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Sergio FT Professor

The document outlines various medical cases and questions related to respiratory conditions, cancers, and other health issues, including specific symptoms, diagnostic methods, and treatment options. It includes details on conditions like berylliosis, small cell carcinoma, interstitial pneumonia, asthma, and more, along with questions about histology and pharmacology. The document serves as a study guide or review for medical professionals or students preparing for exams.

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sk5358685
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0% found this document useful (0 votes)
77 views24 pages

Sergio FT Professor

The document outlines various medical cases and questions related to respiratory conditions, cancers, and other health issues, including specific symptoms, diagnostic methods, and treatment options. It includes details on conditions like berylliosis, small cell carcinoma, interstitial pneumonia, asthma, and more, along with questions about histology and pharmacology. The document serves as a study guide or review for medical professionals or students preparing for exams.

Uploaded by

sk5358685
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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7th july 2022

beryliosis occurs in upper lobes of lungs


1. Long CV… Patient come with shortness of breath in the end of CV it was written
that he was Navy Officers 36 year(only clue) , CXR given too Berryllium Expsure
2. Small Cell carcinoma case : a old male smoker presenting with cough , when you
stain histology it is neuroendocrine stained positive.
3. Classic case of usual interstitial pneumonia; fibrosis in interstitium and mainly in
subpleural region , No granuloma found case of idiopathic pulmonary fibrosis
Options: A hypersensitivity pneumositis B Usual Interstitial pneumonia. it is seen on histology pattern.
4. A middle aged person come with shortness of breath , BMI 46 , then asking
parameters?
A. FEV1 78 , FVC 84 , TLC 92 , DLCO 102
B. FEV1 84 , FVC 78 , TLC 78 , DLCO 92 (I picked this.)
5. In asthma other than bronchoconstriction,, most common cause of mortality in
asthma ; mucosal plugging in bronchial tree
6. Why DLCO for carbon monoxide is decreased in Older patient as compare to healthy
adult ; options A. V/Q mismatch B. Decreased pulmonary capillary surface areas. C
Upper trachea resistance D Increased elastin around alveoli surface/septa.
7. Asthma patient taking inhalant albuterol n budenosinide ; taste alteration like
metallic taste n cottage chese like in mouth,, white plaques on buccal mucosa n
tongue having erthyamteous base.. Nothing about scraping was mentioned in stem.
as budesonide causes oral thrush so after taking it do use a
Options A. Due to budiesonide B. Cigarettesspacer or rinse mouth after use to prevent oral thrush.
8. A person with classic symptom of allergic rhinitis.. runny nose, conjuctival injection,,
drug diven MOA asked,>? Ans; Antagonism of histamine receptors.
9. A person came with shortness of breath,, sleeping , non-medistainal
lymphadenopathy found. and very vague symptoms, taking thiazide use for
something. On endomycardial histology I saw tryanopsomas clearly visible in zoom in
figure …. Options were A Idiopathic, B viral, C parasite , D. thiazide use, E
case of trypanosoma brucei causing african sleeping sickness transmission
bacteremia ( picked C parasite ) occur through tsetse fly.
10. PQ; Maligancy Red bloody, 0.6
11. A classic case of cystic fibrosis ,, pseudomonas infection,, and other symptoms of
increased sweat chloride( had to diagnosis this)
12. A CV saying that Right axis deviation is due in pulmonary arterial HTN ( patient
developed secondary PAH from chronic heart failure )
options ; A. hypoxia induced vasoconstriction, B increased sympathetic tone of
pulmonary venules C.. increased parasympathetic tone of pulmonary venule.
13. 2 year old child with no any classy symptoms , In the end of CV written that
decreased or absent femoral pulse, asking from where or which extremities B.P
7th july 2022

measurement should be taken to have B.P measurement in normal range Option: A


Right Upper, B Left upper, C right lower, D left lower
14. S2 increased , VSD with shunt reversal recent PQ
15. Internal thoracic artery grafted, asked from which it emerges? Left subclavian artery
, Left common carotid, right branchiocephalic trunk
16. PDA repair; left recurrent laryngeal nerve PQ
17. UTI with negative nitrite PQ
18. Endocarditis after TURP PQ
19. Patient came with urethral discharge. Gram stain show no organism. Pic given
Neutrophils seen. Ans is Neiseeria Gonorrhea ( No Chlamdyia in option)

acute cholangitis
Also called
ascending
cholangitis.
Infection of biliary
tree usually due
20. A Women has Cervical Mass. Asking organism? Ans is HPV to obstruction that
leads to
21. Acute cholangitis case, classic triad explained , stone lodged where>? Cystic ductstasis/bacterial
,
overgrowth.Charc
common bile duct, right hepatic,, intra hepatic ot triad of
22. Gout patient with Peptic ulcer disease, asked drug for acute stage? MOA cholangitis
includes jaundice,
Option; Dysfunction neutrophil chemotaxis, XO inhibiors fever, RUQ
pain.Reynolds
23. Patient is having diet plan… CV says 300 carbohydrates with amino acid. What pentad is Charcot
triad plus altered
process will be increased ? mental status and
A De novo lipid synthesis, B Purine metabolism other were about protein n carbohydrates shock
(hypotension).
metabolism
24. Asthma, Wheezing, given aspirin , what other findings? Nasal polyps
7th july 2022

25. A case children with severe dehydration.. sunken fontaelles,, B.p decreased ,,, due to
what mechanism? Options increase GIT water absorption,, increased surface area
with respect to total body volume, others option were of increased water content
26. Hysterotectomy price is 4200 dollar with SD of 1000 dollar,, what will be found at
95th percentages exact line>? Options 2200,3200,5200,6200,7200 95 % means 2 SD so 1 SD equals to 1000 2
SD will be 2000 so just add 2000+4200
27. ARDs case classic in very small child,, asked caused of hypoxemia?
I marked physiological Pulmonary shunt,, there was one confusing option so when
you come across that ques , check that options,, 3 other option were easily excluded
28. Small glans penis very very small,, figure given same ques in anonymous biopsi where it is mentioned that failure
of fusion is asked so ans should be failure of urogenital folds.
asking defect? Genital tubercles , labioscrotal swelling,, paramesonephritic duct
29. Ovarian torsion case; decreased blood to ovarian vein
30. Experiment done, Oral ectoderm cells migrates and fuse with cell from
neuroectoderm : what is release from that ? Prolactin
31. Doctor wants to pierce needle anterior to SCM , through which muscle ? A
Omohyoid, B mylohyoid
32. Many drugs given,, options were related to digoxin
in the , it was said that what will be result from action of this drug is ? Inhibition of
Na-Ca cotransporter(b/c asking result),, there was option Inhibition of Na-K ATPase,
Direct inhibition
you don’t have to pick this. of
Na+/K+-ATPase.
33. Case of MI due to hypercholesterol, then drug given? Mechanism of action asked..which causes
indirect inhibition
You have to mark on figure (HMG coA – melvanote steps ) of Na+/Ca2+
34. A case of DKA was explained in CV ; what is cause of hyperkalemia in this patient?exchanger. inc
[Ca2+]i leads to
option were challenging,,, right ans is decreased NA-K Pump positive inotropy.
Stimulates vagus
35. Secondary Hyperparathyroidism F.A graph nerve which dec
HR.
36. Polypoid Mass and no organism founds in bladder? Urothelial cancer
37. Kenya patient with terminal hematuria, cause is S.hematobium
38. A Case of Parkinson Syndrome was explained ( tremor at rest, decreased facial
expression). Asked that which or the following has increased activity. On figure you
have to mark on globus pallidius externus
39. A Case of alzehimer memory loss n difficulting remembering anything, aged 65 year.
Due to: Aberrant Proteolytic Cleavage.
40. A experiment ques, alpha synuclein found,, asked where this experiment has been
done ? Substantia nigra
41. Classic CV of CJD ; asked cause ? Prion inclusion something related option
42. 65 year old with increase Prostatic Specific antigen… asked histology? I marked
increased glandular n stromal with nodular thickening.

In DKA, the combination of insulin deficiency and the


hyperglycaemiainduced hyperosmolality frequently
leads to hyperkalaemia, even though the patient may
be markedly potassiumdepleted owing to potassium
losses in the urine secondary to osmotic diuresis
[1,2]. Insulin promotes potassium entry into cells.
7th july 2022 An enlarged prostate often feels uniformly enlarged, firm and even rubbery. DRE is also
conducted to assess for prostate cancer in which nodules may be felt on the prostate. Prostate
Specific Antigen (PSA) is a marker in the blood stream that provides insight on the prostate,
specifically for cancer and growth.
43. A Class case with BPH? Asked how will prostatic look? Ans; Diffusely enlarged
Prostate and rubbery
44. Therapeutic Hyperventilation done? What would happen due to this therapy?
Cerebral vasoconstriction due to decrease CO2
45. Meningits case, increased neutrophils in CSF is due to? I marked Increase E-selectin
expression on endothelial. Other options; pericyte retraction by histamine.
46. Another meningitis case,,, 3 months of fatigue, weight loss,, then now develops
meningitis.. CSF findings were Total protein 250, glucose 14 only,,increased
granulocytes(80% lymphocytes mostly) options were CMV, Neiserria,
Mycobacterium tuberculosis
47. A trauma related patient, CT given found unconscious, temporal bone or lobe
necrosis given then asked this is caused to tearing of vessel which run through?
Options were Foramen spinosum, foramen magnum. The middle meningeal artery (MMA) normally
branches off the maxillary artery, which is an
extension of the external carotid artery. The artery will
then travel through the foramen spinosum, which is
posterolateral from the foramen ovale, to supply blood
to the dura mater.

48. A classic pic showing blood on sulcus of brain,,, CV says patient developed sudden
headache(Subarachnoid hemorrhage?
Blood accumulate where circle of wills is right answer.
49. Lateral sulcus marked,, asked part of thalamus ? Medial geniculate Nucleus

50. A 50 year patient came with different stages of ecchymosis, when asked how they
occurred, patient said I fall onto short tables and falls on wall, then asked which of
the following test will be consistent with diagnosis? 2 option which will find related
to Propioception ,, other were about different unrelated pathways,,, options 1.
Decreased sensation to vibration 2. Finger nose Test.
7th july 2022

51. Figure given, lost sensation on outer thigh. Basically ques was about Meralgia
Paraesthetica. Asked Risk Factor. Ans is Obesity
lateral cutaneous branch of femoral nerve will be affected.

52.
53. Long CV,, in middle of ques,, experiment done for partial nictonic agnonist,,, basically
Partial nAChR agonists have been studied since they seem to be helpful in smoking
asking for varencilcine cessation. The partial agonists are believed to bind to the nAChRs and stimulate the
54. Paclitaxel; tubulin is target release of dopamine in smaller portions than the agonists and therefore compensate for
the absence of nicotine.
55. Long CV, at the end written k gram positive lacent shaped dipplococci,, Drug MOA?
An enzyme that catalyzes a nucleophilic carbonyl substitution reaction necessary for
Transpeptidase cross-linkage of bacterial cell wall peptidoglycan.
56. ADHD very very long Case,, asked drug which will target what ? GABA, serotonin,
Glutamine, Dopamine
57. Avoidant Personality disorder Case, Patient is alone doing in college, he doesn’t have
any friend, but says I will make some friends someday. Patient appears restricted.
58. Altriusm Famous PQ
59. Denial Famous PQ
60. A very long ,, patients is worried about upcoming graduation n wedding,,, previously
patient has lateny of 20min to fall asleep.. now has latency for 60-90mins to fall
asleep,,, patient sleep through the cycle normally,,worried ? asked diagnosis Options
Normal response to response , Insomina disorder, Disruptive disregulated Mood
disorder ,, option one option was easily ruled out
61. A long CV in which patient has multiple episodes of delusion hallucination,, asked it
due to ? I marked increased activity in mesolimbic pathway ,, purely positive
symptoms in CV
7th july 2022

62. Factitious disorder case,, patient is putting pressure on doctor to do multiple biopsy
for some cancer,, willing to undergo various painful biopsy…. She was an health
worker
63. Conversion disorder case; Patient developed blurry vision after hearing that his son
has been affected in some pandemic disorders, All examinations were normal
64. Very long cv of anoria nervosa ,, in the whole cv it was said about multiple drugs,, at
last patient was infused with something,, then she developed hypophosphatemia,
hypokalemia,, basically saying all parameters decreased. Diagnosis is Refeeding
Syndrome.
65. Taking monoamine oxidase inhibitor, asking what will happen after this therapy?
Options were: Increased uptake, increase VOMT, decreased degradation by synthetic
Nonselective MAO inhibition which causes inc
neuron, increased norepinephrine synthesis by adrenal medulla. levels of amine neurotransmitters
(norepinephrine, 5-HT, dopamine).
66. A long CV of Narcolepsy: cataplexy was given in simple words like loss of muscle tone
following strong emotional stimulus) then asked what will be necessary to make
history ? Options : Abdominal pain, dizziness , daytime somelence
67. One ques from Gbob solved was about antidepressants discontinuation syndrome..
in CV there were symptom liked increase Electric chock sensations ….other options :
neuroleptic malignant syndrome
68. A very long of Tuberculosis…in middle of CV there was CD count was 150 ml …then
PPT test done ; it was non-conclusive…asked why? Option were: decrease CD4 cells…
BCG vaccination…
69. SSRI taking , 2 weeks later ? Are you having concern about this drug PQ
70. Lithium toxicity: nephrogenic DI case PQ
71. Mother taking Polysubstance is pregnant. At present 16th weeks of gestation she is
on nicotine patch …then fetus develop; ilea atresia, limb reduction and procephalon
cyst…asked due to what? Cocaine, caffeine , opioid. I marked Cocaine b/c
vasoconstrictor. Look for nicotine patch option. May be I miss that option
72. Opioid Intoxication case…dose was 1 hour ago…respiratory rate 4 only….asking
parameters:
A; pH: 7.25, PaCO2 60 mmHg, HCO3 24 marked A b/c dose was 1 hour ago, there no
metabolic compensation has happened.
B; pH 7.30, PaCO2 60 mmHg, HCO3 31
73. Brain figure showing holoprosencephaly and CV saying cleft palate ? Asking gene:
SHH gene
74. Fetus was born that polydraminos and classic presentation of clubfoot asking defect
due to : deformation
75. Abdominal pain , dermatitis, corn based diet ? Which vitamin Niacin N3
7th july 2022
Ascorbic acid facilitates iron absorption by forming a chelate with ferric iron at acid pH that remains soluble at the
alkaline pH of the duodenum.
76. A patient having menopausal bleed. CV mentions that iron supplements was
given…then asking that micronutrients given…which help in which step ? Synthesis of
collagen b/c vit c increase iron absorption, other options include various steps
covered by vitamins
77. Experimental question: A drug given before phenylephrine, decreased 25% dose
response even after increased phenylephrine dose? Due to inverse agnosim of
alpha1, competitive antagonism of alpha 1, allosteric activator of alpha1. (I marked
inverse agonism of alpha1)
78. Experimental question: non virion vs virion …virion has increased uptake of DNA in
cell. Researcher who is doing experiment continuing study in non virion b/c of what?
two confusing options: decrease plasma membrane destruction , decrease
insertational mutagenes(marked this)
79. ACE inhibitors: Decreased B.P , Increase Creatinine , Increase K
80. ACE inhibitors: Increase Renin , Decrease Aldosterone, decrease Angiotensin II
81. G6PD Deficiency: Reduced NADPH, Reduced Glutathione and Present Sulfhydryl
group
82. Hypovolemic Shock classic case : Decreased Preload , Increased SVR
83. Another Hypovolemic Shock : Decrease Pulse pressure, Decrease CVP , increased SVR
84. 6 Membrane receptor with ATP : transport of solute across membrance
85. First serology tier, case of Lyme disease saying what should be plated at ELISA plate ?
IgM from diseased(marked this) , IgG from diseased, IgM from control , IgG from
control , something other options was there
86. Mother comes to doctor and says that vaccine are not important or I don’t want my
child to be vaccinated…and also she says that my child has not be diagnosed with
vaccine preventable disease. What is correct for this scenario? Underdiagnosed
may be this but not confirmed
vaccine illness(marked this) , herd immunity, eradication of vaccine related disease.
if there is any past
history of radiotherapy
87. Long CV says that dilation of all chamber of heart.Distant silhouette.
or indirectly cancer
treatment history then
Options: Amyloidosis, radiation fibrosis, endomycardial fibrosis , rheumatic fever …..CV
answer should be include no any concern for any related option. Ans should be Rheumatic fever leading to
radiation fibrosis otherwise
it is rheumatic fever. Myocaridits. Do Confirm
88. Ischemic colitis case explained : risk factor , Patent foramen ovale , Atrial fibrillation,
HTN
89. A ECG was given…. It was looking like Ist AV block to me …then very vague symptoms
like shorts of breath… drug given, where will it act? AV Node , His Bundle , right
bundle , left bundle
90. 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
7th july 2022

91. Cut incision on hand, which of the following will be first step? Platelet aggregation,
reepithelization , fibrin deposit, mononuclear infiltrate
92. CV says that hypopigmented area on back and cardiac rhabhyoma histology was
Hamartomas in CNS and skin,
given, basically case of Tuberous sclerosis asking gene? TSC angiofibromas
C , mitral regurgitation, ash-leaf spots
93. Pancreas tail carcinoma , asking which vein will drain ? Spleen vein D, cardiac rhabdomyoma, intellectual
disability, renal angiomyolipoma E ,
94. Long CV of hepatic cirrhosis, capsut Medusa.Asking for collateral ? seizures, shagreen patches.
Paraumbilical vein and superficial epigastric vein , There was also option for
hemorrhoids collateral i.e superficial Rectal vein and inferior rectal vein…but question
was asking for capsut Medusa.
95. There was Painful mass around anus …then asked for nerve innnveration ? Pudendal
nerve b/c somatic…other options were about visceral afferents , clunial nerve
96. Patient has Epigastric tenderness , asking for pain taken by ? Celiac ganglion
97. Baby was born, his shoulder was stretched by vaginal delivery …he presented with
pronation and medial rotation, asking about muscle who’s innervation will remain
intact ? Biceps brachii, tricep brachii , deltoid , supraspinatus, infraspinatus
98. Long CV saying that decrease tricep reflex, ques was also explaining related to C7
innervation defect. Asking root C7 is ans …other options C5, C6 ,C8, T1
99. CV saying that patient has multiple episode of VZV, herpes 1 n 2.. 4 years ago he also
episode of CMV something …asking what is defective in that ? Options were
segmented neutrophils, CD4 T cells , C1 complent inhibitors
100. A patient is taking emctribance and tenofovir for hepatic B ? Asking which they
Competitively inhibit nucleotide binding to
will inhibit ….I marked viral reverse transcriptase.reverse transcriptase and terminate the DNA
chain (lack a 3 OH group). Tenofovir is a
nucleoTide; the others are nucleosides. All IL-4 stimulates IgE
101. Allergic Rhinitis case explained ….now mediator needasked? IL-4,toIL,-1
to be phosphorylated be active., Tgf-B ,
production.
102. Fever followed by Maculopapular rash. Posterior auricular lymphadenopathy:
HHV-6 ….No rubella in option.
103. Long CV about dengue, retrooribtal headache, decreased platelet, arthralgia. Pic
was given of ecchymosis Options were CMV , Zika ,dengue….actually question ma
axillary lymphadenopathy bh tha…but I ignored b/c classic dengue case….and
chickenguyuma was not in option
104. One ques was on EBV but I forget…doable
105. Nurse received all 3 doses of hepatitis B vaccine , accidentally prick …now we will
check for what anitbodies ? Antibody against surface antigen
106. IgM positive for Hep E …Famous PQ
107. Wild berries…camper …giadria lambia
108. Acute pericarditis CV explained. Pain increases on lying down….you will look for
what? Rub , murmer , click , S3 , S4
7th july 2022

109. Cardiac tamponade classic CV , basically metastasis through cardiac tamponade


huyi …then asking k metastasis to what structure : pleura , pericardium
110. 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
111. 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 other is right answer..
112. Kallamn syndrome: diencephalon
113. Experimental question: Pressure volume looop…. Experiment done saying that
mark the point on which mitral valve closes?
114. Increased creatinine kinase and tropinin in serum: due to membrane damage
115. MI CV, RCA was stenosed saying what will be increased during reverble injury of
myocardium ? Options were Na K pump, ATP , mixed venous oxygen saturation,
Nitrix oxide
116. ROC curve , asking for most accurate. UWSA2
117. Case control case : hepatitis patients vs non hepatitis patient , check for some
incidence for 10 years…
118. Biological gradient, strength of association, plausibility(Bradford Hill criteria) Drug
association
119. Taking Ca supplement, asking where is should start exercise or not : Preparation
vs action
120. Normal palmitic acid, increased linoleic acid , increased linelenic acid : pancreatic
lipase
121. 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
122. Patient having hematuria, taking Prednisone and cyclophosphamide, basically
asking for hemorrhagic cystitis , organ involved prostate, bladder, kidney , ureter ,
uretha cyclophosphamide causes hemorrhagic cystitis and bladder cancer
(prevent with mesna).
123. Pain spilled , protective layer : stratum corneum
124. Brother diagnosed with acute leukemia: normal response to stress
125. Progresterone D graph
126. One ques was on intention to treat analysis…include all patients
7th july 2022

127. A kidney picture was there …it seemed enlarged kidneys. Ans is Hydronephrosis.

C. immitis is transmitted by spore inhalation. Spores are formed by


fragmentation of hyphae. Once inside the lungs, the spores turn into
spherules that contain endospores. The spherules subsequently rupture and
release endospores that disseminate to other organs and tissues. Each
endospore is capable of forming a new spherule.
128. Coccidomyocosis case : pneumonia like symptoms…south California , US
….spherule histo given …asking for route ? Inhalation, feco oral , direct inoculation UW 269
129. Tinea ringwom classic pic , and CV says that KOh preparion confirm diagnosis: so
also called tinea corporis. Occurs on body (usually torso). Characterized by enlarging
asking what diagnosis? Simple fungal infection erythematous, scaly rings (“ringworm”) with central clearing C . Can be
acquired from contact with infected pets or farm animals.
130. Hypocalcemia, absent thymic shadow : 2211q deletion syndrome
131. A classic pic of broad-based budding , no need to read CV : blastomycosis
132. Tinea dermatophytes in nails…drug given? Moa asked : inhibition of squalene
oxidase terbinafine

133. Classic midgut malrotation : X ray given , asked what normal process is impaired
in this patients ? Counterclockwise rotation of SMA around Midgut
134. Pompes disease: What is deposited in hepatocytes? Glycogen
135. Pompes diseases: where will accumulation occur? Lysosomes
136. Classic case of nephrotic syndrome: pedal edema given , total album 1.2
Massive proteinuria (>
3.5 g/day)
only…hepatomegaly given , increased total cholesterol? Why …due to increased
with edema,
hypoalbuminemia
hepatic synthesis, increase excretion of HDL in urine
causes inc hepatic
lipogenesis
137. PNH case: cola colorured urine in morning , increase hemosiderin. Defect?
which leads to
hypercholesterolemia
Complement inhibitors
Frothy urine with fatty 138. Case of AML, all symptoms of anemia , leukocytes deficiency, ,
casts
Associated with
hypercoagulable
thrombocytopenia, peripheral blood smear shows blast cell? Cause Is malignancy,
state due to antithrombin
III loss in urine and inc
autoimmune destruction, alloimmune destruction
risk of
infection (loss of IgGs in 139. Classic case of rheumatic arthritis …osteopenia, narrow joint spacing,
urine
and soft tissue subcutaneous nodules , very stiffness of hand in morning? Due to formation of
compromise by
edema). pannus
7th july 2022

140. Remodeling enzymes: metalloproteinase PQ


141. Hemochromatosis classic case, easy to diagnose then asking why diabetes occur
in patient ? Increased iron depostion in pancreases
142. Women with fatigue , occult blood positive , RDW increase ? Case was of Iron
Inflammation (eg, inc
IL-6) which inc hepcidin
(released by liver, binds
deficiency anemia…had to diagnosis
ferroportin on
intestinal mucosal cells
143. Anemia of chornic disease case : macrophages stores iron , ….very easy(had to
and macrophages,
thus inhibiting iron
diagnose)
transport) which dec
release of iron from
macrophages and dec
iron absorption from gut. 144. Pyruvate kinase deficiency: Decreased ATP , peripheral blood smear shows bur
Associated with Autosomal recessive. Pyruvate kinase defect burr cells are also known as
conditions such cells which dec ATP lead to rigid RBCs causes extravascular echinocytes.
as chronic infections, hemolysis. Increases levels of 2,3-BPG
neoplastic disorders, Had to diagnosis this. which dec hemoglobin affinity for O2
chronic kidney disease, .Hemolytic anemia in a newborn.
and autoimmune
diseases (eg, SLE,
145. Gamma carboxylation PQ Labs: blood smear shows burr cells.
rheumatoid arthritis).
146. A Catheter is inserted and blood oozzing out from sites? Due to deficiency of
1.plasminogen 2. platelets.
147. ADAMTS13 deficiency: abdominal pain confusion , increased LDH …. Had to
diagnosis this thrombotic thrombocytopenic purpura
148. A girl with Heavy menstrual bleed , no any familiar history …only superficial
bleeding was given ? Asking that which of the following finding will be most
consistent with history? Hemarthosis , ecchyomosis, dysmenorrhea, pelvic
case of ITP.
inflammatory diease
149. Leiomyosacroma case : gray tan area in intramural region with area of necrosis
and hemorrhagic….
150. Endemotriosis case : nodular thickening of uterosacral ligament, cyclic menstrual
pain explained in CV.. easy to diagnose
151. Skin excoriation with increase direct hyperbilirubinemia…options were hemolytic
anemia , scabies, Gilbert syndrome , cholestatsis, atopic dermatitis
152. Patient taking OCP , developing Painful nodule : Erythema Nodosym
153. Clear case showing cellulitis… I just saw pic and pick StrepA pyogenes
Destruction of platelets in spleen. Anti-GpIIb/IIIa
Endometriumlike glands/stroma outside endometrial cavity, most commonly in the ovary antibodies cause splenic macrophages
(frequently bilateral), pelvis, peritoneum (yellow-brown “powder burn” lesions [oval phagocytose platelets. May be idiopathic or 2° to
structures above and below asterisks in A ]). In ovary, appears as endometrioma (blood-filled autoimmune disorders (eg, SLE), viral illness (eg,
“chocolate cysts”). May be due to retrograde flow, metaplastic transformation of multipotent HIV, HCV), malignancy (eg, CLL), or
cells, transportation of endometrial tissue via lymphatic system. Presents with pelvic pain
(dysmenorrhea, dyspareunia, dysuria, dyschezia), abnormal uterine bleeding, infertility; normalsized uterus. drug reactions.
Treatment: NSAIDs, OCPs, progestins, GnRH agonists, danazol, laparoscopic Labs: inc megakaryocytes on bone marrow
removal. biopsy, dec platelet count.
7th july 2022

No Streptococcus aurues in option.


154. A long CV, a child has type 1 DM , antibodies against b cell …Insulin levels are
Autoimmune T-cell– below baseline…Now we gave monoclonal antibody moramumab to patient. What
mediated destruction of
cells (eg, due to presence will it do ? 1. It decrease isoantibdoies that were produced for B cell antigen, 2. It
of glutamic acid
decarboxylase antibodies) decreases presentation of antibodies on b cell antigen…options I don’t remember

properly… check of T cell related option…may by I missed that option…


155. CV says patient has allergy to peanut. now doctor is given very huge supply of
peanut to patient under supervision, basically for developing tolerance…I marked
something related to presentation of antigen concerning options( CD40L expression
something)
156. Earliest changes in female? She was at 8 year…Breast development
157. Increased CA+2 n pO4+ due to what? 25-dehydrocholesferol(Only Vitamin D
related option)
158. Young adult comes with history of trauma then he develop tissue injuries swollen
erythematous. Fever is 100F. ESR and CRP was raised.. X ray shows lytic bone lesion
with rim of sclerotic bone… options : 1. Staphycoccal osteomyelitis , 2.
Osteosarcoma…other options were easily ruled out. for osteomylitis we commonly prefer MRI.so answer can be
osteosarcoma here.

159. A patients comes with symptoms of hyperthyroidism. In the last patient was
given propanol then asking another drug we will add, what is mechanism of action of
that drug ? Options 1. Inhibition of thyroglobulin hydrolysis 2.inhibition of 5-
deiodoniase 3. inhibtion of the iron..4. inactivation of TSH 5. Inhibition of 3 deamiase
gamaa Carboxylation something.
160. Classic history of whorled pattern given …no need to read the case…Meningioma
161. Very very Long CV. Patient has exposure of Pet dogs… CV also explain that he has
not had exposure to Cats…comes with symptoms of ulcer at lesion site , then axillary
lymphadenopathy… options were bartonella hanselae…Francisco tularemia….I was
Propylthiouracil: Block thyroid peroxidase, inhibiting the oxidation of iodide as well as the organification and
coupling of iodine leads to inhibition of thyroid hormone synthesis. PTU also blocks 5-deiodinase
causes dec Peripheral conversion of T4 to T3.
7th july 2022

very confused b/c presentation was giving kill for Cat scratch disease… but CV clearly
says that he hasn’t exposure to cat.
in exam P50 value is 162. Mutation of cytochrome C has been been…what will be it’s effect?
mentioned if after mutation
p50 decreases then O2Increased affinity for oxygen uptake, decrease affinity for oxygen uptake, overall
affinity increases should be
increased efficacy or efficiency of ETC…other 2 options were related to ist step of ETC.
picked but if after mutation
p50 increases then O2
affinity decreases and 163. A very long CV , patient comes with 4 hour pain for left flank tenderness. He has
if there is no any p50 value
nausa vomiting…and he has not voided for while…CV explains that this person
given then pick simply decrease
affinity for oxygen uptake.
develop pyelonephritis 4 years ago…on examination left costovertebral tenderness
also given.. then asking what drug will be given at this? I thought of ureter calculi
Options: Antibiotics, thiazide diuretics, alkalization…no option related to nsaids… other
options forget
164. A mother to doctor with her baby, doctor ask that your child shoudle be given
influence vaccine…she says no b/c vaccine will make child sick … what will be your
response ? Why do you think that it will sick your child ? Very clear options.
165. Power 0.80 , P value = 0.06 ? Long CV in the end it was written
Options 1. Null hypothesis rejected , beta 0.20 , alpha 0.05
2. Null hypothesis retained, beta 0.20, alpha 0.05
165. patient comes with her husband. We doctor saw patient has different stage of
ecchyomosis, after her husband goes out of room…doctor response after intial remark ?
Options 1. I routinely come across this situation, it is normal. Do you feel safe at home? 2. Do
you feel feel to go home today ? Other options were very judgemental.. I picked 2 b/c 1 seems
like abuse is very common
166. Lumbosacral radiculopathy ques…patient has decreased sensation on lateral leg, and
difficult in planterflexion…what would be lost ? S1 radiculopathy…. Options were 1. Absent
ankle tendon reflexes 2.gastroneumics atrophy Weakness of plantar flexion
Difficulty in toe walking disc level herniation at L5-S1
dec Achilles reflex affected nerve root is S1
167. Trochanteric bursitis case … no recall…but it was easy to diagnose…other options were
very away(Same case as in UWorld) uw ques 20099
168. CMV retinitis case explained …patient is hiv positive? Drug given MoA DNA polymerase
Cidofovir: Preferentially inhibits viral DNA polymerase. this is also used in foscarnet: Viral DNA/RNA polymerase inhibitor
CMV retinitis pts with immunocompromised. and HIV reverse transcriptase inhibitor. used
169. Colomba of iris was explained. Cause is? Failure of choroid fissure. in CMV retinitis in immunocompromised
patients when ganciclovir fails;
acyclovir-resistant HSV
170. Herpes zoster case was explained.. Fluorescence was explained…excessive tearing
MECH ANISM Nonabsorbable phosphate binder that prevents phosphate absorption
…stained is due to ? Cornea, iris, anterior chamber from the GI tract.
phosphate binder drug name is sevelamer CLINIC AL USE Hyperphosphatemia in CKD.
ADVERSE EFFECTS Hypophosphatemia, GI upset.
171. Phosphate binder was given in Chronic Kidney Disease? Then asked mechanism of action
how it will decrease mortality …1. Increased absorption of Ca 2. Increase resistance to PTH on
PCT. 3. Increase PTH Decrease GI absorption of phosphate

CHARGE syndrome: Coloboma of the iris is a hole or Colobomas of the iris or ciliary body
Coloboma of eye defect of the iris of the eye. result from failures of complete
Heart defects Most colobomas are present anterior closure, while colobomas of
Atresia of choanae since birth (congenital). A cat the choroid, retina or optic nerve
Restricted growth and development eye is a type of coloboma. Any result rom failures of posterior
Genitourinary defects defect in the iris that allows light closure. Coloboma of the lens is due
Ear defects to enter the eye, other than to defective or absent development
through the pupil, is called a of the zonules in any segment.
coloboma.
7th july 2022

172. Central DI case explained…Motor vehicle collisions.. then asked about ADH and plasma
osmolarity on graph ? Had to mark on low ADH and High plasma osmolarity
173. A pic given , I saw staghorn calculi …clearly visible. asked which stone ?
Uric acid, cysteine , struvite , calcium acetate
174. Construction builder collapse : ATN …Tubular casts PQ
175. Another ATN due to hypovolemic shock …long CV … then asking what will be found?
Brown granular cast. muddy brown cast

177. Another ATN due to something else I don’t recall… then asking what will be find in tubule
? Sloughing of epithelium
178. A patent came with road traffic accident, bruise over left flank tenderness… ATN
develop….I saw Creatine kinase is 76000 very high…. Then asked why it develop? ATN due to
myoglobinuria, direct injury to kidney
179. A GERD patient explained. Drug given…patient develop hypomagnesemia…basically
mechanism of PPI on graph ? Had to mark on H-K ATPase.
180. A patient women comes is having 26 day of menses. She has unprotected sex with 10
different male partners… she took emergency contraceptive pill on 10th day of menses. What is
mechanism of action of that drug? 1. Inhibition of ovulation 2. Prevent entry of ovum due to
transport defect in fallopian tube 3.produces local informatory reaction toxic to sperm….I pick
A b/c saying pill …it is very true that “ IUD is very emergency contraception…but I didn’t pick
option of MOA of IUD…b/c pill
181. Patient came with unilateral testicular swelling… On U/S there was aneochoc cyst was
found around testis…Hydrocele case… asked due to what? Failure of obliteration of process
vaginalis …options were very away …appealing . incomplete obliteration of process vaginalis.

182. Urethralial cathetization was done…not mentioned any especial urethra…saying if


damaged where will fluid accumulate? Perineal space or pouch, peritoneal cavity, other 3
options easily excluded.
183. Pelvic organ prolapse case … CV was explaining rectocele …like she use finger in vagina to
go for washroom etc… multiple pregnancy history… several surgery …what other findings?
Cystocele…other options urethral diverticulum, skene’s duct, urachus.
Herniation of pelvic organs to or beyond the vaginal walls (anterior, posterior) or
apex. Associated
184. Lymphatic drainage of testes: Paraaortic (lumbar) with multiparity, inc age, obesity. Presents with pelvic pressure, bulging
sensation or tissue protrusion from vagina, urinary frequency, constipation,
sexual dysfunction.
Anterior compartment prolapse—bladder (cystocele). Most common type.
Posterior compartment prolapse—rectum (rectocele) or small bowel
(enterocele).
Apical compartment prolapse—uterus, cervix, or vaginal vault.
Uterine procidentia—herniation involving all 3 compartments.
7th july 2022

185. Seizure history…asking about state of action potential. PQ


Rest, inactived, activated, other options forget
186. Famous PQ uterine didephylys
187. Bladder show mucosal epithelium with normal nuclear: cytoplasm ration …options
atrophy, metaplasia, dysplasia, anaplasia. I marked metaplasia b/c only epithelium change
normally bladder epithelium is transitional only .
188. A patient come with stroke…. Treatment given basically asking for reperfusion injury is
due to?
Reactive oxygen species, Lactic acid …
189. 100% something solution used, allowed to dry by itself… not cleaned, after one month
which organism will be found ? Pair of options given …. I marked C.difficle and bacillus
cereus….other options were consisting of virus n bacteries that were not feco oral route…
kikuchi disease
190. Kluchi disease case… I did it by rule out…other options were scarlet fever, necrotizing
fasciitis, erythema infectiosum , scaphyloccal scallled syndrome. I don’t remember case …but
case was not giving kill among below written 4 options… painful cervical swollen lymph nodes in the neck, mild fever, and night
sweats. Less common symptoms include weight loss, nausea, vomiting, and
sore throat.

191. Something acetylation was done…. Experimental question? What will happen. 1. Decrease
chromatin packing 2. Increase nuclear transcription factors….I marked 1. acetylation causes decreases chromatin
packing as heterochromatin will be converted
into euchromatin so that translation can occur.
192. A patient has been diagnosed with appendicitis, in the end microscopy was done ? I saw
swollen appendix with neutrophils infiltrate, red. Factor responsible? Histamine, leukotriene ,
Thromboxane A2.
193. A patient 16 years old had trauma comes….when CT scan done …on CT there was
horseshoe kidney It is due to fusion of metonephric duct.
194. Tyrosine receptor kinase mechanism explained? Asked about which will mediate though
this? Insulin other growth factors which bind to tyrosine kinase are PDGF, EPO, EGF.
195. Adenomatous Polyp seen. Family history of colon cancer Explained. Due to? A inactivation
of beta catenin, B direction of mismatch repair APC is Negative regulator of -catenin/WNT pathway and it is associated
with familial adenomatous polyposis (colorectal carcinoma).

196. Papillary carincoma: psammoma bodies in CV


7th july 2022

197. Based on only histology. Orphan annie seen, Papillary Pattern (CV says that thyroid
excised lump found with no any lymphadenopathy) picture was somewhat similar to this

198. CV of adrenal insufficiency was explained…like hypotensive , high potassium, tanning or


hyperpigmentation? What will be decreased? Renin , Aldosterone, dopamine, ACTH , CRH
199. Double Cortex: Radial migration
200. Abdominal aoritc aneurysm repair…pain over buttocks and erectile dysfunction… pelvic
ischemia PQ
201. Erlyen Meyer deformity, defect in Cl transport? Bone resorption PQ
202. Whipple triad given classic.Tumor developed…. increased secretion from where it
secreted ? Beta cell( insulinoma)
203. A patient comes with symptoms of pheochromocytoma. Father has thyroid
cancer…patient has marfanoid habitus symptom.. what other finding will be found. ? Ans is
mucosal neuroma… other options pancreas enzymes elevation , prolactin increased, decrease
Medullary thyroid carcinoma
calcitonin. Pheochromocytoma Mucosal neuromas A (oral/intestinal
MEN 2B
ganglioneuromatosis)Associated with marfanoid habitus; mutation in
RET gene.
204. Basal cell carcinoma case: pic was given, patient has rolled in border clear cut…he was
Most common skin cancer. Found in
farmer. It is due to ? Age, occupation, ethnicity sun-exposed areas of body (eg, face). Locally
invasive, but rarely metastasizes. Waxy, pink,
Tumor of pancreatic cells which causes overproduction of insulin and leads to hypoglycemia. pearly nodules, commonly with telangiectasias,
May see Whipple triad: low blood glucose, symptoms of hypoglycemia (eg, lethargy, syncope, rolled borders A , central crusting or ulceration.
diplopia), and resolution of symptoms after normalization of plasma glucose levels. Symptomatic BCCs also appear as nonhealing ulcers with
infiltrating growth B oras a scaling plaque
patients have dec blood glucose and inc C-peptide levels (vs exogenous insulin use). 10% of cases
(superficial BCC) C . Basal cell tumors have “
associated with MEN1 syndrome. palisading” (aligned) nuclei D
Treatment: surgical resection.
galactosemia:
Absence of galactose-1-phosphate uridyltransferase. Autosomal recessive. Damage is caused by
accumulation of toxic substances (including galactitol, which accumulates in the lens of the eye).
7th july 2022 Symptoms develop when infant begins feeding (lactose present in breast milk and routine formula)
and include failure to thrive, jaundice, hepatomegaly, infantile cataracts, intellectual disability.
Can predispose to E coli sepsis in neonates.
Treatment: exclude galactose and lactose (galactose + glucose) from diet
205 Long CV , patient wants to quit smoking …he comes with wife…. Motivational
interviewing…. what will you advise? Gradually slow down smoking by day to day pill…..other
options 1. Caease it immediately 2. Tell me date when you will quiet.
206. Galactosemia case….patient develops symptoms after milk feed, jaundice , hepatomegaly,
E.coli sepsis … other options fructosuria , Maple syrup urine disease, purine metabolism
207. A young child is vegan…presenting with symptoms of megaloblastic anemia…Then asking
formation of which substance will be defective? A Homocysteine.
208. Patient has sickle cell anemia …then he taking hydroxyurea…what will be formed ? Fetal
hemoglobin homotetramer , alpha n fetal heterotertamer, beta and fetal heterotertamer. Do
correct answer is fetal
check for Fetal hemoglobin n gamma hemoglobin heterotertamer related options.hemoglobin and alpha
hetrotetramer.
209. Radiolabelled linoleic acid ; it will be incorporated into ? Thromboxane A2..Recent PQ
210. Contaminated Normal Saline : Release of Cystokines
211. Normal Mucosa PQ
212. Patient comes with symptoms of cystic fibrosis …very long CV? What other will be found
…Infertility was answer
213. Case of Kartagener syndrome….CT given.. Dextrocardia given. Heart sound on right
instead of left.. Options were confusing alpha tubulin , beta tubulin…. Do confirm
214. Murmer on 69 year old women….history doesn’t contain any specific information…
nothing was picked by me in murmer…I listened at all areas.. I picked it is due to dystrophic
calcification….non option related to normal findings etc…other options were related to MVP.
216. CD4 positive and CD8 positive ; thymus PQ
217. Acute rejection case : mononuclear infiltrate after 3 weeks…PQ
218. Mechanism of resistance of acyclovir : mutation of thymidine kinase PQ
219. Peroxisome pipecollinic acid , whole scenario of zellwger syndrome given in the end asked
hepatocytes are deficient of what? Peroxisome. PQ
220. Patient comes with blurry vision…methanol toxicity case…Increased anion gap metabolic
acidosis was explained in CV… antidote given MOA ? Inhibition of alcohol dehydrogenase
221. Endothelium attached to smooth muscle causes vasodilation, endothelium scrapped off
caused vasoconstriction due to which mediator? Nitric oxide Pq
222. P anca positive…UC diagnosis…drug ? TNF a inhibitors
7th july 2022

223. Patient was diagnosed with polydraminos after birth cyanosis…due to failure of bronchial
bud n trachea (TEF)
224. Experimental question: CV says that in absence of oxygen, microbicidal or substance from
leukocyte is formed…what is that ? Lysozyme is ans…other options was Myeloperoxidase,
Catalase , lactoferritin , defensin.
225. Scabies : web excriotaion between finger….Nurse home PQ
226. WT1 …wilms tumor , aniridia
227. Growth hormone : Rat on Treadmill
228. IGF1 resistance: IGF1 Inc, growth Inc
229. 80 year old men present with pain in upper throacic , lower lumbar area..He has
Ankllosing spondylitis history.. several year ago he was infected with syphilis. He smoke one
packet daily for 50 years…CT given ; showing crescent sign ( abdominal aortic aneurysm). Risk
factor asked for this ? Options A Due to severity of Ankllysoing spondylitis, B due to history of
syphilis C. Due to Smoked ( picked C )… CT crescent sign pic is from old nbme.
Associated with transmural (all 3 layers)
inflammation and extracellular matrix
degradation. Risk factors include tobacco use,
inc age, male sex, family history. May present as
palpable pulsatile abdominal mass (arrows in
A point to outer dilated aortic wall). Rupture
may present as triad of pulsatile abdominal
mass, acute abdominal/back pain, and
resistant hypotension. Most often infrarenal
(distribution of vasa vasorum is reduced).

230.
7th july 2022

231.

232.

233. CREST Syndrome Case. Anticentromere antibody given. Asked what is pathophysiology?
Limited scleroderma—limited skin involvement confined to fingers and face. Also with
Ans is Deposition of collagen in dermis CREST syndrome: Calcinosis cutis C , anti-Centromere antibody, Raynaud phenomenon,
Esophageal dysmotility, Sclerodactyly, and Telangiectasia. More benign clinical course.
234. Case of Achondroplasia explained. Ans; Fibroblast growth factor Failure of longitudinal bone growth (endochondral
ossification) cause short limbs. Membranous
ossification is not affected causing large head relative
to limbs. Constitutive activation of fibroblast
235. Another same case of achondroplasia. Ans; Fibroblast growth factor growth factor receptor (FGFR3) actually inhibits
chondrocyte proliferation. > 85% of mutations
occur sporadically; autosomal dominant with full
236. A case explaining alcohol use disorder. Patient has smell of alcohol on breath. ALT raised penetrance (homozygosity is lethal). Associated
with inc paternal age. Most common cause of
and gamma GGT raise? Asked what will be most consistent with this disorder? Ans is Gamma short-limbed dwarfism.

GGT raised
237. Case explaining that patient has greasy stool and increase fat in stool. Patient has cystic
fibrosis
Treatment asked? Pancreatic Enzyme supplements
Systemic sclerosis. Triad of autoimmunity, noninflammatory vasculopathy, and collagen deposition
with fibrosis. Commonly sclerosis of skin, manifesting as puffy, taut skin A without wrinkles,
fingertip pitting B . Can involve other systems, eg, renal (scleroderma renal crisis; treat with ACE
inhibitors), pulmonary (interstitial fibrosis, pulmonary HTN), GI ( dec peristalsis and LES tone causes
dysphagia, heartburn), cardiovascular. 75% female.
7th july 2022

238. Case explaining that patient is experiencing severe symptoms of anaphylaxis. Most
consistent marker?
Ans is Tryptase
239. Patient was experiencing symptoms of Esophagitis. He was also taking multiple drug like
statin, Alderonate, and many other. Asked that what drug caused that and mechanism?
Osteoclast Inactiavtion
240. Patient was taking thiazide drug. He develops muscle cramps. Asked due to? Potassium
241.

242. Avascular Necrosis of Femoral Head X-ray given. Case was also explained. Asked it is due
to interruption of which artery? Ans is Medical circumflex artery
243. Patient has Polycthemia vera symptoms like facial plethora. Hematocrit 60. CV further
explains symptoms of budd chiari syndrome. Then asked due to? JAK2 Gene mutation,
Autonomous EPO Production
7th july 2022

244. Ethics ques; patient came first time in hospital. He was lying on his belly with his hand on
it. He was very anxious. After intial remark and saying hello, what will be doctor response? A
Are you nervous b/c of first time visit B. What kind of pain you are feeling?

245. Pedigree given. It was like no father to son transmission. CV explains that many patient of
family has bilateral hearing loss. Examination shows normal external auditory meatus and
shiny tympanic membrance. Patient also had sepsis. I marked X Linked may be alport syndrome
246. Another Pedigree of X linked disorder. You have to pick option like no father to son
transmission therefore X linked.
Bother pedigree were very tough. It looked 5 minutes each to interpret. Gentics :p
247. Hidradenitis Supprativa case; Female patient has recurrent tender mass in axilla, foul
smelling, sinus tract formed
248. Patient has colon cancer. Father and grandfather has colon cancer. Sister n mother had
endometrial cancer
asking diagnosis? Lynch Syndrome
249.

250. Patient has Increased Fasting glucose. Asking why? Increased Gluconeogenesis
Other option were like decreased ketone, decrease leptin, increase insulin

251. Lipopolysachharide and Saline were mixed. Then asking which mediate will be released or
increased?
Intferon a, Interferon b, Interferon gamma, IL-1beta
7th july 2022

252. Consent from mother and assent from child wala PQ


253. Picked D

254. Experiment done, we increased arginine content on insulin, that increased packing and
decrease water content. It formed he Neutral Hagedorn. Question was on crystal clear as I
explained. Then graph given how will it work? Picked C it was decreasing blood glucose level by
7th july 2022

6 hour. I tried my best to make graph as clear as possible as it was in my exam

255. Ques based on acetycholine response and miosis. Neostigmine given? Graph given

256. Mifeprostone; Emergency contraceptive wala PQ


7th july 2022

257. Patient developed Retinblastoma. Now asked that mutation of gene(Rb gene) causes
upregulation of cycle in which phase(simply DNA synthesis puch rha tha). Ans is S phase
258. Patient has developed symptoms of celiac disease like bloating, flatulence. Then given pic
of herptiform dermatitis on shins asked? Deposition of IgA at tip of papillae.

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