Question 1

Kernicterus is caused by deposition of unconjugated bilirubin in?

Accepted Answer

Answer reason: Kernicterus is bilirubin-induced neurologic dysfunction caused by deposition of unconjugated (lipid-soluble) bilirubin in the brain, particularly the basal ganglia and brainstem nuclei. In neonates, high levels of unconjugated bilirubin can cross the immature blood–brain barrier. This leads to encephalopathy with signs such as lethargy, hypotonia, and seizures. Therefore, the site of deposition is the brain.

Question 2

Breast milk jaundice usually appears on?

Accepted Answer

Answer reason: Breast milk jaundice is a late-onset unconjugated hyperbilirubinemia that typically appears after the first week of life, often between days 6–14, due to increased enterohepatic circulation from substances in human milk (e.g., β-glucuronidase). Day 1 or days 3–5 fit physiologic or breastfeeding (suboptimal intake) jaundice. It may persist for several weeks but does not usually first present at the end of the first month.

Question 3

The primary risk factor for lung cancer is?

Accepted Answer

Answer reason: Cigarette smoking is the leading and most significant risk factor for lung cancer, accounting for the majority of cases. Tobacco smoke contains numerous carcinogens that cause DNA damage and malignant transformation in bronchial epithelium. Asbestos exposure, air pollution, and genetic mutations can contribute, but their overall population-attributable risk is far lower than smoking.

Question 4

Most common cancer in men worldwide is?

Accepted Answer

Answer reason: Globally, lung cancer is the most commonly diagnosed cancer in men and the leading cause of cancer death. GLOBOCAN/WHO data show lung cancer slightly exceeds prostate cancer in incidence among males worldwide. Prostate cancer predominates in many high‑income countries, but lung cancer remains the top overall when considering all regions.

Question 5

Dengue hemorrhagic fever can lead to?

Accepted Answer

Answer reason: Severe dengue (dengue hemorrhagic fever) is characterized by increased vascular permeability, thrombocytopenia, and coagulopathy, leading to plasma leakage and hemorrhage. This can progress to dengue shock syndrome with hypotension and organ hypoperfusion. Dehydration, paralysis, and skin ulcers are not defining complications of DHF. Thus, bleeding and shock are the cardinal, life-threatening outcomes.

Question 6

Viral infection of liver is?

Accepted Answer

Answer reason: Hepatitis is inflammation of the liver, most commonly caused by viruses such as hepatitis A, B, C, D, and E. The suffix -itis denotes inflammation of an organ. Nephritis refers to kidney inflammation, gastritis to stomach inflammation, and colitis to colon inflammation. Therefore, the viral infection of the liver is hepatitis.

Question 7

Rose spots on the abdomen are characteristic of?

Accepted Answer

Answer reason: Rose spots are faint, salmon-colored blanching macules on the trunk/abdomen that occur in enteric fever due to Salmonella Typhi, typically during the first week of illness. Measles produces a cephalocaudal morbilliform rash with Koplik spots, not isolated rose spots. Dengue may cause a diffuse maculopapular rash with "islands of white in a sea of red," and malaria usually lacks a characteristic rash. Thus, typhoid fever is the classic association.

Question 8

Cervical cancer is most strongly associated with?

Accepted Answer

Answer reason: Persistent infection with high-risk human papillomavirus types (especially HPV 16 and 18) is the primary etiologic factor for cervical cancer. Viral oncoproteins E6 and E7 inactivate tumor suppressors p53 and Rb, driving dysplasia and carcinoma. Smoking and other factors can act as cofactors, but none are as strong a causal association as HPV.

Question 9

The most common cause of chronic liver disease worldwide is?

Accepted Answer

Answer reason: Hepatitis B virus is the leading cause of chronic liver disease globally due to its high endemicity in many parts of Asia and sub-Saharan Africa and the large number of chronic carriers. Chronic HBV infection can progress to cirrhosis and hepatocellular carcinoma. Hepatitis A and E typically cause acute, self-limited infections without chronicity. Hepatitis C is a major cause in some regions, but worldwide burden is lower than HBV.

Question 10

Wound healing in hernioplasty is better assisted by?

Accepted Answer

Answer reason: Iron is a key cofactor for prolyl and lysyl hydroxylases involved in collagen synthesis during the proliferative phase of wound healing. Iron deficiency impairs fibroblast function, collagen deposition, and epithelialization, leading to delayed wound repair. Ensuring adequate iron supports optimal tensile strength of the repair after hernioplasty.

Question 11

Shock is a condition of inadequate?

Accepted Answer

Answer reason: Shock is characterized by failure of the circulatory system to deliver adequate oxygen to tissues, resulting in cellular hypoxia. This encompasses decreased or maldistributed blood flow, reduced oxygen delivery, and overall inadequate tissue perfusion. Therefore all listed components describe shock.

Question 12

Which of the following is a classical feature of tetanus?

Accepted Answer

Answer reason: Tetanus is caused by tetanospasmin from Clostridium tetani, which blocks inhibitory neurotransmitters and produces sustained muscle spasms. The hallmark early sign is trismus (lockjaw) due to spasm of the masseter muscles. Other signs include risus sardonicus and opisthotonos. Vomiting, pyrexia, and cyanosis are nonspecific and not classic diagnostic features.

Question 13

The main symptoms of measles do not include...?

Accepted Answer

Answer reason: Classic measles presentation includes high fever and the “3 Cs”: cough, coryza, and conjunctivitis, followed by a maculopapular rash and Koplik spots. Hematuria is blood in the urine and is not part of the typical clinical features of measles. Therefore, it is not one of the main symptoms.

Question 14

The term "meningocele" means?

Accepted Answer

Answer reason: Meningocele is a neural tube defect characterized by herniation of the meninges through a vertebral defect, forming a CSF-filled sac. The spinal cord itself remains in the canal and is not part of the sac. When both meninges and cord protrude, it is called myelomeningocele, and isolated cord protrusion would be myelocele. Thus the best definition is protrusion of the meninges through the spinal canal.

Question 15

Jaundice affects newborn babies when they have too much bilirubin in their...?

Accepted Answer

Answer reason: Neonatal jaundice results from hyperbilirubinemia—excess unconjugated bilirubin circulating in the blood due to increased red blood cell turnover and immature hepatic conjugation. The bilirubin in the bloodstream deposits in tissues, causing yellow discoloration of the skin and sclera. Thus, the critical location of excess bilirubin is the blood, not organs like the pancreas, lungs, or kidneys.

Question 16

Study of diseases is called?

Accepted Answer

Answer reason: Pathology is the scientific study of diseases, including their causes, mechanisms, structural changes, and clinical manifestations. Oncology focuses specifically on cancers, not all diseases. Physiology deals with normal body function, and anatomy (misspelled as ‘Anotomy’) concerns body structure rather than disease.

Question 17

Which organ is mainly affected in malaria?

Accepted Answer

Answer reason: Plasmodium parasites infect red blood cells, which are cleared by the spleen. This leads to splenic congestion and hyperplasia of the reticuloendothelial system, causing splenomegaly and hypersplenism. The spleen is thus the organ most prominently affected and can even rupture in severe malaria.

Question 18

The most common complication of measles in children is?

Accepted Answer

Answer reason: In measles, gastrointestinal involvement and immune suppression commonly lead to diarrhea, making it the most frequent complication in children and a major cause of dehydration. Pneumonia is the most common cause of measles-related death but occurs less often than diarrhea. Malaria and typhoid are unrelated infections and not considered complications of measles.

Question 19

The most common symptom of COVID-19 is?

Accepted Answer

Answer reason: COVID-19 commonly presents with respiratory symptoms, with cough among the most frequently reported, along with fever and fatigue per WHO/CDC data. Joint pain and hair loss can occur but are not predominant presenting features. Yellow eyes indicate jaundice and are unrelated to typical SARS-CoV-2 infection. Therefore, cough is the best single answer.

Question 20

A 37-year-old patient with a spinal tumor has been having a difficult time sleeping. Which best explains how a tumor can make sleep more difficult for a patient with cancer?

Accepted Answer

Answer reason: Tumors can produce mass effect and local tissue invasion that cause nociceptive and neuropathic pain, especially with spinal involvement. Pain and discomfort when lying down or with movement commonly fragment sleep and delay sleep onset. Disrupted melatonin production is not a typical direct effect of most tumors, and cognitive changes or depression are less direct explanations than pain from pressure effects.

Question 21

Which of the following is a common sign of neonatal sepsis in a newborn?

Accepted Answer

Answer reason: Neonates with sepsis commonly present with temperature instability, and hypothermia is more typical than fever because their thermoregulatory mechanisms are immature. Other findings include lethargy, poor feeding, apnea, and respiratory distress. Sneezing and increased crying are nonspecific, and while bradycardia can occur, it is not as common an early indicator as temperature instability.

Question 22

Neurogenic shock is considered this type of shock?

Accepted Answer

Answer reason: Neurogenic shock results from loss of sympathetic tone (often after spinal cord injury), causing widespread vasodilation and maldistribution of blood flow. This leads to hypotension with warm, dry skin and often bradycardia. These features define it as a distributive shock, along with septic and anaphylactic shock types.

Question 23

Bone disorder caused by a deficiency of vitamin D, calcium, or phosphate is ...?

Accepted Answer

Answer reason: Rickets is a pediatric bone disorder characterized by defective mineralization of the growth plate due to deficiency of vitamin D or inadequate calcium/phosphate. It presents with bone pain, deformities such as bowing of the legs, and growth delay. Cancer, anemia, and goiter are unrelated to this specific nutrient deficiency–induced bone mineralization defect.

Question 24

Birth asphyxia means?

Accepted Answer

Answer reason: Birth asphyxia refers to impaired gas exchange around the time of delivery resulting in hypoxemia and hypercapnia, i.e., lack of oxygen at birth. It can lead to metabolic acidosis and potential hypoxic‑ischemic injury if prolonged. Fever, tachycardia, and infection are not definitions of asphyxia and may occur from other conditions.

Question 25

Chronic hepatitis can lead to?

Accepted Answer

Answer reason: Chronic hepatitis causes persistent hepatic inflammation with progressive fibrosis, eventually leading to cirrhosis and architectural distortion of the liver. Cirrhosis is a well-known complication of chronic hepatitis B and C. Heart failure, kidney stones, and pneumonia are not direct consequences of chronic hepatitis.

Question 26

The advanced stage of shock is called?

Accepted Answer

Answer reason: Shock progresses from initial/early to compensatory (nonprogressive), then progressive (decompensated), and finally refractory or irreversible. The advanced stage is characterized by profound cellular hypoxia, severe metabolic acidosis, and multiorgan failure that no longer responds to therapy. At this point, tissue damage is irreversible and death is imminent despite resuscitation. Therefore, the advanced stage is the irreversible stage.

Question 27

The common clinical feature of malaria is?

Accepted Answer

Answer reason: Malaria classically presents with paroxysms of fever accompanied by chills/rigors due to synchronous rupture of infected red blood cells and cytokine release. The fever pattern is often intermittent (periodic) depending on the Plasmodium species’ erythrocytic cycle. Cough/cold suggest a respiratory infection, while diarrhea or skin rash are not the common hallmark features of uncomplicated malaria.

Question 28

A common symptom of Typhoid fever is?

Accepted Answer

Answer reason: Typhoid fever (Salmonella Typhi) classically presents with sustained, stepwise-rising to continuous high fever along with systemic toxicity. Gastrointestinal symptoms like constipation can occur, especially early, but fever is the most consistent and common feature. Jaundice is not a typical presenting symptom, and cough with sputum suggests a primary respiratory infection rather than enteric fever.

Question 29

Which hepatitis type can cause chronic infection in most cases?

Accepted Answer

Answer reason: Chronic infection in most cases is classically associated with hepatitis C, which is not listed among the options. Hepatitis A does not cause chronic hepatitis, and hepatitis E is typically acute (chronicity mainly in immunocompromised patients, not “most cases”). Hepatitis B can become chronic, but in a minority of adults (higher in neonates/children), so it is not “most cases.” Therefore, none of the listed types fit the stem best.

Question 30

Gout is caused by excess ?

Accepted Answer

Answer reason: Gout is caused by hyperuricemia, which leads to precipitation of monosodium urate crystals in joints and surrounding tissues. These crystals trigger acute inflammatory arthritis with pain, erythema, warmth, and swelling. Therefore, excess uric acid is the direct pathogenic factor among the options.

Question 31

The rash of measles is usually of what type?

Accepted Answer

Answer reason: Measles (rubeola) classically causes an erythematous maculopapular rash that starts on the face/hairline and spreads downward (cephalocaudal) and outward. This contrasts with varicella, which is typically vesicular, and with bacterial skin infections that may be pustular. Nodular lesions are not characteristic of measles.

Question 32

Most common cancer in women worldwide is?

Accepted Answer

Answer reason: Globally, breast cancer is the most frequently diagnosed cancer among women, exceeding cervical, lung, and skin cancers in incidence. Cervical cancer remains common in some low-resource settings but is not the most common worldwide overall. Lung cancer is a leading cause of cancer death in women, but it is not the most common by incidence. Therefore, breast cancer is the best answer.

Question 33

HELLP syndrome includes all EXCEPT?

Accepted Answer

Answer reason: HELLP is defined by Hemolysis, Elevated Liver enzymes, and Low Platelet count (the acronym itself). These findings reflect microangiopathic hemolysis and hepatic involvement associated with severe preeclampsia. Hyperglycemia is not part of the diagnostic criteria for HELLP and instead points toward disorders such as diabetes mellitus or stress hyperglycemia.

Question 34

Which hepatitis virus is often silent and asymptomatic?

Accepted Answer

Answer reason: Hepatitis C infection is frequently asymptomatic or minimally symptomatic during the acute phase, so many patients are unaware they are infected until abnormal liver enzymes or chronic liver disease is detected. In contrast, hepatitis A more commonly causes an acute symptomatic illness with jaundice. Hepatitis B can be asymptomatic but is less characteristically “silent” than HCV in typical exam framing, and hepatitis E usually presents as an acute symptomatic hepatitis (notably severe in pregnancy). Therefore, Hepatitis C is the best answer.

Question 35

Which of these is a chronic liver disease caused by hepatitis?

Accepted Answer

Answer reason: Chronic viral hepatitis (especially hepatitis B and C) can cause ongoing hepatic inflammation and progressive fibrosis, which can ultimately lead to cirrhosis. Cirrhosis is a chronic liver disease characterized by diffuse scarring and nodular regeneration that impairs liver function. Pneumonia and bronchitis are respiratory infections, and diabetes is an endocrine/metabolic disorder, not a primary chronic liver disease caused by hepatitis.

Question 36

A common complication of untreated Typhoid is?

Accepted Answer

Answer reason: Untreated typhoid fever (Salmonella typhi) can cause necrosis of Peyer patches in the terminal ileum, leading to intestinal hemorrhage and intestinal perforation. Perforation is a classic, relatively common severe complication and can progress rapidly to peritonitis and sepsis. Renal failure can occur secondarily in severe sepsis/dehydration but is not the typical hallmark complication tested. Liver cirrhosis and lung abscess are not common direct complications of typhoid fever.

Question 37

Persistent high fever for more than 2 weeks is called?

Accepted Answer

Answer reason: Fever patterns are commonly categorized by duration and temperature pattern. A persistent fever lasting more than about 2 weeks is considered prolonged/chronic in many nursing/medical teaching classifications. Intermittent fever refers to periodic spikes with return to normal in between, and relapsing fever refers to episodes of fever separated by afebrile periods. Therefore, the best answer is chronic fever.

Question 38

Skin Color is yellow due to excess of...?

Accepted Answer

Answer reason: Yellow discoloration of the skin (jaundice) occurs when bilirubin accumulates in the blood and deposits in tissues. Bilirubin is a breakdown product of heme from hemoglobin, and it rises with increased hemolysis, impaired hepatic conjugation, or biliary obstruction. Excess hemoglobin or myoglobin more typically causes red-brown discoloration (e.g., hemoglobinuria/myoglobinuria), and melanin excess causes hyperpigmentation (brown/black), not yellow skin.

Question 39

Hepatitis E is mostly dangerous in which group?

Accepted Answer

Answer reason: Hepatitis E infection carries a markedly higher risk of severe disease, fulminant hepatic failure, and maternal mortality in pregnant women, especially in the third trimester. This increased severity is well documented in outbreaks and is a key distinguishing clinical risk group for HEV compared with other viral hepatitides. Children, teenagers, and elderly men can be infected, but they do not have the same consistent high-risk profile for life-threatening complications.

Question 40

Causes of decreased platelets count in Dengue Fever?

Accepted Answer

Answer reason: Thrombocytopenia in dengue is multifactorial: transient bone marrow suppression reduces platelet production, while immune mechanisms (including antiplatelet antibodies and immune complex–mediated clearance) increase platelet destruction. In addition, platelet activation and consumption occur due to endothelial activation and coagulation pathway disturbances, contributing to increased peripheral use. Therefore, all listed mechanisms can contribute to the decreased platelet count.

Question 41

A 30-year-old male presented to the OPD with painful genital ulcers. Which of the following can cause a painful ulcer on the glans penis?

Accepted Answer

Answer reason: Painful genital ulcers are classically associated with chancroid (Haemophilus ducreyi), which causes a painful, soft chancre often on the glans or prepuce and may be associated with tender inguinal lymphadenopathy. Primary syphilis typically presents with a painless, indurated chancre. Lymphogranuloma venereum often causes a small, transient (often painless) ulcer followed by painful inguinal lymphadenopathy (buboes) rather than a prominent painful glans ulcer. Uncomplicated chlamydia most commonly causes urethritis/cervicitis rather than genital ulcer disease.

Question 42

Following is a sign of reversible damage to cell?

Accepted Answer

Answer reason: Reversible cell injury is characterized by decreased ATP production and a shift to anaerobic glycolysis, which rapidly consumes cellular glycogen stores. Decreased glycogen is therefore a classic early, reversible change. In contrast, significant calcium influx is more associated with progression toward irreversible injury via activation of phospholipases, proteases, and endonucleases. "Loss of Na+" is opposite of typical early injury (cells usually gain Na+ and water due to Na+/K+ pump failure).

Question 43

The most common site of prostate cancer metastasis is?

Accepted Answer

Answer reason: Prostate adenocarcinoma most commonly metastasizes to bone, particularly the axial skeleton (spine, pelvis, ribs), via venous spread through Batson’s plexus. These metastases are classically osteoblastic/sclerotic rather than lytic. Bone involvement is a major cause of pain and pathologic fractures in advanced prostate cancer, making it the most typical metastatic site compared with liver, lung, or brain.

Question 44

Which of the following is not a chronic disease?

Accepted Answer

Answer reason: Chronic diseases are long-lasting conditions that typically persist for months to years and often require ongoing management (e.g., hypertension and diabetes). Many cancers also behave as chronic illnesses due to prolonged course and long-term treatment/surveillance. The common cold is an acute, self-limited viral upper respiratory infection that usually resolves within about 7–10 days, so it is not considered a chronic disease.

Question 45

An 11-year-old girl has had increasing headaches upon awakening for the past month. On examination, papilledema is present bilaterally. An MRI of her brain reveals a 3-cm solid circumscribed mass within the fourth ventricle. There is third and lateral cerebral ventricular dilation. The mass is excised and microscopically shows perivascular pseudorosettes with round, regular tumor cells arranged around vessels. Which of the following neoplasms is she most likely to have?

Accepted Answer

Answer reason: A pediatric posterior fossa tumor arising in the fourth ventricle with obstructive hydrocephalus (morning headaches, papilledema, ventricular dilation) is classic for an ependymoma. The key histologic clue is perivascular pseudorosettes, where tumor cells are arranged around blood vessels. Astrocytomas are often cerebellar and do not characteristically form pseudorosettes, while medulloblastomas typically arise in the cerebellar vermis and show small blue cells with Homer Wright rosettes rather than perivascular pseudorosettes. Glioblastoma is usually a supratentorial adult tumor, and schwannoma most commonly involves CN VIII at the cerebellopontine angle, not the fourth ventricle.

Question 46

Which type of shock occurs due to severe infection?

Accepted Answer

Answer reason: Septic shock is a form of distributive shock caused by severe infection leading to systemic inflammation, pathologic vasodilation, and capillary leak. This results in relative hypovolemia and impaired tissue perfusion despite (often) adequate intravascular volume initially. Hypovolemic shock is due to true volume loss (e.g., hemorrhage), cardiogenic shock is due to pump failure, and neurogenic shock results from loss of sympathetic tone (e.g., spinal cord injury).

Question 47

The “risus sardonicus” sign in tetanus means?

Accepted Answer

Answer reason: Risus sardonicus is the characteristic sustained grimace or “sardonic smile” caused by spasm of the facial muscles in tetanus. It results from tetanospasmin blocking inhibitory neurotransmission (GABA and glycine), producing generalized muscle rigidity and spasms. Loss of vision, facial swelling, and skin rash are not defining clinical signs of tetanus and do not explain the classic facial expression.

Question 48

All of the following symptoms are associated to prion, except;?

Accepted Answer

Answer reason: Prion diseases (transmissible spongiform encephalopathies) primarily affect the central nervous system, causing progressive neurodegeneration with symptoms such as rapidly progressive dementia, ataxia, and other motor deficits that can include weakness or paralysis. The hallmark pathology is neuronal loss and spongiform change, i.e., destruction of nerve tissue. Severe diarrhea is not a typical feature of prion disease and would more strongly suggest a primary gastrointestinal infection or toxin rather than a prion-mediated neurologic disorder.

Question 49

Temperature pattern in Typhoid fever is?

Accepted Answer

Answer reason: Typhoid fever classically shows a gradual, progressive daily rise in temperature over the first week, producing a characteristic “step-ladder” fever curve. This pattern reflects the systemic bacteremia and inflammatory response of Salmonella typhi early in the illness. Intermittent and relapsing fever patterns are more typical of other infections (e.g., malaria for intermittent, Borrelia for relapsing). Therefore, the step-ladder rise best matches typhoid fever.

Question 50

What is the first-line treatment for sepsis?

Accepted Answer

Answer reason: Sepsis is a life-threatening organ dysfunction caused by a dysregulated response to infection, so rapid source control with empiric broad-spectrum antibiotics is a cornerstone first-line therapy. Antibiotics should be started as soon as possible after obtaining appropriate cultures, because delays increase mortality. IV crystalloids are also part of initial management to support perfusion, but they do not treat the underlying infectious cause. Vasopressors are added only if hypotension persists despite adequate fluid resuscitation, and blood transfusion is not routinely indicated unless there is significant anemia or bleeding.

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