SURGERY PRIMARY EXAMINATION

QUESTIONS
WEST AFRICAN COLLEGE OF SURGEONS
001
A
B
C
D
E

The ischiorectal fossa:

contains the pudendal canal
is limited medially by the rectal wall
is bounded laterally by the ischium directly
is roofed by the skin of the anal triangle
extends deep 2 the perineal membrane in the
urogenital triangle

002 in the foot:

A both the tibialis anterior and Tibialis posterior are
responsible for inversion
B inversion of the foot is accompanied by abduction
of the forefoot.
C the peronei are responsible for inversion of the foot
D most of the full range of inversion and eversion
occur in the midtarsal joint
E bony factors are the most important aspect of
maintaining the lateral longitudinal arch
003 The oesophagus:
A passes through the diaphragm at the level of lie
eighth thoracic vertebra
B passes through the right crus of the diaphragm
C has a three centimetre intra-abdominal portion
D is lined in part by squamous, and in part by
columnar, epithelium
E is separated from the vertebral column by the right
posterior intercostal arteries.

007
A
B
C
D
E

the contents of inguinal canal are

the vas deferens
the broad Ligament in female
testicular artery
the inferior epigastric vessels
lymphatics from the uterus.

008 The main features of renal juxtaglomerular

apparatus are:
A efferent arterioles
B afferent arterioles
C macula densa round the DCT
D juxtaglomerular cells containing rennin granules
E renal nerves
009
A
B
C
D
E

sesamoid bones in the foot are found in

flexor hallucis longus
flexor digitorum longus
flexor digitorum brevis
flexor hallucis brevis
quadratus plantae

010 By the 48 day, the whole of the developing

skeleton is cartilage except the:
A terminal phalanges
B proximal phalanges
C distal interphalangeal join
D medial ray of the limb
F the lateral ray of the limb

004 blood supply of the pancreas is derived from the

following arteries:
A gastro-duodenal
B splenic
C Lt gastric
D Right gastric
E superior mesenteric

012 the foregut extends from the

A mouth to the Cardiac notch
B pharynx to the cardiac notch
C mouth to ampular of Vater
D pharynx to ampular of Vater
E pharynx to the pylorus

005
A
B
C
D
E

branches of the trunk of brachial plexus are:

long thoracic nerve
nerve to subclavius
medial cutaneous nerve o f forearm nerve
thoracodorsal nerve
suprascapular nerve

013
A
B
C
D
E

006
A
B
C
D
E

the obturator nerve

has the root value of L35
gives articular branch to hip and knee joints
supplies obturator internus muscle
supplies obturator externus muscle
supplies gracilis muscle

014 prominent collateral circulation seen in portal

hypertension include
A haemorrhoids
B oesophageal varices
C caput medusa
D arc of Riolan
E vasa recta

the following parts of the GIT do not have a serosa:

oesophagus
middle rectum
distal rectum
ileum
jejunum

_________________________________________________________________________________________________________
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 conscience, To your God, 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

015
A
B
C
D
E

the deep muscles of the back include

interspinalis
multifidus
longissimus
trapezius
rectus abdominis

016
A
B
C
D
E

Suprahyoid group of muscles includes

omohyoid
digastric
mylohyoid
geniohyoid
thyrohyoid

017 The thoracic duct

A lies anterior to the internal Jugular vein
B lies posterior to the suprascapular artery
C is anterior to the phrenic at the level of C7
D crosses anterior to the oesophagus at level of T4
E is posterior to the posterior intercostal arteries
018
A
B
C
D
E

in the adult heart:

pericardium has 3 layers
sulcus terminalis is often seen in the right atrium
musculi pectinati develop from the primitive sinus
venosus
interventricular septum is entirely fleshy
oblique sinus is and immediate anterior relation of
the oesophagus

019 the deep perineal pouch:

A is limited by the superficial fascia and the perineal
membrane
B contains the bulbourethral glands and the openings
of their ducts
C contains the narrow membranous urethra
D contains sphincter urethrae and the deep transverse
perineal muscles
E transmits the dorsal nerve of the penis
020 The shoulder joint;
A is u synovial ball and socket joint
B depends on strong capsule and ligaments for
stability
C the bony constituents of the joint are therefore
arranged to give mobility rather than security
D the anterior part of the capsular ligament is its
weakest part
E circumflex nerve is an important relation as injury
to it may complicate dislocation of the joint
021
A
B
C
D
E

the largest bursa in the body is:

subacromial
infraspinatus
Subscapularis
semitendinosus
none of the above

022
A
B
C
D
E

Meckels diverticulum is:

is found 2% of paediatric population
2 inches from the ileo-caecal valve
symptomatic in 2% of the affected population
is the site of injury in 2% of blunt abdominal
trauma
is 2 feet in length

023 Peritoneal folds that contain an artery and a vein

include:
A median umbilical
B falciform ligament
C linorenal Ligament
D lateral umbilical Fold
E medial umbilical Fold
024 Which of following structures are found in the
medulla oblongata?
A hypoglossal nucleus
B pyramidal decussation
C red nucleus
D medial and spinal vestibular nuclei
E reticular formation
25
are:
A
B
C
D
E

Event occurring during 3rd week of Embryonic life

026
A
B
C
D
E

The following develop from neural crest cells

Suprarenal cortex
Schwann cell layer / neurilemma
pia mater
Para sympathetic ganglia
pigment.

Organogenesis
Neurilation
Formation of intraembryonic mesoderm
Gastrulation
Formation of primitive streak

027 the following muscles develop from the 3rd

pharyngeal arch:
A Superior constrictor muscle of the pharynx
B Thyrohyoid
C Stylopharyngeus
D Cricothyroid
E cricopharyngeus
028 formation of the mouthparts
A The stomodium is present at the third week when
somites appear and the Bucco-pharyngeal
membrane breaks down
B The frontonasal process and the beginning of
mandibular and hyoid arches appear in the fourth
week
C The teeth beg at the dental lamina in the sixth
week
D Calcification of the first dentine, being following
by the enamel begins in the 5th month
E Calcification of the first dentine begins in the
eighth month

__________________________________________________________________________________________________
. 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 simply because your were once hurt. Be good to all. You may not know who may later be your saviour!
Courtesy of Dr Muslim Goodheart

Surgery Primary Examination Questions Collection

029
A
B
C
D
E

Mediastinal surface of the left lung is related to the:

Oesophagus
Infundibulum
Left atrium
brachiocephalic trunk
inferior vena cava

030 the first intercostal nerve:

A runs in the intercostal space b/w internal and
external intercostal muscles
B supplies the adjacent pleura with sensory
innervation
C has no anterior cutaneous branch
D is the ventral ramus of the first thoracic nerve
E has a lateral cutaneous branch, which forms the
intercostobrachial nerve
031 following structures lie in contact with the neck of
the first rib
A Superior intercostal vein
B Superior thoracic artery C Sympathetic trunk
D Stellate ganglion
E Anterior primary ramus of the first thoracic nerve
032 The following are important landmarks in the
surface anatomy of the oblique fissure of the lung:
A 4th left costal cartilage at the junction of the
sternum
B 5th intercostal space midaxillary line
C spine of third thoracic vertebra
D 4th rib in the midclavicular line
E xiphisternal junction
033 oesophagus
A Has a length of 40 cm from the incisor teeth
B begins to curve at the intervertebral disc between
T4T5
C Has three natural (physiological) constrictions .
D has an outer circular and an inner longitudinal
muscle
E Movement of food down the oesophagus is by
means peristalsis
034
A
B
C
D
E
035
A
B
C
D
E

the diaphragm.
is developed partly from septum transversum
Pushes the lungs up when it relaxes
has an opening for the inferior vena cave at the
level of eighth thoracic Vertebra
has a central tendon, which lies at the same
horizontal level as the right dome
on contraction reduces the vertical diameter of the
thorax
the following are saddle joints
Atlanto-axial
Knee
Radio ulnar Subtalar -Carpometacarpal of the thumb

036 movement at the hip joint:

A Abduction is done by the anterior fibres of the
gluteus medius and minimus
B The gluteus maximus is active when the thigh is
extended against resist
C abduction is limited by the pubofemoral and medial
band of iliofemoral ligament
D Lateral rotation is brought about by the obturator in
assistance with piriformis and quadratus femoris
E dislocation of the joint is common because of the
weak ligament
037 the following arteries are readily palpable in the
lower limb
A profunda femoris
B Anterior tibial
C Posterior tibial
D dorsalis pedis
E Medial plantar.
038
A
B
C
D
E

the adductor canal adductor longus forms the posterior boundary

The vastus medialis is found on the medial side
The sartorius forms the immediate relation of the
roof
The deep lymphatics of the leg drain into a group of
lymph nodes that lie in the canal
The saphenous nerve form part of the contents

39 The medial longitudinal arch of the foot:

A Is more elevated when the feet are planted close
together, than when they are apart
B Is more mobile and resilient than the lateral
C has its summit at the subtalar joint
D Is maintained by, the peroneus longus
E makes more extensive contact with the ground than
the lateral under the stress of weight and muscular
thrust.
040
A
B
C
D
E

fertilisation results in
initiation of cleavage
chromosomal sex determination
restoration of the diploid number of chromosomes
formation of the zygote
completion of meiosis
SECTION B: PHYSIOLOGY

041 Peripheral resistance

A is the sum of the resistance of all vessels in the
vascular tree
B lies largely in the capillaries
C lies largely in the arterioles
D falls in exercise
E is unchanged in exercise.

__________________________________________________________________________________________________
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

042
A
B
C
D
E

from an ECG one can obtain:

cardiac out put
heart rate
force of ventricular contraction
A-V conduction time
information as to the presence of ectopic foci

043
A
B
C

sweat glands that play a role in thermoregulation

produce a hypotonic solution
prod a secretion comprising mainly KCl
are innervated by the parasympathetic nervous
system
have acetylcholine as the transmitter
are innervated by the sympathetic nervous system

D
E

044 glomerular filtration rate

A is independent of fall in the mean systolic blood
pressure
B can be assessed by endogenous creatinine clearance
measurement
C rises with increases in the blood urea levels -D correlates well with body surface area
E is reduced in the presence of low plasma protein
concentration
045 glycosuria may occur.
A after physical trauma
B after mental trauma
C in the presence of normal blood glucose
D in gross renal tubular diseases
E in diabetes insipidus
46
A
B
C
D
E

the D Vitamins
are fat soluble
are- stored in the liver
comprises two main forms: D2 and D3
if deficient result in osteomalacia in adults
if present in excess causes hypercalcaemia and
generalised metastatic calcification

047
A
B
C

prostaglandins
are small molecular weight polypeptides
are chemically related to thromboxane
have been clearly shown to be responsible for
luteolysis in women
inhibit secretion of renin
are produced in the seminal vesicles in man

D
E
048
A
B
C
D
E

in the colon
water is absorbed
bicarbonate is secreted
Na is secreted
potassium is absorbed
a number of vitamins are synthesised and
reabsorbed

49 The lower small intestine is the primary site for the

absorption of
A fatty acids

B
C
D
E

bile salts.
calcium
iron
vitamin B12

050 intracranial pressure may be increased by

A an increase in venous pressure
B hypocapnia
C hypoxia
D hypothermia
E negative gravity (acceleration downwards, force
moving towards the head)
051 following the passage of an action potential, there is
hyperpolarisation
A when the nerve cell is more excitable than at rest
B when the membrane potential is l0-20 mV less than
at rest
C produced by a sudden massive influx of sodium
D which is influenced by agents that inhibit
metabolism
E which lasts for 35 40 msec
052
A
B
C
D
E

The blood brain barrier

is poorly developed at birth
is not present in the posterior pituitary
can be easily crossed by dopamine
can be easily crossed by penicillins
is not broken by tumours

053 The spindle

A. supplies the central nervous system with
information concerning muscle length
B supplies the central nervous system with info
concerning muscle tension
C is sensitised by fusimotor nerve activity
D possess TWO types of sensory endings
E contributes to the tone of the surrounding muscle.
054 given the following data: pH=7.31; PO2=70
mmHg (9.33kPa); PCO2=51 mmHg ( 6.8 kPa); base
deficit=11Which of the following apply:
A pure respiratory acidosis is present
B mixed respiratory and metabolic acidosis is present
C treatment with 35% O2 is indicated
D pyloric stenosis and chronic bronchitis are present
E diabetic keto-acidosis is a likely explanation.
055 lung compliance is
A decreased by pulmonary congestion
B is a measure of change in lung volume per unit
change in airway pressure
C is decreased by emphysema
D is approximately half in a person with one lung
E is determined by using peak flow metre
056 concerning plasma membrane:
A the lipid bilayer is hydrophilic
B the integral or transmembrane proteins are involved
in molecular transport
C membrane components are symmetrical

__________________________________________________________________________________________________
. 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 simply because your were once hurt. Be good to all. You may not know who may later be your saviour!
Courtesy of Dr Muslim Goodheart

Surgery Primary Examination Questions Collection

D it originates from pre-existing membranes

E components are in a steady state
057 The drug of choice in acute gouty arthritis is
A allopurinol
B piroxicam
C probenicide
D phenylbutazone
E colchicine
058 with respect to pain:
A pain fibres are essentially located in the Lateral
spinothalamic tract
B the alpha and delta fibres are myelinated and
responsible for dull pain
C the thalamic syndrome results from the blockage of
the thalamogeniculate branches of the posterior
cerebral artery
D bilateral anterior cordotomy is not advisable
because of the resulting g dysasthesia
E barbotage is a form of treatment modality
059
A
B
C
D
E

features of hypocalcaemia include

Chvosteks sign
Trousseaus sign
abdominal cramps
stridor
increased deep tendon reflexes

060
A
B
C

in the respiratory system, physiological shunt:

is smaller than the anatomical shunt
is not present in the healthy adult
affects arterial carbon dioxide more than arterial
oxygen tension
has the same effect on respiratory gas exchange as
does physiological dead space.
is abolished when the subject breathes pure oxygen

D
E
061
A
B
C
D
E

in the normal ECG tracing

P-wave is due to atrial excitation
upper limit of the normal P-R interval is 0.1 sec
QRS complex represents ventricular excitation
the R-wave may be inverted in lead I and upright
in lead III
T-wave occurs during ventricular systole

062 A patient who has lost HCl through vomiting due to

pyloric obstruction is likely to have low:
A plasma chloride concentration
B plasma potassium concentration
C plasma urea concentration.
D plasma standard bicarbonate concentration
E arterial carbon dioxide pressure (PaCO2)
063 Which of these concerning the intracellular fluid
(ICF) is/are true?
A It contains over 50% of the body water
B It has a higher osmotic pressure than extracellular
fluid
C it has a higher concentration of organic anion than
ECF
D it has potassium as its principal cation

interstitial fluid is a component of the ICF

064
of:
A
B
C
D
E

systolic murmur over the manubrium is indicative

an increased haematocrit
aortic stenosis
aortic insufficiency
mitral stenosis
potent ductus arteriosus

065 positive nitrogen balance in the adult occurs

A when dietary intake of protein is increased in the
healthy subject
B during a debilitating illness
C during prolonged strenuous exercises
D during recovery front a debilitating illness
E during protein starvation
066 which of the following are produced from the
thyroid gland?
A thyroxine (T4)
B triiodothyronine
C parathormone
D calcitonin
E Somatostatin
067 fever induced by a bacterial toxin is caused by
A the production of an endogenous pyrogen by the
leukocytes and macrophages
B direct action of the toxin on skeletal muscles and
cutaneous blood vessels
C an elevation of the set level in the heat regulator)
centre of the substantia nigra
D direct action of the toxin on the hypothalamus
E an inhibition of prostaglandin synthesis and
release in the fore brain
069 What percentage of effective renal plasma flow
passes into the glomerular capsule in a healthy subject?
A Less than 5%
B Between 15% and 20%
C Between 40% and 50%
D Between 70% and 80%
E Greater than 90%.
070
A
B
C
D
E

Which of the following are ketone bodies?

acetoacetic acid
acetone
carbonic acid
pyruvic acid.
-OH butyric acid
SECTlON C

071 The following are recognised associations

A aniline dyes and squamous carcinoma of urinary
bladder
8 Radioactive iodine and carcinoma of the thyroid
C clonorchis sinensis (liver fluke) and primary liver
cell carcinoma

__________________________________________________________________________________________________
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

D
E

arsenic and skin cancer

asbestosis and carcinoma of the lung

072 The following tumours are derived from at least two

germ cell layers:
A mixed salivary gland tumour
B lympho epithelioma
C dermoid cyst of ovary
D mesenchymoma
E choriocarcinoma
073
A
B
C
D
E

Vaccines are now available for the following:

infective hepatitis
meningococcal meningitis
gonorrhoea
measles
malaria

074 Staphylococci are the usual causative agents in he

following
A erysipelas
B scarlet fever
C carbuncle
D acute osteomyelitis in children
E bullous impetigo of the newborn,
075 The following are e.g. of pure hypertrophy:
A breast enlargement during pregnancy
B enlargement of the left ventricular wall in systemic
hypertension.
C benign senile enlargement of the prostrate gland
D enlargement of the remaining kidney after
nephrectomy
E the increase in volume of the myometrium during
pregnancy
076 Ventilatory failure is usually xterised by
A an elevation of plasma standard bicarbonate
B a drop in arterial PO2 in the presence of a normal
PCO2
C hypercapnia
D an elevation of blood pre
E papilloedema
077 Which of the following factors may determine the
extent of Ischaemia in arterial obstruction?
A speed of onset
B the pathological state of the collateral circulation
C haemoglobin level
D nature of the affected organ
E elevated blood urea.
078 In Nigerians, gall tone
A consist mainly of calcium bilirubinate
B made of cholesterol may be dissolved in
chenodeoxycholic acid
C when caught in the cystic duct will cause profound
obstructive jaundice
D when blocking the common bile duct will cause rise
in bilirubinuria

when blocking the common bile duct will give rise

to a raised serum acid phosphatase

079 Carcinoid tumour of the appendix is commonly

associated with:
A no symptoms
B raised 5HIAA (5-hydroxyindoleacetic acid) in urine
C raised blood pressure
D flushing attacks
E intussusception of the colon.
080 the following serum enzymes may be elevated in
liver disease:
A 5-nucleotidase
B aspartate aminotransferase
C lactate dehydrogenase
D pseudocholinesterase
E alkaline. phosphatase
081 the malabsorption syndrome
A. does not usually occur after removal of a short
segment of jejunum or ileum
B may result in bleeding tendencies
C may decrease the quantity of fat in the faeces
D may present with oedema
E does not occur in tropical sprue and celiac disease
082
A
B
C
D
E

Osteoporosis is commonly seen in

Vit D deficiency
scurvy
prolonged recumbency
chronic renal failure
hyperparathyroidism

083
A
B
C
D
E

the following organisms are resistant to gastric acid;

diphtheriae
salmonellae
M. tuberculosis bovis
Poliovirus
diplococcus pneumoniae

084 Bacteroides
A are common commensals in the mouth and
intestines
B are gram positive small bacteria
C are sensitive to metronidazole
D delay wound healing
E can only be grown under anaerobic conditions
085
A
B
C
D
E

phaeochromocytomas
are catecholamine secreting tumours
are derived from sympathetic nervous system
may be derived from autonomic nervous system
tissue
are usually malignant
occur mainly in adult life

086
A
B
C

the following are Y-linked traits:

hairy pinnae
haemophilia
Duchenes muscular dystrophy

__________________________________________________________________________________________________
. 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 simply because your were once hurt. Be good to all. You may not know who may later be your saviour!
Courtesy of Dr Muslim Goodheart

Surgery Primary Examination Questions Collection

D
E

cardiomyopathy
Vit D resistant rickets

087
A
B
C
D
E

neuropathic joint can result from:

syphilis
tabes dorsalis
syringomyelia
rheumatoid arthritis
gout

088 The pathognomonic feature of adult Rheum.

arthritis:
A positive Rh factor
B Rh Nodules
C involvement of the proximal joints of the hand
D subluxation of the metacarpo-phalangeal joint
F early morning stiffness
089 the following investigations are readily available for
prenatal diagnosis of congenital malformation:
A amniocentesis
B foetoscopy
C ultrasonography
D laparoscopy
E none of the above
090
A
B
C
D
E

bacterial plasmids:
are extrachromosomal genetic elements
may code for virulence factors
can be separated by electrophoresis
may be transmissible among different spp of
bacteria
may be used to xterised bacterial strains

091
A
B
C
D
E

Helicobacter pylori
rarely infects people in developed countries
has faeco-oral transmission
may be identified by its urease production
is assoc with duodenal ulcers
infection can be ctrl by long-term antibiotics

092
A
B
C
D
E

rotavirus infections:
are rare in adults
are diagnosed by stool culture
do not require specific antibiotic therapy
can be reliably prevented by immunisation
can be easily spread from person to person

093 gram positive bacteria genera include:

A Brucella
B Lactobacillus
C Bacteroides
D Neisseria
E Yersinia
094 causes of surgically correctible hypertension
include:
A hypoparathyroidism
B renal artery stenosis
C coarctation of the aorta
D phaeochromocytoma

Potts disease

095
A
B
C
D
E

tissue Eosinophilia is xteristic of

amoebiasis
bronchial asthma
filariasis
tertiary syphilis.
viral infections,

096
A
B
C
D
E

metastasis in lymph nodes are a common feature of:

basal cell carcinoma
fibroadenoma
malignant melanoma
Seminoma
squamous cell carcinoma

097
A
B
C
D
E

A raised plasma cholesterol is a feature of

chronic biliary obstruction diabetes mellitus
haemolytic anaemia
myxoedema
nephrotic syndrome

098
A
B
C
D
E

acquired preneoplastic disorders include:

Liver cirrhosis
Complex endometrial hyperplasia
Chronic ulcerative colitis
solar keratosis of the skin
Cervical dysplasia.

99 The ff is true of immediate transient increase in

vascular permeability:
A It is suppressed by pre-treatment with antihistamine
B is exaggerated by the administration of aspirin
C Chemical mediators in general elicit this
phenomenon
D It is a venular leakage
E leakage is across the microvasculature
100 The following are e.g. of complementary adhesion
molecules present on leukocytes and endothelial
surfaces
A selectins
B Von Willebrand factor
C intercellular adhesion molecules1 (ICAM1)
D integrins
E vascular cell adhesion molecule1 (VCAM1)
101 The following are examples of pure hypertrophy
A breast enlargement during pregnancy
B enlargement of the left ventricular wall in systemic
hypertension
C benign senile enlargement of the prostate
D enlargement of the remaining kidney after
nephrectomy
E the increase in volume of myometrium in
pregnancy

__________________________________________________________________________________________________
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

102
A
B
C
D
E

Hypercalciuria
is a feature of parathyroid adenoma
may be seen in sarcoidosis
predisposes to renal stones
is a feature of immobilisation
is seen in renal tubular acidosis

103
A
B
C
D
E

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

104
A
B
C
D
E

Which is not true of insulin? It

acts to stimulate enzyme action
increases protein synthesis
increases fat storage
increases ketone bodies uptake by muscles
is secreted when blood sugar level rises

105
A
B
C
D
E

external carotid artery gives rise to

thyrocervical trunk
vertebral artery
facial artery
internal thoracic artery
occipital artery

106 in the heart

A mitral valve guards the entrance of the right
ventricle
B pulmonary valve is at the outlet of the left
ventricle
C chordae tendinae are not present on the
semilunar valves
D the tricuspid valve is in the left ventricle
E the crista terminalis is a smooth vertical fissure
in the wall of the right atrium
107 Which of the following statements concerning the
rectus abdominis muscle are true?
A the nerve supply enters from the lateral side
B a part of the blood supply enters from the lateral
side
C the tendinous intersections are attached to the
sheath anteriorly
D the muscle is inserted into the 5th, 6th, and 7th
costal cartilages only
E the upper lateral part of the left rectus is anterior
to the apex of the heart
108
A
B
C
D

The nuclei of the facial nerve are;

motor
mesencephalic
nucleus ambiguus
tractus solitarius

inferior salivatory

109 The branches of the facial nerve that are given in

the middle ear are:
A lesser superficial petrosal nerve
B chorda tympani
C nerve to posterior belly of the digastric
D stapedial nerve
E temporal branch of facial
110
A
B
C
D
E

The motor nucleus of the facial nerve:

lies at the, lower border of the pons
is found dorsal to the abducent nerve nucleus
is divided into superior and inferior divisions
lies deeply embedded in the reticular formation
has a bilateral connection to the cortex

111
A
B
C
D
E

Facial Artery:
is a branch of the internal carotid
lies below the superior constrictor muscle
supplies the anterior belly of the digastric muscle
it lies deeply in the submandibular gland
lies superficial to the dilator muscles of the lip

112
A
B
C
D
E

Foetal facial bones;

mostly develop from cartilage
the mandibular angle is obtuse
the- mental foramen is closer to the dental margin
the maxillary sinus is very large
the tympanic membrane is usually facing upwards

113
A
B
C
D

The mandible:
formed from second pharyngeal arch
formed solely from Meckel's cartilage
embryologically arises from hyoid bone
the mandibular angle is obtuse in edentulous old
people
has a coronoid process.

114 Simple columnar epithelium Can be located in the

lining of the
A stomach
B oesophagus
C trachea
D transverse colon
E gall bladder
115 Branchial fistula.
A usually opens into the posterior triangle
B usually arises in connection with the 3rd
branchial or visceral arch
C usually traverses-the fork of the carotid
bifurcation
D may terminate close to the tonsilar bed
E lies deep to the hypoglossal nerve and the
internal jugular vein.

__________________________________________________________________________________________________
. 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 simply because your were once hurt. Be good to all. You may not know who may later be your saviour!
Courtesy of Dr Muslim Goodheart

Surgery Primary Examination Questions Collection

116 The hypophysis cerebri

A is derived from ectoderm
B the posterior lobe is smaller but more vascular
than the anterior lobe.
C is anteriorly in direct contact with the optic
chiasma
D lies in a fossa roofed by dura mater
E Is related posteriorly to the posterior
intercavernous sinus,
117 The pectoralis major muscle
A the sternocostal fibres are inserted by a tendon
into the lateral lip of the bicipital groove of
humerus
B the clavicular fibres are inserted Into the
anterior lip of the deltoid tuberosity
C the muscle is supplied by the medial and
lateral pectoral nerves.
D is essentially a lateral rotator of the arm
E the costal fibres arise from bone rather than
from cartilage of the upper 6 ribs
118
A
B
C
D
E

The posterior interosseous nerve;

supplies the anconeus
supplies the extensor digitorum muscle
passes between the radius and ulna
lies on the interosseous membrane throughout
its course
is cutaneous to the back of the hand

119 The testis

A is developed from the germinal ridge while the
epididymis and the ductus deferens are developed
from the Wolffian body and the Wolffian duct
respectively
B Is innervated from the 10th dorsal/thoracic
segment of the cord
C secretion of testosterone begins at about 12 weeks
intrauterine life
D the peritoneum herniates posterior to the testis as
the processus vaginalis
E the gubernaculum testis plays an important role
in testicular descent
120
A
B
C
D
E

Femoral artery
is a continuation of the internal iliac artery
enters the thigh at the mid-inguinal point
enters the thigh lateral to the deep inguinal ring
gives off the profunda femoris artery from its
medial side
has no branches proximal to the origin of the
profunda femoris artery

121 Optic chiasma

A lies anterior to the stalk of the hypophysis cerebri
B is lateral to the internal carotid artery

contains fibres from the bipolar neurones of the

retina

contains fibres which end in the lateral geniculate

body
contains crossed fibres associated with nasal field
vision

E
122
A
B
C
D
E

Hypoglossal nerve
innervates all the extrinsic muscles of the tongue
has a nucleus in the floor of the fourth ventricle
emerges lateral to the pyramid from the hindbrain
leaves the skull through the anterior condylar
canal
pursues a course between the internal and external
carotid arteries

123 Crypts of Lieberkuhn

A are confined to the duodenum, Jejunum and
ileum
B are restricted to the mucous membrane
C secrete digestive enzymes
D contain enterochromaffin cells and Paneth cells
E rective the secretion of Brunner's glands
124 Right and left ventricles of the heart are both
represented on
A The anterior (sternocostal) surface
B the right border
C the inferior (diaphragmatic) surface
D the inferior border
E the base (posterior surface)
125 the internal thoracic (mammary) artery.
A passes through the Inlet of the thorax ,
B lies between sternocostalis muscle and parietal
pleura
C is accompanied during part of its course by venae
commitantes
D has the superficial epigastric artery as a terminal
branch
E parses through the outlet of the thorax
126
A
B
C
D
E

The clavicle is related anatomically to

the manubrium sterni
the acromium
subclavius muscle
the subclavian artery
the glenoid cup

127
A
B
C
D
E

Posteriorly to the left kidney are;

diaphragm
left testicular or ovarian vein
quadratus lumborum muscle
inferior mesenteric vein
iliohypogastric nerve

128 Section of the radial nerve above the elbow causes

A wrist drop

__________________________________________________________________________________________________
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.

10

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

B
C
D

failure of supination
elbow lock
limited loss of sensation at the bases of
digits 1 and 2
E claw hand
129 Adductor canal conveys.
A the superficial femoral artery
B the femoral vein
C the saphenous nerve
D the distal femoral nerve
E the femoral chain of lymph nodes
130
A
B
C
D
E

The lymphatic drainage of the breast include;

axillary lymph nodes
internal mammary chain
interjectorily chain
infraclavicular nodes
supraclavicular nodes

131
A
B
C
D
E

The trigeminal nerve

is the 7th cranial nerve
contains only sensory fibres
supplies the face in three zones
often described with Pes anserinus
it supplies the platysma

132
A
B
C
D
E

The facial nerve:

is the 7th cranial nerve
supplied all muscles of mastication
passes through stylomastoid foramen
has mandibular branch
its central damage Causes extensive loss of
sensation on the face.

133
A
B
C
D
E

The buccinator
has relationship with the modiolus
forms the intrinsic muscle of the lip
innervated by nerve of second branchial arch
arises only from upper and lower jaws
parotid duct passes just above its upper border

134
A
B
C
D
E

Medial wall of the orbit is made up of:

greater "wing of the sphenoid bone
orbital process of the zygomatic bone
ethmoidal bone
lacrimal bone
frontal bone

135 An L4 nerve root lesion is typically associated with

A an impaired sensation over the lateral border of
the foot
B a positive femoral nerve stretch test
C absent knee jerk
D an extensor plantar response
E weakness of extensor hallucis longus
136 The muscles of the hand supplied by the median
nerve include;
A opponens pollicis
B adductor pollicis brevis

C
D

abductor pollicis brevis

the- lateral two lumbricals

137
A
B
C
D

The duodenum
is entirely retroperitoneal
lies anterior to both ureters
lies anterior to both testicular/ovarian arteries
the first part lies in contact with the quadrate lobe
of the liver
lies anterior to the left Adrenal gland

138 Which of the following are not correct regarding the

spinal cord?
A it begins at the foramen magnum
B receives its entire nourishment from the CSF
C its "smallest cross-sectional area is at the midthoracic region
D may be involved in the inflammatory process
E terminates at theS2 level
139
A
B
C
D
E

The jugular foramen transmits

hypoglossal nerve
the inferior petrosal sinus
the jugular lymph trunk
vagus nerve
glossopharyngeal nerve

140
A
B
C

The clinical features of an S 1 root lesion include:

decreased ankle jerk
exacerbation by couching
sensory impairment of the medial aspect of the
thigh
pain on straight leg raising
difficulty with micturition

D
E

141 Compliance of the lung is;

A equal to the volume increase in the lung for each
unit
change in Tran pleural pressure
B equals to the increase in intrapleural pressure for
each
unit increase in intrapleural pressure
C more than the compliance of the lung and thorax
together
D about 1 litre/cm, water pressure
E is a measure of the 'distensibility of the lung.
142
A
B
C
D
E

In clinical doses, atropine has significant effect on:

the inhibition of acetylcholine release
the skeletal 'neuromuscular junction
the autonomic ganglia
the parasympathetic nerve endings,
the sympathetic nerve endings

143
A
B
C
D
E

Administration of cortisol
causes water retention
causes potassium retention
causes gluconeogenesis
causes eosinophilia
increases RBCs count

__________________________________________________________________________________________________
. 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 simply because your were once hurt. Be good to all. You may not know who may later be your saviour!
Courtesy of Dr Muslim Goodheart

Surgery Primary Examination Questions Collection

144 Essential amino acids that must be supplied in our

diet are
A glycine, serine,
B lysine, arginine
C proline, hydroxyproline
D Leucine, isoleucine
E tryptophan
145 The vasomotor centre of the medulla
A is inhibited by baroreceptor impulses due to rising
pressure
B receives its afferents through glossopharyngeal and
vagus
C its efferents pass through the sympathetic segment
of the ANS
D acts as a unit to alter the tone of arterioles
throughout the body
E discharges via the parasympathetic efferent fibres
during haemorrhage
146
A
B
C
D
E

Increased motility of the GIT is caused by;

vagal stimulation
splanchnic stimulation
acetylcholine
distension of the gut
enterogastrone

147
A
B
C
D

In a healthy 70 kg male the

total body water approximates 40 L
total blood volume approximates 5.5 L
ECF approximates 8 L
plasma volume approximates 1 L

148
A
B
C
D
E

11

Growth hormone
stimulates somatic and genital growth
stimulates the entry of amino acids into cells
enhances lipolysis
increases the peripheral uptake of glucose by the
cells
its release is controlled by specific hypothalamus
releasing factors

149 In contrast to an artificial membrane the living

excitable membrane
A has the chloride ion distributed evenly
B actively extrudes the Na+ ion
C actively extrudes the K+ ion
D transports chloride against an electro-chemical
gradient;
E is in a steady state
150 The knee Jerk:
A is due to stimulation of receptors in the patellar
tendon
B is propagated through L 2, L3 and L4
C has a reflex arc involving a single interneuron
D the impulse passes through the femoral nerve
E is abolished immediately after transection of the
spinal cord at T6
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.

__________________________________________________________________________________________________
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.