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Question 1
Correct
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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.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 2
Correct
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A 50-year-old woman with painful joints had some blood tests done with her GP. The test showed she had anti-double stranded DNA antibodies.
Which one of these disorders is most likely to be associated with anti-double stranded DNA antibodies?Your Answer: Systemic lupus erythematosus (SLE)
Explanation:CREST syndrome is usually associated with anti-centromere antibodies.
Primary biliary cirrhosis is associated with anti-mitochondrial antibodies.
Sjogren’s syndrome is associated with anti-Ro and anti-La antibodies.
Polymyositis is associated with anti-Jo1 antibodies.
Anti-double stranded DNA antibodies are highly characteristic of systemic lupus erythematosus (SLE). They are a group of anti-nuclear antibodies (ANA) that target double stranded DNA and are implicated in the pathogenesis of lupus nephritis.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 3
Correct
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A 40-year-old man with reduced urine output, nausea, and confusion also has a 150% rise of creatinine from baseline over the past 7 days. A diagnosis of acute kidney injury (AKI) is made after more tests are done.
His AKI stage is?Your Answer: Stage 2
Explanation:This patient with a 150% rise of creatinine above baseline within 7 days has stage 2 Acute kidney injury (AKI).
AKI stages are as follows:
Stage 1
Creatinine rise of 26 micromole/L or more within 48 hours, or
Creatinine rise of 50-99% from baseline within 7 days (1.5-1.99 x baseline),or
Urine output <0.5 mL/kg/hour for more than 6 hours Stage 2
Creatinine rise of 100-199% from baseline within 7 days (2.0-2.99 x baseline),or
Urine output <0.5 mL/kg/hour for more than 12 hours Stage 3
Creatinine rise of 200% or more from baseline within 7 days (3.0 or more x baseline), or
Creatinine rise to 354 micromole/L or more with acute rise of 26 micromole/L or more within 48 hours or 50% or more rise within 7 days, or
Urine output <0.3 mL/kg/hour for 24 hours or anuria for 12 hours -
This question is part of the following fields:
- General Pathology
- Pathology
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Question 4
Incorrect
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A newborn baby is rushed to the neonatal ICU 4 hours after birth due to sudden onset severe jaundice and generalised oedema. Family history reveals that this is the second baby, while blood testing shows that the mother has an Rh-negative blood group while the baby is Rh-positive. A diagnosis of haemolytic disease of the newborn is established.
Which one of the following hypersensitivity reactions have occurred in this case?Your Answer: Type III hypersensitivity reaction
Correct Answer: Type II hypersensitivity reaction
Explanation:Hepatitis A usually doesn’t pose a special risk to a pregnant woman or her baby. Maternal infection doesn’t result in birth defects, and a mother typically doesn’t transmit the infection to her baby. HAV is almost always transmitted by the faecal-oral route and is usually acquired through close personal contact or via contaminated food.
When a woman has chickenpox in the first 20 weeks of pregnancy, there is a 1 in 50 chance for the baby to develop a set of birth defects. This is called the congenital varicella syndrome. It includes scars, defects of muscle and bone, malformed and paralyzed limbs, small head size, blindness, seizures, and intellectual disability.
TORCH Syndrome refers to infection of a developing foetus or newborn by any of a group of infectious agents. “TORCH” is an acronym meaning (T)oxoplasmosis, (O)ther Agents, (R)ubella (also known as German Measles), (C)ytomegalovirus, and (H)erpes Simplex.
Infection with any of these agents may cause a constellation of similar symptoms in affected newborns. These may include fever; difficulties feeding; small areas of bleeding under the skin, causing the appearance of small reddish or purplish spots; enlargement of the liver and spleen (hepatosplenomegaly); yellowish discoloration of the skin, whites of the eyes, and mucous membranes (jaundice); hearing impairment; abnormalities of the eyes; and other symptoms and findings. -
This question is part of the following fields:
- General Pathology
- Pathology
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Question 5
Correct
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A dermatological examination on a patient presenting with a skin lesion which shows a solid, well circumscribed, lump measuring 0.8 cm in diameter. Which one of these best describes the lump you have found on examination?
Your Answer: Papule
Explanation:Macule— a small patch of skin that is altered in colour, but is not elevated.
Patch — a large area of colour change, with a smooth surface.
Papule— elevated, solid, palpable lesion that is ≤ 1 cm in diameter. They may be solitary or multiple. Papules may be:
Nodule — elevated, solid, palpable lesion > 1 cm usually located primarily in the dermis and subcutis (deeper layers of the skin). The greatest portion of the lesion may be above or beneath the skin surface.
Vesicle — a small blister. It is a circumscribed lesion ≤ 1 cm in diameter that contains liquid (clear, serous or haemorrhagic).
Cyst — papule or nodule that contains fluid or semi-fluid material so is fluctuant
Plaque — a circumscribed, palpable lesion more than 1 cm in diameter; most plaques are elevated.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 6
Correct
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A 30-year-old male with a known allergy to natural latex rubber presents with an allergic reaction to a food he has just eaten.
Which ONE of these foods is most likely to cause an associated hypersensitivity in him?Your Answer: Banana
Explanation:About one third of patients with allergy to natural latex rubber (NRL) have an associated allergy to some plant-derived foods. It is known as the latex-fruit syndrome and occurs commonly with consumption of fresh fruits. Banana and avocado are the most implicated fruits but it can also be seen with tomato, kiwi and chestnut.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 7
Correct
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A patient presents to your clinic with fever of unknown origin. His blood results shows a markedly elevated C-Reactive Protein (CRP) level.
Which of these is responsible for mediating the release of CRP?
Your Answer: IL-6
Explanation:C-reactive protein (CRP) is an acute phase protein produced by the liver hepatocytes. Its production is regulated by cytokines, particularly interleukin 6 (IL-6) and it can be measured in the serum as a nonspecific marker of inflammation.
Although a high CRP suggest an acute infection or inflammation, it does not identify the cause or location of infection.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 8
Incorrect
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A 58-year-old man with a traumatic brain injury is brought into the ER. A medical student asks you about the processes that occur in the brain following a traumatic injury.
One of these best describes the central nervous systems response to injury.Your Answer: Axonal regeneration is carried out by Schwann cells in the brain
Correct Answer: Degeneration of the axon occurs proximally before it occurs distally
Explanation:Following neuronal injury, as seen in traumatic brain injury, the axon undergoes anterograde degeneration. Degradation starts from the cell body (proximally) and progresses distally. The axon becomes fragmented and degenerates.
The brain shows no reactive changes to injury is incorrect. Following major injury such as stroke, the brain undergoes a process of liquefactive degeneration, which leaves cystic spaces within the brain.
Axonal regeneration does not occur to any significant extent within the central nervous system unlike what is seen in the peripheral nervous system.
Astrocytes undergo reactive gliosis, leaving behind a firm translucent tissue around sites of damage.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 9
Correct
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A patient presents with a rash for a dermatological examination. A flat circumscribed area of discoloured skin measuring 0.7 cm in diameter is seen on examination.
What is the best description of this rash that you have found on examination?
Your Answer: Macule
Explanation:A macule is a flat, well circumscribed area of discoloured skin less than 1 cm in diameter with no changes in the thickness or texture of the skin.
A vesicle is a visible collection of clear fluid measuring less than 0.5 cm in diameter.
A papule is a solid, well circumscribed, skin elevation measuring less than 0.5 cm in diameter.
A nodule is a solid, well circumscribed, raised area that lies in or under the skin and measures greater than 0.5 cm in diameter. They are usually painless.
A plaque is a palpable skin lesion that is elevated and measures >1cm in diameter.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 10
Incorrect
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A 66-year-old male was admitted from the Emergency Department due to severe pain in the left forearm and hand, refractory to pain medication along with pallor and hypothermia of the affected limb. Ultrasound doppler showed an arterial embolism. Circulation was restored after vascular surgery, but there was extensive, irreversible muscle damage.
How will the muscle heal from an injury of this type?Your Answer: Organised scar formation
Correct Answer: Diffuse formation of fibrous tissue
Explanation:Once muscle tissue is damaged, there will be healing via diffuse formation of fibrous tissue, especially due to the widespread ischemia.
Callus formation takes place in the healing of bone, not muscle.
Organised scar formation occurs when a lacerated wound is approximated by sutures so that primary intention wound healing can occur.
Liquefaction degeneration occurs following ischemia in the brain.
Volkmann’s ischemic contracture may occur, but it is not the primary type of healing that will take place but rather the effect of the fibrous scar formation.
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This question is part of the following fields:
- General Pathology
- Pathology
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SESSION STATS - PERFORMANCE PER SPECIALTY
