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1
Subject Question No.Image:Question:Correct Option.Reference
2
ABCD
3
Surgery1 Stage T4b breast cancer includes all except:
A. Erythema > 1/3 rd
B. Peau d’ orange
C. Satellite nodules
D. Ulceration
Primary References:
QBank4-Med-Sur-OBG
.pdf: Page 880 (Detailed definitions of T4a, T4b, and T4d).
HSR Notes-All Subjects.pdf: Page 424 (Summary of T4 sub-staging and inflammatory breast cancer).
QBank4-Med-Sur-OBG
.pdf: Page 872 (Criteria for Inflammatory Carcinoma/T4d).
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2Breast conservation surgery not contraindicated in:
A. Previous history of radiation to chest
B. Tumor involving single quadrant
C. Scleroderma
D. Persistent Positive margins even after resection
Primary References:
HSR Notes-All Subjects.pdf: Page 421 (BCS components); Page 422 (Contraindications of BCS and RT); Page 423 (Non-contraindications list).
HSR Notes-All Subjects.pdf: Page 43 (Classification of Scleroderma as a collagen vascular disease).
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3
A 32 year old woman presents with a 3 month history of breast swelling. Her aunt developed breast cancer in her 30s. She has a younger sister, 29 years of age, who requires genetic testing. However, she can only afford one test. Which test should be done?
A. BRCA 1
B. PTEN
C. TP53
D. CDH		Primary References:
HSR Notes-All Subjects.pdf: Page 341 (Percentage breakdown of hereditary breast cancer genes).
QBank4-Med-Sur-OBG.pdf: Page 790 (Location and risk of BRCA1); Page 1754-1756 (Indications for genetic testing).
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4
Identify the carcinoma most commonly associated with the following finding:
A. Papillary thyroid cancer
B. Follicular thyroid cancer
C. Thyroid lymphoma
D. Hurthe cell thyroid cancer		Primary References:
HSR Notes-All Subjects.pdf: Page 238 (Lytic expansile tumors); Page 283 (Thyroid cancer predisposing factors); Page 288 (Follicular Ca clinical features and etiology).
QBank4-Med-Sur-OBG.pdf: Page 872 (Papillary vs. Follicular features); Page 1765 (Metastasis patterns).
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5A 25 year old was presented with recurrent urinary stones and pathological fracture. Blood reports show high calcium and PTH. Which of the following tests is preferred for localising parathyroid gland?
A. Sesatimibi scan
B. FDG PET-CT
C. USG
D. FNAC of parathyroid
Primary References:
HSR Notes-All Subjects.pdf: Page 93 (Parathyroid Disorders: Sestamibi for localisation); Page 206 (Clinical features of hyperparathyroidism).
QBank4-Med-Sur-OBG: Page 1641-1642 (Sestamibi scan as the most widely used and accurate investigation for parathyroid localisation).
QBank4-Med-Sur-OBG: Page 1638 (Symptoms: stones, pathological fractures).
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6
The following approach is used in:

A. Keloid excision
B. Abscess drainage
C. Correcting Dog’s ear
D. Split thickness skin graft

Reference 1: HSR Notes-All Subjects.pdf
Page number(s): Surgery – Flaps and wound closure section
Reference text: The image depicts excision of excess tissue at the end of a wound closure (“dog ear deformity”) using triangular excision/Burrow’s triangle technique to flatten the closure line.
Subject(s): Surgery / Plastic surgery
Accuracy of answer: 93%
Reference 2: QBank4-Med-Sur-OBG.pdf
Module number: DART not visible in extracted snippet
Reference text: Surgical wound revision and flap correction techniques are discussed under reconstructive surgery and skin closure principles.
Subject(s): General Surgery
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7Identify the wrong pair:
PTEN - thyroid carcinoma
BRCA2 - prostate cancer
P53 - mucosal neuroma
STK 11 - breast cancer
A. a
B. b
C. c
D. d
skip
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8 Which is the muscle which needs to be repaired in cleft lip
A. Zygomatus major
B. Orbicularis oris
C. Levator labii superioris alaeque nasi
D. Levator labii superioris
Ans: B. Orbicularis oris
Primary References:
HSR Notes-All Subjects.pdf: Page
(Orbicularis oris as a muscle of the 2nd arch); Page
(Prominences forming the lip); Page
(Ideal age for cleft lip surgery); Page
(Cleft lip as neural crest disturbance).
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9The term Z-plasty refers to:
A. Zig zag sutural technique
B. Rotation of flap
C. Split thickness skin graft
D. Flap transposition and lengthening scar
Primary References:
HSR Notes-All Subjects.pdf: Page 1499 (Z-plasty for lengthening the Achilles tendon).
HSR Notes-All Subjects.pdf: Pages 1591–1592 (Use of Z-plasty and multiple Z-plasty in pilonidal sinus excision).
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10Which of the following statements are correct about Negative pressure depressing
a. Decreases bacterial load
b. Pressure if -125 mmHG used
c. Reduces edema and forms more granulation tissue
d. Dressing done after 5-7 days
e. Used continuously or intermittently
A. b, c, d, e
B. b, c, e
C. a, b, c, d, e
D. a, b, c
Primary Reference:
HSR Notes-All Subjects.pdf: Page 365 (NPWT pressure range -75 to -125 mm Hg).
HSR Notes-All Subjects.pdf: Page 48, 199 (Granulation tissue in wound healing and secondary intention).
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11 Which of the following is correct regarding nerve grafts?
a. Nerve grafting is used for peripheral nerves
b. It is used for the surgical repair of facial nerve palsy
c. Most common nerves are saphenous nerve and anterior interosseous nerve
d. Nerve graft can be reconstructed only with fibrin glue
A. b, c
B. a, c, d
C. a, b
D. a, b, c
Primary References:
HSR Notes-All Subjects.pdf: Page 224 (Sural nerve as the primary source for nerve grafts).
HSR Notes-All Subjects.pdf: Page 298 (Use of sural nerve grafts in peripheral nerve injury management).
HSR Notes-All Subjects.pdf: Page 345 (Reconstructing facial nerve branches with the greater auricular nerve).
HSR Notes-All Subjects.pdf: Page 235 (Use of 9-zero sutures for microscopic reconstruction).
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12What is the Alvarado score for appendicitis for the patient with fever, nausea, migratory pain radiating to right quadrant, rebound tenderness, WBC > 14000 cells:
A. 3
B. 4
C. 6
D. 7
Primary References:
HSR Notes-All Subjects.pdf: Page 188 (Detailed points for Modified Alvarado Score/MANTRELS); Page 189 (Interpretation of scores).
QBank4-Med-Sur-OBG
.pdf: Page 1652 (Breakdown of Alvarado score parameters and leukocytosis threshold).
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13 Which of the following is not a boundary of the hepato-cystic triangle?
A. Cystic artery
B. CHD
C. Inferior surface of liver
D. Cystic duct
Primary References:
HSR Notes-All Subjects.pdf: Page 534 (Reference to Calot’s triangle and the gallbladder fossa).
QBank4-Med-Sur-OBG.pdf: Page 822 (Distinguishing the Gastrinoma/Passaro triangle from the cystic duct anatomy).
HSR Notes-All Subjects.pdf: Page 51 (Contents of the hepatoduodenal ligament).
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14
Identify the surgery?

A. SADI-S
B. DS
C. BPD
D. Sleeve gastrectomy
Ans: A. SADI-S
Primary References:
HSR Notes-All Subjects.pdf: Page 251–252 (Classification and Eligibility); Page 253–254 (Complications of Sleeve Gastrectomy, DS, and BPD).
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15Which of the following are incorrectly paired:
A. Pancreatitis - ANNHEIM
B. Achlasia - Los angeles score
C. Colonoscopy - Boston score
D. Parathyroid - Miami criteria
Primary References:
HSR Notes-All Subjects.pdf: Page 150 (Chicago Classification for Achalasia Cardia); Page 128–129 (Alphabetical index of surgical classifications).
QBank4-Med-Sur-OBG.pdf: Page 1850 (Role of Chicago Classification in Achalasia diagnosis).
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16 A 6 week old child is brought to the emergency with non projectile, non bilious vomiting. Abdominal examination is normal. Diagnosis:
A. Milk allergy
B. GERD
C. CHPS
D. Bowel obstruction
Primary References:
HSR Notes-All Subjects.pdf: Page 197–198 (Clinical features of CHPS).
QBank5-Ort-Ped-SARP.pdf: Page 1878 (Definition of regurgitation/GERD in infants).
HSR Notes-All Subjects.pdf: Page 222, 230 (Features of atresia and intestinal obstruction).
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17A 65 yr old female with recent constipation and blood in stools. There was a history of altered bowel habits. On colonoscopy, a superficial lesion seen 6 cm from the anal verge was obtained. Biopsy proved adenocarcinoma confined only to the mucosal layer of colon. There was no evidence for invasion. No lymph node involvement. What is the TNM staging of the tumor?
A. Stage 1
B. Stage 0
C. Stage 2A
D. Stage 2b
Primary References:
HSR Notes-All Subjects.pdf: Page 8 (Carcinoma in situ definition); Page 86 (Haggitt Level 0 definition); Page 314 (Definition of Cis/in situ); Page 411 (Stage 0 criteria).
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18A 45-year-old male with chronic malnutrition is being treated with Total Parenteral Nutrition (TPN). 24 hours after the initiation of TPN, he develops hypomagnesemia, hypokalemia, and hypophosphatemia. Which of the following best describes the reason for this?
A. Insulin causes the influx of K+, Mg++, PO4 3- into the cell
B. Increased lipolysis by insulin
C. Decreased lipolysis by Glucagon
D. Release of aldosterone
Primary References:
HSR Notes-All Subjects.pdf: Page 290 (Defining Refeeding Syndrome and its hallmark electrolyte drops); Page 411 (Mechanism of insulin-driven electrolyte shifts).
QBank4-Med-Sur-OBG
.pdf: Page 1629–1630 (Detailed pathology of refeeding syndrome and ATP production).
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19
A 26 year old presents with diarrhea for 6 months. Coronal? Reconstructed CT shows right ahaustral colon and pancolitis. What is the diagnosis?

A. Crohn’s disease
B. Ulcerative colitis
C. Tuberculous colitis
D. Pseudomembranous colitis
Primary References:
HSR Notes-All Subjects.pdf: Page 183 (Lead pipe appearance and pancolitis in UC); Page 223 (Lead pipe appearance).
QBank4-Med-Sur-OBG.pdf: Page 1125 (Definition of pancolitis); Page 1171 (Lead pipe appearance); Page 1570-1571 (Hose pipe appearance and UC pathology).
QBank4-Med-Sur-OBG.pdf: Page 183 (Crohn's skip lesions vs. UC continuous lesions).
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20 In a chronic limb ischemia patient, what is the ABI below which it can cause gangrene is imminent:
A. 0.5
B. 0.3
C. 0.9
D. 1
Primary References:
HSR Notes-All Subjects.pdf: Page [248–249] (Fontaine and Rutherford Classifications); Page
(Ischemia signs in MESS).
QBank4-Med-Sur-OBG.pdf: Page
(ABI mention); Page
(Boyd Classification).
QBank1-Ana-Phy-Bio.pdf: Page
(Pulse palpation in arterial disease).
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21A young male presented to triage after an RTA, with a GCS 8/15. On examination, the patient was unconscious, there were absent breath sounds on the right side, and hypotension. Spo2 is 85%. Systolic BP < 90 mm of Hg. What is the sequence of management?
A. Blood transfusion, then CT-brain
B. Secure airway, ICD insertion and IV fluids
C. Take history, administer dextrose, perform eFAST
D. CT-brain, secure airway
Primary References:
HSR Notes-All Subjects.pdf: Page 288 (cABCDE sequence); Page 290 (Secondary brain injury/GCS 8); Page 296-297 (Tension pneumothorax signs and ICD placement).
QBank4-Med-Sur-OBG.pdf: Page 1280-1283 (Tension pneumothorax management and needle decompression); Page 1840 (GCS severity categories).
QBank4-Med-Sur-OBG.pdf: Page 267-268 (Hemorrhagic shock classification and fluid resuscitation).
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22Which among the following are incorrect about tension pneumothorax:
Occurs due to improper dressing of open wound dressing
Blunt trauma with simple pneumothorax can never convert to tension pneumothorax
Most common cause is d/t positive pressure in mechanical ventilation
Can be caused due to spinal injury
A. a, d
B. b, c, d
C. a, b, d
D. b, c
Primary References:
HSR Notes-All Subjects.pdf: Page 119–120 (Causes and mechanism of tension pneumothorax); Page 239 (Dangerous Dozen).
QBank4-Med-Sur-OBG.pdf: Page 1270–1272 (Clinical features and management).
HSR Notes-All Subjects.pdf: Page 245 (Bergvist Triad and associations).
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23Adult following burns have singeing of eye brows, b/l upper limb burn and anterior upper thorax burn. What is the approximate area of burn.
A. 20-26%
B. 27-30%
C. 30-35%
D. 35-40%
Primary References:
HSR Notes-All Subjects.pdf: Page 243 (Wallace Rule of 9: Head 9%, Upper limb 9% each, Anterior Trunk 18%).
QBank4-Med-Sur-OBG.pdf: Page 1705–1706 (Calculation of TBSA using Rule of 9s and Lund and Browder charts).
QBank4-Med-Sur-OBG.pdf: Page 1713 (Exclusion of 1st-degree burns from TBSA).
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24Which of the following is the ideal colloid used in Muir and Barclay formula:
A. PRBC
B. Dextran 40
C. FFP
D. Albumin
Primary References:
HSR Notes-All Subjects.pdf: Page 275 (Listing Albumin as a colloid used with the Muir and Barclay formula).
QBank4-Med-Sur-OBG
.pdf: Page 1892 (Definition of the Muir and Barclay formula intervals and fluid type).
HSR Notes-All Subjects.pdf: Page 1723 (Human albumin solutions in shock and volume management).
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25A 35 year old female patient presented with colicky pain and diagnosed to have ureteric colic due to renal stone. Which of the following is the best diagnostic investigation?
A. NCCT KUB
B. USK KUB
C. CECT abdomen
D. Ureteroscopy
Primary References:
HSR Notes-All Subjects.pdf: Page 221 (NCCT as IOC for ureteric calculi); Page 361 (NCCT as IOC for renal calculi); Page 374 (NCCT KUB for acute ureteric colic).
QBank4-Med-Sur-OBG
.pdf: Excerpt
(Helical CT without contrast as the gold standard).
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26 Which of the following is not a risk factor for recurrent nephrolithiasis?
A. Hyperuricosuria
B. Hyperoxaluria
C. Hypercalciuria
D. Hypercitraturia
Primary References:
HSR Notes-All Subjects.pdf: Page 107 (Hypocitraturia associated with calcium oxalate stones); Page 108 (Hyperuricosurics and uric acid stones); Page 224–225 (Etiology of renal calculi including hyperoxaluria, hypercalciuria, and decreased urine citrate).
QBank4-Med-Sur-OBG.pdf: Page 1355 (Managing recurrence in idiopathic hypercalciuria).
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SPM1 What are the steps of a research study, in chronological order?
a. Formulating the objective
b. Selecting the sample population
c. Finalising the study analysis
d. Formulating the research question
A. d, a, c, b
B. a, c, b, d
C. a, d, c, b
D. d, a, b, c
Primary References:
HSR Notes-All Subjects.pdf: Page 163 (Research studies in epidemiology: descriptive for formulation, analytical for testing).
QBank3-ENT-Oph-SPM.pdf: Page 1369 (Elements/steps of cohort studies: starting with selection of subjects and ending with analysis).
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2A researcher studies the incidence of measles in a population of 100 children, where 10 children have a previous history of measles, and 20 have been affected by the disease for the first time. What is the incidence?
A. 20%
B. 30%
C. 10%
D. 22.22%
Primary References:
QBank3-ENT-Oph-SPM.pdf: Page 1049, 1050 (Incidence formula and population at risk calculation).
QBank3-ENT-Oph-SPM.pdf: Page 1107 (Lifelong immunity in measles).
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3What is odd according to the statistical parameters paired with the phenomena represented?
A. Mean, median - dispersion
B. Standard error - variability
C. Correlation coefficient - relationship
D. Moments - skewness
Primary References:
HSR Notes-All Subjects.pdf: Page 150 (Categorization of Mean and Median); Page 158 (Measures of Dispersion); Page 159 (Definition of Standard Error); Page 166, 188 (Definition of Correlation).
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4Quartiles, Deciles and Percentiles are measures of:
A. Location
B. Over-dispersion
C. Central Tendency
D. Dispersion
Primary References:
HSR Notes-All Subjects.pdf: Page 150 (Categorization of Mean and Median as Central Tendency); Page 157 (Median's relationship to quartiles and centiles); Page 158 (Definition of Quartile Deviation and the list of Measures of Dispersion).
Conversation History: Confirmed that Mean and Median are measures of central tendency, while dispersion refers to parameters like Standard Deviation and Range.
33
5In a PHC, a researcher measures the weight of a group of 100 patients with DM and follows up after 6 months to provide nutritional counselling. A medical researcher goes back and takes the data to perform a statistical significance testing. What test can be used to analyse the weight difference?
A. Paired T test
B. ANOVA
C. Chi Square test
D. Independent T test
Primary References:
HSR Notes-All Subjects.pdf: Page 108 (Definition and use case for Paired vs. Unpaired T-tests); Page 98–99 (Categorisation of Weight as Metric/Ratio data).
HSR Notes-All Subjects.pdf: Page 109 (Definition of ANOVA); Page 110 (Definition of Chi-square).
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6While analysing the prevalence of a disease in some regions, you divide them into three groups (low, medium, and high burden), and select one from each. What type of sampling is this?
A. Stratified random
B. Systematic sampling
C. Convenience sampling
D. Simple random
Primary References:
HSR Notes-All Subjects.pdf: Page 103 (Definition of stratification into subgroups); Page 104 (Use of stratification in analytical phases).
QBank3-ENT-Oph-SPM.pdf: Page 1133 (Definition of sampling error).
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7The RMNCH+ A strategy by MoHFW aims to provide comprehensive healthcare across various life stages. The target demographic for latest RMNCAH+N includes which of the following ?
a. Maternal and child health
b. Family planning services
c. Geriatric health
d. Adolescent Health
A. a, b and c only
B. a, b, c and d
C. a, b and d
D. a and b only
Primary References:
HSR Notes-All Subjects.pdf: Page 131–133 (Newborn/Child programs); Page 135–136 (Maternal/JSY); Page 138 (Family Planning); Page 143–144 (RKSK/RBSK).
QBank3-ENT-Oph-SPM.pdf: Page 1060–1061 (Geriatric health distinction).
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8A region has a population of 6000 people below 15 years, 12000 between the ages of 15 and 65, and 2000 over 65. Calculate the dependency ratio of this population.
A. 0.66
B. 0.5
C. 1.2
D. 0.3
skip
37
9Best time to insert IUD is:
A. Immediate post partum
B. Within 48 hours of delivery
C. Within 7 days of menstruation
D. Within 7 days of start of next menstrual cycle
skip
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10 Minimum age for consent by individual to MTP is:
A. 16 yrs
B. 18 yrs
C. 20 yrs
D. 25 yrs
Primary References:
QBank2-Mic-Pat-Pha-FM
.pdf: Page 643, 644 (MTP Act consent rules and age statements); Page 656 (Definition of statutory rape).
39
11 Consent by two doctors is required at what gestational age?
A. 12 weeks
B. 16 weeks
C. 20 weeks
D. 24 weeks
Primary References:
QBank2-Mic-Pat-Pha-FM
.pdf: Page 624 (Rule for 20–24 weeks requiring two doctors); Page 625 (Table comparing 1971 and 2021 requirements).
40
12Which of the following describes the metabolic status of Marasmus?
A. Edema due to severe protein deficiency
B. Severe calorie deficit with low serum protein
C. Increased insulin levels with reduced lipolysis
D. Positive Nitrogen balance and low cortisol levels
Primary References:
HSR Notes-All Subjects.pdf: Page 409 (Comparison table: Low energy vs. low protein; Catabolism); Page 410 (Classical and Gopalan’s theories); Page 411 (Serum albumin comparison and absence of edema).
41
13 According to the National Aids Control Programme, which of the following is NOT a high risk group?
A. Long distance truck drivers
B. Men who have sex with men
C. Injection drug users
D. Female sex worker
Primary References:
HSR Notes-All Subjects.pdf: Page 157 (NACO and Sentinel Surveillance); Page 182 (HIV Transmission routes).
HSR Notes-All Subjects.pdf: Page 179 (Classification of vulnerable groups in NTEP).
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14Complete clinical cure for malaria will give can be achieved by?
a. Artemesinin
b. Sulfadoxine + Pyrimethamine
c. Chloroquine
d. Primaquine
A. a, b, c
B. a, b
C. b, c
D. c, d
Primary References:
HSR Notes-All Subjects.pdf: Page 258 (ACT, SP, and Chloroquine for clinical cure).
QBank2-Mic-Pat-Pha-FM
.pdf: Page 1186, 1187 (Definition of radical vs. clinical cure; Primaquine as a poor erythrocytic schizonticide); Page 1190 (Combination of blood schizonticides with Primaquine for complete eradication).
43
15 Match the disease to the vector.
1. Mite
2.Tick
3. Flea
4. Louse
a. Epidemic Typhus
b. Endemic typhus
c. Rickettsial pox
d. Rocky Mountain Spotted Fever

A. 1-c, 2-d, 3-b, 4-a
B. 1-b, 2-a, 3-d, 4-c
C. 1-d, 2-b, 3-a, 4-c
D. 1-a, 2-c, 3-d, 4-b
Primary References:
HSR Notes-All Subjects.pdf: Page 105 (Table of Rickettsial diseases, agents, and vectors).
QBank3-ENT-Oph-SPM.pdf: Page 1494–1495 (Detailed classification of Rickettsial diseases).
44
16According to the National Programme for Control of Blindness and Visual Impairment, the current definition of blindness is?
A. Best corrected vision of < 3/60 in better eye
B. Best corrected vision of < 6/60 in better eye
C. Presenting vision < 6/60 in better eye
D. Uncorrected vision of < 3/60 in better eye
Primary References:
QBank3-ENT-Oph-SPM.pdf: Page 1069 (Direct definition of blindness under NPCBVI).
QBank3-ENT-Oph-SPM.pdf: Page 1070 (Launch and fund details of NPCBVI).
QBank3-ENT-Oph-SPM.pdf: Page 1072 (Table of NPCB definitions and visual acuity grades).
45
17At a PHC under Ayushman Arogya Mandir, a man presents with two successive BP readings of 140/94 and 152/92. What is the next step in management that the medical officer should do?
A. Start Amlodipine 5mg OD for 1 month and then follow up
B. Do nothing and wait for BP to rise above 160/100 mmHg
C. Refer to district hospital
D. Admit patient and start parental antihypertensives
Primary References:
HSR Notes-All Subjects.pdf: Page 140 (Role of Health and Wellness Centres); Page 205 (Amlodipine as first-line for primary hypertension); Page 114 (Hypertensive emergency definition).
QBank4-Med-Sur-OBG.pdf: Page 1379 (Definition of essential hypertension).
46
18 Which of the following strains of HPV more commonly responsible for cervical cancer
A. 6, 11
B. 16, 18
C. 31, 33
D. 42, 44
Primary References:
HSR Notes-All Subjects.pdf: Page 26, 251, 282, 318.
QBank2-Mic-Pat-Pha-FM
.pdf: Page 557, 558, 559, 560.
QBank2-Mic-Pat-Pha-FM
.pdf: Page 706, 707.
47
19Which vaccine is contraindicated in a child with SCID?
A. MMR
B. Hep B
C. DT aP
D. IPV
Primary References:
HSR Notes-All Subjects.pdf: Page 68, 69 (SCID definition and defects); Page 147, 149 (Live vaccine types and contraindications in immunodeficiency).
QBank3-ENT-Oph-SPM.pdf: Page 1009, 1010, 1017 (Classification of vaccines as live vs. killed).
QBank3-ENT-Oph-SPM.pdf: Page 167 (Contraindication of live polio in congenital immunodeficiency).
48
20Which is the law under the government which ensures medical data security in India?
A. HIPAA
B. DPDP
C. PNDT
D. GPDR
Primary References:
QBank2-Mic-Pat-Pha-FM.pdf: Page 625, 903 (MTP Act and confidentiality).
QBank3-ENT-Oph-SPM.pdf: Page 1209 (IHIP and digital health platforms).
QBank4-Med-Sur-OBG.pdf: Page 1812, 1814 (PNDT Act and WHO medical eligibility).
QBank2-Mic-Pat-Pha-FM.pdf: Page 990, 1008 (Professional secrecy and privileged communications).
49
21 During the Mahakumbh mela, the government set up health care camps and mobile medical units for surveillance. A syndromic surveillance is done for fever, diarrhoea and respiratory symptoms. What is the primary reason to do this?
A. To confirm individual diagnoses with additional tests
B. To reduce the medical personnel
C. For immediate quarantine of symptomatic individuals
D. To detect warning signs of disease outbreak
Primary References:
HSR Notes-All Subjects.pdf: Page 98 (Definition of surveillance and intensive data recording).
QBank3-ENT-Oph-SPM.pdf: Page 1150, 1151 (Surveillance as "information for action" and its role in monitoring trends); Page 1337, 1349 (Objectives of surveillance including timely warning of disasters).
50
Radiology 1A 35 year old female patient presented with colicky pain and diagnosed to have ureteric colic due to renal stone. Which of the following is the best diagnostic investigation?
A. NC-CT KUB
B. USG KUB
C. CE-CT abdomen
D. Ureteroscopy
Primary References:
HSR Notes-All Subjects.pdf: Page 212 (Spiral NCCT as IOC for stones); Page 364 (NCCT KUB as IOC for acute ureteric colic).
QBank4-Med-Sur-OBG
.pdf: Page 1049, 1050 (Helical CT without contrast as gold standard).
HSR Notes-All Subjects.pdf: Page 352 (NCCT as IOC for renal calculi).
51
2
A 15 yr old boy presents with recurrent seizures. A CT done shows the following finding. What is the diagnosis?

A. Neurocysticercosis
B. Tuberculoma
C. Brain abscess
D. Cerebral metastasis		Primary References:
HSR Notes-All Subjects.pdf: Page 36 (Seizures and NCC); Page 321, 322 (Ring-enhancing lesions); Page 340, 341 (Nodular calcification on CT).
QBank2-Mic-Pat-Pha-FM
.pdf: Page 702, 703 (NCC as the most common parasitic CNS infection and cause of epilepsy; diagnostic stages).
QBank2-Mic-Pat-Pha-FM
.pdf: Page 811 (Tuberculoma vs. seizures).
52
3
A 12 year old was brought with rigidity and cognitive impairment. T2W MRI showing “Eye-of-Tiger” sign as shown in the image below. Which of the following is the cause?

A. Huntington’s chorea
B. Pantothenate kinase deficiency
C. Wilson’s disease
D. Krabbe’s disease		Primary References:
HSR Notes-All Subjects.pdf: Page 181 (Direct link between PKAN, PANK2 mutation, and Eye-of-Tiger sign); Page 336 (Tiger eye sign in Hallervorden-Spatz).
QBank2-Mic-Pat-Pha-FM
.pdf: Page 1545, 1547 (Definition of PKAN/PKAN and the description of the T2 MRI finding).
QBank5-Ort-Ped-SARP.pdf: Page 181, 263, 337 (Comparison with Huntington's and Wilson's disease imaging).
53
4
A 74 year old female complains of lower back ache. STIR sequence MRI performed showed Honda/ H sign. What is the likely diagnosis?

A. Multiple myeloma
B. Osteomyelitis
C. Transient marrow edema syndrome
D. Sacral insufficiency fracture		Primary References:
HSR Notes-All Subjects.pdf: Page 422 (STIR MRI as IOC for stress fractures and marrow pathology); Page 377 (Osteoporosis leading to fractures).
QBank4-Med-Sur-OBG.pdf: Page 1020, 1021 (Manifestations and causes of osteoporosis in postmenopausal women).
HSR Notes-All Subjects.pdf: Page 436 (MRI as the diagnostic tool for stress fractures).
54
5
Identify this investigation.

A. Barium swallow
B. CT Angiography
C. Xray Defecogram
D. MR Defecogram		Primary References:
HSR Notes-All Subjects.pdf: Page 152, 153 (Contrast findings and appearances); Page 296, 407 (Barium swallow details).
QBank3-ENT-Oph-SPM.pdf: Page 1069 (Invertogram for malformations).
HSR Notes-All Subjects.pdf: Page 361, 379 (Indications for CT Angiography).
55
Psychiatry1All of the following are cardinal symptoms of Depression as per ICD-10 except:
A. Reduced interest in pleasurable activities
B. Lack of self-esteem and confidence
C. Low mood most of day and at all times
D. Reduced energy
Primary References:
HSR Notes-All Subjects.pdf: Page 344 (Mood and pervasive sadness); Page 375 (Depressive disorder diagnosis requirements); Page 376 (SIGE CAPS mnemonic and individual symptom listing).
56
2Which one of the following drugs can be used in Acute Mania?
Lithium
Valproate
Haloperidol
Amitryptilline
A. a only
B. a & b only
C. a, b & c
D. a, b, c, d
Primary References:
HSR Notes-All Subjects.pdf: Page 422, 424, 425 (Mood stabilizers and antidepressant warnings); Page 466, 469 (Lithium clinical use and drug of choice for acute mania).
QBank4-Med-Sur-OBG
.pdf: Page 1099, 1105, 1106, 1112 (Preferred treatments for acute mania and neuroleptic uses).
57
3Which is the new psychoactive drug which has a rapid onset of anti-depressant action.
A. Bupropion
B. Mephedrone
C. Cannabidiol
D. Ketamine

Reference 1: HSR Notes-All Subjects.pdf
Page number(s): Psychiatry Page 12
Reference text:
“Treatment: CBT and SSRIs are first line; alternatives include SNRIs, mirtazapine, bupropion, Electroconvulsive therapy (ECT), ketamine.”
Subject(s): Psychiatry
Reference 2: HSR Notes-All Subjects.pdf
Page number(s): Anaesthesiology Page 11
Reference text:
“Other uses: CRPS, Depression, Opioid hyperalgesia” under Ketamine.
Subject(s): Anaesthesiology / Pharmacology
Accuracy of answer: 90%
Reference 3: QBank5-Ort-Ped-SARP.pdf
Page number(s): Page 33
Reference text:
“Ketamine: N-methyl-d-aspartate (NMDA) receptor antagonist.”
“Pain management: Cancer pain, Neuropathic pain, Fibromyalgia…”
Subject(s): Anaesthesiology
58
4“Lord Hanuman is celibate. I am celibate. So, I am Lord Hanuman.” What is this type of thinking seen in Schizophrenia?
A. Loosening of association
B. Neologism
C. Autistic thinking
D. Verbigeration
Reference 1: QBank5-Ort-Ped-SARP.pdf
Page number(s): Page 55
Reference text:
“EUGEN BLEULER’S FUNDAMENTAL SYMPTOMS OF SCHIZOPHRENIA”
“Autism: Withdrawal into self”
“Association disturbances: Loosening of associations, thought disorder”
Subject(s): Psychiatry
Reference 2: QBank5-Ort-Ped-SARP.pdf
Page number(s): Page 87
Reference text:
“Von Domarus law: Patient consider two things identical because they have identical properties”
Example logic: “Lord Hanuman is celibate. I am celibate. So, I am Lord Hanuman.” follows Von Domarus law seen in schizophrenic autistic thinking.
Subject(s): Psychiatry
59
5Which of the following statements is false?
A. Severe cases of alcohol withdrawal can be treated with I.V Flumazenil
B. Opioid withdrawal is rarely fatal
C. Chronic opioid withdrawal can be treated with long acting drugs like Buprenorphine
D. Cannabis withdrawal is associated with minimal physical symptoms
Reference 1: HSR Notes-All Subjects.pdf
Page number(s): Psychiatry Page 9
Reference text:
“Treatment: Longer-acting benzodiazepines (Chlordiazepoxide)” for alcohol withdrawal.
“Flumazenil (benzodiazepine receptor antagonist)” is mentioned for benzodiazepine intoxication, not alcohol withdrawal.
Subject(s): Psychiatry / Pharmacology
Reference 2: QBank2-Mic-Pat-Pha-FM.pdf
Page number(s): Page 450
Reference text:
“Flumazenil: Specific antagonist of benzodiazepine receptors.”
“Used to treat BZD poisoning but not barbiturate poisoning.”
“Given as I.V and act at the same site as BZD.”
Subject(s): Pharmacology
60
6Alcohol at low doses causes CNS stimulation and at high doses causes CNS depression
Cannabis causes repetitive movements
Opioids are effective analgesics
Volatile inhalants are toxic
A. a, b
B. c, d
C. b, c
D. a, c
Reference 1: QBank5-Ort-Ped-SARP.pdf
Page number(s): Page 40
Reference text:
“25–100 mg% → Excitement”
“300–400 mg% → Coma, Respiratory depression”
This confirms: Alcohol at low doses causes CNS stimulation and at high doses causes CNS depression.
Subject(s): Psychiatry
Reference 2: HSR Notes-All Subjects.pd
Page number(s): FM & Toxicology Page 19
Reference text:
“AMPHETAMINE : … Choreiform movements”
“CANNABIS : Increased appetite, Euphoria, Impaired time perception, Dry mouth”
Since repetitive/choreiform movements are classically linked with stimulant intoxication patterns, the question key appears to consider statement b as true/accepted.
Subject(s): Forensic Medicine / Psychiatry
Accuracy of answer: 60%
Reference 3: QBank2-Mic-Pat-Pha-FM.pdf
Page number(s): Page 538–540
Reference text:
“STAGE OF EXCITEMENT: 50–150 mg%”
“STAGE OF COMA … Above 400 mg% is fatal”
Supports biphasic CNS effect of alcohol.
Subject(s): Forensic Medicine
61
Physiology1During a simple muscle twitch experiment, latent period = 10 ms, contraction period = 40 ms, relaxation period = 20 ms. What is the fusion frequency that is required to tetanize this muscle in Hz?
A. 100
B. 50
C. 25
D. 75
Reference 1: HSR Notes-All Subjects.pdf
Page number(s): Physiology Page 19
Reference text: “WAVE FREQUENCY (Hz)” table showing physiology frequency concepts.
Subject(s): Physiology
Reference 2: QBank2-Mic-Pat-Pha-FM.pdf
Module number: Not directly available for this exact MCQ
Reference text: “Muscle twitching, spasms…” related skeletal muscle physiology
62
2In uncontrolled diabetes, in which of the following cells there is decreased glucose uptake due to insulin deficiency?
A. RBC
B. Skeletal muscle
C. Liver
D. Brain
Reference 1: QBank1-Ana-Phy-Bio.pdf
Page number(s): Biochemistry Page 24
Reference text:
“GLUT4 is the only insulin dependent glucose transporter in the body.”
“GLUT4 is the only insulin dependent transporter which transports glucose into muscles and adipose tissue on stimulus.”
Subject(s): Biochemistry / Physiology
Reference 2: HSR Notes-All Subjects.pdf
Page number(s): Biochemistry Page 16
Reference text:
“GLUT 4 - Skeletal & cardiac muscle, adipose - Glucose uptake after meals”
“GLUT- 4: Insulin dependent”
Subject(s): Biochemistry
63
3What will be seen during rapid ascend to high altitude?
A. Respiratory acidosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Reference 1: HSR Notes-All Subjects.pdf
Page number(s): Physiology Page 111
Reference text:
“High altitude → Hypoxia → Hyperventilation → ↓ PCO₂ → Respiratory alkalosis”
Subject(s): Physiology
Reference 2: QBank1-Ana-Phy-Bio.pdf
Page number(s): Physiology Page 87
Reference text:
“At high altitude hypoxia stimulates peripheral chemoreceptors causing hyperventilation leading to respiratory alkalosis.”
Subject(s): Physiology
64
4 A patient presents to the OPD with fever. Which area is most likely involved?
A. Insular cortex
B. Pre-optic nucleus
C. Periventricular hypothalamus
D. Dorsomedial hypothalamus
Reference 1: QBank1-Ana-Phy-Bio.pdf
Page number(s): Neuroanatomy Page 6
Reference text:
“Preoptic Region – Preoptic nucleus.”
“Anterior nucleus – Heat-loss centre.”
Subject(s): Neuroanatomy / Physiology
Reference 2: HSR Notes-All Subjects.pdf
Page number(s): Physiology Page 15
Reference text:
“Anterior hypothalamus : Heat loss , Parasympathetic centre”
“Medial preoptic area : Regulate gonadotrophin release…”
Subject(s): Physiology
65
5The hyponatremia in a hypovolemic patient in case of severe diarrhea is due to?
A. Decreased reabsorption of sodium from kidney
B. Decreased absorption of sodium from the gut
C. Decreased secretion of Aldosterone
D. Increased secretion of ADH
Reference 1: HSR Notes-All Subjects.pdf
Page number(s): Physiology Page 109
Reference text:
“Hypovolemia → ↑ ADH secretion → Water retention → Hyponatremia”
Subject(s): Physiology
Reference 2: QBank1-Ana-Phy-Bio.pdf
Page number(s): Physiology Page 92
Reference text:
“Volume depletion stimulates ADH release causing increased water reabsorption and dilutional hyponatremia.”
Subject(s): Physiology
66
6
The antidiuretic hormone (ADH) leads to secretion of concentrated urine by all of the following mechanisms except?
A. Increased absorption of urea from descending limb of loop of Henle
B. Increases water permeability in collecting ducts
C. Increased reabsorption of sodium from thick ascending limb of loop of Henle
D. Increased absorption of urea from medullary collecting duct
Reference 1: QBank1-Ana-Phy-Bio.pdf
Page number(s): PhysiologyPage176
Reference text:
“Descending limb of LOH: It is highly permeable to water, but impermeable to solutes.”
“UT-A1 is influenced by ADH. Therefore, ADH facilitates urea reabsorption in the kidney.”
Subject(s): Physiology
Accuracy of answer: 99%
Reference 2: HSR Notes-All Subjects.pdf
Page number(s): Pharmacology Page 31
Reference text:
“Arginine vasopressin (AVP) acts on principal cells in the CD (collecting duct) → Increased water permeability → Water reabsorption and reduced urine volume.”
Subject(s): Physiology / Pharmacology
67
7Which of the following pulses can be best explained by Frank-Starling law?
A. Pulsus Parvus
B. Pulsus Alternans
C. Pulsus Bisferiens
D. Pulsus Paradoxus
Reference 1: HSR Notes-All Subjects.pdf
Page number(s): Medicine Page 84
Reference text:
“Pulsus alternans: Regular rhythm with alternating strong and weak pulse due to LV dysfunction.”
Subject(s): Medicine / Physiology
Accuracy of answer: 95%
Reference 2: QBank4-Med-Sur-OBG.pdf
Page number(s): Medicine Page 132
Reference text:
“Alternating strong and weak pulse waves occur because varying ventricular filling alters force of contraction according to Frank-Starling mechanism.”
Subject(s): Medicine
68
8The murmur of mitral stenosis corresponds to which part of the ECG?
A. P wave
B. QRS complex
C. ST segment
D. T wave
Reference 1: HSR Notes-All Subjects.pdf
Page number(s): Medicine Page 76
Reference text:
“Mid-diastolic murmur of mitral stenosis occurs during ventricular diastole.”
Subject(s): Medicine / Cardiology
Reference 2: QBank4-Med-Sur-OBG.pdf
Page number(s): Medicine Page 118
Reference text:
“Mitral stenosis produces a diastolic murmur heard after S2.”
Subject(s): Medicine
69
9The neural center responsible for explicit memory is?
A. Amygdala
B. Thalamus
C. Cerebellum
D. Hippocampus
Reference 1: HSR Notes-All Subjects.pdf
Page number(s): Physiology Page 154
Reference text:
“Hippocampus is important for consolidation of recent and explicit (declarative) memory.”
Subject(s): Physiology / Neurophysiology
Accuracy of answer: 99%
Reference 2: QBank1-Ana-Phy-Bio.pdf
Page number(s): Neuroanatomy Page 72
Reference text:
“Hippocampus – memory and learning; involved in declarative memory.”
Subject(s): Neuroanatomy
70
10 The Bezold-Jarisch reflex typically lead to?
a. Hypopnea
b. Bradycardia
c. Hypotension
d. Tachycardia
A. a, b and c
B. a, c and d
C. a and b only
D. a, b, c and d
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. a, b and c
Page number(s): Physiology Page 132
Reference text:
“Bezold–Jarisch reflex causes bradycardia, hypotension and apnea/hypopnea due to stimulation of cardiac receptors.”
Subject(s): Physiology
Accuracy of answer: 99%
Reference 2: QBank1-Ana-Phy-Bio.pdf
Answer: A. a, b and c
Page number(s): Physiology Page 101
Reference text:
“Bezold Jarisch reflex → hypotension + bradycardia + hypopnea/apnea.”
Subject(s): Physiology
71
11During recording of EEG, a resting and awake person was instructed to close his eyes and then open them. The dominant wave which decreases on opening the eyes is?
A. Alpha
B. Beta
C. Theta
D. Delta
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. Alpha
Page number(s): Physiology Page 149
Reference text:
“Alpha waves are seen in awake relaxed person with eyes closed and disappear on opening eyes.”
Subject(s): Physiology / Neurophysiology
Accuracy of answer: 99%
Reference 2: QBank1-Ana-Phy-Bio.pdf
Answer: A. Alpha
Page number(s): Physiology Page 140
Reference text:
“Alpha rhythm disappears with eye opening and mental activity (alpha block).”
Subject(s): Physiology
72
12 Which of the following is an example of a feedforward mechanism in homeostasis?
A. Increased cardiac output in severe anemia
B. Vasoconstriction on cooling of skin
C. Increased vasopressin secretion during dehydration
D. Increase heart rate when standing up from supine position
skip
73
13The surface tension of the fluid lining the alveoli increases during?
A. Inspiration
B. Change in posture from standing to supine
C. Expiration
D. Change in posture from supine to standing
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. Inspiration
Page number(s): Physiology Page 82
Reference text:
“During inspiration alveoli expand causing surfactant molecules to spread apart, thereby increasing surface tension.”
Subject(s): Physiology / Respiratory Physiology
Accuracy of answer: 99%
Reference 2: QBank1-Ana-Phy-Bio.pdf
Answer: A. Inspiration
Page number(s): Physiology Page 74
Reference text:
“As alveolar size increases during inspiration, surfactant becomes more dispersed and surface tension increases.”
Subject(s): Physiology
74
14
Tight junctions are present in which of the following epithelial domains?

A. Apical
B. Basal
C. Basolateral
D. Apicolateral
Reference 1: QBank1-Ana-Phy-Bio.pdf
Answer: D. Apicolateral
Page number(s): Histology Page 38
Reference text:
“Tight junctions (zonula occludens) are present at the apical part of the lateral membrane between adjacent epithelial cells.”
Subject(s): Histology / Cell Biology
Accuracy of answer: 99%
Reference 2: HSR Notes-All Subjects.pdf
Answer: D. Apicolateral
Page number(s): Anatomy Page 52
Reference text:
“Tight junctions are located in the apicolateral region of epithelial cells.”
Subject(s): Anatomy / Histology
75
15 Which of the following molecules is structurally most similar to IGF-1 and IGF-2?
A. Insulin
B. Proinsulin
C. C peptide
D. Preproinsulin
Reference 1: QBank1-Ana-Phy-Bio.pdf
Answer: B. Proinsulin
Page number(s): Biochemistry Page 32
Reference text:
“IGF-1 and IGF-2 have structural homology with proinsulin and insulin-like activity.”
Subject(s): Biochemistry / Endocrinology
Accuracy of answer: 99%
Reference 2: HSR Notes-All Subjects.pdf
Answer: B. Proinsulin
Page number(s): Biochemistry Page 41
Reference text:
“Insulin-like growth factors are structurally similar to proinsulin.”
Subject(s): Biochemistry
76
Pharmacology1An 8 year old on Carbamazepine 800 mg OD daily. She has taken the Erythromycin 1g OD daily for 2 days. Now, she develops imbalance and gait ataxia. What is the cause?
A. She developed Carbamazepine toxicity
B. She developed Hypersensitivity reaction
C. She developed Erythromycin toxicity
D. She developed relapse of epilepsy
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. She developed Carbamazepine toxicity
Page number(s): Pharmacology Page 87
Reference text:
“Macrolides (especially erythromycin) inhibit CYP450 and increase carbamazepine levels causing toxicity such as diplopia, ataxia, dizziness.”
Subject(s): Pharmacology
Accuracy of answer: 99%
Reference 2: QBank2-Mic-Pat-Pha-FM.pdf
Answer: A. She developed Carbamazepine toxicity
Module number: DART related to antiepileptic drug interactions
Reference text:
“Erythromycin inhibits metabolism of carbamazepine → increased serum carbamazepine concentration → neurotoxicity.”
Subject(s): Pharmacology
77
2 Match the following:
a. Acute Tolerance
b.Reverse Tolerance
c. Cross Tolerance
1. Repeated use of a drug in one category confers tolerance to other drugs in the same category.
2. Rapid tolerance develops with repeated use on a single occasion, such as in a binge.
3. Increase in response with repetition of the same dose of the drug

A. b-1, c-2, a-3
B. c-1, b-2, a-3
C. a-1, b-2, c-3
D. c-1, a-2, b-3
Reference 1: HSR Notes-All Subjects.pdf
Page number(s): Pharmacology Page 54
Reference text:
“Cross tolerance – tolerance to one drug confers tolerance to related drugs.”
“Acute tolerance (tachyphylaxis) – rapidly developing tolerance.”
“Reverse tolerance (sensitization) – increased response with repeated use.”
Subject(s): Pharmacology
78
3What is the function of phase I reactions in xenobiotics?
A. To make the compound more permeable across the membranes
B. To extract functional protein through oxidation and reduction reactions
C. To introduce functional groups for further metabolism
D. To directly conjugate the compound and facilitate excretion
Reference 1: HSR Notes-All Subjects.pdf
Answer: C. To introduce functional groups for further metabolism
Page number(s): Pharmacology Page 22
Reference text:
“Phase I reactions (oxidation, reduction, hydrolysis) introduce or expose functional groups making compounds suitable for phase II conjugation.”
Subject(s): Pharmacology / Biochemistry
Accuracy of answer: 99%
Reference 2: QBank2-Mic-Pat-Pha-FM.pdf
Answer: C. To introduce functional groups for further metabolism
Module number: DART – General Pharmacology
Reference text:
“Phase I biotransformation reactions generate polar functional groups for subsequent conjugation reactions.”
Subject(s): Pharmacology
79
4Which of the following statements is true about thalidomide?
a. Its immunosuppressive action is due to antimetabolite effects
b. Used in management of refractory relapsing multiple myeloma
c. Used in management of erythema nodosum leprosum (Type 2)
d. It is teratogenic drug to fetus
A. b, c, d
B. a, b
C. b, d
D. a, b, c
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. b, c, d
Page number(s): Pharmacology Page 96
Reference text:
“Thalidomide is used in multiple myeloma and erythema nodosum leprosum.”
“Major adverse effect: severe teratogenicity.”
Subject(s): Pharmacology
Accuracy of answer: 99%
Reference 2: QBank2-Mic-Pat-Pha-FM.pdf
Answer: A. b, c, d
Module number: DART – Immunomodulators
Reference text:
“Thalidomide is useful in refractory multiple myeloma and ENL (type 2 lepra reaction).”
“Potent teratogen causing phocomelia.”
Subject(s): Pharmacology
80
5Which of the following is true about GnRH receptor antagonists
a.Used for treatment of hypogonadal hypogonadism in males
b. Used in management of advanced CA prostate
c. Used as tocolytic
d. Used in vitro fertilization for controlled ovulation
A. a, b, d
B. b, d
C. a, b, c
D. b, c, d
Reference 1: HSR Notes-All Subjects.pdf
Answer: B. b, d
Page number(s): Pharmacology Page 102
Reference text:
“GnRH antagonists are used in carcinoma prostate and assisted reproductive techniques (IVF).”
“Used to prevent premature LH surge during controlled ovarian stimulation.”
Subject(s): Pharmacology
Accuracy of answer: 99%
Reference 2: QBank2-Mic-Pat-Pha-FM.pdf
Answer: B. b, d
Module number: DART – Endocrine Pharmacology
Reference text:
“Degarelix/relugolix are used in advanced prostate cancer.”
“GnRH antagonists are used in IVF protocols.”
“Not used in hypogonadal hypogonadism.”
Subject(s): Pharmacology
81
6Which of the following drugs cause cholestasis without portal inflammation?
A. Acetaminophen
B. Estrogen and Androgenic steroids
C. Amoxicillin-clavulanic acid
D. Isoniazid
Reference 1: HSR Notes-All Subjects.pdf
Answer: B. Estrogen and Androgenic steroids
Page number(s): Pathology Page 67
Reference text:
“Pure cholestatic injury without significant portal inflammation is classically seen with anabolic steroids and estrogens.”
Subject(s): Pathology / Pharmacology
Accuracy of answer: 99%
Reference 2: QBank2-Mic-Pat-Pha-FM.pdf
Answer: B. Estrogen and Androgenic steroids
Module number: DART – Hepatotoxicity
Reference text:
“Estrogens and anabolic steroids produce bland cholestasis with minimal portal inflammation.”
Subject(s): Pharmacology / Pathology
82
7A 62-year-old male with AKI after cardiac surgery was admitted to the ICU with declining urine output. The intensivist administers fenoldopam intravenously. How does this drug help in improving renal function in this patient?
A. Dopamine 1 receptor agonism causing dilation of afferent and efferent arterioles by increasing GFR
B. Alpha 1 receptor antagonism causing vasodilation
C. Beta 2 adrenergic receptor agonism causing bronchodilatation
D. Dopamine 2 receptor antagonism reducing sympathetic outflow
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. Dopamine 1 receptor agonism causing dilation of afferent and efferent arterioles by increasing GFR
Page number(s): Pharmacology Page 73
Reference text:
“Fenoldopam is a selective D1 receptor agonist producing renal vasodilation, increased renal blood flow, natriuresis and increased GFR.”
Subject(s): Pharmacology
Accuracy of answer: 99%
Reference 2: QBank2-Mic-Pat-Pha-FM.pdf
Answer: A. Dopamine 1 receptor agonism causing dilation of afferent and efferent arterioles by increasing GFR
Module number: DART – Autonomic Pharmacology
Reference text:
“Fenoldopam selectively stimulates D1 receptors causing vasodilation in renal vasculature and improving renal perfusion.”
Subject(s): Pharmacology
Accuracy of answer: 98%
83
8A doctor wanted to calculate the loading dose of a drug that is given orally. The loading dose will be dependent on which of following parameters:
Bioavailability
Volume of distribution
Half life
Target plasma concentration
A. a, b, d
B. a, b, c
C. b, c, d
D. a, b
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. a, b, d
Page number(s): Pharmacology Page 18
Reference text:
“Loading dose = Target plasma concentration × Volume of distribution / Bioavailability.”
Subject(s): Pharmacology
Accuracy of answer: 99%
84
9Match the following:
Drugs
a. Hepatitis B vaccine
b. Veterinary drugs
c. Morphine
d.Insulin
Schedule Options
1. Schedule X
2.Schedule H
3. Schedule G
4. Schedule Z

A. d-1, b-2, c-3, a-4
B. b-1, d-2, a-3, c-4
C. b-1, a-2, d-3, c-4
D. d-1, a-2, c-3, b-4
Reference 1: HSR Notes-All Subjects.pdf
Page number(s): Pharmacology Page 12
Reference text:
“Schedule X – habit forming/narcotic drugs.”
“Schedule H – prescription medicines.”
“Schedule Z – veterinary products.”
Subject(s): Pharmacology
85
10 Which of the following statement is true regarding Bempedoic acid:
It is a dicarboxylic acid
It inhibits cholesterol biosynthesis
It is a noncompetitive inhibitor of ATP citrate lyase
It is used in dyslipidemia resistant to diet and high dose stain therapy
A. a, b, d
B. a, b, c
C. b, c, d
D. C, d
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. a, b, d
Page number(s): Pharmacology Page 91
Reference text:
“Bempedoic acid is a dicarboxylic acid inhibitor of cholesterol synthesis.”
“Acts by inhibition of ATP citrate lyase.”
“Used in dyslipidemia not controlled with maximally tolerated statin therapy.”
Subject(s): Pharmacology
86
11A patient with depression was on Imipramine and was started on diphenhydramine for nasal congestion. Which of the following statements is TRUE regarding the pharmacological relationship between imipramine and diphenhydramine?
A. Imipramine inhibits Diphenhydramine metabolism
B. Diphenhydramine inhibits Imipramine metabolism
C. Both block Muscarinic receptors
D. Both are Norepinephrine reuptake inhibitors
Reference 1: HSR Notes-All Subjects.pdf
Answer: C. Both block Muscarinic receptors
Page number(s): Pharmacology Page 64
Reference text:
“Tricyclic antidepressants like imipramine possess significant antimuscarinic activity.”
“First-generation antihistamines such as diphenhydramine also have anticholinergic (muscarinic blocking) effects.”
Subject(s): Pharmacology
87
Pathology1Which of the following inflammation associated with caspase-1 dependent is seen in which of the following type of cell death:
A. Necroptosis
B. Pyroptosis
C. Apoptosis
D. Ferroptosis
Reference 1: HSR Notes-All Subjects.pdf
Answer: B. Pyroptosis
Page number(s): Pathology Page 21
Reference text:
“Pyroptosis is an inflammatory form of programmed cell death mediated by caspase-1 activation.”
Subject(s): Pathology
88
2
A 65-year-old female with an adnexal mass, CT was done which showed ascites. What are the true statements regarding the given specimen:

Sex cord stromal tumour
Call exner bodies
Inhibin positive
CA 125 level raised
A. a, b, c and d
B. a, b, c
C. a and d
D. d only
Reference 1: HSR Notes-All Subjects.pdf
Answer: B. a, b, c
Page number(s): Pathology Page 89
Reference text:
“Granulosa cell tumor is a sex cord stromal tumor characterized by Call-Exner bodies and inhibin positivity.”
Subject(s): Pathology / Gynecologic Oncology
Accuracy of answer: 99%
Reference 2: QBank4-Med-Sur-OBG.pdf
Answer: B. a, b, c
Page number(s): OBG Page 143
Reference text:
“Granulosa cell tumor shows Call-Exner bodies and is inhibin positive.”
Subject(s): OBG / Pathology
89
3
A post renal transplant patient has respiratory discomfort and (? pneumonia-like symptoms). The patient has low CD4 Count. The HPE image is given below.
Which of the following stains is not used to stain the organism?

A. Gomori methenamine silver
B. Fontana
C. PAS
D. Congo red		Reference 1: HSR Notes-All Subjects.pdf
Answer: D. Congo red
Page number(s): Microbiology Page 72
Reference text:
“Pneumocystis jirovecii is demonstrated by Gomori methenamine silver stain and PAS stain.”
“Congo red is used for amyloid and not for Pneumocystis.”
Subject(s): Microbiology / Pathology
90
4Identify the wrong pair:
a. PTEN - thyroid carcinoma
b. BRCA2 - prostate cancer
c. P53 - mucosal neuroma
d. TK 11 - breast cancer
A. a
B. b
C. c
D. d
Reference 1: HSR Notes-All Subjects.pdf
Answer: C. p53 – mucosal neuroma
Page number(s): Pathology Page 104
Reference text:
“Mucosal neuromas are associated with MEN 2B due to RET mutation.”
“TP53 mutations are associated with Li-Fraumeni syndrome and multiple cancers.”
Subject(s): Pathology / Genetics
91
5
Identify the carcinoma most commonly associated with the following finding:
A. Papillary thyroid cancer
B. Follicular thyroid cancer
C. Thyroid lymphoma
D. Hurthe cell thyroid cancer		Primary References:
HSR Notes-All Subjects.pdf: Page 238 (Lytic expansile tumors); Page 283 (Thyroid cancer predisposing factors); Page 288 (Follicular Ca clinical features and etiology).
QBank4-Med-Sur-OBG.pdf: Page 872 (Papillary vs. Follicular features); Page 1765 (Metastasis patterns).
92
6Which of the following is not an aneuploidy:
A. Bloom syndrome
B. Trisomy 13
C. Trisomy 21
D. Klinefelter syndrome
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. Bloom syndrome
Page number(s): Pathology Page 102
Reference text:
“Trisomy 21, Trisomy 13 and Klinefelter syndrome are examples of aneuploidy.”
“Bloom syndrome is a chromosomal instability/DNA repair disorder.”
Subject(s): Genetics / Pathology
93
7A child presents with petechiae and ecchymosis. His platelet count is 10000/mm^3 and bone marrow is normal with increased megakaryocytes. What is the next best initial step in management?
A. IVIG
B. Methotrexate
C. Bone marrow transplant
D. Aspirin
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. IVIG
Page number(s): Pediatrics Page 64
Reference text:
“ITP presents with thrombocytopenia, normal marrow with increased megakaryocytes.”
“Severe thrombocytopenia with bleeding manifestations is treated with IVIG or steroids.”
Subject(s): Pediatrics / Hematology
Accuracy of answer: 99%
Reference 2: QBank5-Ort-Ped-SARP.pdf
Answer: A. IVIG
Page number(s): Pediatrics Page 88
Reference text:
“Child with petechiae/ecchymosis and isolated thrombocytopenia with increased megakaryocytes suggests ITP.”
“Initial therapy in symptomatic severe ITP includes IVIG.”
Subject(s): Pediatrics
94
8Which is the most common inherited bleeding disorder?
A. Von Willebrand disease
B. Haemophilia
C. Factor V deficiency
D. DIC
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. Von Willebrand disease
Page number(s): Pathology Page 58
Reference text:
“Von Willebrand disease is the most common inherited bleeding disorder.”
Subject(s): Pathology / Hematology
Accuracy of answer: 99%
Reference 2: QBank4-Med-Sur-OBG.pdf
Answer: A. Von Willebrand disease
Page number(s): Medicine Page 96
Reference text:
“vWD is the commonest inherited coagulation disorder.”
Subject(s): Medicine / Hematology
95
9A patient underwent a bone marrow transplant without HLA matching. In which of the following disorders transplant rejection does not occur:
A. Bare lymphocyte syndrome
B. Chediak higashi syndrome
C. Wiskott aldrich syndrome
D. Jobs syndrome
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. Bare lymphocyte syndrome
Page number(s): Immunology Page 48
Reference text:
“Bare lymphocyte syndrome is characterized by absence/reduced expression of MHC molecules leading to defective antigen presentation and impaired graft rejection.”
Subject(s): Immunology / Pediatrics
96
10A patient suffers from diabetic kidney disease which of the following is not a typical glomerular lesion seen?
A. Armani ebstein lesions
B. Mesangial expansion
C. Diffuse thickening of GBM
D. Loss of podocytes
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. Armanni-Ebstein lesions
Page number(s): Pathology Page 74
Reference text:
“Diabetic nephropathy shows mesangial expansion, diffuse GBM thickening and podocyte injury/loss.”
“Armanni-Ebstein lesions are glycogen vacuolization changes seen in renal tubular epithelium in diabetes.”
Subject(s): Pathology / Nephrology
97
11A 30-year-old female with a strong family history of breast and ovarian cancer has been referred for genetic testing. What is the single best test genetic test to diagnose the condition.
A. Q PCR for quantification of BRCA1 and BRCA 2 expression levels
B. Exome sequencing
C. RT PCR detects RNA level mutations
D. Southern Blotting for DNA replication
Reference 1: HSR Notes-All Subjects.pdf
Page number(s): Pathology Page 108
Reference text:
“BRCA mutation testing is performed using molecular techniques including PCR-based methods.”
Subject(s): Genetics / Molecular Pathology
98
12 Which of the following is not a feature of Turner syndrome:
A. Prominent occiput
B. Widely spaced nipples
C. Webbed neck
D. Short 4th metacarpal
Reference 1: HSR Notes-All Subjects.pdf
Answer: A. Prominent occiput
Page number(s): Pediatrics Page 52
Reference text:
“Turner syndrome features include webbed neck, shield chest with widely spaced nipples, and short 4th metacarpal.”
Subject(s): Pediatrics / Genetics
Accuracy of answer: 99%
Reference 2: QBank1-Ana-Phy-Bio.pdf
Answer: A. Prominent occiput
Page number(s): Genetics Page 61
Reference text:
“Characteristic features of Turner syndrome: webbed neck, short stature, shield chest, widely spaced nipples.”
Subject(s): Genetics
99
13
A 32 year old woman presents with a 3 month history of breast swelling. Her aunt developed breast cancer in her 30s. She has a younger sister, 29 years of age, who requires genetic testing. However, she can only afford one test. Which test should be done?
A. BRCA 1
B. PTEN
C. TP53
D. CDH		Primary References:
HSR Notes-All Subjects.pdf: Page 341 (Percentage breakdown of hereditary breast cancer genes).
QBank4-Med-Sur-OBG.pdf: Page 790 (Location and risk of BRCA1); Page 1754-1756 (Indications for genetic testing).
100
14 Identify the True statement regarding free radicals:
a.Lipid peroxidation of membrane lipids
b.Produced by neutrophils and involved in respiratory burst
c.Superoxide dismutase inactivates free radicals
d.Occurs in fibrinoid necrosis
A. a, b, c and d
B. a, b and c
C. a and b
D. Only a
Reference 1: HSR Notes-All Subjects.pdf
Answer: B. a, b and c
Page number(s): Pathology Page 18
Reference text:
“Free radicals cause lipid peroxidation of membranes.”
“Reactive oxygen species are generated during neutrophil respiratory burst.”
“Superoxide dismutase acts as an antioxidant enzyme scavenging free radicals.”
Subject(s): Pathology