1 .. 2555 1 ()

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11)

1) Biology of Cells 11) Hematopoietic and Lymphoreticular

2) Biochemistry and Molecular biology system 12) Human Development and Genetics

3) Skin and related connective tissue 13) Immune response

4) Reproductive system 14) Microbial biology and Infection

5) CNS and PNS 15) Musculoskeleton system

6) Cardiovascular system 16) Pharmacology

7) Endocrine system 17) Quantitative methods

8) Gastrointestinal system 18) Renal/Urinary system

9) Gender, Ethnic, Behavior considerations 19) Respiratory system

10) Specimen collections and Lab interpretations

1

Biology of cell

1. Botulinum toxin A (Botox) action receptor

a. Catalytic receptor

b. Intra-cellular receptor

c. G protein coupled receptor

d. tyrosine kinase

e. Ligand gated ion channel

2. 20 6

a. Collagen synthesis

b. ... contraction

c. Coagulative necrosis

d. Influx of inflammatory cell

3.

a. Glucose

b. Thyroxine

c. Prostaglandin

d. Progesterone

e. Mineralocorticoid

4. (* Multiple myeloma ) bone marrow

a. Lysosome

b. Mitochondria

c. Endoplasmic reticulum

d. Ribosome

e. Golgi complex

5. Organelle nucleus

a. Lysosome

6. CO

a. Cytochrome complex ( ETC )

7. PCP

8. ( histo)

a. basal cell carcinoma b. squamous cell carcinoma

2

Biochemistry and Molecular biology

1. 55 Gout analogue

a. Cytosine

b. Purine

c. Pyrimidine

d. Ribonucleotides

e. Thymine

2. DM type I, , ketoacidosis

a. Growth hormone

b. Leptin

c. Cortisol

d. Glucagon

e. Norepinephrine

3. 30 24 MCV > 100

Hypersegmented PMN

a. Thiamine

b. Riboflavin

c. Pyridoxine

d. Folic acid

e. Nicotinic acid

4. pneumonia CBC

a. Sodium citrate

b. EDTA

c. Heparin

d. Acid citrate dextrose

e. Buffer sodium citrate

5. insulin

a. Lipolysis

b. Glycogenesis

c. Gluconeogenesis

d. Protein degradation

e. Hepatic glucose uptake

3

6. 60 lipid profile; total cholesterol 280 mg/dl, triglyceride 260 mg/dl, LDL 150 mg/dl HDL

30 mg/dl

a. omega-3

b. omega-5

c. omega-7

d. omega-9

7. 10 folate ferrous sulfate folate

a. Meningomyelocele

b. Spina bifida

c. Anemia

d. Neural tube defect

8. 3 Prolonged prothrombin time

a. Proline hydroxylation

b. Glutamate carboxylation

c. Methionine synthesis

d. Cystathionine Degradation

e. Methylation of Succinyl CoA (or ethylation )

9. 20 G1 GA 10wk Investigation

a. Urine ketone

b. Complete blood count

c. Creatinine

d. Fasting blood glucose

10. 100 10

a. Krebs cycle

b. Existing ATP

c. Anaerobic glycolysis

d. Pentose phosphate pathway

11. 5 chronic renal failure . x-ray

cupping , fraying with irregular of the metaphyses

a. Retinal

b. Ascorbic acid

c. 1,25 dihydroxycholecalciferol

4

12. 5

a. Ketone

b. Glycogen

c. Glucose

d. Glycogen Glucose

e. fat

13. 20 carnithine deficiency

medium chain fatty acid medium chain fatty acid

a. ketosis

b. acidity

c. BBB

d. mitochondia

e. long chain fatty acid

14. ornithine decarboxylase gene gene plasmid E.coli enzyme E.coli

a. Northern blot

b. Southern blot

c. Western blot

d. RFLP-PCR

e. DNA sequencing

15. 30

enzyme

a. Lactase

b. Sucrase

c. Isomaltase

d. Collagenase

e. Pancreatic Amylase

16. Xantoma 50 80

a. Ca2+

b. Glucose

c. Urate

d. Cholesterol

e. Triglyceride

5

17. 5

a. Metemoglobin

b. Sulfhemoglobin

c. Deoxyhemoglobin

d. Carboxylhemoglobin

18. enteropeptidase enzyme

a. Colipase

b. Trypsin

c. Pepsin

d. Amylase

19. 3 , 2 /

a.

b. Vitamin

c. Protein

d. +Protein

e. +Vitamin

20. AIDS encapsulated yeast

a. CD4

b. CD21

c. ICAM-1

d. Sialic acid

e. Heparan sulfate

21. 55

a. ATP-ADP

b. cytochrome oxidase

c. cytochrome 2 electron transport system

22. Paracetamol 10 .

Paracetamol

a. Ascobic Acid

b. Glutathione

c. Retinoid

d. Tocopherol

e. Cholecalciferol

6

Skin and related connective tissue

1. (blister)

a. Desmosome

b. tight junction

c. gap junction

d. zona adherens

e. zona occudens

2. 50 1 cm. cell

a. Stratum corneum

b. Stratum lucidum

c. Stratum granulosum

d. Stratum spinosum

e. Stratum basale

3. Marfan aortic dissection

a. Fibroblast

b. Adipose

c. Connective tissue

d. Smooth muscle

4. 10

a. merkel cell

b. yolk sac cell

c. endodermal cell

d. neural crest cell

e. Intermediate mesodermal cell

5. palisading cell

6. erythematous papules plaque cell

a. monocyte

b. epithelial cell

c. melanocyte

d. neutrophil

e. langerhan cell

7

7. cell

a. stratum corneum

b. stratum granulosum

c. stratum basale

d. stratum spinosum

8. 25

a. epidermis

b. reticular dermis

c. papillary dermis

d. subcutaneus fasia

8

CNS and PNS

1. 70

a. Insular lobe

b. Frontal lobe

c. Parietal lobe

d. Temporal lobe

e. Occipital lobe

2. 40

N.

a. ilioinguinal n.

b. iliohypogastric n.

c. genitofemerol n.

d. lateral femeral cutaneous n.

e. anterior femeral cutaneous n.

3. CSF ()

a. lumbar puncture trauma

b. subdural hemorrhage

c. epidural hemorrhage

d. subarachnoid hemorrhage

e. intracerebral hemorrhage

4. 55 3

Webers test : normal (not lateralized) Rines test : positive both

ear(AC>BC) test

a. Dix Hallpike test

5.

PE Lt-normal ear drum Rt dark blue , retracted ear drum Weber lateralize to Rt Rinne Lt

AC>BC Rt BC >AC

a. Loratadine

b. Pseudoephedine

c. Prednisolone

d. steroid + ATB ear drop

e. Myringotomy

9

6. 20 180 170 ()

a. Amygdala

b. Thalamus

c. Hippocampus

d. Limbic system

e. Hypothalamus

7. C4 vertebral fracture muscle tone 0 loss proprioception areflexia vital sign

1 reflex

a. Spinal shock

b. Neurologic shock

c. Polyradiculopathy

d. Multiple nerve root defect

e. Incomplete spinal cord injury

8. 20

a. Pain

b. Touch

c. Vibration

d. Temperature

e. Proprioception

9. 10 5

abnormal esophageal peristalsis

a. Phrenic vagus

b. Splanchnic vagus

c. Hypoglossal phrenic

d. Hypoglossal splanchnic

e. Glossopharyngeal vagus

10. Absent deep tendon reflex

a. Hypoglycemia

b. Cardiac arrhythmia

c. Transient ischemic atherosclerosis

d. Neuropathy

e. Convulsion

10

11. cervical traction 30 /

a.

b. traction

c. MRI

12. epidural anesthesia sacral canal

a. Ligamentum flavum

b. subcutaneous fat

c. posterior sacral ligament

13. interspinous ligament 25 2

a. Lens

b. Cornea

c. Cilliary ganglion

d. Optic nerve

e. Occipital lobe

14.

a. Hypothalamus

15. 50 dx Thrombotic stroke

a. muscle fasciculation

b. rapid muscular atrophy

c. positive babinski sign

d. reduce deep tendon reflex

e. Reduce .superficial reflex

16. 25 6 1 10

Neurotransmitter

a. Acetylcholine

b. Norepineprine

c. 5-HT

d. Gamma aminobutaric acid

e. Dopamine

17. block nerve

a. ulnar nerve

b. musculocutaneous nerve

c. median nerve d. radial nerve

e. axillary nerve

11

Reproductive system

1. injury vacuum right temporal mass size 3x3 cm other normal

management

a. cold compression

b. oral cloxacillin

c. needle aspiration

d. I&D

e. Observe

2. 25 forcep extraction 800 cc

BP 90/60 mmHg, Pulse 110 bpm, above suprapubic

a. Uterine atrophy b. Retain placenta

c. Laceration

d. Coagulopathy

e. Rupture varicose vein of vagina

3. G2P1 GA 42 wks PE: fundal height above umbilicus, uterine contraction 20 sec, cervical dilate 2 cm, 50% EF, cephalic presentation, station 0, MI

a. b. induction

c. Emergency C/S

d. Elective C/S

e. Progesterone

4.

a. Oxytocin

b. Prolactin

c. Prostaglandin

5. 30 G1P0 GA 39 wk 3000 g 2 PV station +3, fully dilate, FHS 148 Management

a. Oxytocin

b. c/s

c. F/E

d. Vacuum

e.

12

6. 19 G1 GA 35wk follow up BP 160/100mmHg pretibial edema PV : os closed , urine protein 2+ BP 160/110

a. Severe preeclampsia b. Mild preeclampsia c. Transient hypertension d. Chronic hypertension

7. G1 GA 30 wk ANC 2 PE: vital sign stable,

uterine height 3/4 above umbilicus, cephalic presentation, longitudinal line, FHR 148,

a. UA

b. fern test

c. pelvic exam

d. U/S

e. Toco

8. 50 Cyclophosphamide

a. Peptic ulcer

b. Aplastic anemia

c. Rhabdomyolysis

d. Pulmonary fibrosis

e. Hemorrhagic cystitis

9. 50 cystic mass right scrotal sac ciliated columnar epithelium + spermatozoa

a. seminiferous tubule

b. rete testis

c. efferent ductule

d. vas deferens

e. tunica vaginalis

10. 25 3 ectopic pregnancy

a. Cervix

b. fallopian tube

c. uterus

d. ovary

e. pelvic wall

11. Hodgkin lymphoma estrogen FSH&LH

a. ovary failure

b. hypothalamic pituitary failure

13

12. 45 20 a. vulva

b. cervix

c. ovary

d. endometrium

13. 2 well baby clinic PE:

Asymmetrical scrotal sac , transillumination test ( positive )

a. Varicocele

b. Hydrocele

c. Inguinal hernia

d. Torsion of testis

e. Testis tumor

14. 35 5 FSH LH testosterone a. cryptorchidism

b. Testiscular failure

c. Spermatocyte maturation arrest

d. Androgen

15. 13 Imperforated hymen

a. Mullerian agenesis

b. Absent resorption of Mullerian duct

c. Incomplete fusion of Mullerian duct

d. Failure of lateral fusion of Mullerian duct

e. Failure of vertical septum canalization

16. 30 11

2 body temp biphasic pattern

a. Anovalation

b. Tubal adhesion

c. Cervic stenosis

d. Immunologic incompatibility

e. Endomethiumatophy

17. 25 32

a. Hcg

b. prolactin

c. oxytocin

d. estrogen

14

18. 20 NL Step1

11 HCG test negative

a. FSH insensitivity

b. Hyperprolactinemia

c. Estrogen insensitivity

d. Gonadotropin deficiency

e. Progesterone insensitivity

19. placenta membrane amniotic fluid

a. uterine atony

b. Thrombotic thrombocytopenic purpura

c. Disseminated intravascular coagulation

d. respiratory distress

20. 35 ( 1st trimester villi)

a. chronic endometriosis

b. luteal phase defect

c. papillary carcinoma

d. endometrial polyp

e. Incomplete abortion

21. cell Endometrium Menstrual phase

a. apoptotic process

b. lack of blood supply

c. glucose insufficiency

d. internal timing mechanism

e. thickening of the cervical mucus

22. 12 155 (

77) 77 breast tunner stage II , pubic hair tunner I

a.

b.

c. 2-3

d.

e.

15

23. 20 XY preconcious development hyperaldosteronism ACTH

testosterone progesterone cortisol

a. alpha-hydroxylase

b. 17 alpha-hydroxylase

c. 21 alpha-hydroxylase

d. alpha-reductase

e. Aldosterone synthase

24.

a. Oxytocin

b. Prolactin

c. prostaglandin

d. progesterone

e. vasopressin

25. 60 5 20 BMI40

endometrial carcinoma

a. Obesity

b. Smoking

c. multisexual partner

d. alcohol

e. multiparity

26. 25 13 2

a. Ovary

b. Uterus

c. Hypothalamus

d. Pituitary gland

e. Thyroid gland

27. 28 embryonic age ()

a. 18

b. 20

c. 22

d. 24

16

28. 40

a. Melatonin

b. Aldosterone

c. Testosterone

d. Thyriod hormone

e. Parathyriod hormone

29. 30 5

5 . cyst

a. Luteal cyst

b. Follicular cyst

c. Serous cyst

d. Endometriotic cyst

e. Polycystic cyst

30. 40

squamous cell carcinoma

a. Rhinovirus

b. Adenovirus

c. Ebstein-barr virus

d. Herpes simplex virus

e. Human papilloma virus

31.

testicular biopsy sertorli only in semiferous tubule

a. decrease sperm count

b. decrease serum LH

c. decrease plasma Mullerian inhibitory substance

d. increase GH

e. increase testosterone

32. P2 2 IUD 2 T 38 c, abdomen tender, PV cervical exciting positive, bilateral adnexal mass 4 cm. cystic consistency, tender IUD cervix

a. tuboovarian abscess b. bilateral ovarian tumor c. ectopic pregnancy d. rupture ovarian cyst e. IUD associated perforation

17

Cardiovascular system

1. .... 3500 HR

a. BP

b. Baroreceptor

c. Chemoreceptor

d. Electrolyte change

2.

a. clear audible 3rd heart sound

b. 1st heart sound apex of heart

c. systolic ejection murmur grade 1

d. occasional split 2nd heart sound

e. maximal pulse at 4th intercostal space

3. Pt. 30 1 Rheumatic fever PE:Pansystolic murmur at medial to left

midclavicular line

a. Aortic valve

b. Mitral valve

c. Pulmonary valve

d. Tricuspid valve

e. Semilunar valve

4.

a. cardiac contractility

b. preload

c. Total peripheral resistance

d. Mean arterial blood pressure

e. After load

5. 30 BP 150/110 mmHg Right renal artery stenosis BP

a. Increase renal Na exchange

b. Increase blood volume

c. Increase pressure in renal artery

d. Decrease renal blood flow

e. Decrease plasma oncotic pressure

18

6. 50 tennis

Acute myocardial infarction EKG morphology

a. Depressed P wave amplitude

b. Prolonged PR segment

c. Prolonged QT segment

d. Elevated ST segment

e. Elevated T segment

7. 20 3

a. left atrium

b. left ventricle

c. arch of aorta

d. right atrium

e. right ventricle

8. Aortic dissection

a. Aorticitis

b. Medial degeneration

9. 70 aortic aneurysm

a. Aortitis

b. aortic stenosis

c. artherosclerosis

d. coarctation of aorta

e. cystic medial degeneration

10. 6 BP

a. TOF

b. AS

c. PDA

d. Patent Foramen ovale

e. Coarctation of Aorta

11. 70

a. Autonomic neuropathy

b. TIA

19

12. 10 1 2

acute heart failure

a. Fibrinoid necrosis

b. Caseous necrosis

c. Coagulative necrosis

d. liquefactive necrosis

e. suppurative inflammation

13. 60 Myocardial Infarction 6 .

a. Contraction of

b. Coagulative necrosis

c. Influx inflam. Cell

d. New vascularization

14. 45 30 2

medium to small vessel vasculitis with neurophilic microabscess

a. Atherosclerosis

b. Hypertensive vasculopathy

c. Immune complex formation

d. Direct endothelial cell toxicity

e. Damage by microorganism

15. HR = 60 / 70 ml 150 ml cardiac

output

a. 4.2 b. 4.8 c. 5

16. trauma crepitation fluid

thoracic duct thoracic duct mediastinum

a. Superior mediastinum

b. Middle mediastinum

c. Anterior mediastinum

d. Posterior mediadtinum

17. 20

a. Diffuse wavy

b. Lymphocyte infiltration

c. Coagulation necrotizing

20

18. 65 Electrocardiogram Inferior wall myocardial infraction

a. Right coronary a.

b. Left coronary a.

c. Circumflex a.

d. Left anterior descending a.

e. Posterior descending a.

19. Factor

a. contractility

b. sympathetic activity

c. central venous pressure

d. TPR

e. mABP

20. maculopapular rash Kawasakis disease complication

a. Aortic stenosis

b. Coronary artery aneurism

c. Cervical lymphadenopathy

21. 20

a. serum iron

b. serum ferritin

c. Hb

d. Hct

e. EPO

22. 70 30

a. Aortitis

b. aortic stenosis

c. atherosclerosis

d. coarctation of aorta

e. cystic medial degeneration

21

Endocrine system

1. mediastinum thymus thymus gland

a. Hassall corpuscle

b. Lymphoid follicle

c. fat tissue

d. Psammoma

e. Corpora amylase

2. 16 3 Physical Examination: BP 140/80 mmHg , facial acne, acanthosis nigricans at neck Investigations: FBS 110 mg/ml LH 10.5mIU/ml FSH 6.2mIU/ml

a. DM b. Primary ovarian failure c. Polycystic ovarian syndrome d. Hypogonadotropic hypogonadism e. Androgenic adrenal tumor

3. 35 3

BP90/60 PR60 dry skin loss of pubic hair

a. ovary

b. adrenal grand

c. thyroid gland

d. pituitary gland

e. Hypothalamus

4. 45 electrolyte Na 150, K 2.5, Cl ..., HCO3- ...

a. Thalamus and pars distalis

b. Thalamus and pars nervosa

c. Hypothalamus and pars distalis

d. Hypothalamus and pars nervosa

e. pars nervosa and pars distalis

5. Addison disease adrenal cortex

a. hyper Na+

b. hyperkalemia

c. hyperglycemia

d. hypo NE

e. hypo ACTH

22

6. 10 hormone deficiency recombinant growth hormone 1 serum glucose

105mg/dl glucose metabolism

a. insulin receptor

b. insulin resistance

c. insulin degradation

7. 30 spec.1.001

a. Thalamus and pars distalis

b. Thalamus and pars nervosa

c. Hypothalamus and pars distalis

d. Hypothalamus and pars nervosa

e. pars nervosa and pars distalis

8. 30 SLE steroid 5 buffalo hump, moon face striae

adrenal gland

a. cortical atrophy

b. cortical adenoma

c. medullary infarction

d. medullary hypotrophy

e. nodular hypotrophy

9. 30 galactorrhea pituitary adenoma

a. Oligozoospermia

b. Gonodal dysgenesis

c. Testicular hypertrophy

d. Hypogonadotropic hypergonadism

e. Hypergonadotropic hypergonadism

10. 83 chronic renal failure Ca2+ Phosphate

hormone Ca

a. Calcitonin

b. 1,25-vitD

c. PTH

d. ACTH

e. Cortisol

11. 45 BP 150/110 ,Pulse , Na+ 135 ,K+ 5 mg/Eq diagnosis

a. Pheochromocytoma

23

12. 40 bp 150/100 buffalo hump striae

a. Pineal gland

b. Thalamus

c. Adrenal cortex

d. adrenal medulla

13. Hormone ()

a. Aldosterone

b. Angiotensin II

c. Renin

d. ANP

e. ADH

14. 60 chronic renal failure Ca2+ PO43-

a. Calcitonin

b. 1,25 dihydroxy D3

c. Thyroxine

d. Glucocorticoid

e. PTH

15. 60 40 3 Abdominal ultrasound porcelain calcification

a. Lipase

b. CCK activity

c. Secretin

d. Insulin

16. ______________ blood vessel

a. Dopamine

b. Vasopressin

c. Sympathetic

17.

a.

b.

c.

d. BMI 25 kg/m2

e. BP 140/90 mmHg

24

18. 32 () 36 .

a. Insulin

b. Aldosterone

c. ADH

d. GH

19. 35 ( thyroid) T3 ,Free T4 TSH

a.

b.

c.

d.

e.

20. 40 diffuse symmetrical enlargement

T3,T4 TSH

a. Grave disease

b. Subacute thyroiditis

c. Hashimoto thyroiditis

d. Toxic nodular goiter

e. Toxic Follicular adenoma

21. 45 2 . 3 FNA nuclear groove,

psammoma body

a. Follicular adenoma

b. Grave disease

c. Medullary adenoma

d. adenomatous goiter

e. Papillary adenoma

22. 25 6 BP 110/80 Pulse 70 generalize enlargement, Firm consistency TF4 0.96

TSH 5.4 antithyroid peroxidase 1:65,000

a. Lymphocyte infiltration

b. Enlargement follicular

c. Suppurative inflammation

d. Granuloma inflammation

e. Diffuse follicular enlargement

25

Gastrointestinal system

1. 50 pneumonia antibiotic IV 14 WBC RBC

a. Ulcerative colitis

b. Granulomatous colitis

c. Pseudomembranous colitis 2. 50 carrier hepatitis B 6 CT scan

5 .

a. AFP

b. Heptoglobin

c. glycoprotein acid

d. albumin

e. HBsAg

3. 80 CT : Aortic dissection celiac trunk

a. Stomach

b. Spleen

c. Jejunum

d. Liver

e. Pancrease

4.

a.

b. hepatitis C

c.

d.

e. hepatitis B

5. . esophagus

esophagogastric junction 3cm

a. increase goblet cell

b. squamous cell hyperplasia

c. granulomatous necrosis

d. infiltration of signet ring cell

e. loss of myenteric neuron

26

6. -------increase globlet cell

7. 2 dilated colon, anal sphinter -----aglangion colon

8. 25 computer tomography scan (abdomen)

()

a. Liver

b. Colon

c. Spleen

d. Stomach

e. Pancrease 9. 60 duodenum

a. Right gastric a.

b. Proper hepatic a.

c. Gastroduodenal a.

d. Common hepatic a.

10. 50 serum ceruloplasmin

a. Lead

b. Copper

c. Billirubin

d. Hemosiderin

e. Zinc 11. 55 1 67

60

a. H2-blocker

b. PPI

c. PPI + amoxy + metro

d. double contrast upper GI

e. gastoscopy 12. 60 2 cm head of pancreas

a. Decrease urine total bilirubin

b. Decrease plasma urobilinogen

c. Increase urine urobilinogen

d. increase stool unconjugated bilirubin

e. Increase plasma conjugate bilirubin

27

13. Partial ileum bypass 10-12/

P-lactic acidosis lactic acidosis

a. Bile salt excretion

b. Fat absorption

c. Water absorption

d. Vitamin B12 absorption 14. 50 investigation: AST 100, ALT 80,

prolong PT, Bilirubin 5 () albumin 2 () globulin 3

a. GERD

b. Esophageal varice

c. splenic infarct

d. inflammatory bowel 15. 42 70

a. CEA

b. barium enema

c. sigmoidoscopy

d. colonoscopy 16. 4 hr

a. Heat stable Bacillus cerues

b. Heat stable E.coli

c. Heat stable C.perfingen 17. 50 2 esophagoscopy smooth

muscle cell striate muscle cell

a. Lower esophageal sphincter

b. middle third of esophagus

c. lower third of esophagus

d. upper third of esophagus

e. upper esophageal sphincter 18. 2wk 1 distend abdomen PR: tight sphincter tone Barium enema :

large sigmoid colon

a. Duodenal atresia

b. Vitelline duct

28

19. 4 Abd : no

mass, abdominal distension, no hepatosplenomegaly PR : tight sphincter tone

a. CBC

b. serum electrolyte

c. thyroid function test

d. abdominal ultrasound

e. barium enema 20. 60 40 3 upper abdominal ultrasonography:

pancreatic calcification

a. Increase lipase activity

b. Increase glucagon activity

c. Increase CCK activity

d. Decrease insulin activity

e. Decrease secretin activity 21. 20 2

a. viral hepatitis A

b. viral hepatitis B

c. leptospirosis

d. scrub typhus 22. 30 Atrial fibrillation blood clot Superior mesenteric artery

a. Esophagus

b. Stomach

c. Ileum

d. Descending colon 23. 55 1 2

Marked jaundice, liver 6 cm BLRCM, no palpable gallbladder

a. Hepatocellular carcinoma

b. Cholangiocarcinoma

c. CA head of pancreas

d. CA ampulla of vater

29

24. 70 6

a.

b.

c.

d.

Gender, Ethnic and Behavioral considerarions

1. 40 ovary

a.

b.

c.

d.

e. ovary

2. 20 .

a. Denial

b. Projection

c. Depressive

d. Bargain

3. 40

a.

b.

c.

d.

4. 13 .

a.

b.

c.

d.

e. .

30

5. 15 2-3 /

4-5

a. Epilepsy

b. Learning disorder

c. Mental retardation

d. Organic Personal Disorder

6. 3

a.

b.

c.

d. 7.

a. Faith

b. Value

c. Belief

d. Norm

e. Attitute

31

Specimen collections and Lab interpretation

1.

a.

b.

c.

d.

e. Normal flora

2. wet swab eosinophil/Chacot-Leden

a. asthma

b. tuberculosis

c. tuberculosis

d. bacterial pneumonia

3. 50 .RUQ pain 2 T 38.3 C PR

90 RR 22 BP 130/80 Abdomen: moderate tenderness, voluntary guarding at RUQ investigation for

diagnosis

a. Hemoculture b. LFT c. U/S d. plain film e. CT

4. 65 2SD

a. Free style swimming

b. Yoka

c. Short distance running

d. Short distance bicycle

e. Low impact anaerobic dance

5. 40

a. wright stain

b. H&E stain

c. Giemsa stain

d. congo red

e. Papanicolaou stain

32

6. 2 .

a. EDTA

b. Heparin

c. Sodium Citrate

d. NaF

e. Plain tube

7. chronic HBV protein

a. transaminase

b. alpha-fetoprotein

c. gamma glutamyl transferase

8.

a. clear audible 3rd heart sound

b. 1st heart sound apex of heart

c. systolic ejection murmur grade 1

d. occasional split 2nd heart sound

e. maximal pulse at 4th intercostal space

9. 20 T=39 C PP=120 RR=26 septicemia

a. 2 1 .

b. 2 1 2 .

c. 3 30

d. 3 3

10. DNA

a. Hair Blub

b. Hair Fiber

c. Hair Medulla

d. Dermal root sheath

11. 40 2009

a. Serum

b. Sputum

c. Throat swab

d. Nasopharyngeal swab

e. Bronchoalveolar lavage

33

12.

a. scotch tape technique

13. localized sign CSF RBC

( 2 1 CSF

2 CSF )

a. Trauma

b. Subarachnoid hemorrhage

c. Epidural hemorrhage

d. Subdural hemorrhage

Hematopoietic and Lymphoreticular system

1. 65 1 CBC: Hb 7.5 g/dl Hct 22% WBC 3,500 (N 72%

L25%) Plt?? BUN 40 creatinine 4 Calcium 12 urine protein 4+

a. Myeloblast

b. Promyelocyte

c. Lymphoblast

d. Erythroblast

e. Plasma cell

2. Hb 7 g/dL, WBC

3,800 (N45% L50% E5%) Platelet 80,000, MCV 120 smear

a. Aplastic anemia

b. Chronic liver disease

c. Megaloblastic anemia

d. AML

e. Anemia of chronic disease

3.

a. Ferritin

b. Bilirubin

c. Porphyrin

d. Transferin

e. Hemosiderin

34

4. 30 1 Hb 12

Hct 36 Wbc 6000 N 70 L 20 M 8 E 2 Plt 30000

a. CFU-GM

b. Plasma cell

c. Macrophage

d. Pronomoblast

5. Megakaryocyte 60 3 degeneration dorsal root ganglion dorsal

columnspinal cord

a. HSV

b. Treponema pallidum

c. Hemophilus influenza

d. Cryptococcus neoforman

e. Mycobacterium tuberculosis

6. 30 CBC (

35

9. 20 24

neutrophil hypersegmentation

a. Thiamine

b. Riboflavin

c. Paridoxime

d. Folic acid

e. Nicotinic acid

10. 7 O A

a. immature blood brain barrier

b. diffuse cerebral hemorrhage

c. decrease cerebral blood flow

d. hydrophilic proper of bilirubin

e. immature bone marrow

11. 10 4 CBC Hct 56% WBC 4,000 [N 40% lym 55% atypical 15% Plt 80,000

a. DHF

12. Platelet cell

a. Howell jolly body

13. 2 Hb typing:A2F

a. alfa-thal1/cs

b. alfa-thal1/thal2

c. /

d. /

e. /

14. 18 5 3 Pallor, mild jaundice, spleen is just

palpable CBC : Hb = 7.2 g/dL, MCV = 90 fL, WBC = 4,200/cumm, N = 60% L = 40%, Plt =

140,000/cumm

a. Thalassemia HbH Disease

b. Leptospirosis c. Acute Leukemia

d. G6PD Deficiency

e. Hereditary Spherocytosis

15. Complication

a. Respiratory Distress

36

16. 30 Nephrotic syndrome prednisolone Hb 12 Hct 36 WBC 15000 (N 80%,

L 20%) Platelet 200000 WBC

a. Neutrophil

b. Lymphocyte

c. Neutrophil cell

d. Granulocyte colony stimulation factor

17. 25 Hct Hb WBC plt. RBC

a. Autoimmune

b. Membrane defect

c. Enzymatic defect

d. Hematoglobinopathy

18. 2

a. Fibroblast

b. Eosinophil

c. Neutrophil

d. Lymphocyte

e. Monocyte

19. 30 CBC: Hb 12 Hct 22 MCV 75 fl platelet : normal WBC :

3800

a. iron

b. folate

c. Vitamin B12

d. Intrinsic factor

e. Erythropoietin

20. 10 Hct 63% WCB 6,000 plt 80,000 atypical lymphocyte Antibody

a. Leptospira

b. Ritketsia

c. EBV

d. O.tsutsugamushi

e. Dengue

37

21. Tonsil Adenoid Tonsillectomy Adenoidectomy

a. Sinus Histeocytosis

b. Follicular Hyperplasia

c. Paracortical Hyperplasia

d. Interfollicular Hyperplasia

e. Granulomatous inflammation

22. (ecchymosis) 1 Hb, WBC platelet .... = megakaryocyte

23. 10 2 Hb 12 WBC 8,000 (Neutrophil 20%,

lymphocyte 60%, Atypical lymphocyte 15%)

a. Infectious mononucleosis

b. Dengue fever

c. ALL

d. Group A Streptococcal tonsillitis

e. AIDS

24. ... CBC ...... OF test positive

a. immune

b. membrane surface

c. antigen antibody complex

d. complement

e. cytotoxic T cell

25. 2 hr PTA PE: cant seen TM,

a. 70% alcohol

b. 3%boric acid

c. Vegetable oil

d. NSS

38

Human development and Genetics

1. Achondroplasia

Achondroplasia

a. 0% de novo mutation

b. 50%

c. incomplete penetration

d.

39

6. 25

a. 2

b. 4

c. 8

d. 12

e. 16

7. 1 Karyotyping Downs syndrome

a. Cord blood

b. Amniocentesis

c. Chorionic villus sampling

d. Alpha-fetoprotein

8.

Hemolytic disease of the newborn

a. AB Rh+ AB Rh-

b. AB Rh+ O Rh-

c. O Rh+ B Rh-

d. B Rh- AB Rh+

e. O Rh- A Rh+

9. acardia spleen germline

a. ectoderm

b. Paraxial mesoderm

c. Intermediate mesoderm

d. Lateral mesoderm

e. Endoderm

10. HbE/Hb0 carrier

a. 0%

b. 25%

c. 50%

d. 75%

e. 100%

40

11. HT ACEI CCB

a. CXR

b. PFT

c. discontinue ACEI

12. 2 beta-thal/HbE 2 Hb 13 MCV 80

a. 0%

b. 25%

c. 50%

d. 75%

e. 100%

13. 15 Hemophilia A obligate carrier

a.

b.

c.

d.

e.

41

Immune response

1. 30 HIV Follicular

hyperplasia

a. B-cell

b. T-cell

c. Dendritic cell

d. Natural Killer Cell

e. Macrophage

2. 45 3 cavitary lesion acid fast

bacilli

a. cell-mediated immunity

b. IgE-mediated hypersensitivity

c. IgG-mediated hypersensitivity

d. neutrophil ingestion of bacteria

e. antibody-mediated phagocytosis

3. 15 1 1

a. Innate immune response

b. Irritant contact response

c. Immune complex response

d. cell mediated immune response

e. complement mediated immune response

4. cell

a. Fibroblast

b. Eosinophil

c. Neutrophil

d. Lymphocyte

e. Macrophage

5. 7 2 secretion Ig

a. IgA

b. IgG

c. IgE

d. IgD

e. IgM

42

6. aluminium adjuvant

a. preservative

b. enhance antigen processing

7.

a. stasis of blood

b. decrease blood flow

c. lymphatic dilate

d. increase permeable of blood vessel

e. Increas blood flow

8. 20 7

a. Myocyte

b. Adipocyte

c. Fibroblast

9. 15 3 CBC Plt.80000 /monocyte 5% Lymphocyte 55%

neutrophil 40%Hb 14.2 Hct. 43% tourniquet

a. Neutrophil

b. Monocyte

c. Langerhan

d. helper T cell

e. cytotoxic T cell

10.

a. mast cell

b. neutrophil

c. lymphocyte

d. Eosinophil

11. 45 3 2-3

a. B-cell

b. T-cell

c. Phagocytosis

d. Opsonization

e. Complement

12. 4 UTI Immune deficiency Secretion Upper respiratory

a. IgA

43

13. 40

a. Complement activation

b. Cytokine release from T-cell

c. Cytotoxic C hypersensitivity

d. Immune complex deposition

e. IgE mediated hypersensitivity

14. 25 chemical mediator

a. Histamine

b. Bradykinin

c. Leukotriene C4

d. C3a

e. Platelet activating factor

44

Microbial biology and Infection

1.

a.

b.

c.

d.

2.

a. Egg from stool exam

b. Egg from serum

c. Adult from stool exam

d. Perianal scotch tape technique

3. 20

a. Taenia saginata

b. Hymenolepis nana

c. Dipylidium caninum

d. Hymenolepis diminuta

e. Capillaria philippinensis

4. 40 US5 cm hilum

a. Cholangiocarcinoma

b. hepatocellular carcinoma

c. carvernous hemangioma

d. angiosarcoma

e. liver cell adenoma

5. 25

a. pin worm

b. whip worm

c. round worm

d. thread worm

e. dog hook worm

6. 30 , red papule ,coalescent ulcerpenis, 2 ()

a. Herpes simplex virus

b. HPV

c. H.ducrei

45

7. 20 murmur

a. Chlamydia

b. S. aureus

c. S. pyogenese

d. S. agalactiae

e. S. pneumoniae

8. Vibrio Chlorela gene toxin

a. Plasmid

b. Prophage

c. Toposporin

d. Insertion sequence

e. Inverted sequence

9. 45 5 . 4 hr.

a. Heat stable E.coli

b. Heat stable Bacillus cereus

c. Heat labile C.jejunum

d. Heat labile Yersinia

10. 20 2 a. Gram negative diplococci

b. gram negative bacilli

c. gram positive diplococci

d. gram positive bacilli

11. smear (wet-prepared)

a. Trichomonas hominis

b. Trichomonas vaginalis

c. Candida

d. Gardnerella

e. Giardia lambia

12. 35 2009

a. Sialic acid

b. Hemagluttinin

c. Capsid antigen

d. Neuraminidase

e. Fusion protein subunit

46

13. Vibric chorela 5

a. G protein

b. Adenyl cyclase

14. 6

a. E. coli

b. Candida

c. H. pylori

d. E. histolytica

e. Cryptosporium spp 15. 10 1 PMN

( Gram-ve diplococci)

a. Brucella melitans

b. Neisseria meningitides

c. Listeria monocytogenes

d. Hemophilus influinzae

16. gram stain

a. Gram positive cocci

b. Gram negative diplococcic

c. Gram positive bacilli

d. Gram negative bacilli

e. Gram negative coccobacilli

17. Leukemia Chemotherapy

( Aspergillus : braching septate hyphe ( 45 )

a. Candida spp.

b. Penicillium spp.

c. Aspergillus spp.

d. Histoplasma spp.

18. 50 Rifampicin Gene

Mutation

a. rrs

b. rpoB

c. catG

d. gyrA

e. pare

47

19. 20 ??

a. Entamoeba coli

b. Balantidium coli

c. Campyrobacter jejuni

d. Entamoeba histolitica

e. Cappillaria philippinensis

20. 6

a. E.coli

b. Candida albican

c. H.pylori

d. Cryptosporidium parvum

e. E. histolytica

21. intracellular fission yeast

a. penicillium marneffei

b. histoplasma capsulatum

c. cryptococcus neoform

22. 50 (nasophalynx CA)

a. HIV

b. EBV

c. HSV8

d. HPV

23. squarmous cell carcinoma

a. Adenovirus

b. Retrovirus

c. Herpes simplex virus

d. Human Papilloma virus

24. HIV

a. Candida albicans

b. penicillium marneffei

c. Histoplasma capsulatum

48

25. 1021 wheezing 2

a. Adenovirus

b. H. influenza

c. Respiratory syncitial virus

d. C. diptheriae

Musculoskeleton System

1. 40

a. Ilioinguinal nerve

b. Iliohypogastric nerve

c. Genitofemoral nerve

d. Anterior femoral cutaneous nerve

e. Lateral femoral cutaneous nerve

2. 60 TL junction muscle strain

a. CBC b. ESR c. CPK d. Plain film TL spine e. CT

3. Oral ulcer at hard palate , UA RBC 5-10/HPF , WBC 10/HPF , proteinutia 3+

a. Juvenile rheumatoid arthritis b. Polyarteritis nodosa c. SLE d. Henoch schonlein purpura e. Post strep glomerulonephritis

4. 2

a. left facial nerve

b. right facial nerve

c. left genu of facial nerve

d. left corticobulbar tract

e. right corticobulbar tract

49

5. 30 0.2 . block nerve

a. axillary nerve

b. ulnar nerve

c. median nerve

d. Radial nerve

e. musculocutaneous nerve

6. 30 structure

a. femoral head

b. femoral shaft

c. humeral head

d. humeral neck

e. humeral shaft

7. X-ray head neck fibula nerve

a. Tibial nerve

b. Sciatic nerve

c. Common peroneal nerve

d. Deep peroneal nerve

e. Superficial peroneal nerve

8. 40 nodule

a. ANA

b. Rheumatoid factor

c. C-reactive protein

d. Uric acid level

9. 60 2 6 osteophyte

joint space

a. Autoimmune

b. Chronic infection

c. Degenerative process

10. scaphoid injury

a. Ulnar artery

b. Radial artery

c. Radial incidis .artery

d. Deep palmar artery

50

11. 60 TL junction muscle strain

a. CBC

b. ESR

c. CPK

d. Plain film TL spine

12. head & neck of fibular

a. common peroneal

b. superficial peroneal

c. deep peroneal

d. tibial

13. 20 anterior drawer sign positive

a. Anterior cruciate ligament

b. Posterior cruciate ligament

c. Medial meniscus

d. Lateral meniscus

e. Medial collateral ligament

14. 20 bicep

a. capillary density

b. muscle fiber number

c. muscle fiber size

d. sarcomere length

e. sarcomere thickness

15. Bone mass -2.0 SD

a. hot yoka

b. free swimming

c. short running

d. short walking

e. low impact aerobic exercise

51

Pharmacology

1. 35 methanol Ethanol

Ethanol methanol

a. Production inhibition

b. Irreversible inhibition

c. Competitive inhibition

d. Non-specific inhibition

e. Non-competitive inhibition

2. 65 essential hypertension Losartan

a. Renin

b. Bradykinin

c. Aldosterone

d. angiotensin II

3. pharmacokinetics; 2 X X Y

Y

a. Opioid receptor agonist

b. Histamine H2 receptor agonist

c. 5-HT receptor antagonist

d. Dopamine receptor antagonist

e. Muscarinic receptor antagonist

4. 45 6

15

a. 6

b. 8

c. 12

d. 15

e. 18

5. [Vit A]

a. Respiratory

b. Endocrine

c. Reproductive

d. GI

e. CNS

52

6. 20

a. Atropine

b. Adrenaline

c. Neostigmine

d. Organophosphate

e. Activated charcoal

7. 55 2 enalapril amlodipine

2 PE: lungs are clear

a. chest x-ray

b. dextromethorphan

c. inhaled corticosteroids

d. reduced amlodipine dosage

e. enalapril

8. 50 PE: pansystolic murmur, fine crepitation in both lower digoxin ,

furosemide digoxin

a. Preload

b. Afterload

c. Contractivity

d. beta recepto

e. Na2+/K+ ATPase inhibitor

9. 25 10L/24hr. investigation: BUN 40, Cr 1.0, Na

160, K 3.6, Cl 120, HCO3- 30 vasopressin

a. Serum bicarbonate

b. Serum potassium

c. Serum creatinine

d. Serum sodium

e. Serum osmolality

10. 60 3 FBS 140-160 HbA1C 7.8% hypertension + dyslipidemia BP 140/90 mmHg 150/90 mmHg manage

a. Amlodipine b. HCTZ c. Atenolol d. Enalapril e. Lifestyle modification

53

11. 25Asthma Corticosteroid 2-3

Salbutamol , Chlorpheniramine , Bronhexine , Dextromethorphan

side effect

a. Salbutamol

b. Bromhexine

c. Corticosteroid

d. Chlorpheniramine

e. Dextromethorphan

12. pulmonary edema

a. acetazolamide

b. furosemide

c. spironolactone

d. Hydrochlorothiazide

13. acetaminophen cell injury

a. Ascorbic

b. vitamin E

c. glutathione

d. folic acid

14. Phamacokinetic 4

A B C D Clearance 200 150 100 50 VD 10 20 0.5 15 Oral bioavailabity 0.2 0.1 0.5 1

4 steady state loading dose

a. A

b. B

c. C

d. D

e.

15. 71 2 morning stiffness 10 min bony prominent at DIP,

MCP joint, Cr 1.5

a. Celecoxib

b. Paracetamol

c. Glucosamine

d. Chloroquine

54

16. asthma

a. adenergic receprtor

17. 55 flurosemide

a. Na

b. K

c. Ca

d. Mg

18. 6

a. Phenyltoin

b. Phenobarbitol

c. Carbamazepine

19. UTI ----------Ciprofloxacin

20. Vasoactive substance blood vessel

1. Kinin

2. Renin

3. Dopamine

4. Angiotensin

5. Vasopressin

21. Gram positive cocci in cluster

a. Cloxacillin

b. Amoxycillin

c. Fluoroquinolone

22. acute cholangitis

a. Opioid

b. Hydrosine

c. Meperidine

d. Paracetamol

e. Aspirin

23. irritable bowel syndrome

a. Cholinergic agonist

b. Dopamine 2 antagonist

c. 5-HT antagonist

d. Opioid antagonist

55

24. 50 ,

a. Laroxifene

b. Bisphosphate

c. Conjugated estrogen

d. Minimized progesterone

25. 40 UTI co-trimoxazol

a. FADH

b. NADPH

c. Lactate

d. Pyruvate

e. Acetyl-CoA

26. 50 2 Deep vein thrombosis

heparin

a. plasmin

b. antithrombin

c. Ca2+

d.

e. clotting factor

27. 25 Haloperidol SE Clozapine SE

a. weight gain

b. diabetes mellitus

c. extrapyrimidal effect

d. agranulocytosis

e. postural hypotension

28. 30 sulfa

a. Celecoxib

b. Meroxicam

c. Perixicam

d. Ibutophen

e. Dicloenac

29. uric acid analog

a. purine

b. pyrimidine

c. thymine

56

30. 70 2 cerebro-vascular thrombosis 1

warfarin 5 Lab prolonged

PTT

a. Ranotidine

b. Cimetidine

c. Famotidine

d. Misoprostal

e. Omepagel

31. 50 abdominal ultrasonography

gall bladder contraindication

a. Morphine

b. Hyoscine

c. Diclofenac

d. Meperidine

e. Paracetamol

32. M phase

a. Actin

b. Tubulin

c. DNA gyrase

d. DNA polymerase

e. RNA transcriptase

33. 35

a. amphetamine

b. marijuana

c. gasoline

d. alcohol

34. 6 BP 60/40 PR 50 bpm RR 18/min PE: swelling fg lip and face

epineprine IM 2

a. Hydrocortisone IV

b. Diphenhydramine IV

c. Aminophyline IV

d. Epinephrine 1:10000 IV

e. Nebulized Beta2 agonist IV

57

35. 10 Hydrocorlisone cream Enzyme

a. Lipoxygenase

b. Cyclooxygenase

c. Phospholipase A2

d. Leukotriene Syntase

e. Leukotriene Hydrolase

36. Acute effect chlorpheniramine syrup

a. Miosis

b. Vomiting

c. Sedation

d. Dyspnea

e. Convultion

37. 40 amniocentesis Karyotype Chromosome

metaphase

a. Cochicine

b. Dexorubixin

c. Metrotrexate

d. 5-FU

e. 6-MP

38. 60 10 Acute Myocardial Infarction

Streptokinase

a. Plasmin

b. Thrombin

c. Antithrombin

d. thomboxane A2

e. Activate protein C

39. 5 1 1

1

a.

b.

c.

d.

58

Drug A

Drug B

MIC

40. pharmacodynamic interaction (MIC) A

B pharmacodynamic interaction

a. Addition

b. Antagonist

c. Potentiation

d. Synergist

41. KOH prep Branching septate hyphae Fungicide crme

a. 7

b. 14

c. 21

d. 28

e. 35

42. 70 Atrial fibrillation warfarin 1

Drug interaction

a. Terbenafide

b. Griseofulvin

c. Caspofungin

d. Ketoconazole

e. Amphotericin B

43.

a. Cloxacilin

b. Gentamycin

c. Erythromycin

44. 30 3

PE ill-defined erythematous plague with scale and serum oozing both earlobes

a. Oral antihistamine

b. Oral antibiotic

c. Topical steroid

d. Topical antibiotic

e. Topical antifungal

59

Quantitative methods

1. = 20/1000; = 10/10000

a. Relative risk = 1

b. Relative risk = 5

c. Relative risk = 20

d. Attributable risk = 1

e. Attributable risk = 20

2.

a. Clinical trial

b. Correlation study

c. Case control study

d. Cohort study

e. Cross sectional study

3. intervention

a.

b.

c.

d. Intervention

e.

4. (mean2SD) 200

a. 3

b. 5

c. 10

d. 20

e. 30

5. Visual analog scale

a. Ratio

b. Interval

c. Ordinal

d. Nominal

60

6. tumor marker cut-point

a. Sensitivity

b. ROC curve

c. survival curve

d. positive predictive value

e. nagetive predictive value

7. 500,000 pancreatic cancer 250 1

pancreatic cancer 200 Cause-specific mortality rate pancreatic cancer

a. 0.1

b. 20

c. 80

d. 4/10,000 /

e. 5/10,000 /

8. Intervention /

a.

b.

c.

d. Intervention

e.

9. Mean +/- 2SD 200

a. 10

b. 20

c. 30

d. 50

e. 70

10. 7 90,90,110,110,110,290,600

110

a. Mode

b. Mean

c. Mean

d. Median

e. Median

61

11. 150 20 1,100

a. 0.02

b. 0.01

c. 0.1

d. 0.2

12. 10,000 1,000 anti-HIV positive 1

positive 1,090 HIV Seroconversion

a. 9/1,000 /

b. 10/1,000 /

c. 100/1,000 /

d. 109/1,000 /

e. 121/1,000 /

13. Tumor marker CA colon cut off point

a. Sensitivity

b. ROC curve

c. survival curve

d. NPV

e. PPV

62

Renal/Urinary System

1. 20 2

GFR

a. Angiotensin II

b. Vasopressin

c. Prostaglandins

d. Sympathetic activity

a. Hydrochlorothiazide

2. Fistulo... umbilicus bladder

a. Gastrochisis

b. Omphalocele

c. Patent urachus

d. Umbilical hernia

3. 50 2 papillary mass 2 cm posterior

wall

a. Fibroblast

b. Urothelium

c. Blood vessel

d. Smooth muscle

e. Lymphoid tissue

4. 3 CT scan 3 .

a. Wilms tumor

b. Neuroblastoma

c. Polycystic

d. Renal cell carcinoma

5. 8 2 week generalized edema ,leg pitting 2+, heart-lung

normal

a. acute renal failure

b. nephrotic syndrome

c. Henoch-Scholein purpura

d. PSGN

e. SLE

63

6. 30 10 Blood pH 7.26 Urine pH 5.5

a. Plasma Urea

b. Plasma Chloride

c. Urine Bicarbonate

d. Urine Ammonium

7. 60 CBC : WBC 10,000 Cells, Hct 65 %

UA (Urine Analysis) : numerous RBC, proteintrace, sp.gr.1.010, WBC 3-5 cell/HPF

U/S (Ultrasound) : 6 cm.

a. Glomerulus

b. Proximal tubule

c. Henles loop

d. Collecting duct

e. Renal Calyx

8. 5 metabolic acidosis normal gap

a. Uremia

b. Ketoacidosis

c. lactic acidosis

d. severe diarrhea

e. ethylene glycol poisoning

9.

a. immune complex deposit mesargial

b. proliferate

10. 15 gross hematuria upper respiratory tract 1-2

a. Blunting of foot process

b. Lymphocyte infiltration

c. Deposit of immune complex at mesergium

d. Laceration at basement membrane

11. 50 blood pressure 150/110 Na+ 150 K+ 2.5 Cl- 104 HCO3- 36 rennin

a. hyperthyroidism

b. Pheochromocytoma

c. Renal artery stenosis

d. Primary hyperaldosterone

64

12. 60 UA : sp.gr 1.020 ; red turbid appearance ;

glucose - ; protein 1+ ; RBC 50-100 cells/HPF ; WBC 5-10 cells/HPF; Culture : Proteus spp.

a. Urate

b. Cysteine

c. calcium oxalate

d. calcium phosphate

e. Magnesium Ammonium Phosphate

13. 30

Na+=135 , K+=3 , Cl-=110 , Serum glucose= 100 , HCO3-=18 , urine glucose 2+

a. Glomerular basement membrane

b. Proximal convoluted tubule

c. descending limb of loop of henle

d. ascending limb of loop of henle

e. distal convoluted tubule

14. 25 BP60/40

a. Plasma oncotic pressure

b. Plasma hydrostatic pressure

c. Bawmans space oncotic pressure

d. Bawmans space hydrostatic pressure

e. Glomerulus membrane permeability

15.

a. ADH

b. ANP

c. Angiotensin II

d. Aldosterone

e. Cathecholamine

16. proteinurea 1+ 2-3 lesion

a. immune complex deposit in mesengium

b. lamination in membranous

17. 20 BUN40 renal blood flow

18. oliguria

a. Acute tubular necrosis

65

Respiratory System

1. 70 Chronic pulmonary distress disease Pulmonary Function (at rest) Tidal Volume 400, Physiological dead space 100, Ventilation rate 4,000 Alveolar Ventilation rate

a. 3500

b. 3000

c. 2500

d. 2000

e. 1500

2. 1 3 PE: no cyanosis, RR40, PR 120, subcostal retraction, inspiratory stridor adrenaline

a. IV dexamethasone

b. inhaled budesonide c. inhaled beta2 agonist

d. IV cefotaxime

e. Intubation

3. 30 pH 7.3, PaO2 90, PaCO2 40, HCO3- 20, O2Sat 80%

a. Sepsis

b. Anemia

c. Hyperventilation

d. High Altitude

e. Carbon monoxide Poisoning

4. 3 3 investigation

a. CXR PA, lat

b. AP, lat

c. Inspiration & expiration

d. Left lateral decubitus

e. Right lateral decubitus

5. cushing syndrome, lung biopsy small cell carcinoma

a. ADH b. Cortisol

c. ACTH

66

6. pH = 7.22 PaCO2 80 HCO3- 34 a. partial compensate respiratory acidosis

b. partial compensate metabolic acidosis

c. mined metabolic and respiratory acidosis

d. full compensate respiratory acidosis

e. full compensate metabolic acidosis

7. 25R 40/min drowsiness plasma glucose 400 Arterial blood gas pH 7.10, pCO2

= 22, pHCO3- = 12

a. combined metabolic acidosis & metabolic alkalosis

b. combined metabolic acidosis & respiratory acidosis

c. metabolic acidosis with respiratory alkalosis compensation

d. respiratory acidosis with metabolic alkalosis compensation

e. respiratory alkalosis with metabolic acidosis compensation

8. 70 65 kg

a. Vital Capacity

b. Residual Volume

c. Alveolar Elastic recoil

d. Maximum Voluntary ventilation

e. Functional expiratory volume 1 (FEV1)

9. 20 a. Myoepithelium

b. Columnar epithelium

c. Squamous epithelium

d. Transitional epithelium

e. Endothelium

10. 6010 Wheezing FEV1/FVC FEV1/FVC

a. Airway obstruction

b. Increase pulmonary resistance

c. Increase pulmonary elasticity

d. Decrease chest wall compliance

e. Decrease numberof peripheral airway

67

11. 1 X-ray mass hilar Biopsy small nucleus with scant cytoplasm internuclear molding , prominent mucleolus , fine granule in

cytoplasm

a. smoking

b. cotton

c. silica

d. coal

e. asbestos

12. 35, 10

a. Byssinosis

b. Siderosis

c. Asbestosis

d. Silicosis

e. Bagassosis

13.

a. RR

b. Erythropoietin production

c. Diameter of pulmonary vessel

d. Bicarbonate excretion

e. Mitochondria vessel

14. bronchoalveolar larvage M.. silver structure PCP a. Alveolar epithelium

b. Pneumocyte

c. Macrophage

d. Bronchial epithelium

15. HIV several intracystic bodies ( PCP )

a. Neutrophil

b. Macrophage

c. Pneumonia

d. Endothelial capillary

68

16. 35 Neonatalrespiratory distress syndrome Hyaline membrane cell

a. Respiratory reserve cell

b. Respiratory epithelial cell

c. Respiratory Fibrous

d. endothelial cell

e. macrophage

17. 70 Aortic Aneurysm a. Trachea

b. Right main bronchus

c. Left main Bronchus

d. Right pulmonary vein

e. Left pulmonary vein

18. 45middle conchae a. frontal sinusitis

b. maxillary sinusitis

c. ethamoidal sinusitis

d. sphenoid sinusitis

e. lacrimal sac infection

19. 50 Stratified Squamous epithelium Trachea Bronchus

a. Dysplasia

b. Metaplasia

c. Hypertrophy

d. Pathologic hyperplasia

20. 5 bronchopulmonary segment a. Apical segment of left upper lobe

b. Apical segment of right upper lobe

c. Middle segment of right middle lobe

d. Posterior segment of left lower lobe

e. Superior segment of right lower lobe

21. COPD

a. lung capacity

69

b. elastic alveolar recoid

c. residual volume

d. FEV1

22. 5 a. Epiglottis

b. Palatine tonsil

c. Lingual tonsil

d. Nasal cavity

e. Adenoid

23. 55 3 BP 180/110 crepitation

a. ADH

b. Na retention

c. Glomerular filtration

d. plasma oncotic pressure

e. ANP