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  • Question 1 - 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: Pancreas

      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
      7.4
      Seconds

  • Question 2 - A 34-year-old woman has been suffering from headaches, fever, vomiting, and confusion for...

    Incorrect

    • A 34-year-old woman has been suffering from headaches, fever, vomiting, and confusion for the last 5 days. A CT scan reveals an oedematous mass with ring enhancement in the left temporal region. It is biopsied, revealing glial cells, necrosis, neutrophils and lymphocytes. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Cerebral abscess

      Explanation:

      A cerebral abscess can result from direct extension of cranial infections, penetrating head trauma, haematogenous spread, or for unknown causes. An abscess forms when an area of cerebral inflammation becomes necrotic and encapsulated by glial cells and fibroblasts. Oedema around the abscess can increase the intracranial pressure. Symptoms result from increased intracranial pressure and mass effects. It is most frequent in the third decade of life, and when it occurs in children, it is usually associated with congenital heart disease.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      0
      Seconds

  • Question 3 - A 62-year-old woman presented to the doctor complaining of spine pain, fatigue and...

    Incorrect

    • A 62-year-old woman presented to the doctor complaining of spine pain, fatigue and oliguria. She is diagnosed with chronic renal failure. Dipstick testing shows no protein, glucose, nitrite or ketones but a semi-quantitative sulphosalicylic acid test for urine protein is positive. Which of the following is the most probable cause of chronic renal failure in this patient.

      Your Answer:

      Correct Answer: Multiple myeloma

      Explanation:

      Dipstick results are negative because the proteins found in the urine of this patient are not albumin but Bence Jones proteins. A Bence Jones protein is a monoclonal globulin protein commonly detected in patients affected by multiple myeloma. Multiple myeloma is a malignancy of plasma cells characterised by the production of monoclonal immunoglobulin. Symptoms include bone pain, bone fractures, bleeding, neurologic symptoms, fatigue, frequent infections and weight loss.

    • This question is part of the following fields:

      • Pathology
      • Renal
      0
      Seconds

  • Question 4 - A 41 year old women presents with a history of carcinoma involving the...

    Incorrect

    • A 41 year old women presents with a history of carcinoma involving the right breast with enlarged axillary nodes on the same side. She underwent mastectomy and axillary node clearance. These were sent for histopathological examination. They showed no signs of metastasis. What could be cause of this enlargement in the lymph nodes?

      Your Answer:

      Correct Answer: Sinus histiocytosis

      Explanation:

      Sinus histiocytosis also referred to as reticular hyperplasia, refers to the enlargement, distention and prominence of the sinusoids of the lymph nodes. This is a non-specific form of hyperplasia characteristically seen in lymph nodes that drain tumours. The endothelial lining of the lymph node becomes markedly hypertrophied, along with an increase in the number of macrophages which results in the distortion, distention and enlargement of the sinus. In this scenario there is no evidence that an infection or another malignancy could account for the enlargement. Paracortical lymphoid hyperplasia is caused by an immune response.

    • This question is part of the following fields:

      • Inflammation & Immunology; Female Health
      • Pathology
      0
      Seconds

  • Question 5 - 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 6 - Which of the following morphological features is most characteristic of hyaline degeneration? ...

    Incorrect

    • Which of the following morphological features is most characteristic of hyaline degeneration?

      Your Answer:

      Correct Answer: Homogeneous, ground-glass, pink-staining appearance of cells

      Explanation:

      The characteristic morphological features of hyaline degeneration is ground-glass, pinking staining cytoplasm with an intact cell membrane. The accumulation of lipids, calcium salts, lipofuscin and an amorphous cytoplasm with an intact cell membrane are all characteristically found in different situations.

      Pyknotic nucleus and orphan Annie eye nucleus are not seen in hyaline degeneration.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      0
      Seconds

  • Question 7 - What class of drugs does buspirone belong to? ...

    Incorrect

    • What class of drugs does buspirone belong to?

      Your Answer:

      Correct Answer: Anxiolytic

      Explanation:

      Buspirone is an anxiolytic agent and a serotonin-receptor agonist that belongs to the azaspirodecanedione class of compounds. It shows no potential for addiction compared with other drugs commonly prescribed for anxiety, especially the benzodiazepines. The development of tolerance has not been noted. It is primarily used to treat generalized anxiety disorders. It is also commonly used to augment antidepressants in the treatment of major depressive disorder.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds

  • Question 8 - A man had an injury to his right brachial plexus. After examination by...

    Incorrect

    • A man had an injury to his right brachial plexus. After examination by the doctor they found that the diaphragm and the scapula were unaffected however the patient could not abduct his arm. When helped with abducting his arm to 45 degrees he was able to continue the movement. This means that he was unable to initiate abduction. Where is the likely site of injury?

      Your Answer:

      Correct Answer: Suprascapular nerve

      Explanation:

      The loss of ability to initiate abduction means paralysis of the supraspinatus muscle. This muscle is supplied by the supraclavicular nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 9 - Selective destruction of which of the following cells will affect antibody synthesis? ...

    Incorrect

    • Selective destruction of which of the following cells will affect antibody synthesis?

      Your Answer:

      Correct Answer: Plasma cells

      Explanation:

      Plasma cell are memory cells. After the antigen Is engulfed by the B cells it is presented to the CD4+ helper cells via the MCH II receptor and this leads to their activation which in turn stimulates the B cells to form antibodies against that specific antigen. Some B cells differentiate into plasma cells also called memory cells that get activated after subsequent infection.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 10 - A medical intern wanting to perform her first thoracentesis (remove fluid from the...

    Incorrect

    • A medical intern wanting to perform her first thoracentesis (remove fluid from the pleural cavity) wishes to be reminded where to insert the needle to aspirate in order to avoid injuring the lung or neurovascular elements. Where is this place?

      Your Answer:

      Correct Answer: The bottom of interspace 9 in the midaxillary line

      Explanation:

      Thoracentesis is performed in the costodiaphragmatic recess. The needle needs to be inserted below the level of the lungs to avoid injury to the lungs. At the paravertebral line, is between ribs 10 and 12, at the midaxillary line between ribs 8 and 10 and at the midclavicular line between interspaces 6 and 8. The needle should be inserted at the top of the rib (or the bottom of the interspace) to avoid damage to the neurovascular structures found below the rib running in the costal groove.

      The recommended location for the needle insertion varies depending upon the source. It is critical that the patient hold his or her breath to avoid piercing of the lung.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 11 - During a surgical procedure involving the carotid artery, which nerve in the cervical...

    Incorrect

    • During a surgical procedure involving the carotid artery, which nerve in the cervical plexus of nerves that is embedded in the carotid sheath is most susceptible to injury?

      Your Answer:

      Correct Answer: Ansa cervicalis

      Explanation:

      The ansa cervicalis is a loop of nerves that are part of the cervical plexus. They lie superficial to the internal jugular vein in the carotid triangle. Branches from the ansa cervicalis innervate the sternohyoid, sternothyroid and the inferior belly of the omohyoid. The superior root of the ansa cervicalis is formed by a branch of spinal nerve C1. These nerve fibres travel in the hypoglossal nerve before leaving to form the superior root. The superior root goes around the occipital artery and then descends embedded in the carotid sheath. It sends a branch off to the superior belly of the omohyoid muscle and is then joined by the inferior root. The inferior root is formed by fibres from spinal nerves C2 and C3.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 12 - An old man presented with atrophy of the thenar eminence despite the sensation...

    Incorrect

    • An old man presented with atrophy of the thenar eminence despite the sensation over it still being intact. What is the injured nerve in this case?

      Your Answer:

      Correct Answer: Median nerve

      Explanation:

      Atrophy of the thenar muscles means injury to the motor supply of these muscles. The nerve that sends innervation to it is the median nerve. But the median nerve does not provide sensory innervation to the overlying skin so sensation is spared.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 13 - A 46-year old lady presents with chief complaints of a large mass in...

    Incorrect

    • A 46-year old lady presents with chief complaints of a large mass in the left breast. Histopathology of the mass revealed a stromal component with an epithelial component. What is the likely lesion?

      Your Answer:

      Correct Answer: Phyllodes tumour

      Explanation:

      Phyllodes tumours are large, quickly growing tumours which arise from the periductal stroma of the breast. These are fibroepithelial tumours and account for less than 1% of breast cancers. These tumours can be benign, borderline or malignant based on the histology. The tumour usually affects adult women, mostly between the age of 40 to 50 years. It can be confused with fibroadenoma, which however affects much younger patients.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      0
      Seconds

  • Question 14 - After a total colectomy and ileotomy, a 50-year old diabetic man who was...

    Incorrect

    • After a total colectomy and ileotomy, a 50-year old diabetic man who was a known case of diabetic nephropathy had persistent metabolic acidosis. The patient appeared well perfused, with normal vital signs and normal fluid balance. Investigations revealed:

      Sodium = 132 mmol/l

      Potassium = 6.6 mmol/l

      Creatinine = 185 μmol/l (2.16 mg/dl)

      Chloride = 109 μmol/l

      8am cortisol = 500 nmol/l (18 μg/dl)

      pH = 7.29, p(CO2) = 27 mmHg

      p(O2) = 107 mmHg

      standard bicarbonate = 12 mmol/l.

      What is the likely causes of his acidosis?

      Your Answer:

      Correct Answer: Renal tubular acidosis

      Explanation:

      Acidosis here is due to low bicarbonate. The low p(CO2) is seen in compensation. The anion gap is normal, ruling out intra-abdominal ischaemia (which leads to metabolic acidosis). If it was a gastrointestinal aetiology, low potassium would be seen. The history of diabetic nephropathy predisposes to renal tubular acidosis. Type 4 (hyporeninaemic hypoaldosteronism) is associated with high potassium and is found in diabetic and hypertensive renal disease.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds

  • Question 15 - A chloride sweat test was performed on a 13-year-old boy. Results indicated a...

    Incorrect

    • A chloride sweat test was performed on a 13-year-old boy. Results indicated a high likelihood of cystic fibrosis. This diagnosis is associated with a higher risk of developing which of the following?

      Your Answer:

      Correct Answer: Bronchiectasis

      Explanation:

      Cystic fibrosis is a life-threatening disorder that causes the build up of thick mucus in the lungs, digestive tract, and other areas of the body. It is a hereditary autosomal-recessive disease caused by mutations of the CFTR gene. Cystic fibrosis eventually results in bronchiectasis which is defined as a permanent dilatation and obstruction of bronchi or bronchioles.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      0
      Seconds

  • Question 16 - Etoposide is a chemotherapeutic agent used in the treatment of different types of...

    Incorrect

    • Etoposide is a chemotherapeutic agent used in the treatment of different types of cancer. Which of the following is the correct indication for this drug?

      Your Answer:

      Correct Answer: Lung cancer

      Explanation:

      Etoposide phosphate is an inhibitor of the enzyme topoisomerase II. It is used as a form of chemotherapy for malignancies such as lung cancer, testicular cancer, lymphoma, non-lymphocytic leukaemia and glioblastoma multiforme. Side effects are very common and can include low blood cell counts, vomiting, loss of appetite, diarrhoea, hair loss, and fever.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds

  • Question 17 - A 45-year-old-female is suspected to have a pulmonary mass. Supposing that she has...

    Incorrect

    • A 45-year-old-female is suspected to have a pulmonary mass. Supposing that she has a neoplasm, which of the following are most commonly found to involve the lung:

      Your Answer:

      Correct Answer: Pulmonary metastases

      Explanation:

      Lung metastases occur when a cancer started in another part of the body (primary site) spreads to the lungs. The lungs are among the most common site where cancer can spread due to its rich systemic venous drainage, almost every type of cancer can spread to the lung. The most common types of cancer that spread to the lung are breast, colorectal, kidney, testicular, bladder, prostate, head and neck cancers.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      0
      Seconds

  • Question 18 - A chef, whilst preparing food, cut her thumb with a knife. She transected...

    Incorrect

    • A chef, whilst preparing food, cut her thumb with a knife. She transected the arteria princeps pollicis. This artery is a branch of the?

      Your Answer:

      Correct Answer: Radial artery

      Explanation:

      The radial artery branches into the arteria princeps pollicis as it turns medially into the deep part of the hand. The arteria princeps pollicis is distributed to the skin and subcutaneous tissue of the thumb.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 19 - Routine evaluation of a 38 year old gentleman showed a slightly lower arterial...

    Incorrect

    • Routine evaluation of a 38 year old gentleman showed a slightly lower arterial oxygen [pa(O2)] than the alveolar oxygen [pA(O2)]. This difference is:

      Your Answer:

      Correct Answer: Is normal and due to shunted blood

      Explanation:

      Blood that bypasses the ventilated parts of lung and enters the arterial circulation directly is known as shunted blood. It happens in normal people due to mixing of arterial blood with bronchial and some myocardial venous blood (which drains into the left heart). Diffusion limitation and reaction velocity with haemoglobin are immeasurably small. CO2 unloading will not affect the difference between alveolar and arterial p(O2). A large VSD will result in much lower arterial O2 as compared to alveolar O2.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds

  • Question 20 - Which of the following enzymes is secreted by the small intestinal mucosa? ...

    Incorrect

    • Which of the following enzymes is secreted by the small intestinal mucosa?

      Your Answer:

      Correct Answer: Lactase

      Explanation:

      Lactase, an enzyme belonging to β-galactosidase family of enzymes, brings about the hydrolysis of the disaccharide lactose into galactose and glucose. In humans, it is present along the brush border membrane of the cells lining the small intestinal villi. Deficiency of lactase causes lactose intolerance.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds

  • Question 21 - Which of the following is a likely consequence of severe diarrhoea? ...

    Incorrect

    • Which of the following is a likely consequence of severe diarrhoea?

      Your Answer:

      Correct Answer: A decrease in the sodium content of the body

      Explanation:

      Diarrhoea can occur due to any of the numerous aetiologies, which include infectious, drug-induced, food related, surgical, inflammatory, transit-related or malabsorption. Four mechanisms have been implicated in diarrhoea: increased osmotic load, increased secretion, inflammation and decreased absorption time. Diarrhoea can result in fluid loss with consequent dehydration, electrolyte loss (Na+, K+, Mg2+, Cl–) and even vascular collapse. Loss of bicarbonate ions can lead to a metabolic acidosis.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds

  • Question 22 - Which of the following conditions is characterized by generalised oedema due to effusion...

    Incorrect

    • Which of the following conditions is characterized by generalised oedema due to effusion of fluid into the extracellular space?

      Your Answer:

      Correct Answer: Anasarca

      Explanation:

      Anasarca (or ‘generalised oedema’) is a condition characterised by widespread swelling of the skin due to effusion of fluid into the extracellular space. It is usually caused by liver failure (cirrhosis of the liver), renal failure/disease, right-sided heart failure, as well as severe malnutrition/protein deficiency.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds

  • Question 23 - A patient is diagnosed with Conn’s syndrome. Aldosterone is secreted from where? ...

    Incorrect

    • A patient is diagnosed with Conn’s syndrome. Aldosterone is secreted from where?

      Your Answer:

      Correct Answer: Zona glomerulosa of the adrenal cortex

      Explanation:

      The adrenal gland comprises an outer cortex and an inner medulla, which represent two developmentally and functionally independent endocrine glands.

      The adrenal medulla secretes adrenaline (70%) and noradrenaline (30%)

      The adrenal cortex consists of three layers (remembered by the mnemonic GFR):

      G = zona glomerulosa – secretes aldosterone

      F = zona fasciculata – secretes cortisol and sex steroids

      R = zona reticularis – secretes cortisol and sex steroids.

      Aldosterone facilitates the reabsorption of sodium and water and the excretion of potassium and hydrogen ions from the distal convoluted tubule and collecting ducts. Conn’s syndrome is characterized by increased aldosterone secretion from the adrenal glands.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds

  • Question 24 - Lung compliance is increased by: ...

    Incorrect

    • Lung compliance is increased by:

      Your Answer:

      Correct Answer: Emphysema

      Explanation:

      Lung compliance is increased by emphysema, acute asthma and increasing age and decreased by alveolar oedema, pulmonary hypertension, atelectasis and pulmonary fibrosis.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds

  • Question 25 - A 45-year-old pregnant woman develops high blood pressure at 20 weeks. She complains...

    Incorrect

    • A 45-year-old pregnant woman develops high blood pressure at 20 weeks. She complains of headaches and swollen feet, and a test reveals proteinuria (350 mg/day). Which of the following is the most likely diagnosis?

      Your Answer:

      Correct Answer: Pre-eclampsia

      Explanation:

      Pre-eclampsia (PE) is a disorder of pregnancy characterized by the onset of high blood pressure (two separate readings taken at least 6 h apart of 140/90 or more) and often a significant amount of protein in the urine (>300 mg of protein in a 24-h urine sample). While blood pressure elevation is the most visible sign of the disease, it involves generalised damage to the maternal endothelium of the kidneys and liver, with the release of vasopressive factors only secondary to the original damage. Pre-eclampsia may develop at varying times within pregnancy and its progress differs among patients; most cases present pre-term. It has no known cure apart from ending the pregnancy (induction of labour or abortion). It may also present up to 6 weeks post partum. Risk factors for pre-eclampsia include obesity, prior hypertension, older age, and diabetes mellitus.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 26 - What causes a reduction in pulmonary functional residual capacity? ...

    Incorrect

    • What causes a reduction in pulmonary functional residual capacity?

      Your Answer:

      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
      0
      Seconds

  • Question 27 - Internal haemorrhoids are painless and only sensitive to stretch. They are formed from...

    Incorrect

    • Internal haemorrhoids are painless and only sensitive to stretch. They are formed from folds of the mucous membrane and the submucosa of the anal canal which contain varicose branches of the:

      Your Answer:

      Correct Answer: Superior rectal vein

      Explanation:

      Internal haemorrhoids are formed by varicosities of the branches of the superior rectal vein.

      External haemorrhoids are formed by varicosities of the branches of the inferior rectal vein.

    • This question is part of the following fields:

      • Anatomy
      • Colorectal
      0
      Seconds

  • Question 28 - Langhans giant cells are characteristically seen in which type of inflammation? ...

    Incorrect

    • Langhans giant cells are characteristically seen in which type of inflammation?

      Your Answer:

      Correct Answer: Granulomatous inflammation

      Explanation:

      Langhans giant cells are characteristically seen in granulomatous inflammation. They form when epithelioid cells fuse together. They usually contain a nuclei with a horseshoe-shaped pattern in the periphery of the cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      0
      Seconds

  • Question 29 - What is the primary function of the Kupffer cells found in the liver?...

    Incorrect

    • What is the primary function of the Kupffer cells found in the liver?

      Your Answer:

      Correct Answer: Recycling of old red blood cells

      Explanation:

      Kupffer cells found in the liver are part of the monocyte-reticular system. They are specialised macrophages and primarily function to recycle old and damaged RBCs. The RBCs are phagocytosed and the haemoglobin is broken down into haem and globin. The haem is further broken down into iron that is recycled and bilirubin that is conjugated with glucuronic acid and excreted in the bile.

    • This question is part of the following fields:

      • Inflammation & Immunology; Hepatobiliary
      • Pathology
      0
      Seconds

  • Question 30 - Rapid eye movement (REM) sleep is likely to be affected by a lesion...

    Incorrect

    • Rapid eye movement (REM) sleep is likely to be affected by a lesion in the:

      Your Answer:

      Correct Answer: Pons

      Explanation:

      Rapid eye movement (REM) sleep is also known as paradoxical sleep, as the summed activity of the brain’s neurons is quite similar to that during waking hours. Characterised by rapid movements of the eyes, most of the vividly recalled dreams occur during this stage of sleep. The total time of REM sleep for an adult is about 90–120 min per night.

      Certain neurones in the brainstem, known as REM sleep-on cells, which are located in the pontine tegmentum, are particularly active during REM sleep and are probably responsible for its occurrence. The eye movements associated with REM are generated by the pontine nucleus with projections to the superior colliculus and are associated with PGO (pons, geniculate, occipital) waves.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds

  • Question 31 - What is the result of maltase deficiency in the brush border of the...

    Incorrect

    • What is the result of maltase deficiency in the brush border of the small intestine?

      Your Answer:

      Correct Answer: Results in increased passage of maltose in stool

      Explanation:

      Maltase is an enzyme produced from the surface cells of the villi, lining the small intestine and aids in hydrolysing the disaccharide maltose, which splits into two molecules of α-glucose. It is done by breaking the glycosidic bond between the ‘first’ carbon of one glucose and the ‘fourth’ carbon of the other (a 1–4 bond). Hence, a deficiency of enzyme maltase will result in the increased passage of maltose in the stool.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds

  • Question 32 - A patient who has used NSAIDS for many years presents to the A&E...

    Incorrect

    • A patient who has used NSAIDS for many years presents to the A&E with symptoms of acute haemorrhagic shock. An emergency endoscopy is done that shows that a duodenal ulcer has perforated the posterior wall of the first part of the duodenum. Which artery is most likely to be the cause of the haemorrhage?

      Your Answer:

      Correct Answer: Gastroduodenal

      Explanation:

      The gastroduodenal artery is a branch of the hepatic artery and descends near the pylorus between the first part of the duodenum and the neck of the pancreas to divide at the lower border of the duodenum into the right gastroepiploic and pancreaticoduodenal arteries. Before it divides, it gives off a few branches to the pyloric end of the stomach and to the pancreas. The artery that is most likely involved in this situation is the gastroduodenal artery since it is posterior to the first part of the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 33 - Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of...

    Incorrect

    • Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of the popliteal fossa?

      Your Answer:

      Correct Answer: Biceps femoris

      Explanation:

      The popliteal fossa is located at the back of the knee. It is bounded laterally by the biceps femoris above and the plantaris and lateral head of the gastrocnemius below and medially by the semitendinosus and semimembranosus above and by the medial head of the gastrocnemius below.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 34 - Evaluation of a 60-year old gentleman, who has been a coal miner all...

    Incorrect

    • Evaluation of a 60-year old gentleman, who has been a coal miner all his life and is suspected to have pulmonary fibrosis reveals the following: normal FEV1, arterial oxygen saturation 92%, alveolar ventilation 6000 ml/min at a tidal volume of 600 ml and a breathing rate of 12 breaths/min. There are also pathological changes in lung compliance and residual volume. Which of the following is most accurate about his residual volume?

      Your Answer:

      Correct Answer: Cannot be measured directly with a spirometer

      Explanation:

      Residual volume is the air left in the lungs after maximal expiration is done. Thus, this is not a part of vital capacity and cannot be measured with a spirometer directly. It can be measured by the methods such as body plethysmography or inert gas dilution. Expiratory reserve volume is vital capacity minus inspiratory capacity. Resting volume of lungs is he sum of residual volume and expiratory reserve volume. Lungs recoil inward until the recoil pressure becomes zero, which corresponds to a volume significantly lower than residual volume.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds

  • Question 35 - 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 36 - A 58-year-old woman presents with signs of inflammation in the first metatarsophalangeal joint:...

    Incorrect

    • A 58-year-old woman presents with signs of inflammation in the first metatarsophalangeal joint: redness, swelling and pain. The analysis of synovial fluid reveals needle-shaped, strongly negatively birefringent crystals. What's the most likely diagnosis in this case?

      Your Answer:

      Correct Answer: Gout

      Explanation:

      Gout is a rheumatic disease caused by the precipitation of monosodium urate crystals into tissues, usually joints. This causes acute or chronic pain; the acute illness initially affects only one joint, often the first metatarsophalangeal joint. The diagnosis of the disease requires the identification of crystal in the synovial fluid. These crystals are needle-shaped and strongly negatively birefringent.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
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  • Question 37 - An abdominal aortogram shows occlusion of the inferior mesenteric artery. Which of the...

    Incorrect

    • An abdominal aortogram shows occlusion of the inferior mesenteric artery. Which of the following segments of bowel is most likely to have preserved arterial supply?

      Your Answer:

      Correct Answer: Caecum

      Explanation:

      The inferior mesenteric artery supplies blood to the end of the transverse colon and all distal structures in the gastrointestinal tract i.e. splenic flexure, descending colon, sigmoid colon and rectum would all be deprived of blood if it were occluded. The caecum receives blood from the superior mesenteric artery so it would not be affected.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 38 - Regarding the venous drainage of the heart which of these is correct? ...

    Incorrect

    • Regarding the venous drainage of the heart which of these is correct?

      Your Answer:

      Correct Answer: The great cardiac vein is the largest tributary of the coronary sinus and this vein starts at the apex of the heart and ascends with the anterior ventricular branch of the left coronary artery

      Explanation:

      Most of the veins of the heart open into the coronary sinus. This is a wide venous channel, about 2.25 cm in length, situated in the posterior part of the coronary sulcus and covered by muscular fibres from the left atrium. Its tributaries are the great, small and middle cardiac veins, the posterior vein of the left ventricle and the oblique vein of the left atrium. The great cardiac vein is the largest tributary of the coronary sinus.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 39 - A 40 year old woman, who is under anaesthesia for an elective procedure,...

    Incorrect

    • A 40 year old woman, who is under anaesthesia for an elective procedure, received an antibiotic injection. She immediately developed a rash and her airway constricted raising the airway pressure. Which mechanism is responsible for this reaction?

      Your Answer:

      Correct Answer: Type I hypersensitivity

      Explanation:

      Type I hypersensitivity reaction is an immediate reaction that occurs due to binding of the antigen with antibodies attached to mast cells in a previously sensitized person. It has an immediate phase, which is characterised by vasodilation, leakage of plasma, smooth muscle spasm, or glandular secretions. This manifests in about 5-30 min and usually resolves within 60 mins. The delayed phase follows after 24 hours and can persist up to several days. It is due to infiltration of eosinophils, neutrophils, basophils and CD4+ cells and leads to tissue destruction. The nature of the reaction varies according to the site. It can take the form of skin allergy, hives, allergic rhinitis, conjunctivitis, bronchial asthma or food allergy.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
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  • Question 40 - In what form are fats primarily transported in the body? ...

    Incorrect

    • In what form are fats primarily transported in the body?

      Your Answer:

      Correct Answer: Free fatty acids

      Explanation:

      Fat is mainly transported in the body as free fatty acids. Once out of the adipose cell, the free fatty acids get ionized and combine with albumin.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
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  • Question 41 - A 48-year-old woman has a mass in her right breast and has right...

    Incorrect

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

      Your Answer:

      Correct Answer: IIB

      Explanation:

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

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
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  • Question 42 - A 13-year-old girl has complained of pain in her left arm for 4...

    Incorrect

    • A 13-year-old girl has complained of pain in her left arm for 4 months. An X-ray reveals a mass along with erosion of the affected humerus. Histologically, the tumour is found to be formed by small, round, blue cells. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Ewing’s sarcoma

      Explanation:

      Ewing’s sarcoma is formed by small, round, blue cells, and is common in children. The usually develop in limbs, and clinical findings include pain and inflammation, with lytic destruction showing up on X-rays.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
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  • Question 43 - 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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  • Question 44 - Identify which of the following muscles acts on two joints? ...

    Incorrect

    • Identify which of the following muscles acts on two joints?

      Your Answer:

      Correct Answer: Sartorius

      Explanation:

      The sartorius muscle, the longest muscle in the body, is one of the two jointed or biarticular muscles. It originates from the anterior superior iliac spine and part of the notch between the anterior superior iliac spine and anterior inferior iliac spine and crosses both the hip joint and the knee joint. At the hip joint the sartorius flexes and rotates the thigh at the hip joint and flexes the leg at the knee joint.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 45 - An X ray of a 60 year old male brought to the accident...

    Incorrect

    • An X ray of a 60 year old male brought to the accident and emergency following a fall down stairs shows a fractured olecranon process of the right ulna with the line of fracture passing through the superior surface, disrupting a muscle. Which among the following muscles was most likely injured?

      Your Answer:

      Correct Answer: Triceps brachii

      Explanation:

      The superior surface of the olecranon process forms an attachment for the insertion of the triceps brachii on the posterior aspect. It also has a minor transverse groove for the attachment of part of the posterior ligament of the elbow on the anterior aspect.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 46 - Which of the following two cerebral veins join up to form the great...

    Incorrect

    • Which of the following two cerebral veins join up to form the great cerebral vein, otherwise also known as the great vein of Galen?

      Your Answer:

      Correct Answer: Internal cerebral veins

      Explanation:

      The great vein of Galen or great cerebral vein, is formed by the union of the internal cerebral veins and the basal veins of Rosenthal. This vein curves upwards and backwards along the border of the splenium of the corpus callosum and eventually drains into the inferior sagittal sinus and straight sinus at its anterior extremity.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 47 - What is a major source of fuel being oxidised by the skeletal muscles...

    Incorrect

    • What is a major source of fuel being oxidised by the skeletal muscles of a man who has undergone starvation for 7 days?

      Your Answer:

      Correct Answer: Serum fatty acids

      Explanation:

      Starvation is the most extreme form of malnutrition. Prolonged starvation can lead to permanent organ damage and can be fatal. Starved individuals eventually lose significant fat and muscle mass as the body uses these for energy.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
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  • Question 48 - A 12-year old girl was brought to the hospital with recurrent headaches for...

    Incorrect

    • A 12-year old girl was brought to the hospital with recurrent headaches for 6 months. Her physical examination revealed no abnormality. A CT scan of the head revealed a suprasellar mass with calcifications, eroding the surrounding sella turcica. The lesion is likely to represent:

      Your Answer:

      Correct Answer: Craniopharyngioma

      Explanation:

      Craniopharyngiomas (also known as Rathke pouch tumours, adamantinomas or hypophyseal duct tumours) affect children mainly between the age of 5 and 10 years. It constitutes 9% of brain tumours affecting the paediatric population. These are slow-growing tumours which can also be cystic, and arise from the pituitary stalk, specifically the nests of epithelium derived from Rathke’s pouch. Histologically, this tumour shows nests of squamous epithelium which is lined on the outside by radially arranged cells. Calcium deposition is often seen with a papillary type of architecture.

      ACTH-secreting pituitary adenomas are rare and mostly microadenomas. Paediatric astrocytoma’s usually occur in the posterior fossa. Although null cell adenomas can cause mass effect and give rise to the described symptoms, they are not suprasellar. Prolactinomas can also show symptoms of headache and disturbances in the visual field, however they are known to be small and slow-growing.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
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      Seconds

  • Question 49 - Cervical intraepithelial neoplasia on Pap smear of a 34-year old lady is most...

    Incorrect

    • Cervical intraepithelial neoplasia on Pap smear of a 34-year old lady is most likely associated with which of the following?

      Your Answer:

      Correct Answer: Human papillomavirus infection

      Explanation:

      CIN (Cervical intraepithelial neoplasia) is considered a precursor of cervical cancer and is likely caused due to infection with human papillomavirus (HPV) types 16, 18, 31, 33, 35 or 39. The risk factors for cervical cancer include multiple sex partners, young age at the time of first intercourse, intercourse with men whose previous partners had cervical cancer. Also, smoking and immunodeficient states are considered contributory. CIN is graded as mild (grade I), moderate (grade II) and severe dysplasia or carcinoma in situ (grade III). CIN III rarely regresses spontaneously and can lead to invasive carcinoma by invading the basement membrane. Squamous cell carcinomas are the commonest cervical cancer seen in 80-85% of all cases. Others are commonly adenocarcinomas. Cervical cancer can spread by direct extension, lymphatic spread to pelvic and para-aortic nodes or by hematogenous route.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
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      Seconds

  • Question 50 - Which of the following diseases is caused by intra-articular and/or extra-articular deposition of...

    Incorrect

    • Which of the following diseases is caused by intra-articular and/or extra-articular deposition of calcium pyrophosphate dihydrate (CPPD) crystals, due to unknown causes?

      Your Answer:

      Correct Answer: Pseudogout

      Explanation:

      Pseudogout or chondrocalcinosis is a rheumatological disease caused by the accumulation of crystals of calcium pyrophosphate dihydrate (CPPD) in the connective tissues. It is frequently associated with other conditions, such as trauma, amyloidosis, gout, hyperparathyroidism and old age, which suggests that it is secondary to degenerative or metabolic changes in the tissues. The knee is the most commonly affected joint. It causes symptoms similar to those of rheumatoid arthritis or osteoarthritis.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      0
      Seconds

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