ASIM & SHOAIB (GYNAE & OBS.) Biochemistry

3. A requirement for conversion of Glucose-1-Phosphate to Glucose-6-Phosphate a. ATP b. NAD+ c. Fructose-1, 6-bisphosphatase d. Glucose-1, 6-bisphosphatase e. Phosphoglucose isomerase pg34

14. Removal of some of Carbohydrate bound to serum proteins results in a. aggregation and precipitation b. Proteolysis by serum proteases c. Rapid excretion by kidney d. Rapid uptake and destruction by the liver e. Their becoming antigenic pg36

23. In Diabetes a. conversion of extracellular glucose to intracellular glucose-6-phosphate decreases b. glucose-6-phosphate activity increases c. glucose utilization becomes independent of blood glucose concentration d. glucose-6-phosphate activity decreases e. glycogen synthesis decreases pg38

24. Concerning pernicious anemia a. cause by an inadequate intake of vitamin B12 b. caused by inadequate intake of iron c. The gastric juice of patient is deficient in HCL and pepsin d. The hemopoietic failure is caused by overproduction of a specific glycoprotein e. Vitamin B12 is identified with intrinsic factor pg38

Gynae & Obs 15. 42 year old para 3 reported with heavy cyclic vaginal bleeding for the last 6 months. Her clinical examination was unremarkable. She had a recent D&C Histopathology showed early secretory phase endometrium. What is the best standard first line of treatment a. Anti-fibinolytic agents b. Gn Rh analogeus c. Mefenamic acid d. Danazol e. norethisterone pg41

20. Hormones or substances synthesized by the kidneys include the following except a. 1, 25 dihydroxycholecalciferol (vit D3) b. Erythropoietin c. Kinins d. Prostaglandins e. Renin pg 42 61. Drug not useful in Dysmenorrhea is a. Aspirin b. Ibuprofen c. Naproxen d. Nevaquin-P e. Piroxicam pg51 76. During sexual excitement in female, fluids are secreted by vaginal walls mainly due to action of a. Adrenaline b. Bombesin c. GnRH d. Relaxin e. VIP pg54 97. Which of the following would be expected to reduce Maternal behavior a. Hysterectomy b. Lesions of the mediobasal hypothalamus c. Lesions of occipital cortex d. Loss of expression of the gene for fos-B e. Ovariectomy pg58 116. The most important physiological buffer in the blood is a. Acetate Buffer b. Bicarbonate Buffer c. Haemoglobin buffer system d. Phosphate buffer e. Proteinate Buffer pg62

131. The mean corpuscular volume ‘MCV’ is high in a. Chronic blood loss b. iron deficiency c. pernicious anemia d. sickle cell anemia e. tahlasemia pg65 132. First line of defence during bleeding is provided by a. blood vessels b. Coagulation inhibitors c. Coagulation mechanism d. fibrinolysis e. platelets pg65 144. The absorption of iron is adversely affected by except a. Excess of phosphate, oxalates or phytic acid b. Ingestion with citrus fruits c. Ingestion with meals d. Partial gastrectomy e. The trivalent, Ferric form pg67 146. After two abortions in first trimester patient reported during third pregnancy and is concerned about the porsibility of recurrence of abortion. Change of recurrence a. Depends about genetic make up of previous abortions b. depends upon sex of previous conceptus c. is more than 50% d. Is not increased e. Is upto 50% pg68 222. The highest content of triglyceridies is present in a. chylomicrons b. high density lipoproteins c. intermediate density lipoproteins d. Low density lipoproteins e. very low density lipoproteins pg83

244. When a firm stroke with a pointed object is applied on the skin, there is spreading redness (flare) due to arteriolar dilatation. This response is due to a. Axon reflex b. Histamine c. Kinins d. Mechanical stimulation e. Tissue injury pg87 256. Regarding allantois, Following statements are true except that it a. contributes in development of cloaca b. Doesn’t function in human embryos c. Extend from the umbilicus to the urinary bladder d. is purely endodermal in origin e. Takes part in blood formation during third to fifth weeks pg90 262. As compare to the male pelvis, the female pelvis has a. A large pelvic outlet b. narrow subpubic angle c. A relatively shallow false pelvis with flaring of the ilia d. An oval shaped pelvic inlet e. Larger diagonal conjugate pg91 274. The sacro iliac joint a. has less mobility b. Is a plain variety of synovial joint c. is covered by psoas and iliacus d. is innervated by ventral rami S1+S2 and lateral branches of dorsal rami S1+S2 e. Is supported by posterior division of external iliac artery pg93 325. Leptin is a hormone produced from fats cells in the body. Its plasma level is higher in a. Fasting b. Increased cortisol secretion c. Males d. Obese persons e. Hypothyroidism pg103

342. Which of the following statements regarding vitamins is correct a. All coenzymes contain vitamins or are vitamins b. All vitamins can act as coenzymes c. All water soluble vitamins act as coenzyme or coenzymes precursosrs d. Ergosterol is provitamin A e. Prostaglandins can be derived from fat soluble vitamins pg107 346.Haemorrhagic disease of newborn is caused by the deficiency of vitamin K because a. mother had malabsorption during pregnancy b. normally the plasma concentration of vitamin K drops immediately after birth c. Placenta does not pass the vitamin to the fetus d. Prothrombin drops too low soon after birth in new born e. The gut is sterile immediately after birth pg108 347. Which of the Following is not a phospholipid a. Cephalin b. Gangliosides c. Lecithin d. Lysolecithin e. Plasminogen pg108 377. Increased urinary excretion of calcium mainly occurs in a. Hyperparathyroidism b. hyperthyroidism c. Magnesium depletion d. metabolic acidosis e. Phosphate depletion pg114 385. A 25 year old female presents with a typical chest pain, Dyspnoea on exertion and palpitations. Clinical examination shows pulse rate 80/min, BP 130/80 mmHg , and a grade II systolic murmur at 4 sternal boder. ECG was normal, Chest X-ray normal. Which of the following is the most likely diagnosis a. Aortic stenosis b. Atrial septal defect c. Coarctation of aorta d. Normal Heart e. Pulmonary stenosis pg115

412. Meiosis is a type of cell division in which a. DNA synthesis takes place b. exchange of genetic material takes place in autosomes c. one cell give rise to eight spermatozoa d. take place in somatic cells e. total number of chromosomes remain the same after the process is complete pg121 467. Enzymes and co-enzymes are essential to life, each of the following serves as a cofactor for enzymes except a. ascorbic acid b. Biotin c. Copper d. Pantothenic acid e. Zinc pg132 473. The rate of excretion of certain substances in the urine on a 24 hours basis can be used to estimate the rate of muscle protein loss. Which of the following substances falls into the category a. 3-Methyl histidine b. Ammonia c. None of above d. Urea e. Uric acid pg133 522. Pelvic tuberculosis is a. Most often bovine b. Post secondary c. Associated with amenorrhoea d. precuasor of endometrial cancer e. Decreasing in Pakistan pg143 599. Premenstural syndrome is characterized by the following a. Sudden weight loss b. Lightness in breast c. Bloating feeling d. euphoria e. Nauses, vomiting, backache pg158

606. Essential tuberculosis a. Can be diagnosed on X-ray b. Amenorrhea is frequent presentation c. Tubes are rarely involved d. can be asymptomatic e. Usually secondary pg160 624. In cervix a. Erosion can be symptomatic b. Polyp is a malignant condition c. Squamous metaplasia always leads to invasive carcinoma d. Dyslplasia is a malignant condition e. Carcinoma in situ is malignant condition pg163 641. Carcinoma cervix is associated with the following a. Multiparity b. Nulliparity c. Diabetes mellitus d. hypertension e. promiscuity pg167 704. tubal patency test can be done by a. Can not be done by laparoscopy b. Blood test c. Hysterosalpingography d. MRI e. Computerized tomography scan (C.T. Scan) pg179 761. A 22 year old primigravida at 28 weeks of gestation has come for her first antenatal checkup, Scan reveals an intact intra uterine pregnancy. Haematological Investigation reveals a low HB and abnormal red cells. Which single further investigation will you perform at this stage to diagnose the type of anaemia a. Absolute values (MCV, MCH, MCHC, PCV) b. Bone marrow biopsy c. Hb electrophoresis d. RBC count e. Serum iron/ serum ferritin pg191

789. Antenatal care helps in reducing a. postnatal mortality b. neonatal mortality c. Postnatal morbidity d. Congenital malformations e. Gestational amenorrhea pg196 793. Antenatal care: a. Oral iron should be given as soon as patient missed her periods b. pelvic examination should be done on first visit c. Pelvic assessment should be done at 32 weeks d. Tetanus toxoid should be given in 4 doses every 4 weeks from 22 weeks of pregnancy e. Hb. And urine D/R should be done on each visit pg197

Pathology 4. Omphalocele occurs due to failure of the bowel to return to the body cavity from its physiological herniation during the following weeks a. 11th – 13th week b. 14th – 16th week c. 17th – 20th week d. 5th – 6th week e. 6th – 10th week pg210 6. The most common cause of gram negative infection in a patient with septic shock is the infection in a. biliary tract b. Colon c. Small bowel d. Tracheobronchial tree e. Urinary tract pg211 51. When no specific factor VIII concentrate available the next best source of factor VIII is a. Albumin infusion b. Cryoprecipitate c. Packed cells d. Platelet concentrate e. Whole blood pg220 122. The most important microscopic diagnostic criteria for premalignant lesions is a. Enlargement of cells b. High N.C ratio

c. mitotic figures d. Pleomorphism e. Presence of the nucleolus pg234 132. One of the following not parasites transmitted by faecal oral route is a. Entamoeba histolytica b. Enterobius vermicularis c. Giardia lamblia d. trichinella spiralis e. Troichuria trichuris pg236 141. Following immunoglubulins are transferres from material to fetal circulation except a. Ig A b. Ig D c. Ig E d. Ig G e. Ig M pg238 157. One of the following is not a tumor markers a. Alpha-fetoprotein b. CEA (carcino-embryonic antigen) c. HCG (human chorionic gonadotrophin) d. PLAP (placental alkaline phosphate) e. Prostatic acid phosphatase pg241 162. One of the following condition is not in klinefelter’s syndrome a. A lower incidence of mental retardation b. A male phenotype c. A raised urinary excretion of pituitary gonadotrophin d. Gonadal dysgenesis e. More than one X chromosome pg242 167. Chronic inflammation results from a. Acute inflammation in which the causative agents persist b. Auto immune reaction c. Infection by intracellular microorganisms d. Persistent infection by organisms of low virulence e. Repetitive bouts of acute inflammation pg243

212. A 65 year old female had chronic obstructive airway disease. She develops fever and later on septicemia due to salmonella infection. Her acid-base profile revealed pH 7.37 (7.35-7.45), pco2 (mmHg) 48 (35-45), Hco3 (mmol/l) 30 (23-29) The most likely biochemical diagnosis is a. Fully compensated respiratory acidosis b. Metabolic acidosis with metabolic alkalosis c. Metabolic acidosis with respiratory alkalosis d. Respiratory acidosis with metabolic alkalosis e. Respiratory acidosis with respiratory alkalosis pg252 216. A known case of rheumatic mitral stenosis develop fever, Lassitude, Body ache after tooth extraction. Doctor is suspecting subacute bacterial endocarditis. The most likely organism present in blood culture would be a. H. Influenza b. Staphylococus aureus c. Strept. Faecalis d. Strept. Pneumonia e. Strept. Viridans pg253 229. A new born baby develop fever, fits, neck rigidity and head retraction. The CSF examination show counts mostly neutrophyls. The most likely organism present in CSF culture would be a. haemophilus influenza b. Neisseria meningitis c. Staphylococeus aureus d. Streptococus agalactiae e. Streptococus pneumoniae pg255 261. A 24 year female, six month pregnant, complains of generalized weakness and lethargy. Her Hb is 9.8 GM/dl , M.C.V. 58 FL and M.C.H 15 Peg. She probably has a. Anaemia of chronic liver disease b. folic acid deficiency c. Iron-Deficiency anemia (WHY NOT ??) d. Megaloblastic anemia e. Thalassemia major pg262 267. In true hermaphroditism, the genetic configuration is a. XO b. XX c. XX/XY d. XXY e. XY pg263

284. Pedigree analysis is essential in ascertaining some inherited disorders. The “Proband” is one of the following a. The affected person who presents for medical attention b. The offspring of the person who presents c. The person who presents for medical attention, whether affected or unaffected d. The suppose of the concerned individual e. The unaffected parent who presents for medical attention pg266 294. CD4+TH cells have at least two different profiles of cytokine production, TH1 and TH2. TH1 cytokines do not include a. IL-12 b. IL-2 c. Interferon-gamma (IFN-Gamma) d. Interleukin (IL-4) e. Tumor necrosis factor beta (TNF-Beta) pg268 322. 25 year old girl with fever and ESR 40 in operated for right adnexal mass. She is found to have right fallopian tube distorted and covulated round right ovary. During dissection it ruptured and white cheesy material came out. The most likely diagnosis is a. Aqute salpingitis b. Dermoid Cyst c. Mucinous cyst adenoma d. Pyosalpinx e. tuberculos salpingitis pg274 360. A woman was admitted in hospital suffering from puerpueral sepsis. The lochia was sent for Bacteriological examination. The most likely organism for this sepsis is a. Bacteroides b. Candida albicans c. Lacto bacillus d. Mixed bacterial infection e. Proteus mirabilis pg281

Pharmacology

29. Propranolol differs from atenolol in having a. Less membrane stability activity b. Less first pass effects c. Lesser lipid solubility d. Equal effects on beta-1 and beta-2 receptors e. More effects on periphery nervous system pg300

Physiology 12. Mole for mole..which of the following has greatest effect on Na excretion? a. ANP b. Aldosterone c. Cortisol d. Progesterone e. Vasopressin pg307 23. Stimulus increasing aldosterone secretion without affecting glucocorticoid secretion include a. Anxiety b. Haemorrhage c. Low potassium intake d. Physical trauma e. Surgery pg309 42. A 32 year old obese male complains of rapid heart rate, 9kg weight loss in 2 months and heat intolerance. His pulse is 110/min Serum T4 is elevated. On questioning he admits that he is using Thyroxine tablets to lose weight. The parameter which shows an increase is a. Serum T3 b. Serum T4 c. Serum TSH d. Serum free T3 e. Serum free T4 pg313 101. Development of Alveoli and lobules in the breast is primarily by a. Cortisol b. Estrogens c. Human chorionic somatomamotropin d. Progesterone e. Prolactin pg325

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