​1. Which of the following anatomical considerations is correct?

1. optic chiasm lesions characteristically produce a bitemporal hemianopia

2. central scotoma occurs early in papilloedema

3. in cortical blindness pupillary reactions are abnormal

4. optic tract lesions produce an ipsilateral homonymous hemianopia

5. opticokinetic nystagmus is found with bilateral infarction of the parieto-occipital lobes

 

2. Which of the following regarding Helicobacter pylori is false?

1. Infection may elevate serum gastrin

2. It is the cause of > 90% of duodenal ulceration

3. It is associated with gastric adenocarcinoma

4. Eradication of the infection is curative in gastric mucosa associated lymphoid tissue (MALT) lymphoma

5. It is a Gram positive spiral flagellated organism

 

3. The following statements are true regarding pregnancy following breast cancer

1. pregnancy should be deferred for at least 2 years following treatment

2. women below 30 years of age should be advised to delay pregnancy for at least three years

3. prognosis is adversely affected by future pregnancy

4. breast feeding is discouraged

5. is associated with an increased risk of pre-eclampsia

 

4. Regarding breast cancer in pregnancy:

1. has an incidence of 2%.This is the correct answer

2. has worse prognosis compared with non-pregnant women

3. Chemotherapy can be safely used in the first trimester

4. can be treated with mastectomy and axillary clearance

5. CA 19-9 is used as a tumour marker

 

5. Which of the following are true of a cervical rib?

1. It occurs commonly

2. It is apparent on palpation in the supraclavicular region.

3. It originates from the 7th cervical vertebra.

4. It commonly causes compression of the subclavian artery and brachial plexus.

5. All of the above

 

6. Pretracheal fascia invest following except:

1. Thyriod gland

2. Submandiblar gland

3. Parotid gland

4. Trapezius muscle

5. Sternocleidomastoid muscle

 

6. Investing layer of deep fascia of neck invest following except:

1. Thyriod gland

2. Submandiblar gland

3. Parotid gland

4. Trapezius muscle

5. Sternocleidomastoid muscle

 

7. In the axilla:

1. The pectoral lymph nodes drain chiefly the upper limb

2. The posterior cord of the brachial pexus lies posterior to the 1st part of the axillary artery

3. The tendon of latissimus dorsi lies anterior to the tendon of teres major

4. The long thoracic nerve can be damaged in mastectomy

5. Damage to the intercostobrachial nerve causes sensory loss over the medial part of the arm

 

8. Breast cancer risk is increased in association with the following factors

1. Nulliparity

2. Immediately after pregnancy

3. Early menarche

4. Early age at first pregnancy

5. Late menopause

 

9. Regarding benign breast disease

1. Cyclical mastalgia is the commonest reason for referral to the breast clinic

2. Fibroadenomas are derived from the breast lobule

3. Lactational breast abscesses are usually due to Staphylococcus aureus

4. Duct ectasia is more common in smokers

5. Atypical lobular hyperplasia is associated with an increased risk of breast cancer

 

10. Concerning mamographic screening for breast cancer

1. There is good evidence to show that screening reduces mortality from breast cancer in women over the age of 50

2. It should be performed annualy in women over the age of 50

3. There is no evidence to support screening beyond the age of 70

4. Women on HRT should undergo more frequent screening than those not taking HRT

5. Is associated with a false positive rate of approximately 15%

 

11. In the axilla

1. T2 supplies sensation to the skin of the lateral wall

2. The axillary artery lies anterior to pectoralis minor

3. A rich anastomosis permits the second part of the axillary artery to be ligated

4. Section of the long thoracic nerve will affect adduction

5. Lymph nodes enlargement may due to an abscess in the epigastric region of the abdominal wall

 

12. The following statements are true regarding pregnancy following breast cancer

1. Treatment of stage I breast cancer is associated with impaired future fertility

2. Chemotherapy with Cyclophosphamide does not affect future fertility

3. Resumption of menstruation following treatment confirms restoration of fertility

4. Early pregnancy loss is more likelyThis is the correct answer

5. Radiotherapy following mastectomy is associated with premature ovarian failure

 

13. Breast cancer risk is increased in association with the following:

1. immediately after a preterm delivery

2. a pregnancy complicated by preeclampsia

3. microprolactinomas

4. prolonged breast feeding

5. pregnancy complicated with a smaller placenta

 

14. Regarding male breast cancer

1. carries a worse prognosis than female breast cancer

2. has an incidence of approximately 1 in 100, 000 of the male population

3. is more common in association with Klinefelter's syndrome

4. is more common in men treated for prostate carcinoma

5. has a higher incidence in men of afro-caribbean origin than caucasians

 

15. Concerning the female breast:

1. It is firmly attached to the pectorus major muscle

2. There is a subareolar lymph plexus

3. Axillary lymph nodes receive more than half the lymph from the breast

4. Lymph from the lateral part of breast may drain to the para-sternal nodes

5. Approximately 90% of the lymph passes to the posterior infraclavicular nodes

 

16. Select the structures of stomach bed:

1. Spleen

2. Left crus of diaphragm

3. Splenic artery

4. Left gastric artery

5. Liver

 

17. A 50 years gentleman underwent surgery for ruptured aortic aneurysm. Anterior/vental branch of abdominal aorta are:

1. Superior mesenteric artery

2. Lumber arteries

3. Renal arteries

4. Coeliac trunk

5. Left gastric artery

 

18. A 18 yaers boy had a splnectomy for thalassemia. He is more vulnerable to which of the following infections

1. Malaria

2. Streptococcus

3. Pneumococcus

4. H.influenza

5. Staphylococcus

 

19. A 45 years lady developed DIC on 4th POD following hip replacement. What are the other causes of DIC

1. Extensive burn

2. Malignancy

3. Air embolism

4. Amniotic fluid embolism

5. Aortic aneurysm

 

20. Which of the following are part of meninges except

1. The cavernous sinus

2. The diaphragma sellae

3. The falx cerebriCorrect

4. The tentorium cerebelli

5. The tentorium cerebri

 

21. A 44-year-old lady with a history of alcohol abuse is brought to A + E after a large haematemesis. Fluid resuscitation is started, but it appears that bleeding is ongoing. An emergency endoscopy is arranged. The gastroenterologist notes that she is bleeding from varices in the lower part of her oesophagus. Which vein/veins drain this area into the portal system?

1. Azygous vein

2. Inferior mesenteric vein

3. Left gastric vein

4. Lower oesophageal vein

5. Thoracic vein

 

22. During the posterior approach to the hip which of the following muscles are normally divided to expose the joint capsule?

1. piriformis

2. superior gemellus

3. obturator externus

4. oburator internus

5. inferior gemellus

 

23. A 20-year-old woman was referred for investigation of iron deficiency anaemia. Her mother died aged 28 years from colonic carcinoma complicating Peutz-Jeghers syndrome. Which statement/statements about Peutz-Jeghers syndrome are correct?

1. Autosomal dominant

2. Autosomal recessive

3. Mitochondrial

4. Polygenic

5. X-linked dominant

 

24. Which of the following is/are polygenic disorder?

1. Ankylosing spondylitisThis is the correct answer

2. Erythropoietic porphyria

3. Fragile X syndromeIncorrect answer selected

4. Huntington's disease

5. Pendred’s syndrome

 

25. A researcher compared the mean scores for nausea on a rating scale between standard therapy and a new drug in the treatment of chemotherapy induced nausea. Which is/are the most appropriate statistical test?

1. Chi-square test

2. Paired T-test

3. Life table analysis (log rank test)

4. Pearson correlation

5. Unpaired T-test