SURGERY PRIMARY EXAMINATION

QUESTIONS
WEST AFRICAN COLLEGE OF SURGEONS
For each of the following Multiple choice Questions choose the MOST appropriate answer
001 Which of the following is not increased during
exercise?
A Respiratory rate
B Stroke volume
C heart rate
D total peripheral resistance
E. Systolic blood pressure.
002 Which of the following organs has the greatest
blood flow per 100g of tissue?
A brain
B heart muscle
C Skin
D liver
E The kidney
003 Which of the following organs has the most
permeable capillaries?
A the brain
B posterior pituitary gland
C liver
D small intestines
E The kidney
004 Which of the following is responsible 4 the
movement of oxygen from the alveoli into the blood in
the pulmonary capillaries?
A Active transport
B filtration
C Secondary active transport
D Facilitated diffusion
E simple diffusion
005 Which of the following has the greatest buffering
capacity in the intestinal fluid?
A The haemoglobin system
B carbonic acidbicarbonate system
C The phosphate system
D protein in the intestinal fluid
E the ammonium-ammonia system
006 which of the following has the greatest effect on
the ability of the blood to transport oxygen
A capacity of the blood to dissolve oxygen
B amount of haemoglobin in the blood
C the pH of plasma
D the CO2 of the RBC
E the temperature of the blood
007 which of the following discharge spontaneously
during quiet breathing!
A Respiratory neurons

B
C
D
E

Motor neurons to respiratory muscles

Neurons in the apneustic centre
expiratory neurons
stretch receptors in the lungs

008
A
B
C
D
E

Glucose reabsorption occurs in

Proximal tubule
Loop of Henle
Distal tubule
cortical collecting duct
medullary collecting duct

009 An irregular rapid heart rate with normal QRS

complex and no P waves suggests:
A Sinus arrhythmia
B Second degree heart block
C Paroxysmal tachycardia with a ventricular pace
maker
D Atrial fibrillation
E pulmonary embolism
010 Which of the following tend to produce oedema in
the tissues?
A Increased precapillary vascular resistance
B Decreased postcapillary vascular resistance
C increased plasma colloid osmotic pressure
D Increased venous pressure
E Decreased precapillary hydrostatic pressure
011 Under normal conditions which of the following
has the lowest renal clearance?
A Urea
B creatinine
C Sodium
D glucose
E water
012 Damage to which of the following areas of the brain
results in anterograde amnesia?
A Prefrontal cortex
B occipital cortex
C The amygdala
D hippocampus
E thalamus
013 What chemical component of gall stones renders
them radio opaque?
A Calcium
B bile salts
C bilirubin
D cholesterol
E phospholipids

__________________________________________________________________________________________________________
Let the Knowledge flow. The more specialists we have the better our health care delivery is Likely to be.
Remember your responsibility is first and fore most To your God, to your conscience, to your oath, to your patient and to your
Nation.
Courtesy of Dr Muslim Goodheart.

Dedicated to all those interested in the progress of surgery on our continent

014
A
B
C
D
E

Serum rennin increases when there is a fall in blood

Calcium ions
Arterial blood pressure
Osmolarity
pH
Circulatory adrenocorticotropic hormone

015
A
B
C
D
E

impulses to postganglionic cells can be blocked by:

Acetylcholine Adrenaline Curare
Noradrenaline
Atropine

016
A
B
C
D
E

A receptor which does not adapt to a stimulus is:

Phasic
tonic
Not found in man
hyperpolarised
Assoc with chemoreceptors

017 In the normal adult male the total energy reserve

from carbohydrate stores is:
A 4,000 K calories
B 2,000 K calories
C 3,500 K calories
D 2,500
K calories
E 1,000
K calories.
018 The approximate minimum daily requirement of
iodine in adult human in microgrammes is:
A 120
B 140
C 500
D 100
E 150
119 The following is NOT true of calcium metabolism:
A About 500mmol per day is exchangeable in bone
B 60% of filtered calcium is reabsorbed in the distal
convoluted tubule
C Absorption in the intestine is by active and passive
transport
D Intestinal absorption is NOT directly influenced by
the parathormone
E the total body store in the adult male is 27.5mmol
20 In haemostasis, following the division of a small
blood vessel, the following occur EXCEPT
A Local vasoconstriction
B Release of tissue thromboplastin
C Thromboplastin induced platelet agglutination
D Activation of intrinsic clotting system
E Activation of the extrinsic clotting system.
021 The actions of endothelins include the following
ECEPT
A Vasoconstriction
B Increased sodium reabsorption in the kidney

C stabilisation of cell membrane

D bronchodilation
E gluconeogenesis
022
A
B
C
D
E

The following occur during muscle contraction:

Motor neuron discharge
generation of action potential in the muscle fibres
binding of acetylcholine to muscarinic
acetylcholine receptors
Ca2+ release from the sarcoplasmic reticulum
Shortening of the muscle fibre.

023 Secretion of rennin from juxtaglomerular cells of

the kidney is mediated by:
A 1-adrenergic receptors
B 2-adrenergic receptors
C 1-adrenergic receptors
D 2 -adrenergic receptors
E None of the above.
024 Concerning micturition
A the first urge to micturate is fell when the bladder
volume is 100ml
B the motor nerves to the detrussor muscle are the
hypogastric nerves L1-L3
C the external sphincter is supplied by the
parasympathetic nerves from S2, S3. S4
D after urination the male urethra empties by gravity.
E None of the above.
025 Which of the following nerves carries both afferent
and efferent impulses in deglutition?
A Trigeminal
B facial
C glossopharyngeal
D Vagus
E hypoglossal
026 Which of the following is not true of gastric
secretion of HCl?
A ATPase is involved
B Na/K ATPase is involved
C Cyclic AMP is involved
D Carbon anhydrase is involved
E The HCl contains 100 mmol of H+ and 100 mmol
of Cl per litre,
027 In temperature regulation of the body:
A Reflex responses activated by cold are ctrl from
posterior hypothalamus
B Reflex responses activated by heat are controlled
from the pons
C The stimuli which activate the defence against
high temperatures in humans come mainly from
cutaneous temperature sensitive cells.
D Cold activates increased secretion of adrenalin but
not noradrenalin
E The pons is involved.

__________________________________________________________________________________________________
. Be caring to your patients and your colleagues so that The Lord may have compassion on you. Think twice before you hurt others.
Do Not hurt people simply because your were once hurt. Be good to all even if for your own good, at least.
Courtesy of Dr Muslim Goodheart.

Surgery Primary Examination Questions Collection

028
A
B
C
D
E

Environmental cold:
Increases respiration
Activates hunger
Causes apathy
Depresses adrenalin secretion
causes mesenteric vasoconstriction.

029 Secretin:
A Is increased by S-cells located deep in the mucosal
glands of the upper and lower small intestine
B Augments the action of CCK in producing
pancreatic secretion of digestive enzymes
C Is increased by acid and products of carbohydrate
digestion bathing the mucosa of the small intestine
D Decreases gastric acid secretion and may relax
pyloric sphincter
E has a 1/2 life of 15min
030 Polypeptides secreted by sensory neurons in the
enteric nervous system include:
A VIP
B (calcitonin generated polypeptide
C Somatostatin
D Neurotensin
E enkephalins
031 Which of the following terms refers to a malignant
neoplasm of mesenteric tissue?
A Carcinoma
B Adenoma
C teratoma
D Choriostoma
E none of the above
032 The pathological lesion in an immune complex
reaction is due to the action of
A The deposited complex
B the antibody
C fragments of complements
D products of leukocytes
E clotting factors.
033
A
B
C
D
E

Ring haemorrhages in the brain are associated with:

Meningo-encephalitis
Tb meningitis
Raised intracranial pressure
cerebral abscesses
Cerebral malaria

034
A
B
C
D
E

In man, a truly sequestrated antigen is:

lens crystalline of the eye
thyroglobulin
intrinsic factor
collagen
DNA

035 The following are examples of autoimmune disease

except:
A Rheumatoid arthritis
B Polyarteritis nodosa

C
D
E

SLE
Graves disease
Scleroderma

036 The most important immunological mechanism of

auto-immune diseases is:
A By-pass of helper T-lymphocytes tolerance
B Polyclonal B-lymphocyte activation
C Molecular mimicry
D Imbalance of suppressor-helper T-lymphocytic
function
E Emergence of sequestered antigen
037
A
B
C
D
E

The antigen-binding site of B-lymphocytes is:

IgG present on the cell membrane
IgM present on the cell membrane
IgM present in the cytoplasm
IgA present on the cell membrane
Membrane bound CD28.

038
is:
A
B
C
D
E

Most important source of interferon-gamma (IFN-)

T-helper lymphocytes
T-suppressor lymphocytes
Macrophages
dendritic cells
Natural killer cells.

039 These are clinical features of dehydration due to

sodium depletion except:
A Nausea
B Vomiting
C decreased salivation
D thirst
E oliguria
040 True of endotoxic shock except:
A results from spread of microrganisms from severe
local bacterial infection
B is caused by gram negative bacilli
C It is caused by gram-negative cocci
D endotoxins are bacterial cell Wall
lipopolysaccharide
E the toxic component is the lipid-A core
041 Reversible disorderly maturation with loss of
polarity is:
A metaplasia
B dysplasia
C anaplasia
D aneuploidy
E desmoplasia
042 The following causes total degranulation of the
platelet
A Prostacycline
B adenosine diphosphate (ADP)
C Nitric oxide
D thrombin
E thromboxaneA2.

__________________________________________________________________________________________________
3
Let the Knowledge flow. The more specialists we have the better our health care delivery is likely to be. Remember your
responsibility is first and fore most to your God, to your conscience, to your patient and to your Nation. Be a good Nigerian today!
Courtesy of Dr Muslim Goodheart.

Dedicated to all those interested in the progress of surgery on our continent

043 Commonest site of impaction of a systemic

embolus is:
A heart
B Kidney
C spleen
D Brain
E lower limb.
044
A
B
C
D
F

Von-Willebrand factor:
Is a naturally occurring coagulation protein
Is synthesised by macrophages {
Is essential for the adhesion of platelets to collagen
Is essential for the adhesion of Leukocytes to
endothelial cells
Is secreted by platelets

045 The anticoagulant property of the endothelium is

mediated by:
A thrombomodulin
B thromboxane A2
C Prostacycline
D tissue plasminogen activator
E None of the above
046 The most important factor that predisposes to
thrombogenesis is
A Atherosclerosis
B Varicosity
C turbulence
D hypercholesterolemia
E nephrotic syndrome
047 The most freq systemic manifestation of
inflammation is
A neutrophilia
B Lymphocytosis
C Fever
D Vomiting
E Oliguria
048 The most important mechanism of macrophage
accumulation at the site of granulomatous inflammation
is:
A Continued recruitment of monocytes from the
circulation
B Continued destruction of neutrophils at the site of
inflammation R
C Immobilization of macrophages at the site of
inflammation
D Local proliferation of macrophages. E None of the above
049 The most potent mediator for fever in acute
inflammation is
A Interleukin-2 (IL-2) P
B interleukin-6 (IL-6)
C Interleukin-12 (IL-12)
D Exogenous pyrogens
E Tumour necrosis factor (TNF)

050 The complement system:

A Is activated by an antigen-antibody system only
B is a secondary mediator for both inflammatory and
immunological responses
C Is responsible 4 the tissue destruction in severe
acute inflammation
D Participates in anaphylactic reaction
E the activated fragments circulate in the blood
051 The most potent oxygen-free radical for killing
bacteria is:
A Hydrogen oxychloride (HOCl)
B hydroxyl radical (OH-)
C Hydrogen peroxide (H2O2)
D Superoxide (02)
E None of the above
052 The most potent vasodilator in acute inflammation
is:
A Nitric oxide
B C5a
C Platelet activating factor
D Tumour necrosis factor (TNF) E interleukin-8 (IL-8)
053 Mediators of inflammation:
A Nitric oxide is a product of arachidonic acid
metabolism
B Bradykinin mediates pain in acute inflammation
C Leucotriene C4 is a potent vasodilator
D Aspirin potentates the cyclo-oxygenase pathway of
arachidonic acid metabolism
E Prostaglandins E2 and PGI2 arc strongly
chemotactic for neutrophils.
054
A
B
C
D
E

An ectopic nest of normal tissue refers to:

teratoma
hamartoma
Choriostoma
hepatoma
Oncocytoma

055 Coagulative necrosis can occur in the following

organs except
A Liver
B Heart
C Kidney
D Brain
E Spleen.
056
A
B
C
D
E

Oedema of acute inflammation is due to:

Lymphatic obstruction
Hypoproteinaemia
Proteinuria
Increased hydrostatic pressure
None of the above.

__________________________________________________________________________________________________
. Be caring to your patients and your colleagues so that The Lord may have compassion on you. Think twice before you hurt others.
Do Not hurt people simply because your were once hurt. Be good to all even if for your own good, at least.
Courtesy of Dr Muslim Goodheart.

Surgery Primary Examination Questions Collection

057
A
B
C
D
E

Which of the following is not true of typhoid fever?

Haemorrhage is not a complication
The ulcers tend to perforate
The ulcers are more common in the terminal ileum
than elsewhere in the gut
There is leucopoenia
The causative organism can survive in the gall
bladder

058 The following is true of type II hypersensitivity

reaction except
A The antigen is on the target cell
B The antibody is in the blood
C antibody is complement activating
D Good pasture syndrome is a clinical disorder
E None of the above,
059 Adhesion of platelets to fibrillar collagen is
enhanced by:
A Von Willebrand factor\
B Endotoxin
C Integrin
D Fibrinogen
E Thromboplastin
060 A biopsy of the stomach shows an area of normal
looking pancreatic tissue. This is an example of:
A Adenoma
B Choriostoma
C hamartoma
D Metastatic carcinoma
E Teratoma.
061 The following genetic disorders result in
abnormalities in carbohydrate metabolism:
A galactosaemia
B Gauchers disease
C Niemann -Picks disease
D Krabbes disease
E Farbys disease.
062 Coagulative necrosis occurs in the following
conditions:
A ischemic brain infarction
B Myocardial abscess
C Renal infarct
D tuberculosis
E Acute pancreatic necrosis
063
A
B
C
D
E

Fatty change of the liver is seen in:

Kwashiorkor
Marasmus
Aflatoxin toxicity
Yellow fever
Chronic viral hepatitis.

C
D
E

Is an autosomal dominant disorder

Onset is in the 4th decade of life
Is a disorder of lipid metabolism

065 Reversible disorderly maturation with variability in

size, shape and polarity of cells is:
A Metaplasia
B Dysplasia
C Anaplasia
D hyperplasia
E Desmoplasia
066 The following cytoplasmic organelles belong to the
membranous system except:
A Endoplasmic reticulum
B Mitochondria
C Microtubules
D Golgi apparatus
E Lysosomes
067
A
B
C
D
E

Neonatal infection can be confirmed by Elevated

IgM
IgG
IgA
IgD
IgE

068
A
B
C
D
E

The characteristic feature of amyloid on x-ray is?

Alpha-pleated sheet conformation
-pleated sheet conformation
Cross -pleated sheet conformation
Pentagonal doughnut shaped
Birefringence with Congo red stain

069
A
B
C
D
E

The most freq used fixative in histopathology is

Formaldehyde 5%
formol saline 10%
glutaraldehyde 5%
Zenkers solution
Boins Solution.

070 The following are characteristics of cell death

except:
A Increased cytoplasmic basophilia
B Increased cytoplasmic Eosinophilia
C Dystrophic calcification of the dead cell
D karyorrhexis
E discontinuation of plasma membrane or organellar
membrane on electron microscopy
071
A
B
C
D
E

Liquifactive necrosis occurs in:

Wet gangrene
Ischaemia
Tuberculosis
Pancreatitis
Renal infarction

064 Von Gierkes disease

A is a result ofglucose-6phosphate deficiency
B Results in hyperglycaemia
__________________________________________________________________________________________________
5
Let the Knowledge flow. The more specialists we have the better our health care delivery is likely to be. Remember your
responsibility is first and fore most to your God, to your conscience, to your patient and to your Nation. Be a good Nigerian today!
Courtesy of Dr Muslim Goodheart.

Dedicated to all those interested in the progress of surgery on our continent

072 The various types of amyloid fibril protein are

matched with the clinical conditions in which they are
found. Which is correctly matched?
A A2 Alzheimers disease
B AA Multiple myeloma
C AL Rheumatoid arthritis
D Familial amyloidotic polyneuropathy
E TTR(transthyretin) familial Mediterranean
fever.

079 Immediate sustained increase in vascular

permeability:
A is dependent on chemical mediators
B Leakage occurs at the level of superficial capillaries
C Leakage is due to direct destruction of the
endothelium
D Is essentially a venular leakage
E Can be prevented by pre-treatment with an
antihistamine

073 In acute inflammation the following cell type

predominates:
A lymphocytes
B plasma cells
C epithelioid cells
D Monocytes
E Neutrophils

080 The following inborn errors of metabolism are

autosomal recessive
A Von Gierkes disease
B Fabrys disease
C Coins disease
D alkaptonuria
F Phenylketonuria

74
of
A
B
C
D
E

081
A
B
C
D
E

The pectoralis major muscle inserts on the:

Lesser tubercle of the humerus
Lateral third of the clavicle
Coracoid process of the scapular
lateral lip of the intertubercular groove.
head of the humerus.

082
A
B
C
D
E

Chief action of the P. major is

Abduction and lateral rotation of the humerus
elevation and upward rotation of the Scapula
Elevation of the sternum
abduction and medial rotation of the humerus
Elevation of the clavicle.

Chronic inflammation is the histological hallmark

Chronic osteomyelitis
Typhoid enteritis
hepatic malaria
Laryngeal oedema due to anaphylaxis
Allergic reaction to parasites.

075 The following arc examples of adaptive cellular

responses:
A hyperplasia
B agenesis
C hyperchromia
D Metastasis
E Necrosis.
076 Wound healing is adversely affected by the
following except:
A Ischaemia
B Vitamin C deficiency
C Corticosteroid therapy
D old age -r
E pre-operative depilation
077
A
B
C
D
E

The pathogenesis of trauma _related shock is:

Transient hypovolaemia
Disseminated intravascular coagulopathy (DIC)
Peripheral pooling of blood
septicaemia
microvascular collapse

078 The most susceptible neurons to hypoxia due to

prolonged shock is:
A Pyramidal cells of the neocortex
B Purkinje cells of the cerebellum
C Dorsal ganglion cells
D All of the above
E None of the above.

083 Innervation of the triceps brachii involves which of

the following nerves?
A Long thoracic
B Lower subscapular
C Musculocutaneous
D Axillary
E Radial
084 Which of the following statements correctly
describes the axillary artery?
A It originates from the arch of the aorta
B It gives origin to the thoracoacromial artery
C It has the lateral thoracic artery as its first branch
D it divides into radial anti ulnar arteries
E It provides no blood supply to the humerus.
085 Which of the following statements correctly
describes the lateral cord of the brachial plexus?
A It represents lateral divisions of the plexus
B Typically, it has five branches
C It contains nerve fibres from C8 and TI
D t gives rise to the ulnar nerve
E It gives rise to the Musculocutaneous nerve.

__________________________________________________________________________________________________
. Be caring to your patients and your colleagues so that The Lord may have compassion on you. Think twice before you hurt others.
Do Not hurt people simply because your were once hurt. Be good to all even if for your own good, at least.
Courtesy of Dr Muslim Goodheart.

Surgery Primary Examination Questions Collection

C
086 Primary lateral rotators of the arm are described as
including the
A infraspinatus
B Subscapularis
C Supraspinatus
D triceps brachii and latissimus dorsi
E Serratus anterior and rhomboideus major.
087 When the arm is abducted the strength of the
shoulder joint is largely dependent on the:
A Depth of the glenoid fossa
B Heavy joint capsule
C transverse humeral ligament
D Musculotendinous cuff
E Glenohumeral ligaments.
088
the:
A
B
C
D
E

The structure found at the distal end of the ulna is

Olecranon
Trochlear notch
Styloid process
ulna tuberosity
coronoid process

089 Structures adding strength to pelvic girdle are the

following except:
A Transverse acetabular ligament
B Sacroiliac ligament
C Sacrotuberous Ligament
D Sacrospinous ligament
E Iliolumbar ligament.
090
A
B
C
D
E

Blood to upper end of femur is mostly from:

Artery of the ligament of the head of the femur
Inferior gluteal artery
Medial femoral circumflex artery
Superior gluteal artery
Superficial iliac circumflex artery.

091
A
B
C
D
E

Gluteus maximus:
passes through the greater sciatic foramen
inserts into the head of the femur
is innervated by the inferior gluteal nerve has the chief action of the abduction at the hip joint
arises partly from the sacrotuberous Ligament

092
A
B
C
D

The sciatic nerve:

It consists of two nerves
passes anterior to the obturator internus
It gives off several branches to the buttock
runs superficial to the thigh muscles that arise from
the ischial tuberosity.
It generally runs through the piriformis muscle.

093 All of the following statements correctly describe

the fascia lata of the thigh except:
A it consists of dense deep fascia
B It is reinforced by a strong medial part, the iliotibial
tract

It splits to cover both sides of the tensor fascia lata

muscle of the thigh
D At the knee it blends with expansions from the
muscle tendons
E Just below the inguinal ligament, it presents the
saphenous hiatus.
094 Which of the following is true in relation to the
femoral triangle?
A Its medial border is the Sartorius
B The femoral nerve is its most medial structure
C its upper border is the inguinal ligament.
D the femoral canal is its most lateral structure
E the iliopsoas is its anterior wall.
095 Which of the following is correct in relation to
extension at the knee with the hip extended?
A the sartorius begins the movement
B rectus femoris is the most efficient actor
C vastus medialis docs not assist in the movement
D vastus lateralis does not participate
E The articularis genus is a primary actor.
096 Which of the following is correct about the
compartments of the femoral sheath?
A intermediate compartment contains the femoral
artery
B The lateral compartment contains the femoral vein
C The medial compartment is the femoral canal
D The femoral canal contains the genitofemoral nerve
E The .upper end of the intermediate compartment
forms the femoral ring.
097 The body of the mandible has a sharp inferior
margin that ends posteriorly in which of the following?
A Mental protuberance
B Mental tubercle
C Angle of the mandible
D Mandibular condyle
E Mandibular notch.
098 As a rule the isthmus of the thyroid gland crosses
which of the following structure
A hyoid bone
B Second to fourth (2nd-4th) tracheal rings
C Cricoid cartilage
D Thyroid cartilage
E inferior belly of the omohyoid.
099 The prevertebral layer of the cervical fascia forms
the floor for which of the following triangles?
A Submental
B Posterior cervical
C Submandibular
D carotid
E Muscular

__________________________________________________________________________________________________
7
Let the Knowledge flow. The more specialists we have the better our health care delivery is likely to be. Remember your
responsibility is first and fore most to your God, to your conscience, to your patient and to your Nation. Be a good Nigerian today!
Courtesy of Dr Muslim Goodheart.

Dedicated to all those interested in the progress of surgery on our continent

100 Cervical branch of the facial nerve supplies which

of the following?
A sternocleidomastoid
B Geniohyoid
C Sternohyoid
D platysma
E masseter

108 The vertical length of the rib cage is increased by

which of the Following?
A Movement of ribs at the costovertebral joints
B Movement of the diaphragm
C Movement of the ribs at the costotransverse joint
D Pump-handle movement of ribs
E bucket-handle movement of ribs.

101 Which of the following veins unites with the

retromandibular to form the external jugular vein?
A Posterior auricular
B Superficial temporal
C Transverse facial
D internal jugular
E Facial

109 Which of these statements correctly describes

intercostal muscles?
A External intercostals begin anteriorly
B External intercostal membrane is posterior
C fibres of external intercostals slant upward and
backward.
D Fibres of internal intercostals run upward and
forward.
E innermost intercostals are the best developed of the
intercostals.

102 Which of the following nerves is a dorsal ramus of

the second cervical nerve?
A Great auricular
B Greater occipital
C Lesser occipital
D transverse cervical
E Supraclavicular
103 The superficial layer of the cervical fascia splits
into two sheets to enclose which of the following?
A Sternothyroid
B Anterior scalene
C Trapezius
D mylohyoid
E semispinalis capitis
104 The superior thyroid artery is Usually the first
branch of which of the following arteries?
A common carotid
B External carotid
C Internal carotid
D Subclavian artery
E maxillary artery
105
A
B
C
D
E

Components of the thoracic wall proper include the

Pectoral muscles
Serratus anterior
Trapezius
intercostal muscles
Latissimus dorsi,

106
A
B
C
D
E

The sternal angle located at which of these sites?

Jugular notch
Xiphoid process
level with the 4th costal cartilage
level of lower border of the 6th thoracic vertebra
manubriosternal joint

107 Ossification of the parts of the body of the sternum

usually is complete by age (in years)
A 1
B 3
C 6
D 15
E 21

110 The surface of the developing lung is covered by a

layer of mesothelium called the:
A Parietal pleura
B Visceral pleura
C diaphragmatic pleura
D costal pleura
E Mediastinal pleura
111 The remnant of the primitive heart tube giving rise
to the aortic sac is the:
A Bulbus cordis
B primitive ventricle
C Truncus arteriosus
D primitive atrium
E Sinus venosus.
112 Which of these correctly describes the azygous
venous system?
A Primarily drains blood from the body wall
B Normally it drains into the inferior vena cava.
C is located entirely on the right side of the vertebral
column
D It receives no blood from the thoracic viscera
E It has a number of valves.
113 The highest point of the iliac crest is at the
transverse level of which of the following stxs
A inguinal ligament
B Xiphosternal joint
C Fourth (4th) lumbar vertebra
D Anterior iliac spine
E Ischial tuberosity.
114 Which of the following nerves traverses the
superficial inguinal ring?
A illiohypogastric
B Subcostal
C ilioinguinal
D pudendal
E Obturator.

__________________________________________________________________________________________________
. Be caring to your patients and your colleagues so that The Lord may have compassion on you. Think twice before you hurt others.
Do Not hurt people simply because your were once hurt. Be good to all even if for your own good, at least.
Courtesy of Dr Muslim Goodheart.

Surgery Primary Examination Questions Collection

115 The tunica dartos scroti contains which of the

following?
A fat
B striated muscle
C illiohypogastric nerve
D inferior epigastric artery
E smooth muscle
116 The superficial circumflex iliac artery arises from
which of the following?
A external iliac
B internal iliac
C superior epigastric
D inferior epigastric
E femoral artery
117 The upper five slips of origin for external
abdominal oblique muscle interdigitate with which of
the following
A P. major
B rectus abdominis
C Serratus anterior
D L. dorsi
E Subscapularis
118 Which of the following structures contributes to the
formation of the lumbar triangle?
A Rectus sheath
B crest of the ilium
C ischial tuberosity
D inguinal ligament
E Serratus posterior.
119
A
B
C
D
E

The remnant of the gubernaculum testis is known as

processus vaginalis
tunica vaginalis testis
inguinal canal
Scrotal ligament
genitoinguinal ligament

120 Which of the following is a derivative of the ventral

mesogastrium?
A Mesoappendix
B Gastrorenal ligament
C Leiorenal ligament
D hepatoduodenal ligament
E Sigmoid mesocolon.
INSTRUCTION
For each of The incomplete statements below, one or
more of the completions are correct. Decide which
combinations are correct and mark the appropriate letter
as follows
A If only 1,2 and 3 are correct
B.
If only 1 and 3 are correct
C.
If only 2 and 4 are correct
D
If only 4 is correct
E
If some other completion or combination of
completions of those given are correct.

121 The following need to be intact for normal

stereognosis:
1 Dorsal columns
2 parietal lobe
3 touch pathways
4 Lateral spinothalamic tract
122 The following may he chemical mediators of pain
i.e., substances that are produced locally and act on
naked nerve endings to initiate impulses in pain fibres.
1 Histamine
2 prostaglandins
3 Kinins
4 Adenosine.
123
1
2
3
4

The causes of syncope include:

Pressure on carotid sinus
Paroxysmal ventricular fibrillations
Autonomic insufficiency
Strong emotion

124 The effects of prolonged physical training on the

CVS include
1 increased maximum oxygen extraction by tissues
2 Decreased resting heart rate
3 Increased heart size
4 Increased mean arterial pressure.
125 Cerebrospinal fluid (CSF):
1 Contains very little glucose
2 is the major source of nutritive substances for the
brain
3 is a major pathway for delivery of hypothalamic
hypophyseotropic hormones to the anterior pituitary
gland.
4 Contains less than 1% as much protein as plasma
126
I
2
3
4

Coronary arteries are:

Dilated by adenosine
Constricted by a direct effect of noradrenalin
Dilated by an indirect effect of noradrenalin
Constricted by hypoxia.

127
1
2
3
4

Arterioles in the skin dilate when exposed to:

Increased body temperature
Adrenaline
Bradykinin
Vasopressin

128 The following cause contraction of bronchial

smooth muscle.
1 Leucotrienes
2 Vasoactive intestinal peptide
3 Acetylcholine
4 Adrenaline
129
1
2
3
4

Surfactant lining the alveoli

Helps prevent alveolar collapse
is decreased in hyaline membrane disease
is decreased in the lungs of heavy smokers
is a mixture of proteins and lipids.

__________________________________________________________________________________________________
9
Let the Knowledge flow. The more specialists we have the better our health care delivery is likely to be. Remember your
responsibility is first and fore most to your God, to your conscience, to your patient and to your Nation. Be a good Nigerian today!
Courtesy of Dr Muslim Goodheart.

Dedicated to all those interested in the progress of surgery on our continent

130
1
2
3
4

During inspiration there is increase in

Intra abdominal pressure
Venous return to the heart
heart rate
intrapleural pressure.

131 The following definitions are correct:

1 Dystrophic calcification is the deposition of Ca2+ in
normal tissue
2 hyperplasia is the increase in size of an organ due to
increase in the number of its constituent cells
3 A granuloma is a localized collection of histiocytes
and modified histiocytes
4 A harmatoma is a malignant neoplasm of
connective tissue.
132
1
2
3
4

The following agents are carcinogenic for man:

hepatitis B virus (HBV)
Aflatoxin
Aniline dyes
human papiloma virus (HPV)

133
1
2
3
4

Macrophages
Arc absent in the liver
Arc derived from blood monocytes
Fuse to form giant cells
Lyse the fibrin in an exudates.

134
1
2
3
4

The characteristic cell in granulation tissue are:

Neutrophils
Epithelioid cells
Macrophages
Langhans giant cells.

I 35 Fatty change of the liver:

1 may complicate pregnancy
2 May complicate tetracycline therapy
3 Occurs in Reyes syndrome
4 Occurs in diabetes mellitus.
136
1
2
3
4

Hyperparathyroidism is associated with:

Chronic renal failure
Dystrophic calcification
Metastatic calcification
Cystic changes in bone

137
1
2
3
4

Liquifactive necrosis:
Is encountered in the brain
Is typically seen in boils
May present as structured necrosis
Occurs in wet gangrene.

138 The following tumours arc associated with

paraneoplastic syndromes:
1 Carcinoma of the breast
2 Oat cell carcinoma of the lung
3 bronchial adenoma
4 Bronchogenic squamous carcinoma

139
1
2
3
4

The following pathologic changes are reversible:

Metaplasia
Dysplasia
hyperplasia
Anaplasia.

140
1
2
3
4

Labile cells:
Proliferate throughout life
Are present in the liver
Are present in the bone marrow
Are not capable of postnatal proliferation.

141 The brachial artery has the following

characteristics:
1 Has palpable pulsations along the medial bicipital
aspect of the arm
2 Divides into terminal branches just below the crease
the elbow
3 Gives off the profunda brachii artery
4 Gives off the subscapular artery.
142 Radial nerve is described correctly by the
following:
1 It lies on the capsule of the elbow joint
2 It descends along the origin of the lateral head of
the triceps
3 Its terminal branches lie in the roof of the
anatomical snuff box
4 it terminates in a motor branch
143 In the standing position, support of the arch of the
foot depends primarily on:
1 tibialis anterior
2 Plantar ligaments
3 Flexor digitorum brevis
4 plantar aponeurosis
144
1
2
3
4

The first layer of plantar muscles includes the

Flexor digitorum longus
Flexor digitorum brevis
Quadratus plantae
Abductor digiti minimi.

145 Superior and inferior ophthalmic veins may

communicate with the following
1 Cavernous sinus
2 superficial temporal vein
3 pterygoid plexus
4 infraorbital vein
146
1
2
3
4

In the eyeball;
The cornea is the principal refractive structure
The sclera is perforated by varicose veins
The choroids layer consists of a dense capillary
plexus
The ciliary body is part of the choroid layer.

__________________________________________________________________________________________________
. Be caring to your patients and your colleagues so that The Lord may have compassion on you. Think twice before you hurt others.
Do Not hurt people simply because your were once hurt. Be good to all even if for your own good, at least.
Courtesy of Dr Muslim Goodheart.

10

Surgery Primary Examination Questions Collection

147 These statements are true regarding the veins of the

heart:
1 The middle cardiac vein runs in the coronary sulcus
2 The coronary sinus is the main vein of the heart
3 The anterior cardiac veins end in the left atrium
4 The great cardiac vein ascends in the anterior
interventricular sulcus.
148 Correct description of the thymus includes the
following:
1 Location in the middle mediastinum
2 A blood supply from the aorta
3 A structure of one lobe
4 Involution by adulthood.
Good Luck In All Your Endeavor Especially
As You Let The Knowledge Flow. The Joy Of Life Is
Indeed In The Act Of Sharing.
So, Let Us Share The Knowledge.

__________________________________________________________________________________________________ 11
Let the Knowledge flow. The more specialists we have the better our health care delivery is likely to be. Remember your
responsibility is first and fore most to your God, to your conscience, to your patient and to your Nation. Be a good Nigerian today!
Courtesy of Dr Muslim Goodheart.