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Question 1
Incorrect
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What will the destruction of endoplasmic reticulum stop?
Your Answer: Autolysis of proteins
Correct Answer: Synthesis of proteins
Explanation:The rough endoplasmic reticulum is the factory for the manufacturing of proteins. It contains ribosomes attached to it and transports proteins that are destined for membranes and secretions. The rough ER is connected to the nuclear envelope and to the cisternae of the Golgi apparatus by vesicles that shuttle between the two compartments.
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This question is part of the following fields:
- General
- Physiology
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Question 2
Incorrect
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Ventricular filling follows a delay caused by?
Your Answer: Ventricular muscle
Correct Answer: AV node
Explanation:The AV node is a conducting tissue found between the atria and the ventricles of the heart. It conducts electrical signal from the atria to the ventricles and acts a delaying mechanism preventing the atria and the ventricles from contracting at the same time. This decremental conduction prevents premature ventricular contraction in cases such as atrial fibrillation. A delay in the AV node is the reason for the PR segment seen on the ECG. In certain types of supraventricular tachycardia, a person could have two AV nodes; this will cause a loop in electrical current and uncontrollably rapid heart beat. When this electricity catches up with itself, it will dissipate and return to a normal heart rate.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 3
Incorrect
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A pedestrian sustained a left fibula fractured following a hit-and-run. X-rays showed that there was a transverse fracture of the upper end of the fibula. It was manifested clinically by inability to flex his foot at the ankle joint plus weak extension of the phalanges. What nerve is suspected to be injured in such a case?
Your Answer: Superficial peroneal
Correct Answer: Deep peroneal
Explanation:The deep peroneal nerve supplies the muscles allowing for flexion of the foot at the ankle joint, namely the tibialis anterior and peroneus tertius muscles. The peroneus tertius, peroneus brevis, and peroneus longus evert the foot, whereas the tibialis anterior and tibialis posterior invert the foot. Fibres of the deep peroneal nerve originate from L4, L5, and S1.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 4
Incorrect
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Most of the coagulation factors are serine proteases. Which of the following is not one of them?
Your Answer: Factor I
Correct Answer: Factor XIII
Explanation:Serine protease coagulation factors include: thrombin, plasmin, Factors X, XI and XII. Factor VIII and factor V are glycoproteins and factor XIII is a transglutaminase.
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This question is part of the following fields:
- General
- Physiology
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Question 5
Incorrect
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A 42 year old man with an abdominal aortic aneurysm (AAA) underwent an abdominal aortic angiography which revealed that his inferior mesenteric artery was occluded. If this patient showed no symptoms, the most likely reason is that the area the inferior mesenteric artery supplies, must be supplied by collateral blood flow from which arteries?
Your Answer: Right and middle colic
Correct Answer: Left and middle colic
Explanation:The arterial branches that form an anastomosis between the superior mesenteric artery and the inferior mesenteric artery are the left colic artery and the middle colic artery. The middle colic artery is the most distal branch of the superior mesenteric artery while the left colic forms the most proximal branch of the inferior mesenteric artery. These two arteries will give collateral blood flow in the case that the inferior mesenteric artery gets occluded. The superior mesenteric artery gives off the following branches; ileocolic, appendicular, ileal artery, right colic and middle colic arteries. The left colic, sigmoid and superior rectal arteries are branches of the inferior mesenteric artery. The marginal artery branches off directly from the abdominal aorta.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 6
Incorrect
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In the emergency room, a nurse was introducing a catheter into the patients femoral vein for rapid fluid therapy. The femoral vein is situated inside the femoral sheath. Which of the following is true about that sheath?
Your Answer: The femoral sheath is formed by a prolongation downward of the pelvic fasciae
Correct Answer: The medial compartment is called the femoral canal
Explanation:The femoral sheath is situated ,4cm below the inguinal ligament. It is a prolongation of the abdominal fascia. The anterior wall is a prolongation of the transversalis fascia and the posterior wall, the iliac fascia. It is divided by two vertical septa into 3 compartments, lateral, intermediate, and medial. The medial compartment is known as the femoral canal and contains some lymphatic vessels. The lateral one contains the femoral artery and the intermediate one contains the femoral vein.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 7
Incorrect
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Which of the following organs of the abdominal cavity is completely covered by the peritoneum?
Your Answer: Kidney
Correct Answer: Spleen
Explanation:Of the organs listed, the spleen is the only organ that is completely intraperitoneal, that is entirely in the peritoneum. Other completely intraperitoneal organs include the stomach, liver, appendix and the small intestines. The kidney, Inferior vena cava, aorta and the suprarenal glands are all retroperitoneal organs. The pancreas and the duodenum are partially retroperitoneal, with the tail of the pancreas in the peritoneum found in the splenorenal ligament while only the first part of the duodenum is intraperitoneal. For the intraperitoneal organs remember SALTD SPRSS
S = Stomach
A = Appendix
L = Liver
T = Transverse colon
D = Duodenum (only the 1st part)
S = Small intestines
P = Pancreas (only the tail)
R = Rectum (only the upper 3rd)
S = Sigmoid colon
S = Spleen
For retroperitoneal, just remember SADPUCKER:
S = suprarenal glands
A = Aorta and IVC
D = Duodenum (all but the 1st part)
P = Pancreas (all but the tail)
U = Ureter and bladder
C = Colon (ascending and descending)
K = Kidneys
E = Oesophagus
R = Rectum (Lower two-thirds)
For secondarily retroperitoneal remember ‘Pussy Cat Dolls“:
P = Pancreas
C = Colon (only ascending and descending)
D = Duodenum (only parts 2-4) -
This question is part of the following fields:
- Abdomen
- Anatomy
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Question 8
Incorrect
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Which of the following is responsible for the maximum increase in total peripheral resistance on sympathetic stimulation?
Your Answer: Capillaries
Correct Answer: Arterioles
Explanation:Arterioles are also known as the resistance vessels as they are responsible for approximately half the resistance of the entire systemic circulation. They are richly innervated by the autonomic nervous system and hence, will bring about the maximum increase in peripheral resistance on sympathetic stimulation.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 9
Incorrect
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A 54-year-old woman with amyotrophic lateral sclerosis is diagnosed with respiratory acidosis. The patient’s renal excretion of potassium would be expected to:
Your Answer: Fall, since the filtered load of potassium to the tubules falls in acidosis
Correct Answer: Fall, since tubular secretion of potassium is inversely coupled to acid secretion
Explanation:Respiratory acidosis is a medical emergency in which decreased ventilation (hypoventilation) increases the concentration of carbon dioxide in the blood and decreases the blood’s pH (a condition generally called acidosis). Secretion of acid and potassium by the renal tubule are inversely related. So, increased excretion of H+ during renal compensation for respiratory acidosis will result in decreased secretion (or increased retention) of potassium ions, with the result that the body’s potassium store rises. An increase in K+ excretion would be associated with renal compensation for respiratory alkalosis. The filtered load of K+depends only on K+ plasma concentration and glomerular filtration rate, not on plasma pH.
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This question is part of the following fields:
- Physiology
- Renal
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Question 10
Incorrect
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Blood investigations of a patient with vitamin K deficiency revealed a prolonged prothrombin time. This coagulation abnormality is most probably due to:
Your Answer: Thrombocytopenia
Correct Answer: Factor VII deficiency
Explanation:Factor VII deficiency is a bleeding disorder caused by a deficiency or reduced activity of clotting factor VII. It may be inherited or acquired at some point during life. Inherited factor VII deficiency is an autosomal recessive disorder caused by mutations of the F7 gene. Factor VII is vitamin K-dependent, as are Factors II, IX and X and therefore lack of this vitamin can cause the development of acquired factor VII deficiency. Other causes of acquired deficiency of this factor include liver disease, sepsis and warfarin therapy.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 11
Incorrect
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Elevated mean corpuscular volume with hypersegmented neutrophils and low reticulocyte index is seen in on the blood count of a middle-aged lady about to undergo elective surgery. On enquiry, she mentions feeling tired for a few months. Which of the following investigations should be carried out in her to reach a diagnosis?
Your Answer: Bone marrow biopsy
Correct Answer: Serum vitamin B12 and folate
Explanation:Elevated levels of MCV indicates megaloblastic anaemia, which are associated with hypersegmented neutrophils. Likely causes include vitamin B12 or folate deficiency. Megaloblastic anaemia results from defective synthesis of DNA. As RNA production continues, the cells enlarge with a large nucleus. The cytoplasmic maturity becomes greater than nuclear maturity. Megaloblasts are produced initially in the marrow, before blood. Dyspoiesis makes erythropoiesis ineffective, causing direct hyperbilirubinemia and hyperuricemia. As all cell lines are affected, reticulocytopenia, thrombocytopenia and leukopenia develop. Large, oval blood cells (macro-ovalocytes) are released in the circulation, along with presence of hypersegmented neutrophils.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 12
Correct
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A teacher had varicosities in the region of the small saphenous vein. Which of the following is true about that vein?
Your Answer: Has nine to twelve valves
Explanation:It is known that the small saphenous vein has nine to twelve valves along its course. This vein begins as a direct continuation of the lateral marginal vein posterior to the lateral malleolus. It is superficially situated but closer to its termination, perforates the deep fascia in the lower part of the popliteal fossa to end in the popliteal vein.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 13
Incorrect
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When one is silently counting, what part of his brain will show increased regional cerebral blood flow (rCBF)?
Your Answer: Occipital cortex
Correct Answer: Supplementary motor area
Explanation:Regional cerebral blood flow (rCBF) increases in the superior speech cortex (supplementary motor area) during periods of silent counting, whereas speaking aloud will do so in the motor cortex and medial temporal lobe, along with the superior speech cortex.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 14
Correct
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Etoposide is a chemotherapeutic agent used in the treatment of different types of cancer. Which of the following is the correct indication for this drug?
Your Answer: Lung cancer
Explanation:Etoposide phosphate is an inhibitor of the enzyme topoisomerase II. It is used as a form of chemotherapy for malignancies such as lung cancer, testicular cancer, lymphoma, non-lymphocytic leukaemia and glioblastoma multiforme. Side effects are very common and can include low blood cell counts, vomiting, loss of appetite, diarrhoea, hair loss, and fever.
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This question is part of the following fields:
- Pathology
- Pharmacology
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Question 15
Correct
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Pain in the right upper quadrant of the abdomen on ingestion of a fatty meal is seen in a condition which involves which of the following substances?
Your Answer: Cholecystokinin
Explanation:The clinical scenario described here favours the presence of gallstones. During food ingestion, vagal discharges stimulate gallbladder contraction. Moreover, presence of fat and amino acids in the intestinal lumen stimulates the release of cholecystokinin (CCK) in the duodenum. This causes sustained gallbladder contraction and relaxation of the sphincter of Oddi. If gallstones are present, there will be inflammation in the gallbladder and CCK will aggravate it due to contractions.
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This question is part of the following fields:
- Gastroenterology
- Physiology
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Question 16
Incorrect
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Purkinje fibres in the heart conduct action potentials at the rate of:
Your Answer: 0.2–1.1 m/s
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.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 17
Correct
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In which of the following situations will fat necrosis occur?
Your Answer: Trauma to the breast
Explanation:Fat necrosis is necrosis of adipose tissue with subsequent deposition of calcium, giving it a white chalky appearance. It is seen characteristically in trauma to the breast and the pancreas with subsequent involvement of the peripancreatic fat. In the breast it may present as a palpable mass with is usually painless or as an incidental finding on mammogram. Fatty acids are released from the traumatic tissue which combine with calcium in a process known as saponification, this is an example of dystrophic calcification in which calcium binds to dead tissue. The central focus is surrounded by macrophages and neutrophils initially, followed by proliferation of fibroblasts, neovascularization and lymphocytic migration to the site of the insult.
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This question is part of the following fields:
- Cell Injury & Wound Healing
- Pathology
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Question 18
Incorrect
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Which antibiotic acts by inhibiting protein synthesis?
Your Answer: Penicillin
Correct Answer: Erythromycin
Explanation:Penicillins and cephalosporins (e.g. cefuroxime, cefotaxime, ceftriaxone) inhibit bacterial cell wall synthesis through the inhibition of peptidoglycan cross-linking.
Macrolides (e.g. erythromycin), tetracyclines, aminoglycosides and chloramphenicol act by interfering with bacterial protein synthesis.
Sulphonamides (e.g. trimethoprim, co-trimoxazole) work by inhibiting the synthesis of nucleic acid
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This question is part of the following fields:
- Pharmacology; Microbiology
- Physiology
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Question 19
Correct
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Which of the following arteries branch from the deep femoral artery and course between the pectineus and iliopsoas muscles?
Your Answer: Medial femoral circumflex
Explanation:The medial femoral circumflex artery is an artery in the upper thigh that supplies blood to the head and neck of the femur. It arises from the deep femoral artery and winds around the medial side of the femur. It passes first between pectineus and psoas major, and then between obturator externus and adductor brevis.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 20
Incorrect
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When a patient that is less than 21 years of age develops a bone tumour. What is the most common benign bone tumour that would be considered in individuals below 21 years?
Your Answer: Chondromyxoid fibroma
Correct Answer: Osteochondroma
Explanation:Osteochondroma is a benign new bone growth that protrudes from the outer contour of bones and is capped by growing cartilage. Nearly 80% of these lesions are noted before the age of 21 years.
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This question is part of the following fields:
- Neoplasia
- Pathology
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Question 21
Correct
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During cardiac catheterisation, if the blood sample from the catheter shows an oxygen saturation of 70%, and the pressure ranging from 12 to 24 mm Hg, it implies that the catheter tip is located in the:
Your Answer: Pulmonary artery
Explanation:Normal values for various parameters are as follows:
Systolic arterial blood pressure (SBP): 90–140 mmHg.
Diastolic arterial blood pressure: 60–90 mmHg.
Mean arterial blood pressure (MAP): SBP + (2 × DBP)/3 (normal range: 70-105 mmHg).
Right atrial pressure (RAP): 2–6 mmHg.
Systolic right ventricular pressure (RVSP): 15–25 mmHg.
Diastolic right ventricular pressure (RVDP): 0–8 mmHg.
Pulmonary artery pressure (PAP): Systolic (PASP) is 15-25 mmHg and Diastolic (PADP) is 8–15 mmHg.
Pulmonary artery wedge pressure (PAWP): 6–12 mmHg.
Left atrial pressure (LAP): 6–12 mmHg.
Thus, the given value indicates that the position of catheter tip is likely to be in the pulmonary artery.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 22
Correct
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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: 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.
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This question is part of the following fields:
- Pathology
- Pharmacology
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Question 23
Correct
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The pleural cavity is the space between the two pulmonary pleurae which cover the lungs. What is the normal amount of pleural fluid?
Your Answer: 10 ml
Explanation:Pleural fluid is a serous fluid produced by the serous membrane covering normal pleurae. Most fluid is produced by the parietal circulation (intercostal arteries) via bulk flow and reabsorbed by the lymphatic system. The total volume of fluid present in the intrapleural space is estimated to be only 2–10 ml. A small amount of protein is present in intrapleural fluid. Normally, the rate of reabsorption increases as a physiological response to accumulating fluid.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 24
Correct
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A patient is brought to the accident and emergency department. He is said to have been involved in a mall explosion. Chest imaging reveals metal fragments in his thoracic cavity. He also has a pericardial effusion suggestive of a pericardial tear. An emergency thoracotomy is done which revealed a tear of the pericardium inferiorly. The surgeon began to explore for fragments in the pericardial sac with his hand from below the apex. He slips his fingers upward and to the right within the sac until they were stopped by the cul-de-sac formed by the pericardial reflection near the base of the heart. His finger tips were now in the:
Your Answer: Oblique pericardial sinus
Explanation:Transverse sinus: part of pericardial cavity that is behind the aorta and pulmonary trunk and in front of the superior vena cava separating the outflow vessels from the inflow vessels.
Oblique pericardial sinus: is behind the left atrium where the visceral pericardium reflects onto the pulmonary veins and the inferior vena cava. Sliding a finger under the heart will take you to this sinus.
Coronary sinus: large vein that drains the heart into the right atrium. Located on the surface of the heart.
Coronary sulcus: groove on the heart demarcating the atria from the ventricles.
Costomediastinal recess: part of the pleural sac where the costal pleura transitions to become the mediastinal pleura.
Sulcus terminalis: a groove between the right atrium and the vena cava.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 25
Correct
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 A 45-year-old man presented to the doctor complaining of a flank pain and episodes of haematuria. Abdominal ultrasound revealed a left renal mass and the patient underwent a nephrectomy. Histopathological pattern was triphasic with blastemal, epithelial, and stromal components. The pathologist suggested the tumour resulted from the lack of a tumour suppressor gene on chromosome 11. Which of the following tumours is the pathologist most likely suggesting?
Your Answer: Wilms’ tumour
Explanation:Wilms’ tumour is one of the most common malignant tumours of childhood but it can also rarely be found in adults. In biopsy, classical histopathological findings include the triphasic pattern composed by blastemal, epithelial, and stromal elements. First symptoms in children include an abdominal palpable mass, while in adults pain and haematuria are the most common complaints. Deletions of tumours’ suppressor genes on chromosome 11 are usually associated with Wilms’ tumour.
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This question is part of the following fields:
- Pathology
- Renal
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Question 26
Correct
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Some substances, such as Chromium-51 and Technetium-99, are freely filtered but not secreted or absorbed by the kidney. In these cases, their clearance rate is equal to:
Your Answer: Glomerular filtration rate
Explanation:If a substance passes through the glomerular membrane with perfect ease, the glomerular filtrate contains virtually the same concentration of the substance as does the plasma and if the substance is neither secreted nor reabsorbed by the tubules, all of the filtered substance continues on into the urine. Glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidney.
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This question is part of the following fields:
- Fluids & Electrolytes
- Physiology
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Question 27
Incorrect
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A 46 -year old patient diagnosed with chronic rhinosinusitis, was to undergo surgery to improve drainage from his frontal sinus to the nose. Which is a route that one would take to enter into the frontal sinus through the nasal cavity?
Your Answer: Inferior meatus
Correct Answer: Middle meatus
Explanation:The middle meatus is a nasal passageway located inferior to the middle concha and superior to the inferior concha. On the superior aspect of this meatus is a bulge produced by the middle ethmoidal cells known as the bulla ethmoidalis. Below this bulge is a curved fissure, the hiatus semilunaris, which is also bordered inferiorly by the edge of the uncinate process of the ethmoid. It is through this curved fissure, hiatus semilunaris, that the middle meatus communicates with the frontal sinus. It first forms a communication with a curved passage way known as the infundibulum. The infundibulum anteriorly communicates with the anterior ethmoidal cells and continues upward as the frontonasal duct into the frontal sinus.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 28
Incorrect
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The surgical registrar is doing an exploratory laparotomy on a 35 year old lady of African descent with tuberculous of the abdomen and suspected perforation. The small bowel is matted due to adhesions and it is difficult to differentiate the ileum from the jejunum. Which of the following features is typical of the jejunum?
Your Answer: It has numerous aggregated lymph nodules
Correct Answer: It has sparse aggregated lymph nodules
Explanation:The jejunum has a wider diameter, is thicker and more vascularized, hence of a deeper colour compared to the ileum. The valvulae conniventes (circular folds) of its mucous membranes are large and thick and its villi are larger than those in the ileum. The jejunum also has sparse aggregates of lymph nodules and most of its part occupies the umbilical and left iliac regions whilst the ileum is mostly in the umbilical, hypogastric, right iliac and pelvic regions.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 29
Correct
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A 65-year old man, known with Type 2 diabetes and chronic renal failure, is likely to eventually present with which of the following conditions?
Your Answer: Secondary hyperparathyroidism
Explanation:When the parathyroid glands secrete excess parathyroid hormone (PTH) in response to hypocalcaemia, it is known as Secondary hyperparathyroidism and is often seen in patients with renal failure. In chronic renal failure, the kidneys fail to excrete adequate phosphorus and also fail to convert enough vitamin D to its active form. This leads to formation of insoluble calcium phosphate in the body which ultimately causes hypocalcaemia. The glands then undergo hyperplasia and hypertrophy leading to secondary hyperparathyroidism. Symptoms include bone and joint pains, along with limb deformities. The raised PTH also results in pleiotropic effects on blood, the immune system and nervous system.
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This question is part of the following fields:
- Endocrine
- Pathology
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Question 30
Correct
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Which of the following arteries is the posterior branch of the external carotid artery?
Your Answer: Superficial temporal
Explanation:The external carotid artery is a branch of the common carotid artery that supplies parts of the neck, head and face. It branches off from the common carotid artery at the level of the thyroid cartilage. The external carotid, at the level of the mandible divides into the maxillary artery and the superficial temporal. The superficial temporal artery is the posterior branch of these two arteries. It starts off, somewhat, as a continuation of the external carotid artery at the substance of the parotid gland. Anterior cerebral and middle cerebral arteries are branches of the internal carotid artery.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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SESSION STATS - PERFORMANCE PER SPECIALTY
