Medicine & Allied 17th Aug —- Afternoon 2022 Imran 004

A 23-year-old man is stabbed in a bar fight. TN blade of the knife enters his chest in the led 5th intercostal space, just lateral to the sternum, and pierces to a depth of approximately 4 cm. What structure is most likely damaged?

The fastest conduction speed of cardiac impulse is observed in?

Muscle/structure posterior to the lateral arcuate ligament of diaphragm?

The dilation of which structure leads to compression of esophagus?

Serum creatinine is markedly raised in?

The common side effect of an anti- hyperlipidemic drug is?

Lumbar triangle is anteriorly related to posterior part of which structure?

Secretion of growth hormone is stimulated by:

A 6year-old boy presents with fever, malaise. cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. OIE, his temperature is 102.7 F and there are white spots on a red base (KopIik spot) close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face. behind his ears and spreading to his chest. What is the most likely diagnosis?

Patient presented with history of head trauma his urine osmolarity was decreased and also developed symptoms of polydipsia and polyuria. Likely cause would be?

A soccer player developed swelling thigh due to some injury in the game. The swelling remained for 3 months but resolved slowly in a 1 year. What was the cause of swelling?

In research, a group of mice were given a carcinogenesis injection of hydrocarbon Which act as initiator. The carcinogenesis Will cause?

Heterotopic Agranular Neocortex

A pt presented with arm weakness. O/E side of the body was unattended by him along with tongue deviation. The lesion is

Adductor canal lies between?

An HIV positive patient in his follow up, asks if the disease will progress to symptomatic Stage. Which test will be most useful?

Primordial germ cells appear in the wall of yolk sac during 3rd week of intrauterine life. Their origin is most likely from:

An unconscious boy of 11 year is brought to the emergency department of a hospital in a state of shock. Doctor on duty is unable to find any vein. The vein of lower limb most likely to be chosen for venesection is:

The H+/k+ pump in parietal cells controlled by?

During fetal life , the blood having the maximum oxygen saturation is in the:

A 55-year male presents with right sided headache, visual disturbance. O/E ESR raised, Temporal artery firm, tender and the biopsied. What is the probable diagnosis?

A patient with severe gastroenteritis develops hypokalemia. To treat it, IN potassium is advised to bring the intracellular K to normal. MOA of IV potassium in this patient is through?

During which of the following phase of the cardiac cycle does ventricular pressure rise, but ventricular volume remains constant?

Resting membrane potential is maintained by?

While studying cell, scientist note cells having decrease cellular replication and DNA damage. This is seen in?

The neurotransmitter involved in the slow sleep is?

A 20 years male with gum hypertrophy, ecchymosis and hepatomegaly. Labs show Hb 7.3, TLC 69*10A9 and platelet 18x10A9. The most likely diagnosis is?

A man diagnosed to have mitral stenosis presents in the clinic with palpitation. His ECG shows atrial fibrillation. ECG finding which support atrial fibrillation most is?

Surface epithelium of ovary is lined by?

A 15-year-old boy complained moss of appetite, vomiting and dark colored urine. Examination revealed yellow coloration of sclera. The most relevant investigation would be?

The extensor carpi Ulnaris muscle is innervated by the?

Basal bodies are derived from?

A patient underwent abdominal surgery after which he repeatedly required fluid resuscitation due to water and electrolyte loss. He does not remember which part of intestine was operated. The resection of which portion of gut has caused this condition?

An elderly OBESE female was started on IV Gentamicin BD post laparotomy. Which of the following will be disturbed?

A patient in 40’s presented with dilated and tortuous superficial veins with no other abnormality present. What is the likely cause of such veins?

A patient has episodes of fevers and chills which recur after 36-48 hours. Blood staining shows ring and crescent shape organism. The organism involved is?

Trigone of bladder is formed by?

Teenager girls playing with shooting gun when suddenly one of then get injured in the abdomen at right side just lateral to the rectus abdominus at the level of 9th vertebrae. The structure most likely injured is?

Lesion to medial lemniscus at the level of mid brain will cause ipsilateral loss in?

A patient of colon pathology was operated. and diagnosis of colon cancer was made at that time. After months/years, CEA was checked & markedly raised. What is importance of CEA after so much time?

finding in Goodpasture syndrome is?

A 36 yr. old athlete who works out excessively. During her exercise increase water loss will be through?

The most common protein that may be defective in hereditary spherocytosisis?

The component of the cell containing microtubules in its structure is:

A young lad had an RTA presents With right leg injury. O/E it is swollen, warm and crepitus positive, foul-smelling discharge, hypotensive and feels chills. The reason behind this condition is?

A 5-year boy with unilateral blindness was diagnosed with on CT with blue cells and roseate tumor. The gene involved is?

Neutrophils kill bacteria by Reactive oxygen species (ROS) which are produced by?

A Pt had obstruction for Which resection done. sample was taken for biopsy Which Showed chronic granulomatous necrosis. Type of necrosis seen is?

Most important for bone regeneration is?

A Diabetic pt having headache and vomit with recent history of starting anti-depressant (TCA). Labs reveal low sodium level. The likely cause of hyponatremia is?

A young female taking analgesics for back ache presented with blooding gums, epistaxis. She has fever of 101 mild jaundice and hepatosplenomegaly. HB TLC 7000 neutropenia, thrombocytopenia and peripheral smear shows immature cells. What is the probable diagnosis?

A man working in a cotton mill industry is likely to suffer from?

What is the role of giving somatostatin in pancreatic fistula?

A 50 year’s old lady complains of hot flushes and frequent body aches. Laboratory investigation is to show raised levels of:

On DRE, anterior surface of Which bone palpable?

At steady state, which of the following occurs?

A 40-year known alcoholic male. His lab shows Raised ALP and bilirubin. ALT was raised twice than normal and GGT was raised 6 times than normal. What will be seen on microscopic examination of liver?

A patient undergoes Radical mastectomy and now presents with painless swelling of arm. This is likely due to?

Aortic insufficiency is associated with?

Acute asthmatic patient with ABGs Showing pH 7.33, pC02 48, HC03 25. What is the metabolic abnormality?

Most common cancer in male in Karachi is?

A 35-year-old man has experienced a malar skin rash, polyarthritis with swelling and warmth of his hands. and sensitization to cold for the past 6 months. O/E he has generalized lymphadenopathy and pale conjunctivae. Lab reports include a hemoglobin of 9.5 g/dL, total WBC count of 2100/microliter, total serum protein 8.8 g/dl„ albumin 3.6 g/dL, creatinine 1.1 mg/dL, and creatine kinase of 468 t.J/L. His antinuclear antibody test is positive at 1:256. Which of the following additional serologic tests is likely to determine his underlying disease process?

Which of the following occurs in Cushing syndrome?

Pellagra is caused by deficiency of which vitamin?

A female with complains of wrist pain and numbness in index. lateral ring finger and thumb. The movement of which hand muscle will likely be effected?

The confidentiality of patient’s clinical data can be breached:

A 49-year-oid female with shortness of breath and dry cough is found to have hilar lymphadenopathy on chest x-ray. Biopsy of one of the lymph nodes reveals non caseating granulomas. Diagnosis is?

A patient was put on ventilator support, PEEP set at high, Flo2 100%. 5 days later patient died there were hyaline streaks on lungs with increased number of macrophages along with neutrophils, likely cause is?

Pituitary tumor invades which bone?

A RBC is kept in a hypertonic solution to Which urea is added. What will be the effect on RBC?

A patient with 1-year history of shortness of breath present with cough. O/E wheeze hyper resonant chest and decrease vocal fremitus. PFTs show disease FEV/FVC and cause of increased activity of neutrophil elastase?

Difference in size and shape with loss of polarity of cells, having increased NIC ratio and is reversible. These feature define?

A lady in her third trimester presents with severe headache and vomiting. O/E BP 180/110 and she is edematous. She has history of seizures during her past pregnancy. The treatment of choice will be?

The artery palpated between trachea and Infrahyoid is?

A man after lifting heavy weight experiences sudden pain in his arm. O/E swelling in upper forearm is noted at the site where the muscle is attached to radial tuberosity. The muscle likely injured is?

Changes in motor aphasia are often associated with a lesion of?

Goosebumps occur due to?

Xerostomia involves which nucleus?

The zymogen form of trypsinogen of pancreatic juice is converted to active trypsin by:

During surgery, splenic vessels need to ligated. In which ligament are these vessels present?

A patient who had kidney transplantation develops cyanosis and organ failure within 10 minutes. What is the likely etiology?

The oxygen haemoglobin dissociation cure shifts to the extreme left by:

Which structure lies anterior to thoracic part of trachea?

A 45-year male presents with sudden retrosternal pain associated with sweating and breathlessness. O/E vitals were BP 90/60 pulse 110, low volume. What is the diagnosis?

Sense of steady joint angle is perceived by?

Boy after a blunt trauma to eye presents to You with lower orbital rim fracture. O/E blackening of the orbital area, swelling was noted and crackling sound were heard on Palpation. The most likely diagnosis is?

Oropharyngeal Ca is caused by?

Gram positive cocci not appear on staining, what other test can be used?

The most effective way to prevent heat joss

Dorsal column-medial lemniscus (DCML) is formed by:

Sublingual nitroglycerin is absorbed readily into?

Plasma colloid oncotic pressure is maintained by?

In acute Myocardial Infarction, the type of Shock is?

Decrease brush border enzyme result in?

Hyphema is the collection of blood in?

REM sleep neurotransmitter is?

The storage cell for carbohydrate. protein and lipid is?

A patient with has been pre-eclampsia has been admitted for emergency C-section. On preoperative assessment her BP is 190/120 mmHg, heart rate is 70 per min. The most suitable drug to control her blood pressure before induction of general anesthesia will be:

Which of the following should not to be given in myasthenia gravis?

Neurotransmitter present in the Nigrostriatal pathway of caudate and putamen?

If IL Normal saline solution is infused to a person, then which of the following occurs?

A patient unconscious from half hour after accident is bought to tile hospital looks pate cold and clammy, pulse rapid and thready. His MAP is €60, POQ 60,nmhg. Which will provide rapid response?

A man hiking up a mountain, having low P02 developed SOB. This is likely due to?

Sympathetic cholinergic stimulation causes?

50 years old presented in emergency department with failing heart. Which drug of Choice should be given?

Coagulation and kinin pathway are activities via?

A 70 years’ lady presented with fever. cough with yellow sputum, involvement of the lower lung lobes and was unable to recognize her family. The organism Observed was gram eve and catalase -ve, Most likely cause is?

Anterior pituitary tumor compressing central optic chiasma. Vision field defect will be?

Patient with bronchogenic carcinoma mass in left hilar lung. Which structure is likely to be affected?

Para-neoplastic syndrome is exhibited by one of the following tumours:

Drug of choice for Pseudomembranous colitis is?

Eight patients have entered a trial. Their ages are 20, 20. 30, 35, 40, 25.25 and 30. The median value in this case is?

An 80-year female presented with skin pigmentation. tingling sensation and unable to maintain postural balance for the last 3 months. Labs shows Hb 8, WBC 3.2x10A9 MCV 112 MCH 26, ferritin 600. What is the likely diagnosis?

HI-A ORA ix associated with?

Shigella dysentery effects are due to?

On H&E staining a student sees the hallow structure around the nucleus. What could it likely be?

A female had a crush spinal injury to sacral region in a RTA after which she complained of lower limb weakness and urinary incontinence. The is likely due to?

LOW doses of aspirin reduce platelet aggregation and clot formation by inhibiting the production of?

Maximum 02 tension is in?

A man presents with gradual loss of vision Radiological studies show a growing clot in vessel. Most likely involved vessel is?

Following nerve injury Pt develops weakness in touching the thumb to the tip of index finger The muscle weakened is?

High output cardiac failure is found in?

Mother had alcohol during pregnancy, baby is at risk of developing?

Which PFTs findings are closely related to a patient of bronchial asthma?

Inhibitory neurotransmission of substantia nigra is?

Side effects of recombinant human growth hormone therapy include?

After 5 years of transplant surgery, there is increased risk of?

Median arcuate ligament arises from?

Vasopressin is synthesized in the:

ABGs show pH 7.3 pCO2 39, pO2 95 HCO3 19. The acid base disorder is?

Common features of normal kidney:

In DVT. the emboli first get lodged into which of the following?

An old diabetic hypertensive lady with CRF is on dialysis. Her femur head shows loss of trabecular bone. Which hormone is responsible?

Increase levels of phenylalanine in blood occurs in?

A known CKD, DM patient who is dialysis dependant develops a leg ulcer, the treatment of which requires antibiotics. Which drug can be given without change in dose (renal dose adjustment)?

A 30-year-old pregnant lady with mitral stenosis presented with atrial fibrillation in the first trimester. The most appropriate therapy would be:

Type of joint present in between the intervertebral disc is?

Reliability:

A 30-Year female in village presents with fever, weakness. rigor and chills with weakness. She has been passing cola colored urine since 2 days (NO drug history mentioned). A mobile health team visited her to carry out some investigation and diagnosed her as?

Hopat0ionticu1ar degeneration also known as Wilson disease, is related to?

Ectopic thyroid hormones are usually Secreted by?

Neurosecretory hormone is?

ABGs show PH HC03 38, 40. The acid base disorder is?

The difference between PCT and DCT is?

Horse rider fall and developed bruises and scratches, after few days presented with lock jaw and spasm due to?

Abductor of vocal cord is?

Glint cell arteritis is associated with which one of the following disease?

in a grip test, a man is unable to hold a piece of paper between his thumb and index finger. O/E the flexion of thumb at interphalangeal joint has been affected. Which of the following nerves has most likely been injured?

Which of the following is a benign tumor?

A 2-year-old off the-bed and develops a hematoma on forehead. Routine labs show no abnormality but the mother says her daughter are fine but gives history of her brother profusely bleeding from circumcision. Next investigation done should be?

Regarding aneuploidy, true is

Mass of lymphoid tissue with surrounding stratified Squamous epithelium is?

Which of the following should be given to a 3^rd post operation day patient for moderate pain?

A student was examining a under microscope. He found mass Of lymphoid tissue covered With Simple cub0idal epithelium. the structure he is examining is?

What is the most important factor in pathogenesis of thrombosis?

Costal Cartilage is composed of?

A young female presented in OPO with IOSS of light reflex but intact accommodation reflex. The lesion is at?

which factor is directly proportional for oxygen diffusion?

The blood group A will have?

Absence of cartilage in terminal bronchioles differentiate it from:

A Young gift with nasal polyp. CT presence of a non-septate hyphae with right angle branching. The likely cause is?

The most likely condition which causes the severe form of steatorrhea is:

A 30-year man complains of fatigue and dyspnea. O/E he has left parasternal heave and systolic thrill with a harsh pan-systolic murmur at left parasternal region. What is the most probable diagnosis?

Phrenic nerve is the sole motor supply to the diaphragm. The root value of phrenic nerve with major contribution is by?

The middle ear cavity. the most prominent nerve On medial and posterior wall is?

The transport of D-glucose and L-glucose proceeds at the same rate down an electrochemical gradient by Which one of the following processes?

Which structure is closest crus cerebri?

Colls that commonly form the foam cells of an atheroma are derived from the arterial wa and from circulating elements. The latter are most likely?

Odd one out?

Antacid which delay gastric emptying?

The biconcave shape of RBC is maintained by which protein?

An ICU patient with CVP line in subclavian vein for the past 10 days is on parenteral nutrition. He develops fever and Gram staining reveal clusters of gram-positive diplococci. The Drug of choice in this patient is?

ABC shows pH 7.3, P02 90..hg, C02 20mmhg and HC03 18. Diagnosis is?

A 49-years male patient with severe Crohns disease has been unresponsive to drug therapy and undergoes ileal resection. After surgery he will have steatorrhea because?

A lady had colostomy and was put on total parenteral nutrition (TPN). She is prone to develop which of the following initially?

What is the most common cause of congenital cyanotic heart disease?

Investigation of choice for MI after 3hour onset?

A patient With LRTI was admitted in pulmonology ward. He was started on beta lactamase inhibitor and shows good response but has now developed diarrhea. The drug of choice to treat this condition is?

A young medical technician had a history of acute eczematous dermatitis on her hands and wrist after wearing latex gloves The was dry. crusted and thickened. The eczematous reaction cleared after a a-week vacation but returned after 72hrs back on the job and continued to grow worse. The reaction to latex gloves was most likely:

A 45 years old mai6 had automobile with fracture of femur. He died after 5 days. Autopsy showed widespread petechiae in cerebral white matter. The most likely cause of death is?

Cells containing Ig E receptors and dense basophilic granules with histamine are?

Information care session is for:

The laboratory test to correctly identify individuals who are free of disease is referred to as:

A has a Blood Pressure of 70/40 mmHg & serum Lactate 30mg/100ml (Normal 6 to 16). cardiac output is 2L/min & CVP is 2cms of water. Most likely cause of this condition is?

Drug of choice for treatment of Neisseria meningitis is?