VOLDEMORT

01. Experimental question. A gene has been inserted in fibroblast and that gene is I marked B
expressed also, but after sometime expression of that gene stopped. The
researcher said that the gene is “silenced”. By what mechanism that gene has been
silenced?
A) DNA heterochromatization
B) Decrease expression of transcriptional regulators.
02. An experimental question asking I marked E
about what happened in high fat
diet as compared to normal diet?
A) Decrease DNA
methyltransferase
B) Decrease lysine
methyltransferase
C) Decrease histone
deacetylase complex
D) Increase histone acetylase complex
E) Increase heterochromatin protein 1

03. Isoniazid drug; which vitamin deficiency? B6

04. Isoniazid drug; the vitamin which is deficient works in which metabolism? C
A) Cholesterol
B) Fatty acid
C) Amino acid
D) Phospholipids

05. They gave me an autopsy picture of heart and asked pt had which
condition/disease? There was concentric hypertrophy so I marked Hypertension.
Other options were viral pericarditis, amyloidosis
06. A pt had vague chest pain for four days, and after that he died. On autopsy, they I marked B; it
gave me picture, it looked like dark marron heart, and asked pt had what looked like pt
condition/disease? had
A) Myocardial infarction hemorrhagic
B) TB pericarditis pericarditis.
C) Fungal myocarditis
07. Experimental question describing cells have a finite number of cell divisions
around 50 division now which thing we will modify/disrupt to increase the
number of cell divisions?
a) Telomerase

08. A pt came for general health checkup. Hand disability, an autosomal I marked B; do
dominant disease, runs in her family. She and her mother are healthy. Her check.
brother and aunt have the disease. Now they asked how this disease runs
in her family or this disease has what characteristics?
A) Complete penetrance
B) Incomplete penetrance
C) Variable expressivity
09. A pt is having colon cancer in ascending colon; pt mother had ovarian A
cancer, his grandfather had colon cancer too. What gene defect?
A) MLH1
B) APC
10. Pt is having sun sensitivity for 6 months when she travelled from Wisconsin I marked C. Do
to Florida. On physical examination, Blonde hair, pink iridia, Fair skin. Her check!!
family members also have same disease. What will we find on biopsy?
A) Absence of melanocytes
B) Absence of melanosomes
C) Normal number of melanocytes.
11. 62 year old male had crushing chest pain came to emergency department. I did it wrong. It
Pt has history of COPD and 1 year history of peptic ulcer disease. On ECG, should be A;
we found NSTEMI. After his condition is stabilized, we started him on cimetidine and
clopidogrel. Which additional therapy is contraindicated in this patient? clopidogrel has
serious
A) Cimetidine
interaction. Rest
B) Diphenhydramine do check.
C) Simethicone
D) Acetaminophen

12. A 3 year old kid has jaundice, AST and ALT both raised, his liver biopsy I marked B
showed a PiZZ gene mutation. What will be happening in his liver?
A) Increase elastase activity in liver and damaging it
B) Mutated misfolded protein, causing stress in ER and Apoptosis.
13. We designed a new therapy for emphysema pts which is a proteinase
inhibitor. This therapy will target which cells?
A) Segmented Neutrophils

14. By what mechanism Nk cells and CD8 T cells kill cells?

A) Granzyme
15. A pt had sign and symptoms of acute hepatitis. And in the question he told A; in liver biopsy
that pt had Hep A. and showed a liver biopsy. Hepatic injury in this pt is It looked like a
occurring by what mechanism? Councilman
A) Apoptosis by extrinsic pathway via death receptor activation. body.
2 options were of Necrosis.
16. A long scenario, at last it said we found decrease plasmalogen and Increase
VLCFA. Which organelle defect?
A) Peroxisome
17. 10 month old child has Generalized rash for 1 day. He has 2 day history of I marked B; it
fever. He is no distress. 2 weeks ago another child in Day care(may be) had seemed like the
same disease. They showed me a picture of the baby and asked which lesions were at
infection? different stages.
A) Adenovirus
B) VZV
C) Measles
D) Variola
18. A pt came with abdominal cramps, diarrhea, nausea, vomiting. He is allergic D
to NSAIDs. He had an acute gouty attack so we started him on a drug. His
labs show agranulocytosis. What was that drug?
A) Indomethacin
B) Allopurinol
C) Probenecid
D) Colchicine

19. 1 year ago, a pt had a 3 cm and 0.6 cm deep cut. Now that area has a faint I marked B
scar. Compare to the normal skin, what is the tensile strength of this area
at this time?
A) 30%
B) 70%
C) 100%
D) 130%

20. Pt has chronic renal failure. His family has hearing and eyes problems. Gave A
me pedigree of X-linked dominant. What will we find on his kidney biopsy?
A) Abnormal type 4 collagen
B) Thin basement membrane
21. A famous thymus question. Flow cytometery showing double positive and
double negative CD4 and CD8 cells and asks which tissue we got the sample
from?
22. Pt has Digeorge syndrome. What will we find?
CD3 decreased, CD19 normal.
23. Mother brings her 3 or 4 year old child with complain that her child is D
growing slowly. He is at 5th percentile of his height. His IGF-1 and GH are in
his upper limits. What is the defect?
A) GH excess
B) GH receptor resistance
C) IGF-1 excess
D) IGF-1 receptor resistance
24. A pt has increase GH and decrease IGF. and asked about the parameters;
Decrease bone age, decrease osteoblastic activity, decrease
osteoclastogensis
25. Pt has taken 100 tablets of Aspirin 30 minutes ago. We gave her 100% Do check. No
oxygen through cannula. What will we find in her labs at this time? option for
Levels of sodium, potassium, H+, HCO3, Pco2. I did sodium (no change), normal HCO3 so
potassium (increased), H+ (increased), HCO3 (decreased), PCO2 (decrease). had to go for
mixed.
26. A researcher said that we cant cure HIV because HIV DNA is incorporated C
into host immune cells genome. So what enzyme should be targeted to
cure HIV?
A) Reverse transcriptase
B) DNA polymerase
C) Integrase.
27. Pt went to wooden area and got himself a cut on the hand 2 days ago. Now I probably
there is a pustule in that area. This pustule is due to involvement of overthought on
neutrophils by what mechanism? this; and did C,
A) Increase adhesion on endothelial cells mediated by LTB4 Do check.
B) Migration through endothelial gaps mediated by IL-8
C) Rolling of neutrophil on endothelial cells regulated by selectins.
28. 1/2500 is a disease frequency and asked about heterozygote carrier B
frequency?
A) 0.39%
B) 3.9%
29. A couple came for preconceptional counseling. They are European descent. I marked B; and
In these people, which of the following diseases should be tested for? ( not likely wrong.
exact words, but meaning same) Should be A.
A) Cystic fibrosis
B) Tay sachs disease
C) Familial dysautonomia

30. 54 year old woman fell on the kitchen floor. She has tenderness on her I marked E; do
arm. She has 4 year history of celiac disease but she is not adherent to check.
medication. Her Calcium, phosphate and 25- OH Vitamin D3 are decreased.
On Xray we found a radial fracture and diffuse osteopenia. They gave me
biopsy of bone around the fracture site. Diagnosis?
A) Osteogenesis imperfecta
B) Pagets disease
C) Osteopetrosis
D) Osteoporosis
E) Osteomalacia
31. Researcher wants to check the function of cell mediated immunity. For this C
purpose, which of following organisms should be picked?
A) S. aureus
B) S. pyogens
C) Mycobacterium Tuberculosis
D) Pseudomonas
32. Pt had intracranial hemorrhage, has A
HTN, showed me a gross picture of
Polycystic kidneys, asked about the
mode of inheritance?
A) Autosomal dominant
B) Autosomal recessive
C) X-linked recessive

33. Pt came to physician with jaundice, fever, and back pain for 2 days. She and I marked B
her sister were going to Malaria endemic country so they took prophylaxis
for that. Her sister also experienced same symptoms but they resolved w/o
any intervention. Why this difference in these 2 sisters?
A) Coding sequence of G6PD on X chromosome is different
 B) Pattern of X inactivation
34. A guy/child has prominent ears, small jaw, and prominent nose. His
karyotype is 46 XY. In his lymphocyte we found tenfold increase in sister
chromatids and genomic instability. He is at risk of?
A) I did Lymphoma.
Other options I don’t remember. Vague question.
35. Pt has 1 year history of dementia. 2 months ago he also developed ataxia
and myoclonus. On brain biopsy we found spongiform cortex. What
happened in this pt?
A) Conformational change in normal protein
Other options were related to Alzheimer’s, Huntington, etc

36. A newborn has rocker bottom feet, punched out lesion on scalp, midline A
cleft lip, polydactyly. Asked which trisomy?
A) 13
B) 18
C) 21

37. In pregnancy, why HCG goes up while

TSH goes down? With the following
graph:
A) HCG mimics activity of TSH

38. A pt with Crohn disease, terminal ileum is resected. Other than vitamin b12
deficiency, what other thing will be deficient in this pt?
A) Bile acids
39. Gave me gross picture of staghorn calculi similar to this C
one (90% match) . Ph of 8 in question stem. Asked about
the composition of stone?
A) Calcium oxalate
B) Cysteine
C) Magnesium ammonium phosphate
D) Uric acid

40. Pt had classic pellagra symptoms, asked which vitamin deficient? B3

41. A very long scenario, just read on peripheral smear we found
hypersegmented neutrophils. Gastric biopsy showed gastric fold atrophy
and lymphocytic infiltration. This anemia is due to antibodies against?
A) Intrinsic factor.
42. What happens to following parameters if we double the cholesterol
concentration in liver cells?
Decreased HMG Coa reductase, Decreased LDL receptor density,
Increased ACAT activity.
43. Why decrease glucose in alcohol intoxication?
A) Increase in NADH
44. Pt with alcohol intoxication came with slurred speech, ataxic gait, not I marked E. As
oriented to person and place. 1 year ago he was admitted to hospital due chronic alcohol
to alcohol intoxication. In his blood we found 120mg/dl alcohol and glucose intake will act as
60 mg/dl. What else we might find in this pt? a CYP inducer.
A) Undectable aldehyde
B) Decrease alcohol dehydrogenase activity
C) Increase pyruvate to lactate ratio
D) Decrease NADH
E) Increase Cytochrome 2E1 pathway.
45. Pt with RTA, cannot move his body below his neck, has some difficulty in I marked A. do
respiration on supine. No wheezing and lungs are clear. Abdomen falls check.
during inspiration. Touch sensation and muscle movement is lost below C5
dermatome. Respiratory issue is due to paralysis of which muscle?
A) Diaphragm
B) Latissimus dorsi
C) Rhomboids
D) Sternocleidomastoid
46. Experimental question. We silenced some genes in a mice. Now that mice I marked E. As
has intellectual disability, motor impairment. Its CSF glucose concentration GLUT 1 is
is low but its fasting and fed state is within reference range. His alanine, present in Brain.
glycine concentration are normal. When we give High fat, low carb, and
protein diet, he becomes normal. What is the defect?
A) Pyruvate dehydrogenase
B) HMG Coa synthase
C) Aceyl Coa dehydrogenase
D) Carnitine acyltransferase
E) Glucose transporter 1
47. 49 year old woman, has hot flashes. Menstrual irregularities. What will you C
measure to confirm your diagnosis?
A) Estrogen
B) Progesterone
C) FSH
D) Testosterone
48. Experimental question. We give nitroglycerin and Acetylcholine to normal I marked D.
coronary artery, they both cause vasodilation. But when I give nitroglycerin
and acetylcholine in atherosclerosis plaque containing coronary artery,
nitroglycerin dilates but Acetylcholine constricts. Which of the following
best explains these findings?
A) Afferent reflexes of acetylcholine are diminished in atherosclerotic
plaque artery
B) Atherosclerotic plaque is not letting Acetylcholine to enter into
smooth muscles
C) Nitric oxide is not working on atherosclerotic plaque artery
D) Damaged endothelial cells are not producing nitric oxide.
49. A guy comes with complain of insomnia. He says it takes 3 to 4 hours to get I marked E. do
me to sleep, but once I get asleep, it’s a sound sleep. I take evening naps or check.
 4 coffee to catch up. It’s frustrating that I lay on bed at 10 am and keep
waiting for sleep. What will the physician advise him?
A) Low dose TCA
B) Lorazepam
C) Regular exercise
D) Sleep hygiene
E) Stress management techniques
50. A 12 year old kid, has chorieform movement. They gave me Kayser- B
Fleischer ring picture. They also told they found decrease ceruloplasmin in
his blood. Treatment?
A) EDTA
B) Penicillamine
51. 2 year old, cardiomegaly, hypotonia. On biopsy we found glycogen in
lysosomes. Which enzyme defect?
A) Acid maltase
52. Pt had Esophageal surgery for some issue. Now came with decrease A
breathing on left side. Chest x ray showed left side white out like pleural
effusion. They took fluid out it was milky fluid. What will be increased in
this fluid?
A) Increase TGs
B) Increase cholesterol
53. 9 months old baby, otitis media hx since birth, his IgG2, IgG3, IgG4 are low, I marked A.
his IgM is normal. He has decrease T lymphocytes also. Gave me normal
picture of lymph node and pointed an arrow to germinal center and said pt
has loss of this in lymph node. What process occurs here?
A) B cell proliferation
B) Egress high endothelial venules

54. They gave me a picture of prepuce enlargement. It was a confusing picture I marked C.
to distinguish the swelling/enlargement of prepuce from glans penis. Asked deep inguinal
if left untreated, where will it drain? was not in
A) Internal iliac option. :P
B) External iliac
C) Superficial inguinal
55. Pt has sore throat, fever, and lymphadenopathy. Rapid streptococcal test is Should be A. do
positive. Which of the following nodes would be affected? check.
A) Anterior cervical
B) Post auricular
C) Submental
D) Submaxillary
E) Supraclavicular
56. A pt with S/S of ankylosing spondylitis. They literally tell you everything.
They ask HLA association. HLA-B27 is the answer.
57. A pt has recurrent oral and scrotal ulcers for 4 years. Scrotal ulcers are less I marked A
frequent. Erythematous nodules on shins are also found. Nail capillary bed
something we find also. Asked the diagnosis.
A) Behcet syndrome
 B) Churg straus syndrome
58. A kid has a rash on his face, trunks and extremities. There was a picture. It Should be E.
looked like scalded skin syndrome to me. They asked that this infection
most likely involves which cells initially in its pathogenesis?
A) Eosinophils
B) Mast cells
C) Nk cells
D) Plasma cells
E) T lymphocytes.
59. Pt has lytic bone lesions. We found a protein in his blood which is of
150,000 daltons. This pt has cancer of which cells?
A) Plasma cells.
I don’t remember other options. I thought they were talking about
any antibody. So went for MM.
60. Pt is being treated with chemotherapy for some cancer. We infused I marked A. do
rituximab in this pt. 45 minutes after infusion he had fever and diffuse check.
muscle tenderness. No urticaria or angioedema. Why this happened?
A) Basophilic degranulation
B) B lymphocyte cytokine release
61. We gave vancomycin, cefuroxime and other drugs for some infection.
Shortly after, he developed red man syndrome. Why this occurred?
A) Due to vancomycin
62. A clear case of Paraoxysmal nocturnal hemoglobinuria with classic morning
hematuria. Asked what’s the defect?
A) Complement inhibition
63. Another case of PNH with same idea, did acid test which came positive,
direct coombs test negative. What’s defective?
A) CD59
64. Pt had urethral discharge. Did gram staining and showed me a picture.
Clear Neisseria picture as in nbmes. Asked which media to select to grow
this organism?
A) Chocolate agar with antibiotics
65. Pt had S/S of pneumonia. Asked which cytokine is causing fever in this pt? I marked C.
A) Bradykinin
B) Serotonin
C) TNF-a
D) Histamine
66. Pt has knee pain. We gave him NSAIDs and his pain vanished. By decreasing B
what, NSAID relieved this pt pain?
A) Prostacyclin
B) Prostaglandin E2
C) Thromboxane A2
67. Pt is taking prednisone, asked me the following parameters.
Decrease Arachdonic acid, decrease prostagland H, decrease prostacyclin,
decrease leukotrienes.
68. Unilateral renal artery stenosis, has HTN also. Asked following parameters.
Increase Renin activity, Increase Angiotensin 1, increase Aldosterone
69. Pt for some reason we put a IV catheter. He was neutropenic too. Around B
that catheter macules were formed and necrosis occurred. We also found 2
x2 cm rash which become a black ulcer surrounded by erythema. Which
organism?
A) S. aureus
B) Pseudomonas
70. Graph of Dihydrorhodamine test for CGD in which there is increased
fluorescence with normal patient serum, the fluorescence was given in 10з
10ч and the normal patient has increased fluorescence like 10 power 9 and
the patient has 10 power 2 fluorescence and asked about the enzyme
defect
A) NADPH oxidase 2

71. Pt had sore throat, fever. On examination, we found a gray membrane. Very twisted
Throat swab we got gram positive bacilli. Pt had respiratory distress and way of asking
died. They gave me an unnecessary picture of trachea. And asked what diphtheria.
other organ this infection would effect?
A) Heart
73. Pt had palpitations, heat intolerance, and weight loss. His thyroid was I marked D
diffusely enlarged. The bruit can be heard on his thyroid. Radioactive iodine
uptake was increased. What will we find on his thyroid biopsy?
A) Neutrophilic infiltration
B) Eosinophilic infiltration
C) Hypotrophic cells
D) Hypertrophic cells
74. Pt had weight gain, cold intolerance, and painless thyroid enlargement.
Antithyroid peroxidase and antithyroglobulin antibodies were positive.
Diagnosis?
A) Hashimoto’s thyroditis
75. A clear case of Digeorge, asked what’s the defect?
A) Failure of invagination of third and fourth pouches.
76. A 22 year old male, came with complains of headache. They showed me I marked B
MRI. I found cerebellar tonsil herniated. Asked what else will we find/ will
develop in future?
A) Aqueductal atresia
B) Syringomyelia.
77. Pt had has cerebellar ataxia signs like unilateral fall. On MRI they found a I marked A.
mass in cerebellum. The incipient hernia of which of the following in this
pt?
A) Cerebellar tonsils
B) Inferior olivary nuclei
C) Inferior cerebellar peduncles
78. A clear case of Chadiak Hegashi syndrome. Fair skin, history of infections.
They also told they found azurophilic granules in neutrophils. Asked which
gene defect?
A) CHS/Lyst gene
79. We transplanted a kidney in a pt 2 hours ago. Now his kidney function is
deteriorating. We found fibrinoid necrosis and thrombosis on kidney
biopsy. Why this?
A) Preformed anti HLA antibodies.
80. Kidney transplanted 6 weeks ago. takes cyclosporine. Now his kidney A
function is deteriorating. On kidney biopsy we found mononuclear cells
infiltrate. Why this?
A) Acute rejection
B) Chronic rejection
C) Drug effect
81. A pt comes to physician for some complain which I don’t remember. She I marked C. do
says that she will stab her boyfriend. She has been thinking this over a check!!
month now. She looks malnourished. Asked which of the following is the
greatest predictor of her being success in carrying out her threat?
A) History of violence
B) History of psychiatric illness
C) Physical distance with the intent victim
82. A pt came with some complains I don’t remember. They gave me occult I did according
blood test positive and decrease hemoglobin and decrease Hct. And then to iron
they asked what will be erythrocyte count and MCV? deficiency
A) I did both decrease. anemia.

83. Experimental question. We made a drug which inhibits necrosis. This drug I marked D.
will target which of following processes?
A) DNA fragmentation
B) Phosphatidylserine receptor bodies something
C) Autophagocytic vacuoles
D) Increased permeability of cell membrane
84. Pt had prostate cancer. He was treated with leuprolide and flutamide. His C
prostatic parenchyma is shrunken now. DNA fragmentation is also found
inside cells. Macrophages came and start eating autophagic
bodies/vacuoles. Macrophage eat these bodies through which receptor?
A) Granzyme
B) Fas
C) Phosphatidylserine
85. Pt going on a trip to malaria endemic country; I think Kenya. Physician gave I marked A
him malarial prophylaxis but he forgot to take the medication with him.
After 2 weeks, he has fever, jaundice. Ring shaped RBCs on peripheral
smear; gave me a picture. Asked which of the following Plasmodium
species is the cause?
A) Falciparum
B) Vivax
C) Ovale
86. Patient presented with some neurological symptoms and vivid dreams, she A
has some travelling history and started taking mefloquine prophylaxis, and
she is also taking OCPs. Now these symptoms are due to what?
A) Drug adverse effect
 B) Drug drug interaction

87. A very twisted question. General idea was that which of the following in
fungi is different from human cells?
A) Chitin
88. A pt has HIV. He some pulmonary S/S. On CXR, bilateral chest infiltrates. In I marked B.
his sputum or lung biopsy don’t remember we infused 3% saline we found
tropism of that organism and with silver stain we found cell wall. Which of
the following is the organism?
A) Cryptococcus neoformans
B) Pneumocystis jiroveci
89. B

It's an experimental question in which people get infected with polio even
though they have been vaccinated after gene extraction there is gene X which
belong to some enterovirus, which make polio gene virulence? What’s this??
A) Reassortment
B) Recombination

90. Patient went hiking, drank water from freshwater lakes, developed non I marked A.
bloody diarrhea for 10 days. What is the cause?
a) Giardia lamblia
b) Enterotoxicogenic E.coli
c) Shigella

91. P has watery diarrhea for 1 day. We gave him oral rehydration and I marked D.
antimoltility drug. Which of the following is the next best step in
management?
A) Stool parasite and ova testing.
B) Fecal leukocyte or erythrocyte
C) Clostridium toxin in stool
D) No further investigation at this time.
92. A 4 year old kid has one day history of pain on urination. Mother said when I marked B. do
I was bathing her she said she has pain in genital area. On physical check!!
examination, there is erythema around urethra and urethral meatus
swelling. On urinalysis, WBCs were too many to count and on urine culture
we found gram negative bacilli. Why this occurred or most likely cause?
A) Sexual abuse
B) Poor hygiene
C) Prolonged period of wearing wet bathing suit
D) Swimming in fresh water
93. Patient with vaginal discharge, on PE foul smelling gray white discharge was A
there, the patient is not taking any medication, picture of clue cells. Asked
about the cause/pathogenesis?
a) Decrease number of lactobacillus
b) Decrease Vaginal Ph
c) Decrease number of anaerobic bacteria

94. A pt with HIV, has dementia, A

confusion. Recently he was treated
for pneumocystic jiroveci (PCP). He
is not adherent to antiretroviral
therapy. On MRI, lesions in white
matter. Biopsy picture similar to
this. Asked the diagnosis?
A) HIV encephalopathy
B) Protease inhibitor toxicity
C) Again PCP infection
95. A kid came with itchy head. D; no
Picture similar to this. Asked terbinafine in
treatment? option.
A) Acyclovir
B) Metronidazole
C) Caspofungin
D) Griseofulvin

96. Pt has conjunctivitis, knee pain. He had chlamydial urethritis 2 weeks ago.
What has happened in this pt?
A) Reactive arthritis.
97. 38 year old male has some pulmonary S/S don’t remember exactly. He has Do check!!
crackles I guess and 1+ pedal edema. His PFTs were given. FEV1 65% of
predicted value, FEV1/FVC 60% of predicted value, and FVC 90% of
predicted value. What this pt has?
A) COPD
B) Congestive heart failure
C) Sarcoidosis
D) Pleural effusion.
98. Pt had fever, thrombocytopenia. We found morula in granulocytes. Asked
treatment?
A) Doxycycline
99. A

Patient who is HIV positive, he is not adherent to his antiretroviral

medications, his CD4 count is 145 mm3, now presented with all the finding
of pulmonary (it was a long scenario but easy to get with these 2 pictures).
A) P. jiroveci
B) Histoplasma

100. A patient who owns a cat, A

her cat got stuck in bushes,
she went to take her out
from the bushes now
presented with rash like this
what is underlying
pathogenesis?
A) Sensitization of
primed T-cells
B) Apoptosis of Langerhans cells

101. A picture of Diphyllobothrium latum A

similar to this but in petri dish. Asked the
treamtment?
A) Praziquantel
B) Metronidazole

102. We gave an influenza vaccine. Against which component antibodies will be A

formed?
A) Hemagglutinin
B) Neuraminidase
C) Capsid
103. We did a cross-sectional study, a significant relationship exists between I marked B. as in
exposure to UV light from tanning equipment seems to increase cross-sectional
dysplastic melanoma risk. There was a clear association between dose study we don’t
follow pts, we
and risk, where increase number of tanning beds had association with won’t be able to
see temporal
 increase dysplastic nevi something along those lines. Which of the sequence of
following is the limitation in this study? events like one
A) Dose-response relationship x preceded the
other thing.
B) Temporal sequence of events
C) Biological plausibility x
D) Strength of association
E) Consistency x
104. Physician who is taking care of an Ebola patient, get the Ebola (all the No fluids in
features of multiorgan failure etc. was given) now this physician acquired option.
the infection through?
A) Direct physical contact

105. Patient who has all 3 doses of hepatitis B vaccine, has pin prick from hep B
pt. Now what thing we will find in the serum of this patient?
A) Antibodies against the surface antigen of hepatitis B (HBsAg)

106. A pregnant female came with fever, jaundice, and other symptoms. She C
went to India 1 month ago there she also had flu like symptoms. Her AST
and ALT were 380 and 470 respectively. Her ALP was 60. What is the cause?
A) Cholelithiasis
B) Cholestasis
C) Hepatitis E
D) Primary biliary cholangitis
107. Pt came with abdominal cramps, diarrhea, and 9 day history of generalized I marked B.
rash. Fever of 104. 2 weeks ago he went to Africa to his parents. He went to maybe this pt
Africa 1 year ago also. Blood pressure was 96 or 100/ something and pulse had sepsis or
is raised. He has epistaxis also. The organism tropism causing these S/S via dengue
hemorrhagic
infecting what?
fever. Not sure.
A) Infection of lymphocytes and macrophages, leading to suppressed Other options
immunity and susceptibility to opportunistic infections. don’t
B) Infection of monocytes and endothelial cells, causing remember.
proinflammatory cytokine release and vascular leakage.
108. RTA pt comes in emergency department. We found blood in D
retroperitoneum. Which of the following is damaged?
A) Jejunum
B) Ileocecal
C) Transverse colon
D) Descending duodenum
E) Ileum
109. Patient having ischemic colitis of the ascending colon which artery will be A
stenosed/blocked
A) Right colic
B) Celiac
C) Splenic
110. Pt has vulvovaginits; has white discharge and erythema. S/S of bilateral
peripheral neuropathy on lower extremities. On funduscopy we found
punctate hemorrhages. Diagnosis?
A) Diabetes mellitus type 2
111. They gave a picture of vagina with lesions. Those lesions looked like vesicals A
to me. Pt has 2 day hx of painful vaginal ulcers. She has 2 sexual partners
and uses condom inconsistently. Which of the following will be the
complication of this infection?
A) Recurrent infection
B) Salpingitis
C) Infertility
112. Patient who is 17 year old started having intercourse and she had 3 A
intercourse and in all 3 intercourse she had pain, she came to the physician
when the physician put the speculum into the vagina it was interrupted
with a vertical membrane in between which was dividing the vagina in 2
lumen. What will we find in this pt?
A) Uterine didelphys
B) Renal anomalies

113. A 14 year old girl came with her mother. Mother said she had not started I marked A; do
menstruating yet. As mother leaves the room, pt tells that she has no check!!
sexual hx, no drug abuse. Grades in school are As and Bs. I play soccer 3
times a week. Breast development tanner stage 4 and pubic hair tanner
stage 3. Which of the following is the cause of loss of menstrual cycle?
A) Female athlete triad
B) Normal puberty
114. A G2P2, 29 to 32 year old woman comes to physician and says I have I marked D; Do
gained 11 lbs or kgs in this pregnancy. She has a family history of CABG. She check!!!
is concerned about her cardiovascular risk. Her BMI is 29. Her lipid profile
has been sent. Physician in addition to recommending exercise every day
and low carb diet, what else he would do or say for her cardiovascular risk?
A) Do ECG
B) Do Echocardiography
C) Recommend her to a cardiologist
D) No further thing is indicated at this time.
115. 30 week gestation woman, her BP is 190/110. Few months back her BP was A
120/80. Cause of hypertension?
A) Vascular endothelial dysfunction.
B) Hepatic dysfunction
Don’t remember other options.
116. A woman increased seaweed in her diet, she started having S/S of C
hypothyroidism like weight gain, cold intolerance, etc. physician said stop
seaweed, and she was fine after 2 weeks. Which of the following is the
effect of iodine which caused these symptoms in this pt?
A) Increase in 5’ deiodinase
B) Inhibition of cAMP
C) Inhibition of Na iodine transporter.
117. Pt had breast cancer for which she was treated with chemo and radio Don’t
therapy. Now she has S/S of pleural effusion. What will be increased in remember other
pleural fluid? options.
A) LDH
118. Pt has abdominal distention. She has jaundice, splenomegaly, and other S/S A
of cirrhosis. Asked why this pt developed ascites?
A) Increase in hydrostatic pressure
B) Leakage of albumin from liver sinusoids

119. A woman has sudden onset of right lower quadrant pain for 2 hours. This I marked B; may
pain started when she was working out. Adnexal tenderness is present. She be the case of
is previously diagnosed with stable, asymptomatic ovarian cyst. Her ovarian torsion.
pregnancy test is negative. Which of the following is next best step?
A) Colposcopy
B) Vaginal Doppler U/S
C) Aspiration of Cyst.
120. Female Patient (don't remember the age) with severe right adnexal/right A
quadrant pain presented to ER, her pregnancy test is negative, rating pain
on 10/10 scale, if we do the Doppler ultrasound in which we will find the
less signal in which vein/artery
A) Ovarian vein
B) Internal iliac artery
C) Uterine artery

121. Woman has abdominal distention, right or left side mass. What will be I marked A; I
raised in this pt? don’t remember
A) CA 125 this question
B) AFP exactly but it
took me to
ovarian cancer.
122. Pt has lung mass. That mass is keratin positive. Which of the following is I marked B.
likely?
A) Osteosarcoma
B) Adenocarcinoma
C) Rhabdomyosarcoma
D) Lymphoma
123. Pt has breast anaplastic carcinoma. Which of the following is decreased in C
this anaplastic cancer?
A) Laminin
B) Metalloproteinase
C) Intercellular adhesions
D) collagenase
124. On endoscopy we found a flesh colored mass in stomach. On biopsy we
found it’s a gastrointestinal stromal tumor they told this in stem. Which of
following is likely gene defective or something?
A) Increase in c-kit leading to tyrosine phosphorylation.
125. A case of CML, we have given a tyrosine phosphorylation inhibitor in this I marked A;
patient. How this or through what component this cancer will be resistant don’t remember
to this drug? other options.
A) Kinase
B) Coiled something.
126. Patient with aniridia and abdominal mass, which on CT scan was a Renal
mass this child has defect in which gene?
A) WT1

127. Question stem described a mass in thyroid and on biopsy we found

psammoma bodies which of the following is this thyroid cancer
A) Papillary

128. Pt has weakness and loss of

sensation in left lower
extremity. On CT brain, we
found a mass. Brain biopsy
was shown. A picture
somewhat similar to this.
Asked what’s the diagnosis?
A) Meningioma

129. A case of myasthenia gravis. They literally told everything even that we
found antibodies against acetylcholine receptor. Asked which of following
is mostly likely in this pt?
A) Thymic hyperplasia
130. A pt had generalized tonic clonic seizures.. His labs were Na 115, K 4.0,
urine osmolality was 380. Asked what’s increase in this pt?
A) ADH

131. A pt has nausea and vomiting for 4 days. Dry mucous membranes. Which of A
the following is likely electrolyte abnormality in this pt?
A) Hypokalemia
B) Hyperkalemia
C) Hypercalcemia and so on.
132. Pt is being treated for Chronic renal failure. Gave me an ECG with
hyperacute T waves. Asked which of the following is the cause of finding in
ECG?
A) Hyperkalemia
133. A 29 year of female pt, came for inguinal hernia repair. No other history in D; heart sounds
the stem. Gave me a media. Asked what’s the finding? were normal.
A) VSD
B) Aortic stenosis
C) Mitral stenosis
D) Normal cardiac exam.
134. 68 year old male pt came with complain of syncope. He never had syncope,
chest pain or light headedness before. Gave me a media. There was a
crescendo decrescendo murmur on Aortic area. So I chose Aortic stenosis.
135. A pt in his 60s, has dizziness, lightheadedness and syncope. During I marked B.
examination, he had an episode of dizziness and lightheadedness. His BP at
that time was 90/60, pulse 138 and irregular. On ECG, we found a new
Atrial fibrillation with rapid ventricular response they told this in stem.
Asked the cause of hypotension in this pt?
A) Right ventricular infarction leading to decrease cardiac output.
B) Due to rapid heart rate, there is decrease ventricular filling( wording
may not be the same, but meaning same)
136. They give me picture B
like this and ask you
about drug X?
A- Antagonist
B- Partial agonist

137. They did a case control study between 2 variables I don’t remember now. I marked B
Odds ratio was 1.03 and p value 0.04. Asked what’s the clinical and
statistical significance?
Statistical significance clinical significance
A) Yes yes
B) Yes no
C) No yes
D) No no
138. I marked B

They gave me these 2 graphs and asked about three parameters.

Correlation program A program B
A) Positive higher lower
B) Positive lower higher
C) Negative higher lower
D) Negative lower higher
E) Correlation cannot be determined.
139. A disease in unexposed people is 75/300. And in exposed people 45/300.
What’s ARR? 0.1
140. A question on stress incontinence, had multiple vaginal deliveries. Asked A
what’s defective?
A) Levater ani
B) Pudendal nerve
141. Pt has severe congestive heart failure and persistent hypokalemia. He is I marked C. do
taking bumetanide, Lisinopril, statin, and carvedilol. His potassium was 2.9. check!!
We gave him potassium supplements. After 1 month, we again checked his
Potassium was 3.0. Asked what to do next?
A) Add amiloride
B) Add triamterene
C) Add spironolactone
D) Replace bumetanide with Hydrochlorothiazide
E) Replace carvedilol with bismolol
F) Replace Lisinopril with losartan.
142. Asked the site of action of
sildenafil. The arrow.

143. Clear case of pituitary adenoma. Amenorrhea, galactorrhea, visual

problems. Gave me a MRI and asked where the problem is? Had to choose
pituitary on MRI.
144. 7 year old kid came with his mother. Mother said he complains that bugs I marked B
are crawling all over his body. Even now he shouted “get these of me”. He
was diagnosed with ADHD, and was on methylphenidate 1 day ago. These
symptoms are due to which neurotransmitter?
A) Norepinephrine
B) Dopamine
C) Serotonin
D) GABA
145. A guy was working on a solution. He has diarrhea, salivation, lacrimation I marked C;
and other S/S of cholinergic toxicity. We gave him atropine and options did
pralidoxime. What was in this solution? confuse me :P
A) Pyrethrin
B) Paraqual
C) Parathion

146. A guy came in emergency department with sudden onset of tachycardia, Other options
palpitations, tremor, and chest pain. On ECG, ST elevation on II, III, and avF. don’t
What next to do for diagnosis? remember. Was
A) Toxicology screen
 a teenager I
guess.
147. A woman has breast cancer with multiple mets. She says I don’t want I marked A; do
chemo or radiotherapy. She has pain and distress findings. She is being confirm this.
transitioned to hospice care. Initial management for pain?
A) Morphine
B) Tramadol

148. Another guy has some cancer with multiple mets. And his life expectancy is I marked D
2 to 4 weeks. He is in hospice care and physician prescribed him opioid for
his pain. After 6 weeks, his family called that he is asking for opioid for first
time. What should be the physician response?
A) Wait for 4 hours, if he still has pain then give him opioid
B) Don’t give him opioid or else he’ll die due to respiratory depression
C) Don’t give him opioid, let the nature take its course
D) I told him I will not let him suffer. Please give him opioid.
149. A pt came for end of life care discussion. Some cancer with mets. Physician Other options I
for end of life care, what would he say? Something along those lines don’t remember
A) Advise him to fill his do not resuscitate form.
150. Pt had chest pain 2 days ago. We treated him for that. Now he has no chest I marked B. do
pain. He says I am afraid of dying and anxious when I am alone in the room. check.
His family members have been contacted and are on their way. He is
Roman Catholic and worries whether he will be able to recite his last rites.
What will be physician response?
A) Order a bedside attendant
B) Ask the pt whether he would like to speak with the Priest.
C) Don’t worry. You won’t die for tonight
151. A guys had UTI 3 days ago. He was prescribed TMP-SMX 2 days ago. Now I marked B.
he has fever and rash. On urinalysis, WBC and leukocyte esterase positive.
Asked for diagnosis?
A) Acute glomerulonephritis
B) Acute interstitial nephritis
C) Papillary necrosis
D) Acute tubular necrosis
152. A 12 or 14 year old kid has epistaxis, punctate lesions on extremities which I marked A.
are non-blanchable. On labs, platelet count is 7000. Asked what’s the
problem?
A) Specific IgG antibody
B) Splenic sequestration.
153. Paclitaxel binds to which structure
A) Tubulin

154. Pt has Crohn’s disease. He is on azathioprine, metronidazole and other I marked A.

drugs. On his labs, he has leukopenia. What’s the cause leukopenia? other drugs
A) Azathioprine were not
B) Metronidazole related to Bone
marrow
suppression.
155. Pt was on glipizide, hydrochlorothiazide, statin and one more drug. He had I marked B.
some neurological symptoms. On labs, he had hypokalemia. Asked his labs those symptoms
are due to which drug? may be were
A) Glipizide due to
hypercalcemia.
B) Hydrochlorothiazide
C) Statin
156. Experimental question. They I marked A;
wanted to compare arterial-venous options were
oxygen gradient and blood flow of confusing there.
muscle with kidney during exercise. Do check!!
They took the readings before and
during the exercise. And asked what
the best to define these changes is?
A) Kidney consumes oxygen by
largely unchanged ion
channel transport
B) Ineffective oxygen
extraction by muscle than kidney
C) Shunting of blood from the renal cortex to medulla.
157. We want to check the attitude of physicians when we implement the new I marked E; do
procedure. We took 20 physicians and divide them into 4 groups. A confirm it.
moderator goes to each group and asks them question from standardized
questionnaire. Their audio and video is being recorded and it’s being
analyzed by an investigator. What’s the type of study?
A) Case series
B) Case control
C) Cross sectional
D) Systemic review
E) Qualitative analysis
F) Clinical trial

158. Government in a town, to decrease the prevalence of obesity they put I marked D; 2
taxes on carbonic drinks. Which type of intervention? line question.
A) Secondary Do check!
B) Tertiary
C) Clinical
D) Community
159. They have come up with new procedure to decrease pain in pudendal I marked D;
neuralgia. They gave pts the scale of 1 to 10 and asked them about the pain check it!
before the procedure and after 7 months of procedure. They compared
their pre-op and post-op pain, they saw pain was significantly reduced; p
value <0.05. Which of the following is the greatest limitation of internal
validity to this study?
A) Lead time bias
B) Type 1 error
C) Type 2 error
D) Lack of control group.
160. I don’t remember the question exactly. But it was something about CMV I did A.
infection in pregnancy. They were asking pregnant women that did they
have any kind of rash in their pregnancy. Asked what’s the limitation to
validity in this study?
A) Recall bias
B) Type 1 error
C) Type 2 error.
161. A graph of negative skewed. Asked what will we use to measure central I did B.
tendency?
A) Mean
B) Median
C) Mode
D) Standard deviation
162. They were doing a cross sectional study to see the relation between I marked A.
smoking and hypertension. Gave me 2x2 table with labels of smokers vs
nonsmokers and hypertension vs no hypertension. Asked which test?
A) Chi square
B) T-test
C) Anova.
163. We are repairing PDA of a child which nerves are at risk of getting damage?
A) Recurrent laryngeal

164. Patient had an MI and his distal anterior interventricular (descending) A

artery is blocked, which artery will anastomosis and supply this collateral
A) Posterior interventricular (descending) artery
B) Left Circumflex
C) Artery to SA node
D) Left main coronary

165. Pt has lightheadedness. His BP is 180/110. On physical examination, I marked B;

crackles in his lungs and S4 sound. Ejection fraction was normal. Asked why because
symptoms in this pt? ejection fraction
A) Left ventricular outflow tract obstruction was normal.
B) Impaired Left ventricular relaxation
166. During exercise, what will be the same between pulmonary and systemic
circulation?
A) Stroke volume per unit time.
167. Pt has mitral valve prolapse. And asks what the most likely complication is? I marked it
A) Infective endocarditis wrong. It’s
B) Rheumatic heart disease probably C.
C) Rupture of chordae tendinae most common
complication is
D) No significant complication
MR.
168. A long scenario, in the last line it says the burn in this pt is leathery and D
non-sensate. What is the degree of burn?
A) First
B) Superficial second
C) Deep second
 D) Third
169. Pt when stands from supine position, which of following increases? B
A) Baroreceptor firing
B) Sympathetic flow to vasculature
170. A scenario of tricuspid valve infective endocarditis. And asked to identify
the affected heart valve on CT scan of chest. Do learn this guys. I practiced
it on X-ray.
171. Superior mesenteric aneurysm will compress which organ’s blood flow or B.
vessel?
A) Right kidney
B) Left kidney
C) Spleen
172. Pt’s DEXA scan score is -3.5. Dysfunction of which of the following is the I marked A. just
cause of this pt’s score? 2 line question.
A) Chief cells of parathyroid gland Nothing else.
B) Follicular cells of thyroid gland
C) Oxyphil cells of parathyroid gland
D) Parafollicular cells of thyroid gland
E) Zona glomerulosa cells of adrenal (suprarenal) gland.
173. Pt had biventricular enlargement with ejection fraction of 40%. They gave I marked A.
me his heart biopsy. I found multiple lymphocytic infiltrate. Asked the
diagnosis?
A) Myocarditis
B) Endocarditis
174. Pt with hypertension. His BP is 110/70. Distant heart sounds and pedal
edema and crackles. Don’t remember this scenario. There was cardiac
tamponade in the option but I didn’t chose it. I did something else I don’t
remember it now. COPD also in option.
175. Daughter brought her father with complain of sudden loss of vision on left B
side 30 minutes ago. He is fine now. Multiple arterial bruit in periphery.
Which artery is stenosed in this pt?
A) Anterior cerebral
B) Internal carotid
C) Middle meningeal
D) Vertebral
E) Temporal
176. Pt has 2000 Triglycerides. Asked about the treatment? Fibric acid
derivatives was the answer.
177. Pt has paraoxysmal supraventricular tachycardia (PSVT). We gave him B
adenosine and his PSVT stopped. Increase in which of the following
stopped it?
A) Calcium conductance
B) Potassium conductance
C) Na conductance.
178. Pt came with complain of delayed puberty and small testes. They told that A
he has KAL 1 gene mutation. Asked what’s the defect?
A) Gnrh migration defect
 B) Downregulation of Gnrh receptors
C) Gnrh not released from vesical
179. Pt came with complain of fasting hypoglycemia. We gave him glucose and D
he is normal after that. We found a mass in pancreas. Antibody will bind to
which of following cells in excess in pancreas?
A) Alpha
B) Delta
C) Acinar
D) Beta

180. A long scenario. Mother is diabetic and her newborn is macrosomic. This A
child might develop hypoglycemia immediately due to which of the
following?
A) Increase fetal insulin release
B) Increase MAP pathway in skeletal muscle.
181. Pt with S/S of meningitis. Organism we found was Nisseria meningitides.
We treated him for that. He still is hypotensive, hyperkalemic, and
hyponatremic. Asked what to do next?
A) Serum cortisol measurement.

182. A case of 21 hydroxylase deficiency. They told you this pt has hirsutism, No option for
increased 17 hydroxysteriods. Asked these symptoms are due to increase in androgens.
what?
A) Adrenocorticotrophic hormone
183. RANK-L will activate which cells? I marked D.
A) Bone marrow stromal cells
B) Bone marrow mesenchymal cells
C) Osteoblasts
D) Osteoclast precursors
E) Osteocytes.
184. Case of postpartum hemorrhage. Uterine massage didn’t help. We gave IV
drug. What will this drug do to stop bleeding?
A) Gq couple receptor activation.
185. We mutated a regulator protein. Mice contracts but can’t relax its muscle. I marked A.
Where this protein is mutated or where is this protein?
A) Sarcoplasmic reticulum
B) Cytoplasm
C) Transverse tubule.
186. Curve of ADH and plasma osmolality in a
patient with schizophrenia on lithium.
Choose point which represents his
situation. It’s the circled point in the graph.
Due to NDI.

187. A newborn has scaphoid abdomen. Left side no air entry. Mediastinum is
shifted towards the right. Diagnosis?
 A) Congenital diaphragmatic hernia.
188. Pt had peptic ulcer which is perforated. And gave me an X-ray showing I marked A.
classic air under the diaphragm. Where it occurred?
A) Anterior duodenum wall
B) Second part of duodenum
189. They gave me pt labs. Increase GGT, Increase ALP. And asked me where is A.
the issue?
A) Bile ductules
B) Hepatocytes
C) Kupffer cells
D) Sinusoidal cells
190. Guy eats French fries, cheese burger, and drinks milk shake. Which I did A.
hormone is increased in this pt?
A) Cholecystokinin
B) Secretin
C) Gastrin
D) Somatostatin
191. This picture and asked what’s
fused?
A) Metanephric blastema.

192. 3 weeks old child. Has clay colored stools and dark urine. Hepatomegaly, I did C.
jaundice, AST and ALT are raised. What’s the diagnosis?
A) Dubin Johnson
B) Rotor syndrome
C) Extrahepatic biliary atresia.
193. We have given a drug to decrease acid. It decreases the acid secretion by PPI.
all stimuli including acetylcholine, gastrin and histamine. Where does this
drug work?
A) H-K ATPase pump.
194. We are giving O group which is RH -ve, to a patient with AB group with RH C
+ve, now there is reaction which of the thing reacted against the patient
blood?
A) Anti A
B) Anti B
C) Anti Kell
D) Anti O
E) Anti RH
195. Pt has fatigue, his hemoglobin was low, and thrombocyte count was also Other options I
low. On peripheral smear we found reticulocytes. On physical examination don’t
S2 click was heard. Low haptoglobin and increase LDH. Cause of fatigue in remember.
this pt?
A) Mechanical shear forces.
196. They gave me peripheral smear picture and I found spherocytes w/o B
central pallor. Asked what’s the defect?
A) Actin
B) Ankyrin
C) Alpha globin
D) Beta globin
E) tubulin
197. We gave heparin to the pt for some reason. He developed I marked C.
thrombocytopenia so we stopped his heparin. Now which of the following Fondaparinux is
is contraindicated in this patient? not LMWH.
A) Argatroban
B) Bivelirudin
C) Dalteparin
D) Fondaparinux
198. A twisted question with easy thing asking. We are developing a protein A; just asking
which causes hypoxia induced erythropoietin expression. Which cells of where from EPO
human we should take for this purpose? Not exact words but meaning is released.
same.
A) Renal cortex fibroblasts
B) Bone marrow stromal cells
199. Pt has pain on abduction. They gave me X-ray similar B.
to this. And asked which muscle tendon is calcified?
A) Deltoid
B) Supraspinatus
C) Subscapularis
D) Teres minor
E) Infraspinatus

200. Picture similar much clearer with tendon of bicep I marked A

brachii was torn ulna and humerus was shown
properly with mark on them and asked due to
tear of this thing which function will be lost?
A) Forearm Supination
B) Elbow flexion

201. Pt lacerated his wrist 2 cm proximal to median eminence. He cannot I did B; yes they
oppose the thumb but can adduct all fingers. His sensation is also lost in gave me both
median eminence area. Asked which nerve is damaged? sensory and
 A) Palmer branch of median nerve motor deficits.
B) Recurrent branch of median nerve Do check!
202. Pt came with complain of Exact same
weakness in hand when she picture. She had
comb her hair and any activity cervical rib.
which required her over the
head movement. Gave me this
picture. And asked why these
symptoms?
A) Brachial plexus
compression.
B) Stress fracture of first rib

203. A man with pain when he sits on his buttocks, radiated to upper posterior I marked A.
thigh when that area is palpated. What nerve is compressed?
A) Sciatic
B) Superior gluteal
C) Inferior gluteal

204. Pt has loss of Achilles tendon reflex, lateral side of foot sensation loss. I marked it
Which of the following additional deficits in this patient? wrong. Should
A) Standing from seating position be B.
B) Walking on toe
C) Walking on heel
D) Squatting up and down.
205. Woman fell on floor. Her leg is shortened and externally rotated. On X-ray I marked B.
there was intertrochanteric fracture. Asked me which muscle causes lateral
rotation of hip?
A) Gluteus minimus
B) Piriformis
C) Rectus femoris
D) Pectineus
E) Gracilis
206. 25 years old male with his 26 year old I marked C. first
wife couple come to you to the clinic, the he is 25 year
husband has Huntington disease in his
old so you
family in his mother and aunt like the
pedigree shown, what is the chance that
don’t know if
he will have a child with Huntington he has the
disease: gene or not
A) 0 so, ½ chance
B) ½ that he
C) ¼ inherited the
D) ¾
gene from his
mother,
second is
probability of
giving the
 impaired gene
to his child
which is ½
too, multiply
and the
answer is ¼.
207. A girl or woman has anterolateral tibia pain. She is an athlete. Her pain is I marked A.
increased with movement. Asked me the diagnosis? don’t remember
A) Stress fracture other options.
B) Tibia periostitis.
C) Bone cyst
208. Pt has pain and swelling of distal little finger. His uric acid level is 17. Gave I marked A.
me X-ray which showed as if distal phalanx is eaten. I could not find a
picture. Rheumatoid factor negative, and anti citrullinated peptide
negative. Asked me this destructive lesion is originated from where?
A) Distal phalangeal joint
B) Distal phalanx
C) Proximal phalangeal joint
D) Proximal phalanx
E) Metacarpals
209. They gave me picture of heliotrope rash, malar rash, Gottron papules. She
also had proximal muscle weakness. Asked diagnosis?
A) Dermatomyositis.
210. Pt took aspirin 1 year ago and developed bronchospasm. Now we gave him
naproxen, he again developed bronchospasm. Induction of which of the
following is causing these symptoms?
A) 5 lipoxygenase pathway leading to increase leukotriene.
211. A 3 years old boy which lung structure will still be developing in this child?
A) Alveolar sac branches/septation etc.

212. A 3 month old baby asked which neurological process will still be occurring
A) Myelination

213. Arrow on node of Ranvier and A

asked which channels will be
abundant at this point?
A) Voltage gated sodium
channel
B) Voltage gated
potassium channel
C) Ion mediated calcium
channel

214. Auditory cortex was shaded, and asked that nerve terminals that are A
damaged are originated where?
A) Medial geniculate nuclei
B) Lateral geniculate
215. Pt ventral posteromedial nuclei is damaged. Which of the following will be
effected?
A) Sensation of the face.
216. Pt has shooting pain in the face for 2 days and lasts 30 to 60 seconds. This I marked D.
pain is triggered when I brush, or when I touch that area. Where will we
find abnormality on MRI in this patient?
A) Maxillary sinus
B) Pterygopalatine fossa
C) Superior sagittal sinus
D) No abnormality on MRI.
217. Pt has right side spasticity of lower extremity. Gave me a cross section of
spinal cord and asked where is the lesion? Had to choose corticospinal tract
on the right.
218. Mother brought her 3 month old child with complains of irritability, not I marked A
feeding properly. On MRI we found subdural hematoma. What is the most
likely cause?
A) Child abuse
B) Coagulopathy
219. Pt has suddenly started to stare at the wall, a blank stare. On EEG, we
found 3 hz spikes / sec. We gave a drug which act on which of the
following?
A) Thalamus
220. Patient who is having severe unilateral headache, says before the pain
starts there is flashing zigzag line here visual field and after 10 minutes
there is pain in my head, which is precipitated by light and sound.
Diagnosis?
A) Common migraine

221. A pedigree like this. M stands for I marked D.

some muscle problem. Asked me
mode of inheritance?
A) Autosomal dominant
B) Autosomal recessive
C) X-linked recessive
D) Mitochondrial

222. Bitemporal hemianopsia picture given of a child asked the dx

A) Craniopharyngioma
223. A pt is on levodopa/carbidopa. To prolong the action of levodopa, which
additional enzyme should be inhibited?
A) COMT
224. We gave suxamethonium to a pt, he developed fever and muscle rigidity
which was treated with dantrolene. His brother had the same S/S with
spinal anesthesia. Which receptor is defected?
A) Ryanodine
225. Mother brought her newborn child who has high pitched cry, irritable, and A; neonatal
poor feeding. Mother didn’t have any prenatal care and used oxycodone abstinence
intermittently. The treatment for this child has which of the following syndrome.
mechanisms?
A) Mu receptor agonist
B) Mu receptor antagonist
226. A classic case of Tourette syndrome. Asked treatment has which A
mechanism?
A) Dopamine antagonist
B) Serotonin reuptake inhibitor
C) Norepinephrine reuptake inhibitor
227. Pt has 2 months history of low energy, depressed mood, sleep problem, B.
and lethargy. I keep on getting angry on small things. I don’t go out as I
used to. She also has suicidal tendency. 1 year ago she had an episode
where she was hyperactive, she didn’t need to sleep and other S/S of
mania. Asked the diagnosis?
A) MDD
B) Bipolar disorder.
228. A long scenario, describing a woman who cut her hand every time her
boyfriend said they will breakup. She had 9 boyfriend in few months. And
asked which personality?
A) Borderline
229. Pt has an infection of E.coli. This is the fifth time in the last month she had I marked A.
the same infection with E.coli. Her infection improved rapidly with
treatment. As the nurse check her belongings, she found a dirty bag of
syringe with brown sludge in it. Asked the diagnosis?
A) Factitious
B) Substance abuse.
230. Pt asked for the treatment for his premature ejaculation. Which of the
following is the drug?
A) Fluoxetine
231. Pt may be teenager, took her mother prescription drugs to get “high” 3 A; only one
hours ago. His pulse is 58, bp is 90/60. Respiration were low also. Asked option with
which drug? depressant
A) Lorazepam effect.
B) Bupropion
C) Phenelzine
232. During a study of renal glomeruli, a healthy animal kidney is kept in a D
vascular bath preparation at a constant afferent arterial pressure of 100
 mm Hg. If the efferent arteriole is constricted with a vascular clamp, which
of the following starling forces is most likely to change in glomeruli?
A) Decreased filtration coefficient (kf)
B) Decreased Hydrostatic pressure
C) Decreased oncotic pressure
D) Increased GFR
E) Increased oncotic pressure

233. Pt has vomiting, and dry mucous membrane. What will happen to maintain B
hydration homeostasis?
A) ADH acting on PCT
B) Increase urea absorption from medullary collecting duct
234. Pt had hypotension due to some reason. His urine output was low. We A
resuscitated him. But still his urine out is low. What is affected?
A) Proximal convoluted tubule
B) Ascending loop of Henle
235. Kid who had sore throat 3 weeks ago now presented with dark urine his bp
was 150/100.
Asked about the parameter. Urine color: brown, RBC cast: Present,
protein: 1+
236. Pt had dysuria, urgency and frequency. He worked in paint factory for 10 A
years. He is a smoker too. What else we will find on urinalysis?
A) Hematuria
B) WBC cast
237. A baby born healthy had no particular issues with anything except that his
ring and little finger were missing. Everything else was normal. What can
lead to this complication?
A) Amniotic bands leading to Amputation

238. Newborn baby of few days his umbilical stump has fallen, now there is clear
yellow discharge from the umbilicus this is due to
A) Defect in involution of allantois duct

239. Pt pregnancy test is positive. Said that hormone which is maintaining B

pregnancy released from where?
A) Corpus albicans
B) Corpus luteum
240. A case on choriocarcinoma. Don’t remember it.
241. Much clearer picture of cervix was given, involvement of whole both lips of A
cervix it was all messed up.
a) Invasive SCC
b) Carcinoma in situ
C) Adenocarcinoma
242. A

Patient presented with infertility with her husband, she has cyclic
menstrual pain, her menses are normal,2 picture was given and asked
about the diagnosis.
a) Endometriosis
b) Invasive SCC
c) PID

243. A 23 years old woman has delineated, non-tender, mobile mass on her
breast. Asked the diagnosis?
A) Fibroadenoma
244. A guy worked in shipbuilding 10 or 20 years ago. He smoked for 10 years A
which he quit 30 years ago. He occasionally drinks alcohol. He has left
lower base crackles. This finding is due to?
A) Shipbuilding
B) Smoking
C) Alcohol
245. Pt had pneumonia S/S. Asked why this pt developed pulmonary edema or
exudative pleural effusion? Something like that.
A) Alveolar capillary injury.
246. Truck driver, antiallergic which is not sedating
a) Fexofenadine

247. Congo red stain mentioned in the

scenario and picture similar to like
this was given and asked about this
person has increased risk of which of
the following?
A) Hemorrhage

248. Woman with cancer, says her husband also had cancer and he had I marked B; do
chemotherapy which lead him to vomiting and it also didn’t really treat his check!
cancer. I am afraid of chemotherapy but uncomfortable of the idea of not
getting any therapy. Physician response?
A) Let’s discuss the benefits and side effects of chemo
B) What are your goals for your condition
C) You may not experience the same side effects as your husband.
249. Pt has pancreatic cancer, physician took an hour explaining the procedure. I did A. do
Pt asks about the chance of survival. Physician replies that chance of check!
survival for 5 years is 5%. He said I would think over it. After 1 day he came
back with the decision of not undergoing procedure saying that risks
outweighs benefits. Physician response?
A) Document his decision and reason for refusal in his chart
B) Check capacity to have an informed decision.
250. Pt is on statin, aspirin, dipyradimole, and other drugs. Pt has headache.
Asked which drug causing it?
A) Dipyradimole
251. Renal mass picture and asks what else we will find in this pt? A
A) Erythrocytosis
B) Hypocalcemia
252. A question on case control study. Disease vs healthy people and then
looked for exposure.
253. Pt had deranged lipid profile. So we gave him lipid lowering drugs. Soon he
had flushing and all. Asked which drug causing it?
A) Nicotinic acid.

This is all I can recall. Best of luck guys.