FCPS MCQS OF SURGERY

Q1.False statement  regarding  acute necrotizing pancreatitis is ?

a)  It accounts for 10-15% of all cases of acute   pancreatitis

b) Necrotizing Pancreatitis involves both pancreatic parenchyma and surrounding tissues or sometimes

    either one

c) Peripancreatic involvement means severe disease as comapred to pancreatic parenchyma alone

d) Radioloical diagnosis of necrotizing pancreatitis is difficult in the 1st week

Q2. Which of the following statement is not true for ideal hepaticojejunostomy

a) The anastomosis should be tension free

b) All the suture knoys should  be on the  outside of bile duct

c) Mucosal contact must exist between  the mucosa of the bowel and bile duct

d) Anastomosis done with single layer  absorbable sutures

Q3. Barrett's esophagus is a premalignant condition.

Which of  the following statement is false regarding

Barrett's esophagus

a) Barrett's mucosa predisposes to Squamous cell carcinoma of esophagus

b) Risk of Cancer is 0.5% per year

c) Prevalence of Barrett's esophagus in general  population is  2-7%

d) Intestinal type of mucosa  with goblet cells is the most  common histopathological finding

Q4. A 45 year old lady presents to the HepatoBiliary

Clinic with a  large 3 cm stone in the neck of gall bladder

eroding into the Common Bile duct (CBD) effacing about

50% of its diameter. Patient  has been counselled  about

surgery and is willing for the same.What would be the most

appropriate  surgery for this patient?

a) Cholecystectomy, removal of stone and primary repair of CBD over a T tube

b) Radical Cholecystectomy

c) Cholecystectomy and use of a flap of Gall Bladder to repair the defect in CBD

d) Cholecystectomy and Roux en Y Hepaticojejunostomy

Q5. A 50 year old presents with vague persistent abdominal pain. CT Scan of the abdomen reveals a duodenal diverticulum. Which of the

statements is true regarding duodenal diverticulum.

a) The overall incidence of duodenal diverticulum is 7-20% and about 10%  of these require surgery.

b) Most of the duodenal diverticula are symtomatic and perforation is the most common complication

c) Surgery should be avoided and carried out only in case of complications  like perforation, uncontrooled hemorrahge, persistent biliary or pancreatic symptoms

d) Juxta vaterian diverticulum is the easiest to manage

answers

1) c

Pancreatic necrosis occurs in 10-20% of all cases of Acute pancreatitis and commonly involve both pancreatic parenchyma and peri pancreatic tissue.Involvement of pancreatic parenchyma heralds a disease more severe in intensity than involvement of peripancreatic tissue alone.

2) b

Ideal Hepaticojejunostomy should be tension free with mucosal approximation and done using single layer absorbale suture

All though it is desired that the suture knot should be outside but absorbale suture are bein used , in the posterior layer knots may be place on the inside of the lumen

3) a

Barrett's esophagus is associated with adenocarcinoma and not squmaous cell carcinoma. Metaplasia occurs most commonly because of GERD and the normal esopheal lining is replaced by columnar cells

These columnar cells can be (i) Junctional cells (ii) Gastric cells and (iii) Intestinal Type of cells

Prsence of intestinal type of cells with prsence of goblet cells is the sine quo non of Barrett's esophagus

All other options are true.

4d

This patient has typical feature of Mirizzi's syndrome named after the Pablo Mirizzi.

It is a rare condition in which stone gets impacted in the neck of Gall Bladder. The stone compresses the CBD externally or can lead to fistula formation with the CBD.

Patients generally present with pain abdomen, jaundice and fever.

The Csendes classification of Mirizzi syndrome  is

Type 1: external compression of the common bile duct

Type 2: a cholecystobiliary fistula is present involving less than one third the circumference of the bile duct

Type 3: a fistula is present involving up to two thirds the circumference of the bile duct

Type 4: a fistula is present with complete destruction of the wall of the bile duct

Mirizzi Syndrome Treatment

Type 1 - Mirizzi syndrome  treatment is fundus first cholecytectomy or partial cholecystectomy

  For Type 2 to 4 the best treatment would be cholecystectomy and Roux en Y hepaticojejunostomy. A flap of gall bladder may sometimes be used if it appears healthy.

FCPS MCQS OF SURGERY
1- Which of the following statements about achalasia is/are correct? 

A. In most cases in North America the cause is a parasitic infestation by Trypanosoma cruzi. 

B. Chest pain and regurgitation are the usual symptoms. 

C. Distal-third esophageal adenocarcinomas may occur in as many as 20% of patients within 10 years of diagnosis. 

D. Manometry demonstrates failure of LES relaxation on swallowing and absent or weak simultaneous contractions in the esophageal body after swallowing.

2-The most specific blood test in diagnosing acute pancreatitis is
a) Serum amylase
b) Urinary amylase
c) Serum lipase
d) CA 19-9

surgery mcqs

Q56. Endoscopic stone extraction from CBD is not possible  in all except?

a) Multiple CBD stones

b) Intrahepatic stones

c) Multiple Gallstones

d) Prior Gastrectomy

e)Duodenal diverticula

57. What is the management of choledochal cyst adherent to portal vein?

a) Excision and Roux en y hepaticojejunostomy

b)Internal drainage into roux en y jejunal limb

c) Hepatic lobectomy

d) The internal lining of the cyst can be excised, leaving the external portion of the cyst

      wall intact.

e) Marsupialization

58. The most common cystic disease of the spleen is

a) Hydatic cyst of spleen

b) Pseudo cyst of the spleen

c) Columnar lined cyst of spleen

d) Cystic lymphangioma

e) Dermoid cyst

59. OPSI is commonest in splenectomy done for

a) Thalassemia

b) Trauma

c) Hereditary Spherocytosis

d) ITP

e) Sickle cell disease

Q60. Which of the following is not true regarding wandering spleen?

a) The spleen is attached to a long vascular pedicle without the usual mesenteric  

     attachments.

b) Torsion and infarction of the spleen are common complications

c) There is congenital atresia of the dorsal mesogastrium in children

d) Splenectomy is required in all cases

e) May present as acute abdomen

61. Treatment for bleeding duodenal diverticulum is

a) Diverticulectomy

b) Diverticulopexy

c) Diverticulization

d) Subtotal diverticulectomy

e) Gastro-jejunostomy

62. Which of the following does not appear to cause early dumping

a) Serotonin

b) Bradykinin

c) Neurotensin

d) Secretin

e)Enteroglucagon

63. Which is false for GIST (Gastro intestinal stromal tumor)  of stomach

a) It is the same as leiomyoma and leomyosarcoma as described previously.

b) origin is from mucosa from the interstitial cells of Cajal

c) Associated with C-Kit Mutation

d) Imatinab is a new effective drug for adjuvant therapy

e) Detection of KIT protein distiguishes GIST from smooth muscle tumors

64. Most important investigation for Dysphagia in 60 year old is

a) Upper GI Endoscopy                 

b) CT Thorax
c) Barium meal X-ray 

d) MRI Scan

e) Laproscopy 

65. Maximum potassium concentration is seen in

a)                  Saliva

b)                  Gastric secretions

c)                  Jejunum

d)                 Bile

e)                  Colon                                            

66. Which of the following muscles do not form the posterior relation of breast?

a) Pectoralis major

b) Serratus Anterior

c) Rectus Abdominis

d) Lattismus Dorsi

e) Pectoralis minor

67. Minimum number of lymph nodes to be dissected in Axillary sampling in brest   

      conservation surgery is

a) 2

b) 3

c) 4

d) 5

e) 10

68. Which of the following is a contraindication for breast conserving surgery (BCT)?

a) Small lump to breast ratio

b) Central breast tumor mass

c) Breast Tumor size less than 5 cm

d) Young age

e) Old age

69. Which of the following is not an indication for admission in a case of burns

a) Full thickness burns more than 5% of total body surface area (TBSA)

b) Partial thickness burns more than 10% in adults

c) Partial thickness burns more than 10% in children

d) Inhalationsl burns

e) Electrical burns

70. Which is the site for escharotomies in extremities for deep burns?

a) Anterior aspect

b) Posterior Aspect of the limb

c) Medial or lateral aspect of limb

d) It can be anywhere

e)None of the above

71. The most common Vein to be involved in Extrahepatic portal hypertension in chronic pancreatitis is

a) Portal vein

b) Splenic vein

c) Superior mesenteric vein

d) Inferior mesenteric vein

e) Inferior vena cava

72. Which one is a definite urgent indication of thoracotomy:

a)Bilateral hemothorax

b)Tension pneumothorax containing more than 1.5 litres of air

c)Flail chest with more than 10 ribs fracture

d)Ahemothorax draining more than 200ml per hour

e)All of the above

73. Which one of the following is false regarding hernias:

a) Inguinal hernia is superomedial to pubic tubercle

b) Femoral hernia is inferolateral to pubic tubercle

c) Men are more likely to have inguinal hernia than females

d) Men are more likely to have femoral hernia than females

e) Inguinal hernia are more common in females

74. A lesion typically found on legs in diabetics

a) Erythema nodosum

b) Necrobiosis lipoidica

c) Erythema  ab igne

d) Pyoderma gangrenosum

e) Erythema multiforme

75. Which one of the following is incorrect regarding ulcerative colitis?

a) Smoking is protective

b) Predominantly involves large bowel

c) Can present with erythema nodosum

d) A COBBLE –STONE appearance is seen on colonoscopy

e) Acute episodes are treated by i/v steroids and azothiaprine

76.  Which ONE of the following is NOT an absorbable suture?

a) Catgut

b) polyglyconate

c) PDS (Polydioxanone)

d) Silk

e) Vicryl (Polyglactins.

77. Adequate minimum urine output in a 70kg man during resuscitation is

a)                  35 ml/hr

b)           20 ml/hr

c)                  50 ml/hr

d)                 45 ml /hr

e)                  60 ml/hr

78. Which of the following is true for basal cell carcinoma?

a)                  metastases to lymph node is rare

b)                  common at non-sun exposed area

c)                  UV light is not a cause

d)                 morpheous type is easily treated

e)                  treatment of choice is radiotherapy

79.  A 28 year old lady complains of painful defecation associated with fresh per-rectal bleed. Possible diagnosis to consider:

a)                  hiradenitis suppurativa

b)                  dermoid cyst

c)                  pilonidal sinus

d)                 anal fissure

e)                  pruritis ani

80. Haemorrhoids

a)                  are commonly believed to be venous malformation

b)                  require surgical excision if small and symptomatic

c)                  commonly present with painful bleeding and perianal swelling

d)                 may undergo malignant metaplasia in those with chronic prolapse

e)                  pruritis ani

81. The Thyroid gland:

a)         Is derived from the third and fourth pharyngeal pouches

b)         Isthmus overlies the 5th and 6th tracheal rings normally

c)         Embryologically, descends along the thyroglossal tract

d)         Is supplied by the superior thyroid branch of the internal carotid artery

e)         Is supplied by the inferior thyroid branch of the external carotid artery

82. A nodule in the thyroid gland:

a)         May be a presentation of multinodular goitre

b)         Is unlikely to be a cyst if painful

c)         Should not be investigated with needle cytology

d)         Usually requires excision

e)         Will require radio-isotope scanning to help distinguish between a benign and a malignant nodule.

83. A multinodular goitre:

a)         Is more common in patients who are iodine deficient

b)         Is not preceded by a diffuse goitre in early adult life

c)         Often becomes neoplastic

d)         May be effectively treated with thyroid hormone

e)         Always needs surgical treatment

84. Autoimmune thyroiditis (Hashimoto’s disease):

a)         Characteristically occurs in young females

b)         Always presents with hyperthyroidism

c)         Produces a nodular enlargement of the thyroid gland

d)         Is associated with regional lymph node enlargement

e)         Is associated with raised serum levels of thyroid antibodies

85. Thyroid cancer:

a)         Frequently produces multinodular enlargement of the gland

b)         May well be diagnosed by thyroid scan

c)         Causes a hard nodule in the gland

d)         Often produces a bruit over the gland

e)         Should be suspected if there is vocal cord palsy

86. Papillary carcinoma of the thyroid:

a)         May follow radiation exposure in childhood

b)         Is a rapidly-growing tumour

c)         Doesnot metastasizes to lymph nodes

d)         Is often a localized tumour

e)         Is rarely cured by surgery

87. Follicular carcinoma of the thyroid:

a)         Is more common in males

b)         Is more common below the age of 30 years

c)         Usually metastasizes to lymph nodes

d)         Is associated with a relatively good prognosis in old age

e)         Is best treated by total thyroidectomy

88. Undifferentiated (anaplastic) carcinoma of the thyroid:

a)         Is more common in females

b)         Is less common above the age of 60 years

c)         Is often thyroid stimulating hormone (TSH) dependent

d)         Often exhibits independent thyroid hormone production

e)         Is usually preceded by a long-standing goitre

89. The surgical treatment of differentiated thyroid cancer:

a)         Should be by total thyroidectomy in the potentially curable patient

b)         Should include a frozen section histological examination of the tumour

c)         Should include block dissection of the neighbouring lymph nodes, whether or not they appear to contain tumour

d)         Is most successful in anaplastic cancer

e)         Should be preceded by a therapeutic dose of I131

90. Recurrent thyroid cancer can effectively be treated by all except:

a)         High doses of I131

b)         High doses of thyroid hormone

c)         External irradiation

d)         Chemotherapy

e)         Further surgery

91. Which of the following is not true for Hashimoto thyroiditis?

a)         It is an autoimmune disease caused by CD4 cells with specificity to thyroid antigens

b)         commonly presents as hypothyroidism

c)         Surgery is required in almost all cases

d)         Hashimoto thyroiditis can progress to lymphoma of thyroid

e)         Primary treatment is thyroxine

92. In which of the following conditions anti thyroid antibody may not be elevated?

a)         Hashimoto thyroiditis

b)         Grave's disease

c)         Multinodular goitre

d)         Lymphoma of thyroid

e)         None of the above

93. What is the most common composition of renal stones?

a)         Uric acid stones

b)         struvite

c)         calcium oxalate

d)         Magnesium

e)         Xanthine

94. The most common cause of stone formation is?

a)      metabolic abnormalities

b)      urological abnormalities

c)      infection

d)     Immobilization

e)      Vitamin A deficiency

95. In the ED what is a value for defining hematuria?

a)      Any RBCs/hpf

b)      2 RBCs/hpf

c)      4 RBCs/hpf

d)     5 RBCs/hpf

e)      10RBCs/hpf

96. In the treatment of a 3 year old boy with a UTI,  the strongest indication for admission?

a)         Localized myalgias

b)         Maculopapular rash

c)         Marked fever

d)         Mucoid Diarrhea

e)         Persistent Vomiting

97. Which of the following statements regarding imaging techniques for evaluation of

      suspected kidney stones is correct?

a)         CT scanning poses risk of nephrotoxic contrast

b)         CT scanning provides little data about the adjacent intrabdominal structures

c)         Intravenous pyelogram is highly sensitive but does not provide information on renal function

d)         Plain radiography is highly specific

e)         Ultrasonography is the preferred modality for pregnant pts but might not identify stones smaller than 5mm

98. A 13 year old boy is brought to the ER for sudden onset of groin pain. On

      examination his right testicle is swollen, raised, and tender. Which of the following   

     statements regarding this pts condition is correct?

a)         CT of the affected are is the imaging study of choice

b)         Duplex ultrasonography provides little useful anatomic information

c)         Positive creamasteric reflex confirms the diagnosis

d)         Relief of pain with elevation reliably differentiates this condition from  

            epididymitis

e)         The bell clapper deformity predisposes pts to this condition

99. What is the most common symptom of localized prostate ca.?

a)         Hematuria

b)         Urinary sx’s -- frequency,nocturia

c)         Bony pain

d)         No symptoms

e)         Retention of urine

100.Which one is an absolute contraindication of suprapubic catheterization:

a)         Lower urinary tract infection

b)         Cancer of urinary bladder

c)         Bladder calculi

d)         Interstitial cystitis

e)         Palpable urinary bladder

101- About inguinal hernia, which is FALSE?

a)     deep ring is a defect in fascia transversalis

b)     cannot get above it

c)     cough impulse may be absent in large hernia

d)     mesh repair is contraindicated unless recurrence

e)     repair can be done under local anaesthesia

102. A 40 year old man presented to the A&E department with ureteric colic. Which of the following investigation is not relevant?

a)      abdominal ultrasound

b)      non-contrast CT scan

c)      intravenous urogram

d)     urine dipstick

e)      urine culture

103. Which of the following drugs should not be used in pregnancy?

a)      amoxicillin

b)      tetracycline

c)      erythromycin

d)     acyclovir

e)      zidovudine

104. Endometrioma is associated with

a)      cervical cancer

b)      vulva cancer

c)      clear cell cancer of ovary

d)     cancer of fallopian tube

e)      germ cell tumour of ovary

105. The single largest factor determining long term survival in breast cancer is:

a)      tumour size

b)      tumour grade

c)      tumour subtype

d)     nodal positivity

e)      adjuvant chemotherapy

106. What is not true about nephroblastoma?

a)      also known as Wilm’s tumour

b)      occurs in 10% of children

c)      presents as an abdominal mass

d)     more common in children before 3 years of age

e)      composed purely of epithelial elements

107. Procedure of choice to define anatomic details of calyces, pelvis and ureter is:

a)      intravenous urogram

b)      ultrasound

c)      CT scan

d)     nuclear renogram

e)      retrograde pyelography

108. Effectiveness of breast cancer screening has been shown to be most useful in the following age group

a)      < 35

b)      40 – 49

c)      50 – 64

d)     > 70

e)      All age groups

109. Management of 3cm stone in renal pelvis:

a)     PCNL

b)     ESWL

c)     conservative management

d)     open pyelolitomy

e)     double J-stenting

110. The following is associated with increased risk of breast cancer:

a)     fibroadenoma

b)     fibrocystic disease

c)     atypical duct hyperplasia

d)     ductal papilloma

e)     increase breast size

1. most imp. stress hormone

ACTH*

Epinephrine

Norepinephrine

Growth hormone

2. wat is not in relation with right kidney

decending colon*

ascending colon

duodenum

spleen

3. wat is not in relation with pitutary gland

Facial nerve*

Abducent nerve

Sphenoid sinus

Trigeminal

4. tributery of external carotid vein

Anterior jugular vein*

Facial vein

5. side effect of thophyllin

nausea and vomiting*

hypertension

bradycardia

seizures

6. Nor-epinephrine & serotonin degration by

MAO*

COMT

7. chemotaxic factor

leukoterine B4*

C3b

C5 complex

histamine

8. wat is not in post. relation with left kidney

Deudenum*

Ascending colon

Descending colon

9. wat is in between celeiac trunk and superior messentry artery

Pancreas*

Pancreas + jujenum

Transverse colon + ilium

10. what is secreted in breast milk

Ig G*

Ig A

Ig M

Ig D

Ig E

11. wat cannot pass placenta

Ig G

Ig A

Ig M*

Ig D

Ig E

12.  ant and post spinal arteries arise from

vertebral artery gives anterior spinal, PICA gives post. Spinal*

Internal carotid

Vertebral artery and ant cerebellar artery

13. from which foramen facial nerve enters temporal lobe

internal accustic meatus*

stylomastoid foramen

foramen ovale

foramen spinosum

14. When r the ventricles filled with blood

Diastasis*

Atrial systole

Rapid in flow

15. A boy had behavior problem, loss of memory but resolve …..he is agressive in his mood, where is damage

Mammillory bodies

frontal lobe*

temporal lobe

parital lobe

occipital lobe

16. a new born presented with obstructive jaundice,,,,, gall bladder looks ok in U/s, cause

Atresia of CBD*

Atresia of entire extra hepatic apparatus

Atresia of hepatic duct

Choledochal cyst

17. A man with noticed weakness of left side of the body, hypotonia of the left limb, he swangs to left side, where is the lesion

Cerebral hemisphere

Left cerebellum *

superior c puduncle

Red neucleus

18. adrenalcortical insuficancy causes

hypokelimia

hyponatremis

hypoglycemia*

alkalosis

19. In resting stage actin is attached to

tropomyocin

troponin

titin

myosin

20. if there is damage to sciatic nerve, supply to the dorsum of foot is by

sephenous nerve*

Sural nerve

Common peroneal

Deep peroneal

21. patient with difficulty in standing from sitting postion....

Gluteus Maximum*

Gluteus medius

Tensor fascia lata

Quadricep femoris

22. wat is not in relation with left recurrent nerve

SVC*

Arch of aorta

Lig arteriousum

Trachea

Esophagus

23. stucture compressing Esophagus

Left bronchus (correct)

Left Venticle

Right Atrium

Right ventricle

Thymus

24. Esophagus constriction at

Aortic arch*

Left ventricle

Rt atrium

25. wat vein run with Post. interventricle artery

great cardiac vein

middle cardiac *

small cardiac

26. utrine cancer spread to labia majore via

Round ligament*

utrosacral ligament

27. Basalic vein .

drain in axillary ven*

runs on radial side

starts from palmar surface

28. median nerve

supply lateral 2 lumbricals*

causes wrist drop

29. injury of neck of the humerus, nerve damage

Axillary nerve*

Musculocutaneous

Radial

Ulnar

30. wat is in proximal layer of carpal bone, true

Scaphoid, lunate triqutral & pisiform*

31. broncopulmonary segment wat is true

anatomical,  fuctional n unit of the lung*

contains lobar bronchus

pulmonary veins run in intersegmental tissue

32. urinary bladder, wat is true

supplied by anterior division of internal iliac*

separated from uterus by pouch of Douglas

in males has seminal vesical above and vas deferens below

33. sephenous nerve wat is true

drain into femoral 3.5cm inferior n lateral to pubic tubercle*

has only 1 tributary

connected to short sphenous by perforators

34. down syndrome

trisomy 21*

18

15

13

35.Which of the following tissue is most radiosensitive

Skeletal muscle

Cartilage*

Bone

36. diagnostic test for strptococuss is

ASO titer

Blood culture*

Urine Dr

37. 65% of Na and water reabsorbed from

PCT*

DCT

Loop of Henle

Collecting duct

38. injury to hippocampus

Memory loss*

40. .Erythropoietin is secreted from

Yellow marrow

Macula densa

Preitubualr capillaries*

PCT

41. medial part of breast supply which node

internal thoracic*

lateral grp

ant grp

medial grp

42. diapharam contraction cause

increase in thoracic pressure

increase in thoracic diameter

43. thoracic duct

passes with aorta *

44. sypathetic supply by alpha receptors

dilator pupilary musscle of eye*

brochoconstriction

cardioacceleration

45. parasympathetic supply

inc. secretioin of slivary gland*

46. gastric emptying delayed by

CCK*

Secretin

Gastrin

Vagus

47. A boy has edema due to protien  loss of 3.5g in urine..., wat is the cause of edema

Plasma colloid pressure is decreased*

Increase hydrostatic pressure

Increased capillary permeability

48. wat is not supplied by internal thoracic artery

Inferior portion of rectus muscle*

Ant abd wall upto umbilicus

Pericardium

Thymus

49. Patient  Gravida 4  with anemia and occult blood in stool

Iron deficiency anemia  *

Sideroblastic anemia

Thalassemia

Megaloblastic anemia

50. iron absorb in

ferruos form*

oxalate

51. Bile salt absorb from

Ileum*

Proximal jejunum

Distal jejunum

doudenum

52. Trachea start from ….wat is true

C6*

C4

C5

Cricoid cartilage

53. wat is true abt CSF

secreted at rate of 500 ml/day*

choroid villi are seen by naked eye

aqueduct transmits CSF from 4^th ventricle to spine

54. blood supply to Bundle of His.

Circumflex artery a br. Of left coronary artery

Posterior interventricular artery

Main Left coronary artery

Main right coronary artery

55. metastatic carcinoma least common site

brain

lung

liver

spleen(correct)

56. premotor area , which artery supplies

Anterior and middle cerebral (correct)

Anterior

Middle

Middle and post. Cerebral

Anterior and pst. Cerebral

57. arterial supply to primary visual area

PCA*

ACA

MCA

PICA

58. A boy defecate just after he takes meal, wat the reflex

gagtrogastric reflex

gastro coic reflex (correct)

59. Median of 20,20,25,25,30,30.35,40

25

20

27.5*

30

60. nerve supply to latismus dorsi

thoracodorsal*

subscapular

long thoracic

61. Right bronchus as compare to left

is longer

ant to pul artery

right bronchus is more vertical than left*

62. A surgeon did a study on patients with heamorroids

he included 100 pt in grpA and treated them surgicall

whil kept the other 100pt on high fiber diet

he interviewd them after 12mons and found that the grp with surgical treatment had a better response…… wat type of study is this?

Case control

Cohort

Prospective

Randomized control trial

63. Doctor patient relations and how good a doctor is known by

his degrees

his records

his pleasant behavior and bed side manners*

64. if a patient develops a fatal disease it is best to

hide it from him

tell it to him and his family as soon as possible*

65.Benedicts test is done for

blood sugar

urinary glucose

urinary reducing sugars*

66.sup parathyroid gland

is related to sup thyroid artey*

lies outside the pretracheal fasciae

lies anterolatral to thyroid

67.MHC complex is

related to HLA typing*

blood grp antigens

same in identical twins

68. first part of axillary artery ends at

border of pectoralis major

border of pec minor *

border of teres major

69.Esophagus is related to which structure whose dilatation can cause dysphagia

l atrium*

left vent

SVC

Rt atrium

70. If RCA is occluded distal to the origin of right marginal artery which part of the heart will be affected most?

Rt atrium

SAnode

AVnode*

Apex of the heart

71. Myleination of the brain wat is most inappropriate?

Starts at birth

Occurs hapharzadly

Sensory neuros are myelinated first

Occurs by oligodendrogliocytes

72. A patient with multiple fractures and BP 90/60 pulse 60/min wat is the most appropriate initial treatment?

IV fluids*

Reduction os fractures

73. Factor 9 def  wat is the appropriate treatment?

Cryoppt*

FFP

Whole blood

WBC

74. DIC most inappropriate

low FDP*

consumptive coagulopathy

treated with heparin

low platelets

75. Kleinfelters syndrome

chromosomal deficiency

autosomal dominant

autosomal recessive

extra X chromosome*

extra Y chromosome

76. Fat embolism most unlikely

urinary test is diagnostic*

occurs due to trauma to fatty tissues

caused bt acute pancreatitis

77. Highest mortality rate

Hepatitis A

Hepatitis B

Hepatitis C

Hepatitis D

Hepatitis E

78. Diphtheria is transmitted by

sexual contact

respiratory *

feco oral

79.which organ has least chance of metastasis

lung

bone

liver

kidney

spleen*

80. which organism causes meningitis secondary to pyogenic lung abscess?

Strep

Staph

Pneuococcus

h.influenzae

81. thromboembolism is most common in?

leg*

liver

brain

kidney

82. OCP increase the risk of

breast cancer

endometrial cancer

thromboembolism*

osteoporosis

83. Osteoporosis is less in premenopausal women due to effect of

estrogen*

testosterone

progesterone

androgens

84. A trauma patient in shock with stab wound along left 10^th rib which organ is damaged?

Liver

Spleen*

Colon

Duodenum

85. in autosomal recessive disease

all siblings are affected

both parents are affected

only mother is affected

all siblings have a chance of one into four of contracting the disease*

86.which of these is not caused by bacteria

 histoplasmosis*

87. Most likely finding in CSF

inc glucose in fungal meningitis

dec glucose in viral meningitis

lymphocytosis in aseptic meningitis

dec glucose in pyogenic meningitis

88. most imp for wound contraction

myoblasts

fibroblasts

myofibroblasts*

epithelium

collagen

89. smooth muscles are

striated

voluntary

mostly arranged in circular and longitudinal layers *

90. hyperparathyroidism causes least likely

hypertension

dystrophic calcification*

inc PTH

91.   Ductus deferens ends into

Prostate

u.Bladder

S.vesicles

Prostatic urethra

Ejaculatory duct*

92. About large gut

descending colon has no haustra

appendix has no tenia*

all large gut is supplied by inf mesenteric artery

ascending colon has a mesentry

93. most probable abt gall bladder.

Has thick submucousa

Mucousa has extensive folds*

94. a patient with known HBV infectio comes with

HBSAg + HBe ab+ HBV DNA + HBC IGM ab+

Wat is the diagnosis?

Acute dis *

Chronic carrier

Chronic active

95. Which HBpathy presents with crises

sickle cell trait

sickle cell disease*

thalassemia

Hb C

96. unconjugated bile is carried by which protein?

Albumin *

Pre albumin

A globulin

B globulin

Fibrinogen

97.After gastrectomy patient will develop

iron def anemia

megaloblastic anemia due to folic acid def

pernicious anemia*

sideroblastic anemia

98. 60 yr male with lymphandenopathy and low hb low platelets and increased wbc

microscopy show large mature cells wats the diagnosis?

CLL*

Burkitts

Follicular

NHL

99. what Is true abt Hb

consisits of alpha and gamma chains in adults

imp buffer of H+ *

not assoc with CO2 transport

100.PDGF is secreted from which part of platelets

alpha granules

dense bodies

cytoplasm

lysosomes

101. which cells produce antibodies

 plasma cells*

T cells

Bcells

Platelets

102. Heparin is released from which cells.

Mast cells*

Eosinophils

IgE

103. Epitheloid cells in granulomas are formed by which cells

macrophages

lymphocytes

langerhans cells*

104. thyroid is invested in which fascia?

Pretracheal*

Deep cervical

Prevertebral

105. wat is true abt thyroid

consists of collecting ducts and acini

epi changes shape according to state of activity.*

Has parthyroids ant to it

106. wat is true abt pituitary

 ant pitutiary derived from neurons

no portal vessels btw hypothalamus and post pituitary*

107. Satiety center is located in which part of hypothalamus

anterolateral

VPL

VL

Medial*

108. D & C at 18 days after LMP endometrium will show which stage of uterine cycle?

Follicular

Ovulatory

Secretory*

Proliferative

109. at the end of pregnancy uterus is most sensitive to which hormone?

Estrogen

Progesterone

Prolactin

Oxytocin*

110. Most abundant phagocytic cells in circulation

basophils

monocytes

macrophages

neutrophils*

111. ICF & ECF differ in

inc K+ in ICF

112. most potent stimulus for release of aldosterone is

inc K+ *

inc Na+

inc glucose

113. Pallegra is due to def of

riboflavin

thiamine

niacin *

vit C

114. Trauma to the middle meningeal artey causes

subdural hemorrhage

epidural hemorrhage*

SAH

115. patient with loss of fine touch proprioception and vibration injury to which part of spinal cord?

Fasiculus gracilis

Fasiculus cuneatus

Post white column*

Lateral white column

116. in females which structure lies btw ureter and peritoneum

uterine artery*

inf vesicle artery

117. which of these muscles is a part of the pelvic diaphragm

deep transverse perinei

puborectalis*

bulbospongiosus

ischeocavernosus

118.  wat is not true abt adrenal gland

fetal gland is 1/3 size of the adult gland

it is invested by renal fascia

adrenal cortex is derived from mesoderm

119. which structure is most ant in popliteal fossa

popliteal vein

politeal artey *

tibail nerve

bicep femoris

gastrocnemeus

120.tendon of which of these muscles is intracapsular

bicep femoris

plantaris

popliteus*

semitendinosus

121. which of these are the major resistance vessels

arteries

veins

capillaries

arterioles*

venules

122. patient losses 1 litre of body fliud in 1 hour wat will happen first

inc PR

inc BP

inc veno spasm*

123. a person in a room with optimum enviormental conditions how will the heat loss occur

convections

sweating

breathing

radiation and conduction*

voiding

124. major part of energy utilized during breathing is to overcome

elastic recoil of lungs*

resistance of chest wall

large airway resistance

small airway resistance

125. a bullet pierces the intercostals space which layer will it come after the intercostals muscles

parietal pleura

visceral pleura

endothoracic fascia*

pleural cavity

126. which vessel will be damaged if the phrenic nerve is cut

musculophrenic

int thoracic

pericadiophrenic*

127. which of these is not a branch of internal iliac

sup rectal*

middle rectal

inf vesicle

sup vesicle

128. lymphatic of uterus do not drain into

 int iliac nodes

ext iliac nodes

sup ing nodes

inf mesenteric nodes*

129. a patient with hoarseness and lyrangeal nodule which is most unlikely

atrophy *

nodule

hypertrophy

hyperplasia

130. pseudo hypoparathyroidism.

Due to inc ca

Dec vit D

PTHrP

131. wat is seen in dysplasia

pleomorphism

inc NC ratio*

inc mitosis

132. metastatic tumors are identified by

invasion of other structures*

pleomorphism

inc NC ratio

inc mitosis

133.  sarcomas have

rapid growth

inc vascularity*

capsule

benign

134. epi of a smoker will show

inc ciliated epi

mixture of st sq and pseudostratified cells*

dec goblet cells

135. most unlikely abt glomerulus is

has urinary space btw 2 layers

is cup shaped

is blind ended part of tubule

has stratified epi*

has podocytes

136. which vessel is involved and dilated in portal HTN

portal vein*

hepatic artey

hepativ vien

SMV

137. most unappropraite abt liver

has dual blood supply

hepatic artey gives only 35% of O2

portal vein has 70% O2 *

138. not part of the portal tract

portal vein

hepativ artery

bile duct

hepatic vein*

139. not a part of axillary nodes

ant grp

medial grp

apical grp

central grp

deep cervical*

140. Clavipectoral fascia

completely covers pectoralis minor*

forms suspensory lig of breast

forms axillary tail

141. in males uretric stones mostly lodge at which point

just below kidney*

at crossing of ext iilac vessels

at pelvic brim

at ischeal spine

142. if there is fracture of the acetabulum post and superiorly which bones r inv

ileum and ischium *

ileum and pubis

isschium and pubis

143. most constricted part of the male urethra?

Ext meatus*

Infandibukum

Navicular fossa

144. at the level of second part of duodenum wat is unlikely

aorta at the right of SVC*

left renal vein

145. pain of the ovary is transmitted to the medial side of thigh thru which nerve

femoral

obturator*

ilioinguinal

146. left ventricle does not contain

 supraventricular crest

chordae tendinae

aortic vestibule

papillary muscles

147. epidural space

contains venous plexus*

contiues into skull at foramen magnum

attached  to dorsal coccyx

upto S2

148. Otic ganglion lies under

foramen ovale*

foramen spinosum

maxillart nerve

stylomastoid foramen

149. middle menigeal artery enters thru which foramen?

Foramen spinosum*

Foramen rotundum

Foramen ovale

150. Superior petrosal sinus lies in

falx cereberi

fakx cerebelli

tentorium cerebellli*

diaphragma sella

151. Great cerebral vein does not drain

deep cerebral vein

sup cerebral vein

basal vein

thalamic vein

152.which of these is not a basic tissue of the body

epi

nerve

muscle

blood

CT

153. Osmotic pressure depends on

electrical equivalence

conc gradient

yenp

no of particles

mol size

154. chemoreceptors respond to

inc PCO2*

dec PO2

inc Ph

inc temp

155.  Processus vaginalis

covers testis only*

covers ductus deferens

forms ext spermatic fascia

arises from parietal peritoneum

arises from visceral peritoneum

156. Dorsal rami of nerves supply

ext of trunk

ext of limbs

157. which vessel lies ant to IVC

left renal vein

left renal artery

right renal vein

right renal artery

right testicular vein*

158. if inguinal canal of a female is opened wat does it contain

round ligament and ilioinguinal nerve

159. lymphatic drainage of testis is into

para aortic nodes

sup ing nodes

int iliac nodes

ext iliac nodes