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  • Question 1 - A 45 year-old female presents with a drooping eyelid. During examination, the same...

    Correct

    • A 45 year-old female presents with a drooping eyelid. During examination, the same pupil of the patient is found to be dilated. Which nerve could be involve in this case?

      Your Answer: Oculomotor nerve

      Explanation:

      The oculomotor nerve controls most of the eye muscles. It also controls the constriction of the pupils and thickening of the lens of the eye. This can be tested in two main ways. By moving a finger toward a person’s face to induce accommodation, their pupils should constrict or shining a light into one eye should result in equal constriction of the other eye. The neurons in the optic nerve decussate in the optic chiasm with some crossing to the contralateral optic nerve tract. This is the basis of the swinging-flashlight test. Loss of accommodation and continued pupillary dilation can indicate the presence of a lesion of the oculomotor nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      10.8
      Seconds

  • Question 2 - A 62-year-old man presented with a persistent cough and weight loss. Chest x-ray...

    Correct

    • A 62-year-old man presented with a persistent cough and weight loss. Chest x-ray demonstrated widespread nodular opacities. After a bronchoalveolar lavage, atypical cells were detected. Which is the most probable diagnosis?

      Your Answer: Bronchioalveolar carcinoma

      Explanation:

      Bronchioloalveolar carcinoma (BAC) is a term used to define a particular subtype of adenocarcinoma which develops in cells near the alveoli, in the outer regions of the lungs. On a chest X-ray it can appear as a single peripheral spot or as scattered spots throughout the lungs. Symptoms include cough, haemoptysis, chest pain, dyspnoea and loss of weight.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      11
      Seconds

  • Question 3 - A 45 year-old male, with behavioural changes developed euvolemic hyponatraemia. Which of the...

    Correct

    • A 45 year-old male, with behavioural changes developed euvolemic hyponatraemia. Which of the following conditions most likely predisposed the patient to develop euvolemic hyponatraemia?

      Your Answer: Psychosis

      Explanation:

      In euvolemic hyponatraemia, there is volume expansion in the body, there is no oedema, but hyponatremia occurs. Causes include: state of severe pain or nausea, psychosis, brain trauma, SIADH, hypothyroidism and glucocorticoid deficiency.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      14
      Seconds

  • Question 4 - A cyclist fell and sustained a laceration to his elbow which was shortly...

    Correct

    • A cyclist fell and sustained a laceration to his elbow which was shortly sutured in the emergency department. Which of the following factors will aid in the wound healing process?

      Your Answer: Presence of sutures

      Explanation:

      Foreign bodies including sutures will delay wound healing, however due to the net affect being helpful they are used. Secondary wound infection will delay healing and is a potential post op complication. Corticosteroids depresses the wound healing ability of the body. Poor nutrition will also delay healing leading to decreased albumin, vit D and vit C. Diabetic patients with atherosclerosis with poor perfusion of tissues have notoriously delayed/poor healing.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      16
      Seconds

  • Question 5 - Which of the following is NOT a nutritional factor involved in wound healing:...

    Incorrect

    • Which of the following is NOT a nutritional factor involved in wound healing:

      Your Answer: Zinc

      Correct Answer: Vitamin B3

      Explanation:

      Vitamin B6 is required for collagen cross-links.

      Vitamin A is required for epithelial cell proliferation.

      Zinc is required for RNA and DNA synthesis.

      Copper is required for cross-linking of collagen.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Physiology
      8.9
      Seconds

  • Question 6 - A 38-year old lady presented to the hospital with abnormal passing of blood...

    Correct

    • A 38-year old lady presented to the hospital with abnormal passing of blood per vagina. On examination, she was found to have an endocervical polypoidal mass. On enquiry, she gave history of oral contraceptive usage for 3 years. What finding is expected on the histopathology report of biopsy of the mass?

      Your Answer: Microglandular hyperplasia

      Explanation:

      Endocervical polyps or microglandular hyperplasia are benign growths occurring in the endocervical canal, in about 2-5% women and occur secondary to use of oral contraceptives. They are usually < 1cm in size, friable and reddish-pink. Usually asymptomatic, they can cause bleeding or become infected, leading to leucorrhoea (purulent vaginal discharge). They are usually benign but need to be differentiated from adenocarcinomas by histology.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      30.3
      Seconds

  • Question 7 - After having donated a unit of blood. The blood bank will prefer to...

    Incorrect

    • After having donated a unit of blood. The blood bank will prefer to use which of the following anticoagulants to store the blood?

      Your Answer: Heparin

      Correct Answer: Citrate

      Explanation:

      Calcium is necessary for coagulation to occur. Citrate being a chelator and combining with calcium ions to form un-ionised compound will prevent coagulation. Following transfusion the citrate is removed by the liver with in a few minutes. Oxalate also works on the same principle but it is toxic to the body.

    • This question is part of the following fields:

      • General
      • Physiology
      14.2
      Seconds

  • Question 8 - A 76 year old man who presented with lower back pain is diagnosed...

    Correct

    • A 76 year old man who presented with lower back pain is diagnosed with prostatic carcinoma that has metastasized to his lumber spine. Which of the following markers is characteristically elevated?

      Your Answer: PSA

      Explanation:

      Spread of prostatic carcinoma is common to the lumbar spine and pelvis. This results in osteoblastic metastases that will present as lower back pain with increased alkaline phosphatase, prostatic acid phosphates and PSA. PSA is more specific and a PSA > 10 ng/ml for any age is worrisome.

    • This question is part of the following fields:

      • Neoplasia; Urology
      • Pathology
      5.7
      Seconds

  • Question 9 - Bile salt reuptake principally occurs where? ...

    Incorrect

    • Bile salt reuptake principally occurs where?

      Your Answer: In the caecum

      Correct Answer: In the ileum

      Explanation:

      90 – 95% of the bile salts are absorbed from the small intestine (mostly terminal ileum and then excreted again from the liver. This is known as the enterohepatic circulation. The entire pool recycles twice per meal and approximately 6 to 8 times per day.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      31.1
      Seconds

  • Question 10 - Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal...

    Correct

    • Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal volume of 550 ml and an effective anatomical dead space of 250 ml. What is his alveolar ventilation?

      Your Answer: 3000 ml/min

      Explanation:

      Alveolar ventilation is the amount of air reaching the alveoli per minute. Alveolar ventilation = respiratory rate × (tidal volume – anatomical dead space volume). Thus, alveolar ventilation = 10 × (550 − 250) = 3000 ml/min.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      3.9
      Seconds

  • Question 11 - 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
      149.6
      Seconds

  • Question 12 - Regarding the extensor retinaculum of the wrist, which of these is CORRECT? ...

    Correct

    • Regarding the extensor retinaculum of the wrist, which of these is CORRECT?

      Your Answer: It prevents the tendons of the posterior compartment of the forearm from ‘bowstringing’ when the hand is extended at the wrist

      Explanation:

      This extensor retinaculum, as the name indicates, holds the tendons of the extensors against the dorsal surface of the distal radius and ulna. Therefore, the correct answer is that it prevents bowstringing of the extensor tendons with wrist extension. It forms compartments between it and its bony attachment, and these compartments guide and hold the tendons.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      16.8
      Seconds

  • Question 13 - Which muscle in the neck divides the neck into two large triangles? ...

    Correct

    • Which muscle in the neck divides the neck into two large triangles?

      Your Answer: Sternocleidomastoid

      Explanation:

      The sternocleidomastoid muscle is an important landmark in the neck as it divides the neck into two; anterior and posterior triangles. These triangles help in the location of the structures of the neck including the carotid artery, head and neck lymph nodes, accessory nerve and the brachial plexus. It originates from the manubrium and medial portion of the clavicle and inserts on the mastoid process of the temporal bone, superior nuchal line. The sternocleidomastoid receives blood supply from the occipital artery and the superior thyroid artery. It is innervated by the accessory nerve (motor) and cervical plexus (sensory).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      5.6
      Seconds

  • Question 14 - Which of the following organelles have the capacity to regenerate and spontaneously replicate?...

    Incorrect

    • Which of the following organelles have the capacity to regenerate and spontaneously replicate?

      Your Answer: Golgi apparatus

      Correct Answer: Mitochondrion

      Explanation:

      A mitochondria is a membrane bound organelle found in eukaryotic cells. They are called the powerhouse of the cell and are the place where ATP is formed from energy generated through metabolism. They are capable of replication as well as repair and regeneration.

    • This question is part of the following fields:

      • General
      • Physiology
      6.4
      Seconds

  • Question 15 - When does the heart rate decrease? ...

    Correct

    • When does the heart rate decrease?

      Your Answer: Pressure on the eyeball

      Explanation:

      Various vagotonic manoeuvres (e.g. Valsalva manoeuvre, carotid sinus massage, pressure on eyeballs, ice-water facial immersion, swallowing of ice-cold water) result in increased parasympathetic tone through the vagus nerve which results in a decrease in heart rate. These manoeuvres may be clinically useful in terminating supraventricular arrhythmias.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      14.6
      Seconds

  • Question 16 - The chest X-ray of a 72 year old patient reveals the presence of...

    Correct

    • The chest X-ray of a 72 year old patient reveals the presence of a round lesion containing an air-fluid level in the left lung. These findings are most probably suggestive of:

      Your Answer: Lung abscess

      Explanation:

      Lung abscesses are collections of pus within the lung that arise most commonly as a complication of aspiration pneumonia caused by oral anaerobes. Older patients are more at risk due to poor oral hygiene, gingivitis an inability to handle their oral secretions due to other diseases. Chest X-ray most commonly reveals the appearance of an irregularly shaped cavity with an air-fluid level.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      7.8
      Seconds

  • Question 17 - Infection to all of the following will lead to enlargement of the superficial...

    Correct

    • Infection to all of the following will lead to enlargement of the superficial inguinal lymph nodes, except for:

      Your Answer: Ampulla of the rectum

      Explanation:

      The superficial inguinal lymph nodes form a chain immediately below the inguinal ligament. They receive lymphatic supply from the skin of the penis, scrotum, perineum, buttock and abdominal wall below the level of the umbilicus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      92.8
      Seconds

  • Question 18 - Causes of metabolic acidosis with a normal anion gap include: ...

    Correct

    • Causes of metabolic acidosis with a normal anion gap include:

      Your Answer: Diarrhoea

      Explanation:

      Excess acid intake and excess bicarbonate loss as in diarrhoea, are causes of metabolic acidosis with a normal anion gap. The other conditions all result in an increased anion gap.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      8.2
      Seconds

  • Question 19 - upon stroking the plantar surface of a patient's foot, extension of toes was...

    Incorrect

    • upon stroking the plantar surface of a patient's foot, extension of toes was noted. This is likely to be accompanied with:

      Your Answer: Hyporeflexia

      Correct Answer: Spasticity

      Explanation:

      An upper motor neuron lesion affects the neural pathway above the anterior horn cell or motor nuclei of the cranial nerves, whereas a lower motor neurone lesion affects nerve fibres travelling from the anterior horn of the spinal cord to the relevant muscles. An upper motor neurone lesions results in the following:

      – Spasticity in the extensor muscles (lower limbs) or flexor muscles (upper limbs).

      – ‘clasp-knife’ response where initial resistance to movement is followed by relaxation

      – Weakness in the flexors (lower limbs) or extensors (upper limbs) with no muscle wasting

      – Brisk tendon jerk reflexes

      – Positive Babinski sign (on stimulation of the sole of the foot, the big toe is raised rather than curled downwards)

    • This question is part of the following fields:

      • Neurology
      • Physiology
      10.7
      Seconds

  • Question 20 - When the pitch of a sound increases, what is the physiological response seen...

    Correct

    • When the pitch of a sound increases, what is the physiological response seen in the listener?

      Your Answer: The location of maximal basilar membrane displacement moves toward the base of the cochlea

      Explanation:

      An increase in the frequency of sound waves results in a change in the position of maximal displacement of the basilar membrane in the cochlea. Low pitch sound produces maximal displacement towards the cochlear apex and greatest activation of hair cells there. With an increasing pitch, the site of greatest displacement moves towards the cochlear base. However, increased amplitude of displacement, increase in the number of activated hair cells, increased frequency of discharge of units in the auditory nerve and increase in the range of frequencies to which such units respond, are all seen in increases in the intensity or a sound stimulus.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      29.5
      Seconds

  • Question 21 - A patient sustained an iatrogenic injury to one of the structures passing through...

    Incorrect

    • A patient sustained an iatrogenic injury to one of the structures passing through the deep inguinal ring. This was during an operation to repair an inguinal hernia. Which structure is most likely to be injured?

      Your Answer:

      Correct Answer: Round ligament of the uterus

      Explanation:

      The deep inguinal ring transmits the spermatic cord in the man and the round ligament of the uterus in the female. It is bound below and medially by the inferior epigastric vessels (so these don’t go through it).

      The ilioinguinal nerve, although it courses through the inguinal canal, does not pass through it.

      The iliohypogastric nerves run between the internal oblique and transversus abdominis in the abdominal wall, piercing the internal oblique at the anterior superior iliac spine to travel just deep to the external oblique.

      The inferior epigastric artery runs between the transversus abdominis and the peritoneum forming the lateral umbilical fold.

      The medial umbilical ligament is the obliterated umbilical artery that it lies within the medial umbilical fold of peritoneum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 22 - A 37-year-old woman with a history of rheumatic heart disease presents with 10...

    Incorrect

    • A 37-year-old woman with a history of rheumatic heart disease presents with 10 days recurrent low fever. Patient underwent laboratory work up and was diagnosed with infective endocarditis. What is the most likely organism that caused the infective endocarditis in this patient?

      Your Answer:

      Correct Answer: Streptococcus viridans

      Explanation:

      Subacute bacterial endocarditis  is often due to streptococci of low virulence, mainly streptococcus viridans. It is a mild to moderate illness which progresses slowly over weeks and months (>2weeks) and has low propensity to hematogenously seed to extracardiac sites.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      0
      Seconds

  • Question 23 - Which of the following diseases causes abrupt vertigo, nausea, vomiting, tinnitus, and nystagmus?...

    Incorrect

    • Which of the following diseases causes abrupt vertigo, nausea, vomiting, tinnitus, and nystagmus?

      Your Answer:

      Correct Answer: Vestibular neuronitis

      Explanation:

      Vestibular neuronitis or labyrinthitis causes a self-limited episode of vertigo, presumably due to inflammation of the vestibular division of cranial nerve VIII. Its causes are unknown, It may be due to a virus, but it can be related to a bacterial infection, head injury, stress, allergy, or as a reaction to medication. Symptoms can last up to 7-10 days.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      0
      Seconds

  • Question 24 - A previously healthy 40-year-old housewife suddenly complains of a headache and loses consciousness....

    Incorrect

    • A previously healthy 40-year-old housewife suddenly complains of a headache and loses consciousness. A CT scan reveals subarachnoid haemorrhage. Which of the following is the most probable cause?

      Your Answer:

      Correct Answer: Ruptured berry aneurysm

      Explanation:

      Saccular aneurysms, also known as berry aneurysms, appear as a round outpouching and are the most common form of cerebral aneurysm. They are a congenital intracranial defect, and haemorrhage can occur at any age, but is most common between the ages of 40-65 years. A second rupture (rebleeding) sometimes occurs, most often within about 7 days of the first bleed.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      0
      Seconds

  • Question 25 - A 50 year old man on warfarin therapy following insertion of a pacemaker...

    Incorrect

    • A 50 year old man on warfarin therapy following insertion of a pacemaker presented with epistaxis. Which of the following is true regarding blood coagulation?

      Your Answer:

      Correct Answer: Patients with haemophilia A usually have a normal bleeding time

      Explanation:

      A prolonged bleeding time is seen in platelet disorders like thrombocytopenia. Patients with haemophilia A or B have a prolonged PTT but not a prolonged bleeding time.

      Ca2+ is necessary for coagulation.

      von Willebrand factor is an important part of the factor VIII complex and promotes platelet adhesion and aggregation.

      DIC results in depleted coagulation factors and accumulation of fibrin.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 26 - Following a lacerating injury along the anterior border of the trapezius muscle in...

    Incorrect

    • Following a lacerating injury along the anterior border of the trapezius muscle in the neck, a man has the point of his shoulder (scapula) sagging and he has difficulty with full abduction of his arm. Which nerve is most likely injured?

      Your Answer:

      Correct Answer: Accessory (cranial nerve XI)

      Explanation:

      Injury to the accessory nerve denervates the trapezius muscle so that the person will no longer be able to raise the acromion of the shoulder. The dorsal scapular nerve supplies the rhomboids i.e. major and minor and the levator scapulae so that injury to this nerve weakens retraction of the scapula. The greater occipital nerve is responsible for sensation of the posterior scalp. The axillary nerve innervates the deltoid muscle which is responsible for abduction of the arm and the suprascapular nerve is responsible for rotating the humerus laterally. Cutaneous nerves supply the skin.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 27 - Which statement is correct regarding secretions from the adrenal glands? ...

    Incorrect

    • Which statement is correct regarding secretions from the adrenal glands?

      Your Answer:

      Correct Answer: Aldosterone is producd by the zona glomerulosa

      Explanation:

      The secretions of the adrenal glands by zone are:

      Zona glomerulosa – aldosterone

      Zona fasciculata – cortisol and testosterone

      Zona reticularis – oestradiol and progesterone

      Adrenal medulia – adrenaline, noradrenaline and dopamine.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 28 - How are amino acids transported across the luminal surface of the small intestinal...

    Incorrect

    • How are amino acids transported across the luminal surface of the small intestinal epithelium?

      Your Answer:

      Correct Answer: Co-transport with sodium ions

      Explanation:

      Once complex peptides are broken down into amino acids by the peptidases present in the brush border of small intestine, they are ready for absorption by at least four sodium-dependent amino acid co-transporters – one each for acidic, basic, neutral and amino acids, present on the luminal plasma membrane. These transporters first bind sodium and can then bind the amino acids. Thus, amino acid absorption is totally dependent on the electrochemical gradient of sodium across the epithelium. The basolateral membrane in contrast, possesses additional transporters to carry amino acids from the cell into the blood, but these are sodium-independent.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds

  • Question 29 - A 45-year old lady underwent biopsy of a soft, fleshy mass involving her...

    Incorrect

    • A 45-year old lady underwent biopsy of a soft, fleshy mass involving her left breast. The biopsy showed lymphoid stroma with minimal fibrosis, surrounding sheets of large vesicular cells with frequent mitoses. Which condition is she most likely suffering from?

      Your Answer:

      Correct Answer: Medullary carcinoma of breast

      Explanation:

      Medullary carcinoma is a malignant tumour of the breast with well-defined boundaries and accounts for 5% of all breast cancers. Other special features include a larger size of the neoplastic cells and presence of lymphoid cells at tumour edge. Differential diagnosis includes invasive ductal carcinoma. Prognosis is usually good.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      0
      Seconds

  • Question 30 - A 35-year old lady presents to her GP with vague abdominal symptoms. Examination...

    Incorrect

    • A 35-year old lady presents to her GP with vague abdominal symptoms. Examination reveals a normal size spleen. Which of the following is the likely diagnosis?

      Your Answer:

      Correct Answer: Idiopathic thrombocytopenic purpura

      Explanation:

      Idiopathic thrombocytopenic purpura (ITP) is a disease caused due to development of an antibody against a platelet antigen (autoantibody). In childhood disease, the autoantibody gets triggered by binding of viral antigen to the megakaryocytes. Presentation includes unexplained thrombocytopenia, petechiae and bleeding from mucosal surfaces. The spleen usually does not enlarge in size. However, splenomegaly can occur due to coexisting viral infection. Marrow examination reveals normal or increased number of megakaryocytes. Diagnosis is by exclusion of other thrombocytopenic disorders.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (5/5) 100%
Head & Neck (2/2) 100%
Pathology (6/6) 100%
Respiratory (3/3) 100%
Fluids & Electrolytes (2/2) 100%
Cell Injury & Wound Healing (1/2) 50%
Physiology (4/9) 44%
Women's Health (1/1) 100%
General (0/2) 0%
Neoplasia; Urology (1/1) 100%
Gastroenterology (0/1) 0%
Lower Limb (2/2) 100%
Upper Limb (1/1) 100%
Cardiovascular (1/1) 100%
Neurology (1/2) 50%
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