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  • Question 1 - A CT-scan report of a patient with gastric carcinoma shows that the lymph...

    Incorrect

    • A CT-scan report of a patient with gastric carcinoma shows that the lymph nodes around the coeliac trunk are enlarged. The coeliac trunk:

      Your Answer: Give rise to the splenic, right gastric and common hepatic arteries

      Correct Answer: Gives rise to the splenic, left gastric and common hepatic arteries

      Explanation:

      The coeliac trunk is a branch of the aorta arising just below the aortic hiatus of the diaphragm to pass nearly horizontally forward to divide into 3 large branches i.e. the left gastric, the hepatic and the splenic arteries. Occasionally it may give off one of the inferior phrenic arteries. It is covered by the lesser omentum and on the right side bordered by the right coeliac ganglion and the cardiac end of the stomach. Inferiorly it is bordered by the upper border of the pancreas and splenic vein. The embryonic midgut is supplied by the superior mesenteric artery.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      11
      Seconds
  • Question 2 - A 39-year old female patient was diagnosed with a tumour of the left...

    Incorrect

    • A 39-year old female patient was diagnosed with a tumour of the left adrenal gland. The tumour, which is metastasizing to the adjacent tissues, has already extended to the left suprarenal vein. If the tumour is still spreading, which of the following veins will most likely be affected after the involvement of the left suprarenal vein?

      Your Answer: Inferior vena cava

      Correct Answer: Left renal vein

      Explanation:

      The suprarenal veins or also known as the veins of Warshaw, are the veins that receive blood from the suprarenal glands. These veins receive blood from the medullary venous plexus and the cortex of the adrenal glands (suprarenal glands). They are two in number – the left and the right suprarenal veins. The right suprarenal vein drains into the inferior vena cava while the left suprarenal vein drains into the left renal vein. This therefore means that in the case of a metastasizing tumour involving the left suprarenal vein, the tumour will most likely extend from the left suprarenal vein to the left renal vein into which it drains.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      26.3
      Seconds
  • Question 3 - The gluteus medius muscle: ...

    Incorrect

    • The gluteus medius muscle:

      Your Answer:

      Correct Answer: Is supplied by the superior gluteal nerve

      Explanation:

      The gluteus medius is situated on the outer surface of the pelvis. It arises from the outer surface of the ilium between the iliac crest and posterior gluteal line above and the anterior gluteal line below. The gluteus medius is supplied by the fourth and fifth lumbar and first sacral nerves through the superior gluteal nerve

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 4 - A elderly patient with bulbar palsy is bed ridden. While swallowing he aspirates...

    Incorrect

    • A elderly patient with bulbar palsy is bed ridden. While swallowing he aspirates one of his tablets into his lungs. In which bronchopulmonary segments is it most likely to end up?

      Your Answer:

      Correct Answer: Superior segmental bronchus of the right inferior lobe

      Explanation:

      Inhaled objects are more likely to enter the right lung for several reasons. First the right bronchus is shorter, wider and more vertical than the left bronchus. Also, the carina (a ridge-like structure at the point of tracheal bifurcation) is set a little towards the left. The superior segmental bronchus branches posteriorly off the intermediate bronchus or the inferior lobe bronchus and is thus more likely to receive the foreign body that enters the right main bronchus. The lingula is only found on the left lung. The terminal bronchiole is a very small space almost impossible for the tablet to lodge here.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 5 - During an operation to repair an indirect inguinal hernia, it is noticed that...

    Incorrect

    • During an operation to repair an indirect inguinal hernia, it is noticed that the hernial sac is protruding out of the superficial inguinal ring. The superficial inguinal ring is an opening in which structure?

      Your Answer:

      Correct Answer: External abdominal oblique aponeurosis

      Explanation:

      The superficial inguinal ring is an opening in the aponeurosis of the external oblique just above and lateral to the pubic crest. The opening is oblique and corresponds to the fibres of the aponeurosis. It is bound inferiorly by the pubic crest, on either side by the margins of the opening in the aponeurosis and superiorly by the curved intercrural fibres.

      The inferior crus is formed by the portion of the inguinal ligament that is inserted into the pubic tubercle.

      The falx inguinalis is made of arching fibres of the transversalis fascia and the internal abdominal oblique muscle. It forms the posterior wall of the inguinal canal.

      The internal abdominal oblique forms the root of the inguinal canal.

      Scarpa’s and Camper’s fascia are the membranous and fatty layers, respectively of subcutaneous fascia.

      Transversalis fascia covers the posterior surface of the rectus abdominis muscle inferior to the arcuate line.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 6 - The collaborative effort of the lateral pterygoid muscles produces which action on the...

    Incorrect

    • The collaborative effort of the lateral pterygoid muscles produces which action on the jaw?

      Your Answer:

      Correct Answer: Protrude the mandible

      Explanation:

      The combined effort of the lateral pterygoid muscles results in the protrusion of the mandible. The lateral pterygoid muscle is a muscle of mastication located superiorly to the medial pterygoid muscle and has two heads. The superior head originates on the infratemporal surface and infratemporal crest of the greater wing of the sphenoid bone, and the inferior head on the lateral surface of the lateral pterygoid plate. The insertion of this muscle is on the front margin of the articular disc of the temporomandibular joint. The unilateral contraction of the pterygoid muscle results in the laterotrusion of the mandible. It is important to note that the lateral pterygoid muscle is the only muscle of mastication that can open the jaw.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 7 - A patient who following 20 years of working in the asbestos industry develops...

    Incorrect

    • A patient who following 20 years of working in the asbestos industry develops malignant mesothelioma and is scheduled for pleuropneumonectomy to remove the entire pleura and lung on the affected side. Which layer would provide a natural cleavage plane for surgical separation of the costal pleura from the thoracic wall?

      Your Answer:

      Correct Answer: Endothoracic fascia

      Explanation:

      The endothoracic fascia is connective tissue that is between the costal parietal pleura and the inner aspect of the chest wall. Removing this layer of connective tissue would make it easy to separate the costal pleura from the thoracic wall.

      Deep fascia: is not found around the lungs. It is a layer of connective tissue that invests a muscle or a group of muscles.

      Parietal pleura: part of the pleura that lines the inner surface of the chest/thoracic cavity.

      Visceral pleura: is the serous membrane that lines the surface of the lungs.

      Transversus thoracis muscle fascia is associated only with the muscle transversus thoracis.

      Peritracheal fascia: a layer of connective tissue that invests the trachea. It is not associated with the thoracic wall or the costal pleura.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 8 - A 20-year old college student was diagnosed with meningitis that had developed due...

    Incorrect

    • A 20-year old college student was diagnosed with meningitis that had developed due to an acute cavernous sinus thrombosis from an ear infection. Which of the following superficial venous routes is the usual path that an infected blood clot takes to reach the cavernous sinus?

      Your Answer:

      Correct Answer: Facial vein

      Explanation:

      The facial vein is the usual communication between the cavernous sinus and the pterygoid sinus. It is through this vein that an infected clot can travel to the cavernous sinus and cause infection. The pterygoid plexus is a venous plexus that is situated between the temporalis muscle and lateral pterygoid muscle, and partly between the two pterygoid muscles. The pterygoid plexus is connected to the facial vein by the deep facial vein. This connection is what makes this area where this sinus and the facial vein are located a danger zone. The danger zone or triangle of the face is the area from the corners of the mouth to the nose bridge. The sinus connection in this area makes it possible for infection to reach the cavernous sinus and at times cause meningitis.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 9 - A 78-year-old man who has been bedridden for a month is prescribed griseofulvin....

    Incorrect

    • A 78-year-old man who has been bedridden for a month is prescribed griseofulvin. What class of drugs does griseofulvin belong to?

      Your Answer:

      Correct Answer: Antifungal

      Explanation:

      Griseofulvin is an antifungal drug. It is administered orally, and it is used to treat ringworm infections of the skin and nails. It binds to keratin in keratin precursor cells and makes them resistant to fungal infections. Griseofulvin works by interfering with fungal mitosis.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds
  • Question 10 - A 45-year old man presents with sclerosing cholangitis, blood in his stools and...

    Incorrect

    • A 45-year old man presents with sclerosing cholangitis, blood in his stools and apparent iron deficiency anaemia. What will be the most likely finding on his colonic biopsy?

      Your Answer:

      Correct Answer: Pseudopolyps

      Explanation:

      Sclerosing cholangitis along with the passage of blood in stools suggests ulcerative colitis affecting the mucosa and submucosa of rectum and colon, with a sharp demarcation with the normal tissue. The musclaris layer is involved in severe cases. Initially, the mucosa is erythematous, friable with scattered haemorrhagic areas and loss of normal vascular pattern. Severe disease is indicated by presence of large mucosal ulcers with purulent exudate. There can be islands of normal mucosa between the ulcerated mucosa, along with few hyperplastic inflammatory mucosal lesions (pseudopolyps). Ulcerative colitis does not lead to development of fistulas or abscesses.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      0
      Seconds
  • Question 11 - A 70-year-old female who underwent coronary artery bypass graft developed post-operative acute renal...

    Incorrect

    • A 70-year-old female who underwent coronary artery bypass graft developed post-operative acute renal failure. Her urinary catheter was left in place to monitor urine output. 6 days later she developed fever and chills. She also complained of suprapubic and left flank pain. She is found to have developed acute ascending pyelonephritis. Which of the following organism was most likely isolated during urine culture?

      Your Answer:

      Correct Answer: Escherichia coli with pili

      Explanation:

      The most common cause of urinary tract infection is Escherichia coli. Pilated strains of E. coli ascend the urethra to infect the kidney and the bladder. Catheters have been associated with an increased risk of UTIs.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      0
      Seconds
  • Question 12 - You observe a procedure to harvest the left internal thoracic (mammary) artery to...

    Incorrect

    • You observe a procedure to harvest the left internal thoracic (mammary) artery to be used as a graft for coronary artery bypass surgery. The left internal thoracic artery is mobilised from the inside of the chest wall and divided near the caudal end of the sternum. After dividing the internal thoracic artery at its distal end, the specialist registrar asks you to name the artery that will now have increased blood supply so that adequate blood flow is maintained to the rectus abdominis on the left side. What would your answer be?

      Your Answer:

      Correct Answer: Inferior epigastric artery

      Explanation:

      The rectus abdominis muscle is supplied by the superior epigastric artery which is a branch of the internal thoracic artery. If the internal thoracic artery is thus ligated, blood would no longer flow to it. However, the superior epigastric artery communicates with the inferior epigastric artery (a branch of the external iliac artery). This means that blood could flow from the external iliac, to the inferior epigastric, to the superior epigastric to the rectus abdominis.

      The superficial circumflex iliac artery and the superficial epigastric are two superficial branches of the femoral artery and do not supply the deep branches of the abdomen.

      The deep circumflex iliac artery travels along the iliac crest on the inner surface of the abdominal wall; being too lateral it doesn’t supply blood to the rectus abdominis.

      The distal portions of the umbilical arteries are obliterated in adults to form the medial umbilical folds.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 13 - Acute respiratory distress syndrome (ARDS) is a medical condition that occurs in critically...

    Incorrect

    • Acute respiratory distress syndrome (ARDS) is a medical condition that occurs in critically ill patients, and can be triggered by events such as trauma and sepsis. Which of the following variables is most likely to be lower than normal in a patient with ARDS?

      Your Answer:

      Correct Answer: Lung compliance

      Explanation:

      Acute (or Adult) respiratory distress syndrome (ARDS) is a medical condition occurring in critically ill patients characterized by widespread inflammation in the lungs. The development of acute respiratory distress syndrome (ARDS) starts with damage to the alveolar epithelium and vascular endothelium, resulting in increased permeability to plasma and inflammatory cells. These cells pass into the interstitium and alveolar space, resulting in pulmonary oedema. Damage to the surfactant-producing type II cells and the presence of protein-rich fluid in the alveolar space disrupt the production and function of pulmonary surfactant, leading to micro atelectasis and impaired gas exchange. The pathophysiological consequences of lung oedema in ARDS include a decrease in lung volumes, compliance and large intrapulmonary shunts. ARDS may be seen in the setting of pneumonia, sepsis, following trauma, multiple blood transfusions, severe burns, severe pancreatitis, near-drowning, drug reactions, or inhalation injuries.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 14 - Which of the following muscles may be affected by a fracture to the...

    Incorrect

    • Which of the following muscles may be affected by a fracture to the tuberosity on the medial surface of the right navicular bone?

      Your Answer:

      Correct Answer: Tibialis posterior

      Explanation:

      The navicular bone is situated at the medial side of the tarsus, between the talus and the cuneiform bones. Its medial surface presents a rounded tuberosity, the lower part of which gives attachment to part of the tendon of the tibialis posterior.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 15 - A 40-year old lady presented to the hospital with fever and mental confusion...

    Incorrect

    • A 40-year old lady presented to the hospital with fever and mental confusion for 1 week. On examination, she was found to have multiple petechiae all over her skin and mucosal surfaces. Blood investigations revealed low platelet count and raised urea and creatinine. A platelet transfusion was carried out, following which she succumbed to death. Autopsy revealed pink hyaline thrombi in myocardial arteries. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Thrombotic thrombocytopenic purpura

      Explanation:

      Hyaline thrombi are typically associated with thrombotic thrombocytopenic purpura (TTP), which is caused by non-immunological destruction of platelets. Platelet transfusion is contraindicated in TTP. Platelets and red blood cells also get damaged by loose strands of fibrin deposited in small vessels. Multiple organs start developing platelet-fibrin thrombi (bland thrombi with no vasculitis) typically at arteriocapillary junctions. This is known as ‘thrombotic microangiopathy’. Treatment consists of plasma exchange.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 16 - Following an accident, a man was unable to extend the wrist and metacarpophalangeal...

    Incorrect

    • Following an accident, a man was unable to extend the wrist and metacarpophalangeal joints, despite sensation being intact. Which nerve was likely damaged?

      Your Answer:

      Correct Answer: Posterior interosseous nerve

      Explanation:

      The posterior interosseous nerve which causes, what is known as the posterior interosseous nerve syndrome. The nerve is compressed before it bifurcates to form the medial and lateral branches. The compression is beyond the origin of the branches to the radial wrist extensors and the radial sensory nerve. The result of such a case is paralysis of the digital extensors and the extensor carpi ulnaris, resulting in dorsoradial deviation of the wrist.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 17 - A 24-year old patient diagnosed with a direct inguinal hernia was scheduled for...

    Incorrect

    • A 24-year old patient diagnosed with a direct inguinal hernia was scheduled for surgery to have the hernia repaired. The hernia was discovered to be protruding through the Hesselbach's triangle (inguinal triangle). Which of the following blood vessels that is a branch of the external iliac artery forms the lateral border of this triangle?

      Your Answer:

      Correct Answer: Inferior epigastric

      Explanation:

      The inguinal triangle is formed by the following structures; inguinal ligament at the base; inferior epigastric vessels laterally and the lateral border of the rectus sheath medially. This triangle (also known as Hesselebach’s triangle) is where direct inguinal hernias protrude. The inferior epigastric artery is this the branch of the external iliac artery being referred to. All the other blood vessels are branches of the internal iliac artery.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      0
      Seconds
  • Question 18 - Injury of the ventral rami at this cervical spinal level will result in...

    Incorrect

    • Injury of the ventral rami at this cervical spinal level will result in paralysis of the rectus capitis anterior muscle:

      Your Answer:

      Correct Answer: C1, C2

      Explanation:

      The rectus capitis anterior is a short, flat muscle, situated immediately behind the upper part of the longus capitis. It is also known as the obliquus capitis superior. It aids in flexion of the head and the neck. Nerve supple is from C1 and C2.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 19 - Purkinje fibres in the heart conduct action potentials at the rate of: ...

    Incorrect

    • Purkinje fibres in the heart conduct action potentials at the rate of:

      Your Answer:

      Correct Answer: 1.5–4.0 m/s

      Explanation:

      Purkinje fibres control the heart rate along with the sinoatrial node (SA node) and the atrioventricular node (AV node). The QRS complex is associated with the impulse passing through the Purkinje fibres. These fibres conduct action potential about six times faster than the velocity in normal cardiac muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 20 - Which of the following physiological changes will you see in a young man...

    Incorrect

    • Which of the following physiological changes will you see in a young man who has been trekking in the Himalayas for 3 years?

      Your Answer:

      Correct Answer: Increased renal excretion of HCO3 –

      Explanation:

      The atmospheric pressure is lower at high altitudes as compared with sea level. This leads to a decrease in the partial pressure of oxygen. Once 2100 m (7000 feet) of altitude is reached, there is a drop in saturation of oxyhaemoglobin. The oxygen saturation of haemoglobin determines the oxygen content in the blood. The body physiological tries to adapt to high altitude by acclimatization. Immediate effects include hyperventilation, fluid loss (due to a decreased thirst drive), increase in heart rate and slightly lowered stroke volume. Long term effects include lower lactate production, compensatory alkali loss in urine, decrease in plasma volume, increased erythropoietin release and red cell mass, increased haematocrit, higher concentration of capillaries in striated muscle tissue, increase in myoglobin, increase in mitochondria, increase in aerobic enzyme concentration such as 2,3-DPG and pulmonary vasoconstriction.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 21 - A 6 year-old boy is brought to you coughing. He is suspected to...

    Incorrect

    • A 6 year-old boy is brought to you coughing. He is suspected to have aspirated a Lego piece which he was seen playing with. Where would you expect the piece to be?

      Your Answer:

      Correct Answer: Right main bronchus

      Explanation:

      Inhaled objects are more likely to enter the right lung for several reasons. First the right bronchus is shorter, wider and more vertical than the left bronchus. Also, the carina (a ridge-like structure at the point of tracheal bifurcation) is set a little towards the left. The terminal bronchiole is a very small space and impossible for the seed to lodge here.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 22 - Medulloblastoma usually occurs in children between 5 to 9 years old. Where does...

    Incorrect

    • Medulloblastoma usually occurs in children between 5 to 9 years old. Where does medulloblastoma commonly originate from?

      Your Answer:

      Correct Answer: Cerebellar vermis

      Explanation:

      Medulloblastoma is the most common malignant brain tumour in children, accounting for 10-20% of primary CNS neoplasms. Most of the tumours originate in the cerebellar vermis.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds
  • Question 23 - A 40 year old patient with an history of obesity has been diagnosed...

    Incorrect

    • A 40 year old patient with an history of obesity has been diagnosed with meralgia parasthetica. The condition was discovered to be caused by the pinching of the lateral femoral cutaneous nerve. Injuries at what spinal levels usually affect this nerve?

      Your Answer:

      Correct Answer: L2, L3

      Explanation:

      The lateral femoral cutaneous nerve of the thigh arises from the dorsal division of the lumbar plexus of the second and the third lumbar nerves (L2 – L3). Spinal injuries at this level are likely to affect the lateral femoral cutaneous nerve. The lateral femoral cutaneous nerve innervates the skin on the lateral aspect of the thigh.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 24 - What is the 5-year survival rate of carcinoma of the pancreas? ...

    Incorrect

    • What is the 5-year survival rate of carcinoma of the pancreas?

      Your Answer:

      Correct Answer: 30 per cent

      Explanation:

      Pancreatic cancer typically has a poor prognosis, partly because the cancer usually initially remains symptomless, leading to locally advanced or metastatic disease at the time of diagnosis. Median survival from diagnosis is around 3–6 months. Even in those suitable for resectional surgery, 5-year survival rates are still only 30 per cent.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds
  • Question 25 - Which of the following is the most accurate test for the diagnosis of...

    Incorrect

    • Which of the following is the most accurate test for the diagnosis of primary syphilis?

      Your Answer:

      Correct Answer: Dark-field microscopy

      Explanation:

      Primary syphilis is transmitted via sexual contact. Lesions on genitalia, called a chancre occur after an asymptomatic incubation period of 10-90 days (average 21 days) after exposure. This chancre is a typically solitary (can be multiple), firm, painless, ulceration over the skin at the point of exposure to spirochete, seen on penis, vagina or rectum. It heals spontaneously after 4-6 weeks. Local lymphadenopathy can be seen.

      Diagnosis is made by microscopy of fluid from lesion using dark-field illumination, taking care to not confuse with other treponemal disease. Screening tests include rapid plasma regain (RPR) and Venereal Diseases Research Laboratory (VDRL) tests. False positives are known to occur with these tests and can be seen in viral infections like hepatitis, varicella, Epstein-Barr virus, tuberculosis, lymphoma, pregnancy and IV drug use. More specific tests should therefore be carried out in case these screening tests are positive.

      The Treponema pallidum hemagglutination assay (TPHA) and the fluorescent treponemal antibody absorption (FTAABS) test are based on monoclonal antibodies and immunofluorescence and are more specific. However, they can too show false positives with other treponemal diseases like yaws or pinta. Other confirmatory tests include those based on enzyme-linked immunoassays.

    • This question is part of the following fields:

      • Pathology
      • Urology
      0
      Seconds
  • Question 26 - A 30-year old lady presented to her GP with complaints of tremors, excessive...

    Incorrect

    • A 30-year old lady presented to her GP with complaints of tremors, excessive emotional outbursts, weight loss and increased sweating over 20 days. On examination, she had warm and moist skin, a fine tremor of the fingers and hyperreflexia. Her vital signs were normal. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Hyperthyroidism

      Explanation:

      Excess of circulating free thyroid hormones (thyroxine and/or triiodothyronine) leads to hyperthyroidism. Common causes include Graves’ disease, toxic thyroid adenoma and toxic multinodular goitre. Grave’s disease is the most common cause and is responsible for 70-80% cases of hyperthyroidism. Other causes include excess intake of thyroid hormone, amiodarone-related. It is important that hyperthyroidism is not confused with hyperthyroxinaemia (high levels of thyroid hormone in blood), which includes causes like thyroiditis. Both the conditions lead to thyrotoxicosis (symptoms due to hyperthyroxinemia). Symptoms include weight loss associated with increased appetite, anxiety, weakness, heat intolerance, depression, increased sweating, dyspnoea, loss of libido, diarrhoea, palpitations and occasionally arrhythmias. If there is an acute increase in metabolic rate, the condition is known as ‘thyroid storm’. Elderly sometimes present only with fatigue and weight loss and this is called apathetic hyperthyroidism. Neurological symptoms are also seen in hyperthyroidism and these are tremor, chorea, myopathy and periodic paralysis. One of the most serious complications of hyperthyroidism is stroke of cardioembolic origin due to coexisting atrial fibrillation.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      0
      Seconds
  • Question 27 - A 56 year old gentleman, who is a chronic smoker presents to the...

    Incorrect

    • A 56 year old gentleman, who is a chronic smoker presents to the clinic with dyspnoea. His Chest X-ray shows intercostal space widening with increased blackening bilaterally. What is the most likely finding on his pulmonary function test?

      Your Answer:

      Correct Answer: Increased total lung capacity

      Explanation:

      In patients suspected of having chronic obstructive pulmonary disease, pulmonary function testing (PFT) is useful to confirm airway obstruction, to quantify its severity and reversibility, for following disease progression and monitoring response to treatment. These tests include:

      FEV1 – volume of air forcefully expired during the first second after a full breath

      Forced vital capacity (FVC) – total volume of air expired with maximal force and flow-volume loops. The hallmark of airway obstruction is reduction of FEV1, FVC and the ratio of FEV1/FVC, with a concave pattern in expiratory tracing on the flow-volume loop. FEV1 and forced vital capacity (FVC) are easily measured with office spirometry and are useful to assess the severity of disease. Other parameters include increased total lung capacity, functional residual capacity and residual volume, which can help distinguish chronic obstructive pulmonary disease (COPD) from restrictive pulmonary disease where these values are lower than normal. Along with these, other tests are decreased vital capacity; and decreased diffusing capacity for carbon monoxide (DLCO). DLCO is non-specific and can be low in other disorders that affect the pulmonary vascular bed, such as interstitial lung disease. DLCO is however useful to distinguish COPD from asthma, in which DLCO is normal or elevated.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 28 - A 70-year old man had had a large indirect inguinal hernia for 3...

    Incorrect

    • A 70-year old man had had a large indirect inguinal hernia for 3 years. He presents at the out patient clinic complaining of pain in the scrotum. There is, however, no evidence of obstruction or inflammation. You conclude that the hernial sac is most probably compressing the:

      Your Answer:

      Correct Answer: Ilioinguinal nerve

      Explanation:

      The ilioinguinal nerve arises together with the iliohypogastric nerve from the first lumbar nerve to emerge from the lateral border of the psoas major muscle just below the iliohypogastric and passing obliquely across the quadratus lumborum and iliacus muscles. It perforates the transversus abdominis, near the anterior part of the iliac crest and communicates with the iliohypogastric nerve between the internal oblique and the transversus. It then pierces the internal oblique to distribute filaments to it and accompanying the spermatic cord through the subcutaneous inguinal ring, is distributed to the skin of the upper and medial parts of the thigh, the skin over the root of the penis and the upper part of the scrotum in man and to the skin covering the mons pubis and labium majus in the woman. As the ilioinguinal nerve runs through the inguinal canal, it could easily be compressed by a hernial sac.

      The femoral branch of genitofemoral nerve provides sensory innervation of the upper medial thigh.

      The femoral nerve innervates the compartment of the thigh and also has some cutaneous sensory branches to the thigh.

      The iliohypogastric nerve innervates the skin of the lower abdominal wall, upper hip and upper thigh. The subcostal nerve innervates the skin of the anterolateral abdominal wall and the anterior scrotal nerve is a terminal branch of the ilioinguinal nerve.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 29 - Vincristine is a chemotherapy agent used to treat a number of types of...

    Incorrect

    • Vincristine is a chemotherapy agent used to treat a number of types of cancer. Which of the following is a recognised major side-effect of vincristine?

      Your Answer:

      Correct Answer: Peripheral neuropathy

      Explanation:

      Vincristine is an alkaloid chemotherapeutic agent. It is used to treat a number of types of cancer including acute lymphocytic leukaemia, acute myeloid leukaemia, Hodgkin’s disease, neuroblastoma, and small cell lung cancer among others. The main side-effects of vincristine are peripheral neuropathy and constipation.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds
  • Question 30 - The sciatic nerve does NOT supply which of the following muscles? ...

    Incorrect

    • The sciatic nerve does NOT supply which of the following muscles?

      Your Answer:

      Correct Answer: Obturator externus

      Explanation:

      The sciatic nerve supplies both gemellae, quadratus femoris, semitendinosus, semimembranosus, both heads of the biceps femoris, the hamstring half of abductor magnus and obturator internus. Obturator externus is supplied by the obturator nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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