2nd Year Past Papers UHS PDF

MBBS FIRST PROFESSIONAL: PART-II
Anatomy [Including Histology]

(Short Essay Questions)
Roll No. __________
Max. Marks: 45
Time Allowed: 2 hours & 15 minutes
Attempt ALL Questions
a) A 60 year old patient came in Emergency Department with severe bleeding

from nose. He is known hypertensive. What is this condition called? Which area 0.25,0.25,
and blood vessels of nose are involved in this condition? 02
b) A 7 year old boy was having repeated throat infections. On examination he had
enlarged palatine tonsils. Tonsillectomy was performed and the palatine tonsils
1 along with the facial sheath covering the tonsillar bed were removed. Which
sheath covering the tonsillar bed? Which vessel is common source of bleeding
after tonsillectomy? How pharygeal (Waldeyer’s) lymphatic rign is formed?
01,0.5,01
Give anatomical basis of:

a) During the thyroidectomy, superior thyroid artery is ligated close to the
upper pole of the thyroid gland whereas the inferior thyroid artery is ligated
away from the inferior pole. 02
2 b) Genioglossus is known as safety muscle of the tongue. 01
c) Removal of foreign bodies lodged in pyriform fossa may lead to loss of
protective ‘cough reflex’. 02
a) Draw and label microscopic structure of ureter (transverse section). 03

3 b) Enlist ONE important function of each of its coats. 02
During removal of gall bladder, surgeon stopped bleeding by putting his index finger
into epiploic foramen and pressed the structure.
4 a) Justify it and what is epiploic foramen, give its boundaries? 04
b) Why the gall bladder gangrene is rare and more common of appendix? 01
A 40 year old male weight lifter gradually develops a reductible lump in his left
groin region. The General surgeon on examination found that on coughing this groin
mass become inguinal ring, this mass doesn’t appear on coughing.
5 a) What is the most probable type of inguinal hernia in above scenario? 01
b) Enumerate the structures composing the walls of the inguinal canal. 04
Pudendal nerve block may be performed to provide anesthesia to the perineal

region.
a) What surface marking point is used to give pudendal nerve block? 01
6 b) Enumerate the muscles forming the wall and diaphragm of pelvis along with
their actions. 04
a) Tabulate parts of the brain constituting the brain stem in the inferio-superior
direction alongwith name of dilation of neural tube from which, these develop.
b) Draw and label the gray and white matter of midbrain (transverse section) at 01
7 the level of superior colliculus.
04
A five year old baby has bluish coloration of the skin, shortness of breath and rapid
breathing, especially during feeding or exercise. The pediatrician diagnosed the
baby is suffering from Tetralogy of Fallot.
8 a) What is the most frequent defect leading this anomaly? 01
b) Enlist the classic four co-occuring heart defects in this condition. 04
A person admitted in the hospital with complaints of renal colic. On USG, Horse
shoe shaped kidney was found in the patient.
9 a) What is the embryological cause of this anomaly? 01
b) Enlist adult kidney parts derive from metanephric diverticulum/ureteric bud
and metanephric Blastema. 04
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(compiled by Fraz Mallick, dated 25-12-2018)
Roll No. __________
Max. Marks: 45
a) What is Pharyngeal apparatus? Name derivatives of 2nd Pharyngeal arch. 01,2.5

1 b) From where tympanic membrane is developed? 1.5
a) Give the formation and ultimate fate of the aortic arch system. 03
2 b) Describe Meckel’s diverticulum. 02
a) Name cells in gastric glands mentioning their function. 03

b) Give FOUR different between Proximal and Distal convoluted tubules. 02
3
Draw and label transverse section of Midbrain at the level of superior colliculus. 05
4
a) What are coverings of spermatic cord? From where these are derived? Name
contents of spermatic cord. 02
b) Name the structures piercing perineal membrane in male and female. Why
5
membrane is weak in female? 03
a) What are the boundaries of Epiploic Foramen (omental foramen)? 02

b) Name THREE peritoneal ligaments each which connect liver and stomach to
6 another organ and to abdominal wall. 03
a) What is arterial supply and venous drainage of supra-renal glands? 03

b) Give the lymphatic drainage of stomach. 02
7
a) Name fontanelles of skull. Give signifcance (clinical) of anterior fontanelle. 3.5

b) How external jugular vein is formed? What is its clinical significance? 1.5
8
a) Name the abductor and tensor of vocal cord. What is their nerve supply? 02
9 b) What is nerve supply of tongus? 03
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paper appeared for detained candidates
Roll No. __________
Max. Marks: 45
Draw and label the microscopic pictures of Submandibular Salivary gland.

1 05
a) What are the embryonic components from where the Diaphragm develops?
Write the embryological basis of Congenital Diagphragmatic Hernia. 02,01
2
b) Enumerate the development of different segments of inferior Vena Cava? 02
Describe the development of the Anal Canal explaining its blood supply and nerve
3 supply. 2.5,2.5
a) Give an account of artery supply of Spinal Cord. 03
4 b) What is Brown Sequard Syndrome? Give its manifestations. 02
a) Define Perineal body? Enumerate the muscles converging into it. 0.25,01
b) What is Pudendal Nerve block? Where the block is given and what are its 01,1.5,
5 benefits? 1.25
a) A surgeon has to operate on the large intestines. He opened the abdomen of

the patient. On the operating table, how can he distinguish the large intestines
from the small intestines with the naked eye and proceed with his surgery?
6 b) Describe the Mesentery. Enumerate its contents. What are Arterial Arcades? 02
01,01,
01
a) What are the points a surgeon considers in giving incisions? What is the safest
site for abdominal incisions? Give reasons. 02.1.5
7 b) What is Incisional Hernia? 1.5
a) What is the Danger Triangle of Face? What veins drains this area? 1.5,01
b) Why is it called the Danger Triangle of Face? Explain 2.5
8
a) What are the boundaries of the lateral wall of Tympanic Cavity? What is its
nerve supply? 01,1.5
9 b) Describe the arterial supply of Larynx. 2.52
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Roll No. __________
Max. Marks: 45
a) Draw an label light microscopic picture of transverse section of Ureter. 03

b) Write two points by which you can differentiate a transverse section of vas 02
1
deferens from Ureter.
What are Pharyngeal Pouches? Mention their derivatives in a tabulated form. 05

2
Recalling fetal circulation, name the main fetal vascular shunts & vessels and
mention their adult derivatives. 05
3
Draw & label a diagram of transverse section of caudal parts of pons at the level of
facial colliculus. 05
4
a) Write the boundaries of Pelvic outlet. 02

5 b) Give a brief account of peritoneal reflection on Rectum. 03
A 60 year old man presented with distended subcutaneous veins on his anterior
abdominal wall radiating out from the umbilicus. What is the name and cause of
this clinical picture? Write the formation and termination of the main vessel
6 involved here and list its other tributaries. 02,03
a) Give the posterior relations and source of arterial blood supply of head of
Pancreas. 04
7 b) What is the anatomical cause of Jaundice in patients suffering from cancer of
head of Pancreas? 01
a) Name the components of Waldeyer’s (tonsillar) ring. 02

b) Enlist the structures passing in the gap between superior and middle pharyngeal
8 constrictors to the internal aspect of the pharyngeal wall. 03
a) Name the movements permitted at Temporomandibular Joint. 2.5

b) In a tabulated form, write the attachments, innvervation & actions of superior
9
oblique muscle of eyeball. 2.5
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Roll No. __________
Max. Marks: 45
a) Draw and label histological structure of Fundus of Stomach. 03

1 b) Give histological criteria of terminal bronchioles in lungs. 02
An infant was born with life threatening breathing difficulties and was diagnosed to
be suffering from congenital diaphragmatic hernia.
a) Name the embryonic components from where the diagphragm develops. 02
2
b) What is the correlation between the positional changes and innervations of
diaphragm. 03
Give the communications of the 3rd ventricle of cerebrum. Name the structures
3 contributing to the formation of lateral and posterior walls of 3rd ventricle. 02,03
Draw and label transverse section of midbrain at the level of superior colliculus. 05
4
a) Give the anatomy of various structures supporting the uterus. 04

5 b) Define ante-version and ante-flexion? 01
a) Name the sac like cavity that lies posterior to the stomach and lesser omentum.
Give the formation of its left margin. 0.5,1.5
6 b) Give the nerve supply of parietal peritoneum lining the anterior abdominal wall.
Name the sensations to which it is sensitive. 02,01
A 60 year old woman presented with Jaundice. On examination, her gall bladder
was enlarged. Investigations revealed Cancer of head of pancreas.
a) Name the structure posteriorly related to the pancreatic head which is most
7 likely responsible for producing signs and symptoms in this patient. Give
anatomical justification. 01,02
b) What is Hepatopancreatic Ampulla? Where does it open? 01,01
A 30 year old boxer during the bout was hit on right temple. He became
unconscious. The examination revealed extra dural hemorrhage.
8 a) Enlist the fontanelle. 01
b) Mention the anatomy of pterion. What is its significance? 03,01
a) Enlist the intrinsic muscles of the larynx. 02

9 b) Give the attachments, actions and nerve supply of posterior cricoarytenoid. 03
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Roll No. __________
Max. Marks: 45
Draw and label a diagram to show the histological section of ureter. 05

1
A premature newborn with rapid labored breathing was diagnosed to have

respiratory distress syndrome and was given intensive care.
a) What is the embryological basis of this condition in premature births? What
2
is this called hyaline membrane disease? 04
b) What steps can be taken to prevent this condition and its severity? 01
Enumerate the structures forming the roof and lateral walls of the 4th ventricle. 02,01,02
3 Give the communications of this cavity and their significance.
Draw and label diagrams to show the arterial supply on the medial and lateral
4 surface of cerebral hemishperes. 05
a) Give the lymphatic drainage of uterine cervix. 1.5

b) What is meant by anterversion and anteflexion of uterus? What structure needs
5 to be taken care of while ligating uterine artery during hysterectomy (removal
of uterus)? 02,1.5
a) Give the nerve supply of visceral peritoneum. 01
b) Define omentum. Name and give attachments of various omenta of abdominal 01,03
6 cavity.
Give the arterial supply of the pancreas. List the structure related to the neck of this
region. 02,03
7
In a tabulated manner enumerate and give the actions and nerve supply of muscles
8 of mastication. 01,03.01
Following surgery for cancer of submandibular gland, a 50-year old female

presented with loss of general sensations in anterior part of her tongue.
a) Name the structures most likely damaged during surgery in this case
9
mentioning its relation to the submandibular gland. 01,01
b) Give the formation of pharyngeal plexus. What component of the tongue is
supplied by this plexus? 02,01
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Roll No. __________
Max. Marks: 45
a) Enumerate the endocrine cells of thyroid gland mentioning the substances

synthesized by them. 03
1 b) Give the histological structure of thyroid follicle, when in an active state. 02
During an abdominal surgery in a 25 year old woman, the surgeon observed a low
lying positional congenital anomaly of the kidneys with associated fusion of the
lower poles of her both kidneys.
a) Name the congenital malformation and give the most common site of
2 location of the kidney in this anomaly. Name the structure which prevents
the normal ascent, of kidney prenatally in this malformation. 01,0.5,01
b) Name the two embryological sources of permanent kidneys. Enumerate the
parts of uriniferous tubule derived from each of these sources. 01,0.5
Draw and label a diagram to show a section of midbrain at the level of superior
colliculus. 05
3
In a tabulated manner, give the location, significance and Brodmann’s classification

of sensory and motor speech areas in cerebral cortex. 05
4
a) A 35 year old woman with history of intermittent obstruction of urinary flow,

presented with severe colicky pain in the left lower abdomen. Investigation
revealed obstruction of an abdominopelvic viscus by calculus. Name the viscus
5 most likely involved in this case. Enumerate its normal sites of constriction.
b) Give the course and relations of internal iliac artery. 01,1.5
2.5
Give the location and extent of inguinal canal. Enlist the structures formatting its
posterior wall. Enumerate its contents. 02,1.5,1.5
a) Give the formation of portal vein. 01

b) Enumerate the sites of portosystemic anastomoses in various parts of 01
7 gastrointestinal tract, mentioning the naems of vessels participating in such
anastomoses at these sites and their respective clinical significance. 03
Trace the parasympathetic root of otic ganglion giving distribution of its
secretomotor fibres. Name the cranial nerves related to this ganglion functionally
8 and topographically. 03,02
A 49 year old man with severe pain in his ear was diagnosed to have pus in the
middle ear. In order to release this pus, an incision was made on posteroinferior
9 part of the tympanic membrane.
a) Give anatomical reasons of choosing this site for making the incision. 03
b) Give the nerve supply of tympanic membrane 02
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Roll No. __________
Max. Marks: 45
a) In a tabulated manner give the epithelial lining of various parts of renal tubule.
b) Enumerate the components of Juxtaglomerular apparatus. What is the 03
1 functional significance of this apparatus?
1.5,0.5
A 5 day old baby girl was brought to the hospital with history of turning blue on
crying and exertion. Investigations revealed that she had Tetrology of fallot. Enlist
2 the classic defects presented in this condition, mentioning their embryological
basis. 05
a) Give the location and function of inferior colliculus. Give its connections in
relation to the pathway associated with this colliculus. 03
3 b) Enlist the arteries supplying the cerebellum mentioning the sources from where
they arise. 02
Enlist the functional areas of cerebrum located in the frontal lobe mentioning their
brodmann’s classification. Give the location and arterial supply of the primary area
4 concerned with voluntary motor control of body. 2.5,01,1.5
Enlist the differences in embryological origin, arterial supply, venous drainage and
nerve supply of and canal above and below the pectinate line. Give reason for
5 internal haemorrhoids being painless. 04,01
a) Name the hemia entering the inguinal canal at deep inguinal ring. Give its
relation to inferior epigastric artery. 0.5,01
b) Enlist the structures forming the posterior wall and floor of inguinal canal.
6
Name the contents of this canal in females.b 01,1.5,01
Draw and label diagrams to show anterior relations of right and left kidneys. 2.5,2.5
A 20 year old boy in a roadside accident which took place in front of a hospital was
brought to its emergency. He had an upper airway obstruction. Tracheostomy
8 procedure was performed for maintenance of airway.
a) Name the structures that need to be taken care of while performing child
differ from that of an adult? 02,1.5
b) Give the extent of trachea in adults. Mention its diameter. 01,0.5
a) Give the location of palatine tonsils and enumerate the structures forming the
tonsiliar bed. 1.5,01
9 b) Give the arterial supply of tonsils. Name the vessel most commonly responsible
for postoperative bleeding after tonsillectomy. 1.5,01
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Roll No. __________
Max. Marks: 45
Define Varicocele. The incidence of left sided varicocele is higher than the right side.
1 Give anatomical basis of this difference. 01,04
A patient comes to toe surgical OPD with complaint of fever and painful fullness in
an area on right side of the anal orifice. On examination doctor (Medical Officer)
finds tenderness between the anus and the ischial tuberosity. Using your
2 knowledge of anatomy.
a) Identify the space involved and give its boundaries. 01,02
b) Enlist its contents. 02
“Scalp wounds bleed profusely” Give anatomical justification of this statement.

3 Enlist the artery supplying the scalp. In which layer of the scalp do they run? 01,03,01
What is the nerve supply of the tongue? Correlate this nerve supply with the
4 development of tongue. 2.5,2.5
During cholecystechtomy (surgery on gall bladder) patient started bleeding

profusely. Assistant Surgeon immediately put his index finger into the epploic
foramen and pressed the structures between index finger and thumb. Using your
5 knowledge of anatomy.
a) Identify the space involved and gives its boundaries. 01,02
b) Enlist its contents 02
What is the microscopic structure of the optical (Posterior) part of the retine? Trace
the visual fibres from the retina to visual cortex. 05
6
Name the different types of alveolar cells with their functional histology. What are
the different components of Blood-Air-Barrier? 3.5,1.5
7
Name the different parts of Aorta and give development of each part. 0.75,4.25
8
Name the arteries supplying the medulla oblongata. With their area of supply. What
will be the effects of occulusion of the artery supplying the lateral part? Give
9 anatomical reasoning for your answer. 02,0.5,2.5
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Roll No. __________
Max. Marks: 45
Enumerate FOUR microscopic structural differences between beginning and end of

esophagus in a tabular form. Explain its structural features regarding reflux
1 esophagitis. Mention changes in the epithelium of digestive tract as it is traced from
stomach to anal canal. 02,01,02
Name the chromophils found in pars distalis of pituitary gland, with their general
staining and product in a tabular form; explain the tumors arising from this region. 03,02
2
A pediatrician was called in labor-room to examination revealed flattened abdomen

and gut diagnosed which was confirmed on ultrasound examination.
a) Mention the development defects in this case and the reason for signs and
symptoms flat abdomen, left sided gut sounds and severe respiratory
3 distress. 01,03
b) Name the FOUR sources of development of thoraco-abdominal diaphragm
with the part of diaphragm formed from them. 01
How the neural tube is developed? Explain histogenesis in the neural tube that lead
to the development of spinal cord; mention the positional changes in the spinal
cord till adult age. 05
4
Explain the azygos system of veins; mention the alternate routes followed by
venous blood for drainage into the heart due to obstruction in superior vena cava
and obstruction in inferior vena cava. 03,02
5
Explain the location, afferent and efferents of major groups of lymph nodes of
pelvis. 05
6
Mention the location (with reference to psoas major muslce) distribution and
7 segmental values of nerves lying on the posterior abdominal wall. 05
Draw and label the cutaneous nerve supply of face and scalp. 0.33*15
8
Explain the location and the roots of the largest parasympathetic ganglin. 01,02,02
9
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Physiology
Roll No. __________
Max. Marks: 45
a) A 12 year old boy presented in the medical OPD with complaints of high grade
fever flank pains, oliguria and periorbital puffiness. The history reveals a recent
history of post pharyngitis. After investigation a diagnosis of post streptococcal
glomerulonephritis was made by the physician
i) What will happen to GFR of the patient and how? 01
1 ii) Make a flow chart to show macula densa feedback for auto regulation
of GFR. 02
b) Outline the renal tubular handling of hydrogen ions secretion and bicarbonate
ions reabsorption. 02
A 34 year old man is worried about the excessive amount of urine he is passing
(about 15L/day) and the excessive thirst that makes him drink almost a gallon of
water daily. His complaints started after a roadside accident in which he got severe
head injury but survived. His physician put him on water restriction test during
hospitilization and it led to severe dehydration. Labs show much decreased
2 osmolality of urine.
a) What is the most likely diagnosis? 0.5
b) State the synthesis, storage, release and actions of the hormone deficient in
the above given scenario. 2.5
c) Explain the treatment of this disease. 1.5
A 23 month old male baby was brought to the pediatrician with complaints of
sluggish movements and swallowing problems. Examination revealed physical and
mental retardation hypotonic muscles and enlarge tongue.
a) What is most likely diagnosis? 0.5
3 b) List he steps of synthesis of the hormone which is deficient in this child. 2.5
c) Outline the effects of excess of the same hormone on central nervous
system and cardivascular system in an adult. 02
A 69 year old man is evaluated for a 5 month history of tremor of the right arm and
hand, when these are at rest. The patient is married and has sonss. There is no
family history of neurologic disease. On physical examination, the patient is alert;
and his facial expression is rather blank and unchanging. Vital signs are normal.
There is mild rigidity in the right arm. There is a 4-Hz resting tremor normal. Arm
4
swing is diminished, especially on the right, and his walking pace is slow.
a) What is the most likely diagnosed of this patient’s conditon? 0.5
b) Which part of brain is involved? Explain the pathophysiology of the cardinal 03
features of this disease?
c) Outline all the types of treatment used in this conditon. 1.5
a) Describe the formation, flow and absorption of cerebrospinal fluid. 02
b) What is the consequences of obstrutction to flow of CSF? 02
c) What will be the consequences of the blockage of left middle cerebral
5
artery in a right handed person? 01
A 45 year old woman presents with hirsutism striae, brusising, acne, and
hyperpigmentation of the skin. After a thorough physical examination the physician
notes that she also has hypertension and shows signs of a “buffalo hump” on her
back between the shoulders. The laboratory tests show elevated blood cortisol
levels so she is given a dexamethasone suppresion test. Her results are positive i.e.,
elevated ACTH is not suppressed.
6 a) What is the likely diagnosis? 01
b) Explain the reason of characteristic accumulation of adipose tissue in the
facial, truncal, and cervical regions of the body in such cases. 02
c) What is the cause of hirsutism and hyperpigmentation observed in this
case? 01
d) What are different causes of hypercortisolism? 01
a) Explain the motor functions of Stomach. 02

b) Describe the regultion of gastric emptying. 02
7 c) Name two deficiencies resulting from chronic atrophic gastritis. 01
When we move from a bright, sunny area outside to a relatively dark room inside, it
is difficult to see at first. But gradually our eyes recover and become more sensitive
to the dim light indoors.
8 a) Explain the physiological basis (mechanism) of this phenomon and make a
diagram to elaborate answer. 02,01
b) How does the auditory system determine loudness of sounds? 02
A nursing mother of 3 months old child presents in the gynecology outdoor with the
complaint of cessation of menstruation since birth of her baby. Her pregnancy test
is negative.
9 a) What is the physiological explanation of her amenorrhea during lactation? 02
b) Describe the process of Capacitation of Spermatozoa. 03
--- UHS-I(ii) /18 – A / 2(S) – (05-10-2018) ---

Physiology
Roll No. __________
Max. Marks: 45
a) A middle aged man presents with the following acid base parameters in his
arterial blood; pH =7.5, HCO-3 =35mEq/L and PCO2 =42 mmHg.
i) From which disorder this man is suffering 0.5
1 ii) Give the cause of this disorder. 01
iii) How does the body compensate in this disorder? 02
b) What are features and causes of atonic bladder? 1.5
a) Define Transport maximum. Give the value of transport maximum for

Glucose. 1.5
2 b) What is the role of Tubuloglomerular Feedback Mechanism in
autoregulation of Glomerular Filtration Rate (GFR)? 3.5
A 55 year old man develops tremor in his hands which increase when he tries to do
any voluntary action. He also has difficulty in maintaining balance. On examination,
there is decreased muscle tone.
a) Which part of the brain is affected in this condition? 01
3 b) Enlist FOUR other clinical abnormalities due to lesion of this part of the
brain. 01
c) Enumerate the functions of this part of brian. 03
a) Which reflex is activated due to activation of Golgi tendon organ? Give

stimulus, reflex arc response and significance of this reflex. 03
4 b) Elaborate function of the thalamus. 02
a) A doctor shows the light in one of the eye during eye examination. Name
the reflex and show the neuronal pathway responsible for changes in
pupillary diameter in this reflex. 2.5
5 b) Elaborate the mechanism by which damage to the cochlea by a loud sound
is prevented. 2.5
A 45 year old woman has been taking glucocorticoids for the last one year for
Rheumatoid Arthritis, now she has developed moon shaped face, buffalo torso,
central obesity, hypertension and hyperglycemia.
6 a) Name the conditon she is suffering from. 01
b) Give the physiological basis of developing hyperglycaemia and hypertension
in this condition. 02
c) Give the action of glucocorticoids on protein metabolism. 02
a) A 35 year old woman consults the physician for palpitations, intolerance to
heat, insomnia and weight loss. On examination, she has Exophthalmos.
i) Name the condition she is suffering from. 01
ii) Give the pathophysiology of this condition. 1.5
7
iii) Enumerate TWO important diagnostic tests for this condition. 01
b) What is Aldosterone escape phenomenon? 1.5
a) A baby is born with undescended testes. Which hormone can be injected to

descend the testes? 2.5
8 b) Compare the actions of estrogen and progesteron on the breast and uterus. 2.5
a) Enumerate the factors that regulates gastric emptying. 2.5

9 b) Give pathophysiology features and treatment of Achalasia. 2.5
--- UHS-I(ii) /17 – A / 1(S) – (00-00-00) ---

Physiology
Roll No. __________
Max. Marks: 45
a) Define Obligatory Urine Volume. 01

b) What is the role of Tubuloglomerular Feedback Mechanism in autoregulation of
1
Glomerular Filtration Rate (GFR)? 04
a) A 40 year old male develops micturition abnormality as a result of crush injury

to the sacral region of spinal cord which destroys the sensory nerve fibres from
the Bladder to the Spinal Cord.
2 i) Name the Micturition abnormality he is likely to have. 01
ii) What are the features of this abnormality? 01
b) What is Micturition Reflex? 03
A 55 year old man develops tremor in his hands which increase when he tries to do
any volumetric action. He also has difficulty in maintaining balance. On
examination, there is decreased muscle tone.
a) Which part of the brain is affected? 01
3 b) Enlist FOUR other clinical abnormalities due to lesion of this part of the
Brain. 01
c) Enumerate the functions of this part of the Brain. 03
a) Name the Motor and Sensory speech areas in the Cerebral Cortex. Give their
functions. 03
4 b) What are the effects produced by the lesion of the speech areas. 02
a) A 5 year old obese boy is brought to the physician. He has stunted growth and
appears to be of 2-3 years of age. His body growth is disaproportionate. He
appears mentally retarded.
i) Name the disorder the body is suffering from. 01
5 ii) What are the causes of this disorder? 02
b) Enumerate second messenger mechanisms for mediating intracellular hormonal
functions. 02
a) Name FOUR Hypothalamic hormones that control the secretion of Anterior

Pituitary gland. 01
b) Give the physiological actions of Growth Hormone on Protein and Lipid
6 metabolism. 04
a) What do you understand by Protanope and Deuteranope? 02
b) What receptors are responsible for color vision and where are they located?
c) What is Argyli Robertson Pupil? 02
7 01
a) Give actions of Testosterone during fetal life. 2.5

b) Give the functions of Placental Hormones. 2.5
8
a) Give factors that can initiate Enterogastric Inhibitory Reflexes. 2.5

9 b) What are the actions of Cholecystokinin? 2.5
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Physiology
Roll No. __________
Max. Marks: 45
a) Define Filtration Fraction. 0.5

b) Enumerate the determinants of GFR (Glomerular Filtration Rate). What is the
1 effect of each determinant on GFR? 4.5
a) Enumerate the abnormalities of Micturition. 01

2 b) Give the causes and pathophysiology of each abnormality. 04
A 55 year old artist visits his family physician. He finds it difficult to hold his hand
steady while painting. Examination reveals rigidity of limbs and resting tremors.
a) From which disease the man is suffering? 01
3 b) Which component of the nervous system is involved? 01
c) What is the pathophysiology of this disease and cause of his clinical features?
03
a) Enumerate four sensations carried by dorsal column medial lemniscal system.

b) What is Analgesia system? Briefly explain. 01
4 04
a) What are the actions of Glucocorticoids on Carbohydrate and Lipid metabolism?

b) Differentiate between Cushing’s syndrome and Cushing’s disease. 03
5 02
A 45 year old woman presents with bagginess under the eyes, swelling of face,
intolerance to cold, increase in body weight and sleepiness. On examination,
her Pulse is 55/min. There is edema of legs and features of peripheral vascular
6 disease due to Atherosclerosis are present
a) Name the condition she is suffering from and give its cause. 01
b) List the tests which will help in the diagnosis of this condition. 1.5
c) What is the cause of edema and Atherosclerosis in this patient? 1.5,01
a) Draw Rhodopsin Visual Cycle. 03
b) What is the neural pathway for pupillary Light Reflex? 02
7
A 23 year old newly married girl consults the doctor for Amenorrhea for the last five
weeks. Her blood test indicates that she is pregnant.
8 a) Name the hormone which can be measured in the blood to confirm pregnancy.
b) What is the site of secretion of this hormone. 01
c) Give functions of this hormone. 01
03
a) What is Enteric Nervous System? Give its functions. 03

b) Enumerate the eight neurotransmitters secreted by Enteric Neurons. 02
9
--- UHS-I(ii) /15 – A / 3(S) – (02-11-15) ---

Physiology
Roll No. __________
Max. Marks: 45
a) Enumerate the hormone and autacoids that influence the glomerular filtration
rate. 1.5
b) Briefly describe how macula densa feedback mechanism regulates glomerular
1
filtration rate and glomerular hydrostatic pressure, when arterial pressure is
decreased? 3.5
A middle aged man presents with the following acid base parameters in his arterial
blood; pH = 7.3, HCO-3 = 14mEq/L, PCO2 = 40 mmHg.
a) From which disorder the man is suffering? 01
2 b) Give causes of this disorder. 01
c) Give compensatory mechanism in the body. 03
a) Compare the effects of sympathetic and parasympathetic stimulation on:

i) Eye 01
ii) Heart 01
3 iii) Gastrointestinal tract 01
iv) Male sex organs 0.5
b) What is Horner’s syndrome? 1.5
A 40 year old man was involved in a Road Traffic Accident. X-ray of the spine
showed fracture dislocation of the vertebrae. After few days, he develoed features
4 indicating left side hemisection of spinal cord. Explain the features AT and BELOW
the level of hemisection of spinal cord. 05
A 50 year old man consults a physician. He has complaints of increased volume and
frequency of urination, thirst and increased appetite. He also givves history of
generalized weakness and weight loss. His fasting blood glucose is 160 mg/dL.
a) From which disease the man is suffering? 01
b) What is physiological basis of increase in urinary volume & frequency,
5 increased appetite and thirst? 03
c) Enumerate disease complications he can suffer from. 01
Give physiological actions of:

a) Aldosterone 02
6
b) Growth hormone on carbohydrate and fat metabolisms 03
a) Name any five neurotransmitters released by retinal neurons. 2.5
b) What is “Impedane Matching”? Why this is needed for normal hearing? 2.5
7
a) What is capacitation of spermatozoa? 2.5

b) Give role of Estrogen and Progesterone in breast development. 2.5
8
A two year old child is evaluated for difficulty in swallowing. She regurgitates solid
food and vomits frequently. X-ray study shows dilated lower part of the esophagus.
Manometric study shows absence of primary peristalsis in lower third of esophagus.
a) What is the most likely diagnosis? 01
9
b) Explain the Pathophysiology of this condition. 03
c) How can it be treated? 01
--- UHS-I(ii) /14 – A / 2(S) – (25-10-14) ---

Physiology
Roll No. __________
Max. Marks: 45
A man of 60 years has degeneration in pars compacta of substantia nigra leading to

a neurological disease.
a) From which disease the man is suffering? 0.5
1 b) What is the mechanism of development of this disease? 1.5
c) Give features of this disease. 03
Compare the dorsal column medial lemniscal system anterolateral system

regarding:
2 a) Their pathways and types of nerve fibres. 2.5
b) Types of sensation carried. 2.5
What is enteric nervous system? Give the neurotransmitters released and functions
of this nervous system. What is achalasia of the esophagus? 01,03,01
3
A man focuses his eyes on a near object. Give changes in his eyes during this
focusing. What is the nervous pathway of these changes? 03,02
4
How will you differentiate between Levi-Lorain dwarfism and cretinism? 05

5
a) Define filtration coefficient and filtration fraction. Give their normal values. 02
b) What are features of metabolic acidosis? How does the body compensate in this
6 disorder? 03
a) Give mechanisms that contribute to development of hyperosmolarity of renal

medullary interstitial fluid. 03
b) How is this hyperosmolarity of renal meduallary interstitium maintained? 02
7
A person had undergone thyroidectomy few weeks back. Now he came to the
surgeon with complaints of muscle spasm and feeling of abnormal sensation.
8 a) What is the probable reason for this condition? 01
b) Which hormones are normally involved to prevent this condition? 04
How does ovulation take place? 05
9
--- UHS-I(ii) /13 – A / 1(S) – (00-00-00) ---

Physiology
Roll No. __________
Max. Marks: 45
a) What are determination of glomerular filtrate rate? 03

1 b) Give the effect of sympathetic stimulation on glomerular filtration rate. 02
A man of 50 years old is diagnosed to have tabes dorsalis (neurosyphilis).

a) He has destruction of which nerve supply to the urinary bladder? 01
2 b) Which condition his urinary bladder has? 01
c) Give the features of this condition. 03
a) What chagnes occurs in the electroencephalographic record (EEG) of a normal

human at different stages of wakefulness and sleep? 03
b) During which stage of sleep the EEG recording is similar to recording during
3 alert wakefulness? 01
c) What is the difference between insomnia and somnolence? 01
A man of 60 years old with neurological features consults a neurologist. His CT scan
shows degeneration in substantia nigra.
a) From which disease, the man is suffering? 01
4 b) Imbalance of which hormones is the cause of this disease? 01
c) Outline the features of this disease. 03
a) A young man enters in dim light after remaining for many hours in bright light.
Which changes occur in his eyes in dim light? 03
5 b) What is “Place Principle” for the determination of pitch of the sound? 02
a) Give the mechanism of action of thyroid hormones in target cells. 02

b) Enlist the actions of glucagon. 03
A female of 30 years old was operated for the thyroid adenoma a few months back.
Now she complains of frequent spasm of her hands and feet and tingling sensation
over the body.
7 a) What is the cause of these features in that woman? 01
b) What changes in her palsma C++ level do you expect? Give the normal
plasma calcium level. 02
c) Explain the mechanism of development of this conditon in the woman. 02
a) A lacerating mother is having amenorrhea. Explain the mechanism of this
amenorrhea. 02
8 b) What is capacitation? Give its significance. 03
Give a brief outline of the sequence of events occuring during vomiting reflex. What
do you know about chemoreceptor – trigger zona? 03,02
9
--- UHS-I(ii) /12 – A / 1(S) – (00-00-00) ---

Physiology
Roll No. __________
Max. Marks: 45
a) What are the 3 lines of defense against changes in H+ ion concentration of body
fluids? 1.5
1 b) How kidneys regulate extracellular fluid hydrogen concentration? 3.5
a) Draw and label juxtaglomerular apparatus. 03

b) How macula densa feedback mechanisms help autoregulate GFR during
2 decreased arterial pressure? 02
A boxer at the age of 45 years was diagnosed to be suffering from Parkinson’s

Disease.
a) What are the characteristics of his disease? 03
3 b) Suggest possible treatments? 02
a) What are the various types of pain? 02

4 b) Explain the mechanism of referred pain with the help of diagram. 02,01
Miss R is very selective in her diet. From last few months she is complaining of
difficulty to see at night, she is diagnosed to be suffering from Night Blindness.
a) What is the causeof her night blindness? 01
5 b) What will be the role of her treatment in the formation of Rhodopsin? 04
How 24 hour bood glucose is regulated in a normal person? 05
Enumerate the specific effects of Thyroid Stimulating Hormone (TSH) on thyroid

gland. 05
7
Which hormonal factors cause increased uterine contractility towards the end of a
8 normal pregnancy? 05
a) Enumerate the factors that regulate gastric emptying 02
b) Enumerate the factors that can excite the enterogastric reflexes from the
9 duodenum. 03
--- UHS-I(ii) /10 – A / 1(S) – (00-00-00) ---

Physiology
Roll No. __________
Max. Marks: 45
Name four endocrine functions of the kidney. What is the role of kidney in calcium
ion homeostatis? 05
1
A 60 year old male is a known case of diabetes and hypertension for a long time
presents with generalized oedema, nausea, vomiting, mental deterioration,
confusion and sudden collapse passing on to deep coma, Lab investigation reveal:
BUN (Blood Urea Nitrogen) = high, serum creatine = high pH= 7.2
a) What is the most likely diagnosis of this almost terminal condition of the
2
patient? 01
b) How has the physiology been changed by this disorder? 04
Enlist eight functions of the body controlled by the brainstem. 05

3
A 60 year old man develops tremor in his hands and fingers which becomes more
pronounced as he reaches for a glass of water or points towards an object. He has
difficulty maintaining his balance?
a) Which component of the nervous system is involved? 01
4 b) How are the tremors different from other tremors due to lesions of nervous
system? 02
c) Why this person has difficulty in maintaining balance? 02
A 65 year old man reports to his physician with the principal complaint of
Nyctalopia (night blindness).
a) What is the cause of this disorder? 01
b) Which area of retina becomes impaired? 02
5 c) What is Argyll-Robertson pupil? 02
Name the hormones of anterior pituitary gland. What are somatomdins? 05

6
A 45 years old female gives three month history of fatigue, hunger, and thirst
almost all the time. There is increased frequency of micturition as well and the
complaints have steadily worsened over the last two months. Relevant lab tests
reveal:
a) What is the lady suffering from? 01
7 b) What is the physiological basis of the increased frequency in micturition? 01
c) Why is she hungry all the time? 01
d) Why is she always thirsty? 01
e) What are the diffirent types to this disorder? 01
Briefly mention the changes that occur during the process of capacitation of the
speramatozoa. 05
8
Give five differences between obstructive and hemolytic jaundice. 05

9
--- UHS-I(ii) 2009 – A / 1(S) – (00-00-00) ---

Physiology
Roll No. __________
Max. Marks: 45
A man drinks about 01 litre of water in 10 minutes. What changes occur in his water
and electrolyte balance? 05
1
Give a summary of functions of kidney. 05

2
Explain the functions of cerebrocerebellum. Enumerate EIGHT features of the

cerebellar disease. 05
3
A middle aged man was hit by a motor car resulting into fracture dislocation of the
verterbrae. Later he developed effects indicating right sided hemisection of the
4 spinal cord. Enumerate the features below and at the level of the hemisection. 05
What are the actions of CORTISOL on protein metabolism? How is cortisol secretion
Regulated? 05
5
Enumerate TWELVE effects of SYMPATHETIC STIMULATION in the body. Which

NEUROTRANSMITTERS are released from preganglionic and postganglionic
sympathetic nerve fibres? 05
6
A young female consulted her family physician. She complained of frequent muscle
spasm and numbness of arms and legs. Her plasma calcium was 6.5 mg/dl.
a) From which condition was she suffering? 01
b) Was her plasma calcium normal? 01
7 c) What was the mechanism of her frequent muscle spasms and numbness? 03
What changes occur in eyes when these are focused on a near object? Explain the
nervous mechanism involved. 05
8
Compare the physiological actions of Estrogens and Progesteron on the:
a) Uterus 03
9 b) Breast 02
--- UHS-I(ii) /08 – A / 1(S) – (00-00-00) ---

MBBS Last
11 Years c2008-20181
BIOCHEMISTRY Past Papers
2 nd Year MBBS
Biochemistry 2013
Biochemistry 2014
Biochemistry 2015
Biochemistry 2016
Biochemistry 2017
by:
Fraz Mallick
.::;, :;: PANORAMA

� BY FRAZ MALLICK
MBBS Last
11 Years c2008-20181
BIOCHEMISTRY Past Papers
2 nd Year MBBS
Biochemistry2018
Biochemistry------
Biochemistry------
Biochemistry------
Biochemistry------
by:
Fraz Mallick
.::;, :;: PANORAMA

� BY FRAZ MALLICK
Biochemistry
Roll No. __________
Max. Marks: 45
a) A child accidentally took cyanide and was brought to the hospital in coma. What
is the effect of this poison on mitochondrial respiration? 01
1 b) Give mechanism of ATP production by ATP Synthase. 1.5
c) Name production of lipolysis and give their fate. 2.5
a) Name ketone bodies? How they are synthesized in human body. 03

b) Which fatty acids is the primary end product of fatty acid synthase activity? Give
2 summary of total energy yield from the oxidation of this fatty acid. 02
a) A patient after taking antimalarial drugs developed severe intravascular

hemolysis. Name the enzyme deficient in this patient. Why deficiency of this
enzyme leads to hemolysis? 02
b) A chronic alcoholic has been brought to medical emergency. Blood biochemistry
reveals lactic acidosis. Deficiency of pyruvate dehydrogenase complex is
3 suspected.
i) Give the reaction catalyzed by pyruvate dehydrogenase complex with its
mechanism. 02
ii) Why thiamine deficiency leads to dificient activity of PDH Complex? 01
a) Hyperglycemia and ketoacidosis are the hallmarks of untreated Type 1 diabetes

mellitus. Give biochemical cause of hyperglycemia and ketoacidosis in these
patients. 01
b) What is substrate level phosphorylation? Elaborate with the help of any two
examples? 1.5
c) A young boy with fulminant hepatic failure presented in emergency department
4 in unconscious state. His blood ammonia levels were above normal and he was
diagnosed as a case of ammonia intoxication. Give mechanism of ammonia
intoxication? 01
d) Write extra-mitochondrial steps of urea synthesis. 1.5
a) A four-year old boy of a first degree consanguineous couple was noted by the
parents to have darkening of the urine to an almost black color when it was left
standing. He had a normal sibling, and there were no other medical problems.
Childhood growth and development were normal.
5 i) What is the biochemical disorder child is suffering from? 0.5
ii) Give biochemical reason for the darkening of the urine to an almost black color
when it was left standing. 01
b) Write the reactions catalyzed by alanine aminotransferase (ALT) and aspartate
aminotransferase AST. Give diagnostic value of ALT & AST. 3.5
a) Why do patients with Hartnup’s disease have hyperaminoaciduria without an
associated hyperaminoacidemia? 01
b) Define alkaline tide? What is the role of pepsin in digestion of proteins? 1.5
c) Give normal blood uric acid levels in both males and females. Plasma uric acid
6 leaves are raised in Lesch-Nyhan syndrome. Give biochemical reason for
hyperuricemia in this disorder. 1.5
d) Why Allopurinol is used to treat hyperuricemia in patients who are
“overproducers” of uric acid? Give biochemical reason. 01
a) What do you understand by the term restriction endonucleases? Elaborate

biochemical role of endonucleases. 02
b) In most normal somatic cells, telomeres shorten with each division. In stem cells
and in cancer cells, however, telomeric length is maintained. How? 01
7 c) What are spliceosomes? 01
d) How following antibiotics produce their antibacterial effect?
i) Streptomycin 0.5
ii) Tetracycline 0.5
a) Define proto-oncogenes. Give three mechanisms of activation of proto-

oncogenes. 1.5
b) Enlist five conjugation reactions which prepare xenobiotics for excretion in
phase 2 of their metabolism. 01
c) A 52 year old male with end-stage renal disease (requiring dialysis) is brought to
emergency department, feeling weak and dizzy. He missed dialysis for the first
time over the weekend to attend his niece’s wedding. On presentation, his
heart rate is 50 and his ECG demonstrates: tall peaked T waves with a narrow
base in precordial leads, shortened QT interval, and ST-segment depression. His
blood potassium levels are 6.0 mEq/L.
i) He is suffering from which electrolyte imbalance 0.5
ii) Give any four causes of this electrolyte imbalance. 01
8
d) A 52 year old male patient enters the Emergency Department complaining of
shortness of breath and tingling in fingers. His breathing is shallow and rapid.
He denies diabetes; blood sugar is normal. He has no significant respiratory or
cardiac history. He takes several antianxiety medications. He says he has had
anxiety attacks before. While being worked up for chest pain in ABG is done and
results are:
pH= 7.48 (N=7.34-7.45), PaCO2 = 28 mmHg (N=35-45 mmHg)
HCO3 = 22mEq/L (22-26mEq/L), PaO2 = 85 mmHg
He has acid base imbalance. Give your diagnosis. 01
a) Name any four hormones that bind intracellular receptors. 01

b) How mineralocorticoids are synthesized? 03
9 c) What are trophic hormones? Name trophic hormones of the anterior pituitary?
01
--- UHS-II(ii) /18 – A / 3(S) – (09-10-2018) ---

Biochemistry
Roll No. __________
Max. Marks: 45
a) How the reducing equivalents NADH produced in the glycolytic pathway of

cytosol are transferred to mitochondria for further oxidation. 2.5
b) The breast fed infants and children take Lactose through mother’s milk. How
1 the Galactose component of Lactose is converted to glycogen in the liver. Which
defects cause Galactosemia? 1.5,01
a) How high Fructose intake for prolonged time is more atherogenic than Glucose?
b) Give the hepatic metabolism of Fructose and its regulation. 01
2 04
a) Give the sources of reducing equivalents NADP required for Lipogenesis. 1.5
b) What is the fate of nasant VLDL released from the liver? 3.5
3
a) Define lipotropic factors and give their relationship with fatty liver. 01,1.5
b) Enumerate the amines of biological importance produced from Histidine,
4 Tyrosine and Tryptophan. 2.5
a) What is the Hyperammonemia? Give its types and the defect involved in each
type. 0.5,1.5,1.5
5 b) How urea synthesis is regulated? 1.5
a) A bbay of 6 month, off and on developing severe infection, was diagnosed a

case of severe combined immune deficiency due to deficiency of enzymes
adenosine deaminase.
i) What is the role of this enzyme? 01
ii) Give the biochemical mechanism by which this enzyme deficiency leads to
6
severe combined immune deficiency. 1.5
b) Define Silent, Missense and Nonsense mutations. What is the role of eIF-2 in 0.5,0.5,0.5,01
regulation of protein synthesis in Eukaryotes?
a) Enumerate the proteases of pancreatic juice, give specificity of each. 2.5

b) A bacterial colony in an experimental lab was only administered lactose in the
7 nutritional media. How this nutrient regulate its own utilization by this colony of 2.5
bacteria.
A 50 year old female presented with severe body aches and pains. X-ray picture
shows marked Osteoporosis. Plasma level of calcium was 20 mg/dl (normal 8.5-10.5
mg/dl). CT Scan of neck shows an enlarged mass of the gland, which is involved in
regulation of calcium balance. The size and function of thyroid gland was normal.
a) She is suffering from hypertrophy of which gland? 01
8
b) Which plasma hormone will you advise to determine in lab for diagnosis? 01
c) How the increased secretions of this enlarge gland cause Hyercalcemia and 03
Osteoporosis?
a) Define tumour suppressor genes, how these are linked to Carcinogenesis. 01,01
b) A patient of chronic renal failure was brought in a state of unconsciousness. The
ECG pictures displaying on cardiac monitor shows widening of QRS complex,
and tall tented “T” wave.
9 i) From which electrolyte abnormality he is suffering? 01
ii) What are the normal plasma levels of this electrolyte due to abnormality of
which he presented abnormal ECG pattern? 01
iii) How body regulate this electrolyte? 01
--- UHS-I(ii) /16 – A / 1(S) – (04-10-16) ---

Biochemistry
Roll No. __________
Max. Marks: 45
a) Draw Electron Transport Chain. 1.5

b) Name any FOUR inhibitors of Electron Transport Chain. 01
c) A patient presents with extreme swelling and tenderness in joints of
extremities. Examination of Synovial fluid extracted from big toe reveals and
1 confirms the diagnosis of Gouty Arthritis. Drug Allopurinal is prescribed to treat
the patient. How is this drug helpful in the treatment of this disorder? Which
products are increased in plasma when uric acid production is blocked by
Allopurinol? 2.5
a) What is β-oxidation? How it is regulated? 03

b) What is the fate of products of Lipolysis? 02
2
a) Explain mechanism of Diabetic Ketoacidosis? 02

b) Write down the reaction catalyzed by the enzyme Pyruvate Kinase. What is the
3 cause of Hemolytic Anemia in Pyruvate Kinase deficiency? 03
a) A 20 year old girl presented to Emergency Room with a panic attack. She had
noticed Peri-oral paresthesia. On examination, she was found to be
hyperventilating. Her ABGs (Arterial Blood Gas) results suggeted that she had
developed Respiratory Alkalosis.
i) Enlist any FOUR causes of Respiratory Alkalosis. How it is compensated?
ii) What is Plasma Action Gap? 0.5,01
4 b) Plasma bicarbonate of a male was 22 mEq/L before meal which became 27 01
mEq/L just after meals. How rise in Bicarbonate occurred after taking routine
food?
c) A new born baby developed diarrhea, abdominal distension and foul smell in 1.5
breath after breast feeding. Stool contains reducing substances and Hydrogen
breath test is positive. Which enzyme is deficient in this patient?
01
A 2 year old child was taken to hospital. His mother said that he vomited frequently
sepcially after feeding. The child’s weight and physical development was below
normal. His hair, although dark, had white patches. A urine sample treated with
FeCl3 gave a green color, characteristic of the presence of phenyl pyruvate.
Quantitative analysis of urine sample shows:
5
Concentration (mm) Patient Value
Normal
Phenyl alanine 7.0 0.01
Phenyl pyruvate 4.8 0
Phenyl lactate 10.3 0
a) Which enzyme might be deficient in this case? 0.5
b) Write the reaction catalyzed by this enzyme. 0.5
c) Suggest management of this patient. 02
d) Why does Phenylalanine appear in urine in large amounts? 01
e) What is the source of Phenylpyruvate and Phenyl lactate? 01
a) A 48 year old man had a history of skin cancer. In the past 6 years, he has had
over 30 neoplasms removed from the sun-exposed areas. Skin had scattered
areas of Hyperpigmentation. He has been diagnosed as a case of Xeroderma
Pigmentosum.
6 i) What is the biochemical lesion resulting from UV radiation? 01
ii) How this lesion is repaired? 02
b) What are the Post-Translational Modifications reqquired to convert pre mRNA
to mature mRNA? 02
a) What are the sources of Ammonia in the body? 2.5

b) Define Gluconeogenesis. Write down THREE irreversible reactions of Glycolysis.
7 2.5
a) Enlist the major actions of Gastrin, Seretin and Cholecystokinin. 2.5

b) Calculate total energy produced when one molecule of Palmitic acid is oxidized
8 by β-oxidation. 2.5
a) Write down the steps involved in the biosynthesis of Catecholamines and their
mechanism of action. 02
9 b) Write the effects of cortisol on Carbohyde metabolism in early and late fasting
state. 02
--- UHS-I(ii) /16 – A / 3(S) – (15-10-16) ---

Biochemistry
Roll No. __________
Max. Marks: 45
a) Give all pathways through which high energy phosphate is transferred to ADP
for the formation of ATP 2.5
b) A patient having high grade fever took antimalarial drugs & Aspirin erythrocyte
1 glucose 6-P dehydrogenase activity was markedly low.
i) Which metabolic pathway is suppressed in this patient? 1.5
ii) How he developed intravascular hemolysis? 01
a) Define Gluconeogenesis. How Gluconeogenesis is suppressed after feed and

enhanced during fasting. 2.5
b) In the nutrition medium of cultured hepatocytes, high fructose was added. It
2 was found that the cells were flooded with Chelesterol and Triacylglycerol. Give
the mechanism. 2.5
a) A patient having uncontrolled Diabetes Mellitus developed ketoacidosis, the

cause of which is the increased delivery of fatty acids to liver. The fatty acids are
derived from increased lipolysis in adipose tissues. How lipolysis is increased in
this patient? 2.5
3 b) Give the Purine salvage pathway from Purine bases. Which metabolite will
accumulate in the body if the enzyme of this pathway become deficient? 2.5
VLDL is a transport vehicle of lipids. How is it synthesized in the liver? Which

substances block its synthesis and release? 05
4
There are two pathways for the degradation of tissue proteins inside the cell.
Enumerate both the pathways and describe the ATP dependent pathway. 05
5
a) Give the regulation of hepatic Urea biosynthesis mentioning the abnormality, if

the Ornithine transporter of inner mitochondrial membrane is defective.
b) What is prepriming complex in prokaryotic DNA replication? Give the role of 1.5,01
6 each component of this complex.
01
a) Give the mechanism of removal of Introns from pro-mRNA. 2.5
b) Proto-oncogenes are the normally present genes on DNA giving no harm to the
cells during their life and replication. When these protooncogenes are mutated
7 to oncogenes, the products of these mutated genes become uncontrolled and
lead to cancer formation. Enumerate the mechanisms through which proto-
oncogenes are converted to oncogenes. 2.5
Growth hormone is the most abundantly produced hormone of anterior pituitary.

Give its regulation, structure, mechanism of action and effects of hyperproduction. 01,01,
8 02,01
a) Enumerate the Endopeptidases of pancreatic juice and give the specific roel of
each. 2.5
9 b) A worker while working near an Iron melting furnace on a hot summer day,
developed marked hypovolemia and hyponatremia, due to heavy perspiration.
How the body will compensate the losses? 2.5
--- UHS-I(ii) /15 – A / 1(S) – (30-10-15) ---

Biochemistry
Roll No. __________
Max. Marks: 45
A nine year old boy was rescued alive from earthquake after four days. He was
unconscious with sunken eyes and coated tongue. He was given immediate
management with fluid and electrolyte replacement.
1 a) Which pathway were activated to provide energy to him during period of
starvation? 03
b) Which disorder occurs due to deficiency of glucose-6-phosphate? 02
Give the types of thyroid hormones. Which one is active? How its active form is
produced from prohormone. Give the regulation of biosynthesis and release of
2 Thyroid hormones. 05
A two year old child was taken to the hospital. His mother said that he vomited
frequently, especially after feedings. The child’s weight and physical development
were below normal. His hair, although dark, contained white patches. A urine
sample treated with ferric chloride gave a green colour characteristics of the
presence of phenyl pyruvate. Quantitative analysis of urine sample shows:
Concentration (mm)
Substane Patient’s Urine Normal
Urine
Phenylalanine 7.0 0.01
3 Phenylpyruvate 4.8 0
Phenylacetate 10.3 0
a) Suggest which enzyme might be deficient in this child. Suggest management
of the above case. 01
b) Why does Phenylalanine apear in the urine in large amounts? 01
c) What is the source of Phenylpyruvate and Phenyllactate? 01
d) Why does this pathway (normally not function) come into play when the
concentration of Phenylalanine rises? 01
e) Why does the boy’s hair contain white patches? 01
Fatty acid oxidation leads to formation of Acetyl CoA:

a) Write three fates of Acetyl CoA. 2.5
4 b) How ketone bodies are synthesized? 2.5
a) Write the names of four complexes of Respiratory chain. Write two uncouplers
of oxidative phosphorylation. 03
5 b) Write three specific enzymes which are required to convert amino acids to
glucose. 02
a) How termination of transcription process takes place. Write four post
transcriptional modifications. 2.5
b) Enlist the prerequistes for replication process. How proof reading occurs once
6
DNA is formed? 2.5
a) How carnitine shuttle helps in transport of fatty acids into mitochondria in Beta
oxidation? 2.5
b) A 15 year old boy presents with acute breathlessness. Lab report shows:
Blood Reference Range
pH 7.10 7.35-7.45f
pCO2 12.2 4.6-6.0 kPa
7 pO2 10.1 12-16 kPa
Actual Bicarbonate 22 22-30 mmol/L
Interpret the above case and justify the type of acid base disorder, the patient is
suffering from 2.5
Give the digestion of dietary carbohydrates. 05
a) List the end products formed after degratdation of purine and pyrimidine bases.
How hyper-urecaemia occurs in gout? 03
9 b) Why increased ammonia level in blood is toxic to brain? 02
--- UHS-I(ii) /14 – A / 3(S) – (14-10-14) ---

Biochemistry
Roll No. __________
Max. Marks: 45
a) What is meant by oxidative phosphorylation? Write down uncouplers of

oxidative phosphorylation. 2.5
1 b) Write down the uses of NADPH in our body. (mention at least five uses) 2.5
a) Write down the reaction catalyzed by the enzyme Pyruvate kinase. What
happens in Pyruvate Kinase deficiency? 2.5
2 b) What are the different fates of Pyruvate in our body? 2.5
a) What are the various roles of Paroxisomes in lipid metabolism? 2.5

b) A fifty year old type-2 diabetic patient presented with acidotic breathing and
confusion. Blood glucose level is 415 mg% (Normal less than 160 mg%) and
marked Katonemia is present. Urine examination shows positive. Benedict’s and
Rothra’s test. Blood pH is 7.3 (Normal 7.4 and bicarbonate level is 18 mEq/L,
3 (Normal 22-28 mEq/L).
i) Write the acid base disorder present in this patient. 0.5
ii) Write the name of various ketone bodies. 01
iii) How ketone body – Acetoacetate serve as fuel for extra hepatic tissues?
01
a) How insulin regulates lipogenesis? 2.5

b) A young boy with fluminant Hepatic failure presented in emergency department
unconscious state. His blood ammonia level is 100 µg/dl.
(Normal= 10-20 µg/dl). The doctor diagnosed ammonia intoxication.
4
i) What is the mechanism of Ammonia intoxication? 0.5
ii) How ammonia is transported in blood? 01
iii) What are the various sources of ammonia in our body? 01
a) How proteins are degraded in our body? Name the glucogenic and ketogenic
amino acids. 2.5
b) What important biological compounds are formed from
5
i) Tyrosine 01
ii) Tryptophan 1.5
a) An eight month old child presented with recurrent throat and lung infections
since birth. Blood picture showed decreased amouont of immunoglobulins, T-
Lymphocytes and nautral killer cells.
i) Name the clinical condition and the deficient enzymes present in this
6
child. 0.5
ii) Write down the reaction catalyzed by the deficient enzyme. 01
iii) What should be the appropriate treatment for this child? 01
b) Write the various enzymes and their functions involved in DNA replication. 2.5
a) A young girl presented with butter fly rash on cheeks, phtosensitivity and joint
pains. The doctor diagnosed the disease systematic lupus erythmatosus on
autoantibody analysis.
i) Write down the auto antibodies produced in this disease. 0.5
7 ii) What is the role of small nuclear ribonucleoprotein particels? 01
iii) What is meant by splicing? 01
b) Write down the various roles of kidney in acid base balance. 2.5
a) A thrity five year old female complains of hirsutism, acne, weight gain and
secondary amenorrhea. On examination, she has central obesity and high
pressure. Lab tests revealed elevated levels of Cortisol and aldosterone in
blood. CT Scan of abdomen showed adrenal gland tumor.
i) Write the mechanism of action of Cortisol. 0.5
8 ii) What are the effects of Cortisol on carbohydrate and lipid metabolism?
b) Write down the classification of Hormones on the basis of their chemical 02
diversity.
2.5
a) How carbohydrates are digested in Gestro-intestinal tract? 2.5

b) What are the different mechanisms of absorption of monosachharides in the
9 small intestine. 2.5
--- UHS-I(ii) /12 – A / 1(S) – (00-00-00) ---

Biochemistry
Roll No. __________
Max. Marks: 45
a) Describe complex V of electron transport chain along with its two inhibitors. 1.5,0.5
b) Six year old male child apparently normal at birth but now shows spastic
movements of limbs and mental retardation. Blood chemistry reveals uric
acid and is diagnosed as patient of Lesch-Nyhan syndrome.
i) Which metabolic pathway is affected? 0.5
1
ii) Name the defective/deficient enzyme in this syndrome. 0.5
iii) Write down reaction catalyzed by the enzyme that is deficient in
this syndrome. 0.5
iv) Why is blood uric acid concentration increased in this sydrome? 1.5
a) Write down the reaction catalyzed by glucose-6-phosphate dehydrogenase

(G6PD). Why does G6PD deficiency leads to hemolytic anaemia? 0.5,1.5
2 b) Why is ammonia toxic to brain tissue? How is cytosotic acetyl CoA produced
for de novo synthesis of fatty acid? 01,02
a) Write down reactions of urea cycle occuring in mitochondrial matrix. How is

urea cycle regulated? 01,01
b) Which enzymes are deficient in alkaptonuria and homocystituria? Write
3
down the reaction catalysed by these deficient enzymes. 01,02
a) Write the similar reactions of ketogenesis and cholesterol biosynthesis

occuring in mitochondrion and cytosol respectively. How are chylomicrons
cleared from plasma? 01,01
b) How is 3-hydroxy-3-methylglutary CoA (HMG) reductase regulated as a rate
4
limiting enzyme of cholesterol biosynthesis? 03
a) How do gluconeogenic precursors glycerol and lactate enter the

gluconeogenic pathway. 02
b) How is a little amount of free glucose formed from glycogen degradation in
5 muscle? Write the two reactions of glycolytic pathway in which substrate
level phospharylation of ADP occurs. 03
a) Name five classes of eukaryotic DNA polymerases along with their principal
functions in DNA replication and repair. 02
6 b) Describe two types of posttranslational covalent modifications in
polypeptide chains. What is rho-dependent termination of RNA synthesis? 01,02
a) What are the functions of pancreatic phospholipase A2 and alpha-amylase?
How dietary hexoses are actively absorbed from intestianal lumen? 02
7 b) Describe the role of renal mechanisms in acid-base balance. 02
A 30 year old female complains of hirsutism and acne (although she never had it in
her teenage) weight gain, and amenorrhea. On examination she had fat deposits in
the face, neck and abdomen, and high blood pressure. Laboratory tests lead to the
diagnosis of Cushing’s syndrome caused by adrenal cortical carcinoma with
elevated levels of cortisol, aldosterone and adrenal androgens.
8 a) How does ACTH control the synthesis of cortisol and other cortical
hormones? 01
b) How does aldosterone cause the retention of sodium which contribute to
increase in blood pressure? 02
c) What is the effect of cortisol on carbohydate and lipid metabolism? 01,01
---------------------------------------------------------------------------------------------------------------
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9 ---------------------------------------------------------------------------------------------------------------
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--- UHS-I(ii) /09 – A / 1(S) – (00-00-00) ---

Utmost care has been taken
to make it error free but
still we are sorry if any
sort of error or mistyping
is found.
If found, do let us know.
Compiled by:
Fraz Mallick
Revised by:
Sehar Malik
Saira Zeeshan
Farhan Mubeen
F O R M O R E
MBBSPanorama

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MBBS FIRST PROFESSIONAL: PART-II

Anatomy [Including Histology]

Attempt ALL Questions

a) A 60 year old patient came in Emergency Department with severe bleeding

Give anatomical basis of:

a) Draw and label microscopic structure of ureter (transverse section). 03

Pudendal nerve block may be performed to provide anesthesia to the perineal

--- UHS-I(ii) /18 – A / 1(S) – (02-10-18) ---

Attempt ALL Questions

a) What is Pharyngeal apparatus? Name derivatives of 2nd Pharyngeal arch. 01,2.5

a) Name cells in gastric glands mentioning their function. 03

a) What are the boundaries of Epiploic Foramen (omental foramen)? 02

a) What is arterial supply and venous drainage of supra-renal glands? 03

a) Name fontanelles of skull. Give signifcance (clinical) of anterior fontanelle. 3.5

--- UHS-I(ii) /17 – A / 1(S) – (03-10-17) ---

Attempt ALL Questions

Draw and label the microscopic pictures of Submandibular Salivary gland.

a) A surgeon has to operate on the large intestines. He opened the abdomen of

--- UHS-I(ii) /16 – A / 1(S) – (04-10-16) ---

Attempt ALL Questions

a) Draw an label light microscopic picture of transverse section of Ureter. 03

What are Pharyngeal Pouches? Mention their derivatives in a tabulated form. 05

a) Write the boundaries of Pelvic outlet. 02

a) Name the components of Waldeyer’s (tonsillar) ring. 02

a) Name the movements permitted at Temporomandibular Joint. 2.5

--- UHS-I(ii) /15 – A / 1(S) – (27-10-15) ---

Attempt ALL Questions

a) Draw and label histological structure of Fundus of Stomach. 03

a) Give the anatomy of various structures supporting the uterus. 04

a) Enlist the intrinsic muscles of the larynx. 02

--- UHS-I(ii) /14 – A / 1(S) – (22-10-14) ---

Attempt ALL Questions

Draw and label a diagram to show the histological section of ureter. 05

A premature newborn with rapid labored breathing was diagnosed to have

a) Give the lymphatic drainage of uterine cervix. 1.5

Following surgery for cancer of submandibular gland, a 50-year old female

--- UHS-I(ii) /13 – A / 1(S) – (00-00-00) ---

Attempt ALL Questions

a) Enumerate the endocrine cells of thyroid gland mentioning the substances

In a tabulated manner, give the location, significance and Brodmann’s classification

a) A 35 year old woman with history of intermittent obstruction of urinary flow,

a) Give the formation of portal vein. 01

--- UHS-I(ii) /12 – A / 1(S) – (00-00-00) ---

Attempt ALL Questions

--- UHS-I(ii) /11 – A / 1(S) – (00-00-00) ---

Attempt ALL Questions

“Scalp wounds bleed profusely” Give anatomical justification of this statement.

During cholecystechtomy (surgery on gall bladder) patient started bleeding

--- UHS-I(ii) /09 – A / 1(S) – (00-00-00) ---

Attempt ALL Questions

Enumerate FOUR microscopic structural differences between beginning and end of

A pediatrician was called in labor-room to examination revealed flattened abdomen

--- UHS-I(ii) /08 – A / 1(S) – (00-00-00) ---

Attempt ALL Questions

a) Explain the motor functions of Stomach. 02

--- UHS-I(ii) /18 – A / 2(S) – (05-10-2018) ---

Attempt ALL Questions

a) Define Transport maximum. Give the value of transport maximum for

a) Which reflex is activated due to activation of Golgi tendon organ? Give