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IBE II: MCQ Prepared Based on Memory


Prepared by: (4th Batch)
-Pankaj Kumar Sah
-Sunil Kumar Daha.

CHS

1. paramerers used for calculation of Pearson’s coefficient of skewness.


Ans: Mean, Median and Standard deviation

2. What is the mean of Z-score?


Ans: Zero

3. What is the standard deviation of Z- score?


Ans: One

4.Birth death and migration are recorded at VDC and municipality offices by authority.
What type of data collection method is this? ans: vital registration

5. What is its sequence of earth atmosphere?


Ans: Troposphere, Stratosphere, Mesosphere, Thermosphere and Exosphere

6. Ozone has dual characteristics. It is polluter as well as protector in terms its effect on human
health. What is recommended for better health prospective?
Ans: high concentration of Ozone in Stratosphere and low concentration in troposphere.

7. Stratosphere is interfaced with two different atmospheric layers.

What are these layers?


Ans- Troposphere and Mesosphere

8. There is increasing trend in every cleaner in more efficient and convenient fuel for cooking
results in low emission of air pollutant.

Which sequence based of increasing quality of fuel are true in this case?
Ans: Dung, wood, Kerosene, LPG

9. Some students have been asked to give health education about Diabetes. One of the
methods of health education is giving information.

Which method of teaching should be approached?

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Ans: Formal Teaching

10. Communication has various steps. One type promotes sharing of information, encourage
dialogues among people to make them decisions.

What type of communication is this?


Ans: Interpersonal

11. A 27 year old lady just told you about her first child and has come to you for delivery
counseling.

How much extra calorie does she require during lactation?


Ans: 550 Calories.

12. A two year old male child presented to pediatrics OPD diagnosed with moderate stunting.

What is his height for age Z-score?


Ans: Between -2 and -3

13. A 3 year old child has been diagnosed with Xeropthalmia with Bitot’s Spot.

Which stage his illness has been classified based on WHO classification?
Ans: X 1B

14. Prevention of Iodine Deficiency disorder requires salt fortification with iodine at household
level.

What is the amount of iodine used for fortification at household level?


Ans: 15 parts per million

15. There is prevalence of nutritional status of under 5 children in Nepal is given below:

Underweight>stunting>Wasting
What are the variables used?
Ans: Age, sex, Height, weight

16. A researcher is planning to conduct nutritional assessment of under-five children in the


common child balance available in the market. Therefore, she planned to test three available
balances. So, known weight of four year child and recorded following results:
What the researcher want to know from this test?
Ans: Precision

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17. You are planning to establish nutritional monitoring program for women of reproductive
age. You found female FCHV with digital weighting scale and height good for this.

Which measurement is recommended?


Ans- BMI

18. Sita is first trimester pregnant living in the outskirt of Mugu district. She doesn’t smoke nor
consume alcohol. She does her household work. Her BMI is 22 (normal) and Hb is 13 gm/dl
(normal).

Which information should puts her in the high risk of pregnancy?


Ans: Current place of living

19. At the village level discussion, many people mentioned about that the instrumental
component is necessary for the doctor.

What is the instrumental component?


Ans: Performing diagnostic test

20. A patient with acute trauma brought to hospital. Doctor took position of authority in
relation to patient treatment.

Which model does it represent?


Ans: Active- Passive model

21. In patan hospital, you found the doctor-patient relationship was similar to parent –
adolescent relationship.

Which model does it represent?


Ans: Guidance-Co-operation model

22. In case of endogamy, there is a greater chance of high incidence of inherited disease.
What is the main cause of such disease?
Ans: Marriage Pattern

23. Yesterday, you noticed that some specific group of people suffered from tapeworm
manifestation.
What is the most likely cause of such finding?
Ans: Dietary pattern

24. Public issue affecting the society as a whole or the part of the society and is beyond the
control of the people.

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What is it?
Ans: Social Problem

25. Material culture changes more rapidly than the non-material in industrial society through
evolvement in the science and technology. This results in the disruption of integrity and
equilibrium of these two cultures.

Which term is used for such situation?


Ans: Cultural Lag

26. A 45 year old female complained of very painful periods. Periods are regular and last for 5
days with normal amount of blood.

What is the clinical term for her problem?


Ans: Dysmenorrhea

27. term used for increased frequency of urination aong with inceased volume?
Ans: Polyuria

28. A 36 year old man complained of pain starting from right side of his back which then moves
around to the front towards his right groin. The pain is severe and colicky, comes and goes.

What is the pain likely to have come from?


Ans: Ureter

29. A middle aged man comes to the OPD with complaint of excessive thirst for last few weeks.

Which next relevant information should be useful for while taking his history?
Ans: Polyuria

30. A 34 year male came with complaint of head nodding movement the movement was
involuntary and could be stopped voluntarily?

What is the movement know as?


Ans: Tics

31. A 72 year man came with complaint of inability to move his right upper and lower limb. He
is known to have hypertensive.

Which of the following is important question for history of diagnosis?


Ans: Duration of weakness

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32. A 30 year male was brought to the emergency department following road traffic accident.
Both of his lower limbs were severely crushed. The patient looked pale and his blood pressure
was 80/40mmHg.

What is the site to access pallor in this patient?


Ans: Nail

33. A competent patient makes an informed voluntarily decision to deny treatment. And the
doctor disagrees with this decision and wants to give treatment.

If he is not given treatment, what ethical principal the doctor following?


Ans: Respecting Patient right to informed refusal

34. A 13 year old boy presented with the history of fever and rash. The doctor suspected the
rash may be Patechia?

What clinical finding will further suggest this?


Ans: Non-Blanching with Pressure

Anatomy
35. The male and female gamete is normally fused together in the uterine tube.

Where in that tube usually fusion takes place?


Ans: Ampulla of uterine tube

36. At the end of first week of of development, blastocyst emplant into the endometrium.

Which structure disappears at this stage?


Ans: Zona Pellucida

37. About 6 days after fertilization, the outer cell mass starts to proliferate rapidly and gradually
differentiate into two layers.

What is this mass referred as?


Ans: Trophoblast

38. Amniotic sac and yolk sac are analogous to two balloons present together and suspended
by a cord inside large balloon, the chorionic sac.

What is that cord referred biologically?


Ans: Connecting stalk

39. After fertilization, zygote undergoes series of mitotic division known as cleavage in which
the cell size become smaller with each division.

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What is that cell referred as?


Ans: Blastomeres

40. During development, the primary yolk sac is gradually replaced with secondary yolk sac as
the additional sac migrates along the inside of the exo-coelemic membrane.

Which structure contributes to those cells?


Ans: Hypoblast

41. At the beginning of each ovarian cycle, 15-20 pre-antral follicles are stimulated to grow
under influence of FSH and only one follicle mature, rest are degenerated and replaced by
connective tissue.

What is the connective tissue referred as?


Ans: Corpus Atrecium

42. Gut-associated lymphoid tissue (GALT) makes aggregation of lymphoid tissue in the GI-
Tract?

What are those aggregations at the entrance of oro-pharynx called?


Ans: Tonsil

Biochemistry
43. A woman is referred to the genetics clinic to discuss the fetal abnormality seen in
ultrasound examination at 21 week of pregnancy. The fetal medical specialist advises testing to
determine whether the fetus has chromosomal abnormality.

What is the most appropriate pre-natal test in this case?


Ans: Cordocentesis

44. Eukaryotic and prokaryotic genes have shared regulatory sequence in which RNA
polymerase binds prior to the initiation of transcription.
What is this regulatory sequence known as?
Ans: Promoter

45. Initial RNA transcript undergoes transcription, modification of 5’- capping intron splicing
and 3’polyurinylation for the final transcript that ultimately gets converted to the form that is
translated.

What is this initial RNA known as?


Ans: Heterogonous nuclear RNA

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46. Certain plasma membrane receptors activates signaling pathway usually by forming
molecular demurs that result in protein phosphorylation reaction upon binding of the specific
ligand.
What are these receptors?
Ans: Tyrosine-Kinase receptors

47. Initial signaling splitting of Phospho-Inositol Phosphate (PIP2) into two molecules of Inosityl
Phosphate (IP3) and diacyl glycerol is catalyzed by an enzyme?

What is this enzyme?


Ans: Phospholipase C

48. A child stungged by a bee experience respiratory distress within a minute becomes
unconscious.

What is the most likely antibody for this reaction?


Ans: IGE

49. The main enzymatic activity of DNA polymerase is that 5’-3’ synthetic activity. However it
also has 3’-5’ exonuclease activity.

What is the major role of exonuclease activity?


Ans: Removing mismatched nucleotides

50. BRCA 1 inherited as an autosomal dominant disease but not all women that inherited
mutated copy of BRCA1 gene develop breast cancer.

What is the phenomenon responsible for this relationship between genotype and phenotype?
Ans: Incomplete penetrance

51. Protein phosphorylated by the G1-CDK complex promotes expression of genes important
for initiation of S-Phase.

What is this protein?


Ans: Retinoblastoma protein

52. A 16 years old boy brought to Patan Hospital complaining of symptom, that you believe was
associated with genetic disease. Thorough family history reveals that the patient father has the
similar disease and similar disease has occurred in every generation in both man and women.

What is the most likely mode of inheritance in this genetic disease?


Ans: Autosomal dominant

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53. A 7 month old child with failure to is found to have Hb of 4.4gm/dl. The peripheral smear
shows microCYTIC and hypoCHROMIC red cells. It is determined that child has very low level of
Hb A with elevated fraction of Hb A2 and Hb F.

What is the most likely causes for this condition?


Ans: B-Thallesemia

54. A 19 year old boy comes to OPD with the complaint of dark brown urine when he wakes up
to use bathroom at night. He is diagnosed to have defective red blood cell membrane making
erythrocytes unusually sensitive to serum complement.

Which component in his RBC membrane is defective?


Ans: Glycosyl Phosphatidylinositol anchor

55. The major metabolic product produced under normal circumstances by erythrocytes is
rebuilt through liver in the Cori’s Cycle.

What is that metabolic product?


Ans: lactate

56. Acute intermittent porphyria (AIP) is the major autosomal dominant acute hepatic
porphyria. This disease is caused by deficiency in porphobilinogen deaminase and enzyme of
heme synthesis.

Which bio-molecule is expected to be excreted in excess amount in the patient?


Ans: delta-aminolevulinic acid (delta ALA)

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57. In the emergency department, a new intern has accidently administered blood group A to
blood group O patient. The complement circulating in the patient’s blood immediately react
against antigen expressing to the donor’s red blood cell.

Which antibody initiates the complement cascade against donor red blood cell?
Ans: IgM

58. Rhino virus strain B has infected the nasal epithelium in the host that previously was
infected Rhino virus strain A.

What type of lymphocytes would predominat this acute anti-Rhino Virus immune response?
Ans: Effector and specific for Rhinovirus strain B

59. A sandfly has infected a 25 year old man with parasite Leishmania major. Neutrophils in the
skin are the first to arrive and they recently engulf the parasite, however the parasite manages
to persist in chronic infection.

How did the parasite invade the immune system in this case?
Ans: inhibits phagolysosome formation.

60. A 30 year old man comes to patan hospital with upper respiratory viral infection.

What type of cell of adaptive immune system is most likely fighting this infection?
Ans: CD8 cytotoxic T-cell

61. CD4 regulatory T-cell does not respond aggressively to antigen because they lack expression
of an important signaling molecule for lymphocyte activation.

What is this signaling molecule?


Ans: CD28

62. AIDS caused by Human Immune Virus (HIV) is the result of virus targeting a particular
immune cell infection and subsequent lesion.

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What molecule of surface of particular immune cell is required for this infection?
Ans: CD4 T-cell

63. A 34 years old man visited emergency with fever more than 40 degree centigrade and rapid
onset of liver failure, acute renal failure and circulatory collapse. The dark field microscopy of
his blood showed actively motile spirochete.

What is the appropriate culture media for the pathogen?


Ans: EMJH media (organism is leptospirosis)

64. Small gram-negative coccobacilli were isolated from the blood sample of a person suffering
from undifferentiated fever. A biochemical analysis suggested the organism to be Brucella.
Phage typing by …….reference phase showed lysis only at 10.000 rtd.

Which species of Brucella was isolated?


Ans: Brucella Suis

65. A 15 years old boy from Jhapa presented with prolonged fever, weight loss,
hepatosplenomegaly, pancytopenia and hypergammaglobenemia. The clinician realizes this as
basic feature of visceral Leishmaniasis. Immediate bone marrow biopsy was done and sent for
culture in NNN media.

At what temperature did the microbiologist incubate the mentioned media?


Ans: 22-26 degree centigrade

66. Dengue has been increased worldwide and ranks as one of the important vector borne
disease. Although, isolation can be done in 1st week of illness Serology is the main stable
diagnosis.

Which antigen is used for serology diagnosis of this pathogen?


Ans: NS1

67. Mary Maloon a New York cook caused 7 outbreaks of Salmonella affecting 200 people over
the period of 15 years. She was best known as Typhoid Mary as being carrier for such a long
time.

Which test is done to diagnose the state?


Ans: Bile Culture

68. 14 year old boy from Saptari visited Patan hospital with complaints fever, chills, headache
and bone pain. IGM capture ELISA showed presence of specific antibody against specific Flavi
virus antigen?

What is the vector for this disease?

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Ans: Ades Ageptii

69. A 42 years old hicker presented to OPD with sudden onset of chills, fever, headache and
maculo-papular rash. Attending physician suspects him to be suffering from typhus fever. When
his blood was intraperitoneally inoculated into many guinea pigs negative Neil-Mooser test was
seen.

Which pathogen is responsible for hicker’s condition?


Ans: Rickettsia prowazeki

70. A 35 year old man came to OPD with the swollen area of about 3 cm in his limb. On history
taking, he revealed that swelling appear and disappear in different area of his body. The doctor
suspected to be ‘calabar swelling’.

Which worm is responsible for this disease?


Ans: Loa Loa

71. 55 years old man was brought to the OPD with features of meningitis. On inquiry, he had
been diagnosed HIV positive 3 years ago. His CSF was sent for Indian ink preparation which
showed encapsulated yeast like cells.

Which organism is it likely to be?


Ans: Cryptococcus neoformans

72. A patient has blood stream infection which is determined to be caused by Staphylococcous
Aureus. The patient is experiencing rash, low blood pressure and fever with the sign of systemic
inflammatory response.

What is the most likely cause of the inflammatory response?


Ans: Non-specific activation of helper T-cell act by super antigen

Pathology

73. Septic shock results from spread and expansion of initially localized infection into blood. It is
mostly due to the release of endotoxin by gram -ve bacilli.

Which endotoxin present in the bacteria causes septic shock?


Ans: Lipopolysaccharide

74. A patient of bile stone underwent open cholecystectomy operation. During post-operative
phase, the patient developed thrombus in deep vein of leg.

What could have contributed the thrombus formation in this patient?


Ans: endothelial injury, stasis, hypercoagulability

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75. A man of 62 year old presents with the symptoms of hypercorticism. Finally lung cancer is
diagnosed.

Which type of cancer is this most likely to be?


Ans: Small Cell Carcinoma

76. A colonoscopy of 34 years old male shows a large polypoidal mass in the case. The biopsy of
this mass shows irregular glandular which is crowded and limited by tall columnar cells having
markedly nuclear hyperchromatism.

Which gene alteration is most likely to have?


Ans: Inherited mutant APC gene

77. A positive tuberculin skin test with a 15 mm diameter dark red fine area of integration on
the forearm appears 60 hour following injection of purified protein derivative (PPD).

Which type of hypersensitivity reaction is this?


Ans: hypersensitivity type III

78. A 25 year old lady presented with malar rash in her cheeks(skin). Her blood test was positive
for double stranded DNA anti-ds dna. She was diagnosed with systemic Lupus Erythematous.

Which immune mechanism is responsible for this condition?


Ans: Deposition of Ag-Ab complex (TyPE III)

79. During a routine health maintenance examination of a 40 years old man stool occult blood
test result was positive. A follow up sigmoidoscopy showed L 1.5 cm circumscribed
pedunculated mass on a short stalk located in the upper rectum.

What term best describes this lesion?


Ans: Adenoma

80. A 39 year old woman underwent a routine health examination for the first time. A pap
smear was obtained and the result reported was high grade squamous intraepithelial lesion.

Which lesion is expected on biopsy of her cervix?


Ans: Carcinoma In-situ

81. A 25 years old male came in OPD with petechial rashes in the body and gum bleeding. He
has been diagnosed with idiopathic thrombocytopenia purpura.

Which feature is specifically seen in bone marrow aspiration?


Ans: MegakaryoCYTIC hyperplasia

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82. A 40 years old man with the gastrostomy brought to hospital with fever and gum bleeding.
The investigation revealed Hb 8gm/dl, WBC 3,000 per cu mm and platelets 40,000. Peripheral
blood smear shows macrocyte and hypersegmented neutrophils.

Which condition is he likely to be suffering from?


Ans: Megaloblastic Anemia

83. A young boy complaining of tiredness and shortness of breathing is diagnosed with anemia.
On examination, splenomegaly is present. His peripheral blood smear shows spherocytes.

What is the responsible mechanism behind this condition?


Ans: Mutation in Ankyrin or spectrin

84. Survivor of the Hirosima blast presented to hospital with pallor and gum bleeding. His
investigations revealed pancytopenia, reduced reticulocyte count and normoCYTIC
normoCHROMIC red cell morphology.

What finding do you expect in his bone marrow aspirate?


Ans: Hyper/hypo cellular marrow

85. A 60 years old female with hematuria presented with lassitude and dyspnea on exertion. In
investigation, hemoglobin is 7 gm/dl with normal WBC and platelet count increased. Peripheral
blood smear shows anisopoikilocytosis with microCYTIC hypoCHROMIC RBC. Bone marrow
aspiration was also performed.

Which stain would you use to evaluate the deficient nutrient in the bone marrow aspirate?
Ans: Prussian blue stain

86. A 33 year old woman has experienced low grade fever with night sweats and generalized
malaise for two weeks. On examination, she has non-tender cervical and supraclavicular
lymphadinopathy. On microscopic examination of cervical lymph node biopsy RS cells and had
small lymphocytes and band of fibrosis was noted.
What is most probable diagnosis?
Ans. Hodkings lymphoma

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Pharmacology
87. A 10 year old girl with pharyngitis caused by Group A beta Streptococcus is given
intramuscularly penicillin. Approximately 5 minutes later she is found to be in respiratory
distress and audible wheezing. Her skin is cold. Which type of hypersensitivity reaction is this?
ans: type 1

88. During surgery, a surgeon encounterd a pocket of green pus. On laboratory investigation,
there is presence of pseudomonas species.

Which cephalosporin is indicated in this case?


Ans: cefoperazone

89. A patient receives neostigmine to relieve post-operative paralytic ilius.

Which is the enzyme affected by the drug?


Ans: Acetylcholine esterase

90. A 22 year old male working in the poultry form presented with cough, dyspnea, headache
and gastro-intestinal complaint. He was diagnosed to be infected with H5N1 strain of virus and
was treated with an antiviral drug.

Which drug was he given?


Ans: Oceltamavir

91. A 40 years old lady was given cotrimoxazole for the treatment of UTI; one of the
constituents of this combination drug is sulphamethoxazole.

Which property gives antimicrobial property to this component?


Ans. Interaction with P-amino-benzoic acid

92. A 42 year old female was prescribed vincristine for the treatment Wilm’s tumor.

What is the mechanism of action of drug?


Ans: Prevent the polymerization of tubulin

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93. A patient was being treated for Staphylococcus aureus infection. On sensitivity test he had
methicillin resistant Staphylococcus aureus.

What is the drug of choice to treat the infection?


Ans: Vancomycin

94. A 34 year old patient is diagnosed with typhoid fever and was treated with ofloxacin.

How does this drug act?


Ans: Inhibition of bacterial DNA gyrase

95. A 58 years old asthmatic patient was diagnosed with hypertension and was prescribed with
an antihypertensive drug which blocks the beta receptors.

Which beta blocker is contraindicated in this case?


Ans: Propanolol

96. A 26 year pregnant old lady is diagnosed with cerebral malaria.

Which is the most appropriate important anti-malarial drug to treat this condition?
Ans: Artemisinin

97. 56 years old patient was administered heparin along with the directly acting plasminogen
activated for pulmonary embolism.

What drug was most likely to be administered along with heparin?


Ans: Alteplase

98. A 65 year old male was prescribed clopidogrel for prophylaxis after the episode of
myocardial infarction.

How does this drug act?


Ans: P2Y12 receptor antagonism

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99. 25 years woman was diagnosed with iron deficiency anemia and was prescribed iron
tablets. After 2 days she came with complaint of severe vomiting so doctor gave her iron by I.V.
route.

Which form of iron is appropriate in this case?


Ans. Iron Dextran

100. A 55 year old man was diagnosed to have anemia with chronic kidney disease.

Which drug is the most appropriate to treat his anemia?


Ans: Erythropoetin

Physiology

101. An action potential once generated traveled from soma of the axon to its terminal end
then depolarizes it.

Which channel pump does it open?


Ans: voltage gated Ca++ channel

102. The preganglionic fiber of the sympathetic nervous is originated in the spinal cord and they
pass into the sympathetic chain.

Where on spinal cord do these fibers originate?


Ans: Inter-mediolateral horn of the thoracolumbar region

103. 25 years old man exercise in gymnasium for 30 min. At the end of the exercise his heart
rate, respiratory rate and B.P. are increased. However blood flow to the GI tract is decreased.

Which autonomic function causes the above changes?


Ans: increase in sympathetic function

104. Repeated stimulation of pre-synaptic neuron leads to gradual decrease and finally,
disappearance of post synaptic response. This is one of the most important properties of
synapse which occurs due to inactivation of Ca++ channels.

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What is this property called?


Ans: Fatigue

105. A man was admitted to the hospital with Myocardial infarction and was treated with
Streptokinase that converts plasminogen to plasmin. After few hours of this treatment his
condition improved.

How did the plasmin help him?


Ans: increases coronary artery blood flow by lysis of clot

106. Rh-ve mother gives birth to Rh+ve baby at her first pregnancy. There is a risk of
erythroblastosis fetalis at her second pregnancy after child becomes Rh+ve.

How is this most effectively prevented?


Ans: Passive immunization of the mother against Rh+ve soon after her first child birth

107. A man came with the complaint of easy bruise, gum bleeding and epistasis. On
examination he was diagnosed with a rare autosomal recessive disorder of coagulation factor
deficiency, which is required to convert fibrinogen to fibrin.

Which coagulation factor is this?


Ans: Factor II

108. During the coagulation process, platelets secrete many chemical agents that have role in
the coagulation cascade. Beside these agents, the platelets phospholipid also contributes
without which the cascade doesn’t occur.

What is the main role of phospholipid in blood coagulation cascade?


Ans: Provides a surface for coagulation cascade

109. A 10 year old boy was brought to hospital with the complaint of stomach ache and loss of
appetite on examination of his stool. Fertilized eggs of Ascaris lumbricoides were seen. Which
leukocyte increases in blood in this case?

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Ans: Eosinophil

110. A 10 year old boy was brought to the hospital with the complaint of prolonged bleeding
after dental extraction On examination, he had increased bleeding time and normal clotting
time.

Which factor is deficient in this boy?


Ans: Von-willibrand factor

Best of luck for your Exam……….

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