SURGERY July 07

Contributed By Dr Ahsan Siraj.

FCPS Part 1
SURGERY AND ALLIED
5TH JULY 2007
Note: Only correct answers are given as choice “A”. Some questions do contain other choices but you consider “A” the right choice.
ANATOMY
01. A 10 year old boy with shoulder injury lost abduction of his shoulder up to 30 degree which muscle is lost:
Supraspinatus
Deltoid

02. A boy is brought to a hospital with injury at elbow joint lost extension of medial 4 fingers at MTP joint, abduction of thumb with intact sensation due to:
Injury to Radial nerve at elbow

03. Which of the following muscle is not supplied by median nerve:
Adductor polices.

04. Regarding palm:
Superficial palmer arch is below palmer apeneurosis.

05. Which of the following muscle have dual nerve supply from median and ulner nerve:
Flexor digitorum profundus.

06. Infection of the first pulp space lymph nodes will first drained.
Epitrochlear lymph nodes.

07. Which of the following muscles is flexor at hip and extensor at knee:
Sartorius.

08. In an injury to knee joint a man is unable to extend his knee the root value affected:
L3-L4.

09. In the injury to neck of fibula the artery damaged:
Ant. Tibial artery.
Peroneal artery.

10. Regarding post. Triangle:
Base is form by middle 3rd of clavicle.

11. Bifurcation of common carotid artery:
Beneath the any. Border of sternocladomastoid at the sup. Border of thyroid cartilage.

12. Great saphenous vein has how many valves:
20.

13. Vertebral venous plexus:
Has no communication with cerebral sinuses.
Lies in epidural space.
Is formed by two vertebral veins.

14. A 40 years old man feels pain in his gastrocnemeus muscle after he walks 100 meter which relieves when he stops walking is likely due to obstruction of:
A. Post. Tibial artery.

15. Subclavian artery grooves over:
A. 1st rib.

16. What is inappropriate about azygus vein.
A. It enters the thoracic cavity thru esophageal opening.

17. Which of the following structure arches over root of left lung:
A. Arch of aorta.

18. Weakest point of rib is:
A. Angle of the rib.

19. A pathologist wants to pass dye to the liver he will reach thru:
A. Ligamentum Teres.

20. Internal spermatic fascia is a continuation of:
A. Transversalis fascia.

21. The branch of internal carotid artery which remains in true pelvis throughout its course:
A. Middle rectal artery.

22. During a per rectal examination the examiner will not reveal:
A. Ureter

23. Parasympathetic nerves supplying the urinary bladder are:
A. Pelvic splanchnic nerves.

24. Nerve supply to the lower airways:
A. T3-4

25. During an injury to the bulbar part of urethra the urine will extravasate to:
A. Superficial perineal pouch.

26. Nerve supply to the distal scrotum is thru:
Illioinguinal nerve.
Illiohypogastric nerve.
Genitofemoral nerve.

27. During surgery of right colon for carcinoma which structure would not be injured:
A. Aorta.

28. Slow growing tumor of head of pancreas will compress:
A. Common Bile Duct.

29. Tumor of the head of pancreas will compress:
A. Common Bile Duct.

EMBYROLOGY.

1. Regarding Decidua:
A. Decidua basilis forms the maternal part of placenta.

2. Embryonic period is:
A. 3-8 weeks.

3. Which of the following is a derivative of neuro ectoderm:
A. Sphincter pupili muscle.

4. Derivative of Ectoderm include:
A. Secretary Epithelium of parotid gland.

5. Derivative of Ectoderm include:
A. Secretary Epithelium of parotid gland.

6. Regarding Allantois:
……

7. left umbilical vein will regress to:
A. Ligamentum Teres.

8. Which of the following structure is not an Embryological remnant:
A. Lateral umbilical ligament.

9. Regarding Mesothelium:
A. Lines the body cavities.

10. Physiological hernia occurs in between:
A. 6-10 weeks.

11. What will happen immediately after birth:
Anatomical closure of Ductus arteriosus.
Anatomical closure of Ductus venosus.
Anatomical closure of foramen ovale.
Obliteration of Left umbilical vein.
Obliteration of Right umbilical vein.

12. Which of the following bone is derived from 2nd Pharyngeal arch:
A. Styloid process.

13. Muscles innervated by hypoglossal nerves are derived from:
A. Occipital Somites.

14. Primordial Germ cells are derived from:
A. Yolk sac endoderm.

NEUROANATOMY

1. In adults spinal cord ends at the intervertebral disc between:
A. L1-2.
2. Injury to L1 vertebra will directly damage which of the following spinal structure:
A. Conus Medullaris.
3. Which of the statement regarding Lateral Horn of spinal cord is inappropriate:
A. It is present at the cervical portion of spinal cord.
4. Regarding Trapezoid Body:
A. It is related to the auditory pathway.
5. Loss of Fine and skilled movements of the hand is due to damage of:
A. Corticospinal Tract.
6. What is inappropriate regarding Glossopharyngeal nerve:
A. It is entirely sensory.
7. Loss of temperature regulation is due to damage at:
A. Anterior Hypothalamic Nucleus.
8. Temperature regulation centre is located in:
A. Hypothalamus.
9. In spinal tap the needle which will go across:
A. Epidural Space è Dura Matter è Sudural Space è Arachnoid Matter è Subarachanoid space.
10. Regarding spinal cord what is inappropriate: A. Its dura matter has two layers

HISTOLOGY

1. Simple columner epithelium is present:
A. Choroidal plexus of ventricles.
2. Cytoskeleton:
A. Maintains the integrity of the cell.
3. Mast cell.
……….
4. Newly formed Elastic cartilage looks yellow & dense because of:
A. Large no: of Elastin fibers.
5. Compact bone contains:
A. Osteoblast cells in the lacuner spaces.
6. Which part of the respiratory tract contains mucous glands:
A. Nasal cavity.
7. Skeletal muscles have:
A. Multiple nuclei located at their periphery.
8. Surfaces which are prone to great amount of friction have:
A. Straitifed Squamous Keratinizing Epithelium
.
PHYSIOLOGY

1. Pulmonary Wedge Pressure:
A. Indirectly measures left atrial pressure,
2. Ventricular Depolarization on ECG strip is represented by:
A. QRS Complex.
3. Ventricular preload is measured by:
A. LVEDV.
4. Blood flow to the left ventricles is increase by:
Acetylcholine infusion.
Sympathetic stimulation
5. Bain Bridge reflux.
……………
6. IPSP is generated by opening of:
A. Cl- channels.
7. During Depolarization:
A. There is rapid influx of Na+.
8. Blood group antigen:
A. Will not found in any other tissue than blood.
B. Will be inherited by Autosomal recessive pattern
9. If father’s blood group is B+ve & mother’s blood group is AB+ve there child can not have which of the following blood group:
A. O+ve.
10. ESR will increase with the decrease in:
A. Albumin.
11. ADH will act on:
A. Distal Tubules.
12. Renal absorption of glucose thru secondary transport with sodium occurs at:
A. Proximal Tubules.
12. Simple Diffusion depends on all of the following factors except:
A. Magnetic field.
13. What is the suitable I/V fluid for the patient of acidurea:
Normal Saline.
Dorrow`s solution.
Ringer lactate.
5% dextrose
10% dextrose.
14. Which of the following causes Hyperkelemia:
Zollinger Ellison syndrome.
Cushing syndrome.
Conn`s syndrome.
Pyloric stenosis.
15. Which of the following hormone is called STRESS HORMONE:
A. Cortisol.
16. Inhibitory factor released by hypothalamus against which of the following hormone:
Prolactin
Growth hormone.
17. Bile of the Liver differs from the GB bile because GB bile contains decrease amount of:
A. Water.
18. Which of the following cell can never reproduce:
Erythrocyte.
Neuron.
Skeletal muscle.
Smooth muscle.
19. Which of the following is the NOT non dividing cell:
A. Hepatocytes.
20. Heat loss mainly depends on:
Temperature of the surrounding.
Evaporation.
21. Cortisol decreases which of the following cell:
A. Lymphocyte.
22. Resection of distal ileum will impair the absorption of:
A. Bile Salts.
23. Regarding Bradykinin:
It formation is activated by killkeran.
24. Regarding Interferon:
……….
25. Surfactant is released by:
A. Type II pneumocytes.
26. Increase peripheral resistance is due to:
A. Increase vasomotor tone.
27. Chloride shift means:
A. Transfer of Cl- in erythrocytes in exchange of HCO3.
28. Cardiac muscles are prevented by tetanization due to its:
Rythmicity
Automaticity
Conductivity
Long refractory period.
29. Sustained rhythmic reflex tremors induce by sudden movements is:
A. Clonus.
30. Most active form of thyroid hormone present in circulation is:
A. T3.
31. Regarding conduction of visual pathways:
………..
32. Regarding olfaction:
A. Sharp odors have the quality of water & lipid solubility.
33. Unilateral Anosmia is due to:
A. Affection of Nasal mucosa.

GENERAL PATHOLOGY

1. Irreversible cell injury starts with:
A. Rupture of the Lysosomal membrane.
2. Which of the following is not a mediator of acute inflammation:
A. Dopamin.
3. ICAM & VCAM mediates:
A. Leukocyte Adhesion.
4. Fever in inflammation is caused by:
A. IL1 & TNF α.
5. A 36 years old women presented with acute abdomen. At laparoscopy most of the bowl loops were dark purple black. Her mesenteric veins were patent. The most probable underlying pathological process is:
A. Wet Gangrene.
6. Superimposed infection on necrosis is called:
A. Gangrenous Necrosis.
7. Fluid accumulates in acute inflammation contains:
A. Proteins >3gm/dl.
8. Fat necrosis occurs in:
A. Acute pancreatitis.
9. What is inappropriate about fat necrosis:
A. Only caused by trauma to the fat tissue.
10. A 25 year old lady with 14 weeks pregnancy had a road traffic accident brought to the emergency department with a large open wound on thigh and femur fracture. After 2 days of accident she suddenly collapsed & died. The most probable pathological process involve in her death:
A. Fat Embolism.
11. Regarding Fat Embolism:
It is Fetal in >80% of cases.
IT manifest within 12 hours.
12. A 30 year old women brought to emergency department with bleeding…..


13. A 16 years old boy deeply jaundiced presented with gum bleeding due to:
A. Vitamin K deficiency.
14. A patient presented with enlarge lymph nodes, the diagnosis of Tuberculosis in this patient is confirmed by:
A. Presence of caseous necrosis in lymph nodes.
15. An 18 year old girl came to family doctor complaining of primary amenorrhea, on examination she found to have well formed breasts, blind ended vagina with no uterus & ovary. Her probable Karyotype is:
A. 46 XY.
16. Edema due to increase hydrostatic pressure is seen in:
A. Congestive cardiac failure.
17. Which of the following is a benign tumor:
A. Warthin`s tumor.
18. Which of the following is a premalignant condition:
A. Leukoplakia.
B. Erythroplakia.
19. Which of the following is a premalignant condition:
Condyloma
Metaplasia Endocervix.
Cystic hyperplastic endometrium
20. Metaplasia does not occur in:
Brain.
Vitamin A deficiency.
21. The primary source of Creatinin is:
Liver.
RBC.
Skeletal muscles.
Cardiac muscles.
Lungs.
22. Dystrophic Calcification is seen in all of the following except:
Malarial parasite.
Dead fetus.
Hydatid Cyst.
23. Maximal tensile Strength of a wound is attained in.
3 Months.
Over an unpredictable period of time.
1 Year.
6 days.
10 days.
24. Regarding autosomal recessive disorders:
………………
25. Which of the following are not non-dividing cells.
A. Hepatocytes.
26. In a patient there is atrophy of submandibular gland due to its duct obstruction. Atrophy of the gland is because of:
A. Apoptosis.
27. The mechanism of injury of ionization radiation is:
A. Free radical formation.
28. LASER act by:
Cutting.
Biochemical changes
29. A patient admitted to the hosp. diagnosed as case of gas gangrene dies due to:
A. Toxic shock
30. Which of the following is the confirmatory test of AIDS:
Western blot.
ELISA.

SPECIAL PATHOLOGY
1. Hepatic hemengioma is associated with:
A. Vinyl Chloride.
2. Which of the disease is common in I/V drug abusers:
A. Infective Endocarditis.
3. Typhoid carriers are:
A. Usually asymptomatic.
4. Intestinal metaplasia due to reflux esophagitis leads to:
A. Adenocarcinoma.
5. Embryological marker that reappears in circulation in Ca Colon is:
A. CEA.
6. Which of the following is peculiar for crohn`s disease is:
A. Perianal Lesions.
7. Anemia of pregnancy is due to:
A. Increase plasma volume.
8. Major complication of severe burn:
Formation of granulation tissue.
Carcinoma formation.
9. What is Inappropriate about hyper parathyroidism:
A. There is increase PO4 renal absorption.
10. A 25 year old lady complaining of palpitations, heat intolerance on examination her pulse is 112b/min, BP 120/80, R/R 20 br/min. She is most probably a case of:
A. Hyperthyroidism.
11. Resection of Anterior lobe of pituitary will lead to:
A. Decrease glucocorticoids.
12. A 6 year old boy is complaining of proximal muscular weakness was found to be Ca++ channel antibodies positive. The most probable diagnosis is:
Lambert Eaten Syndrome.
Mysthenia Gravis.
13. In pulmonary embolism, respiratory failure is due to:
A. Ventilation / perfusion mismatch.
14. Left ventricular failure will lead to:
A. Increase pulmonary arteriolar Pressure.
15. Immediate effect after injury to a vessel is:
Vasoconstriction
16. Effects of hyper parathyroidism in Ca. lung is due to:
Parathyroid like protein
Parathyroid hormone
17. Spleenectomy will help in treating which type of anemia:
A. Hereditary Spherocytosis.
18. Malignant Tumor that will not metastasize:
A. Basal cell carcinoma.
19. Achlasia is due to:
A. Absence of Myenteric plexus.
20. After a traffic accident a lady is brought to a hosp the IMMEDIATE step you do:
A. Clear airway.
21. Ameobic infection reaches lungs via:
Direct extension from liver.
By aspiration of ova of Entameoba histolitica.
By aspiration of trophozoits of Entameoba histolitica.
Via Portal vein.
22. In Hypothyroidism there is increase in:
A. Cholesterol
23. In thyroid disease the antibodies are directed against:
A. Thyroglobin.
24. A 50 years old man is awakened in the middle of the night with acute pain & tenderness of the right knee. He has a low grade fever. His knee is hot, tender & swollen. Analysis of fluid from right knee shows: leukocytes 70,000/mm3 with 75% neutrophils, crystal analysis = negative birefringent, gram stain = negative. The most likely diagnosis is:
A. Gout.
B. Pseudo gout.
C. Septic arthritis.

PHARMACOLOGY
1. Which of the following blocks α and β receptors:
A. Labetalol.
2. Ketamin is used as anesthetic in repeated dressings of burn patient because:
A. It relieves pain as well.
3. Drug that decreases the tone of lower esophageal sphincter & increases gastric emptying:
A. Metaclopromide.
4. Which of the following is suitable antihypertensive for asthma & IHD patient during surgery:
I/V sodium nitroprusside.
I/V nitroglycerin.
5. Which of the following is drug of choice for patient of status asthematicus:
I/V aminophylin
Oral steroid
I/V salbutamol.
6. During surgery antibiotics should be given at:
A. At the time of induction of anesthesia.
7. Heparin will inhibit:
A. Clot propagation.
B. Clot organization.
8. Acid suppression is done by blocking:
A. H2 Receptor.
9. Drug of choice for acute pancreatitis.
Pethidine.
Morphine.
Paracetamol