48th Special BCS (Health Cadre) - Medical Science Questions (100 Marks)
Uterine contractions in labour-
Uterine contractions in true labour originate from pacemakers located near the fundal region (fundal dominance) and propagate downward across the uterus.
Component of Active management of third stage of labour (AMTSL) is-
The key components of AMTSL are administration of a uterotonic agent (Inj. Oxytocin 10 units IM within 1 minute of delivery), controlled cord traction (CCT), and uterine massage.
The largest tributaries that drain into Inferior Vena Cava is-
The three hepatic veins (right, middle, and left) are the largest tributaries draining venous blood from the liver directly into the inferior vena cava.
Genital fistula can be prevented by-
Obstetric fistula is predominantly caused by prolonged obstructed labour; providing accessible and timely Emergency Obstetric Care (EmOC) is the primary preventive measure.
Ideal graft for coronary artery bypass graft is-
The Left Internal Mammary Artery (LIMA), also called Left Internal Thoracic Artery, is the gold standard conduit for CABG due to superior long-term patency rates.
Diabetes in pregnancy should be treated by-
Insulin is the drug of choice for managing gestational diabetes and pre-gestational diabetes in pregnancy because it does not cross the placenta.
Most common cause of Epistaxis is-
Most episodes of epistaxis (nosebleeds) occur spontaneously without an identifiable systemic or structural cause, making idiopathic/local trauma the most frequent etiology.
Feature of atropinization is-
Signs of adequate atropinization (used in organophosphate poisoning) include tachycardia (heart rate > 80-100 bpm), dry axillae/mouth, dilated pupils, and clear chest sounds.
Bony metastasis may occur in-
Follicular thyroid carcinoma spreads characteristically via the bloodstream (hematogenous spread), commonly causing osteolytic bone metastases.
Part of Parasympathetic nervous system is-
The ciliary ganglion is a parasympathetic ganglion associated with the oculomotor nerve (CN III), supplying the sphincter pupillae and ciliary muscles.
Primary blood buffer system is-
The carbonic acid-bicarbonate buffer system (H₂CO₃/HCO₃⁻) is the primary and most important extracellular buffer system in whole blood.
Normal anion gap metabolic acidosis is found in-
Official key lists Chronic renal failure/RTA, but early stage renal failure or bicarbonate-loss conditions classically cause normal anion gap acidosis.
Nerve responsible for sensation of smell is
The Olfactory nerve (Cranial Nerve I) transmits special sensory information for olfaction (smell).
Plasma albumin helps in-
Albumin accounts for approximately 75-80% of plasma oncotic (colloidal osmotic) pressure, preventing fluid leakage into interstitial spaces.
Amniotic fluid embolism causes-
Amniotic fluid embolism classically presents with the triad of acute severe respiratory distress/cyanosis, cardiovascular collapse/hypotension, and DIC.
The most common type of anaemia in pregnancy is-
Iron deficiency anaemia accounts for over 90% of all cases of anaemia diagnosed during pregnancy.
The structural and functional unit of Lung is-
The alveolus is the microscopic structural and functional gas-exchanging unit of the respiratory system.
Which of the following is a compressible swelling?
Cavernous haemangiomas and vascular malformations are classically compressible because blood can be displaced out of the vascular spaces on digital pressure.
Acid-Peptic disease include-
Acid peptic diseases include GERD, gastric ulcer, duodenal ulcer, and functional (non-ulcer) dyspepsia.
First step in blood coagulation is-
Primary hemostasis starts with platelet adhesion, activation, and platelet aggregation forming the temporary platelet plug.
Bone metabolism is the primary concern of
Parathyroid hormone (PTH) directly regulates serum calcium homeostasis through bone resorption and renal reabsorption.
Antigen test for COVID-19 is featured by
Rapid Antigen Tests (RAT) for COVID-19 are inexpensive, point-of-care, and provide rapid results compared to RT-PCR.
Indication of hospitalization of a burn patient is
In pediatric patients, partial-thickness burns exceeding 10% TBSA require formal hospital admission and fluid resuscitation.
A 45-year-old man has been suffering from cirrhosis of liver due to Hepatitis B Virus; the sign of decompensation of cirrhosis is
Decompensated cirrhosis is defined by the development of clinical complications such as ascites, variceal bleeding, hepatic encephalopathy, or jaundice.
Protein is digested by
Trypsin is a pancreatic endopeptidase that hydrolyzes peptide bonds in proteins.
Megaloblastic anemia with peripheral neuropathy occur due to deficiency of
Vitamin B12 (cobalamin) deficiency causes megaloblastic anaemia along with neurological manifestations (subacute combined degeneration of the spinal cord / peripheral neuropathy).
Scabies is characterized by
The pathognomonic clinical sign of scabies infestation by Sarcoptes scabiei is the intraepidermal burrow (linear or serpiginous track).
The largest gland of human body is
The liver is the largest internal organ and the largest gland in the human body, weighing roughly 1.5 kg.
Ethambutol is rarely prescribed in children because it causes
Ethambutol can induce optic (retrobulbar) neuritis leading to decreased visual acuity and loss of red-green color discrimination, which cannot be easily monitored in young children.
The base of heart is formed mainly by
Anatomically, the base of the heart faces posteriorly and is formed predominantly by the left atrium and a small portion of the right atrium.
Multidrug resistant tuberculosis is treated by
Second-line aminoglycosides like Amikacin or Kanamycin are standard components of MDR-TB therapy regimens.
Ligature mark in typical hanging is
In hanging, the ligature mark is typically oblique, non-continuous, and located high up in the neck above the thyroid cartilage.
Causes of painless Jaundice in surgical ward is
Progressive, painless obstructive jaundice with a palpable gallbladder (Courvoisier's law) is classical for periampullary or pancreatic head carcinoma.
The following layer of digestive tract contains nerves & vessels
The submucosa contains dense connective tissue housing larger blood vessels, lymphatic vessels, and the submucosal (Meissner's) nerve plexus.
The antigen presenting cell on skin is
Langerhans cells are specialized dendritic antigen-presenting cells residing in the stratum spinosum of the epidermis.
Utero-vaginal prolapse
Symptoms of pelvic organ prolapse (dragging sensation, mass descent) typically worsen with standing, walking, and increased intra-abdominal pressure.
Viral disease that may cause thrombocytopenia is
Dengue virus infection frequently causes severe bone marrow suppression and immune-mediated destruction of platelets, producing rapid thrombocytopenia.
Which of the following antidepressants does not have any weight gain property?
Escitalopram/Fluoxetine are considered weight-neutral compared to TCAs, mirtazapine, or paroxetine.
Most activity growing area of a long bone is
The epiphyseal growth plate (epiphyseal cartilage) is the primary site of longitudinal bone growth through endochondral ossification.
Autoimmune disease includes
Acute rheumatic fever is an autoimmune response triggered by cross-reactive antibodies (molecular mimicry) following group A streptococcal pharyngitis.
Dose schedule of a drug with half life 03 hours will be
For drugs with a short elimination half-life (~3 hours), dosing intervals are typically set at 1 to 2 half-lives (e.g. every 6 hours) to maintain steady therapeutic levels.
Clinical feature of minor surgical site infection is
Superficial or minor SSI is characterized by localized erythema, mild pain, and minor serosanguinous wound discharge without systemic toxicity.
Clinical feature of raised intracranial pressure is
Cushing's triad of raised ICP consists of hypertension (with widening pulse pressure), bradycardia, and irregular/slow respirations.
Cause of maternal death in Eclampsia is
Intracranial hemorrhage (cerebral stroke/bleeding) is the single most common cause of death in women with severe preeclampsia and eclampsia.
Mycobacterium tuberculosis is stained by
Mycobacterium tuberculosis has mycolic acid in its cell wall, making it acid-fast; it is stained red by the Ziehl-Neelsen (acid-fast) staining technique.
Cephalosporin appropriate for renal impairment is
Ceftriaxone has dual biliary and renal excretion pathways; therefore, dose adjustments are usually unnecessary in mild-to-moderate renal failure.
Excess CO₂ retention in blood leads to
Hypercapnia (retention of PaCO₂ > 45 mmHg) generates carbonic acid, lowering blood pH and causing Respiratory Acidosis.
In Ectopic pregnancy
The classical presentation of ectopic pregnancy is a history of short amenorrhoea (6-8 weeks) followed by lower abdominal pain and vaginal bleeding.
Co-administration of Phenobarbital & warfarin shows
Phenobarbital is a potent hepatic microsomal CYP450 enzyme inducer; it increases warfarin metabolism, lowering anticoagulant levels and predisposing to thrombosis.
A 40-year-old man presented at Medicine OPD with recurrent haemoptysis for last 05 years; general examination revealed clubbing. Which one of the following is the most likely diagnosis
Chronic copious purulent sputum, recurrent hemoptysis, and digital clubbing in a middle-aged patient strongly point to Bronchiectasis.
Which one is derived from mesoderm?
All types of muscle tissue (skeletal, cardiac, and smooth) are embryologically derived from the mesoderm germ layer.
Secondary hypertension is caused by
Conn's syndrome (primary hyperaldosteronism) leads to excess sodium retention and potassium wasting, causing secondary hypertension.
Choice of intravenous fluid in burn patient is
Ringer's lactate / Hartmann's solution is the crystalloid fluid of choice for resuscitation in acute burns (Parkland formula).
Which one of the following is reproductive organ?
The uterus is a secondary internal female reproductive organ responsible for gestation and fetal development.
In ECG, which feature is indicative for thrombolytic therapy?
New-onset Left Bundle Branch Block (LBBB) in the presence of acute ischemic symptoms is an established STEMI-equivalent indication for immediate reperfusion/thrombolytic therapy.
Criteria of an ideal suture material is
An ideal suture material should be non-electrolytic, non-capillary, non-allergenic, non-carcinogenic, and elicit minimal tissue reaction.
Congenital malformation can be attributed to maternal infection with
Toxoplasma gondii is a classic member of the TORCH complex that crosses the placenta and causes congenital anomalies (hydrocephalus, chorioretinitis, intracranial calcifications).
Which of the following is not a feature of acute type II respiratory failure
In acute type II failure, renal compensation has not yet occurred, so serum bicarbonate (HCO₃⁻) remains normal, not increased (increased HCO₃⁻ signifies chronic compensation).
Detection of hidden disease among apparently healthy population is done by
Screening is defined as the presumptive identification of unrecognized/hidden disease or defect in apparently healthy individuals by means of rapidly applied tests.
Majority of body fluid remains in
Intracellular fluid (ICF) constitutes approximately two-thirds (~67%) of total body water.
Consent become invalid if taken from
Under law (Section 90 IPC), consent given by a person of unsound mind (insane) or under intoxication/fear of injury is legally invalid.
Feature of a malignant ulcer is
An everted (rolled-out) edge with an indurated base is the classic hallmark of a carcinomatous (malignant) ulcer.
Universally accepted indicator of health status of a population is
Infant Mortality Rate (IMR) is widely recognized as the single most sensitive universal indicator of socioeconomic development and general health care status.
Cause of acute starvation is
Accidental confinement/entrapment (such as in collapsed mines or shipwrecks) without any access to sustenance is a classic cause of acute starvation.
Which of the following is not a typical presentation of pain in acute pancreatitis?
Acute pancreatitis pain is characteristically retroperitoneal, radiating to the back and relieved by leaning forward, with physical abdominal signs often surprisingly modest compared to the severity of pain.
The most reliable clinical feature of strangulated inguinal hernia is
A sudden, irreducible, exquisitely tender, and tense swelling in the groin with loss of expansile cough impulse confirms strangulation.
Solid tumor of ovary is
Ovarian fibroma is a benign solid sex cord-stromal neoplasm composed of spindle-shaped fibroblasts producing collagen (associated with Meigs' syndrome).
Component of secondary survey in a traumatic patient is
In ATLS protocols, the secondary survey is a comprehensive head-to-toe physical evaluation and complete history (AMPLE) conducted after primary resuscitation.
Common feature to all Spondyloarthritis is
A strong genetic association with the HLA-B27 major histocompatibility antigen is shared across all seronegative spondyloarthropathies.
Fibrinolysis is done by
Fibrinolysis is mediated by the conversion of inactive plasminogen to active plasmin, which breaks down the fibrin meshwork.
Which of the following is true for wound healing by secondary intention
Healing by secondary intention occurs in infected, contaminated, or widely separated wounds through formation of abundant granulation tissue and wound contraction.
Example of probability sampling is
Stratified random sampling gives every element in the population a known, non-zero probability of selection, whereas quota, purposive, and convenience sampling are non-probability methods.
Late sign of death is
Adipocere (saponification) and mummification are late postmortem destructive changes occurring days to weeks after death.
Absolute indication of splenectomy is
Grade V splenic trauma (completely shattered spleen or hilar vascular avulsion with hemodynamic instability) is an absolute indication for emergency splenectomy.
Causative Organism responsible for Cervical cancer
High-risk Human Papillomavirus (HPV types 16 and 18) integration into host DNA causes over 90% of invasive cervical cancers.
A 35-year-old man came to you with following reports: HBsAg (-VE), Anti-HBe IgG (+VE), Anti-HBc IgM (-VE), Anti-HBs (+VE). Which scenario will match with the above mentioned reports
Presence of isolated anti-HBs indicates immunity due to vaccination. Post-natural infection would exhibit positive anti-HBc total/IgG.
In normal pregnancy
Pregnancy induces a hypercoagulable state characterized by increases in clotting factors I (fibrinogen), VII, VIII, IX, X, and XII.
The EPI vaccine given at birth is
BCG vaccine (for protection against severe childhood tuberculosis) is routinely administered intradermally at birth or first contact.
Complication of Caesarean section is
Primary postpartum hemorrhage (PPH) from uterine atony, incision extension, or placental site bleeding is a major recognized complication of cesarean delivery.
Cause of severe dysmenorrhea in an adolescent girl is
In adolescent females with severe dysmenorrhea unresponsive to NSAIDs/OCPs, secondary dysmenorrhea caused by pelvic endometriosis is the most common pathology.
Which of the following is a compelling indication of calcium channel blocker in the management of Hypertension?
Dihydropyridine CCBs are preferred first-line agents in elderly hypertensive patients and isolated systolic hypertension.
CA-125 is the tumor marker for-
Serum Cancer Antigen 125 (CA-125) is the primary tumor marker used for monitoring epithelial ovarian tumors.
Adverse drug reaction includes-
Idiosyncrasy is an abnormal, unpredicted, genetically determined adverse reaction to a drug upon initial exposure.
Irreversible sign of Vitamin-A deficiency is-
Keratomalacia (liquefactive necrosis and perforation of the cornea) causes permanent scarring and irreversible blindness.
Fever is mediated by-
Interleukin-1 (IL-1), along with TNF-alpha and IL-6, functions as an endogenous pyrogen that stimulates PGE₂ synthesis in the anterior hypothalamus.
Which of the following is a common complication of SGLT2 inhibitors?
By inducing glucosuria, SGLT-2 inhibitors (e.g., dapagliflozin, empagliflozin) increase the incidence of mycotic genital infections and UTIs.
In Bangladesh minimum recommended number of antenatal care (ANC) visit is-
The national standard guideline in Bangladesh recommends a minimum of 4 focused antenatal care (ANC) visits during uncomplicated pregnancy.
Respiratory Center is Located in-
The primary rhythmic respiratory center (dorsal and ventral respiratory groups) is located in the medulla oblongata.
Forensic radiology deals with determination of-
X-rays of epiphyseal union at various joints are the definitive forensic radiological method for age estimation in living persons and skeletal remains.
Leukocyte induced acute tissue injury is-
Neutrophilic and leukocytic infiltration with release of lysosomal enzymes directly mediates acute joint tissue injury in acute arthritis.
Oligohydramnios is severe in-
Bilateral fetal renal agenesis (Potter's syndrome) results in complete absence of fetal urine production, causing severe anhydramnios/oligohydramnios.
Which of the following drug can be used in a pregnant lady with Rheumatoid Arthritis?
Sulfasalazine (along with Hydroxychloroquine) is considered safe for continued use in pregnancy with folate supplementation, while Methotrexate and Leflunomide are strictly teratogenic.
Programmed cell death is regulated by-
The intrinsic pathway of apoptosis (programmed cell death) is regulated by mitochondrial outer membrane permeabilization and cytochrome c release.
Symptoms of mild shock is-
In early compensated (mild) shock, compensatory renal vasoconstriction conserves fluid, causing reduced urine output (oliguria) before marked blood pressure drop.
Lining of urinary tract is-
The urinary tract (renal pelvis, ureters, bladder, and proximal urethra) is lined by urothelium (Transitional epithelium).
Which of the following signs is characteristic for Stevens-Johnson syndrome?
Nikolsky's sign (epidermal sloughing upon gentle lateral mechanical pressure) is characteristically positive in Stevens-Johnson syndrome and Toxic Epidermal Necrolysis.
Indication of Circumcision-
Phimosis (inability to retract the prepuce over the glans penis) and recurrent balanoposthitis are definitive indications for therapeutic circumcision.
A 35-year-old woman presented with palpitation, excessive sweating and heat intolerance for 02 weeks; her serum FT₃ & FT₄ levels were high and TSH level was undetectable; radio iodine uptake of thyroid gland was low. The most likely diagnosis is-
Official answer key listed Graves disease, although low radioiodine uptake with thyrotoxicosis typically occurs in subacute thyroiditis or factitious thyrotoxicosis.
Cause of intrauterine death (IUD) is-
Poorly controlled maternal diabetes mellitus is a leading cause of unexplained late intrauterine fetal demise (stillbirth).
Carpal tunnel consists of-
The carpal tunnel contains the Median nerve along with 9 flexor tendons (4 FDS, 4 FDP, 1 FPL).
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