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National Test 2553

. (TU BM SI BUU)

40 metatarsophalangeal joint uric acid 8.2mg/dL

metabolism A. PurineB. ProteinC.CholesterolD.TriglycerideE. Phosphoribosylpyrophosphate

cell injury reactive chemical intermediate oxygen A. IronB. ZincC. FolateD. RetinolE. Alpha-tocopherol

Heme organelle A. RibosomeB. PeroxisomeC. MitochondriaD.

Golgi body

E. Endoplasmic reticulumMutation DNA replication

A. Codon substitutionB. Codon deletionC. Single base substitutionD. Single base deletionE. Codon insertion

X-linked dominant

A. B. C. D. E.

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20 A. TestisB. EpididymisC. Scrotal sacD. Prostate glandE. Seminal vesicle

50 155 80 hypertension

A. OsteoporosisB. DiverticulosisC. Endometrial carcinomaD. Collagen vascular diseaseE. Peptic ulcer

3 necrotizing enterocolitis terminal ileum diarrhea megaloblastic anemia

A. IronB. ZincC.FolateD.ThiamineE. Cobalamin

1 2 congenital hypertrophic pyloric stenosis Na+, K+ HCO

3

-(mmol/L)

A. 135, 3.5, 32B. 130, 5, 32C.135, 3.5, 16D.130, 5, 16E. 130, 3.5, 24

26o

C 37o

C

A. Decreased glycogenolysisB. Decreased oxygen consumptionC. Increased gluconeogenesisD. Increased thyroid hormone secretionE. Increased lipolysis of brown adipose tissue

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55 10 decreased deep tendonreflexes & light touch sensation

vitamin A. RetinolB. ThiamineC.Ascorbic acidD.CalciferolE. Tocopherol

35 PR 135/mn, BP160/95 mmHg, bilateral dilated pupils

A.Adrenergic agonistB.Cholinergic agonistC.Dopamine agonistD.Serotonin antagonistE.Histamine antagonist

reuptake serotonin serotonin

A.MigraineB.DepressionC.HypertensionD.Drug-induced vomitingE.Stress-induced peptic ulcer

60 ICU 3 chest x-ray bilateral infiltration numerous polymorphonuclear cells, gram-negative coccobacilli

A.Klebsiella pneumoniaeB.Acinetobacter baumanniiC.

Moraxella catarrhalis

D.Pseudomonas aeruginosaE. Haemophilus influenzae

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70 3

A. AnaerobesB. Nocardia asteroidesC. Klebsiella pneumoniaeD. Staphylococcus aureusE. Streptococcus pneumoniae

50 branching septate hyphae

A. Fusarium spp.B. Rhizopus arrhizusC. Penicillium marneffeiD. Aspergillus fumigatusE. Histoplasma capsulatum

25 KOHpreparation yeast

A.Epidermophyton floccosumB.Candida albicansC.Malassezia furfurD.Microsporum canisE. Trichophyton rubrum

20 gram stain gram-positive bacilli spore

A. Clostridium botulinumB. Clostridium tetaniC. Clostridium difficileD. Clostridium perfringensE. Clostridium septicum

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50% iron deficiency anemia eosinophil

A. Ascarisspp.B. Taeniaspp.C. Ancylostomaspp.D. Gnathostomaspp.E. Opisthorchisspp.

5 prolapsed rectum

A. AscariasisB. TrichuriasisC. CapillariasisD. OpisthorchiasisE. Strongyloidiasis

50

A. B. C. D. E.

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20 A. Diphyllobothrium latumB. Hymenolepis nanaC. Hymenolepis diminutaD. Taenia saginataE. Taenia solium

2 hypocalcemia thymus gland

A. BasophilB. EosinophilC.MonocyteD.B lymphocyteE. T lymphocyte

25 2 wheal

A. Antigen-antibody complexB. Delayed-type hypersensitivityC. Cell-mediated hypersensitivityD. IgE-mediated hypersensitivityE. IgG-mediated hypersensitivity

2 Salmonellameningitis tonsil thymus land

A. Dendritic cellB. MonocyteC. Natural killer cellD. T lymphocyteE. Macrophage

10 3 BP 160/100 mmHg,edema at both legs dysmorphic RBC BUN creatinine

A. Molecular mimicryB. Superantigen stimulationC. Delayed-type hypersensitivityD. Antigen-antibody complex deposition

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E. Antibody-dependent cellular cytotoxicity5 immunoglobulin

A. AB. DC. ED. GE. M

deep vein thrombosis A. B. C.D.E.

15 heme

A. Delta-ALA dehydrataseB. Porphobilinogen deaminaseC. Protoporphyrinogen oxidaseD. Coproporphyrinogen oxidaseE. Uroporphyrinogen decarboxylase

20 RBC central pallor

A. Hemoglobin B. Cytoskeleton C. cell membrane D. Cytoplasmic content E. Cell membrane macrophage24 hemoglobin electrophoresis

hemoglobin thalassemiaA. Hb AB. Hb A

2

C. Hb BartsD. Hb FE. Hb Portland

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40 deep vein thrombosis heparin warfarin warfarin

A. APTT ratioB. PT-INRC. Thrombin timeD. Venous clotting timeE. Bleeding time

70 total calcium 14 mg/dL CBC Hb 10 g/dL, WBC3,400/mm

3, platelet 200,000/mm

3 globulin 7 g/dL, total calcium 14 mg/dL Blood smear

A. ErythroblastB. LymphoblastC. MyeloblastD. MegakaryoblastE. Plasma cell

56 chronic renal failure blood smear normochromic normocytic RBC CBC Hb 8 g/dL, Hct 24%, platelet

A. ErythropoietinB. Ferrous sulfateC. Folic acidD.

Vitamin B12

E. Packed red cell red blood cell

A. Atrial septal defectB. Chronic bronchitisC. Iron overloadD. Nephrotic syndromeE. Rheumatoid arthritis

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40 Hb 8 g/dL, Hct 25%, MCV70 fL, reticulocyte 1%

A. MCVB. HemoglobinC. Reticulocyte countD. Serum ironE. Serum ferritin

25 5 CBC Hb 6 g/dL, MCV 80 fL, WBC 2,300/mm3(N 30%, L 70%), platelet 80,000/mm3

A. -globin chainB. Erythropoietin receptorC. G-6-PDD. Hematopoietic stem cellE. Spectrin

30

A. FerritinB. TransferrinC. HaptoglobinD.

Erythropoietin

E. Fetal hemoglobin70 cerebrovascular accident hypertonia, bradykinesia, resting tremor, poker face

A. MidbrainB. MedullaC.Basal gangliaD.Motor cortexE. Cerebellum55 10 burning sensation 2 2

A. IbuprofenB. ParacetamolC. CarbamazepineD. Vitamin B1-6-12E. Tramadol

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65 10

A. NoradrenalineB. AcetylcholineC. Gamma-aminobutyric acidD. DopamineE. Serotonin

20 1

A. SerotoninB. DopamineC. AcetylcholineD. NorepinephrineE. Gamma-aminobutyric acid

30 valproic acid vitamin

A. Folic acidB. Vitamin B1C. Vitamin B

6

D. Vitamin B12

E. Vitamin C10 2 10 diazepam

A. Enhanced GABA activityB. Increased glutamate activityC. Inhibit sodium channelD. Block neuronal calcium channelE. Inhibit GABA transaminase2 albinism melanocyte A. ProteaseB. TyrosinaseC. HexokinaseD. Protein kinaseE. Cyclooxygenase

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A. Micrococcus luteusB. Staphylococcus aureusC. Streptococcus pyogenesD. Propionibacterium acnesE. Staphylococcus epidermidis

25

A. DermisB. Stratum lucidumC. Stratum corneumD. Stratum germinativumE. Subcutaneous tissue

20 atopic dermatitis triamcinolone

A. Phospholipase inhibitorB. Cyclooxygenase inhibitorC. Lipoxygenase inhibitorD. Leukotriene antagonistE. Mast cell stabilizer

30

A. FilariasisB. ToxocariasisC. TrichinellosisD. StrongyloidiasisE. Gnathostomiasis

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60 2

A. Stratum corneumB. Stratum lucidumC. Stratum spinosumD. Stratum granulosumE. Stratum germinativum

12 2 KOH preparation septate hyphae

A. Tinea crurisB. Tinea corporisC. Tinea versicolorD. Intertrigo candidiasisE. Cutaneous candidiasis

65 osteoarthritis celecoxib celecoxib NSAIDs

A. Myocardial infarctionB. Peptic ulcerC. Renal insufficiencyD. Sulfonamide hypersensitivityE. Hypertension

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23 2 numerous WBC,intra- & extracellular gram-negative diplococci

A. Acinetobacter spp.B. Neisseria gonorrhoeaeC. Haemophilus influenzaeD. Salmonella entericaE. Burkholderia pseudomallei

40 SLE prednisolone calcium estrogen 3 osteoporosis osteoporosis

A. MenopauseB. Low exerciseC. CorticosteroidsD. Calcium supplementE. Autoimmune disease

10 1 X-ray

A. SilicosisB. AsbestosisC.Metalfume feverD.Woolsorters diseaseE. Chemical pneumonitis

50 asthma corticosteroids 1 montelukast

A. Mast cell stabilizerB. Muscarinic antagonistC. Beta-adrenergic agonistD.

Phospholipase A2inhibitor

E. Leukotriene receptor antagonist

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55 20 bronchialcarcinoid tumor

A. Clara cellB. Basal cellC. Goblet cellD. Neuroendocrine cellE. Columnar ciliated cell

30 wheeze 2 oxygen saturation pulse oximetry 95%

A. Inhaled salbutamolB. Inhaled beclomethasoneC. Inhaled cromolyn sodiumD. Intravenous corticosteroidE. Intravenous aminophylline

2 1,200 ground glass appearance respiratory distress syndrome

A. Pulmonary surfactantB. Respiratory muscleC. BronchioleD. Nerve supplyE. Blood supply

50 1 5 . right upper lobeglucose 90 mg/dL, total calcium 14 mg/dL

A. Carcinoid tumorB. AdenocarcinomaC. Small cell carcinomaD. Squamous cell carcinomaE. Undifferentiated carcinoma

20 familial hypercholesterolemia lipid containing plaque Lipid plaque

A. Large veinB. Large artery

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C.Muscular veinD.Muscular arteryE. Arteriole

2 Tetralogy of Fallot ( 4 )

A. Right atriumB. Right ventricleC.Left atriumD.Left ventricle

2 echocardiogram transposition of great vessels aorta

A. Right atriumB. Left atriumC.Right ventricleD.Left ventricleE. Sinus venosus

50 1 BMI 28kg/m

240

A. Peptic ulcerB. Gouty arthritisC. Diabetes mellitusD. CholelithiasisE. Coronary artery disease

30 3 systolic murmur intercostal space 5 (4 )

A. Aortic valveB. Mitral valveC. Tricuspid valveD. Pulmonary valve50 K+-sparing diuretics 1

severe hyperkalemia

A. -blockersB. -blockersC. Direct vasodilatorsD. Calcium channel blockers

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E. Angiotensin-converting enzyme inhibitors12 diastolic murmur intercostal space 2

A. Aortic regurgitationB. Tricuspid regurgitationC. Aortic stenosisD. Mitral regurgitationE. Pulmonic stenosis

60 hypertension enalapril A. HyperkalemiaB. HypernatremiaC. HyperuricemiaD. HypocalcemiaE. Hypophosphatemia

30 2

A. Pulmonic stenosisB. Tricuspid regurgitationC. Aortic regurgitationD. Mitral stenosisE. Mitral regurgitation

20

BP

2

160/100 mmHg

BP

2

110/80 mmHg

A. Patent ductus arteriosusB. Renal artery stenosisC. PheochromocytomaD. Transposition of great vesselsE. Coarctation of aorta

40

A. SclerodermaB. Giant cell arteritisC. Takayasu arteritisD. Polyarteritis nodosaE. Thromboangiitis obliterans

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25 BP 170/100 mmHg

A. Increased aldosteroneB. Increased prostaglandinsC. Increased atrial natriuretic peptideD. Activated renin-angiotensin systemE. Increased vascular sympathetic activity

50 5 serum amylase 5

A. Acute pancreatitisB. Pancreatic pseudocystC.Peptic perforationD.Pancreatic duct obstructionE. Pancreatic adenocarcinoma

bile acid A. StomachB. DuodenumC.JejunumD. IleumE. Colon

35

NSAIDs

peptic ulcer

A. HClB. CCKC. GastrinD. MucinE. Secretin

50 alcoholic cirrhosis splenomegaly, hemorrhoid caputmedusae

Hemorrhoid A. Paraumbilical veinB. Right colic veinC.Splenic veinD. Inferior mesenteric vein

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E. Ileocolic vein50 2 30 portal hypertension

A. HemorrhoidsB. SplenomegalyC.Caput medusaeD.Spider telangiectasiaE. Gastroesophageal varices

6 meconium

A. IntussusceptionB. Pyloric stenosisC.Midgut volvulusD.Duodenal atresiaE.

Esophageal atresia

35 rice watery stoolToxin rice watery stool

A. intestinal epithelial cell proinflammatory cytokinesB. pore intestinal epithelial cell C. protein intestinal epithelial cellD. adenylate cyclase cAMP electrolytes lumen E. Na+ electrolyte imbalance

45 ultrasonography mass 5. biopsy hepatocellular carcinoma

A. B. C. D. E.

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50 peptic ulcer proton pump inhibitor 6

A. Duodenal hypoacidityB. Atrophy of gastric parietal cellC. Down regulation of gastrin receptorD. Occasional gastrointestinal infectionE. Inadequate pancreatic enzyme secretion

40 metocloprami

A. B. C. D. E.

70 2 T 38oC, mild tenderness at lower abdomen without guarding colonic diverticulitis

A. B. C. D. E.

45 20

A. Gastric cancerB. Acute gastritisC. Duodenal ulcerD. Esophageal varicesE. Perforated peptic ulcer

30 Vibrio choleraeA. Tyrosine kinaseB. Guanylate cyclaseC. Adenylate cyclaseD. Phospholipase A2E. Phospholipase C

60 urothelial carcinoma

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A. B. C.D.E.

15 water deprivation test 20 urine concentration ability specific gravity

A. 1.005B. 1.010C.1.020D.1.030E. 1.040

70 end stage renal disease Na+, K+ PO4

3- Ca2+

Ca2+ PO4

3-

A. ReninB. CalcitriolC.CreatinineD.ErythropoietinE. Calcium binding protein

30

tetracycline

acidosis pH 6.5, protein trace, glucose 2+, acetone negative, titratable acid ,bicarbonate

A. GlomerulusB. Proximal tubuleC.Loop of HenleD.Distal tubuleE. Collecting duct

8 3 1 .. 2 BP 150/100 mmHg, generalized non-pitting edema, Heart:- S3

gallop, crepitation at both lungs smoky urine, protein 2+, numerous RBCs furosemide

A. Suppression of ADH releaseB. Binding of aldosterone receptorC. Inhibition of carbonic anhydrase

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D. Blocking of NaCl transporterE. Inhibition of Na+-K+-2Cl-cotransporter

40 4 1 acute tubular necrosis

A. Proximal tubuleB. Descending limb of Henles loopC. Ascending limb of Henles loopD. Distal tubuleE. Collecting duct

60 shock shock serum creatinine

A. Acute tubular necrosisB. Crescentic glomerulonephritisC. Wedge shape infarctionD. Secondary hyperaldosteronismE. Fibrin thrombi

20 urine specific gravity 1.035

A. GlomerulusB. Proximal tubuleC. Descending limb of Henles loopD. Ascending limb of Henles loopE. Collecting duct

35 2 protein 3+, sugar trace, RBC 10-25/hpf, WBC 5-10/hpf, oval fat bodies2-3/hpf, RBC cast 0-1/hpf, fatty cast 0-1/hpf

A. Lupus nephritisB. IgA nephropathyC. Nephrotic syndromeD. Chronic interstitial nephritisE. Acute poststreptococcal glomerulonephritis

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24 140 webbed neck chromosome 45, XO

A. OvaryB. VaginaC.Uterine corpusD.Uterine cervixE. Fallopian tube

30 BMI 28 kg/m2 16 fasting plasma glucose 140mg/dL 2-hour plasma glucose with oral glucose tolerance test 220 mg/dL

A. ProlactinB. EstrogenC.GlucocorticoidsD.CatecholaminesE. Human placental lactogen

35 cyst ovary polycystic ovary syndrome

A. Increased androstenedioneB. Increased progesteroneC. Decreased estroneD. Decreased LHE. Decreased FSH

12 28 endometrium A. Predecidual phaseB. Intraluminal fluid accumulationC. Subnuclear collagen contentD. High proliferative glandular epitheliumE. Saw-tooth appearance of endometrial gland

discharge

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A. EstrogenB. ProgesteroneC. LHD. FSHE. GnRH

55 2 3 . squamous cell carcinoma

A. Epstein-Barr virusB. Herpes simplex virusC. Chlamydia trachomatisD. Human papillomavirusE. Human immunodeficiency virus

65 erectile dysfunction sildenafil

A. Androgen agonistB. Estrogen antagonistC. Inhibit nitric oxide synthaseD. Inhibit phosphodiesterase type 5E. Inhibit prostaglandin E

2synthesis

50 invasive ductal carcinoma tamoxifen

A. 5-reductase inhibitorB. Aromatase inhibitorC. Phospholipase A

2inhibitor

D. Estrogen receptor antagonistE. Androgen receptor antagonist

20 3

A. AmphetamineB. CorticosteroidsC. EstrogenD. TestosteroneE. Thyroxine

65 6 benign prostatic hyperplasia

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A. Peripheral zoneB. Transitional zoneC. Central zoneD. Fibrous septumE. Fibrous stroma

13

A. EpinephrineB. LeukotrienesC. AcetylcholineD. ProgesteroneE. Prostaglandins

30 5 sperm analysis

A. B. C. D. E.

20

0.5

3

A. Treponema pallidumB. Haemophilus ducreyiC. Chlamydia trachomatisD. Herpes simplex virusE. Human papillomavirus

50 1 2

A. EstrogenB. ProgesteroneC. LHD. FSHE. GnRH

20 papillary thyroid carcinoma thyroidectomyrecurrence papillary thyroid carcinoma

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A. T3

B. T4

C. ThyroglobulinD. Anti-thyroglobulin antibodyE. Thyroid stimulating hormone

20 220 .

A. LactotrophB. ThyrotrophC. CorticotrophD. SomatotrophE. Gonadotroph

25

A. ReninB. OxytocinC. VasopressinD. AngiotensinE. Aldosterone

30 diffuse thyroidenlargement (60 g), rubbery consistency, no nodule TSH T

4

A. Idiopathic causeB. Decreased hormone productionC. Iodine deficiencyD. AutoimmunityE. Decreased TRH release

30 BP 210/130 mmHg MRI mass right adrenal gland 2-3

metabolic pathway A. Erythrocyte glycolysisB. Adipocyte lipolysisC. Muscle glycogenolysisD. Adrenal glycogenesisE. Hepatic gluconeogenesis

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32 BP 150/100 mmHg, PR 72/min, proximal muscle weakness grade II/V allextremities glucose 92 mg/dL, Na+146 mmol/L, K+3.0 mmol/L, Cl-109 mmol/L 24-hour urine K+40 mmol

A. Low serum free T3& T

4

B. Low serum calcium & PTHC. High serum cortisol & ACTHD. High urine catecholamines & metanephrineE. High plasma aldosterone, low plasma renin

25 pituitary microadenoma bromocriptine A. Dopamine receptor agonistB. 5-HT

3receptor agonist

C. Muscarinic receptor antagonistD. H

1receptor antagonist

E. Noradrenaline antagonist25 PR 100/min, fine tremor, exophthalmos propylthiouracil thyroid hormone

A. Peroxidation iodide iodineB. Iodide uptakeC. Release of thyroid hormoneD. Colloid resorptionE. Iodothyrosine deiodination

15

craniopharyngioma

sella turcica

urine sp.gr.

Na+150 mmol/L, Cl-110 mmol/L, HCO3

-25 mmol/L

A. ACTHB. OxytocinC. VasopressinD. AldosteroneE. Atrial natriuretic peptide

15 A. CatecholaminesB. Thyroid hormoneC. GlucocorticoidsD. Growth hormoneE. Mineralocorticoids

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80 hypertension Parkinsons disease BP 150/100 mmHg, PR 100/min, RR 30/min, K+2.8 mmol/L, albumin 2.5 g/dL

A. InsulinB. GlucagonC. CortisolD. ThyroxineE. Mineralocorticoids

5 buffalo hump, hyperpigmentation glucose

A. CortisolB. AndrogenC. GlucagonD. AldosteroneE. Growth hormone

A. MelatoninB. Luteinizing hormoneC. TestosteroneD. Parathyroid hormoneE. Thyroid hormone

26 4 1 PR 120/min, BP100/50 mmHg, enlarged thyroid gland, slight exophthalmos

A. Upper airway obstructionB. Cardiac tamponadeC. Pericardial effusionD. Pulmonary hypertensionE. High-output cardiac failure