MD Surgery Part 1 2022 Feb

Paper 1 (2 Hours - 9.30 am - 11.30 am)

Anatomy

1. True or false regarding palmar spaces

A. Radial bursa extends into the forearm deep to the carpal tunnel.
B. Synovial sheaths of 2, 3, 4 fingers are sealed proximally at the heads of
metacarpals.
C. Posterior wall of midpalmar space is bound by metacarpal bones of 3rd, 4th and
5th fingers
D. Pulp space infections can lead to necrosis of epiphysis of distal phalanx
E. Flexor tendons of index finger lie in thenar space

2. Anterior relations of the shoulder joint

A. Coracobrachialis
B. Short head of biceps
C. Long head of biceps
D. Teres minor
E. Subscapularis

3. Regarding the anatomy of the facial nerve

A. It supplies the buccinator
B. It is involved in the corneal reflex arc
C. It supplies the conjunctiva
D. It innervates the tensor tympani muscle
E. Supply secretomotor fibers to parotid gland

4. Which of the following are true/false regarding the coronary circulation.

A. Left coronary artery arises from the posterior aortic cusp
B. Left circumflex artery lies in the anterior interventricular groove
C. Right coronary artery supplies the atrioventricular node
D. Right coronary artery emerges at the area between pulmonary trunk and auricle
of the right atrium
E. Coronary sinus drains into left atrium
5. Regarding the structures in posterior mediastinum
A. Greater splanchnic nerves leave the thorax behind the medial arcuate ligament.
B. Thoracic duct reaches the left side of the midline at the level of T5 vertebra.
C. Left bronchus make a constriction in the esophagus
D. Superior phrenic arteries are given off by thoracic aorta.
E. Azygos vein ascends to thorax through aortic hiatus.

6. Regarding anterior abdominal wall

A. Superficial vein above umbilicus in anterior wall drain to lateral thoracic vein
B. Line of Douglas (Arcuate line) is between umbilicus and pubic crest
C. Rectus abdominis has attachments to costal cartilages
D. Superior and inferior epigastric arteries anastomose superficial to rectus
abdominis muscle
E. Iliohypogastric nerve pierce the rectus sheath above superficial ring

7. Regarding the spleen

A. Develops from dorsal mesogastrium
B. Pancreatic tail is at the splenic hilum
C. Receives afferent lymphatics
D. Splenic artery passes in the gastrosplenic ligament
E. Left end of the omental bursa extends to the hilum

8. Regarding the liver

A. Drains via portal vein
B. Directly related to right suprarenal gland
C. Drains to mediastinal lymph nodes
D. Supplied by the phrenic nerve
E. Derived from the foregut

9. Regarding Hypoglossal nerve

A. Originates between the olive and the pyramid
B. Has bilateral cortical supply
C. It is deep to the digastric muscle
D. Carries C1 nerve supply
E. Runs between internal and external carotid artery

10. Regarding the knee joint

 A. Menisci have blood supply
B. A sagittal section is discoid in shape
C. Transverse ligament is attached to both menisci posteriorly
D. Fibers of popliteal tendon attach to lateral meniscus
E. Meniscofemoral ligament extend from lateral meniscus to medial femoral condyle
posteriorly

11. Regarding the bladder

A. Medial umbilical ligament connect with apex
B. Most inferior part is neck
C. It is in pelvic cavity in complete empty state
D. Ureters enter to the bladder obliquely
E. Is covered by the peritoneum anteriorly

12. Regarding the elbow joint

A. Synovial cavity communicates with the proximal radio ulnar joint.
B. Capitulum and head of radius form saddle joint.
C. Carrying angle less in flexion.
D. Valgus deformity cause ulnar nerve injury
E. Humeral epicondyles are extra capsule

13. Regarding Lumbricals

A. Lumbricals attach to proximal phalanx
B. Lumbricals are involved in the flexion of the metacarpophalangeal joint
C. Fourth lumbrical is bipinate
D. 2nd lumbrical is supplied by the recurrent branch of the median nerve
E. Lumbricals originate from the flexor digitorum profundus

14. Which of the following is true or false regarding ulnar nerve

A. Ulnar nerve supplies lateral half of the flexor digitorum superficialis
B. Ulnar nerve is related to the anterior interosseous artery
C. Ulnar nerve supplies the adductor pollicis
D. Ulnar nerve passes deep to the flexor retinaculum
E. It is medial to the ulnar artery at the wrist

15. Regarding Brachial artery

A. Brachial artery travels with radial nerve in bicipital groove
 B. Brachial artery divides at the level of the head of radius
C. Brachial artery lies medial to median nerve in cubital fossa
D. It gives rise to superior ulnar collateral artery
E. Originates at the lower border of teres major

16. Regarding the development of the testis

A. Paramesonephric ducts contribute
B. Drags a peritoneal covering
C. Full decent may occur up to 3 months postnatally
D. Prcesses vaginalis helps in the descent

17. Regarding the thyroid gland

A. Superior laryngeal nerve is related to the upper pole of the gland
B. Deep cervical fascia invests the thyroid gland with the parathyroid gland in the
same sheath
C. Isthmus is at thyroid cartilage level
D. Inferior thyroid artery arises from the thyrocervical trunk
E. Ectopic thyroid tissue commonly lodge in relation to internal jugular vein

Physiology

21. Factors that increase GFR include

A. Reduced resistance in the afferent arteriole
B. Reduced resistance in the efferent arteriole
C. Increased hydrostatic pressure in the glomerular capillaries
D. Reduced oncotic pressure in the bowman's capsule
E. By an increase in filtration coefficient

22. Regarding opioid peptides

A. acts on alpha receptors
B. Involved in the gate control in pain pathways
C. Found at dorsal horn of spinal cord
D. Causes pain inhibition
E. Found in the gastrointestinal tract

23. Regarding JVP

A. “a” wave corresponds with atrial depolarisation
 B. “a” wave is prominent in atrial fibrillation
C. In IVC obstruction there will be high jugular venous pressures with no waveform
D. Jugular venous pressure is increased in fluid overload
E. “c” wave is associated with ventricular ejection phase

24. A mucus plug obstructing a terminal bronchiole of an alveolus. Regarding that

alveolus
A. PO2 inside the alveolus gradually decreases with time.
B. PCO2 remain unchanged
C. There will be shunting of blood supply
D. Arterioles supplying the alveolus will be dilated
E. Partial pressure of N2 will remain unchanged

25. An amateur mountain climber attempted a climb to mount Everest. At 5280m he felt
difficulty in breathing. His saturation was assessed by the medical officer in the team
and it was 88%.
A. It is due to reduced percentage of oxygen
B. It is due to reduced barometric pressure
C. Respiratory acidosis is likely in this individual
D. Likely to have elevated erythropoietin level
E. Need oxygen treatment in a decompression chamber

26. Following findings are obtained from a patient,

Tidal volume 350ml,
Respiratory rate 15/min
FEV1/FVC 90%
Dead space 150m
A. Alveolar ventilation 3000ml/min
B. Alveolar minute ventilation 5250ml/min
C. He is having restrictive lung disease
D. Peak flow rate value is low
E. Beta 2 agonist will improve his condition

27. A 28 year old motorcycle rider collided with a lorry and was brought to the ETU 2
hours after the injury and was found to have a blood pressure of 80/40 mmHg and a
pulse rate of 140 bpm with cold and clammy peripheries. FAST showed moderate
amounts of free fluid with possible liver laceration. Which of the following compensatory
mechanisms would have been activated?
A. Erythropoietin secretion
B. Baroreceptor stimulation
C. Sympathetic activation
D. Aldosterone secretion
E. Splanchnic venoconstriction

28. Regarding proenzyme pepsinogen

A. Performs digestion of proteins
B. Secreted by the gastric parietal cells
C. Secretion is increased by Gastrin
D. Parasympathetic stimulation via Acetylcholine leads to increased secretion.
E. Hydrochloric acid is needed for activation

29. 40y old man presented with anemia. His investigations showed a Hb of10 g/dl, MCV
110. MCH was low. Vitamin B 12 & folate levels normal. Which of the following are
compatible with his presentation?
A. Increased TSH
B. Normal serum ferritin
C. USS showing cirrhosis
D. Abnormal Schilling test
E. Megaloblast in bone marrow

30. Structures that undergo receptive relaxation when a bolus of food is swallowed
include
A. Orad stomach
B. Palatopharyngeal fold
C. Pharynx
D. Upper esophageal sphincter
E. Lower esophageal sphincter

31. A 55 year old male patient underwent a gastrectomy 2 years back. He was loss to
followup and presented with shortness of breath. Blood picture shows hypochromic
microcytic cells,Macrocytes and neutrophils with hypersegmented nuclei. Causes could
be
 A. Iron deficiency
B. Folate deficiency
C. B12 deficiency
D. Protein deficiency
E. Infection of GI tract due to lack of acid

32. Which hormone is correctly matched with its corresponding actions

A. Glucagon - increased glycogenolysis in liver
B. Glucagon - Increased glycogenolysis in skeletal muscles
C. Glucagon - Increased gluconeogenesis
D. Cortisol- increased gluconeogenesis

33. 23 year old girl presenting with hepatosplenomegaly. What features suggestive of
extravascular haemolysis
A. Anemia and haemoglobinuria
B. Anemia and mild jaundice
C. Koilonychia and clubbing
D. Anemia with angular stomatitis
E. Anemia with chronic leg ulcer
34. Regarding Basal ganglia
A. D1 receptor directly stimulate it
B. Corpus Striatum receive impulse from motor cortex
C. Hypotonia is seen in damage
D. Ataxia is seen in damage
E. In Parkinsonism damage to sub thalamic nucleus is seen

35. Man working under the sun (hot environment) while sweating without access to
water to drink. After 1 hour his parameters
A. Increase ADH level
B. Increase ANP level
C. Increased baroreceptor firing rate
D. Increase osmoreceptor stimulation
E. Plasma Osmolarity towards the upper normal limit

Pathology

41. Regarding specimen collection and transport

A. Sample can be sent in formalin solution for immunohistochemistry.
 B. FISH can be done in formalin fixed samples
C. Sample can be sent in formalin solution for immunofluorescence
D. Positive margin can be identified by fresh frozen tissue sample
E. FNAC sample is fixed on 70% Alcohol

42. Which of the following is true or false regarding liver enzymes

A. In alcoholic liver disease, AST to ALT ratio will be decreased
B. In autoimmune hepatitis ALT will be increased
C. In pregnancy ALP will be elevated.
D. Gamma GT is elevated in Phenytoin therapy

43. Regarding colorectal carcinoma

A. APC/beta catenin mutation seen in sporadic malignancy
B. Hereditary polyps with indiscriminate satellite lesion is premalignant
C. Cyclooxygenase play an important role
D. Caecal carcinoma is commonly annular constricting type

44. Direct manifestations due to ionizing radiation?

A. Growth retardation in children
B. Sterility
C. Tissue scarring due to fibrosis
D. Increased susceptibility to infection
E. Cataract
45. Regarding epithelial mesenchymal transformation
A. Epithelial cells take mesenchymal phenotype
B. Increase migratory capacity
C. Increased E cadherin expression
D. Increase secretion of inhibitors for matrix metalloproteinases
E. Can be seen in wound healing

46. Regarding fine needle aspiration cytology

A. Done in suspected liver lesions
B. Can differentiate follicular adenoma from carcinoma
C. 18G needle is used
D. Can be done as an outpatient procedure
E. Sample is fixed with 70% alcohol

47. Oncogenic viruses and their association correctly marched

A. HSV - Cervical carcinoma
B. EBV - Burkitt's lymphoma
C. H Pylori - MALT Lymphoma
 D. HPV - Oropharyngeal carcinoma
E. Schistosomiasis - Prostate CA

48. Which of the following is true or false regarding papillary carcinoma of thyroid
A. Haematogenous spread is common.
B. BRAF mutation is common.
C. Cytological diagnosis have less sensitivity
D. Common in iodine deficient areas.
E. Tall columnar variant has poorer prognosis

49. Which of the following substance is correctly paired with its relevant tumor
A. AFP - Hepatocellular Carcinoma
B. B-HCG - Mixed tumor
C. ALP- Bone me

50. Factors that facilitate tumor progression

A. Expression E cadherin in tumor
B. Inhibition of plasma metalloprotease
C. Promoting growth factors
D. Laminin expression in tumor cells
E. Platelet adhere to tumor cells

51. Free radicals will be formed by

A. Inflammation
B. Catalase
C. Ionizing radiation
D. Glutathione peroxidase
E. NO

MD Surgery Part 1 2022 Feb

Paper 2 (2 Hours - 2.00 pm - 4.00 pm)

SBR

Anatomy

1. A young singer underwent thyroidectomy for a nodular thyroid lesion. Following

surgery she was unable to sing high pitched notes. The injury mostly responsible for this
finding is
A. L/Recurrent laryngeal nerve
B. Superior laryngeal nerve
C. External laryngeal nerve
D. Posterior Cricoarytenoid muscle
E. Thyroarytenoid muscle

2. Patient presented to the ETU with an injury to the right hip. Shortening of the limb
was noted on examination and the foot was adducted and medially rotated. What are
the muscle action involved in this
A. Adductors + Gluteus Maximus
B. Adductors + Gluteus Minimus
C. Adductors + Pectineus
D. Adductors + Psoas
E. Adductors + Gracilis

3. Cortex of the shaft of the tibia is supplied by

A. Anastomosis around knee joint and ankle joint
B. Nutrient arteries
C. Arteries that supply the muscles in that area
D. Popliteal artery
E. Posterior tibial artery

4. A patient presented with a history of pain in the right shoulder while trying to wear a
shirt. There was a weakness in the lateral rotation in the right arm on examination.
Which muscle is responsible for the above findings?
A. Supraspinatus
B. Latissimus dorsi
C. Infraspinatus
D. Teres major
 E. Subscapularis
5. Upper ureter mobilized for urinary stone removal . bleeding noted. Vessel that cause
bleeding
A. Gonadal veins
B. Common iliac vein
C. Right Colic artery
D. ileocolic artery
E. Appendicular artery

6.What is the structure passing through the esophageal hiatus of the diaphragm
A. Vagus nerve
B. Phrenic nerve
C. Hemiazygos vein
D. Sympathetic trunk
E. greater splanchnic nerve

7. School child presented with cut injury over thenar eminence . What is the most
probable nerve injury
A. Recurrent branch of median
B. Recurrent branch of ulnar
C. Superficial branch of Ulnar
D. Deep branch of ulnar
E. Superficial branch of median nerve

8.Histology shows prominent Internal elastic lamina and abundant smooth muscles in
the tunica media of a vessel. What is the type of vessel is this
A. Elastic artery
B. Muscular artery
C. Arteriole
D. Large vein
E. Endarteriolar capillaries

9. A 50 year old male patient underwent sigmorectal mobilization for rectal cancer
surgery . After 3 months he presented with impared ejculation. Which of the following
injuries best explains his ejaculation failure
A. Pudendal nerve injury
B. Injury to pelvic splanchnic nerve
C. Obturator nerve injury
D. Superior hypogastric plexus injury
E. Injury to the gonadal nerve
10. A young patient presented with an anal fissure. On the digital rectal examination,
there is increased tone in the anal sphincter. Which of the following is mostly involved in
the resting anal tone,
A. External anal sphincter
B. Internal anal spincter
C. Pubococcygeus
D. Levator ani
E. Puborectalis

Physiology

11. Testicular biopsy done in a patient with subfertility. Seminiferous tubules show only
spermatids. What is responsible for fully development and maturation of seminiferous
tubules?
A. Androgen binding globulin (ABG)
B. Aromatase (CYP19)
C. FSH and androgens
D. Mullerian inhibiting substance
E. LH

12. Following ABG was noted in a patient, cause for the below findings would be?
PH 7.15
HCO3 15
PCO2 28
Na 142
Cl 118
A. DKA
B. Severe vomiting with upper small intestinal obstruction
C. salicylate overdose
D. Diarrhea
E. Hyperventilation
13.SOB.Low BP .tachycardia, elevated JVP in inspiration
A. Cardiac tamponade
B. Massive pleural Effusion
C. Pulmonary Embolism
D. SVC Obstruction
E. Cardiac failure

14. Following a natural disaster, there is an outbreak of cholera among displaced

persons living in a tent encampment. There were multiple deaths due to severe
diarrheal symptoms. Later it was diagnosed that it was due to Vibrio cholerae infection.
Which of the following iron channel is involved?
A. Na+
B. HCO3-
C. Cl-
D. K+
E. Ca2+

15. A 40yrs old man presented to the emergency department following a fall from
height. He had severe weakness of dorsiflexion at right ankle and mild weakness of
plantar flexion at right ankle with sensory loss of right foot. Bladder functions are
spared. Best explanation for his presentation would be
A. Spinal cord injury at L1 level
B. Cauda equina injury
C. Disc prolapse at L5
D. Sciatic nerve injury
E. Disk prolapse at S1 level

16. A scientist wanted to evaluate the response of a medication created to control the
pain. Two groups of patients were given two different medications and the pain
threshold was assessed. Which of the following test is most useful to evaluate the
response in the two groups.
A. Student Paired t-test
B. Wilcoxon signed rank test
C. Unpaired t-test
D. Chi square test
E. Pearson correlation

17. A Patient presented with drowsiness to the ETU. His random blood sugar was
35mg/dl and was found to have low C peptide levels. Cause for the above presentation
A. Exogenous Insulin
B. Metformin overdose
C. Sulfonylurea overdose
D. Insulinoma
E. Addison disease

18. A patient was found to have a high T4 and low TSH with an atrophic thyroid gland.
Which of the following could be the reason for this presentation
A. Patient is having a pituitary tumor which prevents TSH secretion
 B. Patient is on propylthiouracil
C. Patient is taking thyroid extract
D. Consume lots of iodine
E. Suffering from Graves disease

19. A 22 year old female presented to the surgical clinic with a history suggestive of
anaemia and the initial evaluation showed the following.
Hb 8.5
PCV 29
MCV 55
MCHC
S.Ferritin 155 (Ref - 115)
Diagnostic test most appropriate to evaluate this situation
A. Hemoglobin electrophoresis
B. Vitamin B12 levels
C. Serum haptoglobin levels
D. Urine for hemoglobin
E. Total iron binding capacity

Pathology

21. Which of the following best describes the reason for the macrophages to have a
variety of functions
A. Ability to get activated through different pathways.
B. Ability to secrete various cytokines in response to different stimuli.
C. Presence in different tissues

22. A 56 year old patient is having a chronic wound over the medial malleolus of the leg
for 10 years. What is the best feature which indicates that there is malignant
transformation in this lesion
A. Firm inguinal lymphadenopathy
B. everted edges
C. Thickening of the surrounding skin

23. A 45 year old DM patient with fungal infection over the thigh was noted. What kind
of tissue response can be seen in his lesion
A. Acute inflammation with suppuration
B. Acute inflammation with abscess formation
C. Acute on chronic inflammation
D.
24. "A part of a histopathology report was given". Condensed Nuclear with atypia, high
rate of mitosis… pleomorphism… tubule formation… Tumour giant cells and areas of
necrosis present…
Which set of features need to be considered for the grading of a tumor
A. Pleomorphism, tubule formation, necrosis
B. Tubule formation, Pleomorphism, Mitotic count
C. Tumor giant cells, Pleomorphism, Necrosis
D. Tumor giant cells, Mitotic count, Necrosis
E. Condensed nucleus, Prominent nucleolus, Necrosis

25. A young patient presented to the emergency treatment unit with multiple injuries
following a road traffic accident. He was managed including fixation of fractures and
developed sudden onset shortness of breath after 2 days while in hospital. Reason for
the shortness of breath
A. Haemothorax
B. Fat embolism
C. Pulmonary embolism
D. Pulmonary infarction
E. Myocardial Infarction

26. Which of the following explains chronic inflammation

A. Inflammation process where the acute inflammation does not resolve
B. An inflammation where tissue injury, healing and repair happening at same time
C. Inflammation process with the presence of macrophages, lymphocytes and
plasma cells

27. Best example for type 4 hypersensitivity

A. Tissue injury of tuberculosis
B. Granuloma formation in sarcoidosis
C. Post streptococcal glomerulonephritis
D. Rheumatic fever
E. autoimmune thyroiditis

28. A 25 year old female patient was evaluated for suspected antiphospholipid
syndrome due to multiple thrombotic events including three first trimester miscarriages.
Which of the following investigations is/are most helpful in a definitive diagnosis
A. Rheumatoid factor
B. Erythrocyte sedimentation rate and Antinuclear antibody test
C. Protein C and Protein S levels
 D. Anti cardiolipin antibody IgG, lupus anticoagulant and anti beta 2-glycoprotein 1
IgG and IgM
E. Perinuclear antineutrophil cytoplasmic antibody titre (P-ANCA)

29. Mechanism responsible for cancer cachexia?

A. Apoptosis
B. Autophagy
C. Necrosis
D. Metaplasia
E. Dysplasia

EMI

Theme 1

A. Hepatorenal pouch (Morrisons)

B. Pouch of Douglas
C. Duodenojejunal fold
D. Intersigmoid recess
E. Right paracolic gutter
F. Omental bursa
G. Waldeyer’s fossa (mesentericoparietal fossa)
H. Left paracolic gutter
Select the abdominal space related to the following statements

1. The most dependent space in a patient who is supine

2. This space that is related posteriorly to the superior mesenteric vessels

3. The following space is related anterior to the upper left ureter

Theme 2

A. Genitofemoral nerve
B. Lateral femoral cutaneous nerve
C. Intermediate femoral cutaneous nerve
D. Iliohypogastric nerve
E. Ilioinguinal nerve
F. Medial femoral cutaneous nerve
G. Sural nerve
H. Tibial nerve

Select the appropriate nerve for the following statements

4. Formed by the L1 and L2

5. Which nerve pierces the sartorius

6. Nerve involved in meralgia paresthetica

Theme 3

A. Ophthalmic division of trigeminal nerve

B. Inferior alveolar nerve
C. Chorda tympani nerve
D. Lingual nerve
E. Glossopharyngeal nerve
F. Oculomotor nerve
G. Facial nerve
H. Hypoglossal nerve

Select the appropriate nerve lesion for the following scenarios

7. A patient fainted and fell down while a medical student was trying to check for the
carotid pulse. What is the nerve responsible for carrying signal to brain in this scenario

9.Lesions of this nerve leads to loss of taste sensations from anterior two thirds of the
tongue

9. The nerve commonly compressed in a posterior communicating artery aneurysm

10. Motor nerve mostly damaged in an acoustic neuroma

Theme 4

A. Ghrelin
B. Leptin
C. Cortisol
D. IGF 1
E. Insulin
F. Glucagon
G. GLP 1
H. Thyroxine
11. During an OGTT test, a patient with normal FBS, increased blood glucose level 1/2
to 1 hr with glycosuria. Blood glucose level rapidly normalized. Above finding is seen in
the hypersecretion of this hormone?

12. This substance leads to Increase GH secretion, increases appetite and increases
gastric emptying?

13. Greatest effector for insulin secretion from Pancreatic B cells after feeding?

Theme 5

A. GABA
B. Glysine
C. Glutamate
D. Noradrenaline
E. Acetylcholine
F. Substance P
G. Enkephalin
H. Endocannabinoid

14. Neurotransmitter involved in inverse stretch reflex

15. Most abundant inhibitory neurotransmitter in the central nervous system

16. Spinal neurotransmitter in stretch reflex

17. Neurotransmitter which is secreted from postsynaptic terminal and acts on

presynaptic membrane
Theme 6

A. Aortic baroreceptor
B. Volume receptor
C. Beta 1 adrenoceptor
D. Beta 2 adrenoceptor
E. Atrial stretch receptor
F. Osmoreceptors
G. Phospholipase A2 receptor
H. Alpha 1 receptor
A 45 year old male patient presented to the primary care unit after hematemesis. His
blood pressure was 60/40 and pulse rate was 140/min. He was a chronic steroid abuser
and a bleeding peptic ulcer was diagnosed as the reason for his presentation. Which of
the above receptors are responsible for the following on presentation

18. The mechanoreceptor that is least firing in this situation

19. The receptor involved in his tachycardia

20. Receptor responsible for his gastric ulcer

Theme 7

A. APC
B. BCL-2
C. HER2
D. JAK2
E. MLH1
F. RAS
G. P53
H. VHL

21. Gene regulate apoptosis and over expressed in B cell lymphoma

22. A tumor suppressor gene which inactivates hypoxia inducible factor

23. A gene involving cell cycle inhibition and apoptosis

24. Mismatch repair gene lost in sporadic colorectal CA

Theme 8

A. Ulcerative colitis
B. Crohn's disease
C. Post primary Tuberculosis
D. Typhoid
E. Amoebic abscess
F. Pseudomembranous colitis
G. Necrotizing enterocolitis
H. Diverticulitis
25. Patient presented with abdominal pain and diarrhea for two months. He underwent a
colonoscopy and was found to have pan colitis involving the rectum. Biopsy showed
lesions involving only the mucosa.

26. A patient presenting with loss of weight and loss of appetite with a history of
abdominal pain. On exploratory laparotomy a colic lesion was identified which was
transverse and had granulomas with no active inflammation on biopsy.

27. A patient presented to his GP with fever and abdominal pain for two days and was
treated with antibiotics. He did not respond and after 5 days presented to the surgical
casualty with features of ruptured bowel and underwent exploratory laparotomy. There
were ovoid ulcers in the antimesenteric border and payer patches were also enlarged.

Theme 9

A. Acute inflammation
B. Chronic inflammation
C. Granuloma formation
D. Granulation tissue
E. Apoptosis
F. Hyaline formation
G. Dystrophic Calcification
H. Coagulative Necrosis
28. 10 year old boy who had a cut injury in the hand. Microscopy shows proliferating
capillaries, fibroblasts and macrophages

29. 45yr old male, known patient with DM having renal artery changes

30. Psammoma bodies in papillary carcinoma in thyroid in 22 year female

Breakdown of Availability of Questions

Subject T/F SBR EMQ

Anatomy 17/20 10/10 10/10
Physiology 15/20 9/10 10/10
Pathology 11/20 9/10 10/10