1. AGS-year-old man presents with dry mouth and ‘ifficultes rising from chain climbing stairs, and Walking, His symptoms started about I year ago, are id improve with exercise. He isa 1d was recently diagnosed with lang ‘cancer, What is the most likely underlying mechanism of his weakness? 8) _ Myasthenia gravis 2 tae ate sponte weal oemee ALS @®) Polymyositis ©) Peripheral neuropathy due to chemotherapy 2. ATb-year-old male visits his gastroenterologist fora check-up one year following resection of a2-em malignant lesion in his sigmoid colon. Serum levels of which of the following can be used in this patient fest for cancer 8) Alpha-fetoprotein (AFP) 2) _Prostate-specific antigen (PSA) 2 eer ato ©) Human chorionie gonadotropin (hCG) 3. A3S-year-old woman consults her gynecologist because ‘she has a blood-tinged diseharge from one nipple. Physical ‘examination demonstrates a small, palpable, subareolar ‘tumor. The tumor is surgically resected and then pathologically examined. Which of the following features is most helpful in establishing its benign, rather than malignant, character? 2) Abnormal mitotic figures QB tosin altar %) Presence ofboth epithelial and myoepithelial cells @) Presence of papillary fronds ©) Small size of rumor 4. AS0-year-old woman presents with a rapidly enlarging ‘mass in her ovary. Biopsy reveals cells with marked pleomorphism, high mitotie activity, and extensive neerosis. What isthe most likely diagnosis? 1) Serous eystadenoma ee 4) Endometrioma ©) Granulosa cell tumor 5S. A4S-year-old woman presents to the primary care provider with an enlarged, non-tender lymph node in the left supraclavicular area she noticed two da biopsy reveals a metastatic tumor. Whi the most likely primary neoplasm? 2) Liposarcoma of retroperitoneum b) Glioblastoma ©) Fibroadenoma of breast ) Laryngeal papilloma testing reveals a mutation in the APC gene, This gene is involved in which pathway? 3) MAPK pathway b)_PISK/AKT pathway 8) Hedgehog signaling WMC:3" YEAR- BLOCK H EXAM, 12-08-2024 WOMEN MEDICAL COLLEGE, ABROTTADAD 3" YEAR MBBS, BLOCK 1 EXAM, 12-08-2024 Page 2 of 10 7. A60-year-old woman undergoes a biopsy of a S-em. lesion in the right upper lobe ofthe lung, Examina the biopsy reveals proliferation of iregularly shaped vs with obvious lumina and crowded lining cells. The de adjacent pulmonary parenchyma and vessels. Which ofthe following isthe mos likely ee d) Squamous cell carcinoma 3 Se ecin d) ERBB2 and TPS3 e) MYC and APC c) Lack of necrosis n of 0 arrest ansriptional activation 10, A'S0-year-old man with a history of working ina shipyard presents with shortness of breath and chest pain. Imaging reveals pleural thickening and masses. What is the most likely carcinogen responsible for his condition? Radon ©) Tobacco smoke @) Benzene ©) Arsenic 11, A60-year-old man is found to have a S-em right renal ‘mass on abdominal CT scan, You inform the patient that staging of this tumor is key to selecting treatment and evaluating prognosis. Which ofthe following isthe most important staging factor for this patient? 8) Histologic grade of the tumor ‘Metastases to regional lymph nodes: ) Proliferative capacity ofthe tumor cells 4) Tumor cel karyotype (aneuploidy) ©) Somatic mutations in the p$3 tumor suppressor gene 12, A42-year-old woman gives birth to a neonate with ‘multiple congenital abnormalities. Physical findings included a flat facial profile, slanted eyes, epicanthal folds, Brushfield spats, short nose, short neck, dysplastic ears, slinodactyly a large protruding tongue, and a pronounced hheart murmur. What is the most common cause ofthis, developmental birth disease? ) Chromosomal deletion ) Chromosomal translocation ©) Expansion of trinucleatide repeat 4) _ Frameshift point mutation3. The most striking example of point mutation is found in which ofthe following diseases? 8) Down's syndrome 9) Thalassaemia 4) Night blindness. ©) Myotonic dystrophy 14, A disease in which most affected children have normal parents, heterozygotes have a normal phenotype, (wo affected parents will alvays have affected children, both females are affected with equal frequency. X-linked recesi ) Autosomal dominance inheritance ©) X-linked dominant inheritance 15, ‘The parents ofa 6-month-old girl palpate a mass on the Ieft side ofthe child's abdomen. Histologic examination of the surgical specimen discloses neuroblastoma. Evaluation of the N-mye protooncozen: 1's tumor will most likely demonstrate which of the flo 8) Chromosomal translocation 'b) Exon deletion ©) Expansion ofa tinucletide repeat 4) Frameshift mutation ee Which ofthe allowing condition show an paternal transmission is? 4) Cystic fibrosis b)Friedreich’s ataxia 2) Hemophilia. 17. Which of the following cytochemical stains distinguishes rmyeloblast from lymphoblast? 8) Alkaline phosphatase D)_Mycloesterase ‘S ©) Sudan Black 18. A°50-year-old woman presents fo her physician with fatigue and a 30 Ib. weight loss. A peripheral smear and ‘bone marrow biopsy demonstrate a leukemia composed of cells in the neutrophil, eosinophil, and basophil lineages. b)emye activation ©) 8,14) 22) 18) ofthe following isthe single best test for diagnosis of iron deficiency anemia? " fevitiny ') Decreased serum iron ©) Decreased soluble serum transferin receptor 4) Decreased total iron binding capacity ©) Decreased transferin saturation WMC-3" YEAR- BLOCK H EXAM, 12-08-2024 Page 3 of 10 20, AdGyearold man has had worsening artis and ‘nga et for the pst ear On pysieat Tenino aan Ach ‘logan shows eardiomenaly and pulmonary edema erty sade show igh 13.0 gl et 391%, MCV Rater patil eunt 2800 and WDC count 89200. crn rm a mcrogram/nL with ron binding ‘capacity 440 microgram/mL and ferritin 830 ng/mL. Which atthe lowing the most ely diagnosis? 4) Detotalseia 3) Autoimmune hemlyi rea ‘Anemia of chronic disease ©) Pemicious anemia 21, Ad-year-old Caucasian female experiences prolonged ‘leeding following a tooth extraction. Her family history is significant for an uncle who suffered from an unspecified ‘bleeding disorder’. The patient's laboratory findings are: Hematocrit - 43%, Bleeding time - Prolonged, PTT ~ Prolonged, Prothrombin time - Normal, Thrombin time ~ Normal, D-dimer Normal, Which ofthe following is most likely diagnosis? 8) Vitamin K deficiency ») He A O)Siaeminecs intYavascular coagulation ) Factor XII deficiency 22, A2S-year-old recent immigrant from Afriea presents to his physician with a rapidly enlarging jaw mass, The mass is biopsied, and numerous mitotie figures and apoptotic bodies are observed on histologic exam. Which of the following genetic features is most likely present int tissue? rere 'b) Overexpression of N-MYC oncogene 6) BCR-ABL rearangement, (9:22) @) BCL2 overexpression 9) Tyrosine kinase activation 23. 20-year-old male s brought tothe BR because of fever, headache, and neck stiffaess He rapidly deteriorates and starts to bleed from the venous acces sites His blood analysis shows elevated protein and low glucose. Spinal ‘uid and blood cultures grow gram-negative diplococei, is peripheral smear would most likely show which of the following? 8) Spherocytes 'b) Schistocytes ©) Biteeells &) Targetcells ©) Teardrop cells 24. A2-year-old man presents with a history of several months of vague sbomial pin and fatigue. Physial examination reveals marked splenomegaly but no evidence of lymphadenopathy. A bone marrow biopsy shows ‘numerous atypical megakaryocytes and marked marrow fibrosis. Which ofthe following is the most likely diagnosis? 1) Acute myelogenous leukemia » Chronic lymphocytic leukemia ©) Chronic myelogenous leukemia2S. A42-yearold female it ho persistent sore threat. On physical examination, there are Several bruises on her trunk and blood is oozing from her TV venipuneture sites, Laboratory analyses typically show PTand PTT prolongation as wel as deerensed fibrinogen creased fibrin degradation products. Bone pay reveals a predominance of immature ‘myeloid cells with giant cytoplasmic granules Chromosomal analysis of these immature eels is most Tikely to reveal which ofthe following abnormalities? 1) Acute myeloblaticlevkem 1) Acute myelomonocytic leukemi ©)__Acute monocytic leukemia ©) Myelodysplastic Syndrome 36, A B8year-old male is found to have 93% HbA, 2% HBF, ‘tnd 5% IbA2 on hemoglobin electrophoresis. Which of the following isthe most ikely diagnosis? 1a) Sickle cell tat 3) _Aipha thalassemia major with Hb Bart opener ) Diabetes mellitus 31, AG8-yearold woman has had chronic lymphocytic leukemia (CLL) for 4 years without marrow failure or any need for medication. At follow up, her hemoglobin has ‘ropped to 78 gil, with other tests showing mean ‘orpuseular volume (MCV) 122 0, platelets 211x100, Iymphocytes 43 * 107, retieuloeyte count 12% Which test 1S most likely to give you the correct diagnosis? 8) Serum B12 level 1b) Marrow aspirate ©) Red eel folate evel Serum ferritin level SE TTEpcoretd man, previosly well eetvesa unit of blood on a surgical ward. Shortly after the transfusi commences you are bleeped and told that he hi ‘severe reaction (othe blood. Which of the follo ‘most common eause ofthis seenario? blood unit being given acterial infection of blood ©) Reaction to HLA antibodies Circulatory overload ©) Graft versus host disease 29, A 63-year-old man is admitted to hospital with pneumonia, His blood count shows hemoglobin 9.2 g/dl, white cell counts 14 x 10°/land platelets 23 « 1070. In his blood film there are blast cells with nucleoli and granules. ‘The most likely diagnosis is: 8) Myelodysplasia b) Acute lymphocytic leukemi ) “Acute myeloid leukemia 4) Chronic lymphocytic leukemia, ©) Myeloma 30, AS8-year-old woman is seen in the clinic for reports of severe back pain. Her chest x-ray demonstrates generalized bone demineralization and compres fracture. Blood studies demonstrate elevated calcium levels and renal insufficiency. The most likely diagnosis i a) Leuke b) Hodgkin disease Back trauma 9) Osteoporosis WMC-3"* YEAR- BLOCK H EXAM, 12-08-2024 aM 2 a 2 2 2 a 9 3. a » ° 34. a » ° a 2 35. a » 9 ’ e) 36. Membranous glomerulonepheit Page 4 of 10 Which isotopes subtype af Hodgkin imphoma is Userbar statement olen bands end rom theinode eau toencrte nodules of erate lacunar ell variant of the Reed-Strmberg, Saa‘one found. The elo infiirate may be ofthe {Sunghocyte: predominant, mized cellularity OF rer eclpleted typi easnephilia frequent jmphoeyte predominant Lymphocyte depleted Mixed eellularity Burkit’s lymphoma F ‘A27-year-old woman has dropped penicillin containing eye drops. In few minutes there appeared feeling of ‘ning, burning ofthe skin, lips and eyelids edem ‘whistling cough, deereasing of BP. What antibodies take part in the development ofthis allergie react gM and fa TgAand IgM TeM and IeD IgG and TeD ‘An experiment involving carcinoma cells grown in culture ‘studies the antitumor surveillance effects of the innate immune system, These carcinoma cells fail to express MHC class antigens. [tis observed, however, that ‘carcinoma cells are lysed in the presence of one type of immune cell that has been activated by IL-2. Which of the following immune cells is most likely to function in this manner? CDs+ lymphocyte CBF lymphocyte ‘Macrophage NKeell) Plasma cell ‘person developed an extracellular bacterial infection, ‘and [gM was made in response. What is the most predominant protective function of IgM in this infection? Aatibody-dependent cell cytotoxicity Direct lysis of bact ‘Neutralization of ba Opsonization ‘Which immune system cells primarily responsible for the formation of granuloma in the Patients with sarcoidosis of lungs? Cytotoxic T cells Dendritic cells Eosinophils ‘Natural killer cells ‘Tht cells aan autoimmune disease, characterized by widespread thickening of glomerular capillary walls. This thickening is attributed to: Deposition of antigen antibody complexes Chronic inflammation ‘Acute Inflammation Delayed type of hypersensitivity . ‘The 25 year old man is experiencing a primary infecti withthe virus. Bells activated ina primary infection secretes which class of antibody first? Tea. ID IgE IeG TeMry oth Te complains of poet tend finde dict fo mobi. Yo Tambar spine whch reported Ayperatensiy ble at he LL hd plate changes sugestiveof verte ssteomitildsetist wot stn ng erpsinsmet ely oe respon? space with vertebral 12) Pseudomonas aerugin ‘39. What bone disorder is eaused by an autosomal dominant defect in the synthesis of collagen type 1? 4) Achondroplasia b) Osteopetrosis 9) Osteomalacia ae ibrous dysplasia 40, A7-year-old man presents with persistent headache and progressive deafness. On examination he has frontal bossing ofthe forehead and conductive deafness, more severe in the right ear His serum alkaline phosphatase is significantly raised at 870 Tu/L. Which ofthe following i, the potential diagnosis? erie Osteoporosis ©) Osteomatacia &) Hyperparathyroidism ©) Multiple Myeloma 41, A.60-year-old woman presents to a physician because her ight knee is painful, swollen and red. Aspiration of the rhomboid erystals. sy composition of joint space demonstrates basop ‘Which ofthe following i the most the erystals? ) Cholesterol b) Cystine Calcium pyrophosphate Morosodfum urate ©) Struvite 42, A.30-year-old man presents to his primary care phy th right leg pain of one year's duration. The ‘worse at night but is fully relieved by aspirin. A plain radiograph reveals a focaly sclerotic expanded area of the tibial cortex, without overlying soft tissue or periosteal abnormalities, A radiolucent nidus i visible in the centre of the focal area of sclerosis. Radionuclide bone scintigraphy reveals a very prominent focal uptake of the radiotracer in the same region. What is the most likely diagnosis? 8) Ewing sarcoma 1b) Metastatic deposit ©) Brodie abscess Peete cece 43, AS2-year-old woman with muscle aches presents to the general practice. She has been experiencing this for well over year and it affects her chest and back more so than her limbs. On questioning, she alludes to having bouts on average every 3 months of becoming short of breath. She 8 a very healthy lifestyle remaining abstinent from Physical therapy 2) Speech therapy ENT 102. The only abductor of the vocal cords is: ) Lateral cricoarytenoid ) _Thyroarytenoid ©) Posterior ericoarytenoid 4) Interarytenoid ©) Cricothyroid WMC-3" YEAR- BLOCK H EXAM, 12-08-2024 ‘EYE = 4103. A 60 year old hypertensive man presented to the OPD Page 9 of 10 Complaining of sudden onset of double vision since Seuerday. On examination, visual acuity was 6/6 in both Spex The righ eye was deviated Inward, andthe patent tras unable fo turn the eye outward. Which of the Tollowing nerves is mes kel tbe involved i this patient? 5) Oculomotor nerve 1b) Trochlear nerve )_ Trigeminal nerve . & ieee acl nerve il z 104. In the context of academie writing, which of the following, actions constitutes plagiarism? iting all sources eortectly and including a reference list ) Using direct quotes with accurate citations 9) Creag ane aguent aed on exiting esearch wih lear references ©) Writing a paper that includes only original ideas and nal analysis 105, Walch principle of medica thesis concerned withthe ‘obligation to avoid causing harm to patients? 2) Beneficence as espect for Persons Justice ) Fidelity 106. Inthe context of medieal practice, which ofthe following, actions aligns withthe principle of confidentiality regarding patient information and interactions with colleagues? 18) Sharing a patient's medical details with colleagues only = when necessary forthe patient's ongoing care and with appropriate consent b) Publicly discussing a patent's case to obtain professional ‘opinions without anonymizing the patient's identity ©) Revealing a patent's health information to family members without obtaining the patient’ explicit consent 4) Using identifiable patient data for personal research purposes without securing proper authorization ©) Announcing a patent's medical condition in a public forum to promote awareness and education 107. Which option correctly describes the difference between references, citations, and bibliography? References are detailed lists, citations re in-text mentions, and bibliography is a comprehensive list of sources. 1) Citations are detailed lists, references are in-text mentions, and bibliography summarizes sources. ©) References are in-text mentions, citations are detailed lists, and bibliography includes read sources, ) Bibliography isa detailed list, references are in-text mentions, and citations are comprehensive ©) Citations are detailed lists, bibliography summarizes sources, and references are in-text mentions, 108. Which ofthe following is NOT one of the key principles of research ethics in medical studies? a) Respect for persons b) Beneficence ©) Non-maleficence Profitability. ©) Justice109. When writing a research proposal using KMU or CPSP ‘guidelines, which section is typically included to describe the ethical considerations of the study? 2) Introduction ') Literature Review 2) Ethical Arora |.A 72 year old woman comes to you in OPD. She complains of sudden onset of pain and stiffness of her shoulder and ‘upper thighs, she has generalized aches and low grade fever. Physical examination was normal, ESR=100 mm/t. ‘What is your diagnosis? 4) Dermatomyositis b) Polymyositis ©)_ Ankylosing spondylitis 111. CREST syndrome stands forall, except: 8) Caleinosis b) Sclerodactyly ©) _Telangiectasia gxant 112, Anold aged patient presented with complains of ‘generalized weakness and exertional dyspnea. His CBC shows operates ‘iter Ded De ietocrey een 3 Acusietens 3) itis meta 11a, oun boy reset youn accent ad tneraeney depen i eam epson is Stnglto pr vas DTel Pa, APES What sour dane 2) Sree Bete 3 tempi 3) Vianney 3) Muni teersy 114.2 layear mal neti cmplning of anleand nee jon pata rom test en monte aed at ‘le ele dtc. tabs show deranged i Met iy Sane oF Witon ese b) Rheumatoid arthritis. Hemechromatosis, PLS €) _ Primary sclerosing chalngtis. ORTHOPEDICS 115. Is not a benign tumor. 4D Ghontoms ©) Enchondroma 4) Osteochondroma ©) None of These 116, The most common site of osteogenic sarcoms ower end 4) femur upper end ©) Tibia lower end @) Tibia upper end ©) None of These WMC-3" YEAR- BLOCK H EXAM, 12-08-2024 Page 10 of 10 Ee 117, Which of the following is mode of inheritance of Duchene ‘muscular dystrophy? 2) Autosomal recessive ') Autosomal dominant inant ®) None ofthe above 118, Which of the following drug is use ©) Methotrexate 3) Allofthe above ‘)_ None of the above 119, Failure of which organ system is usually the eause of dea in Dachene muscular dystrophy? a) Skeletal system. ) Neurological system. ©) Cardiovascular system systems ‘©) Norte ofthe above ich of the following conveys the longest-asting, Passive immunity ‘Both (a) and (b) @) None ofthe above ©) Allofabove