200
The following are anterior relations of the right kidney except?
A. adrenal
B. liver
C. transversus abdominis
D. R colic flexure
E. 2nd part of duodenum
201
This shunt muscle contains the median nerve and the brachial artery.
A. Biceps brachii
B. Brachialis
C. Coracobrachialis
D. Deltoid
E. Triceps brachii
202
The joint that is responsible for thumb opposition is:
A. carpometacarpal joint
B. interphalangeal joint
C. radiocarpal joint
D. metacarpophalangeal joint
E. intercarpal joint
203
During CABG, the surgeon inserted his finger into the transverse pericardial sinus. What structures are demarcated?
A. SVC, pulmonary trunk, and aorta
B. IVC, pulmonary veins
C. Right and left atria
D. Right and left ventricles
E. SVC and IVC
204
The oblique vein of Marshall is a remnant of:
A. Right IVC
B. Right SVC
C. Left SVC
D. Left IVC
E. Left brachiocephalic vein
205
This space is involved in inguinal hernia repair.
A. Space of Burns
B. Space of Bogros
C. Space of Retzius
D. Space of Douglas
E. Space of Nuck
206
What vertebra demarcates the junction of the sigmoid colon and the rectum?
A. L5
B. S1
C. S2
D. S3
E. S4
207
During childbirth, which levator ani muscle is most often injured?
A. Puborectalis
B. Pubococcygeus
C. Iliococcygeus
D. Coccygeus
E. Sphincter urethra
208
Which structure forms the divide between vagal and pelvic splanchnic parasympathetic nerves?
A. Hepatic flexure
B. Splenic flexure
C. Junction between sigmoid colon and rectum
D. Junction between rectum and anus
E. Dentate line
209
The Ligament of Treitz corresponds to what vertebra?
A. L1
B. L2
C. L3
D. L4
E. L5
210
What structures form the left sagittal fissure of the liver?
A. Ligamentum teres and ligamentum venosun
B. Right and left hepatic lobes
C. Caudate lobe and quadrate lobe
D. Galbblader and IVC
E. Falciform ligament and coronary ligament
211
Trigeminal neuralgia most commonly affects what division of cranial nerve V?
A. V1
B. V2
C. V3
D. V4
E. None; it has no preferences
212
Nodose ganglion is associated with what cranial nerve?
A. V
B. VII
C. IX
D. X
E. XI
213
Serous demilunes are seen in:
A. Parotid gland
B. Sublingual gland
C. Submandibular gland
D. Lacrimal gland
E. Sebaceous gland
214
Synapsis during meiosis occurs in:
A. Prophase
B. Metaphase
C. Anaphase
D. Telophase
E. Interphase
215
Schmidt-Lantermann clefts are formed by:
A. Cardiac myocytes
B. Endothelial cells
C. Goblet cells
D. Schwann cells
E. B-cells
216
The acrosome reaction of the sperm involves what receptor of the zona pellucida?
A. ZP1
B. ZP2
C. ZP3
D. ZP4
E. ZP5
217
Which epithelium has only a single layer of cells?
A. Skin
B. Trachea
C. Urinary bladder
D. Cornea
E. Sweat glands
218
Herring bodies contain:
A. Oxytocin
B. Prolactin
C. Growth Hormone
D. Melatonin
E. Aldosterone
219
Which cells undergo endomitosis?
A. Neurons
B. Ovum
C. RBCs
D. Platelets
E. Keratinocytes
220
High endothelial venules are found in:
A. Thymus
B. Lymph nodes
C. Bone marrow
D. Spleen
E. All of the above
221
Which of the following manifestation is consistent if the patient presents with a ® sphenoid wing meningioma?
A. Inability to protrude the tongue
B. Inability to close the ® eye and wrinkle the ipsilateral forehead
C. Weakness in closing the jaw
D. increase risk for aspiration
E. nystagmus
222
which of the following structure will strictly pass through the cavernous sinus along with the internal carotid artery?
A. Abducent nerve
B. Opthalmic division of trigeminal nerve
C. Trochlear nerve
D. Oculomotor nerve
E. Maxillary nerve
223
A 32 y/o male suffered a skull base fracture secondary MVA causing transection of the (L) mandibular nerve. During recovery, which of the
following will the patient unable to perform?
A. Puff the left cheek
B. Taste sensation of the left anterior 2/3rd of the tongue
C. tense the ipsilateral palate
D. raises the soft palate during swallowing
E. none of the above
224
what is the characteristic feature of a 3rd lumbar vertebrae?
A. Short slender transverse process
B. Superior articular process face laterally
C. Thick cylindrical pedicles
D. Large round vertebral foramen
E. Long flat quadrangular spinous process
225
A 56 y/o male underwent a colonoscopy secondary to recent onset weightloss, change in the stool caliber, and hematochezia. During the
procedure, a hemorrhagic polypoid mass noted on the anterior wall of the colon 14 cm from the anal verge. where is the exact location of the
mass?
A. anal canal
B. rectum
C. rectosigmoid
D. sigmoid
E. cannot be determine
226
Which of the following is true about the liver
A. Tha main suspensory structure of the liver is the hepatic veins draining to the inferior vena cava
B. Periportal regions of the liver acinus is highly vulnerable to ischemic insult
C. cantlie line separates the IV segment from V and VII segment
D. the falciform ligament divides the liver into left and right functionally in terms of blood supply
E. the caudate lobe belongs to the left inferior segment
227
aneurysmal dilatation and thrombosis of the proximal segment of the superior mesenteric artery will produce which of the following
symptoms?
A. gross hematochezia
B. Jaundice secondary to necrosis and inflammation of the head of the pancreas
C. Upper GI obstruction presenting as nonbilous emesis
D. compression of the head of the pancreas
E. severe continuous epigastric pain.
228
which of the following is a derivative of the 5th pharyngeal pouch or the ultimobranchial body?
A. thymus
B. Palatine tonsils
C. C cells
D. Superior parathyroid gland
E. None of the above
229
which of the following is a functional remnant of the umbilical arteries?
A. Median umbilical ligament
B. Distal part of the inferior epigastric artery
C. Superior vesical artery
D. Distal part of the common iliac artery
E. None of the above
230
what layer of the epidermis contains eleidin?
A. Stratum spinosum
B. Stratum germinativum
C. Stratum lucidum
D. Stratum granulosum
E. All of the above
231
which of the following is not true regarding regarding the histological difference between an artery and a vein ?
A. The thickest coat of the artery is the tunica media while that of the vein is the tunica adventitia
B. Vasa vasorum is more abundant in the arteries than in the veins
C. the tunica intima of the arteries scalloped or corrugated during cross section.
D. the internal elastic lamina is more prominent in the arteries than in the veins
E. none of the above
232
A 37 y/o male suffered a motor vehicular accident resulting to transection of the deep branch of the radial nerve secondary to comminuted
fracture of the right radius. Which of the following movements will the patient still be able to perform?
A. extends and abducts the hand at the wrist joint
B. extend the distal phalanx of the thumb
C. extends and adducts hand at the wrist joint
D. extends fingers and hands
E. none of the above
233
a 37 y/o male had suppurative inflammation of the wrist joint secondary to previous open trauma. Wrist radiograph shows affectation of the
carpal tunnel. Which of the following structures will not be affected?
A. Flexor digitorum superficialis tendon.
B. Flexor pollicis longus tendon. C. Flexor carpi radialis tendon D. Flexor digitorum profundus E. none of the above.
234
A 47 y/o female is suffering from an suppurative ischial bursitis affecting the lesser sciatic foramen. Which of the following structures will be
affected?
A. Inferior gluteal nerve
B. Sciatic nerve
C. Posterior cutaneous nerve of the thigh
D. tendon of the obturator internus
E. none of the above
235
A 68 y/o female suffering from a chronic osteoarthritis of the ® knee underwent total knee arthroplasty. Which of the following muscle needs
to be strengthen since it is the last to recover among the quadriceps group?
A. Vastus lateralis
B. popliteus
C. Vastus medialis
D. rectus femoris
E. Vastus intermedius
236
A 21 y/o basketball player complains of pain and instability of the (L) knee. Upon your PE. It shows that it is positive for Apley and McMurray
test. Which structure is primarily involved?
A. ACL
B. PCL
C. Medial meniscus
D. Plica syndrome
E. Patella
237
A 21 y/o male suffered a monteggia fracture after being hit during a basketball match. Upon your PE, you noted that he cannot perform OK sign
and there is extension of th index DIP and thumb IP joint. Which of the following is primarily affected. ?
A. radial nerve
B. Median nerve
C. ulnar nerve
D. anterior interosseous nerve
E. none of the above
238
Compression of the nerve that passess through the canal of Frohse will cause which of the following deficit?
A. Weakness of wrist flexors
B. Numbness and paresthesia along dorsal aspect of the lateral hand.
C. Wrist drop
D. Weakness of elbow extension
E. none of the above
239
What structure is an upward extension of the posterior longitudinal ligament of the spine?
A. Tectorial membrane
B. Apical ligament
C. Alar ligament
D. Cruciate ligament
E. None of the above
240
retrolisthesis or backward extension of T8 vertebra will affect what level of spinal cord?
A. T10
B. T11
C. T12
D. L1
E. None of the above
241
The thyroid isthmus is known to lie in which area?
A. 2nd to 4th tracheal rings
B. 3rd to 5th tracheal rings
C. midway from the thyroid and cricoid cartilages at C4
D. C2 to C4
E. C5 to C6
242
A 56 year old male patient suffered a motor vehicular accident, he suffered multiple rib fractures and had ecchymoses along the right
hemithorax, chest xray revealed blunting of the right costophrenic sulci. The surgeon plans to insert a chest tube to drain the fluid at which site?
A. 2nd ICS right mid clavicular line upper border of the rib
B. 7th ICS right posterior axillary line upper border of the rib
C. 5th ICS right anterior axillary line upper border of the rib
D. 5th ICS left midaxillary line lower border of the rib
E. 7th ICS left midaxillary line lower border of the rib
243
The ovaries are lined by this specific epithelium:
A. simple cuboidal
B. simple squamous
C. simple columnar
D. stratified squamous
E. pseudostratified columnar
,
244
The SA and AV node are the primary and secondary pacemakers of the heart respectively, from which of the following vessles does their
predominant blood supply come from?
A. left circumflex
B. left anterior descending
C. right coronary artery
D. left coronary artery
E. both B and C
245
A patient came in with a pea sized lump non tender on the wrist, he was assessed to have a ganglion cyst, the surgeon knows that he must
carefully dissect it out from this underlying tissue?
A. extensor muscles
B. superficial fasia
C. tendon sheath
D. synovial membrane
E. deep fascia
246
Which of the following is considered as a direct branch from the aorta?
A. right common carotid
B. internal jugular
C. right subclavian
D. left subclavian
E. left brachiocephalic
247
56 year old male chronic smoker had a history of weight loss, body malaise comes for consult due to multiple swellings or neck masses. Which
set of lymph nodes should be palpated and biopsied for suspicion of metastasis of nasopharyngeal carcinoma
A. upper jugular
B. lower jugular
C. posterior cervical
D. submandibular
E. middle jugular
248
A 50 year old female patient comes in for a mass near the nipple areolar complex of the right breast, which of the following lymph nodes would
most likely be affected
A. superficial pectoral
B. deep pectoral
C. internal mammary
D. axillary
E. all of the above
249
A farmer swallowed some santol seeds, which area of the GI tract will these seeds most likely cause obstruction
A. antral pyloric area
B. ileocecal junction
C. colorectal junction
D. splenic flexure
E. duodenojejunal junction
250
Which of the following bones in the body undergoes endochondral ossification?
A. mandible
B. clavicle
C. maxilla
D. frontal bone
E. parietal bone
251
Which is responsible for detecting linear (vertical) deceleration?
A. utricle
B. saccule
C. anterior semicircular canals
D. posterior semicircular canals
E. lateral semicircular canals
252
A patient presenting with adenocarcinoma of the lower 1/3 of the esophagus would most likely have metastasis to which of the following lymph
nodes?
A. bronchomediastinal
B. celiac
C. lower jugular
D. diaphragmatic
E. posterior cervical
253
The most common anatomical location of the esophageal tear in boerhaave's syndrome
A. Right distal esophagus
B. Right middle 1/3 of the esophagus
C. Left distal esophagus
D. Left middle 1/3 of the esophagus
E. A and B
254
A 26 year old male was rushed to the ER following a motor vehicular accident, patient was noted to have clear to serosanguinous fluid flowing
from the nose positive for glucose and with (+) halo sign on gauze pad, which of the following bone has most likely been fractured?
A. sphenoidal sinuses
B. petrous portion of the temporal bone
C. cribriform plate of the ethmoid
D. frontal sinus of the frontal bone
E. pterygoid plate
255
a 25 year old male athlete was playing basketball when he experienced sudden inversion of his right foot after landing badly from jumping, which
of the following ligaments are most likely damaged ?
A. anterior tibiotalar ligament
B. deltoid ligament
C. talocalcaneal ligament
D. anterior talofibular ligament
E. calcaneal fibular ligament
256
A 50 year old male hypertensive patient has been experiencing chest pains, syncopal attacks and exertional dyspnea. Physical exam revealed a
systolic murmur, which of the following valvular pathologies are most likely present?
A. mitral regurgitation
B. mitral stenosis
C. pulmonic stenosis
D. aortic stenosis
E. aortic regurgitation
257
A prostate examination via digital rectal examination was done for a 50 year old male patient, which of the following lobes of the prostate can be
directly felt by this examination?
A. middle lobe
B. anterior lobe
C. posterior lobe
D. lateral lobes
E. C and D
258
The membranous urethra is lined by which lining epithelium?
A. transitional
B. pseudostratified columnar
C. stratified squamous
D. simple columnar
E. both B and C
259
A 30 year old male patient had a motorcycle accident, physical examination revealed absence of sensation at the lateral and posterior aspects
of bilateral lower legs, this corresponds to what dermatome level?
A. L2-L3
B. L4-L5
C. L5-S1
D. S1-S2
E. both A and B
260
On reading the CT scan of a patient revealed a mass at the level near the tracheal bifurcation, in determining the level of the lesion, the doctor
is sure that at least part of the mass is at level of
A. T2-T3
B. T3-T4
C. T4-T5
D. T5-T6
E. T6-T7
261
All of the following structures pass through the aortic hiatus EXCEPT:
A. Thoracic duct
B. Aorta
C. Azygos Vein
D. All of the above
E. None of the above
262
A left-sided dominant blood supply of the heart is best characterized by:
A. The posterior 1/3 of the interventricular septum is supplied by a branch from the left coronary artery
B. The anterior interventricular artery is a branch of the right coronary artery
C. The posterior interventricular artery comes from the left main coronary artery
D. A and C
E. A and B
263
A 7 year old child is brought to you for consult by his mother. Upon examination, the child is noted to keep his left forearm pronated and
partially flexed close to the body. Which is the most likely cause?
A. Supracondylar humeral fracture
B. Subluxation of the radial head
C. Surgical humeral neck fracture
D. Colles fracture
E. None of the above
264
A patient comes to your clinic with complaints of hoarseness of voice. History revealed that the patient recently underwent thyroid surgery.
Injury most probably occurred during:
A. Ligation of the inferior thyroid artery
B. Ligation of the superior thyroid artery
C. Section of the ligament of Berry
D. A or C
E. B or C
265
Which of the following statements regarding abdominal structural relationships is correct?
A. The portal vein is formed posterior to the 3rd portion of the duodenum
B. The superior mesenteric artery passes anterior to the horizontal portion of the duodenum
C. The major duodenal papilla is located in the first part of the duodenum
D. All are correct
E. None are correct
266
Which of the following abdominal structures is NOT derived from the embryologic endoderm?
A. Stomach
B. Liver
C. Spleen
D. Pancreas
E. All are derived from the endoderm
267
Which of the following structures forms the majority of the diaphragmatic surface of the heart?
A. Rigth ventricle
B. Left ventricle
C. Right Atrium
D. Pulmonary vessels
E. Left atrium
268
A 62 year old woman presents to your clinic complaining of right arm weakness. Further examination reveals inability to abduct the right arm
past horizontal position and protrusion of the right scapula in an abnormal position noted when instructed to push against a wall. Which will
most likely be a significant finding in the patient’s history?
A. Right Rotator cuff injury
B. Right midshaft humeral fracture
C. Poorly fitted crutches
D. Right modified radical mastectomy
E. History of humeral neck fracture
269
Which of the following structures is NOT transmitted through the superior orbital fissure?
A. Oculomotor nerve
B. Mandibular branch of the mandibular nerve
C. Abducens nerve
D. Ophthalmic branch of the mandibular nerve
E. None of the above
270
A duodenal ulcer located in the lesser curvature of the stomach is most likely to cause which of the following complications:
A. Bleeding from the gastroduodenal artery
B. Bleeding from a branch of the celiac artery
C. Bleeding from the left gastroepiploic artery
D. Pancreatitis secondary to perforation
E. None of the above
271
A 57 year old man presents at the ER with complaints of lower back pain. Physical examination findings reveals weakened dorsiflexion of the
foot and decreased sensation of the lateral surface of the leg and dorsum of the foot. Which of the following nerve root is most likely
compressed?
A. L2
B. L5
C. L4
D. S1
E. S2
272
A 5 year old male patient is noted to have a soft nontender fullness of the left scrotum with associated positive transillumination. The
underlying predisposing factor for this condition is similar to that of:
A. Indirect inguinal hernia
B. Direct Inguinal hernia
C. Femoral hernia
D. Varicocele
E. All of the above
273
A tracheostomy tube is best inserted in which of the following locations?
A. Between 1st and 2nd tracheal rings
B. Between 2nd and 3rd tracheal rings
C. Between 3rd and 4th tracheal rings
D. Between 4th and 5th tracheal rings
E. Between the cricoid and the 1st tracheal ring
274
Which of the following structures is derived from the embryologic common cardinal veins?
A. superior vena cava
B. pulmonary veins
C. right atrium
D. portal vein
E. None of the above
275
A sports player is noted to have an abnormal posterior location of the femur in relation to the tibia upon attempt at passive displacement. Which
structure is injured?
A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Medial collateral ligament
D. Lateral collateral ligament
E. Medial lemniscus
276
When instructed to perform a pudendal nerve block, which of the following landmarks is most important?
A. Tip of the ischial spine
B. Ischeal tuberosity
C. Lesser sciatic foramen
D. Greater sciatic foramen
E. Perineal body
277
Your resident asked you to insert a chest tube thoracostomy on a patient presenting with pleural effusion. Being a stellar intern, you insert the
chest tube on the:
A. 5th ICS MCL upper border of the rib
B. 5th ICS MCL lower border of the rib
C. 8th ICS AAL upper border of the rib
D. 5th ICS AAL upper border of the rib
E. 5th ICS PAL lower border of the rib
278
Failure of closure of the urethral folds will cause:
A. Epispadias
B. Phimosis
C. Extrophy of the bladder
D. Hypospadias
E. None of the above
279
A 43 year old man was brought to the hospital due to a vehicular accident. Patient was noted to have loss of consciousness at the site of the
accident with a lucid interval immediately after. Currently in the ER, the patient is being evaluated for deterioration of sensorium. Careful
history reveals that the patient hit the part of his head near the anatomic region called the pterion. CT scan revealed a lentiform-shaped bleed.
Which structure is most likely injured??
A. MCA
B. Bridging veins
C. Branch of the maxillary artery
D. Superior sagittal sinus
E. Branch of the internal carotid artery
280
A 23 y.o. male patient complaining of left testicular mass underwent biopsy and was diagnosed to have testicular cancer. Which group of lymph
nodes will primarily be affected once the cancer spreads?
A. deep inguinal lymph nodes
B. paraaortic lymph nodes
C. superficial inguinal lymph nodes
D. internal iliac lymph nodes
E. external iliac lymph nodes
281
Pain at the area of the anatomic "snuff box" following a fall on an outstretched hand may be caused by a fracture of which of the following?
A. Scaphoid
B. Capitate
C. Hamate
D. Pisiform
E. None of the above
282
Where is the fundus of the gallbladder located?
A. At the level of the 10th costal cartilage along the linea semilunaris
B. At the transpyloric plane along the linea alba
C. At the level of the umbilicus
D. At the level of the 9th costal cartilage along the linea semilunaris
E. None of the above
283
An individual with tertiary syphilis would have damage involving what structure in the spinal cord?
A. Lateral Corticospinal Tract
B. Dorsal Column
C. Ventral Spinocerebellar Tract
D. Anterior Spinothalamic Tract
E. Lateral Spiothalamic Tract
284
Which of the following structures does not communicate with the middle meatus?
A. Maxillary Sinus
B. Posterior Ethmoidal Sinus
C. Frontal Sinus
D. Anterior Ethmoidal Sinus
E. None of the above
285
Umbrella or Dome cells are part of the lining epithelium of which organ ?
A. Stomach
B. Small intestines
C. Uterus
D. Liver
E. Bladder
286
Which of the following statements is true regarding the abdominal aorta?
A. Enters the abdominal cavity at the level of TV 10
B. It is located to the right of the inferior vena cava
C. It terminates at the level of LV 4
D. Has four (4) unparied visceral branches
E. Terminal branches are the common iliac and inferior phrenic artery
287
A 78 year old male presents with hematuria, urgency, frequency and low back pain. Thorough evaulation eventually lead to a diagnosis of
prostate cancer. Which of the following lobes of the prostate is most commonly involved?
A. Anterior
B. Middle
C. Posterior
D. Right Lateral
E. Left Lateral
288
What muscle serves as guide in dividing the axillary artery into three different parts?
A. Pectoralis Major
B. Pectoralis Minor
C. Serratus Anterior
D. Teres Major
E. Trapezius
289
Which of the following statements regarding the pancreas is correct?
A. It is an intraperitoneal organ
B. It derives its blood supply from the inferior mesenteric artery
C. It primarily located in the hypogastic and left hypochondriac region
D. The portal vein is formed behind the tail of the pancreas
E. The major pancreatic duct joins the common bile duct which drains into the second part of the duodenum
290
Which of the following structures is most likely to be compressed by an enlargement of the left atrium?
A. Esophagus
B. Thymus
C. Thyroid gland
D. Larynx
E. Superior vena cava
291
What is the only cranial nerve that exits from the dorsal surface of the brainstem?
A. Abducens (CN VI)
B. Trigeminal (CN V)
C. Hypoglossal (CN XII)
D. Facial (CN VII)
E. Trochlear (CN IV)
292
Brunner's glands are located in the submucosa of what segment of the gastrointestinal tract?
A. Appendix
B. Ileum
C. Duodenum
D. Stomach
E. Jejunum
293
The fibers of the corticospinal tract passes through what structure at the level of the midbrain?
A. Cerebral aqueduct
B. Superior Colliculus
C. Red Nucleus
D. Medial Longitudinal Fasciculus
E. Cerebral peduncles
294
A 65 year old chronic smoker presented with right arm pain and drooping of the right upper eyelid. Diagnostic work up revealed a mass over
the apex of the right lung. Which of the following muscles is affected to account for the finding of ptosis over the right eye?
A. Lateral rectus
B. Superior Oblique
C. Levator palpebrae superioris
D. Superior tarsal
E. Medial rectus
295
Which of the following structures is not located in the posterior mediastinum?
A. Vagus nerve
B. Esophagus
C. Pericardium
D. Thoracic duct
E. Thoracic aorta
296
A 76 year old male was brought in the ER due to chest pain. A 12L ECG was done which showed ST-segment elevation involving leads II, III and
avF. Involvement of the said leads signify infarction of which area of the heart?
A. Inferior wall
B. Septal wall
C. RV wall
D. Lateral Wall
E. Anterior Wall
297
Which of the following statements concerning the larynx is INCORRECT?
A. Sensory innervation is provided by the recurrent laryngeal and internal laryngeal nerve
B. Extends from the tip of the epiglottis to the lower border of the cricoid cartilage
C. The cricothyroid muscle is innervated by the recurrent laryngeal nerve
D. The posterior cricoarytenoid muscle serves to abduct the vocal folds
E. It can be divided into supraglottic, glottic and infraglottic areas
298
Lead V1 is placed in what location/position in the chest?
A. 5th ICS at the left midclavicular line
B. 5th ICS at the left anterior axillary line
C. 4th ICS at the left sternal border
D. 4th ICS at the right sternal border
E. 5th ICS at the right midclavicular line
299
Which of the following structures pass anterior to the medial malleolus?
A. Tibial nerve
B. Saphenous nerve
C. Tendon of the flexor digitorum longus
D. Tendon of the peroneus longus
E. All of the above
300
Hassall's corpuscles are histologic features of which of the following lymphoid organs?
A. Spleen
B. Lymph Nodes
C. Tonsils
D. Thymus
E. All of the above
301
A 57 y/o hypertensive, diabetic male was rushed to ER secondary to deterioriation of consciousness. Pt was successfully stabilized at the ER.
Upon secondary PE, Pt is confused and oriented to place and person. his BP 170/100mmHg, PR 76 bpm, RR 14 cpm. You noted that his
(L) eye is fixated in an inferolateral direction with dilated nonresponsive pupils. while his (R) arm showed tremors and incoordination when
asked to reach for an object. no paralysis was noted on both UE/LE. CT scan was requested however results were pending. what is the most
probable diagnosis?
A. Weber syndrome
B. Benedikt syndrome
C. Claude syndrome
D. Foville syndrome
E. Wallenberg syndrome
302
Which of the following neck muscles is not supplied by the ansa cervicalis ?
A. geniohyoid
B. Omohyoid
C. sternohyoid
D. Sternothyroid
E. None of the above
303
A 76 y/o male went to your clinic secondary to productive cough, weight loss and voice changes. He was smoker with a 50 pack years and an
alcoholic beverage drinker. Xray was done showing a suspicious mass at the left upper lobe of the lung. a follow up CT scan showed a probable
lung carcinoma with mediastinal Lymphadenopathies compressing the left bronchial airway. which of the following laryngeal muscles will be
spared by this condition?
A. thyroarytenoid
B. cricothyroid
C. posterior cricoarytenoid
D. oblique arytenoid
E. none of the above
304
A 28 y/o male with a history of poorly controlled asthma and Allergic Rhinitis presented to your clinic with a complain of decrease sense of
smell and taste. Upon doing ENT examination, you noted a pale grayish polypoid mass located between inferior and middle nasal concha. which
of the following set of sinuses will most likely obstructed?
A. frontal, posterior ethmoid, maxillary sinuses
B. frontal, middle ethmoid, sphenoid, maxillary sinuses
C. frontal anterior, posterior and middle ethmoid, maxillary sinuses
D. frontal, anterior ethmoid, maxillary sinuses
E. frontal, ant and middle ethmoid, sphenoid, maxillary sinuses
305
A 76 y/o female complaining of chronic vague abdominal pain was found to have aortic aneurysm extending from T11
-to L3 vertebra. What are the other structures will most likely be affected by this condition?
A. thoracic duct
B. vagus nerve
C. inferior vena cava
D. left gastric artery
E. righr phrenic nerve
306
A 27 y/o male was sent to ER following an MVA. Pt was hypotensive, tachycardic and tachypneic along with neck veins distention and (L)
tracheal deviation. There were no breath sounds noted on the left. What landmark will you use inorder to perform needle thoracostomy?
A. (L) 2nd ICS 0.5 cm from sternal edge
B. (L) 2nd ICS midclavicular line
C. (R) 3rd ICS anterior axillary line
D. (L) 5th ICS midaxillary line
E. none of the above
307
the ductus arteriosus is a derivative of what aortic arch?
A. (L) 3rd aortic arch
B. ® 4th aortic arch
C. (L) 5th aortic arch
D. (L) 6th aortic arch
E. ® 2nd aortic arch
308
Which of the following is not a tributary of the coronary sinus ?
A. Great cardiac vein
B. Middle cardiac vein
C. Anterior cardiac vein
D. Small cardiac vein
E. Both B and C.
309
Which of the following is not a true statement regarding the inguinal canal?
A. The superior wall is made up by the arching fibers of the Internal oblique and transversus abdominis
B. The medial side of the posterior wall is reinforced by the conjoint tendon
C. the deep inguinal ring is located at 1.3 cm medial to the ASIS
D. the superficial inguinal ring gives attachment ot the external spermatic fascia.
E. none of the above
310
A 65 y/o male presenting weightloss, anemia and chronic diarrhea underwent a colonoscopy, a polypoid mass was located at the anterior wall
of the colon 40 inches from the anal verge. What part of the colon where the mass is located?
A. sigmoid
B. descending colon
C. transverse colon
D. hepatic flexure
E. ascending colon
311
what is the most dilatable portion of the male urethra?
A. Prostatic urethra
B. Membranous urethra
C. Penile urethra
D. Navicular fossa of the urethra
E. None of the above
312
the physiological umbilical herniation during embryonic development occur in what age of gestation?
A. 5th week
B. 6th week
C. 7th week
D. 8th week
E. 10th week
313
Which of the following is a branch of the anterior division of the internal iliac artery?
A. Lateral sacral artery
B. Superior gluteal artery
C. Inferior gluteal artery
D. Iliolumbar artery
E. None of the above
314
A 27 y/o female was brought to ER secondary to saddle type injury due to MVA, pelvic CT scan was requested showing hematoma on the
superficial perineal pouch. Which of the following structures will most likely be spared in this condition?
A. sphincter urethrae
B. ischiocavernosus muscle
C. bulbospongiosus muscle
D. perineal branch of the pudendal nerve
E. perineal body
315
A 34 y/o female was brought to ER secondary to a diffuse abdominal pain. she was hypotensive, tachycardic at presentation. PE showed diffuse
rigidity of the abdomen with both rebound and direct tenderness prominent on the epigastric area. CT scan was done showing blood collection
in the lesser sac. she was a smoker and alcoholic beverage drinker. she always skip her meals because she want to loose weight and that she
always take mefenamic acid almost everyday for her migraine.prior to onset, she claims to have recurrent history of vague epigastric pain
whenever she skip meal and that there were occasions of nocturnal awakening secondary to epigastric pain. what specific vascular structure will
most likely be affected in this setting?
A. superior pancreaticoduodenal artery
B. portal vein
C. gastroduodenal artery
D. (L) gastroepiploic artery
E. all of the above
316
which of the following is true about the schneiderian membrane of the nasal cavity?
A. Abundant venous plexus in the tunica propria
B. Tall pseudostratified columnar epithelium without goblet cells
C. No distinct basal lamina
D. contains bundles of olfactor y nerves in the lamina propria
E. all of the above
317
complete transection of the lateral cord of brachial plexus will result to which of the following symptoms?
A. Decrease sensation in the lateral dorsal side of the the hand.
B. Decrease sensation in the lateral side of the forearm
C. inability to supinate the forearm
D. inability to flex the forearm
E. all of the above.
318
A 72 y/o male was brought to ER secondary to FOOSH injury ( fall on a outstretched hand). X ray was done showing displaced compression
fracture of the radial head. Physical examination of the arm reveals findings that are consistent with an injury to the deep branch of radial nerve.
which of the following statement is correct. ?
A. MMT 3/5 in forearm supination
B. decrease sensation on the dorsal lateral side of the hand
C. presence of wristdrop
D. all of the above
E. none of the above
319
Which of the following structures is not supplied by the lateral plantar nerve?
A. Adductor hallucis
B. Flexor digitorum brevis
C. Quadratus plantae
D. Flexor digiti minimi
E. None of the above
320
Retrolisthesis of the 8th thoracic vertebra will affect what corresponding spinal segment?
A. T8
B. T9
C. T10
D. T11
E. T12
321
Epithelial lining of the ovaries:
A. simple squamous
B. stratified squamous
C. simple cuboidal
D. simple columnar
E. pseudostratified columnar
322
Tongue papillae with no taste buds and thus serve a mechanical function only:
A. fungiform
B. circumvallate
C. foliate
D. filliform
323
Epithelial lining of lymphangiomas:
A. simple squamous
B. stratified squamous
C. simple cuboidal
D. simple columnar
E. psuedostratified columnar
324
True of the jejunum but not of the ileum, except:
A. makes up the initial 3/5 of the small intestine
B. has longer vasa recta
C. has 1-2 arterial arcades
D. has a thicker wall
E. with prominent Peyer's patches
325
The lower anal canal, as opposed to the upper anal canal:
A. is supplied by a branch of the inferior mesenteric artery
B. is drained by the deep inguinal nodes
C. is derived from the ectoderm
D. is lined by simple columnar epithelium
326
The moderator band is located in which chamber of the heart?
A. right atrium
B. left atrium
C. right ventricle
D. left ventricle
327
True of the right atrium:
A. smaller than the left atrium
B. has thicker walls
C. has a moderator band
D. with a sinus venarum, a coarse muscular portion of the chamber
328
GIST is located in what layer of the gastrointestinal tract?
A. mucosa
B. submucosa
C. muscularis
D. adventitia
E. serosa
329
The accessory nerve crosses this triangle of the neck:
A. submental
B. submandibular
C. carotid
D. muscular
E. occipital
330
the lower ureter is supplied by the:
A. renal artery
B. superior vesical artery
C. gonadal artery
D. middle rectal
E. inferior vesical
331
Found in the superficial perineal space, except:
A. bulbospongiosus
B. ischiocavernosus
C. spongy urethra
D. perineal body
E. membranous urethra
332
A patient with an upper motor neuron lesion is expected to exhibit:
A. flaccid paralysis
B. atrophy
C. clonus
D. fasciculations
E. reduced muscle tone
333
Leaf shaped laryngeal cartilage:
A. thyroid
B. cricoid
C. epiglottis
D. arytenoid
E. corniculate
334
Example of a typical rib:
A. rib 12
B. rib 11
C. rib 10
D. rib 9
335
The triangle of Calot:
A. contains the cystic duct
B. is bounded by the liver laterally
C. is bounded by the cystic artery inferiorly
D. is bounded by the common hepatic duct medially
336
The female pelvis, compared to the male pelvis, has a/n:
A. narrower sacrum
B. longer symphysis pubis
C. oval shaped superior aperture
D. inverted ischial tuberosity
E. deeper iliac fossa
337
Which part of the adrenals contain pale staining cells in cords with foamy appearances due to lipid droplet accumulations?
A. zona glomerulosa
B. zona fasciculata
C. zona reticularis
D. adrenal medulla
338
Fibrocartilage is found in:
A. larynx
B. epiglottis
C. auditory tube
D. costal cartilage
E. intervertebral discs
339
Layer absent in thin skin:
A. corneum
B. lucidum
C. granulosum
D. spinosum
E. basale
340
Thickest layer in veins:
A. tunia intima
B. tunica media
C. tunica adventitia
D. none of the above
341
The carotid sinus is found in the:
A. Anterior surface of the bifurcation of the carotid artery
B. Posterior surface of the bifurcation of the common carotid artery
C. Beginning of the internal carotid artery
D. Beginning of the external carotid artery
342
The muscles that form the superior boundary of the carotid triangle:
A. Posterior belly of digastric
B. Superior belly of omohyoid
C. Sternocleidomastoid
D. Trapezius
343
This nerve accompanies the superior thyroid artery:
A. Superior laryngeal
B. External laryngeal
C. Internal laryngeal
D. Recurrent laryngeal
344
True of meiosis, except:
A. Creates new set of chromosomes by random distribution to daughter cells
B. Bestow each germ cell with the diploid number of chromosomes
C. Provides gamete variabilities
D. Produce daughter cells genetically different from the parent and from each other
345
Which of the following cartilages is characterized by the absence of a perichondrium?
A. Adult hyaline cartilage
B. Fetal hyaline cartilage
C. Fibrocartilage
D. Articular cartilage
346
This structure divides the subclavian artery into 3 parts:
A. First rib
B. Pectoralis minor
C. Scalene anterior
D. Teres major
347
The deep cervical lymph nodes lie along the:
A. Sternocleidomastoid
B. Common carotid artery
C. External jugular vein
D. Internal jugular vein
348
Tracheostomy tube insertion is usually done at the level of the:
A. Cricothyroid membrane
B. 1st-2nd tracheal rings
C. 2nd-3rd tracheal rings
D. 4th-5th tracheal rings
349
After sustaining a fracture of the mid-humerus following a fall, the patient was unable to extend the wrist. This is consistent with injury to the:
A. Axillary nerve
B. Median nerve
C. Radial nerve
D. Ulnar nerve
350
Which of the following is not a characteristic of epithelium in general?
A. Avascular
B. Derived from the ectoderm only
C. Capable of metaplasia
D. Rests on a basal lamina
351
What vein accompanies the anterior interventricular artery?
A. Anterior cardiac
B. Great cardiac
C. Middle cardiac
D. Small cardiac
352
The 6th aortic arch will become the:
A. Common carotid artery
B. Maxillary artery
C. Pulmonary artery
D. Right subclavian artery
353
Melena results from gastrointestinal bleeding found:
A. Proximal to the ligament of Treitz
B. Distal to the ligament of Treitz
C. At the stomach only
D. At the esophagogastric area only
354
A 40 year old man sustained a gunshot wound that traversed segments 1 and 4 of the liver. This means that the parts of the liver affected were:
A. Quadrate lobe
B. Caudate lobe
C. Both
D. Neither
355
The extent to which neoplastic cells resemble comparable normal cells is referred to as:
A. Differentiation
B. Pleomorphism
C. Anaplasia
D. Dysplasia
356
A patient complains of a boil located on her labia majora. Lymphatic spread of the infection would most likely enlarge which nodes?
A. Lumbar nodes
B. Superficial inguinal nodes
C. External iliac nodes
D. Internal iliac nodes
357
A 63 year old female patient says that she has pain in her groin and upper thigh. Upon examination, you palpate a lump located below the
inguinal ligament, lateral to its attachment to the pubic tubercle. You suspect that this may be a hernia passing through the:
A. femoral canal
B. obturator canal
C. adductor hiatus
D. superficial inguinal ring
358
The sensory receptor for hearing is located in the:
A. Macula
B. Ampulla
C. Organ of Corti
D. Saccule
359
A forearm arterio-venous fistula for hemodialysis access is usually done by anastomosing the:
A. Radial artery and basilic vein
B. Radial artery and cephalic vein
C. Radial artery and antecubital vein
D. Ulnar artery and basilic vein
360
The aortic valve is best heard clinically at the:
A. Right 2nd ICS close to the sternal border
B. Left 2nd ICS close to the sternal border
C. Left 5th ICS midclavicular line
D. Xiphisternal junction
361
Gab is an avid tennis player with a killer serve. In order to do this, he must have a good grip around the racket. Which muscle improves the grip
of the palm especially when holding rounded objects?
A. Abductor pollicis brevis
B. Flexor pollicis brevis
C. Palmaris brevis
D. Extensor pollicis brevis
362
Marco Reus of Borussia Dortmund recently damaged his ankle ligaments following a tackle from the outside while on international duty with
Germany. Which ligament was most likely involved?
A. Anterior talofibular ligament
B. Posterior talofibular ligament
C. Calcaneofibular ligament
D. Anterior tibiotalar ligament
363
In order to achieve anesthesia of an intercostal space, an intercostal nerve block can be done by inserting the needle through:
A. the superior margin of the rib above the space
B. the inferior margin of the rib above the space
C. the superior margin of the rib below the space
D. the inferior margin of the rib below the space
E. Between the inferior margin of the rib above the space and the superior margin of the rib below the space
364
A patient with a large fungating tongue mass is schedule to undergo operative intervention. The anesthesiologist plans to do nasotracheal
intubation. He knows that the distance from the external nares to the carina measures:
A. 15 cm
B. 20 cm
C. 30 cm
D. 40 cm
365
During tracheostomy it is important to note that the thyroid isthmus is at the level of the:
A. Cricoid and 1st tracheal ring
B. 1st and 2nd tracheal rings
C. 2nd and 3rd tracheal rings
D. Cricoid and 2nd tracheal rings
366
Dr. Wi, the resident on duty received a patient involved in a vehicular crash and upon seeing the patient noted extensive maxillofacial injuries.
During the subsequent management imaging was done which showed a fracture line involving the frontozygomatic sutures, the ethmoid and
nasal bones, the superior orbital fissures and the greater wings of the sphenoid. His diagnosis would be?
A. Le Fort I
B. Le Fort II
C. Le Fort III
D. Le Fort IV
367
During left radical nephrectomy, the left kidney is removed together with the left suprarenal gland. As part of the procedure, the renal artery is
ligated. To prevent bleeding of the vessels supplying the suprarenal gland, arterial branch/branches coming from which of the following should
also be ligated?
A. Inferior phrenic artery
B. Aorta
C. Splenic artery
D. A and B
E. All of the above
368
True of the rectum:
A. The rectum is a purely retroperitoneal organ and begins as a continuation of the sigmoid colon
B. It is covered by a part of peritoneum up to its distal third
C. The proximal third is covered by peritoneum at its anterior and lateral surfaces
D. All of the above
369
What structure/s pass/es through the diaphragmatic opening at the level of T12?
A. Aorta and Thoracic duct
B. Vena cava and phrenic nerve
C. Azygos vein
D. A and C
E. All of the above
370
A 56/F diagnosed with endometrial carcinoma confined to the uterus on TV-UTZ was about to undergo a radical hysterectomy with bilateral
salpingo-oophorectomy, the attending OBGYN wanting to avoid post operative complications recalls that the ureter can sustain iatrogenic
injury at which of the following locations?
A. As it passes immediately inferior to the uterine artery near the lateral part of the fornix of the vagina
B. As it crosses the uterine artery approximately 2 cms superior to the ischial spine
C. As it crosses the pelvic brim together with the ovarian artery
D. All of the above
371
A 34/M was on his way home when he was suddenly mugged and was hit at the side of the head with a lead pipe by unknown assailants. He
was briefly unconscious and was awakened by concerned bystanders. He then reported the incident to the police and since there were no
obvious external injuries he decided to go home. The following morning, he was found dead by his family. The vessel that was most likely
responsible for the death of the patient is a branch of the?
A. Middle meningeal artery
B. Internal carotid artery
C. External carotid artery
D. Superior sagittal sinus
372
A 60/M smoker, diabetic, suddenly experienced severe crushing chest pain. He was brought to the nearest hospital and an ECG was done
which showed ST elevation of leads V4-V6. Which vessel was most likely occluded?
A. Left circumflex artery
B. Left anterior descending artery
C. Right marginal artery
D. Left main coronary artery
373
A 32/F underwent total thyroidectomy. Postoperatively the patient complains of hoarseness. This suggests damage to the
related to the
.
A. Recurrent laryngeal nerve: Superior thyroid artery
B. Recurrent laryngeal nerve: Inferior thyroid artery
C. External laryngeal nerve: Superior thyroid artery
D. External laryngeal nerve: Inferior thyroid artery
which is closely
374
A 7/M fell while from a tree and landed on his outstretched hand. He was quickly brought to the emergency room and the examining physician
noted that the limb is medially rotated with loss of abduction. There was also a step off deformity palpable at the middle third of the clavicle.
What nerve was most likely injured?
A. Subscapular nerve
B. Median nerve
C. Axillary nerve
D. Suprascapular nerve
375
A 27/F has multiple closed comedones on her nose. She then proceeded to squeeze them individually. After a few days she had a severe headache
which was followed by high grade fever, periorbital edema and diplopia. A diagnosis of cavernous sinus thrombosis was made. Which is/are
found inside the cavernous sinus?
A. Internal carotid artery
B. Trochlear nerve
C. Mandibular nerve
D. A and B
E. All of the above
376
Which of the following is/are TRUE of the inferior vena cava?
A. There are two anterior visceral tributaries
B. There are three veins of origin
C. There are three visceral tributaries
D. All of the above
E. A and C
377
A 30/M has extensive metastatic testicular carcinoma. Metastatic foci would most likely be found where?
A. Superficial inguinal lymph nodes
B. Deep inguinal lymph nodes
C. Para-aortic lymph nodes
D. Pre-aortic lymph nodes
E. All of the above
378
Renal transplantation involves:
A. End to side anastomosis of the donor renal artery to the recipient external iliac artery
B. End to end anastomosis of the donor renal vein to the recipient internal iliac vein
C. Anastomosis of the donor ureter to the recipient bladder through a ureterocystostomy
D. All of the above
E. A and B
379
The following are wholly derived from endoderm EXCEPT
A. Greater vestibular glands
B. Prostate gland
C. Mammary glands
D. Bulbourethral glands
380
Which of the following contains a submucosal layer?
A. Gallbladder
B. Trachea
C. Fallopian tubes
D. Larynx
381
Which of the following best describes the location of the right adrenal gland?
A. Inferior to the right lobe of the liver
B. Posterolateral to the inferior vena cava
C. Anterior to the 1st lumbar vertebra
D. Posterior to the right kidney
E. Medial to the spleen
382
Which of the following drains segment I of the liver?
A. Middle hepatic vein
B. Right hepatic vein
C. Direct venous drainage into the inferior vena cava
D. Direct venous drainage into the common hepatic vein
E. Left gastric vein
383
A 65-year old female who has been bedridden for 3 months presented with symptoms of pneumonia. You suspect an aspiration component for her
disease. In which of the following lung segments will you most likely see the infiltrates on her chest radiograph?
A. Left superior lingular segment
B. Left apicoposterior segment
C. Right superior segment
D. Right posterobasal segment
E. Right medial segment
384
The embryonic right 4th aortic arch develops into which of the following adult structures?
A. Arch of the aorta
B. Right internal carotid artery
C. Right common carotid artery
D. Right subclavian artery
E. Right brachiocephalic artery
385
Which of the following is not true about the lesser sac of the abdomen?
A. The stomach forms its anterior boundary
B. It communicates with the greater sac through the foramen of Winslow
C. The gastrosplenic ligament forms its lateral boundary
D. The lesser omentum transmits the coronary veins which can dilate as varices during portal hypertension
E. The lesser sac is normally filled with fluid and is easily visualized on CT imaging.
386
During a 12-lead ECG, where should lead V2 be normally placed?
A. 4th intercostal space, left parasternal border
B. 5th intercostal space, left parasternal border
C. 4th intercostal space, left midclavicular line
D. 5th intercostal space, left midclavicular line
E. 4th intercostal space, right parasternal border
387
The ureters enter the urinary bladder at which of its aspects?
A. Anterolateral
B. Lateral
C. Posteromedial
D. Posterolateral
E. Superomedial
388
A patient suffered from myocardial infarction and showed signs of hypotension and bradycardia. Which myocardial wall is most likely affected
given this clinical picture.
A. Anterior wall
B. Anteroseptal wall
C. Lateral wall
D. Inferior wall
E. Posterior wall
389
The thyroid isthmus most commonly lies over which tracheal rings?
A. 1st and 2nd
B. 2nd and 3rd
C. 3rd and 4th
D. 4th and 5th
E. 5th and 6th
390
Which of the following paranasal sinuses is the last to develop?
A. Maxillary sinus
B. Ethmoid sinus
C. Sphenoid sinus
D. Frontal sinus
E. Both C and D
391
The superior mesenteric vein drains directly into which of the following structures?
A. Portal vein
B. Celiac vein
C. Inferior vena cava
D. Splenic vein
E. Common hepatic vein
392
Which of the following forms the posterior border of the heart?
A. Right atrium
B. Right ventricle
C. Left atrium
D. Left ventricle
E. Apex
393
Which of the following structures is not contained within the spermatic cord?
A. Vas deferens
B. Ilioinguinal nerve
C. Genital branch of genitofemoral nerve
D. Pampiniform plexus
E. Tunica vaginalis
394
Which of the following parts of the urinary bladder is most sensitive to stretch?
A. Apex
B. Base
C. Trigone
D. Ureteral insertion
E. Urethral opening
395
The stylohyoid muscle is innervated by which of the following nerves?
A. CN V3
B. CN VII
C. CN IX
D. CN X
E. CN XII
396
An avulsion fracture at the base of the first proximal phalanx is known as:
A. Gamekeeper's thumb
B. Bennett's fracture
C. Boxer's fracture
D. Colles fracture
E. Lisfranc fracture
397
Which of the following inner ear structures is involved during horizontal linear deceleration?
A. Utricle
B. Saccule
C. Horizontal semicircular canal
D. Scala media
E. Basilar membrane
398
Gastrointestinal stromal tumor (GIST), the most common mesenchymal tumor of the stomach, most commonly arises from which of its layers?
A. Mucosa
B. Submucosa
C. Muscularis mucosae
D. Muscularis propria
E. Serosa
399
What is the lining epithelium of the ovary?
A. Simple squamous
B. Simple cuboidal
C. Simple columnar
D. Stratified squamous
E. Stratified cuboidal
400
What is the lining epithelium of the prostatic urethra
A. Simple squamous
B. Stratified squamous
C. Transitional
D. Simple cuboidal
E. Stratified cuboidal
401
What is the most common type of Myoma Uteri?
A. Submucous
B. Pedunculated
C. Subserosal
D. Intramural
E. Polypoid
402
The Dosalis Pedis Artery is
A. A continuation of the posterior tibial artery
B. Medial to the adductor longus tendon
C. Medial to the medial malleolus
D. Lateral to the Extensor digitorum longus
E. Lateral to the Extensor hallucis longus
403
Which of the following is derived from the 2nd pharyngeal arch
A. Reichter's Cartilage
B. Meckel's Cartilage
C. Hyoid bone
D. A and C
E. All of the above
404
The Cremaster Muscle is a continuation of which of the following?
A. External Oblique Muscle
B. Rectus abdominis muscle
C. Internal Oblique muscle
D. Transversalis muscle
E. Transversalis fascia
405
Emphysema is a pulmonary disease where expiration is active instead of its passive nature. In a patient with emphysema which of the following is
not a muscle used in forced/active expiration?
A. Internal Intecostal
B. External Intercostal
C. Rectus abdominis
D. Serratus Posterior Inferior
E. Transverse Thoracis
406
Which of the following is the reason for the higher tendency of the Sigmoid Colon for Volvolus?
A. Because it is most redundant
B. Because It is intraperitoneal
C. Because it is the narrowest
D. Because it is hypermotile
E. Because of its thin wall
407
Which of the following Sinuses is/are present at birth?
A. Frontal
B. Maxillary
C. Sphenoid
D. A and B
E. B and C
408
A patient was rushed to the ED after an automobile accident, patient came in with decreased sensorium and multiple abrasions, after a few
hours, the patient became conscious and coherent which was eventually followed by a coma, on physical examination you noted crepitations on
the Left Pterion area. As a brilliant doctor you knew that there was an injured vessel which passes in which foramen of the skull
A. Foramen Magnun
B. Foramen Lacerum
C. Foramen Ovale
D. Foramen Spinosum
E. Foramen Rotundum
409
Which of the following structures traverses the Aortic Hiatus of the diaphragm?
A. Thoracic Duct
B. Hemiazygous vein
C. Right Phrenic Nerve
D. Vagus Nerve
E. Right Lymphatic Duct
410
A 1-month old female patient was noted to have Rib- notching on X-ray, a chromosomal study was done in this patient revealing a chromosomal
count of 45 XO, if this patient would undergo repair of the said cardiac defect what structure may be injured?
A. Right Phrenic Nerve
B. Right Vagus Nerve
C. Left Vagus Nerve
D. Left Phrenic Nerve
E. Hemiazygous vein
411
A male patient was rushed to your trauma center after a massive bleeding secondary to a self-inflicted deep incised wound to the radial aspect
of the left wrist, after a recent break-up with his girlfriend. Which of the following structures is most likely preserved?
A. median nerve
B. flexor carpi radialis tendon
C. palmaris longus tendon
D. flexor carpi ulnaris tendon
E. none of the above
412
A prison inmate was rushed to your emergency department due to an apparent stab wound at the flank on the left midscapular line at the level of
L2 which of the following structures may be least severed?
A. Renal vein
B. Renal artery
C. Renal pelvis
D. Psoas Muscle
E. Quadratus Lumborum muscle
413
An opera singer underwent a Near Total Thyroidectomy due to the discovery of an apparent Papillary Thyroid Carcinoma, post-surgery, patient
was unable to reach high notes, what could have been the reason?
A. Injury to the internal branch of the superior laryngeal nerve
B. Unilateral injury to the recurrent laryngeal nerve
C. Bilateral injury to the recurrent laryngeal nerve
D. Injury to the external branch of the superior laryngeal nerve
E. Injury to the rima glottidis
414
Which of the following is the major blood supply of the parathyroid glands?
A. Superior Thyroid Artery
B. Inferior Thyroid Artery
C. Superior Parathyroid artery
D. Inferior Parathyroid Artery
E. Middle Thyroid Artery
415
Which of the following cells is responsible for Osteoid formation?
A. Osteocyte
B. Osteoblast
C. Osteoclast
D. Langhan's Cell
E. Langerhan's Cell
416
After a prolonged intubation of a COPD patient you decided to perform a tracheostomy to lessen the Dead Space and improve ventilation, on
what location are you going to perform the tracheostomy?
A. at the level of C4 vertebra
B. in between the thyroid and cricoid cartilage
C. above the thyoid cartilage
D. at the 1st to the 4th tracheal rings
E. at the 2nd to the 4th tracheal rings
417
After an automobile accident you realized that the occulomotor nerve has been severed due to what manifestation of the patient?
A. Pinpoint pupils
B. Droopy eyelids
C. Weakness looking down
D. Loss of Corneal reflex
E. Horizontal diplopia
418
The melanocytes are seen in which layer of the epidermis?
A. S. Corneum
B. S. Lucidum
C. S. Granulosum
D. S. Spinosum
E. S. Basale
419
The oxyphil cells are found in which human structure?
A. Pineal Gland
B. Parathyroid Gland
C. Anterior Pituitary Gland
D. Posterior Pituitary Gland
E. Thyroid Gland
420
A 35 year-old female mountain climber went under a Modified Radical Mastectomy after being diagnosed with Breast Cancer. Post-op, patient
can move all her limbs, can protract her scapula, can laterally and medially rotate her arm, can extend MP joints of all digits and can flex the wrist
BUT she can not elevate her trunk. Which nerve may be injured intra-operatively?
A. Long Thoracic nerve
B. Thoracodorsal Nerve
C. Axillary Nerve
D. Lateral Pectoral Nerve
E. Muculocutaneous Nerve
421
The major blood supply to the parathyroid glands comes from:
A. Superior thyroid artery
B. Inferior thyroid artery
C. Superior parathyroid artery
D. Inferior parathyroid artery
422
A 25-year old male patient was observed to have recurrent pyogenic infections of the nasal sinuses. He later on developed cavernous sinus
thrombosis, a potentially serious condition because of the many delicate structures that can be affected. Which of the following is least likely to be
involved?
A. CN II
B. CN III
C. CN IV
D. Internal carotid artery
E. None of the above.
423
Sounds produced by the aortic valve can be best heard at:
A. 5th ICS, left midclavicular line
B. 2nd ICS, right parasternal
C. 2nd ICS, left parasternal
D. Right half of the lower end of the body of sternum
424
A perforating ulcer located at the lesser curvature of the stomach will most likely erode which branch of the celiac artery?
A. Splenic artery
B. Gastroduodenal artery
C. Left gastric artery
D. Left gastroepiploic artery
425
The cell organelle containing oxidative enzymes, synthesizing H2O2 and is involved in beta-oxidation of long chain fatty acids:
A. Lysosome
B. Smooth ER
C. Mitochondria
D. Peroxisome
426
The most common site of aortic aneurysm:
A. Distal to the portion of aorta passing through the diaphragmatic opening
B. Below the origin of the renal arteries
C. Along the portion contained within the posterior mediastinum
D. Just distal to the bifurcation of the common iliacs
427
All of the following muscles are important in plantar flexing the foot at the ankle joint except for:
A. Gastrocnemius
B. Popliteus
C. Soleus
D. Plantaris
428
A 22-year old frisbee player was brought to the hospital after sustaining a knee injury. On physical exam, he was noted to demonstrate a positive
anterior drawer sign. This suggests that:
A. There is injury to the knee ligament that is attached to the lateral condyle of the femur above and to the head of the fibula below.
B. There is injury to the knee ligament that is attached to the medial condyle of the femur above and to the medial aspect of the tibial shaft
below.
C. There is injury to the knee ligament that prevents anterior displacement of the femur on the tibia.
D. There is injury to the knee ligament that prevents posterior displacement of the femur on the tibia.
429
Which of the following is not true about the mucous membrane of the lower half of the anal canal?
A. It is sensitive to pain, temperature, touch and pressure (somatic sensory innervation).
B. It is thrown into vertical mucous folds called anal columns.
C. The lymph drains downward to the medial group of superficial inguinal nodes.
D. Its blood supply comes directly from the inferior rectal artery, a branch of the internal pudendal artery.
E. None of these.
430
A normal individual will usually have how many parathyroid glands?
A. 2
B. 4
C. 6
D. 7
431
Venous drainage of the posterior ventricular walls including the posterior interventricular septum drain directly to:
A. Great cardiac vein
B. Smallest cardiac vein
C. Coronary sinus
D. Middle cardiac vein
432
A 46-year old male was rushed to the ER after getting involved in a vehicular accident. An anterior abdominal blunt injury was suspected. FAST
was performed with focus on 4 areas including the so-called Morrison's pouch. As member of the trauma team you know that this area
corresponds to the:
A. Splenorenal space
B. Suprapubic space
C. Hepatorenal space
D. Subxiphoid area
433
This is one of the five terminal nerves of the brachial plexus which is also the motor innervation of the anterior compartment of the arm,
important in flexing the elbow joint and supinating the forearm:
A. Musculocutaneous nerve
B. Median nerve
C. Radial nerve
D. Ulnar nerve
434
True of utricle and saccule except:
A. Housed by a central cavity known as vestibule
B. Kinetic labyrinth
C. Important for linear acceleration
D. Contain otoliths
E. None of the above
435
Which of the following statements about seminal vesicle is not true?
A. They are lobulated structures that can store spermatozoa.
B. They produce secretions added to the seminal fluid and important in sperm nourishment.
C. Their blood supply comes from the superior vesicle and superior rectal arteries.
D. They can be palpated during digital rectal exam.
E. All of the above.
436
A 15-year old skateboarder lost balance and fell on his outstretched right hand causing hyperextension of the wrist joint . He then manifest
numbness and pain over the palmar aspects of his right thumb, index and middle fingers. Which of the following mechanisms of injury will most
likely explain the symptoms?
A. A fracture of the base of the metacarpal bones
B. A supracondylar fracture of the humerus with compression of the pronator teres muscle
C. An oblique fracture of the trapezium bone
D. A dislocated lunate bone
437
The inferior thyroid vein which receives tributaries from the lower poles of the gland and the isthmus drains directly to:
A. Internal jugular vein
B. Brachiocephalic vein
C. External jugular vein
D. Superior vena cava
438
Melanocytes, the pigment-producing cells, are most numerous in this layer of the skin:
A. Stratum lucidum
B. Stratum granulosum
C. Stratum corneum
D. Stratum basale
439
Which of the following anatomic relationships will best locate the gallbladder?
A. It is medial to the ligamentum teres within the falciform ligament.
B. It lies superior to the porta hepatis
C. It is lateral to the quadrate lobe of the liver.
D. 2/3 of which lies in the left lobe of the liver.
440
In performing the ECG, the V5 lead should be placed over the:
A. 2nd right ICS, parasternal area
B. 4th left ICS, parasternal area
C. 4th left ICS, midclavicular area
D. 5th left ICS, lateral to the midclavicular area
441
A 45 year-old male painter went up to a ladder to paint the roof, however, he slips and fell suffering a straddle injury. Which of the following
structure prevents the spread of urine inferiorly to the thigh in case of ruptured penile urethra:
A. rectus sheath
B. camper's fascia
C. scarpa's fascia
D. denonvilier's fascia
E. conjoint tendon
442
Which is not included in the drainage of the thyroid:
A. Superior thyroid vein
B. Middle thyroid vein
C. Inferior thyroid vein
D. Brachiocephalic
E. Thyroidea ima
443
The non-ciliated secretory cells which randomly interrupt the ciliated epithelial lining of the bronchial mucosa are called:
A. Kulchitsky cells
B. Clara cells
C. Neuroendocrine cells
D. Type 2 pneumocytes
E. Dust cells
444
A 52 year-old man was rushed to the ER after a car accident. He was noted to have clear fluid draining from his nose which is apparently the CSF.
The bone which is most likely fractured is the:
A. nasal
B. ethmoid
C. frontal
D. lacrimal
E. zygomatic
445
Which chamber of the heart is most likely enlarged when there is narrowing of the thoracic esophagus on Barium swallow:
A. right atrium
B. right ventricle
C. left atrium
D. left ventricle
E. left auricle
446
A 23 year-old male patient seen at a clinic cannot focus on near objects but he can move his eyeball normally and see distant objects clearly. This
condition may indicate damage to:
A. Short ciliary nerve and ciliary ganglion
B. Ciliary ganglion and oculomotor nerve
C. Oculomotor nerve and long ciliary nerve
D. Short and long ciliary nerves
E. Long ciliary nerve and superior cervical ganglion
447
A 48 year-old woman was diagnosed of Phyllodes tumor. She underwent mastectomy. However, postoperatively, the woman experiences
weakness in the ability to protract the scapula with difficulty raising the arm above her head.
Damage to which of the following nerves is suggested by this finding:
A. Axillary
B. Supraclavicular
C. Spinal accessory
D. Long Thoracic
E. Thoracodorsal
448
A 55 year-old male sustained from a motor vehicular accident resulting to fracture of the 9th to 11th ribs left posterior. BP is 80/50mmHg,
PR=125bpm, RR=22cpm. The most likely injured organ is the
A. stomach
B. pancreas
C. liver
D. spleen
E. small intestine
449
Massive hemopericardium compromises cardiac and systemic circulation. In emergency evacuation of the blood, the best and safest way to make
an incision en route to the pericardial activity is via:
A. 5th left ICS lateral to sternum
B. 7th left ICS immediately lateral to sternum
C. 6th left ICS 8cm from misdternal line
D. 7th left ICS 8cm from midsternal line
E. immediately subxiphoidal
450
A 65 year-old female, hypertensive, diabetic suddenly developed dizziness and subsequently loss consciousness. She was rushed to the
emergency room, she regained consciousness. She cannot understand or obey commands, she talks and answers to questions irrelevantly. If an
infarct is suspected, what Brodmann Area is affected:
A. Brodmann Area 4
B. Brodmann Area 44 and 45
C. Brodmann Area 8
D. Brodmann Area 21, 42
E. Brodmann Area 3,1,2
451
In portal hypertension, which of the following veins will not engorge and is not a collateral circulation:
A. Superior rectal
B. Median sacral
C. Esophageal
D. Paraumbilical
E. Splenic
452
During a dilatation and curettage in a 23 year-old G1P0 patient after an incomplete abortion at 5 weeks AOG, the instrument accidentally
punctured the uterus anteriorly hitting this structure:
A. Urinary bladder
B. Uterine artery
C. Sigmoid colon
D. Ureter
E. Broad ligament
453
A 19 year-old male suffered from a stab wound at the anterior abdomen and was rushed to the ER. A segment of the intestine protruded and
partially opened. The segment's mucosa had few circular folds. It's mesentery was fatty with many vascular arcades. The segment that is seen
protruding the patient's abdomen is:
A. duodenal bulb
B. distal part of duodenum
C. proximal jejunum
D. distal jejunum
E. distal ileum
454
A 12 year-old boy was brought to the ER because of acute attack of Bronchial Asthma. Symptoms primarily are caused by mucosal inflammation
and airway hyperresponsiveness. The specific part of the airway involved in the pathogenesis of Asthma is:
A. trachea
B. bronchi
C. bronchioles
D. alveolar ducts
E. alveolar sacs
455
A 48 year-old fish vendor was stabbed by an unknown assailant at the back. He was rushed to the ER with BP 60 palpatory, PR=130s, RR=20s.
Which particular structure of the kidney will be stimulated as a result of the above findings:
A. juxtaglomerular cells
B. cells of PCT
C. cells of loop of Henle
D. macula densa
E. mesangial cells
456
Direct inguinal hernias are found within the Hesselbach's triangle. The posterior wall of this triangle where hernias protrude is:
A. Inguinal ligament
B. External oblique aponeurosis
C. Transversus abdominis aponeurosis
D. Internal oblique aponeurosis
E. Transversalis fascia
457
A 35 year-old woman has an infected right big toe with swollen lymph nodes. The group of node that is most likely affected is:
A. Femoral
B. Superficial inguinal
C. Deep inguinal
D. Internal iliac
E. Paravertebral
458
A 46 year-old woman had crow's feet at lateral angles of her eyelids. These are due to contraction of:
A. Procerus
B. Corrugator supercilli
C. Frontalis
D. Orbicularis oculi
E. Levator palpebrae superioris
459
A 35 year-old man complains of inability to flex the elbow joint. It involves a nerve supplying the muscle which branches from the brachial
plexus as:
A. C5
B. C5-C6
C. C5-C7
D. C6, C7, C8
E. C8-T1
460
Pulsation from an artery which is a continuation of anterior tibial artery on the dorsum of the foot can be easily felt. On the medial side of this
artery lies the tendon of:
A. Extensor digitorum brevis
B. Extensor digitorum longus
C. Extensor hallusis brevis
D. Extensor hallucis longus
E. Inferior extensor retinaculum
461
What is the vein that is used in arterio-venous fistula that is located lateral to the biceps brachii?
A. Basilic vein
B. brachial vein
C. Median cubital vein
D. Cephalic vein
E. Axillary vein
462
In the standard 12 lead ECG what is the anatomic placement of the chest electrode lead V2?
A. 4th ICS Right parasternal border
B. 4th ICS Left parasternal border
C. 5th ICS Right MCL
D. 5th ICS Left MCL
E. None of the choices
463
A 55 year old male presents with chest pain. ECG shows ST segment elevation in lead II, III, AVF. What is the most likely affected blood vessel
supplying the affected part of the heart?
A. Right coronary artery
B. Left marginal artery
C. left anterior descending artery
D. Left circumflex artery
E. C and D
464
What is the most common type of myoma?
A. Submucosal myoma
B. Pedunculated subserosal myoma
C. Subserosal myoma
D. Intramural myoma
E. Pedunculated submucosal myoma
465
The following are muscles of inspiration except:
A. Serratus posterior superior
B. External intercostal
C. Internal intercostal
D. Innermost intercostal
E. Subcostal
466
A 25 year old male came in due a stab wound in his abdomen. Upon exploration you noticed a severed blood vessel supplying the lower part of
the the muscular tube from the kidney to the posterior surface of the bladder. What blood vessel is most likely involved?
A. renal artery
B. testicular artery
C. superior vesical artery
D. iliolumbar artery
E. inferior vesical artery
467
A 65 year old female fall from a height of approximately 10 step ladder sustaining injuries. Her right leg is shortened and the thigh is laterally
rotated. What is the most likely diagnosis.
A. Fracture of the neck of the femur, right
B. fracture of the tibia, right
C. dislocation of the head of the femur, right
D. fracture of the fibula, right
E. none of the choices
468
A surgeon harvested part of the great saphenous vein from the right lower extremity of a 30 year old patient. However, after the procedure, the
patient complained of pain and paresthesia in the medial aspect of the leg and foot. What nerve is the most likely affected.
A. saphenous nerve
B. obturator nerve
C. femoral nerve
D. sciatic nerve
E. A and B
469
A 6 month old infant has a long and narrow skull with frontal and occipital expansion was brought in to your clinic by her mother for
consultation. You explained to the mother that the most likely reason for this is the premature closure of the cranial sutures. What suture is
involved in this case?
A. sagittal suture
B. coronal suture
C. lambdoid suture
D. coronal and lambdoid suture
E. coronal and sagittal suture
470
The following cranial nerves are both motor and sensory except:
A. Glossopharyngeal
B. Vagus
C. facial
D. vestibulocochlear
E. No exception
471
A 35 year old male sustained facial laceration due to vehicular accident. The wound tend to gape because:
A. The face has no deep fascia
B. The subcutaneous tissue of the face is loose
C. The face has weak muscles
D. A and B only
E. All of the choices
472
The anal canal is divided into 2 parts by the dentate line. What is the lining epithelium of the anal canal above the dentate line?
A. Simple columnar epithelium
B. Simple cuboidal epithelium
C. Stratified squamous epithelium
D. transitional epithelium
E. simple squamous epithelium
473
A 35 year old female singer underwent a subtotal thyroidectomy due to a thyroid mass. After the surgery, she experienced mild hoarseness of
voice and she can not reach high notes. What nerve is most likely injured?
A. lateral laryngeal nerve
B. superior laryngeal nerve
C. inferior laryngeal nerve
D. phrenic nerve
E. glossopharyngeal nerve
474
In pericardiocentesis, pericardial fluid is apirated between what layers of the heart?
A. Between fibrous and serous pericardium
B. Between the parietal layer of the serous pericardium and the fibrous pericardium
C. Between the myocardium and the epicardium
D. between the parietal layer of the serous pericardium and the visceral layer of the serous pericardium
E. none of the choices
475
When inserting an NGT, the first esophageal narrowing encountered is between the esophagus and the cricoid cartilage. What is the distance
from the external nares up to this point.
A. 30cm
B. 28cm
C. 44 cm
D. 12-14cm
E. 18cm
476
The blood supply of the appendix comes directly from:
A. Posterior cecal artery
B. Ileocolic artery
C. Right middle colic artery
D. Left middle colic artery
E. Jejunoileal artery
477
Which of the following best characterized the parathyroid glands?
A. The inferior parathyroid glands are more variable in location
B. Inferior thyroid artery supplies the inferior parathyroid gland only
C. Usually, there are 4 parathyroid glands
D. All of the above
E. A and C only
478
An 18 year old boy had anterior dislocation of the shoulder joint while playing basketball. An injury to this nerve is suspected which will present
as:
A. Inability to abduct the arm
B. Inability to adduct the arm
C. Weakness in medial rotation of the arm
D. altered sensation in the medial aspect of the arm
E. all of the above
479
The "yes" and "no" joints are synovial joints without intervertebral disc. The "yes" joint is located between:
A. Atlas and occipital condyle
B. Atlas and axis
C. Axis and occipital condyle
D. C3 and C4
E. None of the choices
480
What is the anatomic landmark of the cricoid cartilage?
A. C4
B. C5
C. C6
D. T2
E. C7
481
Which of the following cranial nerves will NOT be affected in cavernous sinus syndrome?
A. CN II
B. CN III
C. CN IV
D. CN VI
482
This type of glia is important for the maintenance of the blood-brain barrier:
A. oligodendroglia
B. astrocyte
C. microglia
D. Schwann cell
483
The V4 precordial lead is placed:
A. On the 4th ICS to the left of the sternum
B. On the 5th ICS to the left of the sternum
C. On the 5th ICS at the left midclavicular line
D. On the 4th ICS at the left midclavicular line
484
This is the most common site of ureteral obstruction:
A. Ureteropelvic junction
B. Ureterovesical junction
C. Pelvic brim
D. None of the above
485
Gastrulation happens within week:
A. 1
B. 2
C. 3
D. 4
486
The following are embryologic derivatives of ectoderm, EXCEPT:
A. Parotid gland
B. Retina
C. Melanocytes
D. Eustachian tube
487
What is the function of Type 2 pneumocytes?
A. For gas exchange
B. Degrade toxins
C. Secrete IgA
D. Precursors to type I pneumocytes
488
A young fetus of 2 months AOG would be expected to be producing RBCs via the:
A. Yolk sac
B. Liver
C. Bone marrow
D. Thymus
489
The left circumflex coronary artery supplies the:
A. Anterior 2/3 of interventricular septum
B. Posterior walls of the left ventricle
C. Posterior 1/3 of interventricular septum
D. Lateral wall of the right ventricle
490
Which of the following hormones is secreted by an acidophil?
A. FSH
B. GH
C. TSH
D. LH
491
This ligament contains the portal triad:
A. gastrohepatic
B. hepatosplenic
C. hepatoduodenal
D. falciform
492
This/these segment/s of the small intestine contain/s the Brunner's glands:
A. duodenum
B. jejunum
C. ileum
D. Both A and B
493
On peripheral blood smear, which cell presents with a large kidney-shaped nucleus?
A. Eosinophil
B. Monocyte
C. B cell
D. T cell
494
Melanocytes are found in the:
A. Stratum basale
B. Stratum germinativum
C. Statum granulosum
D. Both A and B
495
The most commonly injured rotator cuff muscle is:
A. Teres minor
B. Teres major
C. Supraspinatus
D. Infraspinatus
496
A patient needs a femoral tap for ABG determination. What compartment of the femoral sheath should you aspirate?
A. medial
B. lateral
C. posterior
D. anterior
497
A woman suffered a traumatic injury to the upper limb which results to an inability to spread and extend her fingers, with noted clawing of the
ring and little fingers. Which segments of the brachial plexus would have contributed to the nerve that is damaged?
A. C5 and C6
B. C6 and C7
C. C7 and C8
D. C8 and T1
498
A patient suffers an Achilles tendon rupture. Which of the following muscles is NOT affected:
A. soleus
B. plantaris
C. popliteus
D. gastrocnemius
499
During parotidectomy, the main trunk of the facial nerve was accidentally lacerated. Which of the following muscles will be affected?
A. masseter
B. buccinator
C. temporalis
D. pterygoids
500
The nasolacrimal duct drains into which recess?
A. Superior meatus
B. Middle meatus
C. Inferior meatus
D. Lateral meatus
501
This nuclei is the most important source of norepinephrine in the cerebral cortex:
A. Caudate nucleus
B. Substantia nigra pars compacta
C. Raphe nucleus
D. Locus ceruleus
E. Basal nucleus of Meynert
502
A 30-year-old man was allegedly stabbed in his right chest by an unknown assailant as he was going to his car parked 2 blocks away from the bar
where he sings.On physical examination, patient is unable to raise his right arm above the horizontal with winging of his right scapula. Which of
the following nerves is most likely affected?
A. Axillary
B. Thoracodorsal
C. Long thoracic
D. Internal intercosta
E. Spinal accesory
503
This is also known as the morrison's pouch:
A. Hepatorenal recess
B. Splenorenal recess
C. Renocolic recess
D. Costodiagphragmatic recess
504
The following muscles are responsible for dorsiflexing the foot, except:
A. Extensor digitorum brevis
B. Tibialis anterior
C. Peroneus longus
D. Extencsor digitorum longus
E. None of the above
505
The gastric mucosa is lined by which epithelium:
A. Simple squamous
B. Simple cuboidal
C. Simple columnar
D. Stratified squamous
E. Stratified columnar
506
Melanocytes are found in which layer of the skin:
A. Stratum germinativum
B. Stratum granulosum
C. Stratum corneum
D. Stratum basale
E. Stratum spinosum
507
The major mechanism of blindness in glaucoma is:
A. Optic nerve damage
B. Increased intraocular pressure
C. Optic disk enlargement
D. Corneal inflammation
E. Lens opacification
508
Which of the folling statements regarding tube thoracostomy is true? A.
The site of insertion of the tube is at the 4th ICS at the anterior axillary line.
B. The skin incision is usually made over the intercostal space above the space to be pierced.
C. The incision through the intercostal space is kept close to the lower border of the rib to avoid injuring the intercostal vessels and nerve.
D. All of the statement are correct.
E. All of the statements are incorrect.
509
C-shaped organ:
A. Esophagus
B. Duodenum
C. Spleen
D. Pancreas
E. Rectum
510
Which of the following statements is true regarding the right recurrent laryngeal nerve?
A. It hooks around the ligamentum arteriosum and ascends in the groove between the trachea and the esophagus on the right side.
B. It supplies the cricothyroid muscle which is responsible for tensing the vocal cord.
C. It branches to become the right vagus.
D. It loops around the right subclavian artery and ascends between the trachea and esophagus.
E. All of the statements are true.
511
Dorsalis pedis pulse can be appreciated:
A. Between the the tendons of flexor digitorum longus and flexor hallucis longus
B. Between the tendons of extensor hallucis longus and extensor digitorum longus
C. Between the anterosuperior iliac spine and the symphysis pubis
D. Midway between the medial and lateral maleoli on the front of the ankle
E. Both B and D are correct
512
A 23 year-old-man was rushed to the hospital after sustaining multiple physical injuries after jumping from a moving bus. X-ray of the
humerus revealed midshaft fracture. Which of the following nerves would most likely be injured?
A. Ulnar
B. Radial
C. Median
D. Musculocutaneous
E. Axillary
513
ECG of a 74 year old-male complaining of chest heaviness revealed ST-segment elevation in leads II, III and aVF. This signifies?
A. Inferior wall myocaridal infarction
B. Inferior wall myocaridal ischemia
C. Anterolateral wall infarction
D. Anterolateral wall ischemia
E. None of the above
514
An orogastric tube was inserted all the way to the 24-inch mark to a 57 year old male who had an episode of hematemesis. Where is the tip of
the tube located?
A. esophagus
B. cardia of stomach
C. pylorus
D. duodenum
E. Ileum
515
Which of the following is true of jejunum but not of ileum?
A. Jejunum is longer compared to ileum.
B. Jejunum is wider bored, thicker walled and redder than the ileum.
C. Aggregations of lymphoid tissue (Peyer's patches) are present in the mucous membrane of the jejunum.
D. There are no plicae circulares in the jejunum.
E. Jejunal mesenteric vessels receives numerous short terminal vessels that arise from more than 4 arcades.
516
The following are boundaries of the site where breath sounds are best heard except:
A. Latissimus dorsi
B. Trapezius
C. Medial border of scapula
D. External oblique muscle
E. None of the above
517
The following muscles elevate the ribs and increase the anteroposterior, transverse and vertical diameters of the thoracic cage except:
A. Serratus posterior inferior
B. External intercostal
C. Innermost intercostal
D. Subcostal
E. None of the above
518
The following statements concerning the dermatomes are true except:
A. The C5 dermatome includes the tip of the shoulder on the same side.
B. The C8 dermatome includes the thumb on the same side.
C. The T10 dermatome lies over the skin of the umbilicus.
D. The L4 and L5 dermatome runs along the medial side of the foot and big toe.
E. The S1 dermatome includes the lateral side of the foot and the small toe.
519
The cremaster muscle raise the testis and the scrotum upward for warmth and for protection againsts injury. The cremasteric fascia is a derivative
of:
A. Superficial fascia
B. External oblique muscle
C. Transversalis fascia
D. Internal oblique muscle
E. Peritoneum
520
A 30 year old man involved in a car accident was rushed to the ER with severe lower abdominal pain and gross hematuria. Radiologic evaluation
revealed pelvic fracture. Which of the following statements regarding bladder rupture is not true?
A. The bladder may rupture intraperitoneally if the superior wall of a full bladder was injured.
B. The bladder may rupture intraperitoneally or extraperitoneally.
C. Urine and blood escape freely into the peritoneal cavity in extraperitoneal bladder rupture.
D. Extraperitoneal bladder rupture occurs when bony fragments pierce the anterior part of the bladder wall below the level of peritoneal
reflection.
E. All of the statements are correct.
521
The foremost example of a saddle joint
A) 2nd carpometacarpal
B) 2nd metatarsophalangeal
C) 1st metatarsophalangeal
D) 1st carpometacarpal
522
A surgeon tells a medical student to tap the side of the face of a patient who just had thyroid surgery. The surgeon is most worried about damage
to which of the following vessels?
A) Common carotid artery
B) External carotid artery
C) Anterior jugular vein
D) Superior and inferior thyroid artery
523
A 45-year-old woman comes into the ER with abdominal pain that has progressively worsened since the previous night. Imaging reveals that a
loop of small intesting has passed through the epiploic foramen into the omental bursa and is constricted by the margins of the foramen. This
should not be surgically relieved because this procedure would risk cutting the
A) Abdominal aorta
B) Hepatic artery
C) Hepatic vein
D) Pancreatic duct
524
The 2nd rib is atypical because of this feature?
A) groove for subclavian vessels
B) only 1 facet that articulates with a single vertebrae
C) tuberosity for serratus anterior
D) contains the scalene tubercle
525
A 16-year-old teenage boy tried to commit suicide by slashing his wrist after his girlfriend of one week broke up with him. He sustained “suicide
cuts” on the lateral side of his wrist, most likely sparing the:
A) Radial artery
B) Median nerve
C) Flexor carpi radialis tendon
D) Ulnar artery
526
An IVP is performed on a patient to evaluate the function and structure of her kidneys. Examination of the resulting radiographs reveal that the
left kidney is normal but that there is a duplication of the ureter and renal pelvis on the right side. Further testing reveals that kidney function is
normal. This variation is a result of abnormal development of which of the following structures?
A) Ureteric bud
B) Metanephric blastema
C) Mesonephric duct
D) Mesonephric tubules
527
A 12-year-old boy falls from a tree he is climbing, but catches himself on a branch with his right hand. He swings by his right arm and jumps to
the ground. Several hours later he presents to the ER with right hand clumsiness. Which of the following structures has he most likely injured?
A) Lower trunk, brachial plexus
B) Axillary nerve
C) Musculocutaneous nerve
D) Radial nerve
528
A gastric biopsy is performed on a 42-year-old male. The specimen is observed to have numerous cells with apical membrane-bound
secretion granules in the gastric glands. From which area of the stomach was the biopsy taken
A) Cardiac region
B) Columns of Morgagni
C) Fundic region
D) Pyloric region
529
A 52 y/o male has had a chronic cough with occasional low- volume hemoptysis for the past three weeks. He is a two pack-per-day cigarette
smoker, and drinks three to four cans of beer on weekends. PE reveals right-sided face and right arm swelling and engorgement of subcutaneous
veins on the right side of the neck. Which of the following veins is most likely obstructed in this patient?
A) External jugular
B) Subclavian
C) Brachiocephalic
D) Superior vena cava
530
Most of the muscles of the buttocks insert in the
A) Quadrate tubercle
B) Greater tuberosity
C) Lesser trochanter
D) Greater trochanter
531
After a motor vehicle accident, a patient is brought to the emergency room. Xrays reveal that she has fractures of her left ninth and tenth ribs. She
has a rapid heart rate and low blood pressure. Peritoneal lavage reveals free blood in the peritoneal cavity. A surgeon is able to stop the bleeding
by placing a clamp across which of the following structures?
A) Falciform ligament
B) Gastrosplenic ligament
C) Splenorenal ligament
D) Hepatoduodenal ligament
532
The glossopharyngeal nerve is transected accidentally during a surgical procedure in a 45 y/o male. Which of the following is most likely lost in
this patient?
A) Taste sensation from the anterior 2/3 of the tongue
B) General sensation from the tonsillar lining
C) Salivary secretion from the submandibular gland
D) Protrusion of the tongue
533
Laceration of the male urethra just inferior to the urogenital diaphragm would likely result in extravasation of urine into all of the following
regions except
A) The abdominal wall between Scarpa's fascia and deep fascia
B) The anal triangle between superficial fat and deep fascia
C) The penis between the superficial fascia and deep (Buck's) fascia
D) The urogenital triangle between the deep layer of superficial (Colle's)
534
A 5-year-old male with a bounding pulse has a thrill best palpated over the upper left sternal edge. A continuous murmur is heard over the area
on cardiac auscultation. If surgery is planned, the surgeon should intervene on a derivative of which of the following embryologic structures?
A) Sinus venosus
B) Bulbus cordis
C) 4th aortic arch
D) 6th aortic arch
535
In portal hypertension, which of the following veins will not engorge and is not a collateral of the circulation?
A) Inferior rectal
B) Middle rectal
C) Esophageal
D) Hepatic
536
In performing a cricothyrotomy, an incision should be made at which of the following locations?
A) Cricothyroid membrane, at the junction of clavicle and sternum
B) Cricothyroid membrane, between the thyroid cartilage and cricoid cartilage below
C) Thyrohyoid membrane, between the thyroid cartilage and hyoid bone
D) Sternal notch, at the junction of the clavicle and sternum
537
The structure that serves as a landmark in doing pudendal block anesthesia through a transvaginal approach is the
A) Ischial spine
B) Iliac crest
C) Ischial tuberosity
D) Sacral promontory
538
A neurologic exam of a 34-year-old man reveals a direct and consensual light reflex in his left eye; but neither a direct nor consensual reflex in his
right eye. The nerve involved is the
A) Right optic nerve
B) Left optic nerve
C) Right oculomotor nerve
D) Left oculomotor nerve
539
A wall-climber's primary back muscle is in the following group of muscles as which of the following
A) Serratus posterior
B) Trapezius
C) Splenus cervicis
D) Erector spinae
540
A 17-year-old football player comes to the emergency department hopping on his right foot. An X-ray of the left leg shows a fracture of the neck of
the fibula. Which of the following findings do you most expect on physical examination?
A) Loss of sensation on the sole of the left foot
B) weakened inversion of left foot
C) loss of plantarflexion of the left foot
D) Loss of sensation on the dorsum ofthe left foot
541
A 24/M, gang member, is hit over the right side of his head with a baseball bat during a brawl. He loses consciousness for a few minutes, but
recovers promptly. One hour later, he is found unconscious at his home. The right pupil is fixed and dilated. When he was rushed to the ER, stat
CT done showed lenticular hyperdensity in the temporoparietal area. The blood vessel which most likely bled in this case, is a direct branch of
the:
A. Ophthalmic artery
B. Maxillary artery
C. Internal carotid artery
D. Middle cerebral artery
E. Anterior choroidal artery
542
A 40/F with known tooth infection comes in due to a large, tender, fluctuant mass occupying the left lower side of her face and upper neck
including the underside of the mouth. On examination, the mass is seen pushing up the floor of the mouth on the left side. This patient has an
acute infection of this fascial space which is usually due to dental infection.
A. Visceral
B. Retropharyngeal
C. Submandibular
D. Masticatory
E. Sublingual
543
You are performing the neurologic examination on a 45/M, diagnosed with a skull base tumor. When you asked him to protrude the tongue,
you noted that the tongue deviated to the left; indicating involvement of the:
A. Left glossopharyngeal nerve
B. Right glossopharyngeal nerve
C. Left hypoglossal nerve
D. Right hypoglossal nerve
E. Right vagus nerve
544
Which of the following would necessitate cricothyroidotomy or tracheostomy?
A. Section of the external laryngeal nerve
B. Unilateral partial section of the recurrent laryngeal nerve
C. Bilateral partial section of the recurrent laryngeal nerve
D. Unilateral complete section of the recurrent laryngeal nerve
E. Bilateral complete section of the recurrent laryngeal nerve
545
Knowledge of important airway distances would help in the correct performance of procedures such as endotracheal intubation. What is the
average distance between the incisor teeth and the carina?
A. 15 cm
B. 20 cm
C. 25 cm
D. 30 cm
E. 44 cm
546
A 12/M came in due to epistaxis. Most cases of epistaxis occur on the anterioinferior septum and involve septal branches of the:
A. Posterior ethmoidal artery
B. Anterior ethmoidal artery
C. Facial artery
D. Sphenopalatine artery
E. Greater palatine artery
547
A 40/M, a known case of coronary artery disease, experiences severe crushing pain in the chest referred to the medial side of the arm and
armpit. Which nerve is responsible for the referred pain to the medial side of the arm?
A. Anterior intercostal nerve
B. Posterior intercostal nerve
C. Lateral intercostal nerve
D. Intercostobrachial nerve
E. Lateral cutaneous nerve
548
A patient with carcinoma of the lower third of the esophagus who underwent surgical removal of the lesion also had the stomach, upper half of
duodenum, spleen and omenta removed, because all drain commonly into this group of lymph nodes:
A. Deep cervical
B. Mediastinal
C. Celiac
D. Superior mesenteric
E. Inferior mesenteric
549
A barium swallow can also be used to assess the size of this chamber of the heart:
A. Left atrium
B. Left ventricle
C. Right atrium
D. Right ventricle
550
How many intervertebral discs are there?
A. 21
B. 23
C. 25
D. 27
E. 29
551
A 24/M, a member of the college varsity swimming team, comes in to you complaining of shoulder pain. On examination, you note pain on the
shoulder while in the mid- range of abduction. You are considering rotator cuff tendinitis, due to this muscle rubbing on the acromion because
of a degenerated subacromial bursa.
A. Supraspinatus
B. Infraspinatus
C. Teres minor
D. Teres major
E. Subscapularis
552
An infant was diagnosed to have Erb-Duchenne palsy as a complication of difficult delivery. The right limb was seen hanging limp, rotated
medially and pronated. Which of the following muscles is unaffected in Erb-Duchenne palsy?
A. Supraspinatus
B. Infraspinatus
C. Biceps brachii
D. Subclavius
E. None of the above
553
A 55/F obese, diagnosed case of bilateral knee osteoarthritis, has been using crutches for a year to help her ambulate. She comes in to you
complaining of difficulty in abducting her right shoulder. On examination, you note loss of the rounded contour of the right shoulder and loss of
sensation on the lower half of the right deltoid. Which nerve must have been affected?
A. Medial antebrachial cutaneous nerve
B. Medial cutaneous nerve
C. Axillary nerve
D. Musculocutaneous nerve
E. Median nerve
554
Ureteral stones are most likely to lodge at the narrowest part of the ureter which is at the:
A. Ureteropelvic junction
B. Ureterovesical junction
C. Point at which the ureter crosses over the iliac vessels
D. Pelvic brim
555
You were tasked to perform urethral catheterization on a patient prior to surgery. You note resistance in passing the catheter at the narrowest
part of the urethra which is the:
A. External orifice of the glans penis
B. Membranous urethra
C. Bulbar urethra
D. Prostatic urethra
556
In performing lumbar puncture in an infant, it is important to remember that the spinal cord terminates as low as this vertebral level.
A. L1
B. L2
C. L3
D. L4
E. L5
557
In the adult, the notochord gives rise to the:
A. Spinal cord
B. Vertebral body
C. Annulus fibrosis
D. Nucleus pulposus
E. It has no adult derivatives
558
A 24/M basketball player lands awkwardly from a rebound, and feels that his right knee has hyperextended, bent inward and popped. The knee
becomes swollen over the next few hours. On PE, you note a positive Lachman test. The patient has suffered a tear in the ligament which
prevents:
A. Anterior displacement of the tiba on the femur
B. Posterior displacement of the tibia on the femur
C. Adduction of the leg at the knee
D. Abduction fo the leg at the knee
559
A 35/M, known case of Pott's disease, developed a psoas abscess.. On PE, you noted that he had 1+ patellar tendon reflex on the same side and he
had difficulty walking. What nerve is involved?
A. Femoral nerve
B. Obturator nerve
C. Sciatic nerve
D. Genitofemoral nerve
E. Pudendal nerve
560
The germinal epithelium of the ovary is an example of:
A. Simple squamous epithelium
B. Stratified squamous epithelium
C. Simple columnar epithelium
D. Stratified columnar epithelium
E. Simple cuboidal epithelium
561
the structure which passes along the borders of the Simons triangle is the:
a. recurrent laryngeal nerve
b. median nerve
c. superficial peroneal nerve
d. greater auricular nerve
562
the weight of the thyroid gland in a normal adult is:
a. 20g
b. 30g
c. 40g
d. 45g
563
the esophagus is lined by this epithelium
a. stratified squamous
b. simple columnar
c. stratified cuboidal
d. pseudostratified columnar
564
the smooth portion of the ventricles of the heart is derived from
a. primitive ventricle
b. bulbos cordis
c. sinus venosus
d. none of the above
565
a patient presents to the trauma center after a vehicular crash with tachypnea and hypotension. the trachea is deviated to the right with
decrease pulses on both arms and legs. as an initial/immediate life saving procedure, the physician should access the thorax through
a. right 2nd ICS MCl
b. right 5th ICS MAL
c. left 2nd ICS MCL
d. left 2nd ICS MAL
566
blood cell component with the longest half life
a. basophil
b. rbc
c. platelet
d. neutrophil
567
osteoid is predominantly produced by:
a. osteoblast
b. osteoclast
c. osteocyte
d. all of the above
568
branchial arch derivative of the stylopharyngeus is:
a. branchial arch 1
b. branchial arch 2
c. branchial arch 3
d. branchial arch 5
569
oxyphil cell is found in:
a. parathyroid gland
b. pituitary gland
c. adrenal gland
d. thyroid gland
570
the vein that joins the subcostal vein to form the azygos vein is:
a. ascending lumbar
b. musculophrenic
c. ascending phrenic
d. superior epigastric
571
fracture of the humeral midshaft produces this abnormality:
a. inability to flex the elbow joint
b. numbness of the medial portion of the palm
c. inability to extend wrist joint
d. inability to abduct the upper arm
572
the epithelial covering of the lens of the eye is:
a. simple squamous
b. simple cuboidal
c. simple columnar
d. pseudostratified cuboidal
573
the sternal angle of Louis coincides with this vertebral level
a. C4
b. T4
c. T8
d. C6
574
the left gastroepiploic vein drains to the
a. splenic vein
b. SMV
c. IMV
d. Poral vein
575
the major blood supply to the femoral head is
a. medial circumflex artery
b. lateral circumflex artery
c. feeding artery to the femoral head
d. deep femoral artery
576
drainage of the nasolacrimal duct is towards the:
a. superior meatus
b. middle meatus
c. inferior meatus
d. oropharynx
577
a person was stabbed at the transpyloric area through the neck of the pancreas. which of the following structures will be least affected:
a. SMA
b. IMA
c. Splenic vein
d. Portal vein
578
most common site Of ureteral obstruction:
a. ureteropelvic junction
b. pelvic brim level
c. ureterovesical junction
579
the most common hernia in females
a. direct
b. indirect
c. femoral
d. obturator
580
craniophayngioma would present with what visual field defect
a. binasal hemianopsia
b. bitempora hemianopsia
c. right/left homonymous hemianopsia
d. right superior quantantanopsia
581
In endocrine histology, the presence of oxyphil cells will tell us that the tissue specimen came from what organ?
A. Thyroid gland
B. Parathyroid gland
C. Pituitary gland
D. Adrenal gland
E. Gonads
582
Which is the most proximal part of the respiratory conducting system that has absent goblet cells and submucous glands?
A. Lobar bronchi
B. Segmental bronchi
C. Terminal bronchioles
D. Respiratory bronchioles
E. Alveolar ducts
583
A 32 yr old biker fell and sustain lacerations in the right arm with suspicious fracture. In the ER, X-rays were requested which showed fracture
in the midshaft of the humerus.
Which of the following muscles would exhibit weakness?
A. Coracobrachialis
B. Brachialis
C. Brachioradialis
D. Pronator teres
E. Flexor digitorum profundus
584
A patient sustain an injury in the posterior cord of the brachial plexus. The following actions are compromised EXCEPT?
A. Medial rotation of the shoulder
B. Supination of the forearm
C. Elevation of the trunk
D. Extension of the forearm
E. Lateral rotation of the shoulder
585
Which of the following muscles abducts, flexes and laterally rotates the thigh at the knee joint?
A. Sartorius
B. Tensor fascia lata
C. Rectus femoris
D. Gracilis
E. Pectineus
586
A varsity basketball player had an audible pop in his right knee upon landing from a jump shot. This was accompanied by excruciating pain and
swelling of the knee joint. To check for possible ligamental tear, the rehabilitation medicine specialist asked the patient to lie down and perform
the anterior drawer test by doing this maneuver?
A. Forward sliding of the femur on the tibia due to rupture of either the anterior or posterior cruciate ligament
B. Forward sliding of the femur on the tibia due to rupture of the posterior cruciate ligament
C. Forward sliding of the tibia on the femur due to rupture of the posterior cruciate ligament
D. Forward sliding of the femur on the tibia due to rupture of the anterior cruciate ligament
E. Forward sliding of the tibia on the femur due to rupture of the anterior cruciate ligament
587
Which is the final draining vessel of the conventional aqueous humor outflow pathway?
A. Orbital veins
B. Trabecular meshwork
C. Schlemm's canal
D. Episcleral veins
E. Aqueous veins
588
A 60 yr old patient with known atherosclerotic heart disease suddenly complain of an acute onset blurring of vision, in which stroke was
entertained. MRI shows that the lesion involved the cerebral cortex supplied by the left posterior cerebral artery, what visual field defect is
expected?
A. Right homonymous hemianopsia without macular sparing
B. Left homonymous hemianopsia without macular sparing
C. Bitemporal hemianopsia without macular sparing
D. Right homonymous hemianopsia with macular sparing
E. Left homonymous hemianopsia with macular sparing
589
An otorhinolaryngologist is examing the tympanic membrane of a 20 yr old patient with chronic otitis media. He knows that the external
auditory canal is divided into a?
A. 1/2 outer bony portion and 1/2 inner cartilaginous portion
B. 1/3 outer cartilaginous portion and 2/3 inner bony portion
C. 1/3 outer bony portion and 2/3 inner cartilaginous portion
D. 2/3 outer cartilaginous portion and 1/3 inner bony portion
E. 2/3 outer bony portion and 1/3 inner cartilaginous portion
590
A patient had been in a car accident wherein he suffered superfical lacerations but the neurologic exam was normal. 6 months later, he complains
of loss of pain and temperature sensations in the hands and forearm. This progressed to include mild weakness of hand grip and extension of
the sensory loss to the arm and shoulders. An MRI of the spinal cord shows a cyst in a segment of the spinal cord. This pathology is consistent
with?
A. Anterior cord syndrome
B. Central cord syndrome
C. Brown-Sequard's syndrome
D. Posterior cord syndrome
E. Tabes dorsalis
591
During thyroidectomy, the surgeon accidently ligated the right recurrent laryngeal nerve. Which of the following actions on the vocal cord by
the muscles of phonation is SPARED?
A. Tenses
B. Abducts
C. Adducts
D. Relaxes
E. Opens
592
A athlete had just finsihed running a marathon. He has labored breathing. The following muscles are responsible for inspiration EXCEPT?
A. External intercostal
B. Innermost intercostal
C. Serratus posterior superior
D. Serratus posterior inferior
E. Subcostal
593
In the embryology of the primitive heart, which of the following is INCORRECTLY paired?
A. Truncus arteriosus = Pulmonary trunk
B. Bulbus cordis = Right atrium
C. Sinus venosus = Coronary sinus
D. Primitive atrium = Left atrium
E. Primitive ventricle = Left Ventricle
594
A 12-yr old boy was eating hurriedly when the school bell rang which signaled the end of recess period. He suddenly choked while swallowing
the siomai whole without chewing. Heimlick maneuver was done but was unsuccessful to dislodge the food from the airways. Rigid
bronchoscopy was done. The siomai is most likely lodge in the?
A. Posterior bronchopulmonary segment of the right superior lobe
B. Posterior bronchopulmonary segment of the left superior lobe
C. Superior bronchopulmonary segment of the right inferior lobe
D. Inferior lingular bronchopulmonary segment of the left superior lobe
E. Posterior basal bronchopulmonary segment of the right inferior lobe
595
The abdominal cavity is lined by the peritoneum. Which fo the following is TRUE regarding the peritoneum?
A. The peritoneum is divided into two continuous layers, the parietal peritoneum investing the organs and the visceral peritoneum lining the
internal surface of the the abdomino- pelvic wall.
B. The pain fibers subserving the parietal peritoneum is primarily sensitive to stretching.
C. The duodenum, pancreas, and transverse colon are retroperitoneal organs.
D. Pain in the visceral peritoneum is generally localized.
E. The peritoneal cavity is the space between the parietal and visceral peritoneum that contains 50 mL of serous fluid to allow sliding between
the layers.
596
A patient undergone upper GI endoscopy for recurrent peptic ulcer disease. At what level of the gastrointestinal tract is the scope in at 40 cm
from the central incisors?
A. Lower esophageal sphincter
B. Cardia of the stomach
C. Body of the stomach
D. Antrum of the stomach
E. Pylorus
597
A trauma surgeon operated on a patient who had a gunshot wound. In running the bowel, the surgeon differentiates the small intestines because
he knows that the jejunum has the following characteristics EXCEPT?
A. Deeper red color
B. Thinner walls
C. Fewer arcades
D. Longer vasa recta
E. Larger plica circularis
598
What is TRUE regarding the ligametum teres?
A. It forms a border of between the quadrate lobe and the left lobe of the liver.
B. It is a remnant of the right umbilical vein.
C. It contains the portal triad that enters the liver at the porta hepatis.
D. It divides the liver into a left and right lobe.
E. It is a remnant of the ductus venosus
599
In doing pelvic surgery, you noticed that there is a nerve found anterior to the psoas muscle, this is probably the?
A. Iliohypogastric nerve
B. Ilioinguinal nerve
C. Genitofemoral nerve
D. Femoral nerve
E. Obturator nerve
600
Which of the following is NOT located in the deep perineal space in males?
A. Root of the penis
B. Bulbourethral gland
C. Dorsal nerve of the penis
D. Sphincter urethra
E. Deep transverse perineal muscle
601
Adult venous system is derived from the following embryonic structures, EXCEPT:
A. Vitelline vein
B. Umbilical vein
C. Cardinal vein
D. Sinus venosus
E. None of the above
602
EG, 47-year old female, known hypertensive and diabetic, went to your clinic due to sudden onset of left-sided facial weakness. On examination,
you noted that there was asymmetry in facial expression with lagging noted on the left side, blunting of left nasolabial fold and inability to close
the left eyelid. If you are considering Bell's palsy, which of the following is consistent with this finding?
A. Loss of sensation on left side of the face
B. Loss of sensation on right side of the face
C. Unable to wrinkle left side of the forehead
D. Able to wrinkle both side of the forehead
E. A and C
603
A 25-year old male presents with severe colicky lumbar pain on the right. KUB was done, revealing a radioluscent stone, that is most likely
lodged where?
A. Mid-ureter
B. Point where ureter enters the pelvic brim
C. Ureteropelvic junction
D. Point where ureter enters the bladder
E. Any of the above
604
Pringle maneuver involves compression of which of the following?
A. Portal vein
B. Bile duct
C. Hepatic artery
D. All of the above
605
Femoral sheath encloses the following, EXCEPT:
A. Femoral nerve
B. Femoral artery
C. Femoral vein
D. Lymph vessels
E. None of the above
606
The following structures pass through the esophageal perture of the diaphragm, EXCEPT:
A. Right vagus
B. Left gastric vesses
C. Esophagus
D. Lymphatics from lower 3rd of esophagus
E. None of the above
607
A 26-year old male came from a fist fight and was brought to your clinic due to difficulty moving the eyeball. MRI revealed isolated rupture of
annulus of zinn. Which of the following eye muscles whose origin would remain unaffected?
A. Lateral rectus
B. Superior rectus
C. Inferior rectus
D. Superior oblique
E. None of the above
608
During thyroidectomy, the first major blood vessel to be encountered is:
A. Anterior jugular vein
B. External jugular vein
C. Internal jjugular vein
D. Subclavian vein
E. A and B
609
Most common blood supply of the SA node comes from the:
A. Left coronary artery
B. Right coronary artery
C. Left circumflex artery
D. Right marginal artery
E. A and C
610
If the 3rd branchial arch fails to form or mature, which of the following clinical manifestation would be observed?
A. No facial expression would be appreciated
B. Deafness
C. Hoarseness
D. Decreased secretion of parotid gland
E. All of the above
611
The following layers of the anterior abdominal wall give rise to an equivalent covering of scrotal and spermatic fascia, EXCEPT:
A. Subcutaneous fascia
B. External oblique
C. Internal oblique
D. Transversus abdominis
E. A and C
612
A 35-year old male presented with enlarged scrotum on the left. Examination of the scrotal content revealed appearance of "bag of worms."
Which of the following clinical condition/s is/are considered?
A. Varicocoele
B. Orchitis
C. Renal carcinoma
D. B and C
E. A and C
613
Which enteroendocrine cells produce a compound that promotes insulin secretion and inhibits glucagon production?
A. L cells
B. S cells
C. K cells
D. I cells
E. None of the above
614
An athlete suffered from fracture of his left medial malleolus, transecting all structures behind it. Which of the following will NOT be affected?
A. Tibialis posterior
B. Posterior tibial artery
C. Posterior tibial nerve
D. Flexor hallucis longus
E. Deep peroneal nerve
615
Tranverse fracture of the humeral mid-shaft would result to:
A. Loss of sensation on anterior forearm
B. Claw hand
C. Ape hand
D. Inability to extend wrist
E. A and C
616
A stroke patient was found to have a necrotic focus on the brain, specifically identified as Brodmann areas 44 and 45. The patient is then expected
to:
A. have difficulty in speaking but can comprehend
B. have difficulty understanding but can speak
C. not be able to hear and interpret sounds
D. not be able to associate visual input to other information
E. none of the above
617
A trauma patient was found to have total obliteration of foramen rotundum. Which of the following clinical condition would be a finding in this
patient?
A. Loss of sensation along the maxillary area of the face
B. Loss of sensation along the mandibular area of the face
C. Epidural hemorrhage
D. A and C
E. B and C
618
The widest and most dilatable portion of the male urethra:
A. Membranous
B. Spongy
C. Penile
D. Prostatic
E. B and C
619
Arthrocentesis is most difficult to carry out in which joint?
A. Knee
B. Elbow
C. Ankle
D. Wrist
E. A and C
620
Histopath cross-section of the gallbladder shows the following features, EXCEPT:
A. Tall columnar epithelium with microvilli
B. Muscularis mucosae
C. Muscularis
D. Adventitia
E. A and C
621
A part of anterior pituitary gland which has a small collar cells around infundibular stalk that mainly contains the portal venules.
A. Pars Distalis
B. Pars Intermedia
C. Pars Tuberalis
D. Pars nervosa
E. None of the above
622
Which portion or zone of the liver acinus is exposed to blood high in oxygen content and nutrients , and is primarily involved in the pathology of
preeclampsia /eclampsia?
A. Centrilobular
B. Periportal
C. Midzonal
D. Space of Disse
E. Sinusoids
623
The inferior parathyroid glands are derived from which branchial pouch?
A. 1st
B. 2nd
C. 3rd
D. 4th
E. A and B
624
Diaphragm is the most important muscle of inspiration. Which embryonic structure gives rise to the central tendon of the diaphragm which is
fused partially with the fibrous pericardium of the heart?
A. Pleuroperitoneal membrane
B. Dorsal mesentery of the esophagus
C. Septum transversum
D. Body wall mesenchyme
E. All of the above
625
This structure encloses the kidney and suprarenal gland and blends with the fascia of IVC and aorta.
A. Fibrous capsule
B. Perirenal fat
C. Gerota's fascia
D. Renal fascia
E. C and D
626
A 46 year old patient came to emergency department due to gunshot wound. During physical examination, it was found out that the bullet
entered the sternal area. Which chamber of the heart will most probably be injured in this case?
A. Right atrium
B. Right ventricle
C. Left ventricle
D. Left atrium
E. Diaphragm
627
An aneurysm of the abdominal aorta at the aortic hiatus of the diaphragm is most likely to result in the compression of which of the following
pairs of structures?
A. Vagus nerve and azygous vein
B. Esophagus and vagus nerve
C. Azygous vein and thoracic duct
D. Thoracic duct and vagus nerve
E. Inferior vena cava and phrenic nerve
628
During appendectomy performed at McBurney's point, which of the following structures is most likely to be injured?
A. Deep circumflex femoral artery
B. Inferior epigastric artery
C. Iliohypogastric nerve
D. Genitofemoral nerve
E. Spermatic cord
629
As the uterine artery passes from the internal iliac artery to the uterus, it crosses which of the following structures that is sometimes mistakenly
ligated during pelvic surgery?
A. Ovarian artery
B. Ovarian ligament
C. Uterine tube
D. Ureter
E. Round ligament of the uterus
630
During a game, a 25 year old baseball player receives a severe blow to the head that fractures the optic canal. Which of the following pairs of
structures is most likely to be damaged?
A. Optic nerve and ophthalmic vein
B. Ophthalmic vein and ophthalmic nerve
C. Ophthalmic artery and and optic nerve
D. Ophthalmic nerve and optic nerve
E. Ophthalmic artery and ophthalmic vein
631
What is the lining epithelium of the endocervical canal?
A. Simple columnar
B. Simple squamous
C. Stratified squamous
D. Cuboidal
E. Pseudostratified columnar
632
Communication of the scala vestibuli and scala tympani occurs at the:
A. Oval window
B. Round window
C. Helicotrema
D. Endolymphatic sac
E. None of the above
633
Which of the following is a characteristic of the cornea?
A. It represents the anterior portion of the tunica vasculosa
B. It is the anterior transparent portion of the tunica fibrosa
C. It forms the anterior boundary of the posterior chamber of the eye
D. It is devoid of nerve endings
E. All of the above
634
In a surgical procedure in which you are to remove the gallbladder and therefore you need to ligate the cystic artery. This artery arises from
which of the following?
A. Proper hepatic artery
B. Right hepatic artery
C. Left hepatic artery
D. Right gastric artery
E. Common hepatic artery
635
Mrs. Succor suffered from an embolic infarct. She came in to the emergency department complaining of difficulty in speaking and left arm
weakness. Which of the following arteries is most likely affected?
A. Middle cerebral artery
B. Anterior cerebral artery
C. Vertebral artery
D. Posterior cerebal artery
E. Basilar artery
636
The following veins drain into the coronary sinus EXCEPT:
A. Great cardiac vein
B. Small cardiac vein
C. Middle cardiac vein
D. Anterior cardiac vein
E. None of the above
637
Mrs. Jennifer Marikina is suffering from an ovarian malignancy with hepatic metastasis. After 3 days, you noticed that her abdomen is getting
bigger. On physical examination, there is a positive fluid wave which is highly suggestive that the patient has ascites. Her attending physician
decided to do a paracentesis. The PREFERRED entry site for paracentesis is?
A. Halfway between the umbilicus and the pubic symphysis
B. Between umbilicus and ASIS, lateral to rectus abdominis muscle, Left
C. Between umbilicus and ASIS, lateral to the restus abdominis muscle, Right
D. Between umbilicus and ASIS, medial to the Rectus abdominis
E. Any of the above
638
A 58 year old G8P8 underwent TAHBSO with bilateral lymph node dissection for the high grade cervical cancer. Few hours post-surgery, she
complained that she cannot feel her right inner leg. On your physical examination, impaired right thigh adduction was observed. The
iatrogenically damaged structure is most likely the:
A. Femoral nerve
B. Sciatic nerve
C. Obturator nerve
D. Pudendal nerve
E. Superior gluteal nerve
639
The following structures are parts of the osteon, EXCEPT:
A. Osteocytes
B. Concentric Lamellae
C. Canaliculi
D. Volkmann's canal
E. A and B
640
The structure which has a head and a base that are united by two limbs and is connected to the oval window is the?
A. Incus
B. Malleus
C. Stapes
D. Stapedius
E. Tensor Tympani
641
All of the following are contained in the vertebral canal, EXCEPT?
A. Spinal cord
B. Spinal nerve
C. Dorsal nerve roots
D. Ventral nerve roots
E. Meninges
642
Which of the following is/are true regarding the "yes" joint?
A. Atlanto-occipital joint
B. Atlanto-axial joint
C. Joint between C1 and occipital condyles
D. Joint between C1 and C2
E. choices A and C are both correct
F. choices B and D are both correct
643
The vertebral levels are used as reference points for locating anatomical landmarks. Which among the following choices is/are found at the level
of C4 vertebra?
A. Hyoid bone
B. Start of trachea
C. Cricoid cartilage
D. choices A and B are both correct
E. choices B and C are both correct
644
This is a condition which resulted from chronic stress fracture of Pars interarticularis seen as "collar around the neck of Scottie dog" on Xray.
Usually at the L5 vertebra of adolescent athletes.
A. Spondylosis
B. Spondylolisthesis
C. Ankylosing spondylitis
D. Osteoyelitis
E. Herniation of Nucleus Pulposus
645
During an ER duty, a 24 y/o male patient was brought in due to seizure. History revealed severe ear pain 2 weeks prior to consult, followed by
occasional headaches. Four days PTC, patient complained of fever 38-39 degrees Celsius. Upon PE, patient had (+) meningeal signs. You are
entertaining bacterial meningitis. What vertebral level is ideal to insert the needle for Lumbar Tap?
A. between L1 and L2
B. between L2 and L3
C. between L3 and L4
D. choices A and B are both correct
E. choices B and C are both correct
646
A 32 year-old male patient was brought in the ER due to stabbing. Patient was hypotensive and bleeding profusely from the chest. Despite all
efforts of resuscitation, patient subsequently expired. If the wound was located between the 4th and 5th rib Left parasternal line, the chamber
of the heart that is most likely affected was?
A. Left Atrium
B. Left Ventricle
C. Right Atrium
D. Right Ventricle
647
Volksmann Ischemic Contracture is characterized by severe flexion of the affected arm, wrist and fingers. The following structures are affected
EXCEPT?
A. Midshaft of humerus
B. Brachial artery
C. Median nerve
D. A and B
E. B and C
648
The following are the boundaries of the Anatomical Snuffbox, EXCEPT?
A. Extensor Pollicis Longus
B. Extensor Pollicis Brevis
C. Abductor Pollicis Longus
D. Abductor Pollicis Brevis
E. There is NO exception
649
These granulocytes are described with "bilobulated nucleus" and plays roles in fighting viral infections, as proved by the RNAses they contain.
A. Basophil
B. Eosinophil
C. Neutrophil
D. NK cells
E. Lymphocytes
650
While jogging, a 40 y/o male was bumped by a tricycle on the lateral side of his left leg. Patient was unable to evert his left foot, with weakness
in plantar flexion but normal dorsiflexion. What nerve was affected?
A. Common Peroneal Nerve
B. Superficial Peroneal Nerve
C. Deep Peroneal Nerve
D. Tibial Nerve
E. Common Fibular Nerve
651
You are assigned in the Neuro-OPD and saw a patient who presented with gait instability. Patient was NOT able to perform the "heel-to-shin"
movement. You know that Cerebellum is involved. But what lobe?
A. Anterior lobe
B. Flocculo-nodular lobe
C. Posterior lobe
D. Archi-cerebellum
E. Neo-cerebellum
652
Which among the following spinal cord lesions will present as both upper and lower motor neuron lesion?
A. Poliomyelitis
B. Amyotrophic Lateral Sclerosis
C. Brown-sequard
D. Choices A and B are both correct
E. Choices B and C are both correct
653
The muscles of facial expression are derived from?
A. 1st Pharyngeal Pouch
B. 1st Pharyngeal Arch
C. 2nd Pharyngeal Pouch
D. 2nd Pharyngeal Arch
E. None of the above
654
The internal carotid artery (ICA) supplies the anterior part of the brain through the Circle of Willis. The ICA is a derivative of?
A. Proximal Part of the 3rd Aortic arch
B. Distal Part of the 3rd Aortic Arch
C. Right part of the 4th Aortic Arch
D. Left part of the 4th Aortic Arch
E. None of the above
655
The genioglossus is an extrinsic muscle of the tongue and is responsible for what movement?
A. elevation
B. depression
C. protrusion
D. retraction
E. None of the above
656
A patient with Mallory Weiss tear came to ER due to severe hematemesis, pulsating in character. Knowing the diagnosis, you already know that
the bleeding blood vessel is?
A. Middle esophageal artery
B. Middle esophageal vein
C. Left gastric artery
D. Left gastric vein
E. Descending aorta
657
Which among the following statements is/are true regarding the difference between Jejunum and Ileum?
A. Jejunum is shorter
B. Ileum has more fat
C. Jejunum is thicker
D. B and C only
E. All of the above
658
Which among the following statements is/are true regarding the round ligament of the liver?
A. AKA falciform ligament
B. AKA ligamentum teres
C. From the Left umbilical vein
D. A and C only
E. B and C only
659
The rectum is divided into three (3) anatomical divisions. And its inferior part (distal 3rd) is being supplied by a direct branch of?
A. Inferior Mesenteric Artery
B. Sigmoidal artery
C. Internal pudendal artery
D. A and C only
E. All of the above
660
Which among the following statements is/are true regarding the anatomy of the kidney?
A. 12 pyramids
B. 2 major calyces
C. 3 minor calyces
D. A and C only
E. All of the above
661
Which of the following is bilobed?
A. neutrophils
B. basophils
C. lymphocytes
D. monocytes
E. Platelets
662
Which of the following statements is true?
A. Bronchioles have cartilage plates similar to those of bronchi.
B. Bronchioles have greater amount of smooth muscle than bronchi.
C. Bronchioles are formed when the airways are reduced to a diameter of < 1 cm.
D. Bronchioles have greater number of mucous glands than bronchi.
E. None of the above.
663
The following are found inside the lacunae, except?
A. Osteocytes
B. Osteoclast
C. Osteoblast
D. Chrondrocyte
E. None of the above
664
Protein production for extracellular distribution are produced in the:
A. Smooth ER
B. Rough ER
C. Free ribosomes
D. Nucleus
E. Lysozyme
665
In the respiratory tract, what differentiates the terminal bronchioles from the respiratory bronchioles?
A. The presence of alveoli in respiratory bronchioles
B. Presence of greater number of smooth muscle in respiratory bronchioles
C. Presence of greater number of cilia in respiratory bronchioles
D. Lesser elastic fibers in respiratory bronchioles
E. All of the above
666
Cancer of the esophagus presents with early metastasis due to the absence of which layer?
A. epithelium
B. submucosa
C. Muscularis propria
D. Lamina propria
E. Serosa
667
A 15- year old triathlethe complains of low back pain which is aggravated by activity. Physical examination was normal, no neurological
symptoms were noted. After x-ray of his lumbar spine, he was diagnosed to have spondylolysis. What could be the finding which led to this
diagnosis?
A. Degeneration of pedicles of lumbar vertebrae
B. Formation of bone spurs and osteophytes
C. Ossification of annulus fibrosus
D. Scottie dog collar lesion on L5
E. None of the above
668
A patient came to you presenting with fever, nuchal rigidity and changes in sensorium. Meningitis was among the differentials. Lumbar tap was
contemplated. At what level is lumbar tap usually performed?
A. T12 - L1
B. L1 - L2
C. L3
D. L4 - L5
E. None of the above
669
A trauma patient presented with difficulty of breathing. CXR showed blunting of the right costophrenic angle. You decided to do a CTT insertion
to drain the fliud. At what level would you insert the CTT tube?
A. 4th - 5th ICS R Anterior Axillary Line directed superiorly
B. 4th -5th ICS R Mid - axillary line directed inferiorly.
C. 5th - 6th ICS R Mid- axillary line directed superiorly
D. 5th - 6th ICS R Anterior Axillary Line directed inferiorly
E. None of the above
670
Amphiarthrosis:
A. Symphysis pubis
B. Radio - ulnar joint
C. Atlanto - axial joint
D. wrist
E. Distal interphalangeal joints
671
This muscle is considered the main flexor of the forearm and its innervation.
A. Coracobrachialis muscle, musculocutaneous nerve
B. Biceps brachii muscle, musculocuteneous nerve
C. Brachialis muscle, musculocutaneous nerve
D. Deltoid muscle, musculocutaneous nerve
E. None of the above
672
Psoas sign is considered positive if there is
?
A. Increased tenderness at the RLQ with palpation of the LLQ
B. Pain at the RLQ with hip flexion and internal rotation of the leg
C. Pain on passive extension of the right thigh
D. Pain on slow compression of the abdominal wall with rapid release
E. All of the above
673
A complication of radical mastectomy which presents as difficulty in horizontal extension of the upper extermity involves injury to the?
A. Long thoracic nerve
B. Intercostobrachial nerve
C. Medial pectoral nerve
D. Thoracodorsal nerve
E. Axillary nerve
674
A 60 year old smoker presents with hemoptysis, weight loss, weakness of the upper limbs, fatigue and difficulty in swallowing. Electrolyte levels
show hyponatremia. What could be the possible diagnosis for this patient?
A. Oat cell CA of the lung
B. Adenocarcinoma of the lung
C. Squamous cell CA
D. PTB
E. None of the above
675
Lingula is the embryonic counterpart of which lobe of the lung?
A. Right lower lobe
B. Right upper lobe
C. Right middle lobe
D. Left Lower lobe
E. Left Upper lobe
676
The inferior diaphragmatic surface of the heart is composed mainly of the
A. Left atrium
B. Left ventricle
C. Right atrium
D. Right Ventricle
E. Base of the heart
677
Leaflets of the valves which separates the right atrium form the right ventricle except:
A. anterior
B. septal
C. medial
D. posterior
E. None of the above
678
Most ideal site for paracentesis?
?
A.
B.
C.
D.
E.
midway between symphysis and umbillicus
1 cm to the left of the lateral border of the rectus abdominis at the level of the umbillicus
Immediately above the symphysis pubis
Mc Burney's point
above the umbillicus
679
Which of the following associations is correct?
A. Superficialis fascia : external spermatic fascia
B. Transversalis fascia : Dartos muscle
C. Internal Oblique muscle : Cremasteric muscle
D. Peritoneum : none
E. None of the above
680
Which of the ff structures of the renal hilus is most posterior?
A. Renal artery
B. Renal vein
C. Gerotas fascia
D. Perirenal fat
E. Renal pelvis
681
A 15 yo boy complaining of pain in the lower right part of the anterior abdominal wall was seen by a physician. Upon examination, he was found
to have a temperature of 38.3OC. He had a furred tongue and was extremely tender in the lower right quadrant. The abdominal muscles in that
area were found to be firm on palpation and became more spastic when increased pressure was applied. The organ most likely affected in this
case has the following contributory factors why it is predisposed to infection, except;
A. It is a long, narrow, blind-ended tube, which encourages stasis of large-bowel contents.
B. It is supplied by a long small artery that does not anastomose with other arteries.
C. It has a large amount of lymphoid tissue in its wall.
D. The lumen has a tendency to become obstructed by hardened intestinal contents, which leads to further stagnation of its contents.
682
The following statements concerning the pancreas are correct except which?
A. The pancreas receives part of the arterial supply from the splenic artery.
B. The main pancreatic duct opens into the third part of the duodenum.
C. The uncinate process of the pancreas projects from the head of the pancreas.
D. The bile duct (CBD) lies posterior to the head of the pancreas.
683
What part of the ciliary body does the aqueous humor is formed?
A. Pars optica
B. Pars nervosa
C. Pars pigmentosa
D. Pars plicata
684
The intercellular spaces in the stratum spinosum of the epidermis contain lipid-containing sheets that are impermeable to water. This material is
released from
A. Membrane-coating granules
B. Keratohyalin granules
C. Langerhans cells
D. Sebaceous glands
685
Which of the following is lined by an epithelium containing ciliated cells and Clara cells?
A. Trachea
B. Terminal bronchiole
C. Intrapulmonary bronchi
D. Alveolar duct
686
Which of the following cells in the inner ear are involved in detecting movements of the head?
A. Hair cells in the maculae
B. Cells of Hensen
C. Hair cells in the organ of Corti
D. Inner pillar cells
687
The following statements concerning the stomach are true; except
A. The splenic artery runs along the upper border of the pancreas and lies behind the stomach
B. The lesser curvature of the stomach receives its blood supply from the right and left gastroepiploic arteries
C. The lymph drainage from the gastroesophageal junction passess to the celiac lymph nodes
D. The lesser sac lies behind the stomach
688
Ductus/vas deferens is the main content of the spermatic cord. Among these choices, which is not found in the spermatic cord?
A. Hernia sac
B. Genital branch of the genitofemoral nerve
C. Cremasteric muscle fibers
D. Ilioinguinal nerve
689
You asked a patient to look to the left side during a neurologic examination. Patient’s right eye cannot look to his left, with (+) left eye
nystagmus, but convergence is still intact. In order to produce these symptoms, you suspect that the lesion is most probably located in the
.
A. Right medial longitudinal fasciculus
B. Left abducens nucleus
C. Right cerebral cortex
D. Left abducens nerve
690
Name the ocular defect if the lesion is found in the right lateral geniculate body in the thalamus
A. Left homonymous hemianopsia
B. Left nasal and temporal hemianopsia
C. Bitemporal heteronymous hemianopsia
D. Right nasal hemianopsia
691
What is true regarding lymphatic anatomy?
A. The limb lymphatics are valveless.
B. The lymphatic system begins just below the dermis as a network of fine capillaries
C. RBC and bacteria do not enter the lymphatic capillaries
D. Extrinsic factors (muscle contraction, arterial pulsations, respiratory movement and massage)aid in the movement of lymph flow.
E. All of the above.
692
A 10-yr old girl is brought to her doctor because of hypoplasia of her right breast. On closer examination, she is found to have asymmetry of the
chest wall itself. Which of the following is true regarding this syndrome?
A. This affects i in every 10,000 live births.
B. Deformity of the thoracoacromial joint is characteristic of this syndrome.
C. Absence of the sternum is characteristic of this syndrome
D. Absence of the sterna head of the pectoralis muscle is a characteristic of this syndrome.
E. Pectus excavatum is part of this syndrome..
693
Which of the following statements is most accurate regarding branchial cleft anomalies?
A. Third arch anomalies are common
B. Type II 1st branchial anomalies are the most common over-all.
C. The glossopharyngeal nerve is asso. with the 3rd branchial arch.
D. Second arch anomalies end in pyriform sinus.
694
True of liver anatomy:
A. The right lobe extends to the umbilical fissure and falciform ligament.
B. The left lobe end at the falciform ligament.
C. The quadrate lobe is a portion of the medial segment of the right lobe.
D. The lateral segments of the left lobe in the American system consists of segments II & III.
695
All except one drains into the right atrium through the coronary sinus:
A. small cardiac
B. middle cardiac
C. anterior cardiac
D. great cardiac
696
The muscle and central tendon of the diaphragm develop from which of the following embryonic structures?
A. Septum transversum
B. Pleuroperitoneal membranes
C. Dorsal mesentery of esophagus
D. Ventral mesentery of esophagus
697
The blood supply to the thoracic wall mainly comes from the
artery.
A. Lateral thoracic
B. Internal thoracic
C. Posterior intercostals
D. Subcostal
698
I.M. injections should be given in the upper outer quadrant of the buttocks to prevent damage to which of the following nerves?
A. Sciatic
B. Obturator
C. Superior gluteal
D. Lateral femoral cutaneous
699
This ligament prevents posterior dislocation of the femur at the knee joint.
A. Anterior cruciate
B. Ischiofemoral
C. Lateral collateral
D. Posterior cruciate
700
A neurologic exam of a 34 yr-old man reveals a direct and consensual light reflex in his left eye but neither in his right eye. The nerve involved is
the:
A. right optic nerve
B. left optic nerve
C. right oculomotor
D. left oculomotor
Item #
ANSWER
1
2
3
4
5
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84
85
86
KEY
E
E
B
A
C
B
E
D
B
A
C
C
A
E
C
C
D
E
C
D
A
C
D
B
A
B
D
D
C
D
C
C
B
B
C
E
E
A
B
C
C
B
A
B
A
C
A
E
E
C
D
C
C
A
B
E
B
B
C
B
C
A
D
B
B
BONUS
E
D
B
C
B
B
D
E
B
D
C
A
D
C
A
D
B
B
A
D
87
88
89
90
91
92
93
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157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
B
A
A
A
B
B
C
D
B
C
B
E
C
C
D
D
A
C
B
D
A
B
A
C
E
D
B
C
D
A
B
E
A
C
C
A
E
E
C
B
A
B
C
D
B
A
B
C
A
B
D
D
D
E
B
A
A
E
B
B
D
B
A
A
E
B
E
A
B
B
B
A
C
D
D
A
B
B
E
A,B
C
A
E
B
A
B
C
B
175
176
177
178
179
180
181
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261
262
D
E
C
D
A
C
A
D
C
D
B
C
B
A
C
B
E
D
C
B
B
A
B
D
C
C
C
A
A
C
B
D
B
B
B
A
B
D
C
A
D
C
B
A
D
B
C
A
C
C
B
A
A
C
C
C
B
A
C
D
C
C
D
C
A
B
A
C
A
C
C
D
C
D
B
B
B
B
C
C
D
D
C
B
C
C
E
D
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
B
D
B
C
B
D
B
B
B
A
B
A
A
A
D
D
C
B
A
D
B
B
E
C
C
B
E
A
E
C
E
D
C
A
C
D
B
D
C
A
D
A
B
D
C
C
C
A
B
C
A
C
A
B
E
B
D
C
D
A
E
C
C
B
B
E
B
E
C
C
D
D
C
B
E
B
C
C
A
B
B
C
C
D
C
C
B
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
B
C
A
C
A
B
A
C
B
A
C
A
B
C
C
C
D
C
D
D
A
A
B
D
D
D
C
C
C
B
B
C
C
D
E
A
D
D
B
D
A
C
B
C
B
A
B
B
B
C
D
E
D
C
B
A
B
D
A
C
D
A
D
B
A
E
B
E
B
B
B
A
B
C
D
B
B
D
B
B
D
C
A
B
A
D
B
D
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523
524
525
526
527
C
D
C
E
B
B
C
A
D
D
E
D
B
A
E
C
D
E
B
D
C
D
D
B
A
D
C
C
A
A
A
D
D
A
B
D
E
A
E
A
A
C
A
B
C
A
C
D
D
A
B
B
C
A
B
D
C
B
D
C
B
C
D
C
A
C
C
D
A
A
B
D
E
B
A
D
B
D
A
B
D
C
D
D
B
C
D
A
A
528
529
530
531
532
533
534
535
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
586
587
588
589
590
591
592
593
594
595
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
C
C
D
C
B
B
D
D
B
A
C
B
D
B
C
C
C
B
D
D
C
A
B
A
E
C
B
A
C
D
A
A
E
A
A
A
B
C
B
A
C
A
A
C
B
B
A
A
C
B
A
B
B
B
C
C
B
A
E
A
D
B
B
A
D
B
E
E
A
B
A
C
A
D
C
C
C
A
E
D
A
B
D
D
E
A
E
D
A
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655
656
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
687
688
689
690
691
692
693
694
695
696
697
698
699
700
A
D
C
B
C
B
C
C
E
B
C
C
D
C
A
C
B
B
A
D
B
C
D
C
B
E
A
A
C
D
A
D
B
B
A
E
D
B
C
C
E
E
C
E
B
B
C
B
A
E
D
D
D
A
C
C
D
A
C
B
C
A
C
E
B
B
D
A
B
A
B
D
A
A
D
D
C
D
C
A
C
A
A
C