Tanveer Ahmad Important Medical Points for Medical Students

26.phrenic nerve runs on left side with = pericardicophrenic artery

27.hypovolaemia with hypotension isoflurane shud not be given,why? b/c it is =Potent vasodilator

28.Otic ganglion location foramen was asked = inferior border of foramen ovale29.Epitheluim of preterminal bronchiole/ conducting zone = Pseudostratified columnar cilliated…with goblets in larger bronchiole (in resp bronchioles> cuboidal, then simple squamous upto the alveoli] {clara cells in terminal bronchioles} )

30.muscle which causes flexion of elbow and supplied by radial nerve =Brachioradialis

31.hormones during sleep = GH increases (During sleep Inc level than awake = cortisol)

32.chest pain and fever not related to respiration = Myocarduim

33.in later stage of pregnancy oestrogen and progesterone produce by = placenta34.A patient has hypercouagable state having def of = factor v(facror V Leiden)35.difference BTW skeletal and smooth muscle = ca calmodulin

36.Valve involved in Limb sack endocarditis = Mitral & aortic37.Abdominal angina cause by obstruction to = Sup mesenteric38.middle colic is the branch of = Superior mesenteric artery39.geniculate ganglion is located in = facial canal

40.taste sensation is carried to the cortex through = thalamus

41.two point discrimination = merkel disc (If asked ,Maximim 2 point discrimination then = Lips( TIP OF TONGUE BEST IF THERE ) while if the stem is

“Maximim distance of 2 point discrimination at” then = BACK OR scapula)42..oesophageal atresia = drooping of saliva (indicating factor)43.Aluminium hydroxide in = delays gastric emptying (causes constipation) 44.sternum ossification = 21 years

45.mandible = symphsis menti join at midline by joint. 46.broca’s area = area 44 Non Fluent aphasia

47.long refractory period = heart

48.defeciency of glucose 6 Phosphatase causes = hypoglycemia.. 49.Increase GFR causes inc absorption of salt and water from = PCT50.infection in cavournes sinus = inferior opthamic vein

51.cause of damage to lateral rectus = 6th CN

52.During hysterctomy ureters can be damaged while ligating which artery = uterine artery

53.which one is the DNA virus = Infectious mononucleosis

54.injury to surgical neck of humurus damage to which nerve = Axillary nerve55.Axillary nerve damage will cause what = Dec abduction

56. statistical test observed differences b/w 2 means been by chance = variance57.max pressure in aorta during which phase = max during slow ejection phase (

while lowest in isovolumetric contraction)

58.remant of geburnaculum,= Ovarian ligament and round ligament of uterus59-left renal vein relation to aorta = LRV is anterior

60-cause of thromboembolism = prolonged immobilization (most common)61. commonest cause of shift of K from intracellular to extracellular = strenous exercise (releases potassium from skeletal muscle)

62- regarding trachea = commence at lower end of cricoid cartilage63- damage to medulla oblongata during hanging = odontoid

64. sternocleidomastoid causes = movement of head in opposite direction against force(resistance)

65-platelets life span of = 10 days

(note that platlets Count increases after spleenectomy ,the 1st effect we see after spleenectomy is Increased Platelet count ie thrombocytosis as the sequestered RBCs are put into circulation, and the HOWEL JOLLY BODIES are after that, )66.lymphocytes = immunity against cancer cells (NK most potent)

67.multiple bone fractures history,blue sclera which products enzyme is defiecient =Collagen (the scenario is osteogenesis imperfecta)

68.Most common cause of Hepatocellular CA in developing countries = HEP B, C69.Regarding jerks corresponding with spinal segments = Biceps- C6 70.MELAS syndrome histological finding = Red ragged fibers

71.Giant Cell Tumors histo finding = Soap Bubble appearance

72.Young adult with raised ALP, jaundice and decreased Hb Scenario = Pigment stone

73.clostridium = spore producing

74.few weeks after delivery regression of uterus and breast = lysosomes75.inc stroke volume is due To = large blood volume

76.transport of glucose across placenta:-facilitated ( though both simple diffusion and facilitated are involved in glucose transport, while amino acids and fatty acids are only by facilitated diffusion; note that electrolytes use counter transport mechanism)

77.transport of local anesthetic across placenta – simple diffusion

78.Most common injured artery during difficult c- section = uterine artery ( while surgery for ovary damages interna iliac)

79.cutting of parasympathetic nervous system most likely = affects git muscles80.vaginal lymphatic drainage below hymen = Medial group of superficial inguinal lymph nodes

81.alpha amino group of non essential amino acids is derived from = glutamate

82. micturation controlled by = Mechanoreceptors in bladder wall…. ( another question is frequently asked about micturition and the answer will be SELF GENERATIVE )

83.pelvic splanchnic nerve = parasympathetic

84. years old pregnant lady,, suggested for chorionic villous sampling.What you suspect = trisomy 21

85.pt with moon facies excessive fat deposition at chest and abdominal areas,, ACTH raised,, diagnosis = cushing disease ( ITS disease not syndrome as in syndrome ACTH, will not be raised )

86.A patient presented on 18th day of menstrual cycle.Her normal cycke is such that she ovulates on 14th day.Which phase will she be in = secretory

87.standard deviation shows = variability among individuals88.Best test for diabetic nephropathy = urinary albumin

89.child with yellow sclera and colored urine best investigation = ALT & bilirubin90.Uterus remains in position by : Cardinal Ligament ,

91.A girl with primary amenorrhea ,, height 5. 4,, weight 60 kg.well developed breasts , small vagina,, no uterus on u/s,, genotype xy ( no bar body) = testicular feminization

92. Ureteric bud not reaching mesenchyme leads to – Renal Agenesis93.Longest pre erthrocyte stage is longer in = Plasmodium Malariae

94.No agglutinin is present in blood group = AB+ (Right answer is AB+ coz agglutinin means antibodies so in AB +ve blood group no antibodies that’s why no reaction with donor blood hence AB+ve iz universal recipient)

95.Platelets transfusion is contraindicated in = ITP ( if the question asks must not be given then answer is Splenomegaly)

96.4th heart sound is produced by = Atrial Systole

97.Patient is unable to open the mouth due to paralysis of = Lateral pterygoid

98.What is correct about broncho pulmonary segment = Aerated byTertiary bronchi

99.Characteristic of actinomyces = Abscess and granuloma

1200. A carcinoma of vagina below hymen( vaginal orifice) is likely spread via the lymphatics into the = Medial group of horizantal superficial inguinal nodes

SESSION # FIVE ; Sometimes the chains that prevent us from being free are more mental than physical.

1. Councilman bodies seen in – Apoptosis.

( Remember ; if u see word MALLORY BODY = alcoholic liver disease

Myleine figure = Reversible cell injury and councelman body = apoptosis , never click any other option then )

2.Thorn prick in left lower limb caused abscess – Staph aureus

3.Oblique fissure of the lung at level – T3 to T6 Costochondral.

4.Stress hormone of our body – ACTH ( IF cortisole is not given in options prefer ACTH )

5.Superficial temporal artery relation with which nerve – Auriculotemporal nerve.

6.Correct about Thyroid gland – lymph drainage to deep cervical lymph nodes.

7.Anemic hypoxia occur in – Methemoglobulenemia.

8.In cerebral circulation brain arteries – Do not anastomose once entered in the brain (Don’t confuse it with circle of villus that is anastomosis in the sub arachnoid space not in the brain substance).

9.Phase 1 of transformation of drug metabolism – Oxidation.

10.Standard deviation shows – Variability of individual observation.

11.Counseling in patients is – To help themselves.

12.A young girl who is going to die and asks you “Am I going to die?” Doctor response should be – “What your parents have told you?”

13.In whole wheat – Thiamine.

14.Cholesterol enriched diet – Egg

15.Origin of peroxisomes – SER.

16.Organelle where protein combines with carbohydrates, packed and released –Golgi complex.

17.Correct about DNA – Euchromatin is transcriptionally active.

18.ADPKD associated with – CEREBRAL HEAMORRHAGE ( If asked the most common cuase of death/complication in ADPKD then = Renal failure ….. but if asked association then Sub-arachnoid heamorrhage (50%) >> cerebral heamorrhage)

19.Cause of delay in healing – Infections ( infection is the most common cause of delayed wound healing )

20.PaO2 decreased, PCO2 increased, hydrogen ion increased; manifestation –Hypoventilation.( look at CO2 which is increased that means person is not ventellating properly to remove it out that is HYPOVENTELLAION)

22.Person with tachycardia, and heat intolerance with low level of TSH, on giving TRH; level of TSH and thyroid hormones increases. Diagnosis – Hyperthyroidism with thyroid problem.

23.Origin of oxytocin and ADH – Hypothalamus.

24.Difference between systemic and pulmonary circulation – Low resistance in pulmonary circulation.

25.Mean systemic filling pressure is regulated by – Venous return.

26.Systolic pressure is directly related to which one of the following – Renin.

27.ADH responds to – Osmolarity.

28.Osmoreceptors are receptors for – ADH.

29.Right border of heart on X-ray also visible a part of –SVC.

30.In MI sensitive cardio marker – Tropinin T. ( IF asked in 1st hour or Enzyme in stem then prefer CKMB)

31.Diabetic nephropathy investigation – Urine albumin.

32.Young boy with generalized edema and proteinuria – Lesion of basement membrane.

33.Lesion of parasympathetic system affects mostly – GI muscles.

34.Decussating of medial lemniscuses – Internal Arcuate Fibers

35.S2 sound heard on – Closure of aortic and pulmonary valve.

36.A patient with history hemorrhage (trauma) receives a bag stored for 2 weeks mainly contains – RBCs.

37.Due to inspiration what decreases – Volume of atrial pulse( as during inspiration there is minimal blood in the left ventricle that dec blood pressure)

38.Important buffer of blood – HCO3-.

39.Max increase in ECF due to infusion of – Hypertonic NaCl.

40.Auscultation of tricuspid valve best heard at – Right lower end of the body of sternum. ( this is CPSP favorite most question )

41.GVE vagus nerve for preganglionic fiber arises from – Dorsal nucleus( it’s the parasympathetic nucleus of vagus to the viscera that why its supply is so called , GENERAL VISCERAL EFFERENT )

42.Tip of scapula at level – T7.

43.Diabetic female after abdominal surgery; dyspnea and cough – Pulmonary embolism.

44.MCC of pulmonary embolism – DVT. ( NOTE ; if asked the most common site of DVT then Popletial vein if asked most common source for pulmonary embolism then FEMORAL)

45.Typhoid fever 1st week test – Blood culture

46.Typhoid fever 2nd week test – Blood culture and Widal test.

47.Typical feature of falciparum – Black water fever.

48.Alcoholic patient with deranged LFTs; on biopsy – Mallory bodies.

49.Potassium is mainly regulated by – Aldosterone.

50.Natural self-defense against tumors – Apoptosis.

51.P53 gene absent results in – cell survival.

52.Pain mediator – Bradykinins.

53.Metaplasia – Functional change in cells( metaplasia is replacement of one adult cell to type by other , and is mostly due to CHRONIC IRRITATION , it’s a REVERSIBLE condition and most common examples are BARRET ESOPHAGUS AND SQUAMOUS METAPLASIA OF LUNG DUE TO SMOKING)

54.Female with infection of HPV, comes after 2 years, Pap smear shows prominent nucleoli and increased nucleus size – Dysplasia. (Whenever in scenario u see word , change ins SHAPE, SIZE , ORIENTATION, ARCHITECTURE, OR INC NUCLES ISZE, always pick Dysplasia , its also a reversible condition)

55.Gas exchange occur – Simple squamous epithelial layer.

56.Patient with granulomatous disease, biopsy done. Microscopic finding that suggests TB – Caseous necrosis ( if asked the feature of granuloma then click epithloid cells, not otherwise, if asked what will u do next after u see caseous necrosis then click AFB STAINING , if no clue is given the click AFB STAIN)

57.The spindle fibers will decrease in discharge of impulses when – Muscle contracts

(NOTE; the job of spindle is to contract muscle, it means when the muscle contracts , its job is done and it DEC FIRING )

58.Diagnosis for leprosy, initial investigation – Nasal scrapping.

59.Benign neoplasm – Adenoma.

60.3 germ layers tumor – Teratoma.

61.When adrenalin release from medulla, causes vasodilation by acting on – Beta 2 adrenergic receptors. ( ALPHA 1 = contraction , Beta 2= dilation )

62.Increased GFR and increased plasma flow occur due to – Dilation of afferent arteriole.

63.Charateristic of cerebellar lesion – Dysmetria

64.Emax (maximum effect) of a drug depends on – Efficacy ( crame it, is highly repeated)

65.Study in which every person of a population has equal chances of being selected

– Random sampling.

66.Amniocenthesis is done – After 14th weeks.

67.1st response against acute inflammation in tissue – Macrophages.

68.In dark granules containing cells; IgE attaches to – Basophils.

69.Opsonization – C3b. ( also Fc portion of IgG is opsonin, BUT C3b is more potent)

70.Exudate – more than 3g of proteins.

71.About active transport of drug all are true except – All drugs pass via active transport.

72.Pulmonary artery supply to – Alveoli( this is the evergreen question among repeated ones)

73.Muscles of back innervated by – Dorsal rami.

74.In young boy dyspnea produced on lying – Retrosternal goiter.

75.Most important cause of bronchogenic cancer – Smoking.

76.Edema caused by – Increased hydrostatic pressure.

77.Edema caused by – Lymphatic blockage.

78.BP 210/180mmHg and creatinine 8% damaged part – Juxtaglomerular apparatus. ( this ques is mostly repated In same way, so remember if very high BP an raised creatinine and in options there is JG APPARATUS. Don’t click anything else)

79.Female with blood group A, have 2 children; one with O and other with AB, blood group of father is – B.

80.Genetically true hermaphrodite XXY ( This is one of the most controversial MCQ, and according to Goljan xx is correct ans that’s in 50% of cases while other combinations make only little percentage, but cpsp key makes XXY a better option)

81.DNA replication occur in – Interphase( DNA & CHROMOSOMES replication occur in interphase)

82.Glycogenolysis caused by deficiency of which hormone – Insulin

83.Investigation for liver amoebic abscess – Serology.

84.Surgery of submandibular gland; nerve damaged – marginal mandibular branch of facial. ( this branch of fascial nerve runs superfascialy and is mostly damaged during surgery)

85.On posterior surface of oblique and transversalis fascia – Arcuate line.

86.Aspirin overdose causes – tennitus. ( aspirin ….. if asked GI disturbances = click normal dose, if tinnitus then= OVERDOSE)

87.Cardiac output measurement via thermodilution – Temperature change downstream with CO. ( NOTE ; if thermodilution not mentioned then Ficks method)

88.Father with defective gene on one autosomal chromosome, develops disease later in his life; chances of getting disease in children – Half of the children will be affected.

89.If left circumflex artery occluded – Infarction of left atrium and left ventricle.

90.MCC of multiple fractures in adult – Osteoporosis.

91.Patient with fracture of many bones and low BP immediate treatment – Volume replacement.

92.Most common fracture of long bone – Tibia.

93.Collagen fibers – Eosin stain

94.Gamma efferent supply to – Intrafusal muscle spindles. ( memorize by heart, its highly repeated)

95.Micturition – Self generating.

96.Hallmark of HIV – Proliferation of virus in T cell ( if asked about AIDS, THEN progressive immune deficiency).

97.1g protein gives energy – 4 kcalories.

98.Isotonic and isometric contraction difference is that isotonic contraction –comsumes more phosphate bond. ( memorize as such , highly repeated)

99.Autonomic nervous system – parasympathetic increase salivary secretion.

1300.Protrusion of mandible – Lateral pterygoid.

01. After feeding the baby, diarrhea develops – Gastrocolic reflex.

02. Both sides of 5th posterior intercostal spaces is supplied by – Thoracic aorta.03. 2 years old child with medially rotated arm lesion in – Upper trunk.

04. Female with uterus cancer which travels to labia majora following which route –Round ligament.

05. Pain in epigastrium due to ulcer, transmitted by – Greater splanchnic nerve. 06. Vesicular lesion on the tip of nose and eyelid – Ophthalmic nerve.

07. Patient can’t abduct till 30 degree, which muscle is responsible – Supraspinatus. 08. Nerve supply to plantar surface of foot – Posterior tibial.

09.Medial arcute ligament – Psoas major muscle.

10.Bitemporal hemianopia due to lesion of – Central part of optic chiasm.

11.Ventral spinothalamic tract – Coarse touch and pressure.

12.Dorsal column – Proprioception.

13.Vibration and touch via – White matter of posterior spinal cord.

14.Function of notochord – Induction of ectodermal neural plate to produce neural tube.

15.Midbrain reticular system – Unusual stimulus causes arousal.

16.Most radiosensitive tumor – Glioma.

17.Hormone increased during sleep as compare to at day wakefulness – Cortisol.

18.In Trigeminal neuralgia anesthesia given to block trigeminal ganglion at which site – Middle cranial fossa.

19.Patient with intentional tremors and facial paralysis lesion at – Cerebellopontine angle.

20.Opioids produces vomiting by acting on – Chemo trigger zone in medulla.

21.Patient working in mine with tuberculin test positive. Cough, fever, weight loss with hilar lymphadenopathy – Silicosis. ( silicosis = predispose to TB that’s why tuberculin positive)

22.Male working in construct factory with pleural plaques – Asbestosis.( asbestos predispose to bronchogenic carcinoma and mesothelioma )

23.Neoplastic cells with continuous mitosis due to persistence of – Telomerase.

24.During exercise venous return is due to – Contraction of calf muscles.

25.During exercise increased blood supply to muscles – Local metabolites.

26.Action of steroids as anti-inflammatory is due to – Inhibiting phospholipase.

27.Intermediate filaments (keratin) staining with immunofluorescence to diagnose

– Carcinoma( note that if there is mentioned carcinoma then look for keratin , and if meshenchymal tissue tumor then VIMENTIN)

28.VPL nucleus of thalamus when damaged cause – somatosensory loss of contralateral body.(REMEMBER , Ventral postro Lateral nucleus is for somatosensory sensation from contralateral body while ventral postro medial ie VPM is for sensation from face )

29.Thiazide diuretic cause – Hypokalemia.

30.Man living on side of a river, got blindness from nematode; organism –Onchocerca volvulus. ( highly repeated)

31.MCC of HTN – Idiopathic.

32.Adult female with breast atrophy due to decrease in – Estrogen plus progesteron.

33.Female with hirsutism, galactorrhea, infrequent heavy menstrual cycle. U/S both ovaries with cystic lesionsand LH:FSH :: 3:1 – PCOS

34.Female with hot flushes – Increase FSH and LH.

35.Injection of atropine will cause – Dryness of mouth.

36.Female with severe loss of vibration, Investigation of choice – Stomach biopsy.(this scenario is about vitamin B12 deficiency where there is sub-acutecombine degeneration of spinal cord resulting in loss of vibration & position sense , the most common cause of vitB12 deficiency pernicious anemia, for which stomach biopsy is indicated )

37.Child with yellow sclera and colored urine, best Investigation – Bilirubin and ALT

38.Female with weakness and lethargy with RBCs 5.5 diameter and very thin red line of RBC in peripheral smear – Microcytic hypochromic anemia.

39.Monitoring of Hep B – Serum glutamate-pyruvate transaminase.

40.Female with reactive anti HBe and reactive total anti HBc along with non- reactive HB IgM and non-reactive HepBs Ag – Acute recovery phase.

41.Patient with obstruction jaundice; now bleeding cause – Vit K deficiency.

42.Investigation of Hashimoto thyroiditis – Antimicrosomal and anti-thyroglobulinantibodies.

43.Cimetidine interaction with warfarin causes – Decrease hepatic clearance of warfarin.

44.Patient using some anti-coagulant, how will you know that anticoagulant is warfarin because it is being monitored by – PT ( remember the oral anticoagulant means warfarin and to moniter warfarin INR > PT, so if INR is there then click it if not then PT)

45.BP drops from 100mmHg to 70mmHg – Decrease in carotid sinus nerve activity.

46.Erythropoietin is secreted by – Mesangial cells.( erythropoietin is secreted by peritubular capillaries, but in cpsp exams, it is secreted by mesangial cells 

#respect)

47.Patient with all symptoms of Cushing along with increased ACTH cause – Cushing disease. ( simple difference between CUSHING disease and syndrome is , that in cushing diseae ACTH will be high )

48.Child with machinery like murmur – PDA.

49.PaO2 is 100% in – Left to right shunt.

50.Kallmann syndrome – Defect in Arcuate nucleus.

51.Diplamotoylphosphatidyl choline + carbohydrate + proteins is a content of –Surfactant.

52.In asthma = Decrease FEV1.

53.Splenectomy is most useful in – Hereditary spherocytosis.

54.Findings in glycogen storage diseases – Hepatomegaly and hypoglycemia.

55.Corynebacterium diphtheria produces – Exotoxins.

56.Common specie of Corynebacterium affecting human is – Diphtheriae.

57.Typical symptom of food intoxication by Clostridium botulinum – Flaccid paralysis.

58.CSF with increased proteins and polymorphs with decrease glucose the drug of choice = Ceftriaxone.

59.About the pharmacology of Neiserria gonorrhea = Pencilin G.

60.Major histocompatibility is related to – HLA.

61.Kidney is transplanted, gets cyanosed in 10 minutes, type of reaction – Antibody mediated( In case of hyperacute rejection, there are preformed antibodies, which reacts within minutes,)

62.A child with Agammaglobulinemia is prone to – Pyogenic infections.

63.Diagnostic criteria for sarcoma – Increased vascularity.

64.Soldier coming down from height, now with discoloration of fingers, dyspnea –Secondary polycythemia.

65.Vitamin D acts on intestinal mucosa via – expression of genes.

66.Release of neurotransmitter due to – Influx of calcium in presynaptic fiber.

67.Calcium influx via slow channels in ventricle cells causes – Ventricular ejection.

68.Increased ‘a’ wave in JVP due to – Tricuspid stenosis.

69.Person with HR 80/min, on ECG RR interval would be – 0.75 sec.

70.Class III Antiarrhythmic – Amiodarone.

71.Increased ASO titer – Rheumatic fever.

72.In hypertrophic cardiomyopathy – Myocytes disarray.

73.5 month of pregnancy, lady with thyrotoxicosis, drug of choice – PTU.

74.30 years old smoker, psychotic, vomiting of fluid with visible peristaltic movements on abdomen cause -Pyloric stenosis( note that the stomach that you hear ( auscultation give splash sound) , you can see ( visible presitalisis ) and you can feel ( olive like mass on palpation ) is pyloric stenosis )

75.Myenteric system of parasympathetic is potentiated by – Ach.

76.Pethidine is preferred over Morphine – Less addictive ( Another FACT frequently asked about pethidine is , that it causes TACHYCARDIA at therapeutic dose , WHILE morphine causes release of Histamine)

77.Philadelphia chromosome – CML.

78.Male with fever upper lobe consolidation, fever from last 3, productive cough, AST 135 and ALT 111, alkaline phosphatase normal, bilirubin 10, he died on autopsy weight of liver increase and with fat droplets seen on hepatocytes and Mallory bodies , Diagnosis – Chronic alcoholic disease.

79.Alpha 2 macroglobulin inhibit – Trypsin.

80.Male with all symptoms of LV failure and pulmonary edema without any previous illness and BP 125/85mmHg, on X-ray cardiomegaly; cause of heart failure– Bicupid aortic stnosed valve ( if the history of alcohol intake is given, prefer alcoholic cardiomyopathy )

81.Highest potential difference in the wall of stomach is when – Aspirin ingestion.

82.Calculate Alveolar ventilation where Tidal volume is 500ml/respiration. RR 10 –3500ml/min

(Alv ventellation = TIDAL VOL – DEAD SPACE 500 – 150 * 10=350*10

=3500 )

83.Calculate Clearance where Urinary flow 20 ml/min, Concentration of substance in urine 10 and Plasma 10 – 20ml/min.

( clearance = UV/P i-e 20 *10/10 = 200/10 = 20)

84.Excessive eversion of foot damaged which structure – Rupture of deltoid ligament. ( if asked about inversion then talofabular ligament , inversion sprains are more common than eversions)

85.About descending aorta . give branches to pericardium lung etc

86.Counterpart of Mullerin tubercle – Seminal colliculus.

87.Histology of cornea – Stratified squamous non-keratinized.

88.Left shift of HbO2 curve – CO poisoning.

89.Humans are intermediate host in – Hydatid cyst.

90.Clot retraction is mediated by – Thrombosthenin

91.In late pregnancy the uterus is most sensitive to – Oxytocin. ( while for the initiation of labour fetal cortisol is important )

92.About bicep brachialis muscle – attaches to supraglenoid tubercle of scapula. ( cram it, its highly repeated )

93.Hyper-resonance is mostly heard at – T2-T4 of right midclavicular line.( because in this region there is only lung, while on left side there is heart and right side below this ,is liver, so this area is always hyper-resonant)

94.Conus medullaris terminates in neonates at the level of – L3

95.Cimetidine is used preoperatively – Dec acid secretion from stomach.

96.Nursing mother with herpes labialis, drug of choice – Acyclovir.

97.PO4 increased, Calcium decreased and PTH increased – Chronic Renal Failure. ( remember if PHOSPATE IS INC and Ca is dec THEN FIRST EXCLUDE CHRONIC RENAL FAILURE)

98.Labetalol acts on – Alpha and Beta receptors.

99.Women after delivery, Platelet: 70,000, aTTP normal, PT raised – DIC. ( Also note the point that DIC is initiated by THROMBOPLASTIN )

1400.Between umbilicus and suprapubic rectus sheath behind at its lower limit forms – Arcuate line

01.which of the following cranial nerves have parasympathetic nuclei = III, VII, IX,X (

3.7 . 9 & 10 )

02.What is hamartoma = totaly benign (Hemartoma is just jumbled up normal tissue and totally benign)

03.Adrenergic Receptors of Adrenal medulla : cholinergic ( specifically cholinergic nicotinic)

04.Coronary Arteries – always run n in the respective AV septal depression, 05.Scalenus Anterior Muscle – phrenic nerve passes anterior to it

06.loss of sensation of nose, cheek, maxilla, zygoma : maxillary division of trigeminal nerve (if tip of nose mentioned then opthalmic division of trigeminal nerve , the most fav question of cpsp)

07.Which of the following have subcapsular afferent sinuses : lymph nodes( whenever you fine subcapsular afferent in stem , first look for lymphnodes in options)

08.which of the following hormone increases content of skeletal muscle Proteins—testosterone

09.An Ovum is surrounded by corona radiata which is formed by : granulosa Cells10.Patient underwent colostomy after colon resesction for colonic cancer, best way to monitor for recurrenc; CEA levels

11.Growth harmone : is a polypeptide ( a second option is often there in paper, acts indirectly via IGF, if u find it , click it )

12.Man with hx of repeated URTI, hx of passage of fowl smelling stools for 10 years , he would have deficiency of which of following : , vit D ( passage of foul smelling stools indicate loss of digestion and absorption of bowel fats resulting in deficiency of fat soluble vitamins, vit D is fat soluble, )

13.neurogenic shock is different from other types of shock because of : loss of vasomotor tone

14.bleeding time increased : VWbrand’s disease ( in vw disease , both bleeding time and APTT are prolonged )

15.left kidney grossly identified from right kidney by : arrangement of structures in hilum

16.which of the following have highest incidence of bronchogenic carcinoma =smoking

17. A man with third degree burns have increased risk of developing : Contracture18.Which of the following arches over root of right lung : , azygous vein

(● structure arches over left lung root = aorta cz on left there is aorta,structure arches over right lung root = azygous vein as its on right,

structure anterior to the root of both lungs = phrenic nerve,ie phrenic in the frontand posterior to the roots of both lungs = vagus nerve)

19.Stored blood has following characteristics ; increased hemolysis20. Fibrocartillage : present b/w intervertebral discs

21.breaking bad news : should be told to patient in a formal session exclusively (if option another option is present click that, and that option is , PRESENT INFORMATION IN A CRISPY AND ACCEPTABLE WAY )

22.for efficient patient doctor relationship best way to start conversation by ;;,asking about his name, age, address

23.regarding thyroid : active follicles are filled with colloid

24.QRS complex is slightly prior to : ventricular systole (i-e electrical activity before mechanical activity)

25.which of the following predispose to malignancy : proto-oncogenes ( while in case of virus click oncogenes )

26. Myxoid degeneration will occur in which : mitral valve prolapse

27.which of the follow prevents flow of substances in intercellular space : tight Junctions

28.most common cause of fatty liver in our country ; fatty food ( if protein malnutrition present in options then go for it )

29.Aspirin prevents formation of; thromboxin A2

30. Antharax is 90 % associated with : cutaneous lesions31.Hairy Leukoplakia is associated with : AIDS

32.boundaries of Digastric Triangle : anterior and posterior bellies of diagstric muscle and ramus of mandible

33.blood supply of foregut is primarily derived from : celiac trunck

34.man encountered fracture of femure in RTA, died after 5 days, cause of Death =Fat embolism ( if pregnant lady is mentioned and death Is immediate then amnioticfluid-embolism , if time is in days then fat embolism even in pregnant lady will be the ans)

35.follicular cells of thyroid are derived from = endoderm ( follicular cells of thyroid are simple cuboidal epithelium and their embryologic origin is from a median endodermal mass in the region of the tongue , in contrast to the parafolliclar c cells that arise from the 4th pharyngeal pouch)

36.Neutrophillia will be seen in :, after an acute attack of MI ( like all other inflammatory conditions, in MI as well, in day 1 to 3 , neutrophils stay in there, while from day 4 to day 7, macrophages dominate the site )

37.Hepatic pedicle is formed by :, portal vein, common hepatic duct, hepatic artery ( means portal triad)

38.adult male of long hight, well developed , presented with complain of infertility what could be the cause : klinefilter syndrome

39.Nor-Epinephrine and Serotonin are degraded by : MAO,

40.Most potent Response in massive haemorrhage is : CNS ischemic Response

41.In nephrotic syndrome oncotic pressure decreases due to : hypoalbuminemia42.Isthmus of thyroid gland is present in front of : 2nd,3rd, 4th tracheal Rings43.Alternative of schwan cells in CNS : oligodandrocytes

44.Regarding Rectus sheeth tendoneous intersections : upper most is located near xyphoid process

45.Regarding Hymen : lined by stratified squamous

46.Histology of Vagina : str. squamous epithelium with abundant elastic tissue in submucosa, highly vascular, smooth muscles around ( whenever u see ABUNDANT ELASTIC TISSUE in the stem, look first for histology of vagina )

47.Histology of Ureter : small lumen tubular str. lined by transitional epithelium, with complete muscular coat

48.Mother contracted german measles during pregnancy , fetus is on risk of developing : congenital Catract,

49.Risk of Congenital catract by Rubella virus can be prevented by : vaccination of girls of child bearing age

50.Which of the following can be palpated via lateral fornix of Vagina : ureter51.tapping of patellar tendon causes : contraction of quadriceps muscle

52.Pts of different races are coming at emergency , 50% are whites, 20% blacks, 20 % asians, best way to depict there percentages is : pie chart

53.During later stages of pregnancy , Ripening of Cervix is caused by : Hydration of Collagen

54.Simple columnar Epithelium with Goblet Cells and submucosal lumphoid tissue :Ileium ( note that submucosal glands of Brenner are present in duodenum while lymphoid payer pateches are present in lamina propria and submucosa of ileum )55.Patient presented with coagulopathy with dead fetus in uterus most imp. step of initial managment : Evacuation of Uterus

56.A lady is receiving radiotherapy for CA-Cervix, which of the following will be seen on histology : karyorehexis and karyolysis ( chemo and radio both cause apoptosis, that how histology will show the features of apoptosis)

57.acute effect of high dose Radiation : , endarteritis obliterans58.Oliguria is production of urine in 24 hours : less than 500ml,

59.Patient with normal amount of semen production but azospermia : defect in sertoli cells

60.GnRH regulates secretion of : FSH and LH

61.IN preganancy mother feels respiratory distress b/c of = dec.in total lung capacity62.young female with hx of multiple recurrent abortions : anti-phopholipid syndrom63.Hypophysectomy will effect primarily : principle cells of thyroid

64.A young female patient presented with pain RIF with hx of amenhorrea for 6 weeks, pregnancy test is positive : ectopic pregnancy(acute appendicitis if leucocyte count, nausea and fever mentioned )

65.Urogenital diaphragm lateraly attaches to : ischiopubic rami

66.Pregnant patient presented at 3rd month of pregnancy with Hb 12.5 g/dl, later on presented on 9th month with HB 10 g/dl normocytic, normochromic, cause of anemia :, normal physiological change

67.local anaesthetic MOA of ionized substances : cause blockade of Na-channels68.Neuromuscular junction motor end plate : contains acetylcholinestrase 69.Patient presented with Hx dyspepsia, anemia, pale hands, spooning of nails, stool test showed OVA : Ancylostoma Duodenale ,( note that , ascarisias casuse GI obstruction and lung problems, trichuriasis cause dysentery and rectal prolapse, entrobius vermicularis cause pruritis ani, and onchoceercasis cause river blindness)

70.A 23weeks pregnant lady died in RTA type of death is : Fortitious death,

71.While doing appendectomy via incision at Mc’burney’s point artery is damaged :deep circumflex Iliac artery ( if asked about , which STRUCTURE is damanged then , ans should be illeohypogastric nerve)

72.Elderly patients are prone to develop drug toxicities b/c of : dec. renal Excretion73.Patient having menstrual cycle of 32 days will ovulate on : 18th day(the last 14 days of the cycle are fixed, any change in the length only occurs in the days before it, which may either reduce of prolong the total duration so to get the ans ; 32-14 =18)74.Which of the following will cause bradycardia : occulocardiac reflex,

75.neoplasm having rete ridges , malignant infilterating epithelial cells : Verrocous carcinoma

76.In pregnancy there is : hypoalbuminemia

77.Lymphatic drainage of skin around anus : medial group of superficial horizontal lymph nodes

78.Bite cells will be seen in : G6PD def,

79.Inferior layer of urogenital Diaphragm : perineal membrane80.which of the following is benign tumour = warthin tumor

81.septum primum and septum secundum fuse to form septum which separtes :common atria into right and left atria

82.At the end of a marathon race there is = Increased glucagon and low insulin 83.A 7 years old child having generalized edema Investigation of choice is = urine albumin (& for diabetic nephropathy the investigation of choice is = urine albumin )84.Apex of the heart = 8 cm from median plane apex of heart

85.Alpha and gamma motor neurons = Supplied by UMN86.trisomy 21 =Robertsonian translocation

87.agressiv ca = Melanoma

88.regarding malignanct charcter = metastasis89.polyphagia in diabetes ocures due to = inc blood glucose

90.edema of kidney origin is due to = albuminuria and Na retention

91.subacute endocarditis = viridins ( viridns causes sub-acute and damaged valves endocarditis, and is on the top over all, while staph causes acute and in healthy valves, mainly in iv drug abusers, though in new editions, Staph is on the top overall, but for cpsp. Prefer viridins  #respect)

92. Pus contains = dead neutrophils

93.at beginning of 5th week = heart definitive formed ( though in 4th week, four limbs and four chambers of heart are formed and at 4th week primordial germ cells migrate into undifferentiated gonads, but if asked definitive heart then click beginning of 5th week)

94.contraction of pupillary muscle = parasympathetic

95.hormone causing gluconeogenesis = cortisol ( gluconeogenesis ; prefer cortisol over Glucagon, but for Glycogenolysis , prefer Glucagon, though it can cause both)96.primordial germ cells derived from = Ectoderm ( Primordial germ cells have been isolated from the epiblast at posterior end of primitive streak in 2nd week while germ layers are formed in 3rd week by the process of gastrulation, hence primordial cells can’t be considered, the derivative of any of these 3 layers, its believed that, epiblast is the future ectoderm that how, the correct answer is epiblast, if not in options click ECTODERM. Earlier it was believed that PGC’s are derived from endoderm of yolk sac)

97.ureteric bud derived from = Caudal end of mesonephric duct

98.lenght of Right main bronchus = 2.5cm (repeated so many times)

99.anterior (costosternal surface) of heart is formed by = right ventricle

1500. The most important component of shock is = tissue hypoxia

Session # sixLife is really simple, but we insist on making it complicated. Confucius

1.Veins of thorax drains into = azygous drains into superior vena cava ( azygous vein, after arching over the root of right lung drains into superior vena cava behind the sternal angle, also note that there are no valves in superior vena cava, brachiocephalic veins and azygous system of veins)

3.Regarding primary peristalsis = begins when bolus enters the esophagus4.Cardiac transplantation rejection, the cells involved are = T cell (CD8 CYTOTOXIC T CELLS : Recognize antigens in association with class I MHC Proteins Kill virus- infected, neoplastic, and donor graft cells via release of perforins and granzymes.

While in chronic rejection, CD4 T CELLS are involved, as stated “Pathogenesis of chronic rejection, Most likely due to a chronic delayed hypersensitivity reaction involving CD4 T cells” )

5.Tumor cells in the blood , most commonly diagnosed by = tumor marker

6.P53 mutation = cell survival ( P53, brings about cell apoptosis i-e death, means if its mutated, cell will suffer no death and will survive)

7.Liver abscess= serology is done for diagnosis

8.Biopsy taken from posterior triangle = damage to the spinal part of accessory nerve (spinal part of accessory nerve lies in posterior triangle, and is frequently damaged during biopsies or drainage of abscess from this are, not that the loss of accessory nerve result in paralysis of trapezius, and as a consequence loss of overhead abduction and inability to comb hair)

9.Alpha receptors = mainly in the proximal urethra

10.Parasympathetic = inc salivation ( Salivary secretions are inc by both symp and parasymp , but parasym effect is more dominant one.)

11.Receptors causing nor-epinephrine mediated dilation=β2 12.Which muscle causes jaw protrusion = Lateral pterygoid 13.Pancreatic tissue in stomach is =choristoma

14.Sickle cell disease protein affected is = beta globin

15.Iron deficiency anemia = inc TIBC (note that. The most sensitive test for iron deficiency anemia is Serum ferritn )

16.At normal condition, both are equal = venous return and pulmonary blood flow( the reason is that all the blood entering in right side of the heart should be pumped to lungs for oxygenation)

17.Difference between pulmonary and systemic circulation = low resistance in pulmonary circulation

18.Long term memory immunoglobulin is = Ig G ( the initial Ig is always IgM , that’s

followed by IgG )

19.Profofol absolute contraindication =Hypersensitivity to profofol ( profol appears safe in porphyria , note that , barbiturates contraindicated in porphyria )

20.GVE comes out of = dorsal nucleus of vagus ( its also known as posterior nucleus of vagus and is the main parasympathetic outflow of vagus )

21.Which of the fallowing structures doesnot receive innervations from branches of pudendal = Posterior Fornix of Vagina

22.Sructure attached to Lumbar Verebra = Anterior Longitudinal ligament

23.Right horizontal semicicular canal stimulated = Head tilt right

24.Athetosis is due to defect in = Globus pallidus (according to Guyton and hall)

25.Opsonization occurs with the = . Help of c3b

27.Propulsive movement of intestine effected due to lesion of = Aurbach plexus

28.Main class associated wid antigen presenting cells = MHC2

29.About small intestine true is = small intestine 6-8 meters long

30.Lysosome has secretion against bacterial iron because they contain= Hydrolases

31.Blood supply of heart is regulated by = Local metabolites

32.Post synaptic sympathatic mainly secretes = Nor epinephrine

33.True abt vertebral column = Cervical nerves originate abovecorresponding vertebra (Except C8 cervical nerve which is below C7 vertebrae , and all Spinal nerves also originate below the corresponding vertebrae)

34.Confidence interval = Mean n its standard error of mean

35.Positive Predictve valve is affected by = Prevalence of disese

(Remember PPP = Positive Predictive value is affected by Prevalence)

36.In PPD induration u will find = . T cells ( if T-cell & macrophages are present in options prefer that)

37.Which of the following drugs is contraindicated in a patient with raised intracranial pressure = Ketamine (mnemonic = KRANIUM vs KETAMINE)

38.If circumflex branch of left coronary artery is blocked which area will b effected = Posterior surface of left ventricle

39.Draining to Sup Mesenteric nodes = Jejunum

40.Diabetic pt came to ER insulin given what change will happen in blood =

.increased pH ( as dec PH is due to acidosis by ketone bodies and insulin when given, will dec ketone bodies and will inc ph)

41.Potassium will be lost mostly frm which segment following dietary irregularities = distal tubule

42.Main diagnostic feature of DIC = presence of D dimers

43.A man wd his gut removed some weeks ago now showing ↑ gastric motility wid

diarrhea, cause = Osmotic+secretory diarrhea

44.CO poisoning,methemoglobulinemia,anemia dont result in hyperpnoea..this is because = Po2 remains normal

(Anemia- Pa02 and Sa02 – Normal

MethHB and CO Poisoning – Pa02 is normal but , Sa02 DECREASED)

45.Ductus deferens end in = .ejaculatory duct

46.Sjogren associated with = RA

47.Ovarian pain related to = Obturator

48.Antibiotic given , patients PT and APTT deranged what will u give = vit k

49. Subdural hematoma due to = rupture of cerebral vein (note that;

Epidural = Middle Meningeal Artery=Lens shaped Biconvex hematomaSubarachnoid = Cerebral arteries and Vein (Berry Aneurysm in Circle of Villis) Subdural = Superficial Bridging cerebral Veins =Cresecent hematoma)

50.Enzyme in saliva that prevents iron utilalisation by bacteria = Lactoferrin

51.Fio2 max dose which does not cause fetolental adrenoplasia = . 0.6 (Safe limit is 0.6 or less than that)

52.Gardener right side chest pain 3.5 cacific on rt lower lobe = Aspergilosis

53.Recurrent renal stone associated with which amino acid abnormality = Lysine

54.Nerve supply of Lattisimus dorsi = Thoracodrosal Nerve

55.Nerve supply of Rhomboids = Dorsal scapular nerve

56.Nerve supply of Sartorius = Femoral Nerve

58.Vitamin produced by intestinal bacteria = Vitamin K ( new borns have no gut flora and are deficient with vit k , that why soon after birth vitk is administered to the neonates )

59.End product of purine metabolism = Uric acid

60.Arrangement of renal segments: Renal-> Interlobar->Arcuate->Interlobular->Afferent Arteriole ( According to SEMBULINGAM ; Renal arteries directly arises from abdominal aorta and enter the kidney through the hilus, while passing through the sunis , it divides into many segmental arteries which subdivide into interlobar arteries, each interlobar artery passes between medullary pyramids and at the base of pyramid forms arcuate artery, each arcuate artery gives rise to inter lobular arteries , from each interlobular artery numerous afferent arterioles arise)

61.Cervical CA metastasize to = Internal and External LN

62.Prader Willi Syndrome = Hyperphagia and Hypergonadism

63.A patient comes to you in your clinic with lab findings of RBS 198 G/dl and FBS

122G/dl; what is your diagnosis = Impaired glucose (Fasting >110 <126 = IGT

For DM ; RBS must be > 200 with Classical Symptoms and FBS must be > 126)

64.Which of the following have direct relationship = pulmonary blood flow and venous return (Factor That control Cardiac Output also control Pulmonary Circulation-Guyton)

65.In hypoxic vasoconstriction; which of the following is decreased = arterial pO2 66.Screening is done = to detect disease at its early stage

67.In athletes, which of the following is increased even in resting state = Stroke volume ( if not in options the prefer cardiac output)

68.Muscle of quiet inspiration = diaphragm

69.If a foreign body is inhaled; which of the following lung lobes it will go to = Rt inferior lobe

70.Intracellular ANIONS = Proteins

71.Type of junction present in smooth muscles = gap junction

72.Type of junction present in cardiac muscle = gap junction

73.A man moving in an elevator; which of these is working = saccule

( note that

angular acceleration = semi circular canals, ● linear horizontal ie in a car = utricle and

linear vertical acceleration ie in an elevater = saccule)

74.Which of the following has normal anion gap = Diarrhea

75.Which of the following is diagnostic of tuberculous granuloma = epitheliod cells

76.A lady with 26 wks gestation has uterine height of 24 wks. On ultrasound there is no fetus and snowstorm appearance. Which of the following probably associated with it? = karyotype 46 XX

77.A soldier comes with heavy bleeding. The ideal fluid replacement would be =

whole blood

78.Structure accompanying superior temporal artery =auriculotemporal nerve 79.Relation of terminal CBD with head of pancreas is = embedded in head of pancrease

80. Genotype of a true hermaphrodite is= XXY

( in goljan xx is given , while some of the colleagues saying that XXY IS CPSP KEY, though I couldn’t find xxy in any of the cpsp demos, still seniors agree to it, so ans is

xxy , follow cpsp blindly no matter what Goljan says  #respect)

81.Calcitonin is secreted by which tumor = Thyroid

82.Angiotensin 2 is responsible for =systemic vasoconstriction of venules

83.Most common skin malignancy in pt with HIV = Kaposi sarcoma

84.Left gastroepiploic artery is branch of = Splenic artery

85.Organelle that binds carbohydrates with protein enclose them in vesicles n release = GOLGI bodies

86.Child with recurrent infection, which of the following physiological antibody is missing on peripheral smear = igA

87.Plasma membrane thickness is 7-11 (7.5 – 10nm is Range- Guyton)

88.Lady with ventricular rate of 40/m most likely = complete heart block

89.Iron binds to = transferrin

90.Highest carbohydrates is in = wheat (71gm CHO)

91.Resonance of the lungs can b auscultated from back of the chest till = 8th rib (Demarcation Line is 3rd-9th Intercostal Space)

92.Flexion of knee and extension of hip is the action of = semitendinosus

(Also Biceps femoris, Semitendinosus, Semimembranosus – Posterior Compartment Thigh muscles–> Tibial Nerve)

93.Which of the following bones has no muscular attachments = talus

94.Lymph drainage from outer nipple is to which group of lymph nodes = anterior axillary

95.Dorsal scapular nerve supplies which of the following muscle = levator scapulae (Dorsal scapular Nerve also supplies Rhomboids)

96.Which of the following is a pivot joint = atlanto axial joint

98.Motor supply of pharynx is by = nucleus ambiguous (Nucleus Solitarius: Sensory & Ambigous: Motor)

99.Sacroiliac joint = plain variety of synovial joint

1600.Mediator of pain = bradykinin ( Bradykinin > PGE2)

01.RT coronary artery = supplies S.A node

02.Most imp hormone involve in gluconeogenesis = .cortisol

03.A pt presented with rt iliac fossa pain. he is diagnosed to have acute appendicitis on flexing his rt thigh inward n medially he cries with pain. What is the type of appendicitis he has = pelvic

05.Most potent chemotactic factor is = C5a

06.what is the most appropiate ans =.C5a is a potent chemotactic agent 07.Low serum complement seen in which condition = .SLE

08.Pt presented with photosensitivity,rash n joint pain.which is the daignostic in this case = .anti DS antibodies

09.Which of the following has highest cholesterol content = LDL

10.Which drug does not cause gynaecomastia = .Griseofulvin ( some colleagues saying androgen, but remember that gynecomastia is one of the adverse effect of androgen , and beyond all explanations, griseofulvin is cpsp key)

11.Which is the best option in identification of Turner’s syndrome =.karyotyping 12.End product of purine metabolism is = .uric acid

13.Erythropoitin is secreted fro = .Mesengial cells14.ESR is decreased with = albumin is increased15.RBC’are having = glycolytic enzyme activity16.Commonest Cause of PDA = .permaturity

17.Most common Cause of metaplasia is = .chronic irritation

18.What is the differentiating point of hyperplasia fron hypertrophy = .Increase in size n no of cell

19.Dysplasia is seen mainly seen in = .epithelia

20.What is the differentiating feature of hyperplasia from benign tumo = .increase in no of cell

21.What is the most true among following = .rRNA is most abundant & involve as ribosomes on endoplasmic reticulum

22. Deficiency of THAIMINE(B1)causes all except =subacute degenaration of spinal cord

23.AIDS is associated with all of the following except =.leukemia 24.VITAMIN involve in collagen synthesis is = .ascorbic acid 25.Neural tube defects occur due to deficiency of = .folic acid 26.Iron is stored in the form of = .ferritin

27.CO2 is tranported in lungs through = .simple diffusion 28.HPV is associated with = CA cervix

29.Optic groove appears on left side of forebrain on day = 22 ( memorize by mnemonic, 2 eyes and 22 days )

30.Germen measles causes which abnormality. What is the most appropriate answer = .congenital cataract

31.A newborn with anterior abdominal wall swelling and umbilical cord attached to it.what is the condition called = .omphalocele

32.PT has exophthalmos & his T3 n T4 are increased.what is the option for treatment of exophthalmos = .drugs blocking the lymphocytic infiltration 33.Treatment of diabetes in pregnant lady is = insulin

34.side effect of streptomycin = impairment of hearing35.Which of the following is opportunistic organism = .klebsella 36.Psudomembranous colitis is caused by = .Cl.difficile

37.About aspargillosis which is not correct = .is caused by long term antibiotic use. 38.Pt has a history of infection 4 weeks back.now he developed same pain again.what type of cell will present at this time of disease = .neutrophils

39.What is the drug of choice for DVT in ist trimester of pregnancy = .heparin 40.Type 2 hypersensitivity reaction includes = erythroblastis fetalis

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