‫الر ِحيم‬

‫الر ْح َم ِن ه‬ ِ ‫ِبس ِْم ه‬

‫َّللا ه‬

1. A patient suffered sensory deficit over the anterior thigh with inability to extend the
knee after an open hernia repair. What is the affected nerve?
A. Obturator nerve
B. Sciatic nerve
C. Genitofemoral nerve
D. Femoral nerve
E. Ilioinguinal nerve

2.A man presented with complete clawing at little and ring, Sensation at the back of
hand is intact and wasting of hypothenar muscle, what is your diagnosis?

A. At the axilla
B. At the elbow
C. At the upper arm
D. At the wrist
E. Deep ulnar nerve injury

3. A 53 years old female presented with a painless dark black eschar affecting her
hand. What is the likely cause?
A. Streptococcus pyogenes
B. Anthrax
C. Campylobacter
D. Staphylococcus aureus
E. Clostridium perfringens

4. A woman had a routine gynecological check. what is palpated anterior to the cervix
on PV?
A. base of bladder
B. dome of bladder
C. ischiorectal fossa
D. puborectalis muscle
E. none of the above

5. The male pelvis differs from the female one by all of the following except:
A. the female pelvis is wider and shallower than male
B. the female inlet is rounded or oval in shape while male is apple in shape
C. suprapubic angle is acute while male is large
D. the bone is lighter in female than in male
E. coccyx is straight in female while in male is curves

6. A patient diagnosed that he has a herpes zoster complaining of pain in the tip of the
nose.
Which of the following at the same Dermatome of tip of nose?

A. Ear pinna
B. angle of mouth
C. jaw angle
D. cornea
E. None of the above

6.Anterior relation of head of pancreas include:

A. pylorus of the stomach

B. common bile duct
C. portal vein
D. IVC
E. Aorta

7. Bleeding is come from Anterior gastric ulcer between the antrum and the body of
stomach, what is the source of bleeding
A. short gastric
B. left gastroepiploic
C. right gastroepiploic
D. left gastric
E. none of the above

8. 55 years old complained of a stroke affecting Right lower extremity paralysis, what
is the arterial supply responsible for that paralysis

A. right anterior cerebral

B. left anterior cerebral
C. right middle cerebral
D. PICA.
E. anterior spinal artery
9. 55 years old suffered from Vitamin deficiency and the patient is alcoholic and has
manifestations of Wernicke's ataxia with cardiomyopathy

A. thiamine deficiency
B. pellagra
C. folic acid
D. iron
E. vitamin B12

10. Which hormone increases pancreatic secretion rich in bicarbonate?

A. Secretin
B. CCK
C. Gastrin
D. Histamine
E. Serotonin

11. Zinker’s diverticulum in pharynx occur between:

A. Between thyropharengeaous and cricothyroid muscle

B. Between middle and inf constrictor
C. Between thyropharengeaous and cricopharyngeal muscle
D. Between false and true vocal cords
E. None of the above

12. Target INR for warfarin is:

A. 1:2
B. 2:3
C. 3:4
D. 4:5
E. 5:6

13. Electrolyte disturbance that causes flat p wave and inverted T wave is:

A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypercalcemia
E. Hyponatremia

14. Which diuretic acts on Na/k channel in collecting duct and causes hyperkalemia

A. Furosemide
B. Thiazide
C. Mannitol
D. spironolactone
E. None of the above

15. if you do DRE, what will you palpate 4 cm from anal verge posterolateral. What is
the tissue you will find?

A. ischiospinous ligament
B. puborectalis muscle
C. Sacro tuberous ligament
D. seminal vesicles
E. bladder

16. All are content of the posterior mediastinum except:

A. Descending aorta
B. Thoracic duct
C. Azygous vein
D. body of vertebrae
E. splanchnic nerves to heart

17. male 35 years old has blood pressure is 110/80 and ICP is 18, what is cerebral
perfusion pressure

A. 52
B. 72
C. 92
D. 112
E. 132

18. Nor-adrenaline exert its inotropic effect through which receptor?

A. alpha1
B. d1
C. d2
D. alpha2
E. beta1

19. Which cell is dependent on Cori cycle for energy:

A. Erythrocyte
B. Muscle cell
C. Hepatocyte
D. Fat cells
E. All of the above

20. 35 years old patient after eating canned food presented by flaccid paralysis and
diagnosed as botulinum toxin affection. What is the mode of action of botulin toxin

A. Block release of acetyl choline from its vesicles

B. Block nicotinic cholinergic receptors
C. Block muscarinic cholinergic receptors
D. close ca release from sarcoplasmic reticulum
E. Block Na channel

21. Vertebral artery true is enters the foramen transversum at which level?
A. C3
B. C4
C. C5
D. C6
E. C7

22. Nerve of 2nd arch?

A. II
B. V
C. VII
D. X
E. IX

23. A man complains of being thirsty and getting up in the middle of the night to go to
the toilet. His weight is 85.5 kg, height 1.65 in and blood pressure 167/94 mmHg. An
oral glucose tolerance test was performed and produced the following results: Fasting
plasma glucose 11.3 mmol/L The most likely diagnosis:
A. Diabetes insipidus
B. Diabetes mellitus
C. Impaired fasting blood sugar
D. sepsis
E. DKA

24. Caucasian girl with splenomegaly, jaundice and increase bilirubin level. What is the
diagnosis?

A. Spherocytosis
B. Sickle cell anemia
C. Intermittent porphyria
D. ITP
E. none of the above

25. What is the embryological cause of vagino-rectal fistula?

A. Vaginal tube tract

B. Urachus
C. Cloaca
D. Mesonephric duct
E. Metanephric duct

26. After clamping the umbilical cord what will not give oxygenated blood to the
embryo any more

A. Ductus venosus
B. Umbilical artery
C. Ductus arteriosus
D. Pulmonary artery
E. Pulmonary vein

27. A 42-year-old multiparous woman is admitted to the Emergency Department due

to pelvic discomfort. The duty gynecologist diagnoses uterine prolapse. Which
anatomical structure gives significant direct support to the uterus?
A. Cervical ligaments
B. broad ligament
C. Round ligaments
D. Transverse perineal Muscles
E. None of the above
28. A 65 years old man presented with an inguinoscrotal swelling in the right groin
which is non tender. A cough impulse is elicited, at operation, an indirect inguinal
hernia is repaired. The cremasteric muscle is derived from which of the following

A. External oblique aponeurosis

B. Internal oblique muscle
C. Rectus abdominal muscle
D. Rectus sheath
E. Transversalis fascia

29. A Patient presented with fracture of the face involving maxilla and numbness over
the cheek. Which of the following nerve is most likely involved?

A. Mental
B. Infra-orbital
C. Superior alveolar
D. Auriculotemporal
E. Supratrochlear

30. Male patient 58 years old with diabetes and chronic AF and come with sudden loss
left lower limb pain, by examination he has no distal pulsation below knee, what is the
most accepted cause of ischemia?

A. Chronic thrombosis
B. Embolic cause
C. Peripheral hypoperfusion
D. Normal Sequalae in old age
E. None of the above

31. A woman sustained needle brick to her thigh. Several days later she noticed red
streaks around site of the brick. What is the most likely cause of this condition?

A. Streptococcus viridians
B. Streptococcus Pyrogens
C. Staphylococcus aureus
D. Streptococcus pneumonia
E. None of the above
32. A 23 years old patient was admitted after falling on his outstretched hand. His
examination revealed that he has lost sensation over the index and middle finger.
What is the most accepted cause of this injury?

A. Hook of hamate fracture

B. Distal radial fracture
C. lunate dislocation.
D. Scaphoid fracture
E. Montagia fracture

33. Biopsy of normal urinary bladder was done; which cell will be found?

A. Stratified Squamous epithelium non-keratinized

B. Columnar epithelium with goblet cell
C. Columnar epithelium without goblet cell
D. Transitional epithelium
E. Stratified Squamous epithelium keratinized

34. A surgeon made an incision from below the clavicle to the deltopectoral groove.
Which of the following structures will not be encountered?

A. Medial cord of brachial plexus

B. Axillary vein
C. Thoracoacromial artery
D. Pectoralis minor insertion
E. Middle trunk of Brachial plexus

35. A 54 years old man undergone hip replacement for fractured neck femur. During
follow up, the man walks with the Trendelenburg gait. what is the most likely cause?

A. Sciatic nerve injury

B. femoral nerve injury
C. Superior gluteal nerve injury
D. Gluteus maximus muscle paralysis
E. Inferior gluteal nerve injury

36. A child has Pruritis ani, stool analysis showed ova and cysts in stool. What is the
most appropriate treatment option?

A. Metronidazole
B. Mebendazole
C. Estradiol
D. Tinidazole
E. None of the above

37. A 23 years old Patient underwent ORIF for a lateral malleolus fracture. Below knee
cast was applied. The patient then developed inability to evert his foot and
paranesthesia along the dorsum of the foot. Which nerve injury would be the cause of
this case?

A. Common peroneal nerve injury

B. Sural nerve injury
C. Superficial peroneal n injury
D. Deep peroneal nerve injury
E. Tibial nerve injury

38. A 28 years old man developed loss of sensation below the knee after a posterior
hip dislocation. This is associated with weak movements of the leg. What is the most
likely cause?

A. Tourniquet palsy.
B. Sciatic nerve injury.
C. Compartment syndrome.
D. Femoral nerve injury.
E. None of the above

39. Which of the following infections is associated with staghorn stones?

A. Pseudomonas
B. E.coli
C. Acinitobacter
D. Staphylococcus aureus
E. Proteus

40. A woman suffered an arm injury. On examination, she is unable to catch the knife
as her hand flexes. There is loss of sensation over the badge area. What is the likely
cause?

A. Radial nerve
B. Axillary nerve
C. Posterior cord injury
D. Medial cord injury
E. None of the above

41. Which virus is associated with Kaposi's sarcoma?

A. Human herpes virus 8

B. Human papillomavirus 16
C. Human T-lymphotropic virus 1
D. Epstein-Barr virus
E. Human papillomavirus 18

42. Man presenting with head injury showing deterioration in GCS which becomes 3
with unilateral unreactive pupil?

A. tentorial Herniating
B. hydrocephalus
C. papilledema
D. Subarachnoid hemorrhage
E. None of the above

43. A 35-yr-old lady presented with bloody nipple discharge. What is your possible
diagnosis?

A. Duct ectasia
B. Breast cancer
C. Ductal papilloma
D. Fibroadenoma
E. None of the above

44. Esophageal biopsy shows the columnar epithelium containing goblet cells what is
the type of changes occur in cell?

A. aplasia
B. atrophy
C. hyperplasia
D. hypertrophy
E. metaplasia

45. Pt with cervical lymphadenopathy underwent excisional biopsy showed non-

necrotizing granuloma with giant cell and fibrosis what is your possible diagnosis?

A. Sarcoidosis
B. TB
C. Lymphoma
D. Leprosy
E. Fungal infection

46. 60-year-old man presents with a short history of pain in the right cheek and right
upper teeth Maxillary sinus infection is diagnosed. This sinus is particularly prone to
infection because of?

A. absence of Celia on the epithelium lining the sinus

B. closeness of the sinus to the nasal cavity
C. poor blood supply
D. Position of the sinus ostium high on the medial wall
E. relationship of the front teeth to the floor of the sinus

47. A previously fit young man is admitted after a road traffic accident. He is
satisfactorily intubated because of a head injury. He has a Glasgow coma score of 8
(E2, V4, M4) There are no other external injuries and initial cardiorespiratory stability
is achieved during the primary survey. He suddenly becomes hypoxic after log- rolling
to examine the back. What is the most likely cause of his deterioration?

A. Cardiac tamponade
B. Ongoing major hemorrhage
C. Spinal injury
D. Tension pneumothorax
E. Tracheal tube displacement

48. You have collected a data of 87 child’s urea and create levels before anesthesia to
study the effect of anesthesia on dehydration. You matched them with the normal
levels. What is the statistical test to use?

A. Paired T test
B. Un paired T test
C. Mann Whitney
D. Chi-square

49. A 65-year-old man is admitted with a two-week history of vomiting. He also had
succasion splash. What of this finding match with this patient?
PH
K+ Na+
A 2.6 mmol/L 148 mmol/L 7.1
B 3.4 mmol/L 156 mmol/L 7.48
C 3.2 mmol/L 118 mmol/L 7.47
D 6.0 mmol/L 120 mmol/L 7.1
E 2.8 mmol/L 128 mmol/L 7.2
Normal 3.5-4.9 137-144 7.3: 7.4

50. Which of the following serves as the axis of gut rotation during development?

A. aorta
B. Superior mesenteric artery
C. Inferior mesenteric artery
D. Umbilical vessels
E. Vitelline artery

51. Abdominal free fluid will collect in the lowest part of the peritoneal cavity. At
operation with the patient supine, in which of the following will the fluid collect first?

A. Hepatorenal pouch
B. Left anterior subphrenic space
C. Lesser sac
D. Right paracolic gutter
E. Right anterior subphrenic space

52. which of following investigations is most accurate for measuring the GFR?

A. Creatinine clearance
B. Glucose Clarence
C. Inulin Clarence
D. Para-amino-hippuric acid
E. Urea clearance

53. In OT a saline set was connected to bair hugger. which of the following hormone
will decrease?

A. TSH
B. ACTH
C. ADH
D. Cortisol
E. Catecholamine
54. which of these I.V fluid have the highest sodium content

A. Saline glucose fluid

B. Normal saline
C. Hartman solution
D. Glucose 5%
E. 4.8% Sodium-bicarbonate

55. All are content of the posterior mediastinum except:

A. Descending aorta
B. Vagus nerve
C. Thoracic duct
D. Azygous vein
E. Vertebral body

56. A Child with kwashiorkor developed hepatomegaly. What is the deposit in liver?

A. Sarcoid
B. Melanin
C. Lipofuscin
D. Amyloid
E. fat

57. A child with patent ductus arteriosus and left sternum murmur heard on his chest,
what about this anomaly?

A. Shunt from right atrium

B. Shunt to pulmonary artery
C. Shunt to aorta
D. Shunt to left atrium
E. None of the above

58. Where is the major duodenal papillae open?

A. In the anteromedial part of Third part of duodenum

B. In the posteromedial part of Third part of duodenum
C. In the posteromedial part of 2nd part of duodenum
D. In the anteromedial part of 2nd part of duodenum
E. In the posteromedial part of First part of duodenum
59. Vitamin K is required for normal blood clotting. Which one of the following
statements is
true about the effects and availability of vitamin K?

A. Affects platelet function

B. Cause bleeding if taken in excess
C. Is provided only by fresh food
D. Is depleted by oral broad-spectrum antibiotics
E. Vitamin K absorption is affected by gastric resection

60. A 34 years old patient was in operation with tourniquet. after release of
tourniquet, what is the substance released causing VD?

A. Noradrenaline
B. Vasopressin
C. Histamine
D. Serotonin
E. Adrenaline

61. 1-day neonate with history of polyhydramnios intrauterine and after birth, fluid
coming from mouth with dyspnea and cyanosis

A. congenital esophageal atresia with tracheoesophageal fistula.

B. congenital diaphragmatic hernia
C. duodenal atresia
D. Hirschsprung
E. None of the above

62. A man has weakness of sternocleidomastoid mastoid muscle and trapezius muscle
along with loss of gag reflex and loss of sensation on palate, where is the lesion?

A. Foramen ovale
B. Foramen rotundum
C. Jugular foramen
D. Foramen lacerum
E. Hypoglossal canal

63. Man had a brain tumor, supplied by a very large middle meningeal artery, which
foramen was enlarged or dilated?
A. Foramen of ovale
B. Foramen rotundum
C. Foramen spinosum
D. Foramen lacerum
E. Jugular foramen

64.
A surgeon is carrying out an elective splenectomy for congenital spherocytosis. Which
structure will be divided in order to mobilize the spleen from the posterior abdominal
wall?
A. Gastrosplenic ligament
B. Lesser omentum
C. Lienorenal ligament
D. Phrenicocolic ligament
E. Short gastric vessels

65. A woman with increased TSH+ lower limit T4 , what is your diagnosis?

A. primary hypothyroidism
B. primary hyperthyroidism
C. Secondary hyperthyroidism
D. Secondary hypothyroidism
E. sick euthyroid

66. In a patient with Cleft palate, it represents defect in the embryological fusion of
what structures?

A. Frontonasal
B. Maxillary
C. palatal processes
D. lateral nasal
E. medial nasal

67. A 19-year-old man was assaulted and sustained injuries to the right side of his
head. After two weeks he notices dial his right eye is dry and it could not produce
tears. from which ganglion is post synaptic fibers arise to supply lacrimal gland?

A. Geniculate ganglion
B. Inferior ganglion of the vagus nerve
C. Otic ganglion
D. Pterygopalatine ganglion
E. Superior cervical ganglion

68. Closure of the tricuspid valve occurs at the onset of which phase of the cardiac
cycle?

A. Isovolumic relaxation
B. Rapid filling
C. Reduced filling
D. Rapid and reduced ejection
E. Isovolumic contraction

69. Changes happen in septic shock

COP SVR HR
High Low High
Low Low Low
Low High Low
Low High High
Normal Normal Normal

70. A 72-year-old man has just undergone an emergency repair for a ruptured
abdominal aortic aneurysm. Preoperatively he was taking aspirin, clopidogrel and
warfarin. Intra operatively he received 5000 units of unfractionated heparin prior to
application of the aortic cross clamp. His blood results on admission to the critical care
unit are as follows: ull blood count: Hb 8 g/dl, Platelets 40 * 109/l and WBC 7.1 * 109/l
His fibrin degradation products are measured and found to be markedly elevated.
Which of the following accounts for these results?

A. Anastomotic leak
B. Disseminated intravascular coagulation
C. Heparin induced thrombocytopenia
D. Adverse effect of warfarin
E. Dearranged platelet function as the drug not stopped

71. what is not reliable to measure oxygen on low tissue perfusion

A. Pulse oximeter
B. ABG
C. Capillary wedge pressure
D. Swan Ganz catheter
E. None of the above

72.
A person has fracture sternum, which structures mostly to be damaged?
A. Left atrium
B. Left lobe of the liver
C. Left ventricle
D. Right atrium
E. Right ventricle

73. Esophageal varices means increase in pressure in which vessels

A. Short gastric
B. Left gastric
C. Left gastroepiploic
D. Right gastric
E. Right gastroepiploic

74. A man develops septicemia following surgery for perforated acute appendicitis He
is hypotensive. Arterial blood gases reveal: PH= (7.26) PaCo2= (7.2KPA) Pa02= (75
kPa). Bicarbonate= (17 mmol/L) What is the most likely explanation for these
readings?

A. Compensated metabolic acidosis

B. Compensated respiratory acidosis
C. Mixed metabolic and respiratory acidosis
D. Uncompensated metabolic acidosis
E. Uncompensated respiratory acidosis

75. ABG of sepsis after perforated Appendicitis.

76. ABG of DKA

77. In obstetric surgery, Pfannenstiel's incision was made. which structure is divided?

A. Rectus abdominis
B. arcuate ligament
C. external oblique
D. Rectus sheath
E. none of the above

78. Gastrin release is increased by:

A. Adrenaline
B. Glucagon
C. Calcitonin
D. Acetylcholine
E. None of the above

79. Unique features of axis vertebrae.

A. bifid spinous process

B. carotid tubercle(C6)
C. no transverse process
D. no spinous process
E. none of the above

80. A patient suffered a trauma to his thigh leaving a dirty wound with lacerations.
Several days later the wound becomes infected with crepitations. Which Organism?

A. Clostridium deficile
B. Staphylococcus aureus
C. Streptococcus pyogenes
D. Clostridium perfringens
E. Bacillus anthracis

81. A case of intermittent claudication in the calf muscles with loss of pulse below
knee only, where is the most probable site of the arterial lesion?

A. SFA occlusion at the adductor canal

B. CFA before origin of profunda artery
C. External iliac artery
D. Anterior tibial artery
E. Internal iliac artery

82. A 73-year-old man presents with pain in the right buttock. Clinical examination
reveals
weakness of abduction of the right thigh. What is the most likely nerve to have been
affected?
A. Inferior gluteal nerve
B. Nerve to obturator internus
C. Nerve to quadratus femoris
D. Sciatic nerve
E. Superior gluteal nerve

83. Patient has ventricular hypertrophy, microscopy reveals deposition between

muscles. Cause of hypertrophy?

A. Metaplasia
B. Dysplasia
C. Neoplasia
D. Amyloidosis
E. Reactional hypertrophy

84. Patient has Pink fleshy lesion and diagnosed as a case of multiple myeloma, what
is the diagnosis?

A. Metaplasia
B. Dysplasia
C. AL amyloidosis
D. AA amyloidosis
E. Beta 2 micro amyloidosis

85. Lumber puncture is done in which space?

A. Sub Dural
B. Epidural
C. Sub arachnoid
D. Dural
E. Sub pial

86. Patient has Potassium 6mmol/l, what is the causative agent

A. Frusemide
B. Thiazide
C. Acetazolamide
D. Aldosterone
E. Spironolactone

87. Aldosterone acts on?

A. Na/H pump
B. Na/K/2CL pump
C. Na/K pump
D. Na/Ca pump
E. Na/Cl pump

88. Patient presented with dental abscess, causative organism?

A. Staph. Aureus
B. Staph Viridians
C. Klebsiella
D. Enterobacter
E. Bacteroides

89.A boy presented with purpura and fever and lethargy but no palpable lymph node
or spleen, what is your diagnosis?

A. Leukemia
B. Lymphoma
C. HSP
D. ITP
E. Aplastic anemia

90. 2-Month old girl with bowel sound in thorax, what is your diagnosis?

A. Failure of development of right pleuroperitoneal membrane

B. Failure of development of left pleuroperitoneal membrane
C. Cloacal membrane developmental error
D. Mal rotation of gut
E. Ectopia cordis

91.Artery moves above the piriformis muscle and divide into two after originating
from external iliac artery. What is the artery?

A. Superior Gluteal
B. Pudendal
C. Inferior gluteal
D. Circumflex iliac
E. Femoral

92. Patient Presented in the AE with an Injury at the back of elbow joint. It was 4cm
deep and 6cm above the elbow and there is loss of extension of forearm/elbow joint.
Where is the injury?

A. Brachioradialis
B. Radial nerve
C. Median nerve
D. Triceps
E. Biceps Brachi

93. A baby aspirated a peanut what is probable location of it?

A. Left Upper lobe

B. Right Upper Lobe
C. Left Lower Lobe
D. Left Lower Lobe
E. Lingula

94. Patient has diet-controlled diabetes. He will undergo colectomy. How diabetes is
managed?

A. Regular Observation of blood sugar level

B. Insulin
C. Sliding scale insulin
D. Oral Metformin
E. No intervention required.

95. Loss of pupillary reflex and accommodation, which cranial nerve nerve pair is
damaged?

A. 1 and 5
B. 2 and 3
C. 10 and 9
D. 1 and 3
E. 3 and 7

96.Patient has stridor after thyroid surgery which nerve is damaged?

A. Glossopharyngeal
B. Facial
C. Vagus
D. oculomotor
E. Stellate ganglia
97. A test was needed to be performed for 87 people regarding dehydration before
and after anesthesia. The values are within normal limit and data are paired. What is
the best test?

A. Paired t test
B. Wilcoxon test
C. Mann Whitney U test
D. ANOVA test
E. Chi Square test

98. An error in prescription system causes havoc in the ward with potential damage to
patient, what can be done?

A. Research
B. Inform GMC
C. Medical Audit
D. Risk assessment
E. Incident report

99. Fluid accumulates when patient in supine position?

A. Paracollic gutter
B. Recto-vesical pouch
C. Hepato-Renal pouch
D. Pelvic region
E. Thorax

100. Which pathogen is responsible for pneumonia in sickle cell patient?

A. E. coli
B. Salmonella
C. Strep. Pneumoniae
D. Pseudomonas
E. Staph aureus

101. A 2-year old boy presented with fever, halitosis, hot potato voice, what is the
causative organism?

A. Staph. aureus
B. Strep. Pneumoniae
C. H. influenziae
D. E. coli
E. pseudomonas

102. What is responsible for central respiratory drive?

A. H ion concentration
B. Hco3 ion
C. Co2 in medulla
D. Hypoxia
E. None

103. a 45-year old man presented with dilated pupil, where is the probable lesion?

A. Optic nerve injury

B. Trochlear nerve injury
C. 6th Nerve injury
D. Tentorial herniation
E. Facial nerve injury

104. A 10- year old boy presented with scalp injury, what is the best local anesthetic
for primary closure?

A. bupivacaine with adrenaline

B. Lidocaine
C. Lidocaine with adrenaline
D. Levobupivacaine with adrenalin
E. Prilocaine

105. A patient has diminished coronary blood supply what is the responsible
mechanism?

A. Increased preload
B. Decreased cardiac output
C. Decreased diastolic interval
D. Decreased systolic interval
E. Increased systolic interval

106. Paresthesia over check which nerve is damaged?

A. Infra alveolar
B. Zygomatic branch of facial
C. Infra trochlear
D. Supra Orbital
E. Infraorbital

107. Acute response in hypothermia?

A. Vasodilation
B. Shivering
C. Peripheral vasoconstriction
D. Sweating
E. Diminished blood supply to hypothalamus

108. Decreased gastric acid secretion By?

A. Histamine
B. Gastrin
C. PE2
D. NSAID
E. Vagal stimulation

109. Lymph Node metastasis from scrotal carcinoma?

A. Vertical group of inguinal

B. Iliac
C. Para aortic
D. Medial group of inguinal
E. Popliteal

110. S3 Dermatome Territory?

A. Perianal
B. Ischial Tuberosity
C. Anterior Scrotal
D. Perineal
E. Inguinal Region

111. Anal Carcinoma metastasis to?

A. Iliac LN
B. Popliteal LN
C. Superficial Inguinal LN
D. Deep Inguinal LN
E. Obturator lymph node
112. A Patient present in AE department with head injury, Blood pressure 90/70,
passed urine after one hour, what should be possible composition of urine

A. 30ml diluted urine

B. 30 ml concentrated urine
C. 50ml diluted urine
D. 300 ml diluted urine
E. 300 ml concentrated urine

113. A surgeon is incising hydrocele until the fluid comes and found testes is covered
by?

A. Tunica vaginalis (parietal layer)

B. Tunica albuginea
C. Tunica vaginalis
D. Cremasteric Muscle
E. Dartos muscle

114. A 28-year-old girl with single episode of blood stained discharge from right nipple
with no palpable mass what is the diagnosis?

A. Duct ectasia
B. Duct Carcinoma
C. Duct Papilloma
D. Plasma cell mastitis
E. Lobular carcinoma

115. Which System activates after hemorrhage?

A. Bain Bridge
B. Respiratory
C. RAA system
D. Myogenic Contraction
E. None of the above

115. A 60-year-old patient had elective esophagectomy causing injiry to thoracic duct,
where it is injured?

A. Diaphragmatic hiatus to abdomen

B. Crus of Diaphragm
C. Diaphragmatic hiatus to superior mediastinum
D. In middle mediastinum
E. Superior mediastinum in right.
116. Causes of direct inguinal hernia due to defect in?

A. Rectus abdominis
B. fascia transversalis
C. External oblique aponeurosis
D. Internal oblique
E. None of the above

117. A patient present with hypovolemia due to severe dehydration. How kidney
preserve fluid in this situation?

A. Efferent vasoconstriction
B. efferent vasodilation
C. Diminished renal blood flow
D. Diminished GFR
E. Increased flow in kidney

118. What form the posterior layer of inguinal canal?

A. External oblique aponeurosis

B. Conjoint Tendon
C. Lacunar ligament
D. Pectineal ligament
E. Rectus femoris muscle

119. Cutaneous supply of ear lobule?

A. vagus
B. Auriculo temporal
C. greater auricular
D. Nervous intermedius
E. Maxillary nerve

120. Isotonic Fluid?

A. 0.45% NACL
B. 3% NACL
C. .9% NACL
D. 0.25%NACL
E. None
121.Which fluid has more sodium content?

A. 0.9% NACL
B. Hartman solution
C. 5% DA
D. 4.8% sodium bicarbonate
E. 0.45% normal saline

122. What increases in hemorrhage?

A. Insulin
B. Plasma
C. Angiotensin II
D. Plasmin
E. Thrombin

123. A 30-year man present with abdominal pain and diarrhea. In barium follow
through it was found that barium moves from ileum to sigmoid colon, what is the
diagnosis?

A. chrons’
B. Sigmoid diverticulosis
C. AVM
D. Colorectal carcinoma
E. IBS

124. A man experienced loss of taste sensation from anterior 2/3rd of tongue which
ganglion is affected?

A. Gasserian
B. Ottic
C. Geniculate
D. Pterygopalatine
E. Sub mandibular

125. A 30-year-old female has family history of breast cancer and her mother aunt
died Breast cancer, what she should do to avoid breast cancer?

A. Abstain from alcohol

B. Take OCP
C. NSAIDS
D. Avoid early gestation
E. None of the above
126. A hypothyroid person present with low MCV and Low iron content in blood film.
What is the main concern of surgeon during operation?

A. Hypovolemia
B. Hypothermia
C. Iron Deficiency Anemia
D. Heart contractility
E. Wound infection

127. A 80-year old man presented with weight loss and altered bowel habit, imaging
was done and found Cecum cancer, which artery to ligate?

A. MMA
B. IMA
C. Ileo-Colic
D. Middle rectal
E. Superior Rectal

128. A middle age man present with scrotal pain, no abnormality during supine, but
during standing he has cystic mass in cord with cough impulse, what is the diagnosis?

A. Hematocele
B. Hydrocele
C. varicocele
D. Carcinoma
E. Hernia

129. Vertebral artery enters transverse process of which vertebra?

A. C6
B. C5
C. C8
D. C4
E. C2

130. Medial 3 and a half toe has no sensation in planter aspect, what is the nerve
being injured?

A. Lateral plantar
B. Sural
C. Saphenous
D. Common peroneal
E. Medial planter

131. Parasympathetic causes?

A. Pupil dilation
B. Diminished blood flow to skeletal muscle
C. Increase Peristalsis
D. Decrease gastric emptying
E. Ejaculation

132. What diminishes gut motility?

A. Ach
B. Dopamine
C. Dobutamine
D. Nor adrenaline
E. ANP

133. Relation in popliteal fossa?

A. artery superficial
B. artery between vein and nerve
C. Artery lies deep to nerve and vein
D. Artery lies medial to nerve in lower part
E. Artery lies lateral to nerve in upper part.

134. Diminished sensation on medial aspect of arm, injury in

A. Median nerve
B. Ulnar nerve
C. Radial nerve
D. Pan coastal tumor
E. Upper trunk of brachial plexus

135. Metabolic abnormality in metastatic carcinoma?

A. Hypokalemia
B. Hypercalcemia
C. Hypokalemia
D. Hypo Kalema
E. Hypo natremia
136. Pancreatitis with paresthesia and muscle weakness, Electrolyte abnormality?

A. Hypo natremia
B. Hypokalemia
C. Hypo-calcemia
D. Hypercalcemia
E. Hypo-thyroidism

137. A 45-year old female present with urinary retention and lower limb diminished
sensation which artery is involved?

A. Anterior spinal
B. Posterior Spinal
C. Artery of Adamckweiz
D. Vertebral
E. Median sacral

138. A patient has Bp 100/70 HR 115 and SPO2 99% after operation. He has diminished
urine output, what is the cause?

A. PE
B. MI
C. Hypovolemia
D. Septic shock
E. Overdose of analgesic

139. A-60-year-old has multiple adhesions, a gastroenterologist was performing

cholangiography, she can not bear the pain and asked to stop the investigation, she
has no any other abnormality What to do next?

A.MRI
B. CT colography
C. laparotomy
D. Biopsy
E. Laparoscopy

140. A patient has a laparotomy wound which is normally healing for 2 months.
Whuch healing process is occurring?

A. vasculogenesis
B. Angiogenesis
C. Neutrophil infiltration
D. Diminished blood supply
E. Granulation tissue

141. Destruction of bacteria is enhanced by?

A. Seminization
B. Neutralization
C. Opsonization
D. Pinocytosis
E. None of the above

142. Arteriolar dialation is caused by?

A. Serotonin
B. Adrenalin
C. Nor-adrenalin
D. Histamine
E. Angiotensin ii

143. A 23-year-old female present with breast pain; no palpable mass was found and
analgesic was given which subsided her symptoms. Now again present with breast
pain, what to do next?

A. Reasure
B. MRI
C. Biopsy
D. Mammogram
E. USG

144. Patient had mesenteric embolus what is the next investigation?

A. MRI
B. CT abdomen
C. CT angiography
D. USG
E. X-ray

145. management of post gastrectomy megaloblastic anemia?

A. Methionine
B. Iron
C. B6
D. Folic acid
E. B12
146. A patient has supra clavicular lymph node with iron deficiency anemia, what is
the diagnosis?

A. Bronchial carcinoma
B. Renal carcinoma
C. Colonic carcinoma
D. Laryngeal carcinoma
E. Gastric carcinoma

147. Causes of cleft palate?

A. Unfused primary palate

B. Unfused palatine shelves
C. Unfused maxilla
D. Unfused nasal process and maxillary process
E. None

148. farmer present with black eschar what is the diagnosis?

A. BCC
B. SCC
C. Clostridium histolyticum
D. Bacillus anthraces
E. Nocardia

149. A man presented with necrosis and crepitus what is the causative organism?

A. Staph aureus
B. Staph. Epidermidisae
C. Streptococcus pyogens
D. Clostridium perfringens
E. Bacillus anthraces

150. A patient present with lung cancer with cerebral metastasis what to give next?

A. Dexamethasonae
B. Cyclizine
C. Ondansetron
D. aspirin
E. Chemotherapy

151. Which nerve injury in loss of sensation over deltoid?

A. Musculo cutaneous
B. Median
C. Radial
D. Axillary
E. Radial.

152. Patient has injury in lower thigh with absence of planter flexion which nerve is
damaged?

A. Sural
B. tibial
C. Femoral
D. Common peroneal
E. Planter

153. Loss of flexion of wrist and loss of sensation over the ulnar side of forearm, nerve
affected?

A. Upper trunk
B. Lower trunk
C. Middle trunk
D. Median
E. Ulnar

154. hypokalemia Ecg?

A. ST elevation
B. Prolong QRS
C. Wide T
D. Tall T
E. Inverted T

155. Septic Shock Finding

A. Increased HR Increased SVR Decreased CO

B. Increased CO decreased SVR Increased HR
C. Increased BP Decreased HR Decreased SVR
D. Decreased HR Decreased SVR Decreased CO
E. none of the Above
156. Imaging for DVT

A. Compression Ultrasound
B. CT
C. Venography
D. Duplex
E. None

157. Determinant of cerebral blood flow in head injury

A. Hypocapnia
B. Hypoxia
C. ICP
D. Parasympathetic stimulation
E. Heart rate

158. What happen in ARDS?

A. Reduced diffusion
B. Co-officiant of diffusion
C. Embolism
D. Thrombosis
E. None

159. Bleeding after intercoastal intubation?

A. Damage to intercoastal vein

B. Damage to intercoastal artery
C. DCA
D. Musculophrenic artery
E. Mammary artery.

160. Enlarged lymph node with Non-necrotizing granuloma, cause?

A. Lymphoma
B. TB
C. Syphilis
D. Cat scratch disease
E. Multiple myeloma