SINAG SET 1

ANATOMY c. Radial nerve

1. Which of the following movement occurs when d. Median nerve
one is standing on his or her toes? 10. What landmark/structure corresponds to the
a. plantar flexion inferior angle of the scapula?
b. dorsiflexion a. 5th rib
c. inversion b. 7th rib
d. eversion c. 6th thoracic vertebra
2. Which of the following movement occurs in d. 8th thoracic vertebra
shrugging of the shoulders? 11. Which of the following structures is commonly
a. extension involved in fractures of the surgical neck of the
b. circumduction humerus?
c. elevation a. Axillary nerve
d. protrusion b. Ulnar nerve
3. Which of the following bones undergoes c. Radial nerve
endochondral ossification? d. Median nerve
a. femur 12. The axillary artery does NOT give rise to which of
b. clavicle the following blood vessels?
c. scapula a. Anterior circumflex humeral artery
d. frontal bone b. Posterior circumflex humeral artery
4. Which of the following transmits the middle c. Subscapular artery
meningeal d. Suprascapular artery
artery? 13. Which of the following muscles does NOT
a. optic canal medially rotate the arm?
b. foramen lacerum a. Suprascapularis
c. foramen spinosum b. Latissimus dorsi
d. foramen magnum c. Teres minor
5. Which of the following does NOT characterize a d. Pectoralis major
typical 14. In performing a lumbar tap, an imaginary line
cervical vertebra? drawn between the highest point of the iliac crest
a. the spinous process of C4 vertebra is bifid and is considered a guide in determining the level of:
short a. L1
b. the transverse foramen of C3 contains the b. L2
vertebral artery c. L3
c. the body is wider from side to side than d. L4
postoanteriorly 15. Which of the following branches of the brachial
d. the vertebral foramen is circular and large artery accompanies the course of the radial
6. Which of the following is NOT TRUE of the atlas? nerve?
a. it has no body a. Profunda artery
b. it has no spinous process b. Superior ulnar collateral artery
c. the inferior articular processes receive the c. Nutrient artery of the humerus
occipital condyles d. Axillary artery
d. it consists of anterior and posterior arches, 16. The lateral thoracic artery is a branch of the
each of which has a lateral mass segment of the axillary artery that is between:
8. The intervertebral discs form approximately what a. The lower border of the teres major and the
percentage of the length of the adult vertebral deltopectoral groove
column? b. Lateral and medial borders of the pectoralis
a. 15% minor
b. 25% c. Medial border of the pectoralis minor and outer
c. 40% border of the first rib
d. 50% d. Lateral border of the pectoralis minor and the
9. Which of the following structures is commonly lower border of the teres major
affected in fractures of the medial epicondyle? 17. Which of the components of the quadriceps
a. Axillary nerve femoris flexes the thigh?
b. Ulnar nerve a. Vastus intermedius
 SINAG SET 1
b. Vastus lateralis 7. Which is true about neurotransmitters in the
c.Vastus medialis extrapyramidal system?
d. Rectus femoris A. Dopamine is inhibitory to the direct pathway
18. The femoral vein enters the thigh passing through B. Dopamine is excitatory to the indirect pathway
an opening of which of the ff. muscles? C. Acetylcholine is an excitatory
a. Tibialis anterior neurotransmitter
b. Adductor magnus D. GABA is an excitatory neurotransmitter
c. Vastus intermedius 8. All of these are manifestations of Parkinson’s
d. Peroneus brevis disease except:
19. The medial compartment of the femoral sheath is A. Bradykinesia
occupied by which of the ff. structures? B. Resting Tremors
a. Lymphatics C. Intention tremors
b. Femoral vein D. Masked face
c. Femoral nerve 9. Which structure in the extrapyramidal system
d. Femoral artery secretes dopamine?
20. The sternocostal surface (anterior) of the heart is A. Pars compacta of Substantia nigra
formed mainly by which chamber? B. Pars reticulata of Substantia nigra
a. Right atrium C. Internal portion of globus pallidus
b. Left atrium D. External portion of globus pallidus
c. Right ventricle 10. Parts of the frontal lobe except:
d. Left ventricle A. Motor speech area
B. Precentral gyrus
NEUROANATOMY C. Angular gyrus
1. Among adults, the spinal cord terminates inferiorly D. Orbital gyrus
at which vertebral level? 11. 60-year old woman, loss of pin-prick sensation,
A. L1-L2 which lobe is affected?
B. S3-S4 A. Frontal
C. S4-S5 B. Parietal
D. T11-T12 C. Temporal
2. In embryology, the following are primary brain D. Occipital
vesicles EXCEPT 12. Which contains pyramidal cells?
A. Telencephalon A. Parahippocampal gyrus
B. Mesencephalon B. Suprmarginal gyrus
C. Prosencephalon C. Precentral area
D. Rhombencephalon D. Uncus
3. Which of the following are the myelin sheath 13. Patient manifests with visual disturbances, which
producing cells in the PNS? of the following is affected?
A. Oligodendrocytes A. Middle frontal gyrus
B. Microglia B. Uncus
C. Myelocytes C. Cuneus
D. Schwann cells D. Paracentral lobule
4. Which of the following does not comprise the 14. The diencephalon is divided into symmetrical
brainstem? halves by the
A. Midbrain A. Massa intermedia
B. Pons B. Hypothalamic sulcus
C. Medulla Oblongata C. Stria medullaris
D. Thalamus D. Third ventricle
5. The following are part of the basal nuclei except: 15. Lesions in which hypothalamic nuclei would
A. Substantia nigra cause starvation?
B. Amygdala A. Posterior
C. Claustrum B. Anterior
D. Globus pallidus C. Medial
6. Globus pallidus, putamen, and caudate nucleus D. Lateral
are collectively known as 16. A 56-year old patient developed loss of sensation
A. Lentiform nucleus from the opposite side of the lower limbs. The
B. Corpus striatum lesion probably affected which thalamic nuclei?
C. Neostriatum A. Lateral dorsal
D. None of the choices B. Anterior
C. Dorsomedial
 SINAG SET 1
D. Ventral posterolateral D. Phosphatase
17. Which of the following thalamic nuclei receives a
major input from the cerebellum? 6. The DECREASE of which of the following will
A. Ventral posterior INCREASE the rate of diffusion:
B. Mediodorsal A. Distance
C. Ventral lateral B. Lipid solubility
D. Lateral posterior C. Number of channels
18. The thalamus is a primary site for: D. Temperature
A. Motor reflex coordination
B. Autonomic regulation 7. What mode of transport is used for releasing
C. Sensory integration enzymes and other products out of the cell?
D. Hormone production A. Active transport
19. Which of the following is not a midbrain structure? B. Exocytosis
A. Cerebral peduncles C. Passive Diffusion
B. Red nucleus
D. Diffusion
C. Inferior colliculus
D. Third ventricle
20. A small group of neurons situated close to the 8. Which of the following transporters is responsible
for the normal cellular ionic and voltage gradient
lateral part of the superior colliculus which is
and also helps maintain normal cell volume.
responsible for the pupillary light reflex
A. Aquaporins
A. Red nucleus
B. Pretectal nucleus B. Sodium-glucose transporter
C. Na-K ATPase
C. Oculomotor nucleus
D. Lateral geniculate body D. Voltage gated sodium channels

BIOCHEMISTRY 9. Most common lipid in the cell membrane

A. Glycosphingolipids
1. In what part of the cell does the tricarboxylic acid
cycle and oxidative phosphorylation take place?l B. Cholesterol
C. Phospholipids
A. Cell membrane
D. Triglycerides
B. Cytosol
C. Mitochondria
D. Nucleus 10. At isoelectric point, an amino acid
A. Solubility would be increased
B. Buffering capacity would be minimized
2. In what process is micelle formation important?
A. Carbohydrate metabolism C. Would have a positive charge
B. Fat Emulsification D. Would become mobile
C. Immune reaction
D. Protein metabolism 11. Which amino acid is used in the production of
citrulline in the urea cycle
A. Histidine
3. Based on Osmosis, the presence of salt in the
B. Glutamine
external environment of the cell would cause?
C. Alanine
A. Water to go inside the cell D. Arginine
B. Water to go outside the cell
12. What amino acid has an indole ring as its side
4. As compared to Simple Diffusion, Facilitated chain?
Diffusion is characterized by which of the
A. Phenylalanine
following?
A. Is an energy requiring process B. Tyrosine
B. Rate is limited by Vmax C. Tryptophan
C. Movement of molecules is unidirectional D. Histidine
D. Movement is along the concentration gradient

5. At the end of signal transduction, which enzyme MEDICINE

inactivates secondary messenger cAMP and 1. The patient mentions his brother as having
converts it to AMP? financial problem and his wife suffering from
A. Adenylate cyclise diabetes mellitus and hypertension which caused
B. GTPase him worry. What part of the history is the brother
C. Phosphodiesterase and wife included?
 SINAG SET 1
A. Past medical history A. 34-year old male with blood pressure of
B. Family history 130/88
C. Personal and social history B. A 63-year old female with BP of 140/100
D. Review of systems C. A 42-year old male with BP 164/94
A patient who has been smoking 30 sticks of D. A 74-year old male with BP of 150/100
cigarette for the past 10 years has how many pack years? If the patient has difficulty in visualizing the
A. 10 biggest letter in the Snellen’s chat, what is the next PE
B. 15 that should be done
C. 20 A. Pinhole test
D. 30 B. Counting finger or light perception test
Based on the studies mentioned in Harrison’s , C. Ishiara test
which among those listed below is suffering from fever? D. Test vision by asking the patient to use
A. A 21-year old male with temperature of glasses
37.2°C at 7 am The patient is instructed to look at a small fixation
B. A 34-year old female with 37.5°C at 5 pm target in the distance. One eye is covered suddenly while
C. A 17-year old female with 37.6°C at 6 pm the second eye is observed. If the second eye shifts to
D. A 40-year old female with 47.7°C at 7 am fixate on the target, what is the most logical conclusion
Uncontrolled increase in body temperature that (based on Harrison’s)?
exceeds the body’s ability to lose heat in a setting where A. It is misaligned.
the hypothalamic thermoregulatory center is unchanged B. There is a mild error of refraction on the
A. Fever second eye.
B. Hyperpyrexia C. This is normal.
C. Hyperthermia D. There is mild paralysis on the second eye.
D. Heat stroke The pupil does not respond well to light, but the
Temperature-pulse dissociation (relative response to near stimulus is often relatively intact. When
bradycardia maybe seen in which of the conditions listed the near stimulus is removed, the pupil dilates very slowly
below? compared with the normal pupil. The patient is a young
A. Typhoid relatively healthy female. What medical condition is this?
B. Influenza A. Mild cranial nerve III involvement
C. Dengue B. Marcus Gunn pupil
D. Malaria C. Horner’s syndrome
A distinctive thickening of the skin that is D. Adie’s syndrome
characterized by accentuated skin-fold markings What is the direction of the cone of light in the
A. Lichenification right ear?
B. Crust A. Downwards to the left
C. Scale B. Upwards to the left
D. Echar C. Downwards to the right
Excessive accumulation of stratum corneum D. Upwards to the right
A. Lichenification A 66-year old patient with ciliary injection has a
B. Crust deep aching pain, reduced vision, a dilated fixed pupil, but
C. Scale absent discharge. Which of those listed is the most likely
D. Echar cause?
Dried exudate of body fluids that may be either A. Subconjunctival hemorrhage
yellow (i.e., serous crust) or red (i.e., hemorrhagic crust) B. Glaucoma
A. Lichenification C. Iritis
B. Crust D. Acute conjunctivitis
C. Scale Which of the following is defined as crackling or
D. Echar grinding sound over bones, joints, and skin with or without
Which of the following statements below describes pain due to air in the subcutaneous tissue?
a focused history? A. Crepitus
A. Appropriate for new patients in the office B. Fremitus
B. Provides fundamental and personalized C. Pleural friction rub
knowledge about the patient D. Mediastinal crunch
C. Provides a baseline for future assessments Where is the lower border of the lung laterally?
D. Appropriate for established patients, A. 6th ICS at midclavicular line
especially during routine or urgent visits B. 6th ICS at anterior axillary line
Who among those listed below has stage 1 C. 8th rib at the midaxillary line
th
hypertension based on the JNC 7 classification? D. 8 ICS at the posterior axillary line
 SINAG SET 1
Where is the landmark for thoracentesis with 7. This type of metabolizer produced relapse in the
needle insertion? therapy of breast cancer by tamoxifen in genetic
A. T7-T8 ICS polymorphism.
B. T4-T5 ICS A. Ultrarapid
C. T10 spinous process B. Extensive
D. Manubriosternal junction C. Poor
What is the normal extent of the diaphragmatic D. Non-metabolizer
excursion? 8. A 70-year old woman is treated with sublingual
A. 3-5.5 cm nitroglycerin for occasional bouts of effort-induced
B. 4-6 cm angina. What best describe part of the mechanism
C. 5-8 cm by which nitroglycerin cause its desired anti-
D. 5-8 mm anginal effects?
Which of the following percussion note has loud A. Selectively dilate/relaxes coronary arteries
intensity, low pitch, and long duration? B. Increases local synthesis and release of
A. Resonant adenosine
B. Dull C. Raises intracellular cGMP levels
C. Tympanitic D. Blocks α-adrenergic receptors
D. Flat 9. A patient who has been taking an oral anti-HTN
drug for about a year develops a (+) Coombs’ test,
PHARMACOLOGY and now you are worried about the possibility
1. The presence of antagonist at the receptor site will (although low) that hemolytic anemia may develop
block the access of agonists to the receptor, if the drug is continues. Which drug was the most
preventing the usual agonist effect. This is termed likely cause?
as: A. Prazosin
A. Inverse B. Captopril
B. Neutral C. Methyldopa
C. Partial D. Clonidine
D. Full 10. Which of the following is a very short-acting and
2. P-glycoprotein pump mechanism is the most acts by releasing nitric oxide?
common etiology of the multidrug type I: E. Atenolol
A. Sensitization A. Nitroprusside
B. Immunization B. Fenoldopam
C. Resistance C. Prazosin
D. Tolerance 11. A patient has periodic episodes of paroxysmal
3. Phenylephrine, a nasal congestant, is an α- supraventricular tachycardia (PVST). What drug
agonist that is a weak: would be the most suitable for outpatient
A. Acid prophylaxis of these worrisome electrophysiologic
B. Base events?
C. Neutral A. Furosemide
D. No reaction B. Nitroglycerin
4. Thalidomide was discovered in Europe (1958) and C. Verapamil
was marketed as a non-toxic drug as: D. Captopril
A. Hypnotic 12. Which of the following is an important effect of
B. Convulsant chronic therapy with loop diuretics?
C. Analgesic A. Metabolic alkalosis
D. Antiseptic B. Decreased urinary excretion of calcium
5. The renal toxicity of gentamicin antibiotic is less C. Teratogenic action in pregnancy
when given by this route of administration: D. Elevation of BP
A. Po 13. A 45-year old woman with hyperlipidemia and
B. Si frequent migraine headaches develops angina of
C. IV constant infusion effort. Which of the following is relatively
D. Intermittent IV dosing contraindicated because of her migraines?
6. Biotransformation processes of acetaminophen A. Verapamil
include/s the ff: B. Amlodipine
A. Glucoronidation C. Nitroglycerin
B. Sulfonylidation D. Metoprolol
C. Glutathione-absorption 14. An experimental drug A was applied to the eyes of
D. Glutathione-sulfonylidation the lab animal. You observed that pupils
constricted accompanied by cyclospasm.
 SINAG SET 1
Thereafter, drug B was applied. You noticed that G. Increased intracellular Ca2+ levels also result
the pupils dilated; however, cyclospasm did not in the induction of apoptosis by direct
disappear. What do you think is the identity of activation of caspases
drug B? H. All are true
A. Alpha-agonist 22. The cardinal sign of inflammation called calor is
B. Anticholinergic mainly the result of
C. Beta-agonist A. Increased circulation and vasodilation in
D. Cholinomimetic the injured tissues
15. A patient was given trimetaphan to have a B. Increased flow of blood
controlled bleeding during surgery. Which among C. Increased fluid escaping the tissues
following will happen after its introduction? D. The stimulation of nerve endings
A. HTN 23. During the early stages of the inflammatory
B. Mydriasis response, histamine-induced increased vascular
C. Bradycardia permeability is most likely to occur in
D. Peristalsis A. Arteries
16. This mixed acting sympathomimetic drug being B. Pre-capillary arteries
used for conditions to increase vascular tone and C. Capillaries
can cause tachyphylaxis. D. Post-capillary venules
A. Metaproterenol 24. Increase of calcium deposition on normal tissues
B. Ephedrine as a consequence of hypercalcemia
C. Terbutaline A. Metastatic calcification
D. Phenylephrine B. Saponification
17. Which of the following drugs will increase the C. Dystrophic calcification
activity of acetylcholinesterase? D. All of these
A. Atropine 25. A 56-year old man has had increasing dyspnea for
B. Neostigmine 6 years. He has no cough or fever. He was
C. Pralidoxime inhaling silica dust for many years in his job. A
D. Edrophonium chest x-ray now shows increased interstitial
18. If atropine is given prior to institution of markings and parenchymal 1 to 3 cm nodules. His
norepinephrine, this scenario will happen: pulmonary problems are most likely to be caused
A. Increase BP, decrease HR by which of the following inflammatory processes?
B. Increase BP, increase HR A. Neutrophilic infiltration with release of
C. Decrease BP, increase HR leukotrienes
D. Decrease BP, decrease HR B. Plasma cell production of immunoglobulin
19. Miosis with accommodation to near vision C. Foreign body giant cell formation
happens by giving any of the following drugs, D. Release of growth factors by macrophages
except: 26. Premature labor with premature rupture of fetal
A. Pilocarpine membranes occurs at 20 weeks gestation in a 20-
B. Echothiopate year old woman. Prior to that time, the pregnancy
C. Physostigmine had been proceeding normally. A stillbirth occurs
D. Prazosin two days later. Microscopic examination of the
20. Following the principle of innervation and normal sized placenta reveals numerous
dominance, all of the following happens upon neutrophils in the amnion and chorion, but no
activation of all autonomic ganglia, except: villitis. These events are most likely to be
A. Decrease transit time of the gut mediated by the effects from release of which of
B. Increase secretion of the bronchial glands the following substances?
C. Decrease activity of the heart A. Immunoglobulin
D. Decrease TPR B. Prostaglandin
C. Complement
GENERAL PATHOLOGY D. Fibrinogen
21. It is said that calcium ions are important mediators 27. A 40-year old woman has had a chronic cough
of cell injury. One of the following statements is with fever and weight loss for the past month. A
TRUE: chest radiograph reveals multiple nodules from 1
E. Failure of the Ca2+ pump leads to efflux of to 4 cm in size, some of which demonstrate
Ca2+, with damaging effects on numerous cavitation in the upper lobes. A sputum sample
cellular components reveals the presence of acid fast bacilli. Which of
F. The accumulation of Ca2+ in mitochondria the following cells is the most important in the
results in the closing of the mitochondrial development of her lung lesions?
permeability transition pore A. Macrophage
 SINAG SET 1
B. Fibroblast are most likely to be mediated by the release of
C. Neutrophil which of the following chemical mediators?
D. Mast cell A. Complement C3b
28. A 90-year old woman has developed a fever and B. Platelet activating factor
cough over the past 2 days. Staphylococcus C. TNF
aureus is cultured from her sputum. She receives D. Histamine
a course of antibiotic therapy. Two weeks later 33. Within minutes following a bee sting, a 37-year old
she no longer has productive cough, but she still man develops marked respiratory stridor with
has a fever. A chest radiograph reveals a 3 cm dyspnea and wheezing. He also develops swelling
rounded density in the right lower lobe whose and erythema seen in his arms and legs. An
liquefied contents form a central air-fluid level. injection of epinephrine helps to reverse these
There are no surrounding infiltrates. Which of the events and he recovers within minutes. Which of
following is the best description for this outcome of the following chemical mediators is most important
her pneumonia? in the pathogenesis of this man’s condition?
A. Hypertrophic scar A. Bradykinin
B. Abscess formation B. Complement C5a
C. Regeneration C. Nitrous oxide
D. Progression to chronic inflammation D. Histamine
29. A small sliver of wood becomes embedded in the 34. In an experiment, Enterobacter cloacae organisms
finger of a 25-year old man. He does not remove are added to a solution containing leukocytes.
it, and over the next 3 days the area around the Engulfment and phagocytosis of the microbes is
sliver becomes red, swollen, and tender. observed to occur. Next a substance is added
Neutrophils migrate into the injured tissue. which enhances engulfment. Which of the
Expression of which of the following substances following substances is most likely to produce this
on the endothelial cells is most instrumental in effect?
promoting this inflammatory reaction? A. Complement C3b
A. Interferon gamma B. Glutathione peroxidase
B. Hageman factor C. IgA
C. Lysozyme D. P-selectin
D. E-selectin 35. A 23-year old female complains of right lower
30. An inflammatory process that has continued for 3 quadrant pain. Her last menstrual period is
months includes the transformation of tissue unrecalled and denies any sexual contact. She
macrophages to epithelioid cells. There are also has not yet eaten anything since the occurrence of
lymphocytes present. Over time, fibroblasts lay the right lower quadrant pain 6 hours ago. On
down collagen as the focus of inflammation heals. physical examination, there is a direct tenderness
These events are most likely to occur as an on her right lower quadrant. Her vital signs are:
inflammatory response to which of the following Temperature 38.5C, Heart rate 100 bpm, RR 20
infectious agents? breaths/min, and BP 120/90 mmHg. Which of the
A. Mycobacterium leprae following statements will most probably describe
B. Pseudomonas aeruginosa her condition?
C. Cytomegalovirus A. There is increased neutrophils in her blood
D. Giardia lamblia B. Acute phase reactants are elevated
31. A 37-year old man has had nausea and vomiting C. Her fever is caused by circulating PGE2
for 4 weeks. He experienced an episode of D. All are occurring at the same time
hematemesis yesterday. On physical examination 36. A 25-year old male complains of a pinkish red,
he has no abnormal findings. Upper GI endoscopy tender, tense lesion on his right elbow. His
is performed, and there is a 1.5 cm diameter attending physician advised drainage and
lesion in the gastric antrum which appears to be antibiotics to relieve him of his condition. After 7
an area with loss of the epithelial surface. These days on antibiotics, his condition improved, and
findings are most typical for which of the following the site of drainage slowly formed a whitish scar.
pathologic processes? Which of the following statements describes his
A. Abscess condition?
B. Serositis A. It is a result of infection
C. Granuloma B. It is a possible outcome of acute inflammation
D. Ulcer C. It is more likely a result of chronic
32. A 15-year old girl has had episodes of sneezing inflammation
with watery eyes and runny nose for the past 2 D. A and B
weeks. On physical examination she has red, 37. A 10-year old male tripped on an iron bar and his
swollen nasal mucosal surfaces. Her symptoms right knee skidded on the roughened floor of the
 SINAG SET 1
public market. A small abrasion was noted on his 2. Which of the ff statement regarding cortisol is
right knee which he immediately cleaned with true?
soap and water. Which of the following will most a. It is secreted in the zona glomerulosa
likely happen immediately after the accident? b. It counters the effects of insulin
A. Extravasation of plasma proteins c. It causes severe hypoglycemia
B. Emigration of leukocytes d. Secretion is decrease
C. Change in vascular caliber
D. Formation of a cell rich exudate 3. The production or action of this inflammatory
38. A 45-year old female suffering from diabetes mediator is inhibited by cortisol.
slowly developed brown-black discoloration of her a. Interleukin-6
right toe. She did not pay much attention to her b. Epinephrine
right toe because she did not feel any symptoms c. Norepinephrine
associated with it. As weeks passed by, she d. Atropine
noted that the discoloration is slowly spreading
proximally to the dorsum of her right foot. This 4. Which of the ff statement is true regarding
made her seek consult for her condition. Besides aldosterone?
being negligent, she would have sought consult a. It stimulates the renal arteries to reabsorb
earlier had symptoms been present. The lack of potassium
symptoms and tissue reaction is attributed to: b. It stimulates renal tubules to reabsorb
A. Damaged local nerves sodium
B. Dysfunctional inflammatory response c. It comes from the conversion of ACTH
C. Damaged blood vessels stimulated by renin
D. All of the above d. Its secretion follows a diurnal pattern
39. A 40-year-old woman had bilateral silicone breast
implants placed two years ago. Since that time, 5. Injury causes release of CRH from the brain which
she has noted increased firmness with slight in turn stimulates the release of cortisol what
deformity of the breast on the left. The implants pathway?
are removed, and there is evidence for leakage of a. Renin-angiotensin-ACTH pathway
the implant contents on the left. Which of the b. Acetylcholine receptor pathway
following cell types is most likely to be most c. Hypothalamic-pituitary-adrenal
characteristic of the inflammatory response in this pathway
situation? d. Hypothalamic-neuronal signal
A. Mast cell transduction pathway
B. Eosinophil
C. Giant cell 6. Stimulation of catecholamines causes which of the
D. Neutrophil ff?
40. A 40-year-old man incurs a burn injury to his a. Hyperinsulinemia
hands and arms while working on a propane b. Diabetes insipidus
furnace. Over the next 3 weeks, the burned skin c. Galactorrhea
heals without the need for skin grafting. The most d. Gluconeogenesis
critical factor in determining whether the skin in
the region of the burn will regenerate following this 7. Which of the ff statements is true about the role of
is the presence of which of the following factors? macrophages in wound healing:
A. Good cardiac output a. Macrophages are the most dominant
B. Skin appendages inflammatory cells during the initial period
C. Underlying connective tissue inflammatory phase
D. Granulation tissue b. Macrophages appear foremost after
wounding
SURGERY c. Its role is limited to phagocytosis
1. Sepsis refers to SIRS with an infection in the d. Serve as sources of number of growth
body, characterized by which of the ff factors essential for wound healing
a. WBC <12000/mm3 or >10% bands and
BP >90/60 8. Which of the ff statements is true regarding
b. WBC >12000/mm3 or <10% bands and vascular response in tissue injury
BP >90/60 a. Thromboxane and prostaglandin are
c. WBC >12000/mm3 or >10% bands and responsible in hemostasis
C b. Serotonin has an important role in
d. Heart rate , , 8C vasoconstriction
 SINAG SET 1
c. Vasodilation precedes constriction to c. Increased renal tubular sodium
explain bleeding concentration excretion
d. Mediators of vasoconstriction include d. Hyperkalemia
histamine and bradykinin
16. What platelet pathology is associated in patients with
9. Which of the following is TRUE of bacteremia? portal hypertension due to schistosomiasis?
a. Low bacterial load in the blood commonly A. Thrombocytopenia due to increased platelet
results to symptoms destruction
b. High toxin load in the blood does not result to B. Thrombocytopenia due to impaired clotting factors
symptoms of bacteremia C. Insufficient platelet production due to decreased
c. Antibacterial prophylaxis has no role on erythropoietin levels
preventing bacteremia specially in D. Release of immature platelets
immunocompromised patients
d. Minor dental procedures may cause 17. What clinical features distinguish classic haemophilia
bacteremia from haemophilia B?
A. Hemarthrosis
10. In septic shock syndrome, which of the following is B. Age of onset of bleeding
the most significant event preceding tissue injury? C. Pattern of transmission
a. Endothelial damage D. None
b. Release of TNF
c. Release of bacterial degradation product 18. What complication of classic haemophilia accounts for
d. Phagocytosis by the activated macrophage ¼ of mortality of these patients
A. Retroperitoneal bleeding
11. A 47-year old female is to be operated for B. Intracranial bleeding
obstructive jaundice due to a common bile duct stone. C. Pericardial tamponade
She is in a septic condition and needs to be operated D. Massive hemothorax
as soon as possible but her pro time is only 45%
activity- highly suggestive of bleeding during 19. What common characteristic orthopaedic problem is
operation. To improve her condition, which blood associated with classic haemophilia?
product should be given? A. Arthralgia
a. Fresh frozen plasma B. Thinning cartilage
b. Packed BC’s C. Joint effusion
c. Platelet concentrate D. Hemarthrosis
d. Fresh whole blood
20. Which of the following coagulation defect is autosomal
12. The rate of fluid infusion of a 65 kg patient is: dominant?
a. 100 ml/hr A. von Willerbrand’s disease
b. 105 ml/hr B. true haemophilia
c. 110 ml/hr C. Factor X deficiency
d. 115 ml/hr D. Factor IX deficiency

13. Hemodynamic criteria used to diagnose the presence 21. A 35-year-old female had total thyroidectomy. Two
of cardiogenic shock includes the following EXCEPT: days later she developed circum-oral paresthesia, stridor
a. Less than 90 mmHg SBO for at least 30 and tetany. Which of the following should be instituted?
minutes A. Immediate calcium level determination
b. Cardiac index < 2.2 L/min/ sq meter B. Correction of sodium and potassium
c. Central venous pressure of 8 mmHg C. Give thyroid hormone replacement
d. Pulmonary artery pressure of > 15 mmHg D. Calcium gluconate intravenously
14. Which of the following is found to best improve
peripheral vasoconstriction in septic shock? 22. An 18-year-old male came in the emergency room with
a. Epinephrine a gunshot wound in the abdomen. Patient was tachycardic
b. Dopemine and his BP was palpatory. On physical examination, he
c. Arginine vasopressin had a slightly distended abdomen which was tender in all
d. Dobutamine quadrants. Your initial circulatory management is:
15. The following causes the release of renin from the A. Infuse 1 unit PRBC
juxtaglomerular apparatus EXCEPT: B. Bolus infusion of 1L Plain LRS
a. Alpha-adrenergic stimulation C. Bolus infusion of plain NSS at 20 ml/kg
b. Decrease renal perfusion D. Infusion of IV dextran
 SINAG SET 1
23. A 6-year-old child was brought into the emergency 11. What condition happens when nitabuch layer is absent
room because of 3 days history of diarrhoea. The child or abnormal?
came in weak and restless. On physical examination, she Placenta accreta
was tachycardic, had weak pulse, dry oral mucosa and 12. What do you call the condition wherein there is a
slight loss of skin turgor. Her basal body temperature was combination of hypogonadotropic, hypogonadism and
38.0 C. Your initial management of this patient is: anosmia?
A. Fluid replacement with D5 Normosol solution Kallman Syndrome
B. Fluid replacement with Plain Lactatetd Ringers 13-14. By the 8th day of postfertilization, the trophoblast
Solution divides into which 2 distinct layers?
C. Fluid replacement with 0.9 NaCl solution Syncytiotrophoblast and Cytotrophoblast
D. Fluid replacement with D5 0.45 NaCl solution 15. Term used to describe placental circulation:
Hemochorial or hemochondroendothelial
24. A 35-year-old intoxicated male patient was brought in 16. By what day is the blastocyst completely buried and
because of a vehicular accident. His vital signs showed a covered by the maternal endometrium?
BP of 110.80, PR of 100/min and RR of 30/min. on Day 10
examination, he had abrasions over his upper extremities 17-19. Stages of blastocyst implantation
and anterior trunk. Abdominal examination was Apposition, Adhesion, Invasion
unremarkable except for a 5cm transverse incisional scar 20. By what week does fetal weight = placental weight?
on the right lower quadrant of his abdomen which was due Week 17
to a previous appendectomy. An ABG done showed a pH 21. Condition that proves that there are breaks in the
of 7.47, PCO2 of 30 mmHG and plasma bicarbonate of 24 placental barrier
mEq/L. This patient is suffering from: Erythroblastosis fetalis
A. Metabolic Acidosis 22-23. Conditions that cause lower plasma hCG:
B. Respiratory Acidosis Pregnancy wastage (e.g. miscarriage), Ectopic
C. Metabolic Alkalosis pregnancy, Nonpregnant female
D. Respiratory Alkalosis 24-25. Conditions that cause higher plasma hCG;
Multifetal pregnancy, Erythroblastosis fetalis,
25. The recovery phase following surgical or traumatic Down’s Syndrome, Gestational rophoblastic Disease
injury is characterized by:
A. Reduced total body energy expenditure PEDIATRICS
B. Increased urinary Nitrogen wasting 1. Perinatal period according to Nelson’s
C. Augmented metabolic rate and oxygen 28 weeks AOG – 7 days after birth
consumption 2. What percentage of newborn infants require initial
D. Decreased metabolic rates assessment:
100%
OBSTETRICS 3-6. Give the 4 core components of EINC
1. What is the most potent naturally occurring estrogen? Immediate and thorough drying, early skin-to-
17 β estradiol skin contact, properly timed cord clamping, and non-
2. What day is the window implantation of the blastocyst? separation of mother and child
Days 20-24 7. 1st step in resuscitation
3. What is a more inconsistent and superficial zone of Immediate and thorough drying
fibrinal degeneration? 8- . Preferred alternatives to breastfeeding if it isn’t
Rohr Stria possible
4. Which hormone renders a contraceptive effect by Direct expression of milk and cup feeding
thickening the cervical mucus? 10-11. Components of maturational assessment
Progesterone Physical Maturity
5. When is the day of menstrual cycle where in the Neuromuscular Maturity
epithelial surface of endometrium has been fully restored? 12-14. Parameters that determine the appropriateness of
Day 5 AOG
6. What is the precursor of estradiol in the ovaries? Weight, Length, Head Circumference
Androstenedione 15. Type of care which provides the benefits of an
7. What is the hallmark of luteal phase? incubator
Progesterone secretion Kangaroo Mother Care
8-9. Give 2 effects of prostaglandins during the 16. Type of intrauterine growth restriction in which the
menstruation of a woman. insult is recent and the brain is spared
Vasoconstriction and myometrial contraction Asymmetric
10. What is the precursor of progesterone? 17. Give an example of a normal reflex in infants
LDL cholesterol Babinski, Moro, etc.
18. Death to hypothermia is due to what immediate cause:
 SINAG SET 1
Metabolic Acidosis 1. Which of the following can produce the most
19. What is EO 51? potent hazardous effect in the body?
The Milk Code A. UV light
20. What is RA 10028? B. Ionizing radiation
Expanded Breastfeeding Promotion Act C. Ultrasonic and sonic vibrations
21. Infancy growth period is rapid and is critical for D. All of the above
complete development during the first ____ days
starting from _____. a. 1000 days; birth 2. Cells placed in a hypotonic environment will result
b. 1000 days; conception in _____.
c. 750 days; birth A. Normal cell growth
d. 750 days; conception B. Plasmolysis
22. Average daily nutrient intake level estimated to C. Cell shrinkage
meet the requirements for 50% of the population D. Cellular edema
assuming normal distribution. a. LRNI
b. AMDR 3. RNA Synthesis is performed by:
c. DRI A. RNA dependent RNA polymerase
d. EAR B. DNA dependent DNA polymerase
23. How many types of growth charts are currently C. RNA dependent DNA polymerase
used by the WHO in measuring growth parameters? D. DNA dependent RNA polymerase
a. Two
b. Three 4. this form of mutation occurs when a purine is
c. Four replaced by another purine.
d. None of the above A. Silent Mutation
24. In general, a plotted point that is far from the B. Nonsense Mutation
median in either direction may represent a growth C. Transversion
problem. D. Transition
a. True
b. False 5. This term refers to the average time required for a
25. Food type given in limited amounts bacterial population to double.
a. Sugar A. Biomass density
b. Lean Meat B. Generation time
c. Fried food C. Logarithmic growth rate constant
d. Fruits D. Viable cell count
26. Acanthosis nigricans is an indicator for
a. Type II DM 6. These are organisms that are responsible for
b. Insulin resistance causing food spoilage inside the refrigerator.
c. Both A. Psychotrophs
d. None B. Mesophiles
27. Important role of fibers includes all of these, C. Halophiles
except D. Thermophiles
a. Diluting toxins, carcinogens, & tumor
promoters 7. The following is true of cell-mediated immunity
b. Decreasing transit time (CMI) EXCEPT
c. Increasing colonic mucosal exposure A. Most antigens that stimulate SMI are
d. Promoting their expulsion in fecal stream extracellular in nature
28. RENI of Fats and Fatty Acids in Infants B. Generally requires the continued presence of
a. 55%-70% antigen to maintain the effectivity
b. 30%-40% C. It is not transferred via placenta
c. 20%-30% D. Based on the activity primarily of the T cells
d. 10%-15%
29. Correction of iron deficiency occurs in? 8. The following is true on cytotoxic T cells
a. Initial Treatment (Day 1-2) A. Specifically attack virus-infected cells only
b. Initial Treatment (Day 3-7) B. Continue activity as long as antibody persists
c. Rehabilitation (Weeks 2-6) C. Produce perforin which forms pores in
d. Follow-up (Week 7-26) the membrane causing infected cells to
30. What is the hallmark of refeeding syndrome? lyse
Severe Hypophosphatemia D. All of the above

MICROBIOLOGY 9. Normal flora are regularly be found in several

 SINAG SET 1
anatomical sites. Which of the following sites are D. Both Classical and Alternative
devoid of such organisms?
A. Skin 20. Which of the following is NOT an ANTI-
B. GI tract INFLAMMATORY cytokine.
C. Mouth A. IL-11
D. Muscle B. TGF-β
C. IFN- β
Determine whether the following characteristics are D. IL-1
that of innate or specific immunity. Choose from:
A. Innate Immunity Match the following to the correct type of
B. Specific Immunity Hypersensitivity
A. Type I Hypersensitivity
10. Does not rely on specific pathogen recognition A B. Type II
11. Does not confer long-lasting protective immunity C. Type III
A D. Type IV
12. Immediate response to a pathogen A
21. Tuberculin Testing D
Match the following normal flora species to their . Goodpasture’s Syndrome B
correct description/characteristic. 23. 12 y/o male developed acute post-streptococcal
A. Lactobacillus acidophilus glomerunonephritis C
B. Bifidobacterium bifidum 24. 28 y/o female with SLE C
C. Streptococcus mutans 25. IgE mediated A

13. Dental caries C

14. Breastfed infants B
15. Vagina A

16. Which of the following is true about passive

immunity
A. May be passed via transplacental
transmission
B. Allows prompt availability of large amounts
of antibody
C. Requires prolonged or repeated contact with
the antigen
D. A and B only
E. All of the above

17. The following can induce immunogenicity except

______.
A. Antigen
B. Immunogen
C. Hapten-carrier conjugate
D. Hapten

18. This comprises the membrane attack complex

(MAC):
A. C1qrsC4C2C3
B. C5C6C7
C. C5bC6C7C8C9
D. C3bBbC5C6C7

19. This pathway is an important component of the

innate immune response and is initiated by the
binding of MBL to polysaccharides on bacterial
surfaces.
A. Lectin pathway
B. Classical pathway
C. Alternative pathway