Questions

.u idi e as supli e ted….defe t i hi h path a

Denovo purine
Denovo pyrimidine
.h of gout…..a ti ati g utatio of hi h of the path a
Purine denovosynthesis
Pyrimidine denovosynthesis
Salvage pathway
3.a ase he e sole of feet as sho …. ith sloughi g of
epide is . ed ess i e spa e…it as ed..i had ot see
such pic before
Where does he work
As a swimming pool worker
Cowshed
Nurse in nursing home
4.a case where there was hx of fainting for three hrs..and also
guy had max intensity of musrmur in 5th ic space in mid
clavicular line mur mur of??
Mr
As
5Hx of pregnancy on 10th week, then she had murmur ..which
was it
Mr
Functional
6..3 question from ecg..pericarditis, af,
7.hx of htn, with ecg, tall t a e… hat is hea ed o
auscultation
S3
S4
As
.a ase of sti fi osis…si ple o e
9.the e as a g aph a out i e se ago ist….
. eta h d o lase i hi ito is gi e …so patie t is at
greatest risk of??
Hyovolemia
Hypokalemia
Natriuresis
11..what happen when u ingest food in first 4 hrs which
increases in which hrs??
Garsti c acid secrection increases
Gastic ph increases
Gastric acid secrecrion decreases
Gastric acid ph decreases
Arrange hrs wise like..1,2, 3 ,4 hrs
12.hx of polyp in colon..what utatio …the e as eta ate i
in option..no fap
13.a pic of uterus, there was hhg which was not controlled by
oxytocin..n hysterectomy was done. Cause??
Atonic uterus
14..artery damaged in inguinal hernia repair???
Inf epigastic artery
Circumflex
15.a female with a case of femoral hernia..it liles where??
Medial to femoral vein
Latral to femoral artery
16.a boy came to the er with a coach due to sport injury n u
cant contact his parents..n u need to immediately suture the
wound??
Take consent from coach
Repair with out consent
17.a girl ask for oral contraceptive is is minor n said her mother
is agaist premarital sex??
Ask her about safe sex bahaviour
Encourage her to talk to her mom
18. an old man comes to doc with his son, he is 80 yr, has lots
of bruises, his son want to keep him in old age home..old man
want to stay in his home even if he is culsmy???
Talk to patient in private
Encourage him to go to old age home
19.p>0.05..interpreat it
More than 5 result due to chance
.a ase of pleu al lesio …. isk fa to …
Asbestosis
. a as sho , h of hogki l pho a… ediasti a l
lymphadenopathy
Which part
Ant mediastinum
Middle mediastinum
22..a typical case of myasthenia gravis with ct pic of thymus??
What is the dx..mg
23.GBS case..lesion in which type of neurone??
Large size mylinated peripheral neurone
Small size myelinated peropharal neurone
24 A case of hirsprung dx..??
Lesion in swann cell
Enteric nerve
Large size neurone
Small size neurone
25. a case of achalasia with x ray??
Cause
Dec ach secretion
Defect in enteric neurone
. a ase of Hu ti gto dz…. ith peg ee gi e …slight defe t i
ga d o i , o u le e ildl e tall et aded….so
is showing mr at the age of 12..his borther has similar
problem??
Anticipation
Variable expression
. t pi al ase of d… o e ith eedi g diso de , f o
gum, n heavy meanses with , pt , ptt inc given
28 a case of polycystic kidney dz
. H of ht / ith sah… t gi e ause
Malformation
Htn
30. a case of dm, with peripheral neuropathy, joint pain, joint
mouse, ??
Oa
Charcoat joint
31.a case of hyper TG, CAUSE.
Apoc2
Apo a1
32. hx of pneumonia , with silver stain of pneumocstis jirovici
Org??
 .pi of t i ho o as gi e …h of agi al dis ha ge
34.Hep b,with only igm for anti hbe , igm for anti core antibody
positive..all other negative
Acute recovering
Chr
35.tenofovir was given for hiv??
Becoz its orally available
Bec its only for hiv 1..
Its 5 AMP analogue
36.causes of resistance for miconazole??
14 alpha demethylase defect /mutation
37.hx of blood transfusion, anaphylaxis??
Cause
igA deficiency
38. a cases of apotosis..which increases in
cytoplasm..cytochrome c
39.a 20 yr old female with night sweat, wt loss, mediastinal
widening, xray show reticular pattern in apex??
Cause..
Tb
Sarcoidosis
40.which stimulates ecrine sweat gland??
Ach
Adrenaline
Sympathetic
41. drug that increases hr, conduction in av node but no effect
in ventricular contraction
Beta agonist
Muscarinic antagonist
42. typical sace of g6d deficiency
43.pic of mi..diaphragmatic surface was shown..
Old mi / rt coronary artery
New /rt coronary artey
Old /left coronary artery
.su as gi e ..patie t is at i eased isk of…h pogl e ia
45.hx of pregnancy n hyperthyroidism with pic of
e opthal ous…dx
Graves
Subacute thyroditis
. a ase of e … hat happe to i suli , glu ose
47.a case of carcinoma in with hilar ln enlargement, renal
mass..multiple, hematuria??
Primary renal cell carcinoma with lung mets
Primary lumg cancer with lrenal mets
48.which one is the adenosine receptor blocker in platelets??
Clopidogel
49.pain in shoulder , no tender point , pain mainly during
medial rotation of shoulder??
Supraspinatus
Subspinatus
Subscapularis..n other muscles
50.there was a graph..one with normal tension in muscles ,
a othe ith p olo ged te sio …
Cause of prolonged tension
Mutation of ranodine receptor
Mutation of sarcoplasmic calcium atpsase receptor
 . t pi al uestio of pseudogout… auses.. al iu
pyrophosphate
52 ana positive, renal dz, facial rash
Sle
53 arachdo i a id path a … eed to at h the d ug, ith
moa, zilutin, aspirin, corticosteroid
. poo epetitio , a speak o p e ehd… o du tio
aphasia
55. pic of swannoma, gross n ts
56 asth a…ph a idi , o i eased, h o slightl de .. hat it
is??
57 56 yr old , lump in upper outer quadrant of breast. Most
likely dx?
Ca breast
Fibroadenoma
Fibrocystic dz
,the a ell a o i et ee g a ulose ell… hi h ho o e
does arrow indiacctes??
Androstenedion
59.from 3 month to bith what happens in hb??
Dec affinity for 23bpg
Increased synthesis of alpha to beta globin
Increased hb synthesis in liver
60.which trial is done in healthy volunteers, to find out drug
toxicity?/
Phase 1
61.sensitivity n specificity calculation from table, norm needed
to treat..2/3 questions
62..p e ale e of disease as fo d out i o u it … hi h
study??
Cross sectional
63.2 hit mutation was given..which type of gene??
64..typical of pellagra..with casal neck pic
. hat happe i agei g hea t….de eta o idatio of fatt
acid
6 .PEPCK..eha ed … o tisol
67.a female with hx of constipation, she alwz takes laxatives,
stool is not so hard, pettet like, she does not feel rt until she
takes laxative, she avoids milk becoz it does not do gud to her??
Chr laxative abuse
Lactase deficiency
68..udp glucose transferase deficiency..what do u avoid??
Galactose
Lactose
69.the e as a ase of a esia… hid goes to pla …I do ’t
remember..:(
.U i a i o ti e e e.. us les i ol ed…le ato a i
71.urge n stress incontinenece questions
72..sx of CJD dz… hat u ill do…to the ele t ode…i o ize, o
discard
73.most common mass in upper outer quardent of breast of 55
old o e …. a east
. a ase of u of uppe a …ho u h pe e t?
75 a guy goes to a new town n marriage a girl n transmit
hu ti to g to all…..fou de effe t
1. Case Control Study: Described a study
2. Forest Plot interpretation where the study variables touched the
line of no significance; odds ratio of each were far and wide
though.
3. Median preferred over mean: There were outliers in the bar
diagram
4. Gout C/V and picture: Everybody gets it
5. DNA gyrase vis a vis fluoroquinolones
6. Telomerase related question where length of terminal ends
decreases in successive generation
7. Mischarged tRNA yields?
8. Retinoblastoma protein vis a vis HPV
9. C/V of bread and butter diet and its implication in collagen
synthesis pathway
10. Hardy-Weinberg calculation of autosomal recessive disease
11. X-linked recessive mode of inheritance interpretation: No
male to male transmission plus skip generations
12. ADPKD: picture showing cysts in kidney- What to consider
during examination/investigation? MRI for intracranial aneurysm
13. Osler-Weber-Rendu syndrome: epistaxis in cv, pic of
telangiectasias; asked at risk for: AV malformation
14. Puetz- Zeghers explained in CV; patient should be
examined/investigated for one of these: Hamartomatous polyp
15. Huntington disease C/V: Caudate lobe identification
16. Fragile X syndrome in a child of phenotypically normal
mother: Mother has permutation in FMR1 gene
17. 22q11 deletion: CATCH-22 features from FA given
18. Pyruvate metabolism defect: PDH defect
19. Carb metabolism: Von Gierke and McArdle asked
20. Lipid metabolism: systemic primary carnitinedeficiency
metabolism c/v: muscle weakness, hypotonia and hypoketotic
hypoglycemia
21. Hyperchylomicronemia c/v: LPL deficiency
22. Elongated rods after cataract surgery: Bacillus/Actinomyces
23. Mycobacterium tuberculosis bacilli grows in phagosomes
immediately after primary infection in a host
24. Neisseria gonorrhea and reactive arthritis c/v
25. Pseudomonas aeruginosa and hot tub folliculitis:
Involvement of TNF-alpha
26. Lyme disease c/v in a 13 year old child. Rx: Doxy/ Penicillin/
Ceftriaxone
27. Syphilis Penicillin regimen begun- Jarisch Herxheimer
reaction c/v explained
28. Gardnerella vaginallis c/v explained
29. M. pneumonia: cold hemolytic reaction in c/v: Treatment
begun with penicillin, doesn’t work d/t lack of cell wall
30. Coccidioidomycosis spherules filled with endospores
31. IVDU and Candida albicans- germ tubes
32. CT scan: Neurocysticercosis
33. Pharyngeal tonsillectomy: damaged Eustachian tube
34. HIV virus: MOA of ZDV
35. Neurofibrillary tangles+, senile plaques+, MRI showed
diffuse cortical atrophy, Beta amyloid core+ Neuronal cytoplasmic
vacuoles (spongiform change+): NO ALZHEIMERS in option. Chose
CJD
36. Mononuclear infiltrate EM picture of renal tubules after
cadaveric kidney transplantation in a patient receiving
Mycophenolate mofetil and Tacrolimus: Acute rejection/ Drug
toxicity
37. Retinopathy of prematurity vis a vis Bevacizumab
38. Pt. with MI came to ER with high BP and increased HR
(measured prior to admission), just after admission his BP
decreases and HR decreases, this is due to activation of which
receptors: B1/B2/M1/M2/D1/D2/H1/H2
39. Photosensitivity reaction in a patient with UTI receiving
TMP-SMX
40. Endocardial cushion defect vis a vis membranous VSD
41. Pregnant female, murmur heard @ 3rd IC space in left sternal
border. This is due to?: Increased preload
42. CVS Media: Normal findings and AS ( I know writing them as
such won’t be of any help but listen to heart sounds and murmurs
from the android app of same name)
43. ECG: ST elevation in anteroseptal leads; other ECG was to
interpret Amiodarone’s effect
44. DCM in pregnant female
45. C/V of coarctation of aorta: UWorld and NBME
46. C/V of Dressler syndrome
47. Past h/o Rheumatic fever as a child; now presents with
decrescendo murmur: Dx
48. Pulsus paradoxus explained with a typical pericarditis CV
49. 21-OH deficiency classic CV
50. Insulin vis a vis intrinsic tyrosine kinase signaling pathway
51. Picture showing increased radioiodine uptake, c/v of
hyperthyroidism,; arrow pointed to a midline structure; this
pointed structure is: pyramidal lobe of thyroid/ follicular adenoma
52. Cusinhg syndrome and interpretation on RAAS axis. Arrows.
53. Hypothyroid myopathy C/V with increased CK
54. C/V of Albright hereditary osteodystrophy
55. Histo showing prominent rosettes: Increase in 5-HIAA
56. Celiac sprue c/v and histo: Blunting of villi and intraepithelial
lymphocytes+
57. Skip lesions in COLON: MOA of drug to be used against it
58. Appendicitis Pic and histo findings selection: NBME qsn
59. Meckel diverticulum c/v and gross
60. ALD, cirrhosis c/v, ascites+ physiological changes regarding
Na, K, catechola i es…. Arrows
61. Child with suspected viral infection, vomiting+, diarrhea+, In
addition to acetaminophen you’ll consider: fluid and electrolyte
replacement
62. Agonist at Gi: Misoprostol/ Ranitidine/
Omeprazole/Sucralfate
63. Hematonco consisted of c/vs relating to: CML, VWF, Factor 8
deficiency, ITP (questions focused on dx only)
64. TAO cv vis a vis use of cilostazol
65. Cisplatin nephrotoxicity and ototoxicity
66. Swelling behind lateral malleolus, muscle injured?: Peroneus
brevis
67. Erb Palsy: c/v and pic from NBME
68. =Obturator nerve vis a vis adduction problem
69. Shaft of radis X-ray and c/v: Deficiency asked
70. Osteomalacia: Serum calcium and PTH levels
71. C/V of tenosynovitis
72. SLE, B/L crackles heard; do next: CXR/ Echo/ ECG (I chose
CXR because the c/v stem didn’t mention about basal crackels
73. Non small cell lung cancer with Lambert-Eaton myasthenic
syndrome
74. Leser-Tre’lat sign picture
75. Dermatomyositis vis a vis occult malignancy
76. Classic Sonic hedgegog gene c/v of embryogenesis
77. Sleep physiology- Narcolepsy- REM WITHIN 10
MINUTES/ alpha waves in EEG
78. Neurological deficits with site identification: Same as that of
FRED (spoiler alert, chose not to post the same question here)
79. Locked in syndrome, C/V
80. Transient ischemic stroke: To decipher from
pathophysiologic changes ala NBME
81. C/V showing deficit in spinal roots of CN XI and hypoglossal
nerve: These structures pass through?: Formaen of Magnum
82. Classic cv of Trigeminal Neuralgia (within 30 seconds)
83. Pituitary adenoma c/v and physiological changes given
84. Drug just like dextromethorphan: Ketamine (dissociative
anesthesia/amnesia in C/V)
85. Transference C/V: Pt. vents out his anger towards his
mother toward the doc
86. ADHD c/v explained: Drug to be used?
87. Alcohol withdrawal in a homeless man (bugs crawling)
88. Stages of change in overcoming substance addiction:
Contemplation phase explained
89. Gender dysphoria question ala Uworld
90. Uric acid stones not visible on X-Ray
91. Chronic pyelonephritis c/v: Coarse, asymmetric
corticomedullary scarring
92. Thiazide diuretics vis a vis hyperglycemia and hyperuricemia
93. FEV1/FVC ratio:110%, history of productive cough since last
six months, no bronchodilation under beta agonists, forced
expiratory flow increased: Restrictive lung disease/ Chronic
bronchitis/ Emphysema
94. Spontaneous Pneumothorax c/v in a tall (>6 ft) thin (BMI
<=20) male varsity player
95. CT scan of lung tumor invading left main pulmonary
bronchus
96. Classic C/V of Sarcoidosis-- ala Uworld and NBME
Exam date 30th august 2017

"Sorry i couldn't remember many qns, and for being late "

"This is all I could, "

I will add if i remember any new qns

Thanks to this group and members

"I typed it in tablet, remind me, ask me if any error, typos, i will clarify as much i
can, "

"First option is preferred option, or the one i choosed "

"I may be wrong, "

BPKIHS graduate 09

"1. Patient on multiple medicines,prednisolone, aspirin, 5fu,what will be most

likely be seen on 4 week follow up on blood smear, "

" MACROCYTE, SPHEROCYTE, MICROCYTE "

"2.patient with immune deficiency T and B cell combined, final diagnosis as ADA,,
adenosine deaminase deficiency done. Here defect will be synthesis of "

"DNA, RNA, PROTEIN, "

3.10000 pateients treated aggresively with high dose combination chemotherapy

for DLBCL"Diffuse large b cell lymphoma, few patients died on follow up,
crystalline structure found on renal biopsy these will be made of "
"URIC ACID, XANTHINE, HYPOXANTHINE, STRUVITE "

"4.white pupillary reflex shown in child picture genetic analysis conformed the
involved gene in family, this will regulate cell cycle at. "

"G1>S, S2>M,G0>G1"

5.follow up patients of muscle degenerative disorder on molecular analysis will

show

"UBIQUITINATION,PHOSPHORYLATION, ACETYLATION"

"6.cv describing non localizing cns symptoms, dark colored skin lesion in arms,
altered sensorium, microscoanalysis showed large cells with intracellular
brownish pigmentation,cells will be positive for "

"MELAN-A, GFAP, VIMENTIN, DESMIN, "

"7.Hardy weinberg principle, with no natural selection if applied in AR disease

disease frequency 1/10000, how many people do you expect to be carrier for
disese, "

"2%,1%,3%,10%,11% "

"8.Radiilabelled linoleic acid used to assess if nutrients are necessary for body,
which of following most likely have this, "

"TxA2, INSULIN, ESTROGEN , TGF BETA "

"9.pedigree given with mitochondrial inheritance described, which one will have
least chance of getting disease"

One WITH FATHER TO CHILD TRANSMISSION

"10.pedigree evaluated for CKD patient found to be due to inheritated disease,

some family members also had history of hearing loss and vision problem, is due
to, "

"ALPORT SYNDROME, ADPKD, ARPKD, MULTICYSTIC KIDNEY DISEASE "

"11. Cv descibing vague cns symptoms molecular analysis revealed to be

trinucleotide repaeat expansion disorder, most likely expalination for earlier
onset of sympatoms in subsequent generation "

"ANTICIPATION, PLEIOTROPY, VARIABLE EXPRESSIVITY, CODOMINANCE "

"12. newborn baby born via SVD, HAS multiple congenital defects, facial
abnormality, mother has history of Recurrent abortions, most likely due to, "

"TRANSLOCATION, ANEUPLOIDY,HETEROLPLASMY "

"13.a man trapped in tall storeyed building on ER with altered sensorium, lab
reports given with increased venous oxygen content, due to "

"ETC INHIBITION, DECREASED OXYGEN EXCHNGE, DEFECTIVE OXYGEN

TRANSPORT "
14.type 2 familial hypercholestrolemia is due to defect in

"LDL RECETOR, APO CII, APO E "

15.patient developed hypoglycemia after consumption of fruits due to defect in

"ALDOLASE B, PFK -1, FRUCTOKINASE, GALACTOKUNASE "

"16. Patient with cv and diagnosis given PKU, ASKED what to evaluate next, "

"BIOPTERIN METABOLISM, FOLIC ACID, VIT B12 "

"17.patient evaluated for increased homocysteine level and diagnosis of CBS

ENZYME defect found, it may be due to defective vitamin "

"B6 B9. B12, B3 "

"18. Remnant glucose analysis of pt diagnosed with glycogen storage disease

found to be defect of alpha 1-6 glucosidase, enzyme is known As"

"DEBRANCHING ENZYME , BRANCHING ENZYME , GLYCOGEN SYNTHASE "

"19.a patient started on medicine that decreaes mevalonate synthesis drug is, "

"STATIN, FIBRATE, RESINS "

20.lymphatic drainge of area below pectinate line will drain to

"SUP INGUINAL, INTERNAL INGUINAL, PARAAORTIC "

"21.ASTHMA patient with increased Ig E and eosinophil described, is due to "

"TH2 TH17, TH1, Tregs "

"22.cell triple knockout on CD 14, TCR AND. FcyRII, if there is defect in detection
of cell wall component of bacteria including LPS, IT is due to "

"CD 14, TCR, FcyRII "

"23. Patient given HPV vaccination, her mother anxious if she will get disease
from the. Vaccination you councelled that she won't because it is "

"SUBUNIT VACCINE , TOXOID , POLYSACCHARIDE CONJUGATED "

"24.newborn baby Rh positive born of RH negative mother, Rhogam given

antepartum and post portem, post delivery fetal blood analysis revealed, Direct
coombs positive test, it is due to "

"IgG PLACENTAL TRANSFER , INTRAUTERINE INFECTIONS , HEMOYTIC DISEASE

of NEWBORN "

"25.patient Renal transplant under tacrolimus, profound immune suppression and

defective T cell function it is due to "

IMPAIRED IMMUNE STIMULATION FROM CYTOKINES

IMPAIRE ANTIGEN PRESENTATION

26. White colonies in on sorbitol Mac conkey organism is

"EHEC,ETEC,EAEC,EPEC"

"27.pathogenic strain A of strep pneumonia and non pathogenic strain B, killed

and mixed, later strain A turned to pathogenic form, is due to "

"TRANSFORMATION, TRANSDUCTION, CONUGATION "

28.Dagnosis of breast abscess done on postmenopausal female non responsive to

cloxacillin

"A mycobacterium organism which grew within 4 hours, it is "

"M.FORTUITUM , M.MARINUM, M.KANSAII ,M.TB ,M.SCROFULACEUM "

"29.2 weeks following immunization patient presented with fever malaise, most
likely diagnosis "

"SERUM SICKNESS, REACTIVATION, REACTION TO ADJUVENTS "

"30.auramine rhodamiine assy with greenish organism on usa immigrant from

india with typical history of TB, organism "

"MTB,COXIELLA, STREP PNEUMONIA, STAPH AUREUS "

31.uti caused by gram negative organism antibiotics given with good coverage it
will be

"Ciprofoxacin, vancomycin, metronidazole, albendazole "

32.pic of rash on palm and perianal flat lesion shown asked which organism
caused this

"SPIROCHETE, VIRUS , COCCI,ATYPICAL ORGANISM, "

33.clue cells typical microscopy given with cv drug to give asked

"METRON, ALBENDAZOLE, cefixime,azithromycin"

"34. Cv of vaginal discharge NAAT test negative, on microscopy motile organism

seen, DOC IS "

"METRON, CIPRO, ALBENDAZOLE, "

35.pic of typical cutaneous larvae migrans DOC

"ALBENDAZOLE , METRONIDAZOLE, AZITHROMYCIN "

"36.army officer presented with respiratory symptoms, reddish nodules on ant

shin bilateral, recently posted in desert area, most likely organism, "

"COCCIODIDMYCOSIS,HISTOPLAMOSIS,BLASTOMYCOSIS,"

"37.3 years old baby on total parenteral nutrition via Central vein , no discharge
and erythema on cannula site culture of blood showed germ tube test positive,
most Plausible organism "

"C. ALBICANS , C PARASOLIOSIS , ASPERGILUS , CRYPTOCOOUS gatti/

NEOFROMANS "
"38.trypanosoma species microscopy shown typical as of FA, JUST TO diagnose "

"TRYPANOSOMA , LEISMANIA , "

"39.strongyloides species typical rhabditiform larvae shown, asked mode of

transmission "

"CUTANEOUS , FECOORAL , BLOOD BORNE "

"40.patient, altered sensorium, CT showed temporal edema most likely organism

"

"HSV, ENTEROVIRUS, MUMPS "

41.ASIAN IMMIGRANTS TO usa TB DIAGNOSED Mode of transmission

"DROPLET, AIRBORNE, VECTORBORNE "

"42.blood screened after blood donation, random sampled reveled"

" IgM HbC +,"

IgM Hbe +

HbsAg -

IgG HbsAg -

Most likely diagnosis

"ACUTE RESOLVING , ACUTE RESOLVED, CHRONIC CARRIER WITH HIGH

INFECTIVITY "

CHRONIC CARRIER WITH low INFECTIVITY

"43.new viral drug that interfere with with sialic acid function discovered, it will
have similar function as "

"OSELTAMIVIR , AMANTADINE , ACYCLOVIR "

"44.patient with combined hep B and HIV INFECTION, drug that can be used for
both "

"LAMIVAUDINE, ENTECAVIR, PEG INFN "

"45.cv described Recurrent infection with defect in component of cell that

mediates integrated adhesion and migration diagnosed, it is due to "

"LFA-1, PECAM, P selectin "

46. Which one is most impt mediator for neutrophils migration

"C5A, C3A, C4A, c1r "

"47. Patient renal biopsy with pink material shown, with macroglossia,with
splenomegaly additional feature will be "

"RESTRICTIVE CARDIOMYOPATHY , PANCYTOPENIA , DYSELECTROLYTEMIA "

I preferred first option thinking it as systemic amyloidosis

"40.patient follow up for multiple lung nodules, with proximal muscle weakness
that improves with use,it is most likely due to "
"ANTIBODIES AGAINST PRESYNAPTIC VOLTAGE GATED CHANNEL,"

ANTIBODIES AGAINST POST SYNAPTIC Ach RECEPTOR

DEFECTIVE DOCKING of VESICLES

"41.patient with neck mass on biopsy cells with amyloid background seen, most
likely used parameter for follow up "

"CALCITOININ , PTH, CALCIUM "

42.Typical VT shown on cocaine abuser asked for cause of arrythmia

Increased

"44.prostate mass shown on coronal CT to diagnose pathology, "

"45. Xray shown ischial tuberosity, defective muscles of this origin will affect
which movement of hip joint "

"EXTENSION , FLEXION , ADDUCTION ,ABDUCTION "

46..Bronchial biopsy with squamous cells islands and keratin pearls shown to
diagnose it

47.chest xray with bronchioles deviation shown towards rt right side involved
lymph node
"PARATRACHEAL , MEDIASTINAL , HILAR , SUBCARINAL , "

48. Typical graph of competitive agonist given to identify among options

"49.A drug that works on asthma was discovered, it was found to block
leukotriene receptor "

It would affect the intracellular concentration of which of following

"IP3 DAG, cAMP, cGMP "

"50. Worker in industry that produces brakes, presented with pleural effusion and
diaphragatic calcification, most likely diagnosis, "

"ASBESTOSIS, BERYLIOSIS, SILICOISIS"

"51.oxygen hb dissociation curve given, as compared to normal which will be

graph of person at high altitude, "

"RT SHIFTED, LFT SHIFTED, "

52.main constituent of surfactant is

"DIPALMITOYLPHOSPAHTIDYLCHOLINE. ,........ SERINE, ......... GLYCEROL "

"53.long cv described with clue given patient has estrogen excess, asked which of
the following drug can be given to prevent estrogen production from androgens "

"ANSTROZOLE, FLUTAMIDE, CLOMIPHENE, LEUPROLIDE "

"54. Diagnosed case of melanoma given, which is most impt parameter with
prognostic significance "

"THICKNESS, CELLULAR ATYPIA, ARCHITECTURE "

"55.high grade scrotal tumor with dx of embryonal carcinoma, patient

presented with mass in retroperitoneum tumor, biopsy given on exibit, with
glandular, cartilage and columnar epithelium clerarly "

seen diagnosis

"RETROPERITONEAL TERATOMA SEMINOMA, SERTOLI LEYDIG CELL TUMOR "

"56.molar pregnancy cv with vescicles described in usg reports, "

Cells that give rise to tumor mass will normally give

"TROPHOBLASTIC VILLI, FETAL TISSUE, EXTRAEMBRYONIC CELOMN "

"57. 45 yrs female patient diagnosed as cervical carcinoma most important risky
factor will be, "

"HPV INFECTION, AGE, SEX,MULTIPLE SEXUAL PARTNER "

"58. Patient with past history of motor deficit, now has periventricular plaque,
also has oligoclonal bands on csf analysis, it is due to "

"T CELL MEDIATED DISODER, IMMUNE COMPLEX DEPOSITION,"

"59.typical CV OF 21 OH deficiency described with increased 17 hydroxyl
products, hypotension and decresed cortisol, what additional finding will be there
"

"INC ACTH, DEC K+,INCREASED CORTISONE "

"60. A male patient with history of pelvic trauma, xaray reveled pelvis fracture,
most likely site of damage "

"MEMBRNOUS URETHRA,PROSTATIC URETHRA,BULBAR URETHRA"

61.female patient with minimal involuntary loss of urine while laughing

"Gravida 3 para 3 living 3, what is cause of symptoms "

"HER FIRST VAGINAL DELIVARY, BLADDER OUTLET OBSTRUCTION, UTI"

"62.similar vignettes descriptions of stress incontinence, while laughing, it is due

to"

"LEVATOR ANI WEAKNESS, RECTOCELE,UTI "

"63.18 weeks preg on regular anc visit usg confirmed of same gestational age,
multiple fibrotic bands in amniotic cavity seen, most likely complications in fetus
will be. "

"AMPUTATION,TORTICOLLIS ANENCEPHALY, HOLOPROSENCEPHALY "

I selected first one because i felt like it was amniotic band syndrome
"64. A couple presented with exibit shown in lady with. Severe acne, they won't
accept OCP and other contraception because of religious beliefs, "

Which medication will be contraindicated

"ISOTRETINOIN, TTC, AZITHROMYCIN, CLINDAMYCIN "

"65.A couple diagnosed with tay sachs syndrome, who wont accept abortions
because of religious beliefs, to prevent the next child from getting disease what is
to be done IN addition to IVF and sperm donation "

GENETIC ANALYSIS WHILE DOING IVF

CHORDOCENTASIS

AMNIOCENTASIS at 12 WEEK

AMNIOCENTASIS at 15 WEEKS

USG

66.a couple presented on ANC clinic with lady smoking regularly what is most
anticipated outcome

GROWTH RESTRICTION of FETUS

PRETERM LABOUR

ANTEPARTUM HEMORRHAGE

67. 2 questions

"GRAPHS shown PTH Vs Ca, which quadrants will be most likely seen in "
"Patient with high phosphorus and very low calcium on regular dialysis, "

Another patient diagnosed as osteomalcia

Graph as of nbmes or FA given

LEFT UPPER CORNER IN BOTH PATIENT

"68. To reach renal artery when approached via femoral artey, which artey is to
be just crossed "

TESTICULAR ARTERY

SUP MESENTERIC ARTERY

INF MESENTERIC ART

CELIAC ARTEY

69. For csf tapping from subarachnoid space which are to be pierced sequentially

SUPRASPINOUS> INTERSPINOUS> Ligamentum flavum >DURAMATER

70. Cv and diagnosis of bacterial vaginosis given pathogenesis is due to

ALTERED ANEROBIC FLORA

INCREASED PH

ENTERIC INFECTION

71.marathon runner didn't drank water in long running competition as she feared
she will have nausea and vomiting what will ADH do
INCREASED UREA REABSORPTION FROM TUBULES

INCREASED Na+ REABSORPTION from LOH

INCREASED REABSORPTION from PCT

No option given indicating collecting tubule and aquaporins

"72.xray of upper chest, neck shown like birds beak, main mediator defective in
this disease is "

"NO, MOTILIN, EPINEPHRINE, SEROTONIN , VIP "

"I preferred NO OVER VIP IN ACHALASIA CARDIA, "

73. A nicotinic cholinergic agonist used to treat tobacco addiction

"VARNECLINE, PILOCARPINE, ATROPINE, "

"74. A patient with motor and vocal tics described clearly, which receptor must
be blocked "

"DOPAMINE, NE, ACH,SEROTONIN "

"75.Narcolepsy typical cv given with hypnopompic hallucinations, excess daytime

sleepiness, defect in orexin prodn "

"LATERAL HYPOTHALAMUS , THALAMUS ,MIDBRAIN "

"76.9 year baby with suspicious trauma, when asked how she got these, she looks
at father and remains silent, father is apprehensive to each qns "

What to do next

"CALL CPS, TREAT, COUNCELL THE FATHER "

"77.couple came to ER with child with fracture in rib in multiple stages of healing,
when asked to mother, she took the baby to father and father confronted
physician with rage for his suspicion on them what next, "

"Call CPS, TREAT, COUNCELL THE PARENTS "

"78.you. Are female physician and your patient is known case of General anxiety
disorder on regular visit, and now patient does not have symptoms, you like him,
so does he, He Mentioned He Finds you attractive, he asks for the dinner what
next to say "

I AM HAPPY THAT YOU IMPROVED BUT I CANT

I LIKE YOU BUT I CANT

I will REFER YOU TO MY FRIEND

I dont have TIME NOW BUT I WILL CALL YOU FOR COFFEE LATER

79.A terminal staged cancer patient is admitted to hospital how will you councel
the patient regarding all

STAND NEAR PATIENT BED

SIT NEAR PATIENT BED

STAND NEAR MONITOR

STAND WITH ALL STAFFS AROUND YOU

"80.typical cv of body dysmorphic disorder, wont go outside with friends because

of atypical beard and pimples, what other feature may be found here "

PROLONGED LOOKING IN MIRROR

ALTERED SLEEP

SUICIDAL THOUGHS

"81.couple, delivered newborn baby, nonhealing wound in perineum, at

episiotomy site, lady when asked, told her husband insisted for sex within 10
days of delivery, they are having regular sexual relationship 3 4 times a week,
what next to do "
ASK IF HER HUSBAND FORCED HER FOR SAME IN PAST

COUNCELL HUSBAND HAVING SEX SOON WILL DELAY HEALING

TREAT HER

TELL HER SHE MUST FIND SOME SOUTION to THIS RELATIONSHIP ISSUE

"82.a patient came to clinic (neither to opd nor to ER) ON severe pain speaks
chinease what next to do to ask more about disease,his grandson speaks
mandarin but not present at clinic "

TELL NURSE TO FIND SOMEONE AMONG STAFF

CALL HIS GRANDSON OVER TELEPHONE

CALL PROFESSIONAL INTERPRETATION SERVICE of CHINESE LANGUAGE

USE HANDY APPLICATION in MOBILE to CONVERT LANGUAGE

"83.17 years male child who has best grades all A+ UNTILL recently, now mother
complains he has impulsivity, inattention, memory problems what is most likely
cause "

NORMAL AGEING

ADHD

ANTISOCIAL DISORDER

CONDUCT DISORDER

"84.GI bleeding from hepatic flexure, in addition to right colic artery which artey
also to be clamped "
"MIDDLE COLIC, "

ILIOCLOIC

CELIAC

85.82 years patient tells physician he goes to bed at 10 and gets up at 4

"With frequent waking every 2 hours, he adds in past he would goto bed at 10
and would have sleep till 5 6, what to do next "

COUNCELL FOR NORMAL AGEING

PRESCRIBE BDZ

INQUIRE FOR DEPRESSION

86.a patient have shooting pain in facial region in zygomatic distribution

Most likely origin is from

PONS

Midbrain

MEDULLA

87.hearing assessment given weber localized right ear and rinnes test bone
conduction greater than air right air defect is

CDHL RIGHT EAR

SNHL RIGHT EAR

CDHL RIGHT EAR

SNHL RIGHT EAR

"88.a case with spinal cord given with pic showing involvement of all tracts and
cords except dorsal column, what sensation will be spared "

FINE TOUCH AND VIBRATION SENSE

Pain and TEMPERATURE FROM UPPER LIMB

PAIN AND TEMPERATURE FROM LOWER LIMB

89.cerebral aqueduct pic given and asked when this duct is obstructed which
chambers will be enlarged

"LATERAL AND THIRD, LATERAL ONLY, THIRD ONLY "

"90.decreased facial expressions with pin rolling tremor complained by wife of

patient,she adds he walks slowly, brain section at Midbrain shown to localize
involve site"

TO LOCALIZE SUBSTANTIA NIGRA IN MIDBRAIN SECTION

"91.saggital section of brain stem given with clear ectopia of cerebellar tonsils,
what feature will be there "

MENINGOMYLOCELE

MYRINOMELIA

ENCEHALOCEL

UNFUSED LAMINA Dura

"92.cv where a man can't understand spoken words but can speak, repititions is
also impaired, defect lies in "

WERNICKES Areas

BROCA AREA

ARCUATE FASCICULUS

93.sensory input from face will relay to which nuclei of thalamus

VPM

VPL

MEDIAL GENICULATE

LATERAL GENICULATE

"94. Cv of myocardial infarction given with graphs of cardiac enzymes given, asked
which one is most specific marker. "

"But were unlabelled, Pic as below but unlabeled

TROPONIN (longest graph @ troponin stays for 10 days)

CKMB

MYOGLOBIN

LDH

"95.a patient with bulla that forms at trauma site, they are flaccid antibodies
deposition leads to separation of epithelium at which layer "

SPINOUS LAYER

BASALE LAYER

CORNEAL LAYER

LUCIDUM LAYER
"96.malar rash patient with, ANA positive serology, proximal thigh muscle
weakness, with pic of dorsum of hand shown grotton papules, what do you want
to screen for at earliest. "

HIDDEN MALIGNANCY

RENAL PATHOLGY

PULMONARY PATHOLOGY

ANTI CCP

"97.a patient with knee pain known case of pagets disease. Under alendronate
therapy, xray revealed, codmans triangle, there is also history of breast.
Carcinoma, rhabdomyosarcoma, it is due to "

P53 mutation

RB MUTATION

CDK MUTATION

"98.newborn baby with short height normal sized head, intelligence, most likely
cause is "

SPORADIC MUTATION

AUTOSOMAL DOMINANT

TRISOMY

LOSS of FUNCTION MUTATION

"99.a 78 years female patient presented with back pain, x ray revealed collapsed
vertebrae, what do you want to investigate for "

DEXA

CT SCAN ABDOMEN

USG OF ABDOMEN

"100. A hiv patient presented with purplish lesion over different parts of body,
biopsy description, spindle shaped cells with vascular spaces seen most likely
diagnosis "

KAPOSI SARCOMA

BARTONELLA HENSELAE

STAPHYLOCOCCUS

PARVOVIRUS

"101. A child presented with cystic mass in ant border SCM muscle, what is most
likely cause "

DEFECTIVE PHARYNGEAL CLEFT

ABNORMALLY LOCATED THYROID TISSUE

BACTERIAL INFECTION

"102.mother presented with pustular lesion on back, no history given like below
except for family picnic and swimming in water park causal organism "
PSEUDOMONAS

STAPHYLOCOCCUS

CANDIDA

CORYNEBACTERIUM

"103.typical cv with history of canned food, presented with muscle weakess,

hoarseness mechanism behind pathogenesis "

DEFECTIVE DOCKING OF NEUROTRANSMITTERS VESICLES IN PRESYNAPTIC

ANTIBODIES AGAINST VOLTAGE GATED CALCIUM CHANNEL

ANTIBODIES AGAINST ACH RECEPTOR

104. Long CV with classical machinery murmur given as clue and asked if surgical
intervention done to correct patholgy what is most likely complications

LFT RECURRENT LARYNGEAL NERVE INJURY

VAGUS TRUNK INJURY

105.a patient undergone resection of terminal ilium and proximal colon for crohns
disease most likely complication expected in the patient

DEFCTIVE BILE SALT ABSOTPTION

DUMPING SYNDROME

ELECTROLYTE ABNORMALITY

106.perianal area shown in picture and asked which nerve recieves sensory
information from this area

INFERIOR CLULEAL NERVE

INFERIOR RECTAL NERVE

GENITOFEMORAL NERVE

"107.ischial tuberosity shown in xray, when muscles from this origin point
damaged which group of muscles will not function aroun hip joint "

EXTENSORS

FLEXORS

ADDUCTION GROUP

ABDUCTION GROUP
"108. Long cv with rotator cuff muscles described, which muscles among "

Them is only external rotator which is supplied by axillary nerve

TERES MINOR

SUPRASPINATOUS

INFRASPINATOUS

SUBSCAPULARIS

"109.breast cancer patient on multiple medicines, presented with burning

sensation on both extremities, and wrist drop which is most likely med causing
the symptom "

VINCRISTINE

VINBLASTINE

5FU

"110.patient undergone valve replacement and started on proper medicine,

presented with dark skin patches soon diagnosed as skin necrosis, what pathology
predisposed the patient to this event "

DEFECTIVE SUBASTANCE THAT CLEAVES THE FACTOR 5 AND 8

AT-III DEFICIENCY

VITAMIN K DEFICIENCY
"111. A patient who works on asbestos factory presented with dyspnea, sob, xray
revealed bilateral fibrotic areas, which of following initiated this event "

DENDRITIC CELL

TYPE 2 PNEUMOCYTE

RBCS

There was no option as endothelium or macrophages

"112.a classical history with fever and malaise for months, lymph node biopsy not
descibed, molecular analysis revealed t(14,18), what lead to tumor development "

FAILURE TO UNDERGO APOPTOSIS

INCREASED RESPONSE TO GROWTH FACTOR

"113. A study done to reveal association between sugar consumption and

hypertension, sugar consumption was self reported in appropriate amount per
day consumed, most of them are smoker too, data was interpreted via multiple
regression analysis, when this method of analysis used what is benefit "

ELIMINATES DEMOGRAPHIC AND SMOKING RELATED EFFECTS ON STUDY

ELIMINATES SELF SELECTION BIAS AND EFFECT OF DEMOGRAPHY

"114. Many studies shown where p values for all of them is significant, only
difference was confidence interval, only one study was there that didn't included
1, i ticked the same "
"115.family history of endometrial cancer, and ovarian cancer in mother, patient
is at increased of colonic cancer what is most likely explaination "

MISMATCH REPAIR

APC BETA CATENIN FUNCTION

NUCLEOTIDE EXICISION REPAIR

"115.x ray of patient who presented with prolonged diarrhoea revealed

calcification, there is also history many emergency visits with abdominal pain,and
regular alcohol consumption, he should be supplied "

LIPASE

LOPERAMIDE

METRONIDAZOLE

METOCHLORPROMIDE

"116.A Male patient presented with bloody diarrhoea and abdominal pain not
improved with conservative therapy, biopsy revealed, neutrophils collection in
crypts,most likely diagnosis,"

ULCERATIVE COLITIS

CD

IBD

COLONIC CANCER
"117.a patient on chemotherapy for lymphoma, intestinal biopsy taken, which will
most likely contribute to regeneration of epithelium, "

CRYPTS

"TIP OF MUCOSA, "

SUBMUCOSAL LYMPHATIC NODULES

LAMINA PROPRIA

118.multiple duodenal and jejunal ulcers seen in addition to Pancreatic mass on

CT SCAN of abdomen most appropriate therapy will be

PPI

RANITIDINE

MISOPROSTOL

ANTIBIOTIC THERAPY

"119.a patient Who presented with APD like symptoms, on radiological

examination, Gastroesopaheal junction is displaced upward, diagnosis"

SLIDING HIATAL HERNIA

ROLLING HERNIA

ZENKER DIVERTICULUM

"120. A immigrant from india, smokes cigarette, consumes alcohol,chews

tobacco, presented with APD like symptoms, most impt cause for his symptoms. "

H PYLORI
ALCOHOL

TOBACCO

"121.pregnant lady presented with, altered liver markers and rash which of
following is most likeley used medicine "

PTU

METHIMZOLE

RADIOACTIVE IODIDE

Propranolol

"121.pic of thyroid ophthalmopathy shown, exopthlamous present, other

hyperthyroidism features as racing heartbeat, sweating and weight loss given,she
is pregenant lady,what is most likely cause "

GRAVES DISEASE

TOXIC GOITRE

THYROIDITIS

HASHIMOTOS

"122. Action potential 2 graphs given ionic flow shown all sodium, potassium and
calcium given almost both graphs had similar ionic heights and action potential
width except for calcium and action potential which was larger in width in second
graph, qn asked "

Which ionic flow contributed to the difference in action potential

CALCIUM
SODIUM

Potassium

Chloride

"123.patient on metformin, with renal failure, patient at greatest risk because of

Medicine "

METABOLIC ACIDOSIS

HYPERCALCEMIA

HYOERCALCEMIA

HYPOKALEMIA

"124.as compared to fetal circulation newborn baby have, systemi vascular

resisiatance, pulmonary vascular resistance, pulmonary blood flow, all options
given "

DECREASED DECREASED INCREASED

"125. Patient with pulmonary nodules and Recurrent rhinosinusitis, patient

presented with worsening creatinine values, patient is at increased risk of "

PAUCI IMMUNE GLOMERULONEPHRITIS

IMMUNE COMPLEX DEPOSITION GLOMERULONEPHRITIS

NODULAR GLOMERULOSCLEROSIS
"126. A patient's report for hiv came positive, he also has extramarital affairs in
addition to his spouse, what is best approach at this time "

IT'S YOUR RESPONSIBILITY TO TELL BOTH OF YOUR PARTNERS

I WILL BOTH OF YOUR PARTNER

I WILL TELL STATE HEALTH BOARD AND THEY WILL TAKE ACTION

"127.a study revealed association between risk factor and disease with
correlation Coefficient of 0.1 and p value 0.001, what can be said about the
association "

STATISTICALLY SIGNIFICANT WEAK POSITIVE CORRELATION

STATISTICALLY SIGNIFICANT STRONG POSITIVE CORRELATION

Similar other options with combination of them

"128. Study done with alpha criterion of 0.05, calculated value is 0.001, clearly
said that calculated value is statistically significant this study is at risk of "

ALPHA ERROR

BETA ERROR

RANDOM ERROR

"129.a study was done to find any association between risk factor unknown and
CML, investigators took sample from all the patient that visited OPD IN medical
college, was double blinded and analysed whatis limitation of the study "

EXTERNAL VALIDY

INTERNAL VALIDITY
RANDOM ERROR

"130.OCP taking female came to obg opd with positive UPT /HCG test,"

"Past history is not significant except for positive PPD test 2 months ago, "

Most likely cause for her positive UPT test Is

DRUG INTERACTION by RIFAMPICIN

NON COMPLIANCE of MEDICINE

"131.a patient taking st johns wort as alternative therapy for Depression, most
likely interactions with other medicine is due to induction of "

CYP 3A4

CYP 2C9

CYP 2E1

And many other option

132. A full third degree burn will be completely epithlialized by regeneration of

basale layer of epithelium by

1 MONTH

1 WEEK

2 WEEK

3 MONTH

"I am confused between 1 month and 3 month but it asked for how much time to
regenerate from basale layer, so i picked 1 month, if it would have asked, how
much time would it take to completely regenerate, i would have preferred 3
month "

133. A patient known and under treatment for C DIFFICILE

to prevent spread to other patients floor should be washed with

"BLEACH, "

CHLORHEXIDINE

HYDROGEN PEROXIDE

"134.a child presented with high grade fever, which resolved on its own, he had
single episode of seizure, followed by rash most likely cause of the symptoms is "

HHV 6

PARVOVIRUS

RUBELLA

MEASLES

"135.a patient presented with undercooked hamburger, with nausea, vomiting,

and diarrhea, patient is at greatest risk of "

TTP HUS

PROLONGED DIARRHOEA

BLEEDING MANIFESTATION

"136. A sample from EBOLA epidemic area was analyzed for molecular anaylysis,
for it to replicate, what is, most essential enzyme, "
RNA DEPT DNA POLYMERASE

RNA DEPT RNA POLYMERASE

DNA DEPT RNA POLYMERASE

DNA DEPT DNA POLYMERASE

"137. A patient who presented with persistent itching since months, physician
visited his house and collected sample shown in pic, pic was of bed bug "

This will most likely transmit following organism

STAPH AUREUS

HEP B

Hep C

HIV

138.an antibody and antigen titre shown where will be the maximum reaction

ANTIGEN : 1.+++ 2. ++++++ 3. ++++

ANTIBODIES : 1.+++ 2.+++ 3.++++++++++

"I selected 1, both titre in equal titre, reaction will be maxm, maximum "

Lattice formation

"139. A patient was on ibuprofen and new medicine, after 2 weeks therapy he
developed chronic interstitial nephritis, whom to report first. "

FDA

LOCAL REPRESENTATIVE of ANTIBIOTICS COMPANY

STATE MEDICINE BOARD

Final thoughts

"Past qns are extremly helpful not because you will get same repeat questions,
but because you get to know familiar options that helps to rule out other options,
"

"I personally highly recommend doing remmbered questions, they just help
where uworld, first aid, pathoma, golijan,nbme misses to teach, or we fail to
learn, "

"when done in groups they are gold, please don't ignore them, it took much time
for me to realize that, "

"Best of luck for all, happy reading

July 5th
=====
Behavioural Science

1. Patient wants to inhaler, but can't afford, not an

emergency situation. What should the doctor do?/ send
her to the emergency department/ Give her 50 dollars/ tell
her you can't help her because it is unethical/ ?
2. Drug trial, Which stage requires to monitor
pharmacokinetic and pharmacodynamics of drug?
3. Patient’s daughter and talks about her father. She lives in
another state. What should your response be? / Keep
listening to daughter concern / Ask the daughter to take
active involvement in father care
4. Patient keeps talking about everything, in order to control
that you interrupt her and what should you say next?
Looks like you have a lot in mind today, let's get over the
topics that concerns you the most/ can we get to the part
where you mention about disease./
5. Insurance man tell you to drop diabetic patients because
they never show up for regular check up’s. What should
your response be like? I can not drop patient's/ Let me talk
to those patients before we drop them,may be i can
change their mind/ yeah i think we could save a lot of
money if we did that? ( This was my first question)

========================================
===============================
Biostats

1)Calculation of NPV
2) Calculation of Confidence Interval
3) Gaussian Curve, why is the curve bell shaped ? Cause the
sample size with 5000
4) Calculate Prevalence and Annual Incidence rate from (
previous question)
5) Attack rate, two attack rates were given,did not have to
calculate, just asked which food caused this outbreak. First row
showed that the people developed illness with food and second
showed people who developed illness without taking food.
Deviled Eggs/ potato salad

Biochemistry

1. CV of TS/ Subependymal tubers

2. CV of NF/optic gliomas
3. CV of Achondroplasia /inhibits chondrocyte proliferation
4. CV of HNPCC/Lynch Syndrome 17 year old boy with
colon cancer and father had colon cancer too, what's the
mode of inheritance ? APC/Microsatellite instability ?
5. CV of Xeroderma Pigmentosum with picture showing skin
lesion, gets burned every time goes out. Mode of
inheritance Nucleotide excision repair
6. CV of women with endometriosis and colon cancer.
Cause?/Mismatch repair
7. MTX toxicity, Folinic acid is given, which enzyme does it
by pass?
8. Live is donated to bother, and the remaining liver
generates from which cells?/Hepatic cells
9. Gamma Carboxylation of protein happens in which
organelle?/ER/Golgi
10. CV Zellweger's Syndrome, which organ involved?/
Peroxisomes
11. CV of a boy with multiple skin blisters and tibial
fracture just few months old baby, what the defect in ?
Options had Type four Collagen defect/ Pemphigus
Vulgaris/ Bullous Pemphigoid
12. CV about a boy with kidney problems and relatives
had hearing and eye problem and pedigree was also
present. Where is the defect in? Type IV collagen
13. CV of Klinefelter's Syndrome. Defect in?
14. Male with refractory Acne, Vitamin A was give,
develops alopecia, dry skin (eg,scaliness). What causes
this? Isotretinoin toxicity
15. Person taking Isoniazid, develops peripheral
neuropathy. What vitamin is the reason behind? Vitamin
B6
16. Biotin deficiency with too much egg, which pathway
is decreased? Alanine to Glucose
17. CV of CKD and question was regarding the decrease
in which vitamin? 1,25-(OH)2 D3 (calcitriol)
18. Kid with rickets and decrease in Phosphate, calcium,
where is the defect in ? PTH with Gs/Gi/Gq or Calcitonin
Gs/Gq/Gi
19. GGP Dehydrogenase Deficiency, what happens to
NADPH, Glutathione Reductase and Suphahydrl groups
with arrows
20. Aldose B is deficiency which food to avoid ? Sucrose
21. CV of Urea cycle defect, what increases in blood?
22. CV of Pompe disease, PAS stain of heart, what is
accumulated? Glycogen
23. Systemic 1° carnitine deficiency, question was about
which pathway will be least possible? Decrease in
NADPH, decrease in energy for Gluconeogenesis.
24. Leucine Zipper, what the characteristic of one of two
helix? ( U world assessment) Hydrophobic
interaction/Hydrophilic
25. CV of kid with starvation for more than a week, the
brain utilizes which pathway to provide energy? Ketone
body synthesis
26. Remnant defect of Lipoproteins, where is the defect
in ? Apo E
 27. Patient develops negative bifergent crystals ( with
picture) after taking Lipid lowering drug. Which drug
caused it? /Niacin
28.

Microbiology

1)Graph of DHR test, question was about which Organism

would this person be susceptible to?/ CGD Catalase postive
Organism/ Stap Aureus
2)CV of Interstitial pneumonia suggestive of Mycoplasma
Pneumonie what antibiotic to give? Azithromycin
3)C/V Gas Gangrene, what can this organism turn to?
/Endospores/ capsulated
4)Picture showing Coccoidioes. What's characteristics? Glucan
5) Question with bacterial Genetic transfer
6)Endotoxin is responsible for release of what?/ Cytokines
7)Pic of Cellusitis with Gram + organism in chain( from NBME)?
Organism Involved? Strep
8) Dental Extraction, later develops murmur?
9) Pregnant women with vaginal swab positive for
Streptococcus agalactiae (group B streptococci) what antibiotic
to use? Ampicillin
10)C/V of Tuberculosis, chest x-ray findinga and symptom will
guide you. what organism?
11) C/V Gonorrhea with pic ( NBME), what organism?
12)Ulcer in patient, in addition of antibiotic what to use? PPI
13) C/V of Chlamydia Infection. What can be found in
specimen? Reticulate body
14) Baby with features of congenital infection with hepatitis.
CMV/ Step/ all other options were bacterial
15)HIV patient with Pneumocystis jirovecii ( X-ray + slide) what
is deficient in order to cause this? Tcells/ Neutrophils/Mast cells
16) US Army guy went on a mission, develops pink colored (
pic given) slightly raised. Something like this. Gave a guess.
Microorganism only mentioned./? Leishmania???.
17)Mechanism of metronidazole.
18)Treatment of Trichomonas Vaginalis
19)Chloroquine works on which stage of Malaria? Merozoites /
hyponozites/ spermatoids
20)Some virus undergoes dissection with DNAase/heat/ether.
What finally remains? Non-enveloped RNA/DNA eneveloped/
uneveloped DNA etc
21)C/V of Kaposi sarcoma. Histology shows spindle cells. Its is
defect of? Neoplasm of endothelial cells
23)C/V of Encephalitis involving temporal lobe? Which
organism responsible? Herpes
Simplex virus.
24)C/V of Mononucleosis, monospot test—heterophile
antibodies detected by agglutination. What cells were initially
active in the early phase of the disease?
Neutrophils/macrophages/ T-cells
25)Hepatitis, patient was given vaccine before travel to some
place then she develops hepatitis stiil. Labs showed that she
received hepatitis A vaccine ( anti HAV IgG),Anti-HBS +ve and
Hepatitis E IgM and IgE +ve. What is the organism
responsible?
26)Pic with Cervical carcinoma, both gross and histology,what
the most major risk factor for developing? HPV/nulliparity/ early
menarche
27)2 Men travel to Oklahoma forest, days later die suddenly.
Brain Biopsy shows vacuolation. The defect is in ? CJD Protein
defect
28) female travels to Middle east, develops hematuria. What
organism involved? S.hematobium
29)Patient has fever 102 degree celcius, develops UMN signs?
Which organism is involved?
Cryptococcus ??
30)Osteomyelitis in Kid, what organism is responsible? Staph
Aures
31 ) C/V suggestive of viral fever and pericarditis? Causative
organism ?Coxsackievirus B
32)Amoxicillin+ Clavulanic acid is given for ear infection.
Resistance is due to? penicillin-binding protein site chage
33)M/A of Oseltamivir? Decrease progeny release

Immunology

1. Patient develops Laryngeal Carcinoma. What LN will drain

it first? Supraclavicular/ Deep Cervical
2. Flow Cytometry was given showing all the T cells in all
four quadrants. What organ can we see this in? Thymus
3. C/V of Myasthenia patient. What else can we see? Thymic
Hyperplasia
4. Transgenic mice experiment, Toll like receptors/
Complement product and Fc is absent. Macrophage will
have hardest time recognising pathogen due to loss in
which component ?
5. Antibody cleaved by papain.Fab is capable to do what
still?
6. Neisseria Meningitidis in a kid, brother died due to similar
condition. Patient is deficient in what C9/C3/
7. Sucrose test done on RBC’s and lysis occurs.RBC’s lacks
what? DAF (GPI-anchored
8. enzyme) deficiency
9. B-cell does not become activated this is due to ? Anergy
10. Man buys a watch then develops skin rash( pic was
give) darkish brown color, what cells are present?
CD8+ve/ B cells/Macrophages/Eosinophils
11. Blood group A+ve patient receives blood from a O
+ve patient, patient develops hemolytic reaction. Cause
is? Anti A-Ab / Anti-B ab
12. CV of Bruton agammaglobulinemia, all the lab values
were given with decrease in all immunoglobulin. What test
to do next? Flow Cytometry ?(to rule out SCID’s?)
 13. Vasculitis of graft vessels with dense interstitial
lymphocytic infiltrate. What's the pathology? Acute
Rejection
14. Patient taking Immunosuppressants and develops
fungal infection. What’s the reason behind developing
fungal infection ? Unable to activate T-cell activation by
preventing IL-2 transcription

Pathology

1)Experiment trying to show intrinsic apoptosis, what do we

monitor? Membrane cytochrome c release
2) Experiment in which said that the ball is coated with P/L-
selectin and for tight adhesion what molecule should be present
in a vessel wall? Integrin
3)What's the cause of metastasis of a cancer, what enzyme is
involved in breaking the ECM? Metalloproteinases
4) What's the cause of Parapneumonic Pleural effusion?
Hydrostatic pressure increased/ inflammatory lung/ increase in
pressure due to pus accumulation
5)C/V of Lung mass in upper lobe and hyponatremia. What's
the cause ? SIADH
6) Japanese Man with gastric cancer, risk factor is?
Nitrosamines
7) Patient has history of Ionizing radiation, what’s the increased
risk in this patient? Papillary thyroid carcinoma

Pharmacology

1. Graph has to identify,which drug has Constitutive Activity?

2. Graph had to identify non-competitive antagonist?
3. Drug X was given with Succinylcholine and the activity
increases in phase I but in phase II the action decreases.
What drug is used? /?Neostigmine( partial agonist)
4. Mechanism of Amphetamine in ADHD? Reuptake
inhibitor of what? Dopmaine/NE/ Serotonin
 5. C/V of child with hepatic encephalopathy. What did the
patient give the child? Acetoamiophen
6. Bioplar patient develops constipation? Cause ?
Hypothyroidism

CVS
1)Two Heart Sounds MR and TR
2)ECG and CV suggestive of Atrial Fibrillation. What drug
should the patient be sarted on ? / Warfarin
3)Starling Curve with CV suggestive of severe Heart failure,
drug was given to increase contractility. What drug was that?
Dobutamine
4) CV suggestive of Heart Failure. What the cause of S3 heart
sound? /rapid ventricular
filling phase
5) Wide fixed splitting of second heart sound. Diagnosis? ASD
6) Stenotic coronary artery, what changes can be seen post
obstruction? / increase in ca2+/plasma membrane damage
7) CV of cardiac rupture in a patient, what caused it?
Macrophages/ Neutrophils/fibrin
8)Picture of Pericarditis, had to identify the cause ???
9) CV of pregnant women, what can be seen in heart? DCM
10)CV of Athlete, severe pain in back right before pay-off then
suddenly collapses and low JVP and pulse. What's the cause?
HCM?
11) CV of female patient develops vision problems which
resolves on its own. She also complains of pain when wearing
hat. What test should be done? ESR( Giant Cell Arteritis)
12)CV Granulomatosis with polyangiitis (Wegener). What
vessel involved? Small vessel vasculitis
13)Mechanism of action of Nitartes/Increases cGMP
14)CV of SVT, treatment which involves hyperpolarization ?
Adenosine
15) CV of Turner's syndrome with cystic hygroma, this mass
arises from ? Endothelium?/ lymphatic vessels/
Endocrine

1)CV of Insulinoma in Adult, mass resected what can be seen

in histology? /Beta Cell Hyperplasia
2) CV of pituitary adenoma with Acromegaly. What increases ?/
Growth hormone (somatotropin)
3) CV of CAH, which enzyme was missing? 21-hydroxylase
4) CV of women ( XY) has normal breast and suddenly she
starts to develop facial hair and hoarseness of voice ? Which
enzyme is deficient ? / 5 Alpha reductase inhibitor?
5) Two graphs with Calcium and PTH hormone association in
CKD
6) Arrow questions with calcium, calcitonin and Vitamin D in
CKD
7)CV of old women with constipation for a prolonged period of
time and takes over the counter laxative for it chronically. Now
presents with weakness. What’s the
diagnosis?/Hypothyroidism
8) Cv of hypothyroid patient, now presents with RR-12
beats/min. What will be High? PaCo2/PaO2 /Diffusion
9)CV of Athletic patient using anabolic steroids and testicular
atrophy. What does the hormone responsible for this act on?
/Nucleus
10) Picture showing Conns Tumor, the serum sodium was low
and features of hypertension. What enzyme is released by
tumor? / Aldosterone
11) CV of Hashimoto thyroiditis, they just wanted the diagnosis
12)CV of Pregnant women with features of hypothyroidism
only, lactation not hampered. Diagnosis?
/Hypothyroidism of Pregnancy
13) CV of Bipolar patient taking Lithium and then develops
extreme thirst. Labs suggestive of DI
14) CV of boy with DM features, what's the etiology
? Infection/HLA-DR3
15)CV of DKA patient, what should be given now?
Insulin/Glucose/

GIT
1. CV of Hypertrophic pyloric stenosis Pathogenesis?/
Decrease in NO
2. Need to stop bleeding during cholecystectomy, what
artery should be ligated ? Rt Hepatic artery( Bascially
wanted to know where the cystic artery came from)
3. Hepatic Flexure ischemia of the colon and now they
wanted to do embolization, so which artery is should be
used? The choices involved all the branches of IMA and
Superior mesenteric artery. / Ileocolic artery
4. CV of Hepatic Carcinoma,portal hypertension, now the
patient will develop hypertension in which vessel?
Superior rectal/ other options did not involve portal
circulation vessels
5. Femoral Triangle, a female 16 years old develops mass in
the femoral region, the mass will be located in ? medial or
lateral to NAVEL
6. CV of Pancreatitis, what the enzyme that causes
autodigestion of the pancreas? /Lipase/
7. What's the function of the enzyme that causes the
autodigestion of pancreas in pancreatitis? Degrade
proteins, phospholipids, carbohydrates ?/ phospholipids
8. Pic of Achalasia with Vignette and asked about etiology
?Nitric Oxide?
9. Patient comes to the ER with bloody vomiting two time
today, previously she had similar episode but the vomitus
consisted of blood and food. She also complains of
epigastric pain. Where is the pathology in ? Pharynx/
nasopharynx/ esophagus/stomach/ duodenum
10. CV of Wilson's with Kayser-Fleischer ring picture.
What the pathology? Autosomal Recessive Genetic
condition/
 11. CV and X-ray of Chronic pancreatitis, the patient has
repeated history of abdominal pain and sticky stool.
What's the pathogenesis behind the sticky bulky stool?

Hemato-oncology
1. CV of boy with constipation. Picture of Basophilic
Stippling. What should be checked in ths patient? Heavy
Metal blood content
2. Patient has pneumonia and also has Cold IgM agglutinn.
Whats the organism ? Mycoplasma pneumonia
3. CV of bloody diarrhea, petechial rash on pharynx,
PBF shows schistocytes. What's the diagnosis?
/Microangiopathic anemia
4. Mechanism of action of Clopidogrel?

Musculoskeletal and Dermatology

1. 3d MRI showing Hip bones, what action can not be

performed if fracture takes place at this site?
Abduction/adduction/ flexion/extension
2. Two questions regarding rotator cuff muscles, one
question was about patient is unable to internally rotate
the arm and the other was patient was unable to adduct
3. CV OF Osteopetrosis, the defect is in ? Osteoclast/
osteocytes/ osteoblast ?
4. CV of rickets, up and down what's the labs like?
5. 50+ year old women with well controlled paget's disease,
then she starts developing bone pain. What's the
pathogenesis? P53 mutation/
6. CV of reactive arthritis
7. Two questions regarding the Sarcoidosis the vingette
were easy to pick up just waned to know diagosis and the
other question wanted to know the histology.
8. CV of women with muscle pain and picture showing
Dermatomyositis, what's the underlying pathology behind
this? Maligancy/
 9. Picture of Mongolian spots on baby. Pathogenesis?
Dermal neural crest migration defect
10. CV of man with severe dryness in his skin. He also
has increased cerumen production and presbyopia.
What's the pathogenesis? Normal Aging/ Eczema
11. How would manage acute gout?
12. CV of Diabetic man with severe foot pain especially
metatarsophalangeal joint involvement , what's the
diagnosis?/ Uric acid accumuation/peripherial neuropathy
( My answer Diabetic nephropathy→ unable to excrete Uric
acid---> Urate crystal deposition)

Nervous system

1. Gross pathology of Chiari II malformation. This patient

also had an associated condition of ?/meningomyelocele
2. Patient has difficulty in feeling sensations in face. Stroke
involves which part of the brain? Ventral posteroMedial
nucleus of Thalamus
3. Tumor resected due to tumor, gross picture showing
absence of hippocampus and amygdala. What structure
will also be resected? / Hippocampus
4. CV of Charcot-Bouchard microaneurysm. What's the
underlying pathology? Chronic Hypertension
5. Tumor obstruction in cerebral aqueduct which ventricles
will enlarge?
6. Spinal Cord section picture, pointed to Intermediate horn,
what are the fibers that arise from that?
7. CV suggestive of Anterior Cord Syndrome.
8. Rinne test and Weber interpretation
9. CV of Alzheimer's disease, What's the pathogenesis ?/
presenilin-1
10. What’s the most important risk factor for development
of MS? female/ no other suitable option was there, i
thought of whites living further from equato which was not
there..
11. Histology of GBM, just wanted diagnosis.
Psychiatry
1. Defense mechanism, CV’s were easy to pick up, I had
questions on Displacement, Splitting
2. CV of Autism Spectrum Disorder
3. Kid who talks normally at home but does not talk in
school. At the doctor's office also the kid does not speak.
Diagnosis? Social anxiety disorder / selective mutism
4. US Soldier returns from war and has amputation of left
arm, now presents with pain in the left forearm ? Chronic
regional pain/ PTSD / a lot of new options never heard of
5. female , chronically presents to the hospital with skin
ulcers. Nurse caughts the patient while she was mixing
her feces with ulcer, and she says that “ I don't know why I
keep doing this to myself? / Factitious Disorder/ OCD
6. CV of ADHD,what's the mechanism of action of
amphetamine.
7. What antidepressant drug should be avoided in Eating
disorder?/Bupropion
8. Patient wants to quit smoking , no mention of decreasing
craving, what drug to be given ?/Varenicline
9. Overdose question with acid base abnormality, please
learn acid base status for all Stimulants and Depressants

Renal
1. CV of Wegener's, what can be seen in light microscopy?
2. Picture showing Glomerulus with numerous leukocytes,
older patient has history of URTI and then started to have
hematuria and proteinuria. Whats deficient? And whats
the diagnosis?
3. SLE patient with nephrotic features, what's the diagnosis?
4. X-ray of right kidney stone with history of repeated pain in
flank with radiation to groin. What's the diagnosis? /
Nephrolithiasis
5. CV of mass in flank with Aniridia (absence of iris), what's
the gene involved?/ WT1
6. Pathogenesis of lithium involved Nephrogenic DI
 7. Patient using diuretics develops hypokalemia what should
be added to that?
8. AT-II receptor blocker and how does it decrease GFR
initially ?

Reproductive

1)PDA arises from which aortic arch?/6th aortic arch

2)Inferior parathyroid gland arises from which pouch? / 3rd
pouch
3) Before the cervical dilatation occurs in labor, patient starts
experiencing pain, which ligament is stretched? Uterosacral??l/
round ligament/ Broad ligament
4) Some cells are bound by zona occludens, which cells are
these? Sertoli/ Leydig
5)Male patient has infertility problem, it was found that
spermatogenesis was hampered due to heat changes in the
testis. What's the diagnosis? / Hydrocele
6) Pregnat+HTN patient, what next to check?/ Proteinuria
7)Lichen Sclerosis, what's the risk factor?
HPV?/Smoking/Infection
8) Breast Cancer, please learn all the histology with pics, got
LCIS.
9) BPH gross pathology of bladder, what causes this?
10) BPH CT scan, what organ will be compressed?
11) Leuprolide is given continuously what happens to
testosterone, LH ?
12) Phosphodiesterase type 5 inhibitors, mechanism of action

Respiratory

1. Oxygen Dissociation curve, why the curve shifts to the

right ?
2. Person decides to go to hike and takes acetazolamide,
what happens to the oxygen dissociation curve ?
3. CV of Asbestosis, increased risk of ?
4. CV of Coal workers’ pneumoconiosis.What can be seen in
histology ?
5. CV and picture of ARDS histology, just asked diagnosis
6. Sleep Apnea, what's the etiology ? / atony of pharyngeal
muscles?/ did not see excess parapharyngeal muscle in
the choices
7. Cytokeratin and calretinin ⊕ diagnosis?Mesothelioma
8. Patient develops hoarseness of voice, picture of larynx is
give, one side of the vocal cord in adducted and the other
abducted. In the question, it was asked where the tumor in
the lung is in ? Right lung UL,LL/left lung UL LL
9. Long CV and histology shows cells with large number of
long, slender microvilli tonofilaments also present. Dx?
Mesothelioma
10. CT showing a mass obstructing a vessel, vignette
about a women with puffiness in face in sweeling in both
arms. What's the diagnosis? / Superior venacava
11. Asthma management,what to do next in a person
wakes up three times a week due to attack. The patient is
already taking inhaled beta agonist?
12. A patient decides to get high on cough suppressant,
what's the most likely drug that he took ?
Dextromethorphan/Guaifenesin/N-acetylcysteine
13. Graph depicting three drugs that increase or
decrease PG and Leukotrienes. Had to identify which drug
was X, Y, Z. Options included Aspirin, Zileuton and
Prednisolone.
Questions were familiar but cases were vague and options were
difficult. Cool mind is as important or more important than
knowledge.

 Gastrinoma- parietal cell hyperplasia

 Role of cysteine in phagocytosis: I have no idea

 Diabetic mother, hyperinsulinemia, beta cell hyperplasia and

hypoglycemia in infant

 EKG of chronic renal failure: peaked T waves were present –

hyperkalemia

 Treatment of malabsorption – pancrelipase

 Italian pale n weak with antibiotic use – G6PD def

 Murmur of AS, MR and TR

 Drug causing pulm fibrosis – amiodarone

 Man returned from middle east pancytopenia – leishmania

 Many pictures of gross brain

 Usg of yolk sac

 Amyloidosis

 Stone in crohns dz –oxalate

 Mechanism of acne by testosterone

 A man suffering from arthritis and relieved after his morning

walk is pale and lethargic, which drug if added will help him

–Leukovorin (methotreaxate-RA)

 21 hydroxylase def

 MOA of hydroxyurea – ribonucleotide reductase inhibitor

 Elementary bodies found in genital tract, risk for baby

 Identifying aspirin, zileuton, prednisolone and celecoxib I a

graph of PGs and LTs.

 a trial done to define causation of ADHD and prematurity,

1000 premature and 2000 mature children are followed over

5 years and then examined by paediatricians, type of study:

clinical trial and cohort (I chose clinical trail as both outcome

and exposure was set by researchers)

 lesion produced in PPD (I was confused between

macrophage and CD8+ T cells. In a question it was written

CD8+ T cell is responsible for cutaneous lesion in poison ivy,

both being type 4 I chose CD8 cells, may be I am wrong)

 patient oin metformin+Glypizide, which drug to add? Options

were 1. Acarbose, 2. Insulin lispro 3. Insulin glargine 4.

 Insulin aspart (I chose insulin aspart, had no idea wat to

chose)

 a female has pain in wearing old hat – pituitary adenoma

 confidence interval

 normal curve

 all ethics questions were doable, one was confusing: a man

falls sick, lives alone, visited occasionally by son and

daughter lives in another state, daughter calls and

expresses her concern; 1. Listen to the daughter (I chose)

2. Ask daughter to assign family spokeperson between her

and her brother

 sacoidosis (case was vague; but AFRICAN AMERICAN

FEMALE, so I chose option of non caseasting granuloma)

 transgenic mice (very difficult, immune system + transgenic

mice)

 biostat questions twisted but doable (I question was very

long and needed multiple calculations, may be I had no idea

of shortcut, had no time nad I ticked randomly) question

was: In a population of 200 there are 20% HPV positive

cases in first year, the % increases to 32% in next year and

 43% in third year. Calculate annual incidence and

prevalence rate

 founder effect

 HIV patient with CD4+ cells <100 and HCV positive. Wat to

add in therapy: 1. Azt 2. Interreron alpha (I chose) 3. TMP-

SMX

 MRI of brain, symptoms of hungtintons like dz, arrow in

caudate area, where will axons project? I chose thahlamus

in hurry but it must be globus pallidus.

 A man gets infected after moving in woods of his nurding roo

and dies in 18 month- CJD

 Lewy body dementia

 Graves disease

 Hashimoto thyroiditis

 5-6 up and down questions about hypothyroidism

 Spial cord section, lesions described in very very long

vineatte, confused between lesion in cervical or thoracic

 Slide of atypical lymphocyte

 EBV- Heterophile antibody test

 A man wounded in chest in MVA, dies, wy he dies: 1.

Neutrophil could not phagoctose 2. Etc hard options

 ADPKD

 ARPKD

 Gross picture of osteosarcoma, muatation in 1. P53 2.

Exostin 1

 Histo slide of lobular/ductal carcinoma to identify

 A 8 yr old girl with clear vaginal discharge, cleans genitals

with soap; cause: 1. Bact vaginosis 2. Increased gardenella

number (I chose as no whiff test or other specified)

 A parent of 2 month old child come to assess his risk of

falling for next 2 months which is correct? 1. Risk of fall while

standing 2. Risk of fall from bed 3. Risk of fall from stairs 4.

No risk at all (I chose as child cant roll until 4-6 month)

 Hepatic encephalopathy in alcoholic confusing with

wernickes encephalopathy (aterexis given)

 Hypothyroid patient, wat is increased: 1. Alveolar co2 2.

Alveolar o2 3. Diffusion capacity $. Inspiratory capacity 4.

Expiratory capacity ( had no clue in xm due to lack of time,

may be due to weak muscles, of GAGs deposition, find this)

  Well child with 12 mg/dl direct bilirubin – others options not fit

except biliary atresia

 Difficulty swallowing liquid n solid, CV to rule out CREST

syndrome, problem in : 1. NO production 2. Smooth muscle

I chose 1

 Interleukin clearing inflammation : IL 10 ( I chose dunt

remember other)

 Post MI change in 12-24 hrs (no eosinophilia and contraction

band necrosis) : I chose loss of myofibril other options were

1. Loss of cell membrane (necrosis, should be after 24 hrs,

not sure check well) 2. Lots of macrophages 3. Granulation

tissue

 A man treated for hospital acquired diarrhea with metallic taste

– metronidazole

Q. In a population of 200 there are 20% HPV positive cases in

first year, the % increases to 32% in next year and 43% in third

year. Calculate annual incidence and prevalence rate

Ans : Incidence at end of 3rd year is new cases that yr divided by

at risk pop at the beginning of 3rd yr. so new cases:43% -

32%=11%of 200=22

And at risk pop: 200-32%of 200=136

So annual incidence at end of 3rd yr = 22/136

Hello guys these qs are totally written on the basis of memory and
expressed on subjective perception

BEHAVIOURAL SCIENCE

1. q explained about a disease and asked which study is to know

prevalence.

2.Study is to be done in 18-24 year old randomly selected from

population to know about new drug for hypertension ..not much hint
i optio s all the phases of RCT as the e … ell I ti ked phase 1

3.In a village diz X prevalence was given , in another village same diz
X prevalence was given , asked about the its effect in positive
predictive valve in accordance to prevalence of diz X with lower
prevalence.

4.this is a past q asked to analyse about the

Left is post op and right is pre-op

Pre-op opoid administration and post op opoid administration. X axis

is pain perception from 1 to 10 and y axis is no. of pt. sorry cant
e e e the optio ….as the g aph at hes ith ske …there was
option matching to negative skew(I ticked this )…I got o fused ith
one option that says about increased range ..
5.A study done p=0.05, confidence interval given mean given asked
a out ….. e plai ed sth a out t pe e o a d asked to fi d out
False positive

a) 5% b)0.5% c)50%.....

6.A study done , mean given ,SD given and says it follows bell graph
a d eed to fi d out a ge…. a ge at hes to optio ..

7. q explained about triage and asked to identify ethical principles

…JUSTICE as the e i optio

8.An ethics q was there saying a pt cannot speak English ,son can
speak both English and his native language,pt symptom explaind was
kind of not e e ge … at should u do …..a)ask so to t a slate.
b)get a hospital staff who can translate. c)get a professional
t a slato …

9.developmmental milestone q 8 mth old he can roll ,raise his head,

sits without support, raises both hand to catch objects,cries wen sees
stranger but could says ma-ma.wat about motor Normal/abnormal,
social N/abn. , verbal N/abn. I ticked all normal

BIOCHEMISTRY

1.An experiment q explained saying a factor wen binds to DNA

increases transcription and wen removed transcirptiond does not
o u ..optio i luded it a et lates a d dea et lates ….

Microbiology

1.picture of blastomycosis

2.picture of Cryptococcus

3.picture of pneumocystis jirovecii same picture of FA 2016

4.C/V asked about the gardner in which q says lymphangitis
… hi hof the follo i g at hes ha a te isti of o ga is

a)Dimorphic was in option

. / of s histoso a gi e a d asked a out host…SNAIL as the e i

option

6.q asked about which virus is envolped virus sorry guys don’t
e e e i uses a e …

.pi tu e of he pes i a k he e does its late t phase eside ….

8.diarrhoea clinical vinette all viruses was there in option a)rotavirus

b)Norwalk virus

9.c/ of osteo elitis i old hild …o ga is ..staph.au eus

.pt is o iso iazid …a a ia p ese t …. at t pe .. i o ti

11.which of the following drug affect cell memberane of fungi

…a pho B

12.which of the following drug affect cell wall synthesis

… aspofu gi as the e i optio

IMMUNOLOGY

. / of a a s ess p ese t i pe ia al a ea …sup. I gui al l ph

node was there in option

.C/ a out RTA sple e to as do e … hi h of the follo i g ill

be affected a)chemotaxis b)margination c)opsonisation’

3.chemotaxis :-C5a

4.IL-5 = stimulates growth and differentiation of eosinophils

5.C/V of SCID
 . / of sepsis looks like DIC ith eutope ia … oth a te ia a d
candida was in option

7. hi h d ug affe ts i di g of platelets a d platelets ….a i i a

8.lights criteria:it was exudates

.the e as t o i t o hit theo …

10.c/v of hepatocellular ca in chineese pt ..wat is due aflatoxins

11.
1. Transudate (Light’s Criteria for pleural effusion)
2. SCC of lung ( Central tumour, hyperCa)
3. Sleep Apnoea
4. ARDS(Pulmonary congestion w/ Normal PCWP)
5. Lung CT in Idiopathic pulmonary fibrosis
6. Bronchiectasis (C/V of Kartagener, what would you expect)
7. What spirometric parameter inc in Emphysema (RV)
8. DVT
9. Oxygen disso curve
10. which lobe is more susceptible to aspiration while standing (Rt inf)
11. where are large particles >10micron trapped
12. Down’s synd (changes in AFP, hCG, estriol given)
13. Letrozole MOA
14. PCOS: inc oestrogen from adipose due to DHEA aromatisation
15. Pre-eclampsia dx
16. C/V of Klinefelter, karyotype?
17. HHAVOC symp, Dx? Menopause
18. which cell has Aromatase? Granulosa cell
19. pudendal n injury with perineal tear
20. inf PTH gland from 3rd pouch
21. stylopharyngeus supplied by IX
22. omphalomesenteric cyst is a derivative of
23. Fetal alcohol syndrome
24. organ morphogenesis error (Deformation )
25. had to recognise neural crest derivative from given options
26. holoprosencephaly gene mutation? Sonic hedgehog
27. hypercalciuria treatment? Thiazide
28. serum [H+]/[K+] change with thiazides
29. ATN : muddy granular cast
30. C/V of bladder cancer: identify the risk factor
31. pic of staghorn calculus and hx of UTI: which stone? amm mag phosphate
32. crescentic glomerulonephritis: Ab against which structure? GBM (Goodpasture)
33. had to recognise type of acid base abnormality
34. MOA of BNP
35. segment of nephron whose water permeability is adaptable? Collecting tubule
36. Calc of GFR(using creat)
37. Calc of RPF (using PAH)
38. St John’s Wort: enzyme inducer
39. how does Lithium cause DI
40. C/V of Dystonia. which drug? Haloperidol
41. Clozapine: Agranulocytosis
42. MOA of CNS stimulant
43. C/V of Opioid withdrawal
44. C/V of Person in preparation phase of behavioural change
45. Schizoid personality D/O
46. Antisocial personality D?O
47. Munchausen’s syndrome by proxy
48. Diff between obsession and compulsion
49. C/V of Atypical depression. MX? MAO inhibitors
50. C/V of Major depression
51. Countertransference
52. Q on parkinsonism
53. Q on Alzheimer
54. Craniopharyngioma ( BT hemianopia in child, which CNS tumour?)
55. Prolactinoma (BT hemianopia in adult, what is common)
56. Hereditary demyelination of motor and sensory neurons. (Charcot marie tooth?)
57. Lt homonymous hemianopia, where’s the lesion?
58. recognise foramen rotundum on a pic of skull showing cranial fossae
59. LMN features only, what’s affected? Anterior motor horn neurons
60. some question on nucleus gracilis i guess
61. CT of Normal Pressure Hydrocephalus
62. Couple of questions on Sub Arachnoid Hmg
63. hypertensive, tremor, hemiballism. which vessel involved? lenticulo-striate?
64. motor/sensory loss of upper limb . MCA territory
65. CN III palsy with Post comm artery aneurysm
66. fluent, comprehension intact, no repetition. Conduction aphasia
67. C?V of huntington’s. Caudate involved
68. CNS phagocytes. MIcroglia
69. C/V of syringomyelia, which fibres involved
70. C/V of meningomyelocele. what else can be expected.. Hydrocephalus?
71. Infliximab MOA
72. Albinism cause? dec tyrosinase activity (failed neural crest migration was also an option)
73. Thymoma (myasthenia graves assos with)
74. Anti jo Ab : polymyositis
75. C/V of Sarcoidosis, risk factor: ethnicity
76. ANA: SLE
77. nodes on PIP and DIP: OA
78. C/V of Paget’s dzs of bone, tumour shown on gross. Osteosarcoma
79. some question on hip trauma resulting in dec knee extension, i was confused between rectus femurs
and vastus lateralis
80. inability to extend thumb, which n injured? post. interosseous n? radial n was also an option but the pt
could extend wrist
81. peripheral neuropathy with vincristine
82. hmg cystitis with cyclophosphamide
83. TRAP positive hairy cell leukaemia
84. C/V of multiple myeloma
85. C/V and lab values of haemophilia
86. C/V of Acute intermittent porphyria. enzyme def Porphobilinogen deaminase
87. menorrhagic female, PBS shown: Fe def anemia
88. traumatic hemolysis, what do you expect to see: Schistocytes
89. Macrophage marker: CD14
90. Myeloperoxidase produced by
91. Sibutramine use
92. few questions on PPI
93. C/V of chronic pancreatitis, what to give: pancreatic enzymes
94. FAP: autosomal dom mutation in APC
95. C/V of peutz jeghers: hamartomas in GIT
96. Q on NEC
97. C/V of IBS
98. question on chronic gastritis
99. C/V of gastrinoma, what happens to pancreatic secretion?
100. C/V of direct inguinal hernia
101. pic of int hemorrhoid
102. arterial supply to splenic flexure of colon
103. content of hepatoduodenal ligament
104. CXR and C/v of cong diaphragmatic hernia
105. ret gene mutation in MEN
106. PTH level vs Ca++ level graph, which falls under normal? Osteoporosis
107. C/v of pseudohypoPTH, changes in Ca++ and PTH levels
108. Calcitonin produced in medullary ca of thyroid
109. C/V of de Quervain’s thyroiditis
110. C/V of pheochromocytoma
111. 21-OHase deficiency
112. where is aldosterone produced? show on histology section
113. how to prevent flushing with niacin? give prior aspirin
114. C/V of wegener’s granulomatosis. c-ANCA positive
115. C/V of Kawasaki. what else to expect? Coronary aneurysm
116. C?V of LA myxoma
117. S3: Systolic failure
118. S4: Diastolic failure
119. 5 days post MI, free wall rupture. mechanism?
120. C/V of aortic dissection
121. Couple of ECGs forgot which ones, seemed easy back then
122. Heart sounds: AS and MR, pretty obvious from history as well
123. transverse CT of thorax, identify aortic valve
124. wide Fixed splitting of S2 heard. ASD
125. Q on Starling curve change with heart failure
126. Q on endocardial cushion defect
127. Pheochromocytoma sx, what’s given prior? Phenoxybenzamine
128. Mx of atropine overdose. Physostigmine
129. partial agonist on dose-response curve
130. calculate half-life
131. Q on lineweaver-burke plot
132. C-kit mutation in GIST
133. Which is pro apoptotic? BAX
134. type of necrosis in brain infarct. liquefactive
135. Q on GVH disease
136. C/V of Burton’s agammaglobulinemia
137. C/V of CGD. test? dihydrorhodamine flowcytometry
138. Anti-thyroglobulin Ab in Hashimoto
139. Rheumatic fever, type of HS? II
140. Which inflammatory mediator causes fever? PGE2 was the only likely answer
141. Recurrent neisseria inf. C5-C9 def
142. lymphatic drainage of testes? para-aortic
143. MOA of HIV fusion inhibitor: blocks CCR5 attachment was an option
144. Acyclovir is analogous to what? Guanosine
145. Anti- HCV: Ribavirin
146. prevents viral release? Neuraminidase inhibitor
147. MOA of Caspofungin
148. Moa of Rifampin
149. MOA of Aminoglycoside
150. PDA assoc w? Cong Rubella
151. Osteomyelitis in pt with sickle cell dos. Salmonella
152. EBV infects B cells via? CD 21
153. Reassortment in viruses
154. cholangio ca assoc with? fluke
155. motile trophozoite on wet mount in pT with vaginal d/c: trichomonad
156. Ascaris treatment
157. diabetic with fungal inc showing non-septate hyphae. Mucor
158. Pic of tinea capitis: trychophyton
159. pic of coccidioidomycosis spherule ( larger than 10 micron): pt from california?
160. hx of atypical pneumonia, then anemia… cold agglutinins in serum
161. virulence factor of E. coli UTI: pili
162. Q on TB pathogenesis
163. mechanism of gas gangrene: alpha lecithinase
164. T/T of pseudomembranous colitis
165. which can grow on bile? Enterococcus
166. mechanism of transfer of Diphtheria toxin? spec transduction
167. TSST-1 mechanism
168. tetanus mechanism
169. botulism mechanism
170. medium for neisseria: VPN(Thayer Martin)
171. C/V of actinomycetoma
172. C/V of septic shock. induced by LPS
173. C/V of Tay Sachs
174. C/V of McArdle
175. C/V of Pompe
176. Q on glycogen reg by glucagon
177. Dihydrobiopterin reductase deficiency
178. Classic galactosemia
179. which enzyme produces peroxide? SOD
180. Fomepizole MOA
181. what to check in serum look for B12 def? Methylmalonic acid
182. Down syndrome due to meiotic nondisjunction
183. Q on Cystic fibrosis
184. C?V of Achondroplasia. Defect? FGF receptor
185. Pedigree chart of AR disorder
186. Prader-Willi due to uniparental disomy
187. Few Q on Southern blotting, had to infer results
188. Which step of collagen synth depends on Vit C? Hydroxylation of proline
189. Desmin is a marker for? muscles
190. I-cell disease
191. Q on tRNA wobble
192. Q on role of snRNP in splicing
193. Q on telomerase
194. Few q on developmental milestones
195. Few q on ethical situations, some looked straight forward, had to take a haunch on a few
196. ANOVA (to check diff b/w means of 3 or more groups)
197. inc sample size, what happens to power
198. Q on type 1 error
199. change in mean, median, mode with change in value of a data. ( had to calculate)
200. Q on gaussian curve
201. Calculate sensitivity
202. Phase III clinical trial
203. retrospective cohort( had to recognise type of study)
204. question on PTEN gene relation to cancer???
 Exam is like NBME Not much longer questions Time was adequate Break time was
adequate.
Confusing questions in ethics, biostats, up & down esp in renal & endocrine & CVS,
genetics & esp experimental questions
Questions were not as straightforward as written down, they are beating around the bush.
Past questions are useful.
Q with the first answer in the questions below is what I thought right and ticked.
Q with ??? in the beginning are ones where I had no clue to the answer & had wild guess.
168 questions could be recalled. Will post if any new ones pop

Best of luck

BHS:
1. Patient invites the doctor for dinner to her house? 1. Refuse, but thank for invitation.
2. Accept but in neutral place like restaurant, but not house
2. Attending physician asks for gastroenterologist opinion for a women admitted for
pneumonia who has pain abdomen now? 1. Provide opinion 2. Ask the attending
physician to reconsider Dx
3. Trisomy fetus, parents decide to keep the child whatsoever? 1. Autonomy
4. ???? Woman with husband lost job recently, now with head abnormal movements,
doing many jobs at a same time? 1. Conversion disorder 2. Malingering 3. Factitious
5. data given, calculate relative risk of hypercholesterolemia persistence in treated
group compared to the placebo group.
6. metanalysis analysis interpretation.
7. Confidence interval is ……; what to be done to increase precision? 1. Increase sample
size
8. If the criteria of PSA decreased from 5 to 3 ng, changes in specificity and sensitivity?
9. Research studies described, need to identify as case control.
10. Research studies described, need to identify as cohort study.
11. Healthy college student enrolled for antiHTNsive drug trial, which phase? 1. Phase I
12. Doctor receives fixed amount of money, does not depend on the number of time the
patient visits the doctor? 1. Capitation
13. 18 year diabetic daughter brought by mother, mother secretly tells physician that
the daughter does not take insulin regularly & eats candies, response by physician;
but daughter tells that her sugar is normal and she is taking the medication
regularly? 1. Can’t discuss with you unless your daughter consents according to
HIPAA 2. Congratulate daughter for adherence
14. developmental milestone for 9 month old, motor, social, verbal cognitive? 1. Normal
given
15. nurse with red hands on dorsum, cycling ….. ? 1. Apply sunscreen on hand
16. narcolepsy CV, EEG changes? 1. Decreased REM latency
17. another question on CV narcolepsy, EEG? 1. REM begins in 30 minutes
18. young male living with other 2 mates, eats junk food, do not like to cook like other
roommates, persistent high BP in 3 readings 1. Prescribe antiHTNsive 2. Ask if
interested in exercise and healthy diet plans
19. falling grades in school, mother thinks ADHD, father had ADHD, 1. Ask other
questions for other causes of falling grades in school 2. Treat for ADHD 3. Diagnostic
workup for ADHD
 20. friend died in front of patient eyes 3 months back, now have feeling of palpitation,
sweating whenever reminded of the patient 1. Classical conditioning 2. Negative
reinforcement 3. ……
21. CV of RCC, which lab finding is possible? 1. Hb 20gm%
22. CV of flank pain & tenderness, RBC, few WBC but no cast or fever? 1. Ureteral
calculus
23. CV of limb shortening in a newborn with thunk on abduction of hip? 1. DDH
24. Cleft lip & palate? 1. Malformation
25. Ectopic location of palatine tonsil, derivative of ? 1. Second pharyngeal pouch
26. Which H prevents lactation during pregnancy? 1. Progesterone
27. CV of pneumonia, healed, what after 3months in lung biopsy? 1. Normal finding
28. ??? Fetal Hb gets O2 from maternal Hb d/t (very difficult indirect options- not easy
as low 2,3 BPG)? 1. maternal deoxyHb more stable than deoxy HbF 2. Deoxy HbF
more stable than maternal deoxy Hb 3. Maternal carboxyHb more stable than fetal
carboxyHb 4. Fetal carboxyHb more stable than maternal carboxyHb
29. right shift in O2 Hb dissociation curve? 1. Hypercapnia
30. maxillary sinusitis with polyp formation in ? 1. Middle meatus
31. CV of mesothelioma, occupation? 1. shipyard
Genetics & biochem:
1. CV of McArdle disease
2. 6 transmembrance domains with ATP binding domain, where is this protein found.
1. Ion channel 2. Protein synthesis, etc.
3. CV of I cell disease, which sugar residue is not phosphorylated? 1. Mannose
4. Mannose phosphorylated, where does the protein accumulate normally? 1.
Lysosome
5. HPV causes Ca cervix by Tumour suppressor gene inactivation & cell cycle
dysregulation
6. Pedigree: AD disease, one parent disease, risk of disease in a child? 1. 50%
7. Pedigree: multiple members of family tree with varying Cancers mainly cerebellar
hemangioblastoma, RCC, gene involved VHL
8. 3 nucleotide deletion, effect on protein? 1. Loss of a single amino acid 2. Change in
AA sequence distal to deletion site
9. CV of Lesch Nyhan syndrome, E defect? 1. HGPRT
10. VLCFA metabolism site? 1. Peroxisome
11. ADPKD CV with berry aneurysm, gene defect? 1. Polycystin
12. ADPKD in son with high creatinine but ADPKD in father with normal creatinine,
cause? 1. Variable expression
13. Child with T2 hyperintense lesion in brain, seizure & with lactic acidosis, cause
mutation in mitochondrial DNA
14. CV of folate deficiency, methylmalonic acid normal? 1. Folate
15. CV with elevated methlymalonic acid elevated? 1. Vit B12
16. Biotin deficiency d/t avidin in raw egg, which pathway affected? 1. Alanine to
glucose
17. CV of cystinuria, defect in ? 1. AA transporter

Microbio:
1. CV of galactosemia, meningitis organism? 1. E coli
2. CV of pulmonary TB, renal TB gross specimen provided, asked organism? 1. M Tb
3. AIDS case with bone marrow image showing fungus, looked like 1. Histoplasma 2.
Coccidiomycosis (no information about the geographical location)
 4. Skin rashes, diarrhea in 2 yr old child CV of salmonella, exposure to 1. Pet turtle 2.
Shelter home
5. CV of influenza, RNA –ve sense virus with 8 segmented genome influenza virus
6. CV of sepsis, d/t ? 1. LPS
7. Post cataract surgery, Gm +ve rods? 1. Bacillus 2. Actinomyces
8. ??? autoclave kills but bleach does not? 1. HSV 2. MRSA 3. M Tb 4. C difficile
9. CV of nasal packing & TSS? 1. TCR beta with MHC II binding
10. CV of cavitory tuberculosis, cytokine involved? 1. IFN gamma
11. CV of promiscuous female with joint pain, image showing Gm –ve cocci? 1.
Gonococcus
12. CV of Indonesia visit, voluminous watery diarrhea with no mucus or blood on stool
examination? 1. V cholera
13. CV of drinking bottle water, nice food, walking in forest, on fresh and salty water,
presenting with diarrhea but generalized lymphadenopathy? 1. S mansoni 2. V
parahemolyticus
14. Image of roundworm, mode of transmission? 1. Feces contaminated food
15. Rash in palm and soles, promiscuous male, walking in forest, LAD in epitrochlear,
cervical, etc 1. T pallidum 2. Coxsackie 3. Rickettsiae
16. CV of DKA, black eschar on sinus and eye swelling, etc, slide showing 1. Rhizopus
17. Travel to Vietnam, now has fever, hepatosplenomegaly, images shown 1. Malaria
18. CV of infectious mononucleosis, look for? 1. Antibody against sheep or horse RBC
19. CV of post transplant immunosuppression, antibody against B lymphocytes? 1. CMV
2. EBV
20. CV of fever followed by rash, virus related to? 1. VZV 2. Parvo virus
21. CV of pityriasis rosea, next inv? 1. KOH 2. Biospy
22. Anti smooth cell antibody +ve, anti HAV IgM +ve, anti HBS Ab? 1. Autoimmune
hepatitis 2. HAV 3. HBV
23. HIV enters body through which receptors? 1. CCR5

Immunology;
1. Self antigens injected into thymus, what? 1. Destruction of self reactive lymphocytes
2. ??? Recurrent meningococcus infection, deficiency in? 1. C5 2. C6
3. CV of ampicillin tubulointerstitial nephritis, culprit is ? 1. Ampicillin
4. ??? CV of drug induced interstitial nephritis, mediator is? NO TGF-BETA provided 1.
TNF alpha
5. bacteria killed by ROS d/t action of E? 1. NADPH oxidase 2. SOD
6. CV of RA with image showing swan neck deformity, specific? 1. Anti CCP Ab
7. ??? CV of lymphoma with underlying immunological disorder with low all Ig, man 34
yr old? 1. CVID
8. tumour- specific immunity by? 1. CD8 T 2. Natural killer
9.

Physio:
1. Cellulitis case, 0.9% NaCl infused, changes in  serum Na, Na excretion, GFR,
2. Diabetic patient with lab values s/o low sodium and high K, low HCO3, changes in
renin & aldosterone? Renin low, aldosterone low
 3. Graph of hormonal levels in pregnancy, identify the HCG graph.


Patho:
1. Chance of infarction in pulmonary embolism? 1. 10%
2. DVT with cerebral embolism? 1. PFO
3. Experiment, want cell growing without apoptosis, need? 1. BCl-2
4. Experiment, need more growth in cell, need to add gene for ? 1. Telomerase
5. Low APGAR score at birth, later child developmentally retarded? 1. Perinatal
hypoxia
6. CV of thalassemia? 1. Mutated beta globin chain from each parent
7. ECG: ST elevation in II, III, aVF, but also in V3, V4, bradycardia, Hx like ACS? 1. MI
8. ECG: Peak T waves, electrolyte change? 1. Hyperkalemia
9. Murmur: preconception evaluation of 22 yr F? 1. Normal
10. Murmur: young female with episodes of palpitation and SOB? 1. MVP
11. Cellular swelling d/t 1. Decrease Na efflux d/t low action of NaK ATPase
12. Image of adenomatous polyp as in NBME? 1. Adenomatous polyp 2. Sessile
13. Image showing lip with petechiae, CV of HHT, finding? 1. AV malformation in GIT
14. ???? Cystic fibrosis patient, spirometry finding? 1. Low FEV1/FVC 2. High FEV1 3.
Low FRC 4. Low RV
15. CV of Down syndrome at birth? 1. Trisomy 21
16. Parathyroid taken out during thyroidectomy, hypocalcemia, calcium tablet given,
but no improvement until vit D is given as well? 1. Vit D increases Ca absorption
from GIT
17. ?? Weight reduction surgery, kidney stone? 1. Oxalate
18. CV of nephrolithiasis with no stone in X ray abdomen, type of stone? 1. Uric acid
19. Gout, inflammation is due to? 1. Release of neutrophil lysosomal enzymes
20. 4 month child with recurrent hypoglycemia, treated with glucose or glucagon only
to recur after some hours, no ketones in blood? 1. Increase release of insulin 2.
Glucose 6 phosphatase def
21. H causing passage of food from stomach to duodenum? 1. Gastrin
22. CV of multiple gastric ulcer, Biopsy negative for H. pylori, next inv? 1. CT of abdomen
2. H pylori testing
23. CV of moribund patient, pain RUQ with Murphy sign +ve, next inv? 1. USG
24. CV of hyperchylomicronemia, defect in? 1. LPL
25. Multiple rashes on torso, lymphocytes show cerebriform nuclei? 1. Mycosis
fungoides
26. CV of farmer, nonsmoker, anemia, macrocytosis, low platelet? 1. MDS
27. Tumour invasion helped by? 1. Loss of cadherin
28. Lung cancer with keratin pearls, associated finding? 1. Renal stone, constipation
29. Metastatic lung cancer, with facial plethora, dilated chest wall veins, spread to? 1.
Upper portion of Rt lung
30. CT image: thrombus in left pulmonary artery, decrease blood flow to ? 1. Left lung 2.
Left atrium 3. Left ventricle
31. RTA with bleeding from spleen, embolization needs cannulation of which artery? 1.
Celiac trunk 2. Common hepatic artery
32. Variceal bleed with schematic image showing need for artery ligation at proximal
end of lesser curvature? 1. Left gastric A
33. HCC on left lobe of liver, needs chemoembolization through which vessel? 1. Left
hepatic artery 2. Portal vein 3. Rt hepatic artery
 34. CV of stress incontince
35. Another CV of stress incontinence
36. HIV patient with dementia features but with altered consciousness, hallucination? 1.
Delirium 2. HIV dementia
37. CV of Tourette syndrome, drug? 1. Haloperidol
38. Graph of starling curve, change in point from normal to where if aortic aneurysm
rupture? 1. Same curve but down and near to zero
39. SABE, multiple rashes on palm and soles, not painful d/t ? 1. Septic emboli
40. CV of sarcoidosis with rash on nasal bridge with hypercalcemia? 1. sarcoidosis
41. CV of wegner with nasal septum erosion & saddle nose deformity, hemoptysis, lung
nodules, ? 1. ANCA
42. Surgery of PDA, post surgery change in pitch of voice, which pharyngeal arch
derivative is injured? 1. Sixth
43. CV of 21 hydroxylase deficiency
44. CV of internuclear ophthalmoplegia bilateral? 1. MS
45. TEF repair which N injured? 1. Recurrent laryngeal N
46. Mass in rectum, which LN? 1. Inferior mesenteric LN (no internal iliac in option) 2.
Superficial inguinal
47. CV of varicocele, thrombosis of which vessel? 1. Renal vein 2. Renal A
48. CV of esophageal rupture with pneumomediastinum
49. Commonest location of diverticula? 1. Sigmoid colon
50. CV of meckel diverticulum, i.e. detected by pertechnetate scan? 1. Gastric mucosa 2.
Pancreatic mucosa
51. CV of hemophilia
52. CV warfarin skin necrosis d/t ? 1. Factor C deficiency
53. CV of multiple myeloma, Dx? 1. Urine electrophoresis 2. Total urinary protein
measurement
54. CV of polycythemia vera
55. CV of osteopetrosis, defect in ? 1. Osteoclast
56. Osteosarcoma gross structure, predisposing condition? 1. Paget
57. CV of gout, crystal? 1. MSU
58. CV of Lambert myaesthenic syndrome? 1. Difficult release of Ach
59. CV of bullous pemphigod, separation of? 1. Stratum basale from basement
membrane
60. CV of holoprosencephaly, gene defect in ? 1. SHH
61. Gross anatomy picture of sagittal brain with CV of lower limb paralysis in a newborn
? 1. Chiari II
62. Injury to left solitary tract, deficient? 1. Taste sensation ipsilateral
63. CV of parkinsonism? 1. Lewy body, apoptosis of dopaminergic neurons
64. Gross brain structure of brain showing rt MCA, if occluded deficient ? 1. Lt hand
weakness 2. Unable to speak
65. MRI showing T2 high signal on posterior part of the spinal cord on both sagittal and
axial images, which pathway injured? 1. Dorsal column
66.
67.
Anatomy:
1. Identify nerve in gross brain specimen, trigeminal.
2. CV of trigeminal neuralgia
3. CV of hamstring pull during sports, which bony structure avulsed? 1. Ischial
tuberosity
 4. CV of pop sound during basketball layup, unable to ? 1. Stand on toes

Pharmacology:
1. CV of lups, drug causing? 1. Hydralazine
2. Plague drug used which acts by protein synthesis inhibition? 1. Streptomycin (other
options did not inhibit protein synthesis)
3. Tinea pedis picture given, DOC MOA? 1. Squalene monoxidase 2. Chitin synthase
4. ?? Which drug for osteoporosis with least DVT risk? 1. SERM 2. Bisphosphonate 3.
Estrogen 4. Progesterone
5. which drug used for long term anticoagulation? 1. Drug inhibiting epoxide reductase
6. trichomoniasis drug MOA? 1. DNA disruption
7. bronchodilator drug using GPCR other than Beta agonist? 1. Anticholinergic
8. CV of opioid withdrawal, drug to administer? 1. Clonidine
9. CV of opioid overdose with pin point pupil, RR=4/min, drug? 1. Naloxone
10. CV to identify partial agonist?
11. From the dose response curve, identify the most potent competitive antagonist.
12. Excess sweating requires which neurotransmitter? 1. Ach
13. CV of urge incontinence, drug used? 1. Antimuscarinic
14. Child drinks liquid from garage, given dimercaprol, which poisoning? 1. Hg
15. CV of sulfamethoxazole use f/b rash, bulla in mucosa, why? 1. SJS
16. Pulmonary fibrosis, drug? 1. Bleomycin
17. Methotrexate therapy, which organ function to monitor? 1. Liver
18.