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  • Question 1 - When a patient that is less than 21 years of age develops a...

    Incorrect

    • When a patient that is less than 21 years of age develops a bone tumour. What is the most common benign bone tumour that would be considered in individuals below 21 years?

      Your Answer: Chondromyxoid fibroma

      Correct Answer: Osteochondroma

      Explanation:

      Osteochondroma is a benign new bone growth that protrudes from the outer contour of bones and is capped by growing cartilage. Nearly 80% of these lesions are noted before the age of 21 years.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      285.6
      Seconds

  • Question 2 - Digital rectal examination of a 75-year old gentleman who presented to the surgical...

    Incorrect

    • Digital rectal examination of a 75-year old gentleman who presented to the surgical clinic with urinary retention revealed an enlarged, nodular prostate. PSA was found to be elevated, favouring the diagnosis of prostatic malignancy. Which of the given options is the most common malignant lesion affecting the prostate gland?

      Your Answer: Squamous cell carcinoma

      Correct Answer: Adenocarcinoma

      Explanation:

      Prostatic adenocarcinoma is the commonest solid malignancy and non-dermatological cancer in men above 50 years age. Increasing in incidence with age and the highest risk seen in the black population. About 75% of cases are seen in men over 65 years. Other tumours affecting the prostate include undifferentiated prostate cancer, squamous cell carcinoma, and ductal transitional carcinoma, but these occur less commonly. Sarcomas usually affect children. Hormones play a role in the aetiology of prostate adenocarcinoma unlike the other types. Intraepithelial neoplasia is considered a precursor of invasive malignancy.

    • This question is part of the following fields:

      • Pathology
      • Urology
      21.7
      Seconds

  • Question 3 - A 34-year old gentleman presented with acute pancreatitis to the emergency department. On...

    Incorrect

    • A 34-year old gentleman presented with acute pancreatitis to the emergency department. On enquiry, there was found to be a history of recurrent pancreatitis, eruptive xanthomas and raised plasma triglyceride levels associated with chylomicrons. Which of the following will be found deficient in this patient?

      Your Answer: HMG-CoA reductase

      Correct Answer: Lipoprotein lipase

      Explanation:

      The clinical features mentioned here suggest the diagnosis of hypertriglyceridemia due to lipoprotein lipase (LPL) deficiency. LPL aids in hydrolysing the lipids in lipoproteins into free fatty acids and glycerol. Apo-CII acts as a co-factor. Deficiency of this enzyme leads to hypertriglyceridemia.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      7.6
      Seconds

  • Question 4 - Which of the following conditions is characterized by generalised oedema due to effusion...

    Correct

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

      Your 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
      25.7
      Seconds

  • Question 5 - A 37-year-old woman with a history of rheumatic heart disease presents with 10...

    Incorrect

    • A 37-year-old woman with a history of rheumatic heart disease presents with 10 days recurrent low fever. Patient underwent laboratory work up and was diagnosed with infective endocarditis. What is the most likely organism that caused the infective endocarditis in this patient?

      Your Answer: Escherichia coli

      Correct Answer: Streptococcus viridans

      Explanation:

      Subacute bacterial endocarditis  is often due to streptococci of low virulence, mainly streptococcus viridans. It is a mild to moderate illness which progresses slowly over weeks and months (>2weeks) and has low propensity to hematogenously seed to extracardiac sites.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      19.3
      Seconds

  • Question 6 - Two boys were playing when one of them brought the forearm of the...

    Incorrect

    • Two boys were playing when one of them brought the forearm of the other behind his back. This resulted in a stretching of the lateral rotator of the arm. Which of the following muscles was most likely to have been involved?

      Your Answer: Supraspinatus

      Correct Answer: Infraspinatus

      Explanation:

      There are two lateral rotators of the arm, the infraspinatus and the teres minor muscles. The infraspinatus muscle receives nerve supply from C5 and C6 via the suprascapular nerve, whilst the teres minor is supplied by C5 via the axillary nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      23.7
      Seconds

  • Question 7 - Injury to this nerve may result in loss of sensation of the mandibular...

    Incorrect

    • Injury to this nerve may result in loss of sensation of the mandibular teeth and bone:

      Your Answer: Auriculotemporal nerve

      Correct Answer: Inferior alveolar nerve

      Explanation:

      The inferior alveolar nerve (sometimes called the inferior dental nerve) is a branch of the mandibular nerve, which is itself the third branch of the trigeminal nerve. The inferior alveolar nerves supply sensation to the lower teeth of the mandible.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      5.3
      Seconds

  • Question 8 - Dicloxacillin is an antibiotic; the subclass that dicloxacillin belongs to is: ...

    Incorrect

    • Dicloxacillin is an antibiotic; the subclass that dicloxacillin belongs to is:

      Your Answer: Tetracycline

      Correct Answer: Penicillin

      Explanation:

      Dicloxacillin is a narrow-spectrum beta-lactam antibiotic. It is used to treat infections caused by susceptible Gram-positive bacteria and most effective against beta-lactamase-producing organisms such as Staphylococcus aureus. To decrease the development of resistance, dicloxacillin is recommended to treat infections that are suspected or proven to be caused by beta-lactamase-producing bacteria.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      95.4
      Seconds

  • Question 9 - In order to arrest sudden bleeding during pericardiectomy that started after accidental injury...

    Incorrect

    • In order to arrest sudden bleeding during pericardiectomy that started after accidental injury to a major vasculature in the pericardium; the surgeon inserted his left index finger through the transverse pericardial sinus, pulled forward on the two large vessels lying ventral to his finger, and compressed these vessels with his thumb to control the bleeding. Which vessels were these?

      Your Answer: Pulmonary trunk and brachiocephalic trunk

      Correct Answer: Pulmonary trunk and aorta

      Explanation:

      Transverse pericardial sinus: located behind two great vessels (aorta and pulmonary trunk) and in front of the superior vena cava and is accessed from above as in this case. The brachiocephalic trunk is located above the pericardium and the right pulmonary artery is above the pericardial reflections.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      28.5
      Seconds

  • Question 10 - A patient is brought to the accident and emergency department. He is said...

    Incorrect

    • A patient is brought to the accident and emergency department. He is said to have been involved in a mall explosion. Chest imaging reveals metal fragments in his thoracic cavity. He also has a pericardial effusion suggestive of a pericardial tear. An emergency thoracotomy is done which revealed a tear of the pericardium inferiorly. The surgeon began to explore for fragments in the pericardial sac with his hand from below the apex. He slips his fingers upward and to the right within the sac until they were stopped by the cul-de-sac formed by the pericardial reflection near the base of the heart. His finger tips were now in the:

      Your Answer: Sulcus terminalis

      Correct Answer: Oblique pericardial sinus

      Explanation:

      Transverse sinus: part of pericardial cavity that is behind the aorta and pulmonary trunk and in front of the superior vena cava separating the outflow vessels from the inflow vessels.

      Oblique pericardial sinus: is behind the left atrium where the visceral pericardium reflects onto the pulmonary veins and the inferior vena cava. Sliding a finger under the heart will take you to this sinus.

      Coronary sinus: large vein that drains the heart into the right atrium. Located on the surface of the heart.

      Coronary sulcus: groove on the heart demarcating the atria from the ventricles.

      Costomediastinal recess: part of the pleural sac where the costal pleura transitions to become the mediastinal pleura.

      Sulcus terminalis: a groove between the right atrium and the vena cava.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      7.2
      Seconds

  • Question 11 - In a young, sexually active male, what is the most common cause of...

    Incorrect

    • In a young, sexually active male, what is the most common cause of non-gonococcal urethritis?

      Your Answer: Treponema

      Correct Answer: Chlamydia

      Explanation:

      Non-gonococcal urethritis is most commonly caused by Chlamydia trachomatis (50% cases). Less common organisms include Mycoplasma genitalium, Urea urealyticum and Trichomonas vaginalis. Chlamydia is also the commonest cause of non-gonococcal cervicitis in women and proctitis in both sexes.

    • This question is part of the following fields:

      • Pathology
      • Renal
      45.8
      Seconds

  • Question 12 - A 70-year-old female who underwent coronary artery bypass graft developed post-operative acute renal...

    Incorrect

    • A 70-year-old female who underwent coronary artery bypass graft developed post-operative acute renal failure. Her urinary catheter was left in place to monitor urine output. 6 days later she developed fever and chills. She also complained of suprapubic and left flank pain. She is found to have developed acute ascending pyelonephritis. Which of the following organism was most likely isolated during urine culture?

      Your Answer: Clostridium difficile

      Correct Answer: Escherichia coli with pili

      Explanation:

      The most common cause of urinary tract infection is Escherichia coli. Pilated strains of E. coli ascend the urethra to infect the kidney and the bladder. Catheters have been associated with an increased risk of UTIs.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      15.6
      Seconds

  • Question 13 - Calculate the stroke volume in a patient admitted for coronary bypass surgery, with...

    Correct

    • 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: 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
      37.6
      Seconds

  • Question 14 - A 20 year old is brought to the A&E after he fell from...

    Incorrect

    • A 20 year old is brought to the A&E after he fell from a moving cart. The boy has sustained blunt abdominal injury, and the there is a possibility of internal bleeding as the boy is in shock. An urgent exploratory laparotomy is done in the A&E theatre. On opening the peritoneal cavity, the operating surgeon notices a torn gastrosplenic ligament with a large clot around the spleen. Which artery is most likely to have been injured in this case?

      Your Answer: Splenic

      Correct Answer: Short gastric

      Explanation:

      The short gastric arteries branch from the splenic artery near the splenic hilum to travel back in the gastrosplenic ligament to supply the fundus of the stomach. Therefore, these may be injured in this case.

      The splenic artery courses deep to the stomach to reach the hilum of the spleen. It doesn’t travel in the gastrosplenic ligament although it does give off branches that do.

      The middle colic artery is a branch of the superior mesenteric artery that supplies the transverse colon.

      Gastroepiploic artery is the largest branch of the splenic artery that courses between the layers of the greater omentum to anastomose with the right gastroepiploic.

      Left gastric artery, a branch of the coeliac trunk. It supplies the left half of the lesser curvature.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      4.5
      Seconds

  • Question 15 - When a young boy falls on his outstretched hand, he fractures one of...

    Incorrect

    • When a young boy falls on his outstretched hand, he fractures one of the bones at his wrist joint. The doctors told his parents that the fractured bone has special importance as it is that bone that articulates with the distal end of the radius. Which one of the following is it?

      Your Answer: Pisiform

      Correct Answer: Scaphoid

      Explanation:

      It is the scaphoid bone that articulates with the radius at this level. It is located at the radial side of the wrist and is considered the largest bone in the proximal row of carpal bones. It articulates with the radius via its superior surface. This bone also articulates with trapezium and trapezoid bones via the inferior surface, capitate and lunate medially.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      7.1
      Seconds

  • Question 16 - When a patient is standing erect, pleural fluid would tend to accumulate in...

    Incorrect

    • When a patient is standing erect, pleural fluid would tend to accumulate in which part of the pleural space?

      Your Answer: Cupola

      Correct Answer: Costodiaphragmatic recess

      Explanation:

      The costo-diaphragmatic recess is the lowest extent of the pleural cavity or sac. Any fluid in the pleura will by gravity accumulate here when a patient is standing erect.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      5.1
      Seconds

  • Question 17 - What is the normal duration of PR interval on an electrocardiogram of a...

    Incorrect

    • What is the normal duration of PR interval on an electrocardiogram of a healthy individual?

      Your Answer: 0.25–0.35 s

      Correct Answer: 0.12–0.20 s

      Explanation:

      PR interval extends from the beginning of the P-wave until the beginning of the QRS complex. The normal duration of the PR interval is 0.12-0.20 s. It can be prolonged in first degree heart block, and reduced in Wolff-Parkinson-White syndrome.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      20.8
      Seconds

  • Question 18 - A terrorist running away from the police was shot in the back. The...

    Incorrect

    • A terrorist running away from the police was shot in the back. The bullet hit his left lung halfway between its apex and the diaphragmatic surface. Which part of the lung was most likely to be injured?

      Your Answer: Cupola

      Correct Answer: Inferior lobe

      Explanation:

      The oblique fissure of the left lung is so sharp that the posterior surface of the left lung is mostly composed of the inferior lobe so that the point halfway between the apex and the diaphragmatic surface of the lung would result in injury to the inferior lobe.

      The hilum is the point on the medial surface of the lung where the structures that form the root of the lung enter and leave the lung.

      The lingual on the other hand is part of the superior lobe of the left lung and it is part of the anterior and superior sides of the lung.

      The middle lobe is only found on the right lung.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      10.7
      Seconds

  • Question 19 - An excised lesion is found to be a premalignant during examination by the...

    Correct

    • An excised lesion is found to be a premalignant during examination by the pathologist. What is the most likely histopathology report of this lesion?

      Your Answer: Solar keratosis

      Explanation:

      Premalignant condition is a state of disordered morphology of cells that is associated with an increased risk of cancer. If this condition is left untreated, it may lead to the development of cancer. The following are examples of pre-malignant lesions: actinic keratosis, Barret’s oesophagitis, atrophic gastritis, ductal carcinoma in situ, dyskeratosis congenita, sideropenic dysphagia, lichen planus, oral submucous fibrosis, solar elastosis, cervical dysplasia, leucoplakia and erythroplakia.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      6.5
      Seconds

  • Question 20 - Muscles and tendons in the planter region of the foot mainly take blood...

    Incorrect

    • Muscles and tendons in the planter region of the foot mainly take blood supply from:

      Your Answer: Fibular artery

      Correct Answer: Posterior tibial artery

      Explanation:

      The posterior tibial artery is the main source of blood supply to the posterior compartment of the leg.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      17.3
      Seconds

  • Question 21 - Action potentials are used extensively by the nervous system to communicate between neurones...

    Correct

    • Action potentials are used extensively by the nervous system to communicate between neurones and muscles or glands. What happens during the activation of a nerve cell membrane?

      Your Answer: Sodium ions flow inward

      Explanation:

      During the generation of an action potential, the membrane gets depolarized which cause the voltage gated sodium channels to open and sodium diffuses inside the neuron, resulting in the membrane potential moving towards a positive value. This positive potential will then open the voltage gated potassium channels and cause more K+ to move out decreasing the membrane potential and restoring the membrane potential to its resting value.

    • This question is part of the following fields:

      • General
      • Physiology
      6.6
      Seconds

  • Question 22 - 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: G6PD deficiency

      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
      7.6
      Seconds

  • Question 23 - A cancer patient was found to have a radio resistant tumour. Which tumour...

    Incorrect

    • A cancer patient was found to have a radio resistant tumour. Which tumour does the patient most likely have?

      Your Answer: Adenocarcinoma of breast

      Correct Answer: Liposarcoma

      Explanation:

      Liposarcoma is a cancer that arises in fat cells in deep soft tissue. Commonly it occurs inside the thigh or retroperitoneum. It usually affects middle-aged and older adults, over 40 years. Liposarcoma is the most common soft-tissue sarcoma. It is very radio resistant. Five-year survival rates vary from 100% to 56% based on histological subtype.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      21.5
      Seconds

  • Question 24 - A woman that presented with dyspnoea, chest pain and cough was found to...

    Correct

    • A woman that presented with dyspnoea, chest pain and cough was found to have a serous pleural effusion. This finding is most likely to be associated with which of the following conditions?

      Your Answer: Congestive heart failure

      Explanation:

      A pleural effusion is defined as an abnormal collection of fluid in the pleural space. Pleural effusion can result from excess fluid production or decreased absorption or both. Thoracentesis and laboratory testing help determine the origin of the accumulated fluid. Serous fluid accumulation in the pleural space indicates the presence of a hydrothorax and is most likely to develop secondary to congestive heart failure.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      9.4
      Seconds

  • Question 25 - Hormones of the anterior pituitary include which of the following? ...

    Incorrect

    • Hormones of the anterior pituitary include which of the following?

      Your Answer: Antidiuretic hormone (ADH)

      Correct Answer: Prolactin

      Explanation:

      The anterior pituitary gland (adenohypophysis or pars distalis) synthesizes and secretes:

      1. FSH (follicle-stimulating hormone)

      2. LH (luteinizing hormone)

      3. Growth hormone

      4. Prolactin

      5. ACTH (adrenocorticotropic hormone)

      6. TSH (thyroid-stimulating hormone).

      The posterior pituitary gland (neurohypophysis) stores and secretes 2 hormones produced by the hypothalamus:

      1. ADH (antidiuretic hormone or vasopressin)

      2. Oxytocin

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      42.8
      Seconds

  • Question 26 - A 40-year old gentleman, who is a known with ulcerative colitis, complains of...

    Incorrect

    • A 40-year old gentleman, who is a known with ulcerative colitis, complains of recent-onset of itching and fatigue. On examination, his serum alkaline phosphatase level was found to be high. Barium radiography of the biliary tract showed a 'beaded' appearance. What is the likely diagnosis?

      Your Answer: Gallstone ileus

      Correct Answer: Sclerosing cholangitis

      Explanation:

      Primary sclerosing cholangitis is characterised by patchy inflammation, fibrosis and strictures in intra- and extra-hepatic bile ducts. It is a chronic cholestatic condition with 80% patients having associated inflammatory bowel disease (likely to be ulcerative colitis). Symptoms include pruritus and fatigue. ERCP (endoscopic retrograde cholangiopancreatography) or MRCP (magnetic resonance cholangiopancreatography) are diagnostic. Disease can lead to complete obliteration of ducts, which can result in liver failure. Cholangiocarcinoma is also a recognised complication..

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      27.9
      Seconds

  • Question 27 - An enlarged lymph node which shows well-defined, prominent paracortical follicles with germinal centres...

    Incorrect

    • An enlarged lymph node which shows well-defined, prominent paracortical follicles with germinal centres is most likely from which of the following patients?

      Your Answer: A 35-year-old woman who was scratched by her cat

      Correct Answer: A 5-year-old boy with a sore throat and runny nose

      Explanation:

      Lymphadenopathy is common in children and is usually reactive in nature. The description fits that of a benign, reactive lymph node.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      5
      Seconds

  • Question 28 - After a cerebral infarction, which of these histopathogical findings is most likely to...

    Incorrect

    • After a cerebral infarction, which of these histopathogical findings is most likely to be found?

      Your Answer: Gangrenous necrosis

      Correct Answer: Liquefactive necrosis

      Explanation:

      The brain has a high lipid content and typically undergoes liquefaction with ischaemic injury, because it contains little connective tissue but high amounts of digestive enzymes.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      21.2
      Seconds

  • Question 29 - A 49-year-old man, smoker, complains of a persisting and worsening cough over the...

    Incorrect

    • A 49-year-old man, smoker, complains of a persisting and worsening cough over the past few months. He also has noted blood in his sputum. The patient has no other major health conditions. Which of the following investigative procedures should be done first?

      Your Answer: Pleural fluid cytology

      Correct Answer: Sputum cytology

      Explanation:

      Sputum cytology is a diagnostic test used for the examination of sputum under a microscope to determine if abnormal cells are present. It may be used as the first diagnostic procedure to help detect a suspected lung cancer or certain non-cancerous lung conditions.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      22.5
      Seconds

  • Question 30 - A 15 year old girl presented to the emergency with a history of...

    Incorrect

    • A 15 year old girl presented to the emergency with a history of chronic cough, fever and weight loss. Her chest X-ray showed multiple nodules 1-4 cm in size and some of them with cavitation especially in the upper lobe. A sputum sample was positive for acid fast bacilli. Which of the following cells played a part in the development of the lung lesions?

      Your Answer: Neutrophil

      Correct Answer: Macrophage

      Explanation:

      The characteristic cells in granulomatous inflammation are giant cells, formed from merging macrophages and epithelioid cells elongated with granular eosinophilic cytoplasm. Granulomatous reactions are seen in patients with tuberculosis. A tuberculous/caseating granuloma is characterised by a zone of central necrosis lined with giant multinucleated giant cells (Langhans cells) and surrounded by epithelioid cells, lymphocytes and fibroblasts. The caseous zone is present due to the damaged and dead giant cells and epithelioid cells.

      Mast cells are only few in number and fibroblasts lay down collagen.

      Basophils are not present.

      The giant cell made up of macrophages are the most abundant cells in this inflammatory process.

    • This question is part of the following fields:

      • Inflammation & Immunology; Respiratory
      • Pathology
      10.4
      Seconds

  • Question 31 - A 55-year old gentleman presented to the doctor with worsening dysphagia for both...

    Incorrect

    • A 55-year old gentleman presented to the doctor with worsening dysphagia for both solids and liquids over 6 months. This was associated with regurgitation of undigested food and occasional chest pain. Barium swallow revealed distal oesophageal dilatation with lack of peristalsis in the distal two-third oesophagus. The likely diagnosis is:

      Your Answer: Oesophageal cancer

      Correct Answer: Achalasia

      Explanation:

      Achalasia is an oesophageal motility disorder where inappropriate contractions in the oesophagus lead to reduced peristalsis and failure of the lower oesophageal sphincter to relax properly in response to swallowing. Classical triad of symptoms include dysphagia to fluids followed by solids, chest pain and regurgitation of undigested food. Other symptoms include belching, hiccups, weight loss and cough. Diagnosis is by:

      – X-ray with a barium swallow or oesophagography : narrowing at the gastroesophageal junction (‘bird/parrot beak’ or ‘rat tail’ appearance) and various degrees of mega-oesophagus (oesophageal dilatation) as the oesophagus is gradually stretched by retained food. Effectiveness of treatment can be measured with a 5-minute timed barium swallow.

      – Manometry – probe measures the pressure waves in different parts of oesophagus and stomach while swallowing.

      – Endoscopy

      – CT scan to exclude other causes like malignancy

      – Pathological examination showing defect in the nerves which control oesophageal motility (myenteric plexus).

      In Chagas disease, there is destruction of ganglion cells by Trypanosoma cruzi.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      4.5
      Seconds

  • Question 32 - A 38-year-old woman with end-stage renal disease, is undergoing haemodialysis. She has normocytic...

    Incorrect

    • A 38-year-old woman with end-stage renal disease, is undergoing haemodialysis. She has normocytic normochromic anaemia. What is the best treatment for her?

      Your Answer: Ferrous sulphate

      Correct Answer: Erythropoietin

      Explanation:

      E erythropoietin (EPO) is a hormone that is released by the kidney. It is responsible for the regulation of red blood cell production in the body. It can be made using recombinant technology and is used in the treatment of anaemia of chronic renal failure and in patients under going chemotherapy

    • This question is part of the following fields:

      • General
      • Physiology
      31.4
      Seconds

  • Question 33 - A 55-year old patient with signs and symptoms of internal haemorrhage was brought...

    Correct

    • A 55-year old patient with signs and symptoms of internal haemorrhage was brought in for emergency surgery to control the bleeding. Angiography results revealed an advanced duodenal tumour that had perforated the blood vessel immediately behind the first part of the duodenum. Which of the following is the most likely blood vessel that was ruptured by the cancer?

      Your Answer: Gastroduodenal artery

      Explanation:

      The gastroduodenal artery is the artery that lies just behind the first portion of the duodenum. The gastroduodenal artery would be the most likely artery to be perforated by a cancer in this area. The perforation is as a result of the spillage of the acidic content of the chyme in the duodenum. All the other blood vessels in the list would less likely be affected by the gastric expellant from the duodenum. The coronary vein is located in the lesser curvature of the stomach. The inferior pancreaticoduodenal arcade is located inferiorly to the first part of the duodenum on the head of the pancreas. The hepatic artery proper is a branch of the common hepatic artery that is located superior to the first portion of the duodenum. The splenic vein arises from the spleen; it forms the portal vein by joining the superior mesenteric vein. It is laterally detached from the duodenum. Both the left gastric vein and the splenic vein are located superior to the first portion of the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      17.3
      Seconds

  • Question 34 - When conducting an exploratory laparotomy procedure of a patient diagnosed with a bleeding...

    Correct

    • When conducting an exploratory laparotomy procedure of a patient diagnosed with a bleeding ulcer of the lesser curvature of the stomach, which artery in this patient are you most likely to ligate to control the bleeding?

      Your Answer: Left gastric

      Explanation:

      The lesser curvature of the stomach is supplied by the left gastric artery along with the right gastric artery. These two arteries are the ones to most likely be ligated if bleeding was to be stopped at the lesser curvature of the stomach. The splenic artery branches from the celiac branch and supplies the spleen. The left gastro-omental, the right and left gastroepiploic arteries supply the greater curvature.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      14.8
      Seconds

  • Question 35 - During hysterectomy, the ureter is most likely to be ligated when a surgeon...

    Incorrect

    • During hysterectomy, the ureter is most likely to be ligated when a surgeon is clamping the?

      Your Answer: Uterine tubes

      Correct Answer: Uterine arteries

      Explanation:

      The ureter forms the posterior boundary of a shallow depression which lodges the ovary and then runs medially and forward on the lateral aspect of the uterine cervix and upper part of the vagina to reach the fundus of the bladder. It is also situated about 2cm from the side of the cervix of the uterus. The relationship of the ureters and uterine arteries is of clinical significance because the arteries are at risk of iatrogenic injury during hysterectomy.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      24.8
      Seconds

  • Question 36 - Following a lacerating injury along the anterior border of the trapezius muscle in...

    Incorrect

    • Following a lacerating injury along the anterior border of the trapezius muscle in the neck, a man has the point of his shoulder (scapula) sagging and he has difficulty with full abduction of his arm. Which nerve is most likely injured?

      Your Answer: Axillary

      Correct Answer: Accessory (cranial nerve XI)

      Explanation:

      Injury to the accessory nerve denervates the trapezius muscle so that the person will no longer be able to raise the acromion of the shoulder. The dorsal scapular nerve supplies the rhomboids i.e. major and minor and the levator scapulae so that injury to this nerve weakens retraction of the scapula. The greater occipital nerve is responsible for sensation of the posterior scalp. The axillary nerve innervates the deltoid muscle which is responsible for abduction of the arm and the suprascapular nerve is responsible for rotating the humerus laterally. Cutaneous nerves supply the skin.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      23.5
      Seconds

  • Question 37 - The muscle which has an antagonistic action to the serratus anterior muscle and...

    Incorrect

    • The muscle which has an antagonistic action to the serratus anterior muscle and is one of the retractors of the scapula is the?

      Your Answer: Pectoralis minor

      Correct Answer: Rhomboid major

      Explanation:

      Protraction is accomplished by the actions of the serratus anterior, pectoralis major, and pectoralis minor muscles. Retraction is accomplished by the actions of the trapezius, rhomboids, and latissimus dorsi muscles.

      The rhomboid major arises from the second, third, fourth and fifth thoracic vertebrae. It is inserted into a narrow tendinous arch attached to the root of the spine of the scapula and the inferior angle. By its insertion in the inferior angle of the scapula, it acts on this angle and produces a slight rotation of the scapula on the side of the chest. It also retracts the scapula by working with the trapezius muscle.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      15.7
      Seconds

  • Question 38 - A 55 year-old construction worker is diagnosed with malignant mesothelioma. Exposure to which...

    Incorrect

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

      Your Answer: Nitrogen dioxide

      Correct Answer: Asbestos

      Explanation:

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

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      12.6
      Seconds

  • Question 39 - A 25 year old man presented with a history of headache and peripheral...

    Correct

    • A 25 year old man presented with a history of headache and peripheral cyanosis. He had been living in the Himalayas for 6 months prior to this. What is the reason for his condition?

      Your Answer: Physiological polycythaemia

      Explanation:

      Polycythaemia is a condition that results in an increase in the total number of red blood cells (RBCs) in the blood. It can be due to myeloproliferative syndrome or due to chronically low oxygen levels or rarely malignancy. In primary polycythaemia/polycythaemia vera the increase is due to an abnormality in the bone marrow, resulting in increases RBCs, white blood cells (WBCs) and platelets. In secondary polycythaemia the increase occurs due to high levels of erythropoietin either artificially or naturally. The increase is about 6-8 million/cm3 of blood. A type of secondary polycythaemia is physiological polycythaemia where people living in high altitudes who are exposed to hypoxic conditions produce more erythropoietin as a compensatory mechanism for thin oxygen and low oxygen partial pressure.

    • This question is part of the following fields:

      • General
      • Physiology
      73.4
      Seconds

  • Question 40 - Atractyloside is an inhibitor of electron transport chain. It is expected to have...

    Incorrect

    • 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:

      Correct 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.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Pathology (15/15) 100%
Urology (1/1) 100%
Gastroenterology (2/2) 100%
Physiology (9/10) 90%
Fluids & Electrolytes (1/1) 100%
Microbiology (2/2) 100%
Anatomy (11/14) 79%
Upper Limb (3/4) 75%
Head & Neck (1/1) 100%
Pharmacology (1/1) 100%
Thorax (3/4) 75%
Renal (1/1) 100%
Cardiovascular (1/2) 50%
Abdomen (2/3) 67%
Neoplasia (3/3) 100%
Lower Limb (1/1) 100%
General (4/4) 100%
Haematology (2/2) 100%
Respiratory (2/2) 100%
Endocrine (1/1) 100%
Gastrointestinal; Hepatobiliary (1/1) 100%
Neurology (1/1) 100%
Inflammation & Immunology; Respiratory (1/1) 100%
Pelvis (1/1) 100%
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