KHYBER MEDICAL UNIVERSITY PESHAWAR

Skomu SECOND PROFESSIONAL MBBS SUPPLY EXAM 2020

Category: B

Rolt No:
Paper E Timet 120 Minutes Marks- 120
Note: Fill in the single Det ChOCe in the response sheetro
0 e ouowing hormones is responsible for increasinsconene tn tne iver during prolonged starvation?
nsulin
C. Thyroxine D Glucagon
EPTH
sterol
e aea s derived from: DrHamdard Official
B. Amino acids
Faty ac
CHs . Blirubin E Steroid

X Regarding abdominal aorta. All of the following is true ekcept

A e aoruc biatus is lying at TO level B.The bifurcation occurred at L4-L5 level
uring its course, it slightly deviated fo the D, Hiturcation can s c u in Burcation occurs at 18
2.5cm
hel a l t at

Aarold male presented in emerency with itory ef painfat defecation for ane week and atreaking of stol with fresh red
e e r he passes stool. There is history of chronie comstipation most likely patient is sufering from:
Inter
Rectal carcinoma D.Perianal abscess E. Anal tistula

. 5 Acidification af the duodenum wil

Secretion of bicarbonate gastric acid
pncreaC eton
ot

D. Increase contraction of uhe

gall . Increase contraction of the sphincter of Oddi
ladder

.6 Isulin enhances the uptake of triacylgycerols in adipose tissues. Which of the following enzyme is activated that facilitates the

Apoo C-ll LCAT

B. Hormone-sensitive lipase
E None of Above
Lupoprotein lupase D.

Q. 7 Which
statement O e r
C. Involve muscles which are innervated by a D. s the processin which bolus
is n u i t and
branch of Sth cranial nerve preparcd for swallawing vegetables

tienti e
a t t t o solid toods,
tray shoid the * pauent
The patient's lunch arrives, Which fond

A. Orange B. White rice

C.Milk Apple Banaa

Q. 9 Esophgaus lues- to trachea

A. nte
C. Lateral D. Medial
Posterior inferior

Q10 The act of micturition involves:

eral spaincter
D. Relaxation of detrusor muscle

the simple lipid from the following

Q1ldentify
Lecithin B. Fatty acid

9Triacylplycerol . Steroids E. Cerumide

unes the urinary bladder and uretha?

ptneiam B. Stratified urothelium
C. Pseudo stratified columnar D. Stratified columnar E. Both a and b

Q. 13 egarding the lumbar vertebrae

8ney
have short pediclcs

a punous process is Touna in them

Articular proces
superiorly & inferiorly
All ot the above
are correct

. 14 The skin around the umbilicus is innervated by which of the following spinal segment
B. 19
D. TI E. TI2

Relating to and sigmoid colon

rectum
B. Sigmoid cofan end at the level of S3
A. The rectum is retroperitoneal structure
 Suppiy eopmentally part of the
directly from the intermal Af te sbeve
910 Tbe lumen ef which of the
following structure n star shaped due
DrHamdard Offiial
te mucosal
datie
Bladder
folds
C.Urethrs
Nephron
Collectung tubule
rie r e s p e c t e of the type all lasatives exert the same effect
o i d in feces
C
D. ncrease water content in feces
Increase intestinal motalaty Decreae iniestinal motiliey
e t the lolowing statements are correct for Kwashiorkor ExCEPT

BThere is muscle wasting

Diet 15 Geticient sn caleties D. Occurs in post weaning peernod E. Occurs in diet deficient n
prltins
Which ene ef the f tis mot a pilar or social
sccountabun
nd
C. Contet and cultual
capable citizens B.Context and culturgl pproprialen
appropa to omaton Social
Q. 20 Which membrane fatty acids are
precursors for
rthe
A. C20 and C22 saturated faty ecosanoos . CS and C22 polyunisaturated fatty acids
C and c
acids
monounsaturated farty a c i d s D Ca0 and C22 polyunsaturated fatty E CIB&C22 saturated fay acids
cds

Q2 sample is said to be a
n E ncluded in the sample.
sample, if it h selected in such a manner that each unit in the population has an cqua
A. Stratiticd r a n o e n p e . Systematic random sample
Clhuster samplie Non probability sarnple
E the tolowings are the intermrdintes or products eflH u n t EXCEIT

C. NADPH . Ribulese, S-phiosphale Seuneptulose 7. phosphaie

nt 3 A4year-old woman complains of severe polyuria (producing about 0.5 Lef urine each hour) and polydipsia (drinking twoto
Ruer r n e t a n no c o e , and she p l a c e d on overnight water restriction for further

A. a Diabetes insipidus B.b Diabetesmellitus

C.c Primary aldosteronism D. d Renin-sccreting thurmo E Syndrome of inappropriate antidiuretic
horimone

9. 24 What is the stroma of the prestate?

A Loose irregular connective tissue Smooth m

C. Fibromuscular D. Adipse tissue Dense Tegular
connective tissue
2 5 h i c h of the following hormones decreaes blood glucose and increases the uptake of glucose in various tissurs like skeletal
i ues
. nsuli . rtisol
C. Glucagon D.Epinepihirine E Thyroid bormone

Q26 Damage to the gastric mucosal barrier is a forerunner of a gastric ulcer. Which substance can both damsge the gastric mucosal
uarrier and stimulate pastric acid secretion
Builes B. Epidermal growth factor
C. Gastrin Hpylori E Mc

Q. 27 1fa patient has a creatinine clearance of 90 mVmin, a urine fow rate of 1mlimin, a plasma K+ concentrationof 4 mEq/'L, and a
urine Ke concentration of 60 mEq't. what is the approximate r
A. 0.06 o10mEo/min
C 0.36 mEq/min D. 3.6 mEq/min E 60 mEq/imin

2 The Following leatures are present in asCenaing portion or the olon.ccept

A. Adventitia uncularts mucosae
C.Serosa D.SuPE cournar Epinetn Eaminapropia
Q9 HCL secretion in the stommach:
. Requireo
Asa function of peptie cels GGells secrete HC
C)Occurs by passive diffision of both H+ and
CLin the gastric huma
D.Require presence
anhyurase enzyme
of carbonie

Q 30 The act of micturition involves

A. Contraction of external uritheral sphincier . Contraction of
internal uritheral sphincier
C. Contraction of triagone D. Relaxation of detrusor muscle Relaxation of external
orcthral sphincier

Q 31 Thesalivary seeretion:
 * i acose
dhel ets starch to glucose D. Has the large a Produced by a nervout i v e 1o plaumals
other digestive iui v e to ma

blac Q. 32 The bile salt synthesis is

subjected to feedback regulatien
t e n by ble aaltrresbsarbed and recirclated
e

imiting enrv by a lsaltt reabsorbed

the ileum
A ch ef the following enzyme is the a from
roxylase E y dase
Cc 12-beta-hydroxylase
* eta isomerase E SAlpha hydroxy lase
0 33 Hlow long is the small intestine?
neters B 2 metr
4meter 3meters
Ch
d y to maintain 11OMEOSTASIS (neutrality)-to de this and maintain the bouy pi
em ielved
chemical and res
yen EChemical, respiratory and renal ystems
y n d chemical
D. Re chem
systems
d o m 1ampling. the probability of selecting an tem trun the populaton
DrHamdard Official
hin .unknown
CAnown E 2ero

frum
atrrha is daily fats fecal excretion of more than égm due to defective digestion and absorptien. Patients sutfering
of which of the following en
malfunction
suffering irum pon.Patients

A. Acetyl Co-Aca
ein lipase
be CPancreatic lipase D. Phospholipase-D E Thiokinase

emale does not permit

.
C.Remnant of Tonu
processes vaginalis D. Lymph vessels e
tternal pudendal aney
W e E Eanges would tend to tncrease
Cua Teasorption in the reaa
C. Tncreased blood ure
D. Increased plama pa rathas aalasis sis
Orimone concentration

t h e tolowing Provides tatgy atracellular

verts cholesterol to cholesterel ester?
acd f r
A cete ractin
C Mevalonic acid D. Phosphatidylcholine E
Noneoof above
Q. 40 Pancreatic B-amyjaje
ucos I. Hydrolyae
AWN n ehucosidic bonds D. Is aymogen
s-limit dextris
Requires acidic pt for its activity

4which statement is most likely regarding Saliva

A. Contains a higher concentration of potansium than does plaama . Coatains a large quantity of Ch

alrtht ef elasma pncentratior

t s more acidic when secreted at a high rate
l and sublingual glands

m Q. 4 The covering layer of the kidneys, that also cover the adrenal plands is:
PerineptrE tat Pararenal fat
C Gerota faicia D. Renal capsule - Renal p e c u m

Q 43 Which of the following tends to decrease potassium secretion by the cortical collecting tubule:
A. Adiuretic that decreases proximal tubule s0dium reatsorption Adiuretie tht nubi ue oa teE

pitonolacone)
C. Acuie alkalosis D. High sodium intake (ncreaned p

Q.A.4Glutamine
Buffering action
residues
of hemoglobin is mainly due to its
%. Arginine residucs
C. Imadazole ring ne residues E Gcine resioues

45
A34year-eld female has reported with history of fargetfulnes, loas of hair and cald intolerance. She has been dingnosed wits
this disease t
a
of c

A. BMR remains unaltered

R goes dow
B.BMR increases
D. Initaly rise witha subiequent fall E Initially unallereu tmcn n

946 Lver gycogen contributes to the maintenance of glucose but not muscle glycogen. Which of the follow i n g entyme aun

Aalycogen phosphorylase B. Hexokinase

C. Glucose-6-phosphatase D. Debanching enzyme . E Glucokinase

Pus1
 47 The symptoms ef mental dation, flat foot eeopia lentis an
follewing enzyme? thrombosis are most likely related to
mportance otlrottins deficiency of which of
Describe the Biomedica
A. aheo
D. 1yrosinase Homogentisate oxidase
E. Histidase
Q. 48 Regarding develepment of kidney,
nterimediate mesoderm
It is derived from:

D. Endoderm lyer ParaNAI esoderm

mainly
DrHamdard Official
Neural crest cells mainly
Q. 49 An 8 months-old-child has been brought to the pediatrie OPDT
o a a an retusal to leeds iro he last few days. The child has been dia maciated child."
been the source of e n e r to the brain cells duri agasedwu marAus. What Ther
couldishave
Fatty acids
ne
e bodies
hodies D. Branched chain
amino acids EFFructose
Q. 50 Which ef the followin g GI hormones s respone or iakatlon ofgastrointestinal smooth?
AAcetylcholine
Dopamine
CSomatosain D. Substance P E Vasoactive intestinal
peptide
nwith polyhydramnios and repeated bilous Emei. The stomach " dstended and a small amount of meconium passed
A. Annular pancreas Duodenal atresia
C.Esophageal atresa D. Extra hepatic bliary atresia E. Hypertrophie py loric stetenosis

Q S I n infants delecation often follows a meal. 1he caute ot colonie contractions in this situation is:

C Increased level of choleceystokinin D. Increased level of secretin E The cnterogastric retiek

Q. 3 Which of these foods added to diet would lower LDL. cholestergl

YOgirt Chicken
C. Beef D. Cheese E. Cream

e g a r d i n g gastrointestinal tract, the duodenum continue distally as:

Stomach
Jejunu
CAscending colon D. Duodenum E. Descending colon

hee o sence of which strweture is the key differentiatint print between duodenum and the rest of the small intestine?
B.
serosal lining D. epithlial lining
MMac E basenent memo
56What is not true about the
malratatian of small intestine
i n incomplete rotation, rotation is arrested at 180 degrees t h e small intestine lics on the right with cecum in the midline
C. Ladds band extends from right upper
most common all exceptA
57 Increases in bath renal blood flow and GFR are cnused by which of the following?
B.
Dilation of the afferent arterioles
C. Increased plasma colloid osmotic pressure D.
Increased glomerular capillary filtration
Dilation of the efferent arterioles
coefficie
blood
Encreased viscosity
dur to increased
hematocrit

. 5S Mass movements are often stimulated after smeal by datention af the stomach (gastrocalic refies) and distention ef the duedenum
(duodeno-colic relex). Which of the following is a mass movement?
A. Bowel moverments .topa coiraCton
D. uastriC tmovement . Haustratons
Esophageal reiaxatien

Q. 59 In chronie respiratory acidosis with partial rensl compeaatioan, yuu weuld espect to find the follwing changes, compared to
xeretion of NH4 -plasma tHco3 concentratin and rine p i
A. increased, increased, decreased Bncreasec, decrcascu, decreased
cange n, tncreaeu, decreseu
D. no changE in, no change
in, decreascdEtncreased, no change in, increased
by
Q 00 FUFTATPase activity is
directly blocked B. Bilinabin
Aspirin D. Rotenoee Thyroxin
Gogomycin
t
trigycerides
Lingual lipase converts dietary
Q. 61
Diglycerides and fatty acids Glycerol an
. Al of
C. Monoglycerides and faty acids
D. None Ot e
above
62 PFeptic ulcers occur mostt commonlyin
Q. Duodenum
A. Small intestine
Reetum E Cardia of
the stomach
C. Pylorus
 eatinine clearance tae
Renal blood presre
Gilomenular Filtrato
D.Renal plasma flow E. Urea ciearance
.94
Cholic ncid snd
Chenodeosycholic acu ArE te
primarybu
ythesized in the liver. The bile a c i coerteu
bile
acids (eg. s
A. Entymes present in the gall bladders
C Entymes produced
i Eymes present in the duodenum
by exocrine pancreas
D. al oda
ntestine
the small E Enymes
present in the
e
h i c h of the following reglons of the Gl tract is characters umerous short tubular invaginations but no vin?

uodenum jtiunum
E anal canal

9 96The coomonmest
A. Heputitis CVinas
cause
of Chronie liver diseases (cuD), et,
nie hepatitis and cirrhesis ef liver in P'akistan is due to

Alcochol D. Gal
E. HIV

Q. 97 Ahealthy 21-year-old woman eats a big meal ane

t to defecate,
miinutes atter eating,. the weman feels a strong urge hourb ride on a
bus that dos nat Eathreom.
have e . Twenty
1wny
woman?
No Relaxation of the Intermal Anal Sphincter, No Cotraction of the

Relaxation of the Intenal Anal Sebinrtee a on ef the

nte
*th No Contraction of the External Sphincter with centraction of thee No Contraction of the Extermal Anal ncter witn
Exiernal Anal Sncter and bp
and Contraction of the Rectum
Contraction ot tme Rectum

Non-verbal communication s believed to uecount Tor betwre % of overall comunication.a. 20J0%

10-15 B30-40
C30-709 5-80 E 85-80

99 All ef the follewing statements arE correct for Kwashiorkor PT

Anemia ec
e c e n t n calories D. Occurs in post weaning period
B There is muscle wasting
E. Occurs in diet deficient in
proteins
0 00 lomerular lination rate and Plasma Creatinine concentratien are

C. Have no relationship with cach other D.Invesely proportional to cach E. Directly proportional 1o the square root ot

101 ONd ative decarboylations Involve loss of cU2 and the production of NAD.
Acycle
D. Tavelve leas of C
Iavolve loss of CO2 and the production of production of FADH2 Occur three limes in the TCA cyele.
NADH

ot
esoplhageal cancer is
p e
E Adenocarcinoma
C. Squamous carcinorma D. Mucoid E
Adeno-squamous cartunoma

Q. 103 T he pancreas first appear at pproimately of gestation as two outpouchings of the endodermal lining of the
Just distai to the fori
A. Ah r
s. Sth week
C 6th w D. 7th week E 8th weck

Q. 104
A. Alakaptonuria
A low phenyialanine diet is recommended in DrHamdard Official
Al Albintsm
C.Hartnup' discase D, apie Syrup Syndirome E Phenylketonuria

9 105 Apleen underlies TOth, T1th,

C9th and 100h 120h fib
D. 11th and 12th rib 10th rib

1 0 6 Regarding development of kidney. It is derived from:

A. Lateral plate mesoderm Paraxial mesodermm
C Intermediate mesodem D,Endoderm laycr e u a l crest cels maniy

0Ayoung ma is found comatose, having taken an unknow m

am ple yields the tollowing value: pH- 7.02, HCOS
r leeping pils an unnon ume
c 0 65 mm Hg Thn panen

A. respiraton acidosis with complete renal compensation o n acidoss with partial reta ca

C.
simultaneous respiratory and metabolic D. uncompensated meuouic acidosis E uncompenssicd respy
acidosis
 0 Anion pp increased
Metabolic acidosis resulting from diathoca
Renalfubu
lic acidosis resulting
from intestinalD.Dabetuc
ketoacidosis
obstruction
. 10
e glomerular capillaries s 0 mm
Hg, Colloid osmotic pressure in the
the pressure in the Bowinan's capsueo
g, Ho glomerular
pressure?
capillaries abouto

S mm Hg L 10 mmHg ion
D. 32 mmHg
C. 28 mmHg E. 60 minHg

unger strike and confines hime qa diet with minimal calories. Which of the follawing would occur
A. decreased liver Glycogenolysis

D. Increased Liver
Increased Glycolysis
Cnereacd Lipogenesis Gilyeogenolysis E ncreased TCA
. 111 To calculate renal bload flow we divide renal plasma flow by

A. I-hematocrit
hematocrit
B.1+ hematocrit
C.-hematocrit
E. hematocrit-PCV

Q. 112 The myenteric (Auerbach's) plexus is located:

Au ele within lamina

in the D. propria, adjacent to the E. in serosa and/or adventitia.
muscularis muscularis mucosa

. 113 Your patients left hypoplossal nerve has been damaged. which ef the following would you expect to see?
left side of the
sons on the tongu
ngue
when asked to stick
tienit's ability to protrude the tongue is
deviate (point) towards the Ieft would deviate (point) towards the normal
right

i c h o the 1ollowing changes tends to inereae prroutar capaty nud reasorption

C. Increased efferent arteriolar resistance D. Decreased angiotensin I E. Increased renal blood tlow

earald oman complains ofeverepolyuria (eroducing about .51of urine each hour) and polydipsia (drinking two to
thrre a s e f watereveryhour). Her urine centaias no glucose, and she is placed on overnight water restriction for further
E ne s eak And co
A. Diahetes ini "
A a
B. b. Diabetes tmellitus
C.e Primary aldosteronisen D.d Renin-secreting umor E
e Syndrome at
inapproprinte antidiuretic
hormone
9.
Duodenum
16 h e cardiac notch is related to which of the following organ
B. Liver
DrHamdard Official
C. Heart D. Stomach Pancreas

Q17 Loop diuretics lnke furosemide causes diuresis by blocking which of the following mechanisms?
calcium ions
ctveansport o 8 . Sodiuim-2 chloride-potassium co-" usport
Sodum-nydrogenco-transport D. Sodiurn-hydrogen counter-transport Sodur-pON.3aluin aALPaMe

18 Ayear-old boy with siekie cell anema presents wth recurrentsevere riht upper quadrant colicky abdominal pain At the time
ol surgery muluple dark biack stones are 0una witnin the gal bladuer, thesestones,are com posed of which one of the following

substances
Struvite E Urate

Q. 119 A physician prescribes a Proton-Pump Inhibitor to patient witha gastric ulcer, Which mcdication is considered a PPI?
anone
Aanio D. Metronidazole . Pluoxetune
gnsu yaroXIde
120 All of the following statements are correct for Ketone bodies EXCEPT
hesis is inhibited when excess of carbohydrate is availab Produced durit acrobic ex ercise
C. HMG CoA synthetase and HMG Co lyase D. L C a n used these R 0urce o E Increase Ketogeniesis cause metabolic acidosis

are required