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UNIVERSITY OF SANTO TOMAS-FACULTY OF MEDICINE AND SURGERY MEDICAL BOARD REVIEW 2017

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MOCK BOARD EXAMINATION-ANATOMY & HISTOLOGY August 09, 2017, Wednesday SET A A 3

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, 1: CHOOSE THE BEST ANSWER: E 1. A victim of mauling came to the ER with vertigo, hearing loss and facial paralysis. Which part of the skull has been most likely fractured? (LJ "l I‘l ' ' .4. boneA. Frontal rim" amp. ’B. Temporal bone .h w"... r; a -, C. Occipital bone , jut , .v.’ . 3.; my. . ’ C D. Parietal bone r ' ‘ 2. Injury to the trigeminal nerve WI” cause the following manifestations, EXCEPT: A. Hemianesthesia of the face ’ B. Deviation of jaw to the injured side / C. Loss of taste sensation in ipsilateral anterior 2/3 of tongue r C D. Loss of afferent limb of corneal reflex , 3. A mauling victim who sustained blunt trauma to the left side of his neck was brought to the ER complaining of breathlessness. Chest x-ray showed an helevated left hemJidiahragm. This x-ray finding may be due to injury to: A. CN X B. CN XI C. Cervical plexus 3-5 D. Ansa cervicalis 4. After a tonsillectomy procedure, the patient complained of loss of taste sensation in the posterior 3'“ of the tongue. What nerve might have been affected in the operation? A. Lingual branch of CN V ox! B. Chorda tympani of CN Vll 0'4 "43 C. Glossopharyngeal n. PM '3 A D. Superior branch of CN X ik 5. Le Fort fracture classification describe fractures in which part of the facial skeleton? A. Midface B. Nose C. Mandible D. Orbit _{>"6. Pain in parotitis is due to the stretching of what fascial layer? ‘ . 1? -" "‘3‘ A. Investing ' “7“” E ‘ 1 ~ 5"“. ' t" f " B. Pretracheal \_ C. Carotid D. Prevertebral 7. Infections involving the prevertebral space may migrate inferiorly to the level of the:

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8. This neck triangle may harbor metastatic nodes from malignancies in theabdomen and thorax via lymphatic drainage from the thoracicJ UCIIH‘,‘ gm; - — .lr . " ‘ .i :4 ~ r ‘- ‘ v A. Muscular ' ' B. Left Carotid C. Right Occipital

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GENERAL INSTRUCTIONS: This questionnaire is composed of 100 items. On the box provided in the front page of the EXAMINATION ANSWER SHEET, kindly write name and code. All final answers should be made on the back page of the EXAMINATION ANSWER SHEET provided for. SHADE SET A. Only Mongol 1 or 2 may be used. Do not leave any blanks as this will be considered incorrect. Submit your answer sheet. Please be guided accordingly

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V1 6 9. In a patient diagnosed with acute tonsillitis, the lymph nodes that are expected to be ' enlarged are: :1 L I, -V,}_ r l A. Submental (“xii ‘ I B. Upper jugular C. Lowerjugular r 4.1: c .' . D D. Anterior compartment -. _ r 10. A patient consulted with a 1-month history of right sided ear fullness and an enlarged lPSiIateral non-tender. fixed Upper jugular lymph node. Which of the following areasiis the most = likely source of the adenopathy? lip A. Upper B. Tip of tongue C. Nasopharynx r

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D. Larynx Q) U 11. A patient consulted due to a 2-day history of painful thyroid enlargement. In this condition, which fascial layer is involved? ,,,' . ' 2A. .|.h-‘ ' kit A. investing layer ' f A 2 "\ B. Pretracheal layer C. Prevertebral layer w A“ D. Superficial cervical fascia ’ 12. One day after total thyroidectomy, the, patient complained of circumoral numbness, and tingling sensation on tips of fingers and toes as well as muscle cramps. What clinical maneuver can be done to confirm the cause of these symptoms? A. Tapping the parotid gland overthe facial nerve to induce facial muscle spasm B. Tapping of the median nerve to elicit carpopedal spasm C. Deep palpation of the post-op site to elicit a cough reflex D. Stimulating the sole of the foot with a blunt instrument to induce plantar reflex 13. In what area is tracheostomy best done? A. Between trachea and cricoid ‘ \frrv B. Tracheal ring 2-3 ‘ I C. Tracheal ring 4-5 R D. Tracheal ring 5-6 a 14. The nerve that is injured when one hastily ligates the inferior thyroid artery dun'ng thyroid surgery: A. recurrent laryngeal B. external laryngeal ' .. . -. C. phrenic ‘ D. vagus 15. The bifurcation of the common carotid artery is at the level of: A. Hyoid bone B. Upper border of the thyroid cartilage C. Laryngeal prominence C‘ D. Upper border of cricoid cartilage _’16. A 56 year old male patient suffered a motor vehicular accident. he suffered multiple rib fractures and had ecchymoses along the right hemithorax, chest xray revealed blunting of the right costophrenic sulci. The surgeon plans to insert a chest tube to drain the fluid at which site? A. 2nd ICS right mid—clavicular line upper border of the rib B. 7th ICS right posterior axillary line upper border of the rib C. 5th ICS right anterior axillary line upper border of the rib & D. 5th ICS left mid-axillary line lower border of the rib 17. What is the most common lobe to be affected in atelectasis? . L: K ’ A. Right upper lobe Q

B. Right middle lobe ‘ C. Left upper lobe

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D. Left lower lobe C, .V 18. Inverted or retracted nipple is due to cancer invasion of the: A. B. C. D.

Deep fascia of the pectoralis muscle Lactiferous duct Subcutaneous Lymphatics —> PM Superficial fascia

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A. Ophthalmic B. Trigeminal C. Facial D D. Cervical sympathetic ganglion 25. Thin plate of bone that is responsible for spreading infection of the ethmoid sinusitis to the orbital cavity? A. Hiatus seilunaris B. Ethmoidal bulla C. Lacrimal fossa D. Lamina papyracea 26. Breast primarily drains into which of the lymph node? A. Apical nodes B. Anterior(pectoral) nodes v r 1 ’ " C. Parasternal nodes -0 D. Supraclavrcular nodes 27. Considered as the dangerous area of the scalp due the presence of emissary veins: ,

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' u.’-(£i,'.J:.«, B. Aponeurosis ‘ l ) I" C. Loose connective tissue ~ D. Pericranium 28 A 44-year-old man with a stab wound was brought to the emergency department, and a physician found that the patient was suffering from a laceration of his right phrenic nerve. Which of the following conditions has likely occurred? A. lnjury to only GSE fibers*4? l ‘3' . 8. Difficulty in expiration l C. Loss of sensation in the fibrous pericardium and mediastinal pleura D, Loss of sensation in the costal part of the diaphragmw'~ t.~ -'J . -.V a l! l

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EL 19. A75-year-old patient has been suffering from lung cancer located on the lingula, a tongue like structure of the lung Which of the following lobes is most likely to be excised? A. Superior lobe of the right lung 8. Inferior lobe of the right lung C. Superior lobe of the left lung D D. lnfen’or lobe of the left lung ' 20. Post total thyroidectomy of A 50 year female developed stridor and cyanosis immediately after extubation. Prior to re-intubation, the anesthesiologist noticed that both vocal cords are in median position. What nerve was/were affected? A. Unilateral superior external laryngeal B. Bilateral superior external laryngeal C. Unilateral recurrent laryngeal e D. Bilateral recurrent laryngeal 21. Which of the following two ribs is thoracentesis performed to avoid puncturing the lung in a patient with pleural effusion? (3-5. ,. A. Ribs 1 & 3 1,7 . B. Ribs3&5 t-"‘~'ir”r"») 'V" C. Ribs5&7 1. I‘. '" " ’ ' D. Ribs9&11 C 22. A few minutes prior to consult, 4 year old male accidentally swallowed a 1 peso coin. The child apparently had difficulty of swallowing and breathing. On Chest X-ray, the coin appeared circular on the longitudinal view at the level of manubrium, where was the location of the coin? I ,_ ‘ L _ _' A. Pharynx ’ I x" "’ B. Esophagus j C. Trachea ‘ D. Right Primary bronchi .23. The pain conveyed on a vestibulitis of the nose is via what nerve: A. Ophthalmic division of the trigeminal B. Maxillary division of the trigeminal C. Mandibular division of the trigeminalC D. Facial ‘ ' 24. What nerve is responsible for the increase nasal congestion and secretion in allergic rhinitis?

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,*—————r \ of cavern ' *0 3" 'InfeCted pustule on the nose 3 diagnos's thrombosis clal veln 29. After w as Squeezmg y made Infecti n Sinus through the .._..______ V em. -°. from ms area was camed by the fa

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A. Superior ophthalmic B. Retromandibular C. Angular

A. 30 WD.h_Shuperficial temporal IC 1 of the followin ardin the ne ____ . ‘ structures of the neck? g 9 Statement IS TRUE reg COUrs during . its

d A. In.Ththe internk'al carotid artery does not give any branchesd' ehin I“ r ' . e nec . Vem b B. thThe internal jugular vein terminates by joining thaberac‘ub‘hiocephal'c hm I e medial end of the clavicle to form the subclavian vein. be C. The left common carotid artery arises from the brach‘l'locehph,a,“° artery I. dd m ‘ sternoclavicularjointr . " mu‘ahgp‘um an foramen the D. The through A", vagus nerve leaves the skull acid will the neck within the carotid sheath ‘ "I E , 3 gas tric stomach the of __31. In perforation of ulcers in the posterior wall of the body escape to which of the following spaces? A. Left sub-phrenic ‘ ' . B. Morrison’s pouch {.Iri- 3 5"“‘l' D C. Lesser sac A D. Pelvic cavity varices to rm esophageal 32. Which of the following venous drainage of the stomach will

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in portal hypertension? A. Right gastric B. Left gastric C

C. Left gastroepiploic D. Short gastric

of Descendens/ 2nd part 33. The duodenal papilla is located in which partt of Pars

duodenum? A. Anterior B. Antero-medial C. Postero-medial

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' D. Posterior superior mesenteric vessels 34. Part of the duodenum ,that is located posterLo‘r to the 3' A. 1St — {‘i .' P '..“"“‘i 0,“. Lu B. 2nd ’7 ’1

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C. 3rd ’ ~i r ‘.‘ ‘. a ' 4th k in the ileum? 35. Which of the following characteristics is found " ' .Vl A. Longer and fewer arcades [I 1* 1. Thinnerwall B. ‘ C. Plicae circularis present on its entirety ’ ’6 - .

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C. Transverse colon D. Descending colon intestine is mobile and is not attached 37. Which of the following segments of the large

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D. Sigmoid will produce fecal peritonitis? 38. Which of the following perforated rectal cancer A. B. C. D.

Upper 1/3 posterior wall Middle 1/3 anterior wall Middle 1/3 lateral wall Lower 1/3 anterior wall

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Venous drainage from which of the following part of the gastrointestinal tract does not drain into the portal vein? A. Distal esophagus B. Stomach C. Sigmoid \b)

D. Distal rectum 40. The internal or deep ring of the inguinal canal is a defect in which layer of the

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A. Parietal peritoneum B. Transversalis fascia C. Internal oblique muscle D. External oblique aponeurosis/ 41. Blockage of which of the following arteries would lead to arrythmias which will eventually require a pacemaker? A. Anterior interventricular artery B. Posterior interventricular artery C. Circumflex artery Q 2 D. Right coronary 42. Which posterior mediastinal structure is most closely applied to the posterior surface of pen'cardial sac?

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A. Aorta 5) LY." A B. Thoracic duct .«w 4‘, I: E C. Azygos vein /" D. Esophagus ‘ 43. The Thoracic Aorta: , , , L I A. begins as a continuation of the ascend'i‘n'g’aorta 3" " ’1‘" l B. terminates at the level TV10 1x" 75"" 3* b C. located in front of the trachea at its commencement D. passes behind the esophagus before its termination

44. The sound associated with mitral stenosis (narrowing) in a 40-year-old male would be best heard at which location on the anterior chest wall? A. Xiphisternal junction B. over the apex of the heart C C. Over the sternal angle D. In the right 2nd intercostal space near the sternum 45. The base of the pericardium is attached to this structure: A. Adventitia of the great vessels B. Sternopericardial ligaments to the corpus sterni

C. Respiratory diaphragm Q) D. Epicardial layer of the heart ‘ 46. Type of trabecula carnae. the entire length of which is attached to the wall of the ventricles A. Papillary muscles

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B. Ridges C. Chorda tendinae D. Moderator band 47. Which muscle of the heart carries the right branch of the AV bundle A. Septomarginal trabecula B. Musculipectinate C. lnterventricular septum D. Papillary muscles 48. Location of the deep Cardiac plexus A. beneath the bifurcation of the trachea * B. beneath the arch of the aorta -- it; fly. i‘wJ m 3‘ win,» l H in» t r C . . l l \ . anterior to the tracheal bifurcation '

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49. Where is SA node located?

A. tip of the sulcus terminalis B. right of the Inferior vena cava opening C. left of the coronary sulcus

D. between the inferior vena cava and superior vena cava openings\

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Q50. Which valve suggests stenosis when there is elevated systolic blood pressure in the fig t ventricle? A, Aortic B. Mitral

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C. Pulmonary D. Tricuspid 51. Which skeletal feature would you consider to be most characteristic of the

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male pelvis? A. Subpubic angle of 90 degrees or greater B. Pelvic cavity is narrow and deep C. lschial spines are not prominent D. lschial tuberosities are everted 52. A patient complains of a boil located on her labia majora. Lymphatic spread of “the infection would most likely enlarge which nodes? . ' ' A. Internal iliac nodes B. Sacral nodes . A C. External iliac nodes "(WM ‘.o! _ D. Superficial inguinal nodes ’ l 53. Support for the uterus is provided by the following structures EXCEPT which? A. Broad ligament B. Uterosacral ligament C. Transverse cervical (cardinal) ligaments , D. Levator ani muscles 54. The boundan’es of the perineum include all the following EXCEPT: A. lschiopubic rami B. lschialtuberosity , C. Tip of the coccyx ~ D. lschial spine 55. In males. traumatic injury to the perineum may rupture the bulb of the penis or the penile urethra. The resulting leakage of blood or urine may be found in all of the following areas EXCEPT which? A. Anterior abdominal wall B. ischiorectal fossa a

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j. C. Scrotum s D. Superficial perineal pouch .V 56. The sphincter vesicae receives its innervation from the: A. Pudendal . h ' B. Hypogastric plexus” »— "J .L. C. Obturator D. lnferior rectal 57. A median episiotomy should least likely damage which muscles? A. Bulbospongiosus B. Superficial transverse perineal C. Deep transverse perineal P D. lschiocavernosus 58. An elderly man with prostitis. The seminal colliculus of his prostate gland is infected and its openings are closed. Which of the following structures are most likely affected? A. Ducts of the prostate gland B. Prostatic utricle C. EJaculatory ducts D. Ducts of the seminal vesicle 59. What nerve crosses the ischiorectal fossa that is most likely injured when l&D is p; ormed for lschiorectal abscess A. Obturator B. Pudendal ‘\ C. Perineal D. Inferior rectal \ 60. True of the components of the pelvic diaphragm: A. Effectively forms a muscular sling B. Contributes to rise in intraabdominal pressure C. Origin: ischial tuberosities , . D. insertion: anterior surface of sacrum J ALL-J. o. F ‘ ,"l , r“ ..~‘\i.-.-'”°"'““ I I

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A. fatty layer of the abdomen: dartos muscle >1 B. Camper’s fascia: Colle's fascia 05H so C. aponeurosis of external oblique: cremasteric fascia '»' "

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62. The vagus nerve passes into the abdomen by passing through which opening of the respiratory diaphragm A. Aortic hiatus B. Esophageal hiatus C. Caval foramen .PT D. Lateral arcuate ligament \ 63. An MRI exam of a 3 year old boy reveals that he has a double ureter. Which of the following embryonic structures is most likely failed to develop normally A. Mesonephric (wolffian duct) 5" o B. Paramesonephric (mullerian duct) C. Ureteric bud * 1 -‘ ‘ D. Metanephros .U i. LEE64. The rectouten'ne pouch (pouch of Douglas) can be most efficiently entered by a surgical incision through the: A. Posterior fornix of the vagina B. Anterior fornix of the vagina C. Anterior rectal wall I

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D. Lateral fornix of the vagina / V65. A 43 year old female presents with pain in her external genitalia. Physical examination reveals an inflamed swelling on the right side of the vaginal vestibule consistent with Bartholinitis. The greater vestibular gland (Barthfolin): A. is modified erectile tissue - ' ‘ " B. is a homologue of the prostate gland —. -~ r' C. is located deep to the bulbospongiosus muscle D. has a duct that opens into the deep perineal pouch 66. True of the suprarenal gland A. surrounded by renal capsule and fascia B. is pyramidal on the left and semilunar on the right C. drained by single pair of suprarenal veins ‘ a ‘ c D. retroperitoneal and separated from the kidneys by the renal fascia Q- 1 9“ C“.67. Part of the Levator ani inserted into the perineal body & acts like a sphincter A. lliococcygeus. ‘ in -‘ ‘ B. Levator prostatae/ pubovaginalis

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(71-80) _¥L~71. A patient presents wrth sensory loss on adjacent sides of the great and second toes a d impaired dorsiflexion of the foot. These signs probably indicate damage to which of the ' following nerves? )9 ,t' A. Superficial peroneal...8 Deep peroneal C. Lateral plantar- i r D. Posterior tibial C 72. A motorcyclist falls from his bike in an accident and gets a deep laceration that severs the superficial peroneal nerve near its origin on the Left. He will not be able rd _ , his left foot: r

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D. Plantar flex I “gill—J! 73. PE findingts) in Anterior compartment syndrome of the leg: TU A. Absent posterior tibial artery pulsation B. Loss of sensation to the skin over dorsum of the foot « £9.91“th C. Inability to extend the toes '(‘l ' - ~“ -" ' " . C‘ D. All of the above I,’ {Md 74. True of the deep peroneal nerve: - _’ t'1: l

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A. has sensory and motor component B. lies medial to the tibialis anterior muscles C. supplies the lateral compartment of leg D. a branch of the tibial nerve 75. The radiocarpal joint is what type of joint A. Ball and socket. 0‘ B. Condyloidd C. Hinge D. Plane joint 76. Which neurovascular structures passes below the pyriformis muscle? A. Deep branch of the femoral artery B. Obturator artery C. Sciatic nerve D. Superior gluteal artery 77. Pulsation of the upper extremity located at the cubital area; medial to the tendon of the biceps muscles: A. Radial B. Brachial

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C. Profunda brachii ~ D. Ulnar 78. Loss of sensation over the medial aspect of the leg and inability to extend the knee joint results from injury of which of the following nerve? A. Obturator B. Femoral \C. Sciatic D. Tibial 79.Rupture of the calcaneal tendon will result in inability to _ the foot : A. Invert B. Evert C. Dorsiflex D. Plantan‘lex 80. Fracture of the medial epicondyle will result in injury of which of the following nerve? A. Radial B. Median C. Ulnar D. Musculocutaneous

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(81.3100) L81. This cytoplasmic structure is considered the “mobile power plant” of the cell: A. Endoplasmic reticulum B. Mitochondria C. Golgi apparatus D. Centriole J" 82. One of the following is the site of ribosomal RNA synthesis: A. Nucleolus B. Rough endoplasmic reticulum C. Chromatin C 0. Smooth endoplasmic reticulum ‘ 83. Which is the most prominent coat in the medium—sized vein? A. Endothelial layer B. Tunica media C C. Tunica adventitia D. Tunica intima 84. This vessel consists of only a single layer of endothelial cells. with a caliber that is wider in diameter that contains fibrin coagulum in its lumen: A. Arteriole B. Venule C. Blood capillary D. Lymphatic capillary 85. The “chief” or principal cells of the fundus of the stomach secrete: A. Pepsinogen B. HCI éf C. Intrinsic factor D. Gastrin 86. Phagocytic stellate-shaped cells lining the hepatic sinusoids are known as: A l A. Rokitansky-Aschoff sinuses / :‘v « " ' B. Kupffer cells C. lto cells - \J .' ,i g . A D. Portal macrophages 87. One of the following is a characteristic of "thin" skin: A. Numerous arteriovenous anastomoses B. Thick stratum corneum h C. Moderate number of pilo-sebaceous units , D. Abundant sweat glands 88. Minute elevations of the skin that result from an obstruction of the excretory ducts of the sweat glands are known as: A. Comedomes B. Condyloma acuminate C. Acne vulgaris pi D. Miliaria 89. The C-shaped cartilage plates seen in the trachea are made up of: A. Adult hyaline cartilage B. Elastic cartilage D C. Fetal hyaline cartilage D. Fibrocartilage 90.The actual receptor organs for smell are the: A. Glands of Bowman B. Schneiderian membranes C C. Olfactory bulbs D. Olfactory cilia 91. The growth of the ovarian follicles is made possible by the action of this hormone: A. Estrogen B. Progesterone C. FSH D. LH A?

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