7- Fawzia Sheet MSQs (1)

Question 1

1- A 50-year-old woman attends her Genera) Practitioner due to a change in appearance. She finds difficulty removing her rings, reports: an increase ‘in shoe size and photographs reveal a change in her facial appearance. Visual field tests are-performed to direct confrontation. Which of the following e Can defects is most likely to be associated with her presentation?

Answer 1

A. Binasal hemianopia
B. Bitemporal hemianopia
C. Homonymous hemianopia
D. Inferior quadrantanopia
E. Unilateral loss of vision

Ans B

Question 2

2- 60-year-old man presents with a short history of pain in the right cheek and right upper teeth Maxillary sinus infection is diagnosed. This sinus is particularly prone to infection because of?

Answer 2

A. absence of cellia on the epithelium lining the sinus
B. closeness of the sinus to the nasal cavity
C. poor blood supply
D. Position of the sinus ostium high on the medial wall
E .relationship of the front teeth to the floor of the sinus

Ans D

Question 3

3- A 37-year-old man presents with severe headache, photophobia arid neck stiffness. Karnig’s sign is positive and a midline lumbar puncture is performed immediately to determine if a cerebrospinal fluid (CSF) pathogen is involved. In performing this procedure, which is ‘he first of the following structures to be pierced by the lumbar puncture needle?

Answer 3

A. Anterior longitudinal ligament
B. Arachnoid mater
C. Dura mater
D Interspinous ligament
E. Posterior longitudinal ligament

Ans D

Question 4

4- 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 cm 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 medial to the neck of the hernia?

Answer 4

A. Femoral artery
B. Femoral nerve
C. Femoral vein
D Lacunar ligament
E. Pectineal ligament

Ans D

Question 5

5- A 26-year-old man presents to the Emergency Department with extensive bleeding from his arm after sustaining a glass injury. On examination there is a 7 cm transverse laceration across the anterior aspect of his elbow. On exploring the cubital fossa you would expect the brachial artery to be:

Answer 5

A. anterior to the median nerve
B. lateral to the biceps tendon
C. lateral to the median nerve
D. medial to the median nerve
E. superficial to the bicipital aponeurosis

Ans C

Question 6

6- A 45-year-old mart presents with backache and leg pain due to a prolapsed lumbar Intervertebral disc. The pain, which is aggravated by coughing and sneezing, radiates to the lateral aspect of the foot. On examination, there is weakness of the plantar flexors of the foot, which nerve root is most likely to be involved?

Answer 6

A. T12
B. L4
C. L5
D S1
E. S2

Ans D

Question 7

7- A 22-year-old man has been stabbed in the left fifth intercostal space at the edge of the sternum. Which structure is most likely to have been penetrated?

Answer 7

A Left atrium
B Left lobe of the liver
C Left ventricle
D Right atrium
E Right ventricle

Ans E

Question 8

8- An 80-year-old man dislocates his shoulder it is reduced in the Emergency Department. At review three weeks later, he is unable to actively initiate abduction of his arm. Which muscle most likely damaged?

Answer 8

A Clavicular head oi pectoralis major
B Infraspinatus
C Supraspinatus
D Teres major
E Trapezius

Ans C

Abduction of the shoulder is initiated by the Supraspinatus; 0 to 15°.

The Deltoid muscle can then abduct to 90°. Its the major abductor. 15° to 90°.

180° (elevation) is brought about by rotation of the scapula upwards by the Trapezius and Serratus anterior.

Axillary Nerve Injury: Causes Deltoid and teres minor paralysis, Loss of rounded contour of shoulder, Sensory loss in skin covering lower part of deltoid (regimental badge anaesthesia), Loss of Abduction from 15° to 90°.

Question 9

9- A 42-year-old multiparous woman is admitted to the Emergency Department due to pelvic discomfort. The duty gynecologist diagnoses uterine prolapse. Which anatomical structure gives significant direct support to the uterus?

Answer 9

A. Cervical ligaments
B. Mesometrial part of the broad ligamente
C Mesosalpingial part of the broad ligament
D. Round ligaments
E. Transverse perinea! Muscles

Ans E

Question 10

10- In describing the sino-atrial node, which one of the following statements is correct?

Answer 10

A it is part of the somatic nervous systemWe
B It is usually supplied by the left coronary artery
C If lies in the wall of the left atrium
D It lies in the wall of the right ventricle
E It receives fibers derived from the vagus nerves

Ans E

Question 11

11- A 45-year-old man presents with fever and pain in his right loin and groin. A soft swelling was noted in his femoral triangle. Diagnosis of a psoas abscess was made. Which of the following statements is most accurate regarding psoas major?

Answer 11

A. It arises from the lateral borders of the bodies of T12 to L5
B. It extends the hip
C. It inserts into the greater trochanter of the femur
D. It is innervated from T12 and LI
E. It passes posterior to the capsule of the hip joint

Ans A

Origin
Bodies, transverse processes and intervertebral discs of all lumbar vertebrae and T12

Insertion
Top of femur (shares tendon with iliacus)

Joints crossed
. Hip and intervertebral joints of lumbar vertebrae

Joint action
Origin fixed: flexes hip
Insertion fixed: pulls on spine to increase the lumbar lordosis
Unilaterally: assists in lateral flexion of the trunk
Stabilises lumbar spine

Question 12

12- Which one of me following muscles is an extensor of the hip?

Answer 12

A. Adductor longus
B. Gracilis
C. lliopsoas
D. Pectineus
E. Semitendinosus

Ans E

Hip Extension
Range of motion: 0 to 20 degree

Muscles:
· Gluteus Maximus
· Semitendinosus
. Semimembranosus
. Biceps Femoris (long head)

Accessory muscles:
. Adductor Magnus (inferior)
. Gluteus Medius (posterior)

7 Hip Flexor Muscles:

. Anterior Group
- Pectineus
- lliopsoas
- Rectus Femoris
- Sartorius
- Adductor Brevis
- Adductor Longus

. Lateral Group
- Tensor Fasciae Latae

Question 13

13- A 65-year-old man presents with haematuria and left loin pain. Computerised tomography demonstrates a left renal tumour. He undergoes a left radical nephrectomy.

Answer 13

A. Anterior to the left gonadal vein
B Anterior to the left renal vein
C Anterior to the splenic vein
D Posterior to the left renal vein
E Superior to the superior mesenteric artery

Ans D

Question 14

14-Within the posterior triangle, which nerve is at particular risk of damage during surgery?

Answer 14

A. Auricular branch of the facial
B Glossopharyngeal
C Phrenic
D Recurrent laryngeal
E Spinal accessory

Ans E : Spinal Acc nerve = Nerve supply to Trapezius and Sternocleidomastoid

Question 15

15- The right and left pulmonary arteries are derived from which of the following embryological aortic arches?

Answer 15

A Second aortic arch
B Third aortic arch
C Fourth aortic arch
D fifth aortic arch’
E Sixth aortic arch

Ans E

Question 16

16- During arch aortography, the vertebral artery would be seen to arise directly from which of the following?

Answer 16

A. Arch of the aorta
B Brachiocephalic artery
C Common carotid artery
D Internal carotid artery
E Subclavian artery

Ans E

Question 17

17- A 3-year-old boy is admitted to hospital with severe vomiting. Radiographic examination reveals that he is suffering from annular pancreas. Which of these structures
is constricted?

Answer 17

A First part of duodenum
B Second part of duodenum
C Third part of duodenum
D Proximal jejunum
E Pylorus of stomach

Ans B

Congenital Disorders:

. Pancreatic Divisum:
. Most common 3-10%
· Failure of fetal duct union.
· Congenital chronic pancreatitis.

. Cystic Fibrosis:
· CFTR gene mutation
- thick secretions.

. Annular Pancreas:
· 2nd part duodenum obstruction.

· Ectopic Pancreas:
· stomach and duodenum.

Question 18

18- A 36-year-old man presents with a two-month history of low back pain radiating to his left leg After clinical examination he is referred for an MRI scan. This shows a prolapsed intervertebral disc. The clinical signs are consistent with pressure on SI roots. Which combination of clinical signs is most likely?

Answer 18

A Weak ankle plantarfiexion; altered sensation on the dorsum of the foot; normal ankle jerk reflex

B Weak ankle plantarfiexion; altered sensation on the sole of the foot; loss of ankle jerk reflex.

C Weak hallux dorsiflexion; altered sensation on the anterior surface of the leg; loss-of ankle jerk reflex.

D. Weak hallux dorsiflexion; altered sensation on the dorsum of the foot; normal ankle jerk reflex.

E. Weak hallux dorsiflexion; altered sensation on the sole of the foot; loss of knee jerk reflex

Ans B

Question 19

19- A surgeon makes a Pfannenstiel incision for access to the pelvic organs. He incises the abdominal wall down to and through the rectus sheath .- He retracts the rectus abdominis muscles laterally from the midline to expose the:

Answer 19

A. linea alba
B. peritoneum
C. posterior rectus sheath
D. transversalis fascia
E. transversus abdominis muscle

Ans D

In CS section the rectus muscle is not cut

Surgeons don’t cut muscle unless needed

Remember in thyroidectomy the strap muscles are not cut unless it’s needed
if required to be cut cut as high as possible to protect the innervation by the ansa cervicalis
this reminds us with the tracheostomy where the thyroid isthmus might require division unlike the cricothyrodotomy

Question 20

20- A year-old patient in the intensive care unit has a tracheostomy performed via the second, third and fourth tracheal rings. Which intervening structure is most likely to require transection?

Answer 20

A Anterior jugular vein
B Inferior thyroid veins
C Sternothyroid muscle
D Thymus
E Thyroid isthmus

Ans E

Question 21

21- In an emergency situation what is the most appropriate surgical method of obtaining an airway?

Answer 21

A Cutting and retracting the cricothyroid muscle
B Cutting the thyrohyoid membrane .
C Dividing the thyroid isthmus
D Entering the trachea at the C7 level
E Piercing the cricothyroid membrane

Ans E

Question 22

22- A.20-year-old man presents to the Emergency Department with a stab injury to the thenar eminence. On examination he is found to have a 2 cm long laceration with loss of sensation in the thumb and index finger and weakness: of the thenar muscles. Which of the following structures is most likely to have been injured?

Answer 22

A. Anterior interosseous nerve
B. Recurrent branch of median nerve
C. Sensory and motor branches of median nerve
D. Sensory and motor branches of radial nerve
E. Sensory and motor branches of ulnar nerve

Ans C

The thenar eminence is the mound formed at the base of the thumb on the palm of the hand by the intrinsic group of muscles of the thumb. The skin overlying this region is the area stimulated when trying to elicit a palmomental reflex.

Question 23

23- A 65-year-old man presents with vomiting and weight loss. On examination he had 3 palpable epigastric mass. The transpyloric plane lies at which; vertebral level?

Answer 23

A T11
B T12
C L1
D L2
E L3

Ans C

Question 24

24- A 75-year-old man presents with hepatomegaly and ascites. Computerised tomography shows evidence of post hepatic portal hypertension. The inferior vena cava passes through the Diaphragm at which vertebral level ?

Answer 24

A. T8
B. T9
C. T10
D T11
E T12

Ans A

Question 25

27- A 10-year-old child presents with progressive facial weakness and a squint. On examination there is a lower motor neuron facial weakness and failure of abduction of one eye. An MRI scan shows a small, intrinsic mass lesion within the central nervous system. Where is this most likely to be located?

Answer 25

A The cerebellar vermis
B The cerebellar tonsil
C The medulla
D The midbrain
E The pons

Ans E

Squint can occure due to 3rd 4th 6th cranial nerves
Here he is targeting the facialand trigeminal along with the abducense 6th cranial nerve 5678 at the pons

Question 26

28- A 45-year-old woman presents with pain, swelling and stiffness affecting all her metacarpophalangeal joints. She has noticed weakness in her grip and her handwriting has changed. She is unable to extend her fingers fully. The index, middle and ring fingers in both hands show an ulnar deviation. The most Can likely diagnosis is:

Answer 26

A Dupuytren’s contracture
B gouty arthritis
C osteoarthritis
D radial nerve palsy
E rheumatoid arthritis

Ans E

Question 27

29- A 22-year-old man arrives to the Emergency Department with sudden breath less ness due to a large pneumothorax. A chest drain is inserted into the fifth left intercostal space in 5th mid-axillary line. There is haemorrhape into the drainage bottle. Which of the following structures is the most likely cause of this acute haemorrhage?

Answer 27

A Intercostal artery
B Left pericardiophrenic artery
C Lingula of the lung
D Right ventricle of the heart
E Spleen

Ans A

Question 28

30- In order to expose the right axillary artery, a transverse skin incision is typically made below the clavicle from a point just lateral to the sternal end of the clavicle to the deltopectoral groove. Which of the following structures would be encountered in the dissection down to the vessel ?

Answer 28

A Lateral thoracic artery
B Phrenic nerve
C Suprascapular artery
D Thoracic duct
E Thoraco-acromial artery

Ans E

Question 29

31- A 4-year-old boy presents to the Emergency Department with a two-day history of headache vomiting and drowsiness. A CT scan reveals dilatation of both his lateral ventricles and his third cerebral ventricle. His fourth ventricle was of normal size. It is suspected that he has an obstruction to his cerebrospinal fluid flow. At which of the following sites is the obstruction most likely to be?

Answer 29

A Cerebral aqueduct (of Sylvius)
B Infundibular
C Interventricular foramen (of Monro)
D Lateral foramen of fourth ventricle (foramen of Luschka)
E Median foramen of fourth ventricle (foramen of Magendie)

Ans A

Question 30

34- A 12-year-old girl has a diastolic murmur. It is maximally audible in the second left intercostal space. Pathology of which structure is the most likely cause ?

Answer 30

A. Aortic valve
B. Ductus arteriosus
C. Mitral valve
D. Pulmonary valve
E. Tricuspid valve

Ans D

Anatomical site of the valves are not the same as the auscaltatory sites

Question 31

35- A 60-year-old man undergoes cystectomy for a bladder carcinoma. During surgery, the ureters are identified. On which region of the bladder do the ureters pierce the bladder wall?

Answer 31

A. Anterior surface
B Apex
C Lateral surfaces
D Neck
E Posterior surface

Ans E

A very famous Recall Anatomy Question
yet does come with many answsers
if you found Base in the options choose it
if not go for posterior like here

Question 32

36- A 23-year old man is assaulted and sustains a stabbing injury to the left groin. The wound- is cleaned and a simple dressing applied; Six months later the patient returns with pulsatile swelling at the site of the injury. The most probable lesion present is:

Answer 32

A Abscess
B False aneurysm of the femoral artery
C Lymphocoele
D Mycotic aneurysm of the femoral artery
E. Saphena varix

Ans B

Question 33

39- After receiving an intermascular Injection in the buttock, a 25 year-old man complains of inability to evert his foot Which nerve is most likely to have been injured ?

Answer 33

A Common peroneal (fibular) component of sciatic
B Inferior gluteal
C Pudendal
D Superior gluteal
E Tibial component of sciatic

Ans A

The Common Peroneal Nerve
Superficial peroneal nerve:
. Motor functions
. Foot eversion
Deep peroneal nerve:
. Motor functions
. Foot dorsiflexion, toe extension

Question 34

40-After resection of d rectal tumour a patient experiences erectile dysfunction. Which of the following nerves is most likely to have been damaged in surgery?

Answer 34

A Genitofemoral nerve
B Lumbosacral plexus
C Pelvic splanchnic nerves
D Perineal branch of S4
E Pudendal nerve

Ans C

Question 35

42- A 69-year man with recta! cancer undergoes low anterior resection. The liver is disease free. The pathology of his tumour was reported as a large tumour invading from the rectum into the mesorectum. Two nodes of 24 lymph nodes, close to the tumour were carcinoma on histology. The tumour was completely excised. What is the correct pathological staging of his tumour?

Answer 35

A Dukes’ A
B Dukes’ B
C Dukes’ C
D Dukes’ D
E T2 N1

Ans C

Question 36

43- A 76-year-old woman falls and sustains an inter-trochanteric fractured neck of femur Following operative fixation her recovery is prolonged and she is discharged to a rehabilitation unit Six weeks after her original operation she is readmitted. She is drowsy, hypotensive and bradycardic. An ECG shows low voltage complexes and a prolonged QT interval Under-activity of which of the following glands gives the best explanation of the clinical picture?

Answer 36

A. Adrenal
B Pancreas
C Parathyroid
D Pituitary
E Thyroid

Ans E

Question 37

44- A 36-year-old man falls on his outstretched right hand. Examination reveals tenderness in the anatomical snuff box. Which one of the following tendons form a boundary of the anatomical snuff box?

Answer 37

A Abductor pollicis brevis
B Extensor carpi radialis brevis
C Extensor carpi radialis longus
D Extensor indicis
E Extensor pollicis longus

Ans E

Question 38

45- A 55-year-old man presents with back ache. Neurological examination reveals lack of extension of the left great toe .; Which of the following spinal cord segments are likely to be involved?

Answer 38

A L1, L2 & L3
B L2, L3 & L4
C L4, L5 & S1
D S1, S2, & S3
E S3, S4 & S5

Ans C

Question 39

48- A surgeon is carrying out an elective splenectomy for congenital spherocytosis. Which structure will be divided in order to mobilize the spleen from the posterior abdominal wall?

Answer 39

A Gastrosplenic ligament
B Lesser omentum
C Lienorenal ligament
D Phrenicocolic ligament
E. Short gastric vessels

Ans C

Question 41

50- A 66-year-old woman with known tumour of her spine has started to retain urine and is experiencing decreased anal and rectal tone. The tumour is pressing directly on the conus medullaris. At which one of the following vertebral levels is the tumour most likely to be located?

Answer 41

A. T9/T10
B T11/T12
C L1/L2
D L3/C4
E L5/S1

Ans C

The conus medullaris (Latin for “medullary cone”) or conus terminalis is the tapered, lower end of the spinal
cord. It occurs near lumbar vertebral levels 1 (L1) and 2 (L2), occasionally lower. … After the spinal cord tapers
out, the spinal nerves continue to branch out diagonally, forming the cauda equina

Question 42

51- A 50-year-old woman presents with a history of faecal incontinence over the past few year She had a prolonged and difficult first stage of labor 20 years previously. Physical examination reveals a relatively lax anal sphincter. Which nerve is likely to have been damaged in labour?

Answer 42

A Autonomic nerves to the rectum
B Genitofemoral nerve
C Lumbosacral trunk
D Obturator nerv
E Pudendal nerve

Ans E

remember Pudendal nerve s234 keep the poo of the floor it’s responsible for incontence but not erection which was nervi ergintis splanchnic nerves

Question 43

55- A 4-year-old boy, is brought to the Emergency Department with a painful right elbow. His father stales that he was swinging his son by his arms when the pain came on suddenly An X- ray shows that the radial head is displaced from its usual position. What is the ligament (of the proximal radio-ulnar joint) that holds the radial head in place?

Answer 43

A Annular ligament
B Conoid ligament
C Quadrate ligament
D Radial ligament

Ans A

Question 44

53- A 35-year-old man presents with a three-week history of low back pain and a threeday history of pain and weakness in his left leg. Physical examination demonstrates numbness over the posterior aspect of the left calf extending to the lateral aspect of the foot. Left ankle reflex is absent. A magnetic resonance scan shows compression of the left S1 nerve root. What is the most likely responsible structure?

Answer 44

A. Annulus fibrosus
B. Anterior longitudinal ligament
C. Nucleus pulposus
D. posterior longitudinal ligament
E. Vertebral end plate

Ans C

Question 45

46- A 34-year-old man is seen in the Emergency Department with a fibular fracture following football match. On examination he is noted to have loss of foot eversion. Which area of skin should be examined to confirm. loss of the cutaneous distribution of the affected-nerve ?

Answer 45

A. Along the lateral aspect of the foot
B. Along the medial aspect of the footer
C. Cross the dorsal surface of the foot
D. On the plantar Surface of the foot
E. Over the heel

Ans C

The Dorsum is the one you see when you look at your foot :D

Question 46

47- A 50-year-old man complains of recent onset diplopia. On examination he is unable to look inwards and downwards with his right eye; The most likely diagnosis is a lesion of the?

Answer 46

A. abducens nerve
B. ciliary ganglion
C. nasociliary nerve
D. oculomotor nerve
E. trochlear nerve

Ans E

Question 47

41- A 73-year-old man with a history of irregular bowel movements presents with dysuria, pneumaturia and an Escherichia ccli urinary tract Infection. CT scans show a mass involving the sigmoid colon and the bladder. What is the commonest cause of this presentation?

Answer 47

A. Adenocarcinoma of the sigmoid colon
B Colonic diverticular disease
C Crohn’s disease
D Transitional cell carcinoma of the bladder
E Ulcerative colitis

Ans B

Question 48

38- The Cori cycle is important in lactate metabolism in the Septic surgical patient It is used to describe a pathway in which glucose is metabolised anaerobically to lactate in one tissue and the lactate is converted back to glucose in another; Which one of the following relies on this cycle to meet all of its energy needs?

Answer 48

A. Erythrocyte
B. Hepatocyte
C. Leukocyte
D. Osleocyte
E. Pneumocyte

Ans A

Question 49

37- A 16-year-old boy is hit on the left side of the face by a ball. There are no broken bones but the boy complains of numbness of the face below the eye. Which nerve has most likely been compromised?

Answer 49

A Abducens nerve.
B Facial nerve
C Glossopharyngeal nerve .
D infra-orbital nerve
E Zygomatic nerve

Ans D

Question 50

33- A 70-year-old man complains of persistent numbness since.an inguinal hernia repair one year previously. The numbness affects the top of the scrotum, root of penis, and a small area below the medial part of the inguinal ligament. Which nerve is likely to have been damaged?

Answer 50

A. Femoral branch of the genitofemoral nervea
B. Genital branch of the genitofemoral nerve
C. Iliohypogastric nerve
D llioinguinal nerve
E. Medial cutaneous branch of the femoral nerve

Ans D

Question 51

32- A 56-year-old man with chronic emphysema is on the high dependency unit (HDU), ten days after anterior resection. He has developed acute shortness of breath’ and hypotension): Which of the following landmarks would be the most appropriate to use to obtain a femoral arterial blood gas sample?

Answer 51

A. A point midway between the anterior superior iliac spine and the pubic tubercle
B. A point midway between the anterior superior iliac-spine and the’ pubic symphysis
C. A point midway between the greater trochanter and the pubic symphysis
D. A point 1 cm inferior and 4 cm lateral to the pubic tubercle
E. A point 2 cm lateral to the midway point between the anterior superior iliac spine and pubic symphysis

Ans B

Question 52

26- A 35-year-old man is admitted to hospital with vomiting, nausea and severe headaches. An MRI scan reveals a tumour of the cerebellopontine angle. Which one of the following pairs of cranial nerves is most likely to be compressed by this tumour?

Answer 52

A Accessory and vagus
B Facial and vagus
C Facial and vestibulocochlear
D Glossopharyngeal and vestibulocochlear
E Vagus and vestibulocochlear

Ans C

Question 53

25- An 82-year-old man has complete occlusion of his inferior mesenteric artery on angiography but no symptoms or signs of colonic ischemia. Which of the following arteries is the most likely additional source of blood supply to the territory of the inferior mesenteric artery?

Answer 53

A Left colic
B Left gastroepiploic
C Middle colic
D Splenic
E Superior rectal

Ans C

In human anatomy, the marginal artery of the colon, also known as the marginal artery of Drummond : connects the inferior mesenteric artery with the superior mesenteric artery. It is sometimes absent, as an anatomical variant.