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  • Question 1 - Which organ is responsible for the secretion of enzymes that aid in digestion...

    Incorrect

    • Which organ is responsible for the secretion of enzymes that aid in digestion of complex starches?

      Your Answer:

      Correct Answer: Pancreas

      Explanation:

      α-amylase is secreted by the pancreas, which is responsible for hydrolysis of starch, glycogen and other carbohydrates into simpler compounds.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
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  • Question 2 - 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
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  • Question 3 - Pain in the right upper quadrant of the abdomen on ingestion of a...

    Incorrect

    • Pain in the right upper quadrant of the abdomen on ingestion of a fatty meal is seen in a condition which involves which of the following substances?

      Your Answer:

      Correct Answer: Cholecystokinin

      Explanation:

      The clinical scenario described here favours the presence of gallstones. During food ingestion, vagal discharges stimulate gallbladder contraction. Moreover, presence of fat and amino acids in the intestinal lumen stimulates the release of cholecystokinin (CCK) in the duodenum. This causes sustained gallbladder contraction and relaxation of the sphincter of Oddi. If gallstones are present, there will be inflammation in the gallbladder and CCK will aggravate it due to contractions.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
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  • Question 4 - Following a fracture in the fibula, an artery contained in a fibrous canal...

    Incorrect

    • Following a fracture in the fibula, an artery contained in a fibrous canal between tibialis posterior and flexor hallucis longus was lacerated. Which of the following arteries was injured?

      Your Answer:

      Correct Answer: Peroneal

      Explanation:

      The peroneal artery is deeply seated at the back of the fibular side of the leg, contained in a fibrous canal between the tibialis posterior and the flexor hallucis longus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 5 - Which of the following diseases affects young adults, causing pain in any bone...

    Incorrect

    • Which of the following diseases affects young adults, causing pain in any bone -particularly long bones- which worsens at night, and is typically relieved by common analgesics, such as aspirin?

      Your Answer:

      Correct Answer: Osteoid osteoma

      Explanation:

      Osteoid osteoma, which tends to affect young adults, can occur in any bone but is most common in long bones. It can cause pain (usually worse at night) that is typically relieved by mild analgesics, such as non-steroidal anti-inflammatory drugs. X-ray findings include a small radiolucent zone surrounded by a larger sclerotic zone.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
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  • Question 6 - Which is the CORRECT statement regarding the small intestine: ...

    Incorrect

    • Which is the CORRECT statement regarding the small intestine:

      Your Answer:

      Correct Answer: The superior mesenteric artery courses between the body and uncinate process of the pancreas before the artery supplies the jejunum and ileum

      Explanation:

      The small intestine extends from the pylorus to the ileocecal valve where It ends in the large intestine. It is surrounded on the sides and above by the large intestine. It is related anteriorly with the greater omentum and abdominal wall. Is connected to the vertebral column by a fold of peritoneum or otherwise known as the mesentery. Is divided into three portions: the duodenum, jejunum and ileum. The jejunum and ileum are supplied by the superior mesenteric artery that courses between the body and uncinate process of the pancreas before it gives off intestinal branches.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 7 - A sexually active 21 year old man presents with the history of dysuria...

    Incorrect

    • A sexually active 21 year old man presents with the history of dysuria for the past 3 days. Urine culture confirmed Neisseria gonorrhoeae and smear showed abundant neutrophils. Which of the following mediators is responsible for causing diapedesis of the neutrophils to reach the site of infection?

      Your Answer:

      Correct Answer: Complement C5a

      Explanation:

      C5a is part of the complement cascade and is released frim the complement C5. It acts as a chemotactic factor for neutrophils. Other chemotactic mediators are TNF, leukotrienes and bacterial products.

      Bradykinin is associated with the production of pain and vasodilation.

      Hageman factor is a clotting factor.

      Histamine causes vasodilation.

      C3B causes opsonisation.

      IL-6 and IL-12 are inflammatory mediators causing B cell maturation and mediating inflammation and prostaglandins are involved with pain, increasing cell permeability and vasodilation.

    • This question is part of the following fields:

      • Inflammation & Immunology; Urology
      • Pathology
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  • Question 8 - Leakage from a silicone breast implant can lead to: ...

    Incorrect

    • Leakage from a silicone breast implant can lead to:

      Your Answer:

      Correct Answer: Pain and contracture

      Explanation:

      Breast implants are mainly: saline-filled and silicone gel-filled. Complications include haematoma, fluid collections, infection at the surgical site, pain, wrinkling, asymmetric appearance, wound dehiscence and thinning of the breast tissue.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
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  • Question 9 - In the human body, veins often run a course parallel to the artery...

    Incorrect

    • In the human body, veins often run a course parallel to the artery that has the same name. Which of the following listed veins doesn't run parallel to the artery of the same name?

      Your Answer:

      Correct Answer: Inferior mesenteric

      Explanation:

      The inferior mesenteric artery and inferior mesenteric vein don’t run in tandem because the vein is part of the portal venous system-draining into the splenic vein which drains into the hepatic portal vein. The inferior mesenteric artery is a branch of the descending aorta at the level of L3. The inferior mesenteric vein and artery, however, drain the same region i.e. the descending and sigmoid colon and rectum.

      Superior epigastric vessels course together and are the continuation of the internal thoracic artery and vein.

      Superficial circumflex iliac vessels course together in the superficial fat of the abdominal wall.

      Superior rectal vessels are the terminal ends of the inferior mesenteric vessels, located on the posterior surface of the rectum.

      The ileocolic artery and vein are branches off the superior mesenteric vessels. Both course in the mesentery, supplying/draining the caecum, appendix, terminal portion of the ileum. The inferior epigastric vessels run together.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 10 - 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
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  • Question 11 - A teenager presents with pain and swelling in a limb which increases after...

    Incorrect

    • A teenager presents with pain and swelling in a limb which increases after activity. X-rays reveal an expansible, eccentric, lytic lesion in the metaphysis distally in the affected bone surrounded by new bone. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Aneurysmal bone cyst

      Explanation:

      Aneurysmal bone cysts tend to develop in patients younger than 20 years old. They usually occur in the metaphyseal region of long bones, and are cystic lesions composed of numerous blood filled channels that grow slowly. In X-rays, they show up as circumscribed lesions, sometimes surrounded by new bone.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
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  • Question 12 - what is the cause of a prolonged PT(prothrombin time)? ...

    Incorrect

    • what is the cause of a prolonged PT(prothrombin time)?

      Your Answer:

      Correct Answer: Liver disease

      Explanation:

      PT measure the intrinsic pathway of coagulation. It determines the measure of the warfarin dose regime, liver disease and vit K deficiency status along with the clotting tendency of blood. PT measured factors are II,V,VII,X and fibrinogen. It is used along with aPTT which measure the intrinsic pathway.

    • This question is part of the following fields:

      • General
      • Physiology
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  • Question 13 - Which of the following statements is true of Colles’ fracture? ...

    Incorrect

    • Which of the following statements is true of Colles’ fracture?

      Your Answer:

      Correct Answer: Is a cause of carpal tunnel syndrome

      Explanation:

      Colles’ fracture is a distal fracture of the radius that is a known cause of carpal tunnel syndrome (compression of the median nerve in the carpal tunnel). It rarely results in ulnar nerve compression. A Colles’ fracture is extra-articular and does not extend into the wrist joint, otherwise this would make it an intra-articular fracture (Barton’s fracture). The distal fragment in a Colles’ fracture is displaced dorsally, unlike in a Smith’s fracture where the distal fragment is displaced volarly (ventrally). Associated fracture of the ulnar styloid process may occur and is a common associated injury.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
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  • Question 14 - The middle meningeal artery is the largest among the arteries that supplies that...

    Incorrect

    • The middle meningeal artery is the largest among the arteries that supplies that dura mater of the brain. The middle meningeal artery is a branch of the?

      Your Answer:

      Correct Answer: Maxillary artery

      Explanation:

      The middle meningeal artery is the largest of the three (paired) arteries that supply the meninges.

      The middle meningeal artery is a large arterial branch of the maxillary artery which is a terminal branch of the external carotid artery. Upon originating, the middle meningeal artery passes through the foramen spinosum. In the skull, it courses in the middle cranial fossa where it provides several branches.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 15 - What percentage of the cardiac output is delivered to the brain? ...

    Incorrect

    • What percentage of the cardiac output is delivered to the brain?

      Your Answer:

      Correct Answer: 15%

      Explanation:

      Among all body organs, the brain is most susceptible to ischaemia. Comprising of only 2.5% of total body weight, the brain receives 15% of the cardiac output. Oxygen extraction is also higher with venous oxygen levels approximating 13 vol%, and arteriovenous oxygen difference of 7 vol%.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 16 - 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
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  • Question 17 - Which of these structures does NOT pass posterior to the medial malleolus? ...

    Incorrect

    • Which of these structures does NOT pass posterior to the medial malleolus?

      Your Answer:

      Correct Answer: Saphenous vein

      Explanation:

      The saphenous vein passes anterior to the medial malleolus. The structures passing posterior, from nearest to furthest include: tibial, posterior tendon, flexor digitorum longus tendon, posterior tibial artery, posterior tibial vein, posterior tibial nerve and the flexor hallucis longus tendon.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 18 - An ECG of a 30 year old woman revealed low voltage QRS complexes....

    Incorrect

    • An ECG of a 30 year old woman revealed low voltage QRS complexes. This patient is most probably suffering from?

      Your Answer:

      Correct Answer: Pericardial effusion

      Explanation:

      The QRS complex is associated with current that results in the contraction of both the ventricles. As ventricles have more muscle mass than the atria, they result in a greater deflection on the ECG. The normal duration of a QRS complex is 10s. A wide and deep Q wave depicts myocardial infarction. Abnormalities in the QRS complex maybe indicative of a bundle block, ventricular tachycardia or hypertrophy of the ventricles. Low voltage QRS complexes are characteristic of pericarditis or a pericardial effusion.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 19 - A 65-year-old man complains of headaches, weakness, cramps, and confusion; blood tests reveal...

    Incorrect

    • A 65-year-old man complains of headaches, weakness, cramps, and confusion; blood tests reveal he has severe hyponatremia. The most likely cause is:

      Your Answer:

      Correct Answer: Severe diarrhoea or vomiting

      Explanation:

      Hyponatraemia occurs when the sodium level in the plasma falls below 135 mmol/l. Hyponatraemia is an abnormality that can occur in isolation or, more commonly as a complication of other medical illnesses. Severe hyponatraemia may cause osmotic shift of water from the plasma into the brain cells. Typical symptoms include nausea, vomiting, headache and malaise. As the hyponatraemia worsens, confusion, diminished reflexes, convulsions, stupor or coma may occur. The cause of hyponatremia is typically classified by a person’s fluid status into low volume, normal volume, and high volume. Low volume hyponatremia can occur from diarrhoea, vomiting, diuretics, and sweating.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
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  • Question 20 - Cancer of the testis most likely metastases to which set of lymph nodes?...

    Incorrect

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

      Your Answer:

      Correct Answer: Aortic

      Explanation:

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

    • This question is part of the following fields:

      • Endocrine
      • Pathology
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  • Question 21 - A 14 year-old girl is found to have haemophilia B. What pathological problem...

    Incorrect

    • A 14 year-old girl is found to have haemophilia B. What pathological problem does she have?

      Your Answer:

      Correct Answer: Deficiency of factor IX

      Explanation:

      Haemophilia B (also known as Christmas disease) is due to a deficiency in factor IX. Haemophilia A is due to a deficiency in factor VIII.

    • This question is part of the following fields:

      • Haematology
      • Pathology
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  • Question 22 - The mechanism of action of streptokinase involves: ...

    Incorrect

    • The mechanism of action of streptokinase involves:

      Your Answer:

      Correct Answer: Direct conversion of plasminogen to plasmin

      Explanation:

      Streptokinase is an enzyme that is produced by group A beta haemolytic streptococcus and is an effective and cost efficient method for the dissolution of a clot used in cases of MI and pulmonary embolism. It works by directly converting plasminogen to plasmin which breaks down the blood components in the clot and fibrin, dissolving the clot. Streptokinase is a bacterial product and thus the body will develop immunity against it.

    • This question is part of the following fields:

      • General
      • Physiology
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  • Question 23 - This structure divides the space between the lens and the cornea into the...

    Incorrect

    • This structure divides the space between the lens and the cornea into the anterior and posterior chambers of the eye:

      Your Answer:

      Correct Answer: The iris

      Explanation:

      The iris divides the space between the lens and the cornea into an anterior and a posterior chamber. The anterior cavity is filled with watery aqueous fluid, and the posterior cavity with a gel-like vitreous fluid. The anterior chamber of the eye is bounded in front by the posterior surface of the cornea; behind by the front of the iris and the central part of the lens. The posterior chamber is a narrow gap behind the peripheral part of the iris and in front of the suspensory ligament of the lens and the ciliary processes.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 24 - The sciatic nerve does NOT supply which of the following muscles? ...

    Incorrect

    • The sciatic nerve does NOT supply which of the following muscles?

      Your Answer:

      Correct Answer: Obturator externus

      Explanation:

      The sciatic nerve supplies both gemellae, quadratus femoris, semitendinosus, semimembranosus, both heads of the biceps femoris, the hamstring half of abductor magnus and obturator internus. Obturator externus is supplied by the obturator nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 25 - Which condition presents with a positive urine dipstick test for blood, but no...

    Incorrect

    • Which condition presents with a positive urine dipstick test for blood, but no blood cells on urine microscopy?

      Your Answer:

      Correct Answer: Myoglobinuria

      Explanation:

      Myoglobinuria, or presence of myoglobulin in the urine is seen due to rhabdomyolysis (muscle destruction). Common causes of rhabdomyolysis include trauma, electrical injuries, burns, venom and drugs. Damaged muscle leads to release of myoglobin in the blood. Ideally, the released myoglobin gets filtered and excreted by the kidneys. However, excess myoglobin can occlude the renal filtration system leading to acute tubular necrosis and acute renal dysfunction.

    • This question is part of the following fields:

      • Pathology
      • Renal
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  • Question 26 - Biopsy of a neoplastic mass was performed. Histologic examination of the specimen showed...

    Incorrect

    • Biopsy of a neoplastic mass was performed. Histologic examination of the specimen showed spindle shaped cells with high nuclear/cytoplasm ratio on immunohisto chemical staining. These pleomorphic cells were vimentin positive, cytokeratin negative and cd45 negative. This type of neoplasm is most commonly found in which patient?

      Your Answer:

      Correct Answer: A 15-year-old boy with a mass in the left femur and lung metastases

      Explanation:

      A histology report that describes spindle shaped cells which are vimentin positive suggests osteosarcoma and hematogenous spread to the lungs.

    • This question is part of the following fields:

      • Neoplasia; Orthopaedics
      • Pathology
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  • Question 27 - A 7-year-old boys undergoes a testicular biopsy after a tumour is found in...

    Incorrect

    • A 7-year-old boys undergoes a testicular biopsy after a tumour is found in his right testis. Elements similar to hair and teeth are found in it. What kind of tumour is this?

      Your Answer:

      Correct Answer: Teratoma

      Explanation:

      A teratoma is a tumour containing tissue elements that are similar to normal derivatives of more than one germ layer. They usually contain skin, hair, teeth and bone tissue and are more common in children, behaving as a benign tumour. After puberty, they are regarded as malignant and can metastasise.

    • This question is part of the following fields:

      • Pathology
      • Urology
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  • Question 28 - A victim of road traffic accident presented to the emergency department with a...

    Incorrect

    • A victim of road traffic accident presented to the emergency department with a blood pressure of 120/90 mm Hg, with a drop in systolic pressure to 100 mm Hg on inhalation. This is known as:

      Your Answer:

      Correct Answer: Pulsus paradoxus

      Explanation:

      Weakening of pulse with inhalation and strengthening with exhalation is known as pulsus paradoxus. This represents an exaggeration of the normal variation of the pulse in relation to respiration. It indicates conditions such as cardiac tamponade and lung disease. The paradox refers to the auscultation of extra cardiac beats on inspiration, as compared to the pulse. Due to a decrease in blood pressure, the radial pulse becomes impalpable along with an increase in jugular venous pressure height (Kussmaul sign). Normal systolic blood pressure variation (with respiration) is considered to be >10 mmHg. It is >100 mmHg in Pulsus paradoxus. It is also predictive of the severity of cardiac tamponade.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 29 - Which of the following compensatory parameters is responsible for causing an increase in...

    Incorrect

    • Which of the following compensatory parameters is responsible for causing an increase in the blood pressure in a 30 year old patient with a BP of 40 mmHg?

      Your Answer:

      Correct Answer: Baroreceptor reflex

      Explanation:

      The baroreflex or baroreceptor reflex is one of the body’s homeostatic mechanisms for regulating blood pressure. It provides a negative feedback response in which an elevated blood pressure will causes blood pressure to decrease; similarly, decreased blood pressure depresses the baroreflex, causing blood pressure to rise. The system relies on specialised neurones (baroreceptors) in the aortic arch, carotid sinuses and elsewhere to monitor changes in blood pressure and relay them to the brainstem. Subsequent changes in blood pressure are mediated by the autonomic nervous system. Baroreceptors include those in the auricles of the heart and vena cava, but the most sensitive baroreceptors are in the carotid sinuses and aortic arch. The carotid sinus baroreceptors are innervated by the glossopharyngeal nerve (CN IX); the aortic arch baroreceptors are innervated by the vagus nerve (CN X).

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 30 - Calculate the stroke volume in a patient admitted for coronary bypass surgery, with...

    Incorrect

    • Calculate the stroke volume in a patient admitted for coronary bypass surgery, with the following parameters pre-operatively:

      Oxygen consumption = 300 ml/min

      Arterial oxygen content = 20 ml/100 ml blood

      Pulmonary arterial oxygen content = 15 ml/100 ml blood and Heart rate = 100 beats/min.

      Your Answer:

      Correct Answer: 60 ml

      Explanation:

      By Fick’s principle, cardiac output can be calculated as follows: VO2 = CO × (CAO2– CVO2) where VO2= oxygen consumption, CO = cardiac output, CAO2 = arterial oxygen content and CvO2 = mixed venous oxygen content. Thus, in the given problem, 300 ml/min = CO × (20 – 15) ml/100 ml CO = 300 × 100/5 ml/min CO = 6000 ml/min. Also, cardiac output = stroke volume × heart rate. Thus, 6000 ml/min = stroke volume × 100 beats/min. Hence, stroke volume = 6000/100 ml/min which is 60 ml/min.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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