SURGERY March 2008

COURTESY: DR: ALTAF GHUMRO &
PREPARED BY DR: MUHAMMAD SHEERAZ AKHTAR SOOMRO


1] A newborn child has abdominal swelling on the right side of the umbilical cord. It is not covered with amnion. The condition is

A} Gastroschisis
B} omphalocele

2] Which of the following is not related to Meckel’s Diverticulum?

A} is remnant of urachas
B} lies 60 cm proximal to illeocecal Valve

3] A boy is excreting meconium from rectum and has severe constipation. The rectal examination showed no ganglion cells. The condition is called

A} Intussusceptions
B} Hirschsprung’s disease

4] Regarding somites

A} They develop on both sides of notochord.
B} they develop from lateral plate mesoderm

5] Regarding diaphragmatic hernia the most likely is

A} Absence of septum transversum
B} Failure of pluiroperitoneal membrane

6] Which one of the following is not the derivative of 1st (mandible) pharyngeal arch?
A} Incus
B} Malleus
C} Stapes
D}
E}

7] Embrologically, Which one of the following is not the developmental remant

A} lateral umbilical ligament
B} Medial umbilical ligament
C} Median umbilical ligament
D} ligamentum teres
E} ligamentum venosum

8] The part of mouth derived from ectoderm is

A} Epithelium of parotid salivary gland
B} Epithelium of Tongue
C} Floor f mouth
D}
E}

9] A male with Gynaecomastia, small testes, diagnosed as Klienfelters syndrome. The karyotype involved is

A} 45 XO
B} 46 XX
C} 47 XXX
D} 47 XXy
E} 47 XX

10] Somites are derived from

A} Intermediate mesoderm
B} Paraxial mesoderm
C} Lateral plate mesoderm
D} Ectoderm
E} Endoderm

11] An I/V Urograph of 8 year old boy shows Excretion of dye normal I kidney but absence of shadow on left side. Instead there is a small shadow just above the bladder on the left side. Which one of the following is most likely?

A} Horse shoe kidney
B} Constricted ectopic kidney
C} Pelvis kidney
D} Non rotating kidney
E} Unilateral renal agenesis

12] Which one of the following is not formed from urogenital sinus?

A} Bartholin’s gland
B} Urethral glands
C} Para urethral glands
D} Seminal vesicle
E}

13] Virus damage the cell by

A} making the pores in cell membrane
B} Forming free radicals
C} Altering the formation of proteins
D} Nuclear damage
E} using energy for their own metabolism

14] The tissue damage by Ionization Radiation is due to
A) Damage to Golgi bodies
B} Formation of free radicals
C} Hydropic degeneration
D} Metaphase of cell
E} Swelling of cells
15] All are features of IRREVERSIBLE cell injury EXCEPT
A} Karyolysis
B} Karyorhexis
C} Autolysis
D} Shrinkage of mitochondria
E} Appearance of myelin figure
16] Which one of the following is least likely involved in increasing Osteoporosis

A} Increased wt: on bone
B} Renal cell carcinoma
C} Carcinoma prostate
D}
E}

17] Patient X-Ray shows hilar lymph nodes. Granuloma but no necrosis. What is the diagnosis?

A} Sarcoidosis
B} Silicosis
C} Tuberculosis
D}
E}

18] In women the most common form of necrosis after trauma is due to

A} Trauma to fatty tissue
B}
C}
D}
E}

19] Dystrophic calcification is present in which of the following

A} Acute pancreatitis
B} Malaria
C} Tuberculosis
D}
E}

20] Which one of the following is most likely feature of reversible injury?

A} Cell swelling
B} Karyorhexis
C} Decreased glycogen
D} Myelin figures
E}

21] A person fell on road and got an abrasion on elbow the first event likely occur would be

A} Vasoconstriction
B} Platelet adhesion
C} Platelet aggregation
D}
E}

22] Which one of the following facilitates phagocytosis in neutrophils?

A} C5a
B} C3a
C} C3b
D} C3 - C5 complex
E}

23] Which one of the following is potent antioxidant?

A} Vitamin A
B} Vitamin C
C} Vitamin E
D} Transferrin
E}

24] Which one of the following among Arachidonic acid metabolite is most likely function mediated in phagocytosis?

A} Chemo taxis
B} Diapedisis
C} Transmigration
D}
E}

25] Which one of the following is potent COX-II INHIBITOR?

A} Aspirin
B} Celocoxib
C} Indomethacin
D} Meloxicam
E} Piroxicam
26] In case of pulmonary embolism extensive infarction causes sudden death due to

A} Air embolism
B} Fat embolism
C} Thromboembolism
D}
E}

27] A patient was operated for abdominal surgery. A few days after he developed pain and swelling in his right leg. Which one of the following is most likely?

A} endothelial injury
B} hypercoagubility
C} stasis and endothelial injury
D}
E}

28] A soldier has profuse bleeding. He was admitted in the hospital. Which one of the following should be given immediately?

Fresh frozen plasma
B} 20 days old blood
C} 3 days old blood
D}
E}

29] A boy was born with the condition of polycystic kidney disease. Which one of the following is correct?

A} Autosomal Dominant disorder
B} Autosomal recessive disorder
C} X- linked disorder
D}
E}

30] In a renal transplantation, which one of the following is single most significant test to be done?

A} ABO blood grouping of donor and recipient
B} HLA typing and matching
C} Donor and recipient should be close relatives
D}
E}

31] A organ was transplanted to the patient, but within 10 mins the organ failed. Which one of the following is likely etiology?

A} Antibody mediated
B} T-Cell mediated
C} Preformed antibodies
D}
E}

32] AIDS occur in the presence of

A} Kaposi’s sarcoma
B}
C}
D}
E}

33] A 2 year old boy is suspected as HIV positive, which one of the following is the confirmatory test in the boy

A} ELISA test
B} Western Blot test
C} PCR
D} Increased levels of HIV in T lymphocytes
E}

34] A 10 year old boy was operated for gastrectomy, which one of the following type of anemia is developed postoperatively

A} Megaloblastic anemia
B} Iron deficiency anemia
C} Normocytic norm chromic anemia
D}
E}

35] Autoimmunity is not involved in which one of the following

A} Pernicious anemia
B} Grave’s disease
C} Diabetes mellitus
D} Hashimoto’s thyroiditis
E} Thymoma

36] In case of hashimoto’s thyroiditis, which one of the following is seen?

A} Anti thyroglobulin
B}
C}
D}
E}

37] To differentiate Chron’s disease from Ulcerative colitis, which one of the following is likely significant regarding Chron’s disease

A} has increased frequency to cancer
B} Involves both small and large intestine
C}
D}
E}

38] Regarding alcoholic hepatitis, following is finding

A} Mallory bodies
B}
C}
D}
E}

39] A 20 year old girl has developed Galactorrhea due to prolactinoma. Bromocriptine is given to treat it the drug causes

A} Inhibition of prolaction from pituitary gland
B} Decreased prolaction from hypothalamus
C} Inhibition of prolaction from breast
D} Stimulation of prolaction of anterior pituitary
E}

40] An unconscious patient presented in ED does not respond to Naloxone. Which of the following drug has been taken by this patient?

A} Morphine
B} Heroine
C} Pethidine
D} Phenobarbital
E}

41] Strongest layer of small intestine is

A} Mucosa
B} Sub mucosa
C} Circular layer
D} Serosa
E} Longitudinal layer

42] Regarding adrenal medulla which one of the following is true?

A} Secretes epinephrine and Norepinepinephrine in 80/20 ratio
B}
C}
D}
E}

43] R.E.R most likely

A} Synthesizes protein
B} Synthesizes lipids
C}
D}
E}

44] Half life of insulin is

A} 5 mins
B} 90 mins
C} 120 mins
D}
E}

45] Insulin

A} Converts glycogen to glucose
B} Stimulates protein synthesis
C} Stimulates lipolysis
D}
E}

46] Which one of the following most likely contains abundant cholesterol?

A} VLDL
B} LDL
C} Chylmicrons
D} HDL
E}


47] Which one of the following most likely causes Increase in GFR?

A} Constriction of afferent arteriole
B} Constriction Of efferent arteriole
C}
D}
E}

48] Gastric emptying is delayed by

A} Gastrin
B} Secretin
C} CCK
D}
E}

49] Which one of the following pancreatic enzyme is most likely involved in fat absorption

A} Amylase
B} Lipase
C}
D}
E}

50] Smooth muscle

A} Contain sarcomere
B} T-tubules are present
C} Gap junctions are present
D} Forms motor end plate
E}

51] Steady pressure on skin is perceived by

A} Pacinian’s corpuscle
B} Ruffini’s corpuscle
C} Meissener’s Corpuscle
D} Golgi tendon organs
E}

52] Which one of the following is related to pain?

A} Serotonin
B} Substance P
C}
D}
E}

53] Free nerve endings have receptor for

A} Light touch
B} Pressure
C} Pain
D} Vibration
E}

54] Which one of the following has highest pressure?

A} Pulmonary artery
B} Left atrium
C} Right atrium
D} SVC
E}

55] Flow of current through junctions in the muscle

A} Smooth muscle
B} Skeletal muscle
C} Cardiac muscle
D}
E}

56] A profusely bleeding patient develops hypotension, which one of the following would be immediate mechanism to maintain B.P

A} Baroreceptor reflex
B} Chemoreceptor reflex
C} Secretion of ADH
D} Aldosterone
E} Renin angiotensin mechanism

57] Water enters into the cell by

A} Pinocytosis
B} through pores
C} Simple diffusion
D} Facilitated diffusion
E} Active transport

58] Insulin secretion is controlled by

A} Glucagon
B} increased glucose
C} Decreased glucose
D}
E}

59] Systolic B.P is highest in

A} Pulmonary arteries
B} Cerebral arteries
C} Renal arteries
D} Brachial arteries
E}

60] End diastolic volume depends on

A} Atrial contraction
B} Distensibility of ventricles
C} Duration of diastole
D} Venous return
E}

61] Mean electrical axis of heart is deviated to left if

A} Heart is angulated on right side
B} Pulmonary stenosis
C} Right bundle branch block
D} COPD
E}

62] Pulse Oxymeter measurement gives error in the reading if

A} Pt. is dark skin
B} Increased conc: of Hb A
C} Increased Conc: of Hb F
D} Aortic stenosis
E}

63] Secretion of potassium by distal collecting tubule decrease by

A} Increase in potassium in diet
B} Hyperaldosteronism
C} Metabolic alkalosis
D} Spironalactone intake
E} Thiazide diuretic



64] Absorption of iron is markedly affected by

A} Ingestion with meal
B} Partial gastrectomy
C} Trivalent form
D}
E}

65] Patient with pancreatitis has developed steatorrhea due to deficiency of

A} Lipase
B} Pepsin
C} Amylase
D} Renin
E}

66] Absorptive surface of small intestine is

A} 50
B} 100
C} 200
D} 350
E} 500

67] Daily dietary protein for 70 kg. Man is

A} 12 gm
B} 120gm
C} 200 gm
D} 150 gm
E}

68] Source for metabolic fuel for liver in post absorptive state is

A} Glucose
B} Ketones
C} Glycerol
D} Fatty acids
E}