Block 6 MCQs by Dr.

XY
Anatomy
N-72
1. Protrusion through linea alba  Epigastric Hernia
2. Neonate present with air in stomach  Tracheoesophageal fistula
3. Base of appendix is identified by  tracing tinea coli
4. Embryological basis of Meckel’s Diverticulum  Failure of Yolk stalk to regress
5. Referred pain from appendicitis  T8-T10 [only T10 was not an option]

6. Bleeding didn’t stop by performing pringle’es Maneuver, the structure

damaged is  IVC

7. Which structure prevents the spread of abscess across midline  Falciform

Ligament
8. Aganglionic segment  Hirchsprung disease

9. midline defect, structure protruding has membranous covering 

Omphalocele
10. Lymphatic drainage of scrotum  superficial inguinal lymph nodes
11. Internal spermatic fascia  Fascia Transversalis
12. Fundus of Stomach is supplied by  short gastric arteries
13. Sq. ep. Changed to columnar  Barret Esophagus
14. Indirect inguinal hernia  Lies lateral to inferior ep. Artery
15. damage to oxyntic cells of stomach  Pernicious anemia
 Physiology
N-72
1. Trypsinogen is activated by  Enterokinase
2. Cholera toxin opens which channels  Cl- channels
3. cimetidine inhibits  H2 receptor
4. WOF eliminates HCl secretion completely  PPI
5. Forerunner of gastric ulcer formation  Backleak of H+

6. Gastric distension leads to relaxation of ileocecal sphincter by  Gastroilial

sphincter
7. Defecation immediately after meal in newborn is due to  gastrocolic reflex
8. Diabetic patient, fruity smell in breath is due to  Ketone bodies
9. Respiration is inhibited during which phase of swallowing  pharyngeal
10. H. Pylori damages the mucosa by inc. mucosal levels of  Ammonia

11. Insulin shock

12. Somatostatin inhibits the secretion of WOF  Both insulin and glucagon

13. Ciliac disease

14. Pancreas
15. Basic electric rhythm in intestine is maintained by  slow waves

Q.No.1: The most likely hormone responsible for stimulating the Sertoli cells to aid
in the process of spermiogenesis is:

Answer: Follicle-stimulating hormone

Reason: Follicle-stimulating hormone (FSH) is crucial for spermatogenesis as it
stimulates Sertoli cells to nourish developing sperm.
Q.No.2: The uterus is highly resistant to infection during menstruation because of:

Answer: Release of leukocytes along with necrotic material and blood

Q.No.3: The function of testosterone in males includes:

Answer: Increase in protein formation and muscle development

Reason: Testosterone is an anabolic hormone that promotes muscle growth,
protein synthesis, and secondary male characteristics.

Q.No.4: The enzyme primarily involved in the conversion of testosterone to

dihydrotestosterone (DHT) in prostatic cells is:

Answer: 5α-reductase
Reason: 5α-reductase converts testosterone into DHT, which is more potent and
essential for prostate development and maintenance.

Q.No.5: Cryptorchidism refers to:

Answer: (c) Failure of the testis to descend from the abdomen into the scrotum
at the time of birth
Reason: Cryptorchidism is a condition where one or both testes fail to descend,
leading to potential fertility issues and increased cancer risk.

Q.No.6: If a female patient eats licorice a lot, the most likely change to be
expected in such a patient will be:

Answer: (c) Overactivity of 11β-HSD 2

Reason: Licorice inhibits 11β-HSD2, leading to cortisol activation, which mimics
aldosterone, causing hypokalemia and hypertension.

Q.No.7: A 45-year-old lady presented to an endocrinologist suffering from

Addison's disease. The most likely cause of hyperpigmentation in this patient is
attributed to:

Answer: Depressed Negative Feedback by Low Cortisol

Reason:
1. Loss of Negative Feedback:

 The low cortisol levels in Addison's disease lead to a failure of the normal
inhibitory effect (negative feedback) on CRH and ACTH secretion.

 "Depressed negative feedback" accurately describes the reduced

suppression of ACTH secretion caused by low cortisol levels.
2. ACTH and Hyperpigmentation:

 The hyperpigmentation in Addison's disease is caused by the excessive

ACTH levels, which stimulate melanocortin-1 receptors (MC1R) on
melanocytes, leading to increased melanin production.

Q.No.8: In some people, the urine in the bladder is propelled backward into the
ureter due to a short course of the ureter through the bladder wall. This condition
is known as:

Answer: (c) Vesicoureteral reflux

Reason: Vesicoureteral reflux is the backflow of urine from the bladder into the
ureters, commonly seen in congenital anomalies.

Q.No.9: The diuretics responsible for the inhibition of sodium-chloride co-

transporter in the distal tubules are:

Answer: (b) Thiazide diuretics

Reason: Thiazide diuretics inhibit the Na+/Cl− co-transporter in the distal
convoluted tubule, reducing sodium reabsorption.

Q.No.10: In minimal change nephropathy, there is increased glomerular

permeability to plasma proteins due to:

Answer: (a) Podocyte effacement

Reason: Podocyte foot process effacement disrupts the filtration barrier, causing
proteinuria.

Q.No.11: Glomerular filtration rate is decreased by an increase in:

Answer: (b) Arterial blood pressure
Reason: High arterial pressure can lead to glomerular injury and reduced
filtration capacity over time.

Q.No.12: A 10-year-old boy presented with periorbital swelling, foamy urine,

weight gain, and loss of appetite. Investigations revealed hypoalbuminemia,
proteinuria, and hypertension. The most likely diagnosis is:

Answer: (c) Nephrotic syndrome

Reason: Nephrotic syndrome is characterized by proteinuria, hypoalbuminemia,
and edema.

Q.No.13: A 19-year-old male with type-1 diabetes mellitus presented with

abdominal pain, vomiting, and drowsiness. Blood sugar was 510 mg/dL, and
blood pressure was 90/60 mmHg. The acid-base imbalance is:

Answer: (a) Metabolic acidosis

Reason: Diabetic ketoacidosis causes metabolic acidosis due to the
accumulation of ketone bodies.
Why NOT metabolic alkalosis?

The vomiting-induced alkalosis is a minor contributor in this scenario and is

overshadowed by the severe metabolic acidosis caused by diabetic
ketoacidosis. Therefore, the correct answer is metabolic acidosis.

Q.No.14: A man excreting dark yellow concentrated urine in a desert is most

likely producing concentrated urine due to which nephron component?

Answer: Collecting duct

Reason: The collecting duct concentrates urine under the influence of
antidiuretic hormone (ADH).

Q.No.15: Physiological effect of acute kidney injury includes an increase in the

plasma concentration of:

Answer: Potassium
Reason: Acute kidney injury impairs potassium excretion, leading to
hyperkalemia.
Q.No.16: Which of the following diuretics would be most useful in the acute
treatment of comatose patients with traumatic head injury and cerebral
edema?

Answer: (d) Mannitol

Reason: Mannitol is an osmotic diuretic used to reduce intracranial pressure and
cerebral edema.

Q.No.17: Furosemide acts by inhibiting the following in renal tubular cells:

Answer: (a) Na+ K+ 2Cl co-transporter

Reason: Furosemide inhibits the Na+ K+ 2Cl co-transporter in the thick ascending
limb of the loop of Henle.

Q.No.18: A 32-year-old woman presents with irregular periods, hirsutism, and

infertility. Ultrasound shows multiple small cysts on her ovaries. The most likely
diagnosis is:

Answer: (a) Polycystic ovary syndrome (PCOS)

Reason: PCOS is characterized by hyperandrogenism, anovulation, and
polycystic ovaries (classic triad for diagnosis of PCOS).

Q.No.19: A 70-year-old man presents with urinary symptoms and an enlarged,

smooth prostate on digital rectal examination. Serum PSA is 4 ng/mL. The most
likely diagnosis is:

Answer: (a) Benign prostatic hyperplasia

Reason: Benign prostatic hyperplasia causes urinary obstruction and is
associated with a smooth, enlarged prostate.
Why Not Prostate Adenocarcinoma?

While prostate cancer cannot be entirely ruled out with this presentation, the
absence of nodularity on DRE, lack of significantly elevated PSA, and typical
BPH symptoms make benign prostatic hyperplasia the most likely diagnosis in this
case.
 Biochemistry
Carbohydrate Metabolism
1. UDP–Glucose is converted to UDP–glucuronic acid by:
a. ATP b. GTP
c. NADP+ d. NAD+
e. FAD
2. All of the following compounds are intermediates of TCA
cycle except:
a. Malate b. Pyruvate
c. Oxaloacetate d. Fumarate
e. Succinate
3. In conversion of lactic acid to glucose, three reactions of
glycolytic pathway are circumvented, which of the
following enzymes do not participate?
a. Pyruvate carboxylase
b. Phosphoenolpyruvate carboxykinase
c. Pyruvate kinase
d. Glucose-6-phosphatase
e. Fructose-1, 6-biphosphatase
4. MacArdle’s disease involves a deficiency of the which
enzyme?
a. Acid maltase b. Glucose-6-phosphatase
c. Hepatic phosphorylase d. Muscle phosphorylase
e. Branching enzyme
5. In the normal resting state of humans, most of the blood
glucose brunt as ‘fuel’ is consumed by:
a. Liver b. Brain
c. Kidneys d. Adipose tissue
e. Muscles
6. A regulator of the enzyme glycogen synthase is:
a. Citric acid
b. 2,3-biphosphoglycerate (2,3-BPG)
c. Pyruvate
d. GTP
e. Glucose-6-PO4
7. Which of the following compound is a positive allosteric
modifier of the enzyme pyruvate carboxylase?
a. Biotin b. Acetyl-CoA
c. Oxaloacetate d. ATP
e. Fructose-6-P
8. A specific inhibitor for succinate dehydrogenase is:
a. Arsenite b. Malonate
c. Citrate d. Cyanide
e. Fluoride
9. Most of metabolic pathways are either anabolic (synthetic)
or catabolic (degradation). Which of the following
pathways is considered as “amphibolic” in nature?
a. Glycogenesis b. Glycolytic pathway
c. Lipolysis d. Citric acid cycle
e. Glycogenolysis
10. Transketolase activity is affected in:
a. Biotin deficiency b. Pyridoxine deficiency
c. PABA deficiency d. Thiamine deficiency
e. Manganese deficiency
11. The following metabolic abnormalities occur in Diabetes
mellitus, except:
a. Increase plasma FFA
b. Increased pyruvate carboxylase activity
c. Decrease lipogenesis
d. Decrease gluconeogenesis
e. Increase PEP–carboxykinase activity
12. A substance that is not an intermediate in the formation of
D-glucuronic acid from glucose is:
a. Glucose-1-P b. 6-phosphogluconate
c. Glucose-6-P d. UDP–Glucose
e. UDP–glucuronate
13. Von Gierke’s disease is characterised by a deficiency of
which enzyme?
a. Glucokinase b. Glucose-6-phosphatase
c. α-1, 6-glucosidase d. Glycogen synthase
e. De-branching enzyme
14. The hydrolysis of glucose-6-P is catalysed by a phosphatase
that is not found in which of the following?
a. Liver b. Kidney
c. Muscle d. Small intestine
e. None of the above
15. An essential for converting glucose to glycogen in Liver is
a. Lactic acid b. GTP
c. CTP d. UTP
e. Pyruvic acid
16. Which of the following is a substrate for aldolase activity
in glycolytic pathway?
a. Glyceraldehyde-3-P b. Glucose-6-P
c. Fructose-6-P d. 1,3-diphosphoglycerate
e. Fructose-1,6-bi-P
17. The ratio that approximates the number of net molecule of
ATP formed per mole of glucose oxidised in presence of
O2 to the net number formed in absence of O2 is:
a. 4:1 b. 10:2
c. 12:1 d. 18:1
e. 24:1
18. The “Primaquin sensitivity type” of haemolytic anaemia
has been found to be related to reduced RB cells activity of
which enzyme?
a. Pyruvate kinase deficiency
b. Glucose-6-phosphatase deficiency
c. Glucose-6-P-dehydrogenase deficiency
d. Hexokinase deficiency
e. Phosphogluconate dehydrogenase deficiency.
19. Which of the following hormones is not involved in
carbohydrate metabolism:
a. Cortisol b. ACTH
c. Glucagon d. Vasopressin
e. Growth hormone
20. Dehydrogenases involved in HMP shunt are specific for:
a. NADP+ b. NAD+
c. FAD d. FMN
e. None of the above
21. Which of the following enzymes in glycolytic pathway is
inhibited by fluoride?
a. Glyceraldehyde 3-P-dehydrogenase
b. Phosphoglycreate kinase
c. Pyruvate kinase
d. Enolase
e. Aldolase
SECTION FOUR
390 Metabolism
22. Out of 24 mols of ATP formed in citric acid cycle, two
molecules of ATP can be formed at “substrate level”, by
which of the following reaction?
a. Citric acid → to isocitric acid
b. Isocitrate → to oxalosuccinate
c. Malate → to oxaloacetate
d. Succinic acid → to fumarate
e. Succinyl-CoA → to Succinic acid
23. The fructokinase reaction in fructose metabolism produces
which of the following intermediates?
a. Fructose-6-P b. Fructose-1-P
c. Fructose-1, 6-bi-P d. Glyceraldehyde-3-P
e. Pyruvate
24. Which of the following statements regarding TCA cycle is
true?
a. It is an anaerobic process
b. It occurs in cytosol
c. It contains no intermediates
d. It is amphibolic in nature
e. It generates 10 molecules of ATP per cycle
25. An allosteric enzyme responsible for controlling the rate
of TCA cycle is:
a. Malate dehydrogenase b. Isocitrate dehydrogenase
c. Fumarase d. Aconitase
e. Succinate thiokinase
26. A liver biopsy from an infant with hepatomegaly, stunted
growth, hypoglycaemia, lactic acidosis, hyperlipidaemia
revealed accumulation of glycogen having normal
structure. A possible diagnosis would be:
a. Branching enzyme deficiency
b. Acid maltase deficiency
c. Liver phosphorylase deficiency
d. Debranching enzyme deficiency
e. Glucose-6-phosphatase deficiency
27. How may ATP molecules will be required for conversion
of two molecules of lactic acid to glucose?
a. Two b. Four
c. Six d. Eight
e. Ten
28. In Rapaport-Leubering shunt in erythrocytes, 2,3-
biphosphoglycerate (2,3-BPG) is produced from which
intermediate in glycolytic pathway?
a. 3-phosphoglycerate b. 2-phosphoglycerate
c. 1,3-biphosphoglycerate d. Glyceraldehyde-3-P
e. Dihydoxyacetone-P
29. Which of the following enzyme is not involved in HMP
shunt?
a. Glyceraldehyde-3-P-dehydrogenase
b. Glucose-6-P-dehydrogenase
c. Transketolase
d. Phosphogluconate dehydrogenase
e. Transaldolase

Answers to MCQs
1. d 2. b 3. c 4. d 5. b 6. e
7. b 8. b 9. d 10. d 11. d 12. b
13. b 14. c 15. d 16. e 17. d 18. c
19. d 20. a 21. d 22. e 23. b 24. d
25. b 26. e 27. c 28. a 29. A

Digestion and Absorption

MCQs (Give one correct answer)
1. Which of the following sugars is absorbed by facilitated
transport?
a. Galactose b. Fructose
c. Xylose d. Glucose
e. Arabinose
2. Amylase present in saliva is:
a. α-amylase b. β-amylase
c. γ-amylase d. All of the above
e. None of the above
3. The absorption of glucose is decreased by the deficiency
of:
a. Vitamin A b. Vitamin D
c. Thiamine d. Vitamin B12
e. Folic acid
4. For activity of salivary amylase. Which of the following is
required as activator:
a. HCO3
– ion b. Presence of Na+
c. Presence of K+ d. Chloride ion
e. None of the above
5. Which of the following hormone increases the absorption
of glucose from GI tract?
a. Insulin b. Thyroid hormones
c. Glucagon d. FSH
e. LH
Answers to MCQs
1. b 2. a 3. c 4. d 5. b.

1. “Micelles” formed in the intestine have which of the

following properties?
a. They are absorbed intact in the duodenun
b. They contain mostly triacylglycerol (TG)
c. They facilitate transfer of hydrolytic products of TG to
intestinal mucosal cell
d. They are secreted by cells lining the intestine
e. They are mainly absorbed from stomach wall
2. Dietary TGs (triacylglycerols) are absorbed from the
intestinal lumen after hydrolysis mainly as:
a. Fatty acids and glycerol
b. Fatty acids and two monoacylglycerol
c. Fatty acids and α, β-diglyceride
d. Acyl-CoA and glycerol
e. Glycerol-phosphate and fatty acids

3. The gastric lipase is inactive because of the following

reasons except:
a. No emulsifications of fats take place in stomach
b. The enzyme is secreted in small quantity
c. pH of gastric juice is not conducive for its action
d. The gastric juice is highly acidic
e. The conc. of bile salts is high in gastric juice

4. Delay in the rate of gastric emptying is due to the action

of:
a. Pancreozymin
b. Enterokinase
c. Enterogastrone d. CCK
e. Gastric lipase

5. Ca++ facilitates action of lipase:

a. By emulsification
b. By inhibiting emulsification
c. By soap formation
d. By formation of micelle
e. By formation of tiny droplets

1. Pancreatic juice contains all of the following, except:

a. Trypsinogen b. Lipase
c. Cholecystokinin d. Chymotrypsinogen
e. Amylase

2. The milk protein in the stomach in an adult is digested by:

a. Pepsin b. Rennin
c. HCI d. Trypsin
e. Chymotrypsinogen

3. Carboxypeptidase A enzyme of pancreatic juice contains:

a. Copper b. Zinc
c. Magnesium d. Manganese
e. Cobalt
4. The enzyme collagenase of pancreatic juice hydrolyses
collagen present in:
a. Milk b. Eggs
c. Cereals d. Meat
e. Soyabeans
5. The zymogen form trypsinogen of pancreatic juice is
converted to ‘active’ trypsin by:
a. Pepsin b. Enterocrinin
c. Enterokinase d. Rennin
e. Gastrin
6. Carboxypeptidase B acts as an exopeptidase and
hydrolyses the terminal peptide bonds containing:
a. Lysine and Arginine b. Leucine and Arginine
c. Glycine and leucine d. Glycine and Valine
e. Leucine and Isoleucine
7. Inactive zymogens (proenzymes) are precursors of all the
following gastrointestinal enzymes, except:
a. Trypsin b. Carboxypeptidase
c. Pepsin d. Aminopeptidase
e. Chymotrypsin
8. Which of the following regarding digestion of proteins are
correct, except:
a. Pepsinogen is activated by autoactivation (pH-2)
or autocatalysis
b. The major products or protein hydrolysis are
large petides and some free amino acids
c. Most of the digested proteins are absorbed in the
intestine in the form of polypeptides
d. Trypsin and chymotrypsin are secreted by the
pancreas as inactive zymogens
e. Enterokinase activates pancreatic trypsinogen
9. Rennin acts on casein of milk in infants in presence of:
a. Mg++ b. Zn++
c. Co++ d. Ca++
e. Mn++
10. Active chymotrypsin is:
a. π-chymotrypsin b. α-chymotrypsin
c. δ-chymotrypsin d. γ-chymotrypsin
e. All of the above
11. During intestinal proteolysis:
a. Enterokinase converts trypsinogen to trypsin
b. Involves conformational change, but no change
in covalent structure
c. Trypsin activates procarboxypeptidase A and
proelastase
d. a + b true
e. a + c true
12. Pepsin contains large amounts of which of the following
amino acids:
a. Aromatic amino acids
b. Acidic amino acids
c. Basic amino acids
d. Sulphur containing amino acids
e. Neutral amino acids
13. D-amino acids are absorbed by:
a. Active transport
b. In presence of a ‘carrier’ molecule
c. In presence of sodium ions
d. Passive diffusion
e. None of the above
14. Chymotrypsin hydrolyses the peptide linkages containing
a. Phenyl alanine and tyrosine:
b. Phenyl alanine and lysine
c. Tyrosine and lysine
d. Tyrosine and leucine
e. Phenylalanine and leucine
Answers to MCQs
1. c 2. a 3. b 4. d 5. c 6. A
7. d 8. c 9. d 10. b 11. e 12. b
13. d 14. a

Errors and Omissions are accepted!

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Regards Dr. X