Jan 2020

1. A man has constipation what will we give to this patient Physillum

2. Artery is derived from Mesoderm
3. A patient having hypokalemia and hypertension, renin angiotensin aldosterone was
normal, there was no renal stenosis and kidney was normalthis is due to pathology in
which gland Adrenal gland
4. A patient with diffuse thyroid gland enlargement, TSH was increased T3 was normal anti
tyroidperoxidase positive and anti-thyroglobulin was positive histo picture was given
asked for diagnosis Hashimoto thyroiditis
5. A patient with symptoms of hypercalcemia, and what will be the other lab changes will
be seen Hypophosphatemia (According to him most common cause of hypercalcemia is
primary hyperparathyroidism)
6. A patient with myasthenia gravis scenario, a picture is given asked which thing you will
target to treat this patient in picture you have to localize Acetylcholine esterase
7. A patient with lambert Eatonscenario, it was told that with repetitive stimuli improves
the condition of the patient asked about auto antibody against which receptor calcium
8. A patient with family of all three tumor of men 1 (Parathyroid,pancreas, pituitary) asked
which gene is affected in this patient tumor suppressor gene (MENIN)
9. A patient with scenario of Parkinson disease asked about which drug should not be
given in this patient chlorpropamide
10. A patient with chronic pancreatitis scenario asked what you will give to this patient
Lipase
11. A patient with recurrent history of pancreatitis asked which drug you will give to treat
this condition of this patient Fibrates (all other cholesterol drugs was also given)
12. A scenario about the thyroglossal cyst in the middle of the neck moves with tongue
protrusion he does not remember the options
13. A question describing a swelling on labia majora asked about the drainage of this area
Superficial inguinal lymph node
14. Which drug causes nephrotoxicity gentamicin
15. A patient with scenario of GERD, which drug should be given PPI
16. Scenario asking that conversion of one immunoglobin in to other immunoglobin (class
switching) occur through Gene rearrangement
17. A patient with red urine when he woke up in the morning it more red than usual asked
what is the defect (PNH) Defect in anchor (GPI anchor for DAG and MIRL)
18. A woman with rashes on her arm, question described that she has a cat, her cat went
into bushes while taking her cat out of the bushes she gets injured from the bushes
(Type IV hypersensitivity poison ivy) which cells are involved in this process Langheran
cells
19. DiGeorge scenario was given absent and present was asked 3 things were given
Induration: Absent, B cell: Normal T cell absent
20. A girl with burn on her hand with hot liquid, having painful blister (2 nd degree burn)
asked what will be the complication Osteomyelitis????
21. A patient with asthma, already taking albuterol, which drug should we give even in high
dose which will have no effect on CNS option were atropine, theophylline,
ipratropium(he did this), scopolamine
22. Patient of anaphylactic shock, given epinephrine, epinephrine causes bronchodilatation
through which mechanism cAMP/b2 receptor agonist
23. Left anterior descending (LAD) is blocked which other artery will anastomose with this
area and supply it Right acute marginal artery was right option (he did PDA)
24. Patient has a murmur, which is increasing when he is standing up from the sitting
position which murmur is this Hypertrophic cardiomyopathy (MVP was not in option)
25. A patient with pulmonary hypertension, valve intensity on closing (pulmonic valve)
asked on the diagram where it is located
26. Patient is taking an antiarrhythmic and is giving history of lung fibrosis we stopped the
drug we stopped the drug and the symptoms improved which antiarrhythmic drug
should be avoided Amiodarone
27. A boy with a tumor in the cerebellum, it was mention that the tumor cells was striated
which tumor is this Rhabdomyosarcoma
28. A scenario of Hepatic encephalopathy was given asked what will increase neuron
Glutamine
29. A patient with Alcoholic hepatitis, Mallory body was described asked cytoplasmic
inclusion of what will accumulate in this cell Keratin filaments
30. Patient is taking Acne treatment; doctor asked the patient not to go on the beach why
did he do that or which drug he was prescribed he was on doxycycline(tetracycline)
31. A patient is hypertensive taking hypertensive drugs scenario defined that he develops
SLE like symptoms which drug he is taking /or you will replace hydralazine
32. A type II hypercholesterolemia was defined that he has high cholesterol asked about the
defect LDL receptor
33. Scenario on bovis and its relation to Colon cancer
34. A 16-year-old who is homosexual he uses to find clients on internet and involve in the
sexual activity with them he has been involved in these activities while he was only 11
years old, now as a primary care physician what will you do?Encourage him that with
these sexual activities you can get infected and get your routine diagnosis,other option
was to report him to police as these activities are illegal or inform his parents.
35. Gardnerella scenario in which it was asked that why it has happened due to decrease in
number of lactobacillus
36. Patient having candida infection, who you will diagnose this KOH
37. Patient having breast cancer now asked why it has happened loss of function mutation
(BRCA)
38. Patient having HIV infection, now gross picture of Vertebrae shown (look like cheesy
material) so he picked TB
39. Patient came from another country, stem described that he has 3rd degree heart block
and right bundle branch block, what is the cause options were: Virus, protozoal,
intracellular organism (he did this)
40. Scenario of Immune thrombocytopenic purpura asked what will be increased on bone
marrow biopsy Megakaryocytes.
41. A physician is treating patient outside US of Ebola, now the physician has got Ebola virus
from this patient, how did this physician get the infectionPhysical contact
42. Patient with lung infection symptom, also has the history of exposure of bird drooping
asked what is the most likely infection Histoplasma capsulatum
43. A patient who has HIV now has stopped taking Antiretroviral drugs, and he has
developed lung infection symptoms, which organism P. jirvoceii(please be cautious
about CD4 count if it is above 200 then S. pneumonia)
44. A patient is hiking now has developed foul smelling diarrhea, there is no blood in
diarrhea all the option given were of bloody diarrhea only Giardia was in option
45. Patient having malaria in Africa having treatment for it, now returned to US, he had
malaria after 2 months, the drug which was given do not work against which stage
Hypnozoite
46. Patient with CMV infection we are giving ganciclovir, but the patient is not responding
(resistant) now what we will give next in this treatment Foscarnet
47. A patient with AIDS, stem mention Spindle shape something on biopsy (Kaposi) what is
offending pathogen HHV-8
48. Cruetz felt Jackob disease scenario patient having myoclonus dementia within a period
of 2 year and he dies what is the cause of this disease, options not confirmedmost likely
will be protein or something.
49. Scenario of AML, we are giving all trans-retinoic acid to this patient, what will be the
action of ATRA Differentiation.
50. Scenario of Dementia asked about the neurotransmitter involved in this acetylcholine
51. Scenario of Maple syrup urine disease, asked about which amino acid will be increase
leucine, isoleucine, valine.
52. A girl 16 years old who lived indoor for a long time due to cold weather, now what we
will found on his labs PTH increase, 25-OH cholecalciferol decrease, one more thing he
don’t remember
53. A patient with Insulin like growth factor receptor mutation, up and down arrow
question Growth hormone increased, IGF-1 increase femur length decrease
54. Similar question with growth hormone receptor mutation up and down arrows growth
hormone increase, IGF-1 decrease
55. Patient who already has a diagnosis of Lactose intolerance, now came to the physician
with rash on her arms, on intestinal biopsy there is inflammation and villous atrophy (he
 dx this as celiac disease)now what will be seen on his serum analysis Igaanti tissue
transglutaminase antibody.
56. a scenario on B12 deficiency all the symptoms and labs were given asked about what
will not be formed/will be decrease Methionine
57. a baby with herniation of gut at umbilicus whichis covered thin silver covering
membrane Omphalocele
58. A patient with shock, his urine production is decreased (oliguria), there is granular cast
on urine analysis, what is the cause Acute tubular necrosis
59. Gross picture of kidney with multiple renal cyst also has the hx of Subarachnoid
hemorrhage, asked about the mode of transmission Autosomal dominant
60. Gross picture of kidney with a brownish, stone looks big just like staghorn, so he picked
Infection (look out for age of the patient, because cysteine also form staghorn calculi)
61. Biopsy histo of kidney was given of clear cell carcinoma (RCC) asked which gene is
defective VHL
62. A kid with kidney tumor also had aniridia asked which gene is defective WT1 deletion
63. Stress incontinence incontinence asked about defect in which structure Pelvic
diaphragm
64. A person who got fired from his job one week ago, spend most of his time watching TV
and playing video games ,he also has history of major depressive disorder , now he
came to his physician stating that I fear that my wife would leave me because she is
happy at her fathers home and she is not happy here , I do not want her to leave me ,
what is the diagnosis adjustment disorder other option dependent personality disorder.
65. A scenario of nephrogenic diabetes insipidus was defined,there was no response on
water deprivation and also there was no response with desmopressin administration
now asked ADH retain water through which mechanism translocation of aquaporin
channel in collecting ducts
66. A pedigree of multiple diseases was given someone was having osteosarcoma while
other were having different tumors what is the gene defected p53
67. Scenario was given with all immunoglobins were decrease asked about the receptor
defect tyrosine kinase BTK (X-linked aggammaglobinumeia)
68. A scenario describing CGD also has a positive Dihydrorhodamine test, graph was also
given but you can guess it from scenario what will be defective/decreased? NADPH
Oxidase-2
69. A patient having recurrent infectiontelangiectasia (spider angiomas) in conjunctiva and
cerebellar signs like intention tremors were given (so you can know it is ataxia
telangiectasia) now asked what this patient will be is at risk of Lymphoma
70. A Scenario of Alport syndrome described patient with hematuria having eye and hearing
problem, what will you find on examination, Thinning of basement membrane other
option were type iv collagen defect (question was same as in Akshay biopsy, it was
asked about the examination not on the gene/molecular level)
71. Patient is taking 5-Flourouracil now asked about the antidote of this drug Uridine
Triacetate (he did leucovorin which is an enhancer not an antidote other option he
didn’t remember but the answer is Uridine Triacetate)
72. A pictogram was given arrow was shown on node of Ranvier and asked about what will
be increase at this area Na channel (previous biopsy)
73. A patient of opioidwithdrawal question scenario asked why we will prefer
buprenorphine over methadone, He don’t remember the options
74. Question on ethics describing , boyfriend got in to an accident had multiple organ
damage and is at the end of life, girlfriend asked the physician to take out his
semen/sperm so that she can continue his generation, and she states that “I also feel
that he also would have wanted this” now as a physician what will be your response
option were 1) that’s a great news , I will help you discuss this with the family of the
boyfriend 2)ok ill take the semen out buthave you discussed this with the family of
boyfriend 3) sorry, I cannot take his semen out without his permission
75. 15 days old baby, having problem with feeding, also having hypoglycemia, liver failure
symptoms was also there, there is reducing sugar in urine what will be increased in
blood galactose 1 phosphate
76. A graph is given in which area under curve is 0.7 if we have to increase the AUC from 0.7
to 0.74 you have to locate in the graph which curve is for 0.74 , so it should be toward
the 1 but not exactly the 1 but a bit closer to 0.7
77. Some question he doesn’t remember on glycosylation asked where it will occur, he did
Golgi apparatus (but remember N glycosylation is in endoplasmic reticulum and O
glycosylation is in Golgi and modification of N-glycosylation on asparagine occurs in
Golgi too so look out niggas!)
78. Tricky question on VLCFA,long scenario, which is confusing, but it mentions VLCFA and
asked about where it is degraded Peroxisome.
79. A question described there was disruption of blood flow to a certain area asked about
up and down arrow that what will happen to these electrolytes inside the cell (loss of
ATPase pump function to low oxygen) Potassium decreased, Na increased Ca increased
80. A woman with hilar lymphadenopathy, with histo slide, sarcoidosis
81. Scenario on pericarditis and also ecg was given and asked the most common cause
coxsackievirus virus
82. a patient with trauma on sternum at the lower area now that sternum will damage to
which part of the heart in this scenario right ventricle
83. A patient is taking paclitaxeldrug, also described that it hyper stabilizesthe spindle, how
it hyper stabilizes it through Tubulin
84. Hirschsprungscenario, a little kid with constipation and he passes stool when his mother
presses near his anus, also described that his rectal tone is increased, at which level
neurotransmitter will be mostly affected Submucosal ACH (mucosal Ach was also in
option)
85. During repair of PDA which nerve will be damaged recurrent laryngeal nerve