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  • Question 1 - Dysarthria, nystagmus and a tremor worsening with directed movement are likely to be...

    Correct

    • Dysarthria, nystagmus and a tremor worsening with directed movement are likely to be seen in:

      Your Answer: Cerebellar disease

      Explanation:

      The given symptoms are seen in diseases affecting the cerebellum. A cerebellar tremor is a slow tremor that occurs at the end of a purposeful movement. It is seen in cerebellar disease, such as multiple sclerosis or some inherited degenerative disorders and chronic alcoholism. Classically, tremors are produced in the same side of the body as a one-sided lesion. Cerebellar disease can also result in a wing-beating’ type of tremor called rubral or Holmes’ tremor – a combination of rest, action and postural tremors. Other signs of cerebellar disease include dysarthria (speech problems), nystagmus (rapid, involuntary rolling of the eyes), gait problems and postural tremor of the trunk and neck.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      4.3
      Seconds

  • Question 2 - A 35-year-old woman is in a comatose state following a traumatic head injury,...

    Correct

    • A 35-year-old woman is in a comatose state following a traumatic head injury, and is receiving intravenous (IV) antibiotics and IV fluids containing saline and 5% dextrose. A serum biochemistry analysis is performed five days later which shows a low serum potassium level. This is most likely to be due to:

      Your Answer: Nothing per oral regimen

      Explanation:

      In this patient the cause for hypokalaemia is insufficient consumption of potassium as she is nil-per mouth with no intravenous supplementation. Parenteral nutrition has been used for comatose patients, although enteral feeding is usually preferable, and less prone to complications.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      13.5
      Seconds

  • Question 3 - Which of the following is true about a patient who has undergone total...

    Incorrect

    • Which of the following is true about a patient who has undergone total colectomy and ileostomy?

      Your Answer: This patient is at increased risk of anaemia due to malabsorption of both iron and vitamin B12

      Correct Answer: Following total colectomy and ileostomy, the volume and water content of ileal discharge decreases over time

      Explanation:

      After a patient has undergone total colectomy and ileostomy, the volume of ileal discharge, along with its water content gradually decreases over time. Post surgery, most patients can live a normal life. Iron and vitamin B12 absorption do not take place in the colon and hence are not affected significantly by a colectomy.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      16.9
      Seconds

  • Question 4 - A 65-year-old smoker presents with painless haematuria, urinary frequency and urgency. He is...

    Incorrect

    • A 65-year-old smoker presents with painless haematuria, urinary frequency and urgency. He is diagnosed with bladder cancer. Which is the most likely type?

      Your Answer: Adenocarcinoma

      Correct Answer: Transitional cell carcinoma

      Explanation:

      90% of bladder cancers are transitional cell carcinomas derived from the bladder urothelium. Risk factors include industrial chemicals, smoking and infection. Schistosomiasis and bladder stones predispose to the squamous cell variety.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      9.9
      Seconds

  • Question 5 - Which one of the following muscles is innervated by the facial nerve? ...

    Correct

    • Which one of the following muscles is innervated by the facial nerve?

      Your Answer: Buccinator

      Explanation:

      Buccinator is a muscle of facial expression and is therefore innervated by the facial nerve. The lateral pterygoid, masseter, anterior belly of digastric and temporalis are all muscles of mastication and therefore innervated by the mandibular division of the trigeminal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck; Neurology
      10.4
      Seconds

  • Question 6 - The renal cortex and medulla, if seen under the microscope, is lacking one...

    Incorrect

    • The renal cortex and medulla, if seen under the microscope, is lacking one of the following:

      Your Answer: A basement membrane

      Correct Answer: Squamous epithelium

      Explanation:

      Capillaries, Henle’s loop, collecting ducts, Bertin columns and type IV collagen in glomerular basement membrane are all structures present in the renal cortex or medulla. The squamous epithelium is the only one that is lacking in both the renal cortex and medulla, because normally it is not found above the outer urethra.

    • This question is part of the following fields:

      • Pathology
      • Renal
      10.5
      Seconds

  • Question 7 - The thyroid gland is a large ductless gland located in which part of...

    Correct

    • The thyroid gland is a large ductless gland located in which part of the neck?

      Your Answer: Visceral space

      Explanation:

      The thyroid gland is an endocrine gland in the neck, consisting of two lobes connected by an isthmus. It is situated at the front and sides of the neck in the visceral space.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      5.5
      Seconds

  • Question 8 - A 40-year old woman with portal hypertension has impaired venous drainage of the...

    Correct

    • A 40-year old woman with portal hypertension has impaired venous drainage of the anal canal above the pectinate line. Thus, there might be an increase in blood flow downward to the systemic venous system via anastomoses with the inferior rectal vein. This is a tributary of?

      Your Answer: Internal pudendal vein

      Explanation:

      The inferior rectal vein drains into the internal pudendal vein. In addition the external iliac vein is one of the two branches of the common iliac vein however the internal iliac vein and it’s tributaries (including the pudendal vein) are much more important in draining the pelvic structures.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      27.4
      Seconds

  • Question 9 - Difficulty in retracting the foreskin of the penis in an uncircumcised male is...

    Correct

    • Difficulty in retracting the foreskin of the penis in an uncircumcised male is known as:

      Your Answer: Phimosis

      Explanation:

      Phimosis is the inability to fully retract the foreskin of the penis in an uncircumcised male. It can be physiological in infancy, in which it could be referred to as ‘developmental non-retractility of the foreskin. However, it is almost always pathological in older children and men. Causes include chronic inflammation (e.g. balanoposthitis), multiple catheterisations, or forceful foreskin retraction. One of the causes is chronic balanitis xerotica obliterans. It leads to development of a ring of indurated tissue near the tip of the prepuce, which prevents retraction. Contributory factors include infections, hormonal and inflammatory factors. The recommended treatment includes circumcision.

    • This question is part of the following fields:

      • Pathology
      • Urology
      3.9
      Seconds

  • Question 10 - What is the pH of freshly formed saliva at ultimate stimulation? ...

    Incorrect

    • What is the pH of freshly formed saliva at ultimate stimulation?

      Your Answer: 3.5

      Correct Answer: 8

      Explanation:

      Saliva has four major components: mucus (lubricant), α-amylase (enzyme that initiates digestion of starch), lingual lipase (enzyme that begins fat digestion), and a slightly alkaline electrolyte solution for moistening food. As the secretion rate of saliva increases, its osmolality increases. Moreover, the pH changes from slightly acidic (at rest) to basic (pH 8) at ultimate stimulation. This occurs due to increase of HCO3-. Amylase and mucus also increase in concentration after stimulation.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      6.3
      Seconds

  • Question 11 - The transverse colon has two curvatures known as the colic flexures on each...

    Correct

    • The transverse colon has two curvatures known as the colic flexures on each side of its lateral ends, the right and left. The left colic flexure found on the side of the descending colon is attached to an organ superiorly by a mesenteric ligament. Which organ is this?

      Your Answer: Spleen

      Explanation:

      The left colic flexure is the bend of the transverse colon as it continues to form the descending colon on the left upper quadrant. The spleen is located on the superior aspect of the left colic flexure. It is commonly referred to as the splenic flexure because of its relation o the spleen superiorly.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      7.5
      Seconds

  • Question 12 - A 20 year old is brought to the A&E after he fell from...

    Correct

    • A 20 year old is brought to the A&E after he fell from a moving cart. The boy has sustained blunt abdominal injury, and the there is a possibility of internal bleeding as the boy is in shock. An urgent exploratory laparotomy is done in the A&E theatre. On opening the peritoneal cavity, the operating surgeon notices a torn gastrosplenic ligament with a large clot around the spleen. Which artery is most likely to have been injured in this case?

      Your Answer: Short gastric

      Explanation:

      The short gastric arteries branch from the splenic artery near the splenic hilum to travel back in the gastrosplenic ligament to supply the fundus of the stomach. Therefore, these may be injured in this case.

      The splenic artery courses deep to the stomach to reach the hilum of the spleen. It doesn’t travel in the gastrosplenic ligament although it does give off branches that do.

      The middle colic artery is a branch of the superior mesenteric artery that supplies the transverse colon.

      Gastroepiploic artery is the largest branch of the splenic artery that courses between the layers of the greater omentum to anastomose with the right gastroepiploic.

      Left gastric artery, a branch of the coeliac trunk. It supplies the left half of the lesser curvature.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      13.5
      Seconds

  • Question 13 - A 18-year old girl presents to her doctor with an excessively enlarged left...

    Incorrect

    • A 18-year old girl presents to her doctor with an excessively enlarged left breast as compared to the right breast since puberty. The most likely cause for this is:

      Your Answer: Fibrocystic disease

      Correct Answer: Virginal breast hypertrophy

      Explanation:

      Virginal breast hypertrophy’ is the term assigned to excessive growth of breasts during puberty and is a common phenomenon. It is also known as ‘juvenile macromastia’ or ‘ juvenile gigantomastia’. The breast hypertrophy often starts with menarche and occasionally occurs in growth spurts. These spurts can cause physical discomfort, red and itchy skin or pain in the breasts. The breasts can also grow continuously over several years and lead to overdevelopment of a normal breast. Nipples also undergo enlargement along with the breasts.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      56.3
      Seconds

  • Question 14 - A lady presents to the out patient clinic with a painful boil on...

    Correct

    • A lady presents to the out patient clinic with a painful boil on the skin of her mons pubis. Which nerve supplies the skin of the mons pubis?

      Your Answer: Anterior labial

      Explanation:

      Anterior labial branch is the terminal branch of the ilioinguinal nerve that innervates the skin of the mons pubis in women and the skin of the anterior scrotum in men.

      The femoral branch of genitofemoral nerve innervates the upper medial thigh.

      The iliohypogastric innervates muscles of the abdominal wall.

      The subcostal nerve innervates muscles of the abdominal wall and the skin of the lower abdominal wall.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      4.3
      Seconds

  • Question 15 - A 55-year-old woman died 3 years after a cardiac transplant due to worsening...

    Correct

    • A 55-year-old woman died 3 years after a cardiac transplant due to worsening congestive heart failure. Autopsy revealed diffuse hyperplasia of the vascular intima involving the entire length of the coronary arteries. The most probable cause of deterioration of the cardiac function is:

      Your Answer: Coronary atherosclerosis

      Explanation:

      Allograft coronary artery disease (CAD) can begin right after the transplant and is the major cause of later death in cardiac transplant recipients. This form of atherosclerosis progresses quickly resulting in allograft failure. Due to lack of premonitory symptoms CAD may lead to sudden death.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      12.4
      Seconds

  • Question 16 - A 48-year-old woman has a mass in her right breast and has right...

    Incorrect

    • A 48-year-old woman has a mass in her right breast and has right axillary node involvement. She underwent radical mastectomy of her right breast. The histopathology report described the tumour to be 4 cm in its maximum diameter with 3 axillary lymph nodes with evidence of tumour. The most likely stage of cancer in this patient is:

      Your Answer: IIIA

      Correct Answer: IIB

      Explanation:

      Stage IIB describes invasive breast cancer in which: the tumour is larger than 2 centimetres but no larger than 5 centimetres; small groups of breast cancer cells — larger than 0.2 millimetre but not larger than 2 millimetres — are found in the lymph nodes OR the tumour is larger than 2 centimetres but no larger than 5 centimetres; cancer has spread to 1 to 3 axillary lymph nodes or to lymph nodes near the breastbone (found during a sentinel node biopsy) OR the tumour is larger than 5 centimetres but has not spread to the axillary lymph nodes.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      14.7
      Seconds

  • Question 17 - Which of the following conditions causes an elevation of the pH in the...

    Incorrect

    • Which of the following conditions causes an elevation of the pH in the tissues with elevated arterial CO2 content?

      Your Answer: Respiratory alkalosis

      Correct Answer: Metabolic alkalosis

      Explanation:

      Metabolic alkalosis is a metabolic condition in which the pH of tissue is elevated beyond the normal range (7.35-7.45). This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate, or alternatively a direct result of increased bicarbonate concentrations. Normally, arterial pa(CO2) increases by 0.5–0.7 mmHg for every 1 mEq/l increase in plasma bicarbonate concentration, a compensatory response that is very quick. If the change in pa(CO2) is not within this range, then a mixed acid–base disturbance occurs.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      22.8
      Seconds

  • Question 18 - A patient who complained of pain on the lower left side of the...

    Incorrect

    • A patient who complained of pain on the lower left side of the back had an x-ray done which confirmed a hernia passing posterolaterally, just superior to the iliac crest. Where is this hernia passing through?

      Your Answer: Inguinal triangle

      Correct Answer: Lumbar triangle

      Explanation:

      The lumber triangle is bound medially by the border of the latissimus dorsi, laterally by the external abdominal oblique and by the iliac crest inferiorly. This is exactly where the hernia that is described is located.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      33.8
      Seconds

  • Question 19 - At which cervical level does the common carotid artery bifurcate into the internal...

    Correct

    • At which cervical level does the common carotid artery bifurcate into the internal and external carotid arteries?

      Your Answer: C4

      Explanation:

      The common carotid arteries are present on the left and right sides of the body. These arteries originate from different sources, but follow symmetrical courses. The right common carotid originates in the neck from the brachiocephalic trunk; the left from the aortic arch in the thorax. These split into the external and internal carotid arteries at the upper border of the thyroid cartilage, at around the level of the fourth cervical vertebra.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      11.9
      Seconds

  • Question 20 - A 34-year-old woman is diagnosed with cerebral oedema after suffering a severe head...

    Incorrect

    • A 34-year-old woman is diagnosed with cerebral oedema after suffering a severe head trauma. Which of the following conditions is not likely to be associated with the extracellular oedema?

      Your Answer: All answers are correct

      Correct Answer: Increased plasma colloid osmotic pressure

      Explanation:

      Cerebral oedema is extracellular fluid accumulation in the brain. Increased capillary permeability, increased capillary pressure, increased interstitial fluid colloid osmotic pressure and lymphatic blockage would increase fluid movement into the interstitial spaces. Increased plasma colloid osmotic pressure, however, would oppose fluid movement from the capillaries into the interstitial compartment.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      10.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Neurology (1/1) 100%
Physiology (2/6) 33%
Fluids & Electrolytes (1/3) 33%
Gastroenterology (0/2) 0%
Neoplasia (0/2) 0%
Pathology (2/6) 33%
Anatomy (7/8) 88%
Head & Neck; Neurology (1/1) 100%
Renal (0/1) 0%
Head & Neck (2/2) 100%
Pelvis (1/1) 100%
Urology (1/1) 100%
Abdomen (3/3) 100%
Women's Health (0/1) 0%
Cardiovascular (1/1) 100%
Lower Limb (0/1) 0%
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