Block H past paper|Modular medical circle

Block H 2021 by mmc

For Third year Mbbs students of Kmu
By Modular Medical circle

NOTE: error and omissions are possible !

1.cubitus valgus deformity is a complication of
a.fracture of lateral condyle of humerus
b.fracture intercondylar of humerus
c. fracture of olecranon
d .fracture of radius

correct option (a)

2.A patient with renal dysfunction has chronic gout .which one of the following is a xanthine
oxidase inhibitor that would be suitable for treatment of chronic gout in this patient
a.Allopurinol
b.febuxostat
c.penicilliamine
d.probenecid

correct option (b)

3.within minutes of a bee sting,15 years opd girl developed generalized pruritus nd hyperemia of
skin followed shortly by swelling of the face nd eyelid ,dyspnea nd laryngeal edema .this
reaction is mediated by which of following
a .Ab.Ag mediated
b. cytotoxic T cell
c. IgA antibodies
d .IgE antiobody

correct option (d)

4.A young boy aged 8 yrs old presented with pain in the arm ,on X ray his upper wnd of
humerus domenstrate an expansile lesion in the metaphysis breeching the overlaying cortex
,most likely diagnosis is
a.unicameral bone cyst
b.aneurysmal bone cyst
c. osteoclastoma
d. giant cell tumor

Correct option A

5 A patient is administrated a neuromascular blocker at the start of operation but afterward he

developed seizures .which one of the following N.M blocker to have caused this adverse effect
a.Atracurium
b.cistracurium
c.Rocurium

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d. succinylcholine

Correct option B

6.The most commonly employed physiochemical test to confirm the presence of blood in stain is
a.latex test
b.kastle meyer test
c.Electrophresis
d.spectroscopy

Correct option C

7.the activity of plasma cholinesterase is decreased by following drug except

a.neostigmine
b.organophosphorus
c.parathion
d.cimetidine

Correct option D

8.In current covid epidemic it has been seen that only 1/3rd of population is immunized nd about
half of population have developed clinical or subclinical infectioj but transmission rate has
decreased as population has developed immunity what is this immunity called?
a.Active immunity
b.passive immunity
c .herd immunity
d. innnate immunity

Correct option C

9 A 65 years old female is diagnosed. She is suffering from chronic obsructive pulmonary
diseases .She experience repeated episode of bronchospasm.which among the following will be
most effective choice for this patient
a.scopolamine
b.oxygen
c.nicotine
d.ipratropium bromide
e.salbutamol (selective b2 blocker)

Correct option E

10 A 20 years opd woman present with malar rash ,arthralgias,low grade fever nd high titer
antibodies to double stranded DNA nd to the smith antigen .Which of follownig is primary
mechanism of abnormality in this disorder ?

a.immediate or anaphylactic hypersensitivity

B.Ab mediated
c.immune complex mediated

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Correct option c

11. Which of the following non probability sampling technique is more close to stratified random
sampling?

a)convenience sampling
b)consecutive sampling
c)snowball sampling
d)purposive sampling
e)quota sampling

CORRECT ANSWER: E

12. A 53 year old man noticed enlargement over two months in the skin lesion on the upper
outer area of his right arm. Histological examination reveals atypical squamous cells with
excessive keratinization . Which of the occupation is this man most likely to have had earlier in
life ?

a) auto repair mechanic

b) chemist in factory
c) lifeguard on beach
d) minor in a coal mine
e) radiation oncologist in a cancer centre

CORRECT ANSWER: C

13. Regarding Duchene muscular dystrophy following statement is incorrect

a) it is the most common type of muscular dystrophies
b) it is an xlinked disease
c) mutations in dystrophin protein are present
d) it is more common in young females
e) it causes death in early 20s

CORRECT ANSWER : D

14. Which of the following is not a cause of conductive hearing loss

a) ottosclerosis
b) tympanosclerosis
c)acoustic neuroma
d) secretory otitis media
e) none

CORRECT ANSWER : C

15. Deliberate intentional acts that cause harm or the threat of harm to a child is known as
a) child abandonment
b) child neglect
c) child discipline
d) child abuse

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e) none

CORRECT ANSWER : D

16. Regarding th1 and th2 which one of the following is least accurate

a)th1 produce gamma interferon and promote cell mediated immunity

b) th2 cells produce interleukin 5 and promote antibody mediated immunity
c) both th1 and th2 cells have both CD3 and CD4 proteins on their cell membrane
d) before naïve th cells differentiate into th1 and th2 they are double positive i-e they produce
gamma interferon and interleukin 4
e) th 2 cells produce interleukin 4 and promote antibody mediated immunity

CORRECT ANSWER : D

17. Most common deformity after malunited supracondylar humerus fracture is

a) flexion deformity
b) extension deformity
c) cubitus varus
d) cubitus valgus
e) myositis ossificans

CORRECT ANSWER : C

18. Barret esophagus is the classic example of

a) metaplasia
b) atrophy
c) necrosis
d) dysplasia
e) none

CORRECT ANSWER: A

19. Pakistan stands among the top five countries with the largest number of children not
vaccinated against measles in 2021 . In Pakistan it is included in EPI Infants should get 2
doses of measles vaccine 1st dose at 9 months and 2nd dose at 15 months. The route of
administration of measles vaccine is
a) intra dermal route
b) IM
C) IV
D) oral
e) S/C ROUTE

CORRECT ANSWER : E

20. A 24 year old post natal had an episiotomy after a few minutes the doctor observed that
there was continuous slight ooze of blood from the external stitch of episiotomy .Which among
the following will be the best option to stop this ooze
a) inj vit C

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b) inj vit K
c) inj tranexamic acid
d) inj F2a
e)tab PGE2

CORRECT ANSWER: c

21)A skeletal disorder phenotypically diverse caused by deficiencies in type 1 collagen and
characterised by skeletal fragility and increased predisposition to fracture is known as
a)osteogenesis imperfecta
b) osteoporosis
c) osteoporosis
d) paget disease

Correct option : a hint: robbins page 800

22)A 55 years old female has presented with pain in left hypochondrium .examination reveal
splenomagaly her FBC shows TLC 55 ×10^9/L ,HB 11gm and platelets count 400 ×109/L .Her
peripheral blood film shows predominant neutrophils and metamylocytes ,basophils count is
also increased all true about her condition except

a)chromosome analysis will shows shortening of long arm of ch 22

b)fish can also detect the abnormality
c)it is a case of CLL
d)it is a case of CML
e) tyrosine kinase inhibitors are used for treatment

Correct option :c robbins

23) low turnover osteoporosis is associated with which of the following

A)Decrease serum estrogen level

B)Increased expression of Rank-rankl
C)Reduce physical activity
D)Increased level of interleukin 1 and 6

Correct option: c

24) A 25 yrs old female with several serious episodes of bacterial pneumonia in last 5 months
she has not had frequent or unusual infections prior to the onset of these pneumonia which one
of the following is most likely immunodeficiency tha That predispose her to these infections
A)She is likely to have a reduced level of immunoglobulin
B)She is likely to have a defect in her cytotoxic t cells
C)She is likely to have mutation in the gene
D)She is likely to have a defect in one of the genes that encode the class II MHc proteins

Corrct option:d ...levenson micro

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25) one of a commonly used sympathomymetic drug is amphetamine characteristic of the

amphetamine include
The following?

A It is sympathomylitic agent
B It cause mode elevation
C It cause MAO activation
D It depress hunger center in hypothalmus
E It can be used for constipation

Correct option: d hint tara page 96

26) infant is a child whose age is

A Birth to 1 year
B Upto 2 yrs
C 2 to 3 yrs
D 3 to 4 yrs

Correct option : a parikh

27) the best initial test when one suspect sickle cell disease is

A Peripheral smear
B Bone marrow examination
C Retic count
D Xray chest
E MRI

Correct option : A

28) A variable that is preseumed to cause

A change in another variable is called

A Discreat variable
B Categorical variable
C Dependent variable
D Independent variable
E Intervening variable

Correct option: e ...defination of intervening variable

29) nature of hurt is a bruise over left upper arm is

A 337 L1
B 337 L 2
C J.G.J baddiah
D Jurh ghyr jsifah damiah
E Shajaha Khalifa

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Correct option : b

30 ) in acute cellular rejection an infiltrate with which of the following types inflammatory cell is
most likely to be prominent

A Neutrophils
B Eosinophil
C Lymphocytes
D Mast cells
E Monocytes macrophages

Correct option : E

31.A thirty five years old gentleman is found in a drowsy state,beaten and abandoned by his
kidnappers.He is taken to the hospital where he pass reddish urine after catheterization. His
labs shows hb=14g/dl, TLC=11000/mm3, platelets=250000/mm3, serum creatinine=9mg/dl,
serum potassium=7.5mEq/L . Urinanalysis is negative for red blood cells. What is the next most
appropriate investigation?

A. Blood urea
B. Creatinine phosphokinase
C. CT brain
D. Random blood sugar
E. Ultrasound kidneys

Correct option. B
Source. Google

32.Framingham heart study initiated in 1948 to prospectively investigate the epidemiology and
risk factors for cardiovascular diseases. Which type of study design is this?

A. Case control study design

B. Cohort study design
C. Cross sectional study design
D. Experimental study design
E. Exploratory study design

Correct option. B
Source. Google and research slides

33.The most common organism responsible for causing pyogenic osteomyelitis is.
A. E.coli
B. Pseudomonas
C. Staph aureus
D. Klebsiella
E. Hemophilus influenza

Correct option. C

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Source. Robbin

34 Which one of these is associated with poor clinical prognosis in acute lymphoblastic
leukemia?

A. Age between 2 and 10 years

B. Normal leukocyte count at diagnosis
C. T(12;21)
D. Male gender
E. Female gender

Correct option. A
Source. Pathoma pg 55

35 Synovial cell hyperplasia, dense perivascular inflammatory infiltrate of CD4 T cells, plasma
cells and macrophages along with increased vascularity and increased osteoclastic activity in
underlying bone are characteristic morphological features of which of the following lesion.

A. Granuloma
B. Pannus
C. Tophus
D. Joint mice
E. Osteophytes

Correct option. B
Source. Robbin

36. NSAIDS are associated with the adverse effects of gastric ulcers, in order to avoid this
unwanted effect, NSAIDS are available in the market in combination (co- formulated) with which
of the following drugs?
A Alprostil
B Prostacyclin
C Misoprostol
D Latanoprost
E Dinoprost

Correct option C

37.When diagnosing JIA healthcare providers look for joint inflammation that lasts for a
minimum of 6 weeks before the age of
A. 10 years
B. 1 year
C. 16 years
D. 5 years
E. 3 years

Correct option.C
Robbin page 821

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38. The best test to detect metals in firearms injury is

A.neuron activation analysis

B.Reinisch test
C. Dermal nitrate test
D. Marsh test
E. Harrison and gallery nitrate test

Correct option B

39. X-ray dorsal apine of a 40 years old male shows bambooing of the spine. The underlying
disease is associated with
A.HLAB51/5
B.HLA B27
C.HLADR1
D.HLADR5
E.none

Ans.B
Pathoma pg 201

40. Polio can be eradicated by

A.Live polio vaccine

B.Killed Polio vaccine
C.Combination of killed and Live polio vaccine
D.Health education and promotion
E.Attention to sewage control and hygiene

Correct option A

41 Which of the following fractures is called as “fracture of necessity” meaning that open
reduction and external fixation has better results than conservative treatment.

A Fracture radius
B Fracture of the Axis
C Fracture neck of femur
D Fracture Acetabulam
E Fracture Calcaneum

Correct answer :A
Hint: Galeazzi fractures are best treated with open reduction of the radius and the distal radio-
ulnar joint. It has been called the "fracture of necessity," because it necessitates open surgical
treatment in the adult. Nonsurgical treatment results in persistent or recurrent dislocations of the
distal ulna.

42 Which of the following is not produced by Atropine when used preoperatively?

A reduced bronchial secretions

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B. prevent laryngospasm
C produce amnesia
D:prevent postoperative urinary retention
E:prevent cardiac arrest during induction of anesthesia

Correct answer :D
Hint: TARA Pg:75

43 :A 72 year old man presents with increasing fatigue. Physical examination reveals multiple
enlarged non tender lymph nodes with enlarged liver and spleen. Lab examination of his
peripheral blood reveals a normocytic normochromic anemia and a slightly decreased platelet
count and a leukocyte count of 72.000/microliter. Examination of the peripheral smear reveals a
marked increase in the number of mature looking lymphocytes and many smudge cells. What is
the most likely diagnosis .

A Atypical lymphocytosis
B Acute lymphoblastic leukemia
C Chronic lymphocytic leukemia
D Immunoblastic lymphoma
E Prolymphocytic leukemia

Correct answer :C
Hint : ( Chronic Myeloid leukaemia) Robbin pg :467
Smudge cells are ruptured chronic lymphocytic leukemia (CLL) cells appearing on the blood
smears of CLL patients

44 A 39-year-old woman gives birth to a term infant with an umbilical hernia, Brushfield spots on
the iris, macroglossia, low set ear obligus palpebral fissures, and a heart murmur. The infant
survives to childhood and exhibits only mild mental retardation. Which of the following
chromosomal abnormalities affecting autosomes, is most likely to be present in the somatic cells
of this child.

A Haploidy
B monosomy
C Mosaicism
D tetraploidy
E triploidy

Correct answer : c

45 An 18 years old boy had an open fracture of humerus 3 weeks ago. It was treated at home.
Now he presents to doctor with pus pouring out of wound. What is the most probable organism
involved in this case?

A Pseudomonas aeruginosa
B E-Coli
C Mycobacterium tuberculosis
D Clostridium deficile
E Staph aureus

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Correct answer :E
Hint : Osteomyelitis caused by staph aureus

46 Within 1 hour after a patient receives blood transfusion, the patient becomes tachycardia
and hypotensive and passes pink colored urine. Which of the following statements best
describes how this reaction mediated?

A Release of tumor necrotic factor alpha into circulation.

B Antibody-dependent cellular cytotoxicity by natural killer cells
C Antigen antibody complex deposition in glomeruli
D Complement mediated lysis of RBCs
E Mass cell degranulation

Correct answer :d

47 A 9 year old girls has difficulty in climbing stairs and combing hair for 6 months. On
Examination Gowers sign is positive and maculopapular rash over metacarpopharyngeal joints
(MCP) . What is the next appropriate investigation to be done.
A RA factor
B Serum Creatinine kinase
C Electromyography
D Muscle biopsy
E None of the above

Correct answer :B

48 A sample frame is

A The summary of the various stages involved in designing a survey

B An outline view of all the main clusters of units in a sample
C A list of the units in the population from which the sample will be selected
D A frame used to display tables of random numbers
E A singular value within a singular database

Correct answer :C

49 Ganglion blockage leads all of the following except

A Venodilation
B Hypotension
C Bradycardia
D Mydriasis
E Constipation

Correct answer :C
Hint : Tara pg no :76

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50 A genetic disorder in which both B&T cells are crippled, due to a genetic defect. Chronic
diarrhea, ear infections, recurrent pneumocystis jirovecci pneumonia & profuse oral candidiasis
normally occur. These babies if untreated die within 1 year due severe , recurrent infections.

A IgG subclass deficiency

B Hyper IgM syndrome
C X linked agammaglobulinemia
D Wiskott Aldrich syndrome
E Severe combined immunodeficiency

Correct answer :E
Hint : Reference: levenson Page 593 combined t and b cell deficiency

51 A 4-year-old girl is being evaluated for the sudden onset of multiple petechiae and bruises.
She is found to have a peripheral leukocyte count of 55,000. 86% of which are small,
homogeneous cells that have nuclei with immature chromatin. Indistinct nucleoli are also
present. Initial tests on these immature cells are as follows: PAS, positive and myeloperoxidase,
negative, Based on these findings, which of the following is the cell of origin of these immature
cells.

A Myloblast
B Monoblast
C. Megakaryoblasts
D Lymphoblast
E Erythroblasts

Correct answer D
Hint : ROBBIN Pg 465
Lymphoblast cells are PAS positive and MPO negative

Q51. Clinical uses of immunosuppressive drugs

A Organ transplantation
B Hemolytic disease of newborn
C Autoimmune disorders
D A AND C
E A,B,C

Ans :D

Q52. How can osteoporosis be prevented?

A.Eat low fat diet
B Eat low calcium diet
C Get calcium and vitamin D in diet
D.Eat low protein diet
E.Eat high carbohydrate

Ans :C

Q53. The most accurate test for diagnosis of sickle cell disease is

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A.Hemoglobin electrophoresis
B CBC
C P.smear
D Retic count
E Bone marrow examination

Ans :A
Robbins chapter:12 page 447

Q54.A 45- Year- old woman presents with marked splenomegaly . Her leucokocyte count in
increased to 300,000 microliter. The differential count reveals the presence of small numbers of
myeloblasts and promyelocytes with a predominance of myelocytes, metamyelocytes ,bands
,and segmented neutrophils. Basophils are also increased in number as are platelets. The
patient is not anemic. Leukocyte alkaline phosphatase is decreased. Which of the following
describes a major characteristic of this disorder?

A 9:22 translocation
B Expansion of mature B lymphocytes within multiple lymph nodes
C Hypogammaglobulinemia
D Neoplastic cells exhibiting hair like filamentous projections
E Peak incidence at 65 years of age

Ans :A
CML,BCR:ABL GENE 9:22 PHILADELPHIA CHROMOSME

Q55. A 5-month old baby presented with a history of crying on touch. The child was exclusively
on cow’s milk. What would be the probable cause?

A Scurvy
B JIA
C Rickets
D Caffey disease
E Achondroplasia

Ans :D Caffey disease also called infantile cortical hyperostosis; an inflammatory disease of
infants that causes bone changes, soft tissue swelling and irritability. Diagnosed in first 3
months

Q56. The most important factor which make smoking cessation program successful is

A The desire of smoker to quit

B Availability of replacement therapy
C A well-planned program
D Advice by competent doctor
E Follow-up program

Ans :A [google]

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Q57. A 76-year-old woman presents to the emergency department following two weeks of
progressive dyspnea and fatigue and a new rash physical examination results are within normal
limits, except for skin pallor and a petechial rash on the lower extremities bilaterally. Complete
blood count with differential is significant for a very raised white blood cell count with40 percent
circulating blasts, hemoglobin 6.7 g/dl and a low platelet count. A bone marrow biopsy reveals a
hypercellular marrow with 22% blasts, consistent with a diagnosis of acute myeloid leukemia
(AML) which is myeloperoxidase negative. Myeloperoxidase negative AML is

A Acute myeloid leukemia M0 [AML MO]

B Acute myeloid leukemia M3[AML M3]
C Acute myeloid leukemia M4 [AML M4]
D Acute myeloid leukemia M6 [AML M6]
E Acute myeloid leukemia M7[AML M7]

Ans :A
AML M0 myeloperoxidase negative occurs in old age [google]

Q58 which of the following is anti-trichogenic agent?

A Propylene glycol
B Alpha hydroxy acids
C Minoxidil
D Urea
E Florinithine

Ans :E
florinithine Anti trichogenic: reduces hair growth.

Q59. A 50-year old male is brought to the emergency department with acute heart failure. He
requires immediate treatment in order to improve his cardiac function. Which among the
following would be the most beneficial for the patient?

A Albuterol
B Nor-epinephrine
C Dobutamine
D Phenylephrine
E Epinephrine

Ans :C

Q60, examination findings of RTA victim’s lower limb are grinding compression of the tissues,
degloving of skin and crushing of the muscles underneath. The injury may be labelled as;

A Internal laceration
B Avulsion
C Split laceration
D Stretch laceration
E Tear

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Ans:B parikh chap 16 pg 219

61)A substance that results in abnormal reaction is called

A allergen
B antigen
C antibody
D chemokine
E cytokine

•Correct opt A ( allergy is abnormal reaction to normal stimulus)#patho

62)A student wanted to conduct a research on a detailed account of the life of Imran khan.
Which one of the following would be an appropriate qualitative study design?

A case study
B content analysis
C Ethnography
D Historical
E narrative

•Correct option A #research

63) A 22 years old man presented with one month history of severe pubic itch that worse at
night.He was diagnosed as scabies patient .what is the most appropriate topical treatment ?

A Hydrocortisone
B Hydroxyzine
C mupiricin
D permethrin
E selenium sulphide

•Correct option D # dermatology

64) burkitt lymphoma is associated with which of the following microbe?

A Human papilloma virus

B H.pylori
C epstein bar virus
D cytomegalovirus virus
E human herpes virus8

• option C #patho mcq robin

65) Best initial treatment for osteoporsis is

A vit D and calcium are best initial therapy
B Bisphosphonate
C RANKL inhibitor
D replacement

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E teriparatide

•Correct option B #pharma

66) Joul burns are the feature of which of the following

A) chemical injury
B) dry flame burn
C) electrical injury
D) scald
E) radiation burns

• option C # Forensic

67) Tumors composed of more than one neoplastic cell types derived from more than one germ
cell layer is:

A) pleomorphic adenoma
B) wilm,s tumor
C) Fibrosarcoma
D) teratoma
E) lymphangioma

Correct Option D # robin

68) Decrease in cell/organ size is called

A) Atrophy
B) Hypertrophy
C) Necrosis
D) apoptosis
E) non of the above

Correct option A

69) A newly described neurological disorder is found to affect multiple family members in three
generations that were available for study.in the first generation two sisters and one brother are
affected and in the 2nd generetion all of the children of the first generetion sisters were effected
but none of the decendents of first generetion son .In the third generetion all of the children of
the affected 2nd generation women were affected but none of the decendents of the 2 nd
generetion man the mood of inheretince exemplified here is

A) autosomal dominant
B) Autosomal recessive
C) mitochondrial
D) X linked dominant
E) X linked recessive

Correct option D#patho

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70) A 23 years old women come to the emergency department with markedly increased
menstraul bleeding .gum bleeding when she brushes her teeth and petechie on physical
examination .physical examination is otherwise normal.The platelate count is 27 000/ul .what is
the most appropriate next step in therapY

A) Bone marrow biopsy

B) intravenous immunogloblin
C ) prednisone
D) antiplatelae antibody
E) platelate transfusion

Correct option E# pharma

78. A middle aged woman presented with Nausea and vomiting, diarrhea, tachycardia,
breathlessness and drowsiness.There is history of procuring abortion by use of some plant root
by Dai 24 hours ago. The most likely diagnosis is:
A. Oleander poisoning
B. Digitalis poisoning
C. Conium poisoning
D. Opium poisoning
E. Nicotine tabacum poisoning

Ans.oleander poisoning

79. A known patient of congenital Hemophilia A has bleeding followed by a Sharp object. He
has been brought to the emergency department. Which of the following drugs will be the best
option for this patient to stop bleeding?
A. Factor VIII B. Factor X
C. Factor IX
D. Amino caproic acid
E. Tranexamic acid

Ans.factor viii

80. A young doctor transferred blood group A +iv to a patient having blood group O+ive. Which
of the following reaction is most likely to occur?
A. Extra - vascular hemolysis
B. Air embolism
C. Transmission of CMV (cytomegalo virus)
D. Febrile reaction
E. Fat embolism

Ans. Extra vascular hemolysis

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81. A drug is being used in combination therapy for cancer. It acts by nucleophilic attack on
DNA that causes disruption of base pairing leading to fragmentation and strands breakage .
which of the following drug it could be .
a . cyclophosphamide
b. fluorouracil
c.methotrexate
d. Prednisone
e. thioguanine

answer... a...

82. An old man died in road traffic accident. police investigating officer send the dead body for
POSTMORTEM examination . in such cases ideally an autopsy is required to.

a. know the cause of death

b. mechanism of death
c. mode of death
d . rule out any foul play
e . proper disposal of body

answer...d...

83. the expected percentage of beta thalassemia major in infants born beta thalassemia trait in
both father and mother.
a. ...
b. 25%
c. 50%
d. 75%
e.100%

answer. b...

84. Blood clot can develop in the lower leg (deep veinous thrombosis) during prolong journey by
air or motor vehicle .How often one should move around to keep the circulation normal
a. every min
b. every hour
c. every 2-3 hours
d.every 4_5 hours
e. every 6_7 hours

answer. c.... google

85. 41 years alcoholic man presenting with increasing fatigue lethargy and muscle weakness.
his CBC reveal decrease number of erythrocytes leukocytes and platelets along with increase in
MCV of erythrocytes. his blood smear shows hypersegmented neutrophils . which of the
following can be deficient in this individual.

a. Vit B 12
b. ascorbic acid

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c. Folic acid
d. retinoic acid
e. venillyl mendelic acid

answer. VIT B 12 or folic acid deficiency

86. A survey on malnutrition needs to establish the percentage of malnourished children in a

certain population which type of study design is this

a. case control study design

b. cohort study design
c. cross sectional study design
d. experimental study design
e. qualitative study design

answer.

87. A macrophage ingest a virion and degrades it so the viral capsid peptides can be linked to
class 1 HLA heavy chain and B2 microglobulin . This trimer is transported to the macrophage
cell surface and displayed . which of the following cells has receptor that can interact with
displayed MHC peptides complex

a. CD 8+ lymphocytes
b . Langerhans cells
c. macrophage
d. mast cell
e. neutrophils

answer... A

88. Constellation of changes that include loss of uniformity cell as well as loss in there
architectural orientation is terms as
a. dysplasia
b. metaplasia
c. hyperplasia
d. Hypertrophy

answer...a ..robin

89. Which of the following type of arthritis predominantly involved articular cartilage .

a. rheumatoid arthritis
b. osteoarthritis
c. gouty arthritis
d. infectious arthritis
e. pseudogout

answer...b... Robin

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90. One of the key areas for workers welfare in the occupational health in field of ergonomics.
Ergonomics basically means.

a. identification of disease of occupational disease

b. identification of cause of occupational origin
c. checking effectiveness of control measures
d. establishing environmental hygiene
e. design of working environment best suited for workers

Answer....e... excel

91) Rofecoxib was used initially as a selective COX-2 inhibitor . The use of this drug has been
banned by FDA because of it's association with
A) hepatotoxicity
B) arrhythmias
C) cinchonism
D) renal failure
E) myocardial infarction

Ans E
{Because of the higher incidence of cardiovascular thrombotic events ...... Ref:katzung}

92) Which of the following is most specific investigation for the diagnosis of rheumatoid arthritis

A) rheumatoid factor (RF)

B) anti-cyclic citrullinated peptide ( anti-CCP)
C) X-rays of joints
D) CBC
E) ESR

Ans B
(Anti-CCP also known as ACPA)

93) self-administration of drug for non-medical reason in quantities & frequencies Which may
impair an individual's ability to function effectively and which may result in social physical and
emotional harm is best named as

A) drug dependence
B)drug tolerance
C) drug abuse
D) self-medication
E) drug therapy

Ans C

94) Philadelphia chromosome positive in CML, is reciprocal translocation between which of the
following chromosomes

A) t(9;22)

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B) t(2;8)
C)t(14;18)
D)t(11;14)
E) t(8;14)

Ans A

95) a beta blocking drug is effective in essential hypertension because

A) it blocks beta receptors and stimulate vagal nerves

B) it causes reduction in both cardiac output and renin release
C) it directly blocks angiotensin receptors
D) it inhibits entry of calcium into blood
E) it produces EDRF

Ans B

96) a febrile 8-year-old boy complaint of left leg pain for 3 days . A radiograph of left leg shows
changes suggesting acute osteomyelitis of femur. Culture of the infected bone is most likely to
grow which of the following organisms ?

A) heamophilus influenza
B) neisseria gonorrhoeae
C) salmonella enterica
D) staphylococcus aureus
E) streptococcus pneumoniae

Ans D

97) large aggregates of urate crystals surrounded by an intense inflammatory reaction of

lymphocytes macrophages and foreign body giant cells . These are morphological manifestation
of which of the following lesions
A) joint mice
B) osteophytes
C) tuberculous granuloma
D) pannus
E) tophi

Ans E
( Ref: gout ;robbins)

98) if patient began oral therapy with alendronate, she should be adviced to drink large
quantities of water with the tablets and remains in upright position for at least 30 minutes and
until eating the first meal of the day these instructions would be given to decrease risk of which
of the following
A) cholelithiasis
B). Diarrhea
C) constipation
D) erosive esophagitis

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E) pernicious anemia

Ans D

99) on autopsy examination the colour of postmortem lividity is almost black, most probable
cause of death is,
A) burning
B) chlorate poisoning
C) phosphorus poisoning
D) opiates poisoning
E) septic abortion

Ans D

100) Child labour is any work performed by children that is dangerous or harmful to them and
affect their physical and mental development. This form of work deprive children of their
childhood and interferes with child's ability to attend and participate in school fully by obligating
them to leave school prematurely .So fundamental convention 1973( No.138) sets by
international Labour organisation that the general minimum age for admission to employment or
work is
A) 12 years
B) 13 years
C) 14 years
D) 15 years
E) 16 years

Ans C

101)Which one is most common hereditary bleeding disorder.

a) haemophilia A
b) hemophilia B
c) Christmus disease
d) sickle cell anemia
e) von willebrand disease

Correct option e (robbins )

102)A 23year old man of Northern European lineage present with anemia .His father and
paternal aunt has similar illness that was treated successfully with splenectomy .His was
diagnosed with hereditary spherocytosis which additional abnormalities are expected.
a)Anemia,
b)splenomegaly,
c) jaundice,
d)cholelithiasis
.
Options D.(but c also seems correct)

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103)A one year old boy is treated in shoukat khanum hospital Lahore getting chemotherapy for
carcinoma .A polio case has been detected in his residential locality due to which pediatrician
decided to protect him against poliomyelitis by giving him .
a) chemoprophylaxis with antiviral
b) human normal immunoglobolin
c) human specific immunoglobolin
d) oral polio vaccine
e) inactivated polio vaccine.

Correct option D

104)A 45year old woman had a bout of sneezing a week ago after which she develop watery
nasal discharge .the discharge is intermittent ,non sticky and increase with stooping .the patient
is afebrile but has mild headache .which is most likely
a) allergic rhinitis
b) chronic rhinosinusitis
c) rhinitis medicamentosa
d) csf rhinorrea
e) pyogenic granuloma

Correct option c

Written & Marked by: KGMCITES (Batch’25)

Edited and Compiled by: SAQIB ISLAM (BMC’25)

Reviewed by: Irfan Ullah Afridi(BMC’25) and Farhad Khan (NMC’25)

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