SURGERY PRIMARY QUESTIONS
001. Concerning
the neural tube
A rostral neuropore closes on day 25
B the neural tube has three
Layers: epidermal, mantle and marginal
C Neuroblasts migrate from the
ventricular zone to complete their
differentiation in the intermediate (mantle)
zone
D the spinal cord develops from the
neural tube caudal to the
4th pair of somites
E Fusion of the neural folds to form
the neural tube begins in the region
of the neck.
002 During the blastocyst stage of development
A The zona pellucida degenerates
B Aggregation of cells at the
embryonic pole is
C There is rapid formation of
amniotic cavity
D Trophoblast cells are of a tall
columnar type
E blastocyst cavity separates in the
inner cell mass forming the
trophoblast
003. The following
events occur during second week of intrauterine life
A formation of notochord
B Differentiation of epiblast cells
into neural plate
C Formation of allantois
D Appearance of bilaminar disc
E Completion of implantation
004 the following are of Endodermal
origin
A epidermis
B Smooth muscle coat of aorta
C Nervous tissue
E Connective tissue
005 Events occurring during 3rd week of
embryonic life are:
A Organogenesis
B Neurilation
C Formation of intraembryonic
mesoderm
D gastrulation
E Formation of primitive streak
006. The following
develop from neural crest cells
A Suprarenal
B Schwann cell layer/neurilemma
C Pia mater
D parasympathetic
ganglion
E pigment
007 the following dev from the 3rd
pharyngeal arch
A superior
constrictor of the pharynx
B thyrohyoid
C Stylopharyngeus
D cricothyroid
E cricopharyngeus
008 formation of
mouth parts
A. The stomodium is present at the
third week when somites appear and
the Bubo-pharyngeal membrane brakes
down
B The fronto- nasal process and the
beginning of mandibular and
hyoid arches appear in the 4th wk
C The teeth begin at the dental
lamina in the sixth week
D Calcification of the first dentine
followed by the enamel begins in
the 5th month
E Calcification of the first dentine
begins in the eight month
009 Mediastinal surface of the Lt lung is
related to the
A oesophagus
B infundibulum
C Lt
atrium
D brachiocephalic
trunk
E Inferior vena cave
010 The first intercostal nerve
A Runs in the intercostal space between
the external and internal intercostal
muscles
B Supplies the adjacent pleura with
sensory innervation
C Has no anterior cutaneous branch
D Is the ventral ramus of the first
thoracic nerve
E has a lateral cutaneous branch,
which forms the intercostobrachial
nerve
011 the following structures lie in contact
with the neck of the first rib
A superior intercostal vein
B Superior
thoracic artery
C Sympathetic trunk
D Stellate ganglion
E Anterior primary ramus of the first
thoracic nerve
012 The following are important landmarks
in the surface anatomy of the oblique fissure of left lung
A 4th left coastal cartilage at the
junction of the sternum
B 5th intercostal space mid- axillary
line
C Spine of 3rd thoracic vertebra
D 4th
rib in the midclavicular line
E xiphisternal
junction
013 the oesophagus
A Has a length of 40cm from the
incisor teeth
B Begins to curve to the left at the
intervertebral disc between T4—T5
C Has three natural (physiological)
constrictions
D Has an, outer circular and inner
longitudinal muscle
E Movement of food down the
oesophagus is by means of
peristalsis.
014 Diaphragm
A Is developed partly from the septum
transversum
B Pushes the lungs up when it relaxes
C Has an opening for the inferior
vena cave at the level of the 8th thoracic vertebra
D Has a central tendon, which lies at
the same horizontal level
as its right dome
E On contraction reduces the vertical
diameter of the thorax.
015 about the heart
A The anterior interventricular
artery is a branch of the right coronary
artery
B The floor of the fossa ovalis is
formed by the septum secundum
C The coronary sinus opening into the
right atrium is guarded by a valve
D The mitral opening is represented
on the chest wall as an opening at
the level of the 4th left costal cartilage
E The aortic opening lies behind the
5th left rib.
016 the following joints in the body can be
classified as “Saddle Joints”
A Atlanto-
axial
B Knee
C Radio ulnar
D Subtalar
E Carpo-
Metacarpal of the thumb
017 regarding movements of the hip joint
A Abduction is done by anterior fibres
of the gluteus medius and minimus
B The gluteus maximus is active when
the thigh is extended against
resistance
C Abduction is limited by the
pubofemoral and the medial band of
iliofemoral ligaments
D Lateral rotation is brought about
by the obturator muscles assisted by
piriformis and quadratus femoris
E Dislocation of the joint is common
because of the weak ligaments
018 the following arteries are readily palpable
in the lower limb:
A Anterior tibial
B Posterior tibial
C profunda femoris
D dorsalis pedis
E Medial plantar.
019 the adductor canal
A The adductor longus forms the
posterior boundary of the canal
B The vastus medialis is found on the
medial side
C Sartorius forms the immediate
relation of the roof
D The deep lymphatics of the leg
drain into a group of lymph nodes that
lie in the canal
E The saphenous nerve forms part of
the contents.
020 The following muscles are active when
sitting astride and riding a horse
A Pectineus
B Gracilis
C Obturator externus
D Sartorius
E iliopsoas.
021 The medial longitudinal arch of the
toot
A Is more elevated when the feet are
planted close together than when
they are apart
B Is more mobile and resilient than
the lateral
C Has its summit at the subtalar
joint
D Is maintained by. the peroneus
longus
E Makes more extensive contact with
the ground than the lateral under the
stress of weight and muscular thrust
022. Fertilisation
results in
A Initiation of cleavage
B sex determination
C Restoration of diploid number of
chromosomes
D Formation of the zygote
E Completion of meiosis
023 The following are mesodermal in origin
A Adrenal medulla
B Muscle
C Spinal ganglia
D Cartilage
E Bone,
024 All of the following nerves contain visceral
afferent fibres EXCEPT
A Dorsal roots of spinal nerves
B Vagus nerves
C Optical nerves
D Phrenic nerves
E Splanchnic nerves.
025 All of the following fibres travel with
the vagus nerve EXCEPT
A Afferent neurons from
mechanoreceptors in The heart and pulmonary vessels
B Afferent neurons from
mechanoreceptors and a chemoreceptors
in the aorta
C. Afferent neurons from mechanoreceptors and a
chemoreceptors in and near the carotid
Sinus
D Preganglionic parasympathetic
neurons innervating the bowels
E Preganglionic parasympathetic
neurons innervating the heart.
026 the French physician Jean L. M.
Poiseuille (1799—1869) defined the factors that regulate the flow of water
through a single, rigid cylindrical tube. Which of the following is correct
with regard to flow rate as expressed in Poiseuille equation?
A Directly proportional to perfusion
pressure
B Inversely proportional to viscosity
C A
and B are correct .
D Directly proportional to radius to
the third power
E A and D are correct.
027 the branches of the anterior division
of the internal iliac artery is/are:
A Obturator
B Superior
vesical
C Ovarian
D Middle rectal
E Inferior gluteal.
028 the three-chambered heart consists of
A Truncus arteriosus
B bulbus cordis
C ventricle
D atrium
E Sinus Venosus
029 testicular tumour may cause enlargement
of the following lymph nodes:
A Superficial horizontal inguinal
B Para
aortic
C internal iliac
D common iliac
F Pelvic
030 The anterior layer of the rectus sheath
below the level of the “arcuate line’’ is formed by:
A Camper’s fascia
B External oblique abdominis
C internal oblique abdominis
D transversus abdominis
E transversalis fascia.
031 Concerning the Lumbar plexus of nerves
A it is formed in the substance of
the Psoas major and the quadratus
lumborum
B The genito- femoral nerve leaves
the plexus through the anterior surface
of the psoas major muscle
C the lumbosacral trunk gives origin
to the femoral nerve
D in the male the illiohypogastric
nerve accompanies the spermatic cord
through the inguinal
E the skin at the level of the
umbilicus gets its innervation from the
Lumbar plexus
032 Structures related to the anterior
surface of the right kidney are:
A stomach
B Duodenum -
C Head of Pancreas
D Spleen
E suprarenal gland.
033 All of the following structures are
found in the pons except
A Motor nucleus of the facial nerve
B Nucleus of the abducent nerve
C Lateral geniculate body
D Lateral and superior vestibular
nuclei
E reticular formation
034 All of the following structures are
found in the diencephalon except
A Mamillary bodies.
B Pineal body
C Subthalamus
D Lateral geniculate bodies
E Reticular formation.
035 Concerning the nerve supply of the
larynx
A All the intrinsic muscles except
Cricothyroid are supplied by
superior laryngeal nerve
B Cricothyroid
is supplied by internal laryngeal nerve
C The
sensory supply above the vocal cord is provided
by the recurrent laryngeal nerve
D The recurrent laryngeal nerve
enters the larynx deep to the lower border
of superior constrictor muscle
E The vocal fold is supplied by both
internal laryngeal and recurrent
laryngeal nerves.
036 Waldeyer’s ring is formed by the
following collections of lymphoid tissue
A Lingual tonsil
B Palatine tonsils
C Payer’s patches
D Tubal tonsil
E Adenoids
037 Structures lying between the
sphenomandibular ligament and the neck of the Mandible include:
A Auriculo temporal nerve
B Maxillary artery
C middle meningeal artery
D Deep p-art of parotid gland
E inferior alveolar vessels and
nerves
038 Which of the following statements is
incorrect? Human spermatozoa normally
A are not motile in the epididymis
but are activated by the secretions of
the prostate and other accessory of the
prostate and other accessory glands of the male
B are produced at an accelerated rate
when testicular temperature is raised
from 35—37oC
C contain 23 chromosomes
D contain either an X or a Y
chromosome but not both
E Can survive in the female
reproductive tract for
1 or 2 days or longer
039 Which of the following statements is
incorrect? Human spermatozoa normally
A remain motile in the female
reproductive tract for a period of less
than 15min after ejaculation during intercourse
B leave the penis, suspended in a
liquid (semen), most of which comes from
the prostate gland and seminal vesicles
immediately prior to and during
ejaculation
C derive from spermatogonia, cells in
the seminiferous tubules that contain the
diploid number of chromosomes
D are stored in the seminiferous
tubules, rete testis, epididymis
and vas deferens
E may remain viable in the epididymis
for period up to 60 days.
-
040 The following statements are correct in
-
A Teres minor
B teres major
C Long head of triceps
D Triangular Space
E Supraspinatus.
PHYSIOLOGY
041 Which of the following statements
concerning intracellular
fluid is true?
A It contains over 50% of the body
water
B It has a higher osmotic pressure
than extracellular fluid
C it has a higher concentration of
organic anions than ECF
D A and C are correct
042 The following data were obtained from a
patient by injecting an indicator and determining its conc. in the blood
A Total body water (indicator = D2O
= heavy water); 42L
B ECF, fast (indicator =-
thiocyanate): 11 L
C ECF, slow (indicator = thiocyanate):
19L
D Plasma water (indicator Evans
blue): 3L
E blood cell volume (calculated from
haematocrit ): 5L
043 One litre of isotonic saline was
injected intravenously into a 70kg woman. The injection had no effect on
capillary hydrostatic pressure. After 15minutes
A Extracellular water would increase
by > 900 mL
B interstitial water would increase
by > 900 ml
C Intracellular water would increase
by > 900ml
D Total body water would increase by >
900 mL
E A and D are correct.
044 A systolic murmur was heard over the
manubrium of the sternum. The most likely diagnosis is
A an increased haematocrit
B aortic stenosis
C aortic insufficiency
D mitral stenosis
E patent ductus arteriosus
045 A physician notes that when taking a
patient’s arterial blood pressure using sphygmomanometer cuff, although the
sound over the artery becomes muffled at a cuff pressure of 7OmmHg, it does not
disappear as the cuff pressure returns to OmmHg. What conclusion is most likely
drawn from this data? The patient:
A has a diastole pressure at or near
OmmHg (i.e., may have aortic
insufficiency)
B Probably has a weakened heart (i.e.
left ventricular congestive heart
failure)
C has a patent ductus arteriosus
D has an aortic stenosis
E has low haematocrit
046 What is the patient’s
average P02 difference between his alveolar gas and his alveolar
capillary blood if the following data were obtained from that patient? Arterial PO2=100 mmHg; Right
atrial PO2=4O mmHg; Diffusing capacity for O2 of 30
ml/min/mmHg and Oxygen consumption= 240
ml/min:
A 8 mmHg
B 20 mmHg
C 40 mmHg
D 50 mmHg
E 60 mmHg
047 An athlete at rest has a cardiac output
of 4 L/min, on oxygen consumption of 0.25 L/min and a pulmonary ventilation of
5 L/min. During running, his cardiac output increases to 20 L/min and his
oxygen consumption to
3 L/min. what
would his pulmonary ventilation be, approximately?
A 5 L/min
B 20 L/min
C 60 L/min
D l44 L/min.
E 200 L/min
048 A positive
nitrogen balance in the adult occurs
A when the dietary intake of protein
is increased in the healthy subject
B during a debilitating illness
C A and B
D during recovery from a debilitating
illness
E during recovery horn a debilitating
illness or during protein starvation
049 Which of the following produces a
markedly more positive nitrogen balance?
A Testosterone
B Prolactin
C Oestrogen
D Chorionic gonadotropin
E None of the above.
050 Which of the following hormones are
produced by the thyroid glands?
A Thyroxine (T4)
B Triiodothyronine (T3)
C A and B
D Calcitonin
E A, B and D.
051 An athlete ran a 42-km race in 158
minutes. During the race, he lost 3 litres of sweat. After the race, he drank
3 litre water.
Several hours later, the subject was studied. Which at the following
conclusions would be MOST likely? Because sweat contains:
A a higher concentration of Na+
than the extracellular fluid, there was
hyponatraemia
B a lower concentration of Na+ than
the extracellular fluid, there was
hypernatraemia
C approximately the same
concentration of Na+ as the extracellular
fluid and there was water replacement but
not Na+ replacement, there was an increase in blood
volume
D approximately the same
concentration of Na+ as the extracellular
fluid and there was water replacement but
not Na+ replacement, there was a decrease in blood
volume
E a lower concentration of Na+ than
the extracellular fluid and there was
water replacement but not Na+ replacement,
there was a decrease in blood volume.
052 A fever induced by a bacterial toxin is
caused by
A the production of endogenous pyrogens
by the leukocytes and
macrophages
B a direct action of the toxin on
skeletal muscles and the cutaneous
blood vessels
C a direct action of the toxin on the
hypothalamus
D an elevation of set point in the heat
regulatory centre of the
substantia nigra
E an inhibition of prostaglandin
synthesis and release in the fore brain
053 In the distal convoluted tubule the cells.
A contain large quantities of
carbonic anhydrase which they
use in secretion of H+
B can reabsorb Na+ in exchange for H+
secretion across the luminal
membrane
C A and B
D reabsorb over 40% of the glomerular
filtrate
E determine the final composition of
urine
054 in a healthy individual, what % of the
effective renal plasma flow would pass into the glomerular capsule?
A Less than 5%
B Between 15% and 20%
C Between 40% and 50%
D Between 70% and 80%
E Greater than 90%.
055 Which of the following statements is
most consistent with a filterable substance being actively reabsorbed from the
renal tubular lumen?
A its renal clearance value is lower
than that of inulin
B its renal clearance value is higher
than that of inulin
C the ratio of its rate of urinary
excretion/plasma concentration
is the same as that of glucose
D the ratio of its rate of urinary
excretion/plasma concentration
is greater than that for glucose
E its concentration in the distal
tubule is higher than that in
plasma.
056 Which of the following are ketone
bodies?
A acetoacetic acid
B acetone
C A and B
D β-OH butyric acid
E A, B and D.
057 Patient 1 is on a protein-rich, caloric
adequate diet. Patient 2 is on a protein poor, but calorie adequate diet.
Patient 1 will have a daily excretion of
A urea that is greater than four
times that for patient 2
B ammonia that is greater than four
times that for patient 2
C Inorganic sulphate that is greater
than four times that for
patient 2 –
D creatinine that is greater than
four times that for patient 2
E A and C.
058 Acid secretion in the stomach is
blocked by
A an H1 histamine blocker
(benadryl)
B an H2 histamine blocker
(cimetidine)
C atropine
D A & C
E B and C
059 The last subject would, during a
strenuous tennis match, lose most of his body heat by
A conduction
B convection
C radiation
D evaporation
E no single mechanism
060 Which of the following symptoms is NOT
characteristic of hypothyroidism in the adult?
A below
normal mouth temperature
B a
feeling of drowsiness
C increased
body hair -
D deposition of mucoprotein in the
subcutaneous and extracellular spaces
that causes oedema
E a negative nitrogen balance.
061 Hyperthyroidism causes
A an increase in concentration of
thyroid-binding globulin (TBG)
B a positive nitrogen balance
C a potentiation of the action of
catecholamines
D a decrease in urinary excretion of
Ca2+
E lethargy.
062 Which of the following is Incorrect? A
patient who, during surgery, has accidentally had all her parathyroid tissue
removed will probably
A develop increased plasma free Ca2+
B develop skeletal muscle spasms
C show improvement in response to
Vit. D
D show improvement in response to
calcium gluconate injections
E develop per changes and anxiety
attacks,
063 Parathormone
A by increasing the renal clearance
of phosphate while decreasing the renal
clearance of calcium, tends to produce
a hypophosphataemia associated with hypercalcaemia
B by increasing the renal clearance
of calcium while decreasing the
renal clearance of phosphate, tends to produce
hypocalcaemia associated with hyperphosphataemia
C produces hypercalcaemia associated
with hyperphosphataemia
D produces hypocalcaemia associated
with hypophosphataemia
E does not affect the renal clearance
of phosphate and calcium.
064 The principal energy source for the
heart of a healthy fasting subject is
A free fatty acids
B glucose
C lactate and pyruvate
D Amino acids
E polypeptides.
065 Which of the following is true within a
few minutes after the birth of a healthy child?
A Permanent fusion of the septum
primum and secundum is
complete
B the foramen ovale is anatomically
closed
C A and B
D the umbilical arteries are
functionally closed by contraction
of the smooth muscles in their wails
E B and D
066 Acromegaly is a condition caused by –
A an excessive release of growth
hormone, which causes, in the
adult enlarged hands and feet and protrusion
of the lower jaw.
B an excessive release of growth
hormone, which causes, in the
adult an elongation of the humerus, femur,
tibia and fibula
C an excessive release of thyroid
hormone, which causes in the
adult, enlarged hands and feet and a protrusion
of-the lower jaw
D an excessive release of thyroid
hormone, which causes, in the adult
elongation of the humerus, femur,
tibia and fibula
E an inadequate release of thyroid
hormone.
067 Which of the following usually has
norepinephrine as its major secretion?
A The adrenal medulla
B The adrenal cortex
C postganglionic sympathetic neurons
to the radial muscles of the iris
D Postganglionic sympathetic neurons
to sweat glands
E Postganglionic parasympathetic
neurons to circular muscles of the
iris.
068 A 70kg, 6ft, normal, healthy subject
standing quietly erect for 30 seconds has a mean arterial pressure of l00 mmHg
in the ascending aorta and a venous pressure of 2 mmHg in the superior portion
of the inferior vena cava.
What is the venous
pressure the dorsum of the foot?
A. less
than OmmHg (i.e. below atmospheric pressure)
B. 2 mmHg
C 4
mmHg -
D about
20 mmHg
E above 40 mmHg.
069 A soldier stands at attention for 30
seconds. How can his femoral vein pressure best he decreased?
A By decreasing the heart rate
B By dilating the systemic arterioles
C By constricting the systemic
arterioles
D By having him hold his breath
E By having him take one step
forward.
070 Venous return to the right heart is
normally increased by
A increased minute ventilation
B increased venous tone
C increased cardiac sympathetic tone
D all of the above
F none of the above.
PATHOLOGY
071 cellular injury could result in any of
the following response:
A Adaptation
B Necrosis
C Apoptosis
D Autolysis
E Heterolysis
072 Fatty change or steatosis
A is a form of cellular injury
B is a form of free radical injury
C occurs commonly in liver, kidney
and heart
D usually causes early organ failure
E it is a form of irreversible
injury.
073 Labile cells
A are continuously dividing
throughout life
B divided only with stimulation
C examples are cells of the bone
marrow, surface epithelia and
lymphoid tissue
D are in the phase of the cell cycle
E usually can reconstitute lost
specialised tissue without
much granulation tissue formation
074. Indicate if
the type of collagen matched with the tissue is true or false
A. Young
granulation tissue = type III
B Mature
scar tissue = type I
C Liver connective tissue = type III
D basement
membrane =type IV
E cartilage = type II
075 Important features of amyloid material
are
A Presence of a serum precursor
B β-sheet conformation on X-ray
crystallography
C Alpha-sheet conformation on X-ray
crystallography
D fibrillary structure on electron
microscope
E congophilia
076 The underlisted are benign neoplasms
A fibroma
B Seminoma
C Melanoma
D Nephroblastoma
E Adenoma.
077 Acquired preneoplastic disorders
include
A Liver cirrhosis
B Complex endometrial hyperplasia
C Chronic ulcerative colitis
D Solar keratosis of the skin
E Cervical dysplasia
078 The following is true of immediate
transient increase in vascular permeability
A It is suppressed by pre-treatment
with antihistamine
B It is exaggerated by aspirin
administration
C Chemical mediators in general elicit
this phenomenon
D It is a venular leakage
E Leakage is across the
microvasculature
079 The following chemical mediators
mediate increased vascular permeability in acute inflammation
A Histamine
B C3a and C5a
C C2a and C3b
D bradykinin
E Leucotriene B4.
080 Chemotaxis and leucocytes activation
are mediated by the following
A C5a
B Leucotrienes C4, D4, E4
C Cytokines
D Bacterial Products
E Prostaglandins.
081 The following are examples of
complementary adhesion molecules present on leucocytes and endothelial surfaces
A selectins
B Von Willebrand factor
C intercellular adhesion molecules —
1 (ICAM-1)
D lntegrins
E vascular cell adhesion molecule-1
(VCAM-1),
082 Inflammatory giant cells include
A Langhan's cells
B Langerhan's cells
C Warthin - Finkeldey cells
D Touton cells
E Reed - Sternberg cell.
083 The following diseases are
characterized by granuloma formation
A Amoeboma
B Cat-scratch disease
C Tuberculosis
D Leprosy
E Histoplasmosis.
084 Antithrombotic properties of
endothelial cells is mediated by. the following
A Prostacycline (PGI2)
B Nitric Oxide (N0)
C Von-Willebrand factor
D Thrombomodulin
E Protein S
085 Alpha granules of platelets contain the
following
A fibrinogen
B Factors V and VIII
C transforming growth factor - β
D Adenosine diphosphate (ADP)
E ionized calcium
086 The following agents stimulate platelet
aggregation
A Adenosine diphosphate (ADP)
B Thromboxane-A2 (Tx A2)
C Thrombin
D Fibrinogen
E. Von-Willebrand factor (VWF):
087 The following clinical disorders
predispose to endothelial damage
A Complicated atherosclerosis
B Inflammation of blood vessels
C Myocardial infarction
D Haemodynamic effect of hypertension
E disorders associated with cigarette
smoking
088 Patients with
overwhelming infection with the following organisms can present in a state of
shock
A E. coli
B Klebsiella species
C Pseudomonas
D Serratia spp.
E Bacteroides.
089 oedema
A Hypoproteinaemia typically causes
localized oedema
B Transudate is characterized by a
low content of proteins but high
cell count
C The oedema of congestive cardiac
failure is more severe than renal
oedema
D The oedema of nephrotic syndrome is
due to primary
hyperaldosteronism
E The oedema of chronic liver disease
is due to hypoalbuminaemia
090 immunologic tolerance
A clonal deletion refers to loss of
B- and T- lymphocytes during their
maturation
B Clonal deletion of self-reactive
lymphocytes is perfect
C Clonal deletion of self-reactive
lymphocytes is not perfect
D Presentation of antigen without
class II molecules by APC
causes anergy of self-reactive lymphocytes
E The mechanism of suppression of
autoreactivity by CD8-positive
lymphocytes involves secretion of cytokines.
091 all the following are important
responses of the body that prevent blood after the rupture of a small blood
vessels except
A formation of a platelet plug
B hypotension, decreasing perfusion
pressure
C vasoconstriction
D an increased perivascular pressure
associated with the production of a
haematoma
E formation of insoluble fibrin
threads.
092 Which of the following is released by
blood platelets during haemorrhage and tends to produce vasoconstriction?
A serotonin
B histamine.
C thrombosthenin
D accelerator globulin
E bradykinin.
093 What function(s) do platelets serve?
A release of a vasoconstrictor
B essential for clot retraction
C formation of a white thrombus (i.e.
a plug)
D through the release of platelet
factors, they initiate and accelerate
the formation of a fibrin clot
E all of the above.
094 Which of the following statements about
albumin is correct?
A Less than 10% is degraded each
month
B it has a molecular weight greater
than that for the gamma globulins
C it is responsible for most of the
Osmotic pressure of plasma
D In plasma, it approaches the
concentration of the plasma
globulins in liver disease and nephrosis
E At a pH of 7.4 it is a positively
charged particle.
095 The plasma proteins function to (1)
destroy certain foreign materials (antibodies), (2) control body activity
(hormones), and (3) prevent bleeding (procoagulants). They serve the other
functions listed except
A they prevent oedema by causing the
plasma osmotic pressure to
be higher than the perivascular osmotic pressure
B they provide 75% of the buffeting
capacity of the blood
C they prevent excretion and
destruction of hormones, vitamins, iron,
lipids, drugs, etc. The plasma proteins do
this by forming complexes with these substances. For example, a 6-year-old girl with a transferrin (a β1-globulin) deficiency had a
plasma iron-binding capacity
of 15 μg/100ml (330 μg/100ml is normal) and
a disappearance time for iron of 5 minutes (70 to 140 minutes is normal)
D they decrease the potency of agents
(thyroxin, for example) by forming
protein complexes that serve as reservoirs
but are not themselves active
E they lyse clots (profibrinolysis).
096 Which of the following statements
concerning antibodies is incorrect?
A they are all proteins
B they are produced by ribosomes in
the cells of the spleen and lymph
nodes
C some cause lysis of antigen
–containing cells
D some cause precipitation of an
antigen
E they have a half-life of less than
24 hours.
097 Which of the following combinations of
substances in plasma will cause the production of a clot?
A Prothrombin, accelerator globulin,
anti-haemophilic factor, platelet factor
3, fibrinogen
B Thrombin and fibrinogen
C Prothrombin, accelerator globulin,
tissue extract, Ca2+
D accelerator globulin,
antihaemophilic factor, platelet factor
3, Ca2+ and fibrinogen
E Prothrombin, accelerator globulin,
fibrinogen & Ca2+
098 Rheomacrodex
(low molecular weight dextran) is administered to a patient and found to have
no effect on his recalcification plasma clotting time or one-stage prothrombin
time but does increase his bleeding time. Which of the following statements is
the most likely explanation of this action? Rheomacrodex does the following:
A inhibits platelet aggregation
B inhibits rouleaux formation
C inhibits fibrin polymerization
D inhibits the action of thrombin
E facilities the activation of factor
X.
099 Which of the following statements
is-correct? Serum does NOT contain
A prothrombin
B plasma thromboplastin component
(PTC, factor IX)
C Ca2+
D serum prothrombin conversion
accelerator (SPCA, factor VII)
E any of the above.
100 Bladder irritability may follow
radiation therapy for cancer of the prostate A sign of this complication would
probably be:
A Dysuria
B polyuria
C Dribbling
D Haematuria
E Bleeding of the gum.
PHYSIOLOGY
101 Hyperthyroidism causes
A increases the concentration of TBG
B causes positive nitrogen balance
C potentiates
actions of catecholamines
D decreases excretion of urinary
calcium
E lethargy.
102 A patient who had all her parathyroid
removed
during surgery
will probably:
A dev increased plasma free calcium
B dev skeletal muscle spasm
C show improvement in response to
vitamin D
D show improvement in response to
calcium
gluconate inj.
E dev personality changes and anxiety
attacks.
103 The principle energy source for the
heart of a normal fasting subject are:
A free fatty acids
B glucose
C lactate and pyruvate
D amino acids
E polypeptides
104 Acromegaly is a condition caused by
excessive release of:
A growth hormone which in the adult
causes
enlarged hand / feet with enlarged jaws.
B growth hormone which in the adult
causes
elongation of humerus, femur, fibula
and tibia.
C thyroid hormone which in the adult
causes
enlarged hands / feet and
protruding jaws
D thyroid hormone which in the adult
causes
elongation
of the humerus, femur, tibia & fibular.
105 Venous return to the heart is normally
increased by:
A increased minute ventilation
B increased venous tone
C increased cardiac sympathetic tone
D decreased venous tone
E decreased minute ventilation.
106 Sweating:
A is primarily under adrenergic ctrl
B is initiated by posterior
hypothalamus
C is inhibited both peripherally and
centrally by
glucopyrolate
D accounts for the largest source of
heat loss from
the
body under resting conditions at room temp
E ceases when pyrexia is associated
with severe
dehydration
and salt loss.
107 Insulin:
A promotes glucose uptake by adipose
tissues
B inhibits hepatic gluconeogenesis
C inhibits lipogenesis
D is necessary for cerebral uptake of
glucose
E inhibits fatty acid release from
adipose tissues.
108 With oral hypoglycaemic drugs:
A metformin stimulates insulin release
B sulphonyl urease do not cause hypoglycemia
C sulphonyl urease are suitable for
initial therapy
in IDDM type I.
D metformin is contraindicated in
renal
impairment.
E aspirin enhances the hypoglycaemic
effects of chlorpropramide.
109 Neonate is characterised by the
following:
A obligatory nose breathing
B increased alveolar ventilation is
achieved
mainly by increasing the tidal
volume
C the stroke volume of the heart is relatively
fixed
D level of Vit K dependent factors
tends to be
low at birth.
E a normal maintenance fluid
requirement of
80 ml /kg/day
110 In carbon monoxide poisoning:
A the P50 is increased
B a pulse oximeter is able to
differentiate b/w
Carboxy-Hb and oxy-Hb
C the elimination ½ life of CO is
decreased by
100% Oxygen at ambient temp.
D cortical blindness is a recognised
complication
E the normal arterial partial
pressure of CO2 is incompatible
with carboxy –Hb concentration of 20%
111 Complications of thermal injury
include:
A myoglobinuria
B encephalopathy
C methaemoglobinemia
D haemoglobinuria
E malignant hyperthermia
112 Fluids used in resuscitation of burn
patients:
A Hartmann solution has Na
concentration of 154mmol/L
B 5% dextrose has a pH of 4.0
C the incidence of allergic reaction
to haemacoele is 2%
D the average particle size of
hydroxymethyl starch is very similar to
that of albumin
E dextran 70 has a ½ life of 12hrs.
113 The characteristic findings in
urinalysis that distinguish the aetiology of acute renal failure include:
A high Na concentration in pre-renal
oliguria
B high urine to plasma osmolality
ratio in intrinsic renal failure.
C absence of casts in pre-renal
causes
D low urine to plasma urea ratio of
?? in
intrinsic failure
E Na+ excretion of >2% in acute tubular
necrosis
114 A biochemical change that commonly
occurs in acute renal failure is:
A hypocalcaemia
B hypophosphataemia
C hyperuricaemia
D hypermagnesaemia
E hypernatraemia.
115 The distinguishing feature b/w acute
and chronic renal failure:
A normochromic normocytic anaemia
B pericarditis
C autonomic neuropathy
D secondary
hyperparathyroidism
E increased bleeding time
116 In cardiogenic shock:
A i.v. loop diuretics are the 1st
line of management
B cardiac tamponade is a likely cause
C opioid should be avoided in simultaneously
ventilating patients
D haemofiltration is contraindicated
E Rx goals include rapid restoration
of splanchnic BP
117 In fat embolism syndrome:
A there is no history of trauma
B the characteristic triad of
respiratory insufficiency, cerebral signs and petechial rash is present only in 5% of cases.
C abnormal X-ray features precede
changes in arterial oxygen tension.
D incidence is increased by early
mobilisation of the fracture site.
E pulmonary insufficiency presents
commonly 48- 72hrs after the injury.
118 Porphyria:
A is less likely to occur in
pregnancy
B can be prevented y dexamethasone
C should be Rx with i.v. dextrose
during an acute attack
D can mimic intestinal obstruction
E causes autonomic instability
119 Regarding the oxygen-Hb dissociation
curve:
A oxy-Hb has higher oxygen affinity than
deoxy-Hb
B iron remains in ferric form when Hb
binds oxygen
C the Bohr effect describes
right-shift of the curve with increasing temp
D the RBCs 2, 3-DPG concentration is
increased in anaemia
E methaemoglobin is unable to bind
oxygen
120 In DIC:
A activation of fibrinolysis precedes
activation of coagulation
B fibrin degradation and production
causes a qualitative platelet effect
C microangiopathic anaemia is a
complication
D bleeding is meritable
E thromboplastin activates the
extrinsic cascade
121 In haemophilia
A males and females are equally
affected
B PTT is normal but PT is abnormal
C there is no platelet defect
D post op bleeding may be decreased
by aminocaproic acid due to its
inhibitory action on fibrinogen.
E at least 30% of factor viii
activity is required for surgery.
122 concerning whole blood and other blood products:
A whole blood contains a normal concentration
of all the clotting factors
B leukocyte depleted plasma reduced
blood must be transfused within 24hrs
of preparation
C donor platelets concentration must
be ABO compatible with the recipient
D fresh frozen plasma is a useful
volume expander.
E fresh frozen plasma must be ABO
compatible with the recipient.
123 Sudden loss of blood in a man leads to
some of the following:
A decreased pulse pressure
B compensatory vasoconstriction esp.
in the skin and splanchnic circulation
C increased pulse rate
D increased fluid filtration at the
capillaries
E vasoconstriction also occurs.
124 Injury or disease of the basal ganglia
may cause
A muscle rigidity
B loss
of pain, temp and some touch sensation
C paralysis of skeletal muscles
D peripheral vasodilatation
E involuntary movement of the limbs.
125 Gastric emptying is expedited
(enhanced) by:
A vagotomy
B fat in the duodenum
C gastric ulcer
D enterogastrostomy
E oral hypertonic saline
126 Hypokalaemia occurs in
A primary hyperaldosteronism
B vomiting in pyloric stenosis
C adrenal insufficiency
D thyrotoxicosis
E villous papiloma of the rectum
127 Rise in RBC may occur in:
A 24hrs after haemorrhage
B SCD
C uncomplicated hypertension
D right to left shunt
E adrenal failure
128 Jaundice following drugs may be due to
A intravascular haemolysis
B intrahepatic biliary obstruction
C development of haemolytic
antibodies
D damage to liver cells
E obstruction of the common bile duct
129 Pre-anaesthetic medication
A permits smooth induction
B decreases the dose of anaesthetic
required
C lowers threshold for cardiac
toxicity
D should be given at least 12hrs b4
operation
E reduces apprehension
130 The following can cause haemolysis in a
G6PD deficient patients.
A sulphonamides
B penicillins
C chloramphenicol
D phenacetin
E primaquine
131 In Prune. Belly Syndrome (also called
Eagle Barrett Syndrome) the anomalies comprise of the following
A hydrocephalus
B severe
urinary tract anomalies
C cryptorchidism
D abdominal muscle deficiency
E PDA
132 In DNA
structure, the DNA is composed of polynucleotide chains- A nucleotide consists
of:
A a
nitrogenous base
B a
hexose sugar
C a chloride
group
D phosphate
group
E pentose
sugar
133 In the favourable histological type of
Wilm’s tumour the following are fond:
A epithelial cells
B blastema cells
C variably differentiated stromal
tissue
D chief cells
E Leydig cells
134 Associated congenital anomalies in Wilm’s
tumour include the following;
A hemihypertrophy
B branchial fistula
C hydrocephalus
D GUS abnormalities
E aniridia
135 Hypothermia in the elderly:
A is nearly always due to hyperthyroidism
B usually caused tremor
C causes slow contraction and
relaxation in tendon reflexes
D if accompanied by hypotension is of
severe degree
E usually causes hypercapnia
136 Vasogenic cerebral oedema;
A is the commonest form of cerebral oedema
B may cause raised intracranial
pressure
C Is associated with meningoencephalitis
D is associated with hypoxia
E may complicate obstructive
hydrocephalus
137 Insulin Secretion:
A rate is 400 units (2870 nmol) per
day
B Is reduced by cAMP
C is increased by thiazide diuretics
D is reduce by somatostatin
E is reduce by vagal stimulation
138 Insulin.
A is synthesized by endoplasmic reticulum
B contains
A and B linked by disulphide bridge
C the number of insulin receptors is
increased in obese subjects
D 80% of secreted insulin is degraded
by the liver and kidney
E the number of insulin receptors is
increased in maturity onset diabetic
SECTION C PATHOLOGY
139 Wound healing is adversely affected by:
A ischeamia
B Vit C def.
C corticosteroid therapy
D old aye
E deficiency of zinc
140 Melanin hyperpigmentation of skin is
associated with:
A melanosis coli
B neurofibromatosis
C albinism
D Peutz - Jegher ‘s syndrome
E pregnancy
141 The following definitions are correct:
A dystrophic calcification is the deposition of calcium in normal tissue
B hyperplasia is the increase in an
organ duo to increase in the number
of its constituent cells
C a granuloma is a localised collection
of histiocytes and modified
histiocytes
D a haematoma is a malignant neoplasm
of connective tissue
E metaplasia is intraepithelial neoplasia
142 Granulomata are classically associated
with:
A tuberculosis
B sarcoidosis
C histoplasmosis.
D schistosomiasis
E amoebiasis
143 the following agents are probably
carcinogenic:
A HBV
B aflatoxin
C aniline dyes
D human papiloma virus
E thorotrast
144 Macrophages:
A absent in the liver
B are derived from blood monocytes
C fuse to form giant cells
D lyse the fibrin in an exudate
E may transform to a lymphoma
145 The characteristic cells in a granulation
tissue
A are neutrophi1
B are epitheliod cells
C are macrophages
D are Langhan’s Giant Cells
E are fibroblasts
146 Fatty change of the liver:
A may complicate pregnancy
B may complicate tetracycline therapy
C occurs in Rye’s
syndrome
D occurs in diabetes mellitus
E may complicate amoebic hepatitis
147 Hyperparathyroidism is associated with:
A chronic renal failure
B dystrophic calcification
C metastatic calcification
D Cystic bone changes
E renal calculi
148 Acquired Immunodeficiency Syndrome (AIDS):
A occurs exclusively in male homosexuals
B has a long incubation period
C is associated with Kaposi’s sarcoma
D spread
by droplet infection
E can
be transmitted from mother to foetus
149 Keloid:
A is a malignant neoplasm
B is
a benign tumour
C is
rare in the tropics
D is a locally invasive tumour
E metastasis
is via lyrnphatics
150 The following diseases predispose to secondary
amyloidosis:
A bronchiectasis
B chronic osteomyelitis
C Tuberculosis
D acute
appendicitis
E chronic cholecystitis
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