**1. EPISPADIAS DIAGNOSIS** ✅ **Answer:** C) Upper side of the penis 🔑 **Key Point:** Differs from hypospadias (ventral opening). --- **2. LI-FRAUMENI SYNDROME** ✅ **Answer:** A) TP53 mutation 🔑 **Key Point:** High cancer risk (breast, sarcoma, brain). --- **3. VOLATILE AGENT TO AVOID IN SHOCK** ✅ **Answer:** 🚫 **Halothane** 🔑 **Key Point:** Causes myocardial depression → unsafe. --- **4. INTRA PLEURAL AGENT FOR PLEURAL PLAQUES** ✅ **Answer:** D) Cisplatin 🔑 **Key Point:** Plaques = benign (asbestos-related). --- **5. CHILD WITH PAINLESS HEMATURIA** ✅ **Answer:** 💊 **Cyclophosphamide** 🔑 **Key Point:** Hemorrhagic cystitis → use mesna prophylaxis. --- **6. METFORMIN ADVERSE EFFECT** ✅ **Answer:** B) Incorrect statement 🔑 **Key Point:** Risk = lactic acidosis (not listed). --- **7. IV H2 BLOCKER IN INTESTINAL OBSTRUCTION** ✅ **Answer:** C) Increase gastric pH 🔑 **Key Point:** Reduces aspiration risk. --- **8. VISCERAL PAIN CAUSE** ✅ **Answer:** A) Distension/contraction 🔑 **Key Point:** Poorly localized + referred pain. --- **9. GASTRIC ULCER PAIN INNERVATION** ✅ **Answer:** A) Greater splanchnic nerve 🔑 **Key Point:** Foregut innervation (T5-T9). --- **10. LIVER BIOPSY APPROACH** ✅ **Answer:** 🩺 **Ultrasound-guided** 🔑 **Key Point:** Avoids lung/gallbladder injury. **11. LIVER BIOPSY NERVE AT RISK (9th ICS)** ✅ **Answer:** A) 9th intercostal nerve 🔑 **Key Point:** Vessels also at risk. --- **12. RIGHT HEMIPLEGIA + LEFT FACIAL DEVIATION** ✅ **Answer:** A) Left cerebral cortex 🔑 **Key Point:** UMN spares forehead. --- **13. RIGHT FACE ANALGESIA + LEFT BODY WEAKNESS** ✅ **Answer:** B) Right lateral medullary syndrome 🔑 **Key Point:** PICA occlusion (Wallenberg). --- **14. NASAL POLYPS WITH RIGHT-ANGLED HYPHAE** ✅ **Answer:** B) Mucormycosis 🔑 **Key Point:** Non-septate hyphae (90°). --- **15. ZELLWEGER SYNDROME** ✅ **Answer:** 🧬 Peroxisome disorder 🔑 **Key Point:** VLCFAs accumulate. --- **16. CHRONIC BRONCHITIS EPITHELIAL CHANGE** ✅ **Answer:** A) Loss of cilia 🔑 **Key Point:** Squamous metaplasia → infections. --- **17. CALCIUM RELEASE ORGANELLE** ✅ **Answer:** D) SER 🔑 **Key Point:** SER = calcium storage. --- **18. TETRALOGY OF FALLOT (TOF)** ✅ **Answer:** B) Pulmonary infundibulum stenosis 🔑 **Key Point:** VSD, overriding aorta, RVH. --- **19. LCX BLOCKAGE** ✅ **Answer:** 🫀 Left atrium + ventricle 🔑 **Key Point:** Lateral STEMI. --- **20. ATRIAL FIBRILLATION ECG FINDING** ✅ **Answer:** ❌ Absent P waves 🔑 **Key Point:** Irregularly irregular rhythm. --- **21. SCAR STRENGTH POST-LAPAROTOMY** ✅ **Answer:** A) 1 year 🔑 **Key Point:** Full strength at 1 year. --- **22. SPECIFIC IMMUNITY** ✅ **Answer:** B) Lymphocytes 🔑 **Key Point:** B cells (antibodies) + T cells. --- **23. NK CELL MECHANISM** ✅ **Answer:** 🦠 Kill infected cells 🔑 **Key Point:** Targets MHC-I negative cells. --- **24. ANTERIOR 2/3 IV SEPTUM BLOOD SUPPLY** ✅ **Answer:** LAD artery 🔑 **Key Point:** Posterior 1/3 = PDA. --- **25. BLACK SHADOW ON X-RAY (BROKEN RIBS)** ✅ **Answer:** B) Hemothorax 🔑 **Key Point:** Blood = radiopaque. --- **26. MCARDLE DISEASE DIET** ✅ **Answer:** C) Low carbs 🔑 **Key Point:** Avoid strenuous exercise. --- **27. HMG-CoA REDUCTASE FUNCTION** ✅ **Answer:** B) Cholesterol synthesis 🔑 **Key Point:** Target of statins. --- **28. LESCH-NYHAN SYNDROME** ✅ **Answer:** 🧬 HGPRT deficiency 🔑 **Key Point:** X-linked → self-mutilation. --- **29. ALLOPURINOL MECHANISM** ✅ **Answer:** A) Xanthine oxidase inhibitor 🔑 **Key Point:** Treats gout. --- **30. NEEDLE OVER EMPTY BLADDER RISK** ✅ **Answer:** A) Inferior epigastric artery 🔑 **Key Point:** Use ultrasound. --- **31. ACUTE CHOLECYSTITIS DIAGNOSIS** ✅ **Answer:** A) Acute cholecystitis 🔑 **Key Point:** RUQ pain + thickened GB. --- **32. SULFUR GRANULES IN ACTINOMYCOSIS** ✅ **Answer:** 🦠 Actinomyces 🔑 **Key Point:** Treat with penicillin. --- **33. ORGANOPHOSPHATE POISONING TREATMENT** ✅ **Answer:** 💉 Atropine 🔑 **Key Point:** Blocks muscarinic effects. --- **34. SUBARACHNOID HEMORRHAGE CSF** ✅ **Answer:** 🩸 Blood-tinged CSF 🔑 **Key Point:** CT head first. --- **35. HUNTINGTON’S DISEASE LESION** ✅ **Answer:** A) Caudate nucleus 🔑 **Key Point:** CAG repeats → autosomal dominant. --- **36. ROOF OF ANTERIOR LATERAL VENTRICLES** ✅ **Answer:** B) Genu of corpus callosum 🔑 **Key Point:** Splenium = posterior roof. --- **37. OCULOMOTOR NERVE PALSY** ✅ **Answer:** A) Oculomotor 🔑 **Key Point:** Ptosis, "down + out" eye. --- **38. CAMPYLOBACTER TREATMENT** ✅ **Answer:** A) Azithromycin 🔑 **Key Point:** First-line for *C. jejuni*. --- **39. HYPOTHYROIDISM IN NORTHERN AREAS** ✅ **Answer:** 🧂 Iodine deficiency 🔑 **Key Point:** Endemic goiter. --- **40. ANTI-TPO ANTIBODIES** ✅ **Answer:** A) Hashimoto’s 🔑 **Key Point:** Autoimmune thyroiditis. --- **41. HYPONATREMIA FROM OVERHYDRATION** ✅ **Answer:** B) ↓ ICF tonicity 🔑 **Key Point:** Cerebral edema risk. --- **42. CILIARY GANGLION PREGANGLIONIC FIBERS** ✅ **Answer:** C) Oculomotor nerve 🔑 **Key Point:** Edinger-Westphal nucleus (CN III). --- **43. STRESS-INDUCED GLYCOGENOLYSIS** ✅ **Answer:** C) Epinephrine 🔑 **Key Point:** Activates β-receptors. --- **44. DIGITALIS EFFECT** ✅ **Answer:** A) Positive inotropic 🔑 **Key Point:** Inhibits Na+/K+ ATPase. --- **45. VOMITING CENTER** ✅ **Answer:** A) Nucleus tractus solitarius 🔑 **Key Point:** Integrates CTZ signals. --- **46. N2O ADVERSE EFFECT** ✅ **Answer:** A) Abdominal distension 🔑 **Key Point:** Avoid in bowel obstruction. --- **47. SICKLE CELL MUTATION** ✅ **Answer:** A) A to T 🔑 **Key Point:** Glutamate → valine. --- **48. HYPERCHLOREMIC ACIDOSIS** ✅ **Answer:** A) Acetazolamide 🔑 **Key Point:** Carbonic anhydrase inhibitor. --- **49. HYPONATREMIA TREATMENT** ✅ **Answer:** C) 0.9% NaCl 🔑 **Key Point:** Avoid rapid correction. --- **50. VENTILATORY DRIVE ACTIVATION** ✅ **Answer:** A) Ventral respiratory group (VRG) 🔑 **Key Point:** Forced breathing. --- **51. HIRSCHSPRUNG DISEASE** ✅ **Answer:** B) Rectum 🔑 **Key Point:** Aganglionosis → constipation. --- **52. SECRETIN RELEASE** ✅ **Answer:** B) Secretin 🔑 **Key Point:** Triggered by duodenal acidity. --- **53. THALAMUS EMBRYOLOGY** ✅ **Answer:** A) Diencephalon 🔑 **Key Point:** Hypothalamus same origin. --- **54. ADNEXAL MASS TUMOR MARKER** ✅ **Answer:** A) CA-125 🔑 **Key Point:** Ovarian cancer marker. --- **55. BITEMPORAL HEMIANOPIA** ✅ **Answer:** A) Middle of optic chiasm 🔑 **Key Point:** Pituitary adenoma compression. --- **56. HYPOKALEMIA IN HYPERTENSION** ✅ **Answer:** A) Aldosterone excess 🔑 **Key Point:** Conn’s syndrome. --- **57. SCIATIC NERVE INJURY** ✅ **Answer:** C) Sciatic nerve 🔑 **Key Point:** Foot drop + hamstring weakness. --- **58. METHOTREXATE MECHANISM** ✅ **Answer:** A) Inhibits DHFR 🔑 **Key Point:** Rescue with leucovorin. --- **59. FEMORAL HERNIA** ✅ **Answer:** A) Femoral hernia 🔑 **Key Point:** Below pubic tubercle. --- **60. POSTMORTEM CLOT IDENTIFICATION** ✅ **Answer:** 🐔 "Chicken fat" clot 🔑 **Key Point:** Pale + red layers. --- **61. GREEN URINE IN ICU** ✅ **Answer:** 🦠 Pseudomonas infection 🔑 **Key Point:** Ceftazidime covers it. --- **62. GREEN SPUTUM ANTIBIOTIC** ✅ **Answer:** A) Ceftazidime 🔑 **Key Point:** Treats *Pseudomonas*. ---