ANATOMY

1. Which of the following is TRUE regarding the peritoneum covering of rectum?

A. Upper 2/3 front and lateral are covered by peritoneumB. Middle 2/3 front is only covered by peritoneumC. Upper 1/3 front and lateral are covered by peritoneumD. Lower 1/3 front is only covered by peritoneum

2. Choose the CORRECT answer:

A. In males, the seminal vesicles and prostate gland are lateral to the rectumB. Levator ani and coccygeus muscles forming the posterior and lateral relations of rectum in both

males and femalesC. Superior rectal and inferior rectal arteries forming the posterior relation of rectum in both males

and femalesD. The base of urinary bladder is anterior to the rectum in females.

3. Regarding the anal canal, all of the following are true EXCEPT:

A. The upper part of the anal canal is supplied by superior rectal artery onlyB. The lower part of the anal canal is supplied by superior, middle and inferior rectal arteriesC. Internal anal sphincter is the thickened inner involuntary circular muscle layerD. The external anal sphincter has 3 parts.

4. What are the contents of anal triangle:

I. Upper part of anal canalII. Lower part of anal canal

III. Ischio-anal (ischio-rectal) fossa on each sideIV. Sigmoid colon

A. I and IIB. II and IIIC. III and IVD. I and III

5. All of the following are FALSE regarding the ischio-rectal fossa, EXCEPT:

A. Skin of perineum on each side of the anus forming the superior boundary of the wedgeB. Linear origin of levator ani forming the lateral boundary of itC. Sacrotuberous ligament forming its posterior boundaryD. Medial boundary is made by the internal anal sphincter

HISTOLOGY

6. Choose the false statement regarding the large intestine:

A. Surface epithelium is smooth with villi and lined by simple columnar cells and goblet cellsB. Submucosa is formed of loose connective tissue containing blood vessels,lymphatics and nerves C. Crypts of large intestine are lined by numerous goblet cells and few absorptive columnar cellsD. Outer longitudinal layer of musculosa is incomplete and represented by taenia coli

7. All the following are true regarding the vermiform appendix except:

A. Wall is thickened and its glands have no digestive functionsB. Its gland is lined by simple columnar cells,many goblet cells and enteroendocrine cells C. Lamina propria does not contain heavy infiltration of diffuse and dense lymphoid tissueD. Muscularis mucosa is not well defined and interrupted by lymphoid tissue

8. The gastro-oesophageal junction is described as follows except:

A. Corium is widen and shows simple branched tubular glands of cardiac end of stomachB. Epithelium changes gradually from non keratinized stratified squamous to simple columnarC. Oesophageal gland stop or continue for a variable distance into submucosa of stomach cardiaD. Additional oblique smooth muscle fibers start to appear towards the stomach cardia

9. Which is the false statement regarding the pyloro-duodenal junction?

A. Surface epithelial cells remain cuboidal and they acquire a brush borderB. Epithelium starts to evaginate into the lumen forming the typical villiC. Intestinal crypts replace the pyloric glands in the corium of the duodenumD. Submucosa becomes studded with a large number of mucous acini forming Brunner’s gland

10. Statements regarding the recto-anal junction are all the following except:

A. Epithelium changes gradually from simple columnar and goblet cells into stratified columnarB. At the level of anal valves, epithelium changes into non keratinized stratified squamousC. Submucosa fuses with the corium above the level of anal valve and shows convoluted veinsD. Inner circular muscle layer is thickened to form internal anal spincter

PATHOLOGY

11. All are causes of of portal hypertension, EXCEPT ?

A. CirrhosisB. Budd chiari syndromeC. SarcoidosisD. Acute prostatitis

12. All are complications of Portal hypertension, EXCEPT ?

A. Fibrocongestive splenomegalyB. Caput MedusaeC. Hepatic encelopathyD. Rhinoscleroma

13. All are true regarding Cholelithiasis, EXCEPT?

A. Pure cholesterol stone is associated with excessive cholesterol in bile.B. Pigmented stone usually due to acute haemolysisC. Pigmented stone are always small, multiple, and Black in colourD. Mixed stones are radio opaque

14. All are complications of Cholelithiasis , EXCEPT ?

A. CholecystitisB. Obstruction of the cystic duct at bladder neckC. Acute pancreatitis in case of obstruction of common bile ductD. High tendency to cause bladder carcinoma.

15. True of False

a. Portal hypertension is due to depression of portal venous pressure below normal upper limit.b. Cholesterol stones result from increased bile salts in bile.

16. Causes of acute pancreatitis are of the following except:

A. A-Pancreatic duct obstructionB. Primary acinar cell injuryC. Hypersecretion of protein from acinar cellsD. Defective intracellular transport of proenzymes within acinar cells

17. Which of the following about chronic relapsing pancreatitis is not true:

A. Frequently affecting middle aged men particularly alcoholicsB. Attacks are precipitated by alcohol abuse,overeating and drug useC. ReversibleD. Characterized by repeated bouts of mild to moderate pancreatic inflammation

18. All of the following about carcinoma of the exocrine pancreas are true except:

A. Arises from ductal epithelial cellsB. Carcinoma of the tail of pancreas has better prognosis than carcinoma of the headC. Mostly adenocarcinomaD. More prevalent in males,diabetics and smokers

19. Chemical irritation causing sterile peritonitis are the following except:

A. Bile B. Pancreatic enzymesC. Surgically introduced foreign materialD. Gastric juice

20. All of the following might be mesenteric cysts except:

A. HerniaB. DiverticulaeC. Urogenital ridge remnantsD. Sequestrated lymphatic channels

PHYSIOLOGY

21. Which of the following is FALSE regarding mixing contraction :A. Stimulus for this contraction is distension of intestinal wall by the chimeB. Maximum frequency of segmenting contraction is determined by basic electrical rhythmC. This movement depends on the sympathetic and parasympathetic innervationsD. Mixing contraction prolonged contact of intestinal contents with enterocytes.

22. Propulsive movements:A. Begin at oesophagus and terminate at sigmoid colonB. There is circular contraction behind stimulus and relaxation in front of itC. Occur between ileum and cecumD. Totally peristalsis

23. Circular smooth muscle contraction is initiated by

A. Activation of myenteric plexusB. Activation of Nitric oxide,VIP and adenotriphosphate secretionC. Secretin hormoneD. Histamine

24. Migrating Motor Complex:

A. Occur in case of infectious diseaseB. Rapid and large peristaltic wavesC. Facilitate by motilinD. May occur in physiological and pathological condition

25. Frequency and magnitude of intestinal motility is controlled by:

A. Myogenic natureB. Peristaltic movementC. Sympathetic and parasympathetic innervationsD. Intra-intestinal pressure

26. Which one of the following is the definition of absorption?

A. Transfer of the digestive product from lumen of small intestine to the blood stream, through the mucosal cells

B. Transfer of digestive product from the blood steam to the lumen of stomach.C. Transfer of blood into the lumen of small intestineD. Transfer of gastric contents, through esophagus, pharynx and mouth.

27. Factors for great absorbing power of the small intestine are as follows EXCEPT:

A. Long absorbing surfaceB. Hormonal regulationsC. Rich blood and lymphatic vessels supplyD. Presence of intestinal villi

28. Which is TRUE regarding Villikin?

I. It’s a local hormone

II. Stimulates movement of villi

III. Its aids absorption

IV. It is released by stomach mucosa when it comes in contact with digestive products.

A. I onlyB. I and IIC. I,II and IIID. I and III

29. Below is the factors affecting the rate of intestinal absorption EXCEPT:

A. Lymph flowB. Proper digestionC. Intestinal movementD. Defecation

30. Regarding physical and chemical factors that affects the rate of intestinal absorption, is the given statement correct or incorrect?

Hypertonic solution are absorbed at a faster rate than hypotonic or isotonic solutions

A. CorrectB. Incorrect

31. Mass action contraction occurs only in:

A. ColonB. Pelvic floorC. External anal sphincterD. Gastro-esophageal opening

32. Distension of stomach and duodenum stimulates :

A. Peristalsis in opposite wayB. Release of motilinC. Gastro colic reflexD. Peristaltic rush

33. Intrinsic defecation reflex mediated by:

A. Parasympathetic nerveB. Pudendal nerveC. Vagus nerveD. Local enteric plexus

34. Parasympathetic defecation reflex involves :

A. Sacral segments of spinal cordB. Lateral horn cell of lumbar 1-4C. Anterior horn cell of sacral 2-4D. Proximal colon

35. Defecation signals initiate other effect, such as :

A. Taking a deep breathB. Closure of glottisC. Contraction of anterior abdominal wall musclesD. All of the above.

36. Concious mind voluntarily controls:

A. External anal sphincterB. Internal anal sphincter

37. Lack of conscious control exercised through voluntary contraction or relaxation of external anal sphincter causes:

A. ConstipationB. DiarrheaC. Automatic bowel emptyingD. Vomiting

38. Distention of rectum causes all of the following except?

A. Increase rectal pressureB. Desire of defecationC. Automatic emptying of the lower bowelD. Increase tone of internal anal sphincter.

BIOCHEMISTRY

39. The product of salivary alpha amylase on starch is:

A. MaltoseB. GlucoseC. alpha-dextrins D. maltotriose

40. What intestinal enzyme that will cleave alpa-limit dextrin?

A. SucroseB. lactase C. isomaltase D. icomaltase

41. Alpha amylase cannot hydrolyze these except :

A. alpha 1,6 linkages B. terminal alpha 1,4 linkages C. alpha 1,4 glucosidaseD. beta 1,4 glucosidase

42. Effect of lactose intolerance:

A. constipation B. FeverC. flatulence D. Itching

43. Absorption of fructose occur through :

A. active transport at duodenum and jejunumB. facilitated diffusion at jejunum and ileumC. Na-dependent carrier protein at duodenum and jejunum D. Na-independent carrier protein at duodenum and jejunum

44. What is the function of isomerase?

A. Isomerase shifts the ester bond from position 2 to1, this is then hydrolysed by the lipase to form free glycerol and fatty acid

B. Produce 2-monoacyl glyceride (72%), 1-monoacyl glycer-ide (6%), glycerol and fatty acids (22%).C. It catalyzes the hydrolysis of cholesterol esters,which are absorbed from the intestine in the free

form

45. What is enterohepatic circulation of bile salts?

A. It will form chylomicrons that are released by exocytosis into lymphB. They are separately reabsorbed from the ileum and returned to the liver to be re-excreted again

to gut.C. It will reabsorbed as micelles to the portal circulation

Questions 46-48

A molecule of palmitic acid,attached to carbon 1 of the glycerol moiety of a triacylglycerol,is ingested and digested.

46. Which of the following molecular complexes in the blood carries the palmitate residue from thelumen of gut to the surface of gut epithelial cell?

A. Very low-low density lipoproteinB. ChylomicronC. Bile salt

47. Which of the following molecular complexes in the blood carries the palmitate residue from the gut epithelial cell to the blood?

A. Very low-low density lipoproteinB. ChylomicronC. Bile salt

48. Which of the following molecular complexes in the blood carries the palmitate residue from the intestine through the blood to a fat cell?

A. Very low-low density lipoproteinB. ChylomicronC. Bile saltD. Lipase

PARASITOLOGY

49. Regarding the morphology of Heterophyes Heterophyes, all are true EXCEPT

A. The fluke possesses oral, ventral and genital suckersB. The fluke is hermaphroditeC. Uterus and seminal vesicles are both open in the genital suckerD. Male genitalia consist of two highly branched testes located posteriorly

50. Cercariae of Heterophyes Heterophyes are of which type?

A. Leptocercous B. PleurocercousC. Furcocercous

51. All of these are true regarding the life cycle of Heterophyes Heterophyes EXCEPT

A. The first intermediate host is a right handed snailB. Cercariae attack the tail and fins of the second intermediate hostC. Eggs are hatched when excreted with the stoolsD. The infective stage is the encysted metacercariae

52. What are the clinical pictures seen in Heterophyes Heterophyes infection?

A. Asymptomatic in mild infected patientsB. Chronic intermittent diarrhea in heavy infectionC. Stomatitis in acute infectonD. Myocarditis and heart failure

53. Attachment of worm at the mucous membrane shows all of these EXCEPT

A. Allergic reactionsB. NecrosisC. Mild catarrhal inflammationD. Superficial ulcers

54. All of these are true regarding the morphology of Diphylobothrium latum EXCEPT

A. Testes and vitelline glands are located in the lateral fields of the segmentsB. Mature segments are broader than long with mid ventral genital poreC. Bilobed ovary present in the posterior part of the segmentsD. Uterus is darker, more coiled and packed with eggs in mature segments

55. The severity of the Diphylobothrium latum infections depend on these factors EXCEPT ?

A. Competition of the host for vitamin B12

B. Invasion of plerocercoid larva in submucosaC. Number of worms present in the intestineD. Amount of metabolic products absorbed by host

56. Regarding the life cycle of Diphylobothrium latum, all are true EXCEPT

A. Intermediate hosts are right handed snail and fresh water fishB. Infective stage is plerocercoid larvaC. The hatched eggs called coracidiumD. Diagnostic stage is unembryonated eggs

57. All of these are the methods for prevention and control EXCEPT

A. Cook the fish thoroughlyB. Treatment for infected patientsC. Deep freezing for 1 or 2 days at 18oCD. Reservoir host should be dewormed periodically

58. Patients infected with Diphylobothrium latum usually present clinically symptomatic

A. TrueB. False

59. Which of the following is wrong regarding geographical distribution of Taenia Saginata ?

A. North AmericaB. EthiopiaC. East AfricaD. West Africa

60. Taenia Saginata has:

A. 3000-4000 proglottidsB. Uterus connected pre-equatoriallyC. 300-400 testesD. Wide neck followed by immature, mature and gravid segments.

61. Which of the following is false regarding the life cycle of Taenia Saginata ?

A. They are filtered to pterygoid muscle,tenderloin region and myocardiumB. The infective stage is cysticercus bovisC. In the transverse colon, the scolex invaginates and fixes itself to the mucosaD. Men are infected by eating infected meat containing cysticercus bovis.

62. Taenia solium has :

A. Bilobed ovary B. Longer segments than taenia saginataC. Less number of testes than taeia saginataD. It’s Uterus possess 14-17 main lateral branches on each side.

63. Which of the following is not true regarding life cycle of Taenia Solium ?

A. The intermediate host is pigB. The rostellum, suckers and hooks are inapparentC. Humans are infected by consuming imperfectly cooked pigs meatD. Man can also act as intermediate host of taenia solium

64. All of following can be seen in patient infected by Taenia Solium EXCEPTA. Vague abdominal discomfortB. InsomniaC. DiarrheaD. Loss of appetite

65. Choose correct characteristics about Taenia Solium

i-It scolex is quadrateii-It mature segment is less than 150iii-It has trilobed ovaryiv-It has rostellum armed

A. i,ii,iiiB. i,ii,ivC. ii,iii,ivD. All of above

66. All of following are wrong statement about H.Nana EXCEPTA. It has rhomboidal scolexB. It has 2 suckersC. It egg has thin hyaline capsuleD. largest tape worm

67. Infected stage of H.Nana is cysticercus cellulosae

A. TrueB. False

68. Choose correct statement about life cycle of T.Solium

i-Intermediate host is pigii-egg are swallowed and pass to duodenumiii-head of cysticerci invaginated appearing as milky spotiv-it larva stage known as cysticercus bovis

A. i,ii,iiiB. i,ii,ivC. ii,iii,ivD. All of above

ANSWERS

1. C2. B3. B4. B5. C6. A7. C8. B9. A10. C11. D12. D13. B14. D15. a. false b. false16. C17. C 18. B19. D 20. A21. C22. B23. A24. C25. C26. A27. B28. C29. D30. B31. A32. C33. D34. A35. D36. A37. C38. D39. C40. C41. C42. C43. D44. A45. B46. C

47. B48. B49. D50. B51. C52. C53. A54. D55. B56. A57. C58. B59. A60. C61. C62. C63. B64. B65. C66. A67. B68. A