – Cerebellopontine angle.

20.Opioids produces vomiting by acting on – Chemo trigger zone in medulla.

21.Patient working in mine with tuberculin test positive. Cough, fever, weight loss with hilar lymphadenopathy – Silicosis. ( silicosis = predispose to TB that’s why tuberculin positive)

22.Male working in construct factory with pleural plaques – Asbestosis.( asbestos predispose to bronchogenic carcinoma and mesothelioma )

23.Neoplastic cells with continuous mitosis due to persistence of – Telomerase.

24.During exercise venous return is due to – Contraction of calf muscles.

25.During exercise increased blood supply to muscles – Local metabolites.

26.Action of steroids as anti-inflammatory is due to – Inhibiting phospholipase.

27.Intermediate filaments (keratin) staining with immunofluorescence to diagnose

Carcinoma. ( note that if there is mentioned carcinoma then look for keratin , and if meshenchymal tissue tumor then VIMENTIN)

28.VPL nucleus of thalamus when damaged cause – somatosensory loss of contralateral body.(REMEMBER , Ventral postro Lateral nucleus is for somatosensory sensation from contralateral body while ventral postro medial ie VPM is for sensation from face )

29.Thiazide diuretic cause – Hypokalemia.

30.Man living on side of a river, got blindness from nematode; organism –Onchocerca volvulus. ( highly repeated)

31.MCC of HTN – Idiopathic.

32.Adult female with breast atrophy due to decrease in – Estrogen plus progesteron.

33.Female with hirsutism, galactorrhea, infrequent heavy menstrual cycle. U/S both ovaries with cystic lesionsand LH:FSH :: 3:1 – PCOS

34.Female with hot flushes – Increase FSH and LH.

35.Injection of atropine will cause – Dryness of mouth.

36.Female with severe loss of vibration, Investigation of choice – Stomach biopsy.(this scenario is about vitamin B12 deficiency where there is sub-acute combine degeneration of spinal cord resulting in loss of vibration & position sense , the most common cause of vitB12 deficiency pernicious anemia, for which stomach biopsy is indicated )

37.Child with yellow sclera and colored urine, best Investigation – Bilirubin and ALT

38.Female with weakness and lethargy with RBCs 5.5 diameter and very thin red line of RBC in peripheral smear – Microcytic hypochromic anemia.

39.Monitoring of Hep B – Serum glutamate-pyruvate transaminase.

40.Female with reactive anti HBe and reactive total anti HBc along with non- reactive HB IgM and non-reactive HepBs Ag – Acute recovery phase.

41.Patient with obstruction jaundice; now bleeding cause – Vit K deficiency.

42.Investigation of Hashimoto thyroiditis – Antimicrosomal and anti-thyroglobulinantibodies.

43.Cimetidine interaction with warfarin causes – Decrease hepatic clearance of warfarin.

44.Patient using some anti-coagulant, how will you know that anticoagulant is warfarin because it is being monitored by – PT ( remember the oral anticoagulant means warfarin and to moniter warfarin INR > PT, so if INR is there then click it if not then PT)

45.BP drops from 100mmHg to 70mmHg – Decrease in carotid sinus nerve activity.

46.Erythropoietin is secreted by – Mesangial cells.( erythropoietin is secreted by peritubular capillaries, but in cpsp exams, it is secreted by mesangial cells

#respect)

47.Patient with all symptoms of Cushing along with increased ACTH cause – Cushing disease. ( simple difference between CUSHING disease and syndrome is , that in cushing diseae ACTH will be high )

48.Child with machinery like murmur – PDA.

49.PaO2 is 100% in – Left to right shunt.

50.Kallmann syndrome – Defect in Arcuate nucleus.

51.Diplamotoylphosphatidyl choline + carbohydrate + proteins is a content of –Surfactant.

52.In asthma = Decrease FEV1.

53.Splenectomy is most useful in – Hereditary spherocytosis.

54.Findings in glycogen storage diseases – Hepatomegaly and hypoglycemia.

55.Corynebacterium diphtheria produces – Exotoxins.

56.Common specie of Corynebacterium affecting human is – Diphtheriae.

57.Typical symptom of food intoxication by Clostridium botulinum – Flaccid paralysis.

58.CSF with increased proteins and polymorphs with decrease glucose the drug of choice = Ceftriaxone.

59.About the pharmacology of Neiserria gonorrhea = Pencilin G.

60.Major histocompatibility is related to – HLA.

61.Kidney is transplanted, gets cyanosed in 10 minutes, type of reaction – Antibody mediated. ( In case of hyperacute rejection, there are preformed antibodies, which reacts within minutes,)

62.A child with Agammaglobulinemia is prone to – Pyogenic infections.

63.Diagnostic criteria for sarcoma – Increased vascularity.

64.Soldier coming down from height, now with discoloration of fingers, dyspnea –Secondary polycythemia.

65.Vitamin D acts on intestinal mucosa via – expression of genes.

66.Release of neurotransmitter due to – Influx of calcium in presynaptic fiber.

67.Calcium influx via slow channels in ventricle cells causes – Ventricular ejection.

68.Increased ‘a’ wave in JVP due to – Tricuspid stenosis.

69.Person with HR 80/min, on ECG RR interval would be – 0.75 sec.

70.Class III Antiarrhythmic – Amiodarone.

71.Increased ASO titer – Rheumatic fever.

72.In hypertrophic cardiomyopathy – Myocytes disarray.

73.5 month of pregnancy, lady with thyrotoxicosis, drug of choice – PTU.

74.30 years old smoker, psychotic, vomiting of fluid with visible peristaltic movements on abdomen cause -Pyloric stenosis. ( note that the stomach that you hear ( auscultation give splash sound) , you can see ( visible presitalisis ) and you can feel ( olive like mass on palpation ) is pyloric stenosis )

75.Myenteric system of parasympathetic is potentiated by – Ach.

76.Pethidine is preferred over Morphine – Less addictive ( Another FACT frequently asked about pethidine is , that it causes TACHYCARDIA at therapeutic dose , WHILE morphine causes release of Histamine)

77.Philadelphia chromosome – CML.

78.Male with fever upper lobe consolidation, fever from last 3, productive cough, AST 135 and ALT 111, alkaline phosphatase normal, bilirubin 10, he died on autopsy weight of liver increase and with fat droplets seen on hepatocytes and Mallory bodies , Diagnosis – Chronic alcoholic disease.

79.Alpha 2 macroglobulin inhibit – Trypsin.

80.Male with all symptoms of LV failure and pulmonary edema without any previous illness and BP 125/85mmHg, on X-ray cardiomegaly; cause of heart failure– Bicupid aortic stnosed valve ( if the history of alcohol intake is given, prefer alcoholic cardiomyopathy )

81.Highest potential difference in the wall of stomach is when – Aspirin ingestion.

82.Calculate Alveolar ventilation where Tidal volume is 500ml/respiration. RR 10 –3500ml/min

(Alv ventellation = TIDAL VOL – DEAD SPACE 500 – 150 * 10=350*10

=3500 )

83.Calculate Clearance where Urinary flow 20 ml/min, Concentration of substance in urine 10 and Plasma 10 – 20ml/min.

( clearance = UV/P i-e 20 *10/10 = 200/10 = 20)

84.Excessive eversion of foot damaged which structure – Rupture of deltoid ligament. ( if asked about inversion then talofabular ligament , inversion sprains are more common than eversions)

85.About descending aorta . give branches to pericardium lung etc

86.Counterpart of Mullerin tubercle – Seminal colliculus.

87.Histology of cornea – Stratified squamous non-keratinized.

88.Left shift of HbO2 curve – CO poisoning.

89.Humans are intermediate host in – Hydatid cyst.

90.Clot retraction is mediated by – Thrombosthenin

91.In late pregnancy the uterus is most sensitive to – Oxytocin. ( while for the initiation of labour fetal cortisol is important )

92.About bicep brachialis muscle – attaches to supraglenoid tubercle of scapula. ( cram it, its highly repeated )

93.Hyper-resonance is mostly heard at T2-T4 of right midclavicular line.( because in this region there is only lung, while on left side there is heart and right side below this ,is liver, so this area is always hyper-resonant)

94.Conus medullaris terminates in neonates at the level of – L3

95.Cimetidine is used preoperatively – Dec acid secretion from stomach.

96.Nursing mother with herpes labialis, drug of choice – Acyclovir.

97.PO4 increased, Calcium decreased and PTH increased – Chronic Renal Failure. ( remember if PHOSPATE IS INC and Ca is dec THEN FIRST EXCLUDE CHRONIC RENAL FAILURE)

98.Labetalol acts on – Alpha and Beta receptors.

99.Women after delivery, Platelet: 70,000, aTTP normal, PT raised – DIC. ( Also note the point that DIC is initiated by THROMBOPLASTIN )

200.Between umbilicus and suprapubic rectus sheath behind at its lower limit forms – Arcuate line

01.which of the following cranial nerves have parasympathetic nuclei = III, VII, IX,X (

3.7 . 9 & 10 )

02.What is hamartoma = totaly benign (Hemartoma is just jumbled up normal tissue and totally benign)

03.Adrenergic Receptors of Adrenal medulla : cholinergic ( specifically cholinergic nicotinic)

04.Coronary Arteries – always run n in the respective AV septal depression, 05.Scalenus Anterior Muscle – phrenic nerve passes anterior to it

06.loss of sensation of nose, cheek, maxilla, zygoma : maxillary division of trigeminal nerve (if tip of nose mentioned then opthalmic division of trigeminal nerve , the most fav question of cpsp)

07.Which of the following have subcapsular afferent sinuses : lymph nodes( whenever you fine subcapsular afferent in stem , first look for lymphnodes in options)

08.which of the following hormone increases content of skeletal muscle Proteins—testosterone

09.An Ovum is surrounded by corona radiata which is formed by : granulosa Cells10.Patient underwent colostomy after colon resesction for colonic cancer, best way to monitor for recurrenc; CEA levels

11.Growth harmone : is a polypeptide ( a second option is often there in paper, acts indirectly via IGF, if u find it , click it )

12.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 D ( passage of foul smelling stools indicate loss of digestion and absorption of bowel fats resulting in deficiency of fat soluble vitamins, vit D is fat soluble, )

13.neurogenic shock is different from other types of shock because of : loss of vasomotor tone

14.bleeding time increased : VWbrand’s disease ( in vw disease , both bleeding time and APTT are prolonged )

15.left kidney grossly identified from right kidney by : arrangement of structures in hilum

16.which of the following have highest incidence of bronchogenic carcinoma =smoking

17. A man with third degree burns have increased risk of developing : Contracture18.Which of the following arches over root of right lung : , azygous vein

(structure arches over left lung root = aorta cz on left there is aorta,structure arches over right lung root = azygous vein as its on right,

structure anterior to the root of both lungs = phrenic nerve,ie phrenic in the frontand posterior to the roots of both lungs = vagus nerve)

19.Stored blood has following characteristics ; increased hemolysis20. Fibrocartillage : present b/w intervertebral discs

21.breaking bad news : should be told to patient in a formal session exclusively (if option another option is present click that, and that option is , PRESENT INFORMATION IN A CRISPY AND ACCEPTABLE WAY )

22.for efficient patient doctor relationship best way to start conversation by ;;,asking about his name, age, address

23.regarding thyroid : active follicles are filled with colloid

24.QRS complex is slightly prior to : ventricular systole (i-e electrical activity before mechanical activity)

25.which of the following predispose to malignancy : proto-oncogenes ( while in case of virus click oncogenes )

26. Myxoid degeneration will occur in which : mitral valve prolapse

27.which of the follow prevents flow of substances in intercellular space : tight Junctions

28.most common cause of fatty liver in our country ; fatty food ( if protein malnutrition present in options then go for it )

29.Aspirin prevents formation of; thromboxin A2

30. Antharax is 90 % associated with : cutaneous lesions31.Hairy Leukoplakia is associated with : AIDS

32.boundaries of Digastric Triangle : anterior and posterior bellies of diagstric muscle and ramus of mandible

33.blood supply of foregut is primarily derived from : celiac trunck

34.man encountered fracture of femure in RTA, died after 5 days, cause of Death =Fat embolism ( if pregnant lady is mentioned and death Is immediate then amnioticfluid-embolism , if time is in days then fat embolism even in pregnant lady will be the ans)

35.follicular cells of thyroid are derived from = endoderm ( follicular cells of thyroid are simple cuboidal epithelium and their embryologic origin is from a median endodermal mass in the region of the tongue , in contrast to the parafolliclar c cells that arise from the 4th pharyngeal pouch)

36.Neutrophillia will be seen in :, after an acute attack of MI ( like all other inflammatory conditions, in MI as well, in day 1 to 3 , neutrophils stay in there, while from day 4 to day 7, macrophages dominate the site )

37.Hepatic pedicle is formed by :, portal vein, common hepatic duct, hepatic artery ( means portal triad)

38.adult male of long hight, well developed , presented with complain of infertility what could be the cause : klinefilter syndrome

39.Nor-Epinephrine and Serotonin are degraded by : MAO,

40.Most potent Response in massive haemorrhage is : CNS ischemic Response

41.In nephrotic syndrome oncotic pressure decreases due to : hypoalbuminemia42.Isthmus of thyroid gland is present in front of : 2nd,3rd, 4th tracheal Rings43.Alternative of schwan cells in CNS : oligodandrocytes

44.Regarding Rectus sheeth tendoneous intersections : upper most is located near xyphoid process

45.Regarding Hymen : lined by stratified squamous

46.Histology of Vagina : str. squamous epithelium with abundant elastic tissue in submucosa, highly vascular, smooth muscles around ( whenever u see ABUNDANT ELASTIC TISSUE in the stem, look first for histology of vagina )

47.Histology of Ureter : small lumen tubular str. lined by transitional epithelium, with complete muscular coat

48.Mother contracted german measles during pregnancy , fetus is on risk of developing : congenital Catract,

49.Risk of Congenital catract by Rubella virus can be prevented by : vaccination of girls of child bearing age

50.Which of the following can be palpated via lateral fornix of Vagina : ureter51.tapping of patellar tendon causes : contraction of quadriceps muscle

52.Pts of different races are coming at emergency , 50% are whites, 20% blacks, 20 % asians, best way to depict there percentages is : pie chart

53.During later stages of pregnancy , Ripening of Cervix is caused by : Hydration of Collagen

54.Simple columnar Epithelium with Goblet Cells and submucosal lumphoid tissue :Ileium ( note that submucosal glands of Brenner are present in duodenum while lymphoid payer pateches are present in lamina propria and submucosa of ileum )55.Patient presented with coagulopathy with dead fetus in uterus most imp. step of initial managment : Evacuation of Uterus

56.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, that how histology will show the features of apoptosis)

57.acute effect of high dose Radiation : , endarteritis obliterans58.Oliguria is production of urine in 24 hours : less than 500ml,

59.Patient with normal amount of semen production but azospermia : defect in sertoli cells

60.GnRH regulates secretion of : FSH and LH

61.IN preganancy mother feels respiratory distress b/c of = dec.in total lung capacity62.young female with hx of multiple recurrent abortions : anti-phopholipid syndrom63.Hypophysectomy will effect primarily : principle cells of thyroid

64.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 )

65.Urogenital diaphragm lateraly attaches to : ischiopubic rami

66.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 :, normal physiological change

67.local anaesthetic MOA of ionized substances : cause blockade of Na-channels68.Neuromuscular junction motor end plate : contains acetylcholinestrase 69.Patient presented with Hx dyspepsia, anemia, pale hands, spooning of nails, stool test showed OVA : Ancylostoma Duodenale ,( note that , ascarisias casuse GI obstruction and lung problems, trichuriasis cause dysentery and rectal prolapse, entrobius vermicularis cause pruritis ani, and onchoceercasis cause river blindness)

70.A 23weeks pregnant lady died in RTA type of death is : Fortitious death,

71.While doing appendectomy via incision at Mc’burney’s point artery is damaged :deep circumflex Iliac artery ( if asked about , which STRUCTURE is damanged then , ans should be illeohypogastric nerve)

72.Elderly patients are prone to develop drug toxicities b/c of : dec. renal Excretion73.Patient having menstrual cycle of 32 days will ovulate on : 18th day, (the last 14 days of the cycle are fixed, any change in the length only occurs in the days before it, which may either reduce of prolong the total duration so to get the ans ; 32-14 =18)74.Which of the following will cause bradycardia : occulocardiac reflex,

75.neoplasm having rete ridges , malignant infilterating epithelial cells : Verrocous carcinoma

76.In pregnancy there is : hypoalbuminemia

77.Lymphatic drainage of skin around anus : medial group of superficial horizontal lymph nodes

78.Bite cells will be seen in : G6PD def,

79.Inferior layer of urogenital Diaphragm : perineal membrane80.which of the following is benign tumour = warthin tumor

81.septum primum and septum secundum fuse to form septum which separtes :common atria into right and left atria

82.At the end of a marathon race there is = Increased glucagon and low insulin 83.A 7 years old child having generalized edema Investigation of choice is = urine albumin (& for diabetic nephropathy the investigation of choice is = urine albumin )84.Apex of the heart = 8 cm from median plane apex of heart

85.Alpha and gamma motor neurons = Supplied by UMN86.trisomy 21 =Robertsonian translocation

87.agressiv ca = Melanoma

88.regarding malignanct charcter = metastasis89.polyphagia in diabetes ocures due to = inc blood glucose

90.edema of kidney origin is due to = albuminuria and Na retention

91.subacute endocarditis = viridins ( viridns causes sub-acute and damaged valves endocarditis, and is on the top over all, while staph causes acute and in healthy valves, mainly in iv drug abusers, though in new editions, Staph is on the top overall, but for cpsp. Prefer viridins #respect)

92. Pus contains = dead neutrophils

93.at beginning of 5th week = heart definitive formed ( though in 4th week, four limbs and four chambers of heart are formed and at 4th week primordial germ cells migrate into undifferentiated gonads, but if asked definitive heart then click beginning of 5th week)

94.contraction of pupillary muscle = parasympathetic

95.hormone causing gluconeogenesis = cortisol ( gluconeogenesis ; prefer cortisol over Glucagon, but for Glycogenolysis , prefer Glucagon, though it can cause both)96.primordial germ cells derived from = Ectoderm ( Primordial germ cells have been isolated from the epiblast at posterior end of primitive streak in 2nd week while germ layers are formed in 3rd week by the process of gastrulation, hence primordial cells can’t be considered, the derivative of any of these 3 layers, its believed that, epiblast is the future ectoderm that how, the correct answer is epiblast, if not in options click ECTODERM. Earlier it was believed that PGC’s are derived from endoderm of yolk sac)

97.ureteric bud derived from = Caudal end of mesonephric duct98.lenght of Right main bronchus = 2.5cm (repeated so many times) 99.anterior (costosternal surface) of heart is formed by = right ventricle300. The most important component of shock is = tissue hypoxia

Session # six; Life is really simple, but we insist on making it complicated. Confucius

1.Veins of thorax drains into = azygous drains into superior vena cava ( azygous vein, after arching over the root of right lung drains into superior vena cava behind the sternal angle, also note that there are no valves in superior vena cava, brachiocephalic veins and azygous system of veins)

3.Regarding primary peristalsis = begins when bolus enters the esophagus4.Cardiac transplantation rejection, the cells involved are = T cell (CD8 CYTOTOXIC T CELLS : Recognize antigens in association with class I MHC Proteins Kill virus- infected, neoplastic, and donor graft cells via release of perforins and granzymes.

While in chronic rejection, CD4 T CELLS are involved, as stated “Pathogenesis of chronic rejection, Most likely due to a chronic delayed hypersensitivity reaction involving CD4 T cells” )

5.Tumor cells in the blood , most commonly diagnosed by = tumor marker

6.P53 mutation = cell survival ( P53, brings about cell apoptosis i-e death, means if its mutated, cell will suffer no death and will survive)

7.Liver abscess= serology is done for diagnosis

8.Biopsy taken from posterior triangle = damage to the spinal part of accessory nerve (spinal part of accessory nerve lies in posterior triangle, and is frequently damaged during biopsies or drainage of abscess from this are, not that the loss of accessory nerve result in paralysis of trapezius, and as a consequence loss of overhead abduction and inability to comb hair)

9.Alpha receptors = mainly in the proximal urethra

10.Parasympathetic = inc salivation ( Salivary secretions are inc by both symp and parasymp , but parasym effect is more dominant one.)

11.Receptors causing nor-epinephrine mediated dilation=β2 12.Which muscle causes jaw protrusion = Lateral pterygoid 13.Pancreatic tissue in stomach is =choristoma

14.Sickle cell disease protein affected is = beta globin

15.Iron deficiency anemia = inc TIBC (note that. The most sensitive test for iron deficiency anemia is Serum ferritn )

16.At normal condition, both are equal = venous return and pulmonary blood flow( the reason is that all the blood entering in right side of the heart should be pumped to lungs for oxygenation)

17.Difference between pulmonary and systemic circulation = low resistance in pulmonary circulation

18.Long term memory immunoglobulin is = Ig G ( the initial Ig is always IgM , that’s

followed by IgG )

19.Profofol absolute contraindication =Hypersensitivity to profofol ( profol appears safe in porphyria , note that , barbiturates contraindicated in porphyria )

20.GVE comes out of = dorsal nucleus of vagus ( its also known as posterior nucleus of vagus and is the main parasympathetic outflow of vagus )

21.Which of the fallowing structures doesnot receive innervations from branches of pudendal = Posterior Fornix of Vagina

22.Sructure attached to Lumbar Verebra = Anterior Longitudinal ligament

23.Right horizontal semicicular canal stimulated = Head tilt right

24.Athetosis is due to defect in = Globus pallidus (according to Guyton and hall)

25.Opsonization occurs with the = . Help of c3b

27.Propulsive movement of intestine effected due to lesion of = Aurbach plexus

28.Main class associated wid antigen presenting cells = MHC2

29.About small intestine true is = small intestine 6-8 meters long

30.Lysosome has secretion against bacterial iron because they contain= Hydrolases

31.Blood supply of heart is regulated by = Local metabolites

32.Post synaptic sympathatic mainly secretes = Nor epinephrine

33.True abt vertebral column = Cervical nerves originate abovecorresponding vertebra (Except C8 cervical nerve which is below C7 vertebrae , and all Spinal nerves also originate below the corresponding vertebrae)

34.Confidence interval = Mean n its standard error of mean

35.Positive Predictve valve is affected by = Prevalence of disese

(Remember PPP = Positive Predictive value is affected by Prevalence)

36.In PPD induration u will find = . T cells ( if T-cell & macrophages are present in options prefer that)

37.Which of the following drugs is contraindicated in a patient with raised intracranial pressure = Ketamine (mnemonic = KRANIUM vs KETAMINE)

38.If circumflex branch of left coronary artery is blocked which area will b effected = Posterior surface of left ventricle

39.Draining to Sup Mesenteric nodes = Jejunum

40.Diabetic pt came to ER insulin given what change will happen in blood =

.increased pH ( as dec PH is due to acidosis by ketone bodies and insulin when given, will dec ketone bodies and will inc ph)

41.Potassium will be lost mostly frm which segment following dietary irregularities = distal tubule

42.Main diagnostic feature of DIC = presence of D dimers

43.A man wd his gut removed some weeks ago now showing ↑ gastric motility wid

diarrhea, cause = Osmotic+secretory diarrhea

44.CO poisoning,methemoglobulinemia,anemia dont result in hyperpnoea..this is because = Po2 remains normal

(Anemia- Pa02 and Sa02 – Normal

MethHB and CO Poisoning – Pa02 is normal but , Sa02 DECREASED)

45.Ductus deferens end in = .ejaculatory duct

46.Sjogren associated with = RA

47.Ovarian pain related to = Obturator

48.Antibiotic given , patients PT and APTT deranged what will u give = vit k

49. Subdural hematoma due to = rupture of cerebral vein (note that;

Epidural = Middle Meningeal Artery=Lens shaped Biconvex hematomaSubarachnoid = Cerebral arteries and Vein (Berry Aneurysm in Circle of Villis) Subdural = Superficial Bridging cerebral Veins =Cresecent hematoma)

50.Enzyme in saliva that prevents iron utilalisation by bacteria = Lactoferrin

51.Fio2 max dose which does not cause fetolental adrenoplasia = . 0.6 (Safe limit is 0.6 or less than that)

52.Gardener right side chest pain 3.5 cacific on rt lower lobe = Aspergilosis

53.Recurrent renal stone associated with which amino acid abnormality = Lysine

54.Nerve supply of Lattisimus dorsi = Thoracodrosal Nerve

55.Nerve supply of Rhomboids = Dorsal scapular nerve

56.Nerve supply of Sartorius = Femoral Nerve

58.Vitamin produced by intestinal bacteria = Vitamin K ( new borns have no gut flora and are deficient with vit k , that why soon after birth vitk is administered to the neonates )

59.End product of purine metabolism = Uric acid

60.Arrangement of renal segments: Renal-> Interlobar->Arcuate->Interlobular->Afferent Arteriole ( According to SEMBULINGAM ; Renal arteries directly arises from abdominal aorta and enter the kidney through the hilus, while passing through the sunis , it divides into many segmental arteries which subdivide into interlobar arteries, each interlobar artery passes between medullary pyramids and at the base of pyramid forms arcuate artery, each arcuate artery gives rise to inter lobular arteries , from each interlobular artery numerous afferent arterioles arise)

61.Cervical CA metastasize to = Internal and External LN

62.Prader Willi Syndrome = Hyperphagia and Hypergonadism

63.A patient comes to you in your clinic with lab findings of RBS 198 G/dl and FBS

122G/dl; what is your diagnosis = Impaired glucose (Fasting >110 <126 = IGT

For DM ; RBS must be > 200 with Classical Symptoms and FBS must be > 126)

64.Which of the following have direct relationship = pulmonary blood flow and venous return (Factor That control Cardiac Output also control Pulmonary Circulation-Guyton)

65.In hypoxic vasoconstriction; which of the following is decreased = arterial pO2 66.Screening is done = to detect disease at its early stage

67.In athletes, which of the following is increased even in resting state = Stroke volume ( if not in options the prefer cardiac output)

68.Muscle of quiet inspiration = diaphragm

69.If a foreign body is inhaled; which of the following lung lobes it will go to = Rt inferior lobe

70.Intracellular ANIONS = Proteins

71.Type of junction present in smooth muscles = gap junction

72.Type of junction present in cardiac muscle = gap junction

73.A man moving in an elevator; which of these is working = saccule

( note that

angular acceleration = semi circular canals, linear horizontal ie in a car = utricle and

linear vertical acceleration ie in an elevater = saccule)

74.Which of the following has normal anion gap = Diarrhea

75.Which of the following is diagnostic of tuberculous granuloma = epitheliod cells

76.A lady with 26 wks gestation has uterine height of 24 wks. On ultrasound there is no fetus and snowstorm appearance. Which of the following probably associated with it? = karyotype 46 XX

77.A soldier comes with heavy bleeding. The ideal fluid replacement would be =

whole blood

78.Structure accompanying superior temporal artery =auriculotemporal nerve 79.Relation of terminal CBD with head of pancreas is = embedded in head of pancrease

80. Genotype of a true hermaphrodite is= XXY

( in goljan xx is given , while some of the colleagues saying that XXY IS CPSP KEY, though I couldn’t find xxy in any of the cpsp demos, still seniors agree to it, so ans is

xxy , follow cpsp blindly no matter what Goljan says #respect)

81.Calcitonin is secreted by which tumor = Thyroid

82.Angiotensin 2 is responsible for =systemic vasoconstriction of venules

83.Most common skin malignancy in pt with HIV = Kaposi sarcoma

84.Left gastroepiploic artery is branch of = Splenic artery

85.Organelle that binds carbohydrates with protein enclose them in vesicles n release = GOLGI bodies

86.Child with recurrent infection, which of the following physiological antibody is missing on peripheral smear = igA

87.Plasma membrane thickness is = 7-11 (7.5 – 10nm is Range- Guyton)

88.Lady with ventricular rate of 40/m most likely = complete heart block

89.Iron binds to = transferrin

90.Highest carbohydrates is in = wheat (71gm CHO)

91.Resonance of the lungs can b auscultated from back of the chest till = 8th rib (Demarcation Line is 3rd-9th Intercostal Space)

92.Flexion of knee and extension of hip is the action of = semitendinosus

(Also Biceps femoris, Semitendinosus, Semimembranosus – Posterior Compartment Thigh muscles–> Tibial Nerve)

93.Which of the following bones has no muscular attachments = talus

94.Lymph drainage from outer nipple is to which group of lymph nodes = anterior axillary

95.Dorsal scapular nerve supplies which of the following muscle = levator scapulae (Dorsal scapular Nerve also supplies Rhomboids)

96.Which of the following is a pivot joint = atlanto axial joint

98.Motor supply of pharynx is by = nucleus ambiguous (Nucleus Solitarius: Sensory & Ambigous: Motor)

99.Sacroiliac joint = plain variety of synovial joint100.Mediator of pain = bradykinin ( Bradykinin > PGE2)

01.RT coronary artery = supplies S.A node

02.Most imp hormone involve in gluconeogenesis = .cortisol

03.A pt presented with rt iliac fossa pain. he is diagnosed to have acute appendicitis on flexing his rt thigh inward n medially he cries with pain. What is the type of appendicitis he has = pelvic

05.Most potent chemotactic factor is = C5a

06.what is the most appropiate ans =.C5a is a potent chemotactic agent 07.Low serum complement seen in which condition = .SLE

08.Pt presented with photosensitivity,rash n joint pain.which is the daignostic in this case = .anti DS antibodies

09.Which of the following has highest cholesterol content = LDL

10.Which drug does not cause gynaecomastia = .Griseofulvin ( some colleagues saying androgen, but remember that gynecomastia is one of the adverse effect of androgen , and beyond all explanations, griseofulvin is cpsp key)

11.Which is the best option in identification of Turner’s syndrome =.karyotyping 12.End product of purine metabolism is = .uric acid

13.Erythropoitin is secreted fro = .Mesengial cells14.ESR is decreased with = albumin is increased15.RBC’are having = glycolytic enzyme activity16.Commonest Cause of PDA = .permaturity

17.Most common Cause of metaplasia is = .chronic irritation

18.What is the differentiating point of hyperplasia fron hypertrophy = .Increase in size n no of cell

19.Dysplasia is seen mainly seen in = .epithelia

20.What is the differentiating feature of hyperplasia from benign tumo = .increase in no of cell

21.What is the most true among following = .rRNA is most abundant & involve as ribosomes on endoplasmic reticulum

22. Deficiency of THAIMINE(B1)causes all except =subacute degenaration of spinal cord

23.AIDS is associated with all of the following except =.leukemia 24.VITAMIN involve in collagen synthesis is = .ascorbic acid 25.Neural tube defects occur due to deficiency of = .folic acid 26.Iron is stored in the form of = .ferritin

27.CO2 is tranported in lungs through = .simple diffusion 28.HPV is associated with = CA cervix

29.Optic groove appears on left side of forebrain on day = 22 ( memorize by mnemonic, 2 eyes and 22 days )

30.Germen measles causes which abnormality. What is the most appropriate answer = .congenital cataract

31.A newborn with anterior abdominal wall swelling and umbilical cord attached to it.what is the condition called = .omphalocele

32.PT has exophthalmos & his T3 n T4 are increased.what is the option for treatment of exophthalmos = .drugs blocking the lymphocytic infiltration 33.Treatment of diabetes in pregnant lady is = insulin

34.side effect of streptomycin = impairment of hearing35.Which of the following is opportunistic organism = .klebsella 36.Psudomembranous colitis is caused by = .Cl.difficile

37.About aspargillosis which is not correct = .is caused by long term antibiotic use. 38.Pt has a history of infection 4 weeks back.now he developed same pain again.what type of cell will present at this time of disease = .neutrophils

39.What is the drug of choice for DVT in ist trimester of pregnancy = .heparin 40.Type 2 hypersensitivity reaction includes = erythroblastis fetalis

41.Transfusion reaction will not occur in a pt if we transfuse the = .group A with O( as O is universal donor )

42.Which of the following does not cross placenta easily = Ig M

45. Which drug is used in the treatment of hirsutism = .antiandrogens

46.Most common organism involved in infection caused by IUCD = .actinomycosis47.ECF differ from ICF in = .high conc. of Na & Ca ( if only volume is mentioned in the options the click that one)

48.diffrence of smooth n skeletal muscle = .Ca-Calmodulin complex is present in smooth muscles

49.In partial mole,karyotype is = 69XXY (46XX is complete mole )

50.If carbohydrate is separated from proteins what will be the fate = aggregation & precipitation

51.Lysozome contains = hydrolases

52. Following is Autosomal Dominant Disorder= Hereditary Spherocytosis 53-Capsule of liver in known as = Glissons

54-Most common site of thyroglossal cyst is: = Infrahyoid

55.Cancer is Least Related To = Traumatic injury

56.What Age The Head Of Fetus Become Exactly Half The Length At CRL =3rd Month

57.Not Included In Blood Coagulation Profile = Anti thromboin 3

58.Starling Law of the heart =Explains increase in Cardiac Output that occurs when venous return is increased.

59.Scenario Of Fissure. Pain Due To Which Nerve = Inferior Rectal

60.Pendular knee jerk is the result of = UMN lesion (Pendular knee Jerk cerebellum >> UMN )

61.Medial side of arm is supplied by =. Medial cord

62.Bare area of liver is limited by= Coronary ligament

63.During a surgery a surgeon nicks hepatoduodenal ligament. Which structure is likely to be damaged = Bile duct

64.Capsule of left kidney prevents the spread of infection to = Other kidney

65.Which one is secreted after sweating = Increase ADH

66.Baby born edematous aftr 2 days shows signs of renal failure on examination rounded mass in pelvic area on autopsy cystic mass is seen. Diagosis = failure of union of mesonephros n ureteric bud

67.B lymphocytes are associated with = CD 19 & 20

68.Which of the following ulcer is caused by synergistic infection by microaerophilic non hemolytic streptococci and aerobic hemolytic staphylococci =

.Meleney’s ulcer

89.testies drain into : para-aortic lymph nodes ( as gonadal vessels arise from abdominal aorta, that why drainage is towards para aortic lymphnodes )

90.Best way to diagnose intraamniotic infection is by : detection IL-6,

91.During exercise increased blood supply to muscles is due to = Local metabolites 92.True regarding male reproductive system = Testosterone produced by leydig cells of testes.

93.ovarian cancer first metastasize to = par aortic lymph nodes. 94.structure passing through pelvic inlet is = ureter95.Mullerian duct counterpart = rete testis cords

96.common iliac arteries = crossed by ureter at their bifurcation 97.Ileococcygeal ligament located at level of = L2

98.which of the following is most likely correct regarding lesser pelvic in female = has an outlet bounded by ischeopubic rami and sacrotuberous ligaments99.secondary oocyte indergoes the 2nd reduction devision = after fertilization– 200.in which of the following conditions ocps contraindicated = migraine

01.after 5 years of transplant surgery there is an increase incidence of : = lymphoproliferative disorders

02.longest incubation period = HIV

03.primary oocyte surrounded by zona pellucida and zona granullosa and fluid filled spaces is most likely = secondry follicle

04.female 28 weeks gestation,, presents with poly hydroamnios what is the problem with fetus = duedenal atresia

05.which of the following are boundaries of pelvic inlet = pubic crest06.female with cervical dysplasia, , which test will be 95% reliable = pap smear 07.Pulmonary blood flow hindered by = Pulmonary embolism

08.ligament which held uterus in anteverted position and can be palpated on rectal examination = uterosacral ligament

09.Female with arthritis, rashes,, rynouds phenomenon, which is “specifiic” test = anti Ds antibodies (note that if asked about sensitive, then ANA is more sensitive) 10.sensitive marker of myocardial damage = Troponin T

11.WHICH of the following is associated with adult polycystic kidney disease =cerebral hemorrhage ( if sub arachnoid heamorrhages is present in options, prefer that)

12.isotonic and isometric cintraction. isotonic contraction is different by =consume more phosphate bonds

13.anemic hypoxia is caused by = methehemoglobinemia

14. inc in both renal blood flow d GFR = dilatation of afferent arterioles15.chronic renal failure cause of anemia = Erythropoieten dec production

16.gamma motor neurons are present at the = end of intrafusal fibers

17.lady with major abdominal surgery develops dyspnea = Pulmonary embolism18.before giving sodium valproate = LFT,s ( as the most dangerous adverse effect of valproic acid is fulminant hepatitis )

19.function of hcg = maintains corpus luteum ( prevents from involution and any of the options can be asked so memorize both)

20.gold standard for breat cancer = Mamography

21.53 years old lady admitted in comatose stated, blood sugar 400, +4 sugar in urine,, no ketone bodies and albuminuria = DM2

22.Philtrum of upper lip = Tw0 Medial nasal processes23.intermittent pain of small intestine is felt = Umblical region

24.after 15 days of c- section due to obstructive labour.. pt developed urinary incontinence. what is the most likely cause = Vesico vaginal fistula

25.breast lobes = separated by interlobar stroma

26.how good is a test at correctly diagnosi diagnosing people with the condition. Feature qualifies = Sensitivity

27.pO2 is lower in arterial blood than pulmonary blood because– diffusion to occur 28.lady with back ach on right side,neck of femur fractured due to slipage in washroom.Blood calcium is raised and calcium appeared in urine,, diagnosis =hyperparathyroidism

29.enzymes are specific for male and female hormones production,,, enzyme only for female hormones production = aromatase

30.male pt with severe hemorrhage,presented in unconscious state,, transfused with 2 weeks old blood ,Blood mainly contain = Rbcs

31.cells which contain sense granules and have igE antibodies on their cell membrane are = basophills

32.current bone density is assessed b = dexa Scan

female presented with some epithelial changes nd hpv +ve.Again presents and pap smear shows large cells with large nucleus.Diagnosis = dysplasia ( note ; Cervical dysplasia, HPV infection > IUCD, while most common cause of cervical metaplasia is Multiparity > IUCD)

33.Tachyphylaxis = Diminish unresponsiveness adapted quickly (in simple words, rapidly developing tolerance to a drug is called tachyphylaxis)

34.Powerful vasoconstrictor = Cocaine

35.True about pudendal nerve = Supplies muscles of perineum 36.GnRh is not inhibited by = Carcinoma

37.Ureter is supplied by all except = Inferior mesenteric arteries38.Myleperoxidase is an enzyme present in = Neutrophil

39.Fourty ears lady with 2 year history of pruritis ,for the last 6 months having xanthoma, hepatospleenomegaly, which investigation will confirm Diagnosis =Antimitochondrial antibody (a scenario of primary biliary cirrhosis)

38.Milk presents in the breast during pregnancy with normal prolactin Level but no lactation it is due to inhibitory effect of = Progesteron (actually estrogen and progesterone both result in the development of breast during pregnancy but at the same time they also inhibit lactation, if in options only one is asked then PROGESTERON should be preferred )

39.Inferior orbital branch is a terminal branch of = Maxillary artery

40.Amniotic fluid embolism = During labor and postpartum (CMDT states , “though uncommon still amniotic fluid embolism is one of the complication of labor and immediate postpartum period” )

41.Nerves/muscle not leaving pelvis thru greater sciatic foramen = Obturator42.Parturition is caused by or started = Fetal cortisol (fetal cortisol increases oxytocin receptors on uterus there by increasing its sensitivity secondly it enhances the enzymatic degradation of Progesteron, resulting in termination of pregnancy)

43.Cardiac output maximum in = After delivery ( though not an easy concept; but let’s simplify, ●● ●after delivery a lot of blood enters into maternal circulation, that inc blood volume and BP, secondly we know that increasing the number of capillaries decreases blood pressure, ie via parallel resistance mechanism, after delivery, placenta is lost decreasing number of capillaries and thus BP shoots up, that’s why most common cause of death after delivery is cerebral hemorrhage, .. Ref Francis physiology)

44.Pars distalis = supplied from superior hypophyseal artery

45.burkits lymphoma is caused by EBV because = Antibodies to viral capsid are present in all individuals with burkitt lymphoma

46.40 years lady with post coital bleeding and inter menstrual bleeding on examination hypertrophic cervix, first investigation to do = Cervical smear47.Inscisionall hernia 1st structure taking from within outwards = Transversls fascia

48.Succinylcholine = Actions is prolonged due to the deficiency of psuedocholinestrase ( because this drug is inactivated by enzyme pseudocholinestrase)

49.If 28 day cycle on day 21 progesterone will be = 10ng ( During Mid leutal phase progestrone should be more than 10 ng)

50.Insulin dependent uptake of Glucose into =skeletal muscle (Sembulingam states that; usually glucose is transported into the cells by Na-Glucoseco-transporter , but most the cells have another transport protein called glucose transporter ie GLUT, among these GLUT-4 is insulin sensitive and it Is present in large amount in muscle fibers and adipose cells and via GLUT-4 transporter, insulin pushes glucose into two cells, ie adipose and skeletal muscles )

51. transpyloric plane is located at = lower border of L1 ( structures lie at the level of trasnpyloric plane = pylorus of stomach , fundus of gall bladder, Hilum of kidney, first part of duodenum , origin of superior mesenteric artery the tips of 9thcostal cartilages, and lower end of spinal cord if lower bordr of l1 is not there click upper border of L2)

52.Pyruvate intermediate between = Glucose and acetyl coA

( Glycolsis ends up giving 2 molecules of pyruvate ,which after conversion into actyl CoA and enters krebs cycle )

53.Pretracheal infection will be transferred to =Anterior mediastinum

54.Spinal anesthesia is given to a patient, there is sudden loss of sensation due to = loss of vasomotor tone

55.Insulin increases by = GIP ( Gastrin, CCK , GIP , secretin and GLP-1 all inc insulin secretion, but GIP AND GLP-1 are the most potent )

56.Basal ganglia is involved in = Initiating movement57.Hypokalemia on ECG is represented by = U wave58.Regarding the end arteries = Present more in the vital organs( End artries then central retinal artery > splenic artery

if asked functional end artry then click heart )

59.Female in labour, station 2 on PV, ischial spines inverted, arch less triangular, which type pelvis is this = Anthropoid

60.Blood leaving placenta has how much percentage of PO2 = 30 %61.Craniophrangioma ablation is done in a woman due to tumor, what is required for ovulation = HMG followed by HCG

62.Which drug does not cause teratogenicity = flouxeten63.In chronic intra vascular hemolysis = Dec heptoglobin

64.Severe bradycardia and low pulse, oculocardiac reflex is stimulated, what is the immediate treatment = Stop stimulus

65.Syncope is not a recognized feature of = Haemophilia

66.The most common cause of anemia in pregnancy = Haemodilution67.Suprapubic incisioňis given by a surgeon, artery injured in the suprapubic fat is

= inferior epigastric

68.Pudndal nerve does NOT supply = Posterior vaginal fornices ( its one of the most frequently repeated question, so memorize it by MNEMONIC; P repels P ie PUDENDAL does not supply Posterior fornix )

69.Least likely cause in 17 to 20 weeek abortion = Fetal cytogenetic abnormality 70.Regarding hylaine cartilage = Collagen fibers are not visible

71.How can rubella infection be prevented = Anti rubella vaccine ( for prevention child bearing females should be vaccinated)

72.Insoluble storage form of iron in iron overload = Hemosiderin73.Torch can causes congenital abnormalities except = Pneumonia74.The gland having more serous portion is = Parotid gland

75.True about kidney and relations of different structures passing through it is = Left renal vein is anterior to aorta and left renal artery

78.Nerve supply of urogenital triangle = Ilioinguinal nerve 79.Nerve supply of detrusor muscle = S2, S3, S4

80.Women having lack of vagitable diet resulting deficiencies = Anencephaly81.Visual impulse is associated with = Dissociation of rhodopsin to retinal and opsin

82.most dangerous type of hepatitis for pregnt ladyin near future = Hep E ( so the rule is , lethal in pregnancy is Hep E while most lethal if pregnancy is not mentions, is Hep D , ie D for Deadly)

83.premalignant leision of vulva = Condyloma

84.breast lymphatic drai upper outer qud = ant axillarynodes ( also remember another frequently tested fact that, sentinel lymph node biopsy is done in order to decrease needles axillary clearance in lymph node negative patients Ref; Oxford medicine)

85.prolactin regultd by = Dopamine ( Dopamine is also called prolactin inhibitory hormone as it inhibits Prolactin)

86.regarding levator ani muscle = Supplied by pudendal nerve

87.UV prolapsed most common complication = Chronic cervicitis and metaplsia 88.regardingg menopause correct one is = Inc gonadotophins ( Dec Estrogen and increase FSH and LH )

89.regarding sorbitol = Alcohol sugar

90.True about uremic nephropathy = Normocytic normochromic anemia 91.A disc is herniated, it will affect = spinal nerve+ posterior root 92.Phrenic nerve is related to which artery = Pericardiophrenic artery

93.Which immunoglobulin is present in RH incompatibility = IgG

94.The most common route of transmission of HBV and HCV is through =Through sharps and needles

95.Thirst is increased by = decrease in plasma volume

96.Which mechanism is involved in carrying the particle inside the cell when actin, myosin and clathrin are involved = receptor medicated Pinocytosis(whenever u see clathrin, in the stem , click receptor mediated endocytosis/pinocytosis, and its most common mechanism for cholesterol uptake by cell)

97. Estrogen’s side effect = Thromboembolism ( while low dose estrogen containing pills cause hepatic adenoma, also note that hepatic adenoma is caused by a class 3 antiarrythmic ie AMIODORONE)

98.Left renal vein = Anterior to aorta and left renal artery

99. local metabolites in skeletal muscles = Decrease TPR ( note that Autoregulation is mainly by Local metabolites in skeletal muscles brain and coronary arteries)300.Below knee amputation irregular mass after sometime = Neuroma

Session # seven; Accept the challenges so that you can feel the exhilaration of victory. George S. Patton

1.Eating undercooked and raw meet can cause infestation by = tape worm

(Note that, taenia solium via uncooked pork , T.Saginata via uncooked beef & fish tape worm (Diphyllobothrium latum) via uncooked fish)

2.A postmenupasual women suffered fracture due to osteoporosis her Ca is decreased and phosphorus is increased , she has = inc PTH

3- Mass movement is affected in colon due to problem in = Auerbach plexus (while submucosal plexus are for secretions )

4- In an adult Ileactomy and jejunectomy has been done. He has diarhoea and 15-20bowel sounds per minute. The most likely cause of this decreased transit time in the intestine is due to = secreroy plus osmotic

5- treatment of vWD = Cryoprecipitate ( cyopreciptate should be pronounced ascryoprecipit-8 as it contains factor 8, and in vwd factor 8 is depleted )

6- The head of femur in adult is supplied by = Medial and lateral circumflex artery ( while in children its supplied by OBTURATER artery)

7- Head of humerus is supplied by = Anterior circumflex ( while fracture will damage posterior circumflex artery)

8. A man having recurrent bacterial infections with streptococci also having diarrhea which on examination showed giardiasis, further exam revealed normal T cells but ↓B cells levels of igM,igG and igA were given = Bruton’s agammaglobulinemia ( this scenario is repeatedly encountered so plz NOTE THE WORD GIARDIASIS , and that will help u in memorizing stem.)

9- A 6 years child who develops muscular weakness. Anti voltage gated calcium chanel antibodies are presen = Lambert Eaton syndrome

10- Infarction of posterior 1/3 of interventricular septum.artery involed -.RCA ( while the anterior 2/3 of septum is supplied by left ant descending arter ie LAD)11- Right border of heart is formed by = right atrium ( IF ASKED in xray the right border is formed by rt atrium plus SVC, AND if this option is not present then click only SVC )

12. which is a small blue cell tumour asociated with large amount of catecholamines in child = Neuroblastoma

13- which of the following prevents muscle tear under high pressure = Golgi tendon organ (note, when the muscle is in tension = Golgi tendon starts firing and muscle get relaxed in response )

14-Which of the following ulcer is caused by synergistic infection by microaerophilic non hemolytic streptococci and aerobic hemolytic staphlococci = Meleney’s ulcer 15- Cholecystectomy is done, where to put the drain = Subhepatic space

16-Esophagectomy done stomach is mobilized to upper portion of thorax ..To anastomosis with phayrnx, Which artery is responsible for stomach supply now =right gastroepiploic artery ( if this artery is not mentioned in options then click RIGHT GASTRIC artery)

17-common Postop infection in hospital cause by which organism = Staph Aureus ( second most common is E coli)

18-clawhand produced by unopposed action of = extensor digitorum and flexor digitorum profundus

19-Recurrent renal stone associated with which amino acid abnormality = Lysine20- Rotator cuff is formed by = supraspinatus, infraspinatus, teres minor and Subscapularis ( memorize by Mnemonic SITS )

21-If FACTOR IX not available = FFP (Note that if asked which is used as immediate antidote to WARFARIN then as is FFP not Vit K, because vitK Needs time to work and not imp for immediate action )

22-which of the following drain into superior mesenteric lymph node = Jejunum ( also remember that jejunum is supplied by both GREATER , LESSER Splanchnic nerve while stomach by Greater splanchnic nerve )

23-Drug which is strong analgesic but not a good anesthetic –nitrous oxide

24- peptic ulcer profusely bleeding from posterior wall of duodenum…which artery involved = gastroduodenal artery ( memorize this artery by the site of ulcer i-e ulcer is common in Gastric n Duodenal parts of gut so artery should be GASTRO- DUODENAL in case of bleed)

25- Lumbar puncture = L4 L5 (While L3 L4 should be clicked if L4 L5 is not present in option )

26-Seminoma is a tumour in male, its equivalent when occurs in ovary then its called = dysgerminoma

27- Which of the following is mostly premalignant in the oral cavity –Erythroplakia28- A female pt was having generalized pain, and has been taking NSAIDs for a long time. Now developed swelling n big toe, wht will b present in fluid aspirate = mono sodium urate crystals

29- About small intestine true is small intestine = 6-8meters long

30.Compression effects on esophagus by which organ enlargement = Left Atrium ( as it’s the most posterior part of heart and lies almost over esophagus )

31.Prostatic carcinoma spread to skull bones through = Vertebral plexus

32.A Person wid malignant melanoma. Risk factor = Xeroderma pigmentosum33.Apoptosis = cell shrinking ( if councelman body is mentioned in options then click that )

34.Open wound healing includes = myofibroblast

35.An obese man with h/o atherosclerosis underwent laparotomy due to bleeding in abdomen n during surgery, his small gut was purple n sup mesenteric artry was blocked , so what is dx =wet gangrene

36. Aortic aneurysm which structure not compressed = Phrenic nerve37.regarding cimitidine intake what effect causes =.inibition of hepatic enzymes38.ewing sarcoma occurs which site of bone = diaphysis

39.K in diet is excreted in which part of nephron = distal tubules (Note that, 67% of the filtered K is reabsorbed along proximal tubule , but Distal tubules and collecting ducts either reabsorb or secrete K , depending on dietary K intake, the excretion ranges from 1% to 110% . if both DCT and collecting duct are present in options prefer, distal convoluted tubules)

40.after non-lethal MI in 4 minutes = arrhythmias

41.Adductor muscle hamstring muscle supplied by which nerve = tibial

42.a statistical test observed differences b/w 2 means been by chance = variance43..max pressure in aorta during which phase = max during slow ejection phase ( while lowest in isovolumetric contraction)

44.remant of geburnaculum,= Ovarian ligament and round ligament of uterus45.left renal vein relation to aorta = LRV is anterior

46.cause of thromboembolism = prolonged immobilization(most common)s

47.commonest cause of shift of K from intracellular to extracellular = strenuous exercise (releases K from skeletal muscle)

48.damage to medulla oblongata during hanging = odontoid

49.sternocleidomastoid causes = movement of head in opposite direction against force(resistance)

50-platelets have life span of = 10 days

(note that platlets Count increases after spleenectomy the first effect we see after spleenectomy is Increased Platelet count ie thrombocytosis as the sequestered RBCs are put into circulation, and the HOWEL JOLLY BODIES are after that, )

51.multiple bone fractures history,blue sclera which products enzyme is defiecient =Collagen (the scenario is osteogenesis imperfecta)

52..MELAS syndrome histological finding = Red ragged fibers53..Giant Cell Tumors histo finding = Soap Bubble appearance

54.Platelets cannot be given in = Spleenomegaly (if asked contraindicated then Platelets are Contraindicated in Itp)

55.Bipolar cells are found in = olfactory

56.lobes of breast through many terminal ducts open into = lactiferous sinus 57.Left adrenal gland drains into = Left renal (same is the case for left testicular vein that also drains into left renal vein )

58.Free radical injury produces pathology by affecting = DNA

59.A 60 year old woman known case of Ischemic heart disease, Carcinoma breast has now come with osteoporosis. Which drug you will prescribe to treat her = Raloxifene60.In osteoporosis which of the fallowing is defective = Ostoclasts

61.Fast impulse passes through = Pukinje fibers

62.Internal laryngeal nerve passes through = thyroid and hyoid63.liver development = from ventral mesentery proximal Foregut

64.patient developed hemolysis due toG6PdD deificiency nxt happen = self limiting65.required for transport of B12 in blood = TC2

66. Anemia with Blast Cells in peripheral blood = Erythroblastosis fetalis ( note the point ie BLAST in the question and BLAST in the answer )

67.Deep to post digastric and near palatoglossus a structure runs obliquely upwards = Lingual artery

68.hip extension and leg flexion by = semitendonosis

69.Universal donor = O negative ( while universal recipient is AB positive )70.Which structure is formed by the end of first week = blastocyst

71.-injury above sacral spinal cord result in = Spastic bladder (note that UMN lesion ie the lesion above sacral spine is = spastic bladder while due to lesion of the sacral spinal cord segments or sacral spinal nerve roots , means LMN lesion result in so called Atonic bladder. Neurogenic bladder is the term used for both spastic and atonic, so if clear-cut point is not asked then , prefer neurogenic bladder)

72.Cell membrane structure primarily maintained by = Cholesterol bilayer73.Enzyme may fall in liver injury = Pseudocholinesterases [decrease in liver disease(hepatitis and cirrhosis)]

74. which part of liver with poor supply = poor oxygenation of zone 3 ( note that zone 1 is richly supplied with blood and is mainly effected by VIRUSES & INGESTED TOXINS, while zone 3 is poorly perfused and mainly affected by metabolic toxins )75.trachea is = has 16-20 incomplete rings

76.hyper eosinophilia occurs in = hodgkin ( due to IL5, that stimulates the esinophills production )

77.corticopsinal track ends at which level = spinal cord (if asked anterior corticospinal tract or anterior spinothalamic tract ends at ?? the ans for both is = midthoracic region )

78.warthin starry stain used for = spirochete( S for starry and S for spirochete)79.phrenic nerve runs on left side with = pericardicophrenic artery

80.hypovolaemia with hypotension isoflurane shud not be given,why? b/c it is =Potent vasodilator

81.Otic ganglion location foramen was asked = inferior border of foramen ovale82.Epitheluim of preterminal bronchiole/ conducting zone = Pseudostratified columnar cilliated…with goblets in larger bronchiole (in resp bronchioles> cuboidal, then simple squamous upto the alveoli] {clara cells in terminal bronchioles} )

83.muscle which causes flexion of elbow & supplied by radial nerve= Brachioradialis84.hormones increased during sleep = Growth hormone (note growth hormone increases during sleep but if asked During sleep inc level than awake click cortisol)85..chest pain and fever not related to respiration = Myocarduim

86..in later stage of pregnancy oestrogen and progesterone produce by = placenta87..A patient has hypercouagable state having def of = factor v(facror V Leiden)88..difference BTW skeletal and smooth muscle = ca calmodulin

89..Valve involved in Limb sack endocarditis = Mitral & aortic90..Abdominal angina cause by obstruction to = Sup mesenteric91..middle colic is the branch of = Superior mesenteric artery92..geniculate ganglion is located in = facial canal

93..taste sensation is carried to the cortex through = thalamus

94..two point discrimination = merkel disc (If asked ,Maximum 2 point discrimination at then= Lips( TIP OF TONGUE BEST IF THERE ) while if the stem is

“Maximum distance of 2 point discrimination at” then = BACK OR scapula)95..oesophageal atresia = drooping of saliva (indicating factor)96..Aluminium hydroxide in = delays gastric emptying (causes constipation)

97..long refractory period = heart ( and due to this long refractory period cardiac muscles cannot be tetanized )

98..defeciency of glucose 6 Phosphatase causes = hypoglycemia.. 99. Increase GFR causes inc absorption of salt and water from = PCT

98.Infection in cavournes sinus = INF OPTH VEIN (inferior ophthalmic vein for infection and superior for thrombosis )

99..cause of damage to lateral rectus = 6th CN

100..which one is the DNA virus = Infectious mononucleosis

01..Arterial emboli mostly arises from = Mural left atrium

02.Most of girls have amenorrhea during lactation, cause is = It inhibits gonadotropin releasing hormone ( ie FSH and LH)

03.True about breast = Arise from mammary buds present on the memory line04.A patient having AIDS may also have one of the following with AIDS = cervical Carcinoma

05.Severe hypomagnesemia may result in one of the following = Hypocalcemia (note that hypomagnesaemia causes hypercalcemia while severe hypomagnesaemia causes HYPOCALCEMIA )

06.The time interval between 1st and 2nd heart sound is almost equal to =Ventricular systole

07.The side effect of chewing betal nut = submucosal Fibrosis

08.Aldosterone is secreted in response to = inc in plasma potassium

(inc in plasma potassium is the most potent stimulant for Aldosterone,

while the most potent stimulant for ADH is nausea &

most potent stimulus for renin is sympathetic drive )

09.More mitochondria are present at the apex of which of the following = ciliated cells

10.Physiological jaundice = After the 2nd day of birth of the baby (JAUNDICE on day 1 is always pathologic while in preterm babies, even jaundice on day 2 is pathologic )11.Parents are informed about the disability of their child due to a debilitating disease. The first reaction of the parents is = Denial

12.shortening of chromosome in mutation….enzyme responsible is = telomerase ( this enzyme is responsible for the specific number of divisions a cell should go through, and with every division cell shortens and apoptosis is the end result, if this mechanism is defective , cell will evade apoptosis and proliferates to become neoplastic)

13.Regarding red infarcts = dual blood supply14.pressure is dissipated at = arterioles capillaries15.highest cross sectional area is of = capillaries

16.After 6 day of MI shock occurs d/t = pericardial tamponade17.Highest magnesium stores r present in = bone

18.diabetic pt loss of sensation n vibration n has ulcer in foot mechanism behind =angiopathy and neuropathy

19.turbulence of blood in anemia occur d/t = dec viscosity

20.regargding breast atrophy oin young is caused by = Estrogen n progesterone ( so many explanations for the breast atrophy, but I am always in the favor of estrogen and progesterone both as one causes proliferation of glands and other causes proliferation of stroma, and for atrophy of breast, both glands and stroma should be involved)

21. Fracture of surgical neck of Humerus damage to = Axillary Nerve ( note that deltoid is supplied by axillary and damage to it result in loss of abduction,supraspinatus – by suprascapular nerve = 15 to 30 degree abduction

Deltoid – by axillary nerve = upto 90 degree abduction

trapezius – by accessory nerve = above 90 degree abduction)

22.. Period where heart is susceptible to fibrillation = At the end of action potential

23.Aortic pressure is lowest during = isovolumic contraction ( about 70mmHg)

24.Labrynthine artery is the branchof = basilar (it arises form AICA but if not in options click Basilir )

25.Lady after cholecystectomy , having microcytic anemia = Blood loss

(questions onward are from cps demo ; try not to mess with the key )

1.Patient has aphasia and facial nerve palsy on same side the artery involved is =middle cerebral artery

2.Regarding l and d sugars = D sugars has oh on right side

3.A patient has non-reactive HbSAg , non-reactive HbeAg , and reactive anti-HBC =transient resolving stage

4.Urine examination of a patient with DM demonstrates ketones bodies,, what’s the mechanism of formation of these ketone bodies = insulin deficiency

5.Which is not a tumor marker = acid phosphatase6.Most sensitive cells to hypoxia = neuron

7.Tyrosine derivative doesn’t include = prolactin8.Organ having least chances of infarction = liver

9.Primary malignant melanoma of choir dost commonly metastasize to = liver10.Which is the site of fusion of binocular vision = visual cortex

11.A newborn baby with hydrocephalus ha swelling in lumbosacral lesion of spine which contain neural tissue in it what’s diagnosis = meningomyelocel 12.Regarding trigeminal ganglion the correct statement is = it’s like a posterior root ganglion of spinal cord

13.The total power of the eye is 59 diopters the main role in maintaining this is played by = anterior surface of cornea

14.In case of six days typhoid the test of choice is = blood test

15.After giving blood transfusion the patient develops hypersensitivity reaction which of reaction is this = type 2 hypersensitivity

16.For diabetic patient the best antihypertensive is = captopril17.Patient with bronchial asthma the best antihypertensive = verapamil18.Mesothelioma is associated with = asbestos

19.Nerve injured in anterior dislocation of shoulder is = axillary nerve20.Hypoglycemia increases = secretin

21.Drug that increases extracellular K moves K out of the cell = angiotensin22.Dark urine after starting ATT = rifampin

23.Thirst is decreased by = baroreceptor efferent

24.A diabetic patient is advised fasting blood glucose level at what value doctor is confusing and needs further evaluation with Glucose tolerance test = 7 mmol/l25.A female has goiter and she feels difficulty in breathing while lying down, what type of goiter she has = retrosternal

26.A patient with enlarged parotid gland with pain in this region, which nerve is carrying pain fibers from parotid gland = auriculotemporal nerve

27.A patient develops lesion in the caudate nucleus , what is the most common clinical feature indicating this lesion = chorea

28.Regarding the vibration sense what is INCORRECT = its receptor is messner corpuscle

29.Defect in the formation of bulbus cordis results in all of the following except =ASD

30.A 40 weeks pregnancy lady has irregular uterine contractions, which drug will be beneficial for this lady = oxytocin

31.A patient with aplastic anemia is given anti lymphocytic globulin, one week later she developed skin rashes. Mechanism for this presentation is = type 3 hypersensitivity

32.Which of the following is the most common cause of osteoporosis except old age =Cushing disease

33.A male patient with the antibody again FSH receptors which one will be lower than normal I this person = sperm count

34.The most common site of fertilization ins human is = fallopian tube35.Structure entering the thoracic inlet is = aorta

36.Needle inserted at the 5th intercostal space on the left side of sternum pierces =intercostal muscle

37.Somatostatin decreases the secretion of which hormone = insulin38.Gastric acid is stimulated by = Gastrin

39.Regarding SA node = automatically generates impulses,

40.During stretch in the skeletal muscle, which of the following change will occur in nuclear bag fibers = they increase impulse generation

41.Pulmonary artery pressure increases in= hypoxia

42.Which of the following structure in the mouth is derived from ectoderm =epithelium of the parotid gland

43.Oxygen level in the blood will decreases in = Hypoxic hypoxia

44.A 6 cm lump in the breast is removed, four lymph nodes and skin were involved, biopsy decided invasive ductal carcinoma , this tumor is called high grade because of = Pleomorphism

45.Diagnostic finding on investigation of metabolic alkalosis is = HCO3 more than 24meq/liter

46.In a patient with sympathetic stimulation what will be the effect on his heart = dec AV Nodal delay

47.What is the nerve supply of the tip of nose = ophthalmic

48.A patient old male has central retinal artery occlusion what could be the most likely cause = embolism

49.A patient with recurrent epistaxis, lab investigations show decrease factor 2, 7 , 9 , 10 , protein c and s , what will be the most likely cause = vitamin k deficiency50.Most common malignancy in person suffering from nuclear blast = hematopoietic51.In turner syndrome the genotype is = XO

52.Vertebreae are derived from= slcerotome

53.Regarding filliform papillae = they are present on the dorsum of the tongue till the tip

54.A patient is unable to extend metacarpophalangeal joint , abduct and extend his thumb, but intact sensation, which nerve is damaged = radial nerve

55.A young patient blood pressure is 150/95 his serum renin level is higher than normal which one is the stimulus for higher renin = increase sympathetic stimulation via renal nerves

56.Which one is the characteristic of IgM = it’s a largest molecule

57.A patient with chronic renal failure needs transplantation. For this reason HLA matching is required , which is the best site for sample for HLA matching = WBC 58.A young child has increase BP in upper limb while decrease BP in lower limb, the pulse is also weak, what is the most probable diagnosis = Post ductal coarctation of aorta

59.Penetrating injury in the 4th left intercostal space just lateral to the sternum will damage, which one of the following structure first = intercostal membrane

60.Best pulmonary function test for asthma is = FEV1

61.Nerve injured in anterior dislocation of shoulder joint is = axillary62.Presene of pancreatic tissue in the gastric mucosa is = choriostoma63.Least common site for ectopic pregnancy is = ovary

64.Least chances of renal stone is associated with = hyperlipidemia65.Which enzyme is released form small intestine = enterokinase

66.A patient has finger like projection on upper eyelid, histopathlogical reports show epithelial cell along the fibrous element what is the most probable diagnosis = papilloma

67.Parotid gland is supplied by = GVE

68.Which one is most strong antioxidant = Glutathion

69.A patient develops paralysis of the left side of the body , after few days his behavior for pain is changed, and eh become angry after touching, where could be the lesion = right thalamus

70.Most early diagnosis of vita min a deficiency = night blindness

71.Patient with bone pain, normal calcium and in alkaline phosphatase = Paget disease

72.which of the following structures is produced in 3rd week of development = Heart tube

73.Antibodies are produced by = Plasma cells

74.Patients come with deviation of tongue to right side. Decreased sense of touch and vibrations, the artery commonly involved in brain is = Anterior Spinal75.Patient with injury to left 8th cervical segment of spinal cord will not show following sign = Dec sense of pain and temperature below the lesion on same side

76.Foetal period starts after which week = 8th

77.Patient with old history of adenocarcinoma of colon operated for polypectomy, on histologic evaluation pathologist labeled it as benign growth with no chances into malignant transformation, it would be = Tubular adenoma

78.Soldier comes with heavy bleeding. The ideal fluid replacement would be = Whole blood for 3 days

79.. A Patient has anemia, hyper-segmented Neutrophils on peripheral blood examination & neurological manifestations. Which type of anemia he is suffering from = Pernicious anemia

80.Heme binds with = Haptoglobin

81.A pregnant lady develops pain few hours after delivery. E.C.G. shows S1, Q3 and T3. What is another investigation most appropriate for the diagnosis of this case =Gallium Scan

82.In a patient diarrhea are corrected after the fasting. Which is most likely type of diarrhea = Osmotic

83.Councilman bodies are formed in the process of = Apoptosis

84.A middle aged male presents with joint pain since one week. His serum Uric Acid level is 156 mg/dl. What is the best investigation for confirmation of the disease =Synovial fluid for polarized light

85.A patient comes to you in ill condition. His blood pH is 7.3 PCO2 is 44 mmHg & HCO3 is 17 meq/L. What diagnosis you are thinking of this patient = Metabolic acidosis

86.During general anesthesia Halothane is given in combination with which of the following drugs = Nitric oxide

87.Most common cause of the pelvic inflammatory disease is = Chlamydia88.Which cranial nerve carry parasympathetic fibers = 3, 7,9 ,10 89.Which is the characteristic feature of rheumatic fever = mitral stenosis

90.Axillary and pectoral group of lymph nodes drains = upper and lateral quadrant91.A 20 weeks pregnant lady presented with BP of 140/95 she complains of vomiting and headache, what is the most probable diagnosis = pregnancy induced hypertension

92.Brucellosis is transmitted by = unpasteurized milk

93.A patient develops sudden breathlessness , hypotension , severe itching and other features of anaphylactic shock ,which drug will be beneficial for this patient failing heart = adrenaline

94.Parasympathetic stimulation causes = opening of intestinal sphincters

95.A patient with trauma of the head developed cerebral edema, which is the cause of inc respiratory rate in this patient = raised ICP

96.Secondary hyperaldosteronism can occur due to = inc renin

97.All of the following mechanisms are involved in development of diabetic gangrene

EXCEPT = Arterioscierosis leading to reduced blood flow to foot

98.Blood brain barrier is formed by = Capillary endothelium

99.On H & E staining a student sees the hallow structure around the nucleus. What it could be = Lysosomes

100.A middle aged male has non-healing wound for long time in presence of regular dressing; random blood sugar is 130 mg/dl. What could be the cause of delayed healing in this patient = Vascular insufficiency

01.Which of the following is diagnostic of granuloma = Epithliod cells 02.Medial orbitotomey is done in a patient with tumor in orbit. Now he is complaining of numbness at upper part of head up to vertex & medial part but

medial part is intact. Which of the following nerves is damaged = Supraorbital nerve03.In inferior wall Myocardial Infraction, which artery should be blocked = Right marginal artery

03.A young women, complains of Dry mouth & Dry eyes. Which investigation will give clue to her diagnosis = Anti – SS A/B

04.Esophagus histology = Has str. sq in upper 1/3

05.Example of carrier mediated counter transport = Na – glucose transport06.Following is true regarding sterilization = Autoclaving is heating objects at 121 degree C at 15 psi for 3min

07.Pt complains of chest pain for more than 30 min. ECG shows changes in V1-V4. It denotes = Anterior wall MI

08.Depolarization of cell is maintained by = Na influx

09.Spinal cord ends at the level of lower border of = L2 vertebra10.Dry mouth increases all except = Plasma volume

11.Urine Examination of a patient with diabetes demonstrates. Ketone-bodies. What is the mechanism of formation of these ketone-bodies = Insulin deficiency

12.A lady received DES during pregnancy for prevention of the abortion. Her baby will be on the risk of = Clear cell carcinoma of Vagina

13.Prenatal chromosomal abnormality can be detected at = 14-18 weeks

14.All of the following mechanisms are involved in development of diabetic gangrene EXCEPT = Arterioscierosis leading to reduced blood flow to foot

15.A patient presents with dislocation of hip after an accident. Which of the following muscle group is involved =Gluteus Maximus + Minimus + Medius

16.No question, = just chill

17.A patient has history of recurrent abortion. Which of the following enzyme analysis will give help to diagnosis = Progesterone

18.A patient presents with secondary amenorrhea. One year back she has history of P.P.H for that she received six pints of blood what is most probable cause of her menstrual problem = Sheehan’s syndrome

19.A 60 years old women is brought with bleeding per vagina. She is diabetic & hypertensive & one year back she was diagnosed as having carcinoma of breast. What can be most probable diagnosis for this bleeding p/v = Carcinoma of endometrium

20.A Patient is suffering from carcinoma of rectum. He develops pain in the posterior aspect of thing due to involvement of nerve. Which nerve supplies the posterior aspect of thigh & that can be involved in the malignancy of rectum = Sacral nerves21.A semiconscious patient is brought to emergency department. He has history of taking some unknown drug. NaHCO3 reverses the action of drug. Which drug he has most likely taken = Phenobarbital

22.A lady with 26 weeks gestation has uterine height of 24 weeks. On sonography there is no fetus & snowstorm appearance. Which of the following probably associate with it = Karyotype-46XX

23.Normal female pelvis has = Oval inlet

24.Ascent of the horse shoe shape kidney is prevented by = inf mesenteric artery25.Which of the following is characteristic of polycystic ovary disease = Inc L.H26.Milk is notoriously deficient in = pantothenic acid

27.Down syndrome Is characterized by= mental retardation and abdominal hernia28.A lady undergoing surgery for cranyophargioma , what you could expect to be present in this lady = Hyperprolactemia

29Regarding nitroglycerine all are true except = increase heart rate

30.A person presented with the loss of visual acuity which artery is most likely affected = posterior cerebral artery

Good Luck for exam

Regards; Tan Veer Ahmads




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