42nd Special BCS (Health Cadre) - Medical Science Questions (100 Marks)
A major sign of cardiac tamponade is
Signs of cardiac tamponade include: Raised JVP, Marked hypotension, Muffled heart sounds (Beck's triad), and Pulsus paradoxus.
Causes of short stature include following except
Klinefelter syndrome (47, XXY) is characterized by tall stature (eunuchoid proportions), whereas hypothyroidism, GH deficiency, and psychosocial deprivation cause short stature.
Bleeding time is Prolonged in
Bleeding time tests platelet function and primary hemostasis; it is prolonged in thrombocytopenia (ITP) and qualitative/factor defects like Von Willebrand disease (vWD).
A stretch reflex is
The deep tendon/myotatic stretch reflex (e.g. knee jerk) is a classic monosynaptic reflex arc mediated by muscle spindle afferents (Ia fibers) synapsing directly with alpha motor neurons.
Following cells are involved in Acute inflammation
Polymorphonuclear neutrophils are the hallmark cellular component and first-line cellular defenders in acute inflammation.
Clearance of drug depends on-
Drug clearance (CL) is mathematically related to elimination rate constant, volume of distribution, and plasma elimination half-life (t₁/₂ = 0.693 × Vd / CL).
Following muscles are involved in forceful respiration
External intercostals, scalenes, and sternocleidomastoid act in forced inspiration; internal intercostals and abdominal muscles (rectus abdominis) act in forced expiration.
Phagocytosis is promoted by
Complement fragments (C3b) promote opsonization to enhance phagocytic engulfment; HMP shunt supplies NADPH required for the respiratory burst and bacterial killing.
Pyrimidine bases are catabolised to
Unlike purine degradation which produces insoluble uric acid, pyrimidine bases (cytosine, uracil, thymine) are catabolized into highly water-soluble products: β-alanine, β-aminoisobutyrate, CO₂, and ammonia (NH₃).
In Graves disease, one would least likely expect
In primary hyperthyroidism (Graves' disease), high circulating levels of free T3/T4 exert negative feedback on the anterior pituitary, leading to suppressed (decreased/undetectable) TSH levels.
Linear growth is determined by
Growth hormone exerts its major growth-promoting longitudinal bone effects via Insulin-like Growth Factor 1 (IGF-1 / somatomedin C) acting at epiphyseal plates.
Contraindication of lumbar puncture
Raised intracranial pressure (commonly seen in head injury/space-occupying lesions) and deep uncal herniation risks are absolute contraindications to lumbar puncture.
Formation of clot is affected by
Factor IX (Christmas factor) is an essential component of the intrinsic tenase complex in the coagulation cascade; deficiency causes Hemophilia B.
Vit K
Vitamin K2 (menaquinone) is synthesized by normal bacterial microflora in the human large intestine/gut.
Extra articular manifestation of rheumatoid arthritis are
Extra-articular features of rheumatoid arthritis include rheumatoid nodules, pulmonary fibrosis, pleurisy, and bronchiolitis obliterans.
Organism that can cross placenta
Toxoplasma gondii (a protozoan parasite) is a classic TORCH organism capable of transplacental transmission, leading to congenital toxoplasmosis.
Causes of haematuria include
Genitourinary tuberculosis classically presents with sterile pyuria and microscopic or macroscopic painless hematuria.
Complete destruction of zona glomerulosa result in unable to produce
The outermost layer of the adrenal cortex, the zona glomerulosa, contains aldosterone synthase and exclusively produces mineralocorticoids (aldosterone).
Deep cervical fascia encloses
The pretracheal layer of the deep cervical fascia encloses the thyroid gland, trachea, and esophagus.
Renal control of acid base balance is a function of
The proximal convoluted tubule reabsorbs ~85-90% of filtered bicarbonate (HCO₃⁻), while the distal nephron and collecting duct secrete H⁺ ions.
Sustained elevation of cardiac output occurs in
Chronic severe anaemia reduces blood viscosity and causes compensatory peripheral vasodilation with sympathetic stimulation, resulting in a hyperdynamic high-output state.
Causes of hyperpyrexia
Severe falciparum malaria (as well as pontine hemorrhage, heat stroke, and thyroid storm) is a well-recognized cause of hyperpyrexia (core body temperature > 41.5°C).
Parasites usually cross lungs during their life cycle
Nematodes that undergo heart-lung migration include Ascaris lumbricoides, Ancylostoma duodenale, Necator americanus, and Strongyloides stercoralis (mnemonic: ASH).
Precancerous condition is
Oral leukoplakia is a clinical white patch of questionable risk that cannot be wiped off, established as a major potentially premalignant oral mucosal disorder.
Umbilical cord contains
The mature umbilical cord typically contains two umbilical arteries, one umbilical vein (carrying oxygenated blood), and remnants of the allantois/vitelline duct embedded in Wharton's jelly.
Autosomal recessive disorder
Autosomal recessive inheritance requires both mutant alleles (homozygosity); parents are typically asymptomatic heterozygous carriers (horizontal pedigree pattern).
DNA viruses are
Parvoviridae (e.g. Parvovirus B19) is a non-enveloped single-stranded DNA virus. Reovirus, Picornavirus, and Orthomyxoviruses possess RNA genomes.
In Addison’s disease, there is
Primary adrenal insufficiency (Addison's disease) causes low cortisol (leading to impaired gluconeogenesis and fasting hypoglycemia), hypotension, and hyperpigmentation.
In blood CO₂ is transported from tissue to lungs mainly as
Carbon dioxide is transported in venous blood primarily as bicarbonate ions (HCO₃⁻, ~70%), followed by carbamino compounds (~20-23%) and physically dissolved CO₂ (~7%).
Testosterone is synthesised from
Testosterone, like all steroid hormones synthesized in Leydig cells of testes and adrenal cortex, is derived from cholesterol via pregnenolone.
Which of the following organ is specially vulnerable during haemorrhagic shock
In hemorrhagic hypovolemia, sympathetic vasoconstriction shunts blood away from the splanchnic and renal circulations to preserve cerebral/coronary perfusion, rendering the kidneys highly prone to acute tubular necrosis.
Which of the followings are unencapsulated receptor
Unencapsulated sensory receptors include free nerve endings, Merkel's discs (tactile menisci), and peritrichial hair follicle endings.
In basal condition, most of the energy used by cardiac muscle from metabolism of
Under basal resting conditions, the adult myocardium derives approximately 60-70% of its ATP from the beta-oxidation of free fatty acids.
The major function of surfactant is to
Pulmonary surfactant (dipalmitoylphosphatidylcholine) reduces surface tension at the air-water interface, thereby increasing lung compliance and preventing end-expiratory atelectasis.
Spores are killed by
Bacterial endospores are killed by autoclaving (moist heat 121°C for 15-20 min), dry heat (hot air oven 160°C for 2 hours), and high-level chemical sterilants (stabilized hydrogen peroxide).
In haemolytic anemia
Intravascular and extravascular hemolysis produces increased indirect bilirubin, elevated urinary urobilinogen, reticulocytosis, elevated serum LDH, and absent/low haptoglobin.
Acute renal failure following mismatched blood transfusion is due to
ABO incompatibility produces massive acute intravascular hemolysis, causing intense reflex renal cortical vasoconstriction, circulatory shock, and intratubular obstruction by free hemoglobin casts.
The affinity of Hb for O₂ is increased by
Left-shift of the oxygen-hemoglobin dissociation curve (increased O₂ affinity) is caused by alkalosis, hypothermia, decreased 2,3-DPG, and carboxyhemoglobin formation (CO poisoning).
In aerobic exercise there is decrease in
At the initial onset of intense exercise, sympathetic splanchnic and cutaneous vasoconstriction shunts blood towards working muscles, causing transient reduction in skin temperature.
Following predispose to the development of tuberculosis
Impaired cell-mediated immunity due to protein-energy malnutrition, Vitamin D deficiency, silicosis, and HIV infection significantly predisposes to active tuberculosis reactivation.
Complication of typhoid fever is
During the 3rd week of enteric (typhoid) fever, necrosis of Peyer's patches in the terminal ileum can cause life-threatening intestinal perforation and lower GI hemorrhage.
Third aortic arch derivatives
The embryonic 3rd pharyngeal (aortic) arch gives rise to the Common Carotid Artery and the proximal part of the Internal/External Carotid arteries.
A regurgitant aortic valve in a nonfunctioning heart causes
In aortic regurgitation, retrograde blood flow into the left ventricle during diastole causes rapid runoff, collapsing peripheral pulses, and a marked reduction in diastolic blood pressure.
Insulin causes
Insulin stimulates the Na⁺/K⁺-ATPase pump, driving potassium (K⁺) from the extracellular space into the intracellular compartment (used therapeutically in acute hyperkalemia).
Vitamin K is necessary for synthesis of
Vitamin K serves as an essential cofactor for gamma-glutamyl carboxylase in the hepatic synthesis of clotting factors II (prothrombin), VII, IX, and X, as well as proteins C and S.
Causes of high ESR is
Monoclonal paraproteinemia in multiple myeloma causes dramatic erythrocyte rouleaux formation, resulting in extremely high (> 100 mm/1st hr) ESR.
Features of aortic stenosis includes
Left ventricular pressure overload and concentric hypertrophy in severe aortic stenosis produce a sustained/heaving, non-displaced apical impulse.
Polycythemia occurs in
Tissue hypoxia (high altitude, chronic cyanotic heart disease, COPD) stabilizes HIF-1α, triggering renal erythropoietin secretion and secondary polycythemia.
Medial cord of brachial plexus gives rise to
The branches of the medial cord include: Ulnar nerve, Medial cutaneous nerve of arm, Medial cutaneous nerve of forearm, Medial pectoral nerve, and the medial root of Median nerve (mnemonic: 4M & 1U).
Jaundice within 24 hrs. of age
Jaundice appearing within the first 24 hours of life is always pathological, most commonly due to hemolytic disease of the newborn (Rh/ABO incompatibility, red cell enzyme/membrane defects).
Which anti diabetic drug causes weight loss
GLP-1 receptor agonists like Liraglutide and SGLT-2 inhibitors promote significant satiety, delayed gastric emptying, and weight loss.
Cerebellar lesion causes
Cerebellar hemispheric lesions classically produce ipsilateral ataxia, dysmetria, dysdiadochokinesia, nystagmus, and an intention tremor.
Bence-Jones proteins are
Bence Jones proteins are free monoclonal immunoglobulin light chains (kappa or lambda) excreted in the urine of patients with multiple myeloma.
Axillary nerve supplies the
The axillary nerve (C5-C6) innervates the deltoid and teres minor muscles and provides sensory supply over the regimental badge area.
In secondary hypothyroidism
Secondary (central/pituitary) hypothyroidism is characterized by deficient anterior pituitary TSH secretion, resulting in both low free T4 and low (or inappropriately normal) TSH.
ECG changes in hyperkalaemia
The earliest electrocardiographic manifestation of hyperkalemia (serum K⁺ > 5.5 mEq/L) is the appearance of tall, peaked, narrow-based, symmetrical T waves.
Killed vaccine are except-
Oral Polio Vaccine (Sabin) and MMR (Measles, Mumps, Rubella) are live attenuated vaccines, whereas Salk IPV, rabies, and hepatitis A are inactivated/killed vaccines.
Continuous capillaries are found in
Continuous non-fenestrated capillaries equipped with tight intercellular junctions (claudins/occludins) constitute the anatomical basis of the blood-brain barrier in the cerebral cortex.
Antibody present in highest percentage in newborn is
Maternal Immunoglobulin G (IgG) is the only antibody class actively transported across the placenta via the neonatal Fc receptor (FcRn), comprising virtually all antibody in a neonate.
Which of the following hormones exhibits a diurnal rhythm in its secretion
Adrenocorticotropic hormone (ACTH) and cortisol exhibit classic circadian (diurnal) periodicity, peaking early in the morning (~6–8 AM) and nadiring around midnight.
In an immune mediated response, which of the following leukocytes becomes an activated macrophage.
Circulating blood monocytes extravasate into tissue spaces and differentiate into tissue-resident and activated inflammatory macrophages.
Which of the following does not have a membrane
Ribosomes and centrioles are non-membrane-bound ribonucleoprotein complexes, whereas nuclei, mitochondria, and lysosomes are enclosed by phospholipid bilayers.
The diaphragm is pierced by
The left phrenic nerve pierces the muscular left dome of the diaphragm; the sympathetic trunk passes behind the medial arcuate ligament/crura.
Excitatory cells of nervous system includes
Anterior horn alpha motor neurons generate excitatory action potentials releasing acetylcholine at neuromuscular junctions, while Purkinje cells of the cerebellum are GABAergic inhibitory neurons.
In which poisoning gastric lavage is contraindicated
Gastric lavage is strictly contraindicated in hydrocarbon (kerosene, gasoline) and corrosive acid/alkali poisoning due to high risk of chemical pneumonitis from aspiration and esophageal perforation.
Following infections are common in immunodeficient patient except
Opportunistic infections (Pneumocystis jirovecii, CMV, Candida) are hallmark infections in immunodeficient hosts, while Corynebacterium diphtheriae is a vaccine-preventable toxin-mediated infection.
ACE inhibitor are contraindicated in
ACE inhibitors are absolute teratogens (inducing fetal renal dysgenesis, oligohydramnios, skull hypoplasia) and are strictly contraindicated across all trimesters of pregnancy.
Retroperitoneal structures include
Primary retroperitoneal structures include the inferior vena cava and abdominal aorta; ascending and descending colon are secondary retroperitoneal organs.
Omega 3 essential fatty acid are
Omega-3 fatty acids include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Linoleic and arachidonic acids are omega-6 fatty acids.
Continuous capillaries gaseous exchange occurs in
Pulmonary alveolar capillaries are continuous capillaries with intact basement membranes optimized for alveolar-capillary gas exchange.
Commonest tumors of the central nervous system arise from
Gliomas (astrocytomas, glioblastomas arising from neuroglial cells) and meningiomas (arising from arachnoid cap cells of the meninges) account for the vast majority of primary intracranial tumors.
Antigen presenting cell except
Professional antigen-presenting cells (APCs) expressing MHC Class II molecules include dendritic cells, macrophages, Langerhans cells, and B lymphocytes (neutrophils are phagocytes, not professional APCs).
DNA synthesis is inhibited by
Azathioprine (converted to 6-mercaptopurine) inhibits purine nucleotide synthesis and blocks de novo DNA synthesis in proliferating lymphocytes.
Common organism for neonatal sepsis
Group B Streptococcus (Streptococcus agalactiae) and Escherichia coli are the two most common causative pathogens of early-onset neonatal sepsis.
Rickets radiology
Radiological signs of active rickets in children include cupping, splaying, fraying, and widening of the metaphysis and growth plate.
X-linked disorder is
Hemophilia A (factor VIII deficiency) and Hemophilia B (factor IX deficiency) are classic X-linked recessive genetic coagulation disorders.
Mood stabilizer is
Lithium carbonate is the established gold standard mood stabilizer for acute mania and maintenance therapy of bipolar affective disorder.
Normal saline is
Normal saline (0.9% NaCl) contains 9 g of NaCl per liter and has an osmolarity of approximately 308 mOsm/L, making it isotonic with human plasma.
Pancreatitis causes elevation of plasma
Serum lipase (and amylase) elevated at least 3-fold above the upper limit of normal confirms the laboratory diagnosis of acute pancreatitis.
Complete lesion of oculomotor nerve causes
Complete 3rd cranial nerve (oculomotor) palsy results in severe ptosis (levator palpebrae superioris paralysis), a dilated fixed pupil (mydriasis), and a 'down-and-out' eye deviation.
Avascular structures include
Enamel, cornea, hyaline articular cartilage, and the epidermis of skin are completely avascular anatomical structures.
Substance that can easily diffuse through lipid bilayer is
Small, non-polar, lipid-soluble molecules like Oxygen (O₂) and Carbon Dioxide (CO₂) diffuse rapidly and freely through the cell membrane phospholipid bilayer.
Blood brain barrier formed by
The anatomical basis of the blood-brain barrier (BBB) is formed by non-fenestrated capillary endothelial cells interconnected by continuous tight junctions and wrapped by astrocytic end-feet.
Features of CSF in pyogenic meningitis
CSF analysis in acute pyogenic meningitis demonstrates marked polymorphonuclear pleocytosis, markedly elevated protein, and very low glucose/CSF-to-plasma glucose ratio.
Major antibody content of the serum is
On serum protein electrophoresis, immunoglobulins (antibodies) migrate predominantly in the gamma-globulin (γ) fraction.
The followings are mainly intracellular parasites
Leishmania donovani amastigotes replicate obligately inside macrophages and reticuloendothelial cells in visceral leishmaniasis (kala-azar).
Following menopause there is increased secretion of
Ovarian follicular exhaustion after menopause eliminates negative feedback of estrogen and inhibin, leading to marked compensatory hypersecretion of Follicle-Stimulating Hormone (FSH).
Biochemical disturbance occurs in fulminating hepatic failure is
Acute liver failure is clinically defined by severe coagulopathy (prolongation of prothrombin time / INR ≥ 1.5) and hepatic encephalopathy within 8–24 weeks.
Which type of epithelium is found in thyroid follicles
Thyroid follicles in normal functional state are lined by simple cuboidal epithelium surrounding the central colloid lumen.
Which among the following is protozoal infection
Giardia lamblia (duodenalis) is a flagellated protozoan causing giardiasis, while Schistosoma (trematode), Wuchereria (nematode), and Echinococcus (cestode) are helminths.
Ionising radiation-following is true
Ionizing radiation can induce direct DNA double-strand breaks, radiation necrosis, microvascular endothelial injury, and secondary neoplasms in brain tissue.
Coombs' test is used for detecting
The direct and indirect antiglobulin (Coombs') tests detect autoimmune hemolytic antibodies, such as warm IgG and cold IgM agglutinins binding to RBCs.
Content of the broad ligament
The broad ligament contains the uterine tubes, round ligament of uterus, ovarian ligament, ovarian and uterine blood vessels, and nerve plexuses.
Myoepithelial cells found in
Contractile myoepithelial cells surround the acini and ducts of exocrine glands including sweat, mammary, lacrimal, and salivary (parotid) glands.
Local blood vessels are dilated due to increased concentration of
Local accumulation of interstitial potassium ions (K⁺), lactate, adenosine, and H⁺ ions during active metabolic hyperemia causes vascular smooth muscle hyperpolarization and vasodilation.
Hemorrhagic lesions may occur in
Vitamin C (ascorbic acid) deficiency impairs collagen prolyl/lysyl hydroxylation, weakening capillary walls and producing perifollicular hemorrhages, purpura, and bleeding gums (scurvy).
Structure passes through greater sciatic foramen
Structures passing through the greater sciatic foramen include the piriformis muscle, sciatic nerve, superior and inferior gluteal nerves and vessels, and pudendal nerve.
Major source of progesterone in early 8 weeks of pregnancy is
During the first 7–8 weeks of gestation, the corpus luteum of pregnancy (maintained by hCG) is the primary source of progesterone until the luteal-placental shift is complete by week 10.
In emphysema, pulmonary function test shows
Emphysema causes alveolar septal destruction and loss of elastic recoil, resulting in severe air trapping, elevated residual volume (RV), reduced FEV₁/FVC (< 0.70), and increased Total Lung Capacity (TLC).
Hot air oven is used for sterilization of
Dry heat sterilization in a hot air oven is ideal for sharp instruments (scalpels, scissors) as it does not dull sharp cutting edges unlike moist heat autoclaving.
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