-

1) man presented to the office for a regular health

maintenance checkup. His VDRL testing, hepatitis testing,
HIV testing were all negative.
He has 5 sexual male partners. Which of the following is
recommended in this patient?
a. HIV pre exposure prophylaxis and HPV vaccine
b. Pneumococcal vaccine and hiv preexposure prophylaxis c.
Pneumococcal and HPV vaccine
d. Pneumococcal vaccine

2) 50 year old woman comes with a complaint of decreased

libido and says she divorced and now she has been engaged in
sex with a new guy. On further questioning she also mentions
that she has been using some herbal testosterone which has
really done good for her libido. On examination her pubic area is
hyperpigmented that it was on previous visit .What is your
response?
a. The product you are using might be causing these side effects.
b. Most menopausal women have decrease in sex drive. What is
decreased libido according to you?

3) PQ, pleural fluid with RBC , malignancy

4) PQ about a boy with middle lobe pneumonia 4 weeks back

which was in the process of recovery. His symptoms became
more severe around 10 days ago. His two siblings have recent
history of URTI. His father returned from the Middle east 2
weeks back. He had an episode of seizure 2 weeks back. What is
the cause for his symptoms?
a. Father returning from middle east
b. Sibling with URTI
c. Seizure

,5) ovarian torsion and ovarian vein decreased blood flow

6).Female patients under OCP use. Complaints of painful

erythematous lesions over the shin. Asked cause
a. Erythema Nodosum
b. Erythema Gangrenosum

7) ACEi (up/down) Renin, AngiotensinII, aldosterone

8) female 55 years old is brought to the ER after she was found

wandering on the street.when asked her name she cant tell
properly, can't walk due to abnormal gait. On arrival at the ER
she falls asleep. Her vitals are:
Bp: 110/ 75 mm hg
PR: 65 bpm
RR: 12 per minute
She has a normal size pupil reactive to light. ( no dilated and
constricted mentioned). blood alcohol concentration was normal
.
Which of the following is responsible?
a. Gamma amino butyric acid receptors (went with this, thought
of benz toxicity)
b. Opioid receptors
c. Dopamine receptors
d. Cholinergic receptors
e. Histamine receptors

9) DENIAL
10) ALTRUISM

11) a female child with no puberty achievement , anosmia

present , likely cause for this is due to region of brain ?
diencephalon mesencephalon diencephalon

12) PQ- medial geniculate body gross figure

13) A child presented to ED with acetaminophen tablets

ingestion 30 mins ago, few tabs were vomited out by the child,
all his vitals WNL. NAC given, what should be further given to
the child orally to avoid absorption ?
a. desferrioxamine
b. activated charcoal
c. milk

14) A boy presents with skin lesions , filled with fluid and easily
layering skin, painful , no other signs of infection was given.
lesion occurred after he had been treated with TMP-SMX for
UTI. likely cause for this condition ?
a. TEN b. TSS c. SSSS d. PV e.Erythema nodosum

15)
16) boy with a known case of sickle cell anemia came to the
office with the complaint of sudden onset of painful hip joint.
There is decreased range of motion of the hip joint. He was then
given NS and analgesics. He feels better on the next day of
hospital admission. What is the reason behind it?
a. Aplastic crisis
b. Avascular necrosis
c. Hemolysis
d.Osteomyelitis

17) patient presents with multiple fractures , hypovolemic shock

vignette ( up down qsn)
PP-SVR-lactic acidosis

18) Child presented with VSD, parents want to know the cause
for this .
a. trisomy 21
b. trisomy 13
c. aneuploidy
d. multifactorial
19) PQ- VSD with shunt reversal , CV given of baby with
cyanosis

20) What happens to the CI when the population is increased ?

a. increases
b. decreases c. constant

22) PQ - coccidiomycosis had to identify histo, patient was from

San Francisco
Nonproductive cough

23) A patient with SLE and RA has increased risk of getting MI ,

most likely explanation for this is due to ?
a. IL-6
b. TNFalpha
c. IFNgamma

24) PQ, PHN - complement mediated hemolysis

25) CV of a 40s male h/o splenectomy done for abdominal

trauma, now presents with fever 104, lower limbs rash, neck
rigidity. His wife mentions him having penicillin allergy. current
BP 90/60 , medications and fluid therapy doesn't improve his
vitals. What is important in his history ?
a. drug allergy
b. h/o splenectomy

26) testicular ca , LN drainage to where ?

No option for para-aortic, pre-aortic etc
They mentioned different plexuses and retroperitoneum(I
marked this)

27) PQ, 6 membrane transporters

28)

29)Bitemporal hemianopsia picture given of a child along with

ahx of headache and asked the dx
A) Craniopharyngioma (similar picture given)

30) Astraunout PQ
31) Pseudohypoparathyroidism
PTH, Serum ALP( elevated)
Urine cAMP and phosphate after pth infusion (no change)

32) NSAID for pain given. Inhibits what?

PGE2
PGI2

33) By what mechanism Nk cells and CD8 T cells kill cells?

A) Granzyme
34) Patient went hiking, drinks water from freshwater lakes, eat
wild berries developed non bloody diarrhea for 10 days. What is
the cause?
a) Giardia lamblia
b) Enterotoxicogenic E.coli
c) Shigella

35) Much clearer picture of cervix was given, involvement of

whole both lips of cervix it was all messed up.
a) Invasive SCC
b) Carcinoma in situ
c) Adenocarcinoma

36) A baby born healthy had no particular issues with anything

except that his ring and little finger were missing. Everything
else was normal. What can lead to this complication?
A) Amniotic bands leading to Amputation
B) FGF related masla

37) Auditory cortex was shaded, and asked that nerve terminals
that are damaged are originated where?
A) Medial geniculate nuclei B) Lateral geniculate

38) Question stem described a mass in thyroid and on biopsy we

found psammoma bodies which of the following is this thyroid
cancer
A) Papillary
B) Medullary
C) Follicular

39) Delusional disorder tv host

40) Nurse pinprick (antibody against HBgAs)
41) pelvic Ischemia
42) Osteoporotic patient on calcium supplements wants to
maintain their bone density. She wants to know what sort of
exercises will help with that. Which phase of change is she in?
prepration
43) Patient having difficulty pen holding and problem in
vibration and position(yes you read it right, it was position not
pressure). What receptors impaired?
Ruffini
Merkels
Pacinian
44) Patient who is having severe unilateral headache, says
before the pain starts there is flashing zigzag line here visual
field and after 10 minutes there is pain in my head, which is
precipitated by light and sound. Diagnosis?
A) Common migraine

45)One question on qualitative analysis (was very easy, they

mentioned interview stuff etc)

46) man comes with chronic history of epigastric pain. H pylori

test negative. On investigation: gastrin level normal, basal
gastric acid secretion increased. Diagnosis?

a. Z.E.S
b. Chronic gastritis
c. Acute gastritis
d. G.E.R.D.
e. Idiopathic gastric hypersecretion (did this, only option that
was making sense to me there)

47) Upper gastrointestinal endoscopy picture given. Patient hast

chronic epigastric pain. Similar history also present in mother
and grandmother. Cause?
a. H pylori

48) A patient has features typical of pneumonia. Pleural effusion

shown in x-ray. Cause of effusion
a. Increased vascular permeability (I marked this)
b. Increased hydrostatic pressure
c. Decrease lymphatic drainage
d. Decrease oncotic pressure

49) Subclavian catheter inserted in a patient. Following the

 procedure, patient develops shortness of breadth. On
examination decrease breadth sound heard over right side.
Tracheal deviation, resonance, vocal fremitus not mentioned.
Damage to which of the following?
a. Cervical pleure.... Went with this one
b. Phrenic nerve

50) Dermatology picture of psoriasis. Which cell mediated?

a. T cell
b. Neutrophil
c. Macrophage
d. Eosoniphil

51) A man with chronic history of hypertension of diabetes and

hypertension comes with severe flank pain. Angiograpgy sows
severe narrowing of right renal artery C.T. sacn of kidney given,
wedge shaped opacity. Which of the following mode of cell
death
a. Coagulative necrosis (was a very long and weird Q )

52) Kid coming to hospital with salicylate poisoning after 15

mins. Asked for metabolic and respiratory changes

Metabolic Respiratory
a)Alkalosis. Alkalosis
B)Alkalosis. Acidosis
C)Acidosis. Alkalosis (Marked this)basically
early aspirin poison
D)Acidosis. Acidosis

53) A man underwent coronary stenting procedure. Following

the procedure, developed lividereticularis, gangrene of toes and
renal failure. Reason?
banical elever raised after this
 a.Artheroembolism (marked this)
b. Renal ischemia

54) . A lady had accident ko history 2 months back. Now

presents with lump in brease. On examination, skin retracted.
Biopsy take, which shoys foamy macrophage, calcification.
Diagnosis?
a. Fat necrosis

55) A 60 years man has features of restrictive lung disease.

Fibrosis present over subpleural area mentioned. No granuloma
specifically mentioned in the vignette. Cause?
a. Usual Interstitial pneumonia (marked this, not sure)
b. Hypersensitivity pneumocystis
3
an

c. Sarcoidosis ->
inme
growlomas
so balli ase
d. Tuberculosis famed option.
incorrect
e. Lung cancer but do
cheek.

56) woman diagnosed with bipolar disorder. Taking lithium. Has

increased her dose of lithium for better relief of symptoms
Comes with polyuria. Cause?
a) Nephrogenic DI (went with this, again very long long and
tiring CV)
b) Central DI
c) DM
d) Psychogenic Polydipsia

57) Ajeeb question showing ecg of the patient smth like this,
Pehle it was kinda normal and then it became like this. Question
asked for the origin and pathway of cardiac activity.
 Origin. Pathway
A) SA. Cell to cell
B) SA. Purkinje
C) AV. Cell to cell
D) Ventricle Cell to cell. (Went with this but samj nai
aya why )
E) Ventricle Purkinje

58) Long flight ma travel. Has D.V.T. family history not

mentioned
H a. Factor 5 leiden... common
b. Protein C deficiency
c. Protein S deficiency
d. Antithrombin 3 deficiency

59) Typical vignette of polycythemia vera. Erythtromelalgia,

aquagenapruritis described, hemoglobin 19, JAK 2 mutation
a. Polycythemia vera

60) typical sace of bipolar disorder. A 19 yrs girl, thinks she is

the real queen of her kingdom, has pressured speech. When
asked about sleep, she says who needs them?
a. Bipolar disorder

61) patient who is maid, comes to us with the fracture smth. Has
a history of lactose intolerance so she doesn’t take dairy
products. Husband died last year in an accident so her diet is
also not sufficient because of budget issues. She comes to work
before sunrise and leaves after sunset. Black woman and wears
scarf. What is decreased?
a) cholecalciferol
b) Baki options I don’t remember

62) Long vignette. At the end asked, what will

lipopolysaccharide activate? a. Toll like receptor 4

63) C.M.V. wala, child with sensorineural hearing loss

64) Patient has C.L.D. C.T. scan of abdomen with dilated

paraumblical vein given. Patient is appropriate candidate for
tips. Excess blood flow is shunted to which vessel?
a. Azygous vein
b. I.V.C ( went with this)
c. Splenic vein
d. Superior mesenteric vein
e. Paraumbilical vein

Question was really weird. Didn’t understand if they wanna ask

the backflow or where blood should be shunted to relieve Portel
hypertension

65) women with ptosis and weakness after excretion (basically a

case of myasthenia gravis). X-ray shows widening of anterior
mediastinum.
Why?
a) Thymic hyperplasia

66) pork, cardiomegaly - trichenilla spiralis

67) very long long question

In the last they mentioned intracytoplasmic tetrads in some
erythrocytes. From where this patient has travelled abhi?
a) India
b) Senegal
c) Connecticut (yes that’s the right option)

68) Women wants to conceive, what is the action of vitamin

giving during prenatal phase?
Nucleotide synthesis

69) yellowing tinge to palm and soles. Cause? Long cv and all
lab findings were normal. No scleral icterus
a Carotene (marked this. Thought of excess vit A)

70)Pactitaxel? Tubulin

71) What should be the position of primer to most accurately

determine the gene of interest?
se
72) Hepatomegaly, lactic acidosis, hypertriglyceridemia. Which
enzyme is deficient?
Glucose-6-phosphatase

73) Tay-sacks vignette given. In the end they asked where does umz,ganglio.
this accumulate in?
a) neuronal cortex
b) Peripheral nerves

74) A pregnant female was treated for UTI which was

completely resolved by the time of delivery. She had a GBS
infection in her previous pregnancy. In second pregnancy, the
infant has neonatal sepsis. Right before delivery, she is
administered antibiotics. What is the reason?
a. UTI in current pregnancy
b. GBS infection in previous pregnancy
c. Infection of second child

75) Patient had bladder cancer. The mass is removed and BCG
vaccine is administered into the bladder. What is the purpose of
this?
a. Increases cell mediated immunity
b. Improves wound healing
c. Kills remaining cancerous cells

76) Patient had heavy menstrual bleeding. Where is the most

appropriate drug absorbed in the body?
a. Skin
b. Stomach
c. Colon
d. Duodenum
e. Jejunum
f. Ileum

77) Pathogenesis of BPH? Hormonal stimulation.

78) Features of PNH (symptoms given). Absence of GPI on

RBCs on further testing. Patient had a hx of splenectomy from a
motor vehicle accident. Vaccination againt which pathogen
would you consider before starting the appropriate treatment for
PNH? Vaccinate patients undergoing
a. Strep pneumoniae
b. H.influenza
splenectomy or with splenic
c. Neisseria meningitidis dysfunction against encapsulated
d. Hepatitis B organisms (pneumococci, Hib,
e. HPV meningococci)

79)Symptoms of intermittent claudication due to peripheral

artery disease. What is the drug of choice?
a. COX inhibitor
b. Gp IIb-IIIa inhibitor
c. PDE inhibitor
d. Xa Inhibitor

80) Arrow question estrogen dec

Hormone levels of FSH, LH, estrogen, progesterone after fsh inc
menopause? lh inc

81) Kid with perianal pruritus. Pathogen? Enterobius

82)

a) Ancylostoma

83)
 a) Treatment A the, was
treatment
as
were.
the
(g.
is aus
b) Treatment B n o came
but

c) No treatment

84) A table was given with AUC for oral and IV administration
of several different drugs. Had to determine the correct
Auc
statement oal
An IV

the value all

V
Du 20% 80
W
40
100 not feel
excit

i justwa n t give
to

you an
Idea.
85) Conjunctival injection, myalgias. Had some renal issues as
well. What will you find in history?
a) Swimming in water

86) Alcohol use disorder

87) Anti kell
88) pelvic ischemia
89)Astraunaut arrows
&
90)chemotherapy induced nausea- NK1 antagonist (5At-1 antagonist
91)Straph saprophytic (2questions) 511.3againene
93)pin point heroin
94)germ cell tumour & histo picture
was
given.
-> one
Goss one

95)redness and erythema- histamine and bradykinin

96)first mediator in laceration smth- histamine
97)habituation
98)what channels involved in cystic fibrosis- one option with
apical Cl written
99 and 100)
 -
in aus wer
Beg was
of cans-
-
mode
they asked for
mission.

101)aspirin induced asthma and nasal polyps mentioned

Leukotreine antagonist

102)benzocaine- methemoglobemia
103)

104)

105) When asked about his medication of a patient you have

been treating for the last 5 years he gets angry and says “of
course You don't remember me, i always have to repeat my med
list”. What do you say?
-sorry, it is required
-it helps me understand your health better ~
-of course i remember you, i have taken care of you for 5 years -
i like to be as thorough as possible

106)Meckel’s diverticulum, they said they did techenium scan

 refer smbryological
in
DocentMajutai
and found
↑what
gastric mucosa t, answer choice was malrotaiton, improper
or

placement, remnant of yolk sac,-

-i chose malrotation
- one because
yolk sac remnant is urachus. Meckel’s is vetilline duct
⑦

107)BRCA gene mutation= Incomplete penetrance

108) alcohol use, Nystagmus, ataxia and confusion = thiamine

deficiency

110). child had whitish/silver eye lashes and no skin color, asked
what is the
defect or deficiency: answer tyrosinase

111)Couple brings 9 month child in because he wont stop

crying. They ran
in the room because they heard a thump. Child also has
scratches all over stomach and trunk that they said the cat did.
Mother didn’t do prenatal care. The couple is vague about some
other questions. It is found that patient has a fracture. Answer:
Child abuse

112)man had e.coli infection and they asked where can you get
it from, answer: uncooked beef
113)Isotretinoin - craniocaudal
114) Sarcoidosis CV given. Asked for mediator for following
histology findings.
a) Inf gamma
115) Cv of allergic (runny nose, red teary eyes etc) findings
given. No known allergies. What medication to give?
Histamine receptor blockers
116) Asthma patient taking inhalant albuterol n budenosinide ;
taste alteration like metallic taste n cottage chese like in mouth,,
white plaques on buccal mucosa tongue having erthyamteous
base.. Nothing about scraping was mentioned in stem.
Options A. Due to budiesonide B. Cigarettes

117) A Women has Cervical Mass. Asking organism? Ans is

HPV

118) Acute cholangitis case, classic triad explained , stone

lodged where>? Cystic duct , common bile duct, right hepatic,,
(A)
intra hepatic

119)Kenya patient with terminal hematuria, cause is

S.hematobium

120)ADHD very very long Case,, asked drug which will target
what ? GABA, serotonin,Glutamine, Dopamine (NE not
mentioned in options)

122)Long CV: inguinal hernia repair done then saying that

poorly Healed incision with draining fluid is seen saying what is
defective? Collagen , fibrillin, elastin , laminin

123)Acute pericarditis CV explained. Pain increases on lying

down....you will look for what? Rub , murmer , click , S3 , S4

124)CV about tricuspid regurgitation, giant v wave , lung clear

to auscultation, pedal edema , mild JVP Increase ? What will
you find ? S3, S4 , accentuation of S2 , Delayed carotid Pulse.
Do Confirm A. left sided S3 B. accentuation of 2nd part of S2

125). Narcissistic case, in the I read that he is saying that he is

always on the top ...must be the best...asking about other
finding? Envious of others is right answer..

126)A patients comes with 3 hours history of nausea vomiting ,

watery diarrhea....only one options for watery diarrhea was there
bacillus cereus other options were related to bloody diarrhea

127) ATN due to hypovolemic shock ...long CV ... then asking Ewanit
what will be found? Pigment granular cast.
-ii.Wie optionat the
128). Another ATN due to something else I don’t recall... then making
sense.
asking what will be find in tubule?
Sloughing of epithelium

129)Seizure history...asking about state of action potential. PQ

Na channel spending less time in inactivated state

130)Basal cell carcinoma case: pic was given, patient has rolled
mentioned
in border clear cut...he was farmer. also
they
pink, pearly etc.
It is due to ? Age, occupation, ethnicity

131)Endothelium attached to smooth muscle causes

vasodilation, endothelium scrapped off caused vasoconstriction
due to which mediator? Nitric oxide

132)
133) 1 month old infant came with complain of non bilious basically
vomiting for 1 week and 2cm mobile palpable mass on right georis
war
upper quadrant, baby has passed stool once in two days and Lane

stool color is yellow, what is the cause? given.

a) Smooth muscle cell hyperplasia b) Malrotation c) Myenteric
plexus absent

134)CV of SNHL, has to vestibulocochlear nerve identify nerve

on brain autopsy.

135)CV of homonymous hemianopia, has to identify artery

damaged on brain autopsy. Right and left both sides were
marked.

136) 2 questions on ventricle dilation.

Ek me substanstia nigra was seen so marked lateral and third
ventricles.
Second was I guess foreman of monro so marked lateral
ventricles

137)Thrombophlebitis CV. Asked for origin of cancer.

Marked pancreas

138)
 varice dilation
a duction on
obstruction
Right Bencher
3)Alilris-
Y
e
to
after came
-> Butunion aveness t -
breath sauc
lower lobe.
in light

toxic myopathy
Polymyon
us
u) It by sequte
mule
poxima
weaken
wok
Histay
2
d taking
unl
state
-

atovastatin
back.
2
I -
musucess
stu space in

both
↓
audible at
Live
mentioned
middovilull
(u)
white
showing
pecies given
Picture of
active.
I infections/seate
vericht.
rement mentioned
in

not where?
(painlpainces damant
Sewaim
vinu seve
Pliphead
L

-
8) Deetinwouldbeans Iyetre
what? in
dee
a) collagen b) Elastin -) fibrillin
A.

B) mentioned of Implenza vine

stain.
year's
-

compared to last
-

was different.
· Lemairgin genome
drift.
cause
undering gee
e drift

a wn
via I/

1/
// gleift
vines
virus
I
1/ sligt.

pia
ol aut save

given. asked.
organism
Didn't reacte
Wide CU.

Preumauptic
pivousei
is Efficacy potty
vs were.

a given.
Inhibitor
against
(2) keloid TGA B
what?
-

7 en
I
what
B Asked God amen
and to
iS
overall patient satisfaction- -

medium) mode d) ptest. 2) I-test

a) mean by

re
in a

in
separate
MENDA pheochsomotor
is -
diagnosis of
Asked for symphon
Hyperthyroidism
mule. givedas.comme
1) Thyard,
in polodution antibodice
against
A also
hand

option
↑ SASceptor. given.
picente
mutation.
lovemutation of gene
holding
t
iD tractivative
->

EF2.
 work
wel evenness. pt.can't
18] 51 on

his toes.
where finding positive.
other

SLR+ve to hypercapnia
Deport
1)
->
WREM

mode
ocam is
an block
e
20) were
making
not
same.

synaptic test.
other options
⑯ We in
envious of others.
personality
->
anostic
rancissitic
all way
to diagnose
2) Definative
nervose? weight
gaining
of
fear Where
is the

i ammenace.
Allte git
issue?
hypothalamu
picture of asite
weseethe
webbed
24
in

wate
& they
of
consation chromosome.
ore
missing obstruction.
astctinal Becamin Ave,
vimentin tre

metam spindle
cres.

25)
becomysascome
cu Inclina, c-peptite
Insulinome diagnosis

⑭ -

came
Ex=
of
blause we
in next child.
carrier.

orlinkedseenintheener
women was

26 discare

carrier. mutation?
asked fa
TTP cave.
21) ADAMYS13
fathoman
Wild a

your
450
28) covered -

O2-werybeigt
normal
&4 - >

mentation
exception
ro2
developed covinfection.
worker it
when

Drain
be given
a) should inhibitor
metae
DNA POL
crystals
so positivebilling,
calcium pyrophosphate.
I
·on
given
j
shaded
in av
t
area was

occluded.
Invasive device
calinome
cerical trauma vs

62)3swprgnant woman

discharge.
bleeding.
i post cited
evix was somewhat
effaced condett,
i ↓water in option.
also
PROM was

seizure.
with

3, care of baby seizure

peculiar
ama
before
mask on
starts.
And to
seizure
diagram
the origam of
alcohol
caved
34) Bladder
RR:4 were them
& Nonsmoker
smokers

Iseparated !0 - vesant?
this
RR + 1 to

Megan
amazingenterscience
 35CREST
Edommpteendie described
Asked visto? answer
for was
wall south
the

fibrosis of
mein war table
35) Ka a

a iling
31) very simple it.
could Damon the
given. conserval
Jailer of