Jan 2016
1. A 76 years old man presented with nocturia, frequency urgency and frank hematuria. Ultrasound reveal
2cm filling defect at left bladder wall and left hydronephrosis. What is the diagnosis?
A. Transitional cell carcinoma of bladder
B. Renal cell carcinoma
C. Leiomyoma
D. Squamous cell carcinoma
E. Nephroblastoma
2. The most commonly injured ligament in ankle injury is:
A. Posterior talofibular ligament
B. Anterior talofibular ligament
C. Deltoid ligament
D. Calcaneotalar ligament
E. None of the above
3. A 21-year-old man has been stabbed in the back of the knee, dividing the popliteal artery, and is
undergoing repair via a posterior approach. Which of the following structures is most likely to be
encountered first, when dissecting deep from the skin incision?
A. Popliteal artery
B. Popliteus muscle
C. Popliteal vein
D. Tibial nerve
E. Soleus muscle
4. A 30-year-old man is involved in a road traffic accident and sustains a dislocation of the knee. This is
reduced under anaesthesia and immobilized in a cast. He was given a sciatic nerve block and has a painless
and pulseless limb. Which structure is injured?
A. Femoral artery injury
B. Popliteal artery injury
C. Sciatic nerve injury
D. Tibial nerve injury
E. Common peroneal nerve injury
5. A 23 years old athlete developed inability of plantar flexion due to pain after a prolonged period of
casting for fractured tibia. Where would you expect the sensory loss to be?
A. Dorsum of the foot
B. Plantar aspect of the foot
C. 1st web space
D. Dorsum of the foot except 1st web space
E. None of the above
6. A 70-year-old woman from a nursing home presents to the Emergency Department with abdominal pain
and vomiting. On examination, she is dehydrated, and her abdomen is distended. There is a 3 x 4 cm
swelling in her right groin which is non-tender, and there is no cough impulse. At operation, a femoral
Hernia found. Which of the following lies lateral to the neck of the hernia?
A. Femoral artery
B. Femoral nerve
C. Femoral vein
D. Lacunar ligament
E. Pectineal ligament
1
,7. A 32 years old patient presented with recurrent loin to groin pain. Xray revealed multiple radio-opaque
stones. Analysis confirmed Ca oxalate stones. What is the most likely cause of this condition cause?
A. Hyperparathyroidism
B. Familial hyperoxaluria
C. Urinary tract infection
D. Hypoparathyroidism
E. None of the above
8. A 54 years old man undergone hip replacement for fractured neck femur. During follow up, the man
walks with the Trendelenburg gait. what is the most likely cause?
A. Sciatic nerve injury
B. Gluteus Medius muscle paralysis
C. femoral nerve injury
D. Gluteus maximus muscle paralysis
E. Inferior gluteal nerve injury
9. During posterior hip approach for a fractured neck of femur. Bleeding occurred and the surgeon tried to
control the bleeder with ligation. Which blood vessel is mostly injured?
A. Femoral artery
B. Superior gluteal artery
C. Inferior gluteal artery
D. Saphenous vein
E. None of the above
10. A 54 years old man was hit on his left knee. He developed knee swelling immediately with positive
anterior drawer test. Aspiration was done few days later & revealed blood. What is the most likely cause?
A. Meniscal tear
B. Medial collateral ligament injury
C. Lateral collateral ligament injury
D. Anterior cruciate ligament injury
E. Posterior cruciate ligament injury
11. A 25-year-old man is playing football when he complains of posterior thigh pain whilst sprinting with the
ball. On examination he has tenderness in the lower lateral posterior thigh. He is unable to fully extend the
knee due to pain. What is the most likely injury?
A. Biceps femoris tear
B. Gracilis tear
C. Gastrocnemius tear
D. Semimembranosus tear
E. Semitendinosus tear
12. A patient was admitted to ER with painful arc between 60-120 degree of shoulder. Which of the
following would be the causative pathology?
A. Frozen shoulder
B. Rotator cuff tear
C. Supraspinatus tendinitis
D. Shoulder dislocation
E. None of the above
13. A 70 years old man complained of painless hematuria and frequency. On PR examination, there is a hard-irregular mass in the
prostate. PSA is 300. Gleason score is 8. What is the first line of management?
A. Radiotherapy
B. Hormonal therapy
C. Radical prostatectomy
D. Watchful waiting
E. PCA
2
,14. A 52 years old man sustained an arm injury. On examination, he is unable to extend his elbow and wrist with loss
of sensation over the posterior arm. Where is the lesion?
A. Radial nerve
B. Ulnar nerve
C. Median nerve
D. Posterior cord of brachial plexus
E. Lateral cord of brachial plexus
15. A 25 years old man sustained an arm injury. On examination, there is numbness over thenar eminence with
thenar muscle wasting. What is the lesion?
A. Radial nerve
B. Ulnar nerve
C. Median nerve
D. Posterior cord of brachial plexus
E. Lateral cord of brachial plexus
16. A 25 years old man undergone a hernia repair. Post operatively, there is numbness over the scrotum. What is
affected nerve?
A. Ilioinguinal nerve
B. Femoral nerve
C. Genital branch of genitofemoral nerve.
D. Sciatic nerve
E. Obturator nerve
17. A 25 years old man undergone a hernia repair. Post operatively, there is numbness over the anterior thigh with
loss of ability to extend his knee. What is affected nerve?
A. Ilioinguinal nerve
B. Femoral nerve
C. Genital branch of genitofemoral nerve.
D. Sciatic nerve
E. Obturator nerve
18. A slightly overweight 13-year-old boy presents with a three-week history of right hip pain and limping. On
examination the hip moves into external rotation when flexed. Which of the following is the most likely diagnosis?
A. Developmental dysplasia (congenital dislocation) of hip
B. Juvenile rheumatoid arthritis
C. Perthes disease
D. Slipped upper femoral epiphysis
E. Traumatic dislocation of the hip
19. A 6-year-old boy presents with a two-day history of right hip pain and an inability to bear weight. On examination
he is apyrexial and systemically well, but his hip movements are generally painful. Which of the following is the most
likely diagnosis?
A. Congenital dislocation of the hip
B. Juvenile rheumatoid arthritis
C. Perthes disease
D. Septic arthritis
E. Slipped upper femoral epiphysis
20. Stroke volume
A. 50 ml/min
B. 70 ml/min
C. 90 ml/min
D. 110 ml/min
E. 130 ml/min
3
, 21. 45 years post-parotidectomy presented with facial palsy feature ,which of the following is one of these
features
A. Dropping of angle of mouth
B. Loss sensation to angle of jaw
C. Scalp loss sensation
D. Ant 2/3rd tongue loss sensation
E. Affection of muscle of mastication
22. Middle meningeal artery passes through which foramina?
A. Foramen of ovale
B. Foramen rotundum
C. Foramen spinosum
D. Foramen lacerum
E. Foramen magnum
23. A 28-year-old women collapses and is found to be deeply comatose with a GCS of 3. She is admitted to
hospital, intubated and ventilated. A CT scan shows an extensive sub arachnoid hemorrhage. A urinary
catheter is inserted. What type of urine output would be expected?
A. 30ml concentrated urine per hour
B. 30ml diluted urine per hour
C. 60ml diluted urine per hour
D. 300ml concentrated urine per hour
E. 300ml diluted urine per hour
24. Which of the following makes the posterior wall of inguinal canal?
A. Conjoint tendon
B. Internal oblique muscle
C. Transversus abdominus
D. External oblique muscle
E. Rectus abdominus
25. Woman has a gunshot to her back, which transect cord at Lt side presents with features suggestive of a
Brown-Sequard syndrome. The clinical findings will include which of the following ?
A. Left sided weakness, left sided proprioception and vibration loss, right sided loss of pain and temperature
B. Right sided weakness, right sided proprioception and vibration loss, left sided loss loss of pain and
temperature
C. Right sided weakness, right sided proprioception and vibration loss, right sided loss loss of pain and
temperature
D. Right sided weakness, left sided proprioception and vibration loss, right sided of loss of pain and
temperature
E. left sided weakness, right sided proprioception, and vibration loss, left sided loss of pain and temperature
26. What are the spirometry changes in COPD?
A. Increase tidal volume
B. decrease tidal volume
C. increase inspiratory volume
D. increase residual volume
E. none of the above
27. While placing a chest tube and giving local anesthesia. What is the sensory supply to parietal pleura?
A. phrenic nerve
B. intercostal nerve
C. vagus nerve
D. spinal accessory
E. none of the above
4
1. A 76 years old man presented with nocturia, frequency urgency and frank hematuria. Ultrasound reveal
2cm filling defect at left bladder wall and left hydronephrosis. What is the diagnosis?
A. Transitional cell carcinoma of bladder
B. Renal cell carcinoma
C. Leiomyoma
D. Squamous cell carcinoma
E. Nephroblastoma
2. The most commonly injured ligament in ankle injury is:
A. Posterior talofibular ligament
B. Anterior talofibular ligament
C. Deltoid ligament
D. Calcaneotalar ligament
E. None of the above
3. A 21-year-old man has been stabbed in the back of the knee, dividing the popliteal artery, and is
undergoing repair via a posterior approach. Which of the following structures is most likely to be
encountered first, when dissecting deep from the skin incision?
A. Popliteal artery
B. Popliteus muscle
C. Popliteal vein
D. Tibial nerve
E. Soleus muscle
4. A 30-year-old man is involved in a road traffic accident and sustains a dislocation of the knee. This is
reduced under anaesthesia and immobilized in a cast. He was given a sciatic nerve block and has a painless
and pulseless limb. Which structure is injured?
A. Femoral artery injury
B. Popliteal artery injury
C. Sciatic nerve injury
D. Tibial nerve injury
E. Common peroneal nerve injury
5. A 23 years old athlete developed inability of plantar flexion due to pain after a prolonged period of
casting for fractured tibia. Where would you expect the sensory loss to be?
A. Dorsum of the foot
B. Plantar aspect of the foot
C. 1st web space
D. Dorsum of the foot except 1st web space
E. None of the above
6. A 70-year-old woman from a nursing home presents to the Emergency Department with abdominal pain
and vomiting. On examination, she is dehydrated, and her abdomen is distended. There is a 3 x 4 cm
swelling in her right groin which is non-tender, and there is no cough impulse. At operation, a femoral
Hernia found. Which of the following lies lateral to the neck of the hernia?
A. Femoral artery
B. Femoral nerve
C. Femoral vein
D. Lacunar ligament
E. Pectineal ligament
1
,7. A 32 years old patient presented with recurrent loin to groin pain. Xray revealed multiple radio-opaque
stones. Analysis confirmed Ca oxalate stones. What is the most likely cause of this condition cause?
A. Hyperparathyroidism
B. Familial hyperoxaluria
C. Urinary tract infection
D. Hypoparathyroidism
E. None of the above
8. A 54 years old man undergone hip replacement for fractured neck femur. During follow up, the man
walks with the Trendelenburg gait. what is the most likely cause?
A. Sciatic nerve injury
B. Gluteus Medius muscle paralysis
C. femoral nerve injury
D. Gluteus maximus muscle paralysis
E. Inferior gluteal nerve injury
9. During posterior hip approach for a fractured neck of femur. Bleeding occurred and the surgeon tried to
control the bleeder with ligation. Which blood vessel is mostly injured?
A. Femoral artery
B. Superior gluteal artery
C. Inferior gluteal artery
D. Saphenous vein
E. None of the above
10. A 54 years old man was hit on his left knee. He developed knee swelling immediately with positive
anterior drawer test. Aspiration was done few days later & revealed blood. What is the most likely cause?
A. Meniscal tear
B. Medial collateral ligament injury
C. Lateral collateral ligament injury
D. Anterior cruciate ligament injury
E. Posterior cruciate ligament injury
11. A 25-year-old man is playing football when he complains of posterior thigh pain whilst sprinting with the
ball. On examination he has tenderness in the lower lateral posterior thigh. He is unable to fully extend the
knee due to pain. What is the most likely injury?
A. Biceps femoris tear
B. Gracilis tear
C. Gastrocnemius tear
D. Semimembranosus tear
E. Semitendinosus tear
12. A patient was admitted to ER with painful arc between 60-120 degree of shoulder. Which of the
following would be the causative pathology?
A. Frozen shoulder
B. Rotator cuff tear
C. Supraspinatus tendinitis
D. Shoulder dislocation
E. None of the above
13. A 70 years old man complained of painless hematuria and frequency. On PR examination, there is a hard-irregular mass in the
prostate. PSA is 300. Gleason score is 8. What is the first line of management?
A. Radiotherapy
B. Hormonal therapy
C. Radical prostatectomy
D. Watchful waiting
E. PCA
2
,14. A 52 years old man sustained an arm injury. On examination, he is unable to extend his elbow and wrist with loss
of sensation over the posterior arm. Where is the lesion?
A. Radial nerve
B. Ulnar nerve
C. Median nerve
D. Posterior cord of brachial plexus
E. Lateral cord of brachial plexus
15. A 25 years old man sustained an arm injury. On examination, there is numbness over thenar eminence with
thenar muscle wasting. What is the lesion?
A. Radial nerve
B. Ulnar nerve
C. Median nerve
D. Posterior cord of brachial plexus
E. Lateral cord of brachial plexus
16. A 25 years old man undergone a hernia repair. Post operatively, there is numbness over the scrotum. What is
affected nerve?
A. Ilioinguinal nerve
B. Femoral nerve
C. Genital branch of genitofemoral nerve.
D. Sciatic nerve
E. Obturator nerve
17. A 25 years old man undergone a hernia repair. Post operatively, there is numbness over the anterior thigh with
loss of ability to extend his knee. What is affected nerve?
A. Ilioinguinal nerve
B. Femoral nerve
C. Genital branch of genitofemoral nerve.
D. Sciatic nerve
E. Obturator nerve
18. A slightly overweight 13-year-old boy presents with a three-week history of right hip pain and limping. On
examination the hip moves into external rotation when flexed. Which of the following is the most likely diagnosis?
A. Developmental dysplasia (congenital dislocation) of hip
B. Juvenile rheumatoid arthritis
C. Perthes disease
D. Slipped upper femoral epiphysis
E. Traumatic dislocation of the hip
19. A 6-year-old boy presents with a two-day history of right hip pain and an inability to bear weight. On examination
he is apyrexial and systemically well, but his hip movements are generally painful. Which of the following is the most
likely diagnosis?
A. Congenital dislocation of the hip
B. Juvenile rheumatoid arthritis
C. Perthes disease
D. Septic arthritis
E. Slipped upper femoral epiphysis
20. Stroke volume
A. 50 ml/min
B. 70 ml/min
C. 90 ml/min
D. 110 ml/min
E. 130 ml/min
3
, 21. 45 years post-parotidectomy presented with facial palsy feature ,which of the following is one of these
features
A. Dropping of angle of mouth
B. Loss sensation to angle of jaw
C. Scalp loss sensation
D. Ant 2/3rd tongue loss sensation
E. Affection of muscle of mastication
22. Middle meningeal artery passes through which foramina?
A. Foramen of ovale
B. Foramen rotundum
C. Foramen spinosum
D. Foramen lacerum
E. Foramen magnum
23. A 28-year-old women collapses and is found to be deeply comatose with a GCS of 3. She is admitted to
hospital, intubated and ventilated. A CT scan shows an extensive sub arachnoid hemorrhage. A urinary
catheter is inserted. What type of urine output would be expected?
A. 30ml concentrated urine per hour
B. 30ml diluted urine per hour
C. 60ml diluted urine per hour
D. 300ml concentrated urine per hour
E. 300ml diluted urine per hour
24. Which of the following makes the posterior wall of inguinal canal?
A. Conjoint tendon
B. Internal oblique muscle
C. Transversus abdominus
D. External oblique muscle
E. Rectus abdominus
25. Woman has a gunshot to her back, which transect cord at Lt side presents with features suggestive of a
Brown-Sequard syndrome. The clinical findings will include which of the following ?
A. Left sided weakness, left sided proprioception and vibration loss, right sided loss of pain and temperature
B. Right sided weakness, right sided proprioception and vibration loss, left sided loss loss of pain and
temperature
C. Right sided weakness, right sided proprioception and vibration loss, right sided loss loss of pain and
temperature
D. Right sided weakness, left sided proprioception and vibration loss, right sided of loss of pain and
temperature
E. left sided weakness, right sided proprioception, and vibration loss, left sided loss of pain and temperature
26. What are the spirometry changes in COPD?
A. Increase tidal volume
B. decrease tidal volume
C. increase inspiratory volume
D. increase residual volume
E. none of the above
27. While placing a chest tube and giving local anesthesia. What is the sensory supply to parietal pleura?
A. phrenic nerve
B. intercostal nerve
C. vagus nerve
D. spinal accessory
E. none of the above
4
