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  • Question 1 - Regarding myeloma, which of the following statements is CORRECT: ...

    Correct

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

      Your Answer: Myeloma is associated with marked rouleaux formation on blood film.

      Explanation:

      98% of cases of myeloma occur over the age of 40 years with a peak incidence between 65 and 70 years. The disease is twice as common in black individuals compared to those of white or Asian origin. Laboratory findings include presence of a paraprotein in serum/urine (the paraprotein is IgG in 60% of cases, IgA in 20% and light chain only in almost all the rest) and marked Rouleaux formation on blood film. There is no cure for myeloma. The overall median survival is now 7-10 years and in younger (less than 50 years) patients it can be over 10 years.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      13.8
      Seconds

  • Question 2 - Leukaemia has been diagnosed in a 6-year-old child on your list. He comes...

    Correct

    • Leukaemia has been diagnosed in a 6-year-old child on your list. He comes to the ER with a complication related to this diagnosis.

      Which type of leukaemia do you think this is?

      Your Answer: Acute lymphoblastic leukaemia

      Explanation:

      Acute lymphoblastic leukaemia (ALL) is the most common childhood cancer that primarily affects children. ALL is most common between the ages of 2 and 4, and it is uncommon in adults.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      11.7
      Seconds

  • Question 3 - Antinuclear antibodies (ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that...

    Correct

    • Antinuclear antibodies (ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that bind to contents of the cell nucleus.

      Which ONE of these statements about ANAs is true?

      Your Answer: They can be of any immunoglobulin class

      Explanation:

      Anti-nuclear antibodies(ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that bind to contents of the cell nucleus. They can be of any immunoglobulin class.

      CREST syndrome is usually associated with anti-centromere antibodies.

      ELISA testing is cheaper but not the most accurate means of testing for ANAs. Indirect immunofluorescence testing is the most reliable.

      Nucleolar staining is suggestive of scleroderma, while homogenous staining is suggestive of lupus.

      Anti-dsDNA antibodies are found in 80 – 90% of patients with SLE

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      25.1
      Seconds

  • Question 4 - A 26-year-old female cuts her hand on a knife while preparing dinner but...

    Correct

    • A 26-year-old female cuts her hand on a knife while preparing dinner but the bleeding stops within a few minutes.

      Which one of the following cells will be among the first to be present at the wound site to be involved in haemostasis?

      Your Answer: Platelets

      Explanation:

      Platelets are the first cells to be attracted to the wound site due to the release of the Von Willebrand factor from the damaged endothelium. Platelets, in turn, release cytokines such as platelet-derived growth factor, which will attract other inflammatory cells to the wound site.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      10.2
      Seconds

  • Question 5 - A 20-year-old female presents with painful wrist following a fall while skating. X-rays...

    Correct

    • A 20-year-old female presents with painful wrist following a fall while skating. X-rays shows fracture of the ulna.

      The initial phase of bone healing is?

      Your Answer: Haematoma at the fracture site

      Explanation:

      Haemorrhage occurs into the fracture site from the ruptured vessels in the bone marrow and those supplying the periosteum immediately after fracture. This hematoma formation is the first phase of bone healing.

      The 4 stages of bone healing are:
      Haematoma at the fracture site (provides a framework for healing)
      Callus formation
      Lamellar bone formation
      Remodelling

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      12.7
      Seconds

  • Question 6 - A 29-year-old female with a swollen red finger presents to your clinic and...

    Correct

    • A 29-year-old female with a swollen red finger presents to your clinic and you suspect that the underlying process is of acute inflammation. You request for some bloods investigations.

      Which statement about histamine as a chemical mediator of the acute inflammatory response is TRUE?

      Your Answer: It increases vascular permeability

      Explanation:

      Histamine increases vascular permeability in the acute inflammatory response.

      Histamine causes vasodilation.

      It is released from Mast cells and basophils, eosinophils and platelets.

      Mast cells and basophils are its primary source

      Nitric oxide (not histamine) is a major factor in endotoxic shock

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      49.1
      Seconds

  • Question 7 - A 40-year-old woman presents with a red, scaly, itchy rash around her navel...

    Correct

    • A 40-year-old woman presents with a red, scaly, itchy rash around her navel that occurred after contact with a nickel belt buckle. A diagnosis of allergic contact dermatitis is made. Which type of hypersensitivity reaction is this?

      Your Answer: Type IV hypersensitivity reaction

      Explanation:

      A type IV hypersensitivity reaction occurred in this patient. Allergic contact dermatitis is an inflammatory skin reaction occurring in response to an external stimulus, acting either as an allergen or an irritant, caused by a type IV or delayed hypersensitivity reaction. They usually take several days to develop.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      9.7
      Seconds

  • Question 8 - A 23-year-old male presents to his family physician with the complaint of repeated...

    Correct

    • A 23-year-old male presents to his family physician with the complaint of repeated episodes of abdominal pain and the passage of dark coloured urine every morning. He also reports increasing fatigue over the past several months. On examination, there are raised, painful red nodules over the skin of the back. Laboratory workup shows haemolytic anaemia, leukopenia and thrombocytopenia.

      Which one of the following disorders is this patient most likely to have?

      Your Answer: Paroxysmal nocturnal haemoglobinuria

      Explanation:

      Paroxysmal nocturnal haemoglobinuria is an acquired genetic disorder that causes a decrease in red blood cells due to a membrane defect that allows increased complement binding to RBCs, causing haemolysis. Patients complain of dark-coloured urine first in the morning due to haemoglobinuria secondary to lysis of red blood cells overnight.

      Thrombosis occurs, which affects hepatic, abdominal, cerebral and subdermal veins. Thrombosis of hepatic veins can lead to Budd-Chiari syndrome, thrombosis of subdermal veins can lead to painful nodules on the skin, and thrombosis of cerebral vessels can lead to stroke. The presence of dark urine in the morning only and at no other time differentiates this condition from other conditions.

      Multiple myeloma would present with bone pain, signs of radiculopathy if there were nerve root compression and a history of repeated infections.

      Patients with Non-Hodgkin Lymphoma would complain of enlarged lymph nodes, fatigue, fever, weight loss and a history of repeated infections.

      Acute lymphoblastic leukaemia presents more commonly in children than in adults. The patient would complain of bone pain, and on examination, there would be hepatosplenomegaly.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      11.6
      Seconds

  • Question 9 - Which of the following is NOT a typical clinical feature of sickle cell...

    Correct

    • Which of the following is NOT a typical clinical feature of sickle cell disease:

      Your Answer: Neutropaenia

      Explanation:

      Features of sickle cell disease include:
      Anaemia (symptoms are usually mild because the O2 dissociation curve of Hb S is shifted to the right)
      Vaso-occlusive crisis
      Visceral sequestration crisis
      Aplastic crisisIncreased susceptibility to infection
      Other clinical features: Pigment gallstones with cholecystitis
      Chronic leg ulcers
      Avascular necrosis of the femoral and humeral heads or other bones
      Cardiomyopathy
      Pulmonary hypertension
      Proliferative retinopathy
      Priapism
      Renal papillary necrosis
      Stroke

    • This question is part of the following fields:

      • Haematology
      • Pathology
      13
      Seconds

  • Question 10 - Regarding T helper cells, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding T helper cells, which of the following statements is CORRECT:

      Your Answer: They initiate cytotoxic killing of target cells.

      Correct Answer: They form the vast majority (about 75%) of the total circulating T-cell population.

      Explanation:

      CD4+ T-cells (Helper T cells)Recognise antigen only in association with HLA class II molecules (found on antigen presenting cells (APCs) e.g. dendritic cells, B-cells; present exogenous antigens that have been phagocytosed/endocytosed into intracellular vesicles)Form most of the circulating T-cell population (about 75%)Secrete cytokines (e.g. IFN-gamma) which are required for recruitment and activation of other immune cells such as macrophages, T cytotoxic cells and NK cells and for the activation of and production of immunoglobulin from B-cells

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      19.3
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Haematology (4/4) 100%
Pathology (9/10) 90%
General Pathology (5/5) 100%
Immune Responses (0/1) 0%
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