Question 1

Year-old baby is brought by the mother complaining of cystic mass on back and inability to move both legs ever since birth. Possible diagnosis is?

Accepted Answer

Answer reason: A cystic mass on the back present since birth with bilateral lower-limb paralysis strongly suggests an open neural tube defect with involvement of spinal cord/nerve roots. Meningomyelocele (myelomeningocele) includes herniation of meninges plus neural tissue, commonly causing motor and sensory deficits in the legs and bowel/bladder dysfunction. A meningocele contains only meninges and CSF and typically has less severe or absent neurologic deficits. Pilonidal cyst and sacrococcygeal teratoma do not classically present with congenital paraplegia from birth.

Question 2

Loss of weight due to illness is called?

Accepted Answer

Answer reason: Cachexia is a complex metabolic syndrome associated with underlying disease (e.g., cancer, chronic infections, advanced heart failure) characterized by unintentional weight loss and muscle wasting, often with anorexia and inflammation. It differs from simple starvation because nutritional supplementation alone does not fully reverse the catabolic state. Atrophy refers to decreased size of a specific organ/tissue, apnea is cessation of breathing, and adhesion refers to fibrous bands between tissues.

Question 3

Which of the following is a common early symptom of viral hepatitis?

Accepted Answer

Answer reason: In early (prodromal/pre-icteric) viral hepatitis, systemic “flu-like” symptoms such as fever, fatigue, malaise, anorexia, and sometimes nausea commonly occur before jaundice develops. Jaundice is typically a later finding (icteric phase) after bilirubin rises. Abdominal/RUQ discomfort can occur but is less characteristic as an early, common presenting symptom than fever and malaise. Weight gain is not typical in acute viral hepatitis.

Question 4

What are the main features of a cirrhotic liver?

Accepted Answer

Answer reason: Cirrhosis is defined pathologically by diffuse fibrosis with conversion of normal liver architecture into structurally abnormal regenerative nodules. The fibrosis forms bridging septa and the nodules represent hepatocyte regeneration within the distorted framework. Necrosis and apoptosis can occur in many liver injuries, but they are not the defining, main morphologic features of cirrhosis. Therefore the best answer is fibrosis and nodule formation.

Question 5

In lung cancer staging, what does “T” stand for in TNM classification?

Accepted Answer

Answer reason: In the TNM cancer staging system, "T" describes the primary tumor—specifically its size and the extent of local invasion into nearby tissues. "N" refers to regional lymph node involvement and "M" refers to distant metastasis. Therefore, among the options provided, "Tumor size and extent" is the correct definition of T.

Question 6

A Biopsy is ________?

Accepted Answer

Answer reason: A biopsy is the removal (by excision, needle core, punch, etc.) of tissue from a living patient for microscopic examination to establish or confirm a diagnosis, commonly malignancy or specific inflammatory/infectious processes. It is not removal of an entire organ (that would be organ resection/excision). A post-mortem examination is an autopsy, and removal of biological fluid is aspiration (e.g., thoracentesis/paracentesis), not a biopsy.

Question 7

Transformation of one type of cells into another type is called-?

Accepted Answer

Answer reason: Metaplasia is the reversible change in which one differentiated (mature) cell type is replaced by another differentiated cell type, typically as an adaptive response to chronic irritation (e.g., smoking causing squamous metaplasia in bronchial epithelium). Anaphase is a stage of mitosis, not a cell-type transformation. Hyperplasia is an increase in the number of cells, not a change in cell type. “Dysphase” is not the correct pathology term for this concept.

Question 8

What is the heightened risk linked to infection with Clonorchis sinensis?

Accepted Answer

Answer reason: Clonorchis sinensis (Chinese liver fluke) chronically inhabits the biliary tree, causing persistent inflammation, epithelial hyperplasia, and biliary obstruction. This long-standing biliary irritation is a well-established risk factor for cholangiocarcinoma. The other cancers listed are classically associated with different etiologies (e.g., Schistosoma haematobium with bladder cancer, HPV with cervical cancer). Therefore, cholangiocarcinoma is the single best answer.

Question 9

Dengue infect?

Accepted Answer

Answer reason: Dengue virus commonly causes hepatic involvement, with hepatomegaly and elevated AST/ALT, and severe dengue can progress to acute liver failure. While dengue can rarely involve the heart (myocarditis) or CNS (encephalitis), these are less typical compared with liver involvement. Therefore, among the listed single organs, the liver is the best answer.

Question 10

Pathological jaundice is considered when bilirubin rises more than?

Accepted Answer

Answer reason: A bilirubin rise greater than 2 mg/dL per day in neonates exceeds normal physiologic limits and indicates pathological jaundice requiring further evaluation.

Question 11

Study of tumors is called?

Accepted Answer

Answer reason: Oncology is the medical specialty and scientific discipline that studies tumors (neoplasms), including their biology, diagnosis, and treatment. Pathology is broader and covers the study of all diseases, not only tumors. Cytology focuses on the study of cells (often for screening/diagnosis), and hematology focuses on blood and blood-forming organs.

Question 12

The nurse has attended a staff education program about caring for clients with acute osteomyelitis. Which of the following statements by the nurse would indicate a correct understanding of the teaching?

Accepted Answer

Answer reason: Acute osteomyelitis (an acute bone infection, most often bacterial such as Staphylococcus aureus) commonly presents with systemic signs of infection including fever, often >38.3°C (101°F), along with localized bone pain and tenderness. IV antibiotic therapy is typically required for weeks (often 4–6+ weeks), not just 7–14 days. Viruses are not the most common cause, and petechiae are not a typical finding of osteomyelitis (they suggest other conditions such as thrombocytopenia or meningococcemia).

Question 13

What is the only organ that cannot have cancer?

Accepted Answer

Answer reason: Among the options, the heart is classically taught as the organ least likely to develop primary cancer because cardiomyocytes are terminally differentiated with very low mitotic activity, reducing the chance of malignant transformation. Primary cardiac tumors are rare compared with cancers in highly proliferative tissues. By contrast, kidney and brain cancers (e.g., renal cell carcinoma, gliomas/meningiomas) are well-recognized. Therefore, the best answer from the listed choices is the heart.

Question 14

What serious complication may occur if appendicitis is left untreated?

Accepted Answer

Answer reason: Untreated appendicitis can progress to appendiceal rupture, spilling bacteria and inflammatory contents into the peritoneal cavity. This can lead to diffuse peritonitis, a life-threatening intra-abdominal infection and inflammatory response. The other options are not typical direct complications of appendiceal perforation, whereas peritonitis is a classic and serious consequence.

Question 15

Hydatidiform Mole is an abnormal condition affecting-?

Accepted Answer

Answer reason: A hydatidiform mole is a form of gestational trophoblastic disease characterized by abnormal proliferation of trophoblast and hydropic swelling of the chorionic villi. The hallmark pathology is edematous, grape-like chorionic villi, often with varying degrees of trophoblastic hyperplasia. Therefore, the primary structure affected is the villi rather than the amnion, chorion as a whole, or embryonic blastomeres.

Question 16

Abnormal accumulation of fluid is known as -?

Accepted Answer

Answer reason: Edema refers to abnormal accumulation of fluid in the interstitial spaces, leading to visible swelling and often pitting on pressure. Inflammation is a broader tissue response that may include edema but is not synonymous with fluid accumulation alone. Epistaxis means nosebleed, and necrosis is tissue death. Therefore, the correct term for abnormal fluid accumulation is edema.

Question 17

The commonest cause of maternal mortality in eclampsia is?

Accepted Answer

Answer reason: In eclampsia, severe hypertension can cause loss of cerebral autoregulation leading to cerebral edema, ischemia, and intracranial bleeding. Cerebral hemorrhage (including intracerebral and subarachnoid hemorrhage) is classically the most common direct cause of maternal death in eclampsia. Other options like renal failure and heart failure can occur but are less frequent causes of mortality compared with catastrophic CNS hemorrhage.

Question 18

The commonest leukemia in children is?

Accepted Answer

Answer reason: Acute lymphoblastic leukemia (ALL) is the most common leukemia in children, accounting for the majority of pediatric leukemia cases. It arises from malignant transformation of lymphoid precursor cells and typically presents in early childhood. In contrast, AML is less common in children, and CLL/CML are predominantly adult leukemias.

Question 19

Measles can lead to which serious brain complication?

Accepted Answer

Answer reason: A classic delayed, serious neurologic complication of measles is subacute sclerosing panencephalitis (SSPE), a progressive, usually fatal degenerative disease of the CNS that appears years after the initial infection. It is caused by persistent mutated measles virus in the brain leading to cognitive decline, myoclonus, and neurologic deterioration. While measles can also cause acute encephalitis, SSPE is the hallmark severe late brain complication among the choices given.

Question 20

Indication of ECT-?

Accepted Answer

Answer reason: Electroconvulsive therapy (ECT) is indicated for severe major depression, particularly when depression is life-threatening (e.g., suicidality, refusal to eat/drink) or when rapid symptom relief is required and medications are ineffective or not tolerated. It is also used in certain cases of catatonia and treatment-resistant mood disorders, but among the listed options, severe depression is the classic indication. Epilepsy is not an indication for ECT, and eyestrain and phobia are not treated with ECT.

Question 21

Using the “Rule of nines”, percentage of right lower extremity that is burned is –?

Accepted Answer

Answer reason: In the adult “Rule of Nines” for estimating total body surface area (TBSA) burned, each lower extremity accounts for 18% (9% anterior + 9% posterior). Since the question asks for the right lower extremity, the correct TBSA percentage is 18%. This standardized estimate is commonly used in burn assessment to guide resuscitation and management decisions.

Question 22

Evening rise of temperature is evident in?

Accepted Answer

Answer reason: The question is asking about a characteristic fever pattern (diurnal variation). An evening rise in temperature is classically described with tuberculosis due to the typical low-grade, late-day fever and night sweats seen in chronic infection. Typhoid more often shows a step-ladder pattern, kala-azar typically causes prolonged irregular fever, and dengue commonly presents with a sudden high fever rather than a consistent evening rise. Therefore, the best answer is Tuberculosis.

Question 23

Which is not a sign of tetanus?

Accepted Answer

Answer reason: Classic tetanus features include trismus (lockjaw), risus sardonicus (facial muscle spasm with grimace), and generalized muscle rigidity with spasms that can cause opisthotonos. Tetany, however, refers to muscle spasms from hypocalcemia or alkalosis and is not a characteristic clinical sign of tetanus. Therefore, among the options, tetany is the best choice for "not a sign" of tetanus.

Question 24

Which organ is affected by Reye’s syndrome?

Accepted Answer

Answer reason: Reye’s syndrome classically causes acute hepatic dysfunction with microvesicular fatty change, often after a viral illness and aspirin exposure in children. The resulting liver failure leads to hyperammonemia and hypoglycemia, contributing to cerebral edema and encephalopathy. Among the options, the liver is the primary organ characteristically affected.

Question 25

A 5-year-old child presents with cough, runny nose and conjunctivitis. The physician notices small white lesion inside patient’s mouth. Next day red rash started on face and then covered the trunk part of the body. What is the most likely diagnosis?

Accepted Answer

Answer reason: The combination of cough, coryza (runny nose), and conjunctivitis followed by Koplik spots (small white lesions on the buccal mucosa) is classic for measles (rubeola). The rash typically begins on the face/hairline and spreads cephalocaudally to the trunk and extremities. Chickenpox would show a vesicular rash in different stages, and rubella usually has milder prodrome with posterior auricular/occipital lymphadenopathy and no Koplik spots. Smallpox is eradicated and presents with a different rash pattern and systemic severity.

Question 26

Which of the following lesions is a benign epithelial neoplasm?

Accepted Answer

Answer reason: Adenoma is a benign neoplasm derived from epithelial tissue, typically forming glandular patterns or arising from glandular epithelium. In contrast, glioma is a tumor of neuroglial (non-epithelial) origin, fibroma is a benign tumor of fibrous connective tissue, and myoma is a benign tumor of muscle. Therefore, the only benign epithelial neoplasm listed is adenoma.

Question 27

Which of the following is most common type of Hernia present in new Born baby?

Accepted Answer

Answer reason: In infants, the most common hernia is an indirect inguinal hernia, usually due to a patent processus vaginalis that allows abdominal contents to protrude through the inguinal canal. This is especially common in newborns and premature infants. Umbilical hernias are also frequent in infants but are generally less common than inguinal hernias overall and often close spontaneously. Femoral and epigastric hernias are uncommon in newborns.

Question 28

Itai -itai disease is caused by?

Accepted Answer

Answer reason: Itai-itai disease is classically caused by chronic cadmium poisoning, historically linked to cadmium-contaminated water and rice in Japan. Cadmium toxicity leads to renal tubular dysfunction with phosphate wasting and impaired vitamin D activation. This results in osteomalacia/osteoporosis with severe bone pain and fractures, giving the characteristic presentation. Mercury is associated with Minamata disease, not itai-itai.

Question 29

Which infection causes blocked fallopian tubes?

Accepted Answer

Answer reason: Genital tuberculosis can involve the endometrium and fallopian tubes, causing chronic granulomatous inflammation that heals with fibrosis and scarring. This scarring can lead to tubal obstruction and infertility. Hepatitis primarily affects the liver, and malaria and dengue are systemic febrile illnesses that do not characteristically cause fallopian tube blockage.

Question 30

A patient presents to the clinic with back pain that improves with exercise but worsens with rest. Radiographic examination reveals bamboo spine appearance. What is the most likely diagnosis?

Accepted Answer

Answer reason: Inflammatory back pain classically improves with activity and worsens with rest, which points to a spondyloarthropathy rather than mechanical causes like disc herniation or spinal stenosis. The “bamboo spine” radiographic appearance is characteristic of ankylosing spondylitis due to syndesmophyte formation and vertebral fusion. Osteoporosis does not cause bamboo spine and typically presents with fragility fractures rather than inflammatory pain pattern.

Question 31

The events in acute inflammation occurs first?

Accepted Answer

Answer reason: In acute inflammation, the earliest event is transient vasoconstriction followed quickly by arteriolar vasodilation mediated by histamine and other mediators. Increased blood flow (hyperemia) occurs immediately with vasodilation and produces local warmth (heat) and then redness. Swelling occurs later as vascular permeability increases and protein-rich fluid exudes into tissues. Pain typically follows due to bradykinin/prostaglandins and tissue edema stimulating nerve endings.

Question 32

Which of the following is not considered a type of shock?

Accepted Answer

Answer reason: The major physiologic categories of shock include hypovolemic, distributive (e.g., septic/anaphylactic/neurogenic), cardiogenic, and obstructive shock. “Hypoglycemic shock” is not a standard shock classification; hypoglycemia causes altered mental status, diaphoresis, and possible loss of consciousness, but not shock as defined by systemic circulatory failure and inadequate tissue perfusion. Therefore, among the options, hypoglycemic shock is the one not considered a type of shock.

Question 33

'Cold Shock' is also called as?

Accepted Answer

Answer reason: “Cold shock” is a traditional clinical description of shock with cool, pale, clammy extremities due to peripheral vasoconstriction and reduced perfusion, which is most characteristic of hypovolemic shock. In hypovolemia, decreased circulating volume lowers preload and cardiac output, triggering sympathetic vasoconstriction that makes the skin cold. Vasogenic (distributive) shock typically presents as “warm shock” early due to vasodilation. Cardiogenic and obstructive shock can also be cool, but the classic pairing of “cold shock” in basic nursing/medical terminology is with hypovolemic shock.

Question 34

A patient who is scheduled for a right breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is correct?

Accepted Answer

Answer reason: The key distinguishing feature of malignant tumors is their ability to invade surrounding tissues and metastasize to distant sites via lymphatic or hematogenous spread. Benign tumors generally remain localized and do not metastasize, though they can still cause local tissue damage by compression or functional obstruction. Recurrence is more associated with malignant tumors and incomplete excision rather than being a defining benign feature. Increased proliferation can occur in malignancy, but metastatic potential is the most definitive difference among the options.

Question 35

__________ occurs when excess fluid builds up in the body, when pressure is applied to the swollen area, a “pit”, or indentation?

Accepted Answer

Answer reason: Pitting edema is edema in which applied pressure to a swollen area leaves a persistent indentation (“pit”). It reflects excess interstitial fluid and commonly occurs with conditions such as heart failure, venous insufficiency, or hypoalbuminemia. The defining feature is the retained indentation after pressing on the skin, distinguishing it from non-pitting edema (e.g., lymphedema).

Question 36

Hirschsprung disease is due to absence of?

Accepted Answer

Answer reason: Hirschsprung disease results from failure of neural crest cell migration, causing aganglionosis (absence of enteric ganglion cells) in the distal bowel. Missing ganglion cells in the submucosal (Meissner) and myenteric (Auerbach) plexuses leads to absent peristalsis and functional obstruction. The affected segment remains tonically contracted, producing proximal dilation (megacolon). Therefore, the key absent structure is ganglion cells.

Question 37

The most common cause of severe dehydration in children is?

Accepted Answer

Answer reason: In children, the most common overall cause of dehydration (including severe cases) is acute gastroenteritis because vomiting and especially diarrhea rapidly deplete body water and electrolytes. This is particularly impactful in pediatrics due to higher baseline fluid requirements and smaller fluid reserves. Cholera can cause very severe dehydration, but it is not the most common cause compared with routine viral/bacterial gastroenteritis. Typhoid fever and pneumonia may contribute to dehydration via fever and poor intake, but typically cause less rapid fluid loss than gastroenteritis.

Question 38

Which of the following viruses affects the liver?

Accepted Answer

Answer reason: Hepatitis viruses (e.g., HAV, HBV, HCV, HDV, HEV) are hepatotropic and primarily infect hepatocytes, causing liver inflammation and potential jaundice, elevated transaminases, and hepatic dysfunction. Rabies virus primarily targets the central nervous system. Rhinovirus typically infects the upper respiratory tract, and rotavirus primarily causes gastroenteritis affecting the intestines rather than the liver.

Question 39

Which of the following is most common cancer in men?

Accepted Answer

Answer reason: Among the listed options, prostate cancer is the most commonly diagnosed cancer in men in many populations, making it the best answer. Lung cancer is a leading cause of cancer death in men, but it is not typically the most common by incidence compared with prostate cancer. Male breast cancer and mouth (oral) cancers are less common than prostate cancer overall. Therefore, "Prostate" is correct.

Question 40

Which organ is most injured in blunt abdominal trauma?

Accepted Answer

Answer reason: In blunt abdominal trauma, the spleen is classically the most frequently injured solid organ due to its relatively fragile parenchyma and location under the left lower ribs. Splenic laceration can cause significant intra-abdominal hemorrhage and rapid hemodynamic instability. While the liver is also commonly injured, it is typically second to the spleen in frequency in blunt mechanisms.

Question 41

Which electrolyte is most affected in crush injury?

Accepted Answer

Answer reason: Crush injury causes rhabdomyolysis with breakdown of skeletal muscle cells, releasing large amounts of intracellular potassium into the bloodstream. This commonly leads to hyperkalemia, which is the most critical electrolyte abnormality because it can precipitate life-threatening cardiac dysrhythmias. Other electrolyte changes (e.g., hypocalcemia early, hyperphosphatemia) can occur, but potassium is the most prominently and urgently affected.

Question 42

Name the disease that causes the weakening of bones in children?

Accepted Answer

Answer reason: Rickets is a childhood disorder of defective bone mineralization, most commonly due to vitamin D deficiency (or impaired vitamin D metabolism), leading to soft/weak bones. It can cause bone pain, delayed growth, and skeletal deformities such as bowed legs. Chickenpox, measles, and mumps are viral infections that do not primarily cause bone weakening through impaired mineralization.

Question 43

Which type of shock shows warm skin initially?

Accepted Answer

Answer reason: Septic shock is a distributive shock characterized early by peripheral vasodilation and increased cardiac output, producing “warm shock” with warm, flushed skin. In contrast, hypovolemic and cardiogenic shock cause compensatory vasoconstriction leading to cool, clammy skin. Neurogenic shock can have warm skin due to loss of sympathetic tone, but the classic and most tested cause of initially warm skin in shock states is early septic shock.

Question 44

Death of tissue due to lack of blood supply is known as?

Accepted Answer

Answer reason: Gangrene is tissue death (necrosis) that occurs due to loss of blood supply (ischemia), often with superimposed infection, classically affecting extremities. Ischemia alone refers to reduced perfusion, not necessarily tissue death. Necrosis is the general term for cell/tissue death from many causes, whereas the question specifies necrosis due to lack of blood supply. An ulcer is a break in skin or mucosa and is not defined as tissue death from ischemia.

Question 45

Which shock shows warm skin initially?

Accepted Answer

Answer reason: Early ("warm") septic shock is characterized by peripheral vasodilation and increased capillary permeability due to inflammatory mediators, which increases skin blood flow and makes the skin warm and flushed initially. In contrast, hypovolemic and cardiogenic shock reduce cardiac output and trigger sympathetic vasoconstriction, producing cool, clammy skin. Neurogenic shock can cause warm, dry skin from loss of sympathetic tone, but the classic teaching for warm skin initially among common shock types is early septic shock (warm phase) before later vasoconstrictive "cold" shock may develop.

Question 46

Inflammation of joints due to the accumulation of uric acid crystals occurs in?

Accepted Answer

Answer reason: Gout is an inflammatory arthritis caused by deposition of monosodium urate (uric acid) crystals in joints, triggering acute pain, swelling, warmth, and redness. It classically affects the first metatarsophalangeal joint (podagra). Osteoporosis is loss of bone mineral density, tetany is neuromuscular irritability (often from hypocalcemia), and rickets is defective bone mineralization from vitamin D deficiency—none are due to urate crystal deposition.

Question 47

Yellowing skin is caused by?

Accepted Answer

Answer reason: Yellowing of the skin and sclera is characteristic of jaundice, which results from elevated bilirubin (hyperbilirubinemia). Bilirubin can accumulate due to increased hemolysis (prehepatic), impaired hepatic uptake/conjugation (hepatic), or obstruction to bile flow (posthepatic). Cyanosis causes a bluish discoloration from hypoxemia, pallor reflects reduced oxyhemoglobin or perfusion, and melanosis refers to increased melanin pigmentation (darkening), not yellowing.

Question 48

Type of shock seen in burn cases?

Accepted Answer

Answer reason: Major burns cause large fluid shifts from the intravascular space into the interstitium due to increased capillary permeability, leading to decreased circulating volume. This results in reduced venous return and cardiac output, producing hypovolemic (burn) shock, especially within the first 24–48 hours. Cardiogenic shock is not the typical primary mechanism in uncomplicated burns, and neurogenic shock is associated with loss of sympathetic tone (e.g., spinal cord injury), not burn injury.

Question 49

A Child born with mass in left flank no other symptoms diagnosis is?

Accepted Answer

Answer reason: A painless abdominal/flank mass in a young child with few or no other symptoms is classic for Wilms tumor (nephroblastoma), a renal malignancy that often presents as an incidental unilateral flank mass. Intussusception typically causes episodic abdominal pain, vomiting, and sometimes “currant jelly” stools rather than an isolated flank mass. Primary liver cancer would more likely present with right upper quadrant mass/hepatomegaly and systemic symptoms, not specifically a left flank mass.

Question 50

Multiple myeloma is a cancer of?

Accepted Answer

Answer reason: Multiple myeloma is a malignant clonal proliferation of plasma cells in the bone marrow. These abnormal plasma cells overproduce a monoclonal immunoglobulin (M protein) and can cause bone lesions, anemia, renal dysfunction, and immunosuppression. The other choices are blood elements that may be affected secondarily, but they are not the primary malignant cell type in multiple myeloma.

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