SURGERY PRIMARY EXAMINATION

QUESTIONS
WEST AFRICAN COLLEGE OF SURGEONS
For each of the Multiple choice Questions 1120 choose the MOST appropriate answer
001
A
B
C
D
E

Free fatty acids:

are synthesized from amino acids in the liver
have a half life of 60min
circulate bound to globulin in the blood stream
are synthesised from glucose in the muscles
are a major source of energy for the heart

007
A
B
C
D
E

Thirst is stimulated by:

decreased osmolality of the ECF
ADH
hypervolaemia
increased osmotic pressure of the ICF
aldosterone

002
A
B
C
D
E

Essential amino acid is:

histidine
glycine
serine
lysine
proline

008
A
B
C
D
E

Vasopressin is manufactured by:

posterior pituitary
anterior pituitary
posterior hypothalamic nucleus
ventromedial hypothalamic nucleus
supraoptic and paraventricular nuclei

003
to:
A
B
C
D

The initial depolarisation of cardiac muscle is due

009 In acidification of urine:

A H+ is secreted into the urine by DCT tubular cells
B K+ is normally reabsorbed form the tubular fluid in
exchange for H+
C the H+ reacts with the NaHPO4 in the tubular fluid
to give Na2HPO4
D most of the H+ appears in the urine in the form of
ammonium salt, normally.
E H2CO3 has a higher concentration in the urine than
in the plasma

increased Na permeability
decreased Na permeability
in creased Ca permeability
increased K+ permeability

004 Which of the following is not true of myocardial

fibres?
A. resting membrane potential of -80mV
B separated from one another by membrane
C. have gap junctions
D. the action potential of a single cell shows slow
depolarisation, then a plateau followed by a rapid
repolarisation
E depolarisation spreads radially thru them
005. in the mechanism of pains:
A Fast pain is caused by C fibres
B slow pain is caused by fibres
C The farther from the brain the stimulus is the
greater the temporal separation of the fast and
slow pains
D fast pain is dull, intense and diffuse
E Slow pain is sharp and localised
006 Centrioles:
A are concerned with movement of chromosomes
during cell division
B Are Located near the cell membrane
C are four short cylinders in most cells
D Are arranged in the form of a circle
E Have microtubules in groups of six running
longitudinally in their walls.

010 The following is brought about by parasympathetic

nerve fibres:
A sweating
B ejaculation
C pupillary dilatation
D vasodilatation
E Micturition
011 Which of the following is (are) reabsorbed with
Na+ in the proximal tubule?
A glucose
B amino acids
C bicarbonates
D chloride
E all of the above
012 Which of the following is NOT true of water
excretion by the kidney?
A fluid in the descending limb is hypertonic to plasma
B fluid in the ascending limb is hypotonic to plasma
C about 160ml of fluid is filtered thru the glomeruli in
24hrs
D about 80% of the filtered fluid is reabsorbed b4 the
distal tubule
E about 15% of the filtrate is reabsorbed in the distal
tubule and 40% from the collecting ducts.
013 Vasoactive intestinal peptide (VIP):

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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

A
B
C
D
E

Is a circulating and not a neuro-endocrine hormone

is found in the Autonomic nervous system, brain,
stomach and intestines
Stimulates gastric secretion
May be a cause of constipation
its Release is stimulated by acid in the duodenum

014
A
B
C
D
E

Insulin:
is a glycoprotein
synthesised by the -cells of the islet
binds to RBCs
increases ketone uptake in muscles
increases amino acid uptake in muscles

015
A
B
C

Which of the following is true of gastric function?

It produces about 4L of gastric juice daily
It stores reasonably large quant of food for 4--6hrs
It manufactures and secretes intrinsic factor,
amylase and lipase
the mucosal barrier is due in part to tightness and I
permeability of the apical cells
it absorbs some water, alcohol and amino acids.

D
E
016
A
B
C
D
E

HCl:
activates trypsinogen to trypsin
destroys all bacteria entering the stomach
concentration in gastric juice varies directly with
Na+ concentration
is essential for iron absorption in the small intestine
secretion is stimulated by product of carbohydrates
digestion in the stomach

017 Gastric emptying:

A there is a pace maker in the cardia
B Carbohydrate rich food leaves the stomach faster
than
protein rich food
C Gastric peristalsis originate in the pace maker
every 30 seconds
D About 2030ml of chime passes thru the pyloric
sphincter with ach contraction
E The pylorus and duodenum normally relax at the
same time
018
A
B
C
D
E

In the large bowel there is net secretion of

H+
Clwater
Na+
K+

019 Which is NOT true of the colon:

A The frequency of nonepropagated contraction is
38/min
B propagated contraction may involve long or short
segments
C mass peristalsis involves 25cm or more of the
transverse or descending colon
D mass peristalsis Occurs once a day
E mass peristalsis propels the faeces distally in to the
sigmoid colon and rectum
020 gastro-jejunal anastomosis does not result in:

A
B
C
D
E

steatorrhoea
early dumping
macrocytic anaemia
late dumping
osteomalacia

021
A
B
C
D
E

Glycogenolysis is stimulated by
insulin
glucagon
thyrotropin
ACTH
cortisol

022 After a major operation the daily weight loss (g) in

adult is :
A
100-200
B
300-350
C
400-600
D
700-900
E
1000
023
A
B
C
D
E

Which of these are/is not used for gluconeogenesis

Glycerol
Amino acid
pyruvate
Lactate Fatty acid:

024 The following derive their energy essentially from

glucose
A heart
B kidney
C RBCs
D Liver
E Thyroid cells
025 Fluid losses in the adult from:
A lungs and skin in the temperate region is 500ml
B urine in the temperate region is 2000ml
C urine in the tropics is 1000ml
D lungs and skin in the tropics is 1700ml
E faeces in the tropics or temperate region is 300ml
026 A litre of Ringers lactate contains in mmols
A Cl- 108
B bicarbonate 25
C calcium 5
D potassium 2
E sodium 130
027 Which of the following is true of potassium in a
70kg man?
A 4% of it is in ECF
B serum concentration is a reliable measure of ICF
concentration
C 5 mmol is lost in sweat daily
D total amount is about 3150mmol
E about 20 mmol is lost in faeces daily

__________________________________________________________________________________________________
2
. 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 for your own good, at least.
Courtesy of Dr Muslim Goodheart.

Surgery Primary Examination Questions Collection

.
028 The serum electrolytes (mmols/L) of a patient are
Na: 128; K;3.2; Cl- 90; H2CO3: 30; blood urea: 9.0
and the pH 7. 46 The most likely clinical diagnosis is:
A Diarrhoea
B Peritonitis
C Renal failure
D Gastric outlet obstruction
E Enterocutaneous fistula
029
A
B
C
D
E

Acidosis may cause

muscle cramps
Hypokalaemia
convulsions
rapid shallow breathing
hypotension

030 which is true of the circulation?

A 90-100 of blood /kg in an average adult
B each heart beat propels 70-90ml of blood at a
pressure of 120mmHg
C 30% of blood is in the microcirculation
D 20% is in the main arteries
E about 1/3 of the capillaries are opened at any one
time
031 Which of the following is not a cause of shock
lung?
A Direct effect of shock on the lung
B Direct injury of the lung
C Excessive Fluid administration
D Oxygen toxicity
E Fat embolism and thromboembolism
032
A
B
C
D
E

Angiotensin II
Is a weak vasopressor
Is elaborated essentially in the kidneys
Stimulates release of cortisol
Is slowly destroyed
Stimulates release of ADH

033
A
B
C
D
E

Poor tissue perfusion pressure is not suggested by

Cold extremities
Restlessness
Oliguria
Hypotension
Anxiety

034
A
B
C

Parotid gland secretion:

Is secreted at a rate that is hormone dependent
Increases at the thot of food
Contains less mucus than saliva from
Submandibular gland
Continue during sleep
has Cl- concentration that increases with the rate of
secretion but a fixed Na concentration

D
E
035
A.
B.
C.

iron
Content of the body Is 50g
Is stored in the body in the ferrous state
Absorption is enhanced by phosphates

D. Absorption is passive
E. Absorption is controlled by the iron content of the
duodenal mucosa.
036. Surfactant
A Is mixture of carbohydrates and lipids
B. is found in the fluid lining the alveoli
C. increases surface tension
D is increased in cigarette smokers
E responsible for the initial expansion of the lungs at
birth.
037
A.
is
B.
C.

In lung volume measurements:

The amount of air moved out with each expiration
called residual Volume
The normal tidal volume is 1000ml
The normal Resting respiratory Minute vol is about
6L
D The total, lung capacity in men is 9 litres
E. The total, lung capacity in women is 6 litres
038
A
B
C
D
E

The partial pressure (mmHg) of

Carbon dioxide of blood in the left heart is 40
CO2 in the alveoli is 47
nitrogen of venous blood is 600
Oxygen in inspired air is about 140
Oxygenic in expired is about 100

39. Carbonic anhydrase: A. Is a proteolytic enzyme

B. is a lipoprotein with a molecular weight of 30,000
C Is found in high concentration in oxyntic and chief
cells
D. inhibits sulphonamides
E Occurs in red blood cells and not in plasma
040 Calcium
A Bound to plasma protein occupies 10-20% of the
total. Albumen
B Absorption in the small intestine is enhanced by
calcitonin
C is essential for maintaining ECF volume
D Reabsorption from the kidney is regulated by
parathormone
E Mobilisation from bone is enhanced by calcitonin
041 Which of the following is assoc with a dominant
pattern of Inheritance?
A Ankylosing spondylitis
B Breast cancer
C neurofibromatosis
D Glycogen storage diseases
E Duchene muscular dystrophy
042 C. Welchii alphatoxin causes
A Failure of oxidative phosphorylation in
mitochondria
B Mechanical rupture of cell membrane
C Poisoning of cell membrane ion pump
D stimulation of cell membrane ion pump
E Digestive damage to cell membrane

__________________________________________________________________________________________________
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 Increased permeability of the vascular endothelium

in acutely inflamed tissue is believed to be due to:
A Cytoplasmic micropinocytic vesicles
B Gaps in basement membrane
C increase in the number of phagolysosomes
D gaps in endothelial tight junctions
E No morphological changes
044
A
B
C
D
E

C3b component of complement

Is chemotactic for neutrophils
Adheres to surface receptors on macrophages
def has no pathologic effects
inhibits most cell degranulation
Causes targets cells plasma membrane injuries

045
A
B
C
D
E

IgG class Specific antibody is assoc with

Mast cell degranulation
Secondary antibody response
Jchain
Lymphocyte surface antigen receptor
Primary antibody response

051 Osteoid tissue is:

A Rich in Ca2+
B Characteristic of osteosclerosis
C Calcified cartilage
D Abundant in osteoporosis
E Collagenous tissue
052
A
B
C
D
E

Metaplasia is least likely to be associated with

Vitamin A deficiency
chronic bronchitis
long standing gall stones
Vitamin C def
Haematoma of the quadriceps

053
in
A
B
C
D
E

The serum alkaline phosphatase is xtically normal

osteomalacia
haemolytic jaundice
Osteitis deformans
hypophosphatasia
primary hyperparathyroidism

046 Which of the following is not a feature of

interferon?
A resistance to virus infections
B Inhibits virtually all viruses
C Released from cells in response to virus infections
D Virus specific antiviral effect E Species specific cellular protein

054 Which of the following is not associated with

hyperthyroidism? Increased.
A amount of colloid in thyroid follicles
B size of the gland
C height of the epithelium of the thyroid follicles
D vascularity of the thyroid gland
E Iodine uptake by the thyroid gland

047
A
B
C
D
E

An example of cytotoxic antibody reaction is

Infantile eczema
Asthma
autoimmune haemolytic anaemia
tuberculoid leprosy
Tuberculosis

055
A
B
C
D
E

048
A
B
C
D
E

Which of the following occurs in tertiary syphilis?

Milliary gummas
Rash on the soles
Degeneration of posterior columns of spinal cord
Destruction of nasal bones
pale brown nodules on the penis

056 Infection with Entamoeba hystolytica is most likely

to occur when the patient ingests:
A Cysts
B Eggs
C Drug resistant amoeba
D mature amoeba
E immature amoeba

049 Which of the following is not a feature of

thromboxane A2?
A inhibits platelets adenyl cyclase
B produced by conversion of cyclic endoperoxidase
C stimulates platelets adhesion and aggregation
D Produced by action of an endothelial enzyme
E prostaglandin with half life of 30 seconds
050. Basal cell carcinoma:
A Very rarely metastasise
B Is squamous carcinoma in-situ on the legs
C is a tumour of sweat glands
D Is a tumourlike self-healing lesion
E Is Squamous carcinoma in-situ on the sun
exposed skin

Epitheliod cells are derived from:

mast cells
plasma cells
Macrophages
Pericytes
Langhans giant cells

057 which of the following inocula contains an

attenuated Living organisms?
A
pertussis
B
TAB vaccine
C
Salk polio
D
tetanus Toxoid
E
BCG
058
A
B
C
D
E

Ionising radiation does Not give rise to

Squamous cell carcinoma of the skin
Lymphoedema
osteosarcoma
Teratoma of the ovary
leukaemia

__________________________________________________________________________________________________
4
. 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 for your own good, at least.
Courtesy of Dr Muslim Goodheart.

Surgery Primary Examination Questions Collection

.
59 In selecting human kidney donors it is essential to
ensure that the donor and host arc
A
ABO identical
B
ABO compatible
C
HLA identical
D
HLA compatible

67 Which of the following disaggregates platelets?

A Fibrinogen degradation products
B Antithrombin III
C First component of complement
D Adenosine diphosphate
E Prostacycline

60 in rickets there is
A nephrocalcinosis
B Osteoid border around calcified trabeculae
C persistent unabsorbed cartilage
D subperiosteal new bone formation in various bones
E failure of mineralization of cartilage of epiphyseal
growth plate

68 Which of the following surface markers are

associated with helper T- lymphocytes?
A. T10 positive cells
B. T9 positive cells
C. T8 positive cells
D T4 positive cells
E T4, T8 Positive cells

61
A
B
C
D
E

69 Contraction of a wound is due .to:

A Fibrocytes
B. type III collagen
C. type I collagen
D granulation tissue at the margin of the wound
E
granulation tissue at the centre of the wound

urine urobilinogen is diminished or absent in

Viral hepatitis
liver cirrhosis
SS disease
Carcinoma of the head of the pancreas
SC disease

62 Which of the following is Not necessary in extrinsic

pathway of coagulation? A Tissue factor
B Factor XII
C Factor V
D Factor VII
E Ca2+
63 Endarteritis of the vasa vasorum supplying the aorta
is characteristic of:
A. Tuberculous aortitis
B Idiopathic aortitis
C. Dissecting aneurism
D Syphilitic aortitis
E thrombo-angitis obliterance
64
A
B
C
I)
E

A known manifestation of yaws is:

.Pyoderma gangrenosum
scaling dermatitis of the palm
.Erythema nodosum
.Pachyderma keratitis
lymphoedema of the affected limb

65 The Larvae of dracunculus enter the circulation

through
A .Intestine
B lungs
C .Stomach
D Mouth
E .Skin
66 Collagen is mainly made up of which of the
following amino acids?
A. Hydroxylysine and hydroxyproline
B. praline and lysine
C. hydroxyproline and lysine
D Glycine and glutamic acid
E. methionine and cystine

70
A
B
C
D
E

leucopenia occurs in
Actinomycosis
uraemia
acute haemolytic anaemia
typhoid fever
acute glomerulonephritis

71 In Stored RBCs there is

A
striking decreased K+ concentration
B
no loss of ATP
C
change in the disc share
D
K+ concentration increase
E. 2, 3DPG concentration increase
72 Which of the following plasma ion is decreased in
concentration in acute tubular necrosis?
A. Calcium
B phosphate
c. Potassium
D H+
E Mg2+
73 In acute tubular necrosis:
A. The urine urea concentration is raised
B The urine sodium concentration is reduced
C. hypertension is usual
D .The renal medulla is mainly affected
E. interstitial oedema is characteristic
74 To abort an attack paroxysmal tachycardia, a house
officer massaged the carotid sinus to reduce the heart
rate. Which is the landmark to the sinus?
A. inferior border of the mandible
B. Laryngeal prominence
C. Hyoid bone
D Cricoid cartilage
E. Suprasternal notch

__________________________________________________________________________________________________
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

75 ptosis and abduction of left eye suggest lesion

involving
A. Trochlear nerve
B. Abducent nerve
C. Oculomotor nerve
D superior cervical sympathetic ganglion
E Facial nerve
76 during incision of tympanic membrane the corda
tympani and ossicles are best avoided by incising the
A centre of the membrane
B pars flaccida
C posterior superior quadrant
D inferior quadrant
E anterior superior quadrant
77
A
B
C
D
E

Regeneration is complete in
cartilage
bone marrow
smooth muscle
tendon
striated muscle

78. The most important reservoir of pathogenic

staphylococci is the:
A. Perineum
B Hands
C Faeces
D Throat
E Anterior nares
79
A
B
C
D
E

Actinomyces israeli
Is gram negative
Is aerobic
Has no branching filaments
Forms colonies in the form of black
granules
is a bacterium

80
not
A
B
C
D
E

Which of the following tumours

arise from embryonic tissues?
Nephroblastoma
Hepatoblastoma
Retinoblastoma
Seminoma
Neuroblastoma

81
A.
B.
C
D
E

An example of inflammatory cyst

Dermoid cyst
Branchial cyst
ranula
Dental (radicular) cyst
Hydatid cyst

does

is

82 Which of the following acute-phase proteins

rises rapidly And markedly in the first 48 hrs after
trauma or infection?
A Fibrinogen

B
C
D
E

Haptoglobin
C-reactive protein
Caeruloplasmin
Complement component

83 Winch of the following is not true of the

ESR?
A It falls with age
B It is higher in normal women than in normal men
C It is raised in macroglobulinaemia
D It is raised in the acute-phase response
E On the Westergreen the upper limit is 15 mm/h
for men and 20 mm/h for women under 50
84 The smiling muscle of the face is the:
A .Orbicularis oris
B. risorius
C. buccinator
D Zygomaticus major
E. Levator anguli oris
85 Which of the following set of features is peculiar to
man?
A .Chin and temporal fossa
B Anterior nasal spine and inions
C .Frontal hone and superior orbital fissure
D Maxilla and chin
E .Chin and inferior nasal spine
86 inferior thyroid artery supplies the
A. Submandibular gland
B Upper part of the larynx
C .Lower part of the larynx
D .Pharynx
E Parathyroid glands.
87 The foramina rotundum, ovale and spinosum
situated in which of the following bones?
A Ethmoid
B Petrous temporal
C frontal
D greater wing of the sphenoid
E palatine

are

88 The largest artery supplying the dura mater of the

brain is the:
A . Anterior cerebral
B . Posterior cerebral
C . Anterior meningeal
D . Middle meningeal
E . Posterior meningeal
89
A.
B.
C.
D
E.

The platysma is innervated by the:

XII nerve
XI nerve
Cervical branch of VII
Mandibular branch of V
X nerve

__________________________________________________________________________________________________
6
. 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 for your own good, at least.
Courtesy of Dr Muslim Goodheart.

Surgery Primary Examination Questions Collection

.
90 The maxillary- sinus (antrum of Highmore)
communicates with the nose through the:
A Sphenoidal recess
B Superior meatus
C. Middle meatus
D Inferior meatus
E none of the above
91 A horizontal anteroposterior bullet wound at the
right edge of the Sternum in the fifth intercostal space
would most like penetrate the:
A Right ventricle
B. Right atrium
C. Superior Vena cave
D inferior vena cava
E Ascending aorta
092 The posterior Mediastinal Lymph nodes receive
lymph from the
A pulmonary pleura
B Lung
C diaphragm
D oesophagus
E Pericardium
093 The arch of the aorta is related to the following
except
A
Innominate artery
B
thoracic duct
C. Right recurrent laryngeal nerve
D
Innominate vein
E . Pulmonary trunk.
094 Which of the following is not true of the anatomy of
the oesophagus?
A The narrowest part is t beginning
B. The distance from front incisorteeth to the
beginning is 20cm
C. The distance from the front Incisor teeth to
hiatus is 37 cm
D The distance from incisor teeth to the gastrooesophageal junction is 40 cm
E. from the front incisor to where it is crossed by the
aortic arch is 22cm
095 Which of the following ribs has a single facet on the
head for articulation, no tubercle, and no neck?
A 9th
B Eleventh
C Fifth
D 7th
E 3 rd
096
A.
B.
C.
D.
E.

the heart gets innervation from

Parasympathetic via the vagi
Parasympathetic via the phrenic
Sympathetic via the vagi
Sympathetic via the phrenic
None of the above

097 The right lung

A. Is related to the oesophagus only in the lover part of
its medial surface
B has 10 broncho-pulmonary segments
C Is equal to the left lung in weight
D is divided by fissures into upper and lower lobes
and the lingula
E has 5 segments in the upper lobe
098. In muscular activity
A A synergistic muscle is one that relaxes against the
pull of gravity
B innervation is by the muscle spindle
C A parallel arrangement of fibres provides a more
powerful movement than an oblique arrangement
D antagonist opposes the prime movers
099 Left recurrent laryngeal nerve
A. Supplies branch to the inferior constrictor muscle
b4 entering the larynx
B hooks round the arch of aorta anterior to the
attachment of the ligamentum arteriosus
C. Supplies the left crico- thyroid
D Supplies sensation to the whole of laryngeal
mucosa
E. contains motor fibres derived from the spinal root
of the accessory nerve
100. Downs syndrome (Trisomy 21)) is xtrised by all of
the following EXCEPT
A. A flat broad face
B. Epicanthus (fold of skin hanging from the nose)
C. Testicular atrophy
D. Oblique palpebral fissure
E Congenital heart diseases
101 which of the following is Not true of Meckels
diverticulum?
A is a finger like pouch
B averages 4-5cm in Length
C it represents the remains of the uracus
D It may have a fistulous opening at the umbilicus
E It occurs along the last meter of the ileum.
102 Which nerve is invariably cut in a Kochers
Subcostal incision?
A Right eleventh intercostal nerve
B Right seventh intercostal nerve
C Right eighth intercostal nerve
D Right ninth intercostal nerve
E Right tenth intercostal nerve
103. Following extraperitoneal rupture of the bladder,
the thickening and inflammation caused by the presence
of extravasated urine may first be detected in the
A. Scrotum
B. Penis
C. Anterior abdominal wall
D Upper thigh
E. Perineum

__________________________________________________________________________________________________
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

104. Which of the following may be immediately related

to an aneurysm of the abdominal aorta?
A
liver
B
stomach
C
first part of the duodenum
D
third part of the duodenum
E
sigmoid colon

110. Which of the following is Not due to persistence of

the processus vaginalis
A
indirect inguinal hernia
B
congenital hydrocele
C
infantile hydrocele
D
vaginal hydrocele
E
hydrocele of the cord

105. A patient with proven carcinoma of the prostate and

metastases in the lateral mass of the 1st sacral vertebra,
experiences pain down the front leg and dorsum of the
foot. What nerve is involved?
A
lumbo-sacral trunk
B
2nd sacral nerve
C
lateral cutaneous nerve of the thigh
D
femoral nerve
E
obturator nerve

111. In the upper limb A primary centre of ossification appears in the

humerus in the twelfth week of intrauterine life
B The upper humeral condyle contains a single
secondary centre of ossification
C Ossification of the root of the coracoid process
spread from the primary centre of the body of the
scapula.
D Growth in length of the radius occurs mostly at its
distal end.
E ossification of the scaphoid bone occurs during the
second year of life

106 Structures in contact with the left kidney include all

the following except:
A . Psoas major
B
Lt crus of the diaphragm
C . Subcostal nerve
D
ilioinguinal nerve
E
illiohypogastric nerve
107. Which of the following is not true of the (common)
bile duct?
A it Opens into the postero-medial wall of the
descending (2nd) part of the duodenum
B lies to the left of the hepatic artery
C posterior to the superior part of the duodenum
D lies behind the head of the pancreas
E is anterior to the epiploic foramen of the lesser sack
108 The rectum
A begins In front of the 1st sacral Vertebra
B Has venous drainage into the superior mesenteric
vein
C. has no mesentery
D has a lining of stratified squamous epithelium
E Has some lymph vessel drain into the superficial
inguinal lymph nudes 109. In the anatomy of the small intestine
A The lumen narrows and the circular folds of the
mucosa become smaller but more freq distally
B mesenteric vessels to the jejunum are shorter but
have more arcades than those to the ileum
C. The entire small intestine is 6m long
D mesentery of the jejunum is thicker than that to the
ileum
E aggregation of lymph follicles is more marked
towards the terminal ileum

112
of
A
B
C
D
E

effect of division of ulnar nerve at the thumb is loss

Flexion
Abduction
Circumduction
Adduction
Opposition

113 The movements of Supination and pronation occur

primarily at
A Elbow joint
B Superior radio-ulnar joint
C both inferior and superior radio--ulnar joints
D Inferior radioulnar joints
E Elbow, superior and inferior radioulnar joints
114 which of the following is a ginglymus?
A hip joint
B Interphalangeal joint
C Shoulder joint
D Ankle joint
E Acromioclavicular joint
1 15. In the sitting position the Weight of the body is
supported by the
A Inferior ramus- of the ischium
B body of the Ischium
C Ischial tuberosities
D Body of the pubis
E None of. the above
116 The most important factor in the stability of the
patella is the
A Vastus Medialis whose lower fibres are attached to
the patella
B capsule of the knee joint
C Ligamentum patellae
D. Tension of the medial patellar retinaculum
E Forward prominence of the lateral femoral. condyle

__________________________________________________________________________________________________
8
. 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 for your own good, at least.
Courtesy of Dr Muslim Goodheart.

Surgery Primary Examination Questions Collection

.
117. The unlocking movement of the early stages of
flexion of the knee is effected:
A Passively.
B by the hamstrings
C by the quadriceps
D by popliteus
E by none of the above
118. In the popliteal fossa
A The supero-medial boundary is formed by t he
Semimembranosus
B From without in, the Fossa contains the popliteal
nerve vein and artery
C. the biceps femoris tendon forms the inferoradial
boundary
D The roof of the roof of the fossa is pierced by the
long saphenous vein
E The floor from above down is formed by popliteus,
popliteal surface of femur and knee joint
119. The first organ in the embryo to become lymphoid
is
A. Vermiform appendix:
B Spleen
C. Lymph node
D palatine tonsil.
E. Thymus
120. The synthetic or S phase of the cell cycle is the
period during which
A. RNA is synthesised
B. mitochondria are synthesized
C. Microtubules are synthesised for the mitotic
apparatus
D Centrioles are reduplicated for the spindle
formation.
E. DNA is synthesized
INSTRUCTION
For each of the incomplete statements below, one or
more of the completion is correct. Decide the correct
one(s)
And mark the appropriate letter
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 any other combination is correct
121. Dopamine
1. increases cardiac out put but decreases heart rate
2. is the precursor of noradrenaline
3. Causes vasoconstriction of renal and mesenteric
vascular beds
4. Acts on specific dopamine receptors on renal and
mesenteric vessels

122. As blood passes through systemic capillaries

1 Its pH rises
2. Bicarbonate ions pass from the red cells to the
plasma
3. The concentration of Cl- ions in red cells falls
4. Its Oxygen dissociation curve shifts to the right
123. Somatostatin:
1 is found in the brain, CNS and nerves in the wall of
the stomach and intestines
2 inhibits the release of glucagon, insulin and TSH
3 . Inhibits gastric emptying
4 . Is a steroid
124 skeletal muscle cells:
1 the inside is negative with respect to the outside at
the resting membrane potential
2 Is normally innervated by more than one motor
neurone
3 Contains intracellular stores of Ca2+
4 becomes less excitable when its resting membrane
potent is decreased
125. Parasympathetic nerves
1 generally have opposite effects to those of
sympathetic when both supply the same organ
2 plays an important role in vasodilatation of skeletal
muscle during prolonged exercise
3 liberate acetylcholine at both pre- and postganglionic endings
4 tends to have longer post- than pre-ganglionic fibres
126
1
2
3
4

Example of active transport:

Cl- shift b/w RBCs and plasma
movement of O2 from alveoli into blood
O2 movement within a muscle fibre
Na+ reabsorption in the DCT of the kidney

127
1
2
3
4

The 2,3-DPG concentration in RBCs

is increased by thyroid hormone
falls with rise in pH
may increase during exercises
falls at high altitude

128 gas transport b/w lungs and tissues

1 250ml of O2 is transported /min from lung to
tissues at rest
2 200ml of O2 is transported /min from tissue to
lungs at rest
3 most of the O2 In the blood is in the form of
bicarbonate
4 in venous blood the O2 Hb saturation is 75%
129 lack of exocrine pancreas
1 fasting blood sugar is normal
2 protein digestion is inefficient and loss of weight
tends to occur
3 bleeding tendency may occur
4 fat absorption is normal provided bile is still
Produced

__________________________________________________________________________________________________
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 Lysosomes
1 engulf worn-out components of the cell in which
they
are located
2 may contain fragment of other cells structures
3 contain phosphatase, collagenase and cathepsins
4 contain glycosidase, lactases, and acetylcholine
131 in inflammation
1 there is increased fluidity of tissue ground
substance
2 hydrostatic pressure is decreased at the venous end
of the capillary
3 inflammatory exudate has high fibrinogen content
4 the fibrin clot impedes phagocytosis
132 interleukin -1
1 stimulates production of acute phase proteins in the
hepatocytes
2 is responsible for pyrexia of inflammation or
trauma via hypothalamic stimulation
3 causes proteolysis of skeletal muscle thru
stimulation of PGE2
4 Is a glycoprotein

138
1
2
3
4

in haemophilia
is sex-linked dominant
the gene is transmitted from the father to the sons
there is deficiency of factor IX
the commonest lesion is haemarthrosis

139
1
2
3
4

haemolysis is a feature of
SC disease
Christmas disease
spherocytosis
thrombocytopenic purpura

140
1
2
3
4

hypoglycaemia is a feature of
hyperthyroidism
complication of partial gastrectomy
haemochromatosis
adrenocortical failures (Addisons disease)

141 temporo-mandibular joint:

1
is a synovial joint
2
articular surfaces are lined by hyaline cartilage
3
is divided by a disc into two separate cavities
4
is supplied by the greater auricular nerve

133. A Mother whose blood group is O Rh negative and

a father whose blood group is AB Rh positive can have
child whose blood group is
1 Group A Rh .negative.
2 Group A Rh +ve
3 Group B Rh negative
4 Croup O Rh +ve

142 cervical part of the sympathetic trunk

1 gives fibres, which accompany the internal carotid
arteries and its branches
2 lies deep to the prevertebral fascia
3 has 3 ganglia all of which give branches to the
carotid plexus
4 is crossed anteriorly by the inferior thyroid artery

134. A positive tuberculin (Manteux or Heaf) test

indicates that the host
1 is manifesting type III hypersensitivity to M.
tuberculosis
2 probably has no impaired T-cell function
3 Is harbouring M. tuberculosis
4 is hyposensitive to tuberculo-protein

143
1
2
3

135 examples of metastatic calcifications

1 nephrocalcinosis
2 Calcification of old scar
3 Calcification of internal elastic lamina of arteries
4 phlebolith

144 sensations transmitted by the cuneate fasciculus

include:
1 pain
2 touch
3 temperature
4 position sense

136. In gas gangrene the spread of organisms is

I Assisted by hyaluronidase and collagenase
produced by clostridia
2 via the blood stream only as a terminal event
3 assisted by ischaemic necrosis of muscles
4 assoc with intense polymorphs infiltration
137
1
2
3
4

oesophagus
is crossed anteriorly by the thoracic duct
is lined by pseudostratified columnar epithelium
has an outer longitudinal coat consisting along the
its whole length of striated muscle
enters the abdomen at the level of 10th thoracic
vertebra

145 club foot (talipes equinovarus) is characterised by

1 adduction of the fore foot
2 inversion of the foot
3 plantar flexion of the ankle
4 dorsal flexion of the ankle

neutrophils
are incapable of dividing
survive for less than 48 hrs in acute inflammation
are an absolute prerequisite for pus formation
can transform into other cell types on appropriate
stimulation

__________________________________________________________________________________________________
10
. 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 for your own good, at least.
Courtesy of Dr Muslim Goodheart.

Surgery Primary Examination Questions Collection

.
146 the penis:
1 glans is supplied by artery to the bulb and the dorsal
artery
2 the fascia penis is a tough fibrous membrane which
encloses the corpora cavernosa and spongiosum
3 fossa navicularis is lined by stratified squamous
epithelium
4 lymphatic drainage of the glans is to para-aortic
nodes
147
1
2
3
4

carpal tunnel transmits

median nerve
flexor carpi radialis
flexor pollicis longus tendon
ulnar nerve

148 femoral ring is

1 larger in females
2 bounded anteriorly by medial end of the inguinal
ligament
3 bounded medially by the lacunar ligament
4 bounded inferiorly by femoral artery

149
1
2
3
4

coronary arteries
lie superficial to the myocardium
their branches are end arteries
they are the first branches of the aorta
there are usually 2 of them: the left and the right

150 pectinate line:

1 is at the junction of the upper and middle 3rds of the
anal mucosa
2 is formed by valve-like folds enclosing crypts
opening caudally
3 has above it a transitional epithelium
4 below it is a squamous epithelium

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.