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  • Question 1 - Which of the following muscles winds around the pterygoid hamulus? ...

    Correct

    • Which of the following muscles winds around the pterygoid hamulus?

      Your Answer: Tensor veli palatini

      Explanation:

      The tensor veli palatini tenses the soft palate and by doing so, assists the levator veli palatini in elevating the palate to occlude and prevent entry of food into the nasopharynx during swallowing. It arises by a flat lamella from the scaphoid fossa at the base of the medial pterygoid plate, from the spina angularis of the sphenoid and from the lateral wall of the cartilage of the auditory tube. Descending vertically between the medial pterygoid plate and the medial pterygoid muscle, it ends in a tendon which winds around the pterygoid hamulus, being retained in this situation by some of the fibres of origin of the medial pterygoid muscle. Between the tendon and the hamulus is a small bursa. The tendon then passes medialward and is inserted onto the palatine aponeurosis and the surface behind the transverse ridge on the horizontal part of the palatine bone.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      9.2
      Seconds
  • Question 2 - A football player sustained an injury to his ankle. The wound went through...

    Incorrect

    • A football player sustained an injury to his ankle. The wound went through the skin, subcutaneous tissue and flexor retinaculum. Which other structure passing under the retinaculum may be injured?

      Your Answer: Anterior tibial artery

      Correct Answer: Tibial nerve

      Explanation:

      The flexor retinaculum is immediately posterior to the medial malleolus. The structures that pass under the flexor retinaculum from anterior to posterior are: tendon of the tibialis posterior, flexor digitorum longus, posterior tibial artery (and vein), tibial nerve and tendon of flexor hallucis longus. The tibial nerve is the only one which lies behind the flexor retinaculum.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      46
      Seconds
  • Question 3 - A 28 years old women presents with a history of chronic cough with...

    Incorrect

    • A 28 years old women presents with a history of chronic cough with fever for the past 2 months. A chest x ray revealed a diffuse bilateral reticulonodular pattern. A transbronchial biopsy was performed and histological examination showed focal areas of inflammation with epithelioid macrophages, Langhans cells and lymphocytes. Which of the immune reaction is responsible for this?

      Your Answer: Type II hypersensitivity

      Correct Answer: Type IV hypersensitivity

      Explanation:

      A reactivated tuberculosis with granuloma formation is characteristic of type IV reaction. It is also called a delayed type of hypersensitivity reaction and takes around 2-8 days to deliver. It is a cell mediated response with the involvement of CD8 and CD4 cells and the release of IL-1 from macrophages that further activate these CD cells.

      Granulomatous reactions are mostly cell-mediated.

      Type I reactions are allergic and anaphylactic reactions and type II are complement-mediated immune reactions.

    • This question is part of the following fields:

      • Inflammation & Immunology; Respiratory
      • Pathology
      45
      Seconds
  • Question 4 - A 35-year-old woman in her 37th week of pregnancy complains of urinary incontinence....

    Incorrect

    • A 35-year-old woman in her 37th week of pregnancy complains of urinary incontinence. She is most likely to have:

      Your Answer: Urge incontinence

      Correct Answer: Stress incontinence

      Explanation:

      Urinary incontinence is the involuntary excretion of urine from one’s body. It is often temporary and it almost always results from an underlying medical condition. Several types include:

      – Stress incontinence is the voiding of urine following increased abdominal pressure e.g. laughing, coughing, pregnancy etc. It is the most common form of incontinence in women, most commonly due to pelvic floor muscle weakness, physical changes from pregnancy, childbirth and menopause. In men it is a common problem following a prostatectomy. Most lab results such as urine analysis, cystometry and postvoid residual volume are normal.

      – Urge incontinence is involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urinate. The most common cause of urge incontinence are involuntary and inappropriate detrusor muscle contractions.

      – Functional incontinence – occurs when a person does not recognise the need to go to the toilet, recognise where the toilet is or get to the toilet in time. The urine loss may be large. Causes of functional incontinence include confusion, dementia, poor eyesight, poor mobility, poor dexterity or unwillingness. t

      – Overflow incontinence – sometimes people find that they cannot stop their bladders from constantly dribbling or continuing to dribble for some time after they have passed urine.

    • This question is part of the following fields:

      • Physiology
      • Renal
      21.6
      Seconds
  • Question 5 - A 38 year-old man falls on an outstretched hand. X-rays indicate an anterior...

    Correct

    • A 38 year-old man falls on an outstretched hand. X-rays indicate an anterior dislocation of one of the carpal bones. Which carpal bone is most commonly dislocated?

      Your Answer: Lunate

      Explanation:

      The scaphoid bone is the most commonly fractured carpal bone and has an increased risk of avascular necrosis.

      The lunate is the most commonly dislocated carpal bone. The displaced bone may compress the median nerve in the carpal tunnel.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      17.2
      Seconds
  • Question 6 - 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: Transversus thoracis muscle fascia

      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
      36.5
      Seconds
  • Question 7 - During pregnancy the uterus enlarges however after delivery it regresses to its original...

    Incorrect

    • During pregnancy the uterus enlarges however after delivery it regresses to its original size. Which of the following organelles is responsible for this regression?

      Your Answer: Endoplasmic reticulum

      Correct Answer: Lysosomes

      Explanation:

      Lysosomes are formed by budding of the Golgi apparatus and contain enzymes which digest macromolecules. They are found in both plants and animals and are active in autophagic cell death, digestion after phagocytosis and for the cells own recycling process. They fuse with the molecules and release their content resulting in digestion.

    • This question is part of the following fields:

      • General
      • Physiology
      16.3
      Seconds
  • Question 8 - A 35 year-old woman is undergoing thyroidectomy. The external laryngeal nerve may be...

    Correct

    • A 35 year-old woman is undergoing thyroidectomy. The external laryngeal nerve may be injured whilst ligating this artery during the procedure due to its close relationship?

      Your Answer: Superior thyroid artery

      Explanation:

      The superior thyroid artery arises from the external carotid artery just below the level of the greater cornu of the hyoid bone and ends in the thyroid gland. This artery must be ligated at the thyroid when conducting a thyroidectomy. If the artery is severed, but not ligated, it will bleed profusely. In order to gain control of the bleeding, the surgeon may need to extend the original incision laterally to ligate the artery at its origin at the external carotid artery. The external laryngeal branch of the superior laryngeal nerve courses in close proximity to the superior thyroid artery, making it at risk for injury during surgery.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      42.4
      Seconds
  • Question 9 - upon stroking the plantar surface of a patient's foot, extension of toes was...

    Correct

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

      Your 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
      20.5
      Seconds
  • Question 10 - An explorative laparotomy is done on a 23 year old following a gunshot...

    Incorrect

    • An explorative laparotomy is done on a 23 year old following a gunshot abdominal injury through the right iliac fossa. It is found that the ileocolic artery is severed and the bullet had perforated the caecum. From which branch does the ileocolic artery originate?

      Your Answer: Inferior mesenteric artery

      Correct Answer: Superior mesenteric artery

      Explanation:

      Ileocolic artery branches off from the superior mesenteric artery. It then divides to give a superior and inferior branch.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      56.2
      Seconds
  • Question 11 - Where do the cells belonging to the mononuclear phagocyte system originate? ...

    Correct

    • Where do the cells belonging to the mononuclear phagocyte system originate?

      Your Answer: Bone marrow

      Explanation:

      The macrophage originates from a committed bone marrow stem cell. It is called the pluripotent hematopoietic stem cell. This differentiates into a monoblast and then into a promonocyte and finally matures into a monocyte. When called upon they leave the bone marrow and enter into the circulation. Upon entering the tissue they transform into macrophages. Tissue macrophages include: Kupffer cells (liver), alveolar macrophages (lung), osteoclasts (bone), Langerhans cells (skin), microglial cells (central nervous system), and possibly the dendritic immunocytes of the dermis, spleen and lymph nodes.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      22.6
      Seconds
  • Question 12 - In the emergency room, a nurse was introducing a catheter into the patients...

    Correct

    • 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 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.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      34.1
      Seconds
  • Question 13 - Which of the following can occur even in the absence of brainstem co-ordination?...

    Correct

    • Which of the following can occur even in the absence of brainstem co-ordination?

      Your Answer: Gastric emptying

      Explanation:

      Although gastric emptying is under both neural and hormonal control, it does not require brainstem co-ordination. Increased motility of the orad stomach (decreased distensibility) or of the distal stomach (increased peristalsis), decreased pyloric tone, decreased duodenal motility or a combination of these, all increase the rate of gastric emptying. The major control mechanism for gastric emptying is through duodenal gastric feedback. The duodenum has receptors for the presence of acid, carbohydrate, fat and protein digestion products, osmolarity different from that of plasma, and distension. Activating these receptors decreases the rate of gastric emptying. Neural mechanisms involve both enteric and vagal pathways and a vagotomy impairs the gastric emptying regulation. CCK (cholecystokinin) slows gastric emptying at physiological levels of the hormone. Gastrin, secretin and glucose-1-phosphate also slow gastric emptying, but require higher doses.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      20.1
      Seconds
  • Question 14 - A 30-year old lady presented to her GP with complaints of tremors, excessive...

    Correct

    • 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: 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
      29.3
      Seconds
  • Question 15 - Which of the following tumours has the best prognosis following surgery? ...

    Incorrect

    • Which of the following tumours has the best prognosis following surgery?

      Your Answer: Glioblastoma multiforme

      Correct Answer: Schwannoma

      Explanation:

      Schwannomas are histologically benign neoplasms that arise from nerve sheaths, most commonly from sensory nerve roots. They are generally contained within a capsule, and so can be surgically removed without injuring the associated nerve root. They are histologically benign and less than 1% become malignant.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      13
      Seconds
  • Question 16 - A 35 year-old female developed food poisoning 24H after eating canned food. She...

    Correct

    • A 35 year-old female developed food poisoning 24H after eating canned food. She complained of abdominal cramps, with nausea and vomiting. Shortly after she suddenly developed weakness, blurring of vision, difficulty in swallowing and breathing. Which of the following organisms is most likely associated with fatal food poisoning?

      Your Answer: Clostridium botulinum

      Explanation:

      C. botulinum is a Gram-positive, rod-shaped, spore-forming bacterium. It is an obligate anaerobe, meaning that oxygen is poisonous to the cells. Only botulinum toxin types A, B, E, and F cause disease in humans. Types A, B, and E are associated with foodborne illness. Botulism poisoning can occur due to preserved or home-canned, low-acid food that was not processed using correct preservation times and/or pressure. Signs and symptoms of foodborne botulism typically begin between 18 and 36 hours after the toxin gets into the body, but can range from a few hours to several days, depending on the amount of toxin ingested. Botulinum that is produced by Clostridium botulinum can cause respiratory and muscular paralysis.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      23.7
      Seconds
  • Question 17 - Post-total gastrectomy, there will be a decreased production of which of the following...

    Correct

    • Post-total gastrectomy, there will be a decreased production of which of the following enzymes?

      Your Answer: Pepsin

      Explanation:

      Pepsin is a protease that is released from the gastric chief cells and acts to degrade proteins into peptides. Released as pepsinogen, it is activated by hydrochloric acid and into pepsin itself. Gastrin and the vagus nerve trigger the release of pepsinogen and HCl when a meal is ingested. Pepsin functions optimally in an acidic environment, especially at a pH of 2.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      22.3
      Seconds
  • Question 18 - Which of the following associations is correctly matched with the body's defence mechanism...

    Incorrect

    • Which of the following associations is correctly matched with the body's defence mechanism in fighting infection?

      Your Answer: Non-specific humoral mechanism → T lymphocytes

      Correct Answer: Specific cellular mechanism → cytotoxic T cells

      Explanation:

      The immune system has certain levels of defence against pathogens. First line includes simple barriers such as skin, mucosa and stomach acid that prevent the pathogen from entering into the body. If this barrier is breached then the innate immune system is activated which includes leukocytes (macrophages, neutrophils, mast cells, eosinophils, basophils, natural killer cells). If the pathogens invade the second layer of defence then the third layer, adaptive immunity is activated, which includes B and T lymphocytes. B cells provide a humoral response whereas cytotoxic T cells have specific cellular mechanisms. They maintain a memory of past infections and are activated faster following a recurrence.

    • This question is part of the following fields:

      • General
      • Physiology
      24.9
      Seconds
  • Question 19 - Which condition presents with a positive urine dipstick test for blood, but no...

    Correct

    • Which condition presents with a positive urine dipstick test for blood, but no blood cells on urine microscopy?

      Your Answer: Myoglobinuria

      Explanation:

      Myoglobinuria, or presence of myoglobulin in the urine is seen due to rhabdomyolysis (muscle destruction). Common causes of rhabdomyolysis include trauma, electrical injuries, burns, venom and drugs. Damaged muscle leads to release of myoglobin in the blood. Ideally, the released myoglobin gets filtered and excreted by the kidneys. However, excess myoglobin can occlude the renal filtration system leading to acute tubular necrosis and acute renal dysfunction.

    • This question is part of the following fields:

      • Pathology
      • Renal
      38.6
      Seconds
  • Question 20 - The renal tubule is the portion of the nephron that contains the fluid...

    Incorrect

    • The renal tubule is the portion of the nephron that contains the fluid that has been filtered by the glomerulus. Which of the following substances is actively secreted into the renal tubules?

      Your Answer: Amino acids

      Correct Answer: Potassium

      Explanation:

      The renal corpuscle filters out solutes from the blood, delivering water and small solutes to the renal tubule for modification. In normal circumstances more than 90% of the filtered load of K is reabsorbed by the proximal tubules and loops of Henlé and almost all K appearing in the urine has been secreted by the late distal tubules and collecting tubules. So the rate of excretion is usually independent of the rate of filtration, but is closely tied to the rate of secretion and control of K excretion, largely accomplished by control of the secretion rate. Around 65–70% of the filtered potassium is reabsorbed along with water in the proximal tubule and the concentration of potassium in the tubular fluid varies little from that of the plasma.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      33.7
      Seconds
  • Question 21 - Which of the following muscles is solely contained in the anterior triangle of...

    Incorrect

    • Which of the following muscles is solely contained in the anterior triangle of the neck and divides the anterior triangle into three smaller triangles?

      Your Answer: Sternocleidomastoid

      Correct Answer: Digastric

      Explanation:

      The digastric muscle is a small muscle located under the jaw. It lies below the body of the mandible, and extends, in a curved form, from the mastoid process to the symphysis menti. The digastric divides the anterior triangle of the neck into three smaller triangles:

      – The submaxillary triangle, bounded above by the lower border of the body of the mandible and a line drawn from its angle to the sternocleidomastoid, below by the posterior belly of the digastric and the stylohyoid and in front by the anterior belly of the digastric

      – The carotid triangle, bounded above by the posterior belly of the digastric and stylohyoid, behind by the sternocleidomastoid and below by the omohyoid

      – The suprahyoid or submental triangle, bounded laterally by the anterior belly of the digastric, medially by the midline of the neck from the hyoid bone to the symphysis menti and inferiorly by the body of the hyoid bone.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      7.7
      Seconds
  • Question 22 - The mechanism of action of streptokinase involves: ...

    Incorrect

    • The mechanism of action of streptokinase involves:

      Your Answer: Direct lysis of the clot

      Correct Answer: Direct conversion of plasminogen to plasmin

      Explanation:

      Streptokinase is an enzyme that is produced by group A beta haemolytic streptococcus and is an effective and cost efficient method for the dissolution of a clot used in cases of MI and pulmonary embolism. It works by directly converting plasminogen to plasmin which breaks down the blood components in the clot and fibrin, dissolving the clot. Streptokinase is a bacterial product and thus the body will develop immunity against it.

    • This question is part of the following fields:

      • General
      • Physiology
      20.3
      Seconds
  • Question 23 - A young lady visited a doctor with complaints of fever and a dull,...

    Incorrect

    • A young lady visited a doctor with complaints of fever and a dull, continuous pain in the right lumbar region for 6 days. On, enquiry, she recalled passing an increasing number of stools with occasional blood in last few months. Lower gastrointestinal endoscopic biopsy was taken 5 cm proximal to ileocaecal valve which showed transmural inflammation with several granulomas. Tissue section showed the absence of acid-fast bacillus. She denies any history of travel and her stool cultures were negative. What is the likely diagnosis?

      Your Answer: Ulcerative colitis

      Correct Answer: Crohn’s disease

      Explanation:

      Crohn’s disease is a chronic, inflammatory disease that can affect any part of the gastrointestinal tract but is usually seen in the distal ileum and colon. It is transmural and symptoms include chronic diarrhoea, abdominal pain, fever, anorexia and weight loss. On examination, there is usually abdominal tenderness with a palpable mass or fullness seen occasionally. Rectal bleeding is uncommon (except in isolated colonic involvement) which manifests like ulcerative colitis. Differential diagnosis includes acute appendicitis or intestinal obstruction. 25%-33% patients also have perianal disease in the form of fissure or fistulas.

      Extra intestinal manifestations predominate in children, and include: arthritis, pyrexia, anaemia or growth retardation. Histologically, the disease shows crypt inflammation and abscesses initially, which progress to aphthoid ulcers. These eventually develop into longitudinal and transverse ulcers with interspersed mucosal oedema, leading to the characteristic ‘cobblestoned appearance’. Transmural involvement leads to lymphoedema and thickening of bowel wall and mesentery, leading to extension of mesenteric fat on the serosal surface of bowel and enlargement of mesenteric nodes. There can also be hypertrophy of the muscularis mucosae, fibrosis and stricture formation, which can cause bowel obstruction.

      Abscesses are common and the disease can also leas to development of fistulas with various other organs, anterior abdominal wall and adjacent muscles. Pathognomonic non-caseating granulomas are seen in 50% cases and they can occur in nodes, peritoneum, liver, and in all layers of the bowel wall. The clinical course does not depend on the presence of granulomas. There is sharp demarcation between the diseased and the normal bowel (skip areas).

      35% cases show only the ileal involvement, whereas in 45% cases, both the ileum and colon are involved with a predilection for right side of colon. 20% cases show only colonic involvement, often sparing the rectum (unlike ulcerative colitis). In occasional cases, there is jejunoileitis – involvement of the entire small bowel. The stomach, duodenum and oesophagus are rarely involved, although there has been microscopic evidence of disease involving the gastric antrum in younger patients. The affected small bowel segments show increased rick of cancer. Moreover, patients with colonic disease show a long-term risk of cancer similar to that seen in ulcerative colitis.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      97.1
      Seconds
  • Question 24 - A 45-year old male, who was a chronic smoker presented to the clinic...

    Incorrect

    • A 45-year old male, who was a chronic smoker presented to the clinic with backache and dry, incessant cough. On examination, he was found to have raised blood pressure, purplish striae on his abdomen, truncal obesity and tenderness over the lower thoracic spine. These findings are suggestive of which condition?

      Your Answer: Multiple endocrine neoplasia, type I

      Correct Answer: Small-cell anaplastic (oat cell) carcinoma

      Explanation:

      The symptoms suggest Cushing syndrome due to increased glucocorticoid levels. One cause of Cushing syndrome is ectopic production of adrenocorticotrophic hormone from oat cell carcinoma. As oat cell carcinoma is known to be highly metastatic, the tenderness in lower back could represent metastatic involvement.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      38.1
      Seconds
  • Question 25 - Which of the following can lead to haemolytic anaemia? ...

    Correct

    • Which of the following can lead to haemolytic anaemia?

      Your Answer: Presence of haemoglobin S

      Explanation:

      Haemoglobin S is an abnormal type of haemoglobin seen in sickle cell anaemia. This allows for the haemoglobin to crystalize within the RBC upon exposure to low partial pressures of oxygen. This results in rupture of the RBCs as they pass through microcirculation, especially in the spleen. This can cause blockage of the vessel down stream and ischaemic death of tissues, accompanied by severe pain.

    • This question is part of the following fields:

      • General
      • Physiology
      23.5
      Seconds
  • Question 26 - A 7-year-old boy is diagnosed with metabolic acidosis as a result of severe...

    Correct

    • A 7-year-old boy is diagnosed with metabolic acidosis as a result of severe dehydration. Which of the following conditions is most likely to cause severe dehydration and metabolic acidosis?

      Your Answer: Severe diarrhoea

      Explanation:

      Diarrhoea is defined as having three or more loose or liquid stools per day, or as having more stools than is normal for that person. Severe diarrhoea, causing fluid loss and loss of bicarbonate, will result in marked dehydration and metabolic acidosis.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      44.7
      Seconds
  • Question 27 - What is the innervation of the laryngeal mucosa inferior to the true vocal...

    Correct

    • What is the innervation of the laryngeal mucosa inferior to the true vocal cord?

      Your Answer: Recurrent laryngeal nerve

      Explanation:

      Motor innervation to all other muscles of the larynx and sensory innervation to the subglottis is by the recurrent laryngeal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      16.1
      Seconds
  • Question 28 - The Henderson–Hasselbalch equation describes the derivation of pH as a measure of acidity. According to this equation,...

    Incorrect

    • The Henderson–Hasselbalch equation describes the derivation of pH as a measure of acidity. According to this equation, the buffering capacity of the system is at maximum when the number of free anions compared with undissociated acid is:

      Your Answer: Three times more

      Correct Answer: Equal

      Explanation:

      In 1908, Lawrence Joseph Henderson wrote an equation describing the use of carbonic acid as a buffer solution. Later, Karl Albert Hasselbalch re-expressed that formula in logarithmic terms, resulting in the Henderson–Hasselbalch equation. The equation is also useful for estimating the pH of a buffer solution and finding the equilibrium pH in acid–base reactions. Two equivalent forms of the equation are: pH = pKa + log10 [A–]/[HA] or pH = pKa + log10 [base]/[acid]. Here, pKa is − log10(Ka) where Ka is the acid dissociation constant, that is: pKa = –log10(Ka) = –log10 ([H3 O+][A–]/[HA]) for the reaction: HA + H2 O ≈ A– + H3 O+ In these equations, A– denotes the ionic form of the relevant acid. Bracketed quantities such as [base] and [acid] denote the molar concentration of the quantity enclosed. Maximum buffering capacity is found when pH = pKa or when the number of free anions to undissociated acid is equal and buffer range is considered to be at a pH = pKa ± 1.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      19.8
      Seconds
  • Question 29 - Ventricular filling follows a delay caused by? ...

    Correct

    • Ventricular filling follows a delay caused by?

      Your 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.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      7.3
      Seconds
  • Question 30 - A 55-years-old man presented to the emergency department complaining of a squeezing sensation...

    Correct

    • A 55-years-old man presented to the emergency department complaining of a squeezing sensation in his chest that has spread to his neck with associated worsening shortness of breath. Which of these laboratory tests would you ask for in this patient:

      Your Answer: Creatine kinase-MB

      Explanation:

      Creatine kinase-MB is a test that usually is ordered when the patient has chest pain as a cardiac marker. When a heart attack is suspected and a troponin test (which is more specific for heart damage), is not available CK-MB is ordered. There are 3 forms of CK: CK-MM, CK-BB and CK-MB. CK-MB is commonly found in heart tissue, therefore injured heart muscle cells release CK-MB into the blood. Elevated CK-MB levels indicate that it is probable that a person has recently had a heart attack.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      26
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (5/9) 56%
Head & Neck (3/4) 75%
Lower Limb (1/2) 50%
Inflammation & Immunology; Respiratory (0/1) 0%
Pathology (5/9) 56%
Physiology (6/12) 50%
Renal (1/2) 50%
Upper Limb (1/1) 100%
Thorax (0/1) 0%
General (1/4) 25%
Neurology (1/2) 50%
Abdomen (0/1) 0%
Inflammation & Immunology (1/1) 100%
Gastroenterology (2/2) 100%
Endocrine (1/2) 50%
Microbiology (1/1) 100%
Fluids & Electrolytes (1/3) 33%
Gastrointestinal; Hepatobiliary (0/1) 0%
Cardiovascular (2/2) 100%
Passmed