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Question 1
Correct
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A 7-year old child from a rural setting complains of recurrent abdominal pain. The child is found to have a heavy parasitic infestation and anaemia. Which type of anaemia is most likely seen in this patient?
Your Answer: Iron deficiency anaemia
Explanation:The most common cause of iron deficiency anaemia in children in developing countries is parasitic infection (hookworm, amoebiasis, schistosomiasis and whipworm).
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This question is part of the following fields:
- Microbiology
- Pathology
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Question 2
Correct
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Which of these nerves controls adduction of hand?
Your Answer: Ulnar nerve
Explanation:The adductors of the fingers are the palmer interossei. They are supplied by the ulnar nerve, which is a branch of the medical cord of the brachial plexus.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 3
Correct
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What is the most likely condition a new born infant is likely to suffer from, if he/she was born with incomplete fusion of the embryonic endocardial cushions?
Your Answer: An atrioventricular septal defect
Explanation:The endocardial cushions in the heart are the mesenchymal tissue that make up the part of the atrioventricular valves, atrial septum and ventricular septum. An incomplete fusion of these mesenchymal cells can cause an atrioventricular septal defect. The terms endocardial cushion defect, atrioventricular septal defect and common atrioventricular canal defect can be used interchangeably with one another.
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This question is part of the following fields:
- Anatomy
- Embryology
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Question 4
Correct
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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: 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.
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This question is part of the following fields:
- Orthopaedics
- Pathology
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Question 5
Correct
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What's the nodal stage of a testicular seminoma if several lymph nodes between 2cm and 5cm are found?
Your Answer: N2
Explanation:According to the American Joint Committee on Cancer (AJCC) 2002 guidelines, the nodal staging of testicular seminoma is the following:
N0: no regional lymph node metastases
N1: metastasis with lymph nodes 2 cm or less in their greatest dimension or multiple lymph nodes, none more than 2 cm
N2: metastasis with lymph nodes greater than 2 cm but not greater than 5 cm in their greatest dimension, or multiple lymph nodes, any one mass greater than 2 cm, but not more than 5 cm
N3: metastasis with lymph nodes greater than 5 cm in their greatest dimension.
The patient in this case has N2 testicular seminoma. This TNM staging is extremely important because treatment options are decided depending on this classification.
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This question is part of the following fields:
- Pathology
- Urology
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Question 6
Correct
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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: 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.
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This question is part of the following fields:
- Inflammation & Immunology; Haematology
- Pathology
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Question 7
Incorrect
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A patient with testicular seminoma has the following tumour markers: LDH 1.3 times the reference levels, β-hCG 4500 mIU/ml and AFP 875 ng/ml. What's the serum tumour marker stage in this case?
Your Answer: S2
Correct Answer: S1
Explanation:According to AJCC guidelines, the serum tumour marker staging is the following:
S0: marker studies within normal limits
S1: lactate dehydrogenase (LDH) less than 1.5 times the reference range, beta-human chorionic gonadotrophin (β-hCG) <5000 mIU/ml, and alpha-fetoprotein (AFP) <1000 ng/ml S2: LDH 1.5–10 times the reference range, β-hCG 5000–50,000 mIU/ml or AFP 1000–10,000 ng/ml S3: LDH greater than 10 times the reference range, β-hCG >50,000 mIU/ml or AFP >10,000 ng/ml.
According to this, the patient’s tumour belongs to the S1 stage.
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This question is part of the following fields:
- Pathology
- Urology
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Question 8
Correct
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Atractyloside is an inhibitor of electron transport chain. It is expected to have little or no effect on the functioning of which of the following cell types?
Your Answer: Red blood cells
Explanation:Electron transport chain is a series of electron carriers that are embedded in the mitochondrial membrane. It is the place where ATP is made. Inhibiting the electron transport chain will stop production of ATP. Red blood cells are the only cell in the given option which do not contain ATP.
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This question is part of the following fields:
- General
- Physiology
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Question 9
Correct
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The specialist registrar, while performing the repair of an infrarenal abdominal aortic aneurysm, decides not to re-implant the inferior mesenteric artery into the repaired abdominal aorta. She says that an anastomotic artery running along the border of the large intestine is good enough to supply blood to the territory of the inferior mesenteric artery. Which vessel is she referring to?
Your Answer: Marginal
Explanation:The marginal artery is a key anastomosis for the large intestine that runs around the border of the large intestine and is formed by the anastomosis of the branches of the ileocolic artery, right colic artery, middle colic artery, left colic artery and sigmoid artery. If a small artery is occluded, these branches allow blood to reach all segments of the colon.
The arcades are anastomotic loops between the arteries that provide alternative pathways for blood flow. They are more prominent in the small intestine than the large intestine.
Arteriae rectae are small branches that run from the marginal artery to reach the colon.
The ileocolic artery is the branch of the superior mesenteric artery that supplies the caecum, appendix and terminal part of the ileum.
The coronary arteries supply blood to the heart.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 10
Incorrect
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Which of the following structures is derived from the dorsal mesogastrium of the stomach during the development of the gut?
Your Answer: Hepatogastric ligament
Correct Answer: Greater omentum
Explanation:In a developing foetus, the stomach has two mesogastria from which most of the abdominal ligaments develop. These two mesogastria are the; ventral mesogastrium and the dorsal mesogastrium. During the embryological development of the gut, different organs develop in each mesogastrium; the spleen and pancreas in the dorsal mesogastrium while the liver in the ventral mesogastrium (with their associated ligaments). In the dorsal mesogastrium the following structures develop; the greater omentum (containing the gastrophrenic ligament and the gastrocolic ligament), gastrosplenic ligament, mesentery, splenorenal ligament and phrenicocolic ligament. The structures that develop from the ventral mesogastrium include the; lesser omentum (containing the hepatoduodenal ligament and the hepatogastric ligament) in association with the liver; the coronary ligament (left triangular ligament, right triangular ligament and hepatorenal ligament) and the falciform ligament (round ligament of liver and ligamentum venosum within).
There are also folds that develop from the dorsal mesogastrium which include; umbilical folds, supravesical fossa, medial inguinal fossa, lateral umbilical fold, lateral inguinal fossa and Ileocecal fold.
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This question is part of the following fields:
- Abdomen
- Anatomy
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