FCPS PART 1 MEDICINE PAPER I and II

16 NOVEMBER 2011

MEDICINE AND ALLIED 199 QUESTIONS POOL

PAKISTAN ISLAMIC MEDICAL ASSOCIATION (PIMA)

http://www.pima.org.pk

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PIMA
- Pakistan Islamic Medical Association
we seek the pleasure of almighty ALLAH through character building and service to man kind

Our Mission
The Prophet s (P.B.H.) sayings that Allah creates no disease without creating a cure for it as well and the superiority of the learned over the mere pins is like the superiority of the moon when it is full over all other stars and the ink of the sailors is more previous than the Good of the martyrs direct us towards reaching for unknown cures and medical research is thus our religions duty.

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FCPS Part 1 Medicine Paper 1 and 2 ,16 November 2011

1-Following is realted to myxoid degeneration

c-BT d-CT e-measurement of Antithromib III 10-A person is asked to bring down fully abducted arm slowlybut when he tries,limb falls suddenlywhich muscle is diseased/paarlysed? a-deltoid b-subscaoularis c-pectoralis major d-teres major 11-Which antithyroid drug is safe in pregnancy? a-propylthiouracil b-methemazole c-radioactive iodine 12-abscess in posterior triangle of neck operated .now patient cant comb her hair..where is lesion? a-radial nerve b-axillary nerve c- spinal accessory nerve (http://en.wikipedia.org/wiki/Posterior_triangle_of_t he_neck) 13-Isoniazid a-its toxicity reduced by pyridoxine

2-about azathioprine,
a-converted to active metabolite by xanthine oxidase b-does nor affect cells of bone marrow C-fis dihydrflorate reductase 3-nerve supply of plantar surface of foot a-superficial peroneal b-deep peroneal c-sural nerve d-posterior tibial 4-which of following causes increased interstitial pressure a-increased capillary permeability b-increased colloid osmotic pressure 5-lesion of Right optic tract ( came 2 times in paper 2) causes a-left homonymous hemianopia 6-which structure arches over root of right lung a-azygous vein b-hemiazygous vein c-arch of aorta d-esophagus 7-Superficial cardiac plexus in superior mediastinum is formed by a-branches of right vagus b-branches of left vagus(Grays) 8-which antiemetic has highest bioavailability..(oral drug bioavailability in brackets I found) a-ondansteron(56-71%) b-cyclizine(80%)

a-maxillary artery

15-Anterior and Posterior spinal arteries arise from a-Vertebral and PICA respectively 16-initial Most sensitive test for SLE

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c-droperidol(protein bindind 85-90% so less availablty) d-metoclopramide(65-95%) e-porcholrperazine(12.5%)

9-which is not bleeding profile screening test a-PT b-APTT

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a-Anti ds DNA

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a-ANA a-kawaski disease

17-patient with dry eye and dry mouth..most specific test

b-Anti ss DNA (Its Sjogren syndrome) 18-cimetine n ranitidine both have the same mechnism of action..ranitidine is superior because? a.has more bio availability b.has less CNS side effects c.has rapid onset of action d.has more affinity 19-9 year child suddenly died..on autopsy,coronary artery aneurysm

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14-middle meningeal artery is branch of

20-most abundant immunoglobulin a-IgG 21-IgE is found on surface of which a-Basophil? b-Eosinophil? 22-RBCs a-are biconvex b-rich in glycolytic enzymes c-have nucleus 23-17 year old primigravida, which of following if present against Rubella is indication of termination of pregnancy a-IgG (can be from past infection) b-IgM (Current infection) c-IgA 24-HbsAg negative,Anti-Hbc TOTAL reactive,Anti-HBc IgM non reactive,Anti-Hbe reactivewhats the inference? a-Past exposure to HBV b-immunized c-incubation period d-active disease e-Recover phase (CMDT 2012) 25-If patient is HIV seropositive , whats is best approach? a-repeat test with other other methods b-correlate with history c-isolate him d-decalre AIDS 26-9 year old girl who is terminally ill..asks u am I gonna die?childs parents have already told u not to inform her about diagnosis .whats best approach? a-dont worry. you will be fine b- you will die c-what have ur parents told u d-most kids survive 27-Atypical mycobcateria a-most uncommon

d-cause only lung disease 28-heart sound produced by vibrations by filling of ventricle is a-1st b-2nd

c-3rd
d-4th 5-murmur 29- regarding heart sounds , a-S1 is high pitch b-produced by atrial kick is S3 c-ear can detect sound b/w 40 cycles/sec to 500 cycles/sec (Ganong) d-second heart sound relatively louder

29-Cervical cancer is associated with a-HPC 16 b-HPV 6 30-premalignant intra epithelial lesion of vulva a-pagets disease 31-Pansystolic murmur in kid after 5 weeks of birth and cyanosis

32-When aorta and pulmonary trunk does not separate in

33-Atrail fibrillation a-pulse deficit

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b-resistant to common ATT c-heal rapidly

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a-metoprolol

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b-multiple p waves c-regular QRS complex 34-at common dose,tachycardia is effect of which drug a-isosorbide dinitrate 35-which drug is not calcium channel block but given in angina is 36-study in which we have two groups diseased and non diseased personwe have to evaluate cause by history..type a-case control

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a-Truncus arteriosus

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a-VSD

37-sample which is age based griupedthen random people taken from each group..type a-random campling b-stratified random sampling 38-vitamin deficiency by avidin a-biotin 39-hormone which causes storage of carbohydrates,proteins and fat a-insulin b-GH 40-Stress responsewhich hormone is not released a-cortisol b-insulin c-ADH 4-GH 41-Lysomsomes a-arise from golgi apparatus b-have catalase and hydrolase c-have oxidase which generate H2O2 42-Epithelium of larynx a-startified squamous b-pseudostartified columnar ciliated 43-Which cell release extracellular fibers and amorohous substance a-Fibroblasts 44-Which cell is not a part of epidermis a-pacinian corpuscle b-merkle cell c-melanocyets 45-Which is not BASIC TISSUE a-blood b-muscle c-nerve d-epithelium

47-most common genetic diseases are a-chmosomal b-x-linked recessive c-autosomal recessive d-autosonal domiant e-multifactorial 48-Test in cystic fibrosis .. Child has multiple episodes of respiratory infction,otitis media..family history of same disease.. a-sweat chloride test 49-Superior parathyroid a-is at mid of posterior border of thyroid an first tracheal ring 50-Thyroid a-moves with deglutition because its attached with prevertebal facia b-lymph drains to deep cervical lymph nodes 51-Vitamin A source a-carrots 52-Patient is taking immunosupresantsnow has neck rigidity,CSF has high WBC mostly lymphocytes..on microscopy,organism has halo around it..causes a-cryptococcosis b-toxoplasmosis c-histoplasmosis d-candida

a-Urea b-Na c-K

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46-Achondroplasia (a 50 yrs man with short stratue n short upper n lower limbs... with lumber lordosis ) is a-autosomal dominat

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b-autosomal recessive

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d-Glucose b-facilitaed

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54-Glucose is transposrted in kidney by a-simple diffusion b-facilitated diffusion c-primary active transport d-secondary active transport 55-Glucose transport across a membrane is directly proportional to conc gradient..type of transport is a-simple diffusion

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53-which crosses with simple diffucsion

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c-active 56-Number of structural genes is a-5000-10,000 b-20,000-25,000 57-to prevent autodigestion of pancreas,pancreatic enzymes are secreted a-bound to protein b-secrted in preform to be activated by trypsin 58-Corpus callosum a-connects 2 cerebral hemispheres

66-What is true a-Rectum ends at rectalfolds b-Upper limit of rectum is in front of 2nd coccygeal vertebra c-anal cnal is region between anus and where levator ani passes around rectum d-inferior rectal vein drains into portal vein 67-Patient with neck rigidty,CSF proteion 400mg/dl.Glucose 40 mg,WBC raised 400 lymphocyte..Diagnosis A-TBM b-bacterial mengintits

59-Lateral wall of third ventricle a-made by medial 2/3 of thalamus

c-viral meningitis d-encaphilitis 68-Which is osmotic diuretic?

60-In long term memory a-structural changes in synapses b-presynpatic potentiation 61-Baby has hemolytic disease.Blood group is B +..With which blood u will do exchange transfusion a-B negative b-O c-AB d-B+ e-any Rh + blood 62-Nornal FEV1/FVC ration a-0.6 b-0.8 63-Functional Residual capacity is a-air left at end of tidal expiration

a-Mannitol b-acetazolamide 69-EBV is associated with which CA a-Nasopharyngeal 70-Coronary blood supply is regulted by a-duration of diastole 2-local myocardial metabolism 71-Which one has no effect on coronary circulation? a-Parasympathetic nerve supply b-Heart rate

a-Substance P b-serotonin

64-Stab above xiphisternal at 6th costal cartilage just to right,what will be damaged a-right ventricle b-right atrium c-IVC 65-Rectus sheath

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a-incomplete above umbilicus

b-contains superior and inferior gastric arteris c-starts at level of arcuate line

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d-enkaphlin a-seizures b-HTN b-medius c-minimus

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c-Glutamate 73-What is effect of TCA antidepressant overdose? 74-What muscl;e abducts femur t hip joint? a-gluteus maximus

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72-What is released at pain inhibitory fibers when they cntact with incoming fibers

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75-Effect of parasympathic? a-constrics muscle in iris 76-Visual acuity? a-incraeed by foveal cones 2-noraml even if colour vision is lost

a-Left internal capsule b-Right cortex 85-Pupils accommodate but dont react to ht ..Lesion is in a-Pretectum b-edinger westfal nucleus

77-Cardiac output increased in? a-exercise b-pregnancy

86-A man from AJK had fever with chills for last 6 months.he suddenyly died of cough..Ob autopsy,blood clots in peritoneum..daignosis/ a-malaira ? b-leshmenia

78-Pulse pressure? a-determined by stroke volume (http://en.wikipedia.org/wiki/Pulse_pressure) b-measured only in diastole

C-sickle celle anemia 87-a 2 year olf girl from Azad Kashmir presented with off and on fever..looks pale..has pancytopenia and hepatosplenomegaly ESR 80,,,she has a-Acute lymphoblastic leukemia b-gauchers

79-Regarding adrenal coretx a-Adrenal cortex essenrail for life b-Medulla is essential for life

c-visceral leishmaniasis (Muzafarabd has high revalance of leshmania and it do causes pancytopenia .Ref Jewetz micro) 88-Highest amont of triglyceride in a-chylomicron

80-Fight and flight reponse results in a-Decreasd airway resistance

89- about primitive streak a-site of involution of epiblast to make mesoderm

81-Transverse fibers in pons make a-Superior cerebellar penducle(CP) b-Inferior CP c-Middle CP (snell) d-Olivary tract 82-Spaciticity in mid-collicular decerbrate lesion is LEAST LIKELY due to a-Increased activity of gamma motor nuron b-increased activity of inhibitory interneuront c-medullary activity

c-formed in 2nd week

90-Right brachiocephalic vein a-is shorter than left 91-Chorionic villi

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83-B/L complete loss of all sensations below lesion occurs when there is lesion of

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a-Ipsilateral cord transection b-ipsilateral Thamalus lesion

c-Complete Cord transection

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84-Patient has right arm,leg paralysed.Right plantar upgoing,Reflexs exaggerated..Lesion is in?

a.
b-Teratoma

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a-Ductus arteriosus b-Foramen ovale a-small cell lung CA c-chorioccarcinoma d-chondrosarcoma

a-attach chorion to endometrium b-are called primary villi when they have mesodermal core 92-In a premature child,which does not close mostly

93-Which does not produce hormones

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b-formed in first week

e-arhenoblastoma(secrets testosterone) 94-A patient has lung abscess..develops meningitis..causes is a-Pneumococcis b-H.Influenze c-Streptococci d-staphylococcus 95-A patient has cervical ymphadenopathy..shows granoluma..which is necessary for TB diagnosis (2 questions) a-Caseous necrosis 96-Bells palsy..lesion is at a-stylomastoid foramen b-geniculate ganglion c-befor giving branch to stapedius 97-First response to vessel injury a-activation of extrinsic pathway b- activation of intrinsic pathway c-platlet activation d-vessel constriction 98-Prostacyclin is secreted by a-Thrombocytes b-Vascular endothelium 99-Maunto test is a-type 4 hypersensity reaction 100-Which is related to Type 3 hypersensitivity reaction? a-Arthus phenomenon 101-Regarding MRSA, which is LEAST APPROPRIATE a-Vancomysin is given to all contacts b-test all contacts c-isolate patient d-isolate the organism e-subtyping the organism

d-Clest phlogeny 103-Which is not premalignant Leukoplakia precursor a-Spices b-syphilis c-spirit d-sexual contact e-chronic infection 104-in typhoid fever,test in first week is a-Blood culture b-Stool culture c-Urine Culture d-Widal 105-Lobar Pneumonia is diagnosed by a-Blood culture b-Spututm culture 106-Stony dull percussion on anterior chest indicates a-Fluid in pleural cavuty 107-if pleual is ruptuered there is: a-inward collapse and inward chest wall spring b- inward collapse and outward chest wall spring c- outward collapse and outward chest wall spring

108-Lypmh is filtered in a-Lymph nodes b-spleen

c-Thymus

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102-Basal cell CA is least likely realted to a-Smoking b-white shkin c-brown iris

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b-lung c-brain d-lymph node e-spleen 110-Cells is thymus which have least affinity for MHC class 1 develop into a-delta cell b-T helper 1 cell c-T helper 2 cell

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a-liver

109-Which area has least metastasis

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d- outward collapse and inward chest wall spring

d-NK cell 111-Which is pronounced in Penicilin Anaphylaxis a-Bronchospasm b-fever c-gneralized skin ash 112-Enzemye is serotonin,epinephrine metabolism.??/ a-MAO b-COMT c-dopamine hydroxylaSE

d-Medullay Collecting duct e-Renal pelvis 121-Which is not character of MALIGNANT tissues? a-Fibrous reaction around tumor b-increased Nuclear to cytoplasmic ratio c-Abnormal mitosis d-Anaplasia 122-Hormone which si abundant in Fetus but in adults level ioncrease with advancement of CA Colon is a-HCG b-CEA

113-Regarding type 1 hypersensitivty, a-Rheumatoid arthritis is not type 1 114-A person died of CA colon..autopsy showed thousands polyps..his father died of same diease..polyps are which type a-Adenomatous 115-Ionizing radiation injury??/ A-FREE redical 116-Fluid which has 0.5 GRAM/dl protein is a-Saliva b-Lacrimal fluid c-Lymph d-CSF 117- A female jaundice,ALT 17,Alk phos 75,Retics 10Cause of jaundice is a-Hemolytic anemia 118-patient died of CRF ..which tissue will be seen Hypertrophied on autopsy? a-Parathyroid 119-A 59 year female,known hypertensive taking medications presented to emergency in unconscious state..Serum Potassium is 5..Diagnosis? a-ARF b-CRF

c-Alpha Fetoprotein 123-Leftadrenal vein drains into a-Left renal vein 124-Which is not related to anterior relation of right kidney? a-asceding colon b-descending colon c-liver 125-Small intestine brush border DOES NOT play role in digestion by one of following reaction a-Protects epithelium b-secretes enzymes c-faciltates transports

d-increases surface area

e-increases movement of intestine 126-Following does not affect Volume of distribution

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a-Ascending loop of henle

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120-In the presence of ADH,in which segment filtrate will be isotonic to plasma

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b- Descending loop of henle c-Cortical Collecting duct

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a-age b-sex 127-In elderly male a-There is decreased elasticity of Myocardium b-diastolic hypotension c-Systolic hypotension 128-Aldosterone a-causes its affect by increasing Potassium permeability 129-Thirst is stimulated by 1-Extracellular dehydration b-Intercellular dehydration

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130-Aldosterone is increased in response to a-decreased volume b-taking ACE inhibitor c-corticosterone 131-Blood flow to muscle is increased by a-Norepinephrine b-guanthidine 132-Decreased extracellura Calcium a-reduced reuptake of transmitter b-Redcued release of neurotransmitter from presynaptic vesicle

a-ASO ttitre b-Blood culture 141-Which is NOT necessary for liver to be declared chronic diseased? a-Acute inflammation b-loss of total liver architecture c-Fibrosis d-disruption of portal blood flow e-regernearting nodules 142-Female has jaundice,hepatosplnomegaly,Xanthomaswhat test will be Confirmatory? a-Anti mitochondrial antibody

133-Increased Serum Ca does not causes a-Nerve hyper excitability

b-ALT c-AST d-CT scan abdomen

134-Magnesium is stored in a-Bones b-muscles 135-Hyperparathyroisim does not cause a-Demenizerlaiztion of bone b-kidney stone 136-when mean arterial pressure reduces from 100 to 85,one of following DOES NOT OCCUR a-muscle blod flow decreases in 20 min b-GFR is maintained c-CNS ischemic reaction occurs 137-CSF a-has cushioning effect 138-patient has chest pain..ST elevation in V1.2.3.,4.. a-Anteroseptal MI b-anterolateral

e-USG abdomen 143-A quack has given drug to patient after which he developd jaundice..test a-Alanine transaminase b-aspartate transaminase 144-Female patient cough,hemoptysis,..Renal biopsy shows flat ig A deposit

b-FSGS

(IgA Nephropathy was not in option) 145-Hyopnatremia develops in a-CHF

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139-Most specific cardiac marker a-troponin T b-ck mb c-myoglobin d-ldh

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140-A girl in PT prade has developed dyspneafew months back she had sour throadnow what best test to start

a.
b-c AMP c-IP3 a-addison b-cushings

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b-SIADH a-Gene activation a-mtoclopramide

146-Aldosterone acts by

147-patient has skin pigmentation at elbows and exposed parts..BP 90/60,K is 2.5..dioagnosis

148- Which drug to give in diabetic gastropathy?

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a-Goodpasture

b-domerperidone 149-patient breathing deep,resp rate 6/mi..which drug poisoning? a-morphine b-pethidine c-nalbuphine d-pheobarbitone 150-pateint had retrosternal pain..biopsy from esophagus showed columnar epithelium..its called a-barrets esophagus b-esophagitis c151-a patient is having Glycosuria..blood glucose is 100..dioagnosis a-Diabetes b-proximal tubule no reabsorbing glucose c-LOW renal threshold 152-Manoux test negative in TB patientcauses a-taking immunosuppresants 153-artery which crosses third part of duodenum a-superior mesenteric b-inferior mesenteric c-left colic 154-Achalsia cardia a-decreased ganglion calls of vagus in muscle b-increased number of neurons c-occurs only at pharyngoesophagus jusction 155-basal rhythm of small inetsine a-correlatd with stomach b-decraed when mechanical motity starts c-variable affectd by hormons d-constant in duodenum variable elsewhere 156-If vagotomy done a-Gastric acid seretin increases b-Gastric pepsin increases

b-vitamin b12 deficiency 158-Regarding platlets a-formd by fragmentation of megakarycoytes in bone marrow 159-What is not true regarding von Wilibrand disease? a-autosomal dominat b-autosomal recessive c-some family member have normal factor 9 d- some family member have decreased factor 9 e-genetic inheritance 160-patient has pancytopenia..test to do (detail needed) a-bone mwrow biopsy 161-Anticoagulation is contraindicated in a-Thrombocytopenia b-Hypertension c-Cedrebral infarction 162-Trunk muscle supplied by a-posterios primary ramus b-posterior cutaneous nerve 163-What is fast neuron? a-A alpha b-A beta C-A delta d-C fiber

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c-Gasric emptying decreases

157-patient hb 6,dysphagia..cause a-iron deficiency anemia

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d-urination a-Broca area b-bohr effect a-basillar

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b-sweating a-haldane effect

164-Person naked in room ..tempertutre 21 degree centigrade..humidity 80..loss of heat by a-insensicble perspiration

c-conduction and radiation

165-Afluent Aphasia is lsion of (2 questions?)

166-Left shift of oxygen curve

167- Anterior inferior cerebellar artery is branch

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168--Mandible joins midline a-symphsis b-symdesmosis 169-Least mpvable joint a-symphysis b-ball and socket c-Saddle 170-Neuron in olfactory a-bipolar b-sustentaticualr c-brush border 171-IN CHRONIC RESPIRATORY ACIDOSIS,HOW MUCH HCO3 RISE OCCURS FOR 10 MMHG OF PO2 ? a-1 mEQ b-3 mEq c-7 mew d-10meq e-15 meq 172-A patient has fever,weight loss,coughwhats necessary for TBdiagnosis? (TB Q came 2 times) a-isolation of organism b-caseous necrosis 173-A lesion og brocas area causes a-aphasia b-anosmia 174- Lesion of right optic tract causes visual loss(options were wrong) a-right temporal left nasal b-bitemporal hemianopia 175-LYMPHATIC DRAINGAGE OF LOWER LIP a-submental & submandibular a-submental and suraclavicularIron deficiency Iodine deficiency 182-clinically cental cyanosis occur when hb becm more than a-1 g/dl b- 5 g/dl c-3 g/ dl 183-vertebral column a-31 vertebrae b-7 cervical vertebrae 184-Best approach to patient 179- .na is absorbed along basolatral membrane by? a. na k pump b. na glucose cotransport 180- amino acids are absorbed from kidney to blood by a. primary active transport b. simple diffusion c-secondary active transport 181-carcinoma is not related to: 178- Regarding growth Hormone a.its polypeptide b. initiate growth of bone n cartilage by sometomedin c. half life is 20 to 60 min in circulation

a-start with open ended questions

c-start by asking presenting complaint

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176-Which cell produces Histamines a) Fibroblast b) Mast cells c) Lymphocytes e) Neutrophil

177-.lesion of optic chiasm due to pituitary tumour a.causes bitemporal hemianopia.

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c-vasopressin a-Nimodipine

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a-0.9 % Nacl b-isotonic glucose a-its functional unit b-its anatomical unit

d-start by asking his name,age

185-Plasma osmolilaity decreased by giving

186-Which drug used in Subarachnoid hemorrhage?

187-Regarding bronchopulmonary segment

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b-start with closed ended questions

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c-its functional,anatomical and surgical unit

198-Regarding Thyroid a-drains into deep cervical lymph nodes

188-Pressure in aorta is maximum during a-rapid ejection phase b-isovolumetric contraction c-isovolumetric relaxation 199--Cervical cancer is associated with a-HPV 16 b-HPV 6

189-in all types of shock a-there is decreased celluar oxygenation b-dec CO, c-hypovolemia 190-Prenatal diagnosis of thalassemia a-by chorionic villous sampling 191-19 year old male with bruising..only platlets low all else reports normal..diagnosis a-ITP 192-A patient has come to ER with heart rate of 40/min..diagnosis? a-first degree heart block b-2nd degree c-3rd degree heart block 193-a question related to diuretic therapy..dont remember exactly 194-pitutary tumor..visual loss???? a-bitemporal hemianopia

200-

195-enterogastric reflex is not stimulated by a-pancreatic secretions in small intestine b-when chime enters duodenum

a-Ondansterone is effective in cytotoxicity induced vomiting more than metoclopramide 197-Muscular tissue derived from a-Mesoderm b-Endoderm c-Ectoderm

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196-Regarding anti-emetics

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