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  • Question 1 - Blood investigations of a patient with vitamin K deficiency revealed a prolonged prothrombin...

    Incorrect

    • Blood investigations of a patient with vitamin K deficiency revealed a prolonged prothrombin time. This coagulation abnormality is most probably due to:

      Your Answer: von Willebrand’s disease

      Correct Answer: Factor VII deficiency

      Explanation:

      Factor VII deficiency is a bleeding disorder caused by a deficiency or reduced activity of clotting factor VII. It may be inherited or acquired at some point during life. Inherited factor VII deficiency is an autosomal recessive disorder caused by mutations of the F7 gene. Factor VII is vitamin K-dependent, as are Factors II, IX and X and therefore lack of this vitamin can cause the development of acquired factor VII deficiency. Other causes of acquired deficiency of this factor include liver disease, sepsis and warfarin therapy.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      24
      Seconds

  • Question 2 - A 45-year-old woman was brought to the emergency department due to fever and...

    Correct

    • A 45-year-old woman was brought to the emergency department due to fever and chills. She has a history of recurrent UTI and complains of dysuria and urinary frequency. Urinary white blood cell count is >200 cell/high power field. If urine culture is performed, what is the most likely organism that will grow?

      Your Answer: Escherichia coli

      Explanation:

      The pathogen that most likely causes recurrent urinary tract infection in young women are E. coli, Enterococcus and Staphylococcus saprophyticus.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      22
      Seconds

  • Question 3 - When you rest your elbows on a desk, what bony landmark of the...

    Correct

    • When you rest your elbows on a desk, what bony landmark of the upper limb are you resting on?

      Your Answer: Olecranon process of the ulna

      Explanation:

      At the upper and back part of the ulna, there exists a curved eminence which is the olecranon process. This process lodges in the olecranon fossa of the humerus. It’s posterior surface is subcutaneous and this triangular area is what you rest your elbow upon.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      8.5
      Seconds

  • Question 4 - A patient is suspected to have a chromosomal abnormality. Which tumour and chromosomal...

    Correct

    • A patient is suspected to have a chromosomal abnormality. Which tumour and chromosomal association is correct?

      Your Answer: Neuroblastoma – chromosome 1

      Explanation:

      Neuroblastoma is associated with a deletion on chromosome 1 and inactivation of a suppressor gene. Neurofibromas and osteogenic sarcoma are associated with an abnormality on chromosome 17. Retinoblastoma (Rb) is associated with an abnormality on chromosome 13. Wilms’ tumours of the kidney are associated with an abnormality on chromosome 11.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      8.6
      Seconds

  • Question 5 - 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
      24013.6
      Seconds

  • Question 6 - Which muscle originates from the common flexor tendon of the forearm? ...

    Correct

    • Which muscle originates from the common flexor tendon of the forearm?

      Your Answer: Flexor digitorum superficialis

      Explanation:

      The medial epicondyle of the humerus is the site of origin of this group of muscles of the forearm. It originates from the medial epicondyle of the humerus by a common tendon. Fibres from the deep fascia of the forearm, near the elbow and septa, pass from this fascia between the muscles. These muscles include the pronator teres, palmaris longus, flexor carpi radialis, flexor carpi ulnaris and flexor digitorum superficialis.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      453.5
      Seconds

  • Question 7 - The gradual depolarization in-between action potentials in pacemaker tissue is a result of?...

    Correct

    • The gradual depolarization in-between action potentials in pacemaker tissue is a result of?

      Your Answer: A combination of gradual inactivation outward IK along with the presence of an inward ‘funny’ current (If) due to opening of channels permeable to both Na+ and K+ ions

      Explanation:

      One of the characteristic features of the pacemaker cell is the generation of a gradual diastolic depolarization also called the pacemaker potential. In phase 0, the upstroke of the action potential caused by an increase in the Ca2+ conductance, an influx of calcium occurs and a positive membrane potential is generated. The next is phase 3 which is repolarization caused by increased K+ conductance as a result of outwards K+ current. Phase 4 is a slow depolarization which accounts for the pacemaker activity, caused by increased conductance of Na+, inwards Na+ current called IF. it is turned on by repolarization.

    • This question is part of the following fields:

      • General
      • Physiology
      70595.1
      Seconds

  • Question 8 - A brain tumour causing blockage of the hypophyseal portal system is likely to...

    Incorrect

    • A brain tumour causing blockage of the hypophyseal portal system is likely to result in an increased secretion of which of the following hormones?

      Your Answer:

      Correct Answer: Prolactin

      Explanation:

      The hypophyseal portal system links the hypothalamus and the anterior pituitary. With the help of this system, the anterior pituitary receives releasing and inhibitory hormones from the hypothalamus and regulates the action of other endocrine glands. One of the inhibitory hormones carried by this system is the prolactin-inhibitory hormone. In the absence of this hormone which might occur in case of a blockage of the system, prolactin secretion increases to about three times normal levels.

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      0
      Seconds

  • Question 9 - Which of the following organelles have the capacity to regenerate and spontaneously replicate?...

    Incorrect

    • Which of the following organelles have the capacity to regenerate and spontaneously replicate?

      Your Answer:

      Correct Answer: Mitochondrion

      Explanation:

      A mitochondria is a membrane bound organelle found in eukaryotic cells. They are called the powerhouse of the cell and are the place where ATP is formed from energy generated through metabolism. They are capable of replication as well as repair and regeneration.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 10 - A 60 year-old patient being treated for hypertension presents to the ED with...

    Incorrect

    • A 60 year-old patient being treated for hypertension presents to the ED with swelling of the left upper limb due to poor venous return. On examination, it is found that an aneurysm of the ascending aorta is impinging on a large vein lying immediately anterosuperior to it. Which vein is it likely to be?

      Your Answer:

      Correct Answer: Left brachiocephalic

      Explanation:

      Among the veins listed, only the left brachiocephalic vein is anterosuperior to the ascending aorta. The right brachiocephalic vein being on the right side would not be affected by the aortic aneurysm.

      The azygos vein lies deep in the chest on the right side.

      The internal thoracic vein lies interior to the anterior wall of the chest.

      The left superior intercostal vein is close to the aortic arch, crossing it laterally. This vein drains the 2nd to 4th interspaces on the left side.

      The Right internal jugular vein joins the right brachiocephalic vein which would not be affected by the aneurysm.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 11 - In a hypertensive patient with secondary hyperaldosteronism, aldosterone is released mainly in response...

    Incorrect

    • In a hypertensive patient with secondary hyperaldosteronism, aldosterone is released mainly in response to:

      Your Answer:

      Correct Answer: Angiotensin II

      Explanation:

      Secondary hyperaldosteronism in hypertension is either due to primary renin overproduction by the kidneys or renin overproduction secondary to decreased renal blood flow. The main stimulus for aldosterone release are adrenocorticotrophic hormone (ACTH), angiotensin II and high plasma K+ levels. Low plasma Na+ might also stimulate the adrenal cortex. Fluid overload will reduce aldosterone secretion. Atrial natriuretic peptide is secreted under conditions of expanded extracellular volume and will not lead to aldosterone secretion.

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      0
      Seconds

  • Question 12 - Which of these antibiotics is the first choice treatment for infections caused by...

    Incorrect

    • Which of these antibiotics is the first choice treatment for infections caused by Pseudomonas aeruginosa?

      Your Answer:

      Correct Answer: Piperacillin

      Explanation:

      Piperacillin is an extended-spectrum beta-lactam antibiotic of the ureidopenicillin class. It is normally used with a beta-lactamase inhibitor such as tazobactam. The combination has activity against many Gram-positive and Gram-negative pathogens and anaerobes, including Pseudomonas aeruginosa. Piperacillin is sometimes referred to as an anti-pseudomonal penicillin.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds

  • Question 13 - A cell is classified on the basis of its regenerative ability. Which of...

    Incorrect

    • A cell is classified on the basis of its regenerative ability. Which of the following cells represent a permanent cell?

      Your Answer:

      Correct Answer: Erythrocyte

      Explanation:

      An erythrocyte is the last cell in the progeny of RBC cell division and is not capable of further division and regeneration. Hepatocytes, osteocytes and epithelium of kidney tubules are all stable cells. Colonic mucosa and pluripotent hematopoietic stem cells are all labile cells.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      0
      Seconds

  • Question 14 - A patient in the recovery ward after cardiac surgery is noticed to have...

    Incorrect

    • A patient in the recovery ward after cardiac surgery is noticed to have a small effusion in the lowest extent of the pleural cavity, into which no lung tissue extends. What is the name of this part of the pleural cavity?

      Your Answer:

      Correct Answer: Costodiaphragmatic recess

      Explanation:

      The costodiaphragmatic recess is the part of the pleural cavity where the costal pleura is in continuity with the diaphragmatic pleura. It forms the lowest extent of the pleural cavity.

      Costomediastinal recess: a tiny recess that is anteriorly located, where the costal pleura becomes continuous with the mediastinal pleura.

      The cupola is the pleural cavity that extends above the first rib.

      The inferior mediastinum refers to the posterior, middle and anterior mediastinal divisions together.

      The pulmonary ligament on the other hand, is a pleural fold that is situated beneath the root of the lung on the medial aspect of the lung.

      Oblique pericardial sinus is not part of the pleural cavity.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 15 - Which muscle in the neck divides the neck into two large triangles? ...

    Incorrect

    • Which muscle in the neck divides the neck into two large triangles?

      Your Answer:

      Correct Answer: Sternocleidomastoid

      Explanation:

      The sternocleidomastoid muscle is an important landmark in the neck as it divides the neck into two; anterior and posterior triangles. These triangles help in the location of the structures of the neck including the carotid artery, head and neck lymph nodes, accessory nerve and the brachial plexus. It originates from the manubrium and medial portion of the clavicle and inserts on the mastoid process of the temporal bone, superior nuchal line. The sternocleidomastoid receives blood supply from the occipital artery and the superior thyroid artery. It is innervated by the accessory nerve (motor) and cervical plexus (sensory).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 16 - During an operation to repair an indirect inguinal hernia, it is noticed that...

    Incorrect

    • During an operation to repair an indirect inguinal hernia, it is noticed that the hernial sac is protruding out of the superficial inguinal ring. The superficial inguinal ring is an opening in which structure?

      Your Answer:

      Correct Answer: External abdominal oblique aponeurosis

      Explanation:

      The superficial inguinal ring is an opening in the aponeurosis of the external oblique just above and lateral to the pubic crest. The opening is oblique and corresponds to the fibres of the aponeurosis. It is bound inferiorly by the pubic crest, on either side by the margins of the opening in the aponeurosis and superiorly by the curved intercrural fibres.

      The inferior crus is formed by the portion of the inguinal ligament that is inserted into the pubic tubercle.

      The falx inguinalis is made of arching fibres of the transversalis fascia and the internal abdominal oblique muscle. It forms the posterior wall of the inguinal canal.

      The internal abdominal oblique forms the root of the inguinal canal.

      Scarpa’s and Camper’s fascia are the membranous and fatty layers, respectively of subcutaneous fascia.

      Transversalis fascia covers the posterior surface of the rectus abdominis muscle inferior to the arcuate line.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 17 - Under normal conditions, what is the major source of energy of cardiac muscles?...

    Incorrect

    • Under normal conditions, what is the major source of energy of cardiac muscles?

      Your Answer:

      Correct Answer: Fatty acids

      Explanation:

      Under basal conditions, most of the energy needed by cardiac muscle for metabolism is derived from fats (60%), 35% by carbohydrates, and 5% by ketones and amino acids. However, after intake of large amounts of glucose, lactate and pyruvate are mainly used. During prolonged starvation, fat acts as the primary source. 50% of the used lipids are sourced from circulating fatty acids.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 18 - A patient is brought to the accident and emergency department. He is said...

    Incorrect

    • A patient is brought to the accident and emergency department. He is said to have been involved in a mall explosion. Chest imaging reveals metal fragments in his thoracic cavity. He also has a pericardial effusion suggestive of a pericardial tear. An emergency thoracotomy is done which revealed a tear of the pericardium inferiorly. The surgeon began to explore for fragments in the pericardial sac with his hand from below the apex. He slips his fingers upward and to the right within the sac until they were stopped by the cul-de-sac formed by the pericardial reflection near the base of the heart. His finger tips were now in the:

      Your Answer:

      Correct Answer: Oblique pericardial sinus

      Explanation:

      Transverse sinus: part of pericardial cavity that is behind the aorta and pulmonary trunk and in front of the superior vena cava separating the outflow vessels from the inflow vessels.

      Oblique pericardial sinus: is behind the left atrium where the visceral pericardium reflects onto the pulmonary veins and the inferior vena cava. Sliding a finger under the heart will take you to this sinus.

      Coronary sinus: large vein that drains the heart into the right atrium. Located on the surface of the heart.

      Coronary sulcus: groove on the heart demarcating the atria from the ventricles.

      Costomediastinal recess: part of the pleural sac where the costal pleura transitions to become the mediastinal pleura.

      Sulcus terminalis: a groove between the right atrium and the vena cava.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 19 - A 39-year old female patient was diagnosed with a tumour of the left...

    Incorrect

    • A 39-year old female patient was diagnosed with a tumour of the left adrenal gland. The tumour, which is metastasizing to the adjacent tissues, has already extended to the left suprarenal vein. If the tumour is still spreading, which of the following veins will most likely be affected after the involvement of the left suprarenal vein?

      Your Answer:

      Correct Answer: Left renal vein

      Explanation:

      The suprarenal veins or also known as the veins of Warshaw, are the veins that receive blood from the suprarenal glands. These veins receive blood from the medullary venous plexus and the cortex of the adrenal glands (suprarenal glands). They are two in number – the left and the right suprarenal veins. The right suprarenal vein drains into the inferior vena cava while the left suprarenal vein drains into the left renal vein. This therefore means that in the case of a metastasizing tumour involving the left suprarenal vein, the tumour will most likely extend from the left suprarenal vein to the left renal vein into which it drains.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 20 - The inferior palpebral nerve ascends behind the orbicularis oculi. What is the terminal...

    Incorrect

    • The inferior palpebral nerve ascends behind the orbicularis oculi. What is the terminal branch of the inferior palpebral nerve?

      Your Answer:

      Correct Answer: Infraorbital nerve

      Explanation:

      The inferior palpebral nerve is a branch of the maxillary nerve. It supplies the skin and conjunctiva of the lower eyelid.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 21 - A patient had sudden complete loss of vision of the right eye. Fundoscopy...

    Incorrect

    • A patient had sudden complete loss of vision of the right eye. Fundoscopy showed the distinct cherry red spot on the retina. Which of the following arteries was occluded?

      Your Answer:

      Correct Answer: Central artery of the retina

      Explanation:

      The central retinal artery supplies all the nerve fibres that form the optic nerve, which carries the visual information to the lateral geniculate nucleus of the thalamus. Thus if the central retinal artery gets occluded, there is complete loss of vision in that eye and the entire retina (with the exception of the fovea) becomes pale, swollen and opaque while the central fovea still appears reddish (this is because the choroid colour shows through). This is the basis of the famous Cherry red spot seen on examination of the retina on fundoscopy of a central retinal artery occlusion (CRAO).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 22 - What is the basic chemical reaction that takes place in the breakdown of...

    Incorrect

    • What is the basic chemical reaction that takes place in the breakdown of complex foodstuffs?

      Your Answer:

      Correct Answer: Hydrolysis

      Explanation:

      Breakdown of complex food into simpler compounds is achieved by hydrolysis, with the help of different enzymes specific for different compounds.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds

  • Question 23 - Which of the following factors will not affect the wound healing process in...

    Incorrect

    • Which of the following factors will not affect the wound healing process in a young women who suffered serious burns to her chest and hands?

      Your Answer:

      Correct Answer: Vitamin A deficiency

      Explanation:

      Healing can be sped-up or slowed down due to various reasons: 1. blood supply, 2. infection, 3. denervation, 4. collection of blood/hematoma, 5. mechanical stress, 6. foreign body, 7. techniques used during surgery and 8. dressing of the wound. Other systemic factors include 1. nutrition e.g. deficiency of zinc, vitamin C, protein deficiency, 2. metabolic status, 3. circulatory status and 4. hormonal influence

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      0
      Seconds

  • Question 24 - What is the reason for a deranged thrombin clotting time? ...

    Incorrect

    • What is the reason for a deranged thrombin clotting time?

      Your Answer:

      Correct Answer: Heparin therapy

      Explanation:

      Thrombic clotting time is also known as thrombin time. It is clinically performed to determine the therapeutic levels of heparin. After plasma is isolated from the blood, bovine thrombin is added to it and the time it takes from the addition to clot is recorded. The reference interval is usually <21s. deranged results are indicative of heparin therapy, hypofibrinogenemia, hyperfibrinogenaemia or lupus anticoagulant.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 25 - Which of the following cytokines produced by the T cell induce MHC-II proteins?...

    Incorrect

    • Which of the following cytokines produced by the T cell induce MHC-II proteins?

      Your Answer:

      Correct Answer: γ-Interferon

      Explanation:

      Interferons elicit a non-specific antiviral activity by inducing specific RNA synthesis and expression of proteins in neighbouring cells. Common interferon inducers are viruses, double-stranded RNA and micro-organisms. INF-γ is produced mainly by CD4+, CD8+ T cells and less commonly by B cells and natural killer cells. INF-γ has antiviral and antiparasitic activity but its main biological activity appears to be immunomodulatory. Among its many functions are activation of macrophages and enhanced expression of MHC-II proteins or macrophages.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 26 - Which of the following foramen provides passage of the facial nerve? ...

    Incorrect

    • Which of the following foramen provides passage of the facial nerve?

      Your Answer:

      Correct Answer: Internal acoustic meatus

      Explanation:

      The internal auditory meatus provides a passage through which the vestibulocochlear nerve, the facial nerve, and the labyrinthine artery (an internal auditory branch of the basilar artery) can pass from inside the skull to structures of the inner ear and face.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 27 - Nephrotic syndrome is a condition that causes proteinuria, hypoalbuminemia and oedema. Which of...

    Incorrect

    • Nephrotic syndrome is a condition that causes proteinuria, hypoalbuminemia and oedema. Which of the following is the cause of the oedema in these patients?

      Your Answer:

      Correct Answer: Decreased oncotic pressure

      Explanation:

      The glomeruli of the kidneys are the parts that normally filter the blood. They consist of capillaries that are fenestrated and allow fluid, salts and other small solutes to flow through, but normally not proteins. In nephrotic syndrome, the glomeruli become damaged allowing small proteins, such as albumin to pass through the kidneys into urine. Oedema usually occurs due to salt and water retention by the diseased kidneys as well as due to the reduced colloid oncotic pressure (because of reduced albumin in the plasma). Lower serum oncotic pressure causes fluid to accumulate in the interstitial tissues.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 28 - The muscles of the superficial posterior compartment of the leg insert into the:...

    Incorrect

    • The muscles of the superficial posterior compartment of the leg insert into the:

      Your Answer:

      Correct Answer: Calcaneus

      Explanation:

      The muscles of the superficial posterior compartment of the leg form the characteristic ‘calf’ shape of the posterior leg and include the gastrocnemius, soleus and plantaris. The gastrocnemius and soleus together form a muscular mass which is occasionally described as the triceps surae; its tendon of insertion is the tendo calcaneus. The tendo calcaneus is the thickest and strongest in the body and together with the tendon of the plantaris muscle is inserted into the posterior part of the calcaneus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 29 - Which of the following foramina will the ophthalmic artery pass through in order...

    Incorrect

    • Which of the following foramina will the ophthalmic artery pass through in order to reach the eye?

      Your Answer:

      Correct Answer: Optic canal

      Explanation:

      The optic foramen is the opening to the optic canal. The canal is located in the sphenoid bone; it is bounded medially by the body of the sphenoid and laterally by the lesser wing of the sphenoid. The superior surface of the sphenoid bone is bounded behind by a ridge, which forms the anterior border of a narrow, transverse groove, the chiasmatic groove (optic groove). The groove ends on either side in the optic foramen, which transmits the optic nerve and ophthalmic artery into the orbital cavity. Compared to the optic nerve, the ophthalmic artery is located inferolaterally within the canal.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 30 - Which of the following is a likely cause of jaundice? ...

    Incorrect

    • Which of the following is a likely cause of jaundice?

      Your Answer:

      Correct Answer: Hepatic disease if plasma albumin is low and serum aminotransferase elevations > 500 units

      Explanation:

      Jaundice can occur due to any of the possible causes and treatment depends upon diagnosing the correct condition. Mild hyperbilirubinemia with normal levels of aminotransferase and alkaline phosphatase is often unconjugated (e.g., due to haemolysis or Gilbert’s syndrome rather than hepatobiliary disease). Moderate or severe hyperbilirubinemia along with increased urinary bilirubin (bilirubinuria), high alkaline phosphatase or aminotransferase levels suggest hepatobiliary disease. Hyperbilirubinemia produced by any hepatobiliary disease is largely conjugated. In this case, other blood tests include hepatitis serology for suspected hepatitis, prothrombin time (PT) or international normalised ratio (INR), albumin and globulin levels, and antimitochondrial antibody levels (suspected primary biliary cirrhosis). Low albumin and high globulin levels suggest chronic rather than acute liver disease. In cases where there is only a an elevation of alkaline phosphatase, γ-glutamyl transpeptidase (GGT) levels should be checked – the levels of which will be found high in hepatobiliary disease, but not in bone disorder which can also lead to elevated alkaline phosphatase levels. In diseases of hepatobiliary origin, aminotransferase elevations > 500 units suggest a hepatocellular cause, whereas disproportionate increases of alkaline phosphatase (e.g., alkaline phosphatase > 3 times normal and aminotransferase < 200 units) suggest cholestasis. Because hepatobiliary disease alone rarely causes bilirubin levels > 30 mg/dl, higher levels are suggestive of a combination of severe hepatobiliary disease and haemolysis or renal dysfunction. Imaging is best for diagnosing infiltrative and cholestatic causes of jaundice. Liver biopsy is rarely needed, but can be of use in intrahepatic cholestasis and in some types of hepatitis.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds

  • Question 31 - A young man was thrown from a vehicle in a collision. He landed...

    Incorrect

    • A young man was thrown from a vehicle in a collision. He landed on his head and shoulder tip, stretching the left side of his neck. A neurological examination revealed that the fifth and sixth cervical nerves had been torn from the spinal cord. What is the most obvious clinical manifestation of this?

      Your Answer:

      Correct Answer: Abduction

      Explanation:

      In the case of injuries to the upper roots of the brachial plexus there is complete loss of abduction. The muscle performing this movement is the supraspinatus. This initiates the movement, followed by the deltoid muscle, which allows for complete abduction. Both these muscles are innervated by nerves originating from C5 and C6. The injury to these roots results in a condition named Erb-Duchenne’s palsy.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 32 - During an appendicectomy in a 16 year old girl, the registrar initially did...

    Incorrect

    • During an appendicectomy in a 16 year old girl, the registrar initially did not find the appendix on entering the peritoneal cavity. She, however, remained calm as she knew she could find it by:

      Your Answer:

      Correct Answer: Looking at the confluence of the taenia coli

      Explanation:

      The vermiform appendix arises from the apex of the caecum. Although it has a constant base, it can pass in one of several directions such as upward behind the caecum, to the left behind the ileum and mesentery or downward into the lesser pelvis. It is retained in place by a peritoneal fold, the mesoenteriole derived from the left leaf of the mesentery. Taenia coli meet at the appendix which is the terminal portion of the caecum. The appendix is below the ileocecal valve, not above. It is not near the right colic artery (which supplies the ascending colon). It would not be found by removing a layer of the jejuno-ileum and is not in the pelvic brim.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 33 - Atrial septal defect (ASD) is most likely to be due to incomplete closure...

    Incorrect

    • Atrial septal defect (ASD) is most likely to be due to incomplete closure of which one of the following structures:

      Your Answer:

      Correct Answer: Foramen ovale

      Explanation:

      Atrial septal defect is a congenital heart defect that results in a communication between the right and left atria of the heart and may involve the interatrial septum. It results from incomplete closure of the foramen ovale which is normally open during fetal life and closes just after birth.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 34 - A 43-year-old diabetic man complains of headaches, palpitations, anxiety, abdominal pain and weakness....

    Incorrect

    • A 43-year-old diabetic man complains of headaches, palpitations, anxiety, abdominal pain and weakness. He is administered sodium bicarbonate used to treat:

      Your Answer:

      Correct Answer: Metabolic acidosis

      Explanation:

      Sodium bicarbonate is indicated in the management of metabolic acidosis, which may occur in severe renal disease, uncontrolled diabetes, circulatory insufficiency due to shock or severe dehydration, extracorporeal circulation of blood, cardiac arrest and severe primary lactic acidosis. Bicarbonate is given at 50-100 mmol at a time under scrupulous monitoring of the arterial blood gas readings. This intervention, however, has some serious complications including lactic acidosis, and in those cases, should be used with great care.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds

  • Question 35 - A 70-year-old man who was previously healthy develops a rapidly progressing neurological deficit....

    Incorrect

    • A 70-year-old man who was previously healthy develops a rapidly progressing neurological deficit. A MRI reveals a large, poorly defined mass with central necrosis in his left temporal lobe. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Glioblastoma multiforme

      Explanation:

      Glioblastoma multiforme, or grade 4 astrocytoma, is the most common and aggressive primary brain tumour. They are formed by small areas of necrotising tissue surrounded by highly anaplastic cells. Most of them arise from the deep white matter of the brain and quickly infiltrate it, becoming very large before they are symptomatic. The most common symptom is progressive memory, personality or neurological deficit due to temporal and frontal lobe involvement. It is most common in men, and risk factors include: neurofibromatosis, tuberous sclerosis, Von Hippel-Lindau disease, Li-Fraumeni syndrome, and Turcot syndrome.

    • This question is part of the following fields:

      • Neurology
      • Pathology
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  • Question 36 - What Is the mechanism behind rhesus incompatibility in a new born baby? ...

    Incorrect

    • What Is the mechanism behind rhesus incompatibility in a new born baby?

      Your Answer:

      Correct Answer: Type II hypersensitivity

      Explanation:

      In type II hypersensitivity the antibodies that are produced by the immune response bind to the patients own cell surface antigens. These antigens can be intrinsic or extrinsic. Destruction occurs due to antibody dependent cell mediated antibodies. Antibodies bind to the cell and opsonise the cell, activating phagocytes to destroy that cell e.g. autoimmune haemolytic anaemia, Goodpasture syndrome, erythroblastosis fetalis, pernicious anaemia, Graves’ disease, Myasthenia gravis and haemolytic disease of the new-born.

    • This question is part of the following fields:

      • Inflammation & Immunology; Haematology
      • Pathology
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  • Question 37 - A 35 year-old man presents with high grade fever for 7 days after...

    Incorrect

    • A 35 year-old man presents with high grade fever for 7 days after returning from a trip to India. He tested positive for widal test. What is the most likely organism that caused his fever?

      Your Answer:

      Correct Answer: Salmonella typhi

      Explanation:

      Typhoid fever is caused by virulent bacteria called Salmonella typhi. Salmonella typhi spread through contaminated food or water and occasionally through direct contact with someone who is infected.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
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  • Question 38 - A 16-year old boy was brought in an unconscious state to the emergency...

    Incorrect

    • A 16-year old boy was brought in an unconscious state to the emergency department. Clinical evaluation pointed in favour of acute adrenal insufficiency. On enquiry, it was revealed that he was suffering from a high grade fever 24 hours prior. On examination, extensive purpura were noted on his skin. The likely diagnosis is:

      Your Answer:

      Correct Answer: Meningococcaemia

      Explanation:

      Findings described are suggestive of Waterhouse-Friderichsen syndrome which develops secondary to meningococcaemia. The reported incidence of Addison’s disease is 4 in 100,000. It affects both sexes equally and is seen in all age groups. It tends to show clinical symptoms at the time of metabolic stress or trauma. The symptoms are precipitated by acute infections, trauma, surgery or sodium loss due to excessive perspiration.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
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  • Question 39 - During an OSCE exam a medical student is asked to locate the sternal...

    Incorrect

    • During an OSCE exam a medical student is asked to locate the sternal angle. The sternal angle is a land mark for locating the level of the:

      Your Answer:

      Correct Answer: Second costal cartilage

      Explanation:

      The sternal angle, a key landmark used in the clinic for auscultating for heart sounds, is the point of attachment of the costal cartilage of rib 2 to the sternum. It thus corresponds to the location of the second rib. A horizontal plane through the sternal angle traverses the T4/T5 intervertebral disc and marks the inferior boundary of the superior mediastinum.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 40 - The presence of oval fat bodies in the urine is most likely to...

    Incorrect

    • The presence of oval fat bodies in the urine is most likely to be seen in which of the following conditions?

      Your Answer:

      Correct Answer: Nephrotic syndrome

      Explanation:

      Nephrotic syndrome is associated with the presence of oval fat bodies on urinalysis due to increased proteinuria and lipiduria.

    • This question is part of the following fields:

      • Pathology
      • Renal
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  • Question 41 - A 50-year-old man is diagnosed with emphysema and cirrhosis of the liver. Which...

    Incorrect

    • A 50-year-old man is diagnosed with emphysema and cirrhosis of the liver. Which of the following condition may be the cause of both cirrhosis and emphysema in this patient?

      Your Answer:

      Correct Answer: Alpha1-antitrypsin deficiency

      Explanation:

      Alpha-1 antitrypsin (A1AT) deficiency is a condition characterised by the lack of a protein that protects the lungs and liver from damage, called alpha1-antytripsin. The main complications of this condition are liver diseases such as cirrhosis and chronic hepatitis, due to accumulation of abnormal alpha 1-antytripsin and emphysema due to loss of the proteolytic protection of the lungs.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
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  • Question 42 - A 34-year-old Asian male presents with cervical lymphadenopathy. The patient is suspected to...

    Incorrect

    • A 34-year-old Asian male presents with cervical lymphadenopathy. The patient is suspected to have tuberculous lymphadenopathy. Excision biopsy of one of the nodes showed granulomatous inflammation. Which histopathologic feature is most likely consistent with the diagnosis of tuberculosis?

      Your Answer:

      Correct Answer: Caseation necrosis

      Explanation:

      The granulomas of tuberculosis tend to contain necrosis (caseating tubercles), but non-necrotizing granulomas may also be present. Multinucleated giant cells with nuclei arranged like a horseshoe (Langhans giant cells) and foreign body giant cells are often present, but are not specific for tuberculosis. A definitive diagnosis of tuberculosis requires identification of the causative organism by microbiological cultures.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
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  • Question 43 - The following organs would be expected to lie within the right lower quadrant...

    Incorrect

    • The following organs would be expected to lie within the right lower quadrant of the abdomen, assuming that the gastrointestinal tract is rotated normally:

      Your Answer:

      Correct Answer: Distal jejunum, caecum, vermiform appendix

      Explanation:

      The abdomen is divided by theoretical anatomic lines into four quadrants. The median plane follows the linea alba and extends from the xiphoid process to the pubic symphysis and splits the abdomen in half. The transumbilical plane is a horizontal line that runs at the level of the umbilicus. This forms the upper right and left quadrants and the lower right and left quadrants. Structures in the right lower quadrant include: caecum, appendix, part of the small intestine, ascending colon, the right half of the female reproductive system, right ureter. Pain in this region is most commonly associated with appendicitis.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 44 - Different portions of the renal tubule have varying degrees of water permeability. Which...

    Incorrect

    • Different portions of the renal tubule have varying degrees of water permeability. Which of the following renal sites is characterised by low water permeability under normal circumstances?

      Your Answer:

      Correct Answer: Thick ascending limb of the loop of Henlé

      Explanation:

      Within the nephron of the kidney, the ascending limb of the loop of Henle is a segment of the loop of Henle downstream of the descending limb, after the sharp bend of the loop. Both the thin and the thick ascending limbs of the loop of Henlé have very low permeability to water. Since there are no regulatory mechanisms to alter its permeability, it remains poorly permeable to water under all circumstances. Sodium and chloride are transported out of the luminal fluid into the surrounding interstitial spaces, where they are reabsorbed. Water must remain behind because it is not reabsorbed, so the solute concentration becomes less and less (the luminal fluid becomes more dilute). This is one of the principal mechanisms (along with diminution of ADH secretion) for the production of a dilute, hypo-osmotic urine (water diuresis).

    • This question is part of the following fields:

      • Physiology
      • Renal
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  • Question 45 - A 50-year old, obese gentleman with a compression fracture of T11 vertebra was...

    Incorrect

    • A 50-year old, obese gentleman with a compression fracture of T11 vertebra was admitted in the hospital. Examination revealed a raised blood pressure 165/112 mmHg and blood glucose 8.5 mmol/l. His abdomen had the presence of purplish striae. What condition is he likely to be suffering from?

      Your Answer:

      Correct Answer: Adrenal cortical carcinoma

      Explanation:

      Adrenocortical carcinomas are rare tumours with reported incidence being only two in a million. However, they have a poor prognosis. These are large tumours and range from 4-10 cm in diameter. They arise from the adrenal cortex and 10% cases are bilateral. 50-80% are known to be functional, leading to Cushing syndrome. Even though the tumour affects both sexes equally, functional tumours are slightly commoner in women and non-functional tumours are commoner in men. As compared to women, men also develop this tumour at an older age and seem to have a poorer prognosis.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
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  • Question 46 - A histological examination of a lump showed an abnormal amount and arrangement of...

    Incorrect

    • A histological examination of a lump showed an abnormal amount and arrangement of normal tissue in an otherwise normal area. This condition is known as?

      Your Answer:

      Correct Answer: Hamartoma

      Explanation:

      A hamartoma is a condition best described as tissue normally present in an area arranged haphazardly in an disorganized, abnormal fashion. They are never malignant and do not metastasis.

      All the neoplastic, cancerous lesions comprise of a mixture of different cells that are not normal to that area.

      Metaplasia is a change in the type of the epithelium.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
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  • Question 47 - What best describes the muscles of the posterior compartment of the leg? ...

    Incorrect

    • What best describes the muscles of the posterior compartment of the leg?

      Your Answer:

      Correct Answer: One of the posterior compartment leg muscles laterally rotates the femur

      Explanation:

      The muscles of the back of the leg are subdivided into two groups: superficial and deep. Superficial muscles include gastrocnemius, soleus and plantaris and are the chief extensors of the foot at the ankle joint. Deep muscles include the tibialis posterior, flexor hallucis longus, flexor digitorum longus and popliteus

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 48 - Leukotrienes normally function during an asthma attack and work to sustain inflammation. Which...

    Incorrect

    • Leukotrienes normally function during an asthma attack and work to sustain inflammation. Which of the following enzymes would inhibit their synthesis?

      Your Answer:

      Correct Answer: 5-lipoxygenase

      Explanation:

      Leukotrienes are produced from arachidonic acid with the help of the enzyme 5-lipoxygenase. This takes place in the eosinophils, mast cells, neutrophils, monocytes and basophils. They are eicosanoid lipid mediators and take part in allergic and asthmatic attacks. They are both autocrine as well as paracrine signalling molecules to regulate the body’s response and include: LTA4, LTB4, LTC4, LTD4, LTE4 and LTF4.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
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  • Question 49 - Digital rectal examination of a 75-year old gentleman who presented to the surgical...

    Incorrect

    • Digital rectal examination of a 75-year old gentleman who presented to the surgical clinic with urinary retention revealed an enlarged, nodular prostate. PSA was found to be elevated, favouring the diagnosis of prostatic malignancy. Which of the given options is the most common malignant lesion affecting the prostate gland?

      Your Answer:

      Correct Answer: Adenocarcinoma

      Explanation:

      Prostatic adenocarcinoma is the commonest solid malignancy and non-dermatological cancer in men above 50 years age. Increasing in incidence with age and the highest risk seen in the black population. About 75% of cases are seen in men over 65 years. Other tumours affecting the prostate include undifferentiated prostate cancer, squamous cell carcinoma, and ductal transitional carcinoma, but these occur less commonly. Sarcomas usually affect children. Hormones play a role in the aetiology of prostate adenocarcinoma unlike the other types. Intraepithelial neoplasia is considered a precursor of invasive malignancy.

    • This question is part of the following fields:

      • Pathology
      • Urology
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  • Question 50 - What is correct regarding the obturator artery? ...

    Incorrect

    • What is correct regarding the obturator artery?

      Your Answer:

      Correct Answer: It is found in the medial compartment of the thigh

      Explanation:

      The obturator artery is a branch of the internal iliac artery, which passes antero-inferiorly on the lateral wall of the pelvis, to the upper part of the obturator foramen. The posterior branch follows the posterior margin of the foramen and turns forward on the inferior ramus of the ischium. It also supplies an articular branch, which enters the hip joint through the acetabular notch, sending a branch along the ligamentum teres to the head of the femur. It is the main source of arterial supply to the medial compartment of the thigh

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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SESSION STATS - PERFORMANCE PER SPECIALTY

Haematology (0/1) 0%
Pathology (2/3) 67%
Microbiology (1/1) 100%
Anatomy (3/3) 100%
Upper Limb (2/2) 100%
Neoplasia (1/1) 100%
Head & Neck (1/1) 100%
General (1/1) 100%
Physiology (1/1) 100%
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