SURGERY PRIMARY EXAMINATION

QUESTIONS
WEST AFRICAN COLLEGE OF SURGEONS
For each of the following Multiple choice Questions choose the MOST appropriate answer(s)
001 The intravascular water in a 20year old 60kg
male is about:
A 3.6 L
B 2.8 L
C 3.2 L
D 2.0 L
E 2.4 L
002 A litre of
Ringer lactate
A sodium 130
B K+ 2
C Ca++ 5
D Cal 114
E HCO3- 30

contains (in mmols):

003 Serum electrolytes (mmols/L) of a patient are: Na

126, K 3.0, CF 90, and HCO3 28; blood pH is 7.41
and urea 12 mmols/L. the most likely clinical
diagnosis is
A diarrhoea and vomiting
B Acute tubular necrosis
C Shock D Gastric outlet obstruction
E Severe diarrhoea.
004 Cell membrane:
A Consist almost entirely of protein molecules:
B Are impermeable to fat soluble substances
C Are freely permeable to electrolytes but not to
proteins
D In some tissues, permit the transport of glucose at a
greater in the presence of insulin
E has a stable composition throughout the life of the
cell
005 In the mechanism of pain:
A Fast pain is caused by C fibres
B slow pain is caused by A B fibres
C the further from the brain the stimulus the greater
the separation of the past and slow pains
D slow pain is sharp and localised
E fast pain is dull, intense and diffuse
006
A
B
D
D
E

Proteins that are secreted by cells are generally:

found in vesicles and secretory granules
not synthesised on membrane-bound ribosomes
initially synthesised with a single peptide or leader
sequence at their C-terminal
moved across cell membrane by Endocytosis
secreted in a form that is larger than the forms
present in the endoplasmic reticulum

007 The cross-bridges in the sarcomere in skeletal

muscles are made up of
A actin
B troponin
C myelin
D myosin
E tropomyosin
008
A
B
C
D
E

When sodium intake is high there is

increased renal nerve activity
decrease sodium excretion by intra-renal factors
normal or low GFR
decreased ADH secretion
high natriuretic hormone concentration

009 Which of he following is NOT synthesised in

postganglionic sympathetic neurons?
A adrenaline
B noradrenaline
C dopamine
D L-dopa
E acetylcholine
010
A
B
C
D
E

A primary function of the basal ganglia is:

sensory integration
slow-wave sleep
short-term memory
neuroendocrine control
planning voluntary movement

011 When an individual is standing naked in a room

with temperature of 210C (69.80F) with humidity of
80%, the greatest amount of heat will be lost from the
body thru:
A Respiration
B urination
C sweat evaporation
D elevated metabolism
E radiation and conduction
012 Which of the following is true of water excretion by
the kidneys?
A 80% of the fluid filtered in the glomeruli is
reabsorbed b4 the DCT
B some 15% of the filtrate is reabsorbed in the distal
tubule and 40% in the collecting ducts
C normally about 160L are filtered thru the glomeruli
in 24hrs
D fluid in the descending limb of loop of Henle is
hypertonic to plasma
E Fluid it the ascending limb of the loop of Henle is
hypotonic to plasma

__________________________________________________________________________________________________________
See that you dont make others suffer the way you have suffered. Be kind to all, inconsiderable of their faith,
Ethnic grouping or region. Let them be qualified for help only by the fact that they need it.
-- Dr Muslim Goodheart.

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

014
A
B
C
D
E

Insulin:
is a glycoprotein
is synthesized by the -cells of the islets
binds to red cells
increases ketone uptake by muscles
increases amino acid uptake by muscles

015 Which of the following pituitary hormone is an

opioid peptide?
A ACTH
B a-melanocyte-stimulating hormone (a-MSH)
C growth hormone
D B-endorphin
E b-MSH
016 Which of the following is not synthesised in both
the endocrine gland and the brain?
A Somatostatin
B dopamine
C Vasoactive intestinal peptide
D cortisol
E ACTH
017 Full development and function of the seminiferous
tubules require:
A Somatostatin
B androgens and FSH
C LH
D oxytocin
E FSH
018
A
B
C
D
E

In human males, testosterone is produced mainly by

vas deferens
Leydig cells
seminiferous tubules
epididymis
Sertoli cells

019 Which of the following is true of the colon?

A mass peristalsis occur once a day
B net water absorption is less in the proximal than
distal colon
C net secretion of sodium
D the freq of non-propagated contraction is 38/min
E propagated contractions involve only long segments
020
A
B
C
D
E

Partial gastrectomy does not usually cause:

steatorrhoea
weight loss
megaloblastic anaemia
dumping
osteomalacia

021
A
B
C

Oxyntic (parietal) glands:

Are mainly in the body and pylorus of the stomach
contain oxyntic cells which secretes intrinsic factor
Occupy 60% of the glandular mucosal area

D
E

Contain peptic (chief) cells which secrete pepsin

are straight narrow tubules which open in the
gastric pits

022
A
B
C
D
E

Pepsin
has optimal activity at pH of 2.64.2
has 50% of maximal activity at pH of 4.5
Activity is abolished at pH of 5.0
Is irreversibly denatured at pH of 6.0
secretion is strongest with gastrin stimulation

023 The pathway for a short chain fatty acid (<10 Catoms) from the intestinal lumen to the blood is:
A intestinal mucosal cellchylomicronslymphatic
ductsystemic venous blood
B space b/w mucosal cells lymphatic
ductsystemic venous blood
C space b/w mucosal cellschylomicrons
lymphatic ductsystemic venous blood
D intestinal mucosal cellsLDLhepatic portal
veinsystemic venous blood
E intestinal mucosal cells hepatic portal
veinsystemic venous blood
024
A
B
C
D
E

Which of the following are incorrectly paired?

lingual lipasedigestion in the stomach
elastasetissue rich in elastin
enteropeptidasepancreatic lipase
renincoagulated milk
pancreatic amylasestarch

025
A
B
C
D
E

Calcium absorption is increased by

hypercalcaemia
Oxalate in the diet
increased sodium absorption
low gastric acid secretion
1, 25-dihydroxycholecalciferol

026 After a meal rich in carbohydrate, insulin secretion

is probably stimulated by
A CCK
B VIP
C serotonin
D gastrin
E GIP
027 Which of the following is true of potassium in a
70kg man?
A total amount in the body is 3750 mmol
B about 20 mmol is lost in the faeces daily
C 90 mmol is lost in the urine daily
D amount in ECF is 60 mmol
E 5 mmol is lost in the sweat daily
028
A
B
C
D
E

Erythropoietin is secreted by cells in:

macula densa
PCT
juxtaglomerular cells
cortical peritubular capillaries
renal glomeruli

__________________________________________________________________________________________________
A single act of good is worthier than a multitude of bad / wicked actions. Offer even a smile if that is the only thing you can afford
Donate a book, to your school library, today, if you really appreciate my effort in putting together this compilation.
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Surgery Primary Examination Questions Collection

029 Which of the following is produced only by a large

amount of glucocorticoids?
A normal responsiveness of fat deposits to
noradrenaline
B maintenance of normal vascular reactivity
C inhibition of ADH secretion
D increased water excretion
E inhibition of inflammatory response
030 Carotid sinus massage sometimes stops
supraventricular tachycardia because:
A it decreases sympathetic discharge to the SA-node
B it increases vagal discharge to the conducting tissue
b/w the atria and the ventricles
C it increases vagal discharge to the SA-node
D it increases the refractory period of the ventricular
myocardium
E it decreases sympathetic discharge to the
conducting tissue b/w the atria and the ventricles
031
A
B
C
D
E

The first heart sound is caused by: closure of mitral and tricuspid valves
retrograde flow in the vena cava
vibrations in the ventricular wall during systole
ventricular filling
closure of the aortic and pulmonary valves

033
A
B
C

Catecholamines acting on - adrenergic receptors:

increase the contraction of the Sino-atrial node
increase cardiac output
constrict coronary arteries by a direct action on
them
Dilate blood vessels in skeletal muscles

034 Which of the Following organs has greatest blood

flow per 100 gram of tissue?
A brain
B skin
C kidneys
D liver
E heart muscles
035
A
B
C
D
E

Lymphocytes:
All originate from the bone marrow
Arc unaffected by hormones
converts to monocytes in response to antigens
interact with eosinophils to produceplate.
are part of the bodys defence against cancer.

036 Which of the follow is responsible for the

movement of oxygen from alveoli into the blood in the
pulmonary capillaries?
A Active transport
B passive diffusion
C Filtration
D Facilitated diffusion
E secondary active transport -

037 Which of the following has the greatest buffering

capacity in the interstitial fluid?
A Phosphate system
B haemoglobin system
C bicarbonate system
D ammonium-ammonia system
E proteins in the interstitial fluid
038 Intravenous lactic acid increases ventilation. The
receptors responsible for this effect are located in the:
A carotid bodies
B lung parenchyma
C trachea and large bronchi
D aortic baroreceptors
E Medulla oblongata
039
A
B
C
D
E

Pulmonary fibrosis would be expected to produce

histotoxic hypoxia
emphysema
Decreased vital capacity
stagnant hypoxia
cyanosis

040 On which of the following does aldosterone exert

its greatest effect?
A glomerulus
B proximal tubule
C Thin portion of-the loop of Henle
D cortical collecting duct
E thick loop of Henle
041
A
B
C
D
E

Hyperparathyroidism is not associated with

Chronic renal failure
renal calculi
dystrophic calcification
Cystic changes of bone
metastatic calcification

042
A
B
C

In AIDS:
IgA and interferons are increased
the T4/T8 ratio and interferon are reduced
the T4/T8 ratio is reduced and interferon increased D
the T4/T8 ratio is increased and interferon
decreased
the T4/T8 ratio is decrease and IgA increased

043 When blood is stored, the red cells:

A swell by about 30% and take about 24hrs to regain
their potassium after transfusion
B Swell by about 30% and are lost at 3% for every
day of storage
C lose some 2, 3-DPG but regain it in 72 hrs post
transfusion
D Swell by about 20% and take 24hrs to regain their
potassium after transfusion
E swell by about 30% and are lost at the rate of 1%
for every day of storage

__________________________________________________________________________________________________
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

044
A
B
C
D
E

The drug of first choice against clostridium is:

ceftriaxone
Penicillin
Oxytetracycline
erythromycin
ofloxacin

045
A
B
C
D
E

Which of the Following is NOT increased in DIC?

bleeding time
factor VIII
clotting time
partial thromboplastin time
thrombin time

046
A
B
C

Benign tumours:
grow by invading surrounding tissues
may or may not be surrounded by a fibrous capsule
may or may not have a distinct margins from the
surrounding tissues
show little nuclear alteration
may or may not metastasise

D
E

047 Which of the following is NOT a feature of

carcinoma in-situ? It may:
A be symptomless
B give rise to a mass in the breast
C involve mesenchymal tissue
D be readily detected by cytological examination
E persist for some years without showing invasion
048
A
B
C
D
E

Chemical carcinogenesis may not include:

initiation
activation of protooncogenes
metabolic conversion of procarcinogen
activation of retrovirus
promotion

049 Useful effects of acute inflammation do NOT

include:
A dilution of the toxin
B formation of fibrin
phagocytosis
D swelling of the tissue
E stimulation of tissue response
050 Which of the following is NOT a type II
hypersensitivity disease:
A tuberculosis
B Graves disease
C erythroblastosis fetalis
D myasthenia gravis
051
A
B
C
D
E

Point mutation may not result in:

synthesis of shorter than normal peptides
total lack of transcription
abnormal mRNA processing
synthesis of a normal protein
trisomy

052 In lymphatic filariasis:

A scrotal contents are usually not affected
B nodes may show acute inflammation around the
worms
C there is dermal lymphatic dilation and proliferation
D fibrosis involves only the affected lymph nodes
E chronic lymphatic obstruction occurs many years
after acute filariasis
053 A patient presents with multiple facial skin nodules
with typical leonine facies:
A he has tuberculoid leprosy
B A skin biopsy will contain large numbers of
organisms
C he may have hypogammaglobulinaemia
D destruction of cutaneous nerves is most likely to
develop
E he is not infectious
054 Autoimmunity:
A is exemplified by lupus erythematosis
B Is an immune response-directed against foreign
antigens
C Is seen only in immunodeficient patients
D Leads to tissue damage due to antibodies only
E Involves only T cells in tissue damage
055 Giant cells are characteristically found in lesions
associated with:
A Actinomycosis
B lepromatous leprosy
C Schistosomiasis
D ancylostomiasis
E Ascariasis.
056
A
B
C
D
E

Wound healing is enhanced by:

zinc
cortisol
ACTH
Vitamin A
Alanine

057 If the following events are placed in order of

occurrence in skin wound:
A growth of granulation tissue will be 2nd
B uniting the wound edges by collagen will be 3rd
C loss of vascularity in the wound will be 4th
D migration of epithelial cells from the edges of the
wound will be 5th
E formation of a blood clot comes first
058 Open wounds are assoc with all the following
except:
A formation of granulation tissue
B infection
C migration of surrounding epithelium
D giant cell formation
E wound contraction

__________________________________________________________________________________________________
A single act of good is worthier than a multitude of bad / wicked actions. Offer even a smile if that is the only thing you can afford
Donate a book, to your school library, today, if you really appreciate my effort in putting together this compilation.
Courtesy Of Dr. Muslim Goodheart

Surgery Primary Examination Questions Collection

059 In selecting human kidney donors, it is essential

that the donor and host are:
A ABO compatible
B ABO identical
C HLA identical
D HLA compatible
E Rhesus compatible
060 Which of the following suture material causes most
reaction in a wound?
A silk
B monofilament
C thread
D Teflon
E catgut
061 Which of the following is not premalignant?
A liver cirrhosis
B adenoma of the rectum
C arsenic keratosis
D basal cell papiloma
E asbestosis
062 Eosinophilia is present in
A multiple myeloma
B schistosomiasis
C Rheumatoid arthritis
D Hashimotos thyroiditis
E Actinomycosis

067 The least amount of granulomatous reaction is seen

in a wound sutured with:
A monofilament
B polyfilament silk
C catgut
D thread
E held together by adhesive tape
068
A
B
C
D
E

Osteoid tissue is
rich in Ca
characteristic of osteosclerosis
calcified cartilage
Collagenous tissue
abundant in osteoporosis

069
A
B
C
D
E

Epithelioid cells are derived from:

lymphocytes
mast cells
Pericytes
macrophages
Langhan's giant cells

070 C5a component of complement

A inhibits mast cell degranulation
B promotes emigration and accumulation of
neutrophils and macrophages
C enhances adherence of macrophages and
polymorphs to target cells with C3b on their surface
D deficiency has no pathological effects
E causes target cell plasma membrane injury

063 In haemolytic anaemia:

A RBC survival measured by tagging with
radiochromium is increased
B the urine is usually normal
C reticulocytes count is normal
D red marrow is increased in bulk and cellularity
E daily stercobilinogen excretion is normal

071
A
B
C
D

064 The following acts by inhibiting synthesis of

bacterial cell wall:
A chloramphenicol
B penicillin
streptomycin
D erythromycin
E Oxytetracycline

072 Which of the following is NOT a feature of

thromboxane A2?
A inhibits platelets adenylate cyclase
B It is produced by conversion of cyclic
endoperoxidase by platelets
C It is a prostaglandin with a halflife of 30 seconds
D stimulates platelets adhesion and aggregation
E it is produced by the action of an endothelial cell
enzyme

065
A
B
C
D
E

The larva of dracunculus enters the body thru

intestines
lungs
stomach
mouth
skin

066
A
B
C
D
E

Action of the exotoxin of C. tetani is primarily on:

central nervous system
muscles
neuromuscular junction
CVS
peripheral nerves

073
A
B
C
D
E

In antigen antibody reactions:

IgG appears in the primary antibody response
IgM is produced in the secondary antibody response
Mast cell degranulation is a property of IgD
Lymphocyte surface antigen receptor is a property
of IgE
IgA is secreted by plasma cells

C-reactive protein:
is a carrier plasma protein
rises slowly after trauma or infection
is synthesised by the reticulo-endothelial system
activates compliment
is responsible for pyrexia following trauma

__________________________________________________________________________________________________
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

074 Which of the Following is NOT a feature of

hamartoma?
A it is tumour-like
B is a malformation in which tissues are arranged
haphazardly
C has no tendency for excessive growth
D has a capsule
E stops growing after adolescence
075 The following are examples of paraneoplastic
syndrome EXCEPT:
A diabetes insipidus
B venous thrombosis
C hyperkalaemia
D hypercalcaemia
E hypernatraemia
076
A
B
C
D
E

Which has a dominant pattern of inheritance?

neurofibromatosis
Ankylosing spondylitis
glycogen storage diseases
colonic cancer
Duchene muscular dystrophy

077 Which of the following investigations is most likely

to help in diagnosis of Pagets disease of the bone?
A total serum protein level
B serum calcium
C plasma inorganic phosphates
D serum alkaline phosphatase
E serum acid phosphatase
078 Sqamous cell carcinoma is the commonest type of
primary cancer arising in
A bladder
B lungs
C prostate
D rectum
E stomach
079 Microfilariae of Wuchereria bancrofti enter the
circulation:
A At any time
B 8 p.m. to 2 am.
C 8 a.m. to 2 p.m
D 6 p.m. to 12 midnight
E 2 p.m. to 8 p.m.
080
A
B
C
D
E

In acute tubular necrosis:

urine potassium concentration is normal
urine osmolality is normal
Urine urea concentration is normal or slightly
elevated
Plasma calcium concentration is elevated
urine sodium concentration is raised

081
A
B
C
D
E

As a rule the isthmus of the thyroid crosses the

hyoid bone
24th tracheal rings
cricoid cartilage
thyroid cartilage
inferior belly of omohyoid

082
A
B
C
D
E

The middle thyroid vein empties into

external jugular
anterior jugular
internal jugular
posterior jugular
vertebral

083 The common carotid artery usually bifurcates at the

level of the
A jugular notch
B cricoid cartilage
C neck of the mandible
D upper border of thyroid cartilage
E sternoclavicular joint
084 The blood vessels of the scalp are located primarily
in the:
A skin
B dense subcutaneous layer
C aponeurotic layer
D loose connective tissue layer
E periosteal layer
085
A
B
C
D
E

The principle sensory nerve of the larynx is the

recurrent laryngeal
glossopharyngeal
superior laryngeal
hypoglossal
inferior laryngeal

086 The jaws open by a forward traction on the neck of

the mandible by the:
A Masseter
B temporalis
C Buccinators
D Upper fibres of the medial pterygoid
E Lower portion of the lateral pterygoid
087 Ossification of body of the sternum usually is
complete by age
A 18 yrs
B 15 yrs
C Three yrs
D 21 yrs
E six yrs

__________________________________________________________________________________________________
A single act of good is worthier than a multitude of bad / wicked actions. Offer even a smile if that is the only thing you can afford
Donate a book, to your school library, today, if you really appreciate my effort in putting together this compilation.
Courtesy Of Dr. Muslim Goodheart

Surgery Primary Examination Questions Collection

088 Which of these statements is correct regarding

pulmonary circulation?
A It is the main blood supply to the bronchi
B It is the main blood supply to the connective tissue
of the lung
C the pulmonary trunk goes directly to the left lung
D the pulmonary trunk arises from the right ventricle
E the pulmonary veins enter the right atrium of the
heart.
089 The segment of the primitive heart tube giving rise
to the aortic sac is the:
A bulbis cordis
B Primitive ventricle
C Sinus venosus,
D primitive atrium
E Truncus arteriosus
090 All these statements correctly describe the thoracic
duct EXCFPT:
A It returns lymph from the greater part of the body to
the venous system
B It is the upward continuation of the cisterna chyli
C ends at the confluence of right Subclavian and
brachiocephalic vein
D In most of its course it lies behind the oesophagus
E it contains valves.
091
A
B
C
D
E

Cutting phrenic nerve close to its origin causes.

loss of bronchoconstriction
loss of sensation in the middle diaphragm
loss of power in the intercostals muscles
difficulty in expiration
loss of the respiratory arc.

092 Which of these statements does NQT describe

dermatomes correctly?
A areas of skin supplied by the sensory root of a
spinal nerve
B Areas of touch are more extensive than those for
temperature
C T10 nerve supplies the area of the umbilicus
D there is practically no overlapping of contiguous
dermatomes E the lower six intercostal nerves supply both thoracic
and abdominal walls.
093 Among the covering of the cord and testis which of
the following represents the internal oblique muscle?
A tunica dartos
B external spermatic fascia
C cremasteric muscle and fascia - D Internal spermatic fascia
E subcutaneous layer.
094 Which of the following strx represents the
obliterated remains of the left umbilical vein?
A ligamentum venosus
B Ligamentum teres hepatis

C Falciform ligament
D Porta hepatis
E Lower coronary ligament
095 Both the vagal parasympathetic innervation and
thoracic splanchnic sympathetic of the GIT terminate at:
A duodeno-jejunal junction
B junction of the middle and left thirds of the
transverse colon
C Middle of the transverse colon
D ileoceacal junction
E rectosigmoid junction
096 Which of the following structures is important in
the selective Reabsorption of water and dissolved
materials back into the circulation?
A Straight and convoluted tubules
B Glomerular capsule
C Renal papilla
D glomerulus
E Major calyx
097
A
B
C
D
E

Most peripheral structures send their lymphatics to

internal iliac nodes
Superficial inguinal nodes
Nodes of the lumbar chain
external iliac nodes
hypogastric nodes

098 Which of these statements correctly describes the

course Of the ureter
A right ureter is related to the base of the sigmoid
colon
B After crossing the pelvic brim, the ureter lies lateral
to internal iliac artery
C in the male as it nears the bladder it passes above
the ductus deferens
D in females, the ureter crosses behind and below the
uterine artery
E the ureter enters the supero -lateral aspect of the
bladder.
099 Clitoris of the female is similar to the penis of the
male EXCEPT that it:
A has a corpus spongiosum
B Is composed of erectile tissue
C Is composed of the crura
D it has two corpora cavernosa
E it is suspended by a suspensory ligament.
100 Following extraperitoneal rupture of the bladder the
thickening and inflammation caused by 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

101 In the anatomy of the duodenum:

A the duodenum is retroperitoneal and immobile
except in the first part which is completely covered
with peritoneum
B the first part is related posteriorly directly to the
gastroduodenal artery, common bile duct Portal
vein and the inferior vein cava
C the second may be damaged during surgery on the
right kidney or right ureter and in right
hemicolectomy.
D because of the relationship with the gall bladder, a
large gallstone may ulcerate thru the wall of (he
second part and enter the duodenum
E the third part crosses the superior mesenteric
vessels.
102 In the anatomy of the small intestine:
A Brunners glands extend deep into the muscular
layer and produce alkalinerich mucus
B the absorptive surface of the columnar epithelium is
estimated at 600 m2
C the villi are 13cm long and there are 20
40/mm2
D mucosal cells are shed every 5-6 days and originate
in the crypts of Lieberkuhn
E There are in the outer cell membrane enzymes for
digestion of carbohydrates, polypeptides, nucleic
acid and fats
103
A
B
C
D
E

The nerve of Laterjet:

Is the terminal part of the posterior vagus
Is preserved in selective Vagotomy
Supplies the pyloric antrum
Supplies the pyloric sphincter and the first part of
the duodenum
Is responsible for contraction of the pyloric
sphincter.

104 The gastric mucosa:

A Is thrown into folds which arc most marked along
the lesser curvature B Is divided into oxyntic and pyloric glandular areas
C Is studded with wide opening, the gastric pits
D has surface epithelium formed by alkaline mucus
secreting cells
E has about 1.5 billion oxyntic cells in the male and 1
billion in the female.
105 The epidural or extradural space of the vertebral
column
A may be approached thro the sacral hiatus
B is commonly used to obtain CSF
C is only a potential space
D is filled with fibrocartilage
E contains the external vertebral venous plexus.
106 The spinal cord in adults usually ends at the
following intervertebral level:
A L45
B L12

C
D
E

S23
S45
T1112

107 The following are primary muscle acting during

elevation of the arm at the Glenohumeral joint, except:
A deltoid is a prime mover
B pectoralis major stabilises the joint
C Supraspinatus acts progressively throughout the
movement
D infraspinatus assists in the movement
E Subscapularis assists in the movement
108
A
B
C
D
E

The muscle innervated by long thoracic nerve is:

triceps
Pectoralis major
Serratus anterior
latissimus dorsi
deltoid

109 In the digital synovial tendon sheath, infection can

travel into the common flexor tendon sheath at the wrist
from the:
A thumb
B index
C middle finger
D ring finger
E little finger
110 Which of the following correctly describes the
arteries of the palm?
A palmar metacarpal arteries arise from superficial
palmar arch
B princeps pollicis artery arises from the ulnar artery
C deep palmar arch branches do not connect with
common digital arteries
D ulnar artery is the source of the superficial palmar
arch
E proper digital arteries run only on the radial side of
the fingers
111 Injury to the Upper part of brachial plexus usually
results in:
A spastic paralysis of the upper limb
B Klumpkes paralysis
C paralysis of the hand
D results from violent separation of head and
shoulder
E involvement of nerves C8 and T1.
112
A
B
C
D
E

The sciatic nerve:

passes anterior to the obturator internus
Gives off several fibres to the buttock
runs superficial to the thigh muscles that arise from
the ischial tuberosity
consists of two nerves
generally runs thru the piriformis muscle

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Surgery Primary Examination Questions Collection

113 The following correctly describe the fascia lata

EXCEPT;
A consists of dense deep fascia
B It splits to cover both sides of tensor fascia lata
muscle
C It is reinforced by a strong medial part, the iliotibial
tract
D at the knee it blends with expansions from the
muscle tendons
E just below the inguinal ligament, it presents the
saphenous opening
114 The following statements correctly describe the
adductor canal EXCEPT;
A It lies deep to the sartorius
B It is bounded anteriorly by adductor longus
C begins above at the apex of the femoral triangle
D it ends below at the tendinous hiatus
115 The following state about the hip joint are correct
EXCEPT;
A acetabulum has a labrum attached to its margin
B head of the femur fits deeply into the acetabulum C ligament of the head of the femur strongly resists
adduction of the thigh
D joint is most stable when femur is extended
E the iliofemoral ligament strongly resists
hyperextension at the hip
116 The Following statements regarding the arches of
the foot are correct EXCEPT;
the transverse arch lies at the level of proximal row
of tarsals
B the lateral longitudinal arch passes forward from the
calcaneus through the cuboid to the heads of the
two lateral metatarsals
C the two arches interlock to form a functional single
arch
D the arch is loaded from the top through the talus
E medical part of the longitudinal arch is higher than
the lateral part.
117 The common peroneal nerve is most easily injured:
A Where it leaves the sciatic nerve in the popliteal
fossa
B As it branches into the short head of the biceps
femoris
C Where it emerges below the piriformis muscle
D just behind the head of the fibula
E where it divides into superficial and deep peroneal
nerves
118 In muscular activity:
A synergistic muscle is one that relaxes against the
pull of gravity
B antagonist muscles oppose the prime movers
C innervation is by the muscle spindle
D a parallel arrangement of fibres provides a more
powerful movement than an oblique arrangement
E curare improves skeletal muscle contraction

119
is
A
B
C
D
E

The First organ in the embryo to become lymphoid

Vermiform appendix
Spleen
lymph node
palatine tonsil
thymus

120 The synthetic or S phase of the cell cycle is the

period during which:
A RNA is synthesised
B mitochondria are synthesized to provide energy for
mitosis
C Microtubules are synthesised for the mitotic
apparatus
D Centrioles are reduplicated for the spindle formation
E DNA is synthesised
For each of the incomplete statement below, one or
more of the completions are correct. Decide which
combinations are correct and mark the
Appropriate letter.

E
121
by:
1
2
3
4

A If only 1, 2 and 3 are correct

B if only 1 and 3 are correct
C If only 2 and 4 arc correct
D if only 4 is correct
IF some other completions or combinations of
those given are correct.
The oxygen dissociation curve is shifted to the right
bank blood
anaemia
descent From a high to a low altitude
Pyrexia. -

122 The following cause(s) contraction of bronchial

smooth muscles:
1
Adrenaline
2
Leucotrienes
3 Vasoactive intestinal polypeptide (VIP)
4 Acetylcholine
123
1
2
3
4

During inspiration there is an Increase in:

intraabdominal pressure
venous return to the heart
heart rate
intrapleural pressure.

124
1
2
3
4

Deficiency of thiamine (Vit B1) leads to:

loss of tendon reflexes
Muscle atrophy toe drop
Cheilosis (lip fissuring).

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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

125 Parasympathetic nerves

1 liberate at both pre- and post-ganglionic nerve
endings
2 tend to have longer post-ganglionic than preganglionic fibres
3 Generally have opposite effects to those of
sympathetic nerves when both supply the same
organ.
4 Play an important role in vasodilatation in skeletal
muscle during prolonged exercise
126 Examples of active transport include:
1 Movement of carbon dioxide from the blood into
the pulmonary alveoli
2 Chloride shift between red blood cells and plasma
3 Movement of oxygen within a muscle fibre
4 secretion of hydrogen ions by parietal cell
127 A skeletal muscle cell:
1 becomes less excitable when its resting membrane
potential is increased
2 has a resting membrane potential such that the
inside of the cell is positive with respect to the
outside
3 contains intracellular stores of calcium
4 is normally innervated by more than one motor
neuron
128
1
2
3
4

There is abundant supply of carbonic anhydrase in:

Gastric acid-secreting cells
Red blood cells
Renal tubular cells
plasma

129 Mitochondrion:
1 Is bounded by 2 membranes each consisting of a
lipid bilayer containing proteins
2 compartments lining the interior
3 has ATP production sites
4 Regulates ICF sodium concentration
130 Some chemical messengers:
1 exert their physiological effects by acting directly
on the nucleus of their target cells to increase
transcription of selected mRNA
2 bind to receptors on the membranes of their target
cells and this increases concentration of free Ca2+
in the cytoplasm which in turn produces the effects
3 increases the ICF concentration of cyclic AMP
4 Increase the intracellular concentration of
potassium.
131 The mechanism involved in single gene defects
include:
1 enzyme defects
2 Missense mutation (single base substitution)
3 defects in transport across membrane
4 abnormal embryogenesis

132 Common lesions caused by Staphylococcus

Include:
1 carbuncles
2 toxic shock syndrome
3 gastroenteritis
4 Pyoderma gangrenosum
133
1
2
3
4

Hypersensitivity:
is an exaggerated immune response
is a inappropriate adaptive immune response
is manifested on second contact
Does not cause tissue damage

134 Risk factor for formation of cholesterol stones in

the gall bladder include:
1 chronic haemolytic anaemia
2 heat bypass
3 alcoholic hepatic cirrhosis
4 Obesity.
135
1
2
3
4

Platelet activation includes:

change of shape
Secretion of prostaglandins
Secretion of thromboxane A2
Secretion of ATP

136
1
2
3
4

Chronic inflammation is xterised by

presence of lymphocytes and macrophages
proliferation of fibroblast
blood vessel proliferation
emigration of polymorphs

137 In hypertrophy there is:

1 Increase in size of tissue
2 DNA synthesis
3 Synthesis of more membranes
4 A low level of aerobic respiration.
138
1
2
3
4

An abscess:
Shows coagulative necrosis
1t usually heals by resolution
is commonly associated with clostridial infection
Is a localised suppuration.

139 The following may complicate healing of closed

fracture:
1 pseudoarthrosis
2 osteomyelitis
3 Myositis ossificans
4 renal calculi.140
1
2
3
4

The following occur in stored blood:

plasma Hb level remains normal
the pH falls
Platelets arc viable after 24 hrs
Leucocytes do not survive more than 90 min

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A single act of good is worthier than a multitude of bad / wicked actions. Offer even a smile if that is the only thing you can afford
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Courtesy Of Dr. Muslim Goodheart

10

Surgery Primary Examination Questions Collection

141 The Following structures pass through the foramen

ovale:
1 Mandibular division of the trigeminal nerve
2 Middle meningeal artery
3 Accessory meningeal artery
4 Deep auricular artery
142 The principal bronchi branching from the trachea
demonstrates these xtics
1 A right bronchus wider than the left
2 A left bronchus shorter than the right
3 More foreign bodies are inhaled into the right
bronchus than into the left
4 Division of the right bronchus occurs within the
substance of the lung.
143
1
2
3
4

The common bile duct:

usually lies to the left of the hepatic artery
Lies posterior to the portal vein
is about I cm in diameter
Descends in the free border of the lesser omentum

144 The lumbar nerve plexus includes:

1 greater splanchnic nerves 2 Iliohypogastric nerve
3 Superior hypogastric plexus
4 Obturator nerve. -

147
1
2
3
4

symptoms of carpal tunnel syndrome may include:

loss of sensation in the centre of the palm
loss of abduction of the thumb
paraesthesia on the palmar surface of the middle
finger
loss of flexion at the distal interphalangeal joints of
the fourth and fifth digits

148 The medical epicondyle of the humerus serves as

the site of origin for the:
1 flexor carpi ulnaris
2 pronator teres
3 Palmaris longus
4 flexor digitorum profundus
149
1
2
3
4

The first layer of plantar muscle includes

flexor digitorum longus
Quadratus Plantae
Flexor digitorum brevis
Abductor digiti minimi

150
the:
1
2
3
4

With the knee flexed, the leg is rotated laterally by

Sartorius
semitendinosus
Semimembranosus
Biceps femoris

145 In the anatomy of the adrenal glands:

1 each gland weighs 34 g
2 they cap the kidney at the level of the eleventh
dorsal vertebra
3 They are encapsulated, invested in renal fascia and
embedded in peri-renal fat
4 they consist of an outer smaller cortex and an inner
bigger medulla
146 The sphincter urethrae (external sphincter):
1 surrounds the membranous urethra
2 lies above the upper layer of urogenital diaphragm
3 Is under voluntary control for interrupting or
withholding urine flow for short periods
4 has smooth muscle fibres

Good luck in all your endeavour 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.