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  • Question 1 - Cancer of the testis most likely metastases to which set of lymph nodes?...

    Correct

    • Cancer of the testis most likely metastases to which set of lymph nodes?

      Your Answer: Aortic

      Explanation:

      The lymphatic drainage of an organ is related to its blood supply. The lymphatic drainage of the testis drains along the testicular artery to reach the lymph nodes along the aorta.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      16.4
      Seconds

  • Question 2 - A 23-year-old woman decides to donate a kidney through a kidney chain. Which...

    Correct

    • A 23-year-old woman decides to donate a kidney through a kidney chain. Which of the following indices would be expected to be decreased in the donor after full recovery from the operation?

      Your Answer: Creatinine clearance

      Explanation:

      Since medication to prevent rejection is so effective, donors do not need to be similar to their recipient. Most donated kidneys come from deceased donors; however, the utilisation of living donors is on the rise. Most problems encountered with live donation are associated with the donor. Firstly, there are the potentially harmful investigative procedures carried out in the assessment phase, the most hazardous being renal angiography, where there is cannulation of the artery and injection of a radio-opaque dye to determine the blood supply to the kidney. Secondly, there are the short-term risks of nephrectomy surgery. According to the literature, there is a mortality rate of between 1 in 1600 and 1 in 3000, but this is no more than is associated with any anaesthetic. In the initial postoperative period creatinine clearance may be decreased but this recovers fully over a few weeks to months. Long-term complications include prolonged wound pain.

    • This question is part of the following fields:

      • Physiology
      • Renal
      24.1
      Seconds

  • Question 3 - A 50 year-old man, who sustained a head injury experienced sudden onset of...

    Incorrect

    • A 50 year-old man, who sustained a head injury experienced sudden onset of horizontal double vision. He is diagnosed with lateral rectus palsy. Which of the following nerves is affected in this condition?

      Your Answer: Oculomotor

      Correct Answer: Abducent

      Explanation:

      The lateral rectus muscle is one of the 6 extra-ocular muscles that control eye movements. It is responsible for abduction and is the only muscle that is innervated by the abducens nerve (CN VI).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      22.5
      Seconds

  • Question 4 - An experiment is carried out to observe engulfment and phagocytosis of microbes. Strep...

    Incorrect

    • An experiment is carried out to observe engulfment and phagocytosis of microbes. Strep pneumoniae are added to a solution of leukocytes with a substance added to enhance the process of phagocytosis. What is this substance?

      Your Answer: Immunoglobulin M

      Correct Answer: Complement C3b

      Explanation:

      C3b is cleaved from C3 complement with the help of the enzyme C3- convertase. It binds to the cell surface of the offending substance and opsonizes it. This makes it easy for the phagocytes to detect and eliminate them.

      IgM does not act as an opsonin but igG does.

      Selectins aid leukocytes to bind to the endothelial surfaces.

      C5a is a chemo-attractant and histamine a vasodilator.

      NADPH oxidises offending substance after phagocytosis within the macrophage.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      76.6
      Seconds

  • Question 5 - Which of the following statements regarding the femoral artery is CORRECT? ...

    Incorrect

    • Which of the following statements regarding the femoral artery is CORRECT?

      Your Answer: It pierces the adductor longus muscle

      Correct Answer: It has the femoral nerve lying lateral to it

      Explanation:

      The femoral artery begins immediately behind the inguinal ligament, midway between the anterior superior spine of the ilium and the symphysis pubis. The first 4 cm of the vessel is enclosed, together with the femoral vein, in a fibrous sheath (the femoral sheath). The femoral nerve lies lateral to this.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      27.4
      Seconds

  • Question 6 - A construction worker is brought to the A&E after a fall on site....

    Correct

    • A construction worker is brought to the A&E after a fall on site. The patient is conscious but complains of inability to feel his legs. A neurological examination reveals that he has no cutaneous sensation from his umbilicus to his toes. What is the likely level of the spinal cord that is injured?

      Your Answer: T10

      Explanation:

      The umbilicus has a relatively consistent position in humans and thus serves as an important land mark. The skin around the waist at the level of the umbilicus is supplied by the tenth thoracic spinal nerve (T10 dermatome).

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      82.2
      Seconds

  • Question 7 - Which of the following bones was most likely fractured following an injury in...

    Correct

    • Which of the following bones was most likely fractured following an injury in the medial side of the foot between the navicular behind and base of the first metatarsal in front?

      Your Answer: First cuneiform

      Explanation:

      The first cuneiform bone is the largest of the three cuneiforms. It is situated at the medial side of the foot, between the navicular behind and the base of the first metatarsal in front.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      31.5
      Seconds

  • Question 8 - What causes a reduction in pulmonary functional residual capacity? ...

    Incorrect

    • What causes a reduction in pulmonary functional residual capacity?

      Your Answer: Pulmonary oedema

      Correct Answer: Pulmonary fibrosis

      Explanation:

      Pulmonary functional residual capacity (FRC) is = volume of air present in the lungs at the end of passive expiration.

      Obstructive diseases (e.g. emphysema, chronic bronchitis, asthma) = an increase in FRC due to an increase in lung compliance and air trapping.

      Restrictive diseases (e.g. pulmonary fibrosis) result in stiffer, less compliant lungs and a reduction in FRC.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      69.6
      Seconds

  • Question 9 - Which of the following has the highest content of triglycerides? ...

    Incorrect

    • Which of the following has the highest content of triglycerides?

      Your Answer: HDL

      Correct Answer: Chylomicron

      Explanation:

      Created by the small intestinal cells, chylomicrons are large lipoprotein molecules which transport lipids to the liver, adipose, cardiac and skeletal tissue. Chylomicrons are mainly composed of triglycerides (,85%) along with some cholesterol and cholesteryl esters. Apo B-48 is the main apolipoprotein content.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      11.1
      Seconds

  • Question 10 - Regarding the extensor retinaculum of the wrist, which of these is CORRECT? ...

    Incorrect

    • Regarding the extensor retinaculum of the wrist, which of these is CORRECT?

      Your Answer: It is a direct extension of the axillary fascia

      Correct Answer: It prevents the tendons of the posterior compartment of the forearm from ‘bowstringing’ when the hand is extended at the wrist

      Explanation:

      This extensor retinaculum, as the name indicates, holds the tendons of the extensors against the dorsal surface of the distal radius and ulna. Therefore, the correct answer is that it prevents bowstringing of the extensor tendons with wrist extension. It forms compartments between it and its bony attachment, and these compartments guide and hold the tendons.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      73.5
      Seconds

  • Question 11 - Calculate the cardiac stroke volume of a patient whose oxygen consumption (measured by...

    Correct

    • Calculate the cardiac stroke volume of a patient whose oxygen consumption (measured by analysis of mixed expired gas) is 300 ml/min, arterial O2 content is 20 ml/100 ml blood, pulmonary arterial O2 content is 15 ml/100 ml blood and heart rate is 60/min.

      Your Answer: 100 ml

      Explanation:

      By Fick’s principle, VO2 = Q × (CA (O2) − CV (O2)) where VO2 = O2 consumption, Q = cardiac output and CA(O2) and CV(O2) are arterial and mixed venous O2 content respectively. Thus, in the given problem, 300 ml O2/min = Q × (20−15) ml O2/100 ml. Thus, Q = 6000 ml blood/min. Then, we can calculate stroke volume by dividing the cardiac output with heart rate. Thus, stroke volume = 6000 ml/min divided by 60/min stroke volume = 100 ml.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      72
      Seconds

  • Question 12 - 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 13 - A 45-year old gentleman presents with diarrhoea for two weeks. He has no...

    Incorrect

    • A 45-year old gentleman presents with diarrhoea for two weeks. He has no history of fever and the diarrhoea stops on fasting. Which is the most likely type of diarrhoea that he is suffering from?

      Your Answer:

      Correct Answer: Osmotic

      Explanation:

      The different types of diarrhoea are:

      1. Secretory diarrhoea – Due to increased secretion or decreased absorption. There is minimal to no structural damage in this type. The most common cause is cholera toxin which stimulates secretion of anions (especially chloride), with sodium and water.

      2. Osmotic diarrhoea – Due to increased osmotic load, there is water loss. This occurs in cases of maldigestion syndromes, such as coeliac or pancreatic disease.

      3. Motility-related diarrhoea – Occurs in cases of abnormal gastrointestinal motility. Due to increased motility, there is poor absorption and this leads to diarrhoea. This is seen post-vagotomy or in diabetic neuropathy.

      4. Inflammatory diarrhoea – Due to damage to the mucosa or brush border, there is a loss of protein-rich fluids and poor absorption. Features of all the above three types can be seen in this type. Aetiology includes bacterial, viral, parasitic infections or autoimmune problems including inflammatory bowel disease.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds

  • Question 14 - 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:

      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
      0
      Seconds

  • Question 15 - A 27-yeaar-old woman is diagnosed with candidiasis and prescribed fluconazole. What is the...

    Incorrect

    • A 27-yeaar-old woman is diagnosed with candidiasis and prescribed fluconazole. What is the mechanism of action of fluconazole?

      Your Answer:

      Correct Answer: Inhibits cytochrome P450

      Explanation:

      Fluconazole is a triazole antifungal drug used in the treatment and prevention of superficial and systemic fungal infections. Like other imidazole- and triazole-class antifungals, fluconazole inhibits the fungal cytochrome P450 enzyme, 14-demethylase. It is used to treat candidiasis, blastomycosis, coccidioidomycosis, cryptococcosis, histoplasmosis, dermatophytosis, and pityriasis versicolor.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds

  • Question 16 - What forms the pelvic diaphragm? ...

    Incorrect

    • What forms the pelvic diaphragm?

      Your Answer:

      Correct Answer: Levator ani and coccygeus muscles

      Explanation:

      The pelvic diaphragm is formed by the levator ani and the coccygeus muscles. The levator ani forms the greater part of the pelvic floor supporting the viscera in the pelvic cavity.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      0
      Seconds

  • Question 17 - 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 18 - A tumour on the floor of the fourth ventricle is most likely to...

    Incorrect

    • A tumour on the floor of the fourth ventricle is most likely to compress which of the following cranial nerve nuclei?

      Your Answer:

      Correct Answer: Abducent

      Explanation:

      The fourth ventricle, is a cavity of the brains ventricular system in which the cerebrospinal fluid is formed. This cavity is located behind the pons and upper half of the medulla oblongata. It extends from the cerebral aqueduct, to its connection to the third ventricle, and to the obex- which is the caudal tip of the fourth ventricle. The floor of the fourth ventricle consists of three parts – superior, intermediate and inferior. This inferior aspect of the floor of the fourth ventricle has the nucleus of the abducens nerve, CN VI which is looped over by the facial nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 19 - A 45 year old man who complains of chronic post prandial, burning epigastric...

    Incorrect

    • A 45 year old man who complains of chronic post prandial, burning epigastric pain undergoes a gastrointestinal endoscopy. There is no apparent mass or haemorrhage and a biopsy is taken from the lower oesophageal mucosa just above the gastro-oesophageal junction. The results reveal the presence of columnar cells interspersed with goblet cells. Which change best explains the above mentioned histology?

      Your Answer:

      Correct Answer: Metaplasia

      Explanation:

      Metaplasia is the transformation of one type of epithelium into another as a means to better cope with external stress on that epithelium. In this case metaplasia occurs due to the inflammation resulting from gastro-oesophageal reflux disease. Dysplasia is disordered cellular growth. Hyperplasia is an increase in cell number but not cell type i.e. transformation. Carcinoma is characterized by cellular atypia. Ischaemia would result in necrosis with ulceration. Carcinoma insitu involves dysplastic atypical cells with the basement membrane intact and atrophy would mean a decrease in number of cells.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Gastrointestinal
      • Pathology
      0
      Seconds

  • Question 20 - 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:

      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
      0
      Seconds

  • Question 21 - Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal...

    Incorrect

    • Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal volume of 550 ml and an effective anatomical dead space of 250 ml. Which of the following will bring about a maximum increase in his alveolar ventilation?

      Your Answer:

      Correct Answer: A 2x increase in tidal volume and a shorter snorkel

      Explanation:

      Alveolar ventilation = respiratory rate × (tidal volume − anatomical dead space volume). Increase in respiratory rate simply causes movement of air in the anatomical dead space, with no contribution to the alveolar ventilation. By use of a shorter snorkel, the effective anatomical dead space will decrease and will cause a maximum rise in alveolar ventilation along with doubling of tidal volume.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds

  • Question 22 - Severe abdominal pain radiating to the back, along with increased serum amylase levels,...

    Incorrect

    • Severe abdominal pain radiating to the back, along with increased serum amylase levels, is seen in which of the following conditions?

      Your Answer:

      Correct Answer: Pancreatitis

      Explanation:

      The primary test for diagnosis and monitoring of pancreatitis is amylase. Increased plasma levels of amylase can be found in: salivary trauma (including anaesthetic intubation), mumps, pancreatitis and renal failure. However, a rise in the total amylase levels over 10 times the upper limit of normal (ULN) is suggestive of pancreatitis; 5–10 times the ULN may indicate ileus or duodenal disease or renal failure. Lower levels are commonly found in salivary gland disease.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds

  • Question 23 - A 40-year old Caucasian male came to the hospital with complaints of fatigue...

    Incorrect

    • A 40-year old Caucasian male came to the hospital with complaints of fatigue and lethargy. On examination, he was found to have raised blood pressure. Urine examination showed >300 mg/dl proteinuria (4+) and 24-hour urine protein 3.5g. No glucose, blood, nitrites, urobilinogen or casts were present in urine. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Membranous glomerulonephritis

      Explanation:

      Membranous glomerulonephritis or nephropathy, is a renal disorder with insidious course and usually affects people aged 30-50 years. 85% cases are primary (or idiopathic). The other 15% are secondary to autoimmune conditions like SLE, infections like malaria or hepatitis B, drugs like captopril and NSAIDs, or malignancies (particularly lung or colonic carcinoma). This disease is caused due to circulating immune complexes which are said to form by binding of antibodies to antigens in glomerular basement membrane. This antigens could be endogenous or derived from systemic circulation. This immune complex triggers the complement system, resulting in formation of membrane attack complex (MAC) on glomerular epithelial cells. This further results in release of proteases and oxidants which damage the capillaries making them ‘leaky’. Moreover, the epithelial cells also secrete a mediator to reduce nephron synthesis and distribution.

    • This question is part of the following fields:

      • Pathology
      • Renal
      0
      Seconds

  • Question 24 - A 55 year-old construction worker is diagnosed with malignant mesothelioma. Exposure to which...

    Incorrect

    • A 55 year-old construction worker is diagnosed with malignant mesothelioma. Exposure to which substance increased his risk in developing mesothelioma?

      Your Answer:

      Correct Answer: Asbestos

      Explanation:

      Mesothelioma is a rare, aggressive form of cancer that develops in the lining of the lungs, abdomen or heart. It is linked to inhalation of asbestos commonly used in ship building and the insulation industry. It has no known cure and has a very poor prognosis.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds

  • Question 25 - A young female in the 15th week of pregnancy presented to the emergency...

    Incorrect

    • A young female in the 15th week of pregnancy presented to the emergency department with the passage of grape-like masses per vagina. Dilatation and curettage was done and microscopy revealed large avascular villi with trophoblastic proliferation. Which one of the following investigations is best recommended for her follow-up?

      Your Answer:

      Correct Answer: Serum β-hCG

      Explanation:

      Trophoblast is the layer of cells surrounding the blastocyst and that later develops into the chorion and amnion. Gestational trophoblastic disease is a tumour arising from this trophoblast. It can occur during or after either an intrauterine or ectopic pregnancy. If it occurs in a pregnant woman, it usually leads to spontaneous abortion, eclampsia or fetal death. It can be either malignant or benign.

      In suspected cases, investigations include measurement of serum beta subunit of human chorionic gonadotrophin (β-hCG) and pelvic ultrasound. Confirmatory test is a biopsy. Post-removal, the disease is classified clinically to assess further treatment. To assess the presence of metastases, further work-up includes computed tomography of the brain, chest, abdomen and pelvis. Chemotherapy is usually needed for persistent disease. If at least three consecutive, weekly serum β-hCG measurements are normal, treatment is considered successful. Follow-up is also done by measuring β-hCG.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      0
      Seconds

  • Question 26 - Mallory bodies are characteristic of which of the following conditions? ...

    Incorrect

    • Mallory bodies are characteristic of which of the following conditions?

      Your Answer:

      Correct Answer: Alcoholic hepatitis

      Explanation:

      Mallory bodies (or ‘alcoholic hyaline’) are inclusion bodies in the cytoplasm of liver cells, seen in patients of alcoholic hepatitis; and also in Wilson’s disease. These pathological bodies are made of intermediate keratin filament proteins that are ubiquinated or bound by proteins like heat chock protein. Being highly eosinophilic, they appear pink on haematoxylin and eosin staining.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      0
      Seconds

  • Question 27 - Which of the following is the source of blood supply to the artery...

    Incorrect

    • Which of the following is the source of blood supply to the artery of the round ligament at the head of the femur?

      Your Answer:

      Correct Answer: Obturator artery

      Explanation:

      The posterior branch of the obturator artery provides an articular branch to the head of the femur.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 28 - Which ectopic tissue is usually contained in the Meckel's diverticulum? ...

    Incorrect

    • Which ectopic tissue is usually contained in the Meckel's diverticulum?

      Your Answer:

      Correct Answer: Gastric

      Explanation:

      The Meckel’s diverticulum is a vestigial remnant of the omphalomesenteric duct. This structure is also referred to as the vitelline and contains two types of ectopic tissue, namely; gastric and pancreatic.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      0
      Seconds

  • Question 29 - A 35 year old man presented to the surgical OPD with a lump...

    Incorrect

    • A 35 year old man presented to the surgical OPD with a lump on his right forearm which appeared 3 weeks ago and was tender on examination. He gave a history was being in a car accident with pieces of glass from the windshield piercing his forearm removed manually and on further elective surgery. Which of these cells are characteristically found during inflammation in this situation?

      Your Answer:

      Correct Answer: Giant cell

      Explanation:

      A foreign body reaction Is characteristic of giant cells. Glass being the foreign object initiates an inflammatory response in this condition.

      Mast cells are involved in allergic reactions.

      Eosinophils are characteristic of a parasitic infection and allergic inflammatory process but are not due to foreign bodies.

      Plasma cells are typical of chronic inflammation.

      Lymphocytes are involved in viral infections.

      Macrophages combine together to form giant cells.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      0
      Seconds

  • Question 30 - Following nerve injury, paralysis of the quadriceps femoris muscle occurs. Which of the...

    Incorrect

    • Following nerve injury, paralysis of the quadriceps femoris muscle occurs. Which of the following movements will be affected?

      Your Answer:

      Correct Answer: Extension of the leg

      Explanation:

      The quadriceps muscle is a great extensor of the thigh. Therefore, following nerve injury or cutting nerve supply to the quadriceps will affect extension of the thigh

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Endocrine (1/1) 100%
Pathology (1/2) 50%
Physiology (2/4) 50%
Renal (1/1) 100%
Anatomy (2/5) 40%
Head & Neck (0/1) 0%
Inflammation & Immunology (0/1) 0%
Lower Limb (1/2) 50%
Abdomen (1/1) 100%
Respiratory (0/1) 0%
Gastroenterology (0/1) 0%
Upper Limb (0/1) 0%
Cardiovascular (1/1) 100%
Passmed
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