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  • Question 1 - Due to a plantarflexion–inversion ankle sprain, which is the first ligament to rupture?...

    Incorrect

    • Due to a plantarflexion–inversion ankle sprain, which is the first ligament to rupture?

      Your Answer: Calcaneofibular ligament

      Correct Answer: Anterior talofibular ligament

      Explanation:

      The anterior talofibular ligament passes from the anterior margin of the fibular malleolus. It is the most commonly injured ligament, as part of the lateral ligament of the ankle.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      19.4
      Seconds

  • Question 2 - What is the arterial sequence for an analgesic to reach the latissimus dorsi...

    Incorrect

    • What is the arterial sequence for an analgesic to reach the latissimus dorsi muscle assuming that your starting point is at the subclavian vein?

      Your Answer:

      Correct Answer: Subclavian – axillary – subscapular – thoracodorsal

      Explanation:

      Assuming our starting point is the subclavian artery, the analgesic continues in the same vessel into the axillary artery, as it passes into the axilla. The axillary artery at the lower border of the subscapularis gives rise to the subcapsular artery which is considered the largest branch of the axillary artery. This circumflex scapular branch distributes a serratus branch before entering the substance of the muscle as the thoracodorsal artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 3 - There are several mechanisms involved in the transport of sodium ions from blood...

    Incorrect

    • There are several mechanisms involved in the transport of sodium ions from blood to interstitial fluid of the muscle cells. Which of the following mechanisms best describes this phenomenon?

      Your Answer:

      Correct Answer: Diffusion through channels between endothelial cells

      Explanation:

      Capillaries are the smallest of the body’s blood vessels, measuring 5–10 μm and they help to enable the exchange of water, oxygen, carbon dioxide, and many other nutrients and waste substances between the blood and the tissues surrounding them. The walls of capillaries are composed of only a single layer of cells, the endothelium. Ion channels are pore-forming proteins that help to establish and control the small voltage gradient that exists across the plasma membrane of all living cells by allowing the flow of ions down their electrochemical gradient. An ion channel is an integral membrane protein or more typically an assembly of several proteins. The archetypal channel pore is just one or two atoms wide at its narrowest point. It conducts a specific ion such as sodium or potassium and conveys them through the membrane in single file.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds

  • Question 4 - A 10-year-old boy was sent for an x-ray of the leg because he...

    Incorrect

    • A 10-year-old boy was sent for an x-ray of the leg because he was complaining of pain and swelling. The x-ray showed the classic sign of Codman's triangle. What is the most likely diagnosis of this patient?

      Your Answer:

      Correct Answer: Osteosarcoma

      Explanation:

      Codman’s triangle is the triangular area of new subperiosteal bone that is created when a lesion, often a tumour, raises the periosteum away from the bone. The main causes for this sign are osteosarcoma, Ewing’s sarcoma, eumycetoma, and a subperiosteal abscess.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds

  • Question 5 - A 45-year-old woman was brought to the emergency department due to fever and...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds

  • Question 6 - Which of the following is the most common germ cell tumour of the...

    Incorrect

    • Which of the following is the most common germ cell tumour of the testis affecting an adult male?

      Your Answer:

      Correct Answer: Seminoma

      Explanation:

      Germ cell tumours represent 90% of primary tumours arising in the testis. They are broadly divided into seminomas and non-seminomas. Seminomas are the most common testicular germ cell tumour seen in 40% cases. The other non-seminomatous histological subtypes include embryonal (25%), teratocarcinoma (25%), teratoma (5%) and pure choriocarcinoma (1%).

    • This question is part of the following fields:

      • Pathology
      • Urology
      0
      Seconds

  • Question 7 - Which of the following veins is prostate cancer most likely to metastasize through?...

    Incorrect

    • Which of the following veins is prostate cancer most likely to metastasize through?

      Your Answer:

      Correct Answer: Internal vertebral venous plexus

      Explanation:

      The internal vertebral veins are the most likely route of metastasis as they are valveless. They serve an important clinical role as they are the route of free travel for cancerous cells to other body structures. The other veins on the list have valves and would be the least likely routes for metastasis.

    • This question is part of the following fields:

      • Anatomy
      • Neurology
      0
      Seconds

  • Question 8 - The thoracic duct : ...

    Incorrect

    • The thoracic duct :

      Your Answer:

      Correct Answer: varies in length from 38 to 45 cm

      Explanation:

      The thoracic duct is the main drainage of lymph in the body. It varies in length from 38 to 45 cm and extends from the second lumbar vertebra to the root of the neck.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 9 - After severe injury of the upper limb following an accident. The humerus is...

    Incorrect

    • After severe injury of the upper limb following an accident. The humerus is injured as well as the nerve which innervates the muscles of the anterior compartment of the arm. Which nerve is injured?

      Your Answer:

      Correct Answer: Musculocutaneous

      Explanation:

      The musculoskeletal nerve supplies the muscles of the anterior compartment of the arm including the coracobrachialis, biceps brachii and the greater part of the brachialis. This nerve derives its fibres from the fifth, sixth and seventh cervical nerves and arises from the lateral cord of the brachial plexus. It also provides a branch to the elbow joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 10 - A 33-year old lady presented to the gynaecology clinic with amenorrhoea for 6...

    Incorrect

    • A 33-year old lady presented to the gynaecology clinic with amenorrhoea for 6 months and a recent-onset of milk discharge from her breasts. She was not pregnant or on any medication. On enquiry, she admitted to having frequent headaches the last 4 months. Which of the following findings would you expect to see in her condition?

      Your Answer:

      Correct Answer: Hyperprolactinaemia

      Explanation:

      Excessively high levels of prolactin in the blood is called hyperprolactinaemia. Normally, prolactin levels are less than 580 mIU/l in females and less than 450 mIU/l in men. The biologically inactive macroprolactin can lead to a false high reading. However, the patient remains asymptomatic. Dopamine down-regulates prolactin whereas oestrogen upregulates it. Hyperprolactinaemia can be caused due to lack of inhibition (compression of pituitary stalk or low dopamine levels), or increased production due to a pituitary adenoma (prolactinoma). Either of these causes can lead to a prolactin level of 1000-5000 mIU/l. However, levels more than 5000mIU/l are usually associated due to an adenoma and >100,000 mIU/l are seen in macroadenomas (tumours < 1cm in diameter). Increased prolactin causes increased dopamine release from the arcuate nucleus of hypothalamus. This increased dopamine in turn, inhibits the GnRH (Gonadotrophin Releasing Hormone) thus blocking gonadal steroidogenesis resulting in the symptoms of hyperprolactinaemia. In women, it includes hypoestrogenism, anovulatory infertility, decreased or irregular menstruation or complete amenorrhoea. It can even cause production of breast milk, loss of libido, vaginal dryness and osteoporosis. In men, the symptoms include impotence, decreased libido, erectile dysfunction and infertility. In men, treatment can be delayed due to late diagnosis as they have no reliable indicator such as menstruation that might indicate a problem. Most of the male patients seek help only when headaches and visual defects start to surface.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      0
      Seconds

  • Question 11 - In which situation is a stretch reflex such as knee jerk likely to...

    Incorrect

    • In which situation is a stretch reflex such as knee jerk likely to be exaggerated?

      Your Answer:

      Correct Answer: In upper motor neuron lesion

      Explanation:

      A stretch reflex is a monosynaptic reflex that causes muscle contraction in response to stretching within that muscle. The sensory apparatus in a muscle that are sensitive to stretch are the muscle spindles. The patellar (knee jerk) reflex is an example. In upper motor neuron lesions, the stretch reflexes tend to be brisk due to loss of inhibitory signals on gamma neurons through the lateral reticulospinal tract.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds

  • Question 12 - An 80 year-old lady presents to the out patient clinic complaining of chest...

    Incorrect

    • An 80 year-old lady presents to the out patient clinic complaining of chest pain of 2 months' duration with a normal electrocardiogram and cardiac enzymes. A computed tomographic scan is done which reveals a mass lesion involving a structure in the middle mediastinum. Which among the following structures could be involved?

      Your Answer:

      Correct Answer: Ascending aorta

      Explanation:

      The middle mediastinum is the broadest part of the mediastinal cavity containing the heart enclosed in the pericardium, ascending aorta, lower half of the superior vena cava with the azygos vein opening into it, the bifurcation of the trachea and the two bronchi, the pulmonary artery with its branches, pulmonary veins, phrenic nerves and bronchial lymph nodes. The most likely structure involved is the ascending aorta, perhaps with an aneurysm.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 13 - In the adult heart, the sinus venosus gives rise to the: ...

    Incorrect

    • In the adult heart, the sinus venosus gives rise to the:

      Your Answer:

      Correct Answer: Coronary sinus

      Explanation:

      The sinus venosus is a large quadrangular cavity which precedes the atrium on the venous side of the chordate heart. It exists distinctly only in the embryonic heart (where it is found between the two venae cavae); however, the sinus venosus persists in the adult. In the adult, it is incorporated into the wall of the right atrium to form a smooth part called the sinus venarum, which is separated from the rest of the atrium by a ridge of fibres called the crista terminalis. The sinus venosus also forms the SA node and the coronary sinus.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      0
      Seconds

  • Question 14 - A 4-year-old child was brought to a paediatrician for consult due to a...

    Incorrect

    • A 4-year-old child was brought to a paediatrician for consult due to a palpable mass in his abdomen. The child has poor appetite and regularly complains of abdominal pain. The child was worked up and diagnosed with a tumour. What is the most likely diagnosis ?

      Your Answer:

      Correct Answer: Nephroblastoma

      Explanation:

      Nephroblastoma is also known as Wilms’ tumour. It is a cancer of the kidneys that typically occurs in children. The median age of diagnose is approximately 3.5 years. With the current treatment, approximately 80-90% of children with Wilms’ tumour survive.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds

  • Question 15 - A retroperitoneal structure is: ...

    Incorrect

    • A retroperitoneal structure is:

      Your Answer:

      Correct Answer: Pancreas

      Explanation:

      Retroperitoneal structures are those that are found behind the peritoneum. They include: kidneys, suprarenal glands, bladder, ureter, inferior vena cava, rectum, oesophagus (part of it), part of the pancreas, 2nd, 3rd and 4th parts of the duodenum and ascending and descending parts of the colon.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 16 - A surgeon ligates the left middle suprarenal artery while carrying out a left...

    Incorrect

    • A surgeon ligates the left middle suprarenal artery while carrying out a left adrenalectomy. Where does the left middle suprarenal artery originate?

      Your Answer:

      Correct Answer: Abdominal aorta

      Explanation:

      Middle suprarenal arteries arise from either side of the abdominal aorta, opposite the superior mesenteric artery.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 17 - A patient with Paget's disease of the bone is predisposed to developing which...

    Incorrect

    • A patient with Paget's disease of the bone is predisposed to developing which type of cancer?

      Your Answer:

      Correct Answer: Osteosarcoma

      Explanation:

      Paget’s disease of bone (PDB) is a focal disorder of bone. It is presumed benign in nature and mediated by abnormal osteoclast function. However osteosarcomas may occur in <1% of patients with Paget's disease of the bone. Osteosarcomas are osteogenic in origin, and consistently arise in sites of pagetic bone. This is not to be confused with Paget's disease of the breast.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds

  • Question 18 - A 17-year-old boy, who had developed shortness of breath and a loss of...

    Incorrect

    • A 17-year-old boy, who had developed shortness of breath and a loss of appetite over the last month, was referred to a haematologist because he presented with easy bruising and petechiae. His prothrombin time, platelet count, partial thromboplastin and bleeding time were all normal. Which of the following would explain the presence of the petechiae and easy bruising tendency?

      Your Answer:

      Correct Answer: Scurvy

      Explanation:

      Scurvy is a condition caused by a dietary deficiency of vitamin C, also known as ascorbic acid. Humans are unable to synthesize vitamin C, therefore the quantity of it that the body needs has to come from the diet. The presence of an adequate quantity of vitamin C is required for normal collagen synthesis. In scurvy bleeding tendency is due to capillary fragility and not coagulation defects, therefore blood tests are normal.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

  • Question 19 - A 15-day old baby was brought to the emergency department with constipation for...

    Incorrect

    • A 15-day old baby was brought to the emergency department with constipation for 4 days. On examination, the abdomen of the baby was found to be distended and tender all over. No bowel sounds were heard. A sigmoid colon biopsy was carried out, which showed absent ganglion cells. What is the diagnosis?

      Your Answer:

      Correct Answer: Hirschsprung’s disease

      Explanation:

      Hirschsprung’s disease is characterized by congenital absence of the autonomic plexus (Meissner’s and Auerbach’s plexus) in the intestinal wall. Usually limited to the distal colon, it can occasionally involve the entire colon or even the small bowel. There is abnormal or absent peristalsis in the affected segment, resulting in continuous spasm of smooth muscle and partial/complete obstruction. This causes accumulation of intestinal contents and dilatation of proximal segment. Skip lesions are highly uncommon. This disease is seen early in life with 15% patients presenting in first month, 60% by 1 year of age and 85% by the age of 4 years. Symptoms include severe and complete constipation, abdominal distension and vomiting. Patients with involvement of ultra-short segments might have mild constipation with intervening diarrhoea. In older children, symptoms include failure to thrive, anorexia, and lack of an urge to defecate. On examination, an empty rectum is revealed with stool palpable high up in the colon. If not diagnosed in time, it can lead to Hirschsprung’s enterocolitis (toxic megacolon), which can be fulminant and lead to death. Diagnosis involves a barium enema or a rectal suction biopsy. Barium enema shows a transition in diameter between the dilated, normal colon proximal to the narrowed, affected distal segment. It is to be noted that barium enema should be done without prior preparation, which can dilate the abnormal segment, leading to a false-negative result. A 24-hour post-evacuation film can be obtained in the neonatal period – if the colon is still filled with barium, there is a high likelihood of Hirschsprung’s disease. Full-thickness rectal biopsy is diagnostic by showing the absence of ganglion cells. Acetylcholinesterase staining can be done to highlight the enlarged nerve trunks. Abnormal innervation can also be demonstrated by rectal manometry.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      0
      Seconds

  • Question 20 - A growing tumour is impinging on the lingual artery in the floor of...

    Incorrect

    • A growing tumour is impinging on the lingual artery in the floor of the mouth. Which structure will experience decreased blood flow?

      Your Answer:

      Correct Answer: The sublingual gland

      Explanation:

      The paired sublingual glands are major salivary glands in the mouth. They are the smallest, most diffuse, and the only unencapsulated major salivary glands. They provide only 3-5% of the total salivary volume. The gland receives its blood supply from the sublingual and submental arteries. The sublingual artery is a branch of the lingual artery, thus damage to the lingual artery will decrease the blood flow to the sublingual gland.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 21 - A 78-year-old diabetic man undergoes renal function tests. Which of the following substances...

    Incorrect

    • A 78-year-old diabetic man undergoes renal function tests. Which of the following substances will be the most accurate for measuring glomerular filtration rate (GFR)?

      Your Answer:

      Correct Answer: Inulin

      Explanation:

      Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal glomerular capillaries into the Bowman’s capsule per unit time. Clinically, this is often measured to determine renal function. Inulin was originally used as it is not reabsorbed by the kidney after glomerular filtration, therefore its rate of excretion is directly proportional to the rate of filtration of water and solutes across the glomerular filter. However, in clinical practice, creatinine clearance is used to measure GFR. Creatinine is an endogenous molecule, synthesised in the body, that is freely filtered by the glomerulus (but also secreted by the renal tubules in very small amounts). Creatinine clearance exceeds GFR due to creatinine secretion, and is therefore a close approximation of the GFR.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 22 -  A 45-year-old man presented to the doctor complaining of a flank pain and...

    Incorrect

    •  A 45-year-old man presented to the doctor complaining of a flank pain and episodes of haematuria. Abdominal ultrasound revealed a left renal mass and the patient underwent a nephrectomy. Histopathological pattern was triphasic with blastemal, epithelial, and stromal components. The pathologist suggested the tumour resulted from the lack of a tumour suppressor gene on chromosome 11. Which of the following tumours is the pathologist most likely suggesting?

      Your Answer:

      Correct Answer: Wilms’ tumour

      Explanation:

      Wilms’ tumour is one of the most common malignant tumours of childhood but it can also rarely be found in adults. In biopsy, classical histopathological findings include the triphasic pattern composed by blastemal, epithelial, and stromal elements. First symptoms in children include an abdominal palpable mass, while in adults pain and haematuria are the most common complaints. Deletions of tumours’ suppressor genes on chromosome 11 are usually associated with Wilms’ tumour.

    • This question is part of the following fields:

      • Pathology
      • Renal
      0
      Seconds

  • Question 23 - Which of the following muscles may be affected by a fracture to the...

    Incorrect

    • Which of the following muscles may be affected by a fracture to the tuberosity on the medial surface of the right navicular bone?

      Your Answer:

      Correct Answer: Tibialis posterior

      Explanation:

      The navicular bone is situated at the medial side of the tarsus, between the talus and the cuneiform bones. Its medial surface presents a rounded tuberosity, the lower part of which gives attachment to part of the tendon of the tibialis posterior.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 24 - A man was stabbed in the thigh following a bar brawl. A superficial...

    Incorrect

    • A man was stabbed in the thigh following a bar brawl. A superficial vein was injured which terminates in the femoral vein. This superficial vein is?

      Your Answer:

      Correct Answer: Great saphenous

      Explanation:

      The great saphenous vein is considered the longest vein in the body. It terminates in the femoral vein nearly 3cm below the inguinal ligament. It begins at the dorsum of the foot in the medial marginal vein and ascends at the medial side of the leg in relation with the saphenous nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 25 - Which of the following structures is not easily palpable? ...

    Incorrect

    • Which of the following structures is not easily palpable?

      Your Answer:

      Correct Answer: Styloid process of the temporal bone

      Explanation:

      The styloid process is a thin, pointed process that projects antero-inferiorly from the base of the petrous temporal bone. It can vary in length from a short, stubby process to a slender, four to five centimetre rod. It forms from the cranial elements of the second pharyngeal arch. The tympanic plate of the temporal bone ensheathes the base of this process. The pointed, projecting portion of the process provides attachment to the stylohyoid and stylomandibular ligaments, and to three muscles – the styloglossus, stylohyoid, and stylopharyngeus. As the styloid process is covered by the various muscles, it is not easily palpable in live subjects.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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      Seconds

  • Question 26 - A patient came into the emergency in a state of shock. His blood...

    Incorrect

    • A patient came into the emergency in a state of shock. His blood group is not known, but on testing it clotted when mixed with Type A antibodies. Which blood should be transfused?

      Your Answer:

      Correct Answer: B +ve

      Explanation:

      There are two stages to determine the blood group, known as ABO typing. The first stage is called forward typing. In this method, RBCs are mixed with two separate solutions of type A or type B antibodies to see if they agglutinate. If this blood clumps, this indicates the presence of antigens within the blood sample. For example, a sample of type B blood will clump when tested with type A antibodies as it contains type B antigens. Group B – has only the B antigen on red cells (and A antibody in the plasma)

      Group B – has only the B antigen on red cells (and A antibody in the plasma)

      Group AB – has both A and B antigens on red cells (but neither A nor B antibody in the plasma)

      Group O – has neither A nor B antigens on red cells (but both A and B antibody are in the plasma). Many people also have a Rh factor on the red blood cell’s surface. This is also an antigen and those who have it are called Rh+. Those who have not are called Rh–. A person with Rh– blood does not have Rh antibodies naturally in the blood plasma (as one can have A or B antibodies, for instance) but they can develop Rh antibodies in the blood plasma if they receive blood from a person with Rh+ blood, whose Rh antigens can trigger the production of Rh antibodies. A person with Rh+ blood can receive blood from a person with Rh– blood without any problems. The patient’s blood group is B positive as he has antigen B, antibody A and Rh antigens.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 27 - A 35-year-old woman in her 37th week of pregnancy complains of urinary incontinence....

    Incorrect

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

      Your Answer:

      Correct Answer: Stress incontinence

      Explanation:

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

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

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

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

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

    • This question is part of the following fields:

      • Physiology
      • Renal
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  • Question 28 - 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
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      Seconds

  • Question 29 - 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 30 - In a neurological exam on a robbery with violence victim, it was discovered...

    Incorrect

    • In a neurological exam on a robbery with violence victim, it was discovered that the victim had lost sense of touch to the skin over her cheek and chin (maxilla and mandible region). Where are the cell bodies of the nerve that is responsible for touch sensations of this region located?

      Your Answer:

      Correct Answer: Cranial nerve V ganglion

      Explanation:

      The skin over the cheek and the maxilla are innervated by the trigeminal nerve (CN V). The trigeminal nerve has three major branches and it is the largest cranial nerve. The three branches of the trigeminal nerve are; the ophthalmic nerve, the maxillary nerve and the mandibular nerve. The trigeminal nerves ganglion is a sensory nerve ganglion know as the trigeminal ganglion (also referred to as the Gasser’s ganglion or the semilunar ganglion). It is contained in the dura matter in a cavity known as the Meckel’s cave, which covers the trigeminal impression near the apex of the petrous part of the temporal bone.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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      Seconds

  • Question 31 - An old woman complains of a lack of sensation halfway down the anterior...

    Incorrect

    • An old woman complains of a lack of sensation halfway down the anterior surface of the thigh. The cause of this:

      Your Answer:

      Correct Answer: Would result from damage to the nerve that innervates the pectineus muscle

      Explanation:

      The pectineus is supplied by the second, third and fourth lumbar nerves through the femoral nerve and by the third lumbar through the accessory obturator when it exists. The anterior surface of the thigh receives its innervation from the femoral nerve as well, thus this is the nerve most likely to be injured

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 32 - Which one of the following is a derivative of the midgut? ...

    Incorrect

    • Which one of the following is a derivative of the midgut?

      Your Answer:

      Correct Answer: Caecum

      Explanation:

      The primary intestinal loop is formed from the midgut which gives rise to the distal half of the duodenum, the jejunum, ascending colon, proximal two thirds of the transverse colon and the ileum.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      0
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  • Question 33 - Which of the following will be a seen in a patient with a...

    Incorrect

    • Which of the following will be a seen in a patient with a plasma thyroid-stimulating hormone (TSH) level of 14 mU/l (normal < 5 mU/l) and a low T3 resin uptake of 19% (normal 25–35%)?

      Your Answer:

      Correct Answer: Periorbital swelling and lethargy

      Explanation:

      Low T3 resin uptake combined with raised TSH is indicative of hypothyroidism. Signs and symptoms include dull expression, facial puffiness, lethargy, periorbital swelling due to infiltration with mucopolysaccharides, bradycardia and cold intolerance. Anxiety, palpitations, tachycardia, raised body temperature, heat intolerance and weight loss are all seen in hyperthyroidism.

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      0
      Seconds

  • Question 34 - Which of the following structures is affected or damaged when the 'anterior drawer...

    Incorrect

    • Which of the following structures is affected or damaged when the 'anterior drawer test' is positive?

      Your Answer:

      Correct Answer: Anterior cruciate ligament

      Explanation:

      The anterior drawer test is an important orthopaedic test that is used to test weakness of the anterior cruciate ligament. The test is done by having the patient sit in a supine position with his/her knees flexed at 90 degrees. An examiner stabilises the patients feet and softly pulls or pushes on the proximal tibia. The test is positive if there is translational movement of the tibia in relation to the femur, indicating a weakened anterior cruciate ligament. The anterior cruciate ligament prevents the tibia from sliding out in front of the femur.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 35 - Ventricular filling follows a delay caused by? ...

    Incorrect

    • Ventricular filling follows a delay caused by?

      Your Answer:

      Correct Answer: AV node

      Explanation:

      The AV node is a conducting tissue found between the atria and the ventricles of the heart. It conducts electrical signal from the atria to the ventricles and acts a delaying mechanism preventing the atria and the ventricles from contracting at the same time. This decremental conduction prevents premature ventricular contraction in cases such as atrial fibrillation. A delay in the AV node is the reason for the PR segment seen on the ECG. In certain types of supraventricular tachycardia, a person could have two AV nodes; this will cause a loop in electrical current and uncontrollably rapid heart beat. When this electricity catches up with itself, it will dissipate and return to a normal heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 36 - Which of the following cells would be increased in a patient suffering from...

    Incorrect

    • Which of the following cells would be increased in a patient suffering from a hydatid cyst in the liver?

      Your Answer:

      Correct Answer: Eosinophils

      Explanation:

      Eosinophils are granulocytes that respond to parasitic infections. They are also involved in allergy response and asthma. They contain granules which stain red with Romanowsky’s method and contain peroxidase, Rnase, Dnase, histamine, lipase and major basic proteins that are toxic to the parasite as well as the hosts tissue. They are about 1-5% of the total WBC population and persist in the blood for 6-12 hours.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
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  • Question 37 - Causes of metabolic acidosis with a normal anion gap include: ...

    Incorrect

    • Causes of metabolic acidosis with a normal anion gap include:

      Your Answer:

      Correct Answer: Diarrhoea

      Explanation:

      Excess acid intake and excess bicarbonate loss as in diarrhoea, are causes of metabolic acidosis with a normal anion gap. The other conditions all result in an increased anion gap.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
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  • Question 38 - The prostatic plexus of nerves contains nerve fibres that innervate penile tissue allowing...

    Incorrect

    • The prostatic plexus of nerves contains nerve fibres that innervate penile tissue allowing for erection. From which of the following nerves do these fibres originate?

      Your Answer:

      Correct Answer: Pelvic splanchnics

      Explanation:

      Pelvic splanchnic nerves are examples of the parasympathetic nerves that innervate the smooth muscle and glands of the pelvic viscera. They are also the nerves contributing fibres to the prostatic plexus which innervate penile erectile tissue.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
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  • Question 39 - Which of the cranial nerves is responsible for touch sensation on the skin...

    Incorrect

    • Which of the cranial nerves is responsible for touch sensation on the skin over the maxilla region and the mandible?

      Your Answer:

      Correct Answer: Trigeminal

      Explanation:

      The sensation of the face is provided by the trigeminal nerve which is cranial nerve V. It is also responsible for other motor functions such as biting and chewing. The trigeminal nerve has three branches; the ophthalmic nerve (V1), the maxillary nerve((V2) and the mandibular nerve (V3). These three branches exit the skull through separate foramina, namely; the superior orbital fissure, the foramen rotundum and the foramen ovale respectively. The mnemonic for this is ‘Standing room only’. The sensory fibres of the maxillary nerve are distributed to the lower eyelid and cheek, the nares and upper lip, the upper teeth and gums, the nasal mucosa, the palate and roof of the pharynx, the maxillary, ethmoid and sphenoid sinuses, and parts of the meninges. The sensory fibres of the mandibular nerve are distributed to the lower lip, the lower teeth and gums, the floor of the mouth, the anterior two-thirds of the tongue, the chin and jaw (except the angle of the jaw, which is supplied by C2–C3), parts of the external ear, and parts of the meninges. The mandibular nerve carries touch/ position and pain/temperature sensation from the mouth. The sensory fibres of the ophthalmic nerve are distributed to the scalp and forehead, the upper eyelid, the conjunctiva and cornea of the eye, the nose (including the tip of the nose), the nasal mucosa, the frontal sinuses and parts of the meninges (the dura and blood vessels). The sensory fibres of the maxillary nerve are distributed to the lower eyelid and cheek, the nares and upper lip, the upper teeth and gums, the nasal mucosa, the palate and roof of the pharynx, the maxillary, ethmoid and sphenoid sinuses, and parts of the meninges.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 40 - 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
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  • Question 41 - The proximal tubule is the portion of the ductal system of the nephron of the kidney which leads from Bowman's capsule to the loop...

    Incorrect

    • The proximal tubule is the portion of the ductal system of the nephron of the kidney which leads from Bowman's capsule to the loop of Henle. Which of the following is most likely to be seen in a sample of fluid leaving the proximal tubule?

      Your Answer:

      Correct Answer: It will have no amino acids

      Explanation:

      The proximal tubule is the portion of the duct system of the nephron leading from Bowman’s capsule to the loop of Henlé. The most distinctive characteristic of the proximal tubule is its brush border (or ‘striated border’). The luminal surface of the epithelial cells of this segment of the nephron is covered with densely packed microvilli forming a border which greatly increases the luminal surface area of the cells, presumably facilitating their reabsorptive function. Glucose, amino acids, inorganic phosphate, and some other solutes are100% reabsorbed via secondary active transport through co-transporters driven by the sodium gradient out of the nephron.

    • This question is part of the following fields:

      • Physiology
      • Renal
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  • Question 42 - The extent of cancer growth can be described through staging. What is taken...

    Incorrect

    • The extent of cancer growth can be described through staging. What is taken into consideration when staging a cancer?

      Your Answer:

      Correct Answer: Local invasion

      Explanation:

      Cancer stage is based on four characteristics: the size of cancer, whether the cancer is invasive or non-invasive, whether the cancer has spread to the lymph nodes, and whether the cancer has spread to other parts of the body, in this case beyond the breast. Staging is important as it is often a good predictor of outcomes and treatment is adjusted accordingly.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
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  • Question 43 - Which statement is true regarding the diaphragmatic openings: ...

    Incorrect

    • Which statement is true regarding the diaphragmatic openings:

      Your Answer:

      Correct Answer: The thoracic duct passes through the opening at T12

      Explanation:

      The diaphragmatic openings are:

      T8 – opening for the inferior vena cavaand the right phrenic nerve

      T10 – opening for the oesophagusand the left gastric artery and vein

      T12 – opening for the aorta, the thoracic duct and azygos vein.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 44 - The lateral thoracic artery: ...

    Incorrect

    • The lateral thoracic artery:

      Your Answer:

      Correct Answer: Accompanies the long thoracic nerve to the serratus anterior muscle

      Explanation:

      The thoracic nerve, along with the lateral thoracic artery, follow the pectoralis minor to the side of the chest which supplies the serratus anterior and the pectoralis. It then sends branches across the axilla to the axillary glands and subscapularis. The pectoral branch of the thoraco-acromial anastomoses with the internal mammary, subscapular and intercostal arteries, which in women, supply an external mammary branch.

    • This question is part of the following fields:

      • Anatomy
      • Breast
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  • Question 45 - Which of the following conditions is likely to result in splenomegaly, hypochromic anaemia...

    Incorrect

    • Which of the following conditions is likely to result in splenomegaly, hypochromic anaemia and hemochromatosis in a young male?

      Your Answer:

      Correct Answer: β-Thalassaemia

      Explanation:

      Beta-thalassaemia is due to decreased production of β-polypeptide chains, with an autosomal inheritance pattern. Carrier patients (heterozygotes) are asymptomatic and have mild to moderate microcytic anaemia. This is known as thalassaemia minor. Homozygotes (β-thalassaemia major, or Cooley’s anaemia) develop severe anaemia and marrow hyperactivity. The disease presents at 1-2 years of age with severe anaemia and transfusional and absorptive iron overload. Patients also present with jaundice, leg ulcers, massive splenomegaly and cholelithiasis. The disease can also lead to splenic sequestration leading to faster destruction of transfused red blood cells. Increased marrow activity causes thickening of cranial bones. Involvement of long bones is also seen, which can cause pathological fractures and growth impairment. There is iron deposition in various organs, which can lead to heart failure or hepatic failure (leading to cirrhosis). Thalassaemias are suspected in presence of family history, or signs suggesting microcytic haemolytic anaemia. Further test and quantitative haemoglobin studies are useful. In beta-thalassaemia, there is an increase in serum bilirubin, iron and ferritin levels. There is severe anaemia, often with haemoglobin < 6 g/dl. There is an elevated red blood cell count, which are microcytic. Peripheral blood smear is diagnostic with nucleated erythroblasts, target cells, small pale red blood cells, and punctate basophilia.

    • This question is part of the following fields:

      • Haematology
      • Pathology
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  • Question 46 - Into which vein does the left and right inferior thyroid veins drain? ...

    Incorrect

    • Into which vein does the left and right inferior thyroid veins drain?

      Your Answer:

      Correct Answer: Brachiocephalic vein

      Explanation:

      The brachiocephalic vein is formed by the confluence of the subclavian and internal jugular veins. In addition it receives drainage from: the left and right internal thoracic veins (also called internal mammary veins), left and right inferior thyroid veins and the left superior intercostal vein.
      The superior thyroid veins and middle thyroid veins drain into the internal jugular vein. The right and left inferior thyroid veins to drain into their respective brachiocephalic veins (right and left).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 47 - Which of the following is the cause of flattened (notched) T waves on...

    Incorrect

    • Which of the following is the cause of flattened (notched) T waves on electrocardiogram (ECG)?

      Your Answer:

      Correct Answer: Hypokalaemia

      Explanation:

      The T-wave is formed due to ventricular repolarisation. Normally, it is seen as a positive wave. It can be normally inverted (negative) in V1 (occasionally in V2-3 in African-Americans/Afro-Caribbeans). Hyperacute T-waves are the earliest ECG change of acute myocardial infarction. ECG findings of hyperkalaemia include high, tent-shaped T-waves, a small P-wave and a wide QRS complex. Hypokalaemia results in flattened (notched) T-waves, U-waves, ST-segment depression and prolonged QT interval.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 48 - A 40-year old woman with portal hypertension has impaired venous drainage of the...

    Incorrect

    • 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:

      Correct 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
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  • Question 49 - A 34-year-old woman with severe burns, presented to casualty with a blood pressure...

    Incorrect

    • A 34-year-old woman with severe burns, presented to casualty with a blood pressure of 75/40 mmHg and pulse of 172/minute. Obviously the patient is in shock. Which type of shock is it more likely to be?

      Your Answer:

      Correct Answer: Hypovolaemic shock

      Explanation:

      Shock is a life-threatening condition that occurs when the organs and tissues of the body are not receiving a sufficient flow of blood. Lack of blood flow, oxygen and nutrients results in the inability to function properly and damage to many organs. Shock requires immediate treatment because, if left untreated the impaired tissue perfusion and cellular hypoxia can cause irreversible tissue injury, collapse, coma or even death. There are various types of physiological shock, including: cardiogenic (due to heart damage), hypovolaemic (due to low total volume of blood or plasma), neurogenic (due to nervous system damage), septic (due to infections) and anaphylactic shock (due to allergic reactions). Hypovolaemic shock can be caused by blood loss due to trauma, internal bleeding or other fluid loss due to severe burns, prolonged diarrhoea, vomiting and sweating.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
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  • Question 50 - A 45 years old women was diagnosed with breast cancer. After a radical...

    Incorrect

    • A 45 years old women was diagnosed with breast cancer. After a radical mastectomy to remove all axillary lymph nodes from her right breast, it was noticed that she had a winged scapula. Which nerve injury would explain this?

      Your Answer:

      Correct Answer: Long thoracic nerve

      Explanation:

      The long thoracic nerve supplies the serratus anterior muscle. When this nerve is injured the muscle undergoes paralysis, which is seen clinically as winging of the scapula most apparent when the arm is lifted forward. The long thoracic nerve is greatly susceptible to injury during breast surgery because of its long and superficial course along the thorax from its origin, the brachial plexus, to the lower border of the serratus anterior muscle.

    • This question is part of the following fields:

      • Anatomy
      • Breast
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  • Question 51 - Which of the following arteries branch from the deep femoral artery and course...

    Incorrect

    • Which of the following arteries branch from the deep femoral artery and course between the pectineus and iliopsoas muscles?

      Your Answer:

      Correct Answer: Medial femoral circumflex

      Explanation:

      The medial femoral circumflex artery is an artery in the upper thigh that supplies blood to the head and neck of the femur. It arises from the deep femoral artery and winds around the medial side of the femur. It passes first between pectineus and psoas major, and then between obturator externus and adductor brevis.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 52 - If the blood flow is constant, oxygen extraction by tissues will show the...

    Incorrect

    • If the blood flow is constant, oxygen extraction by tissues will show the greatest decrease due to which of the following interventions?

      Your Answer:

      Correct Answer: Tissue cooling

      Explanation:

      With a constant blood flow to a given tissue bed, there will be an increase in oxygen extraction by the tissue with the following; an increase in tissue metabolism and oxygen requirements: warming (or fever), exercise, catecholamines and thyroxine. With cooling, the demand for oxygen decreases, leading to decreased oxygen extraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 53 - A 76-year-old woman is diagnosed with diabetes mellitus after a urine test revealed...

    Incorrect

    • A 76-year-old woman is diagnosed with diabetes mellitus after a urine test revealed she has glucosuria. Glucosuria may occur due to inadequate glucose reabsorption at:

      Your Answer:

      Correct Answer: Proximal convoluted tubule

      Explanation:

      Glucose is reabsorbed almost 100% via sodium–glucose transport proteins (apical) and GLUT (basolateral) in the proximal convoluted tubule. Glycosuria or glucosuria is a condition of osmotic diuresis typical in those suffering from diabetes mellitus. Due to a lack of insulin, plasma glucose levels are above normal. This leads to saturation of receptors in the kidneys and glycosuria usually at plasma glucose levels above 11 mmol/l. Rarely, glycosuria is due to an intrinsic problem with glucose reabsorption within the kidneys (such as Fanconi syndrome), producing a condition termed renal glycosuria.

    • This question is part of the following fields:

      • Physiology
      • Renal
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  • Question 54 - A 40 year old man suffered severe trauma following an MVA. His BP...

    Incorrect

    • A 40 year old man suffered severe trauma following an MVA. His BP is 70/33 mmhg, heart rate of 140 beats/mins and very feeble pulse. He was transfused 3 units of blood resulting in his BP returning to 100/70 and his heart rate to 90 beats/min. What decreased following transfusion?

      Your Answer:

      Correct Answer: Total peripheral resistance

      Explanation:

      The patient is in hypovolemic shock, he is transfused with blood to replace the volume lost. It is important not only to replace fluids but stop active bleeding in resuscitation. Fluid replacement will result in a decreased sympathetic discharge and adequate ventricular filling thus reducing total peripheral resistance and increasing cardiac output and cardiac filling pressures.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 55 - The basilar artery arises from the confluence of which two arteries? ...

    Incorrect

    • The basilar artery arises from the confluence of which two arteries?

      Your Answer:

      Correct Answer: Vertebral

      Explanation:

      The basilar artery is part of the vertebrobasilar system. It is formed by the confluence of the two vertebral arteries which arise from the subclavian arteries. These two vertebral arteries merge at the level of cranial nerve VI at the junction between the pons and the medulla oblangata to form what is know as the basilar artery. This vertebrobasilar system supplies the upper spinal cord, brainstem, cerebellum, and posterior part of brain.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 56 - You observe a procedure to harvest the left internal thoracic (mammary) artery to...

    Incorrect

    • You observe a procedure to harvest the left internal thoracic (mammary) artery to be used as a graft for coronary artery bypass surgery. The left internal thoracic artery is mobilised from the inside of the chest wall and divided near the caudal end of the sternum. After dividing the internal thoracic artery at its distal end, the specialist registrar asks you to name the artery that will now have increased blood supply so that adequate blood flow is maintained to the rectus abdominis on the left side. What would your answer be?

      Your Answer:

      Correct Answer: Inferior epigastric artery

      Explanation:

      The rectus abdominis muscle is supplied by the superior epigastric artery which is a branch of the internal thoracic artery. If the internal thoracic artery is thus ligated, blood would no longer flow to it. However, the superior epigastric artery communicates with the inferior epigastric artery (a branch of the external iliac artery). This means that blood could flow from the external iliac, to the inferior epigastric, to the superior epigastric to the rectus abdominis.

      The superficial circumflex iliac artery and the superficial epigastric are two superficial branches of the femoral artery and do not supply the deep branches of the abdomen.

      The deep circumflex iliac artery travels along the iliac crest on the inner surface of the abdominal wall; being too lateral it doesn’t supply blood to the rectus abdominis.

      The distal portions of the umbilical arteries are obliterated in adults to form the medial umbilical folds.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 57 - During cardiac catheterisation, if the blood sample from the catheter shows an oxygen...

    Incorrect

    • During cardiac catheterisation, if the blood sample from the catheter shows an oxygen saturation of 70%, and the pressure ranging from 12 to 24 mm Hg, it implies that the catheter tip is located in the:

      Your Answer:

      Correct Answer: Pulmonary artery

      Explanation:

      Normal values for various parameters are as follows:

      Systolic arterial blood pressure (SBP): 90–140 mmHg.

      Diastolic arterial blood pressure: 60–90 mmHg.

      Mean arterial blood pressure (MAP): SBP + (2 × DBP)/3 (normal range: 70-105 mmHg).

      Right atrial pressure (RAP): 2–6 mmHg.

      Systolic right ventricular pressure (RVSP): 15–25 mmHg.

      Diastolic right ventricular pressure (RVDP): 0–8 mmHg.

      Pulmonary artery pressure (PAP): Systolic (PASP) is 15-25 mmHg and Diastolic (PADP) is 8–15 mmHg.

      Pulmonary artery wedge pressure (PAWP): 6–12 mmHg.

      Left atrial pressure (LAP): 6–12 mmHg.

      Thus, the given value indicates that the position of catheter tip is likely to be in the pulmonary artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 58 - A 25 year old women is pregnant with her second child. She is...

    Incorrect

    • A 25 year old women is pregnant with her second child. She is A- blood group. Her first child was Rh+ and the father is also Rh+. The second child is at a risk of developing which condition?

      Your Answer:

      Correct Answer: Haemolytic disease of the new-born

      Explanation:

      This infant is at risk for haemolytic disease of the new born also known as erythroblastosis fetalis. In the pregnancy, Rh-positive RBC’s cross the placenta and enter the mothers blood system. She then becomes sensitised and forms IgG antibodies/anti-Rh antibodies against them. The second child is at a greater risk for this disease than the first child with Rh-positive blood group as during the second pregnancy, a more powerful response is produced. IgG has the ability to cross the placenta and bind to the fetal RBCs (type II hypersensitivity reaction) which are phagocytosed by the macrophages.

    • This question is part of the following fields:

      • Inflammation & Immunology; Haematology
      • Pathology
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  • Question 59 - A 65-year-old female is taking different medications for various medical conditions. Which medication...

    Incorrect

    • A 65-year-old female is taking different medications for various medical conditions. Which medication would most likely predispose the patient to develop hyperkalaemia?

      Your Answer:

      Correct Answer: Spironolactone

      Explanation:

      The most important potential side effect of spironolactone is hyperkalaemia (high potassium levels), which, in severe cases, can be life-threatening. Hyperkalaemia in these patients can present as a non anion-gap metabolic acidosis. 

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
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  • Question 60 - During pregnancy the uterus enlarges however after delivery it regresses to its original...

    Incorrect

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

      Your Answer:

      Correct Answer: Lysosomes

      Explanation:

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

    • This question is part of the following fields:

      • General
      • Physiology
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