These answers are compiled for sharing and peer learning purposes only.

It
is based on my own reading and hence is bound to have some mistakes.

Compiled by GC
Disclaimer: The answers provided are suggested answers. The following information is
solely to discuss questions, identify mistakes and facilitate improvements among medical
students about medical topics. NO OTHER INTENTION IS IMPLIED. Thank you.

BA Paper 1 2022

1) Which muscle dampens loud noise

A.Anterior auricular
B.Posterior auricular
C.Superior auricular
-
D.Tensor tympanic
E.Tensor veli palatini

2) Posterior part of which bone for radial nerve

-
A.Humerus
B.Radius
C.Ulna
D.Scapular
E.Clavicle

3) Which bone of nasal septum is thin, easily fractured due to injury

A.Orbital plate of Ethmoid bone

B.body of sphenoid
C.septal cartilage
-
D.Vomer
E.maxilla

4) When cleft lip is formed, the primary palate

A.Maxillary
B.Medial frontal nasal process
C.Palatine process
D.Mandibular prominence
E.lateral frontal nasal process

5) What is syndactyly?

6) Which of the following muscles are involved in the flexion of both the hip and knee joint?

A.Gracilis
B.Rectus femoris
-
C.Sartorius Yoga position
D.Semimembranosus
E.Semitendinosus
7) A chronic smoker with claudication at the proximal thigh of the adductor canal. Which
artery is most likely to be occluded?

-
A.Femoral artery
B.Obturator
C.saphenous
D.tibial
E.profunda femoris

8) Which of the following is formed from the remnants of a Haversian canal

A.Concentric lamellae
B.osteiod
C.periosteum
-
D.Interstitial lamellae Source: Lecture - Bone and Cartilage
E.circumferential

9) Which of the following layers of epidermis gives rise to the cancer cells in malignant
melanoma?

-
A.Basale Melanocytes are found in stratum basale.
B.Granulosum
C.corneum
D.Lucidum
E.Spinosum

10) Which structure ruptures and can cause valve regurgitation in IE

A.Pectinate Muscle
B.Chordae tendina
S
C.Papillary muscle
D.Moderator band
E.Crista Terminalis

11) During the development, the heart tube is organised into few different regions. Which
region forms the outflow tract of ventricles?

-
A.Bulbus doctis
B.Primitive atrium
C.Primitive ventricle
D.Senous venouses
E.Truncus arteriosus

12) Which rib corresponds to loew limit of pleural reflection at the midaxillary line?
A.4
B.6
C.8
-D.10
E.12
13) A 25 year old woman is presented with persistent left ear pain. Intraoral examination are
revealed with large tonsillolith at the palatine tonsils. Therefore, the clinical diagnosis is
otalgia. Which nerve is affected due to the pain above?

A.Chorda dua
B.Facial nerve
C.Glossopharyngeal nerve
-
D.Maxillary nerve
E.Zygomatic nerve

14) Which of the following is the best lower limb vessel to be used in angiogram?

A.anterior tibial
B.dorsalis pedis
C.femoral
-
D.popliteal
E.posterior tibial

15) Joint when you do the action "NO" Source: Lecture - Diagnostic and Therapeutic Angiography

-
A.atlantoaxial
B.atlanto occipital
C.atlanto occipital & intervertebral
D.zygapophyseal

16) Truncated cftr

Source: Lecture - Cystic Fibrosis as a Genetic Disorder
A.(Class 1 mutation with X) can't rmb which specific gene X means premature stop codon.
-
B.G511D mutation
C.p.Phe 508 mutation

17) Allopurinol method of action on xanthine oxidase

-
A.allopurinol is a structural analogue of substrate of xanthine oxidase
B.irreversible allosteric inhibitor
C.competitive inhibitor

18) A man finished a carbohydrate rich meals. Process of de novo synthesis of fatty acid
happens. Which describe the process

A.A double bond is formed before the fatty acid is released from fatty acid synthase
complex
B.Regulated by pyruvate dehydrogenase
C.18C is the end product
D.
-
E.NADPH is involved in this process
19) Which of the following is the role of calcium ion in skeletal muscle contraction?

A.It activates the calcium ion channel for the power stroke
B.It activates the dihydropyridine receptors
-
C.It binds to a regulatory proteins that exposes the myosin binding site
D.It binds to calmodulin to activate myosin head
E.It generates action potential at the motor-end plate

20) 60 years old man with COPD. What his ABG result most likely indicates？

A.Metabolic acidosis
B.Metabolic alkalosis
C.Mixed acidosis
-
D.Respiratory acidosis Obstructive lung disease - carbon dioxide retention
E.Respiratory alkalosis

21) Frank Starling Law (within physiological limits)

-
A.Increase Preload = Increase Stroke Volume
B.Constant volume at a time
C.Blood from atrium flow into ventricle.
D.Cardiac output depends wholely on myocardial contractility
E.Heart rate determines cardiac output

22) Which of the following increases the affinity of haemoglobin to oxygen

A.decrease in 2,3 biphosphoglycerate in erythrocytes

-
B.Increase in body temp
C.decrease in arterial pH
D.decrease in plasma bicarbonate ion concentration
E.increase in arterial PCO2

23) Primary ATP source in 100m sprint

A.Liver Glycogen
B.Muscle Glycogen
C.Muscle Phosphocreatine
-
D.Plasma free fatty acids
E.Triglyceride in fatty tissue
Source: First Aid for the USMLE Step 1 2018
24) 28 year old with pulmonary edema, an increase to what causes this

A.capillary hydrostatic pressure Pulmonary vessels congestion

-
B.capillary oncotic pressure
C.interstitial hydrostatic pressure
D.interstitial oncotic pressure
E.Capillary permeability
25) Which of the following is a compensatory mechanism in systolic heart failure?

-
A.Binding of angiotensin II to angiotensin-1 receptor
B.Inhibition of angiotensin converting enzyme (ACE)
C.Increase in renal sodium excretion
D.Increase in pulmonary blood flow
E.Reduced arteriole venomotor tone

26) Drug X has passed Phase II trials for colorectal cancer. What is the purpose of Phase II?

A.To assess the chronic and long term effects of the drug
-
B.To test the efficacy, safety, of the drugs
C.To test the drug on a wider demographic
D.To test efficacy and safety with other drugs in the market
E.To test the pharmacokinetics of the drugs

27) A 60yo male had been taking warfarin for 3 years. He started taking ibuprofen for dental
procedures. What may happen.

A.decrease in risk of stroke

B.decrease warfarin effect
C.exacerbation of ibuprofen toxicity
Source: Lecture - NSAIDs
D.decrease ibuprofen effect
E.increase risk of bleeding
-

28) A 27 year old male presented with symptoms of panic attack. He presented with sign of
palpitation, shortness of breath and sweating. Upon examination, the clinician prescribed
him with an anxiolytic to alleviate his anxiety. What anxiolytic can be prescribe to quickly
alleviate his anxiety?

A.Diazepam
-
B.Fluoxetine
C.Flumazenil
D.Ramelteon
E.Zolpidem Source: Lecture - Sedative Hypnotics

29) A 40 year old man, who was a heavy smoker complained of chronic cough and blood
stained sputum. Bronchoscopy showed an abnormal looking hilar mucosa. A biopsy from
this area showed atypical squamous epithelium.
What is the most likely pathological process involved?

A. Aplasia
B.dysplasia
C.hypertrophy
-
D.metaplasia
E.metaplasia

Source: First Aid for the USMLE Step 1 2018

30) A 27 year old woman complained that her fingers were swollen, painful and stiff in the
mornings. Examination showed that the joints were warm, erythematous and tender.
Laboratory serology showed positive for rheumatoid factor.
Which of the following conditions is she most likely to have?

A. Juvenile rheumatoid arthritis

B. Mseleni joint disease
C.osteoarthirits
D. Reiter syndrome
-
E. Rheumatoid arthritis

31) A 27 year old man presented with pathological fracture of his distal femur. Bone
radiograph showed a circumscribed expansile lytic lesion involving epiphysis and
metaphysis, with 'soap bubbles' appearance.
What tumour is he likely to have?

A.Chondroblastoma
B.chondrosarcoma
C.Ewing’s sarcoma
D.giant cell tumour
-
E.osteosarcoma Source: First Aid for the USMLE Step 1 2018

32) A 6 year old girl complained of vague bone pain and muscle weakness. Radiological
examination showed irregular, broadened, cup-shaped epiphyseal growth plates at her
knees and wrists. Examination showed signs of generalised osteopenia.
Which of the following conditions is she most likely to have?

A.Fibrous dysplasia
B.Osteogenesis imperfecta
C.Osteomyelitis
D.Osteoporosis
-
E.Rickets

33) A 24 year old man developed chest pain approximately 2 weeks after a bout of severe sore
throat. Serology showed that the throat infection was caused by group A streptococcus. A
diagnosis of acute rheumatic fever was made.
Which of the following is a characteristic of this condition?

A.Large joint polyarthritis

B.Mycotic aneurysms
C.
-
D.Aschoff body in myocardium
E.Vegetation on heart valve

Source: First Aid for the USMLE Step 1 2018

34) A 60 year old man who had been smoking heavily for more than 40 years developed
chronic productive cough and wheezing. He has no loss of weight or haemoptysis. What is
the most likely diagnosis?

A.Adenocarcinoma
B.Bronchial Asthma
C.bronchiectasis
-
D.emphysema
E.lung abscess

35) A 60 year old woman was diagnosed with hypertension. She was prescribed with an
antihypertensive drug which can help relieve both her palpitation and (high BP?) Then she
develops noisy breathing & nocturnal cough. Which of the following drug has caused her
new problem?

A.Captopril
B.amlodipine
-
C.propanolol Non-selective beta blocker - inhibits b2 receptor causing bronchoconstriction
D.Hydrochlorothiazide
E.valsartan

36) Which of the following best describes the characteristic of SA node?

A.Its depolarization is due to movement of calcium ions out of cell
B.The SA node is located at the opening of the coronary sinus
C.Predominantly innervated by the sympathetic nervous system
D.The rate of the action potential increases with age
-E.Its drifting membrane potential is due to slow Na+ influx Funny current

37) What is the fraction of inspired O2?

-
A.21 21% of oxygen in atmospheric air, 16% of oxygen in exhaled air
B.24
C.28
D.26
E.32

38) Which of the following best describe infective endocarditis

A.Absence of vegetation in echocardiogram

B.
C.Treatment prolonged oral antibiotic
D.Formation of occluding thrombus? warrant for emergency surgery
E.Viridans stereptococcus is the commonest causative organism

Source: AMBOSS
 Source: Lecture - Pathophysiology of OSA

39) which of the following best describes cardiac imaging modalities in coronary artery
disease PSG = polysomnography

A.Cardiac MRI can be used in advanced renal impairment

-
B.CT coronary angiogram is used to exclude coronary artery disease
C.Coronary angiogram is used to evaluate the ejection fraction of the left ventricle
D.Echocardiogram is used to visualize coronary artery occlusion
E.Nuclear perfusion scan is used to visualize coronary artery

40) Which of the following patients fulfill the criteria for diagnosis of obstructive sleep apnea
syndrome?

A.Patient A presented with excessive daytime sleepiness with Polysomnography (PSG) for
apnoea /hypopnea index (AHI) of 10 per hour.
B.Patient B presented with loud snoring, a crowded oropharynx and PSG for AHI of 5 per
hour.
C.Patient C presented with several episodes of waking up at night due to choking with
PSG for AHI of 15 per hour.
D.Patient D with a BMI of 30kg/m2 with PSG for AHI of 20 per hour. No other sleep disorder
-
was reported.
E.Patient E presented with Down Syndrome and PSG for AHI of 10 per hour.

41) 60 year old woman presents with fever, cough and dyspnoea (i think). Respiratory rate of
28 breaths per minute body temperature 38°C. White blood count 16.5x10^9 (Normal = 4.5 -
11). Chest X ray shows consolidations of right middle and bilateral lower lobes. What is
the best choice of antimicrobials for this patient?

/
A.Amoxicillin
B.Coamoxiclav
C.Meropenem (i think)
D.Amoxicillin/clavulanate
E.tetracycline

42) A man hospitalised and given 2L/min nasal cannula. The oxygen saturation is 88% at room
air. What is the FiO2?

A.21%
B.24%
C.28%
-
D.32% Source: NIH
E.36%

43) A 65 y/o man is diagnosed with squamous cell carcinoma of the lung. He is a smoker of a
very long time. He worked in a factory manufacturing asbestos pipes in his thirties and
fourties. Both of his parents died of lung cancer. What is the most likely cause of his lung
cancer?

A.age
-
B.cigarette smoking

Source: National Antimicrobial Guidelines

 C.family history
D.gender
E. occupation

44) Which of the following is a MHC Class I molecule?

A.HLA-8
B. HLA-B
-
C. HLA-DP
D. HLA-DR
E. HLA-I-A

45) A 25 y/o woman came to the hospital with low grade fever, gingival bleeding and muscle
aches. She was suspected with dengue fever. Thus, a blood sample was taken. Which of
the test below would confirm the diagnosis

A. Blood culture
B. Dark field blood test
-
C.Dengue IgM
D.Giemsa stain
E.Gram positive acid bacilli

46) Male 65 y/o, visits GP, carbuncle formation. Symptoms include fever, redness & swelling.
What is the causative agent

A.Legionella
B.Morexella catarrhalis
-
C.Stapylococcus aureus
D.Streptococcus pneumoniae

47) Bangladeshi man, cough and low grade fever. Elevated ig E and high eosinophiles

A.Tropical pulmonary eosinophilia

B.Loeffler Syndrome

48) Haemophilia infection

A.IgG
B.IgA
C.IgE
D.IgM
E.IgD

49) 56yo male, diabetes, HPT, bronchial asthma w/ 5 days cough, dyspnoea, fever, went to
Arabia with friends, friends have same symptoms, RR 60 breaths per minute
BP 90/smtg

-
D.MERS Middle East Respiratory Syndrome
E.strep pneumoniae
50) A man came in with fever and back pain. Vertebrae compressed causing T12-L1 distance
short from lateral radiography. What investigation to do next

A.CT myelopathy
-
B.MRI
C.Oblique view radiography
D.Bone scan
E.CT on lumbar spine
Source: Lecture - Radiology of Vertebral Column
51) A 20 year old woman got into a car accident and had her knee amputated. 6 months later,
her parents observe she is withdrawn and demotivated to go to physiotherapy. She
expressed that she had no will to live.

A.Adjustment disorder
B.OCD
C.Panic disorder
-
D.Major depressive disorder
E.PTSD

52) A 69 years old woman complains of shooting pain at lower back and lower limbs. It is
worsen when prolonged standing and walking. She specifically highlights about pain at
the back of thigh with associated numbness.
What is the most likely diagnosis?

A.Degenerative disc disease

B.Disc herniation
C.Lumbar spondylosis
D.Non specific lumbar pain
E.Lumbosacral radiculopathy
-

53) Which of the following diagnosis will be ruled out if the patient presents with back pain at
rest?

A.herniated disc
B.spondylosis
C.spondylolisthesis
D.spondylitis
-
E.paravertebral muscles sprain

54) Pregnancy test hormone

A.Human chorionic gonadotrophin
B.
C.
D.
E.
 Source: CPG Management of MDD 2e
55) A guy who is stressed with exam, has low mood for 2 weeks and expressed suicide
ideation due to back pain. Physical examination and investigations results were normal.
What is the management?

-
A.Start anti-depressants
B.Start cognitive behavioural therapy

56) Patient A, a child was diagnosed with Tetralogy Of Fallot. Uppn chest xray, what would be
observed?

A.Box shaped heart

-
B.Boot shaped heart
C.Egg on string shape
D.Snowman appearance

57) State of complete physical, mental and social well-being and not merely the absence of
disease

A.Global health
B.Population health
-
C.Health
D.spiritual health
E.public health

58) Which one of these will be reduced by population based-salt reduction program.

A.Atrial fibrillation
B.Cerebrovascular disease
-
C.Congestive heart disease
D.Peripheral vascular disease
E.RHF / RHD

59) Which of these related to RSV infection?

-
A.80% cause bronchiolitis
B.Cause neonatal death (I rmb shud be common in neonate without death)- pretty sure
they didnt mention death
C.Virus that cause the most hospitalisation
D.Virus that has higher morbidity rate

60) Which is the host factor that influence the development of bronchial asthma?

A.Air pollution
B.Chemical fumes
-C.genetic
D.house dust mite
E.tobacco smoke
61) What is the best definition of occupational hazards and safety risks?

A.Checklist of safety rules & routine

-
B.Dangers in the workplace

62) A surgeon is undergoing an operation on colon cancer. Upon opening the abdomen, he
realized that the cancer has spread further. It is beyond his experience to undergo the
surgery.
What is the next appropriate action?

A.Call the Head of Department to ask for advice during the surgery
B.Call another doctor that he thinks is qualified for the surgery
C.Close up the abdomen and refer the patient for radiotherapy
D.Close up the abdomen and reschedule the operation another time with another doctor
E.Continue the operation and do as best as he can
EMQ

A.cornea
B.lens
C.optic nerve
D.oculomotor
E.
F.optic nerve Source: First Aid for the USMLE Step 1 2018

63.Nerve that sends visual impulse from the eye to the brain C

64.What is removed in cataract surgery? B

A.common fibular
B. femoral
C.obturator
D.saphenous
E.sciatic
F.superior gluteal
G.sural
H.tibial

65.Damage of which nerve affect the function of plantar flex ion of leg H

66.Compression of this nerve leads to paresthesia in the posterolateral aspect of the leg and heel. G

A.Aryepiglottic fold
B.false vocal fold
C.Piriform recess
D.Rima glotiddis
E.vestibule
F.
G.true vocal chord

67.This space is called the smugglers fossa where diamonds are hidden. C

68.The shape of this structure is influenced by intrinsic muscles of larynx D

A.Ataxia telangiectasia & Rad3 related (ATR)

B.Ataxia telangiectasia mutated (ATM)
C.cdc25 phosphatase
D.CDK
E.P21
F.P53
G.Rb
69.This protein mediate sresponse to single stranded DNA breaks and mutation in this gene cause
GI and endometrial tumor B

70.This family group of protein that regulates cell cycle progression D

A.P wave
B.Q wave
C.T wave
D.QRS complex
E.PR interval
F.QT interval
G.PR segment
H.ST segment

71.ECG appearance in AV nodal delay E Longer PR interval

72.ECG in someone with thick left ventricular wall D Taller QRS complex

A.B1 Adrenergic receptor at SA

B.B1 Adrenergic receptor at AV
C.B1 Adrenergic receptor at ventricular muscle
D.B2 Adrenergic receptor at SA
E.B2 Adrenergic receptor at AV
F.B2 Adrenergic receptor at ventricular muscle
G.M2 muscarinic receptor at SA
H.M2 muscarinic receptor at AV
Source: Lecture - Cardiac Muscle
73.A full marathon runner has a heart rate of 120 beats per minute. A

74.A women recovers from myocardial infraction but her normal pacemaker is damaged. Now her
normal heart beat is 40 beats per minutes. Under stress, her heartbeat increased to 60 beats per
minute. B

A.Cerebralspinal fluid
B.Extracellular
C.Interstitial
D.Intracellular
E.Lymph
F.plasma
G.Total body fluid
H.Whole blood

75.A 70kg healthy man, the body fluid accounts approximately 5% of the total body weight. F

76.Fluids in this compartment has lower concentration of Na but higher concentration of K D

 A.Beclamethasone
B.Ipratropium Bromide
C.Omalizumab
D.Salbutamol
E.Sodium Cromoglycate
F.Theophylline
G.Zafirlukast
H.Mepolizumab
Source: Lecture - Drugs Used in Bronchial Asthma

77.A patient with frequent asthma exacerbation was given salbutamol. What other drugs should
be given to this patient? B

78.A 23 year old women who has intermittent asthma because she was experiencing tachycardia
after taking her prescribed anti-asthma medication. The doctor informed her that tachycardia is
one of the common side effects of this medicine. D

A.asystole
B.Idiopathic
C.dilated
D.Hypertrophic
E.infective
F.Restrictive
G.Histiocytoid
H.Takotsubo
Source: First Aid for the USMLE Step 1 2018
79.This is the commonest type of cardiomyopathy, affecting the atria and ventricles as well. C

80.Right ventricular endomyocardial biopsy done shows pink Congo fibres penetrating through
the myocardium (Name the type of cardiomyopathy) F Amyloidosis is one of the causes of restrictive CM.

A.beclamethasone
B.Ipratropium bromide
C.Omalizumab
D.(another monoclonal antibody)
E.Salbutamol
F.Sodium cromoglycate
G.theophylline
H.zafirlukast

81.Patient comes in with a chief complain acute asthma exacerbation. She has been prescribed a
drug in addition to beta-2 agonist after admission. Thsi drug is able to relieve bronchospasm.

82.Asthmatic patient prescribed with a drug that causes tachycardia. What is the drug?
 A.mixed respiratory and metabolic acidosis
B.respiratory acidosis
C.respiratory alkolosis
D.metabolic acidosis
E.metabolic alkalosis
F.compensated respiratory acidosis
G.compensated respiratory alkalosis

83.Guy came in for high pH and low C02, bicab normal C

Renal/metabolic problem Acidosis Answer option should have
84.chronic kidney failure, low O2, low CO2, bicab low, pH normal Compensated compensated metabolic acidosis
Respiratory compensation
A.Angiography
B.CXR of lateral cervical
C.CXR of lateral skull
D.CT Angiography
E.MRI T1W
F.MRI T2W
G.Ultrasound of cranium Source: Lecture - Imaging of the MSK System
H.CT brain blabla

85.A man was involved in an accident and was suspected to have intracranial hemorrhage. What
is the best modality to confirm the diagnosis in such emergency situation? H

86.Patient already did CT scan and was suspected to have infarct in the brain. What is the best
modality to locate the area of infarct?i F

A.Ignore request and report to legal department

B.Not give the report but apologize for complication
C.Provide the report and personal opinion that the complication is justified
D.Provide the medical report of surgery and treatment
E.Withhold report because head of department told to do so

87.50 year old woman experienced urine leak from the vagina 7 days after hysterectomy. A
diagnosis of urinary fistula, a known hysterectomy complication was made. She asked for medical
report for her treatment. The doctor suspected potential litigation. What is the most appropriate
action the doctor should take? D

A.
B.conjunctiva
C.cornea
D.lens
E.
F.optic nerve

88.This nerve sends visual impulse from the eye to the brain.

89.What is removed in cataract surgery

 A.femoral
B.sciatic
C.obturator
D.saphenous
E.sural
F.tibial
G.common peroneal nerve

90.Cannot plantarflex

91.compression of this nerve will cause parasthesia on the posteriolateral leg and foot