PAST PAPERS

8 SEPTEMBER,MORNING,SURGERY AND
ALLIED, 2017
(complied by Dr Shahan Saleem; with necessary references and explanations)

1) what are lesser sac relations?

-anterior abdominal wall and stomach
-stomach and pancreas (answer: ref B.D chaurasia)
-stomach and transverse colon

2) mediolateral episiotomy done.which muscle cut?

-bulbospongiosus(ans, ref: ten teachers obs)
-external sphincter
-levator ani

3) medial boundry of ischiorectal fossa formed by ?

-levator ani
-external anal sphincter(ans : ref KLM anatomy)
-obturator internus

4) Embryonic tumor of child hood

-ewing sarcoma
-nephroblastoma(ans :its called Wilms tumor that has embryonic mesenchyme
as its component)
-warthin tumor
-lymphoepithelioma

5) saw tooth waves on ecg

-atrial flutter(ans : ref dale dubbin ecg)
-atrial fibrillation

6) deep sleep is characterized by

-bruxism
-delta waves (ans)
-alpha waves

explanation:N2 stage of NREM sleep is called deeper sleep and bruxism occurs in
it.N3 stage of NREM is called deepest sleep(slow wave sleep) and Delta waves
occur in it.between deeper and deepest sleep I preferred deepest sleep hence
delta waves as answer (ref:first aid neuro chapter)

7) naturally occurring opioid are

-morphine and pethidine
-morphine and codeine(ans : ref : google)
-fentanyl and codeine
-fentanyl and morphine
-fentanyl and pethidine

8) energy used in respiration at rest is ?

-5% (ans:rabia mcq)
-10%
-15%
-20%

9) primary dehydration causes ECF to become

-hypotonic
-hypertonic(ans: loss of water occurs in primary dehydration and hence ecf gets
hypertonic)
-isotonic
-isosmotic

10) A long scenario of laparotomy done of patient having some cancer.in end the
lymphatics of ovaries were asked
-para aortic (ans:ref klm )
-internal iliac
-external iliac
11) lymphatic drainage of prostate
-internal iliac(ans)
-external iliac
-internal plus external iliac

12) levator ani nerve supply

-pudendal nerve(I marked pudendal nerve)
-inferior rectal nerve

13) classical scenario of curd like discharge,with psuedohyphae mentioned

-candidiasis (answer)

14) projection fibres are present In

internal capsule

15) 10 year old boy had cyanotic spells on exertion (cyanotic spells were
mentioned as on and off bluish discoloration of fingers and nails)
-VSD
-TOF (ans)

explanation:this is classical scenario of tet spell that occurs in TOF.TOF has best
prognosis in cyanotic heart diseases and children survive much longer compared
to other cyanotic heart diseases.some colleagues have mentioned VSD as answer
as they say that age for TOF is very high and patient cannot survive.but again TOF
has best prognosis.tet spells occur on exertion/crying/irritation that causes the
infundibular portion of pulmonary valve to undergo spasm.this the blood that was
going to some extent to right circulation via pulmonary valve is totally blocked
and the blood is shunted via over riding aorta in to peripheral circulation causing
cyanosis.this is best tackled by SQUATTING of child that increases the after load
and hence shunts blood again towards moderately stenosed pulmonary valve.

16) hilar lymphadenopathy,noncaseous granuloma,multisystem

involvement,hypercalcemia.what is diagnosis?
-sarcoidosis
17) bicuspid aortic valve association
-tricuspid atresia
-co-arctation of aorta (ans : both bicuspid aortic valve and coarctation are seen
in turner syndrome)

18) best way to manage febrile blood reaction

-washed rbcs
-antipyretics (ans :most common reaction to blood transfusion seen in wards
simply managed by giving paracetamol or other antipyretics)

19) small cell carcinoma causes

cushing syndrome (ans : releases ACTH as paraneoplastic syndrome)

20) major blood vessels present in which space

-extra dural
-subdural
-sub-arachnoid (ans)
-sub-pial

21) subdural hematoma occurs due to rupture of

-superior cerebral veins (ans)
-inferior cerebral veins
-middle meningeal artery

22) short term memory loss occurs de to lesion of

-hippocampus (ans:uworld)
-parahippocampal area
-neocortex
-amygdala

23) hypertensive and diabetic patient came in icu for management.he had
bleeding from nose and right eye orbital invasion and cellulitis.organism
mucormycosis (answer)
24) 1b fibres innervate
-muscle spindle
-golgi tendon (answer:1a innervate muscle spindles)

25) clara cells found in

-terminal bronchiole (ans)
-respiratory bronchiole

26) smooth muscle of alveoli have which channels/work by which mechanism

ATP/k
adp/k
02/k(marked answer)
explanation:this was an unusual question.most marked o2/k channels on basis of
fact that pulmonary vasculature undergoes vasoconstriction due to hypoxia and
thus may have o2 channels -_-

27) most important change in kidney to preserve blood volume is

-dec ADH secretion
-increase blood flow to meduallry interstitium
-increased renin secretion (ans)

28) scenario of cystic fibrosis and type or inheritance was asked

autosomal recessive (answer)

29) which malignancy spreads via blood

-medullary carcinoma of thyroid(ans)
-oat cell ca
-small cell ca
-endometrial ca
explanation :classically 4 tumors spread via blood (follicular ca,choriocarcinoma
etc).robbins and goljan didnt even mentioned medullary ca spread via blood,but
its same copy paste mcq from asim shoaib where key was medullary ca.hence I
had to choose medullary ca

30) function of sternocleidomastoid

turns head to same side
-turns head to opposite side (ans)

31) tumor compressing anterior surface of sternocleidomastoid.which vessel will

be engorged?
-external jugular vein (ans:lies over anterior surface of SCM)
-internal jugular vein

32) there was a scenario of damage to posterolateral surface of forearm that

caused paralysis of abduction and extension of thumb and index finger with no
sensory loss?
-radial nerve
-deeper branch of radial nerve(ans)
-superficial branch of radial nerve
explanation:all seem correct at first glance but deeper branch is specifc option
that causes motor paralysis with no sensory loss.superficial branch causes sensory
loss of lateral half of hand.(ref:KLM anatomy)

33) lymphatic drainage of labia majora is?

-horizontal group of medial group of superficial inguinal L.Ns(ans)
-vertical group of sup.inguinal L.Ns

34) infarction of apex of heart.vessel thrombosed.

-marginal branch of RCA(ans)
-LAD
explanation:apex is part of inferior wall of left ventricle.it is supplied by marginal
branch of RCA.apex is not supplied by LAD except in some cases called WRAP
AROUND LAD .Infarction of this LAD will cause anterior plus inferior wall MI both
called antero-apical MI.

35) SLE scenario.most sensitive initial investigation is?

-ANA(ans)
-anti-ds DNA antibodies (it is most specific test,not sensitive)

36) diabetic patient with pupillary constriction of right eye and partial ptosis
-horner syndrome (ans:past paper qs)
-diabetic opthalmoplegia

37) neurogenic shock is due to?

-loss of vasomotor tone (will decrease both C.O and TPR)

38) patient walks and his right side of pelvis sinks.cause is

-left gluteus maximus paralysis
-left gluteus medius paralysis (ans:Ref KLM anatomy)
-right gluteus maximus
-right gluteus medius
explanation:always remember that the gluteus medius and minimus of opposite
side will be paralysed to where the pelvis will sink e.g if sinks to right ,then left
gluteus medius and minimus and viceversa.

39) cancer metastasis is due to

-loss of e-cadherin(ans)
-invasion of basement membrane
explanation: this was again a controversial mcq with 3 options that were very
similar and confusing.at the end I chose E-CADHERIN as It was answer in most of
past papers and mcq books.Also 1st basic step is loss of e cadherin that separates
individual cells making them dyscohesive after which basement membrane
invasion occurs.

40) example of autoimmune disease involving single organ

-hashimoto thyroiditis (ans)
-rheumatoid arthritis
-SLE

41) structure related to lateral fornix of vagina

-ureters

42) lymphatic drainage of lateral side of foot

-popliteal L.Ns (ans)
great saphenous vein
43) lumbar pain with loss of ankle jerk/weak ankle jerk.which is involved?
-sciatic nerve
-L5
-S1(ans)
explanation: this concept has been well explained in surgery dogar and KLM
anatomy.in simple words if there will b such a scenario and it mentions loss of
ankle jerk/weak ankle jerk/loss of sensation over lateral half of foot then click
S1.if mentions loss of dorsiflexion then click L5.scaitic nerve is also right but we
choose more specific options when 2 correct options are present.Thus S1(nerve
root of ankle jerk) > > sciatic nerve

44) dermatome of lateral side of wrist is?

-c6 (answer)

45) what is absent in atlas?

-body (ans)

46) a boy had RTA and suddenly looses 1.5 litres of blood.what will be seen on
peripheral picture?
-normocytic normochromic anemia (ans :anemia of acute blood loss)

47) pulsating abdominal mass (abdominal aortic aneurysm).most common site

-T12-L3
-L3-L5
controversial mcq .I marked A

48) how to diffrentiate between right and left kidney?

-relation of structures at hilum

49) long scenario from past papers and in the end it was asked that right adrenal
gland is close to which structure
-IVC(ans)
-aorta
50) cancer in upper 1/3rd of esophygus will be ?
-SCC(ans)
-adenoCA

51) submucus fibrosis is ?

-dysplasia
-metaplasia
-premalignant (ans :ref : dhingra ent)

52) common peroneal nerve damaged.what is lost?

-eversion (dorsiflexion was not mentioned hence eversion was answer)

53) midline swelling in neck below hyoid bone.dx?

-thyroglossal duct cyst(ans)

54) cervical cancer drainage?

-internal plus external iliac

55) typhoid 1st week.test?

-blood culture

56) bulbourethral glands are contents of?

-deep perineal pouch

57) mean is?

-sum of all values divided by total

58) refrrel system means?

-sending to a better higher facility

59) sensory supply of ulnar nerve?

-medial 1/3rd both dorsal and palmar aspect

60) lactation controlled by?

ACTH/cortisol,prolactin and oxytocin (ans:ACTH/cortisol is ususal option here
that makes it confusing here but its written in nelson and in obs ten teacher
both)

61) right thumb was lacerated.1st web space infected.lymph will drain to?
-epitrochlear LNs
-infraclavicular L.Ns(ans)
explanation:1st web space mean between thumb and index finger(as question
also mentions injury of thumb) i.e on lateral side. lateral side is drained by
infraclavicular L.Ns. medial side is drained by epitrochlear LNs.(this has been
discussed many times in past paper and some people still opt for epitrochlear
because they think 1st web space is on side of little finger )

62) most common skin malignancy in HIV?

-Kaposi sarcoma

63) people with blood group A have

-type A agglutinins on there cell membrane (ans)

64) histological slide of salivary gland showing mucus acinic with serous
demilunes (past paper qs)
-sub mandibular gland(ans)
explanation: submandibular gland is mixed i.e both serous and mucinous.parotid
is pure serous and sublingual is pure mucinous.ref:jinquira histology)

65) some cancer obstructs pancreatic head.which part of bile duct will be
compressed?
-common bile duct (as it is embedded in head of pancreas)

66) which parasite causes cholangiocarcinoma?

-clonorchis sinensis

67) most common method to detect cancer in blood is?

-tumor marker (ans)
-peripheral smear
-bone marrow biopsy
68) child had eaten from restraunt, then had bloody diarrhea, petechie and facial
swelling. Peripheral blood picture showed shistocytes.what is diagnosis?
-HUS(ans)
explanation: bloody diarrhea occurring after eating hamburger/food from
restraint is classically caused by E.coli 157:H7 strain causing hemolytic uremic
syndrome. Shistocytes shows hemolysis,facial swelling shows ARF and petechie
shows thrombocytopenia completing the triad of HUS.

69) Virus cause mutation by alteration in?

-proto-oncogenes(ans)
-oncogenes
-DNA
explanation:every where in group,dna/oncogene is discussed as answer but go
and read TUMEROGENESIS BY VIRUS in microbiology levinson.It clearly states that
virus cause alteration in /mutation in cellular oncogenes called proto-oncogenes
and cause cancer.read it your self so that u may believe it with your eyes.Also we
have to choose more specific option i.e both DNA and proto-oncogenes are
correct but remember than gene is a specific part of DNA and hence is more
specific option.

70) optic neuritis/red green color issues in a T.B patient taking ATT is due to?
-ethambutol (answer)

71) prenatal diagnosis of thalassemia is done by?

-hb electrophoresis of maternal blood
-CVS(answer)
-maternal urine test
explanation: best and earliest way to detect fetal cytogenetics/abnormalities is
CVS samping done at 8-13+6days (ref range taken from ten teachers).it is a past
paper mcq also. Some people went with maternal hb electrophoresis but that is
wrong because fetal rbcs are antigenic and they wont be found in maternal blood.

72) secondary centre of ossification found in?

-epiphysis (repeated past mcq)
73) patient had took some drug(antibiotic) 2 weeks back and she started having
signs and symptoms of pancytopenia.what is diagnosis?
-myelodysplastic syndrome
-aplastic anaemia(ans)
explanation: most likely drug induced aplastic anemia is answer here.it is not
myelodysplastic syndrome(also associated with pancytopenia) because MDS
classicaly occurs after chemotherapy/anti cancer drugs that leads to dysplasia of
cells in bone marrow leading to their apoptosis and hence pancytopenia. Also
some classical features of MDS were not mentioned such as blast cells(<20%) ,
pawn ball megakaryocytes, ringed sidero-blasts, psudeo-pegler huet
cells(hyposegmented neutrophils)

74) patient had high grade fever and chills, brown colored urine (scenario leading
to malaria).there was no history of anti-malarial drug intake.what is diagnosis?
-malaria(ans)
G6PDH deficiency

75)depressed nasal bridge,simian crease

-trisomy 21

76) patient with 46XX and ambiguous genitalia?

-congenital adrenal hyperplasia(ans:ref first aid)
-mixed gonadal dysgenesis

77) definition of reliability of test?

-ability of test to produce repeatable results
78) Intermediate mesoderm develops into?
-genitourinary system (ref :high yield embryology)

79) there was a swelling in front of neck with multiple sinuses and yellowish
discharge?
-actinomyces(ans)
-staph aureus
explanation: staph aureus causes carbuncle that also has multiple openings but
its classical site is at back if neck/back and occurs in diabetics)

80) in order to prevent complications of a procedure/intervention,what must be

done
informed consent(ans)

81) there was a long scenario about gynaecologist doing some operation and it
was asked that which structure is present between extraperitoneal fat and
transversus abdominus?
-transversalis fascia was answer(not remembering exact stem )

82) dorsalis pedis is absent in a child .Which structure will supply foot in this
case?
-perforating branch of peroneal artery(accessory peroneal artery)

83) what are tremors?

-alternate contractions on each side of muscle spindle(answer)

84) main function of basal ganglia?

planning of movements (ans)

85) which drug used in headache treatment is contraindicated in peripheral

vascular disease?
-ergotamine(causes severe peripheral vasoconstriction:ref big katzung,lipncott)

86) PDGF are derived from ?

-Alpha granules of platelets(ref: 1st aid)

87) taut hemoglobin has reduced affinity for

-O2(ans: ref 1st aid)
-CO2

88) child small bowel was resected(scenario on that).it was asked that which ll
become deficient?
-vitb12(ans)

89) AST/ALT require what as a cofactor

-vit b6 (ref : 1st aid)

89) sciatic nerve was damaged in RTA but still patient had some sensations on
dorsum of foot.this is because of which nerve
-saphenous nerve(ans)
explanation:saphenous nerve is continuation of femoral nerve and it supplies
medial side of of foot upto ball of big toe)

90) bleeding time is normal in?

-factor 9 deficency(ans)
-thrombocytopenia
-vWF disease

91) fertilin present on sperm is involved in?

-attachment of sperm to ovum(I marked this option; confirmed by google)

92) patient was on TPN and he had purpura.what is reason?

-vit K deficiency ( ans)

93) there was scenario in which there was increased b.p in upper limbs and lower
in lower limbs
-co-arctation of aorta(ans)

94) diptheriia has following most likely feature?

exotoxin mediated damage (ans)

95) upper outer quadrent breast tumor.lymph will drain into

-deltopectoral L.Ns
-anterior axillary L.Ns(ans) -_-

96) adrenal medulla develops from

-ectoderm
-neural crest cells (ans :ref 1st aid)

97) patient has hyperosmolar hyperglycemic coma.which insulin given?

-regular (answer)
-ultra lente

98) 1st route of spread of retinoblastoma ?

-hematogenous
-optic nerve(ans)

99) patient had RTA and spoke fluently but with not much sense?
-Wernicke aphasia(ans)

100) M.O.A of acetazolamide?

-increase H+ secretion in exchange for Na and K(ans: this was copy paste mcq
from asim shoaib)

101) a scenario about the tumor most commonly occurring after radiation
meningioma (ans:ref goljan)
glioblastoma
explanation: the question was about cancer arising after radiation.another
question is frequently asked about sensitivity of cancers when treated by
radiation .in that case its seminoma >> glial glioma >> craniopharyngeoma.hence
read the stem carefully

102) oocyte surrounded by flat epithelial cells

-primary follicle
-primordial follicle(ans)

103) amoeba most commonly effects which part

caecum (ans)

104) a patient had undergone resection of large intestine.what complication will

happen?
-water and electrolyte problems(as large intestine normally absorbs them)
105) very long change fatty acids are catalyzed in?
-peroxisomes (ans)

106) what adaptive change will occur in long standing hypertension?

-hypertrophy(most common complication of HTN is left ventricular hypertrophy)

106) chlamydia causes?

-lymhogranuloma venerum(ans)
-condyloma accuminata

107) patient of hepatoma(HCC) had developed ascites and distended abdominal

veins.tumor has spread to which structure to cause these symptoms?
-IVC(ans)
-hepatic veins
-portal vein

107) osteoblastic activity is increased by

-pth
-cortisol
-GH (ans)

108) patient had long standing GERD .endoscpy showed esophygitis and biopsy
showed goblet cells and columnar cells.diagnosis?
-barret esophygus (ans)
-erosive esophygitis

109) pap smear done that showed nucleur chromasia and koilocytes.diagnosis?
-metaplasia
-dysplasia(ans:ref big robbins)

110) vagal stimulation of myocardium acts predominantly at?

-SA node causing altered K+ permeability (ans)

111) cut/damage to anatomical snuff box.structure affected

-radial artery(ref :KLM anatomy)

112) which of following helps in inhibition of wound contraction?

-steroids(ans)
-skin grafing
explanation: wound contraction is caused by myo-fibroblasts that are derived
from fibroblast and modified by various cytokine action. steroids inhibit collagen
production by inhibiting fibroblasts causing there apoptosis. This decreases
fibroblasts.Also it suppresses macrophages and cytokine production.This causes
inhibition of wound contraction(ref:goljan)

113) there was a scenario that how much energy is derived from fats in a
balanced diet?
-correct option had 30% in it as I dont remember exact options
explanation: carbohydrates 50-55% ,fats 30-35% , proteins 5-10% (ref:peadriatric
by pervaiz akbar)

114) ebv causes?

-nasopharyngeal CA

115) bronchogenic carcinoma caused by?

-CMV (strange option to pick but its copy pasted rabia mcq)

116) Primary afferents from nociceptors terminate in?

-dorsal spinothalamic tract
-ventral spinothalamic tract
-lamina 1 of spinothalamic tract (ans)

117) obliteration of uterine cavity occurs due to fusion of?

-Decidua parietalis and capsularis(ref:klm embryology)

118) machinery murmur in new born?

-PDA(ans)
119) dialyzing fluid has high amount of?
calcium
potassium
bicarbonate (ans)

119) artery coming out at back from bifurcation of vessel

-medial sacral artery(ref: BD CHAURASIA)

120) wasting occurs in?

-LMN lesion(ans)

121) neurotransmitter for mood?

-dopamine(ans)
-serotinine

122) a scenario for uncompensated metabolic alkalosis

123) RTA ,injury to cervical sympthatic chain.what will happen

-constriction of pupil (horner syndrome)

124) most common complication of hypertension in eye?

-retinal vessel arteriosclerosis (ans)

125) which are only part of innate imunity?

-NK cells(Ans)
-complement

126) subcapsular afferents drain into?

-lymph nodes

127) stress hormone is?

-ACTH(ans)
-dopamine

128) which hormone is controlled by inhibitory factor from hypothalamus?

-prolactin (by dopamine)

129) most common complication of diabetes ?

-dry gangrene(ans:discussed 1000 times in group with refrences)
wet gangrene

130) most susceptible tissue to ischemic necrosis?

-neurons(Ans)
-cardiac tissue

131) glucose transport is enhanced by?

-increasing the number of carrier proteins in cell membrane(as glucose is
transported by facilitated diffusion that requires carriers)

132) renal plasma flow is measured by?

-hippurate flow

133) one glucose molecule in presence of O2 yeilds

-38 ATPs(aerobic metabolism)

134) lady with pruritis,xanthomas,hepatosplenomegaly and jaundice.test was

asked?
-anti-mitochondrial antibody is diagnostic (ref: goljan)

135) most appropriate about plasma k+?

-98% is inside cell (copy paste asim mcq)

136) a labourer sweats 2 L and drinks 2 L pure water.what will happen?

-increased ICF (highly repeated past paper mcq)

137 pendular knee jerk seen in?

cerebellum lesion

138) epitheloid cells in tuberculous granuloma are derived from?

monocytes(ans:monocytes and macrophages ;ref:robbins pathology)
139) carcinoma of apex of lung.which segment will collapse?
apical superior)

140) confirmatory test for diagnosis of t.b?

-AFB of smear

141) 1st line defence against infection is?

-macrophages(ans)
-T cells
-neutrophils
-lymphocytes
explanation:the 1st line defense against infection is innate immunity. Hence T
cells or macrophages are options left. 1st macrophages recognizes the antigen,
bind it and then present it to T cells .Hence if we go sequentially then
macrophages are best to pick.neutrophils are 1st cells to appear in inflammation
that accompanies infection.

142) a scenario of lymphoblastic leukemia and test was asked

-bone marrow biopsy(ans)

143) dysphagia to liquids is due to?

-neuromuscular incoordination (ref: dhingra)

144) malnutrition,edema and decreased albumin.diagnosis?

-kwashiorkor

145) cataract occurs due to long term use of?

-chloroquine (rabia mcq)

146) pituitary tumor compressing optic chiasm

-bitemporal hemianopia

147) enzymes act by

decreasing the activation energy of reaction
148) most common cause of pulmonary embolism is ?
immobilization (asim mcq)

149) Sa nodal branch in 60% cases is branch of?

-RCA(ans:ref:cardiology secrets)
-LAD

150) cervical cancer caused by?

-HPV

151) rabia scenario of defective migration of mesenchymal migration from

primitive streak to around cloacal membrane will cause?
-ectopic anal opening(ans)

152) regarding parasympathetic system?

-pelvic splanchnic nerves are parasympathetic (ans)

153) dicrotic notch occurs in?

-aortic systole(ans)

154) intervertebral joints are type of ?

-secondary cartilaginous joints/symphysis(ref:KLM anatomy)

155) athelete at rest ll have ?

-increased stroke volume(ref BRS and Kaplan physiology)

156) common cause of liver cirrhosis?

hep C

157)deep inguinal ring is an opening present in?

-transversalis fascia (ans)

158) patient on diuretic theray presents in emergency in a semicomatose

condition with k+levels of 6meq/L.what is the cause?
-diuretic use
-ARF(ans)
explanation:the deterioration patient who is previously hypertensive and now
presenting with comatose state is likely due to ARF .this shows that patient is
having hypertensive emergency that is causing end organ damage evident by
semicomatose condition(may be indicative of cerebral encephalopathy) and ARF
(kidney damage).this is not due to diuretic use as we can see that potassium
levels are high so patient must be on potassium sparing diuretics(if he were on
loop,hypokalemia would have been there with other electrolyte abnormalities
and hypovolemia).potassium sparing diuretics are weak diuretics and thus used
mostly as adjuncts with other drugs.also they take 2 to 3 days to elevate the k+
levels.this mcq is written in 2 places in rabia ali.at one place the answer is ARF and
at other place,in pharmacology section, its diuretic(correct it to ARF)

159) Q fever is caused by?

-virus
-protozoa
-parasite
-ricketssiae(ans)
explanation: Q fever is caused by coxellia burneti which is an intracellular bacteria
similar to ricketssiae.but there was no option of bacteria.hence I marked
ricketssae.

160) which of following is necessary for development of seminiferous tubules?

-FSH and androgens(ans)
-testosterone
-estrogen

161)which is complication of epidural anesthesia given for narcotic

administration?
-urinary retention
-hypotension
-decreased consciousness
answer:controversial.most marked urinary retention
162) there was a scenario about hysterectomy and it was asked that the
gynaecologist must know which relation of ureter?
-crosses pelvic brim
-crosses at bifurcation of common iliac artery
-passes behind broad ligament (ans)
explanation:this question about ureter relation had 3 correct options.but the
relation was asked particularly in relation to hysterectomy.hence I marked behind
broad ligament as broad ligament has blood vessels of uterus that are ligated
during hysterectomy and this is point where ureter injury is supposed to have
maximum chances of injury(confirmed from KLM anatomy and NCBI)

163) surfactant deficiency causes?

-decreased lung compliance (ans)

164) there was another scenario of lymphatic drainage of superolateral breast

-pectoral group (answer)

165) myelination is peripheral nerves is caused by?

-oligodendorcytes
-schwaan cells (ans)
-microglia

166)best test for measuring gfr is?

-creatinine clearance
-inulin clearance(ans)
explanation: best method and most accurate measurement of GFR is by inulin
clearance as it is neither resorbed nor secreted. But the best method clinically is
creatinine clearance as it is found in body and hence easily measurable but its not
the most accurate way because some creatinine is secreted and hence creatinine
clearance slightly over estimates actual GFR.

167) renal column has which structure in it?

-interlobar artery(answer)
Explanation: if asked about medullary rays ,then its collecting ducts.

168) which of following helps in inhibition of thrombus formation

-prostacyclins(answer)

169) insulin enhances entry of glucose in?

-skeletal muscles and adipose tissue

170) p53 mutation occurs.what is mechanism of tumerogenesis?

-increased cell survival (answer)

171) initial mechanism in apoptosis ?

-activation of caspases(ref:goljan)

172) stony dull percussion is due to?

-fluid in pleural space(Answer)

173) ATT combination therapy is given primarily because ?

-to prevent emergence of resistence if bacteria

174) which one will not cause edema?

-constriction of vein
-constriction of arteries(ans)
-nephrotic syndrome

175) progesterone is produced in last 7 months by?

placenta(answer)

176) halothane given alone is not a good analgesic and doesnot causes quick
induction of anesthesia.it is combined with what to enhance these properties?
-NO (answer:ref big katzung,lipncot pharmacology)

177) patient had RTA with fracture of pelvis and right femur with open fracture of
left tibia. vitals: b.p 60/40 RR 24/min pulse 120/min. what ll be first step of
management in emergency?
-fixation if tibial fracture
-IV steroids
-IV fluids(answer)
-oxygen therapy

178) patient had abrasion while playing cricket. what will be first step in
hemostasis?
vasoconstriction(answer)
explanation: vasoconstriction occurs due to release of endothelin from damaged
endothelial cells and via neural reflex.this occurs so that blood flow to the injured
area is reduced that helps in two things;one is prevention of excessive blood
leakage;second is that less blood to injured area will not wash away the formed
thrombus (ref : robbins pathology,1st aid)