FINAL PAPER2/ HP-MSD-RS

Total is 118 questions written

Anatomy
1. what is supplies by anterior interosseous nerve? pronator quadratus
2. glenoid fossa articulates with what? head of humerus
3. knee joint is what? hinge joint
4. boy has injury to shaft of humerus, has wrist drop. which nerve is most likely injured? radial nerve
5. which muscle is found in the lateral compartment of leg? peroneus brevis.
6. rami glottidis is found where? between the true vocal cords.
7. injury to the laryngeal inlet, where do you do an incision so there could be another airway? cricothyroid
membrane
8. chest tube is inserted where? 4 intercostal space, midaxillary line
9. a case about a knife to the chest where you had to write the order of layers from outer to inner in order
(all layers were not necessarily included)? External-innermost- endothoracic fascia- parietal- visceral
10. when someone has pleural effusion, where does the fluid accumalate when they’re standing?
costodiaphragmatic recess

Physiology
1. what keeps lung space open? transpulmonary pressure
2. what happens to intrapleural and alveolar pressure during inhalation? both decrease.
3. RHO-GAM has what function? binds to fetus antigen and makes it invisible to mother’s immune system.
4. what happens in a mismatches ABO blood transfusion? antibody in the recipients plasma binds to
antigen on the RBC of donor
5. where are the neurons located that have control rhythmicity of inhalation (autorythmicity)? DRG.
6. which of those contain cells that are pacemakers of breathing similar to pacemaker of heart? Pre-
Botzinger complex
7. what is inactive during during quiet breathing and active during forceful respiration? VRG
8. what doesn’t affect pulmonary function test? ethnicity.
9. what happens in HDN, there will be destruction of? RBC and IgG.
10. important coagulation factor? fibrinogen.
11. what shortens during muscle contraction? I band
12. what activates extrinsic pathway? factor 3
13. what is the most significant common between extrinsic and intrinsic factor? factor X
14. what is the activated factor at the end of both extrinsic and intrinsic pathway? factor II (thrombin)
15. what is the main stimulus of erythropoiesis? hypoxia
16. what does EPO not stimulate? CO2.

Histology
1. which of the following has a high rate of mitosis? stratum basale
2. which of the following has stem cells? stratum basale
3. which of the following has a single crypt? lingual tonsils
4. which of the following has epithelial reticular cells? thymus
5. what is found in blood air barrier? pneumoycte 1
6. what determines color of skin? amount of melanin granules present.
7. what cell in the epidermis participates in immunity? langerhans cells
8. secretion from what gland produces foul odor after exposed to bacteria? Apocrine sweat glands
Pharmacology
1. what drug do you give for acute attacks of asthma, the drug acts in 5-30 mins and works for 4-6 hours?
SABA
2. what is incorrect concerning pulse oximetry?
3. andexanet alpha is what? antidote for apixaban
4. tranexamic acid has what type of function?
5. clopidogrel MOA? it’s active metabolite binds to ADP receptors and acts as an antagonist.
6. abciximab? is a GP IIb/IIIa antagonist.
7. what is an antidote of muscle relaxants? neostigmine.
8. sugammadex binds to what? rocuronium.
9. what is not given to burn patient? succinylcholine.
10. what is used as treatment for gout by preventing conversion of hypoxanthine to uric acid? allopurinol.
11. what is the primary drug for COVID-19? remdesivir
12. what is used as treatment for G-rods? ceftazidme
13. what is the drug used for otitis media? amoxicillin clavulanate
14. what is used for pruritus? crotamiton.

Medicine
1. which is true? GORD is most common cause.
2. what is true? if a person with normal chest xray and persistent cough is known as chronic cough
3. acute chest pain with normal chest x-ray is not found in? pneumothorax.
4. right joint swelling with fever of 39°c? septic arthritis
5. MCP and PIP swelling? Rheumatoid arthritis

Community Medicine:
1. what is wrong about CO? asphyxiant and toxic at high doses
2. Regarding mycobacterial culture, all of them are true except? (it’s mentioned in the lecture)
A. highly sensitive
B. very slow growth
C. less accessible than smear
D. only test that confirms TB
E. low cost

Biochemistry
1. what’s true about PTH in kidneys? activates a1-hydroxylase in the kidneys.
2. A 10-month-old white boy is being evaluated for weakness, pallor, hemorrhages under the fingernails,
and bleeding gums. Radiographs indicate that bone near the growth plates shows reduced osteoid
formation and grossly defective collagen structure. What would be the most effective treatment for this
patient's condition?
A. Oral vitamin A
B. Oral vitamin C
C. Exclusion of dairy products from the diet
D. Oral iron supplementation
E. Growth hormone treatment
3. pyrophosphate analogue? pamidronate

Embryology
1. what is prune belly syndrome? rare disorder characterized by partial or complete absence of the stomach
(abdominal) muscles
2. which statement is true? the area where more than 2 bones meet is suture
3. what is not true stage of maturation of lung? bronchiole stage
Pathology
1. patient is on aspirin and experiences several episodes of ecchymosis and purpuric skin lesions, what is
the cause? thrombocytopathy
2. patient with hepatosplenomegaly has cbc indices Hb 8g/dl, wbc 2x10^9, and platelet 20x10^9. bone
marrow is hypercellular, biopsy showed no blast cells, what is most likely to be the cause?
hypersplenism
3. you're suspecting an 8 month child has hemophilia, what should you do next? hemophilia 8 and 9 test
and aPTT
4. female has heavy bleeding during menstruation, aPTT is 80 seconds, what is not a cause? aspirin
5. a patient has severe hemophilia what's the chance of his daughter being the carrier? 100%
6. what doesn’t lead to acute leukemia? secondary polycythemia
7. 9:22 translocation? CML
8. high grade lymphoma? Burkitt’s lymphoma
9. when does bone marrow get involved in lymphoma? stage IV.
10. 15:17 translocation? AML M3
11. patient had onset of acute chest pain, x ray showed areas of honey comb lesions, spirometry function
test showed normal fev1/fvc ratio, what is the Dx? IPF
12. patient had onset of dyspnea chest x ray showed hilar lymphadenopathy and histopathological
examination reveals blue cells that was hypernuclear, crushing pattern, what's the dx? small cell
carcinoma
13. patient had severe onset of chest pain, chest x ray revealed fibrotic pattern what's the cause ?
contraction atelectasis.
14. bronchiectasis is characterized by what? dialated bronchioles.
15. poylcythemia vera? JAK-II mutation
16. what happens in aplastic anemia? no organomegally.
17. what happens due to vitamin B12 deficiency? depression
18. a 15 year old boy has benign mass in the middle of tibia, no history of trauma, what serum level
detection helps to exclude the diagnosis? calcitonin
19. what confirms the diagnosis of nutritional rickets? ALP elevation
20. nutritional rickets? craniotabies (ortho)
21. presence of honey colored crusts and vesicles around mouth of 6 year old child, what is the most likely
cause? impetigo.
22. what is due to defect in nuclear protein? syndactyly
23. when can a person remove the braces after they’ve had a leg fracture? during consolidation
24. lesion and vesicles in subepidermal junction? bullous pemphigoid
25. first site of hematopoiesis? Yolk sac
26. which one doesn’t prolong aPTT? ITP
27. what isn’t correct about hemophilia? petechiae

Immunology
1. what is an hematopoietic stem cell marker? CD34.
2. what is not found growth factor for hematopoesis?
A. GM-CSF
B. G-CSF
C. IL-3
D. IL-4
3. HLA-A polymorphism increases risk of what? Vitiligo
4. INF-Y raised where? RA or SLE

Bioethics
1. what does no harm mean in medical bioethics?
2. all of the following can be changed about values except what?
Microbiology
1. what is true about influenza virus? influenza A is more dangerous and causes more epidemic spread
than influenza B.
2. A 32-year-old male physician developed a "flulike" syndrome with fever, sore throat, headache, and
myalgia. To provide laboratory confirmation of influenza, a culture for the virus was ordered. Which of
the following would be the best specimen for isolating the virus responsible for this infection?
A. Stool
B. Nasopharyngeal swab
C. Vesicle fluid
D. Blood
E. Saliva
3. Which of the following is important in the pathogenesis of mycoplasmal infections?
A. The peptidoglycan in the mycoplasmal cell wall
B. The presence of lacto-N-neotetraose with a terminal galactosamine as the host cell receptor
C. The structures and the interactive proteins that mediate adhesion to host cells
D. The absence of cilia on the surface of the host cells
E. Growth in an anatomic site where anaerobic organisms thrive
4. Regarding pediculosis, which one of the following is most accurate?
A. pediculosis has three types of species
B. Nits are the eggs of the louse and are typically found attached to the hair shaft.
C. Praziquantel is the drug of choice for pediculosis caused by both Pediculus and Phthirus.
D. To visualize the organism, a skin sample should be examined using the 10x obiective in a light
microscope.
E. The lesions caused by the body louse are pruritic, but the lesions caused by the pubic louse form a
painful necrotic black eschar.
5. Regarding Ebola virus, which one of the following is most accurate?
A. Skunks and raccoons are the main natural reservoirs for Ebola virus.
B. In endemic areas, most people are latently infected with Ebola virus.
C. People known to be exposed to Ebola virus should be given ganciclovir to prevent disease.
D. Ebola hemorrhagic fever occurs primarily in people with deficient cell-mediated immunity.
E. The appearance of Ebola virus in the electron microscope is that of a long thread, which often
has a curved end.
6. Yellow fever still exists in many tropical areas of the globe. Which one of the following is the best reason
yellow fever still exists?
A. Sewage disposal is inadequate in many areas.
B. Both humans and monkeys are reservoirs for yellow fever virus.
C. The virus has mutated, so the existing vaccine is no longer effective.
D. The vaccine has been withdrawn because it was found to have unacceptable side effects.
E. The people in developing countries cannot afford to take amantadine when they enter endemic
areas.
7. what serves as siderophore (binds to iron)? pyoverdine
8. child presented with ear infection, organism is a hemolysis, optochin sensitive, gram +, cocci? strep
pneumoniae
9. organism identified by nagler reaction, gram +? clostridium perfringins
10. strains were common cause of serious wound infection among military men in iraq, sustained traumatic
injuries? acintobacter baumanii
11. gram + cocci in clusters, catalse positive, coagulase positive? staph aureus
12. presence of vesicles on erythematous base is most likely due to which pathogen HSV-1.
13. HIV patient, does not take drugs, feels well, has previously taken BCG vaccine, how do you determine if
she has tb by tuberclein test? will be positive in HIV patients if more than 5mm in size
14. why does tb recur at apical segment of lung? because increased ventilation:perfusion ratio
15. HPV transmission? fomite spread
Radiology- we’re not sure about the answers
1. rotator cuff injury, had clip in his brain due to aneurysm before that led to intracranial bleeding,
investigation? CT soft tissue
2. woman had hip surgery, now has severe calf swelling and dypsnea? ct angiography
3. case of suspecting femoral neck fracture? plain radiograph (x ray)
4. swelling of joint, temp 39.7c no trauma, what is your investigation? ESR and CRP levels test.
5. presence of swollen MCP and PIP, what’s next investigation? X-ray
6. patient has swollen knee what’s, no trauma, investigation? knee joint aspiration
7. woman has severe abdominal pain, investigation? ultrasound for the abdomen
8. woman has metastases to the lung, recurrence of cancer, modality chosen? PET
9. an elderly woman has osteoporosis, was walking, then she fell down afterwards. a fracture is suspected,
what the first modality chosen? x-ray