1.

A girl was applying red pepper to reef fish for sometime then she started feeling numbness in
her hands. What is the cause?
 Substance p
 Acetylcholine
 Bradykinin
 Serotonin
2. 14M came for sports evaluation. He said he is interested in boys but not sexually active. Vitals
normal. Most appropriate for physician to ask at this event is?
 Vaccinations
3. Patient has blood in urine and flank pain. Radio image showed flank mass.
 Renal cell carcnimoa
 Urothelial carcinoma
4. Patient from ohio has difficulty in breathing and cough. Image showed lesion in upper lung lobe.
Mesothelin +ve
 Berryliosis
 Mesothelioma
 Histoplasmosis
5. ECG sinus bradycardia
6. ECG premature ventricular contraction options were regarding causes i.e. Reenterant circuit,
multiple pulmonary vein firing centers, increase automaticity of SA and AV node
7. ECG big QRS in V4,V5,V6. Young female. Bp 160/100. Cause? Firbomuscular dysplasia of renal
artery
8. Patient has huntington symptoms. Location? Sub thallamic, caudate
9. AIRE problem: anti testicular antibodies
10. Boy collapsed at soccer field, CPR done and revived. Image given showing left ventricular
hypertrophy. Effect of valsalva maneuver on murmur? Increased
11. Baby picture given with hypotelorism. Mother looked like this too. Association?
Holoprosencephaly
12. Upper spine ct scan picture given and problem asked. I did fracture at C3.
13. Syringomyelia case patient has dec pain sensation bilaterally and reduced upper extremity
motor power. Normal position and vibration sense. MRI pic given. Where is the problem in
spinal cord? G (syrinx area in the centre)
14. Baby has been vomiting. What happen? Metabolic alkalosis
15. Baby has severe cough last night and started grunting. Cause? RSV, pneumococci, adenovirus
16. Patient has vesicular lesions in T1 dermatome. Infection from which could precipitate this? CMV,
EBV, HIV
17. Pic given of patient’s forehead, seems like psoriasis? Ans: parakeratosis
18. Pic given of basal cell carcinoma. Origin? Epidermis, dermis
19. Patient took penicillin for infection then nephrotic syndrome developed. Urine has eosinophilia?
Acute interstitial nephritis
20. Patient has struvite stone. Pressure at which site? Ureter, calyces, bladder
21. Young boy, multiple episodes of hyperkaelmia/hypokalemia (can’t remember maybe they asked
hypokalemia) and could not do exertion work. Defect? K channels, Na K ATPase, Ca channel,
Aquaporin 2 channel
22. TSH0.1 (low), T4 20(high). Which cell is effected? NK cell, neurophils,CD4 cell, CD8 cell
23. Case in which child has normal lymphocyte count by shrunken tonsils and multiple infection.
Can’t recall options
24. Which cause healing after inflammation? TGF beta
25. Patient scolded by boss. Dr is 10min late, pt shouted that if the clinic manager do work properly
this doesn’t happen. Ans: displacement
26. 10M has severe umblical pain, dr resected the area. Ans: gastric tissue (meckel diverticulum
case)
27. Old male, bph case on tamsulin. Next drug mechanism? Inhibition of conversion of testosterone
into DHT
28. Pt given heparin and developed low platelet after 5 days? Antigen antibody, splenic
sequestration, protein c deficiency
29. MHC 1 problem. Cell effected? CD8+
30. Baby has hypotonia, hepatomegaly, cadiomegaly, deficiency? Alpha glucosidase
31. Patient has HBA1C of 6.3. started on medicine which targets? Gluconeogenesis, insulin release
32. Adult patient with knee pain and aspirate pic give, showed linear needle like crystal blue colour.
Ans? Septic, crystal deposition
33. Disseminated TB. Impairment? INF gamma
34. Increased bleeding from cut and picky eater child. Deficiency? Vitamin A, vitmain B, vitamin C
35. HIV patient has diarrhea? Cyrptococcus neoformans, cryptosporidium
36. Patient has watery diarrhea with specks of stool. Reason? Spiral shaped bacteria (vibrio)
37. Patient has edema. Cause? Low albumin
38. Fungal infection? Trycophyton
39. Pt given SMX TMP for toxo. Blood has [Link] HB Deficiency? G6PD
40. Pt has hyperventilation, impending doom, worried about another episode? Panic disroder
41. Old age lady is evaluated in nursing care. 2 week ago has below knee aputation. Physical and
occupation therapist that she is progressing well. She is excited to back home and play cards
with club members. What is cause of early acceptance?
 Denial
 Onset of disability acceptance
 MDD
42. Middle choncha relation? Hiatus semilunaris, mastoid sinus, sphenoid sinus
43. Pt with post auricular tenderness? Mastoiditis
44. Pt with glucoma. What is given for relief? alpha adrenergic agonist
45. Athlete has cardiac arrest, revived on CPR and shockable rhythm. A murmur is present at left
sternal border. What is the effect of vassalva manuever on murmur? increased
46. A 16 year old girl came for evaluation for sports team selection she was using phone, dr entered
the room and greeted, she replied and again started using her phone screen. What should be
 the response? Continue examination, continue taking history, what sports are you interested in
tell me more (I guess), i will not be able to do evaluation if you keep looking at your phone.
47. 89 M, htn, dylipidemia and type 2 dm, daughter lives near his city frequently visit him, he
appears depressed. His dog died 5 week pehle and he feel alone and he said he will not be able
to keep another pet because "I'll die first and he'll be alone". Drs response: why do you think
that you'll die before him?, i can see you miss your dog, tell me more,
48. Old lady came for follow up, multiple comorbs but doing well, vitals normal. Dr suggested a new
vaccine for old age people. Lady denied that she'll not undergo vaccine because of what
happened in africa where vaccine trial was done without taking consent. Physician response?
Time has changed and it doesn't happen now, vaccine is so good that I'll hate you if you dont
take it, what have you been reading about it please tell me more so i can help you.
49. Patient scolded by boss for coming late and leaving early. Patient came to hospital and dr was 10
min late. Pt shouted if hospital managed do his work properly this will never happen. Ego
repsonse? Displacement, projection, identification.
50. An old man is going to be retired. What things can be sign of good retirement something?
Altruism, increased voluntary activity something, other options were irrelevant.
51. A 14 year old boy came for sports evaluation, he like boys but is not sexually active, no
significant hx, vitals normal. Most appropriate thing to ask at this time? Vaccination
52. An old man came with chest pain radiating to back, before chest pain he had retching and
vomiting. Radio imaging shows thin air in pericardial mediastinal fascia. Ans: lower esophgeal
rupture
53. Female baby with recurrent UTI. Imaging shows right hydroureter and calyceal [Link]?
urogenital sinus problem, uteropelvic junction
54. Ppi given. Arrows for gastrin and pepsin? Gastrin increased, pepsin decreased
55. Patient has pain at right side of left teeth and dry mouth, can open mouth easily, palpation of
submanibular gland shows peri oral pain. Fever. Dx? Sjogren, sialolithiasis, tooth abcess,
56. Baby has blue iris, nystagmus, transparency of iris? Iridobyemia, fovea, retinoblastoma
57. Picture of hemorrhoid. Answer: venous stasis
58. Elder female pt. 4ft tall, growth late as compared to brother siblings but same length as
compared to her sister at childhood. Has episodes of hypoglycemia in infancy. Ans: growth
hormone insensitivity (other options didn't make sense)
59. Patient has ptosis and eye laterally down and out. Ans: occulomotor nerve palsy
60. Case patient has low IgM and IgA.
61. Ct scan show hydrocephalus? Ans. Cerebral aqueduct stenosis
62. Holocystolic murmurmitral regurgitation
63. Trauma pt, Dyspneapleural bleb rupture case. Arrows asked= hyperresonant, breath sound
decreased, fremitus decreased
64. Indian girl with sensory loss and skin patches (case looked like lepromstous leprosy)=th2 cell
65. Dr told pt about breast lesion shown on mamography. Pt tearful asked what does this mean?
Drs response? We cannot decide it before biopsy results. Other options were not addressing pt
question
66. Wife reports came and she speak Spanish only. Husband can speak english and Spanish and
want to translate. Interpreter not available. Ans. Use telephone interpretor
67. Pt with dextrocardia, problem in concieving nad has recurrent Pulmonary infections. Cause?
Motorciliary problem
68. Asthma patient on alburterol and cortecosteroid. What to add more? Anti leukotriene
69. Pt has high hb and platelet count. Mutation? JAK 2 kinase
70. Drug given to 50, 50 pt with X disease and looked for side effects 44% pt in one group showed
side effects. 24% in 2nd group showed side effects. Relative risk? Ans. 0.54 (i guess)
71. Study conducted on dvt patients divided into 2 groups of who wear stockings and who don’t
wear and followed them for 8 years to see outcomes. Study design? cohort
72. Chinese with Nasopharyngeal lesion-EBV
73. Child fighting and eating alot. Ans: imprinting
74. Diabetic patient start healthy diet. Dr recommend. Ans. Protein intake
75. Female patient with cystic swelling in vestibule-bartholin gland
76. Cephalexin resistance cause? Altered pbp, formation for pore
77. BRCA mutation- homologous repair
78. Pt with cresenscendo decrescendo systolic murmur(aortic stenosis) cause? Bicuspid aortic valve
79. Bacteria become resistant to antibiotic by culturing with other bacteria. Ans: Transformation
80. Pt with abnormal movements and freeze suddenly. Police found him on streets. Ans:
schizophrenia with catatonia/dystonia (cant remember)
81. Ovarian lesion with brown fluid-endometrioma
82. Melanoma pic given. What define prognosis? Size of lesion, color variation, texture of lesion
83. 8M came for evaluation before dental carrier procedure. Has Pulmonary valve replacement at 6
years of age. What is the indication for giving prophylaxis? Dental carrier, history for valve
operation, no indication in this patient
84. Lymph drainage of prostate-internal iliac nodes
85. Sideroblastic anemia case
86. Hemochormatosis case
87. Intestinal polyp. Gene involved? APC
88. Herpetic whiltlow picture of fingerHSV
89. Nail pitting picture given. Cant recall qs
90. Tesitcular tumor. Biopsy and gross Pathology given. Seemed like seminoma
91. Abnormal penile curvature-tunica albugenia
92. Dupuytren contracture case- contracture of palmar fascia
93. Vaginal itchy white discharge-candida infection
94. Colon cancer, ovarian [Link] function-mismatch repair (lynch syndrome case)
95. Female with hematuria. From africa. Intermediate hostsnail
96. Young female. Murmur at left sternal border. Tumor=myxoid