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  • Question 1 - Which of the following abnormalities can be seen in patients with hypermagnesemia? ...

    Incorrect

    • Which of the following abnormalities can be seen in patients with hypermagnesemia?

      Your Answer: Tetany

      Correct Answer: Respiratory depression

      Explanation:

      Hypermagnesemia is an electrolyte disturbance in which there is a high level of magnesium in the blood. It is defined as a level greater than 1.1 mmol/L. Symptoms include weakness, confusion, decreased breathing rate, and cardiac arrest.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      22.2
      Seconds
  • Question 2 - Staphylococcus aureus can be identified in the laboratory based on the clotting of...

    Correct

    • Staphylococcus aureus can be identified in the laboratory based on the clotting of plasma. Which microbial product is responsible for this activity?

      Your Answer: Coagulase

      Explanation:

      Staphylococcus aureus is the most pathogenic species and is implicated in a variety of infections.  S. aureus can be identified due to its production of coagulase. The staphylococcal enzyme coagulase will cause inoculated citrated rabbit plasma to gel or coagulate. The coagulase converts soluble fibrinogen in the plasma into insoluble fibrin.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      16.2
      Seconds
  • Question 3 - A patient had sudden complete loss of vision of the right eye. Fundoscopy...

    Correct

    • A patient had sudden complete loss of vision of the right eye. Fundoscopy showed the distinct cherry red spot on the retina. Which of the following arteries was occluded?

      Your Answer: Central artery of the retina

      Explanation:

      The central retinal artery supplies all the nerve fibres that form the optic nerve, which carries the visual information to the lateral geniculate nucleus of the thalamus. Thus if the central retinal artery gets occluded, there is complete loss of vision in that eye and the entire retina (with the exception of the fovea) becomes pale, swollen and opaque while the central fovea still appears reddish (this is because the choroid colour shows through). This is the basis of the famous Cherry red spot seen on examination of the retina on fundoscopy of a central retinal artery occlusion (CRAO).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      14
      Seconds
  • Question 4 - What principal artery that supplies the meninges is susceptible to rupture following trauma...

    Correct

    • What principal artery that supplies the meninges is susceptible to rupture following trauma to the side of the head over the temporal region:

      Your Answer: Middle meningeal artery

      Explanation:

      The middle meningeal artery normally arises from the first or mandibular segment of the maxillary artery. The artery runs in a groove on the inside of the cranium, this can clearly be seen on a lateral skull X-ray. An injured middle meningeal artery is the most common cause of an epidural hematoma.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      13.2
      Seconds
  • Question 5 - During cardiac catheterisation in a 20-year old man, the following data is obtained:...

    Correct

    • During cardiac catheterisation in a 20-year old man, the following data is obtained: Pressure (mmHg), O2 saturation (%) Right atrium 7 (N = 5) 90 (N = 75), Right ventricle 35/7 (N = 25/5) 90 (N = 75), Pulmonary artery 35/8 (N = 25/15), 90 (N = 75), Left atrium 7 (N = 9) 95 (N = 95), Left ventricle 110/7 (N = 110/9) 95 (N = 95), Aorta 110/75 (N = 110/75) 95 (N = 95) where N = Normal value. What is the likely diagnosis?

      Your Answer: Atrial septal defect

      Explanation:

      A congenital heart disease, ASD or atrial septal defect leads to a communication between the right and left atria due to a defect in the interatrial septum. This leads to mixing of arterial and venous blood from the right and left side of the heart. The hemodynamic significance of this defect depends on the presence of shunting of blood. Normally, the left side of the heart has higher pressure than the right as the left side has to pump blood throughout the body. A large ASD (> 9 mm) will result in a clinically significant left-to-right shunt, causing volume overload of the right atrium and ventricle, eventually leading to heart failure. Cardiac catheterization would reveal very high oxygen saturation in the right atrium, right ventricle and pulmonary artery. Eventually, the left-to-right shunt will lead to pulmonary hypertension and increased afterload in the right ventricle, along with the increased preload due to the shunted blood. This will either cause right ventricular failure, or raise the pressure in the right side of the heart to equal or more than that in the left. Elevation of right atrial pressure to that of left atrial pressure would thus lead to diminishing or complete cessation of the shunt. If left uncorrected, there will be reversal of the shunt, known as Eisenmenger syndrome, resulting in clinical signs of cyanosis as the oxygen-poor blood form right side of the heart will mix with the blood in left side and reach the peripheral vascular system.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      225.4
      Seconds
  • Question 6 - A 33-year old lady presented to the gynaecology clinic with amenorrhoea for 6...

    Correct

    • A 33-year old lady presented to the gynaecology clinic with amenorrhoea for 6 months and a recent-onset of milk discharge from her breasts. She was not pregnant or on any medication. On enquiry, she admitted to having frequent headaches the last 4 months. Which of the following findings would you expect to see in her condition?

      Your Answer: Hyperprolactinaemia

      Explanation:

      Excessively high levels of prolactin in the blood is called hyperprolactinaemia. Normally, prolactin levels are less than 580 mIU/l in females and less than 450 mIU/l in men. The biologically inactive macroprolactin can lead to a false high reading. However, the patient remains asymptomatic. Dopamine down-regulates prolactin whereas oestrogen upregulates it. Hyperprolactinaemia can be caused due to lack of inhibition (compression of pituitary stalk or low dopamine levels), or increased production due to a pituitary adenoma (prolactinoma). Either of these causes can lead to a prolactin level of 1000-5000 mIU/l. However, levels more than 5000mIU/l are usually associated due to an adenoma and >100,000 mIU/l are seen in macroadenomas (tumours < 1cm in diameter). Increased prolactin causes increased dopamine release from the arcuate nucleus of hypothalamus. This increased dopamine in turn, inhibits the GnRH (Gonadotrophin Releasing Hormone) thus blocking gonadal steroidogenesis resulting in the symptoms of hyperprolactinaemia. In women, it includes hypoestrogenism, anovulatory infertility, decreased or irregular menstruation or complete amenorrhoea. It can even cause production of breast milk, loss of libido, vaginal dryness and osteoporosis. In men, the symptoms include impotence, decreased libido, erectile dysfunction and infertility. In men, treatment can be delayed due to late diagnosis as they have no reliable indicator such as menstruation that might indicate a problem. Most of the male patients seek help only when headaches and visual defects start to surface.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      41.2
      Seconds
  • Question 7 - Which of the following statements is true regarding the umbilical cord? ...

    Correct

    • Which of the following statements is true regarding the umbilical cord?

      Your Answer: Is filled with jelly of Wharton

      Explanation:

      The umbilical cord that connects the fetus to the placenta is about 50cm long. This tissue consists of the body stalk and vitelline duct. The former containing the allantoic diverticulum and the umbilical vessels. The latter contains the connection linking the digestive tube and the yolk sac. This cord is wrapped by stratum of ectoderm and gelatinous tissue or jelly of Wharton. The right umbilical vein plus the vitelline vessels and ducts disappear and this at birth the cord has three vessels which are the umbilical vein and two umbilical arteries.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      36.8
      Seconds
  • Question 8 - The tympanic membrane is a thin semi-transparent membrane that separates the tympanic cavity...

    Correct

    • The tympanic membrane is a thin semi-transparent membrane that separates the tympanic cavity from the bottom of the external acoustic meatus. The interior of the tympanic membrane is innervated by which of the following cranial nerves?

      Your Answer: Glossopharyngeal

      Explanation:

      The glossopharyngeal nerve, known as the ninth cranial nerve (CN IX), is a mixed nerve that carries afferent sensory and efferent motor information. The glossopharyngeal nerve has five distinct general functions:

      – The branchial motor (special visceral efferent), supplies the stylopharyngeus muscle.

      – The visceral motor (general visceral efferent), provides parasympathetic innervation of the parotid gland via the otic ganglion.

      – The visceral sensory (general visceral afferent), carries visceral sensory information from the carotid sinus and carotid body.

      – The general sensory (general somatic afferent), provides general sensory information from the inner surface of the tympanic membrane, upper pharynx (GVA), and the posterior one-third of the tongue.

      – The visceral afferent (special visceral afferent), provides taste sensation from the posterior one-third of the tongue, including the circumvallate papillae.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      23.9
      Seconds
  • Question 9 - The uterine artery arises from the? ...

    Correct

    • The uterine artery arises from the?

      Your Answer: Internal iliac artery

      Explanation:

      The uterine artery arises from the anterior division of the internal iliac artery and runs medially on the levator ani towards the uterine cervix.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      16.7
      Seconds
  • Question 10 - Which of the following organs is most likely to have dendritic cells? ...

    Correct

    • Which of the following organs is most likely to have dendritic cells?

      Your Answer: Skin

      Explanation:

      Dendritic cells are part of the immune system and they function mainly as antigen presenting cells. They are present in small quantities in tissues which are in contact in the external environment. Mainly in the skin and to a lesser extent in the lining of the nose, lungs, stomach and intestines. In the skin they are known as Langerhans cells.

    • This question is part of the following fields:

      • General
      • Physiology
      8.6
      Seconds
  • Question 11 - Production of pain is most likely associated with: ...

    Incorrect

    • Production of pain is most likely associated with:

      Your Answer: Bradykinin

      Correct Answer: Substance P

      Explanation:

      Substance P is a short-chain polypeptide that functions as a neurotransmitter and as a neuromodulator, and is thus, a neuropeptide. It has been linked with pain regulation, mood disorders, stress, reinforcement, neurogenesis, respiratory rhythm, neurotoxicity, nausea and emesis. It is also a potent vasodilator as it brings about release of nitric oxide from the endothelium. Its release can also cause hypotension.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      11.8
      Seconds
  • Question 12 - A 55-year old lady underwent a major surgery for repair of an aortic...

    Correct

    • A 55-year old lady underwent a major surgery for repair of an aortic aneurysm. Her blood pressure was low throughout the intra-operative and the post-operative period, along with increasing serum creatinine and urea. Microscopic examination of her urine showed multiple granular and hyaline casts. What is the likely condition the patient is suffering from?

      Your Answer: Acute tubular necrosis

      Explanation:

      The most common predisposing factor leading to acute tubular necrosis is ischemia, typically seen in hospitalized patients with low blood pressure.

    • This question is part of the following fields:

      • Pathology
      • Renal
      53.3
      Seconds
  • Question 13 - A lesion involving the suprachiasmatic nucleus of hypothalamus is likely to affect: ...

    Correct

    • A lesion involving the suprachiasmatic nucleus of hypothalamus is likely to affect:

      Your Answer: Regulation of circadian rhythm

      Explanation:

      The suprachiasmatic nucleus (SCN) in the hypothalamus is responsible for controlling endogenous circadian rhythms and destruction of the SCN leads to a loss of circadian rhythm.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      33.6
      Seconds
  • Question 14 - A 20-year old involved in a brawl was stabbed in the anterior chest...

    Correct

    • A 20-year old involved in a brawl was stabbed in the anterior chest in a structure that is in close proximity to where the first rib articulates with the sternum. What is the structure that was most likely injured?

      Your Answer: Sternoclavicular joint

      Explanation:

      The first rib articulates with the sternum right below the sternoclavicular joint.

      The sternal angle articulates with the costal cartilage of the second rib.

      The nipple is found between the fourth and the fifth ribs, in the fourth intercostal space.

      The xiphoid process is located right below the point of articulation of the costal cartilage of rib 7 with the sternum.

      The root of the lung is the part of the lung where neurovascular structures enter and leave the lung.

      Acromioclavicular joint is the point of articulation between the acromion process and the clavicle, near the shoulder.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      13.9
      Seconds
  • Question 15 - Different substances have different renal clearance rates. Which of the following substances should...

    Correct

    • Different substances have different renal clearance rates. Which of the following substances should have the lowest renal clearance rate in a healthy patient?

      Your Answer: Glucose

      Explanation:

      Under normal conditions the renal clearance of glucose is zero, since glucose is completely reabsorbed in the renal tubules and not excreted. Glycosuria – the excretion of glucose into the urine- is nearly always caused by elevated blood glucose levels, most commonly due to untreated diabetes mellitus.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      14.5
      Seconds
  • Question 16 - Which of the following is a true statement regarding the pupil? ...

    Correct

    • Which of the following is a true statement regarding the pupil?

      Your Answer: Phentolamine causes pupil constriction

      Explanation:

      A balance between the sympathetic tone to the radial fibres of the iris and parasympathetic tone to the pupillary sphincter muscle determines the pupil size. Phentolamine (α-adrenergic receptor blocker) causes pupillary constriction. Dilatation of the pupil occurs with increased sympathetic activity, decreased parasympathetic activity during darkness or block of muscarinic receptors by atropine.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      82.8
      Seconds
  • Question 17 - Which of the following veins is prostate cancer most likely to metastasize through?...

    Correct

    • Which of the following veins is prostate cancer most likely to metastasize through?

      Your Answer: Internal vertebral venous plexus

      Explanation:

      The internal vertebral veins are the most likely route of metastasis as they are valveless. They serve an important clinical role as they are the route of free travel for cancerous cells to other body structures. The other veins on the list have valves and would be the least likely routes for metastasis.

    • This question is part of the following fields:

      • Anatomy
      • Neurology
      20.7
      Seconds
  • Question 18 - Which of these infectious agents tends to affect people under 20 and over...

    Correct

    • Which of these infectious agents tends to affect people under 20 and over 40 years old, can cause acute encephalitis with cerebral oedema and petechial haemorrhages, along with haemorrhagic lesions of the temporal lobe. A lumbar puncture will reveal clear cerebrospinal fluid with an elevated lymphocyte count?

      Your Answer: Herpes simplex virus

      Explanation:

      Haemorrhagic lesions of the temporal lobe are typical of Herpes simplex encephalitis (HSE). It tends to affect patients aged under 20 or over 40 years, and is often fatal if left untreated. In acute encephalitis, cerebral oedema and petechial haemorrhages occur and direct viral invasion of the brain usually damages neurones. The majority of cases of herpes encephalitis are caused by herpes simplex virus-1 (HSV-1), and about 10% of cases of herpes encephalitis are due to HSV-2, which is typically spread through sexual contact.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      33.9
      Seconds
  • Question 19 - A patients sciatic nerve has been severed following a stab injury. What would...

    Correct

    • A patients sciatic nerve has been severed following a stab injury. What would be affected?

      Your Answer: There would still be cutaneous sensation over the anteromedial surface of the thigh

      Explanation:

      The sciatic nerve supplies nearly all of the sensation of the skin of the leg and the muscles of the back of the thigh, leg and foot. A transection of the sciatic nerve at its exit from the pelvis will affect all the above-mentioned functions except cutaneous sensation over the anteromedial surface of the thigh, which comes from the femoral nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      52.1
      Seconds
  • Question 20 - A 62-year-old woman presented to the doctor complaining of spine pain, fatigue and...

    Incorrect

    • A 62-year-old woman presented to the doctor complaining of spine pain, fatigue and oliguria. She is diagnosed with chronic renal failure. Dipstick testing shows no protein, glucose, nitrite or ketones but a semi-quantitative sulphosalicylic acid test for urine protein is positive. Which of the following is the most probable cause of chronic renal failure in this patient.

      Your Answer: Minimal-change disease

      Correct Answer: Multiple myeloma

      Explanation:

      Dipstick results are negative because the proteins found in the urine of this patient are not albumin but Bence Jones proteins. A Bence Jones protein is a monoclonal globulin protein commonly detected in patients affected by multiple myeloma. Multiple myeloma is a malignancy of plasma cells characterised by the production of monoclonal immunoglobulin. Symptoms include bone pain, bone fractures, bleeding, neurologic symptoms, fatigue, frequent infections and weight loss.

    • This question is part of the following fields:

      • Pathology
      • Renal
      82.2
      Seconds
  • Question 21 - A patient is diagnosed with Brucellosis. What is the mode of transmission of...

    Correct

    • A patient is diagnosed with Brucellosis. What is the mode of transmission of this disease?

      Your Answer: Unpasteurised milk

      Explanation:

      Brucellosis is a highly contagious zoonosis caused by ingestion of unpasteurized milk or undercooked meat from infected animals, or close contact with their secretions.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      18.3
      Seconds
  • Question 22 - T lymphocytes that express the MCH type II antigen are most likely to...

    Correct

    • T lymphocytes that express the MCH type II antigen are most likely to produce which of the following cytokines?

      Your Answer: Gamma interferon

      Explanation:

      Interferon gamma is a soluble cytokine previously known as the macrophage activating factor. It is the only member belonging to the type II class of the interferons. It is secreted by a number of cells taking part in the immune reaction including: T-helper cells (CD-4), cells with immunological memory (CD45PA), killer cells (CD8), dendrite cells (CD23,35), natural killer cells (CD16) and B lymphocytes (CD22,CD23). It has both a defending as well as a pathological effect. It induces differentiation in the myeloid cell in the bone marrow. If macrophages are infected by parasites it activates the macrophages to destroy them. IFN-γ strengthens the anti-tumour activities of the cytotoxic lymphocytes. Together with CD4 or CD8 toxins, produced by lymphocytes, it suppresses the growth of the tumour cells. along with these functions it increases the non specific response of the natural killer cells, causing changes in the cell membrane surface to prevent adhesion and penetration of a virus. It can either increase or decrease B cell response and it activates osteoclasts which increases bone resorption.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      241.5
      Seconds
  • Question 23 - An electronic manufacturing engineer had abdominal distension and underwent a CT scan of...

    Incorrect

    • An electronic manufacturing engineer had abdominal distension and underwent a CT scan of the abdomen. Thereafter he was diagnosed with hepatic angiosarcoma. Exposure to what agent is responsible for the development of this neoplasm?

      Your Answer: Aflatoxin

      Correct Answer: Arsenic

      Explanation:

      Hepatic angiosarcomas are associated with particular carcinogens which includes: arsenic , thorotrast, and polyvinyl chloride. With exposure to this three agents, there is a very long latent period of many years between exposure and the development of tumours.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      23
      Seconds
  • Question 24 - To reach the oral vestibule, the parotid duct must pierce this muscle: ...

    Correct

    • To reach the oral vestibule, the parotid duct must pierce this muscle:

      Your Answer: Buccinator muscle

      Explanation:

      The parotid duct or Stensen duct is a duct and the route that saliva takes from the major salivary gland, the parotid gland into the mouth. The parotid duct is formed when several interlobular ducts—the largest ducts inside the parotid gland join. It emerges from the gland and runs forward along the lateral side of the masseter muscle. In this course, the duct is surrounded by the buccal fat pad. It takes a steep turn at the border of the masseter and passes through the buccinator muscle, opening into the vestibule of the mouth, between the cheek and the gums, at the parotid papilla, which lies across the second superior molar tooth.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      17.7
      Seconds
  • Question 25 - Which of the following is an anion? ...

    Correct

    • Which of the following is an anion?

      Your Answer: Phosphate

      Explanation:

      Cations: sodium, magnesium, calcium and potassium

      Anions: chloride, phosphate, bicarbonate, lactate, sulphate and albumin

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      6.9
      Seconds
  • Question 26 - Raised alkaline phosphatase and positive antimitochondrial antibody indicates which of the following conditions...

    Incorrect

    • Raised alkaline phosphatase and positive antimitochondrial antibody indicates which of the following conditions presenting with pruritus?

      Your Answer: Sclerosing cholangitis

      Correct Answer: Primary biliary cirrhosis

      Explanation:

      An autoimmune disease, primary biliary cirrhosis results in destruction of intrahepatic bile ducts. This leads to cholestasis, cirrhosis and eventually, hepatic failure. Symptoms includes fatigue, pruritus and steatorrhea. Increased IgM levels, along with antimitochondrial antibodies are seen in the serum. Liver biopsy is diagnostic, and also aids in staging of disease.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      27.9
      Seconds
  • Question 27 - The wound healing process is documented in patients undergoing laparoscopic procedures. The port...

    Incorrect

    • The wound healing process is documented in patients undergoing laparoscopic procedures. The port incisions are sutured closed and the wounds observed every few weeks for re-epithelialisation and tensile strength. Which substance is mostly likely to be found at a cellular level involved in wound healing?

      Your Answer: Collagen

      Correct Answer: Tyrosine kinase

      Explanation:

      Cell surface growth factor receptors require intercellular proteins such as tyrosine kinase which are necessary to initiate a series of events that eventually lead to cell division and growth. Tyrosine kinase is an enzyme that transfers a phosphate group to the tyrosine residue in a protein. This phosphorylation will lead to an up regulation of the enzyme activity.

      Fibronectin acts in the extracellular matrix to bind macromolecules (such as proteoglycans) via integrin receptors to aid attachment and migration of cells.

      Laminin is an extracellular matrix component that is abundant in basement membranes.

      Hyaluronic acid is one of the proteoglycans in the extracellular matrix.

      Collagen fibres are part of the extracellular matrix that gives strength and stability to connective tissues.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      29
      Seconds
  • Question 28 - What is the arterial sequence for an analgesic to reach the latissimus dorsi...

    Correct

    • What is the arterial sequence for an analgesic to reach the latissimus dorsi muscle assuming that your starting point is at the subclavian vein?

      Your Answer: Subclavian – axillary – subscapular – thoracodorsal

      Explanation:

      Assuming our starting point is the subclavian artery, the analgesic continues in the same vessel into the axillary artery, as it passes into the axilla. The axillary artery at the lower border of the subscapularis gives rise to the subcapsular artery which is considered the largest branch of the axillary artery. This circumflex scapular branch distributes a serratus branch before entering the substance of the muscle as the thoracodorsal artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      90.7
      Seconds
  • Question 29 - A young man was thrown from a vehicle in a collision. He landed...

    Incorrect

    • A young man was thrown from a vehicle in a collision. He landed on his head and shoulder tip, stretching the left side of his neck. A neurological examination revealed that the fifth and sixth cervical nerves had been torn from the spinal cord. What is the most obvious clinical manifestation of this?

      Your Answer: Adduction

      Correct Answer: Abduction

      Explanation:

      In the case of injuries to the upper roots of the brachial plexus there is complete loss of abduction. The muscle performing this movement is the supraspinatus. This initiates the movement, followed by the deltoid muscle, which allows for complete abduction. Both these muscles are innervated by nerves originating from C5 and C6. The injury to these roots results in a condition named Erb-Duchenne’s palsy.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      104.3
      Seconds
  • Question 30 - In the case of an injury to the sub sartorial canal, which of...

    Correct

    • In the case of an injury to the sub sartorial canal, which of the following structures is most likely to be injured?

      Your Answer: Nerve to vastus medialis

      Explanation:

      The adductor canal (sub sartorial canal) is situated in the middle third of the thigh.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      34.2
      Seconds
  • Question 31 - Where do the cells belonging to the mononuclear phagocyte system originate? ...

    Correct

    • Where do the cells belonging to the mononuclear phagocyte system originate?

      Your Answer: Bone marrow

      Explanation:

      The macrophage originates from a committed bone marrow stem cell. It is called the pluripotent hematopoietic stem cell. This differentiates into a monoblast and then into a promonocyte and finally matures into a monocyte. When called upon they leave the bone marrow and enter into the circulation. Upon entering the tissue they transform into macrophages. Tissue macrophages include: Kupffer cells (liver), alveolar macrophages (lung), osteoclasts (bone), Langerhans cells (skin), microglial cells (central nervous system), and possibly the dendritic immunocytes of the dermis, spleen and lymph nodes.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      20.4
      Seconds
  • Question 32 - A surgical registrar performing an adrenalectomy procedure on the left suprarenal gland of...

    Correct

    • A surgical registrar performing an adrenalectomy procedure on the left suprarenal gland of a 25 - year old male patient, accidentally jabbed and injured a vital structure that lies anterior to the left suprarenal organ. Which of the following was the structure most likely injured?

      Your Answer: Pancreas

      Explanation:

      The adrenal (suprarenal) glands are organs of the endocrine system located on top of each of the kidneys. The left suprarenal gland, in question, is crescent in shape and slightly larger than the right suprarenal gland. It is posteriorly located to the lateral aspect of the head of the pancreas which is thus the most likely to be injured. The other organs like the duodenum, liver and the inferior vena cava are related to the right suprarenal gland. The spleen and the colon are not in close proximity with the left suprarenal gland and are not likely to be the organs injured.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      48.9
      Seconds
  • Question 33 - In a splenectomy procedure, special care is emphasized on the preservation of the...

    Correct

    • In a splenectomy procedure, special care is emphasized on the preservation of the tail of the pancreas that is closely associated with the spleen to avoid post operative pancreatic fistula. As a general surgeon conducting a splenectomy where are you most likely to find the tail of the pancreas in the abdominal cavity?

      Your Answer: Splenorenal ligament

      Explanation:

      The tail of the pancreas is the only intraperitoneal part of the pancreas and is found contained in the splenorenal ligament of the peritoneal cavity. The splenorenal ligament is derived from the peritoneum where the wall of the general peritoneal cavity connects to the omental bursa between the spleen and the left kidney. This ligament contains the splenic vessels and the tail of the pancreas.

      The gastrocolic ligament stretches from the greater curvature of the stomach to the transverse colon, connecting the two.

      The gastrosplenic ligament is derived from the greater omentum and is the structure that connects the stomach to the hilum of the spleen. The gastrosplenic ligament continues from the splenic flexure of the colon to the diaphragm and acts as a support to the spleen.

      The transverse colon is connected to the abdominal wall by the mesocolon ligament.

      The falciform ligament on the other hand, attaches the liver to the ventral wall of the abdomen.

      The hepatoduodenal ligament connects the porta hepatis of the liver to the superior part of the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      33.8
      Seconds
  • Question 34 - Endometrial hyperplasia is most likely to be associated with which of the following...

    Incorrect

    • Endometrial hyperplasia is most likely to be associated with which of the following conditions?

      Your Answer: Krukenberg tumour

      Correct Answer: Fibrothecoma

      Explanation:

      A benign tumour arising from the ovarian stroma, fibrothecoma are bilateral in 10% cases. The thecoma component of the tumour can produce oestrogen leading to endometrial hyperplasia. The thecoma is rich in lipid content and is responsible for the yellowish appearance of the tumour. Meig’s syndrome is the presence of fibrothecoma with a right-sided hydrothorax.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      18.7
      Seconds
  • Question 35 - Point of entry of the vagal trunk into the abdomen: ...

    Correct

    • Point of entry of the vagal trunk into the abdomen:

      Your Answer: Oesophageal hiatus

      Explanation:

      The oesophageal hiatus is located in the muscular part of the diaphragm a T10 and is above, in front and a little to the left of the aortic hiatus. It transmits the oesophagus, the vagus nerves and some small oesophageal arteries.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      12.6
      Seconds
  • Question 36 - Which ectopic tissue is usually contained in the Meckel's diverticulum? ...

    Incorrect

    • Which ectopic tissue is usually contained in the Meckel's diverticulum?

      Your Answer: Hepatic

      Correct Answer: Gastric

      Explanation:

      The Meckel’s diverticulum is a vestigial remnant of the omphalomesenteric duct. This structure is also referred to as the vitelline and contains two types of ectopic tissue, namely; gastric and pancreatic.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      22.5
      Seconds
  • Question 37 - A 66-year-old man complains of constant headaches. On physical examination, the only relevant...

    Correct

    • A 66-year-old man complains of constant headaches. On physical examination, the only relevant sign is a dark brown mole located on left his arm which has grown in size over the years and is itchy and painful. A MRI of the brain revealed a solitary lesion at the grey-white junction in the right frontal lobe, without ring enhancement. This lesion is most likely to be:

      Your Answer: Metastatic carcinoma

      Explanation:

      The location of the mass at the grey–white junction is typical of a metastasis. The most frequent types of metastatic brain tumours originate in the lung, skin, kidney, breast and colon. These tumour cells reach the brain via the bloodstream. This patient is likely to have skin cancer, which caused the metastatic brain tumour.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      26.8
      Seconds
  • Question 38 - A 25-year old man presented to the clinic with swelling of the penis....

    Incorrect

    • A 25-year old man presented to the clinic with swelling of the penis. His uncircumcised penis was erythematous and oedematous. The foreskin could not be retracted over the glans. Which of the following agents is the likely cause of his condition?

      Your Answer: Chlamydia trachomatis

      Correct Answer: Staphylococcus aureus

      Explanation:

      Inflammation of the glans penis is known as balanitis. Associated involvement of the foreskin is then known as balanoposthitis. More likely to occur in men who have a tight foreskin that is difficult to pull back, or poor hygiene.

    • This question is part of the following fields:

      • Pathology
      • Urology
      23.2
      Seconds
  • Question 39 - Which of these antibiotics is the first choice treatment for infections caused by...

    Correct

    • Which of these antibiotics is the first choice treatment for infections caused by Pseudomonas aeruginosa?

      Your Answer: Piperacillin

      Explanation:

      Piperacillin is an extended-spectrum beta-lactam antibiotic of the ureidopenicillin class. It is normally used with a beta-lactamase inhibitor such as tazobactam. The combination has activity against many Gram-positive and Gram-negative pathogens and anaerobes, including Pseudomonas aeruginosa. Piperacillin is sometimes referred to as an anti-pseudomonal penicillin.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      15.3
      Seconds
  • Question 40 - After a cerebral infarction, which of these histopathogical findings is most likely to...

    Correct

    • After a cerebral infarction, which of these histopathogical findings is most likely to be found?

      Your Answer: Liquefactive necrosis

      Explanation:

      The brain has a high lipid content and typically undergoes liquefaction with ischaemic injury, because it contains little connective tissue but high amounts of digestive enzymes.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      13
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Fluids & Electrolytes (2/3) 67%
Pathology (10/17) 59%
Microbiology (2/2) 100%
Anatomy (14/16) 88%
Head & Neck (4/4) 100%
Cardiovascular (1/1) 100%
Physiology (6/7) 86%
Endocrine (1/1) 100%
Embryology (1/2) 50%
Pelvis (1/1) 100%
General (1/1) 100%
Neurology (6/7) 86%
Renal (1/2) 50%
Thorax (1/1) 100%
Lower Limb (2/2) 100%
Inflammation & Immunology (2/2) 100%
Neoplasia (0/1) 0%
Gastrointestinal; Hepatobiliary (0/1) 0%
Cell Injury & Wound Healing (0/1) 0%
Upper Limb (1/2) 50%
Abdomen (3/3) 100%
Women's Health (0/1) 0%
Urology (0/1) 0%
Pharmacology (1/1) 100%
Passmed