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Chapterwise Semester Questions of 1st Year

MBBS Students (2021-22)

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 Chapterwise Semester Questions of 1st Year
MBBS Students (2021-22)
Brought to you by

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➢ Diamondharbour Medical College
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➢ Gurunanak Dental College:

• Dr. Tuhin Barman :+919382912290
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❖ Further Contacts:
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• Dr. Apurba Mandal: 9641322061
• Dr. Dipak Giri: 9051878399
• Dr. Sams Mushafir: 9432951327

Doctors! Go to the wounded! Do not wait for them to come to you.

__ Dr. Norman Bethun

|Hold High the Banner of Medical Ethics|

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_____________________SUPERIOR EXTREMITY

A. LONG QUESTIONS (Marks: 15):

1) Mention the extent of mammary gland in females. Describe the lymphatic drainage
of breast. What is 'Peau D'orange'? (5+7+3) [RGKAR]

2) A patient came to hospital with fracture midshaft humerus and inability to extend
wrist Joint.
i) Which nerve is involved in this case?
ii) How the nerve is formed from Brachial plexus?
iii) Name the branches of nerve in the arm.
iv) Describe the course of the nerve.
v) Explain the term 'Wrist Drop'. (2+3+3+4+3) [RGKAR]

3) Describe the brachial plexus with diagram under following heading: root, trunk, cords
and branches. What do you mean by Erb's point? Add a note on Klumpky's
paralysis.(2+2+2+5+1+3) [CNMC]

4) A 65 year old man suffering from breast cancer presents with enlarged nodular
swellings in axilla. How will you explain these nodular swellings? How and in what
groups are they arranged in axilla? Name their respective afferent and efferent
pathways.
Explain the following presentations of breast cancer from your knowledge of anatomy -
i) Retraction of nipple.
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 ii) Fixation of tumour to underlying structures.
iii) The overlying skin is edematous with pitting resembling orange peel
appearance. (1+3+5+2+2+2=15) [NBMC]

5) A lady mountaineer underwent mastectomy for malignancy of the right mammary

gland. Few weeks later she resumed training to small heights with her upper limbs.
To her utter dismay it was almost impossible to raise herself by even a metre with
the right upper limb. The surgeon examined her and diagnosed to be a case of
inadvertent injury to a particular nerve during the surgery. Answer the following
questions based on this scenario :
i) Name the injured nerve.
ii) Correlate that structure to the subsequent problems experienced by her.
iii) Mention its origin and mode of termination.
iv) Along which wall of axilla is it located?
v) State the lymph node group and vessels related to it.
vi) Illustrate the lymphatic drainage of mammary gland.
(1+3+3+1+2+5 =15) [NBMC]

6) A middle-aged driver was brought to ER of a hospital following a high impact trauma.

A radiograph revealed fracture of the proximal end of right radius along with
dislocation of its head. Expecting a damage to a particular nerve related to the bone
the ER doctor searched for signs that would corroborate the diagnosis. Surprisingly
enough, the wrist joint could be extended albeit painfully. However the same was
absent in the fingers. Answer the following questions based on this scenario:
a) Name the injured nerve.
b) State its cutaneous branches.
c) State the type,subtype,ligaments,movements and muscle acting on the
joint related to the head of the radius.
d) How can you explain the presence of wrist extension inspite of injury
to the nerve. (1+2+1+1+2+2+2+4=15) [NBMC]

7) Name the nerve and its root value involved in fracture of medical epicondyle of
humerus. Discus the course and distribution of the nerve beyond the elbow. What is
claw hand? (2+3+4+3=12) [DHGMC]
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 8) A 60 years old female patient comes to the OPD with complains of retraction of
nipple and axillary mass on the right side. What is your probable diagnosis? Explain
her symptoms in support of your diagnosis. What is peau d'orange appearance of
skin and why this patient may develop such feature? What is Krukenberg's tumour?
1+(2+2)+3+2=10 [BMC]

9) A 45 years old lady presents with breast cancer. Briefly describe the lymphatic
drainage of breast with diagram. How will you explain peau'd orange and dimpling of
skin of breast in breast cancer? (7+3)+(3+2)=15 [BSMC]

B. SHORT ANSWER TYPE (Marks: 10)

1) Following a fall from a height on an outstretched hand a 45-year-old man suffered
from dislocation of his right shoulder. Using the knowledge of Anatomy answer the
following:
a. Why the shoulder joint is vulnerable to dislocate commonly?
b. Enumerate the important ligaments of the shoulder joint.
c. What are the factors responsible for stability of this joint? (2+3+2=7) [MCK]

2) Describe the fascial disposition of the upper limb under the following headings:
a. What is clavipectoral fascia?
b. What are the structures piercing the clavipectoral fascia?
c. with the help of a suitable diagram define the fascial compartments of the arm
with its contents.(3+3+4=10)[MCK]

3) Regarding joints answer the following: (a) Classify joints; (b) Describe the movements
of the shoulder joints and muscles assisting each; (c) Which nerve is vulnerable to
injury in dislocation of the shoulder joint?(4+5+1)[MCK]

4) A 25-year-old young man came to the out-patient department with the complaints of
injury around his right knee joint. On examination it was found that he could not
dorsiflex his foot; and there was loss of skin sensation on the web space between 1"
and 2" toes of his right foot. (a) Identify the condition using the knowledge of
Anatomy. (b) Describe the affected structure under headings (1) Origin; (ii) Branches;
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 (iii) Course and (iv) Termination.(2+1+2+3+2=10)[MCK]
5) A clerk doing prolonged desk job and elbow leaning has developed "claw hand”
deformity. What is it and which nerve is involved? With the help of a diagram, give
the formation of brachial plexus. What is "ulnar paradox"? (2+1+5+2= 10) [NRS]

6) Enumerate the intrinsic muscles of the hand. With a labeled diagram illustrate the
different palmar spaces. What is whitlow? (4+4+2=10) [IPGMER]

7) A patient came to the emergency with history of fall on out stretched hand from bike
leading to inability to abduct his right shoulder not more than 15 to 20 degree. On
examination his contour of right shoulder is depressed. X-ray of right shoulder shows
fracture in upper part of right humerus. Which part of humerus is fractured? Write
the nerve is injured and it's route value? Which muscle is paralyzed? Write two
action of that muscle. (1+(1+1)+1+2=6) [Rphgmch])

8) Name the ligaments of the Shoulder joint. Mention the factors that maintain the
stability of the joint. [5+5=10] [Raiganj]

9) Name the nerves supplying the palm. How do they enter the palm? Give their
distribution in the palm. Which nerve will be compressed in long continued swelling
of the synovial sheaths of the long flexor tendons? What is the resulting condition
known as? (1+2+5+1+1) [KPC]

10) Following a fall from a height on an outstretched hand a 45-year-old man suffered
from dislocation of his right shoulder. Using the knowledge of Anatomy answer the
following: (a) Why the shoulder joint is vulnerable to dislocate commonly? (b)
Enumerate the important ligaments of the shoulder joint. (c) What are the factors
responsible for stability of this joint? (2+3+2=7)[MCK]

11) A child cried of pain while his mother lifted him holding his two hands. The child
cannot supinate or pronate his left forearm. Mention the joints involved in
supination and pronation and the types of joints. Name the muscles producing these
movements. What is the axis of this movement? (2+2)+4+2=10 [BSMC]

12) Following a serious lacerated injury of the Supinator muscle, a person developed
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 'wrist drop'. Which nerve is involved here? Explain anatomical reason for the same.
What is the root value of the nerve? Briefly describe the course and branches of the
affected nerve up to elbow. 1+2+1+(3+3)=10 [BSMC]

C. SHORT NOTES (Marks: 5)

1) Carpal Tunnel Syndrome.(5)[MCK][Rphgmch]
2) Abduction movement of shoulder joint [IPGMER]
3) Tennis elbow. (5) [NBMC]
4) Boundaries & contents of the spaces of the scapular region. (5) [Raiganj]
5) Erb's palsy (3) [DHGMC]
6) Ulnar paradox.(4) [BMC] [BSMC]

D. EXPLAIN WHY (Marks: 4)

1) Injury of median nerve causes "pointing index finger."(4)[MCK]
2) In the injury of radial nerve in the cubital fossa, there is no wrist drop .(4)[MCK]
3) A pin prick on the tip of little finger may lead to pain and swelling of the palm. (4)
[RGKAR]
4) Carrying Angle. (4) [RGKAR]
5) A palpable nodule in the axilla of an elderly lady should be properly cared. CNMC
6) Infection of pulp space of little finger is more dangerous than that of index finger.
CNMC
7) Claw hand is more pronounced in distal injury of ulnar nerve than proximal injury.
Explain. (3) [Rphgmch]
8) Basilic vein is preferred over cephalic vein for cardiac catheterization. Explain. (3)
[Rphgmch][Raiganj][BMC]
9) Fracture of the shaft of humerus causes wrist drop. (4) [NBMC]
10) Fracture of scaphoid may lead to avascular necrosis of a segment. (4) [Raiganj]
11) Winging of scapula. (3) [DHGMC]
12) Anatomical basis of peued orenge appearance and retraction of nipples in case of
carcinoma of breast. (3) [DHGMC]
13) A pin prick injury of little finger may lead to swelling of the hand.(4)[BSMC]

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 INFERIOR EXTREMITY

A. LONG QUESTIONS (Marks: 15):

1) Name the bones forming the knee joint. What are the ligaments of the joint?
Describe the locking and unlocking movements of knee joint. (2+5 +8=15) [NRS]

2) What are the superficial, deep and perforating veins present in the leg? Mention
origin, termination, tributaries of the long saphenous in with diagram. What is
Varicosity of leg veins? Briefly describe the anatomical factors preventing the
varicosity of leg veins.[7+ 4+1+3] [CNMC]

3) A patient suffers from injury of knee joint following an automobile accident.

Enumerate ligaments of knee joint.
a. What is unhappy triad? Why medial meniscus is more prone to injury? What is
locking movement of knee joint? What are the factors preventing dislocation
of patella normally?
b. Why is knee joint called a compound joint?
c. Why it is a complex joint? (3+2+2+3+3+1+1=15) [NBMC]

4) Describe the Femoral artery on following headings a. Origin, b. termination c.

branches, d. mention two clinical importance (2+2+5+6) [midnapore]

5) A bus conductor came to surgery OPD with venous ulcer above his left ankle. What is
the most probable cause of this ulcer? Mention the factors which lead to this
condition. Describe the factors which help in venous return from lower limb.
Enumerate the tributaries of great saphenous vein with suitable diagram. What
precaution should be taken during venesection of great saphenous vein at the ankle
and why? (1+3+4+5+2=15) [BSMC]

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B. SHORT ANSWER TYPE (Marks: 10):

1) Describe the joints concerned with inversion and eversion of the foot. Name the
muscles helping those movements. (4+3=7)[MCK]

2) Give an account of the arches of foot under the headings (a) Formation; (b) Factors
responsible for the integrity of the arches and (c) Applied importance of the said
arches.(2+4+4=10)[MCK]

3) Describe the boundaries and main contents of popliteal fossa. Add a brief note on
the locking and unlocking mechanism of the knee joint. (5+5=10)[MCK]

4) Name the bones forming the medial longitudinal arch. What are the factors
maintaining it? What is flat foot? Which joints are involved in inversion and eversion?
Name the muscles producing these movements.(2+3+1+2+2=10) (NRS)

5) A mid-aged woman develops varicose leg veins. How superficial veins are connected
to deep veins? Write a note on Great Saphenous Vein. Briefly describe the
anatomical factors preventing the varicosity of leg veins.(3+3+4=10) (NRS)

6) a) Enumerate(With a short description) the ligaments of hip joint

b) Name the different movements occur in hip joint. (5+5 =10) [RGKAR]

7) a) What is venous ulcer?

b) Write in short about venous drainage of lower limb (3+7 = 10) [RGKAR]

8) What are the structures forming boundaries of the inguinal canal? Name the
contents of the inguinal canal of 60 years old female person. Explain different natural
preventive mechanisms restricting development of inguinal hernia.(3+2+5=10)
[IPGMER]

9) Enumerate the types of ‘Arches of foot'. Describe the factors maintaining the Lateral
longitudinal arch. What is Pes Cavus? (2+6+2 = 10) [IPGMER]

10) A factory worker presents with swollen bintul inguinal lymph nodes following an
uncared wound at the medial side of ankle. Explain the complication from your
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 anatomical knowledge Write a brief note on inguinal lymph nodes with diagram.
(2+5+3) [CNMC]

11) 40 years old male presented in the emergency with pain and swelling in the
lateral aspects of the upper part of right leg just below the knee joint after an injury.
After clinical examinations it was detected that the patient had fout drop in right
side. His right foot was adducted and in inverted position. Radiograph (AP and Lateral
view) showed fracture in the neck of right Fibula. With your knowledge of Anatomy
explain in brief the cause of the injury and the causes of the deformity of the right
foot of the patient. Mention the area of sensory loss of this patient. (2+6+2) [CMSDH]

12) Give an account of semilunar cartilage of knee joint. Which cartilage is more
prone to injury? Why other one is relatively immune to injury? (4+1+3=7) [DHGMC]

13) A 25-year-old young man came to the out patient department with the
complaints of injury around his right knee joint. On examination it was found that he
could not dorsiflex his foot; and there was loss of skin sensation on the web space
between 1" and 2" toes of his right foot. (a) Identify the condition using the
knowledge of Anatomy. (b) Describe the affected structure under headings (i) Origin:
(i) Branches; (i) Course and (iv) Termination. (2+1+2+3+2=10)[MCK]

14) Describe the joints concerned with inversion and eversion of the foot. Name the
muscles helping those movements.(4+3=7)[MCK]

15) Describe in short, the gluteus maximus muscle under the following headings: 1)
origin ii) insertion iii) nerve supply iv) action. Enumerate the muscles and
neurovascular structures undercover gluteus maximus. (2+1+1+2)+(2+2)=10[BSMC]

C. SHORT NOTES (5) :

1) Femoral Sheath. (5)[MCK][RPHGMCH][NBMC]
2) Locking and unlocking of knee joint. [KPC]
3) Medial longitudinal arch of foot. (5) [CMSDH]
4) Pes planus. (4) [BMC]
5) Obturator nerve. (4) [BMC]
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D. EXPLAIN WHY (4) :
1) Tear of medial meniscus is more common than that of lateral meniscus of knee joint.
(4)[MCK]
2) Varicose vein most commonly affects great saphenous vein. (4)[MCK]
3) Injury to Superior Gluteal Nerve leads to positive Trendelenberg sign. (4) (NRS)
4) Foot drop after the fracture of the neck of the fibula. (4) (NRS)
5) Foot drop. (4) [RGKAR]
6) Semimembranosus is true hamstring muscle. (4) [RGKAR]
7) Inflammation of hip joint pain may be referred to the knee joint. (4) [IPGMER]
8) Patella has a tendency to be dislocated laterally. (4) [IPGMER]
9) Medial meniscus is susceptible to injury more frequently than the lateral meniscus.
(4) [CNMC]
10) Peroneus longus muscle has effects on both longitudinal and transverse arches of
foot. (4) [NBMC]
11) Medial meniscal injury is more common than lateral. (5) [midnapore]
12) Avascular necrosis of femoral head. (5)[midnapore]
13) Soleus muscle is known as peripheral heart. [4](CMSDH)
14) The pus from the tubercular infection of thoracic vertebrae often tracks down
into the femoral triangle or even in the popliteal fossa. [4] (CMSDH)
15) A gate keeper has prominent veins in his legs during standing position. (3)
[DHGMC]
16) Fibula violates laws of ossification. (3) [BMC]
17) A patient shows positive Trendelenberg's sign.(4)[BSMC]
18) Explain the directions of femoral hernia. (4)[BSMC]

_____Stop Privatization of Medical Education__

____

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 THORAX
A. LONG QUESTIONS (15):

1) Describe the right lung under the following headings:

a) Structures related to its medial surface with a suitable diagram;
b) Draw a labeled diagram of low power histology/microscopic features of the
lung (description not required);
c) Give a brief account of bronchopulmonary segments of right lung with applied
anatomy. (5+5+5=15)[MCK]

2) A 55 year old man complained of chest pain on exertion, e. g., climbing stairs,
walking briskly, relieved on rest. What is this type of pain called? What is the
anatomical basis of this type of pain? Give a brief outline of coronary circulation.

3) Which is the most commonly blocked artery in myocardial ischemia? Name the parts
of the primitive heart tube with a labeled diagram. What is the fate of foramen
ovale. (1 + 2+6+1+ 3+ 2 =15) [NRS]

4) A 50 yrs old musician after a stressful day of stage-performance, reports an

emergency at your hospital with acute onset of breathlessness. compressive chest
pain referring to his medial aspect of left arm. On ECG it is found ST elevation and he
is admitted with diagnosis of angina pectoris. Echocardiogram reveals wall motion
abnormality in the interatrial septum. Coronary angiogram reveals block in the left
coronary artery with left dominance.
i. Write down about the commencement, course and distribution of the
left coronary artery.
ii. What does coronary dominance mean?
iii. What is angina pectoris? Why does it refer to the medial aspect of the
left arm?
iv. Give a brief account on development of interatrial septum with suitable
diagram ((1+2+4) +2+(1+1) 4= 15 ) [IPGMER].
5) What is mediastinum? Enumerate the contents of superior mediastinum with
suitable diagram. What is thoracic inlet syndrome? What is subcarinal angle?
Mention its clinical importance. (2+5+1+1+1=10) [Rphgmch]

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 6) Give an account of the pattern of coronary ARTERIAL supply of the heart along with
suitable labelled diagrams. Explain the term 'Coronary Dominance'. Outline the
Venous drainage of the heart along with a neat and labelled diagram. (8+2+5=15)
[Raiganj]

7) An elderly man complains of frequent chest pain on exertion and advised to have
coronary artery angiogram.
a) Give the usual pattern of coronary arterial supply of the heart.
b) How interventricular septum in developed? What are the congenital anomalies
of the septum?
c) What is the primary defect in Fallot's tetralogy? (7+4+3+1) [KPC]

8) Describe the azygos vein under the following headings -

a) Formation
b) Course
c) Tributaries
Mention the collateral circulation that occurs in intra-pericardial superior vena caval
obstruction. (1+3+4+3=11) [BMC]

B. SHORT ANSWER TYPE (10) :

1) Describe the interior of the heart under the following headings:
(a) With a suitable diagram describe the interior of the right ventricle;
(b) What is the blood supply of interventricular septum?
(c) Describe embryologically the interventricular septal defect (VSD) and its possible
effects. (5+2+3=10)[MCK]

2) i) What is 'Conducting system of Heart'?

ii) Name the components of this system.
iii) Describe the position, function and blood supply of the main parts. (2+3+5)
[RGKAR]

3) What are the different parts of Pleura? Draw a labeled diagram of costomediastinal
reflection of the pleura of both sides. What is costodiaphragmatic recess of pleura?
Page | 16
 Draw a labeled lateral view diagram of it and mention its clinical importance.
(2+3+1+2+2 = 10)[IPGMER]

4) Explain the term 'Bronchopulmonary segments'. Draw a neat and labelled diagram to
illustrate the Bronchopulmonary segments of the RIGHT lung. Add a note on the
histology of TRACHEA. (2+4+4=10) [Raiganj]

5) A chest physician performed bronchoscopy on his patient. Define bronchopulmonary

segment .Name and number the different segments. Which segments are common
sites of aspiration pneumonia and why? (2+5+3+10) [KPC]

6) Define pleura. Enumerate the parts of the pleura with nerve supply. Describe the
costomediastinal reflection of pleura. (2+3+3=7) [DHGMC]

C. SHORT NOTES (5) :

1) Explain why foreign body is more commonly lodged in the right principal bronchus.
What are the contents of superior mediastinum? (2+3 =5) [NRS]
2) Briefly write about histology of trachea with a labeled diagram. (5) [NRS]
3) Broncho-pulmonary segment. (5) [NBMC] [KPC]
4) Major openings of the diaphragm. (5) [Raiganj] [KPC]
5) Coronary Sinus. (5) [Rphgmch]
6) Costo-diaphragmatic pleural recess. (5) [BMC]

D. EXPLAIN WHY (4) :

1) 2nd intercostal nerve is atypical. (4) [RGKAR]
2) Explain enlarged neck vein and ptosis due to tumour of apical lobe of lung. (4)
[Rphgmch]
3) Only 3 to 6 intercostal nerves are called Typical Intercostal nerves. (4)[Raiganj]
4) A foreign body is more likely to be aspirated into the right lung. [KPC]
5) Abdominal type of respiration is seen in neonates and infants below 2 yrs of age. kpc
6) 1St intercostal nerve is atypical.(3) [DHGMC]
7) Coarction of aorta (3) [DHGMC]
8) In myocardial infarction pain may radiate to the left arm. (3) [BMC]
9) Type of respiration in infants is abdominal. (3) [BMC]

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 ABDOMEN
A. LONG QUESTIONS (15) :
1) Furnish an account on the portal vein under the following headings: (a) Formation (6)
Course and termination; (c) Brief note on its development and (d) Enumerate the
main sites of porta-caval anastomosis and the associated clinical conditions in portal
hypertension.(2+3+3+7=15)[MCK]

2) What is anteversion and anteflexion of the uterus? Give an account of the

ligamentous, muscular and visceral supports of the uterus. What is bicornuate
uterus? (4+(3+3+3)+2=15) (NRS)

3) A) Discuss the supports of uterus. B) What is prolapse of uterus? C) Give an account

of blood supply of uterus. (7+3+5) [RGKAR]

4) A) Describe the different parts of stomach with a neat diagram. Name the different
structures forming stomach bed. Discuss lymphatic drainage of stomach with surgical
importance (5+4+6 =15) [RGKAR]

5) Write down on blood supply and lymphatic drainage of the stomach. (5+5=10)
[IPGMER]

6) A 52 year old alcoholic male attended at emergency with complaints of repeated

vomiting of fresh blood and passage of black colored stool. The attending doctor
finds the 'caput medusae' with presence of free fluid in the abdominal cavity. On
admission and further investigations, in histopathological microscopic examination of
the liver, structure of the hepatic lobules found alerted by fibrosis.
a. Explain anatomically the cause of development of 'Caput medusae' in this case
b. Enumerate the other sites of porto-caval anastomosis mentioning the portal &
caval contributions.
c. With appropriate diagrams elaborate different concepts on 'Hepatic lobules'.
(3+6+6= 15) [IPGMER]

Page | 18
7) A 65-year-old male patient of carcinoma prostate Atse surgery OPD with sudden
onset, low back pain. On x-ray of lumbar spine, it reveals metastatic spread of
carcinoma to vertebral column
a. Justify the proneness of metastatic spread of prostatic carcinoma to the
vertebral column.
b. Write down about the prostate gland under the following headings, coverings,
lobes and relations.
c. Enumerate the zones of the prostate based on recent zonal anatomy concepts
on the prostate.
d. What changes generally take place in the prostate gland with advancement of
age?
e. Draw a proper labeled diagram of the interior of the prostatic urethra.
(2 + (1 + 2 + 3) +2+2+3 =15)[IPGMER]

8) Name the three major openings of the diaphragm. Write down in brief about the
openings in respect to location with vertebral level, major structures passing through
and the effect of inspiration on these openings. Mention nerve supply of the
diaphragm. (1.5 + (3 +4+3) +3.5 = 15) [IPGMER]

9) An elderly lady complains of something coming out of vagina.

What is the condition she is suffering from?
What are the different parts of the organ involved?
Explain the two terms "flexion" and "version" in relation to the position of the organ
concerned. Give an account of blood supply of the organ. Discuss the different
factors supporting the uterus in its normal position. (1+2+2+2+3+5=15) [NBMC]

10) A 50 year old man was brought to the Out Patient Department with a complaint
of a swelling over an operative scar at the midline of the anterior abdominal wall.
The swelling was diagnosed as to be an incisional hernia through the Rectus Sheath.
a. Define the Rectus Sheath (1)
b. Name the contents of the sheath. (3)
c. Describe the formation of the Rectus sheath at different levels along with
suitable diagrams. (6)
d. Explain the term "Tendinous Intersections". Mention its anatomical levels &
functional importance. (1+2)
e. Explain with your knowledge of surgical anatomy the type of incision that is
Page | 19
 usually preferred over the anterior abdominal wall. (2) [RAIGANJ]

11) Describe the development of mesonephric kidney with diaphragm. Write down
about the trigone of urinary bladder. (7+6+3)[midnapore]

12) A 27 day old neonate presented with enlarged kidneys which was diagnosed as
polycystic kidney disease.
a. What is the embryological basis of this condition?
b. Give the relations of the surfaces of the kidney.
c. Give a brief account of development of metanephric kidneys with suitable
diagram. (2+5+6+2) [KPC]

13) Give the presenting parts and relations of the ovary. Give a brief account of
development of ovary. Mention the blood supply of the ovaries. Draw a labeled
diagram of Graufan follicle. (5+4+3+3=15) [KPC]

B. SHORT ANSWER TYPE (10) :

1) Describe the portal vein under the following headings:
a. Formation
b. Tributaries
c. Sites of Porto-caval anastomosis (2+2+6=10) [NRS]

2) A 50 year old man was brought to OPD with a complaint of swelling at the midline of
anterior abdominal wall over an operative scar. Swelling was diagnosed as incisional
hernia through the rectus sheath.
a. Give its formation at different levels.
b. What are the contents of the rectus sheath? c) Why is median incision not
preferred over the anterior abdominal wall? (3+5+2=10) [NRS]

3) A) What is descent of testis?

B) Name the factors of descend of testis.
C) What is ectopic testis? (2+3+5 =10) [RGKAR]

Page | 20
4) Enumerate the structures passing through the Inguinal Canal.
State the coverings of the spermatic cord.
Briefly explain the mechanisms by which the weakness of the Inguinal Canal is
compensated in-situ. (2+2+2=6)[RPHGMCH]

5) Describe the stages in the development of kidneys in humans.

Mention some common anomalies in their development. (6+4=10) [NBMC]

6) Mention the tributarties of portal vein.

Give a brief account of sites and clinical importance of porto-caval anastomosis in
our body. (3+5+2=10) [NBMC]

7) Briefly describe the inguinal lymph nodes and their clinical significance. (7+3=10)
[NBMC]

8) Give an account of anatomical parts, surfaces, ligaments of urinary bladder. Add a

note on interior features of its base. (2+2+3+3=10) [NBMC]

9) Describe the boundaries of the Inguinal Canal. Outline the differences between
Direct & Oblique hernia.[6+4=10] [Raiganj]

10) Describe the internal features of part of Duodenum with diagram. How pyloric
sphincter is formed? What is Ramstedt's operation?(5+3+2)[midnapore]

11) Describe about structure passing through minor openings of the Diaphragm.
What are the effect of respiration on major openings of Diaphragm? Write down
about Bochdalek hemia.(4+4+2) [midnapore]

12) Causes of haematemesis in a patient suffering from cirrhosis of liver were

diagnosed to be due to obstruction of portal venous system.

13) Describe portal vein under following headings-formation, relations, tributaries

and sites of portal systemic anastomosis. (1+3+3+3) [KPC]

14) A 3 day old baby does not pass stool since birth. What is the name of this
Page | 21
 condition? Explain the condition embryologically. Write down the blood supply of the
anal canal: Give the development of anal canal. What is pectinate line? (1+3+2+3+1)
[KPC]

15) Describe the intenal features of anal canal with epithelial lining of each division.
Why the pectinate line is called white shade line of anal canal? What is importance of
hilton's line? Mention the development of anal canal. Define the intenal
haemorrhoids and mention their common sites. (4+2+2+2=7) [DHGMC]

16) Describe the ligaments of spleen. Draw a labeled diagram to lustrate the micro
structure of spleen. (7) [DHGMC]

17) Describe the descent of testis with its anomalies. (6+5=11) [BMC]

18) A patient suffering from carcinoma of head of pancreas presents with obstructive
jaundice. Explain the condition anatomically. Enumerate the parts of extra-hepatic
biliary apparatus with a flow chart. Describe the microanatomy of liver with a
diagram.(1+3+6=10)

C. SHORT NOTES (5) :

1) Pectinate line of the anal canal.(5)[MCK]
2) Polycystic kidney (5) [RGKAR][IPGMER]
3) Cervix of uterus - (i) Relations (ii) Features of cervical canal[IPGMER]
4) Descent of Testis with associated anomalies. [IPGMER]
5) Recesses of Lesser sac with clinical importance. [RPHGMCH]
6) Lumbar Plexus (5) [NBMC]
7) Acinus of Rappaport. (5) [NBMC]
8) Microcirculation of spleen.(5)[midnapore]
9) Hesselback's triangle (3) [DHGMC]
10) Ligamentous support of uterus. (3) [DHGMC]
11) Polycystic kidney.(4) [BMC]

D. EXPLAIN WHY (4) :

1) In surgery, in upper abdominal paramedian incision, rectus abdominis muscle is
retracted laterally. (4)[MCK]
Page | 22
2) In prostatic carcinoma X-ray of lumbosacral vertebrae must be advised. (4) [NRS]
3) Carcinoma of head of pancreas may produce jaundice. (4) [NRS]
4) Varicosity of pampiniform plexus of vein is more common in left side. (4) [NRS]
5) Right shoulder tip pain in acute cholecystitis. (4) [RGKAR] [IPGMER]
6) Appendix is said to be abdominal tonsil. (4) [RGKAR]
7) Pectinate line in anal canal may be referred as 'watershed line'. [IPGMER]
8) Major part of the urinary tract is lined by transitional epithelium. [IPGMER]
9) Extra vasation of urine following rupture of the Bulbar urethra. [RPHGMCH]
10) Lesser curvature of stomach is the frequent site of gastric ulcer formation. (4)
[NBMC]
11) Renal colic radiates from loin to groin. (4) [NBMC]
12) Lumber puncture is done at L3-L4 interspinous space.(4) [NBMC]
13) Shutter mechanism plays an important role in prevention of inguinal hernia (4)
[Raiganj]
14) Carcinoma of inferio-medial quadrant of mammary gland may spread to the
ovary. (4) [Raiganj]
15) Patient with portal hypertension presents with hematemesis, peritoneal effusion
and passage of blood with stool. (5)[midnapore]
16) Pain of pelvic inflammatory disease referred to thigh regione.(5)[midnapore]
17) Pain of cholecystitis referred to tip of right shoulder.(5) [midnapore]
18) Caecum and appendix lie in left iliac fossa. [KPC]
19) Urethral openings found at the base of the glans penis. [KPC]
20) In prostatic carcinoma, X-ray of lumbosacral vertebrae is to be advised. [KPC]
21) Downward displacement of kidney is not accompanied by concomitant
displacement of suprarenal gland. [KPC]
22) Varicoceles of left testis is common (3) [DHGMC]
23) A patient is diagnosed to have horse shoe shaped kidney (3) [DHGMC]
24) Hypospadius (3) [DHGMC]
25) Lumber puncture is done in L3/4 interspinous space .(3) [DHGMC]
26) A new born baby is passing stool through umbilicus.(3) [BMC]
27) Peptic ulcer is more common along the lesser curvature of stomach. (4) [BMC]
28) Acute appendicitis is very common. (4) [BMC]

Page | 23
 HEAD AND NECK
A. LONG QUESTIONS (15) :
1) Give a brief account of the constrictor muscles of the pharynx under the headings (a)
Origin, insertion and nerve supply; (b) Structures passing between the constrictors;
structures passing above the superior constrictor and below the inferior constrictor
and (c) Killian's Dehiscence.(6+6+3=15)[MCK]

2) A middle aged woman presented at the OPD with a midline swelling on anterior
aspect of neck. On examination, it was found to move up and down with deglutition.
From your knowledge of anatomy, answer the following:-
a. Name the structure from which the swelling arises.
b. Explain anatomically why the swelling moves up and down with deglutition.
c. Enumerate the relations of the involved structure with a labeled diagram.
d. If surgical removal is required, what must the surgeon be particularly careful of
during removal of the structure?
e. Draw a diagram depicting the microscopic anatomy of the structure.
f. Mention the sources of development of the said structure.
(1+2+4+3+3+2=15) [NRS]

3) Following an operation of right parotid gland, a patient develops weakness of facial

muscles of that side. State the relations of the affected cranial nerve with respect to
the parotid gland. Give a brief account of the fictional components, intra cranial
course and distributions of the nerve. (2+3+5+5=15) [NRS]

4) A 35 year old man was suffering from type I diabetes mellitus for the last 30 years. 2
weeks ago he experienced sudden onset of diplopia when looking to the right side,
deviation of angle of mouth to the left when smiling and inability to close right
eyelids completely.
a. Name the nerves supplying all the extraocular muscles.
b. What are the functions of different parts of the muscle that closes the eyelid?
c. Name the extracranial branches of the 'nerve of facial expression'.
d. Mention the name (s) and the side of involvement of the affected cranial

Page | 24
 nerve(s) in this patient?
e. Mention the site of lesion with anatomical explanation.
f. Draw a labeled diagram of the floor of the 4th ventricle.
(1.5+1.5+3+3+3+3=15) [IPGMER]

5) A patient comes to the OPD with complains of severe pain in forehead and eyelids,
with signs of ophthalmoplegia an marked edema of eyelids with exophthalmos.
What is the condition he is suffering from?
Write a labeled diagram showing the structures passing through the sinus involved.
What are the tributaries of the sinus?
What are the communications of the sinus?
(1+2+6+6-15) [NBMC]

6) A player suffered injury to the bony rim of the left orbit in a boxing match.
Examination of the orbit revealed fractures to the three sutures between the bones
forming the orbital margin and involvement of the ethmoidal and sphenoidal sinuses.
Additionally, there was exophthalmos and displacement of the maxillary teeth.
Answer the following questions based on this case-scenario:
a. Enumerate the bones forming the orbital margin.
b. Explain the involvement of ethmoidal and sphenoidal sinuses.
c. State the cause of exophthalmos and displacement of maxillary teeth .
d. What are the contents of the bony orbit? Mention in details.
e. Draw a diagram to illustrate the structures present in the superior orbital
fissure.
f. State the actions of the muscles located inside the bony orbit.
(1+1+2+4+4+3=15) [NBMC]

7) Discuss the Temporo-mandibular joint under the following headings?

a. Bones forming the joint,
b. Ligaments of the joint,
c. Relation of the joint,
d. Types of movements,
e. Factors maintaining stability of the joint (3+3+3+3+3 = 15) [COOCHBEHAR]

Page | 25
8) Enumerate the following regarding larynx.
a. Cartilages and sub-divisions of larynx,
b. Rima glottides and its boundaries,
c. Nerve supply and blood supply of larynx (5+3+4+3 =15)[COOCHBEHAR]

9) a) Give an account on branchial apparatus.

b) Describe the development of Face with diagram,
c) Write down about soft palate? (6+3+6) [midnapore]

10) A person develops hoarseness of voice following thyroidectomy operation.

Describe anatomically about the hoarsness of voice. Give a brief account of intrinsic
muscles of larynx and their actions on rima glottis, Mention the nerve supply of intrinsic
muscles of larynx. (2+8+5) [midnapore]

11) Following partial thyroidectomy, a patient developed hoarseness of voice

i. What is the possible reason for this?
ii. Write on 'true' and 'false vocal folds.
iii. Give a brief account of the muscles acting on the 'true' cord with their
innervations.
iv. Give the development of these muscles. (2+3+6+2+2) [KPC]

12) Twenty four hours after partial thyroidectomy where inferior thyroid artery was
ligated (tied off) a patient develops hoarseness of voice and difficulty of breathing.
Which nerve was injured? Mention the motor and sensory nerve supply of larynx.
Enumerate the paired and unpaired cartilages of larynx. Enumerate the arteries which
supply the thyroid gland with a diagram. Mention the important structures related to
the posterior border of lateral lobe of thyroid gland which should not be damaged
during thyroidectomy. (1+5+3+4+2) [CMSDH]

13) Name the nuclei of the Facial nerve. What is the extent (course) and function of
Chorda tympani nerve? Mention the branches of facial nerve in face with the name of
the muscles supplied by each branch of facial nerve in face. If facial nerve is injured just
below the stylomastoid foramen what type of paralysis of the nerve will occur? Mention
four clinical features of this type of facial nerve palsy with explanation. (2+3+5+1+4 )
[CMSDH]
Page | 26
14) Describe the cavernous sinus under the following heading-
i. Location with reflection
ii. Structure passing through sinus
iii. Tributeries
iv. Communication (4+3+3+2) [DHGMC]

B. SHORT ANSWER TYPE (10) :

1) What are the central connections of facial nerve? Briefly describe the extracranial
course of facial nerve. Enumerate its branches. Explain anatomically the clinical
features of Bell's palsy. (2+4+2+2=10) [MCK]

2) Enumerate the features present in anterior and posterior walls of middle ear cavity.
Write down the branches of Facial nerve in the middle ear cavity. What is
hyperacausis, what is the reason behind it? (2+4+2+2=10) (NRS)

3) Enumerate the structures forming the tonsillar bed. Write a note on the blood supply
of the tonsil. What is Waldeyer's ring? (3+4+3=10) (NRS)

4) Draw a labeled diagram of cavernous sinus showing its relation. Mention its
tributaries. What are the effects of cavernous sinus thrombosis? (5+3+2 =
10)[IPGMER]

5) Enumerate nerve supply of the tongue. Give an embryological explanation of such a

mode of supply. (5+5=10) [IPGMER]

6) What are the types of deep cervical fascia of the neck? Trace the different types of
deep cervical fascia with suitable labeled diagram both in horizontal and vertical
disposition. (1+6 =7) [RPHGMCH]

7) Give a brief outline of the development of face. Write short note on cleft lip and cleft
palate. (4+3+3 =10) [NBMC]

8) Enumerate the peripheral parasympathetic ganglia. Describe Pterygopalatine

ganglion under following headings -
Page | 27
 a. Situation,
b. Connection and
c. Branches. (2+2+3+3=10) [NBMC]

9) Enumerate the coverings and structure passing through Parotid Gland. Write a note
regarding parotid duct. (3+3+4=10) [COOCHBEHAR]

10) Enumerate the muscles of tongue. Describe the nerve supply of tongue on
embryological basis what are the feature of hypoglossal nerve palsy? Write about
structure of taste buds. What is ankyloglossia? (2+3+2+2+1) [midnapore]

11) Name the paranasal air sinuses. Where do they drain? Describe the maxillary air
sinuses mentioning factors help its drainage. Why are the sinuse develop around the
nose? (2+2+4+2) [midnapore]

12) A person is unable to close his mouth after yawning (wide opening of the mouth).
What is Ttis condition called? What is the cause? Give the mechanism of depression
of mandible at the temporo mandibular joint. What is the functional range of
opening of the mouth? (1+2+6+1) [KPC]

13) Enumerate the paranasal air sinuses with mention of the area of their drainage
(communications). What is the largest paranasal air sinus? Why it is prone to
infection? (7+1+2 = 10) [CMSDH]

14) Enumerate the extraocular muscle with nerve supply and function.
(4+3=7)[DHGMC]

15) Enumerate the muscle of tongue with nerve supply. (4+3 =7) [DHGMC]

16) Describe the parotid gland under the following heading -

a. Microstructure of gland with labeled diagram
b. Course of the facial nerve within the glands (3+4=7) [DHGMC]

17) Describe the coronary sinus of the heart with location, tributaries and source of
development. (1+4+2=7) [DHGMC]
Page | 28
C. SHORT NOTES (5) :
1) Ciliary body
a. Location
b. Connections
c. Role in light and accommodation reflexes. (5)[MCK] [IPGMER]
2) Nerve supply of tongue. [NRS]
3) Cleft palate. [NRS]
4) Cavernous sinus with connections [KPC]
5) Cartilages of larynx. (4) [RPHGMCH]
6) Rima glottidis. (5)[NBMC]
7) Safety muscle of tongue. (5) [NBMC]
8) Ansa cervicalis. (5) [NBMC] [COOCHBEHAR]
9) Tympanic Membrane[COOCHBEHAR]
10) Palatine tonsil (5)[midnapore]
11) Lymphatic drainage of tongue.(5) [CMSDH]
12) Styloid apparatus (3) [DHGMC]
13) Dangerous layer of scalp [DHGMC]
14) Dangerous area of face (3) [DHGMC]
15) Medial wall of middle ear cavity (3) [DHGMC]

D. EXPLAIN WHY (4) :

1) Inferior pair of parathyroid glands are embryologically superior in position and vice
versa. (4)[MCK]
2) Right recurrent laryngeal nerve hooks round right subclavian artery, while left one
hooks round the ligamentum arteriosum. (4)[MCK]
3) Recurrent laryngeal nerve of both side follow different course. (3) [DHGMC]
4) Bitemporal Hemianopia. (4) (NRS)
5) Macular vision is generally spared in lesion of posterior cerebral artery.(4) (NRS)
6) Cavernous sinus thrombosis may occur following infection of face. (4) (NRS)
7) MaCular vision got spared in posterior cerebral artery lesion. [IPGMER]
8) A-blow on the forehead often produces 'black eye 'a few days after the injury.
[IPGMER]
9) A child suffering from repeated throat infection has discharge of pus through ear.
[RPHGMCH]
Page | 29
10) Posterior cricoarytenoid - is safety muscle of larynx. [RPHGMCH]
11) A patient came with history of fever, altered sensorium and one episode of
seizure following boils around upper lip.[RPHGMCH]
12) Layer of loose connective tissue is considered as the dangerous layer of scalp. (4)
[NBMC]
13) Thyroglossal duct when present extends upto the foramen caecum of tongue.(4)
[NBMC]
14) Following operation to thyroid gland a person suffers from hoarseness of voice.(4)
[NBMC]
15) Lesions in pretectal nucleus causes Argyll-Robertson's pupil. (4) [NBMC]
16) Inflammation of parotid gland is very painful. (4) [NBMC]
17) Cricoarytenoid posterior acts as safety muscle of larynx. (4) [NBMC]
18) Cystic swelling in neck in the middle of anterior border of sternocleidomastoid
muscle.(4) [NBMC]
19) A patient having fracture of sphenoidal spine complains of loss of taste sensation
later on. [COOCHBEHAR]
20) Following thyroidectomy a patient develops hoarseness of voice. [COOCHBEHAR]
21) Increase intracranial pressure may cause medial squint. [COOCHBEHAR]
22) A patient having pituitary tumour is suffering from Bi-temporal hemianopia.
[COOCHBEHAR]
23) Cellulitis of dangerous area of face may develop cavernous sinus thrombosis.
(5)[midnapore]
24) Dry mouth in fracture of spine of sphenoid. (5)[midnapore]
25) Surgical removal of palpabral part of lacrimal glands is equivalent to removal of
whole glands. (5)[midnapore]
26) Syringing of external ear may causes coughing and fatal cardiac
arrest.(5)[midnapore]
27) Inferior parathyroid gland is developmentally superior.
28) Abducent nerve palsy is a common manifestation of increased intracranial
pressure.
29) Trauma to vault of skull may cause black eye.
30) Branchial fistula may communicate with tonsillar fossa.
31) A patient with tonsillitis may feel pain in the middle ear. [4] (CMSDH)
32) Dangerous layer of scalp. [4] (CMSDH)

Page | 30
 NEUROANATOMY
A. LONG QUESTIONS (15):
1) Regarding white matter of brain, answer the following: (a) Define internal capsule.
(b) What is the major blood supply of the internal capsule? (c) Enumerate its parts;
(d) what are the important nerve fibers passing to its different parts? (e) Write a brief
note on the applied importance of the internal capsule.(2+3+3+5+2=15)[MCK]

2) A 27-year-old male comes to the emergency room complaining of 2 days of fever,

headache and stiff neck. He notes pain on movement of his eyes and sensitivity to
light. Investigations revealed abnormalities of CSF. A provisional diagnosis of
meningitis was made based on these findings. Answer the following questions based
on this case-scenario:
i. Name the layers of cranial meninges.
ii. Mention the innervations and vascular supply of these layers.
iii. Name the reflections of the meningeal layer of durameter.
iv. State the differences between cranial and spinal meninges.
v. Describe the circulation of CSF with a flowchart.
vi. What is hydrocephalus? (2+4+2+2+4+1=15) [NBMC]

3) What are the different types of white fibres in brain, give example. Describe internal
capsules under following headings: Parts with relation with diagram, fibres passing
through different parts, blood supply with clinical importance. Describe corpus
callosum. (3+3+3+3+3)[midnapore]

4) What are the different parts of cerebellum? Mention their blood supply. What are
the different tracts connecting cerebellum with other parts of central nervous
system? What is cerebeller ataxia? (4+3+2+1)[midnapore]

B. SHORT ANSWER TYPE (10) :

1) Define the commissural fibers. Enumerate the commissural fibers of the brain. Draw
a labeled diagram showing different parts of the largest commissural fiber of the
brain. Mention relations of different walls of the central part of the lateral ventricle
with a suitable diagram. What is split brain syndrome? (1+2+2+3+2 = 10)[IPGMER]

Page | 31
2) An elderly patient aged 65 years suddenly developed weakness of right side of the
body with slurring of speech. Using your knowledge of anatomy, answer the
following questions:

a. State which part of the brain is affected?

b. How can you correlate the clinical findings with the anatomical structure
affected?
c. With a neat labeled diagram outline the blood supply of the affected part.
(1+5+4=10) [RPHGMCH]

3) Describe the circulation of cerebro-spinal fluid. Describe the features of floor of

fourth ventricle with the help of a neat labeled diagram. (5+5=10) [NBMC]

4) Write briefly about spinal cord under following headings-

i. blood supply,
ii. nuclei,
iii. Modifications of piamater.(4+4+2=10) [NBMC]

5) Draw a suitable diagram and enumerate the structures present at cross sectional
level of superior colliculus of Mid-Brain (3+7=10) [COOCHBEHAR]

6) Make a suitable diagram and enumerate the circle of Willis along with its formation,
boundaries and branches. What is cerebral stroke? (8+2=10)[COOCHBEHAR]

7) Name the ventricles of the brain. Give the boundaries and communications of the
third ventricle. What is hydrocephalus? (2+5+2+1=10) [KPC]

8) Enumerate three types of nerve fibres of cerebrum with two examples for each type
of nerve fibre. What are the parts of Corpus callosum? Which fibres of Corpus
callosum are present in the roof and lateral wall of posterior horn and in the roof of
inferior hom of lateral ventricle of brain? (6+2+2) [CMSDH]

9) Enumerate white fibers of brain. Describe internal capsule under the following
heading- a) Parts with reflection, b) Fibers passing through different parts, c) blood
supply (2+3+3+4) [DHGMC]

Page | 32
C. SHORT NOTES (5):
1) Features of cerebellar syndromes. [IPGMER]
2) Wallenberg's / Lateral Medullary Syndrome. (4) [RPHGMCH]
3) Blood-Brain Barrier. [COOCHBEHAR]
4) Thalamic Nuclei [COOCHBEHAR]
5) Arterial circle of Willis. (5)[midnapore][DHGMC]

D. EXPLAIN WHY (4) :

1) Vascular lesion of upper midbrain causes ipsilateral squint and contralateral
hemiplegia. (4)[MCK]
2) Circle of Willis' unites the carotid and vertebral system of arteries. [IPGMER]
3) Neck rigidity occurs in meningitis. [IPGMER]
4) In occlusion of posterior cerebral artery macular vision is not affected. (4) [NBMC]
5) Magnetic resonance imaging is better tools of investigation over x-ray Or computed
tomography in problem of central nervous system.(5)[midnapore]
6) Asatomical basis of lateral medullary syndrome (Wallenberg's syndrome). (4)
[CMSDH]
7) In thrombosis of posterior cerebral artery, the macular area is spared. (3) [DHGMC]

We Oppose Unscientific NEXT Exam by NMC

Raise voice against NMC

Page | 33
 GENERAL ANATOMY & EMBRYOLOGY
A. LONG QUESTIONS (15):
1) What is 'Placenta previa"? What are its different types? Give a brief account of
formation of different stages of placental villus. With a diagram explain the placental
barrier. (2+3+6+4=15) [IPGMER]

B. SHORT ANSWER TYPE (10) :

1) What do you mean by a 'joint’? With a labeled diagram describe the general features
of a synovial joint. (2+3+7 = 10) [IPGMER]

2) Describe development of inter atrial septum with labeled diagram. Mention

components of Fallot's Tetralogy. (7+3) [RGKAR]

3) Describe the different characteristic anatomical features of interatrial septum. What

are the anomalies found in tetralogy of Fallot? (6+4=10) [NBMC]

4) Mention the structure of placenta with suitable diagram. Add a note on placental
barrier. What is placenta previa? (3+3+3+1) [CNMC]

5) With reference to trilaminar germ disc answer the following:

a. Explain the development of notochord with a labeled diagram.
b. Fate of intermediate mesoderm.
c. Write a note on Neural Crest Cells (5+2+3) [RGKAR].

6) Describe the long bone under following headings: parts, centres of ossification and
arterial supply. Add a note on different types of epiphyses. What is law of union of
epiphysis? (2+1+3+3+1) [CNMC]

7) Enumerate (only name) the septums for septation of different parts of developing
heart from venous end to arterial end. What is atrio-ventricular septum and from
which part of the developing heart is it formed?Mention the congenital defects in
Fallot's Tetralogy. (6+2+2=10) [RPHGMCH]

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C. SHORT NOTES (5) :
1) Notochord. (5) [NRS][DHGMC]
2) Karyotyping. (5) [NRS]
3) Klinefelter's syndrome. (5) [NRS][RPHGMCH][DHGMC]
4) Histology of ovary. (5) [NRS]
5) Histology of testis. (5) [NRS]
6) Translocation (5) [RGKAR]
7) Sebacious gland (5) [RGKAR]
8) Nondisjunction in meiosis & its clinical effects [IPGMER]
9) Shunt & Spurt muscles. [CNMC]
10) Down’s syndrome. [CNMC] [Rphgmch]
11) Ssesamoid bone (3) [DHGMC]
12) Fallot's tetralogy (3) [DHGMC]
13) Chorion. (5) [BMC]
14) Epiphyseal cartilage (5) [BSMC]

D. EXPLAIN WHY (4):

1) Fertilization of male and female gametes prevents polyspermy. (4)[MCK]
2) New-born child having passage of urine through the umbilicus. (4)[MCK]
3) Congenital anomalies of soft tissues of face are often associated with anomalies of
cardiac septa. (4)[MCK]
4) Fibrous pericardium is fused with the central tendon of the diaphragm.(4)[MCK]
5) Patent foramen ovale is absolutely necessary in fetal life, but definitely harmful in
adults.(4)[MCK]
6) Osteomyelitis is common at the metaphysis of a long bone. (4) [RGKAR]
7) Double Superior vena cava. (4) [RGKAR]
8) Vagina is composite in origin. (4) [RGKAR])
9) In embryology week 2 may be referred to as the 'week of 2'.IPGMER
10) Reeto-vescical fistula in a neonate [IPGMER]
11) In general the bones of elderly people break more easily than younger people.
[IPGMER]
12) Chromosomes are studied when the cells are in metaphase of the mitotic division.
[IPGMER]
13) Medial meniscus is susceptible to injury more frequently than the lateral
meniscus.[CNMC]

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14) Epiphyses around knee joint are important medicalegally. [CNMC]
15) Bar body in Turner's syndrome is zero.[CNMC]
16) Double barr body in klinefelter’s syndrome. [NBMC]
17) Explain untreated/neglected whitlow may cause necrosis of distal 4/5 th of distal
phalanx. [Rphgmch]
18) Newborn baby presenting with absence of meconium per anum. [RPHGMCH]
19) Drolling of saliva with inability to feed in a newborn with normal oral cavity
structure - explain embryologically. [RPHGMCH]
20) Drainage of gonadal veins on both side are into different blood vessels in adult
life, but similar vessels in early fetal life-explain embryologically. [RPHGMCH]
21) A newborn baby presented with discharge of urine through umbilicus.
[RPHGMCH]
22) Double barr body in klinefelter’s syndrome. (4) [NBMC]
23) Infection is common in metaphysis of bone. (3) [DHGMC] [BMC]
24) Explain the genotype of Turner's syndrome XO (4)[BSMC]

UNITE, RAISE YOUR VOICE AND STOP RAGGING!

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 GENERAL PHYSIOLOGY
A. Short Answer Type (10 marks):
1) Describe fluid mosaic model of cell membrane. What is the different type of proteins
present in cell membrane? (7+3) [RGKAR]

2) What are the different types of protein in cell membranes? Compare and contrast
between 2 types of Active transport across the biological membrane with examples.
Explain Gibbs-Donnan equilibrium and give one clinical implication.
(2+4+4 =10)[IPGMER]

3) Enumerate the different mechanisms of transport of substances across a cell

membrane. Give short accounts with appropriate example of (i) Primary active
transport; and (ii) Secondary active transport. (2+4+4) [Raiganj]

4) Explain how does intercellular communication affects cellular physiology? What do

you mean by Axonal transport? (6+4) [midnapore]

5) List the different types of transport across a cell membrane. Briefly outline the
mechanism of operation and physiological significance of the Sodium-Potassium-
ATPase pump. (5+3+2=10) [KPC]

6) Write briefly with examples about the mechanisms of primary and secondary active
transports. Add a note on vesicular transport and facilitated diffusion. (6+2+2)[BMC]

B. Short Note (5 marks):

1) Secondary Active Transport. [NBMC]
2) Facilitated diffusion. [RGKAR]
3) Homeostasis. (BMC)
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 4) Vesicular transport (4) (NRS)
5) Gap junction. [DHGMC]
6) Nernst Equation. [BSMC]
7) Osmosis and its physiological importance. [BSMC]

C. Explain Why (4 marks):

1) Cardiac muscle cannot be tetanised. [NBMC]
2) Positive feedback mechanism is often a vicious cycle. [MCK]
3) Na - K ATPase is required for maintenance of cell volume. [RGKAR]
4) Myxedema is different from edema.[IPGMER]
5) Na-K ATPase pump maintains cell volume. (4) (NRS)
6) Membrane channels specific for one ion do not allow other ions to pass through even
when they are smaller than the channel pore. [Raiganj]
7) Negative feedback is more important than positive feedback in homeostatic regulation.
[KPC]
8) Na-K-ATPase pump helps in the regulation of cell volume. [BMC]
9) Carrier proteins are functionally different from ion channels. [DHGMC]
10) Protein hormones have receptors in the cell membrane and they need to carrier
for their transport in plasma. [DHGMC]

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 NEUROMUSCULAR PHYSIOLOGY
A. Long Questions (15 marks):
1) What is Action Potential?
Draw the diagram of the different phases of action potential of a neuron. Describe the
properties of action potential.
What is the difference between graded potential and action potential? Mention the
RMP of a neuron, smooth muscle and skeletal muscle. (2+3+4+3+3=15) [NBMC]

2) Define action potential. Describe the phases of action potential in a nerve along with a
proper diagram. What is refractory period? State briefly about saltatory conduction.
(2+8+3+2) [RGKAR]

3) A 12-year-old boy having no cognitive impairment or history of any fever came to a

doctor with a complaint of difficulty in walking. He has difficulty standing up from a
sitting posture. On examination Gower’s Sign is positive. According to his mother, his
maternal uncle died at the age of 20 years and he also had similar problems. What is the
provisional diagnosis? Add a note on the dystrophin-glycoprotein complex. Describe the
molecular basis of skeletal muscle contraction. Write briefly about oxygen debt and
Muscle heat. 2+3+5+3+2.[BMC]

B. Short Answer Type (10 marks):

1) Draw a neat labeled diagram of the different phases of action potential in a nerve.
Explain the ionic basis of the different phases. Why does hypocalcaemia increase the
excitability of the nerves? (4 + 4 + 2 = 10)[MCK]

2) Name the different types muscles found in human body with the organ where they are
found.
Discuss the molecular basis of skeletal muscle contraction.
What is Rigor Mortis? Narrate the physiological basis of its development (3+4+1+2=10)
[NBMC]

3) Enumerate different types of muscles in our body. Discuss briefly about the molecular
basis of skeletal muscle contraction. What is a motor unit? (1+7+2) [RGKAR]

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4) Draw a labeled diagram of NeuroMuscular junction in a skeletal muscle. What is
Myasthenia Gravis and how it is different from Eaton Lambert Syndrome. (5 + 5 = 10)
[IPGMER]

5) Describe briefly the steps in a cross bridge cycle in skeletal muscles with proper diagram
and flow chart. (NRS)

6) Describe briefly the Molecular basis of skeletal muscle contraction. What is the basis of
Rigor mortis? (5+5)[midnapore]

7) List with a flow chart the sequence of events between a motor neuron action potential
and skeletal muscle fiber contraction and relaxation. What are summation of
contractions and titanic contraction? (6+2+2=10) [KPC]

8) Mention the steps of skeletal muscle relaxation. Why it is an active process? What is
rigor mortis? (4+3+3) [DHGMC]

9) Draw and describe the steps of neuromuscular transmission. Describe pathophysiology

of Myasthenia Gravis. What is the mechanism of action of D-Tubocurarine?
2+3+4+1=10[BSMC]

C. Short Note (5 marks):

1) Excitation-Contraction coupling. [MCK]
2) End-plate potential (4) (NRS)
3) Excitation-contraction coupling. (MCK)
4) Genesis of resting membrane potential.(MCK)
5) Equilibrium Potential. [DHGMC]

D. Explain Why (4 marks):

1) Hypocalcaemia causes tetany. [NBMC]
2) Digitalis is useful in the routine management of heart failure.(4) [NBMC]
3) Profound muscular weakness is the feature of Myasthenia gravis. [RGKAR]
4) Skeletal muscle relaxation is an active process. [RGKAR]
5) A fatigued muscle fails to relax completely. [IPGMER]

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6) Postsynaptic neuronal events determine the flow of information to the next neuron.
[IPGMER]
7) Relaxation in skeletal muscle is an active process.[IPGMER]
8) Relaxation of skeletal muscle is an active process. [RPHGMCH]
9) Neostigmine is used in the treatment of Myasthenia Gravis. [KPC]
10) Action potential cannot revert back. [DHGMC]
11) Extracellular ion concentrations have role in determining the values of RMP and
AP. [DHGMC]

HEMATOLOGY

A. Long Questions (15 marks)

1) What is primary and secondary hemostasis? Discuss the mechanism of primary and
secondary hemostasis. Write a brief account on hemophilia. (2+4+6+3) [RGKAR]

2) A person is on prophylactic low dose Aspirin for many years. At present he needs
dental extraction. Now answer the following questions: (4 + 2 +6 + 3 = 15) [IPGMER]
a. What is the effect of Aspirin in platelet function?
b. What advice to be given to the personaboutAspith-use before dental
extraction?
c. What are the roles of Platelets in Haemostasis?
d. What is the role of Vitamin K in coagulation?
3) A Man, 30 years of age was brought to ER with lacerated injury on limbs. He was
conscious & no abnormality detected except bleeding from injured sites. List the
steps how haemostasis will take place in this case. What is the role of platelet?

Page | 41
 Describe how permanent clot will form in this case. Briefly explain fibrinolytic system
in our body. (2+3+5+5) [midnapore]

4) What is the fate of Haemoglobin in our body? How will you differentiate between
haemolytic and obstractive jaundice?(5+5+5) [midnapore]

5) A 10 year old girl presented with bleeding spots under the skin and one episode of
bleeding from nose. Investigations revealed that her platelet count was very low.
i. What is the normal platelet count? b) How does low platelet count lead
to bleeding?
ii. What are the causes of purpura in presence of normal platelet count?
iii. What do you expect in bleeding time and clotting time of this patient?
Give reasons.
iv. What are the functions of platelets? (1+4+2+3+5) [KPC]
6) A 7-year-old boy in a village came to the OPD with swelling of the left knee joint. On
X-Ray, no bony injury is observed. There is no history of fever. Blood examination
shows that his clotting time is prolonged. His brother also had a similar problem a
few months back What is your provisional diagnosis? Describe the intrinsic and
extrinsic pathways of coagulation. Write briefly about the anti-clotting mechanism.
Describe the antithrombotic role of Aspirin. (2+7+3+3)[BMC]

7) Write in brief the steps of Red cell production in bone marrow. What is reticulocyte
crisis? Write precisely the biochemical findings in blood, urine and stool in
obstructive jaundice.
What is NK cell?
What are the morphological types of anemia? Mention their morphological features
and possible cause. (3+1+3+2+1+2) [DHGMC]

8) a) What is erythropoiesis?
b) Draw and describe the steps of erythropoiesis.
c) Describe the factors affecting erythropoiesis.
i. Define anemia.
ii. Write down the effects of anemia in human body.
(1+5+3+2+4=15)[BSMC]

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B. Short Answer Type (10 marks):
1) Define immunity. Discuss in brief the mechanism of Cell mediated immunity. Briefly
describe the immunological basis of AIDS. (1+6+3=10) [NBMC]
2) What are the different blood group antigens? How ABO and Rh blood grouping is
done according to blood group antigen?
3) Who was the pioneer of this grouping system?
4) Why ABO and Rh blood grouping should be done as a routine check-up as pre-marital
counseling? (2+3+2+3=10) [NBMC]
5) What are MCV, MCH, and MCHC? Mention the stages and factors regulating
erythropoiesis. (3+4+3=10) [NBMC]
6) Explain different anticlotting mechanism present in the body. Explain the utility of
using aspirin, given as a prophylactic drug to prevent coronary artery disease. (7+3)
[NBMC]
7) Describe the structure of the RBC membrane with a neat labelled diagram. What is
the fate of haemoglobin? What is the result of excess haemolysis in newborns?
(3+4+3=10) [MCK]
8) Describe the steps of erythropoiesis. What are the factors influencing erythropoiesis?
(NRS)
9) What is Methyl-Tetrahydrofolate trap? How is it going to cause Megaloblastic
anaemia? [RPHGMCH]
10) Define Hemostasis. Enumerate the different clotting factors. Describe the steps in
the formation of primary hemostatic plug (Platelet plug). (2+3+5) [Raiganj]
11) Define immunity. Classify the different types. What is AIDS? What is its cause?
What are the ways of transmission of the disease? (1+4+2+1+2=10) [KPC]
12) Define haemostasis. What is the role of platelets in haemostasis? Discuss the
fibrinolytic mechanism. Write briefly about the mechanism of action of warfarin.
(1+2+4+3=10)[MCK]
13) What are the sites of erythropoiesis in antenatal and prenatal life? Discuss the
factors regulating erythropoiesis.[MCK]
14) Classify lymphocytes on immunological basis? Write down the functions of CD4
and CD8 cells. What do you mean by "immunologic synapse"? (4+4+2)[BSMC]

C. Short Note (5 marks):

1) Erythroblastosis Foetalis. [NBMC]
2) Chronic liver disease causes oedema formation. [NBMC]
Page | 43
 3) Innate immunity. (RGKAR)
4) Antigen presenting cell[IPGMER]
5) Anticlotting mechanisms. (NRS)
6) NK-cell. (NRS)
7) Cell mediated immunity. [RPHGMCH]
8) Iron deficiency anaemia. [RPHGMCH]
9) Components of Innate Immunity. [Raiganj]
10) Haemophilia. [DHGMC]

D. Explain Why (4 marks):

1) Chronic obstructive jaundice may cause coagulation disorder. [NBMC]
2) Recurrent anemia is a complication of chronic renal failure. [NBMC]
3) Gastrectomy may lead to dimorphic anaemia. [RGKAR]
4) Foetus though genetically different from its mother does not evoke a maternal
immune response. (4) (NRS)
5) Hematocrit of venous blood is higher than that of arterial blood. (4) (NRS)
6) Anaemia is seen in chronic kidney diseases. [RPHGMCH]
7) Cross-matching is a must before transfusion. [RPHGMCH]
8) Foetus is not rejected by mother. [COOCHBEHAR]
9) Low dose aspirin is prescribed to prevent thromboembolic episode. [Raiganj]
10) Foetus is not rejected. [midnapore]
11) Blood stored for a long time suffers preservation injuries. [midnapore]
12) Low dose Aspirin is prescribed to CABG patient. [midnapore]
13) HIV infection has fatal outcome. [midnapore]
14) Explain how bleeding time Increases in thrombocytopenic purpura [KPC]
15) Hypoproteinemia causes edema. [KPC]
16) Hemoglobin count is more in an adult healthy male as compared to an adult
healthy female. (BMC)
17) Vitamin K deficiency leads to bleeding disorder. [BSMC]
18) Erythroblastosis fetalis commonly occurs in Rh incompatibility not in ABO
incompatibility. [BSMC]

Page | 44
 RESPIRATORY PHYSIOLOGY
A. Long Questions (15 marks):
1) What are the different methods of transport of Carbon dioxide in blood? What is the
role of Carbon dioxide in regulation of respiration? What is hypoxia?
What are the different types of hypoxia?
What type of hypoxia occurs in carbon monoxide poisoning? What are the changes
occurs in body in chronic acclimatization? (3+3+2+3+1+3=15) [NBMC]

2) A 6 year old boy presented with shortness of breath, cough, chest tightness and rise in
temperature and audible wheeze. On auscultation of chest, ronchi was heard.
i. What may be the condition the child is suffering from?
ii. Which test should be performed? Which parameters of the test are
diagnostic?
iii. How is oxygen transported in blood?
iv. Draw a neat labelled diagram of Oxygen-Haemoglobin dissociation curve,
mentioning the factors that cause shift of the curve to the left.
v. What is Hamburger effect?(2 + 3 + 2 + 5 + 3 = 15)[MCK]

3) Define and classify hypoxia with examples. Explain the mechanisms of acclimatization to
high altitude. (5+10) [IPGMER]

4) Answer the following questions on respiration: (2+6+3+4=15)[IPGMER]

d) What is the Central Pattern Generator?
e) Outline the role of Herring-Breuer reflex and J-reflex in respiratory functions.
f) Enumerate the chemoreceptors of respiration with their location.
g) Prescribe the mechanism by which hypoxia affects ventilation.

5) Write down the sequence of events in a normal respiratory cycle with reference to the
different pressures present in the respiratory system of adults. Define hypoxia. Discuss
briefly the important causes of hypoxic hypoxia. (NRS)

6) A 56-year-old smoker presents with progressive, productive cough and respiratory

distress over 3 months. His Pulmonary Function test report shows FEV1 is 39% of
predicted and FEV1/FVC 52% of predicted. What is the provisional diagnosis and why?
Page | 45
 What is FEVI and its normal value? How are you going to grade the severity of the
disease according to FEV1 Values? What is the role of bronchodilator drugs in the
diagnosis of the case? (4+2+2+2)[RPHGMCH]

7) A 30 year old athletic male who resides at a place close to the sea-level is fond of
mountaineering. In his first trip to the mountains after a gap of more than 2 years due
to the COVID restrictions he plans to scale a peak whose height is 24000 ft from the sea
level. Being an experienced mountaineer he ascends 2000 ft/day and takes 7 days to
complete the ascent from the base-camp (10000 ft) to the summit successfully.
- What is the principal difficulty the human body faces when it ascends to very high
altitudes and explain why it occurs?
- Enumerate and describe in detail the physiological mechanisms that helped the
mountaineer to cope with the difficulties of high altitude because of his relatively
slow rate of ascent.
- What consequences can occur if one ascends to very high altitudes very rapidly
and what are the features by which it can be identified?
- Briefly describe the steps that should be taken to counteract the ill-effects of
rapid ascent to high altitude in a person. (3+7+3+2) [Raiganj]

8) List the anatomical locations of the central and peripheral chemoreceptors. What are
Glomus cells and what are the types? Write a note on the mechanism of stimulation of
glomus cells.
Describe the effect of changes of arterial po2, pCO2 and hydrogen ion concentration on
alveolar ventilation. (2+3+4+6) [KPC]

9) 50-year-old came so the emergency department with severe respiratory distress. There
was no history of chest pain. Spirometry findings showed that FEV1/FVC ratio was 70%
and the patient improved with the administration of salbutanol.
What is your provisional diagues? Enumerate the mechaniams involved in neural and
chemical regulation of respiration. Add a note on periodic breathing and closing volume
(2+5+5+3+2) [BMC]

B. Short Answer Type (10 marks):

1) Define Hypoxia. What are the types of Hypoxia? Explain the pathophysiology and
compensatory mechanisms of Acute Mountain Sickness. (1+2+7= 10) [RGKAR]
Page | 46
 2) What is Functional Residual Capacity (FRC)? What is the significance of FRC? Describe
one method used for the measurement of FRC. [Raiganj]

3) Describe the physiological changes occurring during acclimatization in high altitude.

What are HAPE & HACE? (6+2+2) [midnapore]

4) Explain Oxygen Haemoglobin dissociation curve will able diagram. Mention the
causes of Left Shift of the curve. What is P50? (5+5) [midnapore]

5) Precisely outline the control of respiration. What factor causes O2- haemoglobin
dissociation curve shift to right and briefly mention their possible explanation.
(4+3=7) [DHGMC]

C. Short Note (5 marks):

1) Respiratory membrane. [NBMC]
2) High altitude pulmonary edema. [NBMC]
3) Timed Vital Capacity. (NRS)
4) Chloride shift. [midnapore]
5) Reflex regulation of respiration[KPC]
6) Ventilation-Perfusion Ratio. (BMC)
7) Application of law of Laplace in physiology. [DHGMC]
8) Vital capacity. [DHGMC]

D. Explain Why (4 marks):

1) There is wasted ventilation at the apex of lung. [NBMC]
2) Cyanosis cannot be detected in severe anemia. [NBMC]
3) 100% oxygen should be administered judiciously in a patient of COPD. [NBMC]
4) Oxygen therapy is of limited value in anaemia as well as in histotoxic hypoxia.
[MCK]
5) Polycythaemia is found in high altitude. [RGKAR]
6) Treatment of Caisson’s disease is gradual recompression followed by prompt
decompression. [MCK]
7) Normobaric oxygen therapy is of no use in the treatment of CO
poisoning.[IPGMER]
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 8) Hyperventilation occurs during physical exercise. (NRS)
9) Alveolar collapse (atelectasis) and pulmonary edema occur in premature
neonates. [Raiganj]
10) In COPD, O2 therapy should be intermittent, controlled & of low
concentration. [midnapore]
11) Explain with Law of Laplace how pulmonary surfactant stabilizes
alveoli.[KPC]
12) Pulmonary surfactant stabilises alveoli (Explain with law of Laplace)[KPC]
13) It is essential to measure alveolar ventilation even if we know the minute
ventilation of the patient. (BMC)
14) Acclimatisation is important for immediate survival as well as for
maintaining physiology one month to years. [DHGMC]
15) Quiet expiration is essentially passive mechanism. [DHGMC]

CARDIOVASCULAR PHYSIOLOGY

A. Long Questions (15 marks)

1) A 27 year old man was brought to the emergency room by the police. He suffered from
a Road traffic accident and lost a lot of blood. The following findings were noted: blood
pressure was very low, pulse was rapid and thready, skin was very pale, cold and
clammy. He had rapid breathing and was confused and restless.
a. What is the condition he is suffering from?
b. What are the mechanisms by which our body tries to compensate to recover from
the condition?
c. What will happen to the urine output?
d. What will happen if the compensatory mechanism fails?
e. Explain why we should not cover this patient with a blanket?
(2+6+2+3+2=15)[MCK]
Page | 48
2) A 70 yr old subject complaint of reeling of head during change in posture from supine to
standing. (3+9+3= 15) [IPGMER]
a. What are the possible mechanisms of this clinical feature?
b. Draw and describe the basic pathways involved in the medullary control of heart
rate and blood pressure.
c. Describe Sinus arrhythmia.

3) Define cardiac output? Discuss the factors that regulate cardiac output? Describe
baroreceptor reflex and its function. Write down briefly the characteristic features of
coronary circulation. (2+5+5+3=15) (NRS)

4) What is hypertension? What is the physiological basis of maintenance of Blood

Pressure? Explain the change in blood pressure in Isometric & Isotonic exercise. (2+8+5)
[midnapore]

5) Draw a diagram of a fast response Action Potential (AP) in cardiac muscle. Explain the
events occurring in phase 0. What contribute to plateau phase of AP? Mention the
points of difference between fast response & slow response AP in cardiac muscle. How
digitalis increases strength of cardiac contraction. (3+2+3+4+3)[midnapore]

6) A 45 years old driver met with an accident and bled 2 lines of blood. He was rushed to
the Hospital, where the physicians found that he had low volume rapid pulse,
hypotension, pallor and cold extremes. He was diagnosed to suffer from shock.

a. What is shock?
b. How does massive hemorrhage lead to shock?
c. What is the mechanism of low volume pulse in this patient?
d. Explain the compensatory roles of baroreceptors and renin-angiotensin system in
restoring the blood pressure. (2+3+3+7) [KPC]

B. Short Answer Type (10 marks):

1) What are the baroreceptors? Describe the role of Baroreceptor Reflex in the
regulation of blood pressure. Does this reflex help to control of chronic
hypertension? (3 + 5 + 2 = 10) [MCK]

Page | 49
 2) Define cardiac output. Enumerate the factors that regulate End Diastolic Ventricular
Volume and End Systolic Ventricular Volume. What is Ejection Fraction & explain its
Implication. (2 + 3 – 3 + 2 = 10)[IPGMER]
3) Define cardiac cycle. Describe the atrial and ventricular events of the cardiac cycle in
detail. What do the ‘P’, QRS and T waves represent in the ECG? (1+1+5+3=10) (NRS)
4) A 75-year-old woman with a history of chronic congestive heart failure undergoes
cardiac catheterization. In which phase of cardiac cycle, her left ventricular pressure
will be maximum? Describe left ventricular, aortic, and atrial pressures in different
phases of cardiac cycle by Wigger’s diagram. What is the effect of systolic
dysfunction on pressure-volume loop of left ventricle? (1+5+4) [RPHGMCH]
5) Describe the factors responsible for the genesis of resting membrane potential. Add
a note on cardiac action potential (fast response and slow response). (5+5)[BMC]
6) Describe the events occurring during a cardiac cycle. Add a note on Frank-Starling’s
Law. (7+3)[BMC]
7) Trace the whole reflex arc controlled by buffer nerve. Precisely mention the
mechanism by which parasympathetic nerve decrease heart rate. (6+4) [DHGMC]
8) Describe the generation of Pacemaker Potential with suitable diagram. Describe the
phases of cardiac cycle if the heart rate is 75 beats/min. (4+4+2)[BSMC]

C. Short Note (5 marks):

1) P-R interval in ECG. (NRS)
2) Baroreceptor reflex. [RPHGMCH]
3) Short term regulation of blood pressure. [RPHGMCH]
4) Cardiac output. [KPC]
5) PR interval in ECG (BMC)
6) Heart Block. [DHGMC]
7) Pacemaker potential. [DHGMC]

D. Explain Why (4 marks):

1) Severe anemia may be associated with palpitation and murmur. [IPGMER]
2) Bradycardia occurs in brain tumour. [MCK]
3) Left ventricular coronary perfusion mainly occurs during diastole. [IPGMER]
4) Precise determination of cardiac output depends both on cardiac and vascular
function.[IPGMER]
5) Left ventricle gets majority of its blood supply during diastole.(4) (NRS)
6) Digitalis is given in heart failure. [RPHGMCH]
Page | 50
 7) Aortic aneurysms are prone to rupture. [RPHGMCH]
8) Cardiac muscles are not tetanised. [RPHGMCH]
9) Raised intracranial tension causes bradycardia. [midnapore]
10) The SA node function as the pacemaker for the entire heart[KPC]
11) Digitalis is used in heart failure. (BMC)
12) T wave (Ventricular Repolarization) in ECG in lead II is in the same direction as
QRS complex (Ventricular Depolarization). (BMC)
13) Frank Starling’s Law and Vavomotor reversal of Dale. [BMC]
14) Cardiac Index and methods of measurements of Cardiac Output. [BMC]
15) Heart muscle cannot be tetanised. [DHGMC]
16) Ventricular filling is decreased in tachycardia. [DHGMC]
17) Cardiac muscle cannot be tetanised. [BSMC]

GIT PHYSIOLOGY
A. Long Questions (15 marks):
1) Describe with diagram the mechanism of secretion of Hydrochloric acid from stomach.
What are the different functions of Hydrochloric acid?
How stomach wall gets protected from damaging effects of Hydrochloric acid?
What is peptic ulcer? Enumerate some causes of peptic ulcer.
(5+3+3+2+2=15) [NBMC]

2) A 40 yr old subject complaint of yellowish discolouration of skin and mucous

membranes and deep Yellow urination -
a. What are the possible mechanisms of this clinical feature?
b. Describe the various stages of bilirubin metabolism
c. Explain the physiological implication of hepatic conjugation of bilirubin with
Glucuronic acid.
d. Compare and contrast pre-hepatic and post-hepatic jaundice. (4+4+4+3)
[IPGMER]

Page | 51
3) A 45 year old lady presented with jaundice and pain in right upper abdomen. On
examination, her conjugated bilirubin was found to be elevated, urine was dark yellow
coloured and stool was clay coloured. Ultrasonography revealed obstruction of common
bile duct by a gall stone.
a. What is the type of jaundice she is probably suffering from?
b. Explain why the conjugated fraction of bilirubin was raised in the subject.
c. How do you explain the clay colour of the stool?
d. What will you expect in her urinary urobilinogen level? Give reasons for your
answer.
e. List the functions of bile (1+3+3+3+5=15) [KPC]

4) A 27 year old female, came to the OPD with history of fever myalgia (body pain),
nausea, vomiting, anorexia, right sided abdominal pain and yellowish discolouration of
eye and high coloured urine for 7 days. Her blood report shows:
Serum bilirubin: Total-6.19mg/dl,
Conjugated: 4.52mg/dl,
Unconjugated: 1.67mg/dl
Total protein: 7.3gm/dl,
Albumin: 4.6gm/dl,
Globulin: 2.7gm/dl,
Albumin-Globulin ratio 1.7:1
SGPT(ALT)=515 IU/L,
SGOT(AST)=392 IU/L,
Alkaline Phosphatase-341 IU/L

a. What is your diagnosis?

b. Schematically present the composition of bile.
c. Write down in brief the different functions of bile.
d. Draw and describe enterohepatic circulation. (2+4+4+5=15) [BSMC]

B. Short Answer Type (10 marks)

1) Discuss the mechanism of gastric acid secretion. Briefly discuss gastric mucosal barrier
with diagram. What is Peptic ulcer disease? (4+4+2) [NBMC]
2) Explain that liver and pancreas must function normally for proper digestion of fat. Give
an account of gastric mucosal barrier. (6+4) [RGKAR]

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3) Describe the mechanism of gastric HCL secretion. List the different factors that regulate
HCI secretion and how they do it? What is the gastric-mucosal barrier?(4+2+2+2=10)
[IPGMER]
4) A 60yr old subject who has undergone gastrectomy (resection of stomach) presents with
anemia and neurological symptoms. [IPGMER]
I. What is the pathophysiology of this condition?
II. What is the management of this condition?
5) What is the physiological basis of Peptic ulcer disease? How is the gastric acid secretion
regulated? What is Zollinger-Ellison syndrome? [RPHGMCH]
6) What are the different bile acids? Describe the function of bile. Describe the
pathophysiology and clinical features of Obstructive Jaundice. [RPHGMCH]
7) Describe with a suitable labelled diagram the mechanism of HCI secretion by the gastric
parietal cell. Name 2 drugs used for the treatment of peptic ulcer, mentioning their
mode of action. [MCK]
8) A 55-year-old man had to undergo gastrectomy due to stomach cancer. Which type of
anaemia do you expect in him and why? What changes do you expect in the bone
marrow and in the peripheral blood smear in this type of anaemia?[MCK]
9) Write precisely with a diagram the mechanism of HCl production in stomach. With a
brief mention of the collecting factors. What are the structures of blood group antigen A
and B? (4+3+3) [DHGMC]

C. Short Note (5 marks):

1) Dumping Syndrome. [NBMC]
2) Role of micelles in handling lipids in GI Tract. [IPGMER]
3) Gastric mucosal barrier. (NRS)
4) Movements in stomach. (NRS)
5) Acid Peptic Barrier. [midnapore]
6) Jaundice. [MCK]
7) Mechanism of secretion of hydrochloric acid in the stomach. (BMC)
8) Gastric mucosal barrier and its clinical implications. [BSMC)
9) Dietary fiber. [BSMC]

D. Explain Why (4 marks):

1) Pancreas is not auto-digested. [NBMC]
2) Proton pump inhibitor is used to treat peptic ulcer. [MCK]
Page | 53
 3) Steatorrhoea occurs in obstructive jaundice. [RGKAR]
4) Explain why glucose is added in oral rehydration solution (ORS) to correct
electrolyte imbalance. [IPGMER]
5) In haemolytic jaundice, fresh urine is colorless.[IPGMER]
6) Stool becomes pale in colour in obstructive jaundice.(4) (NRS)
7) Urine becomes alkaline after a heavy meal. (4) (NRS)
8) Enteric nervous system is called “mini brain” or “second brain”. (NRS)
9) Xerostomia is common in acute stressful conditions. [RPHGMCH]
10) Oral Vit. B12 administration is not useful in pernicious anemia. [Raiganj]
11) People take fried food with alcohol. [midnapore]
12) Explain why hemorrhage occurs in obstructive jaundice.[KPC]
13) Pancreas is not digested by its own enzymes. [KPC]
14) We find bleeding disorder in some cases of obstructive jaundice? [MCK]
15) Oral rehydration solution is used for treatment of diarrhoea. (MCK)
16) ENS has great role in maintaining the physiology of gut. [DHGMC]
17) In some newborn babies – no defecation occurs after birth. [BSMC]
18) Steatorrhoea occurs in obstructive jaundice. [BSMC]

EXCRETORY PHYSIOLOGY

A. Long Questions (15 marks)

1) What are the processes involved in the secretion of H+ in the renal tubules? What is
the significance of these processes in the regulation of acid-base balance? (9+6)
[KPC]

B. Short Answer Type (10 marks):

1) Enumerate the components of the juxtaglomerular and mention their function.
Briefly describe counter current mechanism.(5+5=10)[MCK]
2) What is Juxtaglomerular apparatus? How Tubuloglomerular feedback and
Glomerulotubular balance is mediated in Kidney? (4+6=10) [RGKAR]
Page | 54
 3) Explain the role of the thick ascending limb in the function of Henle’s loop. How does
loop diuretic act? (7+3) [IPGMER]
4) Write down how water is reabsorbed in kidney? What is role of ‘counter current
exchanger’ in concentrating urine. Write a note on Tubuloglomerular feedback.
(4+3+3=10) (NRS)
5) Define GFR. Elaborate the factors regulate GFR. What is tubulo-glomerular feedback?
(1+2+2)[RPHGMCH]
6) What is meant by counter current? Write the role of the system in urine
concentration mechanism. What are the different types of diuretics. Mention any
one of its mechanism of action.(2+4+2+2) [midnapore]
7) What are the processes involved in the secretion of H+ into the renal tubules? What
is the significance of these processes in the regulation of acid-base balance? (6+4)
[KPC]
8) Briefly mention the mechanisms of sodium reabsortion in different parts of renal
tubule. Why inulin is chosen for GFR mesurement ? What causes nephrotic
syndrome? (4+2+2=7) [ DHGMC ]

C. Short Note (5 marks):

1) Splay phenomenon. [RPHGMCH]
2) Tmax G. [IPGMER]
3) The role of urea in maintenance of hypertonic medullary interstitium[KPC]
4) Micturition reflex[KPC]
5) Mechanism of reabsorption of glucose in the renal tubule and renal splay. (BMC)

D. Explain Why (4 marks)

1) The concept of renal clearance is utilized to determine important functional
parameters of the kidney. [IPGMER]
2) Albuminuria is seen in nephrotic syndrome. [RPHGMCH]

|Raise Voice against Charaka Sapath and

Safranization of Medical Education|

Page | 55
 ENDOCRINE PHYSIOLOGY
A. Long Questions (15 marks)
1) Mention the functions of the calcium in the body. What is the normal calcium level in
the blood? How normal calcium level is maintained in the blood? What is hypocalcemia?
Enumerate the clinical features of the patient suffering from hypocalcaemia.
(5+1+6+1+2=15) [NBMC]

2) A 40 year old man presents with persistent headache. On examination, he is found to

have high blood pressure, coarse facial features, frontal bossing, large hands and feet,
and mandibular enlargement (prognathism). His serum IGF-1 is elevated.
i. What abnormality is the patient suffering from and why do you think so?
ii. What defect do you expect in his field of vision? Trace the pathway of field
of vision with a suitable diagram and show the defect.
iii. Explain the mode of action of the hormone whose excess leads to the
above situation.
iv. Can this patient present with diabetes mellitus? If so, explain how.
[2+(1+4)+5+3=15][MCK]

3) A baby of 2 years with protruded abdomen, dry rough skin, and short stature for his age,
attending Pediatric OPD, mother is complaining that the baby can’t understand the
mother’s common commands. (1+8+3+3= 15) [RGKAR]
i. What may be the cause of this abnormality?
ii. Describe the steps of Thyroid hormone synthesis.
iii. What is the difference between Pituitary dwarf and Thyroid dwarf?
iv. Define and Classify Goitre.

4) Enumerate the hormones secreted form the pituitary gland. Describe schematically the
steps of synthesis of thyroid hormones. Give a brief description of the functions of
growth hormone. (5+5+5=15) (NRS)

5) A 60-year-old woman presents with extra-ocular muscle fatiguability which worsens on

activity and improves on rest. Chest X-ray of the patient shows an ovoid mass at thymus.
What is the provisional diagnosis? Give a note on pathophysiology of the disease. How

Page | 56
 are you going to diagnose the case? Give the physiological basis of the treatment of the
case. (1+4+2+3) [RPHGMCH]

6) What are the hormones secreted by adrenal gland? Describe physiological functions of
cortisol and aldosterone. Describe the features of Cushing’s syndrome. What is
Addison’s disease? (2+5+3+3+2) [COOCHBEHAR]

7) A 35 year old female presents with complaints of palpitation, intolerance to heat and
occasional lose motions. On examination, the physician found a swelling over the neck,
protrusion of the eyeball and fine tremor. The doctor indicated that the condition was
caused by hyperfunction of an endocrine gland.
a. Which endocrine gland has been referred to?
b. List the hormones secreted by this gland.
c. Explain the mechanisms behind the above symptoms and signs based on the
physiological actions of the hormone responsible.
d. Outline the pathophysiology of development of the neck swelling and
hypersecretion of the hormone (1+2+9+3) [KPC]

8) Name the different layers of adrenal cortex and enumerate the hormones that each
layer secretes. Outline the steps of synthesis of Aldosterone. Explain the mechanism of
action of Aldosterone on renal tubular cells. How is the secretion of Aldosterone
regulated? (3+5+4+3) [KPC]

9) Precisely outline the steps of thyroxin biosynthesis. Mention the physiological roles of
insulin on different target tissues. What are the roles of PTH during hypocalcaemia due
to any reason? Differnciate between osteomalacia and osteoporosis. (5+5+4+1)
[DHGMC]

B. Short Answer Type (10 marks):

1) Explain glucose homeostatis.Discuss physiological basis of cardinal features of diabetes
mellitus. (6+4=10) [NBMC]

2) Define GFR with its normal value. Draw and describe Juxta-glomerular apparatus. State
briefly the renin-angiotensin-aldosterone axis. (2+1+3+4=10) [NRS]

Page | 57
3) Enumerate the layers of adrenal cortex and the hormones secreted from them. What do
you mean by “Aldosterone escape’? What are the actions of thyroxine on cardio
vascular and nervous system? What is Goitre? (3+2+4+1 = 10) [NRS]

4) During childbirth, a woman suffers a serious haemorrhage and goes into shock. After
she recovers, she displays symptoms of hypopituitarism. Name the syndrome she is
suffering from? Elaborate the features of pituitary insufficiency. Distinguish between
Acromegaly and Gigantism. Why hypersecretion of prolactin causes amenorrhea?
(1+4+3+2) [RPHGMCH]

5) A 24-year-old woman had development of hair on her face, chest, and back as well as
irregular menses for the past 8 months. She says she also has poor wound healing, easy
bruising, and moon face. What is your diagnosis? Why is their poor wound healing and
easy bruising in this patient? This patient may suffer from diabetes mellitus-why?
(1+6+3=10) [RPHGMCH]

6) Explain the endocrinal control of glucose homeostasis. Explain briefly the

pathophysiology of Diabetic ketoacidosis. (7+3) [COOCHBEHAR]

7) Mention the normal plasma level of Calcium in human name the hormone involved in
the Calcium Homeostasis of our body. Explain the role of gut & Kidney in maintaining
Calcium level. [midnapore]

8) Explain the mechanism of Polydypsia, Polyuria & Polyphagia in Diabetes Melitus.

[midnapore]

C. Short Note (5 marks):

1) Rickets. [MCK]
2) Bone remodeling unit. [IPGMER]
3) Cushing’s syndrome. [NRS]
4) Counter-current exchanger. [RPHGMCH]
5) Dwarfism. [midnapore]
6) Aldosterone Escape. [midnapore]
7) Addison’s disease. [KPC]
8) Dwarfism. [KPC]
Page | 58
 9) Diabetic Ketoacidosis. [DHGMC]
10) Cretinism. [DHGMC]

D. Explain Why (4 marks):

1) Glucocorticoids inhibit inflammation. [MCK]
2) Hyperphagia occurs in mellitus. [MCK]
3) Hyper-pigmentation is a common feature in Addison’s disease. [RGKAR]
4) Plasma proteins prolong the half-life of hormones in blood. [IPGMER]
5) Insulin causes movement of K+ from ECF to ICF. [IPGMER]
6) Pigmentation of skin occurs in Addison’s disease.(4) (NRS)
7) Polyuria and polydipsia are seen in diabetes mellitus. (4) (NRS)
8) Parathormone(PTH) has essential role in bone physiology(remodelling). (NRS)
9) Non pitting edema is seen in hypothyroidism. [RPHGMCH]
10) Polyphagia occurs in diabetes mellitus. [RPHGMCH]
11) Thyroid dwarfs are mentally retarded. [COOCHBEHAR]
12) Diabetes Mellitus is more a disease of lipid than of carbohydrate metabolism.
[midnapore]
13) Thyroid hormone increases rate & force of contraction of heart. [midnapore]
14) Vit. D raises blood calcium levels[KPC]
15) Incretin hormones have important role in glucose metabolism. (MCK)
16) Counter regulatory hormones are important to prevent hypoglycemia. [DHGMC]

____________STOP Anti-student CBME Model

STOP communalization of Medical Education_______

Page | 59
 REPRODUCTIVE PHYSIOLOGY
A. Short Answer Type (10 marks):
1) Define menstrual cycle. Briefly describe the uterine changes during different phases
of menstrual cycle. Give a suitable diagram showing the levels of the different
hormones influencing the cyclical changes.(2+5+3=10)[MCK]

2) Describe the stages of spermatogenesis with the factors regulating it. State the
functions and fate of corpus luteum. (2+2+3+3) (NRS)

3) What is ovulation? Describe the factors that lead to ovulation. What are the
indicators of ovulation? Write down the functions of Sertoli and Leydig cell.
(1+3+2+2+2= 10) (NRS)

4) Explain the ovarian cycle of menstruation with proper diagram. What are the
indicators of ovulation? [RPHGMCH]

5) Define menstrual cycle. Describe the changes in uterine endometrium, cervical,

vaginal epithelium and changes in hormonal levels in plasma during menstrual cycle
with suitable diagrams.(2+8) [COOCHBEHAR]

6) Define menstrual cycle. How do hypothalamic and pituitary hormones regulate the
developmet and fate of ovarian follicles? How does the fore of Graffian follicle differ
in pregnant and non-pregnant females? (2+6+2) [KPC]

B. Short Note (5 marks):

1) Blood testis barrier. [MCK]
2) Sertoli cell. [RGKAR]
3) Suckling Reflex. [IPGMER]
4) Milk Ejection Reflex. [midnapore]

C. Explain Why (4 marks):

1) Oxytocin causes uterine contractions during labour although its level remains
normal.(4)[MCK]
2) Child birth is an example of positive feedback mechanism. [RGKAR]

Page | 60
 3) Ovariectomy before 6 weeks of pregnancy may lead to abortion.(4) (NRS)
4) Precocious puberty in prepubertal male occurs in adrenogenital syndrome.
[RPHGMCH]
5) Oxytocin causes uterine contraction at labor although its level is normal. [RPHGMCH]
6) Removal of ovaries before 6 wks of pregnancy leads to abortion. [midnapore]
7) Megaoblastic anaemia may occur during pregnancy. [KPC]
8) Gonads determine the morphological sex of individual. [DHGMC]
9) Many hormones are responsible for breast development throughout the different
stages of life of female. [DHGMC]

Strongly raise your VOICE ________________

__________against RAGGING in the name of intro

Page | 61
 CNS PHYSIOLOGY
A. Long Questions (15 marks):
1) A 65 year old patient walks into the MOPD with a festinant gait and with complain of
postural instability and resting tremor. Clinical examination of patient reveals: mask
faces, bradykinesia, cogwheel rigidity.What is your provisional diagnosis? What is the
pathophysiology of this condition? Describe in brief the connections of the part of
the brain affected here.What is the drug of choice and why it is given along with
carbidopa (1+2+8+1+3) [NBMC]

2) A seventy year old man presents to the out-patient department with tremor at rest,
muscle rigidity, slow body movements, short shuffling gait and reduced facial
expression (masked facies).
i. What is the person suffering from? Where is the problem?
ii. Mention the different parts and connections of the structure involved.
iii. Show with a neat labelled diagram the pathway which is affected in the
above person.
iv. Can we use dopamine as a treatment (2+4+4+3+2) [MCK]

3) A patient complaining of pain over inner aspect of left arm and presented with ST
segment elevation in ECG. (1+1+4+6+3) [RGKAR]
i. What is the probable diagnosis?
ii. What is the cause of pain over inner aspect of left arm?
iii. Describe the probable theory of this type of pain.
iv. Describe the endogenous pain inhibiting mechanism.
v. Write a note on Syringomyelia.

4) Name the ascending pathways. Describe the pathway of pain with a suitable
diagram. List the differences between a UMN and LMN lesion of the spinal cord.
What is Bell-Magendie’s law? (3+2+5+3+2=15) [NRS]

5) What is muscle tone? Describe briefly how it is regulated? What is the physiological
basis of rigidity and spasticity? Describe the dorsal column lemniscal pathway. What
is the function of this pathway? (2+5+2+5+1) [NRS]

Page | 62
6) A 28 year old male patient, while recovering from a spinal injury following a road
traffic accident, developed weakness along with loss of fine touch sensation in right
leg. There was loss of pain, temperature and crude touch sensation in left leg. Muscle
weakness was not significant and fine touch sensation was intact on the left side.
a. What is the probable diagnosis?
b. Explain the symptoms with a suitable diagram.
c. Enumerate the ascending and descending tracts in the spinal cord.
d. Describe the course of ascending tract carrying pain sensation with suitable
diagram. (2+3+4+6) [COOCHBEHAR]

7) Define motor unit. Describe molecular basis of skeletal muscle contraction. How
skeletal muscle contractions differ from smooth muscle contraction? Write a note on
myasthenia gravis. (2+5+3+5) [Raiganj]

8) Name the functional divisions of Cerebellum. Mention the principal function of each
division. Draw a diagram showing the Internal Circuit of cerebellum.What is
cerebellar ataxia. Why cerebellar lesion is ipsilateral? (3+4+3+2+3) [midnapore]

9) Why is it important to maintain our body temperature within a narrow range? What
are the different mechanisms of heat transfer to and from our body? Explain the
different homeostatic control mechanisms that occur on exposure to extreme heat
and cold. (2+3+5+5) [KPC]

10) A patient was brought to the emergency department with a history of loss of
consciousness and on examination; all his four limbs were extended. Muscles tone
was increased in all four limbs and rigidity was seen. Describe a reflex arc with a
diagram. Enumerate the structure of the muscle spindle. Describe the spinal and
supraspinal mechanisms involved in the regulation of muscle tone with the example
of Decerebrate rigidity. Decorticate rigidity, and Ischemic preparation. Add a note on
motor and sensory ataxia. (3+3+7+2) [BMC]

11) Depict the organisation of whole motor system in a suitable diagram with special
mention to its relation with cerebellum and basal ganglia. Mention the difference
between UMN and LMN lesion. Briefly outline the treatment of perkinson disease.
(9+3+3) [DHGMC]
Page | 63
B. Short Answer Type (10 marks)
1) What are nociceptors? What is meant by ‘fast pain’ and ‘slow pain’? What are the
theories governing ‘Referred pain”? (2+4+4)[MCK]

2) Outline the hypothalamic regulation of appetite in response to hunger and satiety

signals from gut and adipose tissue. [IPGMER]

3) Describe the functional subdivision of Cerebellum. Draw and describe the neural
connections in the cerebellar cortex. (4+6) [IPGMER]

4) List different descending tracts from brain to spinal cord. Compare & Contrast the
Pyramidal System and Extrapyramidal System. (4+6) [IPGMER]

5) A 58-year-old man is noted to have a progressive tremor in hands over 5 years, dancing
gait, head nodding and pill rolling movement. What is your diagnosis? Describe the
pathophysiology of the disease with a diagram. Why is Carbidopa combined with
levodopa to treat the disease? (1+6+3) [RPHGMCH]

6) Draw a labelled diagram of a Muscle Spindle. Explain the role of Muscle Spindle in
Stretch Reflex. [midnapore]

C. Short Note (5 marks):

1) Endogenous analgesia system [IPGMER]
2) Stretch reflex. (NRS)
3) Inverse stretch reflex. (NRS)
4) Functions of Hypothalamus. [COOCHBEHAR]
5) Decerebrate rigidity. [COOCHBEHAR]
6) Brown Sequard syndrome. [midnapore]
7) Post Synaptic Inhibition. [midnapore]
8) Intension tremor. [DHGMC]

D. Explain Why (4 marks):

1) a-y(alfa-gama) coactivation helps in keeping the muscles sensitive to stretch.[MCK]
2) Mid-collicular section in an animal produces Decerebrate rigidity. [RGKAR]
3) It is impossible to sleep with severe pain. [IPGMER]
Page | 64
 4) Pacinian corpuscle is ideally suited for perceiving vibration sense.[IPGMER]
5) Rubbing causes temporary relief in pain sensation. (4) (NRS)
6) Clasp knife rigidity is seen in upper motor neuron disease. [RPHGMCH]
7) Cardiac pain is referred to inner aspect of left arm. [RPHGMCH]
8) Bradykinesia seen in Parkinsonism. [COOCHBEHAR]
9) REM sleep is also known as paradoxical sleep. [COOCHBEHAR]
10) Muscle weakness improves with repeated contractions in patients affected by
Lambert-Eaton syndrome. [Raiganj]
11) Explain the physiological basis of dissociated sensory loss in Syringomyelia.[KPC]
12) Patients of tabes dorsalis falls when asked to close eyes in standing position.
[DHGMC]
13) Gamma motor discharge increases the sensitivity of muscle spindle. [DHGMC]
14) Patients of appendicitis first complains of pain around umbilicus and then at Mac
Burney’s point. [DHGMC]
15) REM sleep is rightly called paradoxical sleep. [DHGMC]
16) Morphine is very effective pain killer. [DHGMC]

Raise your Voice against__________________

__________unscientific NEXT Exam
Page | 65
 SPECIAL SENCES
A. Long Questions (15 marks):
1) Describe the functions of the middle ear cavity in the hearing mechanism. What is
conductive deafness? Describe Organ of Corti and its role in perception of sound.
(5+3+7) [IPGMER]

2) Mention the steps of mechanism of Photo-transduction in a flow chart.Draw the Visual

Pathway & enumerate the effects of lesion in different areas of the pathway involved.
(6+3+3) [midnapore]

B. Short Answer Type (10 marks):

1) Name the photoreceptors. Explain the photochemistry of vision. (2+8=10) [RGKAR]
2) Describe the visual pathway with a suitable diagram? What type of visual defect may
happen in case of optic chiasma lesion? [RPHGMCH]
3) Describe the sequence of events involved in photo-transduction in rods and cones.
What is color blindness?(6+4) [COOCHBEHAR]
4) What are photoreceptors? What are their functions? Explain briefly the mechanism of
photo-transduction what is night blindness? (2+2+4+2) [KPC]
5) Briefly mention the sequence of events when light falls on retina. Trace the pathway of
spinothalamic tract from receptor to higher centre for each sensory modality . What is
dissociated anesthesia? ( 3+3+1=7) [DHGMC]

C. Short Note (5 marks):

1) Presbyopia. (5) [NBMC]
2) Organ of Corti (5) (NRS)
3) Errors of refraction[KPC]
4) Organ Of Corti. [midnapore]
5) Olfactory pathway. [DHGMC]
6) Weber test. [DHGMC]
7) Colour vision. [DHGMC]
8) Presbyopia. [DHGMC]

Page | 66
 D. Explain Why (4 marks):
1) Red glasses are used by pilots. (4) [MCK]
2) In conductive deafness sound is lateralized to the deaf ear. [RPHGMCH]
3) Middle ear is an impedance matching device. [COOCHBEHAR]
4) Light reflex should always be tested asking the subject to look at far. [DHGMC]

“When a patient needs sympathy and encouragement, it is the

duty of a doctor and nurse to fulfill it by their best, event at the cost
of their lives.”

- Dr. Dwarkanath S. Kotnis

Page | 67
GENERAL CARBOHYDRATES, LIPIDS AND AMINO ACIDS:

A. Long Questions (15 marks):

1) Define Isoelectric pH. How it is calculated from pK value of different ionisable groups of
neutral, basic and acidic amino acid? How pl is applied to separate & to purify proteins.
Explain the process of determination of primary structure of protein. (1+3+2+6=12)
(NRS)

2) "Proteoglycans are important components of extracellular matrix". Illustrate the general

structure of a proteoglycan with the help of a diagram. Which property of proteoglycans
justify their presence in the extracellular matrix. What is the general chemical structure
of glycosaminoglycans (GAGs)? Describe any two GAGs in our body on the basis of their
composition, location and clinical importance. Mention two differences between
proteoglycans and glycoproteins. (3+2+2+6+2=15) [CNMC]

3) A 1 yr old boy presents with protuberant abdomen and repeated episodes of severe
illness. On examination, hepatomegally is found: On laboratory examination, FBG-
35gm/dl, Serum Uric Acid- 9.8mg/dl; pH- 7.28. What is your diagnosis? Name the
enzyme defect responsible for above condition.
i) Explain each clinical finding in perspective of your diagnosis.
ii) Discuss the physiological role of Glucagon and Insulin in regulation of the
metabolic pathway that is defective in this disease. [2+1+7+5=15] [NBMC]

B. Short Answers Type (10 marks):

1) Classify phospholipid with examples. Mention the name of two omega-3 fatty acids.
What is Trans fat?
2) Define eicosanoids with two examples. (5+1+2+2=10) [RGKAR]

Page | 68
3) What are the factors affecting energy requirements of a healthy adult? What is specific
dynamic activity? Define obesity. What are the metabolic changes seen in obesity.
(3 + 2 + 2 + 3 = 10)[MCK]

4) Classify phospholipids. What are Gangliosides? Enumerate two important functions of

ganglioside. What is L:S ratio? How Glucocorticoid modifies it. (3+1+2+1+1=8) (NRS)

5) Classify phospholipids. Mention functions of individual phospholipid. (3+7= 10) [CNMC]

6) Classify Phospholipids. Explain role of Phospholipids in membrane bi-layer formation.

7) Briefly discuss about the asymmetric distribution of Phospholipids among the outer and
innerlayers of Lipid bi-layer of Plasma Membrane. (3+5+2=10) [NBMC]

8) What is PEM? Briefly discuss the salient features and differences between Kwashiorkor
and Marasmus. (2+8=10) [NBMC]

9) Explain why people suffer from fasting hypoglycemia in Von Gierke's disease. Describe
how glycogen metabolism differs in skeletal muscle & liver. (4+6=10) [COOCHBEHAR]

10) Classify lipids with example. Describe with the help of diagram the Fluid Mosaic
model of biological membrane. (5+5)[RPHGMCH]

C. Short Note (5 marks):

1) Glycosaminoglycans. (5) [RGKAR]
2) Post-translational modifications of collagen & diseases associated with it. (2.5+2.5=5)
(NRS)
3) Protein energy malnutrition. (5) (NRS)
4) What is Severe Acute Malnutrition (SAM). Define Metabolic Syndrome. (3+2=5) (NRS)
5) Lipid peroxidation reaction (5) [CNMC]
6) Defect in beta oxidation leads to hypoglycemia. (5) (NRS
7) Write down a short note on uncouplers of oxidative phosphorylation. (5) [Raiganj]
8) Describe the operation and significance of glycerophosphate shuttle and malate
shuttle.(5) [midnapore]
9) Write a brief account of glycogen storage diseases. (5)[midnapore]
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10) Fish oils are beneficial for cardiac patients.(5)[midnapore]
11) Phospholipases (5) [KPC]
12) Abnormalities in digestion and absorption of lipids. (5) [KPC]
13) Essential fatty acid (2) [DHGMC]
14) Cellulose is considered as dietary fiber. (5) [RPHGMCH]
15) Hyaluronic acid-(5)[BSMC]

D. Explain Why (4 marks):

1) Fibers are of utmost importance in our diet. (4) [RGKAR]
2) Sucrose is an invert sugar. (4) [RGKAR]
3) Ingestion of lactose may lead to bloating, indigestion and pain abdomen.(4)[MCK]
4) Dietary fibres are beneficial for health.(4)[MCK]
5) Reduce glutathione is essential for maintaining membrane integrity of RBC. (4) (NRS)
6) Benedict test is a semi quantitative test. (4) (NRS)
7) Blood specimen for glucose is collected in fluoride vials. (4)
8) Cellulose is an important dietary fibre. (4)
9) Benedict's test can give false positive result with urine.(4)
10) Sucrose is a Non-reducing Sugar. (4) [NBMC]
11) Sucrose is a non-reducing disaccharide. (4) [Raiganj]
12) In humans, glucose can be converted to fat while the reverse is not
possible.(5)[midnapore]
13) Benedict test is used to identify reducing sugar.(5)[midnapore]
14) Glucose and fructose form same osazone while galactose differs. (4) [DHGMC]
15) Glycine and proline is a helix stabilising amino acid. (2) [DHGMC]
16) Oral rehydration solution contains glucose .(4) [BMC]
17) Benedict's test is used to screen diabetic patients.(4) [BMC]
18) Positive Benedict test does not signify Glycosuria always. Redusing Sugar. (4)
[BSMC]
19) G6PD deficiency provides protection against malaria (4) [IPGMER]

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 PROTEINS AND ENZYMES:
A. Long Questions (15 marks):
1) Elucidate the mechanism of action of a multienzyme complex. Explain the amphibolic
role of Citric Acid Cycle. What do you mean by Anaplerotic reactions of Tri carboxylic
Acid Cycle? Give two examples. (6+6+1+2) [RGKAR]

2) Classify enzymes with one example of each. What is Michalis-Menten equation? Define
Km. Explain competitive, non competitive and uncompetitive enzyme inhibitions with
graphical representation. (6+2+1+6 = 15) [RGKAR]

3) Write down the characteristics of peptide bond. What are the different structural
hierarchies of protein?

4) Enumerate forces that stabilize different protein structure. Write down the features of
alpha helix and beta sheet (3+2+4+6= 15) [RGKAR]

5) Define enzyme and cofactor with example. Why the coenzyme are known as co
substrate. Define isoenzyme. Give the clinical importance of isoenzymes with examples.
Enumerate the factors affecting the enzyme substrate catalyzed reaction. Define the
unit of enzyme activity. (4+3+ 1 + 2 + 3 + 2 = 15)[MCK]

6) Write down the mechanisms of ammonia synthesis in our body. Why ammonia is toxic
for our health. Describe the ways of it detoxification (4 + 4 + 7 = 15)[MCK]

7) A 65 year old male presents with painful spongy gum with bleeding hematoma in guri
and anemia since 2 weeks. What is your provisional diagnosis?
What is the micronutrient involved and how does it help to relieve the condition?
How the collagen protein is synthesized and matured in our body?
Define extracellular matrix and give proper examples. (1+3+5+6=15) [Raiganj]

8) Write the Michaelis-Menten equation and explain the role of substrate concentration
on the rate of enzyme catalysed reactions with the help of graphs, illustrate how Vmax
and Km are affected by competitive and non-competitive inhibition of enzymes. The Km

Page | 71
 value for glucokinase is much higher than that of hexokinase though both acts on
glucose- explain this statement. (7+5+3)[midnapore]

9) State the differences between competitive and noncompetitive inhibitors of enzyme.

What is an isoenzyme? Discuss the diagnostic importance of isoenzymes.(6+2+7) [BMC]

B. Short Answers Type (10 marks):

1) Describe the structure of collagen. Explain the difference between oxygen dissociation
curve of Hemoglobin and Myoglobin. (5+5=10) [RGKAR]

2) Define Km and Vmax.

a. Define isoenzyme. Give clinical importance of isoenzyme with an example.

b. How can a competitive and an uncompetitive enzyme be differentiated. (2+3+3)

[MCK]

3) Mention Michaelis Menten equation. What are the linear expressions of it? Mention the
clinical use of coupled enzyme assay. (2+3+3=8) (NRS)

4) Classify Enzymes according to IUB classification with examples. Enumerate different

types of Enzyme inhibition. Justify that kinetic method is better than end point method
with suitable example. (4+3+3)[midnapore]

5) State at least one pathological condition which increases the activity of the following
enzymes in blood:
a. Lipase ii)CPK-MB iii)RBC glutathione reductase iv) SGOT
b. Explain with enzyme velocity curve how following factors regulate the enzyme
c. Concentration of enzymes ii) Concentration of substrate iii) pH iv) Temperature.
d. What is Line weaver burk plot [KPC]

6) Describe different levels of organization of protein structure with example. Explain that
primary structure determines the functional state of proteins. (8+2)[RPHGMCH]

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7) Classify Enzyme according to IUB classification. What is the turnover number of
Enzyme? Enumerate different types of Enzyme inhibition. Illustrate how Vmax & K. are
affected by various types of enzyme inhibition. (3+1+2+4-10)[BSMC]

8) Compare and contrast competitive and noncompetitive mechanisms of enzyme

inhibition with suitable diagrams. Outline the role of competitive inhibitors as drugs.
State in brief the action of allopurinol in gout. (5+3+2=10) [IPGMER]

9) Outline the different orders of protein structure and illustrate it with hemoglobin as an
example. Give a brief account of different classes of immunoglobulins
(7+3=10) [IPGMER]

C. Short Note (5 marks):

1) Alpha helix. (5) [NBMC]
2) Isoenzymes assay is helpful in the diagnosis of myocardial infarction.(5)[midnapore]
3) Intrinsic tyrosine kinase ( 2) [ DHGMC]
4) Isoenzymes (4) [DHGMC]
5) Acute phase Protein (2) [DHGMC]
6) Classification of enzyme with example.(5)[RPHGMCH]
7) Collagen. [IPGMER]

D. Explain Why (4 marks):

1) Pyridoxine has diverse coenzymatic functions. (4) [RGKAR]
2) Chaperone plays significant role in protein folding. (4) [RGKAR]
3) Protein rich food causes alertness, carbohydrate food causes sleep. (4) [CNMC]
4) Histidine imidazole groups in Proteins are responsible for the buffering action shown
by the Proteins at Physiological pH.(4) [NBMC]
5) Detection of different enzyme levels in blood may provide valuable clue for the
diagnosis. (4) [Raiganj]
6) Chaperons play very important role in protein folding.(5)[midnapore]
7) Isoenzyme of alkaline phosphate are of diagnostic significance. (4) [ DHGMC]
8) Ubiquitin is a key molecule in protein degradation. [IPGMER]

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 CELL AND BIOMEMBRANES:
A. Long Questions (15 marks):
1) Enumerate the lipids present in plasma membrane. State their role in maintaining the
fluidity of plasma membrane. Give a brief account on biochemical functions of
peroxisomes. What are ionophores? (3+5+4+3=15)[midnapore]

2) Describe the 'Fluid Mosaic Model' of membrane structure with suitable diagram. How
the fluidity of membrane is maintained? How glucose is transported through intestinal
membrane & adipose tissue? What are ionophores (4+4+4+3=15)[BSMC]

B. Short Answers Type (10 marks):

1) How fluidity of cell membrane is maintained? Explain secondary active transport.
Write down the name of cellular markers for mitochondria, lysosome, goli bodies
and cytoplasm. Name two diseases associated with extracellular matrix. (3+4+2+1 =
10) [RGKAR]

2) Describe the role of check points, cyclins and CDKS in oncogenesis. Add a note on
second messenger. (2+2+2+4) [KPC]

3) Describe the mechanisms of transport of various nutrients across a biological

membrane with schematic diagram wherever applicable.(10) [KPC]

4) Discuss how fluidity of plasma membrane depends on its lipid composition? How are
macromolecules transported across plasma membrane?(4+6)[ BMC]

C. Short Note (5 marks):

1) Secondary active transport & its clinical importance. (2.5+2.5=5) (NRS)
2) Define Apoptosis. What are Caspases? (2+3=5) (NRS)
3) Phases of cell cycle. (5) [CNMC]
4) Oxidative stress damage biomembrane. (5) [KPC]
5) Sub-cellular fraction of a human cell (5) [RPHGMCH]

D. Explain Why (4 marks):

1) Reduce glutathione is essential for maintaining membrane integrity of RBC. (4) (NRS)
2) cAMP act as second messenger. (5) (NRS)
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 3) Almost every component of cell membrane is mobile. (4)
4) Protein misfolding can cause disease.(5)[RPHGMCH]

VITAMINS AND ANTIOXIDANTS

A. Short Answers Type (10 marks):
1) Enumerate the active forms of Vitamin A and Vitamin D. Discuss the role of isomers
of Vitamin A in Visual cycle. Why do you think Vitamin D is considered a hormone?
(3+4+3=10)

2) A 5 year old child was brought to the hospital with complaints of slow growth and
pain inbones. On examination, he was anaemic, had frontal bossing, bowing of legs
and swelling of costochondral junction. Laboratory results were: Serum calcium
8.2mg%, serum phosphorous 2.8mg%, serum ALP-720 1U/L What is your provisional
diagnosis?
Explain how do you arrive at your diagnosis? How the active form of this element is
synthesized in the body? Describe the role of Vitamin A in vision. (2+3+5+5) [KPC]

3) A 6 year old girl brought to eye OPD for downward dislocation of lens. She has
delayed developemental milestones, she had long thin bones with signs of
osteoporosis. A simple cyanide nitroprusside test of patients urine was positive
suggesting homocystinuria. Patient was treated with a low methionine diet
supplemented with folic acid and pyridoxine. State the steps of synthesise of SAM.
Explain why pyridoxine is useful in treatment of patients with homocystinuria. What
effect would a diet low in folate have on this patient. (1+2+2=5) [DHGMC]

4) 4. Mother presents with her five-year-old son, with failure to thrive and irritability in
pediatric OPD. On examination height is below 30th percentile, with a large head,
deformed chest and bowing of legs. (4+4+1+6=15) [IPGMER]

a. list, the biochemical investigation in this child to arrive at a provisional

diagnosis.

Page | 75
 b. justify the need of above. mention investigations in light of your provisional
diagnosis.
c. Enumerate the probable cause leading to the diagnosis.
d. mention the role of altar function of various vitamins and hormones in
causation of the disease process.
.
B. Short Note (5 marks):
1) Vitamin K requires for coagulation. (5) (NRS)
2) Profound Vitamin B6 & biotin deficiency leads to fasting hypoglycaemia. (5) (NRS)
3) Vit E acts as a Chain Breaking Antioxidant. (5) [NBMC]
4) Cytochrome P450. (5) [RPHGMCH]

C. Explain Why (4 marks):

1) Human is unable to synthesise vitamin C. (4) [RGKAR]
2) Patient with carcinoid syndrome may develop pellagra like symptoms.(4)[MCK]
3) Vitamin C deficiency may lead to gum bleeding.(4)[MCK]
4) Vitamin C is required for Collagen Synthesis.(4) [NBMC]
5) Vitamin D acts as a hormone.(4) [NBMC]
6) Vitamin B12 deficiency may lead to methylmalonylaciduria. (4) [Raiganj]
7) Vitamins can act as anti-oxidant. (4) [KPC]
8) Vitamin C is an antioxidant (2) [DHGMC]
9) Vit. B12 deficiency causes folate trap. (2) [RPHGMCH]
10) Vit C helps in collagen maturation. (4)BSMC]
11) Vitamin E is major chain breaking antioxidant in cell membrane. [IPGMER]
12) Vitamin C can act both as pro-oxidant as well as an antioxidant. [IPGMER]
13) 13. Pellagra-like symptoms occur in carcinoid syndrome. [IPGMER]

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 CARBOHYDRATE METABOLISM
A. Long Questions (15 marks):
1) Describe the differences between anaerobic and aerobic pathway of glycolysis. How
glycolysis and gluconeogenesis are reciprocally regulated? Explain how metabolic
pathway of fructose is linked glycolysis. What is galactosemia? (4+ 6+3+2=15) [RGKAR]

2) How glucose enters into the muscles? What is the fate of glucose in muscles during
strenuous exercise? Describe Cori cycle.(2+1+7=10)[MCK]

3) 'Blood glucose regulation is under hormonal control'. In light of this statement answer
the following:
a. Mention the reference range of fasting blood glucose.
b. Elaborate role of insulin and glucagon on reciprocal regulation of glycogen
metabolism.
c. Define the criteria for diagnosis of diabetes.
d. Emphasize the importance of HbA1C alongside measurement of fasting blood
glucose (1+7+3+4=15) [CNMC]

4) In a flow diagram indicate the metabolic steps by which lactate can be converted to
glucose. How the key enzymes of gluconeogenesis are regulated. Explain fat can be
synthesized from glucose but glucose cannot be synthesized from fatty acid.
(6+5+4=15)[midnapore]

5) A patient brought to the emergency in unconscious state. On examination blood sugar

was found to be 700mg/dl, pH is 7.2 with acetotic breath and urine Benedict test
positive. What is the probable diagnosis and how will you establish it? State the criteria
for diabetes mellitus and define insulin resistance.(10+3+2)[midnapore]

6) A 2.5 years old girl child was brought to hospital with complaints of edema on the legs
and hands, poor growth and frequent diarrhea. The mother said the child was breast fed
for 2 years and was now receiving diluted buffalo milk and rice with daal. On
examination, the child looked weak and pale with discoloration of hair and skin,
distended abdomen and enlarged liver.

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 Laboratory results are as follows:
Investigation
Hemoglobin 6.5 g/dl
Total serum protein 4 g/dl
Albumin 2 g/dl
i. What is your probable diagnosis? Explain.
ii. Eumerate the differences between Marasmus vs Kwashiorkar.
iii. Explain the causes and treatment for the condition.
iv. Explain SDA
v. Add a note on dietary fibres. (2+4+4+2+3) [KPC]

Explain how Iron is absorbed, transported, stored in the body. What is bronze diabetes?
Describe the biochemical basis of Wilson's disease. (4+3+3+2+3=15) [KPC]

7) A year old boy is brought to emergency of KPC Medical College in comatose state. He is
a known diabetic since 3 years on irregular insulin treatment. On examination, his palm
was cold and clammy and has breath was having fruity sweet odour Pulse rate was
120/min and respiration fast and shallow. His RBG-408 mg/dl pH 7.15. His urine tested
positive for Benedict's and Rothera's Test.
What is your provisional diagnosis? How did you arrive at the diagnosis? How do you
perform the above tests Write the steps of Ketogenesis and degradation of ketone
bodies in our body, add a note on ketosis. (1+2+4+3+3+2)

8) A 45 year old healthy male completed a 20 km long marathon in record time. He then
quickly consumed alcohol to celebrate his success. He was already having muscle
cramps and pain but now he suddenly fainted.
State the provisional diagnosis of the condition Mention the biochemical basis of this
accident. Outline the role of cyclic AMP in glycogen metabolism. Give a brief account of
type 1 glycogen storage disease. (2+4+6+3=15) [IPGMER]

B. Short Answers Type (10 marks):

1) In a flow diagram describe the steps of glycogenesis. Explain how CAMP integrates the
regulation of glycogenesis and glycogenolysis. (4+6=10) [RGKAR]

Page | 78
2) What is oxidative phosphorylation and how do uncouplers modify it. How does complex
V differ from other complexes in the electron complex chain. (4+4)[MCK]

3) State the component of PDH complex & its mechanism of action. Discuss the
amphibolic role of TCA in the integration of metabolism. Highlight the source and
utilization of Acetyl CoA. (4+4+4=12) (NRS)

4) Mention the role of iron sulphur proteins, ubiquinone & cytochromes in electron
transport chain.What is uncoupler? (2+2+2+2) (NRS)

5) Give a brief outline of carbohydrate & lipid metabolism in Adipose tissue in fasting.
(4+6=10) (NRS)

6) Describe the metabolic steps of citric acid cycle along with a flow diagram indicating the
enzymes and coenzyme involved and highlighting the steps where energy is produced.
Mention the steps in the cycle which are irreversible in nature. Indicate how propionate
is converted to one of the intermediates of this cycle.(6+2+2)[midnapore]

7) Describe the metabolic steps of citric acid cycle in a flow diagram indicating the enzymes
and coenzymes nvolved and highlighting the steps where energy is produced. Mention
the role of vitamins in citric acid cycle. Give a brief account of important anaplerotic
reactions of citric acid cycle.(5+2+3)[midnapore]

8) Describe with diagram the respiratory chain complexes that span the inner
mitochondrial membrane indicating the specific sites of energy production. What are its
mobile components? Mention the role of inhibitors of respiratory chain. What purpose
is served by their use in vitro? What happens when complex I is deficient?
(4+1+4+1)[midnapore]

9) Describe in a flow diagram the metabolic pathways of glycogen formation and

degradation in the body. Describe in separate charts how cyclic AMP regulates these
processes by enzyme modification.(4+6)[midnapore]

10) Describe how different glucogenic amino acids are converted into glucose in the
body through TCA cycle and reverse pathway of glycolysis(10) [KPC]
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11) Discuss the metabolic process that takes place in the body in the fed and fasting
status (10) [KPC]

12) What is neoglucogenesis? Draw a flow diagram on how pyruvate, glycerol and
lactate are converted to glucose. Describe the role of hormones on regulating blood
glucose. (2+5+3=10) [DHGMC]

13) Discuss the pathway of glycolysis in details. What are the differences between
hexokinase and glucokinase?(7+3)[BMC]

14) Enumerate metabolic fate of blood glucose after consumption of food. Describe
the regulation of glycolytic pathway. Describe the common poisons that inhibit crucial
enzymes of carbohydrate metabolism. Justify why gluconeogenesis is not just a simple
reversal of glycolysis. (2+3+2+3=10) [RPHGMCH]

15) Describe Oxidative & Non oxidative phase of HMP shunt pathway. Explain why G
screening of G-6PD is mandatory before prescribing antimalarial drug.( 7+3=10)[BSMC]

16) Explain briefly the metabolic steps needed for final storage of carbohydrates in
the human body with a flow diagram. Differentiate between the breakdown of the
above compound in liver and muscle. State the role of insulin in this metabolism.
(4+2+4=10) [IPGMER]

C. Short Note (5 marks):

1) Pyruvate dehydrogenase complex.(5)[MCK]
2) ATP synthase (5) [KPC]
3) Chemiosmotic hypothesis (4) [DHGMC]
4) Glucose transprters (4) [DHGMC]
5) Inhibitors of Electron Transport Chain (ETC) (5) [RPHGMCH]
6) Uncouples oxidative phosphorylation. (5) [IPGMER]

D. Explain Why (4 marks):

1) Impairment of pentose phosphate pathway leads to hemolytic anaemia. (4) [RGKAR]

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 2) Fructose 2-6 bisphosphate plays a role in regulation of glycolysis and
neoglucogen.(4)[MCK]
3) HbA1c is now-a-days regarded as useful parameter for diagnosis & management of
DM. (5) (NRS)
4) TCA cycle is an amphibolic cycle. (4) [Raiganj]
5) Glucose 6 phosphate dehydrogenase deficiency may lead to hemolytic
anemia.(5)[midnapore]
6) Defective insulin receptors may give rise to insulin resistance in Type 2 diabetes (4)
[KPC]
7) Uncouplers and Inhibitors of ETC are not the same. (4) [KPC]
8) Impairment of Pentose phosphate pathway leads to hemolytic anemia. (4) [DHGMC]
9) Fat can be synthesized from glucose but glucose can not be synthesized from fat. (4)
[DHGMC]
10) Glucose 6 phosphate dehydrogenase deficiency can cause excess haemolysis.(4)
[BMC]
11) Uncontrolled diabetes mellitus can lead to ketosis.(4) [BMC]
12) Blood TSH levels should be determined in obese patients.(4) [BMC]
13) Glycogen metabolism in Liver differs from Skeletal muscles.(4)[BSMC]
14) Obese people are prone to develop type 2 Diabetes Mellitus. [IPGMER]
15) Large amount of fruit intake is not safe in diabetic patients (4) [IPGMER]

_________HOLD HIGH the banner of MEDICAL ETHICS

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 AMINO ACID METABOLISM
A. Long Questions (15 marks):
1) Explain how ammonia is formed, transported and detoxified. Add a note on its
disorders. (4+4+4+3) [KPC]

2) A female neonate appeared healthy until age approximately 24 hours when she became
lethargic. A sepsis workup proved negative. At 56 hours, she started showing focal
seizure activity. The plasma ammonia levels were found to be 887 μmols/L. (Normal 3-
35 μmols/L). Quantitative plasma amino acid levels revealed marked elevation of
citrulline, but not argininosuccinate.

Which enzymatic activities are most likely to be deficient in this patient? Outline the
steps of the metabolic pathway. Justify the supplementation of arginine to this patient.
Mention in brief the special products derived from glycine. (2+7+2+4=15) [IPGMER]

B. Short Answers Type (10 marks):

1) What are the sources and fates of Ammonia? What is the mechanism of Ammonia
toxicity? (3+3+4) [RGKAR]

2) Discuss the molecular defect, signs, symptoms, laboratory investigations and

management of Phenylketonuria. (10) (NRS)

3) A 3yr old boy with history of convulsions, delayed milestones and mousy body odour
was advised some laboratory tests. The tests revealed high blood phenylalanine
level, urine test revealed presence of ketones and IQ test showed presence of mental
retardation.
i. State the biochemical defect in this child.
ii. Enumerate 3 other disorders related to inborn error in protein metabolism.
iii. Explain in brief the tests for detecting inborn error in protein metabolism.
(3+3+4=10) [CNMC]

4) Describe the steps of urea cycle. Why is uraemia clinically significant?(8+2) [BMC]

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 5) Describe the interrelation of urea cycle and citric acid cycle. Enumerate one carbon
groups and their significance for synthesis of various compounds. Write down the
names of important compounds derived from tyrosine and tryptophan.
(4+4+2=10)[RPHGMCH]

C. Short Note (5 marks):

1) Alkaptonuria. (5) [NBMC]
2) Alkaptonuria. (5)[RPHGMCH]
3) Transamination (5) [IPGMER]

D. Explain Why (4 marks):

1) Bile salts and bile acids, when dissolved in water, reduce the surface tension. (4)
[Raiganj]
2) Tyrosinaemia patients may develop acute porphyria type features. (4) [KPC]
3) Transamination is essential for ammonia excretion.(4) [BMC]
4) Ammonia is toxic to the brain (4) [IPGMER]
5) Chronic alcoholism may lead to fatty liver (4) [IPGMER]

Page | 83
 LIPID METABOLISM
A. Long Questions (15 marks):
1) A 62 year old woman with a history of hypertension and presented to emergency with
sudden onset of weakness of the right side. On examination, she had right facial droop,
and right hemiplegia. Her lipid profile reveals the following: - Total cholesterol 300
mg/dl, Triglycerides 200mg/dl, HDL-C 35 mg/dl, LDL-C 225 mg/dl.

2) What is your provisional diagnosis? Mention some cholesterol lowering drug and their
mechanism of action. How cholesterol biosynthesis is regulated? What is reverse
cholesterol transport?(2+4+4+5=15) (NRS)

3) A 52 yr old overweight male with past h/o smoking was suffering from occasional chest
pain. On Coronary Angiogram, his LCA (Left Coronary Artery) was found to be 90%
blocked. What is your provisional diagnosis?
a. Define and Enumerate Lipoproteins.
b. Which of the lipoprotein is known as bad cholesterol.
c. Describe how the alteration of this lipoprotein metabolism may be involved in the
pathogenesis of the above mentioned case. What is Reverse Cholesterol
Transport? (2+3+1+5+4=15) [NBMC]

4) With the help of a flow diagram, give a short account of beta oxidation of palmitic acid.
Calculate the energetics of this process.(10+5) [BMC]

5) Enumerate Lipoproteins. Describe the structure & functions of lipoproteins. Explain the
LDL metabolism in our body. Add a note on dyslipidemia. (2+4+6+3=15)[BSMC)]

6) An obese (BMI 32 kg/m?) 45 year old male presented to the emergency with acute chest
pain radiating to the left arm. His ECG showed changes typical of an acute myocardial
infarction. His troponin levels were also raised. He was given oxygen, vasodilators,
thrombolytics, and pain medication. Angioplasty was done promptly. Before discharge,
the resident on duty got his lipid profile done. His cholesterol levels were300 mg/dI. He
was put on statins.
Outline role of different biochemical markers in diagnosis of myocardial
infarction. Mention the reference interval of serum cholesterol, LDL, and HDL?

Page | 84
 State the mechanism of uptake of LDL in the liver with a diagram. Justify the use
of statin groups of drugs in these patients? (6+3+4+2=15) [IPGMER]

B. Short Answers Type (10 marks):

1) What are ketone bodies? Give the steps of formation of ketone bodies in liver and
utilization in peripheral tissues. (2+4+4=10) (NRS)

2) Enumerate different types of lipase enzymes. Mention the metabolism of VLDL with
a suitable diagram. Mention biochemical basis of broad beta band disease.
(3+5+2=10) [CNMC]

3) Elaborate on fatty acid synthase multienzyme complex. Describe the metabolic for
de novo synthesis of palmitate in the body.(3+7)[midnapore]

4) Give a brief account of Fatty acid synthase multienzyme complex. Describe the
metabolic pathway of de novo synthesis of palmitate in the body. Mention the role
of citrate in fatty acid synthesis. (3+5+2)[midnapore]

5) How an unsaturated fatty acid is oxidised? Show that longer chain fatty and can be
synthesized from shorter fatty acids. Add a note on Refsum disease. (10) [KPC]

6) Name the different lipoproteins in our body. What is reverse cholesterol transport?
Describe the roles of different lipoproteins in the pathogenesis of atherosclerosis.
(3+3+4) [KPC]

7) An obese 50 year old businessman comes to the clinic for routine health check up .
He is hypertensive , chronic smoker and alcoholic . His blood report shows , total
cholesterol 350 mg/dl , HDL 28 mg/dl , Serum TG 210 mg/dl. What is your diagnosis ?
Write regulation of cholesterol biosynthesis . Name one drug that lowers serum
cholesterol and mention it's mechanism of action . (1+2+2=5) [DHGMC]

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 8) A beggar was taken to the emergency room in coma.
On examination, He was drowsy and confused
Dehydration: ++
Breathing: Deep and rapid (Kussmaul respiration)
Blood tests: Glucose: 52 mg/dl
Creatinine: 0.8 mg/dl
Urine : Ketone bodies ++
a. What is your provisional diagnosis?
b. Explain the metabolic adaptation during starvation.
c. Name the ketone bodies that are present in urine.
d. Write down the principle of the test used to detect the ketone bodies in
urine. (1+5+2+2=10) [RPHGMCH]

9) Give a brief account of Fatty acid synthase enzymes. Outline the role of hormones in
fatty acid synthesis. (7+3=10) [IPGMER]

C. Short Note (5 marks):

1) Regulation of cholesterol synthesis (5) [CNMC]
2) HDL is involved in reverse cholesterol transport.(5)[midnapore]
3) Carnitine Shuttle (4) [DHGMC]
4) Apolipoprotein (2) [DHGMC]
5) Role of micelle in the absorption of fats. (5) [IPGMER]

D. Explain Why (4 marks):

1) HDL is good cholesterol & LDL is bad cholesterol.
2) Low dose aspirin therapy reduces chance of heart attack (4)
3) Alpha and omega oxidation are alternative pathways to beta Oxidation. (4) [CNMC]
4) Chronic alcoholism causes fatty liver.(4) [CNMC]
5) Fat can be synthesized from glucose but glucose can not be synthesized from fat. (4)
[DHGMC]
6) Eskimos are more resistant to heart disease. (2) [DHGMC]
7) Liver cannot utilise ketone bodies.(4)[BSMC]
8) HDL acts as a repository o f transferable apoproteins. (4) [IPGMER]
9) Cerebrohepatorenal degeneration is seen in Zwellger’s disease (4) [IPGMER]

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 NUCLEOTIDE METABOLISM
A. Long Questions (15 marks):
1) A diet rich in red meat & seafood (particularly shellfish) precipitates pain and
swelling of knee joints of a 7 year old boy having history of renal stones and self-
mutilation behaviour (biting his own lips & fingers). He comes to OPD with vomiting
& difficulty in swallowing.
a. Give your provisional diagnosis and highlight the enzyme defect in respective
metabolic pathway.
b. Justify the clinical signs & symptoms. How do you confirm your diagnosis?
Enlist some dietary items which must be avoided. Mention two drugs along
with their mechanism which can be prescribed in this patient. (4+4+2+5=15)
(NRS)

B. Short Note (5 marks):

1) Synthetic nucleotide. (5) [RGKAR]
2) Degradation pathway of purine.(5)[MCK]
3) Synthetic nucleotide analogues & its clinical applications. (2.5+2.5=5) (NRS)
4) Underlying genetic disorder of Xeroderma Pigmentosa (5) [CNMC]
5) GOUT (5) [KPC]

C. Explain Why (4 marks):

1) Lesch Nyhan Sydrome is an inborn error of metabolism. (4) [RGKAR]
2) Excessive alcohol intake associate with gout. (5)
3) (NRS)Nucleotides are non-essential from dietary point of view. (4) [CNMC]
4) Nucleotide analogues can act as anticancer agents.(4) [BMC]
5) Allopurinol can be used as treatment for Gout. (2) [RPHGMCH]

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NUTRITION & ACID BASE BALANCE & MINERAL
METABOLISM
A. Long Questions (15 marks):
1) Describe the of absorption, transport & storage of iron in the body. Add a note on
disorders associated with defective iron metabolism. (4+4+4+3=15) [COOCHBEHAR]

2) An elderly patient came to the emergency with acute retrosternal chest pain. Give
explanation for the investigation that you will suggest to confirm the diagnosis. What is
reperfusion injury and how to prevent it? (10+5)[midnapore]

3) A child with anasarca brought to the OPD. On examination, urine protein found to be
++++What are the differential diagnosis of this patient. Write the differences between
nephrotic and nephritic syndrome. Why massive protein urea is seen in nephrotic
syndrome. What is the nephrotic range of protein urea. (3+5+5+2)[midnapore]

4) A car driver was admitted to the hospital with symptoms of carbon monoxide poisoning.
How does carbon monoxide inhibit oxidative phosphorylation? List the various inhibitors
of oxidative phosphorylation Mention the mechanism of action of uncouplers. Explain
the chemiosmotic hypothesis.(2+5+3+5)[BMC]

5) A 5 year old boy is brought with complaints of failure to gain weight. His parents are
illiterate laborers with low income. There is a history of recurrent infections in this child.
The child has not received any vaccination. On examination, the child appears irritable.
Both weight and height are lower than those expected for his age. The skin is dry, hair is
brittle and muscle appears wasted. There is no edema. Mention the diagnosis in this
case and justify. Explain why vitamin D is known as sunshine vitamin. Explain the
mechanism of the said vitamin on calcium regulation in the body. (5+3+7=15)
[IPGMER]

B. Short Answers Type (10 marks):

1) What is Colloidal Osmotic Tension? What compound is responsible for that and why?
flow the compound prevent the development of oedema?(2 + 1 + 1 + 6 = 10)[MCK]

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 2) A young patient of 15 yrs has been brought to the ER with prolonged deep breathing
with fruity smell and semi conscious state Urine examination shows strongly positive
Rothera's Test. a) What are the conditions that may lead to this clinical state. b)
Describe the mechanism of regulation of the condition? c) Enumerate the
compounds responsible for positive Rotheras Test & write down the procedure for
Rothera s Test. (2 + 3 + 5 = 10)[MCK]

3) Discuss the Renal mechanisms of regulating pH of Blood. Briefly Discuss about "Anion
Gap" and its importance in Clinical Diagnostics. (6+4=10) [NBMC]

4) Define BMR. Name the factors affecting BMR. What is the role of carbohydrates,
lipids & proteins in human nutrition? (2+2+2+2+2=10) [COOCHBEHAR]

C. Short Note (5 marks):

1) Role of hormones in Calcium metabolism. (5) [RGKAR]
2) Role of vitamin D & PTH in calcium metabolism. (5) (NRS)
3) Factors influencing calcium absorption (5)
4) Creatinine clearance may give an idea about the renal function.

D. Explain Why (4 marks):

1) Kidney is a strong defense against impaired acid base balance.(4)[MCK]
2) Chronic diarrhea patient may suffer from hyperchloraemic normal anion gap
metabolic acidosis. (4)[MCK]
3) Ferritin and transferrin are two distinct proteins related to iron metabolism.(4)
[CNMC]
4) Low LS ratio in amniotic fluid of a fetus indicates high risk of development of ARDS
post birth. (4) [NBMC]
5) Mild metabolic acidosis can be compensated in our body. (4) [KPC]
6) Starvation causes metabolic acidosis (2) [DHGMC]
7) Absence of lung surfactant can lead to respiratory distress in newborn babies.(4)
[BMC]
8) In Osteogenesis Imperfecta bones becomes brittle. (2) [RPHGMCH]
9) Acidosis leads to hyperkalemia. [IPGMER]
10) Iron supplements should not be consumed with milk. [IPGMER]

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 HAEMOGLOBIN AND JAUNDICE:
A. Long Questions (15 marks):
1) A 44-year-old woman presented with a 2-day history of jaundice, fever and
abdominal pain.Physical examination showed scleral icterus and right upper
quadrant tenderness. Laboratory workup revealed- bilirubin (total) 10.6 mg/dl,
bilirubin (direct) 9 mg/dl, alkaline phosphatase 893 IU/L, aspartate aminotransferase
231 IU/L, alanine aminotransferase 178 IU/L, Abdominal ultrasound demonstrated
impacted large gallstone in the common bile duct.
What is your provisional diagnosis? Justify your answer. Classify jaundice with example.
Discuss bilirubin metabolism. (2+3+3+7=15) (NRS)

2) A 24-year-old female patient, presented with chief complaints of yellowish

discoloration of eyes and urine for the past 5 days followed by disorientation and
irrelevant talks with alteration of sleep rhythm for 2 days. On examination, the
patient was disoriented about time, place, and person. There was marked icterus.
blood ammonia level of 200 micromol/L.
What is your provisional diagnosis? Why ammonia is toxic to CNS? Write down the steps
and regulation of Urea cycle. (2+4+9=15) (NRS)

3) A 1-week old baby boy, whose parents were from a first-degree consanguineous
marriage, was noted by his parents to have frequent darkening of his nappy when
left at room temperature and on application of soap during washing. He has a
healthy sibling. His laboratory reports are normal & imaging shows no bony
abnormalities.
Give your provisional diagnosis. Underline the defect in concerned metabolic
pathway.How do you approach a newborn having inborn error of metabolism?
(2+5+8=15) (NRS)

4) A 13 year old male child of Jharkhand area came to a referral hospital with intense
leg pain and hematuria. On examination of peripheral blood, RBC showed sickling.
What may be the condition the child is suffering from ? Explain the molecular basis of
the disease. Compare and contrast between myoglobin and hemoglobin with the
help of diagram. Write a note on 2,3 BPG and its role on oxygen binding.
(1+4+6+4=15) [CNMC]

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5) An 18 year old female patient was brought to the Emergency of a Hospital in a high
altitude town, with acute Abdominal and Bone pains. On Examination, she was found
to have severe Anemia, Mild Jaundice and her blood picture showed Sickle shaped
Erythrocyte cells. What is your Provisional Diagnosis?
Briefly Discuss the Molecular Pathogenesis of the Disease.
Explain the Patho-Physiology behind the Presenting Signs and Symptoms.
Enumerate the laboratory investigations needed to diagnose this condition.
(2+5+5+3=15) [NBMC]

6) A 40 yr old female presented with acute pain in right upper abdomen with history of
nausea, vomiting, Indigestion since last one week. Biochemical laboratory
investigations revealed the following:- Serum Total Bilirubin-2.4mg/dl, Serum Direct
Bilirubin-1.5mg/dl, Serum ALP-278 IU/L, Serum ALT-112 IU/L, Serum AST-95 IU/L. On
Urine Examination: Dark Yellowish in color and Urobilinogen was absent in urine.
What is your provisional Diagnosis? In light of your diagnosis interpret and explain
the lab results. Classify different types of jaundice and discuss what change in above
parameters is expected in each type. [2+8+5=15] [NBMC]

7) A 65-year-old male presents to orthopedic OPD with complain of generalized bone

pain for past 2 years. He is otherwise well with no significant past medical history.
Following are the results of various laboratory
Investigations
Hb: 9.7gm/di
Urea: 47mg/dl

Creatinine: 1.1mg/dl
Serum Calcium level: 10.2 mg/dl
Serum ALP: 140 IU/L Serum Ferritin: WNL
Serum Vitamin B & Folic acid: WNL
Peripheral smear shows normocytic normochromic anemia Serum protein
electrophoresis is performed that demonstrates M band in gamma region

Skull X-ray revealed multiple lytic lesions

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Urine investigations shows presence of BJP (Bence Jones Protein)

Bone marrow biopsy shows 30% involvement by abnormal appearing plasma cells
i. What is the disorder the patient is suffering from? (1)

ii. What is the common age group involved in this disorder? (2)

iii. What is the reason of normocytic normochromic anemia? (4)

iv. What is M band in serum protein electrophoresis? (2)

v. What is the density of each band in normal electrophoresis? (2)

vi. What is Bence Jones Protein? How to detect this in urine? (2 +2=4)
[COOCHBEHAR]

8) A 20 year old pregnant female in her early 2nd trimester of pregnancy presents with
severe pallor, vertigo & palpitations. Some investigations are done and the results
are Hb% 8.4 gm%, FBG 146 mg/dl, PPBG 290 mg/dL, HbA1c 0.4%, Hbf 5.3%, HbA0
5.2%, HbE88% Her husband's HPLC report shows Hb% 10.5%, HbF 1.8%, HbAD 75%,
HbA2 7.3%. What is your provisional diagnosis?
What should be possible fetal outcome? What is the mode of inheritance?
What are hemoglobinopathies?
What is HbA1c and how it is formed?
Why HbA1c is so low despite high blood glucose in this case?(2+3+1+4+3+2=15)
[Raiganj]

9) A 2 year old child was brought to his pediatrician for evaluation of gastrointestinal
problems. The parents rероrts that the boy has been listless for the last few weeks.
Lab tests reveal a microcytic, hypochromic anemia. Blood lead levels are elevated.
Mention the enzyme being mostly affected in this condition and role of lead in its
inhibition. Define porphyrin and mention its classification. Outline the biochemical
mechanisms involved in hepatic and erythrocytic manifestations in different
porphyrias. (2+2+6+5=15)[IPGMER]

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B. Short Answers Type (10 marks):
1) Mention the following about heme synthesis: a)The first reaction b) cellular
compartmentalisation c) regulation d) any enzyme deficiency of this pathway and
condition arising from that. (2+2+3+3=10) [CNMC]

2) With the example of Hemoglobin and Myoglobin discuss the Structure-Function

relationship of Proteins (10) [NBMC]

3) A 65 years old alcoholic porter comes to emergency with slurred speach and altered
sensorium. On examination he is having jaundice, ascites and low blood pressure. His
blood ures is 168 mg/dl , creatinine is 1.2 mg/dl and blood ammonia is 365 umol/L (
normal is 5-35 ul). Give provisional diagnosis. How ammonia is detoxified in our
body? How ammonia is harmful ? Discus the role of phenylbutyrate in this condition?
(1+3+3+3=10) [DHGMC]

4) Compare the blood and urine parameters between three types of jaundice. (10)
[BMC]

5) Enumerate the structure function relationship of Haemoglobin & Myoglobin.

note on Oxygen dissociation curve of Haemoglobin. (6+4-10)[BSMC]

C. Short Note (5 marks):

1) HbS polymerize in high altitude. (4) [NRS]
2) Levels of hepatic enzymes can differentiate between hemolytic, hepatocellular and
obstructive Jaundice. (5) [KPC]

D. Explain Why (4 marks):

1) Haemolytic jaundice is acholuric.(4)[MCK]
2) Phototherapy is needed for treatment of Neonatal Jaundice.(4) [NBMC]
3) Fatal hemotion has higher affinity for oxygen than adult one. (5)[midnapore]
4) Haemoglobin act as a good buffer.(5)[midnapore]
5) Photo therapy is used in the treatment of neonatal jaundice. (2) [RPHGMCH]
6) Fasting may precipitate acute intermittent porphyria. (4)[BSMC]
7) HbF has higher affinity for oxygen than HbA

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 XENOBIOTICS
A. Short Answers Type (10 marks):
1) Define the term 'xenobiotics*. Indicate the importance of cytochrome P450 and
glutathione in the metabolism of xenobiotics Explain how knowledge of
pharmacogenetics will drive the development of safer drugs.
(2+3+3+2=10) [IPGMER]

B. Short Note (5 marks):

1) Role of Cytochrome P450 in xenobiotic metabolism. (5) (NRS)
2) Cytochrome P450. (5) [NBMC]

C. Explain Why (4 marks):

1) Phenobarbital can be used in certain cases of Neonatal Jaundice. (5) (NRS)

________________________________________________ GENETICS
A. Long Questions (15 marks):
1) Explain the DNA Replication process in the prokaryotes describing the function of
each enzyme and necessary proteins. How does eukaryotic DNA Replication
essentially differ from it? (10+5) [RGKAR]

2) What are the leading and lagging strand ? Classify DNA polymerase in prokaryotes
and describe their role in DNA metabolism. Enumerate DNA repair mechanism &
describe any one. Define telomere & their significance.(2 + 5 + 6 + 2 = 15)[MCK]

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 3) In the light of replication explain the following terms: a) Clamp loader b) Primosome
c) Proof reading. Compare and contrast between prokaryotic and eukaryotic
replication in all three phases.(6+9= 15)

4) What is Cancer? What is Proto-oncogene? Describe the mechanism for activation of

Proto-oncogene to Oncogene. Name two tumor suppressor genes with their
functions. Name three tumor markers and mention their uses. (1+2+5+4+3=15)
[NBMC]

5) A 36 year old female came to OPD with frequency of and pain during micturition. The
doctor diagnosed urinary tract infection and gave ciprofloxacin, which inhibits DNA
replication. Describe the stages of initiation and elongation of replication in
prokaryotes. Differentiate between DNA polymerase I and III. (10+5) [BMC]

6) Describe the steps of replication in prokaryotes with diagram. Write down the names
of 4 (Four) inhibitors of replication that are used for therapeutic purpose. Enumerate
the criteria of Genetic Code. (10+2+3=15) [RPHGMCH]

B. Short Answers Type (10 marks):

1) Explain the Post-transcriptional Modifications of mRNA in cukaryotes. What do you
mean by Post-translational modifications of proteins? Explain with two examples. (6+4)
[RGKAR]

2) What are protooncogene ? What are the types of protooncogene. Describe the
mechanism of activation of protooncogene.(2+2+6=10)[MCK]

3) Expand the term PCR. Describe the different steps of PCR. Enumerate any four uses of
PCR.(2 + 4 + 4 = 10)[MCK]

4) Name the proteins required for prokaryotic DNA replication. Mention there functions.
(10) (NRS)

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5) What is genetic code? Mention its characteristics. Mention some post-translational
modification. (2+4+4=10) (NRS)

6) Discuss the lac-operon model of regulation prokaryotic gene expression along with
catabolite repression. How does it differ from Eukaryotic gene expression? (7+3=10)
(NRS)

7) Discuss the process of Eukaryotic transcription. Enumerate the post-transcriptional

modification of hn-RNA. (6+4=10) (NRS)

8) Define Tumour Marker. State the characteristics of an ideal Tumour Marker.How can
you estimate serum PSA? Mention the principle of the test. (2+4+2+2=10) (NRS)

9) Discuss with diagram the salient features of the Watson Crick model of three
dimensional structure of DNA. Enumerate different forms of DNA. Write a note on
Mitochondrial DNA. (6+1+3=10) [CNMC]

10) What is OPERON? Discuss genetic regulation of Lactose metabolism in E Coli with
example of the relevant operon model. What is Zinc Finger Motif ? (2+6+2=10) [NBMC]

11) Discuss the process of Initiation in Prokaryotic Transcription. Enumerate Inhibitors

of Prokaryotic and Eukaryotic Transcription and briefly mention their mechanism of
action. (6+4=10) [NBMC]

12) What is gene?Mention different parts of a gene. Describe control of gene

expression with a suitable model. (1+3+6=10) [NBMC]

13) An 18-year-old male presents to ophthalmology OPD with complain of difficulty in

visualizing far objects & Involuntary movements in both eyes since long. He also
complains of skin irritation & redness on exposed skin when he goes out in sun. His skin
is white & hair is light brown. On examination, both eyes shows nystagmus

i. What is the condition this male is suffering from? (1)

ii. What is the biochemical pathway involved in this disease? (4)

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 iii. What may be the complication of this disease.(3)
iv. What is the line of management in this case? (2) [COOCHBEHAR]

14) What is organisation of DNA?

Describe nucleosome.
What is post-transcriptional modificatin?
Write down a short note on splisosome. (2+3+2+3=10) [Raiganj]

15) Describe the initiation of replication in prokaryotes. Write down the differences in
replication between prokaryote and eukaryote. What is telomerase(4+4+2=10) [Raiganj]

16) With the help of a flow diagram, write down the life cycle of a protein molecule.
Describe the steps of elongation phase of translation in prokaryotes with suitable
diagram.

17) Name one drug with its mechanism of action that inhibits translation in
prokaryotes. (4+4+2=10 ) [Raiganj]

18) Describe the metabolic steps in initiation, elongation and termination phases of
protein synthesis with flow diagram.(4+4+2)[midnapore]

19) Describe the steps involved in DNA replication in eukaryotes. Name two inhibitors
of the process and their site of action. Give a brief account of DNA polymerase complex.
(4+4+2) [midnapore]

20) Describe in detail with neat diagram the process of replication in prokaryotes. (10)
[KPC]

21) Enumerate different DNA repair mechanisms. State any two DNA repair
mechanisms with a schematic diagram. Justify the necessity of these mechanisms after
cell division. (2+6+2=10)[IPGMER]

22) Write in detail about the initiation and elongation process of protein synthesis on
an eukaryotic mRNA template. Give examples of modification of proteins after

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 synthesis. Name some antibiotics which work by selectively inhibiting protein synthesis
in bacteria. (3+3+2+2=10)[IPGMER]

23) Define oncogene. Write the different mechanisms by which oncogenes are
activated. Name two genes which protect the individual from getting cancer. What do
you mean by oncofetal antigens? (2+4+2+2=10)[IPGMER]

C. Short Note (5 marks):

1) Tumour Supressor Gene (5) [RGKAR]
2) Point mutation. (5) (NRS)
3) Various mechanisms cause activation of protooncogenes. (5) (NRS)
4) P53 & P53 :Their role in cell cycle(5) [CNMC]
5) Major Groove and Minor Groove of DNA. (5) [NBMC]
6) Southern Blotting. (5) [NBMC]
7) Point Mutation. (5) [NBMC]
8) Base excision repair of DNA.(5)[midnapore]
9) DNA mismatch repair. (5) [BMC]
10) Telomere. [IPGMER]

D. Explain Why (4 marks):

1) DNA is much more stable than RNA.(4)[MCK]
2) Alteration of 1 ^ prime base of anti codon can wobble but 2nd and 3rd bases
cannot.(4)[MCK]
3) DNA contains Thymine instead of uracil base. Justify. (4)
4) Procarcinogens can be transformed into carcinogen by xenobiotic metabolism.(4)
[CNMC]
5) Alpha amanitin is a poison to eukaryotes.(4) [CNMC]
6) 6.Histone is essential for organization of DNA to Chromosome. (4) [NBMC]
7) Methotrexate is used as an Anticancer Drug.(4) [NBMC]
8) DNA with higher GC content has relatively higher TM.(5)[midnapore]
9) Nucleotide analogues can act as anticancer agents.(4) [BMC]
10) Post transcription modification is necessary. (2) [RPHGMCH]
11) Telomeres: A Molecular countdown clock. [IPGMER]

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BIOTECHNOLOGY AND NEWER ADVANCES IN
BIOCHEMISTRY:
A. Long Questions (15 marks):
1) Describe the general structure of an antibody with schematic diagram. Define antigen &
hapten. Classify antibodies by briefly explaining their structural specificity & function of
any two Define and explain primary & secondary immune response.
(5 + 4 + 3 + 3=15)[MCK]

2) Short Answers Type (10 marks):

3) What is MHC and briefly discuss their role in immunity. Briefly discuss the structure of
TCR and their role in different types of T Cells and T cell functions. (6+4=10) [NBMC]

4) Classify and describe the function of different types of antibodies. Draw the structure of
immunoglobin. Discuss the primary and secondary immune responses. (1+3+2+4) [KPC]

5) Enlist the enzymes required in recombinant DNA Techniques. Describe any one of the
enzymes in detail. Differentiate between genomic library and cDNA library.
(2+4+4=10) [IPGMER]

B. Short Note (5 marks):

1) Blood group antigens (5)
2) Acute Phase Reactants. (5) [NBMC]
3) Immunoglobulins. (5) [NBMC]
4) Write a note on methods of gene transfer. (5) [COOCHBEHAR]
5) Structure of tRNA.(5) [BMC]

C. Explain Why (4 marks):

1) Antibodies have diverse mechanism of action in defense of our body. (4) [RGKAR]
2) Restriction Endonuclease is an important tool in Molecular Biology.(4) [NBMC]
3) Cellular and Humoral components of the immune system. (5)[RPHGMCH]

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 MISCELLINOUS
1) A 2 year old baby with enlarged abdomen and delayed developemental milestones
came to pediatric OPD. His blood glucose is 50 mg/dl, lactic acid 15 mg/dl,
cholesterol 300 mg/dl. What is your diagnosis? What is enzyme defect here?
Interpret the biological values with the knowledge of biochemistry. (1+1+3=5)
[DHGMC]

2) A 3 year old boy is referred for investigation of failure to thrive to frequent

diarrhoea. A biopsy specimen was obtained from jejunum and showed villus
atrophy. The doctor advised lactose free diet and supplementation of albumin.
Interpret the clinical scenario with your knowledge of biochemistry. (5) [DHGMC]

3) A two year old mentally retarded fair boy was brought to paediatric OPD with
complaints of urine of child having an abnormal odour. Doctor found it was mousy
odour. To arrive at the diagnosis,blood and urine sample were sent to laboratory.
a. Probable Diagnosis and Enzyme deficit.
b. name the tests
c. Write the reactions of the pathway that is affected in this condition. Explain
the biochemical basis for mental retardation, fair skin and mousy odor
(2+2+3+3) [KPC]

“The physicians are the natural attorneys of the poor, and social
problems fall to a large extent within their jurisdiction.”

- Dr. Rudolf Virchow

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 AETCOM
1) Barriers of communication (3)[RPHGMCH]
2) Cadaver as a teacher.(5)[MCK]
3) Attitude, Ethics and Communication )(5)[MCK]
4) In case of Judicial hanging death is instant. (3) [RPHGMCH]
5) Embalming(5)[midnapore]
6) Importance of cadaveric oath taking.5(BMC)
7) Role of a 1 year medical student to motivate people for cadaver donation(.5)[BSMC]
8) Write a short note on Doctor-Patient relationship. [NBMC]
9) Duties of an Indian Medical Graduate. [NBMC]
10) Explain, request for a second opinion does not provide sufficient ground to
terminate doctor-patient relationship. [NBMC]
11) Goals to be achieved by an Indian Medical Graduate. [MCK]
12) Role of a Physician. (RGKAR)
13) Describe the essential qualities that an Indian Medical Graduate (IMG) should
possess. [Raiganj]
14) Doctor-patient relationship.(BMC)
15) Indian Medical Graduate. (5) [Raiganj]
16) Discuss briefly professional qualities a doctor should possess. (5) [COOCHBEHAR]
17) Leadership skill of a doctor. (5) [Midnapore]
18) Importance of good communication with patients. (5) [BMC]
19) Doctor-Patient relationship. (5) [BMC]

Best Wishes for your First Professional Examination!

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