BELLA CIAO

1.Experimental question in which figure was given and we added some factor it induces the transcription
of 2 of 3 mentions genes now asking whatis happening in unaffected gene.

a. I picked option related methylation of unaffected gene

2.Mismatch repair gene

MSH2

3.CV of pompe disease…….lysosome

4.VLCA……peroxisome

5.CV of hemochromatosis now asking gene is mutated in which cell

A]hepatocyte b]enterocyte c]gastric cell

XIAFLEX is injected into the collagen “cord” that is causing the
6.dupuytren contracture treatment asked contracture. After injection, the XIAFLEX enzymes are thought to
attach to the collagen that makes up the rope-like cord in the palm,
a.collagenase b.elastase
unwinding the collagen and eventually, breaking it down.
7.man presented with back pain after lifting weight. asking about which of following is indication for
neuroimaging in this patient

a.i picked pain radiating to leg and foot[considering sciatica].

8.CD4+ CD8+==THYMUS

9.Carpal tunnel syndrome cv asking which function of thumb will be greatest affected

a.opposition b.abduction c. flexion d.adduction

10.remodelling… metalloproteinase.

11.6yrs child with fracture of radius 6weeks back now presents to you with x-ray given which cell is
responsible for finding in x ray [callus was not prominent though]

A .osteoblast b. osteocyte c. osteoclast d. fibroblast

12.patient with little blackish lesion in skin with some itching asking origin of this lesion is from which of
following layer. animated picture was given I picked d in laminated picture considering basal layer other
options were superficial to d option I couldn’t able to distinguish the layers because all layers looked
similar to me I ended up in d option.

13.cv of homocystinuria given with increased homocysteine level in blood asking vitamin is required in
this patient

a.B6 b.B1 C.ZINC D. vitC. NO OPTION OF b12 and folic acid

14.very long pedigree given in which no father to children transmission and all children of diseased mother
are affected so I thought of mitochondrial inheritance. Now asking what will be impaired in this patient
many options of metabolic pathways.
a. I picked option related to mitochondrial enzyme deficiency. Other options couldn’t remember

15. Q on Robertsonian translocation [poor recall]

16.rapidly progressive neurodegeneration with ataxia asking about pathophysiology

A .protein auto conversion to capsid b. tau protein hyperphosphorylstion

17.patient presented with hemiparesis ipsilateral facial palsy ,ipsilateral tongue deviation gross picture
of brain given with marking asking where the lesion occurred

a.hipocampus area b. internal capsule c. caudate nucleus d. medial frontal lobe. no option of brainstem

18.postthalamic stroke syndrome cv now you have to mark the affected structure in laminated picture of
brain .

a.putamen b. caudate c. thalamus.

19.patient have chronic pancreatitis now presents with muscle weakness loss of proprioception asking
about vit deficiency

a.vitE

20.vegan diet…. B12 defecincy

21.patient presented with anogenital rash perioral rash some other feature mentioned

a.zinc deficiency

21.xanthomas on skin with no family hx .. and test tube given with creamy layer in supernatant asking
defect.

A.cholesterol absorption b. TGs degradation

22.esophageal surgery done for carcinoma of esophagus and presented witrh pleural effusion on
histology we found lipid laden macrophages most likely cause?

a.damage to thoracic duct b. pneumothorax

23. old ag patient presented with hoarseness very long cv given with weight loss past hx of asbestos
exposure, long GERD history taking antacids and diabetic taking antidiabetic drugs now asking risk factor
for hoarseness

a.GERD B.asbestos I picked GERD I don’t remember about smoking option was there or not do confirm.

24.patient presented with abdominal pain very long cv given In end they say majority of pancreas drain
through minor duct asked diagnosis

a. pancreatic divisim b. annular pancreas c. gallstone

25.gallstone surgery planned for patient in cv they mentioned we have to maintain the continuous flow
of bile now asking where should we ligate the duct

a. cystic duct before joining common hepatic duct[I picked this]. B.common bile duct
c.between cystic and pancreatic duct. D.major duodenal papilla

26.CT scan of abdomen given there is hypo density in kidney region and in cv mentioned episodic HTN
palpitation =s asked about origin of tumor

A.neual crest cells b.endoderm c.intermediate mesoderm

27.patient have hydronephrosis and enlarged right ureter upto inferior 10% of ureter asking about where
is obstruction occurred

A.renal pelvis b.ureterovesical junction c. prostatic region

28.UTI presentation in old age asked the organism

a.e.coli b.gonnorhea c.chlamydia

29.PSA increased given in cv asked dx

Prostatic adenocarcinoma[no option of BPH]

30.CV Of stress incontinence urine leakage with coughing asked the cause

a.bladder overactivity b. underactivity c. sphincter injury

31.80yrs old female multiple vaginal deliveries presented with urinary incontinence moat likely musle
responsible for this

a.puborectalis b.coccygeus. other options not related

32.women at 38weeks of gestation presented with per vaginal bleeding and previous hx of 3 c sections
given asking what is cause of bleeding

a.placenta insertion around cervical os b.abnormal insertion at basalis c.abruptio placenta

33.prostate lymphatic drainage……internal iliac nodes

34.pompe disease cv asking which substance is accumulated ….glycogen

35.diabetic patient taking daily insulin now presents with sweating palpiations lightheadedness other non
specific symptoms given asking about the cause og these symptoms

a. excess insulin b. decreased glucagon

36.cv of HYPER igM syndrome[like CD40 cells do not interact with other cells] now asked what will you
find in this patient

a.absence of germinal centre

37.symptoms of hypocalcemia and cardiac defects case of digeorge syndrome now asked the defect

a.Defect of 3rd and 4th pharyngeal pouch

38.CD34+ CD117+ …… gastyrointestinal tumor[GIST]

39.CV of infectious mononucleosis now asked which cells will be increased

a.CD4+ B.CD8+ C.B cells d.macrphages

40.chronic granulomatous disease case. Patient with multiple catalase positive infections asked defect in
what ?

a. neutrophil oxidase system B. myeloperoxidase other options unrelated

41.swelling and erythema on arm now asked the mediator

a.histamine b.c5a c.eosinophill

42.vaccinated child [age not remembered] presents with SOB cough hoarseness o/e intercostal
retractions now asked the organism

a.parainfluenza virus

43.RSV enter into cell through what structure /receptor?

a.sialic acid b.intercellular adhesion molecule other options not remember

44.12yrs child up to date vaccinations most appropriate vaccine to administer at this time?

a.polio b.measles c.hepB[NO OPTION OF HPV]

45. Experimental question, normal epithelium of esophagus is destroyed with caustic agent and we
replace it with colon epithelium, after 10 years this epithelium will changes to the pic given now asked
which of following has occurred? PICTURE was given of histology[Pablo escobar biopsy]

a.hyperplasia b. dysplasia c.hypertrophy d.metaplasia

46.4yrs old comes with his father in opd dr is not in room and child is jumping at DR’S table when dr arrive
in room what will be dr first response

a.please sit down b.is it OK I talk to your father c. what brings you here something like that

d.you are jumping brilliantly please note the age of child is 4yrs.

47.telephone in interpreter case

48.reseacher wants to measure relation between height[in cm] and cardiac output[In litre] what study
will be used

a.linear regression b.t test c.odds ratio no option of correlation analysis

48.biostat problem long data given which I don’t remember..

49.sildenafil MOA ASKED

50.Cephalosporin given for some infections now have eosinophilia and fever..

acute interstitial nephritis.

51.graph of norepinephrine and isoprotenol

52.ACE inhibitor up/down arrow q fromm past

53.rituximab given for some malignancy now what will be decreased

a.CD20

54.patient presents with sensory and motor neuropathy of lower limbs family hx positive for foot and leg
deformities asked the dx.

Charcot marrie tooth disease.

55.long cv given in the end mentioned upward gaze palsy asked the where the lesion occurred

Dorsal midbrain

56.patient is taking diphenhydramine ibuprofen and acetaminophen for some conditions which I don’t
remember what additional finding you will see in this patient [asking drug related effects]

I marked mydriasis [considering diphenhydramine ] other options were unrelated to me so I don’t

remember very vague cv was given.

57.NSAIDS moa >deceased prostaglandin synthesis

58.lisinphill act where on nephron>efferent arteriole

59.cv of conversion have to dx. Like diffuse muscle shoulder pain acute stressor was given in cv

60.MDD patient taking SSRI now present with hypotension increased muscle tone other autonomic
symptoms given asked which neurotransmitter is causing these symptoms [considering serotonin
syndrome I market serotonin] other options include acetylcholine dopamine gaba.

61.patient presents with bumps on shin and pulmonary symptos and had travel hx to multiple places
including deserts asked the organism.

a.coccidiomycosis

62.patient presents with maculopapular rash joint pain fever and flue like symptoms and in cv they
mentioned about travel hx now asked the vector for this condition

a.aedes agyptes b.anapheles mosquito

63.patient is taking tmp-smx for some condition now developed anemia asked the dx

a.G6PD deficiency

64.HIV patient HLA-B57 POSITIVE now asked the regimen for HIV I market the option in which abacavir
not there.[2 NRTIs and one INTEGRASE inhibitor]

65.patient presented with syncope lightheadedness palpitations in cv they say patient needs a drug with
beta blocker and K channel blocker effects I marked sotalol

All other options of beta blockers given.

66.cv of asthma given asked what finding you will see in this patient.

a.end expiratory small airway collapsed b. end expiratory alveolar collapse

67.patient with DM HTN had done angiography for heart condition along with kidney histology picture
was given in which cast was present.now asked dx? Other symptoms of kidney I don’t remember

a.ATN B.cast nephropathy c.diabetic nephropathy d, hypertyensive nephrpopathy

68.type-II pneumocyte picture along with ards case you have to pick the type 2 pneumocyte from picture

69.patient having HTN and other symptoms relating to adrenal gland[poor recall] now asked on baisis of
which parameter we further evaluate the HTN>>>> I MARKED HYPOKALEMIA considering primary
hyperaldosteronism..other options I don’t remember do confirm.

70.leukoplakia cv. White patch can’t be scraped off from tongue asked the mutation

A.EGFR b.RET C.JAK no option of p53. I marked EGFR

71.steptococcus pneumonia case along with picture of strep pneumonia asked features of organism

a.catalase negative alpha hemolytic

72.patient presents with UTI symptoms in cv they mentioned gram negative rod now asked the organism

a.klebsiella all other options of gram positive organisms given

73.picture of diphyllobothrium latum in petri dish now asked the host

a.fish

74.military man saving the kitten in military camp area after few days he develops lesions on arm and
lymphadenopathy in arm then axillary lymphadenopathy asked dx

I marked cat scratch disease. But cv was very long and vague other options don’t remember

75.tb case asked mechanism of drug to be given in this patient >RNA polymerase inhibitor

76.acetaminophen toxicity[they mentioned in cv] ASKING what is causing damage to hepatocyte I market
increased conversion of acetaminophen into NAPQ1.

77.patient has mass below the carina of bronchus in cv they mentioned synaptophysin positive asked the
dx

a.small cell lung cancer

78.patient has asbestos exposure in past mass is found on biopsy microvilli are present now asking what
will you find in this patient

a.i marked option related to pleural thickening and plaques something like that not clearly written. other
options you can rule out easily.

79.female patient[age don’t remember] presented with clear nipple discharge and sometimes bloody
discharge and occasional scaling over breast asked the dx

a.paget disease of breast b.intraductal papilloma other options unrelated.

80.postmenopausal patient on HRT presents with vaginal bleeding o/e vaginal mucoa is dry

Asked what is responsible for this bleeding

a.i marked estrogen

81.pressure volume curve given in which there is increased afterload asking what will you find in this
patient

A.. I marked bicuspid aortic vavle[no option of HTN

82.Colon camcer patient develops symptoms of endocarditis in cv they mentioned about s gallolyticus
asked which valve is mostly affected mitral valve was answer

83.dark cola color urine after 2week of strep infections asked through what mechanism it causes kidney
damage

a.immune complex[marked this] b. molecular mimicking

84.CV of follicular lymphoma they mentioned [14;18] translocation asking what will be seen I this patient

a.decreased apoptosis

85.patient with end stage renal disease on dialysis, on multiple areas of body ecchymosis are present what
is cause of these finding

a.i market platelet dysfunction other I don’t remember

86.patient with recent taking Lisinopril, metformin, statins the most appropriate drug we will add in
patient will have mechanism of action?

a.COX inhibitor b. thrombaxe-2 inhibitor c.ADP[P2Y12] receptor blocker I marked A

87. patient with hypertension hyperthermia mydriasis some other symptoms of MDMA asking what will
you ask in history

a.history of injection at antecubital fossa[ I marked this] do confirm whether the MDMA is taken through
IV route or not. Other options I don’t remember.

88.cv of subarachnoid hemorrhage easy to pick.

89.neonate presented with sensorineural hearing loss periventricular calcifications and petechial rash
asking the causative organism

a.cmv b.rubella

90.experimental question patient is taking drug [size of drug is 250dalton] by modifying which property
of drug we increase the concentration of drug in brain

a. increase the size b. decrease the size c. increase the hydrophilicity d. increase the lipophilicity[ picked
this]

91.cv of nephrotic syndrome along with H and E stain, congo red stain and 3rd stain given I don’t remember
a.i picked protein folding related option [considering amyloidosis]

92.patient with chronic hepatitis C and cirrhosis and multiple lesions on body particularly on buttocks
and arthralgias very vague question…in the end they asked dx

I picked cryoglobliblinemia other options I don’t remember

93 old age patient presented with temporal headache, jaw pain [cv of giant cell arteritis] now asking drug
given in this patient will act on which receptor

a. nuclear receptor

94.young lady using tampons and develops symptoms of shock [cv of toxic shock syndrome]

Asking pathogenesis

a. binding of T-cell receptor by bacterial secretory products [uworld concept super antigen directly
activate t cells]
b. activation of toll like receptor by bacterial products. Other options I don’t remember

95.12yrs old child with height of 4.4ft and weight 32kg and tanner stage 1 and his father height is 5.7ft his
mother height is 5.5 ft and father concerned about his child growth/height? Asking diagnosis

a. familial short stature something like that b. constitutional delay[I picked this]

c. growth hormone deficiency other options I don’t remember

96.bullous pemphigoid cv asked about antibody directed against what structure

No option of hemidesmosome

a.collagen b. elastin do check for integrin option may be I missed that because integrin is part of
hemidesmosome but I picked collagen

97.vague cv of echthyosis vulgaris[child with scaly lesions on body blackish type I guess] with positive
family hx asking about pathogenesis

a. I marked impaired keratinization related option. Do check

98.transplant patient with reddish lesion on forearm looked like Kaposi sarcoma to me asking origin of
this lesion

a. I marked endothelial related option.

99.patient presented with ‘tender’ thyroid and signs and symptoms of hyperthyroidism asking the
pathophysiology of condition

I picked acute inflammatory damage to thyroid[considering de quervain thyrosiditis]

100.positive skewed graph now asking parameters

a.median is greater than mean b. mean is greater than median c. mean is equal to median d. data cant
be concluded
101.relative risk of 0.7 AND confidence interval[0.7-1.3] no p value given asking what will you conclude
from this data

I picked statistically non-significant [p>0.05]

Other 3 options included statistically significant and last option says can’t be concluded

102.father with colon cancer [basically cv of AD inheritance] now asking what are chances the offspring
will be affected

a.25% b. 50% if mother is carrier c. 50% only[I picked this] d.100%[I guess]

103.patient presented with signs and symptoms of pernicious anemia asking we will find atrophy of which
cell

A. parietal cell [ans] b. G cell

other options unrelated

104.patient presented with migratory arthritis fever and pustules on body asking about risk factor?

a. sexual activity [considering septic arthritis]

105.picture of gottron papule given what will you ask in history

a. I marked hx of muscle weakness b. lateral rotation of hip joint

106.diabetic patient taking insulin very long cv and patient develops sign and symptoms of hypoglycemia
asking hormone causing hypoglycemia will inhibit what

a.1,6 bisphosphatase [I picked this] other options

107.82yrs old lady presents with fracture[basically case of osteoporosis]

a. decreased bone mass other option was decreased bone mineralization

108.patient presents with personality changes behavioral problems and impulsivity and MRI given where
you can clearly see the atrophy of frontal lobe asking what will you find in histology

a. rounded tau protein

109.case of iron deficiency anemia have to diagnose.

110.patient with past hx of cervical dysplasia and cauterization was done at that time now presents with
some lower genital tract problems[poor reall] asked about risk factor

a.HPV B.SMOKING I marked a

111.patient presents with psychosis hallucinations and paranoid delusions and impulsivity and in last they
mentioned raised ALT and AST [clue about Wilson disease]

a. I marked option related to copper deposition in lenticular nuclei. B.loss of volume of frontal lobe

c.loss of volume of occipital lobe.

112.Nurse after needle prick, she is vaccinated against hepatitis B but doctor said your vaccine is failed
[wording may be change but meaning is same] you need hep B prophylaxis at that time.now asking what
will you find in her serum

a. surface antigen[I picked this] b. core antigen c. antibody against surface antigen d. IgG against core
antigen

113.other question from past like needle prick nurse vaccinated what will you find in serum ans is antibody
against surface antigen. this question was also there but that is different question. So don’t get confused.

114.cardiac tamponade case explained along with x ray given where you can easily find cardiomegaly

Asking what additional finding will be present

a. diminished heart sound

115.patient have ST elevation MI in lead II, III and AVF and second degree heart block asking about which
artery is artery is blocked

a. proximal RCA B. AV nodal artery c. SA nodal artery. I picked A option.

116. Chronic diabetic patient develops orthostatic hypotension now asking cause of orthostatic
hypotension.

A. autonomic [I picked this] b. somatic other options I don’t remember

117.liddle syndrome case explained they tell you in cv mutation of Na channels asked about drug which
will be given in this patient.

a. amiloride all other options of diuretics were there

118.ARDS case in neonate asking about parameters[up/down arrows]

Ph [down] pco2 [up] po2 [down]

119.gross picture of torn bronchus[ I guess] was given and some signs of heart failure were there asking
about cause or something related to it

a. I marked cor pulmonale other options don’t remember

120.kartagener syndrome explained asked defect>>> dynin arm

121. patient with gambling like he lost all his money in betting.

Asked about which neurotransmitter is responsible for this

A. dopamine agonists[picked this] b. dopamine antagonists c. serotonin agonists

122.isotretinoin given and develops some neural defects It increases the expression of which gene

A. HOX gene

123.patient presented with chest pain and radiating to back[cv of aortic dissection] asking treatment in
this patient will do what[wording may not be same]
a. reduce the wall stress[I picked this] b. increase the nitric oxide synthase was also there.

124.L-5 radiculopathy have to diagnose

125.line-weaver-burk plot given in which lines crossed and crossed line is closer to Km on horizontal axis
asking what is conclusion from this graph.

a.decreased affinity for substrate[picked this] b. increased affinity c. increased vmax d. decreased
vmax.

126.patient had oral cancer and removed and the patient develops again oral cancer at other side in oral
cavity now asked reason >>>field cancerization[ans]

127.patient is developing recurrent infections of ear lobe o/e ear is erythematous and pustule was present
and patient says this is due to ear piercing and asked about which cell I responsible for this

a.neutrophill [picked this] b t cell c.mast cell d. eosinophil. I marked it wrong do confirm.

128.RH negative mother given anti-D now asked the mechanism of action

a.it binds to d antigen on fetal erythrocytes [picked this ] b. it prevents entry of fetal rbcs in to maternal
circulation

129.old age patient with recurrent syncope episodes in cv they mentioned orthostatic hypotension by
giving values. Asked reason of orthostatic hypotension in this patient

a.increased baroreceptor responsiveness b. increased stroke volume c. deceased stroke volume

d.decreased baro receptor responsiveness e. increased parasympathetic tone f decreased

parasympathetic tone

130.female patient with menstrual irregularities and picture given in which there was septum in uterine
cavity asked this is due to defect in what

a.paramesonephric duct

131.a drug having half life of 2hrs , this drug will reach 95% of steady state in how much time

a.10hrs on option of 8 hrs

132.patient have polypoid mass in urinary bladder he is home painter for 15yrs and chronic smoker[don’t
remember the duration] asked risk factor ?

A.smoking[picked this] b.painting

now some repeats from past

133.sickle cell electrophoresis given and patient is taking hydroxyurea now you have to pick the option in
electrophoresis[from golden biopsy]

134.competative antagonist[ golden biopsy]

135.question on HHV-6 recent PQ

136.POTENCY GRAPH

137.ulcerative colitis>>>>TNF-alpha inhibitor

138.HOCM>> murmur increases with standing

139.PDA repair>>> recurrent laryngeal nerve injury

140.MI patient angiography done cause of injury>>>ROS

141CASE OF SARCOMA BOTROIDES>>sarcomere

142.chronic pancreatitis case>>vitE deficiency

143.lambert eaton case>>>antibodies against pre-synaptic Ca2+ channels

144.kaplan meyer curve

145.normal response to stress

146.asthma patient>> mucus plugging

147.6-membrane channel >> transport of solutes

148.labia majora drainage>>superficial inguinal nodes

149.normal mucosa

150.OCP>>>erythema nodosum

151.nursing care>>>scabies

152.vsd with shunt reversal

153.erlen mayer flask deformity>>> bone resorption defect

154.mifepristone >>>progesterone antagonist

155.ace inhibitor up/down arrow

156.TLR-4 from past

157.SAAG 0.6 >>>>malignancy

158.denial

159.altriusm

160.stratum corneum

161.WT1 gene

162.medial geniculate

163.diancephalon

164.hepE
165.papilat carcinoma of thyroid>>psammoma bodies

166.phosphatidylserine

167.MI>>>MEMBRANE DAMAGE

168.UTERINE DIDELPHYS

169.glutathione[up/down arrows]

170.VLCFA>>>PEROXISOME

171.LINOLENIC ACID>> THROMBAXANE A2

172.URETER COURSE >>POSTERIOR TO VAS DEFERENSE

173.PELVIC ISCHEMIA

174.IGF-1 RESISTANCE

175.ENDOSCOPY>>>COLOUMNAR EPITHELIUM

176.RAT ON TREADMILL>>>GH

177.ACUTE GRAFT REJECTION

178.NITRITE NEGATIVE>>>SAPROPHYTICUS

179.CONSTRUCTOR WORKER flank pain >>>ATN

180.GRAPH OF 2* HYPERPARATHYROIDISM

181.PROGESTERONE D GRAPH

182.OVARIAN TORSION>> DECREASED FLOW IN OVARIAN VEIN

183.SSRI>>WHAT ARE YOUR CONCERNS

184.PACLITAXEL>>TUBULIN INHIBITOR

185. Q ON RECALL BIAS HAVE TO DIAGNOSE

186.CASE ON SOMATIC HYPERMUTATION[ POOR RECALL]

187.CD4+ CD8+>>>THYMUS

188. THYMIDINE KINASE RESISTANCE[ACYCLOVIR GIVEN]

189.VIT-K>>> CARBOXYLATION

190.2 HEART SOUND QUESTIONS

191. PATIENT ON CHEMOTHERPAY DEVELOPS NAUSEA ANS VOMITING >>>SEROTONIN ANTAGONIST

RMEMBER ME IN YOUR PRAYERS

WISH YOU BEST OF LUCK….