ANATOMY 1. Which of the following is TRUE regarding the peritoneum covering of rectum? A. B. C. D.

Upper 2/3 front and lateral are covered by peritoneum Middle 2/3 front is only covered by peritoneum Upper 1/3 front and lateral are covered by peritoneum 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 rectum B. Levator ani and coccygeus muscles forming the posterior and lateral relations of rectum in both males and females C. Superior rectal and inferior rectal arteries forming the posterior relation of rectum in both males and females D. 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. B. C. D. The upper part of the anal canal is supplied by superior rectal artery only The lower part of the anal canal is supplied by superior, middle and inferior rectal arteries Internal anal sphincter is the thickened inner involuntary circular muscle layer The external anal sphincter has 3 parts.

4. What are the contents of anal triangle: I. II. III. IV. A. B. C. D. Upper part of anal canal Lower part of anal canal Ischio-anal (ischio-rectal) fossa on each side Sigmoid colon

I and II II and III III and IV I and III

5. All of the following are FALSE regarding the ischio-rectal fossa, EXCEPT: A. B. C. D. Skin of perineum on each side of the anus forming the superior boundary of the wedge Linear origin of levator ani forming the lateral boundary of it Sacrotuberous ligament forming its posterior boundary Medial boundary is made by the internal anal sphincter

HISTOLOGY 6. Choose the false statement regarding the large intestine: A. B. C. D. Surface epithelium is smooth with villi and lined by simple columnar cells and goblet cells Submucosa is formed of loose connective tissue containing blood vessels,lymphatics and nerves Crypts of large intestine are lined by numerous goblet cells and few absorptive columnar cells Outer longitudinal layer of musculosa is incomplete and represented by taenia coli

7. All the following are true regarding the vermiform appendix except: A. B. C. D. Wall is thickened and its glands have no digestive functions Its gland is lined by simple columnar cells,many goblet cells and enteroendocrine cells Lamina propria does not contain heavy infiltration of diffuse and dense lymphoid tissue Muscularis mucosa is not well defined and interrupted by lymphoid tissue

8. The gastro-oesophageal junction is described as follows except: A. B. C. D. Corium is widen and shows simple branched tubular glands of cardiac end of stomach Epithelium changes gradually from non keratinized stratified squamous to simple columnar Oesophageal gland stop or continue for a variable distance into submucosa of stomach cardia Additional oblique smooth muscle fibers start to appear towards the stomach cardia

9. Which is the false statement regarding the pyloro-duodenal junction? A. B. C. D. Surface epithelial cells remain cuboidal and they acquire a brush border Epithelium starts to evaginate into the lumen forming the typical villi Intestinal crypts replace the pyloric glands in the corium of the duodenum Submucosa becomes studded with a large number of mucous acini forming Brunners gland

10. Statements regarding the recto-anal junction are all the following except: A. B. C. D. Epithelium changes gradually from simple columnar and goblet cells into stratified columnar At the level of anal valves, epithelium changes into non keratinized stratified squamous Submucosa fuses with the corium above the level of anal valve and shows convoluted veins Inner circular muscle layer is thickened to form internal anal spincter

PATHOLOGY

11. All are causes of of portal hypertension, EXCEPT ? A. B. C. D. Cirrhosis Budd chiari syndrome Sarcoidosis Acute prostatitis

12. All are complications of Portal hypertension, EXCEPT ? A. B. C. D. Fibrocongestive splenomegaly Caput Medusae Hepatic encelopathy Rhinoscleroma

13. All are true regarding Cholelithiasis, EXCEPT? A. B. C. D. Pure cholesterol stone is associated with excessive cholesterol in bile. Pigmented stone usually due to acute haemolysis Pigmented stone are always small, multiple, and Black in colour Mixed stones are radio opaque

14. All are complications of Cholelithiasis , EXCEPT ? A. B. C. D. Cholecystitis Obstruction of the cystic duct at bladder neck Acute pancreatitis in case of obstruction of common bile duct 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. B. C. D. A-Pancreatic duct obstruction Primary acinar cell injury Hypersecretion of protein from acinar cells Defective intracellular transport of proenzymes within acinar cells

17. Which of the following about chronic relapsing pancreatitis is not true: A. B. C. D. Frequently affecting middle aged men particularly alcoholics Attacks are precipitated by alcohol abuse,overeating and drug use Reversible 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. B. C. D. Arises from ductal epithelial cells Carcinoma of the tail of pancreas has better prognosis than carcinoma of the head Mostly adenocarcinoma More prevalent in males,diabetics and smokers

19. Chemical irritation causing sterile peritonitis are the following except: A. B. C. D. Bile Pancreatic enzymes Surgically introduced foreign material Gastric juice

20. All of the following might be mesenteric cysts except: A. B. C. D. Hernia Diverticulae Urogenital ridge remnants 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 chime B. Maximum frequency of segmenting contraction is determined by basic electrical rhythm C. This movement depends on the sympathetic and parasympathetic innervations D. Mixing contraction prolonged contact of intestinal contents with enterocytes.

22. Propulsive movements: A. Begin at oesophagus and terminate at sigmoid colon B. There is circular contraction behind stimulus and relaxation in front of it C. Occur between ileum and cecum D. Totally peristalsis

23. Circular smooth muscle contraction is initiated by A. B. C. D. Activation of myenteric plexus Activation of Nitric oxide,VIP and adenotriphosphate secretion Secretin hormone Histamine

24. Migrating Motor Complex: A. B. C. D. Occur in case of infectious disease Rapid and large peristaltic waves Facilitate by motilin May occur in physiological and pathological condition

25. Frequency and magnitude of intestinal motility is controlled by: A. B. C. D. Myogenic nature Peristaltic movement Sympathetic and parasympathetic innervations Intra-intestinal pressure

26. Which one of the following is the definition of absorption? A. B. C. D. Transfer of the digestive product from lumen of small intestine to the blood stream, through the mucosal cells Transfer of digestive product from the blood steam to the lumen of stomach. Transfer of blood into the lumen of small intestine Transfer of gastric contents, through esophagus, pharynx and mouth.

27. Factors for great absorbing power of the small intestine are as follows EXCEPT: A. B. C. D. Long absorbing surface Hormonal regulations Rich blood and lymphatic vessels supply Presence of intestinal villi

28. Which is TRUE regarding Villikin? I. Its 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. B. C. D.

I only I and II I,II and III I and III

29. Below is the factors affecting the rate of intestinal absorption EXCEPT: A. B. C. D. Lymph flow Proper digestion Intestinal movement 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. Correct B. Incorrect

31. Mass action contraction occurs only in: A. B. C. D. Colon Pelvic floor External anal sphincter Gastro-esophageal opening

32. Distension of stomach and duodenum stimulates : A. B. C. D. Peristalsis in opposite way Release of motilin Gastro colic reflex Peristaltic rush

33. Intrinsic defecation reflex mediated by: A. B. C. D. Parasympathetic nerve Pudendal nerve Vagus nerve Local enteric plexus

34. Parasympathetic defecation reflex involves : A. B. C. D. Sacral segments of spinal cord Lateral horn cell of lumbar 1-4 Anterior horn cell of sacral 2-4 Proximal colon

35. Defecation signals initiate other effect, such as : A. B. C. D. Taking a deep breath Closure of glottis Contraction of anterior abdominal wall muscles All of the above.

36. Concious mind voluntarily controls: A. External anal sphincter B. Internal anal sphincter

37. Lack of conscious control exercised through voluntary contraction or relaxation of external anal sphincter causes: A. B. C. D. Constipation Diarrhea Automatic bowel emptying Vomiting

38. Distention of rectum causes all of the following except? A. B. C. D. Increase rectal pressure Desire of defecation Automatic emptying of the lower bowel Increase tone of internal anal sphincter.

BIOCHEMISTRY

39. The product of salivary alpha amylase on starch is: A. B. C. D. Maltose Glucose alpha-dextrins maltotriose

40. What intestinal enzyme that will cleave alpa-limit dextrin? A. B. C. D. Sucrose lactase isomaltase icomaltase

41. Alpha amylase cannot hydrolyze these except : A. B. C. D. alpha 1,6 linkages terminal alpha 1,4 linkages alpha 1,4 glucosidase beta 1,4 glucosidase

42. Effect of lactose intolerance: A. B. C. D. constipation Fever flatulence Itching

43. Absorption of fructose occur through : A. B. C. D. active transport at duodenum and jejunum facilitated diffusion at jejunum and ileum Na-dependent carrier protein at duodenum and jejunum 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 lymph B. 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 the lumen of gut to the surface of gut epithelial cell? A. Very low-low density lipoprotein B. Chylomicron C. 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 lipoprotein B. Chylomicron C. 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 lipoprotein B. Chylomicron C. Bile salt D. Lipase

PARASITOLOGY 49. Regarding the morphology of Heterophyes Heterophyes, all are true EXCEPT A. B. C. D. The fluke possesses oral, ventral and genital suckers The fluke is hermaphrodite Uterus and seminal vesicles are both open in the genital sucker Male genitalia consist of two highly branched testes located posteriorly

50. Cercariae of Heterophyes Heterophyes are of which type? A. Leptocercous B. Pleurocercous C. Furcocercous

51. All of these are true regarding the life cycle of Heterophyes Heterophyes EXCEPT A. B. C. D. The first intermediate host is a right handed snail Cercariae attack the tail and fins of the second intermediate host Eggs are hatched when excreted with the stools The infective stage is the encysted metacercariae

52. What are the clinical pictures seen in Heterophyes Heterophyes infection? A. B. C. D. Asymptomatic in mild infected patients Chronic intermittent diarrhea in heavy infection Stomatitis in acute infecton Myocarditis and heart failure

53. Attachment of worm at the mucous membrane shows all of these EXCEPT A. B. C. D. Allergic reactions Necrosis Mild catarrhal inflammation Superficial ulcers

54. All of these are true regarding the morphology of Diphylobothrium latum EXCEPT A. B. C. D. Testes and vitelline glands are located in the lateral fields of the segments Mature segments are broader than long with mid ventral genital pore Bilobed ovary present in the posterior part of the segments 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. B. C. D. Competition of the host for vitamin B12 Invasion of plerocercoid larva in submucosa Number of worms present in the intestine Amount of metabolic products absorbed by host

56. Regarding the life cycle of Diphylobothrium latum, all are true EXCEPT A. B. C. D. Intermediate hosts are right handed snail and fresh water fish Infective stage is plerocercoid larva The hatched eggs called coracidium Diagnostic stage is unembryonated eggs

57. All of these are the methods for prevention and control EXCEPT A. B. C. D. Cook the fish thoroughly Treatment for infected patients Deep freezing for 1 or 2 days at 18oC Reservoir host should be dewormed periodically

58. Patients infected with Diphylobothrium latum usually present clinically symptomatic A. True B. False

59. Which of the following is wrong regarding geographical distribution of Taenia Saginata ? A. B. C. D. North America Ethiopia East Africa West Africa

60. Taenia Saginata has: A. B. C. D. 3000-4000 proglottids Uterus connected pre-equatorially 300-400 testes Wide neck followed by immature, mature and gravid segments.

61. Which of the following is false regarding the life cycle of Taenia Saginata ? A. B. C. D. They are filtered to pterygoid muscle,tenderloin region and myocardium The infective stage is cysticercus bovis In the transverse colon, the scolex invaginates and fixes itself to the mucosa Men are infected by eating infected meat containing cysticercus bovis.

62. Taenia solium has : A. B. C. D. Bilobed ovary Longer segments than taenia saginata Less number of testes than taeia saginata Its 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. B. C. D. The intermediate host is pig The rostellum, suckers and hooks are inapparent Humans are infected by consuming imperfectly cooked pigs meat Man can also act as intermediate host of taenia solium

64. All of following can be seen in patient infected by Taenia Solium EXCEPT A. Vague abdominal discomfort B. Insomnia C. Diarrhea D. Loss of appetite 65. Choose correct characteristics about Taenia Solium i-It scolex is quadrate ii-It mature segment is less than 150 iii-It has trilobed ovary iv-It has rostellum armed A. B. C. D. i,ii,iii i,ii,iv ii,iii,iv All of above

66. All of following are wrong statement about H.Nana EXCEPT A. It has rhomboidal scolex B. It has 2 suckers C. It egg has thin hyaline capsule D. largest tape worm

67. Infected stage of H.Nana is cysticercus cellulosae A. True B. False 68. Choose correct statement about life cycle of T.Solium i-Intermediate host is pig ii-egg are swallowed and pass to duodenum iii-head of cysticerci invaginated appearing as milky spot iv-it larva stage known as cysticercus bovis A. B. C. D. i,ii,iii i,ii,iv ii,iii,iv All of above

ANSWERS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. C B B B C A C B A C D D B D a. false b. false C C B D A C B A C C A B C D B A C D A D A C D C C C C D A B C

47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68.

B B D B C C A D B A C B A C C C B B C A B A