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  • Question 1 - A 79-year-old male had a humeral shaft fracture during a road traffic accident...

    Correct

    • A 79-year-old male had a humeral shaft fracture during a road traffic accident and is being followed up in a fracture clinic. He complains of inability to use the limb 6 months after the injury. X-rays of that arm shows non union of his fracture.

      All the following are responsible for this non-union EXCEPT?

      Your Answer: Osteoporosis

      Explanation:

      An imbalance between bone resorption and formation is Osteoporosis. In normal bone, formation and resorption are roughly equal, and the density of bone matrix remains constant but there is more resorption in osteoporosis and the matrix density reduces and bones become weaker. Fractures are more likely to occur but healing is unaffected.

      Non-union of a fracture occurs when the two sides of a fracture fail to unite after 6 months. Causes include: infection, movement at the fracture site, avascular necrosis, tissue interposed between the fracture and gross misalignment.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      15
      Seconds

  • Question 2 - A 56-year-old male with a 10-year history of Diabetes Mellitus and Hypertension was...

    Correct

    • A 56-year-old male with a 10-year history of Diabetes Mellitus and Hypertension was rushed to the Emergency Department due to sudden onset crushing chest pain. ECG showed an ST-elevation myocardial infarct in the left anterior descending artery territory. The patient's condition was stabilised and managed with angioplasty, but he sustained significant myocardial damage.

      Which one of the following statements best agrees with the myocardial healing process?

      Your Answer: The left ventricle will likely hypertrophy first to maintain cardiac output

      Explanation:

      Following a myocardial infarction scar tissue formation will take place at the site of the damaged muscle. This places increased load on the rest of the myocardium causing it to hypertrophy. The left ventricle will hypertrophy first as it is pumping blood against a greater afterload as compared to the right ventricle.

      There are three types of cells in the body with regards to the cell cycle: 1. permanent
      2. labile
      3. stable cells

      Permanent cells do not re-enter the cell cycle and remain in G0. If there is a pool of stem cells the stem cells will enter the cell cycle to form more cells. Myocardial cells are a type of permanent cell and there is no pool of stem cells in the heart muscle. The anterior wall will not hypertrophy as it is formed by the right atrium and ventricle and both of these hypertrophy after the left ventricle.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      48.9
      Seconds

  • Question 3 - A 35-year-old man suffered a severe road traffic accident and has been brought...

    Correct

    • A 35-year-old man suffered a severe road traffic accident and has been brought to the hospital. As part of his treatment, he requires a blood transfusion and experiences a transfusion reaction.

      The most common type of transfusion reaction is which of the following?

      Your Answer: Febrile transfusion reaction

      Explanation:

      During or shortly after transfusion, febrile transfusion reactions, also known as non-haemolytic transfusion reactions, present with an unexpected temperature rise (38oC or 1oC above baseline, if baseline is 37oC). This is usually a one-off occurrence. The fever is sometimes accompanied by chills.

      The most common type of transfusion reaction is febrile transfusion reactions, which occur in about 1 in every 8 transfusions.

      The most common event leading to symptoms of febrile transfusion reactions is cytokine accumulation during storage of cellular components (especially platelet units). White cells secrete cytokines, and pre-storage leucodepletion has reduced this risk.

      Recipient antibodies (raised as a result of previous transfusions or pregnancies) reacting to donor human leukocyte antigen (HLA) or other antigens can also cause febrile transfusion reactions. Donor lymphocytes, granulocytes, and platelets all contain these antigens.

      Treatment is reassuring. Other causes should be ruled out, and antipyretics like paracetamol can help with fever relief. If another cause of fever is suspected, the transfusion should be stopped; however, if other causes of fever have been ruled out, it can be restarted at a slower rate.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      17.6
      Seconds

  • Question 4 - Regarding thalassaemia, which of the following statements is CORRECT: ...

    Correct

    • Regarding thalassaemia, which of the following statements is CORRECT:

      Your Answer: Screening for thalassaemia in pregnancy is offered to all pregnant women.

      Explanation:

      Beta thalassemia is caused by mutations in one or both of the beta globin genes. Alpha thalassemia is caused by a deletion or mutation (less commonly) in one or more of the four alpha globin gene copies. β-thalassaemia is more common in the Mediterranean region while α-thalassaemia is more common in the Far East.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      43.3
      Seconds

  • Question 5 - Which of the following diseases is caused by a build-up of lymphoblasts in...

    Correct

    • Which of the following diseases is caused by a build-up of lymphoblasts in the bone marrow?

      Your Answer: Acute lymphoblastic leukaemia

      Explanation:

      Acute lymphoblastic leukaemia (ALL) is a clonal (malignant) bone marrow disorder in which early lymphoid precursors multiply and replace the marrow’s normal hematopoietic cells. ALL is most common between the ages of 3 and 7, with 75 percent of cases occurring before the age of 6.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      9.5
      Seconds

  • Question 6 - A 66-year-old patient attends the Emergency Department with chest pain. His ECG and...

    Correct

    • A 66-year-old patient attends the Emergency Department with chest pain. His ECG and troponin are suggestive of a new myocardial infarction. You have explained the condition and the prognosis. He asks you about how the damaged area of his heart will heal following this.
      Which answer best describes the process of myocardial healing following myocardial infarction? Select ONE answer only.

      Your Answer: The damaged myocardium will form non-contractile scar tissue

      Explanation:

      Myocardial cells are unable to regenerate, they are unable to divide in response to tissue injury. The remain permanently in G0 and cannot progress to G1. If a segment of muscle dies, for example in myocardial infarction, this tissue will be replaced by scar tissue if the patient recovers. This scar tissue is non-contractile and therefore the remaining myocardium must work harder to maintain cardiac output. As a consequence the remaining undamaged myocardium undergoes compensatory hypertrophy without cell division.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      36.7
      Seconds

  • Question 7 - By the third day of wound healing, which sort of inflammatory cell has...

    Incorrect

    • By the third day of wound healing, which sort of inflammatory cell has predominated:

      Your Answer: Lymphocytes

      Correct Answer: Macrophages

      Explanation:

      The inflammatory phase of healing is sometimes called the lag phase because wound strength does not begin to return immediately. The inflammatory phase is completed within three days except in the presence of infection or other factors associated with impaired wound healing. Mononuclear leukocytes accumulate and are transformed into macrophages. The maturation of blood-derived monocytes into macrophages is heralded by several events, including secretion of vimentin, which is a structural filament protein involved in wound healing.

    • This question is part of the following fields:

      • Pathology
      • Wound Healing
      13.9
      Seconds

  • Question 8 - Which of the following is NOT typically associated with eosinophilia: ...

    Correct

    • Which of the following is NOT typically associated with eosinophilia:

      Your Answer: Whooping cough

      Explanation:

      An eosinophil leucocytosis is defined as an increase in blood eosinophils above 0.4 x 109/L.It is most frequently due to:
      Allergic diseases (e.g. bronchial asthma, hay fever, atopic dermatitis, urticaria)
      Parasites (e.g. hookworm, ascariasis, tapeworm, schistosomiasis)
      Skin diseases (e.g. psoriasis, pemphigus, urticaria, angioedema)
      Drug sensitivity

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      22.1
      Seconds

  • Question 9 - C5 - C9 deficiency increases susceptibility to infection with which of the following:...

    Correct

    • C5 - C9 deficiency increases susceptibility to infection with which of the following:

      Your Answer: Neisseria spp.

      Explanation:

      If the complement sequence is completed, an active phospholipase (the membrane attack complex, MAC) is produced, which punches holes in the cell membrane and causes cell lysis. Because the MAC appears to be the sole means to destroy the Neisseria family of bacteria, C5 – C9 deficiency increases susceptibility to Neisseria infections.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      12.3
      Seconds

  • Question 10 - The following are all examples of type IV hypersensitivity EXCEPT for: ...

    Incorrect

    • The following are all examples of type IV hypersensitivity EXCEPT for:

      Your Answer: Contact dermatitis

      Correct Answer: Extrinsic allergic alveolitis

      Explanation:

      Examples of type IV reactions includes:
      Contact dermatitis
      Hashimoto’s thyroiditis
      Primary biliary cholangitis
      Tuberculin skin test (Mantoux test)
      Chronic transplant rejection
      Granulomatous inflammation (e.g. sarcoidosis, Crohn’s disease)

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      60.2
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

General Pathology (3/3) 100%
Pathology (8/10) 80%
Haematology (3/3) 100%
Wound Healing (0/1) 0%
Immune Responses (2/3) 67%
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