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স্পেশাল বিসিএস (স্বাস্থ্য)

মোট প্রশ্ন৪,২৮৫এই পাতা১০০প্রতি পাতা১০০
প্রশ্ন দেখুনঅনুশীলন
ঘনত্ব
উত্তর
উত্তরিতবর্তমানপুনরায় দেখুনঅসম্পূর্ণ

স্পেশাল বিসিএস (স্বাস্থ্য)

PrepBank · পাতা ২৩ / ৪৩ · ২,২০১–২,৩০০ / ৪,২৮৫

২,২০১.
A chronic alcoholic presents with ataxia, confusion, and horizontal nystagmus. Which of the following vitamin deficiencies is most likely?
  1. ক
    Thiamine (B1)
  2. খ
    Niacin (B3)
  3. গ
    Vitamin C
  4. ঘ
    Vitamin K
ব্যাখ্যা
Wernicke’s encephalopathy (ataxia, confusion, nystagmus) is caused by thiamine deficiency. Niacin deficiency causes pellagra (dermatitis, diarrhea, dementia).
২,২০২.
Location of fenestrated capillaries
  1. ক
    ক) Liver
  2. খ
    খ) Spleen
  3. গ
    গ) Anterior pituitary
  4. ঘ
    ঘ) Choroid plexus
২,২০৩.
In Bangladesh, dispatch of preserved viscera is typically done to:
  1. ক
    Civil Surgeon
  2. খ
    Forensic Science Laboratory (FSL)
  3. গ
    BMDC
  4. ঘ
    Local Hospital
ব্যাখ্যা
Explanation: The FSL conducts chemical analysis of toxicological specimens. (Ref: Bangladesh Police Protocol)
২,২০৪.
Blood-stained pleural fluid isn’t found in
  1. ক
    ক) Malignant disease
  2. খ
    খ) Cardiac failure
  3. গ
    গ) Pulmonary infarction
  4. ঘ
    ঘ) Acute pancreatitis
ব্যাখ্যা
Reference: Davidson 23rd; P-563
২,২০৫.
A 28-year-old woman presents with a history of heat intolerance, weight loss, and palpitations. On examination, she has a diffusely enlarged thyroid and exophthalmos. Which of the following is the most appropriate initial treatment?
  1. ক
    Propylthiouracil (PTU)
  2. খ
    Radioactive iodine
  3. গ
    Beta-blockers
  4. ঘ
    Thyroidectomy
ব্যাখ্যা
Stem Breakdown:

Heat intolerance, weight loss, palpitations: These symptoms suggest hyperthyroidism.
Diffuse thyroid enlargement and exophthalmos: These signs strongly indicate Graves’ disease, an autoimmune form of hyperthyroidism where antibodies stimulate the thyroid to overproduce thyroid hormone.
Option Analysis:

A) Propylthiouracil (PTU): PTU is an antithyroid medication used to inhibit thyroid hormone synthesis. While it is an important treatment for Graves’ disease, it is not the first-line treatment in an acute setting. Beta-blockers are initially used to control symptoms such as palpitations and tachycardia.
B) Radioactive iodine: Radioactive iodine is a definitive treatment for Graves’ disease, as it destroys overactive thyroid tissue. However, it is not used as an initial treatment to control acute symptoms.
C) Beta-blockers: This is the correct answer. Davidson and Harrison explain that beta-blockers (e.g., propranolol) are used to manage the adrenergic symptoms of hyperthyroidism (palpitations, tremors, anxiety) while more definitive treatments (e.g., antithyroid medications or radioactive iodine) are initiated.
D) Thyroidectomy: Thyroidectomy is reserved for patients who fail medical therapy or cannot tolerate other treatments. It is not used as initial treatment for hyperthyroidism.
২,২০৬.
Layers of hair follicle excludes
  1. ক
    ক) Cuticle
  2. খ
    খ) Zonule
  3. গ
    গ) Cortex
  4. ঘ
    ঘ) Medulla
ব্যাখ্যা
A hair may be regarded as a modified part of the stratum corneum of the skin. It consists of three layers named cuticle, cortex & medulla.
২,২০৭.
Which is nuclear maturation defect anemia?
  1. ক
    IDA
  2. খ
    Thalassemia
  3. গ
    Hypersplenism
  4. ঘ
    Refractory anemia
২,২০৮.
Third heart sound is physiologically found in
  1. ক
    Anemia
  2. খ
    Pregnancy
  3. গ
    Thyrotoxicosis
  4. ঘ
    Fever
ব্যাখ্যা
Physiological third heart sound: young people, pregnancy
Pathologicalthird heart sound: heart failure, mitral regurgitation
২,২০৯.
First step of management of acute heart failure is ‘Sit the patient up’, why this step is taken for?
  1. ক
    ক) Reduces preload
  2. খ
    খ) Reduces afterload
  3. গ
    গ) Combats fluid overload
  4. ঘ
    ঘ) Corrects hypoxia
২,২১০.
In a medicolegal autopsy, the medical officer collects viscera but does not label containers properly. What are the implications?
  1. ক
    Evidence remains admissible if container is intact
  2. খ
    Evidence is likely inadmissible due to broken chain of identity
  3. গ
    Labeling is optional if a report is written
  4. ঘ
    No issue if report is consistent
ব্যাখ্যা
Explanation: Reddy stresses that unlabeled or mislabelled specimens jeopardize legal validity. Chain of custody requires sealed, signed, labeled specimens with matching documentation.
২,২১১.
Which nerve is closely related to the superior thyroid artery?
  1. ক
    Superior laryngeal nerve
  2. খ
    Recurrent laryngeal nerve
  3. গ
    External laryngeal nerve
  4. ঘ
    Internal laryngeal nerve
ব্যাখ্যা
The recurrent laryngeal nerve is closely related to the inferior thyroid artery and any damage to it during surgery may result in hoarse ness of the voice. 

Injury to the external laryngeal nerve is more common because of its proximity to the superior thyroid artery. This leads to loss of tension in the vocal cord with diminished power and range in the voice. Patients, particularly those who use their voice professionally, must be advised that any thyroid operation will result in change to the voice even in the absence of nerve trauma. 

[Ref. Bailey & Love's 27th, Page 865] 
২,২১২.
The parietal pleura-
  1. ক
    develops from splanchnic mesoderm
  2. খ
    innervated by phrenic nerve
  3. গ
    lines the fissures of lung
  4. ঘ
    is insensitive to pain
২,২১৩.
Continuous capillaries are found in-
  1. ক
    Connective tissue
  2. খ
    Endocrine glands
  3. গ
    Intestinal villi
  4. ঘ
    Anterior pituitary
২,২১৪.
Which layer of epidermis contains Langerhans cell
  1. ক
    ক) Corneum
  2. খ
    খ) Lucidum
  3. গ
    গ) Granulosum
  4. ঘ
    ঘ) Spiunosum
২,২১৫.
Butterfly shaped gland
  1. ক
    ক) Adrenal
  2. খ
    খ) Thyroid
  3. গ
    গ) Parathyroid
  4. ঘ
    ঘ) Pituitary
ব্যাখ্যা
The thyroid is a highly vascular, butterfly-shaped gland surrounding the anterior surface of the trachea just below the larynx.
২,২১৬.
Atrial fibrillation occurs in about ____________ % of patients with thyrotoxicosis
  1. ক
    10
  2. খ
    20
  3. গ
    30
  4. ঘ
    40
২,২১৭.
Which promotes development of female breast & secretion of milk?
  1. ক
    Prolactin
  2. খ
    FSH
  3. গ
    LH
  4. ঘ
    Oxytocin
২,২১৮.
Clinical features of cardiac tamponade excludes
  1. ক
    Pulsus paradoxus
  2. খ
    Kussmaul’s sign
  3. গ
    Gross elevation of JVP
  4. ঘ
    Hepatomegaly
ব্যাখ্যা
Reference: Davidson 23rd; P-544
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]
২,২১৯.
ECG finding in TCA poisoning is..
  1. ক
    ক) Narrow QRS complex
  2. খ
    খ) Broad QRS complex
  3. গ
    গ) ST elevation
  4. ঘ
    ঘ) ST depression
২,২২০.
In the heart-
  1. ক
    Left border is mainly formed by left atrium
  2. খ
    Right border is formed by right atrium only
  3. গ
    Inferior border formed mainly by the left ventricle
  4. ঘ
    Upper border is formed mainly by left auricle
২,২২১.
Dandy walker malforamtion is associated with
  1. ক
    1st ventricle
  2. খ
    Lateral ventricle
  3. গ
    3rd ventricle
  4. ঘ
    4th ventricle
২,২২২.
1st step in treatment of severe hyperkalemia should be
  1. ক
    ক) IV calcium gluconate
  2. খ
    খ) IV glucose
  3. গ
    গ) IV frusemide
  4. ঘ
    ঘ) Inhaled beta-2 agonist
ব্যাখ্যা
Reference: Davidson 23rd; P-363
২,২২৩.
Amber coloured pleural fluid indicates
  1. ক
    ক) TB
  2. খ
    খ) CCF
  3. গ
    গ) RA
  4. ঘ
    ঘ) SLE
ব্যাখ্যা
Reference: Davidson 23rd; P-563
২,২২৪.
Which hormone is secreted from Throughout GIT?
  1. ক
    ক) Gastrin
  2. খ
    খ) Somatostatin
  3. গ
    গ) Cholecystokinin
  4. ঘ
    ঘ) Secretin
ব্যাখ্যা
Reference: Davidson 23rd Box 21.2
২,২২৫.
Consequence of large emboli -
  1. ক
    Asymptomatic
  2. খ
    Haemoptysis
  3. গ
    Sudden death
  4. ঘ
    Cough
ব্যাখ্যা
Explanation -
Most pulmonary emboli (60% to 80%) are clinically silent because they are small. With time they become organized and are incorporated into the vascular wall; in some cases organization of the thromboembolus leaves behind a delicate, bridging fibrous web.

• Sudden death, acute right heart failure (cor pulmonale), or cardiovascular collapse occurs when emboli obstruct 60% or more of the pulmonary circulation( Large emboli). 

• Embolic obstruction of medium-sized arteries with subsequent vascular rupture can result in pulmonary hemorrhage but usually does not cause pulmonary infarction.
• Embolic obstruction of small end-arteriolar pulmonary branches often does produce hemorrhage or infarction.
• Multiple emboli over time may cause pulmonary hypertension and right ventricular failure.
২,২২৬.
Pansystolic murmur is found in
  1. ক
    MS
  2. খ
    MR
  3. গ
    AS
  4. ঘ
    AR
২,২২৭.
The root of the left lung has-
  1. ক
    one pulmonary vein
  2. খ
    two pulmonary artery
  3. গ
    two bronchial arteries
  4. ঘ
    hyparterial & eparterial bronchi
২,২২৮.
Acute eosinophilic pneumonia is an acute febrile illness (of less than_____________days characterised by diffuse pulmonary infiltrates and hypoxic respiratory failure
  1. ক
    3
  2. খ
    4
  3. গ
    5
  4. ঘ
    6
ব্যাখ্যা
Acute eosinophilic pneumonia is an acute febrile illness (of less than 5 days’ duration), characterised by diffuse pulmonary infilltrates and hypoxic respiratory failure.
২,২২৯.
Part of posterior pituitary
  1. ক
    ক) Pars tuberalis
  2. খ
    খ) Pars intermedia
  3. গ
    গ) Pars nervosa
  4. ঘ
    ঘ) Pars distalis
২,২৩০.
Criteria of smooth muscle fiber excludes
  1. ক
    ক) Fusiform
  2. খ
    খ) Linked by numerous tight junction
  3. গ
    গ) No striation
  4. ঘ
    ঘ) No branching
ব্যাখ্যা
Smooth muscle fibers are individual small, fusiform (tapering) cells, linked by numerous gap junctions.Thin and thick filaments in smooth muscle fibers do not form sarcomeres, and no striations are present. Branching is absent.
২,২৩১.
Which is a initial HIV test?
  1. ক
    ELISA
  2. খ
    Western Blot
  3. গ
    PCR
  4. ঘ
    CBC
২,২৩২.
Among Hepatotopic viruses which concern with major risk factor for developing HCC?
  1. ক
    ক) dfx Hepatitis A
  2. খ
    খ) Hepatitis B
  3. গ
    গ) Hepatitis C
  4. ঘ
    ঘ) Hepatitis E
ব্যাখ্যা
Explanation: Chronic hepatitis B infection increases the risk of HCC 100-fold and is the major risk factor worldwide
২,২৩৩.
Molluscum contagiosum is caused by
  1. ক
    ক) HHV - 8
  2. খ
    খ) Parvo virus
  3. গ
    গ) Pox virus
  4. ঘ
    ঘ) Papilloma virus
ব্যাখ্যা
Reference: Davidson 23rd , Page : 1239
২,২৩৪.
Clinical features of Achalasia excludes
  1. ক
    ক) Dysphagia for solids and liquids
  2. খ
    খ) Low LES pressure on esophageal Manometry
  3. গ
    গ) 'Bird-beak' sign on barium swallow study
  4. ঘ
    ঘ) Increased risk for esophageal squamous cell carcinoma
ব্যাখ্যা

Clinical features of Achalasia:
• Dysphagia for solids and liquids
• Putrid breath
• High LES pressure on esophageal manometry
• 'Bird-beak' sign on barium swallow study
• Increased risk for esophageal squamous cell carcinoma

২,২৩৫.
Cardinal finding in portal hypertension
  1. ক
    Splenomegaly
  2. খ
    Ascites
  3. গ
    Renal fsilure
  4. ঘ
    Variceal bleeding
ব্যাখ্যা
Reference: Davidson 23rd; P-868
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]
২,২৩৬.
Clinical safe range of pH is
  1. ক
    4.5-6
  2. খ
    5.5-8
  3. গ
    7-8
  4. ঘ
    7.3-7.5
ব্যাখ্যা
Clinical safe range of pH is 7.3-7.5

ABC of Biochemistry 6th - P:342
২,২৩৭.
Which condition should be suspected in a patient with unexplained right heart failure and a small heart ?
  1. ক
    ক) Rrstrictive cardiomyopathy
  2. খ
    খ) Chronic constrictive pericarditis
  3. গ
    গ) Acute pericarditis
  4. ঘ
    ঘ) Cardiac tamponade
ব্যাখ্যা
Reference: Davidson 23rd , Page : 543
Explanation : chronic constrictive pericarditis is sometimes overlooked but should be suspected in any patient with unexplained right heart failure and a small heart.
Differential diagnosis of small heart : Chronic constrictive pericarditis,Addison’s disease, Starvation.
২,২৩৮.
Which type of emphysema is seen in α1-antitrypsin deficiency
  1. ক
    ক) Centriacinar
  2. খ
    খ) Panacinar
  3. গ
    গ) Distal acinar
  4. ঘ
    ঘ) Irregular
ব্যাখ্যা

 Emphysema is a chronic obstructive airway disease characterized by permanent enlargement of air spaces distal to terminal bronchioles.
 It is a component of along with chronic bronchitis.
 Subtypes include centriacinar (most common, smoking related), panacinar (seen in α1-antitrypsin deficiency), distal acinar and irregular.

২,২৩৯.
Cell number is increased in
  1. ক
    ক) Hypertrophy
  2. খ
    খ) Hyperplasia
  3. গ
    গ) Atrophy
  4. ঘ
    ঘ) Metaplasia
ব্যাখ্যা

• Hyperplasia is defined as an increase in the number of cells in an organ or tissue in response to a stimulus.
• Hyperplasia is the result of growth factor-driven proliferation of mature cells and, in some cases, by increased output of new cells from tissue stem cells.
• Physiological hyperplasia occurs in – breast during puberty, liver after hepatectomy
• Pathological hyperplasia occurs in – BPH, wart & endometrial tumour

২,২৪০.
Barr body-
  1. ক
    is euchromatin
  2. খ
    represents inactivated Y chromosome
  3. গ
    is absent in normal female
  4. ঘ
    is absent in normal male
২,২৪১.
Slow fibre has
  1. ক
    An extensive sarcoplasmic reticu- lum
  2. খ
    Large amounts of glycolytic enzymes are present in slow fibers for rapid release of energy
  3. গ
    Have a less extensive blood supply
  4. ঘ
    More mitochondria
ব্যাখ্যা
Fast Fibers (Type II, White Muscle)
 The following are characteristics of fast fibers:
1. Fast fibers are large for great strength of contraction.
2. Fast fibers have an extensive sarcoplasmic reticulum for rapid release of calcium ions to initiate con- traction.
3. Large amounts of glycolytic enzymes are present in fast fibers for rapid release of energy by the glycolytic process.
4. Fast fibers have a less extensive blood supply than slow fibers because oxidative metabolism is of sec- ondary importance.
5. Fast fibers have fewer mitochondria than slow fibers, also because oxidative metabolism is secondary.
A deficit of red myoglobin in fast muscle gives it the name white muscle.
২,২৪২.
During normal quiet respiration---------------------of the total energy expended by the body is required for pulmonary ventilation.
  1. ক
    only 1% to 2%
  2. খ
    only 2% to 3%
  3. গ
    only 3% to 5%
  4. ঘ
    only 5% to 8%
ব্যাখ্যা
Energy Required for Respiration.
During normal quiet respiration, only 3% to 5% of the total energy expended by the body is required for pulmonary ventilation. However, during heavy exercise, the amount of energy required can increase as much as 50-fold, especially if the person has any degree of increased airway resistance or decreased pulmo- nary compliance. Therefore, one of the major limitations on the intensity of exercise that can be performed is the person's ability to provide enough muscle energy for the respiratory process alone.
২,২৪৩.
Both Renin & aldosterone level is low in
  1. ক
    ক) Liddle’s syndrome
  2. খ
    খ) Renal artery stenosis
  3. গ
    গ) Barter’s syndrome
  4. ঘ
    ঘ) Conn’s syndrome
ব্যাখ্যা
Reference: Davidson 23rd; P-674
২,২৪৪.
In a female who is a carrier of hemophilia, her offsprings with a normal male will be-
  1. ক
    All sons will be affected
  2. খ
    All daughters will be carriers
  3. গ
    Half of the sons will be affected
  4. ঘ
    One-fourth of the daughters will be carriers
ব্যাখ্যা
Hemophilia is an X-linked recessive trait.

In X-linked recessive disorders-
1. Affected cases are usually males carrying the gene.
2. Homozygous females can be affected, but this is rare.
3. Heterozygous females usually do not express the full phenotypic changes because of the paired normal allele.
4. Only females are carriers.
5. If a female has the allele (female carrier) with a normal male, off springs will be
    - 50% daughters carrier, 50% normal
    - 50% sons affected, 50% normal
6. If a male has the allele (affected male) with a normal female the off springs will be
   - All daughters carrier
   - All sons normal (no male to male
২,২৪৫.
Tributaries of the cavernous sinus exclude -
  1. ক
    ক) Sphenoparietal sinus
  2. খ
    খ) Superficial middle cerebral vein
  3. গ
    গ) Superior opthalmic vein
  4. ঘ
    ঘ) Superior petrosal sinus
ব্যাখ্যা

Tributaries of the Cavernous Sinus:
Superior ophthalmic vein
Inferior ophthalmic vein
Central vein of retina
Superior middle cerebral vein
Inferior cerebral vein
Sphenoparietal vein
Middle meningeal vein

২,২৪৬.
Posterior part of the atriventricular groove contains the-
  1. ক
    Posterior interventricular artery
  2. খ
    Right coronary artery
  3. গ
    Coronary sinus
  4. ঘ
    Left circumflex artery
২,২৪৭.
Mediator of passive immunity
  1. ক
    ক) Antibody only
  2. খ
    খ) T cells only
  3. গ
    গ) Both of them
  4. ঘ
    ঘ) None of them
২,২৪৮.
Which is a branch of the lateral cord of the brachial plexus?
  1. ক
    Axillary nerve
  2. খ
    Musculocutaneous nerve
  3. গ
    Thoracodorsal nerve
  4. ঘ
    Suprascapular nerve
২,২৪৯.
Which investigation will help to differentiate between a Charcot joint and osteomyelitis?
  1. ক
    ক) PET scan
  2. খ
    খ) CT scan
  3. গ
    গ) X-ray
  4. ঘ
    ঘ) MRI
ব্যাখ্যা
Reference: Davidson 23rd; P-762
২,২৫০.
Excess Catecholamine causes-
  1. ক
    ক) Phenylketonuria
  2. খ
    খ) Phaeochromocytoma
  3. গ
    গ) Parinaud syndrome
  4. ঘ
    ঘ) Parkinson disease
ব্যাখ্যা
Phaeochromocytoma is a catecholamine secreting tumor.
২,২৫১.
Which of the following conditions is most likely to present with pulsus paradoxus?
  1. ক
    Aortic stenosis
  2. খ
    Cardiac tamponade
  3. গ
    Pulmonary embolism
  4. ঘ
    Atrial fibrillation
ব্যাখ্যা
Pulsus paradoxus, a decrease in systolic blood pressure of more than 10 mmHg during inspiration, is a classic finding in cardiac tamponade. Davidson explains that in tamponade, fluid accumulation in the pericardium compresses the heart, reducing ventricular filling during inspiration and leading to a drop in blood pressure. Harrison adds that pulsus paradoxus can be detected by palpating the pulse or measuring blood pressure during the respiratory cycle.
২,২৫২.
Multiple myeloma is associated with
  1. ক
    Overproduction of IgG
  2. খ
    Peripheral blood smear shows rouleaux formation
  3. গ
    Bone marrow analysis shows > 10% monoclonal plasma cells
  4. ঘ
    All
২,২৫৩.
Steatorrhoea signify malabsorption of
  1. ক
    Carbohydrate
  2. খ
    Protein
  3. গ
    Fat
  4. ঘ
    Vitamin
ব্যাখ্যা
Reference: Davidson 23rd; P-783
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]
২,২৫৪.
Ep is used in
  1. ক
    CKD
  2. খ
    Dialysis Patients
  3. গ
    During elective surgery
  4. ঘ
    All
ব্যাখ্যা
Erythropoietin is produced by interstitial cells in the peritubular capillary bed of the kidneys and by perivenous hepatocytes in the liver. It is also produced in the brain, where it exerts a protective effect against excitotoxic damage triggered by hypoxia; and in the uterus and oviducts, where it is induced by estrogen and appears to mediate estrogen-dependent angiogenesis.
The gene for the hormone has been cloned, and recombinant erythropoietin produced in animal cells is available for clinical use as epoetin alfa.
The recombinant erythropoietin is of value in the treatment of the anemia associated with kidney failure; 90% of the patients with end-stage renal disease who are undergoing dialysis are anemic as a result of erythropoietin deficiency. Erythropoietin is also used to stimulate red cell production in individuals who are banking a supply of their own blood in preparation for autologous transfusions during elective surgery (see Chapter 31).
২,২৫৫.
Which is the Initial investigation of dementia?
  1. ক
    Lumbar puncture
  2. খ
    HIV serology
  3. গ
    Brain biopsy
  4. ঘ
    anti-dsDNA
২,২৫৬.
MALT lymphoma is associated with
  1. ক
    ক) Lichen sclerosis
  2. খ
    খ) Barret’s oesophagus
  3. গ
    গ) Hashi,oto thyroiditis
  4. ঘ
    ঘ) Opisthorchis
২,২৫৭.
Hallpike manoeuvre is associted in
  1. ক
    BPPV
  2. খ
    Migraine
  3. গ
    Epilepsy
  4. ঘ
    Head injury
২,২৫৮.
Cell membrane is semipermeable because of having
  1. ক
    ক) Lipid
  2. খ
    খ) Protein
  3. গ
    গ) Carbohydrate
  4. ঘ
    ঘ) Glycolipid
ব্যাখ্যা
Explanations:
The cell and the intracellular organelles are surrounded by semipermeable membranes. Biological membranes have a lipid bilayer core that is populated by structural and functional proteins. These proteins contribute greatly to the semipermeable properties of biological membrane.
২,২৫৯.
Most common malignant thyroid tumor
  1. ক
    ক) Papillary carcinoma
  2. খ
    খ) Follicular carcinoma
  3. গ
    গ) Medullary carcinoma
  4. ঘ
    ঘ) Anaplastic tumor
ব্যাখ্যা
Reference: Davidson 23rd; P-649
২,২৬০.
Which of the following is the most common cause of subarachnoid hemorrhage?
  1. ক
    Arteriovenous malformation
  2. খ
    Hypertension
  3. গ
    Trauma
  4. ঘ
    Ruptured aneurysm
ব্যাখ্যা
A ruptured aneurysm is the most common cause of non-traumatic subarachnoid hemorrhage. Davidson explains that aneurysms, particularly berry aneurysms in the circle of Willis, are prone to rupture, causing bleeding into the subarachnoid space. Harrison highlights that patients typically present with a sudden, severe "thunderclap" headache, and diagnosis is confirmed with CT or lumbar puncture showing blood in the cerebrospinal fluid.
২,২৬১.
Which is the best means of detecting ascites?
  1. ক
    Xray
  2. খ
    USG
  3. গ
    CT
  4. ঘ
    MRI
ব্যাখ্যা
Reference: Davidson 23rd; P-863
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]
২,২৬২.
Right atrioventricular valve is known as the
  1. ক
    ক) Tricuspid valve
  2. খ
    খ) Bicuspid valve
  3. গ
    গ) Mitral valve
  4. ঘ
    ঘ) Semilunar valve
ব্যাখ্যা
Right atrioventricular valve is known as the Tricuspid valve
২,২৬৩.
Hematopoietic function of cortisol is to increase count of
  1. ক
    Eosinophil
  2. খ
    Lymphocyte
  3. গ
    erythrocyte
  4. ঘ
    basophil
ব্যাখ্যা
Hematopoietic function of cortisol
·         BEL ↓ (basophil, Eosinophil, Lymphocyte)

·         PEN ↑ (Platelet, erythrocyte, neutrophil)
২,২৬৪.
Fever, cough, night sweats for 6 weeks is suggestive of
  1. ক
    ক) Br. Carcinoma
  2. খ
    খ) Tuberculosis
  3. গ
    গ) Lymphoma
  4. ঘ
    ঘ) Brochietasis
২,২৬৫.
Antihypertensive contraindicated in gout
  1. ক
    Thiazide
  2. খ
    ARB
  3. গ
    CCB
  4. ঘ
    Beta blocker
ব্যাখ্যা
Reference: Davidson 23rd; P-514
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]
২,২৬৬.
Which factor can precipitate hepatic encephalopathy?
  1. ক
    ক) Infection
  2. খ
    খ) IV fluid
  3. গ
    গ) Hyperkalaemia
  4. ঘ
    ঘ) Diarrhoea
২,২৬৭.
Abdominal TB most commonly affects
  1. ক
    ক) Gastroduodenal region
  2. খ
    খ) Ileocecal region
  3. গ
    গ) Left colic flexure
  4. ঘ
    ঘ) Right colic flexure
ব্যাখ্যা
Reference: Davidson 23rd; P-812
২,২৬৮.
Not true about M. tuberculosis
  1. ক
    ক) Lung is the main site of infection
  2. খ
    খ) No skin test in common use
  3. গ
    গ) Multiple drug therapy used
  4. ঘ
    ঘ) Vaccine available
২,২৬৯.
Which cell of the pancreas secrets amylin
  1. ক
    Alpha
  2. খ
    Beta
  3. গ
    Delta
  4. ঘ
    Pancreatic Pol
২,২৭০.
Drug induced lupus is caused by-
  1. ক
    Glucocorticoids
  2. খ
    Rifampicin
  3. গ
    Isoniazid
  4. ঘ
    Ciclosporin
২,২৭১.
Stimuli that inhibit gastrin secretion
  1. ক
    ক) Somatostatin
  2. খ
    খ) Distention
  3. গ
    গ) Increased vagal discharge
  4. ঘ
    ঘ) Calcium
ব্যাখ্যা
Somatostatin inhibits gastrin secretion.
২,২৭২.
Holocrine gland
  1. ক
    ক) Goblet cell
  2. খ
    খ) mammary glands
  3. গ
    গ) Sweat glands
  4. ঘ
    ঘ) Sebaceous gland
ব্যাখ্যা
Sebaceous gland is a holocrine gland.
২,২৭৩.
Which of the following acts as a stimulus for secretion of Ghrelin?
  1. ক
    Fatty acids
  2. খ
    Feeding
  3. গ
    Fasting
  4. ঘ
    Product of of protein digestion
২,২৭৪.
2nd line drug for GTCS
  1. ক
    ক) Lamotrigine
  2. খ
    খ) Valproate
  3. গ
    গ) Ethosuximide
  4. ঘ
    ঘ) Levetiracetam
২,২৭৫.
Less commonn cause of lung cancer
  1. ক
    Adenocarcinoma
  2. খ
    Large-cell
  3. গ
    Squamous
  4. ঘ
    Small-cell
২,২৭৬.
Which of the following is the most revealing investigation for diagnosis of liver abscess?
  1. ক
    ক) CBC
  2. খ
    খ) USG
  3. গ
    গ) LFT
  4. ঘ
    ঘ) Liver biopsy
ব্যাখ্যা
Explanation: Liver imaging is the most revealing investigation
২,২৭৭.
Which one is responsible for development of Nephrotic syndrome?
  1. ক
    Breaks in glomerular basement membrane
  2. খ
    Reactive cell proliferation
  3. গ
    Injury to podocytes
  4. ঘ
    Inflammation
২,২৭৮.
Which one is the first line investigation for stroke?
  1. ক
    Xray skull
  2. খ
    CT
  3. গ
    MRI
  4. ঘ
    MRA/MRV
ব্যাখ্যা
X-rays: used for fractures or foreign bodie
CT: Firrst line for stroke
২,২৭৯.
Cause of major elevation of serum transaminases?
  1. ক
    Fatty liver disease
  2. খ
    Wilson’s disease
  3. গ
    Acute viral hepatitis
  4. ঘ
    Alcoholic hepatitis
২,২৮০.
Which of the following is an antiplatelet drug?
  1. ক
    ক) Warfarin
  2. খ
    খ) Ticagrelor
  3. গ
    গ) Rivaroxaban
  4. ঘ
    ঘ) Heparin
ব্যাখ্যা
Explanation: Ticagrelor is an antiplatelet drug. Warfarin, Rivaroxaban, Heparin are anticoagulants
২,২৮১.
Amastigote form of leishmania donovani are detected in:
  1. ক
    ক) Infected sandfly
  2. খ
    খ) polymorphonuclear leucocytes
  3. গ
    গ) bone marrow aspirates
  4. ঘ
    ঘ) Sputum
ব্যাখ্যা
Amastigote form of leishmania donovani are detected in bone marrow aspirate
২,২৮২.
Extrapyramidal lesion is menifested by -
  1. ক
    Fine tremor
  2. খ
    Chorioathetosis
  3. গ
    Pendular jerk
  4. ঘ
    Clasp like rigidity
ব্যাখ্যা
Explanation :
Features of extrapyramidal lesion -
Corea
Athetosis
Hemibellismus
Bradykinesia
২,২৮৩.
The posterior inferior cerebellar artery is a branch of-
  1. ক
    Internal carotid artery
  2. খ
    Vertebral artery
  3. গ
    Basilar artery
  4. ঘ
    Posterior cerebral artery
২,২৮৪.
Feature of liquor amnii excludes
  1. ক
    ক) Watery
  2. খ
    খ) The fluid gradually increases upto 6th month of pregnancy
  3. গ
    গ) It acts as protective cushion
  4. ঘ
    ঘ) It restricts fetal movement
ব্যাখ্যা
Rather it facilitates fetal movement.
২,২৮৫.
Following parasite affect eye is:
  1. ক
    ক) Angiostrongylus
  2. খ
    খ) Loa loa
  3. গ
    গ) D. latum
  4. ঘ
    ঘ) Ascaris
ব্যাখ্যা
Loa loa affects eye
২,২৮৬.
Predisposing factor for toxic shock syndrome
  1. ক
    ক) Vaginal tampons
  2. খ
    খ) Improper food storage
  3. গ
    গ) Poor skin hygiene
  4. ঘ
    ঘ) IV drug use
২,২৮৭.
Results of fertilization-
  1. ক
    ক) Breakdown of zona pellucida
  2. খ
    খ) Completion of first meiotic divison of the ovum
  3. গ
    গ) Determination of the sex of the embryo
  4. ঘ
    ঘ) Completion of the cleavage
ব্যাখ্যা
-Completion of second meiotic divison of the ovum
-initiation of cleavage
২,২৮৮.
Necroptosis false statement -
  1. ক
    Is genetically programmed
  2. খ
    Is characterized by loss of ATP
  3. গ
    Is exclusively pathological
  4. ঘ
    Shows rupture of the cell membrane
ব্যাখ্যা
Explanation -
Necroptosis -is a hybrid that shares aspects of both necrosis and apoptosis. Morphologically, and to some extent biochemically, it resembles necrosis, as both are characterized by loss of ATP, swelling of the cell and organelles, generation of reactive oxygen species (ROS), release of lysosomal enzymes, and ultimately rupture of the plasma membrane.
Mechanistically, it is triggered by signal transduction pathways that culminate in cell death, a feature similar to apoptosis. Because of these overlapping features, necroptosis is sometimes called programmed necrosis to distinguish it from forms of necrosis driven passively by toxic or ischemic injury to the cell. 
Can occur both physiology and pathological condition.
২,২৮৯.
Accessory pancreatic duct is also called
  1. ক
    ক) Wirsung duct
  2. খ
    খ) Santorini duct
  3. গ
    গ) Henson's duct
  4. ঘ
    ঘ) Hoff man's duct
ব্যাখ্যা
Ref: BD/7th/vol-2/ page 329
২,২৯০.
Which is not Strict anaerobes?
  1. ক
    Bacteroides spp.
  2. খ
    Clostridium spp.
  3. গ
    Fusobacterium spp.
  4. ঘ
    Treponema pallidum
ব্যাখ্যা
Strict anaerobes
Bacteroides spp.
Clostridioides difficile Clostridium spp.
Fusobacterium spp.
২,২৯১.
Which of the following is the site of Na+–bile acid cotransport?
  1. ক
    ক) Gastric antrum
  2. খ
    খ) Gastric fundus
  3. গ
    গ) Duodenum
  4. ঘ
    ঘ) Ileum
ব্যাখ্যা
Explanation-
★Bile salts are recirculated to the liver in the enterohepatic circulation via a Na+–bile acid cotransporter located in the ileum of the small intestine.
Reference-BRS physiology/6th/P-212/Fig-6.12
২,২৯২.
Which one is the most important modifiable risk factor of coronary artery disease?
  1. ক
    Smoking
  2. খ
    Alcohol
  3. গ
    Obesity
  4. ঘ
    Physical inactivity
ব্যাখ্যা
There is a strong relationship between cigarette smoking and CAD, especially in younger (< 70 years) individuals, and this is the most important modifiable risk factor.
২,২৯৩.
Pathological causes of sinus bradycardia exclude
  1. ক
    ক) Pregnancy
  2. খ
    খ) Hypothyroidism
  3. গ
    গ) Myocardial infraction
  4. ঘ
    ঘ) Raised intracranial pressure
ব্যাখ্যা

Explanation:
Pathological causes of sinus bradycardia
• Hypothermia
• Hypothyroidism
• Myocardial infraction
• Raised intracranial pressure
• Cholestatic jaundice
• Drugs (beta-blockers, digoxin, antiarrhythmic drugs)

২,২৯৪.
A 25-year-old woman presents with fever, pleuritic chest pain, and hemoptysis. She has a history of recurrent deep vein thrombosis (DVT). What is the most likely diagnosis?
  1. ক
    Pulmonary embolism
  2. খ
    Pneumonia
  3. গ
    Lung cancer
  4. ঘ
    Tuberculosis
ব্যাখ্যা
Stem Breakdown:

Fever, pleuritic chest pain, and haemoptysis: These are common symptoms of pulmonary embolism (PE), particularly when there is pulmonary infarction.
History of recurrent deep vein thrombosis (DVT): DVT is the most common source of emboli in PE, making this history highly suggestive of PE as the cause.
Option Analysis:

A) Pulmonary embolism: This is the correct diagnosis. Davidson and Harrison explain that pulmonary embolism occurs when a thrombus from the venous system (often from the leg veins) embolises to the pulmonary arteries. The combination of pleuritic chest pain, haemoptysis, and a history of DVT strongly suggests PE.
B) Pneumonia: Pneumonia causes fever, cough, and pleuritic chest pain, but it usually presents with productive sputum, not haemoptysis. Additionally, a history of recurrent DVT is not typically associated with pneumonia.
C) Lung cancer: Lung cancer can cause haemoptysis and chest pain, but it is usually a chronic process associated with weight loss and a mass on imaging. This patient's history of recurrent DVT and acute presentation make PE more likely.
D) Tuberculosis: Tuberculosis can cause fever, haemoptysis, and pleuritic chest pain, but it typically presents with chronic symptoms and is associated with a history of exposure or travel to endemic areas. The acute onset and history of DVT make PE more likely.
২,২৯৫.
Which of the following is pathognomonic hallmark of gout?
  1. ক
    ক) Acute arthritis
  2. খ
    খ) Chronic tophaceous arthritis
  3. গ
    গ) Gouty nephropathy
  4. ঘ
    ঘ) Tophi
ব্যাখ্যা
Explanation: Tophi in various sites are the pathognomonic hallmark of gout
২,২৯৬.
Which of the following neurons are not present in the cerebral cortex?
  1. ক
    Fusiform cells
  2. খ
    Purkinje cells
  3. গ
    Betz cells
  4. ঘ
    Pyramidal cells
ব্যাখ্যা
*** Purkinje cells are inhibitory neurons characteristic of the cerebellar cortex. 

২,২৯৭.
Which is not the feature of tetralogy of fallot -
  1. ক
    VSD
  2. খ
    An aorta that overrides the VSD
  3. গ
    Left ventricular hypertrophy
  4. ঘ
    Obstruction of the right ventricular outflow tract
ব্যাখ্যা
Explanation :
The 4 cardinal features of TOF -
1. VSD
2.Obstruction of the right ventricular outflow tract
3.An aorta that overrides the VSD
4.Right ventricular hypertrophy 
২,২৯৮.
Blood brain barrier is present in-
  1. ক
    Pineal gland
  2. খ
    Anterior pituitary
  3. গ
    Tuber cinerum
  4. ঘ
    Foramen of Monro
২,২৯৯.
A raised blood pH & Bicarbonate level is consistent with-?
  1. ক
    ক) Persistant vomiting of gastric content
  2. খ
    খ) Chronic renal failure with raised PC02
  3. গ
    গ) A reduced PCO2
  4. ঘ
    ঘ) Partly compensated respiratory alkalosis
ব্যাখ্যা

Metabolic effects of prolonged vomiting are-
-Metabolic alkalosis
-Hypovolemia leading to lactic acidosis
-Hypokalemia
-Hypochloremia
-Paradoxical aciduria
-Compensatory hypoventilation

২,৩০০.
Which is not the cause of portal hypertension -
  1. ক
    Cirrhosis
  2. খ
    Obstructive thrombosis of portal veins
  3. গ
    Massive fatty change
  4. ঘ
    Left heart failure
ব্যাখ্যা
Explanation :
Causes of portal hypertension :
Obstructive thtombosis of portal vein
Cirrhosis
Nodular hyperplasia of liver
Massive fatty change
Diffuse granulomatous disease
Right sided heart failure