4th MAY Morning 2017

SURGERY
1.Rapidly adapting receptor
a) pacinian
b) ruffini
c) messiner
d) merkel

2. Hypertensive and chronic renal failure, what is unlikely

a) Anemia
b) Hypophosphatemia
c) Hyperkalemia
d) Hypocalcemia

3. A patient came with complain of severe vomiting with following labs PH=7.33 (7.34-7.44)
PCO2 35mmhg (35-40) HCO3 22 (normal 23-26) whats the interpretation.
a) Metabolic acidosis respiratory alkalosis
b) Respiratory alkalosis, partially compensated.
c) Respiratory acidosis with metabolic alkalosis

4. Pulsating mass in abdomen of an 80-year-old lady. Most common location?

a) T12-L2
b) T9-T11
c) L2-L5
d) S2-S4

5. 2 year old child, born premature. Most common cardiac defect?

a) Foramen ovale failure to close
b) PDA
c) Failure of obliteration of umbilical artery

6. Ligamentum arteriosus mass. Which structure will be damaged?

a) Left recurrent laryngeal nerve

7. What causes constipation?

a) Colchicin
b) Diamorphine
c) Ampicillin

8. Aspirin contraindicated in?

a) Peptic ulcer

9. Alfa fetoprotein
a) Hepatocellular carcinoma
10. lichen planus rate of conversion to cancer
a) 10-15%
b) 1-10%
c) 15-20%
d) 20-25%

10. Most common pre-malignant in oral cavity?

a) Lichen planus
b) Leukoplakia
c) Erythroplakia

11. A 25 year old male has developed cluster of vesicles on lateral side of lips. The causative
organism resides in?
A) Trigeminal Gnaglion
B) Pterygoid gangion
C) Otic ganglion

12. A child of presented with complain of per-rectal bleeding, on examination there is rectal
prolapse, causative organism?
a) Trichurids trichura

13) A child with history of eating mud. He also complains of worms of 6cm coming out.
a) Ascaris Lumbricoid
B) Enterobius wormiculis
c) Tenia Solium
d) Tania Saginita

14. Response of posterior hypothalamus in temperature regulation of body?

a) Peripheral vasodilation
b) Shivering
c) sweating

15. Relation of internal jugular with carotid artery in Neck

a) Post
b) Medial
c) Lateral

16. Retromandibular joins which vein to form external jugular?

a) Posterior auricular
a) Facial
17. Sympathetic fibers in?
a) Each spinal nerve
b) Thoracic spinal nerve
c) Lumbar spinal nerve
d) Cervical spinal nerve
e) Sacral spinal nerves

18. Surgical neck of humerus fractured. Which artery is damaged?

a) Axillary
b) Posterior Humeral
c) Brachial

19. Pterygopalatine raphe provide attachment to?

a) Buccinator
b) Superior constrictor
c) Middle constrictor

20. 78-year-old male presented with burning micturition, urgency, dysuria and back pain. There
is also history of left upper limb pain and fracture of long bone. On labs there is increase
alkaline phosphatase. Most appropriate investigation.
a) Serum PSA
b) Serum Calcium
c) PTH level

21. Blood supply of skin of scrotum.

a) External pudendal artery
b) Testicular artery
c) Inferior epigastric artery
d) Inferior vesicle artery

22. Supra renal gland

A. On each side of IVC
B. Right supra renal gland lying in tendinous ligament
C. Right suprarenal gland lie in central tendon of diaphragm
d) Left suprarenal gland lie in central tendon of diaphragm

23. Water intoxication?

a) slow pulse

24. Infection in pretracheal fascia goes to?

a) Anterior mediastinum

25. Micturition reflex?

a) is integrated sacral spinal segment
b) once initiated its self-regenerating
26. Nerve supply of rectus abdominis?
a) last five intercostal and subcostal nerve
b) subcostal only
c) last five intercostal, subcostal, ilioinguinal and illiohypogastric
d) last five intercostal, subcostal and ilioinguinal only

27. Heparin needs which anticoagulant factor to be present for its action?
a) Antithrombin III
b) Factor XII
c) Inhibitor antithrombin III

28. Mast cells release which anticoagulant substance?

a) Heparin
b) Histamine
c) Bradykinin

29. Which nerve lies in the cavity of cavernous sinus?

a) Abducent

30. Vit K dependent factor?

a) Prothrombin
b) Stable factor
c) Stuart Factor

31. Richest source of Vit K?

a) tubers
b) cereals
c) green vegetables
d) pulses

32. A person has difficulty in vision at night, this due to deficiency of?
a) Retinol
b) Retinoic Acid
c) Retinal

33. A patient with acute pancreatitis, drug appropriate for pain relief?
a) pethidine
b) diamorphine
c) morphine

34. After infusion of propofol, the hypotension occurs due to?

a) its direct effect on vasomotor center
b) It causes peripheral vasodilation
c) its direct effect on metabolites
35. 3 year old boy with flank pain, on ultrasound there is hydronephros of left kidney. What is
the most likely cause of unilateral hyderonephrosis?
a) atony of bladder
b) external urethral meatus stenosis
c) constriction of posterior urethral valves
d) constriction at pelviuretic junction

36. Anterior inferior iliac spine fracture, pelvic avulsion is done by which muscle?
a) rectus femoris
b) Sartorius
c) quadriceps
d) hamstrings
e) obturator internus

37. In dehydration with ADH effect, which part of nephron will be hypotonic fluid
a) PCT
b) DCT
c) Collecting duct
d) Ascending loop
e) Descending loop

38. In Tabes Dorsalis?

a) there damage to posterior column
b) there is atony of bladder
c) is due to loss of parasympathetic efferent nerve

39. A pathologist done a study on risk factors of congenital urinary defect. Which of following
is associated with increased risk of urothelium origin carcinoma?
a) Extrophy of Urinary bladder
b) Duplication of ureter
c) Medullary spong kidney
d) unilateral renal agenesis
e) Horse-shoe shape kidney

40. A patient has swelling of parotid gland and posterior auricular pain which is increased by
mastication is due to the involvement of which nerve?
a) auriculotempral nerve

41. Trachea is supplied by which nerve?

a) recurrent laryngeal nerve
b) glossopharyngeal nerve
c) intercostal nerve
42. There is a patient with jugulodiagastric lymph node enlargement it is due the
a) palatine tonsils
b) pharyngeal tonsil
c) parotid
d) mandibular
e) Sublingual

43. Growth on ductus arteriosis, which structure compresses

a) left recurrent laryngeal nerve
b) right recurrent
c) right phrenic
d) left phrenic

44. Musculophrenic artery branch of?

a) internal thoracic
b) pericardiophrenic

45. Branch of lateral cord of brachial plexus?

a) Musculocutaneous
b) Long thoracic
c)Thoracodorsal

46. During supra pubic catheterization a transverse incision is given. What is most likely to be
damaged here?
a) inferior epigastric artery
b) superior epigastric artery
c) deep circumflex artery

47. Epicardium is supplied by?

a) Pericardiophrenic artery

48.Dorsiflexion is done by which muscle?

a) Tibialis anterior
b) Peroneous longus

49. The flexor sheath in flexor retinaculum contains?

a) Flexor pollicis brevis
b) Flexor pollicis longus
c) Extensor pollicis longus

50.Brodies abscess cause ?

a) pyogenic osteomyelitis

51. Papillary cancer in female patient is due to?

a) she had received radiation
b) exposure to arsenic
52. Body of hyoid bon lies at which level in erect position?
a) C3
b) C4
c) C6

53. Ureter at pelvic brim damage during ligation of which vessel?

a) iliolumbar vein
b) superior gluteal artery
c) ovarian artery

54. Thorn prick abscess causative organism?

a) staph aureus

55. A child with swollen, tender hot joint, movement at joints are limited, joint aspiration is
done, it will yield which organism?
a) staph aureus

56. Infection in pretracheal fascia goes to

a) ant mediastinum

57.Tabes Dorsalis in incontinence

a) affect posterior column

58. Cohort study?

59. Actinomyces

60. preterminal bronchiole

61. Derivative of 2nd pharyngeal arch

a) stylohoid ligamnt

62. Largest epidural space is at

a) L2

63. 80 year old man at high altitude has swelling in legs

a) CO poisoning
b) venous thrombosis
c) cardiorespiratory failure

64. Esophago-gastric junction at level of?

a) T7
b) T11
c) L2
65.OCP increase risk of?
a) thromboembolism

66. Increase BP but decrease heart rate?

a) exercise
b) increase cranial pressure
c) sympathetic stimulation

67. Blood flow velocity increase?

a) SVC
b) right atrium
c) cerebral capillaries
d) pulmonary artery|
e) right ventricle

68. ADH increase when

a) pressure decrease in right ventricle
b) pressure decrease in right atrium

69.Ascitic tap most common organism

a) bacteria E coli

70) Patient of pancreatic CA, right sided leg pain, his pain was relief by cutting down?
a) left lateral spinothalmic
b) left ventral

71. Problem in doctor patient relationship misconception?

a) Hurried and casual approach

72. A person cant scratch on his back rolling back his arm due to damage to?
a) latissimus dorsi
b) seratus ant
c) teres major
d) supraspinatus
e) infraspinatus

73. Distention of rectum is caused by?

a) superior rectal nerve
b) inf. Rectal nerve
c) sympathetic innervation
d) parasympathetic

74. Regarding Skull?

a) pterion is the area where branches of middle meningeal lies
75. Atherosclerosis commonly occur in?
a) Aorta
c) Penetrating myocardial arteries coronary

76. Helminth disease caused by mosquito?

A) filariasis
B) onchocerciasis
C) schistosomiasis

77. A person who does heavy exercises regularly, His resting HR will be
a) less than 60
b) 80
c) 80-100
d)100-150

78. Clostridia causes?

a) gas gangrene
b) Upper respiratory infections
c) necrotizing fasciitis

79. Which drug cause constipation?

a) colchicine
b) digoxin
c) quinine

80. Child PT, APPT are normal but prolonged BT?

a) Factor viii def
b) Christmas disease
c) idiopathic thrombocytopenic purpura

80. In L.P structure pierced?

a)Dura
b)supraspinatus ligaments
c)spinal cord
d)pia matter

81. Ig E binds with ?

a)Platelets
b)Mast cells
c)lymphocytes

82. A hypertensive patient has headache then he suddenly got unconscious. LP was done and it
showed RBC in CSF.
a)SAH
83.Bradychinin pis formed?
a)Platelets
b)by action killikein

84. Which is non-malignant ?

a)Hamartoma
b)Burns Scar

85. Central value of serial data ?

a)Mean
b)Median
c)Average

86. Natural defense against neoplasia?

a)Apoptosis

87. Organelle with double membrane

a)The Nucleus
b)Golgi
c)Centrioles

88. carcinoma is caused by which inorganic compound?

a)asbestoses
c)Silica
d)Dust

89. When more energy is needed to cell what happens to mitochondria?

a)mitochondria divide
b)undergo replication using its own DNA

90. Regarding Dead cell diagnostic on microsopy?

a)karyorrhesis
c)karyolysis
c)cell shrinkage
d)hydropic degeneration

91. Which lung spirometry parameter is helpful in copd?

a)v/q ratio =1
b)v/q ratio=0.1
c)v/q ratio = infinity
d)physiological dead space
e)shunting

92.Atrophy
a)is increase in number of cell
b)increase in call size
93. Hep B spreads
a)Saliva
b)lacrimation
c)Mosquito bite
2.
94. Winging of scapula
a)Serratus Anterior

95. Carpal tunnel

Flattening of thenar emminace

96.IV drug user?

a)infective endocarditis

97.MS murmur best heard at ?

a)at apex of heart

98. Bile salt absorption occurs in?

a) ileum

99.most common position of Appendix?

a) Retrocecal b)pelvic

100. Inguinal hernia most common structure encountered while doing routine surgery for
inguinal hernia?
a) pappiform plexus

101. Action of epinephrine on alpha receptors?

a)pupillary radial muscle constriction
b)bronchodilation
c)Increase heart rate
d)vasodilation

102. angle of axis of head of femur with long axis of shaft of femur?
a)25 b)125 c)67

103.Regarding Aspirin?
a) thromboxane synthase inhibition

104. A baby with mental retardation , upward slanting epicanthal folds, ..?
a)trisomy 13
b)Trisomy 18
c) trisomy 21

104. Deglutination phases?

a) bolus moves down to throat by voluntary movement of tongue
b)upward movement of larynx during pharyngeal phase prevent food aspiration
c)primary peristalsis is initiated by pharyngeal phase of deglutition

105.Focal glomerulosis?
a) deposition under epithelium
b)reoccur in transplant kidney .

106. A baby is suffering from severe diarrhea, develop severe dehydration, IV hydration is
required for treatment, to make an IV line, a saphenous venesection is done , which structure
can be damage by doing this procedure?
a) Saphenous nerve b)peroneal nerve
107. Which does not change during pregnancy?
a)Cortisol
b)PTH
c)GH
d)FSH

108. Increase alpha feto protein is associated with ?

a)hepatocellular carcinoma

109. True hermaphrodite?

a)XXY
b)XYY

110. Basic mechanism involved in aqueous humour production:

a)Active sodium secretion
b)Passive Chloride absorption
c)Glucose diffusion
d)Ultrafiltration
e)Water secretion by simple diffusion

111. A feature of atrial fibrillation?

a)pulses deficit

112. Regarding PTH ?

a)decrease absorption of calcium
b)Decrease conversion of 25-cholicalciferol to 1,25 dicholicholciferol

113.most common congenital anomaly of head and neck ?

a)cleft lip and palate
b)deformities of pinna

114. Hypertrophy ?
a)increase in size of cell
b)increase in number of cell
115. Ventricle systole corresponds on ECG with ?
a)PR interval
b)ST
c)QRS
d)QT

116. Which organ utilizes 70% of O2 of its arterial supply at rest ?

a)liver
b)brain
c) heart
D)kidney
e)skeletal muscles

117. Ca of breast of outer upper quadrant will drain into ?

a)Pectoral nodes
b)internal mammary nodes
c)supra clavicular nodes

118.acute inflammation?
a)systemic response of living tissue to infection
b)local response of living tissue to tissue insult.

119. Prophylactic antibiotic ?

a)should be given at the time of induction of anesthesia
b)should be given post operatively

120. Regarding plasma albumin?

a) more readily bonds with basic drugs
b)more readily binds with acidic drugs
c)all drug are transported binding to plasma protein.

121. Regarding pleuroperitoneal membrane?

a)separates peritoneal cavity from thoracic cavity
122. Decrease FSH in male result in decrease?
a)testosterone
b)sperm count