SEMESTER 2 COMMITTEE 2

ANATOMY

1. Which one of the followings muscles does open the auditory tube to equalize air pressure in the middle
ear and pharynx?

a) levator veli palatini + tensor veli palatini

b) tensor veli palatini + palatoglossus

c) palatoglossus + palatopharyngeus

d) palatopharyngeus + uvulae

e) uvulae + levator veli palatini

Answer: A

2. There is the risk of suffocation which one of the followings muscles is out of order in an unconsciousness
patient?

a) styloglossus

b) palatoglossus

c) genioglossus

d) hyoglossus

e) uvulae

Answer: C

3. Which one of the followings items is FALSE about cremaster muscle?

a) cremasteric reflex occurs when the stroking upper part of the medial surface of the thigh

b) should be not use very tight internal wearing in male

c) in cold temperature, it draws the testis to a more superior position in the scrotum

d) its temperature is approximately one degree cooler than body temperature

e) the lowest fibers of the external abdominal oblique muscle form it

Answer: E

4. Which one of the following veins does NOT participate the porto – caval anastomosis of the abdominal
wall?

a) lateral thoracic vein

b) internal thoracic vein

c) lumbal veins

d) paraumbilical veins
 e) superficial epigastric vein
Answer: B

5. Which one of the following structures is NOT penetrated if a needle is inserted through the
anterior abdominal wall between the semilunar line and midaxillary line?

a) fascia transversalis

b) external abdominal oblique muscle

c) internal abdominal oblique muscle

d) rectus abdominis

e) E. ???????

Answer: D

6 – 7 – 8. ????????????????

9. The right lobe of the liver lies at the right side of the line between which one of the following items?

a) fissure for ligamentum venosum + fissure for round ligament

b) fissure for round ligament + porta hepatis

c) porta hepatis + fossa for inferior vena cava

d) fossa for inferior vena cava + fossa for gallbladder

e) fossa for gallbladder + fossa for ligamentum venosum

Answer: A

10. Which one of the following items is FALSE about the gallbladder, bile and bile ducts?

a) when digestion is not taking place, the sphincter of the bile duct remains closed and bile accumulates in
the gallbladder

b) bile is delivered to the duodenum as the result of contraction of the gallbladder

c) this mechanism is initiated by the entrance of fatty foods into the duodenum

d) the fat causes release of the hormone cholecystokinin from the stomach

e) the hormone cholecystokinin then enters the blood, causing the gallbladder to contract

Answer: D

11. Which one of the following items does permit free movement of the stomach during the digestion?

a) greater omentum

b) lesser omentum

c) omental bursa

d) gastrocolic ligament
 e) gastroduodenal ligament

Answer: C

12. Which one of the following ligaments does divide the subphrenic space as right and left anterior subphrenic
spaces?

a) gastrocolic ligament

b) gastroduodenal ligament

c) gastrohepatic ligament

d) falciform ligament

e) round ligament of liver

Answer: D

13. A tumor that compresses both vagal trunks at the esophagogastric junction can affect the motility of all of the
following structures EXCEPT the?

a) stomach

b) ascending colon

c) duodenum

d) descending colon

e) ileum

Answer: D

14. Commonest location of the free – end of the appendix is:

a) Retrocecal

b) Pelvic

c) Subcecal

d) Preiliac

e) Postiliac

Answer: A

15. Which of the following statement concerning the spleen is false?

a) it is located posterior to the stomach

b) it is anterior to the left kidney

c) it is normally lies anterior to ribs 9-11 on the left side

d) the splenorenal ligament connects it to the parietal peritoneum over the left kidney

e) it is normally palpable below the left costal margin

Answer: E

16. Which statement is FALSE regarding the pancreas?

a) An elongated structure that lies in the epigastrium and the left upper quadrant

b) Situated on the posterior abdominal wall behind peritoneum

c) A part of the head extends to the left anterior to the superior mesenteric vessels and is called the
uncinate (?) process

d) The neck lies in front of the beginning of the portal vein

e) The tail passes forward in the splenorenal ligament

Answer: C

17. Each of the following veins belongs to the portal system, except:

a) Left gastric vein

b) Left suprarenal vein

c) Superior mesenteric vein

d) Superior rectal vein

Answer: B

18. Obstruction of portal venous flow in the liver commonly leads to enlargement of veins in all of the following
EXCEPT the:

a) lower esophagus

b) posterior abdominal wall

c) anal canal

d) umbilical region

e) ileocecal junction

Answer: E

19 – 20 – 21 – 22. SORULAR AÇIK UÇLU OLDUĞUNDAN ALMADIM.

HISTOLOGY

23. Which one of the ducts below is common for oral salivary glands but lacking in the pancreas gland?

a) acinar ducts

b) intercalated ducts

c) striated ducts

d) collecting ducts

e) excretory ducts
Answer: C

24. If the proctodeum would not form, what would happen?

a) urinary bladder would not form properly

b) anal canal would not form properly

c) cecum would not form properly

d) appendix would not form properly

e) transverse colon would not form properly

Answer: B

25. The transverse colon is developed from two different embryonic origins, midgut and hindgut. How those parts
from different origins are recognized in the adult body?

a) they have different cell populations

b) they have different blood supplies

c) they have different diameters

d) midgut part receives sympathetic nerve fibers, hindgut part receives parasympathetic nerve fibers

e) midgut part houses higher amount of lymph nodes than hindgut part

Answer: B

26. Which of the events below attaches the head portion of the pancreas to the tail portion?

a) formation of the omental bursa

b) rotation of the small intestines

c) development of the spleen

d) rotation of the stomach

e) attachment of the dorsal mesogastrium to the abdominal wall

Answer: D

27. Ameloblasts secret enamel in the form of enamel rods during fetal life. Which one of the structures below
give rise to ameloblasts?

a) inner enamel epithelium cells

b) dental papilla cells

c) stellate reticulum cells

d) outer enamel epithelium cells

e) stratum intermedium cells

Answer: A

28. Choose the correct location of an inlet venule

a) they are situated between arterial sinusoids and venous sinusoids

b) they are situated between portal venules and sinusoids

c) they are situated between portal venules and hepatic arteries

d) they are situated between central vein and interlobular veins

e) they are situated between distributing venules and sinusoids

Answer: E

29. The term portal (liver) acinus refers to which of the below?

a) the area located between the portal areas and the central vein

b) the area holds hepatic artery, bile ducts and lymph vessels together

c) the area just around the hilum

d) the area supplied by the same hepatic artery with oxygenated blood

e) the area gives its bile content to the same bile duct at the center

Answer: D

30. Disse space has important functions in liver physiology, which of the below IS NOT correct for Disse space?

a) allows metabolite exchange between blood and hepatocytes

b) houses Ito cells

c) it’s the place of bile production

d) it’s the place of lymph production

e) its obliteration causes cirrhosis

Answer: C

31. Which of the below is WRONG for microfold cells?

a) they are mostly located under lymphatic nodules

b) they have deep cytoplasmic foldings

c) the basement membrane just under those cells are perforated

d) lymphocytes can easily approach to the intestinal lumen inside those cells

e) they can secrete immunoglobulins

Answer: E
32. Which of the below is wrong for the pancreas?
 a) Langerhans islends are mostly located at the tail portion of the pancreas

b) All of the islands have the same proportion of the cell types

c) Langerhans islets can be seen with every type of stains

d) Individual cell types can be differentiated with special staining techniques

e) Langerhans islets have a diameter of 50 to 300 m

Answer: B

33. Secretion of the insulin begins around which week of the embryonal development?

a) 3

b) 5

c) 10

d) 21

e) 28

Answer: C

34. Stem cells of the stomach mucosa located in which part of the stomach mucosa?

a) gastric pits

b) neck region of the glands

c) fundus region of the glands

d) luminal surface

e) isthmus region of the glands

Answer: E

MEDICAL BIOCHEMISTRY

35. Which of the following occur in the liver during prolonged fasting?

a) Increased glycogen degradation

b) Increased phosphorylation of glucose

c) Increased fatty acid synthesis

d) Increased triacylglycerol synthesis

e) Increased protein synthesis

Answer: A
36. Which of the following occur in the fed state?

a) Increased degradation of triacylglycerol

b) Increased fatty acid oxidation

c) Increased synthesis of ketone bodies

d) Increased gluconeogenesis

e) Increased glycolysis

Answer: E

37. Which of the following method is most common method of analyzing plasma proteins?

a) Electrochemiluminescence

b) Electrophoresis

c) ELISA

d) Spectrophotometry

e) Radioimmunoassay

Answer: B

38. Choose FALSE answer about functions of albumin?

a) Albumin is thought to be responsible for 75 – 80 % of the osmotic pressure of human plasma

b) Albumin is its ability to bind various ligands (Free fatty acids, calcium etc)

c) Albumin appears to play an important role in transport of copper in the human body

d) Albumin plays an important role in the fight against infection

e) Albumin bins a variety of drugs, including sulfonamides, penicillin G etc

Answer: D

39. Which of the following is NOT a gastrointestinal hormone?

a) Gastrin

b) Motilin

c) Calcitonin

d) Secretin

e) Gastric inhibitor polypeptide

Answer: C

40. Which of the following is NOT metalloporphyrin?

a) Hemoglobin
 b) Catalase

c) Transferrin

d) D. ????????

e) E. ????????

Answer: C

41. Which of the following types of porphyria occur in deficiency of ferrochelatase?

a) Porphyria Cutanea Tarda

b) Acute Intermittent Porphyria

c) Erythropoietic Protoporphyria

d) Variegate Porphyria

e) Hereditary Coproporphyria

Answer: C

42. Which of the following is NOT one of the factors affecting in the proportion of eicosanoids synthesized form
w-3 and w-6 fatty acids in the direction of meta-inflammation, thrombogenesis hypertension?

a) Diet with inadequate w-3 fatty acids

b) Insulin resistance

c) Increased trans fatty acid content of the diet

d) Increased cholesterol content of the diet

e) Type I DM

Answer: D

43. If a patients’ fasting plasma glucose level is confirmed to be 139 mg/dl twice, what is it called?

a) Type I DM

b) DM

c) Prediabetes

d) Impaired fasting glucose

e) Impaired

Answer: B

44. Which one of the following is NOT correct for HbA1c?

a) May be erroneously low in patients with iron deficiency anemia

b) Correlated with microvascular complication progression rate

 c) NOT recommended for diagnosis of gestational diabetes

d) A well defined marker of beta cell reserve

e) Can be used to assess long-term glucose control

Answer: D

45. In a patient with plasma total bilirubin 5 mg/dl, urine bilirubin negative and increased urinary urobilinogen,
increased bilirubin fraction is most likely...

a) Bilirubin diglucuronide

b) Bilirubin monoglucuronide

c) Delta bilirubin

d) Direct bilirubin

e) Indirect bilirubin

Answer: E

46. Which of the following is capable of transporting conjugated bilirubin through both sides of the cell
membrane thus allowing its’ toxic effect to the peripheral tissue?

a) MRP-2

b) OABP

c) Ligandin

d) Protein Y

e) Glutathion – S Transferase

Answer: A

MICROBIOLOGY

47. A blood sample was sent to clinical microbiology laboratory from intensive care unit. Microbiology doctor
examinated some Gram negative cocci and cocco-bacilli at Gram stain of the blood smear. Triple Sugar Iron agar
was inoculated with the isolate and remained all red after one night incubation with aerobic condition. After
getting identification report and antibiogram, the clinical treated the patient with colistin plus rifampin
combinations. Which of the following bacterial species may be responsible for this infection?

a) Klebsiella spp.

b) Pseudomonas aeruginosa

c) Escherichia coli

d) Bacteroides fragilis

e) Acinetobacter baumannii

Answer: E
48. Which of the following is a Gram positive anaerobic cocci?

a) Prevotella

b) Bifidobacterium

c) Veillonella

d) Peptostreptococcus

e) Bacteriodes

Answer: D

49. Which of the following pathogen and infectious disease correspondence is CORRECT?

a) Leptospira interrogans – Lyme disease

b) Borrelia burgdorferi – Weil’s disease

c) Borrelia recurrentis – Yaws

d) Treponema pallidum ssp. Pallidum – Bejel

e) Treponema carateum – Pinta

Answer: E

50. Which of the following statement is FALSE for Yersinia enterocolitica?

a) It can cause Reiter’s syndrome

b) Streptomycin can be used for treatment

c) It is motile at 22°C and non-motile at 37°C

d) It causes the Plague infection

e) It is from the family Enterobacteriaceae

Answer: D

51. Which antibiotics acts by inhibiting folic acid synthesis?

a) Rifampicin

b) Metronidazole

c) Trimethoprim

d) D. ???????

e) E. ???????

Answer: C

52. Which one of the following antibiotic susceptibility testing methods DOES NOT give a minimum inhibitory
concentration value?
 a) Agar dilution method

b) E – test

c) Disc diffusion method (Kirby Bauer)

d) Broth micro dilution method

e) Broth macro dilution method

Answer: C

53. All Enterobacteriaceae share all of the following characteristics EXCEPT:

a) Ferment glucose

b) Reduce nitrates to nitrites

c) Oxidase positive

d) Gram negative

e) Rod – shaped (bacilli)

Answer: C

54. This urinary pathogen “swarms” across agar surfaces and may cause bladder and renal calculi (stones).

a) Citrobacter freundii

b) Enterobacter aerogenes

c) Serratia marcescens

d) Klebsiella oxytoca

e) Proteus mirabilis

Answer: E

55. Which of the following statement is False about Salmonella diagnostic media from feces?

a) Selenite media

b) Rappaport media

c) Tetrathionate media

d) SS media

e) Blood media

Answer: E

56. A local day care center has several simultaneous cases of diarrhea and occult blood. Culture of the stool
revealed a typical gram negative rod which fermented glucose but not lactose, was nonmotile and did not
produce H2S. The agent which MAY have caused this outbreak was

a) Shigella sonnei
 b) Rota Virus

c) Giardia lablia

d) Escherichia coli

e) Salmonella typhimurium

Answer: A

57. Which of the following statement is False regarding Klebsiella?

a) They are gram negative

b) Show swarming characteristics when grow on solid media

c) Have capsular antigens

d) Are susceptible to amino glycosides

e) Are a common cause of UTI

Answer: B

58. A specimen suspected of containing members of the Enterobacteriaceae was subjected to a few laboratory
diagnostic tests and generated the following results: Gram negative rod; colorless/later pink on MacConkey agar.
All of the following microorganisms may be included in the diagnosis, EXCEPT

a) Shigella spp

b) Citrobacter

c) Proteus spp

d) Salmonella spp

e) Yersinia spp

Answer: B

59. A patient develops explosive, watery diarrhea 24 hours after eating seafood. What bacterium is most likely
involved?

a) Campylobacter fetus

b) Salmonella typhimurium

c) Shigella flexneri

d) Vibrio cholerae

e) Vibrio parahaemolyticus

Answer: E

60. Which of the following statements is False regarding Campylobacter?

a) is responsible for the majority of peptic ulcers

 b) Spiral-shaped Gram-negative bacilli

c) Oxidase – positive

d) Motile bacteria

e) Microaerophilic

Answer: A

61. Which of the following statements regarding Campylobacter jejuni is not correct?

a) It is commonly cultured in antibiotic containing media

b) Throat culture is not useful to diagnosis

c) Incubation temperature mostly is 42°C

d) It is cultured in an atmosphere containing 5% O2 and 10% CO2

e) It is a normal flora of intestine

Answer: E

62. All of the following statements regarding Clostridium perfingens are correct EXCEPT

a) It produces an enterotoxin

b) It produces a double zone of ß – hemolysis when grown on blood agar

c) Nagler reaction is positive

d) It is the most common cause of antibiotic – associated diarrhea

Answer: D

PHYSIOLOGY

63. Which of the following is FALSE about interstitial cells of Cajal (ICC)?

a) ICC is specialized pacemaker cells and connects to the smooth muscle and the myenteric plexus via gap
junctions

b) ICC is located in the outer circular muscle layer near the myenteric plexus throughout all gastrointestinal
tract

c) ICC transmits information from enteric neurons to the smooth muscle

d) ICC has the capacity to generate the basic electric rhythm or slow wave of smooth muscle

e) The frequency of ICC pacemaker activity differs in different regions of the GI tract

Answer: B

64. Which of the following is TRUE about autoregulatory escape?

a) Autoregulatory escape is a vascular arrangement throughout villus of the small intestine

b) Autoregulatory escape is a mechanism that overridden the sympathetic vasoconstriction effects,

returning the normal blood flow to GI muscle and glands
 c) Autoregulatory escape is a metabolic vasoconstrictor mechanism

d) Motilin is responsible for autoregulatory escape mechanism

e) Autoregulatory escape is a mechanism which coordinated by peacemaker activity of ICC along

gastrointestinal tract

Answer: B

65. Which one of the following is NOT an effect of secretin?

a) Inhibition of bile current

b) Inhibition of the gastrin secretion

c) Inhibition of the gastrointestinal motility

d) Excitation of the bicarbonate rich secretion of pancreas cells

e) Excitation of the water secretion of pancreatic ductal cells

Answer: A

66. Which one of the following is NOT an effect of chollecystokinin (CCK)?

a) CCK inhibits the motility of intestine

b) Sphincter of Oddi is relaxed by CCK

c) CCK stimulates the contraction of the gallbladder

d) CCK stimulates the secretion of the insulin

e) CCk stimulates secretion of the enzymes by pancreatic acini

Answer: A

67. Which of the following does NOT occur in pharyngeal stage of swallowing?

a) The soft palate is pulled upward to close the posterior nares to prevent reflux of food into the nasal
cavities

b) The palatopharyngeal folds on each side of the pharynx are pulled medially to approximate each other
and a sagittal sit is formed

c) The pharyngeal – esophageal sphincter contracts, thus allowing food to move easily and freely from
pharynx to esophagus

d) Deglutition apnea becomes in the esophageal stage

e) Uvula moves backward for closing the nasal cavity

Answer: C
 A. Enterogastric reflex 1. Signal includes from stomach and affects the motility and secretion of stomach

B. Gastrocolic reflex 2. Signal includes from small intestine and decreases the motility and secretion of stomach
C. Enterocolic reflex 3. Signal includes from large intestine and decreases the motility and secretion of small intestine
D. Colonoileal reflex 4. Signal includes from stomach and increases the motility and secretion of large intestine
E. Vagovagal reflex 5. Signal includes from small intestine and increases the motility and secretion of large intestine

68. Match the reflexes and their definition. Which of the following is TRUE matching?

a) A – 1, B – 4, C– 3, D – 2, E– 5

b) A – 2, B – 3, C – 5, D – 4, E– 1

c) A – 2, B – 4, C – 1, D – 3, E– 5

d) A – 2, B – 4, C – 5, D – 3, E – 1

e) A – 5, B – 4, C – 2, D – 3, E – 1

Answer: D

69. Which of the following does NOT present in composition of liver bile?

a) Bilirubin

b) Triacylglycerol

c) Cholesterol

d) Lecithin

e) Fatty acids

Answer: B

70. Which of the following is FALSE about absorption?

a) Amino acids transports with sodium ions cotransportally into the cell from the lumen of the small
intestine

b) Water can be transported via paracellular transportation

c) Glucose and fructose transport into the enterocyte by primary active cotransport

d) Sodium is actively transported from inside the intestinal epithelial cells through the basolateral
membrane of these cells into paracellular spaces

e) Glucose and galactose transport into the cell thereby using the same transportation mechanism

Answer: C

71. Which of the following is FALSE about saliva?

a) Saliva secreted in the acini is nearly isotonic to the plasma

b) Saliva is a bicarbonate – rich secretion and neutralizes acids in food

c) The ducts are relatively impermeable to water

 d) Saliva that reaches the mouth is hypotonic

e) The composition of saliva is modified as are K+ and HCO2- absorbed into the cell and Na+ and Cl- are
secreted into the ductal lumen during passage through the ducts

Answer: E

72. Which of the following disease which affected proximal portion of the colon or terminal ileum and caused
inflammation of all layers of the intestinal wall resulting from blockage and inflammation of lymphatic vessels?

a) Crohn disease

b) Intussusception

c) Hirschsprung’s Disease

d) Celiac Spruce

e) Volvulus

Answer: A

73. Which of the following is FALSE about AGRP?

a) AGRP is a natural antagonist of MCR – 3 and MCR – 4

b) Excessive formation of AGRP in mice and humans due to gene mutations is associated with increased
food intake and obesity

c) AGRP releases from the orexigenic neurons of the hypothalamus

d) AGRP increases feeding by inhibiting the effects of a-MSH to stimulate MCRs

e) AGRP increases sympathetic nerve activity which increases metabolic rate and energy expenditure

Answer: E

74. Which of the following is a factor which has an effect on the metabolic rate of the body?

a) Effect of thyroxine

b) Sympathetic stimulation

c) Effect of acetylcholine

d) Basal rate of metabolism

e) Thermogenic effect of food

Answer: C

75. Which one of the following is a mechanism for heart gain?

a) Evaporation

b) Excitation of sympathetic centers in posterior hypothalamus for vasoconstriction

c) Painting
 d) Inhibition of shivering

e) E. ???????

Answer: B

76. Which one is expected when ablation of colon is implemented?

a) Mortality

b) Megaloblastic anemia

c) Severe malnutrition

d) Increase in the level of the blood ammonia from cirrhosis

e) Decrease in urinary urobilinogen

Answer: E