FCPS
Medicine & allied
Paper 2.
25-5-1010
recalled by latifaziz


Q1-A patient comes to a doctor with a complain of pain down the medial side of right forearm & hand ,wasting of the small muscles of hand .on examination ,circulation of right upper limb was also impaired .the anatomical structure:

A. head of right humerus
B. left cervical rib
C. right 2nd rib
D. right first rib
E. right cervical rib



Q 2-A 45 years old man fell on his back from the 2nd storey of building. Two days after admitting in hospital .he complained of inability to void urine & urinary incontinence. Most likely spinal segment involved is:

A. l2.3.4
B. l3,4.5
C. L5, s1, s2.
D. S1.s2.3
E. S2.3.4

Q 3-When performing lumber puncture .the following structure is pierced by needle:
A: the posterior longitudinal ligament
B: dura mater
C: pia mater
D: Denticulate ligament

Q 4.Fat absorption is occurs primarily in the
A: stomach
B: jejunum
C: terminal ileum
D: cecum
E: colon

Q 5. Secretion of HCL by gastric parietal cell is mediated by
A: H1 receptor
B: H2 receptor
C: pepsin
D: intrinsic factor
E: presence of food.





Q-6 Bicarbonate is absorbed from
A: proximal tubule
B: loop of henle
C: collecting tubule
D: proximal tubule & DCT
E: proximal tubule & collecting tubule

Q-7 A young female presented with high grade fever of 6 days duration for a definite diagnosis of typhoid, the most useful test at this stage would be

A: blood culture
B: stool culture
C: typhidot test
D: urine culture
E: widal test

Q-8A young man presented with low grade fever for the last three months, on examination, nasal bridge was distorted & cervical lymph nodes were palpable .histology of these lymph nodes revealed non caseating granuloma & positive AFB stain: most likely diagnosis is:

A: cat scratch disease
B: leprosy
C: sarcoidosis
D: syphilis
E: tuberculosis

Q-9: which of the following lab investigation is the best for monitoring of hepatitis B viral infection:
A: prothrombin time
B: serum Albumin
C: serum bilirubin
D: serum glutamic pyruvate transaminase
E: serum protein

Q-10:A lady had a difficult labour at home in village .she was brought to hospital with history of bleeding p/v & oozing from gums for the last 10 hours. Her blood complete picture revealed .Hb: 6 g/dl, platelets 30,000/cumm, TLC 24,000/cumm with neutophillia.the peripheral blood film shows burr cells. Her PT & APTT were prolonged. Most likely cause is:

A: disseminated intravascular coagulation
B: ITP
C: postpartum hemorrhage
D: septicemia
E: von will brand disease
Q-11: Most abundant endogenous pigment deposition in chronic haemolysis is:

A: bilirubin
B: biliverdin
C: haemosiderin
D: lipfuscin
E: melanin

Q-12: A 30 year old primigravida presented at 36 week of gestation with bilirubin of 20mgldl ,SGPT 275u/l & SGOT 193u/l .two month ago she visited her parents is a remote village .she has no history of surgery in past or blood transfusion .most likely cause of infection is:

A: hepatitis A
B: hepatitis B
C: hepatitis C
D: hepatitis D
E: hepatitis E

Q-13: Which of the following parasite is Associated with urinary bladder carcinoma.
A: leishmania donovani
B: schistosoma heamatobium
C: schistosoma japonicum
D: schistosoma mansoni
E: toxoplasma gondii

Q-14: Respiratory symptoms are characteristic of one of the following conditions:
A: ascariasis
B: billharziasis
C: cysticercosis
D: fascioliasis
E: giardiasis

Q-15: The most important distinguishing feature of exudate, compared to transudate is:
A: above 2.0gms% protein
B: albumin is the main protein
C: presence of the large number of inflammatory cells
D: presence of the large number of the platelets
E: specific gravity is about 1.020

Q-16: The natural antithrombotic agent which is present in blood is :
A: dimercaprol
B: heparin
C: plasminogen
D: vitamin C
E: warfarin
Q-17: A 30 years old female with joint pain & muscle stiffness for 3 years. HLA-DR4 is positive, what is most appropriate diagnosis.
A: ankylosing spondylitis
B: graves disease
C: myasthenia gravis
D: rheumatoid arthritis
E: SLE

Q-18 Regarding digoxin toxicity is increased by
A: hyperkalemia
B: Quinidine
C:
D: hypermagnesemia
E: hypocalcaemia

Q-19: Antiarrythmic Action of lidocaine on hear is.
A: Prolong Action potential duration
B: It Decreases automaticity
C: shortens RMP of heart
D: prolong the effective refractory period
E:

Q-20:A 60 year old patient of emphysema presents with Dyspnoea of sudden onset with chest pain .on examination pulse 110/min; Bp 105/85mmHg.trachea shifted towards right,hyperresonant percussion note & decreased breath sounds on the left side. the investigation which will be most helpful in the diagnosis is:
A: ABGs
B: cardiac enzymes
C: chest x-ray
D: E.C.G
E: sputum routine examination

Q-21: A 70 year old woman undergoes a gastrectomy for the zollinger-ellision syndrome. Her physician informs her that she will need to take intramuscular vitamin-b12 shots for the rest of her life. Absence of which of the following cell type is responsible for this vitamin replacement requirement.

A: chief cells
B: G cells
C: Goblet cell
D: Mucous neck cells
E: parietal cells





Q-22: A patient is to get renal transplant, the tissues for Histocompatibilty required would be.
A: Bone marrow
B: buccal mucosa
C: RBCs
D: renal tissue
E WBC

Q-23: Lesion of the Right optic tract causes:
A: left homonymous hemianopia
B: left nasal hemianopia
C: loss of papillary reflexes
D: Right temporal hemianopia
E; total blindness

Q-24: Slow wave sleep is induced by
A: dopamine
B: epinephrine
C: Glutamate
D: Acetylcholine
E: serotonin

Q-25: Duodenum contains
A: sub mucosal glands
B: well-developed plica
C: crypts
D: aggregation of lymphoid nodule
E: villi

Q-26: A patient has penetrating ulcer of the posterior wall of the first part of the duodenum which blood vessels is subject to erosion:
A: common hepatic artery
B: Gastroduodenal artery
C: left Gastric artery
D: hepatic artery
E: Anterior inferior pancreaticoduodenal artery

Q-27: hemiballismus result from lesion of
A: Globus Pallidus
B: caudate nucleus
C: internal capsule
D: sub thalamic nucleus
E: substantia nigra



Q-28: Subdural hematoma results from head trauma that tears the:
A: middle meningeal artery
B: Anterior division of middle meningeal artery
C: posterior division of middle meningeal artery
D: superficial temporal artery
E: superficial cerebral vein

Q-29: Neonate with erythroblastosis Fetalis is massively transfused with blood, After 10 days developed rash first on palms, then face & trunk along with diarrhea. What is the probable cause?

A: cytomegalovirus infection
B: GVH disease
C: Delayed transfusion reaction
D: Acute hemolytic transfusion reaction
E: ABO incompatibility

Q-30: Pendular knee jerk is seen in lesion of:
A; sub thalamic nucleus
B: cerebellum
C: cerebral cortex
D: basal ganglion
E: spinal cord

Q-31: patient have positive Accommodation reflex but light reflex is lost, the lesion is at the level of.
A: occipital cortex
B: lateral Geniculate Body
C: superior collicilus
D: Pretectal area
E: Optic radiation

Q-32: Primary Hyperaldosteronism
A: Acidosis
B: Hpokalemia
C: hyponatremia
D: hypotension
E: Weakness

Q-33: Functional residual capacity
A: is measured by spirometry
B: is the sum of the Residual volume & inspiratoy reserve volume
C: is the sum o0f residual volume & vital capacity
D: is the sum of the residual volume & tidal volume
E: is the volume of the air remaining in the lungs after a normal tidal volume

Q-34:A 40 year old ,type 2 diabetic, he is 15 Ib overweight ,present with blood sugar of 20mmol/l he has no diabetic complication at the time of presentation .what is the most suitable initial treatment ,in addition to diet & exercise.?
A: Biguanide
B: Biguanide & sulphonylurea
C: insulin
D: insulin & sulphonylurea
E: sulphonylurea

Q-35 Side effects of thiazide diuretics.
A: hyperglycemia
B: hyperkalemia
C: hyperuricemia
D: hypocalcemia
E: hpernatremia

Q-36 Hypospadias occurs due to defect in
A: urogenital Ridge
B: urogenital tubercle
C: urogenital fold
D: urachus
E: Gubernaculum

Q-37: Retroperitoneal Abscess mostly involve
A: Descending colon
B: spleen
C: transverse colon
D: Appendix
E: cecum

Q-38: A 15 year old boy came to the clinic with history of splenomegly
With lymphadenopathy.bone marrow biopsy was performed on medial side of tibia in order to avoid injury to the:
A: common peroneal nerve
B: Tibial nerve
C: superficial nerve
D: saphenous nerve
E: deep peroneal nerve

Q-39: Esophagus is drained by which portal vein tributaries
A: Azygous vein
B: Hemiazygous vein
C: Left Gastric vein
D; Right Gastric vein
E: Posterior intercostals vein

Q-40: A 15 years child came in peadritic clinic with history of sore throat & fever for 10 days .now he has presented with chest pain unrelated with respiration. From which structure pain arises:
A: Lungs
B: pleura
C: myocardium
D: pericardium
E: costochondral

Q-41: During development of testes, internal spermatic fascia is derived from
A: External OBLIQUE muscle
B: internal oblique muscle
C: fascia transversalis
D: psoas muscle
E: external oblique aponurosis

Q-42: Most Appropriate about upper 2/3 of anal canal
A: lined by stratified Squamous Epithelium
B: Drained by inferior rectal vein
C: sensitive to stretch
D: sensitive to pain & temperature
E: supplied by pudendal nerve

Q-43: A 30 years old laborer comes with history of bilateral loss of pain & temperature sensation at T4-8 level while intact sensation of fine & touch, postion & vibration sense. What is most likely cause:?
A: lesion at Anteriolateral tract bilaterally at T4-8
B: hemi section of cord at T4-8
C: thalamic lesion
D: hypothalamus
E: central cavitating lesion at T4-8

Q-44: occulomotor, trochlear & Abducent nerve supplies the muscle of Eye, regarding occulomotor nerve most likely is
A: traverses through superior orbital fissure
B: supplies All extra ocular muscle except lateral rectus & superior oblique
C: supplies medial rectus
D: moves eyeball upward & medially
E: supplies superior oblique muscle

Q-45: when tongue is protruded, it deviates, which nucleus is affected
A: Facial nucleus
B: hypoglossal nucleus
C: Abducent nucleus
D: Facial colliculus
E: Trigeminal nucleus
Q-46 Except Rods & cones, Most of retina is supplied by?
A: central retinal artery
B: short ciliary artery
C: choridal artery
D: short posterior ciliary artery
E: long posterior ciliary artery

Q-47: Final motor pathway:
A: Arises from premotor area of cerebral cortex
B: Arises at the level of the medullary decussation
C: Arises Above the level of medullary decussation
D: emerge at the level of intervertebral foramina from anterior nerve roots
E: Arises at the level of spinal cord only

Q-48: normal fetal heart rate is.
A: 100-140
B: 120-!60
C: 120-140
D: 180-200
E: 220-240

Q-49: young Adult came in OPD .his radial pulse is collapsing type with diastolic murmur, most likely cause is:
A: Aortic stenosis
B: Aortic regurgitation
C: Tricuspid regurgitation
D: Mitral stenosis
E: pulmonary stenosis

Q-50: CVP is decreased in.
A: Gram negative septicemia
B: Cardiac tamponade
C: pulmonary embolism
D: hemopericardium
E: constrictive pericarditis

Q-51: Paraneoplastic syndrome is associated with.
A: Breast cancer
B: Renal cell carcinoma
C: Small cell carcinoma
D: Thyroid carcinoma
E: Liver cancer




Q-52: Warfarin effect is increased when it is given with
A: Rifampicin
B: cimetidine
C: phenytoin
D: Isoniazid
E; carbamazepine

Q-53: Regarding beta blocker most inappropriate is.
A: Increase release of renin from kidney
B: Positive chronotropic
C: Positvie ionotrpoic
D: bronchoconstriction
E: Peripheral vasoconstriction

Q-54: A case of road traffic Accident patient came in emergency with 1.5 L blood loss, His skin is cold & clammy is due to
A: vasodilatation
B: sweating
C: vasoconstriction
D: vasoconstriction & sweating
E: hypotension

Q-55: Nutmeg liver is
A: centrilobular congestion
B: periportal congestion
C: peripheral congestion
D: cental congestion
E: centriacinar congestion

Q-56: A 26 years old patient presented with butterfly rash on face, arthrlgias & low grade fever for 3 month. The rash is accentuated by sun light, moist likely diagnosis is.
A: Dermatomyositis
B: POLYmyositis
C: Rheumatoid Arthritis
D: Sjogren syndrome
E: SLE

Q-57: Female patient is presented in OPD with proteinuria & flank pain. Lab investigation shows Anti ds DNA antibody positive. What is most likely diagnosis?
A: Amyloidosis
B: Lupus nephritis
C: Goodpasture syndrome
D: MPGN
E: RPGN


Q-58: A patient on Glucocorticoid therapy is most likely to decrease count of
A: Lymphocytes
B: Monocytes
C: RBC
D: Neutrophill
E; Platelets

Q-59: Renal blood Flow is best measured by.
A: inulin
B: PAHA
C: urea
D: creatinine
E: PABA

Q-60: A patient present in Emergency with Acute Severe Asthmatic Attack, what should be initial treatment of choice.
A: oral prednisolone
B: Ipratropium
C: Antibiotics
D: Salbutamol Nebulization
E; Zafirlukast

Q-61: A 3 year old child presented with history of fever. Neck & back stiffness of sudden onset, later develops flaccid paralysis of upper limbs, signs of meningeal irritation are present. Child is not immunized .which is most appropriate specimen for diagnosis.

A: Blood
B: CSF
C: stool
D: urine
E: sputum

Q-62: Most appropriate Antibody sequence in the diagnosis of Multiple Myeloma is.
A: IgA=0.3%, IgM0.2 %, IgG 15%
B: I IgA=1.3%, IgM 18%, IgG 23%
C: I IgA=3%, IgM 7%, IgG 13%
D: I IgA=6%, IgM 12%, IgG 10%
E: I IgA=8 %, IgM 2 %, IgG 17%

Q-63: Regarding Sturge Weber syndrome
A: Dislocation lo lens
B: Choroidal tumor
C: glaucoma
D: retinal Heamangiomas
E: Rubeosis iris

Q-64: Mechanism of Action of captopril
A: Inhibit angiotensin receptor
B: Decrease formation of Angiotensin 2
C: Antagonize Aldosterone
D: Releases Renin secretion
E: inhibit v2 receptors

Q-64: Bile salts are absorbed in
A; Duodenum
B: Jejunum
C: colon
D: Ileum
E: Stomach

Q-65: A 40 year old female, patient of DM type 2 since 10 years presented with symptoms of Abdominal distension after meal .what is most appropriate drug to treat her.
A: Diuretics
B: Metoclopromide
C: Antacids
D: proton pump inhibitors
E: H2 receptor blockers

Q-66: Tumor spreading via Lymphatic is.?
A: Angiosarcoma
B: Rhabdomyosarcoma
C: osteosarcoma
D: renal cell carcinoma
E liver cell carcinoma

Q-67: Platelet transfusion is not indicated in.?
A; ITP
B: Leukemia
C: Multiple transfusions
D: Patient with splenomegly
E; DIC

Q-68: A baby born with Erythroblastosis Fetalis, most likely Hypersensitivity reaction is.
A: type -1
B: type -2
C: type 3
D: type 4
E: type 5


Q-69: young female presented with jaundice, direct antiglobulin Antibody is positive. What is most likely diagnosis?
A: Autoimmune hemolytic anemia
B: Hepatocellular jaundice
C: Hemolytic Anemia
D: Obstructive jaundice
E:

Q-70: In HIV patient there is increase risk of infection because of decrease in
A: CD8 count
B: CD4 + lymphocytes
C: Antibodies
D: Natural killer cells
E: Macrophage

Q-71: The following Drug should be Avoided in patient with Renal disease?
A: Macrolide
B: Gentamicin
C: chloramphenicol
D: Isoniazid
E vancomycin

Q-72: Middle aged patient presented with Altered level of sensorium,fever & neck stiffness, signs of meningeal irritations are positive LP was performed which shows protein 600 mg/dl,Glucose 40mmg% WBC is about 120 with predominant of lymphocytes what is most likely diagnosis
A: Bacterial meningitis
B: Viral meningitis
C: TBM
D: septic meningitis
E: fungal meningitis

Q-73: Patient with hypertonia & paresis, lesion is at
A; cerebellum
B: brainstem
C: corticospinal & corticobulbar
D: LMN
E: tectospinal tract

Q-74: Most common cause of pulmonary Embolism is.?
A: paradoxical emboli
B: DVT
C: Immobilization
D: superficial vein thrombosis
E: pulmonary hypertension

Q-75: the part of Hypothalamus which Regulate the circadian Rhythm is.
A: Preoptic nucleus
B: supraventicular nucleus
C: supra chiasmatic nucleus
D: septal nucleus
E: Para ventricular nucleus

Q-76: Most Appropriate Treatment of choice for Hyperthyroidism in Pregnancy is.?
A: Radioactive iodine
B: propylthiouracil
C: carbimazole
D: methimazole
E; iodine

Q-77: while performing bronchoscopy, the doctor introduced bronchoscope .the first structure will seen beyond the level of carina is.
A: upper lobe
B: Anterior upper lobe bronchus
C: Middle Lobe Bronchus
D: apical bronchus of lower lobe
E; lower lobe

Q-78: Absolute Lymphocytosis is not found in.
A: Congenital syphilis
B: infectious mononucleosis
C: pertusis
D: waldenstrom macroglobunimia
E: burkitt’s lymphoma

Q-79: After transplant Surgery which is not possible.
A: leukemia
B: cervical dysplasia
C: leukoblastic leukemia
D: Haemolysis
E: Liver cell carcinoma

Q-80: which of the following is not live Attenuated Vaccine
A: Measles
B: Mumps
C: rubella
D: Pertusis
E: Oral polio




Q-81 Antibody in Tuberculosis is
A: bound to cell
B: Attacked by Bacteria
C: inside the cell
D: provides immunity
E: present in serum

Q-82: Most aggressive tumor is.
A:Basal cell carcinoma
B: Squamous cell carcinoma
C: Melanoma
D: Kerato acnthoma
E sarcoma

Q83: neonate was brought by Mother with complain of failure to pass meconium Abdominal distension, Rectal biopsy shown Absence of Ganglionic cell. What is most likely cause?
A; Hirsh sprung disease
B: Meconium Illeus
C: intersection
D: sigmoid volvulus
E: Mekels diverticulum

Q84: Regarding Isoniazid
A: is nephrotoxic
B: Toxic effects can be prevented by pyridoxine
C: is hemotoxic
D: donot cause peripheral neuropathy
E: causes hyperuricemia

Q-85: In Quite Breathing, the principal inspiratoy muscle is
A: Diaphragm
B: internal intercostal
C: pectoralis major
D: levator costarum
E: scalenus Anterior

Q-86: Bile Acid is conjugated with,
A: Bilirubin Glucronide
B: Glycine & Taurine
C: Bilirubin transferase
D: bilirubin Glucuronyl transferase
E; hemoglobulin



Q-87: Regarding Thrombocyte Function in clotting
A: Adhere to fibroblast
B: Release platelet factor which start coagulation
C: causes clot expansion
D: causes clot retraction
E: causes clot disolution

Q-88: which of following have not effect on best prognosis of patient in renal transplant?
A: HLA typing
B: deceased or live donor
C: relative donor
D: donor having disorder of another organ system
E: sex of donor

Q-89: Human Major Histocompatibilty complex
A: codes for blood group
B: codes for three classes of antigen
C: is composed of HLA genes
D: resides on chromosomes 12
E; will be identical in twins

Q-90: Antigen-Antibody Reaction is characteristically suppressed by
A: ACTH
B: During blood transfusion in recipient
C: Anemia
D: liver failure
E: neutropenia

Q-91: The Diagnostic Differential feature Between Hyperplasia & Benign Tumor is.
A: increase in number of cells
B: increase in size of cells
C; number of mitotic figures
D: presence of capsule
E: resemblance of parent tissue

Q-92: A plumber presented in ER with sudden Onset of SOB, ABGs shown .PH 7.4, pco2= 31, HCO3 = 19, PO2 62. What is most likely diagnosis?
A: Metabolic Acidosis
B: Compensated Respiratory Acidosis
C: Mixed Acid Base Disorder
D: Compensated Metabolic Acidosis
E: Respiratory Acidosis


Q-93: Gastric Motility is increased by
A: HCL
B: Gastrin
C: CCK
D: secretin
E: GIP