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Anatomy & Surgery

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Anatomy & Surgery Practice Examination

Anatomy & Surgery Practice Examination

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Anatomy & Surgery Anatomy & Surgery Document Transcript

  • ANATOMY & SURGERY 1. The part of the inner ear responsible for balance a. vestibular portion b. pars superior c. cochlear portion d. pars inferior e. A and B 2. Herpes Zoster Oticus is characterized by the following except: a. Also known as Ramsay Hunt disease b. Viral infection involving the geniculate ganglion c. Facial paralysis d. Otalgia e. Herpetic eruption of the internal ear 3. A 18 year old female came to the emergency room for complaints of vomiting, anorexia, epigastric and right lower quadrant pain noted 12 hours prior to admission. Digital rectal exam revealed right pararectal wall tenderness. Differential diagnosis would include the following except: a. Acute appendicitis b. Urinary tract infection c. Twisted ovarian cyst d. Ectopic pregnancy e. None of the above8. A 40 year old man who was an unrestrained passenger in a motor vehicle accident was brought to the emergencyroom. He was thrown from the car at impact. The patient is unconscious and, on evaluation becomes apneic. Ventilationshould be achieved by a. endotracheal intubation b. nasotracheal intubation c. face mask d. tracheostomy e. cricothyroidotomy9. A patient has lost cutaneous sensation over the tip of the nose. Which nerve is most likely damaged? a. facial nerve b. ophthalmic division of the trigeminal nerve c. greater auricular nerve d. mandibular division of the trigeminal nerve e. maxillary division of the trigeminal nerve10. Emergency room thoracotomy for cardiac resuscitation would be most commonly indicated for a major blunt traumawith cardiac arrest a. failed closed chest massage lasting 15 minutes b. cardiac arrest after a stab wound to the left parasternal area c. cardiac arrest accompanying a major central nervous system injury d. hypovolemic cardiac arrest e. none of the above11. Injury to the common peroneal nerve would result in an a. inability to evert the foot b. inability to invert the foot c. inability to plantar flex the ankle d. inability to plantar flex the big toe e. inability to feel sensation on the medial side of the leg12. A 55 year old man is involved in a motor vehicular accident. Initial resuscitation is carried out. Cervical spine films arenormal. A supine anteroposterior (AP) chest film suggests a distorted upper mediastinum. The next study should be a. aortogram b. CT scan of the chest c. MRI of the chest d. upright posteroanterior (PA) chest radiograph e. electrocardiogram13. To test trapezius muscle paralysis, you would ask the patient to
  • a. flex the arm fully b. adduct the arm against resistance c. push against a wall with both hands d. shrug the shoulder e. abduct the arm fully14. A 14 year old boy fell off a wall and fractured his right humerus at midshaft. The wrist joint immediately assumed aflexed position that the patient was unable to correct. Extension and supination of the forearm was weakened but notabolished. Select the peripheral nerve damaged that could cause the symptoms. a. radial nerve b. ulnar nerve c. median nerve d. axillary nerve e. musculocutaneous nerve15. In a 23 y.o, male coming in with anorexia, right lower quadrant pain and vomiting, peritoneal irritation is indicated by: a. Dunphy’s sign b. Hamburger Sign c. Rovsing’s sign d. Obturator sign e. Psoas sign16. Blood supply ligated during an appendectomy a. Colonic artery b. branch of celiac artery c. branch of ileocolic artery d. branch of cecal artery e. superior mesenteric artery17. Most common organisms causing acute appendicitis, except: a. e. coli b. peptostreptococcus sp. c. bacteroides fragilis d. enterobacter aeroginosa18. Allelic loss at the site of this tumor suppressor gene is responsible for developing 100% risk of colon cancer: a. BRCA 1 b. BRCA 2 c. myc-trans gene d. APC e. fibrillin19. The following are true of familial adenomatous polyposis except: a. colon becomes covered with polyps after puberty b. autosomal recessive inheritance c. 100% risk of developing colon CA d. May present with weight loss and hematochezia e. common in middle-aged Caucasians20. Tumor marker for Papillary thyroid Carcinoma: a. free T3 b. free T4 c. Free T3 & T4 d. thyroglobulin e. calcitonin21. A 67 y.o, female underwent total thyroidectomy. Biopsy findings revealed abundance of parafollicular cells or C cells.She will most likely manifest with increased levels of the following hormone: a. thyroglobulin b. calcitonin c. parathyroid hormone d. tyrosine e. tryptophan22. The same patient in the previous number had sudden onset of dyspnea and hoarseness of the voice. Serum Calciumrevealed: 7.4 mg/dl. The following are expected, except: a. intraop injury to the recurrent laryngeal nerve b. presence of hematoma at post-op site c. presence of Trousseau’s sign
  • d. carpopedal spasm e. low levels of thyroglobulin23. Amino acid precursor of thyroid hormone a. tryptophan b. tyrosine c. thyroxine d. hyrdoxylysine e. hydroxyproline24. The following contribute to the blood supply of the thyroid gland except: a. superior thyroid artery b. inferior thyroid artery c. brachiocephalic artery d. left common carotid artery e. right common carotid artery25. Gene on chromosome 13 that is associated with early onset breast CA a. fibrillin b. CA-19 c. BRCA1 d. APC e. BRCA 226. The following are risk factors for developing breast CA, except: a. having an aunt with breast CA b. presence of BRCA 1 gene on chromosome 17 c. being 35% above ideal body weight d. Primigravida at the age of 18 e. menarche at 12 years old and menopause at 60 years old27. Most common benign condition of the breast: a. fibrocystic breast disease b. peau d’ orange c. papillary CA d. invasive ductal e. phylloides tumor28. Most common site of breast CA: a. Lower outer quadrant b. Upper outer quadrant c. Upper inner quadrant d. Lower inner quadrant29. A 38 y.o, female noted “Winging of the scapula” after undergoing MRM. The most likely injured structure would be: a. axillary artery b. axillary nerve c. pectoralis minor muscle d. long thoracic nerve e. Batson’s plexus30. The landmark structure used to divide Level I,II, and III in breast surgery a. axillary nerve b. long thoracic nerve c. pectoralis major mm. d. pectoralis minor mm. e. Rotter’s nodes31. A 56 y.o, woman was diagnosed to have Invasive Ductal CA of the left breast. The following would be the mostimportant factor in prognosis: a. Involvement of the Batson’s plexus b. atypia and proliferative changes on biopsy c. axillary lymph node status d. winging of the scapula e. (+) BRCA 1 gene32. The following drugs are contraindicated in a managing a 42, y.o, obese, female coming in for fever, chills and RUQpain: a. tramadol
  • b. morphine sulfate c. famotidine d. omeprazole e. cefuroxome33. Hormone responsible for causing colicky abdominal pain after intake of a fatty meal: a. cholecystoglobulin b. cholecystokinin c. secretin d. pancreatin e. motilin34. The following are characteristics of Carpal Tunnel Syndrome, except: a. common in secretaries and computer programmers & dressmakers b. May be confirmed by performing Tinel’s sign c. Entrapment of the median nerve by the flexor retinaculum d. Numbness and pain over the index finger and hypothenar area e. May be confirmed by performing Phalen’s sign37. The following are Intracranial complications of chronic or recurrent otitis media, except: a. Extradural abscess b. Lateral sinus thrombosis c. Meningitis d. Brain abscess e. Gradenigo’s syndrome or petrositis38. The following characteristics about skin are true except: a. Largest organ of the body b. Average weight = 4 Kg c. thickest at the palms/soles d. thinnest at the eyelids and genitals e. none of the above39. The epithelial layers from Surface to base are the following a. Corneum, Lucidum, Granulosum, Spinosum, Basalis b. Corneum, Lucidum, Spinosum, Basalis, Granulosum c. Granulosum, Corneum, Lucidum, Spinosum, Basalis d. Lucidum, Spinosum, Basalis, granulosum, corneum e. Basalis, corneum, lucidum, spinosum, granulosum40. Sweat is characterized by the following except: a. about 10 L/day (1% Solid, 99% Liquid) b. pH = 4.5-5.5 c. Colorless, odorless, hypertonic d. 1L – removes 540 Calories of heat from the body e. none of the above41. The dangerous area of the scalp a. skin b. subcutaneous tissue c. loose areolar layer d. periosteum e. galea aponeurotica42. Muscles of Mastication except: a. temporalis m. b. masseter m. c. medial pterygoid m. d. lateral pterygoid m. e. buccinator m.43. The following statements are true except: a. Parotid gland is the largest salivary gland b. Whartons duct opens opposite the 2nd upper molar c. Parotideo - massenteric fascia is a fibrous unyielding fascia d. Submandibular is predominantly mucous secreting e. Parotid gland is predominantly serous secreting
  • 44. The following structures arise from the foregut except: a. Pharynx b. Thyroid c. Esophagus d. Lung Alveoli e. none of the above45. The Anterior Pituitary gland arises from : a. foregut b. midgut c. hindgut d. Rathke’s pouch e. A and D46. Waldeyer’s Ring is an imaginary ring composed of tonsils namely a. unpaired nasopharyngeal/adenoids b. paired tubal/tonsils of Gerlach c. paired palatine/faucial tonsils d. lingual e. none of the above47. A 63 year old male is referred for urologic consult after a large prostate gland was found on routine rectal examination.The next diagnostic test of choice should be a. digital rectal examination (DRE) b. prostate specific antigen (PSA) level c. MRI d. transrectal ultrasound e. Computed tomography (CT)48. A male trauma patient is brought in for profound shock can be resuscitated with all of the following except: a. type AB negative blood b. type O negative blood c. type-specific but not crossmatched blood d. type-specific crossmatched blood e. none of the above51. Sustained tension of the vocal cords (folds) is best achieved through the action of which one of the following muscles a. cricopharyngeus b. cricothyroid c. aryepiglottic d. salpingopharygeus e. posterior cricoarytenoiD55. With a patient in the standing position, fluid in the left pleural cavity tends to gravitate down to the a. oblique fissure b. cardiac notch c. costomediastinal recess d. costodiaphragmatic recess e. horizontal fissure56. A 3 month old child has a soft, irregular, compressible, enlarging, posterior neck mass. The most likely diagnosis a. thyroglossal duct cyst d. teratoma b. abscess e. cystic hygroma c. paraganglioma57. A muscle that protrudes the tongue is the a. styloglossus d. hyoglossus b. palatoglossus e. genioglossus c. mylohyoid58. Amebic pericarditis is an extension of amebic A. colitis C. splenitis E. none of the choices B. pneumonia D. hepatic abscess59. If the foot is permanently dorsiflexed and everted, which nerve might be injured? a. Tibial nerve b. deep peroneal nerve c. superficial peroneal nerve
  • d. obturator nerve e. common peroneal nerve60. Portal hypertension hypersplenism is seen in late stage A. ascariasis B. giardiasis C. schistosomiasis D. enterobiasis E. paragonimiasis61. Tissue graft within the same individual is known as A. allograft B. isograft C. autograft D. xenograft62. The portal vein is formed by the following vein(s) a. splenic vein b. superior mesenteric vein c. inferior mesenteric vein d. A and B e. A and C63. Glandular metaplasia in the distal esophagus occurs in the following condition(s): a. chronic GERD d. achalasia b. Barrett’s esophagus e. none of the above c. esophagitis64. Bowel thickening or “String Sign” on abdominal xray is indicative of this disease entity: a. Crohn’s disease b. Ulcerative colitis c. Irritable bowel syndrome d. Toxic megacolon e. Hirschsprung’s disesase65. Characteristics of pancreatic carcinoma are the following except: a. Diabetes and smoking are strong risk factors b. a palpable gallbladder is present in 25% of patients c. Should undergo total pancreatectomy d. Whipple’s triad is a feature e. pain and jaundice is a prominent feature66. Caroli’s disease and clonorchiasis is strongly associated with the following: a. cholangiocarcinoma b. gallbladder CA c. pancreatic CA d. hepatocellular CA e. Bladder outlet obstruction67. Urinary metabolite found in patients with pheochromocytoma a. 5-hydroxytryptamine b. vanillymandelic acid c. organs of Zuckerkandl d. urinary metamphetamines e. valine, leucine, isoleucine metabolites68.Most common type of gastric cancer a. leiomyosarcoma b. adenocarcinoma c. lymphoma d. signet ring adenocarcinoma e. papillary carcinoma69. The following are absolute indications for tonsillectomy except: a. abscess (peritonsillar, recurrent) b. biopsy for suspected malignancy c. dysphagia d. Sleep apnea e. none of the above70. Most common type of thyroid carcinoma a. papillary thyroid carcinoma b. medullary thyroid carcinoma c. anaplastic carcinoma d. poorly differentiated carcinoma
  • e. Hurthle cell carcinoma71. Most common post thyroidectomy complication a. Wound hemorrhage b. Recurrent laryngeal nerve injury c. Hypoparathyroidism d. Thyroid storm e. Winging of the scapula72. The following are contents of Cubital Fossa except: a. Termination of Brachial Artery b. Radial and ulnar arteries c. Biceps tendon d. Median nerve e. none of the above73. The superficial membranous fascia which continues as the Colle’s fascia in the perineum a. Camper’s fascia b. Scarpa’s fascia c. Gimbernat’s fascia d. Cooper’s Fascia e. External oblique fascia74. Internal oblique muscle runs upward and medially and inserts to the public crest, tubercle and pectineal line givingrise to the following except: a. conjoined tendon b. cremasteric muscle c. cremasteric fascia d. all of the above e. none of the above75. Branches of the Coelic Artery except: a. Left. Gastric artery b. Splenic artery c. Hepatic artery d. Renal artery e. none of the above76. The following are signs of advanced disease in gastric carcinoma, except a. Virchow’s node b. Left supraclavicular lymphadenopathy c. Sr. Mary Joseph’s node d. Blumer’s shelf e. none of the above77. Collection of para-aortic & paraganglionic cells that may serve as extra adrenal site for chromaffin cell tumor a. Klatskin tumor b. Organs of Zuckerkandl c. Organs of Zuckermann d. Pheochromocytoma e. none of the above78. Characteristic of barium swallow showing dilated esophagus with area of distal stenosis à ‘BIRD’S BEAK” a. esophagitis b. barrett’s esophagus c. esophageal carcinoma d. tracheo-esophageal fistula e. achalasia79. The best screening procedure for colon carcinoma is the general population is: A. CEA assay B. Colonoscopy C. Barium enema D. Sigmoidoscopy E. Stool Occult Blood Test.80. The following is/are indication/s for diagnostic peritoneal lavage: A. Kitchen knife wound across the belly, eviscerating small intestines B. Gunshot wound to the lower abdomen, non-penetrating
  • C. Ice-pick wound at periumbilical area, 8 cm hematoma at left parieto-occipital area, GCS-4 D. Blunt and abdominal trauma, BP 80/40, RR 36, 2 L lactated Ringer’s already given E. none of the above81. Which of the following is considered pre-malignant A. Pseudopolyp B. Hamartoma C. Villous adenoma D. Pedunculated polyp. E. Tubular polyp82. The following statements are true except: a. Ext. spermatic fascia comes from ext. oblique muscle b. Cremasteric fascia comes from int. oblique muscle c. Int spermatic fascia comes from transversalis muscle d. pampiniform plexus of veins is contained in spermatic fascia e. nerves to spermatic cord are derived from renal and pelvic plexus83. What presenting complaint is most common in a patient with carcinoma of the bladder? a. suprapubic pain b. palpable lower abdominal mass c. painless hematuria d. unexplained fever e. weight loss84. A major cause of nosocomial infection in extensive burns is A. pseudomonas C. bacteroides E. enterobacter B. branhamella D. aspergillus85. During operations on the thyroid gland, the following nerve may be injured when tying the inferior thyroid artery a. sympathetic trunk b. internal laryngeal nerve c. descendens cervicalis d. recurrent laryngeal nerve e. superior laryngeal nerve86. A 65 year old female sought consult due to hematochezia and weight loss. Colonoscopy revealed an ill-definedfungating mass 15 cm from the anal verge causing obstruction. The treatment of choice is: a. Biopsy b. Low Anterior Resection c. Mile’s procedure d. Insertion of Sump tube attached to low pressure gomco e. Radiation therapy87. A 45 year old male executive is seen because he is vomiting bright red blood. There are no previous symptoms. Theman admits to one drink a week with no other significant history. In the hospital, he bleeds 5 units of blood beforeendoscopy. The most likely diagnosis is a. gastritis b. duodenal ulcer c. esophagitis d. Mallory-Weiss tear e. esophageal varices88. The diaphragm is derived from the following except: a. Septum transversum b. Pleuroperitoneal fold c. Body wall d. Dorsal mesentery of esophagus e. C3C4C5 (Phrenic Nerve)89. Work-up reveals an inflammatory process within the colon with skip areas. The rectum is spared. The most likelydiagnosis is a. ischemic colitis d. ulcerative colitis b. amebic dysentery e. Crohn’s Disease c. toxic megacolon90. An elderly woman is admitted for weakness, weight loss, anemia and a palpable abdominal mass. She has coloncarcinoma. The most likely anatomic site is
  • a. rectum d. sigmoid colon b. left colon e. cecum c. transverse colon91. The following statements are true, except: a. Nearly 30% of all patients with colorectal Carcinoma have a synchronous polyp b. 100% of patients with Familial Adenomatous Polyposis will develop colon carcinoma if the colon is not resected c.familial polyposis coli and Gardner’s syndrome are risk factors for carcinoma d. Most common manifestation of rectal CA is change in caliber of stools e. none of the above92. Bone metastasis occurs from the following primary carcinomas, except: a. breast b. lung c. thyroid d. prostate e. none of the above93. Meckel’s diverticulum is characterized by the following except: a. 2 % of population b. commonly presents during 1st 2 years of life c. 2 inches long d. 2 feet from the ileocecal valve e. 2 ectopic tissues: duodenal mucosa and pancreatic tissue94. Acute hematogenous osteomyelitis is often diagnosed by isolation of the organism from the blood and is caused mostoften by A. Proteus mirabilis C. Escherichia coli E. pseudomonas aeruginosa B. Streptococcus epidermidis D. Staphylococcus aureus95. Common pathogen in surgical implants: A. Klebsiella B. E. coli C. S. epidermidis D. S. pyogenes E. Pseudomonas96. The following are risk factors for developing gastric carcinoma except: a. High consumption of smoked fish b. Blood type “A” c. post-gastrectomy patients d. chronic hypochlorhdia e. Virchow’s node97. Most common congenital anomaly of the GI tract characterized by persistence of the vitelline duct or yolk stalk a. Cystic hygroma b. Inguinal hernia c. Meckel’s diverticulum d. omphalocoele e. Vitelloma98. Wrist bone with greatest incidence of aseptic necrosis a. navicular bone b. cuneiform c. lunate d. sesamoid bone e. none of the above99. Condition where pupils accommodates when patient follows finger moving towards the nose but does not react todirect light a. Neurosyphilis b. Horner’s syndrome c. Adies pupil d. Argyll-Robertson pupil e. Weber’s syndrome
  • 100. A 24 year old male was in a vehicular accident. He arrived at the ER with raccoon eyes and otorrhea. On the 3rdhospital day he developed high grade fever and nuchal rigidity. The most common meningeal isolate in this patient wouldbe a. Streptococcus pneumoniae b. H. influenzae c. N. meningitides d. S. aureus e. Listeria monocytogenes1. In cerebrospinal fluid, the presence of encapsulated yeasts is indicative of A. coccidioidomycosis B. candidiasis C. blastomycosis D. cryptococcus2. Which one of the following pairs of drugs has been known to cause lupus syndrome? a. Propranolol and disopyramide b. Guanethidine and reserpine c. Lidocaine and phenytoin d. Procainamide and hydralazine3. The etiologic agent of leprosy: A. appears on smears biopsy from the lesion as acid-fast bacilli arranged like pockets of cigars B. has a special predilection to the skin and peripheral nerve C. has been successfully cultured in artificial media D. A and B4. The superior orbital fissure transmits the fo9llowing structures, except a. optic nerve b. frontal nerve c. abducens nerve d. trochlear nerve e. ophthalmic veins5. The presence of pneumatocoeles on chest radiograph suggest this pathogen a. Klebsiella pneumoniae b. Staphylococcus aureus c. Peudomonas aeruginosa d. Streptococcus pneumoniae6. A 40 year old man who was an unrestrained passenger in a motor vehicle accident was brought to theemergency room. He was thrown from the car at impact. The patient is unconscious and, on evaluationbecomes apneic. Ventilation should be achieved by a. endotracheal intubation b. nasotracheal intubation c. face mask d. tracheostomy e. cricothyroidotomy7. A syndrome characterized by galactorrhea-amenorrhea not associated with pregnancy a. Albright’s Syndrome b. Ahumada-del Castillo syndrome c. Sheehan’s syndrome d. Asherman’s syndrome e. eclampsia8.A 32 year old male hypertensive smoker complains of chest oppression provoked by effort and relieved byrest. The drug to recommend to relieve his oppression is a. Diltiazem b. Aspirin c. Nifedipine d. A nitrate
  • 9. Which one of the following medical fees is considered as unethical: A. dichotomous fees C. retainer’s fees B. contingent fees D. contractual fees10. A resident in the Department of OB-Gyne saw a patient in the ER complaining of left-sided abdominalpain. She was given mefenamic acid and sent home only to come back in shock for ruptured ectopicpregnancy. The hospital is liable in this case under the doctrine of: A. Vicarious liability B. Borrowed servant C. Independent contractor theory D. Corporate liability11. One of the following is a United Nation Millenium Development Goal: A. Family Planning B. Fight Against Child and Maternal Mortality C. Control of Diarrheal Diseases D. Control of Acute Respiratory Infection12. A patient has lost cutaneous sensation over the tip of the nose. Which nerve is most likely damaged? a. facial nerve b. ophthalmic division of the trigeminal nerve c. greater auricular nerve d. mandibular division of the trigeminal nerve e. maxillary division of the trigeminal nerve13. Bacteria that grows at temperatures as high as 50º C to 55º C are known as A. mesophiles B. halophiles C. thermophiles D. psychrophiles14. Delayed speech/language of a child may be caused by the following except a. child neglect d. child abuse b. inborn e. none of the above c. mental retardation15.The standard for diagnosis of pneumonia a. Sputum culture b. Chest radiograph c. CBC d. CT scan16. Emergency room thoracotomy for cardiac resuscitation would be most commonly indicated for a majorblunt trauma with cardiac arrest a. failed closed chest massage lasting 15 minutes b. cardiac arrest after a stab wound to the left parasternal area c. cardiac arrest accompanying a major central nervous system injury d. hypovolemic cardiac arrest 18. Which collaborating agency in the world helps erase Polio in children? a. UNICEF b. Rotary International c. W.H.O d. Canadian International Development Agency18. Sporulation is the feature of all these microorganisms, EXCEPT: A. Corynebacterium diphtheriae D. Clostridium perfringens B. Bacillus anthracis E. Aspergillus flavus C. Coxiella burnetti19.Which of the following is not a major goal in the management of bronchiectasis a. Elimination of underlying cause b. Control of infection c. Reversal of airflow obstruction d. Reversal of bronchiectasis
  • 20. The greatest risk of death from home accidents occurs in children: A. between 5 to 6 years old C. between 12 to 16 years old B. less than 5 years old D. between 9 to 12 years old21. The target group of immunization program is: A. infants ages 1 to 3 years old B. infants and children C. infants, children and pregnant mothers D. all age groups22. A child on consultation was observed to have dementia, diarrhea and dermatitis. This is found in whatvitamin deficiency a. biotin d. niacin b. folic acid e. riboflavin c. ascorbic acid23. Injury to the common peroneal nerve would result in an a. inability to evert the foot b. inability to invert the foot c. inability to plantar flex the ankle d. inability to plantar flex the big toe e. inability to feel sensation on the medial side of the leg24. Bacteremia shock is triggered by A. exotoxins B. endotoxins C. hyaluronidase D. kinase E. hemolysin25. A 55 year old man is involved in a motor vehicular accident. Initial resuscitation is carried out. Cervicalspine films are normal. A supine anteroposterior (AP) chest film suggests a distorted upper mediastinum.The next study should be a. aortogram b. CT scan of the chest c. MRI of the chest d. upright posteroanterior (PA) chest radiograph e. electrocardiogram26. In the child, the chief arterial supply to the head of the femur is derived from the: a. obturator artery b. internal pudendal artery c. branches from the medial and lateral circumflex femoral arteries d. deep circumflex iliac artery e. superficial circumflex iliac artery27. The lymph from the medial quadrants of the breast drains mainly into: a. internal thoracic nodes b. posterior axillary (subscapular) nodes c. anterior axillary (pectoral) nodes d. lateral axillary (brachial) nodes e. infraclavicular (deltopectoral) nodes28. In the absence of an attending doctor at death, the responsibility of signing the death certificate goes to: A. Closest kin C. Local Health Officer B. Nurses D. Midwife29. Criterion/criteria in the selection of a community to be organized: A. all of these B. existence of a serious peace and order problem C. need for basic health services D. extreme economic depression E. strong resistance from the community30. An infectious disease not considered communicable: A. scabies C. pneumonia
  • B. tetanus D. mumps31. Selection of drugs to be sold in the “botika sa barangay” is based on: A. most common morbidity and mortality of the barangay B. effectiveness of the drugs C. all of these D. essential drug list32. The level of prevention employed when a serologic test is done to determine syphilis among suspects: A. rehabilitation C. health promotion B. early diagnosis D. disability limitation33. A 12 year old boy is to be operated on for acute appendicitis. The following can give consent foroperation in the absence of these and others, EXCEPT: A. grandparents C. teachers/professors B. parents D. the hospital director34. What presenting complaint is most common in a patient with carcinoma of the bladder? a. suprapubic pain b. palpable lower abdominal mass c. painless hematuria d. unexplained fever e. weight loss35. Intrauterine synechiae, typically occurring after curettage of the uterus, presenting as amenorrhea a. Asherman’s syndrome b. Ahumada-del Castillo syndrome c. Sheehan’s syndrome d. Alport’s syndrome e. None of the above36. The Mental Health Program aims to reduce the number of mental illness in the country. The thrust of theprogram is to implement and expand: A. Hospital in-patient services B. Out-patient services C. Mental Hospitals D. None of these37. The twin moves to promote rational drug use is the development of the Philippine National DrugFormulary and: A. Control Cost B. review and amend promotion and advertising of drugs C. Control manufacture of drugs D. Control importation of drugs38. This is considered the most common congenital infection today and is known as the “child care virus” a. human immunodeficiency virus b. cytomegalovirus c. rubella d. herpes simplex e. rubeola39. Which testicular cancer cell type is extremely radiosensitive a. embryonal carcinoma b. yolk sac tumor c. seminoma d. choriocarcinoma e. teratocarcinoma
  • 40. Syndrome characterized by postpartum pituitary necrosis resulting from sudden infarction of the anteriorlobe precipitated by obstetric hemorrhage a. Albright’s syndrome d. Sheehan’s syndrome b. Sezary’s Syndrome e. Ahumada- del Castillo syndrome c. Adson’s syndrome41. The mainstay in the treatment of alveolitis is ILD a.Tamoxifen b. Methotrexate c. Glucocorticoids d. Cyclophosphamide42. A 2 year old child partially immunized was exposed to his brother with diphtheria. The prophylactic drugof choice is a. erythromycin d. penicillin b. cephalosporin e. rifampicin c. chloramphenicol43. In order not to overlook coarctation of the aorta, the blood pressure should be measured over thefollowing a. arms and the legs b. one arm c. both legs d. both arms e. none of the above44.Which of the following is most associated with industrial exposure to naphthalenes and related products: A. carcinoma of the cervix B. carcinoma of the stomach C. carcinoma of the urinary bladder D. hepatocellular CA45. In order to maintain the high quality and standard of the medical practice in the Philippines, the followingadministrative bodies were created for the purpose of licensing and regulation of the medical profession,EXCEPT: A. Professional Regulation Commission B. Board of Medicinal Education, Ministry of Education C. Board of Medicine D. Bureau of Licensing and Regulation, Department of Health46. A person affixes his right thumb mark on his residence certificate. This is an example of a: A. real impression C. chance impression B. visible print D. latent print47. An abnormal sexual behavior wherein sexual gratification is obtained by licking or sucking the femaleexternal genitalia: A. Cunnilingus C. Bestiality B. Tribadism D. Fellatio48. A former hospital patient requested access to his clinical records but was refused by the hospitaladministration. He can file a court order of: A. Legal claim C. Injunction B. Mandamus D. Certiorari49. Carbon monoxide may cause death by: A. poisoning all tissues directly B. breaking down hemoglobin C. causing hemolysis D. displacing O2 because of it’s stronger chemical affinity to hemoglobin50. Antibiotic (e.g. clindamycin) associated diarrhea and the more serious pseudomembranousenterocolitis can be caused by A. Clostridium sordelli C. Staphylococcus
  • B. Clostridium perfringens D. Clostridium difficile51. To test trapezius muscle paralysis, you would ask the patient to f. flex the arm fully g. adduct the arm against resistance h. push against a wall with both hands i. shrug the shoulder j. abduct the arm fully52. A 14 year old boy fell off a wall and fractured his right humerus at midshaft. The wrist joint immediatelyassumed a flexed position that the patient was unable to correct. Extension and supination of the forearmwas weakened but not abolished. Select the peripheral nerve damaged that could cause the symptoms. a. radial nerve b. ulnar nerve c. median nerve d. axillary nerve e. musculocutaneous nerve53. The most important laboratory procedure in the diagnosis of subacute bacterial endocarditis is a. ESR b. Blood culture c. Complete blood count d. Throat swab e. ASO titer54. Bacterial meningitis in children between the ages of 6 months and 2 years most commonly is caused by A. haemophilus B. pneumococcus C. staphylococcus D. neisseria55. Children conceived by prostitute: A. manceres C. sacrilegious children B. illegitimate children D. adulterous children56. If the patient died and spouse is incapacitated, the claim for medical fee shall be made from the: A. ascendants from the nearest degree B. sister C. descendents from the nearest degree D. brother57. A pathologist, connected and associated with a hospital on salary contract, reported after tissue biopsythat a patient had cancer when in fact he did not. The patient underwent hysterectomy as a result of themisdiagnosis. The hospital was held liable by the court under the doctrine of: A. ostensible agent C. borrowed servant B. fellow servant D. captain of the ship58. A 63 year old male is referred for urologic consult after a large prostate gland was found on routine rectalexamination. The diagnostic test should be a. digital rectal examination (DRE) b. prostate specific antigen (PSA) level c. digital rectal exam combined with PSA d. transrectal ultrasound e. Computed tomography (CT)59. Pruritus ani is a common manifestation of patient with A. oxyuriasis B. uncinariasis C. capillariasis D. ascariasis E. strongloidiasis60. What is the maintenance therapy among infants with supraventricular tachycardia converted to a sinusrhythm? a. propanolol d. quinidine
  • b. digoxin e. phenytoin c. verapamil61. A major cause of nosocomial infection in extensive burns is A. pseudomonas C. bacteroides E. enterobacter B. branhamella D. aspergillus62. Which of the following is NOT considered as a dangerous drug under the Dangerous Drug Act: A. Codeine C. Methamphetamine B. Atropine D. Phenobarbital63. A 45 year old female had breast surgery for CA of the breast with metastasis. She consented in writingto undergo trial of a new chemotherapeutic modality. The patient continued to deteriorate and sued thephysician. The physician was absolved under the doctrine of: A. Assumption of Risk C. Common Knowledge B. Continuing Negligence D. Contributory Negligence64. An abnormal mental condition wherein a person is performing an act, like walking, while in the state ofnatural sleep? A. hallucination C. somnambulism B. somnolencia D. mesmerism65. All of the following retroperitoneal hematomas should be explored a. central abdominal d. peripancreatic b. pelvic e. paraduodenal c. renal pedicle66. The American Medical Association drafted 10 principles to serve as guidelines in the conduct of medicalresearch. This serves as the cornerstone in the Allied cases against Nazi physicians. This is known as: A. Hippocratic Oath B. Declaration of Helsinski C. Medical Code of Ethics D. Nuremberg Code of Ethics in Medical Research67. An obstetrician had to go out of town for a speaking engagement and duly informed his patients aboutthis, with a qualified obstetrician taking over. A 25 year old, G3P2 (2-0-0-2), previous NSD, 40 weeksAOG, went into labor and had complications. The original obstetrician is: A. not liable for anything B. liable for gross negligent C. liable for breach of contract D. liable for dishonorable conduct68. The following rights inherent in the privilege to practice medicine, EXCEPT: A. right for compensation on all cases B. right to determine the appropriate management procedure C. right to choose patients D. right to limit his practice of the profession69. What is the primary objective of medical practice? A. to safeguard the best interest of our colleague B. serve mankind regardless of race, creed or political affiliation C. the tradition of “friend of man” should be maintained D. fulfillment of a physician’s civic duties70. The body of the crime which points to the act of the criminal is: A. Real evidence C. Corpus delicti B. Circumstantial evidence D. En flagrante delicto
  • 71. During physical examination, a physician fondled the breast of his female patient. He may be chargedwith: A. malpractice C. act of lasciviousness B. qualified seduction D. moral turpitude72. The body vested by law to have general supervision and regulation over the practice of medicine is: B. Commission on Higher Education C. Department of Education D. Professional Regulatory Commission E. Board of Medical Education73. The state of not knowing the nature of sexual life and not having experienced sexual relation is termedas: A. moral virginity C. false physical virginity B. demi-virginity D. true physical virginity74. The following are true of Downs syndrome, EXCEPT: A. Mental retardation and prominent epicanthal folds B. Simian crease C. Development of Alzheimer’s disease in > 35 y.o D. Endocardial cushion defect E. Decreased risk of Acute Lymphoblastic Leukemia75.Antistreptolysin test to diagnoseA. strep fecalis B. peptostreptococcus C. Strep pyogenes D. strep pneumonia76. During operations on the thyroid gland, the following nerve may be injured when tying the inferior thyroidartery a. sympathetic trunk b. internal laryngeal nerve c. descendens cervicalis d. recurrent laryngeal nerve e. superior laryngeal nerve77. The most common cause of arterial hypertension in children a. chronic pyelonephritis b. coarctation of the aorta c. nephritic syndrome d. renal artery stenosis e. post-streptococcal GN78. The most serious consequence of iodine deficiency is a. congenital goiter b. sporadic goiter c. endemic goiter/cretinism d. intratracheal goiter e. thyroiditis79. The following are true about the Renin-Angiotensin-Aldosterone axis, EXCEPT: A. activated during states of hypovolemia B. activation of zona fasciculata for sodium retention C. Conversion of angiotensinogen to angiotensin I in the pulmonary circulation D. Vasoconstriction due to angiotensin II80. Collateral circulation around the shoulder joint would involve all of the following except a. subscapular artery b. superficial cervical artery c. suprascapular artery d. anterior circumflex humeral artery e. lateral thoracic artery81. Malignant tumors of the trigone of the bladder spread /metastasize to the following lymph nodes
  • a. external and internal iliac b. lumbar c. sacral d. external iliac e. superficial inguinal82. A male trauma patient is brought in for profound shock can be resuscitated with all of the followingexcept: a. type AB negative blood b. type O negative blood c. type-specific but not crossmatched blood d. type-specific crossmatched blood e. none of the above83. Acute hematogenous osteomyelitis is often diagnosed by isolation of the organism from the blood and iscaused most often by A. Proteus mirabilis C. Escherichia coli B. Streptococcus epidermidis D. Staphylococcus aureus84. Mycobacterium leprae has been successfully grown in A. footpads of mice C. peritoneum of guinea pig medium E. all of the above B. testicles of rabbits D. Lowenstein-Jensen medium85. A 50 year old man has a right upper lobe cavitary lesion that is 4 cm in diameter and of unknown age.Which test is most likely to establish the diagnosis? a. bronchography b. computed tomography c. bronchoscopy with biopsy brushings and washings d. percutaneous needle aspiration of the cavity contents e. an immunologic skin test86. The anti-TB drug utilized in the treatment of both pulmonary tuberculosis and leprosy: A. dapsone B. rifampicin C. streptomycin D. pyrazinamide87. A 5 year old patient has a midline neck mass that moves with swallowing and is located just below thehyoid. The mass is most likely to be a a. branchial cleft cyst d. thyroglossal duct cyst b. cystic hygroma e. laryngeal papilloma c. teratoma88. A 60 year old smoker complains of dyspnea, wheezing, and non productive cough. Chest radiographappears normal, but computed tomography scan reveals an intraluminal mass located in the distal trachea.The most likely diagnosis is a. adenoid cystic carcinoma b. carcinoid tumor c. squamous cell carcinoma d. mucoepidermoid carcinoma e. squamous papilloma89. Sustained tension of the vocal cords (folds) is best achieved through the action of which one of thefollowing muscles a. cricopharyngeus b. cricothyroid c. aryepiglottic d. salpingopharygeus e. posterior cricoarytenoid90. 96% of children with SLE presents with these manifestations/characteristics a. gastrointestinal symptoms b. malaise, weight loss, growth retardation c. nephritis d. photophobia e. fever and chills
  • 91. Which is NOT the true statement concerning the Mycobacterium avium/intracellulare (MAI) complex: A. Prior to 1980 there were few cases of MAI disease observed. B. Acid-fast stain and culture of the stool are important diagnostic aids. C. MAI infection in AIDS patients is a result of direct contact with another person who is infected with acid-fast bacilli. D. Patients with reduced T-cell-mediated immunity are more susceptible to infection with MAI.92. The type of necrosis seen predominantly in brain infarction: A. coagulative C. liquefactive B. enzymatic fat D. caseation93. The following structures are closely related to the rectouterine pouch (pouch of Douglas) except a. anteriorly is situated the posterior surface of the upper part of the vagina b. posteriorly is situated the upper part of the rectum c. the trigone of the bladder is directly related to the anterior wall d. anteriorly is situated the posterior surface of the body of the uterus e. laterally is situated the sacrocervical ligaments passing forward to the cervix94. The second law of thermodynamics states that in an isolated system: A. any spontaneous process increases the entropy of the universe B. enthalpy increases as the process proceeds C. the entropy tends to decrease with time D. the total entropy change in a spontaneous process is always negative95. A 45 year old male executive is seen because he is vomiting bright red blood. There are no previoussymptoms. The man admits to one drink a week with no other significant history. In the hospital, he bleeds 5units of blood before endoscopy. The most likely diagnosis is a. gastritis b. duodenal ulcer c. esophagitis d. Mallory-Weiss tear e. esophageal varices96. Most common cause of septic arthritis A. Acinetobacter B. Gonococcus C. Staphylococcus D. Listeria E. Streptococcus97. First line agent for patients with congestive heart failure and pulmonary edema A. Furosemide B. Digoxin C. Nitroglycerine D. Nifedipine98. Death from Weil’s disease is usually due to A. renal failure B. meningitis C. pneumonia D. encephalitis99. Which of the following structures may be eroded by a perforating gastric ulcer on the posterior wall of thestomach? a. splenic artery b. inferior mesenteric artery c. right kidney d. quadrate lobe of liver e. second part of duodenum100. Meningitis caused by Listeria monocytogenes in the pediatric age group is seen primarily in A. newborn infants C. patients receiving broad-spectrum antibiotics B. children with chronic otitis media D. children with ventriculoperitoneal shunts
  • 101.This drug lowers plasma lipoprotein concentration by inhibition of HMG CoA Reductase A. Lovastatin B. Nicotinic Acid C. Clofibrate D. Cholestyramine102. Most effective drug for AIDS A. zidovudine B. ribavirin C. isonoplex D. vidarabin E. acyclovir103. A 3-year old child presents at the physician’s office with symptoms of coryza, conjunctivitis, low- grade fever, and Koplik’s spots. The causative agent of this disease belongs to which group viruses? A. adenovirus B. orthomyxovirus C. picornavirus D. herpes virus E. paramyxovirus104. The toxic property of endotoxin lies in the A. protein C C. O antigen E. lipid A B. polysaccharide core D. protein A105. The most common protozoa causing opportunistic infections in patients with AIDS: A. Toxoplasma gondii C. Cryptosporidium E. Sarcocystis hominis B. Pneumoncystis carinii D. Isospora belli106.Most common cause of digitalis toxicity B. Hypomagnesemia C. Hypokalemia D. Hypocalcemia E. Hypochloremia107. With a patient in the standing position, fluid in the left pleural cavity tends to gravitate down to the a. oblique fissure b. cardiac notch c. costomediastinal recess d. costodiaphragmatic recess e. horizontal fissure108.Limited primarily to the testing of new bactericidal agents: A. Zephiran B. phenol C. benzylalkonium chloride D. lime109. A 3 month old child has a soft, irregular, compressible, enlarging, posterior neck mass. The most likelydiagnosis a. thyroglossal duct cyst d. teratoma b. abscess e. cystic hygroma c. paraganglioma110. All of the following areas in the Philippines are known endemic for Schistosoma japonicum,EXCEPT: A. Lake Nauhan in Mindoro C. Sorsogon (southern barrios) B. All of Leyte and Samar (coastal regions) D. Cebu City (southern barrios)111.This antihypertensive agent, if given in the third trimester, may cause fetal bradycardia andhypoglycemia in the neonatal period a. ACE Inhibitor b. Propranolol c. Calcium channel blocker d. Hydrochlorothiazide112. A muscle that protrudes the tongue is the a. styloglossus d. hyoglossus b. palatoglossus e. genioglossus c. mylohyoid113. Plasmid-mediated resistance to penicillins and cephalosporins is due to production of A. beta-lactamase C. adenylating enzyme E. protease
  • B. phosphorylating enzyme D. gyrase114. Amebic pericarditis is an extension of amebic A. colitis C. splenitis E. none of the choices B. pneumonia D. hepatic abscess 115.This agent does not pass through the placenta but causes osteoporosis and thrombocytopenia in the mother, leading to increased incidence of human fetal loss associated with hemorrhage A. Heparin B. Aspirin C. Dicoumarol D. Warfarin116. If the foot is permanently dorsiflexed and everted, which nerve might be injured? f. Tibial nerve g. deep peroneal nerve h. superficial peroneal nerve i. obturator nerve j. common peroneal nerve117. Portal hypertension hypersplenism is seen in late stage A. ascariasis B. giardiasis C. schistosomiasis D. enterobiasis E. paragonimiasis118.All aminoglycosides are useless against A. anaerobes B. pseudomonas C. staphylococcus D. TB E. Klebsiella119. Which is responsible for the biologic activity of cholera toxin? A. Subunit A-1 C. Subunit B B. All three D. Subunit A-2120. Work-up reveals an inflammatory process within the colon with skip areas. The rectum is spared. Themost likely diagnosis is a. ischemic colitis d. ulcerative colitis b. amebic dysentery e. Crohn’s Disease c. toxic megacolon121. Causes chronic debilitating disease characterized by significant arthropathy and cardiovascularsequelae: A. Borrella burgodofori C. Chlamydia psittaci B. Pseudomonas pseudomallei D. none of the above122. Aspiration pneumonia secondary to anaerobic bacteria is more often associated with A. Propionbacterium acne C. Bacteroides melaninogenicus B. Clostridium difficile D. Fusobacterium123. A patient whose job involves worldwide travel presents with complaint of right upper quadrant pain.Examination reveals hepatomegaly and eosinophilia. The most likely diagnosis is a. hepatocellular carcinoma b. hepatitis B c. echinococcal cyst d. candida albicans of the liver e. schistosomiasis124. Stippling produced in infected red cells by Plasmodium vivax: A. Garnham’s bodies C. cuneiform dots E. Zieman’s dots B. Schuffner’s dots D. Maurer’s dots125. In a patient who presents with Cushing’s syndrome and has elevated plasma cortisol and low plasmaadrenocorticotrophic hormone (ACTH) levels, the most likely diagnosis is a. an adrenocortical adenoma b. basophilic adenoma of the pituitary gland c. oat cell carcinoma of the lung
  • d. bilateral adrenal hyperplasia e. malignant islet cell tumor of the pancreas126. A 45 year old woman who has had a hysterectomy presents to the emergency room with abdominalpain and vomiting. A mechanical bowel obstruction is seen on the abdominal radiograph. The most likelycause of the obstruction is a. carcinoma of the colon d. small bowel cancer b. adhesions e. diverticulitis c. incarcerated inguinal hernia127. Which of the following can NOT serve as a vector of rickettsiae? A. ticks B. lice C. mosquitoes D. fleas128. Heterophile antibody test (Paul-Bunnel) is a diagnostic of A. herpes virus C. cytomegalovirus E. brucellosis B. infectious mononucleosis D. polio virus129. Tissue graft within the same individual is known as A. allograft B. isograft C. autograft D. xenograft130. Frank amoebic dysentery in entamoeba histolytica infection: A. sigmoid-rectal B. liver C. all of these D. cecum131. An elderly woman is admitted for weakness, weight loss, anemia and a palpable abdominal mass. Shehas colon carcinoma. The most likely anatomic site is a. rectum d. sigmoid colon b. left colon e. cecum c. transverse colon132. The inclusion body of smallpox virus is A. Miyagawa B. Guarnier-Paschen C. Lipschutz D. Torres-Councilman133. Type I allergic disease of the respiratory tract is exemplified by A. bronchial asthma C. Goodpasture’s syndrome B. farmer’s lung D. tuberculosis134. Which of the following immunosuppressive agents is a fungal metabolite that has been usedclinically? A. methotrexate B. cyclosporine A C. azathioprine D. cyclophosphamide135. Blackwater fever results from A. anaphylaxis C. liver enlargement E. intravascular hemolysis B. splenic enlargement D. melanosacroma136. Chorioretinitis and cerebral calcification are manifestations of A. T. gondii B. all three C. Cryptosporidium sp. D. P. carinii137. A 4-year old boy has a young puppy and a history of pica. He has had the recent onset ofWheezing, hepatomegay, and marked eosinophilia (80% eosinophils). The test most likely to produce aspecific diagnosis is A. histoplasmin test C. tuberculin skin test B. ELISA for Toxocara D. silver stain of gastric aspirate138. The following are prominent hypotensive molecules, except a. nitric oxide d. bradykinin b. beta endorphin e. none of the above c. prostacyclin
  • 139. A 15 year old girl has recurrent abdominal cramping and melena. Physical examination revealsincreased pigmentation on her lips and buccal mucosa. Her sister has a similar history and similar findings.What is the most likely diagnosis a. pseudopolyposis b. Familial polyposis c. Villous adenoma d. Juvenile polyposis e. Peutz-Jegher’s syndrome140. The following are principles of antimicrobial therapy in sepsis, except a. initiate empirical therapy effective against both gram (+) and gram (–) bacteria b. patterns of antimicrobial susceptibility among bacterial isolates from hospitals, the community and patient should be taken into account c. minimum recommended doses of antimicrobial drugs should be given intravenously d. should be initiated as soon as samples for blood culture from at least 2 different sites have been cultured e. none of the above141. Enzyme responsible for hydrolyzing triacylglycerol-associated with VLDL in the blood: A. steapsin B. pancreatic lipase C. lipoprotein lipase D. hormone-sensitive lipase142. Deficiency in availability of which of the following will result in ketosis? A. carbohydrates B. proteins C. lipids D. essential fatty acids143. The prostanoid with the greatest vasodilatory effect is A. PGE2 B. PGF2 C. misoprostol D. prostacyclin E. thromboxane144. Direct synthesis of ATP from high energy compounds is known as A. substrate level phosphorylation C. adenylation B. high energy phosphorylation D. oxidative phosphorylation145. Pancreatic digestion of fats require the action of bile salts to A. enhance peristalsis C. increase lipid surface area B. precipitate the lipids D. activate pancreatic enzyme146. In electrophoresis, antibodies correspond to A. gamma globulin C. alpha-1-globulin B. beta globulin D. alpha-2-globulin147. The platelets produce a potent vasoconstrictor called A. ADP B. phospholipids C. serotonin D. fibrin148. The release of oxygen from oxyhemoglobin due to an increased CO2 is known as A. Pasteur effect C. Bohr effect B. Haldane effect D. Hamburger phenomena E. isohydric transport149. Some antibiotics act as ionophores, which means that they A. interfere directly with bacterial cell wall synthesis B. have a detergent-like effect on cell membranes C. increase cell-membrane permeability to specific ions D. inhibit both transcription and translation E. inhibit only translation150. The Megaloblastic macrocytic anemia with subacute degeneration of the spinal cord is due to a deficiency of A. ascorbic acid C. thiamin E. cyanocobalamin B. folic acid D. biotin