Professional Documents
Culture Documents
INSTRUCTIONS: Select The Letter Of The Best Correct Answer For Each Of The Following
Questions. Mark Only One Answer For Each Item By Shading The Box Corresponding To The
Letter Of Your Choice On The Answer Sheet. Strictly No Erasures Allowed. Use Pencil No. 1
Only.
1.
2.
3.
A 18 year old female came to the emergency room for complaints of vomiting, anorexia, epigastric and right
lower quadrant pain noted 12 hours prior to admission. Digital rectal exam revealed right pararectal wall
tenderness. Differential diagnosis would include the following except:
a. Acute appendicitis
b. Urinary tract infection
c. Twisted ovarian cyst
d. Ectopic pregnancy
e. None of the above
8. A 40 year old man who was an unrestrained passenger in a motor vehicle accident was brought to the emergency
room. He was thrown from the car at impact. The patient is unconscious and, on evaluation becomes apneic. Ventilation
should be achieved by
a. endotracheal intubation
b. nasotracheal intubation
c. face mask
d. tracheostomy
e. cricothyroidotomy
9. A patient has lost cutaneous sensation over the tip of the nose. Which nerve is most likely damaged?
a. facial nerve
b. ophthalmic division of the trigeminal nerve
c. greater auricular nerve
d. mandibular division of the trigeminal nerve
e. maxillary division of the trigeminal nerve
10. Emergency room thoracotomy for cardiac resuscitation would be most commonly indicated for a major blunt trauma
with cardiac arrest
a. failed closed chest massage lasting 15 minutes
b. cardiac arrest after a stab wound to the left parasternal area
c. cardiac arrest accompanying a major central nervous system injury
d. hypovolemic cardiac arrest
e. none of the above
11. Injury to the common peroneal nerve would result in an
a. inability to evert the foot
b. inability to invert the foot
c. inability to plantar flex the ankle
d. inability to plantar flex the big toe
e. inability to feel sensation on the medial side of the leg
12. A 55 year old man is involved in a motor vehicular accident. Initial resuscitation is carried out. Cervical spine films are
normal. A supine anteroposterior (AP) chest film suggests a distorted upper mediastinum. The next study should be
a. aortogram
b. CT scan of the chest
c. MRI of the chest
d. upright posteroanterior (PA) chest radiograph
e. electrocardiogram
13. To test trapezius muscle paralysis, you would ask the patient to
a. flex the arm fully
b. adduct the arm against resistance
c. push against a wall with both hands
d. shrug the shoulder
e. abduct the arm fully
14. A 14 year old boy fell off a wall and fractured his right humerus at midshaft. The wrist joint immediately assumed a
flexed position that the patient was unable to correct. Extension and supination of the forearm was weakened but not
abolished. Select the peripheral nerve damaged that could cause the symptoms.
a. radial nerve
b. ulnar nerve
c. median nerve
d. axillary nerve
e. musculocutaneous nerve
15. In a 23 y.o, male coming in with anorexia, right lower quadrant pain and vomiting, peritoneal irritation is indicated by:
a. Dunphys sign
b. Hamburger Sign
c. Rovsings sign
d. Obturator sign
e. Psoas sign
16. Blood supply ligated during an appendectomy
a. Colonic artery
b. branch of celiac artery
c. branch of ileocolic artery
d. branch of cecal artery
e. superior mesenteric artery
17. Most common organisms causing acute appendicitis, except:
a. e. coli
b. peptostreptococcus sp.
c. bacteroides fragilis
d. enterobacter aeroginosa
18. Allelic loss at the site of this tumor suppressor gene is responsible for developing 100% risk of colon cancer:
a. BRCA 1
b. BRCA 2
c. myc-trans gene
d. APC
e. fibrillin
19. The following are true of familial adenomatous polyposis except:
a. colon becomes covered with polyps after puberty
b. autosomal recessive inheritance
c. 100% risk of developing colon CA
d. May present with weight loss and hematochezia
e. common in middle-aged Caucasians
20. Tumor marker for Papillary thyroid Carcinoma:
a. free T3
b. free T4
c. Free T3 & T4
d. thyroglobulin
e. calcitonin
21. A 67 y.o, female underwent total thyroidectomy. Biopsy findings revealed abundance of parafollicular cells or C cells.
She will most likely manifest with increased levels of the following hormone:
a. thyroglobulin
b. calcitonin
c. parathyroid hormone
d. tyrosine
e. tryptophan
22. The same patient in the previous number had sudden onset of dyspnea and hoarseness of the voice. Serum Calcium
revealed: 7.4 mg/dl. The following are expected, except:
a. intraop injury to the recurrent laryngeal nerve
b. presence of hematoma at post-op site
c. presence of Trousseaus sign
d. carpopedal spasm
e. low levels of thyroglobulin
23. Amino acid precursor of thyroid hormone
a. tryptophan
b. tyrosine
c. thyroxine
d. hyrdoxylysine
e. hydroxyproline
24. The following contribute to the blood supply of the thyroid gland except:
a. superior thyroid artery
b. inferior thyroid artery
c. brachiocephalic artery
d. left common carotid artery
e. right common carotid artery
25. Gene on chromosome 13 that is associated with early onset breast CA
a. fibrillin
b. CA-19
c. BRCA1
d. APC
e. BRCA 2
26. The following are risk factors for developing breast CA, except:
a. having an aunt with breast CA
b. presence of BRCA 1 gene on chromosome 17
c. being 35% above ideal body weight
d. Primigravida at the age of 18
e. menarche at 12 years old and menopause at 60 years old
27. Most common benign condition of the breast:
a. fibrocystic breast disease
b. peau d orange
c. papillary CA
d. invasive ductal
e. phylloides tumor
28. Most common site of breast CA:
a. Lower outer quadrant
b. Upper outer quadrant
c. Upper inner quadrant
d. Lower inner quadrant
29. A 38 y.o, female noted Winging of the scapula after undergoing MRM. The most likely injured structure would be:
a. axillary artery
b. axillary nerve
c. pectoralis minor muscle
d. long thoracic nerve
e. Batsons plexus
30. The landmark structure used to divide Level I,II, and III in breast surgery
a. axillary nerve
b. long thoracic nerve
c. pectoralis major mm.
d. pectoralis minor mm.
e. Rotters nodes
31. A 56 y.o, woman was diagnosed to have Invasive Ductal CA of the left breast. The following would be the most
important factor in prognosis:
d. hyoglossus
e. genioglossus
E. paragonimiasis
d. Sleep apnea
e. none of the above
70. Most common type of thyroid carcinoma
a. papillary thyroid carcinoma
b. medullary thyroid carcinoma
c. anaplastic carcinoma
d. poorly differentiated carcinoma
e. Hurthle cell carcinoma
71. Most common post thyroidectomy complication
a. Wound hemorrhage
b. Recurrent laryngeal nerve injury
c. Hypoparathyroidism
d. Thyroid storm
e. Winging of the scapula
72. The following are contents of Cubital Fossa except:
a. Termination of Brachial Artery
b. Radial and ulnar arteries
c. Biceps tendon
d. Median nerve
e. none of the above
73. The superficial membranous fascia which continues as the Colles fascia in the perineum
a. Campers fascia
b. Scarpas fascia
c. Gimbernats fascia
d. Coopers Fascia
e. External oblique fascia
74. Internal oblique muscle runs upward and medially and inserts to the public crest, tubercle and pectineal line giving
rise to the following except:
a. conjoined tendon
b. cremasteric muscle
c. cremasteric fascia
d. all of the above
e. none of the above
75. Branches of the Coelic Artery except:
a. Left. Gastric artery
b. Splenic artery
c. Hepatic artery
d. Renal artery
e. none of the above
76. The following are signs of advanced disease in gastric carcinoma, except
a. Virchows node
b. Left supraclavicular lymphadenopathy
c. Sr. Mary Josephs node
d. Blumers shelf
e. none of the above
77. Collection of para-aortic & paraganglionic cells that may serve as extra adrenal site for chromaffin cell tumor
a. Klatskin tumor
b. Organs of Zuckerkandl
c. Organs of Zuckermann
d. Pheochromocytoma
e. none of the above
78. Characteristic of barium swallow showing dilated esophagus with area of distal stenosis BIRDS BEAK
a. esophagitis
b. barretts esophagus
c. esophageal carcinoma
d. tracheo-esophageal fistula
e. achalasia
79. The best screening procedure for colon carcinoma is the general population is:
A. CEA assay
B. Colonoscopy
C. Barium enema
D. Sigmoidoscopy
E. Stool Occult Blood Test.
80. The following is/are indication/s for diagnostic peritoneal lavage:
A. Kitchen knife wound across the belly, eviscerating small intestines
B. Gunshot wound to the lower abdomen, non-penetrating
C. Ice-pick wound at periumbilical area, 8 cm hematoma at left parieto-occipital area, GCS-4
D. Blunt and abdominal trauma, BP 80/40, RR 36, 2 L lactated Ringers already given
E. none of the above
81. Which of the following is considered pre-malignant
A. Pseudopolyp
B. Hamartoma
C. Villous adenoma
D. Pedunculated polyp.
E. Tubular polyp
82. The following statements are true except:
a. Ext. spermatic fascia comes from ext. oblique muscle
b. Cremasteric fascia comes from int. oblique muscle
c. Int spermatic fascia comes from transversalis muscle
d. pampiniform plexus of veins is contained in spermatic fascia
e. nerves to spermatic cord are derived from renal and pelvic plexus
83. What presenting complaint is most common in a patient with carcinoma of the bladder?
a. suprapubic pain
b. palpable lower abdominal mass
c. painless hematuria
d. unexplained fever
e. weight loss
84. A major cause of nosocomial infection in extensive burns is
A. pseudomonas
C. bacteroides
B. branhamella
D. aspergillus
E. enterobacter
85. During operations on the thyroid gland, the following nerve may be injured when tying the inferior thyroid artery
a. sympathetic trunk
b. internal laryngeal nerve
c. descendens cervicalis
d. recurrent laryngeal nerve
e. superior laryngeal nerve
86. A 65 year old female sought consult due to hematochezia and weight loss. Colonoscopy revealed an ill-defined
fungating mass 15 cm from the anal verge causing obstruction. The treatment of choice is:
a. Biopsy
b. Low Anterior Resection
c. Miles procedure
d. Insertion of Sump tube attached to low pressure gomco
e. Radiation therapy
87. A 45 year old male executive is seen because he is vomiting bright red blood. There are no previous symptoms. The
man admits to one drink a week with no other significant history. In the hospital, he bleeds 5 units of blood before
endoscopy. The most likely diagnosis is
a. gastritis
b. duodenal ulcer
c. esophagitis
d. Mallory-Weiss tear
e. esophageal varices
88. The diaphragm is derived from the following except:
a. Septum transversum
b. Pleuroperitoneal fold
c. Body wall
d. Dorsal mesentery of esophagus
e. C3C4C5 (Phrenic Nerve)
89. Work-up reveals an inflammatory process within the colon with skip areas. The rectum is spared. The most likely
diagnosis is
a. ischemic colitis
d. ulcerative colitis
b. amebic dysentery
e. Crohns Disease
c. toxic megacolon
90. An elderly woman is admitted for weakness, weight loss, anemia and a palpable abdominal mass. She has colon
carcinoma. The most likely anatomic site is
a. rectum
d. sigmoid colon
b. left colon
e. cecum
c. transverse colon
91. The following statements are true, except:
a. Nearly 30% of all patients with colorectal Carcinoma have a synchronous polyp
b. 100% of patients with Familial Adenomatous Polyposis will develop colon carcinoma if the colon is not
resected
c.familial polyposis coli and Gardners syndrome are risk factors for carcinoma
d. Most common manifestation of rectal CA is change in caliber of stools
e. none of the above
92. Bone metastasis occurs from the following primary carcinomas, except:
a. breast
b. lung
c. thyroid
d. prostate
e. none of the above
93. Meckels diverticulum is characterized by the following except:
a. 2 % of population
b. commonly presents during 1st 2 years of life
c. 2 inches long
d. 2 feet from the ileocecal valve
e. 2 ectopic tissues: duodenal mucosa and pancreatic tissue
94. Acute hematogenous osteomyelitis is often diagnosed by isolation of the organism from the blood and is caused most
often by
A. Proteus mirabilis
C. Escherichia coli
E. pseudomonas aeruginosa
B. Streptococcus epidermidis
D. Staphylococcus aureus
95. Common pathogen in surgical implants:
A. Klebsiella B. E. coli
C. S. epidermidis
D. S. pyogenes
E. Pseudomonas
96. The following are risk factors for developing gastric carcinoma except:
a. High consumption of smoked fish
b. Blood type A
c. post-gastrectomy patients
d. chronic hypochlorhdia
e. Virchows node
97. Most common congenital anomaly of the GI tract characterized by persistence of the vitelline duct or yolk stalk
a. Cystic hygroma
b. Inguinal hernia
c. Meckels diverticulum
d. omphalocoele
e. Vitelloma
98. Wrist bone with greatest incidence of aseptic necrosis
a. navicular bone
b. cuneiform
c. lunate
d. sesamoid bone
e. none of the above
99. Condition where pupils accommodates when patient follows finger moving towards the nose but does not react to
direct light
a. Neurosyphilis
b. Horners syndrome
c. Adies pupil
d. Argyll-Robertson pupil
e. Webers syndrome
100. A 24 year old male was in a vehicular accident. He arrived at the ER with raccoon eyes and otorrhea. On the 3 rd
hospital day he developed high grade fever and nuchal rigidity. The most common meningeal isolate in this patient would
be
a. Streptococcus pneumoniae
b. H. influenzae
c. N. meningitides
d. S. aureus
e. Listeria monocytogenes
8.A 32 year old male hypertensive smoker complains of chest oppression provoked by effort and relieved by
rest. The drug to recommend to relieve his oppression is
a. Diltiazem
b.
Aspirin
c.
Nifedipine
d.
A nitrate
9. Which one of the following medical fees is considered as unethical:
A. dichotomous fees
C. retainers fees
B. contingent fees
D. contractual fees
10. A resident in the Department of OB-Gyne saw a patient in the ER complaining of left-sided abdominal
pain. She was given mefenamic acid and sent home only to come back in shock for ruptured ectopic
pregnancy. The hospital is liable in this case under the doctrine of:
A. Vicarious liability
B. Borrowed servant
C. Independent contractor theory
D. Corporate liability
11. One of the following is a United Nation Millenium Development Goal:
A. Family Planning
B. Fight Against Child and Maternal Mortality
C. Control of Diarrheal Diseases
D. Control of Acute Respiratory Infection
12. A patient has lost cutaneous sensation over the tip of the nose. Which nerve is most likely damaged?
a. facial nerve
b. ophthalmic division of the trigeminal nerve
c. greater auricular nerve
d. mandibular division of the trigeminal nerve
e. maxillary division of the trigeminal nerve
13. Bacteria that grows at temperatures as high as 50 C to 55 C are known as
A. mesophiles
B. halophiles
C. thermophiles
D. psychrophiles
14. Delayed speech/language of a child may be caused by the following except
a. child neglect
d. child abuse
b. inborn
e. none of the above
c. mental retardation
15.The standard for diagnosis of pneumonia
a. Sputum culture
b. Chest radiograph
c. CBC
d. CT scan
16. Emergency room thoracotomy for cardiac resuscitation would be most commonly indicated for a major
blunt trauma with cardiac arrest
a. failed closed chest massage lasting 15 minutes
b. cardiac arrest after a stab wound to the left parasternal area
c. cardiac arrest accompanying a major central nervous system injury
d. hypovolemic cardiac arrest
18. Which collaborating agency in the world helps erase Polio in children?
a. UNICEF
b. Rotary International
c. W.H.O
d. Canadian International Development Agency
18. Sporulation is the feature of all these microorganisms, EXCEPT:
A. Corynebacterium diphtheriae
D. Clostridium perfringens
B. Bacillus anthracis
E. Aspergillus flavus
C. Coxiella burnetti
D. kinase
E. hemolysin
25. A 55 year old man is involved in a motor vehicular accident. Initial resuscitation is carried out. Cervical
spine films are normal. A supine anteroposterior (AP) chest film suggests a distorted upper mediastinum.
The next study should be
a. aortogram
b. CT scan of the chest
c. MRI of the chest
d. upright posteroanterior (PA) chest radiograph
e. electrocardiogram
26. In the child, the chief arterial supply to the head of the femur is derived from the:
a. obturator artery
b. internal pudendal artery
c. branches from the medial and lateral circumflex femoral arteries
d. deep circumflex iliac artery
e. superficial circumflex iliac artery
27. The lymph from the medial quadrants of the breast drains mainly into:
a. internal thoracic nodes
b. posterior axillary (subscapular) nodes
c. anterior axillary (pectoral) nodes
d. lateral axillary (brachial) nodes
e. infraclavicular (deltopectoral) nodes
28. In the absence of an attending doctor at death, the responsibility of signing the death certificate goes to:
A. Closest kin
C. Local Health Officer
B. Nurses
D. Midwife
29. Criterion/criteria in the selection of a community to be organized:
A. all of these
B. existence of a serious peace and order problem
C.
D.
E.
D.
50. Antibiotic (e.g. clindamycin) associated diarrhea and the more serious pseudomembranous
enterocolitis can be caused by
A. Clostridium sordelli
C. Staphylococcus
B. Clostridium perfringens
D. Clostridium difficile
51. To test trapezius muscle paralysis, you would ask the patient to
f. flex the arm fully
g. adduct the arm against resistance
h. push against a wall with both hands
i.
shrug the shoulder
j.
abduct the arm fully
52. A 14 year old boy fell off a wall and fractured his right humerus at midshaft. The wrist joint immediately
assumed a flexed position that the patient was unable to correct. Extension and supination of the forearm
was weakened but not abolished. Select the peripheral nerve damaged that could cause the symptoms.
a. radial nerve
b. ulnar nerve
c. median nerve
d. axillary nerve
e. musculocutaneous nerve
53. The most important laboratory procedure in the diagnosis of subacute bacterial endocarditis is
a. ESR
b. Blood culture
c. Complete blood count
d. Throat swab
e. ASO titer
54. Bacterial meningitis in children between the ages of 6 months and 2 years most commonly is caused by
A. haemophilus
B. pneumococcus
C. staphylococcus
D. neisseria
55. Children conceived by prostitute:
A. manceres
C. sacrilegious children
B. illegitimate children
D. adulterous children
56. If the patient died and spouse is incapacitated, the claim for medical fee shall be made from the:
A. ascendants from the nearest degree
B. sister
C. descendents from the nearest degree
D. brother
57. A pathologist, connected and associated with a hospital on salary contract, reported after tissue biopsy
that a patient had cancer when in fact he did not. The patient underwent hysterectomy as a result of the
misdiagnosis. The hospital was held liable by the court under the doctrine of:
A. ostensible agent
C. borrowed servant
B. fellow servant
D. captain of the ship
58. A 63 year old male is referred for urologic consult after a large prostate gland was found on routine rectal
examination. The diagnostic test should be
a. digital rectal examination (DRE)
b. prostate specific antigen (PSA) level
c. digital rectal exam combined with PSA
d. transrectal ultrasound
e. Computed tomography (CT)
59. Pruritus ani is a common manifestation of patient with
A. oxyuriasis
B. uncinariasis
C. capillariasis
D. ascariasis
E. strongloidiasis
60. What is the maintenance therapy among infants with supraventricular tachycardia converted to a sinus
rhythm?
a. propanolol
d. quinidine
b. digoxin
e. phenytoin
c. verapamil
70. The body of the crime which points to the act of the criminal is:
A. Real evidence
C. Corpus delicti
B. Circumstantial evidence
D. En flagrante delicto
71. During physical examination, a physician fondled the breast of his female patient. He may be charged
with:
A. malpractice
C. act of lasciviousness
B. qualified seduction
D. moral turpitude
72. The body vested by law to have general supervision and regulation over the practice of medicine is:
B. Commission on Higher Education
C. Department of Education
D. Professional Regulatory Commission
E. Board of Medical Education
73. The state of not knowing the nature of sexual life and not having experienced sexual relation is termed
as:
A. moral virginity
C. false physical virginity
B. demi-virginity
D. true physical virginity
74. The following are true of Downs syndrome, EXCEPT:
A. Mental retardation and prominent epicanthal folds
B. Simian crease
C. Development of Alzheimers disease in > 35 y.o
D. Endocardial cushion defect
E. Decreased risk of Acute Lymphoblastic Leukemia
75.Antistreptolysin test to diagnose
A. strep fecalis
B. peptostreptococcus
C. Strep pyogenes
D. strep pneumonia
76. During operations on the thyroid gland, the following nerve may be injured when tying the inferior thyroid
artery
a. sympathetic trunk
b. internal laryngeal nerve
c. descendens cervicalis
d. recurrent laryngeal nerve
e. superior laryngeal nerve
77. The most common cause of arterial hypertension in children
a. chronic pyelonephritis
b. coarctation of the aorta
c. nephritic syndrome
d. renal artery stenosis
e. post-streptococcal GN
78. The most serious consequence of iodine deficiency is
a. congenital goiter
b. sporadic goiter
c. endemic goiter/cretinism
d. intratracheal goiter
e. thyroiditis
79. The following are true about the Renin-Angiotensin-Aldosterone axis, EXCEPT:
A. activated during states of hypovolemia
B. activation of zona fasciculata for sodium retention
C. Conversion of angiotensinogen to angiotensin I in the pulmonary circulation
D. Vasoconstriction due to angiotensin II
80. Collateral circulation around the shoulder joint would involve all of the following except
a. subscapular artery
b. superficial cervical artery
c. suprascapular artery
d. anterior circumflex humeral artery
e. lateral thoracic artery
81. Malignant tumors of the trigone of the bladder spread /metastasize to the following lymph nodes
a. external and internal iliac
b. lumbar
c. sacral
d. external iliac
e. superficial inguinal
82. A male trauma patient is brought in for profound shock can be resuscitated with all of the following
except:
a. type AB negative blood
b. type O negative blood
c. type-specific but not crossmatched blood
d. type-specific crossmatched blood
e. none of the above
83. Acute hematogenous osteomyelitis is often diagnosed by isolation of the organism from the blood and is
caused most often by
A. Proteus mirabilis
C. Escherichia coli
B. Streptococcus epidermidis
D. Staphylococcus aureus
84. Mycobacterium leprae has been successfully grown in
A. footpads of mice
C. peritoneum of guinea pig medium
B. testicles of rabbits
D. Lowenstein-Jensen medium
85. A 50 year old man has a right upper lobe cavitary lesion that is 4 cm in diameter and of unknown age.
Which test is most likely to establish the diagnosis?
a. bronchography
b. computed tomography
c. bronchoscopy with biopsy brushings and washings
d. percutaneous needle aspiration of the cavity contents
e. an immunologic skin test
86. The anti-TB drug utilized in the treatment of both pulmonary tuberculosis and leprosy:
A. dapsone B. rifampicin C. streptomycin D. pyrazinamide
87. A 5 year old patient has a midline neck mass that moves with swallowing and is located just below the
hyoid. The mass is most likely to be a
a. branchial cleft cyst
d. thyroglossal duct cyst
b. cystic hygroma
e. laryngeal papilloma
c. teratoma
88. A 60 year old smoker complains of dyspnea, wheezing, and non productive cough. Chest radiograph
appears normal, but computed tomography scan reveals an intraluminal mass located in the distal trachea.
The most likely diagnosis is
a. adenoid cystic carcinoma
b. carcinoid tumor
c. squamous cell carcinoma
d. mucoepidermoid carcinoma
e. squamous papilloma
89. Sustained tension of the vocal cords (folds) is best achieved through the action of which one of the
following muscles
a. cricopharyngeus
b. cricothyroid
c. aryepiglottic
d. salpingopharygeus
e. posterior cricoarytenoid
90. 96% of children with SLE presents with these manifestations/characteristics
a.
b.
c.
d.
e.
gastrointestinal symptoms
malaise, weight loss, growth retardation
nephritis
photophobia
fever and chills
91. Which is NOT the true statement concerning the Mycobacterium avium/intracellulare (MAI) complex:
A. Prior to 1980 there were few cases of MAI disease observed.
B. Acid-fast stain and culture of the stool are important diagnostic aids.
C. MAI infection in AIDS patients is a result of direct contact with another person who is
infected with acid-fast bacilli.
D. Patients with reduced T-cell-mediated immunity are more susceptible to infection with MAI.
92. The type of necrosis seen predominantly in brain infarction:
A. coagulative
C. liquefactive
B. enzymatic fat
D. caseation
93. The following structures are closely related to the rectouterine pouch (pouch of Douglas) except
a. anteriorly is situated the posterior surface of the upper part of the vagina
b. posteriorly is situated the upper part of the rectum
c. the trigone of the bladder is directly related to the anterior wall
d. anteriorly is situated the posterior surface of the body of the uterus
e. laterally is situated the sacrocervical ligaments passing forward to the cervix
94. The second law of thermodynamics states that in an isolated system:
A. any spontaneous process increases the entropy of the universe
B. enthalpy increases as the process proceeds
C. the entropy tends to decrease with time
D. the total entropy change in a spontaneous process is always negative
95. A 45 year old male executive is seen because he is vomiting bright red blood. There are no previous
symptoms. The man admits to one drink a week with no other significant history. In the hospital, he bleeds 5
units of blood before endoscopy. The most likely diagnosis is
a. gastritis
b. duodenal ulcer
c. esophagitis
d. Mallory-Weiss tear
e. esophageal varices
96. Most common cause of septic arthritis
A. Acinetobacter B. Gonococcus C. Staphylococcus
D. Listeria
E. Streptococcus
97. First line agent for patients with congestive heart failure and pulmonary edema
A. Furosemide
B. Digoxin
C. Nitroglycerine
D. Nifedipine
98. Death from Weils disease is usually due to
A. renal failure B. meningitis C. pneumonia D. encephalitis
99. Which of the following structures may be eroded by a perforating gastric ulcer on the posterior wall of the
stomach?
a. splenic artery
b. inferior mesenteric artery
c. right kidney
d. quadrate lobe of liver
e. second part of duodenum
100. Meningitis caused by Listeria monocytogenes in the pediatric age group is seen primarily in
A. newborn infants
C. patients receiving broad-spectrum antibiotics
B. children with chronic otitis media
D. children with ventriculoperitoneal shunts
101.This drug lowers plasma lipoprotein concentration by inhibition of HMG CoA Reductase
A. Lovastatin
B. Nicotinic Acid
C. Clofibrate
D. Cholestyramine
102. Most effective drug for AIDS
A. zidovudine
B. ribavirin
C. isonoplex
D. vidarabin
E. acyclovir
103. A 3-year old child presents at the physicians office with symptoms of coryza, conjunctivitis, lowgrade fever, and Kopliks spots. The causative agent of this disease belongs to which group viruses?
A. adenovirus B. orthomyxovirus C. picornavirus D. herpes virus E. paramyxovirus
104. The toxic property of endotoxin lies in the
A. protein C
C. O antigen
B. polysaccharide core
D. protein A
E. lipid A
105. The most common protozoa causing opportunistic infections in patients with AIDS:
A. Toxoplasma gondii
C. Cryptosporidium
E. Sarcocystis hominis
B. Pneumoncystis carinii
D. Isospora belli
106.Most common cause of digitalis toxicity
B. Hypomagnesemia
C. Hypokalemia
D. Hypocalcemia
E. Hypochloremia
107. With a patient in the standing position, fluid in the left pleural cavity tends to gravitate down to the
a. oblique fissure
b. cardiac notch
c. costomediastinal recess
d. costodiaphragmatic recess
e. horizontal fissure
108.Limited primarily to the testing of new bactericidal agents:
A. Zephiran
B. phenol
C. benzylalkonium chloride
D. lime
109. A 3 month old child has a soft, irregular, compressible, enlarging, posterior neck mass. The most likely
diagnosis
a. thyroglossal duct cyst
d. teratoma
b. abscess
e. cystic hygroma
c. paraganglioma
110. All of the following areas in the Philippines are known endemic for Schistosoma japonicum,
EXCEPT:
A. Lake Nauhan in Mindoro
C. Sorsogon (southern barrios)
B. All of Leyte and Samar (coastal regions)
D. Cebu City (southern barrios)
111.This antihypertensive agent, if given in the third trimester, may cause fetal bradycardia and
hypoglycemia in the neonatal period
a. ACE Inhibitor
b. Propranolol
c. Calcium channel blocker
d. Hydrochlorothiazide
112. A muscle that protrudes the tongue is the
a. styloglossus
d. hyoglossus
b. palatoglossus
c. mylohyoid
e. genioglossus
C. staphylococcus
E. paragonimiasis
D. TB
E.
Klebsiella
125. In a patient who presents with Cushings syndrome and has elevated plasma cortisol and low plasma
adrenocorticotrophic hormone (ACTH) levels, the most likely diagnosis is
a. an adrenocortical adenoma
b. basophilic adenoma of the pituitary gland
c. oat cell carcinoma of the lung
d. bilateral adrenal hyperplasia
e. malignant islet cell tumor of the pancreas
126. A 45 year old woman who has had a hysterectomy presents to the emergency room with abdominal
pain and vomiting. A mechanical bowel obstruction is seen on the abdominal radiograph. The most likely
cause of the obstruction is
a. carcinoma of the colon
d. small bowel cancer
b. adhesions
e. diverticulitis
c. incarcerated inguinal hernia
127. Which of the following can NOT serve as a vector of rickettsiae?
A. ticks
B. lice
C. mosquitoes D. fleas
128. Heterophile antibody test (Paul-Bunnel) is a diagnostic of
A. herpes virus
C. cytomegalovirus
E. brucellosis
B. infectious mononucleosis D. polio virus
129. Tissue graft within the same individual is known as
A. allograft
B. isograft
C. autograft
D. xenograft
130. Frank amoebic dysentery in entamoeba histolytica infection:
A. sigmoid-rectal B. liver
C. all of these
D. cecum
131. An elderly woman is admitted for weakness, weight loss, anemia and a palpable abdominal mass. She
has colon carcinoma. The most likely anatomic site is
a. rectum
d. sigmoid colon
b. left colon
e. cecum
c. transverse colon
132. The inclusion body of smallpox virus is
A. Miyagawa
B. Guarnier-Paschen
C. Lipschutz
D. Torres-Councilman
E. intravascular hemolysis
c. prostacyclin
139. A 15 year old girl has recurrent abdominal cramping and melena. Physical examination reveals
increased pigmentation on her lips and buccal mucosa. Her sister has a similar history and similar findings.
What is the most likely diagnosis
a. pseudopolyposis
b. Familial polyposis
c. Villous adenoma
d. Juvenile polyposis
e. Peutz-Jeghers syndrome
140. The following are principles of antimicrobial therapy in sepsis, except
a. initiate empirical therapy effective against both gram (+) and gram () bacteria
b. patterns of antimicrobial susceptibility among bacterial isolates from hospitals, the community
and patient should be taken into account
c. minimum recommended doses of antimicrobial drugs should be given intravenously
d. should be initiated as soon as samples for blood culture from at least 2 different sites have been
cultured
e. none of the above
141. Enzyme responsible for hydrolyzing triacylglycerol-associated with VLDL in the blood:
A. steapsin
B. pancreatic lipase
C. lipoprotein lipase D. hormone-sensitive lipase
142. Deficiency in availability of which of the following will result in ketosis?
A. carbohydrates B. proteins C. lipids
D. essential fatty acids
143. The prostanoid with the greatest vasodilatory effect is
A. PGE2
B. PGF2
C. misoprostol
D. prostacyclin
E. thromboxane
deficiency of
A. ascorbic acid
B. folic acid
C. thiamin
D. biotin
E. cyanocobalamin