Medicine & Allied 17th Nov —– Afternoon 2022

Which of the following will be the best enzyme for a patient with acute chest pain for 3 hours?

Regarding Graves ophthalmopathy, correct is?

 A patient unconscious from half hour after accident is bought to the hospital looks pale cold and clammy, pulse vapid and thready. His MAP is <60, P02 60rnmhg. Which will provide rapid response?

Toxoplasmosis is a disease of?

A kidney transplant patient developed severe pneumonia not responding to antibiotics. Broncho-alveolar lavage fluid showed boat shaped cysts. The most likely cause of pneumonia in this case would be:

Which one of the following is anti-apoptotic?

Hormone related to glycogenolysis, gluconeogenesis ketogenesis is?

35-year old common cold along with mild chest pain and breathing problem. Diagnosed with early stage Of pulmonary anthrax infection. Drug of choice is:

An unconscious person presented in Emergency, he had injury to head, he was kept in observation after sometime Lucid interval was seen, this could be result of due to rupture of which artery?

Angioedema scenario mentioning urticaria and anaphylaxis. It is mediated by?

Stomach has some specialized cells that absorb?

Hormone which causes gluconeogenesis and glycogenolysis are released from?

A 60-year man with long standing HTN and aortic stenosis. The histology of his heart will show?

A 40-year-old patient has short stature, normal trunk, marked lumbar lordosis and normal IQ level. The likely diagnosis is?

Lesion top right optic tract will lead to?

A man is lying in a awake in quiet room. He has closed eyes and is mentally relaxed. His electroencephalogram is likely to show Which waves?

Man loses plantar flexion, nerve responsible?

Patient have cushing’s disease increased ACTH in:

In appendicitis, the pain around the umbilicus is felt thorough?

Which cell are involved in Graft transplant rejection?

Feature of a well differentiated squamous cell carcinoma are?

An 18-year-old with abdominal pain. purpura, hematuria. proteinuria and normal platelets is suggestive of?

Aromatase is secreted by?

Eight Months after prosthetic valve replacement, pathogen responsible for infective endocarditis?

Which of the following will help in diagnosis COPD?

Periarticular erosions on radiographs are classically seen in:

Lesion in posterior cerebral artery causes?

 6-year-oid 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. O/E, his temperature is 102.7 F and there are white spots on a red base (Koplik 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?

Which one of the following acts directly on thrombin, independent of Antithrombin 3?

Neurosecretory hormone is?

A man involved in an RTA with multiple rib fractures. He has difficulty in breathing you notice that his abdomen is moving more during breathing. Which Of the muscle is helping?

Damage to cerebro-parietal area (post central gyrus). what will be effected?

Considering the functions of autonomic nervous system, following is the parasympathetic response:

Which of the following has a sour taste?

In Hazelnut/apricot allergy, the allergen name is?

Which of the following structures is found only in Gram-positive microorganisms?

Bar bodies most commonly related with which blood cell.

Which of the following serves as a co-factor synthesis of co enzyme A?

Non-seminomatous germ cell tumor marker?

Some of the neoplasms appear to develop from viral oncogenesis. Which of the following neoplasms is most likely to arise in this manner?

High output cardiac failure is found in?

A 40-year female on steroids since 7 years came for tooth extraction. Which of the following should first be corrected?

Major supply to posterior interventricular septum is from?

 A patient came to ER after a penetrating injury with shortness of breath and sharp chest pain. O/E No air entry on right side and hyper resonant on percussion. the lungs collapsed inward and chest sprung outward. shows trachea shifted towards left. Diagnosis is?

 A postmenopausal woman is on HRT for postmenopausal related osteoporosis. What complication she is at risk of?

 Cranial nerve 7,9,10 take taste sensation to?

Young girl presents menorrhagia, petechiae. Labs show decrease activity of factor 8 and increase BT and PT. Diagnosis is?

In a diabetic pt with multiple abscess. inflammatory cells roach the site by?

Delayed Cell mediated immunity require?

Patient with a deep knife wound in the buttock walks with a waddling gait that is characterized by the pelvis falling toward one side at each step. Which of the following nerves is damaged?

Which drug decreases the triglyceride levels the most?

Which sensation is carried through the nucleus of dorsomedial column of thalamus?

In moderate exercise, blood flow to which organ remains unchanged?

Early pregnancy is best diagnosed within 10 days of conception by?

Diagnostic test for infectious mononucleosis?

Neurotransmitter of outflow of basal ganglia is?

Sarcolemma adjacent to nerve terminal?

To generate forces, calcium binds with actin and?

Memory gets stored in?

A man thirsty for 24 hours:

A male with delayed puberty having small testes, large legs, gynecomastia and karyotype 47XXY. Diagnosis?

Regarding Vibrio Cholera:

Which of the following occurs at the site of Endocytosis?

The main difference between primary and secondary intention wound healing is?

Interruption to cervical sympathetic chain results in Horner’s syndrome. If nerves to the eye are affected. Which of the following is the commonest finding?

Which tumor marker is increased in testicular germ cell tumor and is common to all types?

A known CKD patient diagnosed with Crohns is started on corticosteroids for induction. Which drug is best for disease remission?

The saliva, after eating dry fruits, become?

 A 60-year-old patient reported to the prosthodontist with complaint of inability to place denture into his mouth. The prosthodontist referred the case to the medical specialist, as it was not due to the denture. O/E rigidity and tremors were noted. Which of the following nuclei of brain is involved?

A 30-year-old female with Graves’s disease was started on propylthiouracil. A month later she complained of sore throat, low grade fever and in generally unwell. Which of the following tests constitute initial step evaluation in this patient?

Anterior fontanelle is also known as?

A 45-years lady developed pericardial effusion and pleural effusion. Effusion fluid was examined, it turned out to be Transudative. Normal baseline investigations, Anti-DS titer was 1:560. Urine nitrogen was > 55. Renal biopsy will show?

MOA of acetazolamide?

Renal excretion of drugs is?

The structure which loops around the arch of the aorta is?

8% blood loss in 30 With no change in atrial pressure. The maximum volume reduction will occur in which compartment?

Which of the following is supplied by muscarinic cholinergic via post ganglionic sympathetic fibers?

Squamocolumnar epithelium present 3cm above of cardiac end of esophagus. Cause is?

The major (sensory) nerve sue-ply from the side of the scalp and associated with the temporal and parietal area is via the:

A 45-year-old man was brought to emergency department after a road side accident in a semicomatose condition. Examination reveals pulse 1201min and B.P 90/50 mmHg. There are fractures of right femur. left humerus and right radius with ulna. The first measure required would be:

A 20-year-old patient presents with abdominal bloating following meals, several foul-smelling frothy stools per day. He also complains of weakness. The most appropriate investigation would be:

A 9-year boy admitted for surgery complains of dry mouth with difficult to eat and swallow. O/E white patches on mouth were. What should be treatment?

Thirst is stimulated by?

A Pt with pale nasal mucosa, recurrent rhinitis TX?

Which of the following is a naturally occurring fibrinolytic/thrombolytic?

The most reliable diagnostic test for lobar pneumonia is:

Which statement regarding fibrocartilage is correct?

Female with one sided throbbing headache not relieved by paracetamol that’s associated with nausea, vomiting and photophobia. What first line treatment should be given for this acute condition?

A middle-aged lady complained of pain and tingling in her left hand radiating to the forearm. There was wasting of the thenar eminence and weakness of abduction and opposition of the thumb. Sensory loss over the palmar aspect of the thumb and index finger. The nerve likely involved is?

What segment of ECG coincide with a-wave of JVP?

Sluggish pendular knee jerk reflex seen in?

An ECG snows ventricular extra systole. The next normal ventricular contraction that occurs after extra systole would produce?

A 35-year-old woman presented with H/o weakness, palpitations and breathlessness on exertion, tingling of feet and difficulty in walking. Her blood examination showed Hb 5g/dl, TLC 3,500/cm, Platelet count 120,000/cmm. The most likely diagnosis is:

Correct relation of Lesser sac is?

Patient had recent stroke, now doppler shows increased blood flow. What is the reason for increased cerebral flow?

Pt with low grade fever, weight loss and ascending weakness and decrease power of lower limbs more than upper limb?

In a deep penetrating injury of radial groove of humerus which movement will be affected?

Asthmatic pt not responding to salbutamol next drug:

The structure present between two Z lines is?

Sign Of primary adrenal insufficiency is?

Left shift of the oxygen dissociation curve occurs in?

Which of the following shows complete Ventricular depolarization On ECG?

Biopsy of an unknown CA specimen was observed under microscope showing papillomatous growth septa concentrically laminated calcified shows sand grain appearance and psammoma body-like calcifications were noted. The tissue being observed is?

Aspirin toxicity should be treated With?

 Pericardiocentisis is best achieved by passing a needle through?

Correct relation of Lesser sac is?

Which of the following have the lowest pH?

Irritation, mild jaundice, inc MCV, HB 8. Diagnosis?

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?

What is the mechanism of action of cimetidine in a female pt who is going to undergo a C- sec?

Packing and transport carbohydrates and protein is done by?

Prevalence is?

In right shift of oxygen dissociation curve, the most likely value of P50 would be?

Which of the following parameters is decreased during strenuous exercise?

patient with a painless maxillary swelling. on radiology a radiolucent. radio-opaque lesion ground glass appearance is seen. The likely diagnosis is?

Antidote of Paracetamol toxicity?

The most important pre-requisite to check for before transplantation between donor and recipient is?

Most likely indication of immediate mitral valve replacement is?

Gram negative cause shock by?

About plasma proteins

A 54year-old man with a chronic cough has a squamous cell carcinoma diagnosed in his right lung. While performing a pneumonectomy, the thoracic surgeon notes that the hilar lymph nodes are small, 0.5 to 1.0 cm in size, and jet black in color throughout. Which of the following is the most likely cause?

Man is suffering from testicular Ca; the lymphatic drainage of testis is into?

The height of 7 women in cm 141, 141, 143, 144, 145, 146, 155 respectively. Calculate the mean?

A child known case of cystic fibrosis  presented with acute respiratory infection on investigation the organism diagnosed as  pseudomonas Aeruginosa. What other findings are associated with the patient?

Regarding spinal cord lesion at C7:

Satiety center is located in which part of hypothalamus?

Which of the following values are the best indexes of the preload on the heart?

Most abundant glial cells in gray matter?

After obstruction of a bronchus all the alveoli aerated by that bronchus do not collapse?

A 35 years Old female has slowly enlarged swelling of submandibular gland. During surgery on submandibular gland, the structure most likely to be damaged is:

A 22-year man had unprotected sex ‘QKį prostitute. He developed painless lesions on penis which resolved spontaneously. Now he presents with ulcers/lesions on body. What should be the treatment?

Increase indirect bilirubin with slight decrease haptoglobin occurs in?

How does clostridium botulinum cause paralysis?

 Increased Salivary secretions occurs through?

A 70-year male experiencing problems with urinary outflow. O/E, an enlarged asymmetne firm, nodular prostate Was palpated he had no fever and chills and his PSA level was3.5ng/ml. What is the likely diagnosis?

 Histologically. diagnostic features in a patient with known COPD (chronic bronchitis) is?

A person with lens dislocation (upward) aortic dissection & hyper flexible joints is suffering from:

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

Right optic tract damage results in?

With sudden haemorrhage of two litres of blood. the most likely first response would be:

A Female came to cardiologist with complaint of the receptionist not being in her best behaviour while otherwise everyone else likes her. What would you do?

A 60-year-old male executive who has a history of chronic duodenal ulcer was admitted to the ER exhibiting a sign of severe internal hemorrhage. He was quickly diagnosed with perforation of the posterior wail of the first part of the duodenum and erosion of artery behind it by the gastric expellant. The artery most likely involved is?

Klüver-Bucy syndrome is due to damage to?

Drug used for pharyngitis and lung infiltrates is?

Failure of fusion of cranial vault leading to brain exposure to amniotic fluid?

A professor was talking about a tumor suppressor gene that involves in cancer of long bones due to mutation in single or both allele. He gives example of parents bringing their child being affected by a disease with the rest of the children being normal. The gene involved is?

A 52-years man presented in OPD with unusual facial expressions. Half side of his face was red and absence Of sweating noted. What could be the possible cause?

Erythroblastosis fetalis caused by the destruction Of neonatal red blood cells by which maternal immunoglobulin

 Numbness of ear lobule while doing internal jugular lymph node biopsy? Which of following nerve is damaged?

The first step that occurs when light fails on retina is?

Damage to the articular disk and capsule of the temporomandibular joint results in paralysis of:

During exorcise. the venous blood from the leg is increased by?

The most important role of Estrogen is?

A pregnant lady with lower abdominal pain. On ultrasound, the placenta is attached to myometrium but does not penetrate through it. This is most likely?

Contact lens placed in tap water. Culture reveals which organism that lead to retinitis?

A patient with esophageal bleed and BP 80/70, pulse 160. What will be the immediate management?

Most common cancer in males living in Karachi is?

Tumor suppressor gene involved in renal and gonadal agenesis?

Guillain -Barre syndrome (CBS) involves which layer of peripheral nerve?

A 20-year-old male had injury or the lower trunk of brachial plexus. The muscle most adversely affected by this injury will be?

A new born was her mother with complaints of recurrent multiple pyogenic infections. Investigations revealed that the child has a deficiency of a physiological antibody. The deficiency is of which of the following?

Dementia, dermatitis and diarrhea occur due to deficiency of which vitamin?

Which of the following is a benign tumor?

A 70-year man was brought in ER by his wife with complains Of Rt flank pain and vomiting. A diagnosis of Acute Appendicitis was made and urgent appendectomy was suggested. Man is in delirium state. He cannot give consent. Now who will give the consent?

Parasympathetic supply of anal canal and rectum is by?

steroid hormones act on the target cells by?

Which of the following causes increase in Renin level?

 Patient on schizophrenia medication presents in ER with seizures. This is likely due to?

Pt complains of sudden increase in hunger and sexual arousal. These are controlled by?

Hypoglycemia in Von Gierke disease occurs due to deficiency of which of the following enzymes?

Diagnostic test for infectious mononucleosis?

Landmark muscle used to pass CVP line?

A patient with heart rate of 75 has ventricular systole duration of 0.3 second. At HR of 225 the systole timings Will be?

A pregnant lady presents to you with Hyperemesis gravidum resulting in hypokalemia. Which of the following is likely to occur in her?

What type of necrosis is seen in acute pancreatitis?

A boy after RTA loses 1.5 liters of blood during first hour. What type of anemia will be seen on peripheral smear?

A girl spilled hot water over her hand develops clear fluid bullae. Few hours later, she developed fever, bullae erythema and warm with opaque fluid. Type of inflammation is?

Most common method to detect any cancer in blood is?

During thyroidectomy, the surgeon notice absent superior parathyroid glands. This is due to defect in?

Type of anastomosis that occur when 2 vertebral arteries join to form basilar artery?

Damage to cervical sympathetic fibers may cause?

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

Receptors which prevent tearing of muscles when muscle tension becomes high are:

The superior thyroid artery is usually the first branch of?

 Initial. short-term action of angiotensin 2 is?

A Female with sign and symptoms of Hyperprolactinemia was diagnosed with pituitary adenoma. The growth of this tumor anteriorly will compress which structure:

A 44-year woman is diagnosed with Zollinger Ellison Syndrome. Which of the following is consistent with the diagnosis?

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

Short term memory loss occurs due to lesion in?

A fisherman from sea travelling from the past 6 months develop ecchymosis and recurrent bleeding gums. Most likely it is due to deficiency of?