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Physicians Licensure Examination

June 5, 2009; 8:00am- 12:00nn
1. A patient with an isolated occulomor nerve paralysis would present with the following
findings on the affected side
A) constricted pupils
C) weakness of eyelid closure
B) eyelid deviated laterally
D) all of the above
2. Reproductive adaptations noted in the female true pelvis include the following EXCEPT
A) greater pubic angle
C) longer pelvic cavity
B) wider sacrosciatic notches
D) cylindrical pelvic cavity
3.A high velocity bullet penetrates the posterior aspect of the shoulder and severely injures the
origin of the posterior cord of the brachial plexus. Each of the following nerves might possible be
affected EXCEPT the
A) upper subscapular
C) thoracodorsal
B) radial
D) medial pectoral
4.During the proliferative phase of the menstrual cycle, one can observe that
A) the endometrium thickens largely because of edema
B) glycogen disappears in the basal cytoplasm of the glandular epithelium
C) there is a two to threefold increase in the thickness of the endometrium
D) the endometrial glands become quite tortuous
5. Bile formed by hepatic cells is first secreted into the
A) bile canaliculi
C) space of Disse
B) bile ducts
D) hepatic duct
6. A patient with an isolated injury to the mandibular division of the trigeminal nerve would
present with
A) atrophy of the temporalis muscle on the affected side
B) flattened nasao-labial fold on the affected side
C) numbness of the cheek on the affected side
D)A and C only
7. The landmark structure noted during the dissection of the gluteal area
A) gluteus medius
C) quadratus femoris
B) piriformis
D) obturator externus
8.Semen is composed of products produced by all of the following EXCEPT the
A) seminiferous tubules
C) bulbourethral glands
B) seminal vesicles
D) rete testis
9. True ribs include
A) 5th

B) 7th

C) 8th

D) A and B

10. A patient was noted to have atrophy of the temporalis and masseter muscles on one side of
the face. His corneal reflex on the affected side was normal and he had no sensory deficit in the
cheek area. This patient most probably has a lesion involving the
mandibular division of CN V
maxillary division of CN V

ophthalmic division of CN V
terminal branches of CN VII

11. The primary hip flexor is the

A) sartorius
B) rectus femoris

C) iliopsoas

D) pectineus

Physicians Licensure Examination
June 5, 2009; 8:00am- 12:00nn
12. The following secretions are correctly attached with their cells of origin in every pair
A) glucagon - pancreatic alpha cells
B) intrinsic factor- parietal cells of the stomach
C) insulin - pancreatic beta cells
D) hydrochloric acid - chief cells of the stomach
13. A patient presented with complete paralysis of one side of the face with intact lacrimation
and taste sensation (anterior 2/3 of tongue) The cranial nerve involved in this case most probably
has a tension at the level of the
A) internal auditory meatus
C) sytlomastoid foramen
B) geniculate ganglion
D) external auditory meatus
14. This structure is highly vulnerable in surgical manipulation of the ductus arteriosus
A) esophagus
C) left vagus nerve
B) left bronchus
D) left recurrent laryngeal nerve
15. The three types of granulocytes usually can be distinguished best under the light microscope
on the basis of
A) nuclear morphology and cell size
B) nuclear morphology only
C) cell size only
D) staining reaction of cytoplasmic granules
16. The liver is anatomically divided into right and left unequal halves along the fissure of the
A) ligamentum venosum
C) falciform ligament
B) inferior vena cava
D) porta hepatic
17. Both skeletal and smooth muscle can be found in the muscularis externa of the
A) stomach
C) colon
B) duodenum
D) esophagus
18. This structure is highly vulnerable in cancerous growth in R pulmonary hilum and posterior
A) trachea
C) vagus nerve
B) superior intercostal vein
D) pulmonary ligament
19. During erection of the penis, the volume of the blood occupying the spaces of the cavernous
sinuses is increased by
A) contraction of the musculature of the dorsal artery of the penis
B) relaxation of the musculature of the dorsal artery of the penis
C) contraction of the musculature of the helicine arteries
D) relaxation of the musculature of the helicine arteries
20.The granules found in the cells of the adrenal medulla consist of
A) hydrocortisone
C) epinephrine
B) glucocorticoids
D) mineralocorticoids
21. The deep perineal space in the male contains each of the following EXCEPT
A) membranous urethra
C) bulbourethral glands
B) prostate gland
D) sphincter urethrae muscle
22. Loss of extension of the knee would result from damage to the
A) femoral nerve
C) tibial and common fibular
B) tibial nerve
D) obturator nerve
23. Which of the following epithelia can usually be found in the normal female reproductive
A) stratified squamous and simple columnar

Physicians Licensure Examination
June 5, 2009; 8:00am- 12:00nn
B) transitional and stratified squamous
C) simple columnar and transitional
D) simple columnar and pseudostratified
24. By inserting the finger into the rectum, the following can be readily felt and examined
A) enlarged seminal vesicles
C) A and B
B) prostate gland
D) none of the above
25. The ventral rami of the brachial plexus are seen at the
A) posterior cervical triangle
C) submandibular triangle
B) carotid triangle
D) muscular triangle
26. The function of the interstitial endocrine cells of the testis is to
A) form acrosome
B) secrete testosterone
C) support the germinal epithelium
D) supply nutrients to the sex cells
27. The vermiform appendix is best located by following the
A) anterior cecal artery
B) descending branch of the right colic artery
C) ileum to the ileocolic juncture
D) teniae coli of the ascending colon
28. From which of the following sites is primary cancer most likely to metastasize to the lung by
venous spread?
A) ileum
C) kidney
B) appendix
D) transverse colon
29. Simple cuboidal epithelium is usually found in
A) parietal layer of Bowmans capsule
B) descending limb of the loop of Henle
C) rete testis
D) single layer on the free surface of the ovary
30. The roof of the adductor canal is formed by the
A) rectus femoris
B) vastus medialis

C) adductor longus
D) sartorius

31. Trauma to the sternocostal surface of the heart would more likely damage the
A) right atrium
C) left ventricle
B) right ventricle
D) left atrium
32. Interruption of blod flow in the internal iliac artery would affect blood flow to each of the
following EXCEPT the
A) medial thigh muscles
B) ductus deferens
C) lower abdominal wall and rectus abdominis muscle
D) rectum
33. A child suspected of aspirating a small button is seen in the ER. While there is no complain
of pain, there is frequent coughing. Physical examination showed absence of breath sounds.
Aspirated small objects tend to lodge in the right inferior lobar bronchus for all the following
reasons EXCEPT
A) left main stem ( primary) bronchus is more horizontal
B) right inferior lobar bronchus nearly continues the direction of the trachea
C) right lung has no middle lobe
D) right main stem(primary) bronchus is of greater diameter than the left

Physicians Licensure Examination
June 5, 2009; 8:00am- 12:00nn
34. This structure separates the perineum from the pelvic cavity
A) ischiorectal fossa
C) pelvic diaphragm
B) urogenital diaphragm
D) urogenital triangle
35. Drug detoxification occurs in the
A) Golgi apparatus
B) smooth endoplasmic reticulum

C) rough endoplasmic reticulum

D) lysosomes

36. The ligament that prevents C1 vertebrae from translating against C2 is

A) alar ligament
C) transverse ligament
B) tentorial ligament
D) posterior longitudinal ligament
37. The scala vestibuli of the inner ear communicates with the scala tympani via the
A) modiolus
C) cecum cupulare
B) helicotrema
D) aqueduct
38. The Haversian canals of bone tissue
A) contain chondrocytes
B) are lined by cement lines
C) form the central structure of a Haversian system
D)run perpendicular to the long axis of the bone
39. The hepatic portal vein is correctly described by each of the following EXCEPT
A) it drains most of the venous blood from the gastrointestinal tract
B) it forms by the confluence of the superior mesenteric and splenic veins
C) it is located in the hepatoduodenal ligament
D) it forms posterior to the head of the pancreas
40. The internal spermatic fascia is derived from the
A) external oblique aponeurosis
B) peritoneum
C) transversus abdominis aponeurosis
D) transversalis fascia
41. The vagus nerve enters the abdominal cavity through the
A) aortic hiatus
C) sternocostal hiatus
B) esophageal hiatus
D) vena caval aperture
42. The part of the uterine tube which is removed during fimbriectomy
A) cornua
C) ampulla
B) isthmus
D) infundibulum
43. Pressure developing deep to the flexor retinaculum would affect each of the following
A) median nerve
B) ulnar nerve
C) tendons of the flexor digitorum superficialis muscle
D) tendons of the flexor pollicis longus muscle
44. A patient enters the emergency room not being able to raise his foot. The nerve that is
suspected to be damaged is the
A) tibial
C) obturator
B) common fibular
D) medial plantar
45. Sinusoids are correctly described by each of the following EXCEPT
A) they have a irregular tortuous lumen
B) they are lined by endothelial cells

Physicians Licensure Examination
June 5, 2009; 8:00am- 12:00nn
C) they have a dense connective tissue wall
D) they have no phagocytic elements
46. The opening into the lesser sac is through the
A) foramen of Bochdalek
B) foramen of Winslow

C) foramen of Morgagni
D) foramen transversarium

47.Damage to the obturator nerve on the lateral wall of the pelvis would affect the function of
each of the following muscles EXCEPT the
A) sartorius
C) adductor longus
B) gracilis
D) pectineus
48. When removing the right lung, the surgeon has to be careful to protect which of the
following structures passing posterior to the root of the lung?
A) hemiazygos vein
C) right phrenic nerve
B) right vagus nerve
D) thoracic aorta
49. Which muscle is responsible for expelling the last drops of urine in the male
A) sphincter urethrae
C) sphincter vesicae
B) bulbocavernosi
D) ischiocavernosi
50. At the hepatoduodenal ligament, the structure that occupies a medial location is the
A) common bile duct
C) inferior vena cava
B) portal vein
D) hepatic artery
51. The thoracic duct enters the venous circulation at the junction of
A) superior vena cava and right atrium
B) left subclavian and left internal jugular vein
C) left and right brachiocephalic vein
D) right subclacian and right internal jugular vein
52. The axillary artery may be ligated at this point without compromising the blood supply to the
upper extremity
A) proximal to the thyrocervical trunk
B) distal to the subscapular artery
C) between the thyrocervical trunk and subscapular artery
D) none of the above
53. Separates the submandibular triangle from the carotid triangle
A) posterior belly of digastric
C) sternohyoid
B) omohyoid
D) hyoid bone
54. An occlusion of the superior mesenteric artery would result in necrosis of each of the
following EXCEPT the
A) ascending colon
C) ileum
B) rectum
D) cecum
55. Occupies the tracheoesophageal groove
A) vagus nerve
B) sympathetic trunk

C) recurrent laryngeal nerve

D) phrenic nerve

56. A womans inability to supinate the forearm could result from an injury to which of the
following pair of nerves
A) axillary and radial
C) radial and musculocutaneous
B) median and ulnar
D) suprascapular and axillary
57. Following tonsillectomy, a patient noted loss of general sensation and taste from the posterior
one third of the tongue. It could be assumed that the injured nerve was a branch of the

Physicians Licensure Examination
June 5, 2009; 8:00am- 12:00nn
A) glossopharyngeal nerve
B) facial nerve

C) lingual nerve
D) hypoglossal nerve

58. The median cubital vein is a communication between the

A) cephalic and basilic
C) cephalic and axillary
B) basilic and axillary
D) axillary and subclavian
59. Fenestrated capillaries have
A) extremely attenuated areas of endothelium with pores
B) thickened areas with pores
C) diaphragm that have the same thickness as unit membranes
D) pores that are evenly spaced over the entire surface of the endothelium
60. A severe blow to the side of the head could fracture which one of the following bones in the
roof of the orbit?
A) palatine
C) frontal
B) maxilla
D) zygomatic
61. Occupies a medial location within the carotid sheath
A) internal jugular vein
C) vagus nerve
B) ansa cervicalis
D) common carotid artery
62. Each of the following characterizes the levator ani muscles EXCEPT
A) it forms the principal part of the pelvic diaphragm
B) it separates the floor of the pelvis from the ischioanal fossa
C) it arises from the inner surface of the superior ramus of the pubis
D) it separates the superficial and deep inguinal spaces
63. A basketball player who trips and falls, landing on his outstretched hand will most likely
fractures which carpal bone?
A) trapezium
C) scaphoid
B) capitate
D) hamate
64. Lymphatic nodules are found in each of the following EXCEPT
A) lymph nodes
C) tonsils
B) thymus
D) walls of urinary tract
65. A spleen may be ruptured in traumatic injuries to the chest if these ribs are fractured and
A) 5th, 6th, 7th level of the posterior axillary line
B) 7th, 8th , 9th level of the midaxillary line
C) 9th, 10th, 11th level of the left posterior axillary line
D) 10th, 11th, 12 anteriorly
66. A diastolic murmur coming from a stenosed mitral valve in patient with RHD is best heard or
auscultated at the
A) 5th ICS left midclavicular line
B) 4th ICS left parasternal border
C) 2nd ICS left parasternal border
D)4th ICS right parasternal border
67. Surgically, it is important to locate which one of the following structures located immediately
posterior to the second part of the duodenum
A) transverse colon
C) hilum of right kidney
B) left lobe of the liver
D) gallbladder
68. Podocytes are associated with which of the following parts of the urinary system
A) distal convoluted tubule
C) major calyces

Physicians Licensure Examination
June 5, 2009; 8:00am- 12:00nn
B) thick limb of loop of Henle

D) visceral layer of Bowmans capsule

69. A baby sustained a lower brachial plexus injury due to traumatic childbirth (forceful pulling
on the arm). The following is/are true statements regarding this type of injury
A) results in loss of abduction, flexion and lateral rotation of the shoulder
B) results in clawhand deformity
C) leads to sensory deficit in the lateral aspect of the upper extremity
D) all of the above
70. Which of the following layers in the wall of a medium sized artery contains smooth muscle
A) internal elastic membrane
C) tunica adventitia
B) external elastic membrane
D) tunica media
71. A lesion of the lingual nerve immediately after it receives the chorda tympani nerve could
result in each of the following EXCEPT
A) loss of sublingual gland secretion
B) sensory loss from lower teeth
C) loss of taste from anterior two thirds of the tongue
D) loss of submandibular gland secretion
72. The superior vena cava could be damaged by a stab wound deep to the
A) right first costal cartilage
C) right sternoclavicular joint
B) right fourth costal cartilage
D) left second costal cartilage
73. All of the following statements concerning the uterus are correct EXCEPT
A) the broad ligament reflects from the posterior surface of the uterus to the rectum to
form the rectouterine pouch
B) the round ligament connects the uterus to the ovary
C) the broad ligament extends from the anterior surface of the uterus onto the bladder
forming the vesicouterine pouch
D) the uterine tubes enter the uterus in the superior border of the broad ligament
74. A 58-year-old man presented with a year history of chest pain. The attacks were increasing in
frequency and were only relieved by rest. Cardiac catheterization revealed an area of occlusion
of the circumflex branch of the left coronary artery. The damage to the heart would probably
involve the
A) left atrium and left ventricle C) right and left ventricles
B) right atrium and left ventricle
D) apex of the heart
75. A severe infection that obstructs the middle meatus would affect drainage from each of the
following sinus EXCEPT the
A) maxillary sinus
C) nasolacrimal duct
B) frontal sinus
D) anterior ethmoid air cells
76. Plicae circulares is most abundant in what part of the gastrointestinal tract
A) duodenum
C) ileum
B) jejunum
D) large intestine
77. A woman on her 3rd trimester of pregnancy developed paresthesia of the hands. She has
difficulty in doing her cross-stitch hobby. Her most likely problem affects the
A) median nerve
C) radial nerve
B) ulnar nerve
D) axillary nerve
78.A 9-year-old boy fell hitting his elbow. Physical examination showed weakness in wrist
flexion and loss of adduction. Loss of sensation was noted on the medial side of his hand. What
nerve was most probably injured
A) musculocutaneous
B) ulnar

C) radial
D) median

Physicians Licensure Examination
June 5, 2009; 8:00am- 12:00nn
79. Carcinoma of the _____part of the pancreas usually shows itself first by painless progression
jaundice with enlargement and distention of the gall bladder
A) head
C) body
B) neck
D) tail
80. Sperms found in these structures are capable of fertilizing ova
A) seminiferous tubules
C) ductuli efferentes
B) rete testis
D) epididymis
81. A myocardial infarction that damages the heart muscle in the anterior two thirds of the
interventricular septum would result primarily from occlusion of the
A) posteiror interventricular artery
B) marginal branch of the right coronary artery
C) marginal branch of the left coronary artery
D) anterior interventricular artery
82. The horizontal fissure of the right lung separates the
A) superior and middle lobe
C) inferior and middle lobe
B) superior and inferior lobe
D) superior lobe from cardiac notch
83. In Dupuytrens contracture, the flexion of the MCP joints is actually due to
A) compression of the median nerve at the wrist, leading to atrophy of the muscles of
B) inflammation of the synovium of the long flexor tendons, leading to scarring
C) atrophy of the lumbrical muscles due to disuse
D. fibrosis of the digital slips of the palmar aponeurosis
84. It would be difficult for a gallbladder infection to easily reach which one of the following
A) liver
C) cystic duct
B) third part of the duodenum
D) transverse colon
85. After leaving the trabecular sinuses of a lymph node, lymph passes directly into the
A) afferent lymphatic vessels
C) subscapular sinuses
B) efferent lymphatic vessels
D) medullary sinuses
86. A vertical incision through the midline of the anterior abdominal wall will traverse the
A) rectus abdominis
C) internal oblique
B) external oblique
D) linea alba
87. The contents of an indirect inguinal hernia enters the inguinal canal ______ to the inferior
epigastric artery
A) lateral
C) inferior
B) medial
D) none of the above
88. A penetrating knife wound to the posterior shoulder in the quadrangular space would damage
the axillary nerve and the
A) anterior circumflex humeral artery
C) subscapular artery
B) posterior circumflex humeral artery D) superior thoracic artery
89.A tumor involving the fifth to twelfth thoracic vertebrae could affect each of the following
structures in the posterior mediastinum EXCEPT the
A) thoracic duct
C) azygos vein
B) phrenic nerve
D) descending aorta
90. Damage to the anatomic snuffbox might be expected to injure the
A) ulnar nerve
C) ulnar artery
B) capitate bone
D) radial artery

Physicians Licensure Examination
June 5, 2009; 8:00am- 12:00nn
91. The cerebral arterial circle (circle of Willis) is formed by branches of the internal carotid
artery and the
A) external carotid artery
C) basilar artery
B) vertebral artery
D) middle meningeal artery
92. AS a result of an injury to the ulnar nerve in the arm, all of the following changes in the hand
will be noted EXCEPT
A) sensory loss on the little finger and one half of the ring finger
B) the thumb is strongly adducted
C) loss of flexion of the distal interphalangeal joints of the fourth and fifth digits
D) marked wasting in the hypothenar eminence
For questions 93-95
A 63 year old woman shows a fine, pill-rolling tremor in both upper extremities, with tremors at
rest. There is an overall poverty of movements. The patients gait is shuffling and motor
performance is delayed.
93. The most likely diagnosis is
A) Wilsons disease
B) Parkinsons disease

C) Benedikts syndrome
D) Liver-brain disease

94. Dysfunction of this structure is implicated in the above disease

A) substantia gelatinosa
C) substantia nigra
B) red nucleus
D) cerebellum
95. Treatment involves administration of
A) dopamine
B) L-dihydroxyphenylalanine

C) acetylcholine
D) serotonin

96. The powerful extension of the thigh required when one is standing from a sitting position is
the function of the
A) gluteus maximus
C) psoas major
B) iliacus muscle
D) piriformis
97. Ejaculatory fluid is composed of products produced by all of the following EXCEPT the
A) seminiferous tubules
C) bulbourethral glands
B) seminal vesicles
D) rete testis
98. Respiratory distress syndrome occurs most commonly because
A) too few mature alveoli have developed
B) surfactant production is insufficient
C) the lungs are partially filled with amniotic fluid
D) type I alveolar epithelial cells produce a greatly thickened basement membrane
For question 99-100
A 55-year-old woman complained of numbness in the legs, which spread to involve her hands.
There were sudden sharp pains, variable in location, but usually localized to one or the other leg.
On examination, her pupils were of unequal size. Argyll-Robertson pupils and Rombergs sign
were present. Although the patients strength was normal she was areflexic in all limbs.
99. The most likely diagnosis is
A) Brown Sequard syndrome
B) tabes dorsalis

C) multiple sclerosis
D) meningiona

100. Above findings is the result of

A) degeneration of posterior columns
A) upper motor neuron damage
B) cerebellar disease
C) degeneration of basal ganglia

Physicians Licensure Examination
June 5, 2009; 8:00am- 12:00nn