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  • Question 1 - Coagulation in the body (in vivo) is a process in which several proteins...

    Correct

    • Coagulation in the body (in vivo) is a process in which several proteins known as coagulation factors are activated in a cascade effect to stop bleeding. Which of the following initiates this cascade effect?

      Your Answer: Tissue factor

      Explanation:

      Tissue factor (TF), also known as ‘factor III’ or ‘thromboplastin’, is an anti-coagulation protein that initiates the extrinsic coagulation. TF acts as a transmembrane receptor for Factor VII/VIIa . It is expressed by endothelial cells but also certain tissues, such as the heart and brain.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      27.4
      Seconds

  • Question 2 - Where do the seminal vesicles lie? ...

    Incorrect

    • Where do the seminal vesicles lie?

      Your Answer:

      Correct Answer: Base of the bladder and rectum

      Explanation:

      The seminal vesicles are two lobulated membranous pouches situated between the fundus of the bladder and rectum and act as a reservoir for the semen and secrete a fluid that is added to the seminal fluid. Each sac is pyramidal in shape but they all vary in size not only in different individuals but also in the same individuals. The anterior surface is in contact with the fundus of the bladder, extending from near the termination of the ureter to the base of the prostate. Each vesicle consist of single tube, which gives off several irregular caecal diverticula. These separate coils and the diverticula are connected by fibrous tissue.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      0
      Seconds

  • Question 3 - A lad involved in a road traffic accident is rushed to casualty where...

    Incorrect

    • A lad involved in a road traffic accident is rushed to casualty where physical examination reveals that he has limited extension of his right humerus. Which of the following nerves is most likely to have been injured?

      Your Answer:

      Correct Answer: Thoracodorsal nerve

      Explanation:

      Extension of the humerus is a function of the latissimus dorsi. This muscle is supplied by the thoracodorsal nerve which is a branch of the posterior cord of the plexus whose fibres are derived from cranial nerves V, VI and VII.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 4 - Which of the following is not seen as a complication of wound healing?...

    Incorrect

    • Which of the following is not seen as a complication of wound healing?

      Your Answer:

      Correct Answer: Malignancy

      Explanation:

      Complications in wound healing can originate due to abnormalities in the repair process. These abnormalities are :

      1) Deficient scar formation: insufficient granulation tissue can lead to wound dehiscence and ulceration. Dehiscence or wound rupture is seen most commonly in abdominal surgery due to increased intraabdominal pressure. Ulcerations are common in extremity wounds due to inadequate vascularization.

      2) Excessive formation of repair components: collagen being laid down may begin normally however later lead to a raised scar also called a hypertrophic scar, which can extend beyond its boundaries to form a keloid and

      3) Formation of contractures.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      0
      Seconds

  • Question 5 - Which of the following structures, is the area in which the superior cerebral...

    Incorrect

    • Which of the following structures, is the area in which the superior cerebral veins drain into?

      Your Answer:

      Correct Answer: Superior sagittal sinus

      Explanation:

      The superior cerebral veins are predominantly located on the superior aspect of the brain. They are 8 to 12 in number and they drain the lateral, medial and superior aspects of the cerebral hemispheres.

      These veins drain into the superior sagittal sinus, also known as the superior longitudinal sinus – which is located along the attached margin of the falx cerebri.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 6 - Infection to all of the following will lead to enlargement of the superficial...

    Incorrect

    • Infection to all of the following will lead to enlargement of the superficial inguinal lymph nodes, except for:

      Your Answer:

      Correct Answer: Ampulla of the rectum

      Explanation:

      The superficial inguinal lymph nodes form a chain immediately below the inguinal ligament. They receive lymphatic supply from the skin of the penis, scrotum, perineum, buttock and abdominal wall below the level of the umbilicus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 7 - 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 8 - A 40-year old lady with a flail chest due to trauma was breathing...

    Incorrect

    • A 40-year old lady with a flail chest due to trauma was breathing with the help of a mechanical ventilator in the ICU, and was heavily sedated on muscle relaxants. Due to sudden power failure, a nurse began to hand-ventilate the patient with a Ambu bag. What change will occur in the following parameters: (Arterial p(CO2), pH) in the intervening period between power failure and hand ventilation?

      Your Answer:

      Correct Answer: Increase, Decrease

      Explanation:

      Respiratory acidosis occurs due to alveolar hypoventilation which leads to increased arterial carbon dioxide concentration (p(CO2)). This in turn decreases the HCO3 –/p(CO2) and decreases pH. Respiratory acidosis can be acute or chronic. In acute respiratory acidosis, the p(CO2) is raised above the upper limit of normal (over 45 mm Hg) with low pH. However, in chronic cases, the raised p(CO2) is accompanied with a normal or near-normal pH due to renal compensation and an increased serum bicarbonate (HCO3 – > 30 mmHg). The given problem represents acute respiratory acidosis and thus, will show a increase in arterial p(CO2) and decrease in pH.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds

  • Question 9 - Fine-needle aspiration is a type of biopsy procedure. When performing a fine-needle aspiration...

    Incorrect

    • Fine-needle aspiration is a type of biopsy procedure. When performing a fine-needle aspiration of the lungs, which is the most common complication of the procedure?

      Your Answer:

      Correct Answer: Pneumothorax

      Explanation:

      Pneumothorax is the most common complication of a fine-needle aspiration procedure. Various factors, such as lesion size, have been associated with increased risk of pneumothorax .

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      0
      Seconds

  • Question 10 - Which muscle in the neck divides the neck into two large triangles? ...

    Incorrect

    • Which muscle in the neck divides the neck into two large triangles?

      Your Answer:

      Correct Answer: Sternocleidomastoid

      Explanation:

      The sternocleidomastoid muscle is an important landmark in the neck as it divides the neck into two; anterior and posterior triangles. These triangles help in the location of the structures of the neck including the carotid artery, head and neck lymph nodes, accessory nerve and the brachial plexus. It originates from the manubrium and medial portion of the clavicle and inserts on the mastoid process of the temporal bone, superior nuchal line. The sternocleidomastoid receives blood supply from the occipital artery and the superior thyroid artery. It is innervated by the accessory nerve (motor) and cervical plexus (sensory).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 11 - During an OSCE exam a medical student is asked to locate the sternal...

    Incorrect

    • During an OSCE exam a medical student is asked to locate the sternal angle. The sternal angle is a land mark for locating the level of the:

      Your Answer:

      Correct Answer: Second costal cartilage

      Explanation:

      The sternal angle, a key landmark used in the clinic for auscultating for heart sounds, is the point of attachment of the costal cartilage of rib 2 to the sternum. It thus corresponds to the location of the second rib. A horizontal plane through the sternal angle traverses the T4/T5 intervertebral disc and marks the inferior boundary of the superior mediastinum.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 12 - With respect to far accommodation, which of the following is a TRUE statement?...

    Incorrect

    • With respect to far accommodation, which of the following is a TRUE statement?

      Your Answer:

      Correct Answer: The ciliary muscles are relaxed

      Explanation:

      Myopia or near-sightedness is a disease due to elongated eyeballs or too strong a lens. For far accommodation (focus of a distant object onto the retina), the lens needs to decrease its refractive power, or in other words, increase its focal length. This is done by relaxation of ciliary muscles which tightens the zonular fibres and flattening of the lens. Relaxation of the zonular fibres, rounding of the lens, shortening of the focal length and constriction of the pupil occurs during near accommodation.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds

  • Question 13 - 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
      0
      Seconds

  • Question 14 - A 70-year old man presents to the surgical out patient clinic with a...

    Incorrect

    • A 70-year old man presents to the surgical out patient clinic with a direct inguinal hernia on the right side. He had undergone and appendicectomy 6 months prior. The examining doctor correlated the development of the hernia to iatrogenic nerve injury that happened during the operation. Which nerve had been injured?

      Your Answer:

      Correct Answer: Ilioinguinal

      Explanation:

      Direct inguinal hernias occur because of weakness in the abdominal muscles. The ilioinguinal nerve is important for innervating the muscles of the lower abdominal wall and damage during appendicectomy therefore prevents the man from being able to contract abdominal muscles to pull the falx inguinalis over the weak fascia.

      The genitofemoral nerve innervates the cremaster muscle and injury to it would cause inability to elevate the testes.

      The subcostal nerve and the ventral primary ramus of T10 innervate the muscles, skin and fascia of the upper abdominal wall.

      The iliohypogastric nerve supplies the skin over the upper part of the buttock behind the area supplied by the subcostal nerve.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 15 - Production of pain is most likely associated with: ...

    Incorrect

    • Production of pain is most likely associated with:

      Your Answer:

      Correct Answer: Substance P

      Explanation:

      Substance P is a short-chain polypeptide that functions as a neurotransmitter and as a neuromodulator, and is thus, a neuropeptide. It has been linked with pain regulation, mood disorders, stress, reinforcement, neurogenesis, respiratory rhythm, neurotoxicity, nausea and emesis. It is also a potent vasodilator as it brings about release of nitric oxide from the endothelium. Its release can also cause hypotension.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds

  • Question 16 - The pterion is clinically significant as it marks an area of weakness on...

    Incorrect

    • The pterion is clinically significant as it marks an area of weakness on the skull. What structure lies beneath it?

      Your Answer:

      Correct Answer: Anterior branches of the middle meningeal artery

      Explanation:

      The pterion is the area where four bones, the parietal, frontal, greater wing of sphenoid and the squamous part of the temporal bone meet. It overlies the anterior branch of the middle meningeal artery on the internal aspect of the skull. The pterion is the weakest part of the skull. Slight trauma to this region can cause extradural hematoma.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 17 - Intracellular shifting of hydrogen ions can generate a metabolic alkalosis. In which of...

    Incorrect

    • Intracellular shifting of hydrogen ions can generate a metabolic alkalosis. In which of the following conditions is metabolic alkalosis caused by this mechanism ?

      Your Answer:

      Correct Answer: Hypokalaemia

      Explanation:

      Metabolic alkalosis is characterized by a primary increase in the concentration of serum bicarbonate ions. This may occur as a consequence of a loss of hydrogen ions or a gain in bicarbonate. Hydrogen ions may be lost through the kidneys or the GI tract, as for example during vomiting, nasogastric suction or use of diuretics. Intracellular shifting of hydrogen ions develops mainly during hypokalaemia to maintain neutrality. Gain in bicarbonate ions may develop during administration of sodium bicarbonate in high amounts or in amounts that exceed the capacity of excretion of the kidneys, as seen in renal failure. Fluid losses may be another cause of metabolic alkalosis, causing the reduction of extracellular fluid volume.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      0
      Seconds

  • Question 18 - The posterior cord contains nerve fibres from which of the following levels of...

    Incorrect

    • The posterior cord contains nerve fibres from which of the following levels of the spinal cord?

      Your Answer:

      Correct Answer: C5, C6, C7, C8 and T1

      Explanation:

      THE correct answer is A. The posterior cord derives its fibres from the spinal nerves C5,C6,C7,C8,T1. This cord is formed from the fusion of the posterior divisions of the upper, lower, and middle trunks.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 19 - During clinic, a medical student conducts a physical examination on a teenage boy...

    Incorrect

    • During clinic, a medical student conducts a physical examination on a teenage boy with a lump in the inguinal region. The lump is protruding from the superficial inguinal ring. The student correctly concluded that it was:

      Your Answer:

      Correct Answer: Either a direct or an indirect inguinal hernia

      Explanation:

      It is not possible to tell if an inguinal hernia is direct or indirect just by palpating it. Despite the fact that indirect inguinal hernias commonly come out of the superficial inguinal ring to enter the scrotum, direct inguinal hernia might still do this.

      Femoral hernia goes through the femoral ring into the femoral canal (has nothing to do with the superficial inguinal ring).

      Superficial inguinal lymph nodes lie in the superficial fascia parallel to the inguinal ligament; it would therefore feel more superficial and would not be mistaken for a hernia protruding through the inguinal ring.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 20 - Multiple, non-tender lymphadenopathy with biopsy showing several crowded follicles of small, monomorphic lymphocytes...

    Incorrect

    • Multiple, non-tender lymphadenopathy with biopsy showing several crowded follicles of small, monomorphic lymphocytes and the absence of Reed-Sternberg cells is seen in which of the following?

      Your Answer:

      Correct Answer: Poorly differentiated lymphocytic lymphoma

      Explanation:

      Malignant lymphoma usually causes non-tender lymphadenopathy, unlike the tender lymphadenopathy caused by infections (including infectious mononucleosis caused by Epstein-Barr virus). Also, the lymphoid hyperplasia seen in infectious mononucleosis is benign and polyclonal.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

  • Question 21 - 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
      0
      Seconds

  • Question 22 - Regarding abduction of the digits of the hand, which of the following is...

    Incorrect

    • Regarding abduction of the digits of the hand, which of the following is correct?

      Your Answer:

      Correct Answer: All of the adductors of the digits take at least part of their attachments from metacarpal bones

      Explanation:

      Lying on the palmer surfaces of the metacarpal bones are four palmar interossei which are smaller than the dorsal interossei. Arising from the entire length of the metacarpal bone of one finger, is a palmar interosseous, which is inserted into the side of the base of the first phalanx and the aponeurotic expansion of the extensor digitorum communis tendon to the same finger. All the interossei are innervated by the eighth cervical nerve, through the deep palmar branch of the ulnar nerve. The palmar interossei adducts the fingers to an imaginary line drawn longitudinally through the centre of the middle finger.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 23 - Hyperplastic arteriosclerosis with fibrinoid necrosis, petechial haemorrhages, microinfarcts in the kidneys and elevated...

    Incorrect

    • Hyperplastic arteriosclerosis with fibrinoid necrosis, petechial haemorrhages, microinfarcts in the kidneys and elevated plasma renin are common findings in which of the following patients?

      Your Answer:

      Correct Answer: A 45-year-old woman with scleroderma

      Explanation:

      Scleroderma, also known as systemic sclerosis, is a chronic disease of the connective tissue. Involvement of the kidneys occurs in patients with diffuse scleroderma, causing rapid onset of high blood pressure with hyperreninemia, thrombotic microangiopathy, and progressive renal failure.

    • This question is part of the following fields:

      • Pathology
      • Renal
      0
      Seconds

  • Question 24 - The gradual depolarization in-between action potentials in pacemaker tissue is a result of?...

    Incorrect

    • The gradual depolarization in-between action potentials in pacemaker tissue is a result of?

      Your Answer:

      Correct Answer: A combination of gradual inactivation outward IK along with the presence of an inward ‘funny’ current (If) due to opening of channels permeable to both Na+ and K+ ions

      Explanation:

      One of the characteristic features of the pacemaker cell is the generation of a gradual diastolic depolarization also called the pacemaker potential. In phase 0, the upstroke of the action potential caused by an increase in the Ca2+ conductance, an influx of calcium occurs and a positive membrane potential is generated. The next is phase 3 which is repolarization caused by increased K+ conductance as a result of outwards K+ current. Phase 4 is a slow depolarization which accounts for the pacemaker activity, caused by increased conductance of Na+, inwards Na+ current called IF. it is turned on by repolarization.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 25 - Following a posterolateral thoracotomy, a surgeon may wish to infiltrate local anaesthetic above...

    Incorrect

    • Following a posterolateral thoracotomy, a surgeon may wish to infiltrate local anaesthetic above and below the incision to block the nerves supplying the thoracic wall. This wall is innervated by?

      Your Answer:

      Correct Answer: Intercostal nerves

      Explanation:

      Intercostal nerves are the ventral primary rami of spinal nerves T1–T11. They give branches which supply the thoracic wall.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 26 - The transverse colon has two curvatures known as the colic flexures on each...

    Incorrect

    • The transverse colon has two curvatures known as the colic flexures on each side of its lateral ends, the right and left. The left colic flexure found on the side of the descending colon is attached to an organ superiorly by a mesenteric ligament. Which organ is this?

      Your Answer:

      Correct Answer: Spleen

      Explanation:

      The left colic flexure is the bend of the transverse colon as it continues to form the descending colon on the left upper quadrant. The spleen is located on the superior aspect of the left colic flexure. It is commonly referred to as the splenic flexure because of its relation o the spleen superiorly.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 27 - Which of the following is the most accurate test for the diagnosis of...

    Incorrect

    • Which of the following is the most accurate test for the diagnosis of primary syphilis?

      Your Answer:

      Correct Answer: Dark-field microscopy

      Explanation:

      Primary syphilis is transmitted via sexual contact. Lesions on genitalia, called a chancre occur after an asymptomatic incubation period of 10-90 days (average 21 days) after exposure. This chancre is a typically solitary (can be multiple), firm, painless, ulceration over the skin at the point of exposure to spirochete, seen on penis, vagina or rectum. It heals spontaneously after 4-6 weeks. Local lymphadenopathy can be seen.

      Diagnosis is made by microscopy of fluid from lesion using dark-field illumination, taking care to not confuse with other treponemal disease. Screening tests include rapid plasma regain (RPR) and Venereal Diseases Research Laboratory (VDRL) tests. False positives are known to occur with these tests and can be seen in viral infections like hepatitis, varicella, Epstein-Barr virus, tuberculosis, lymphoma, pregnancy and IV drug use. More specific tests should therefore be carried out in case these screening tests are positive.

      The Treponema pallidum hemagglutination assay (TPHA) and the fluorescent treponemal antibody absorption (FTAABS) test are based on monoclonal antibodies and immunofluorescence and are more specific. However, they can too show false positives with other treponemal diseases like yaws or pinta. Other confirmatory tests include those based on enzyme-linked immunoassays.

    • This question is part of the following fields:

      • Pathology
      • Urology
      0
      Seconds

  • Question 28 - A CT scan of 65 year old male patient at an outpatient clinic...

    Incorrect

    • A CT scan of 65 year old male patient at an outpatient clinic suggested a bone tumour at the stylomastoid foramen. Which of the following cranial nerves is likely to be affected with this tumour?

      Your Answer:

      Correct Answer: VII

      Explanation:

      Cranial nerve VII, the facial nerve, is found in the internal acoustic canal and runs through this canal into the facial canal before exiting through the stylomastoid foramen. In the case of a bone tumour at the stylomastoid process, the facial nerve is the nerve that will most likely be affected.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 29 - A 50-year-old man is diagnosed with emphysema and cirrhosis of the liver. Which...

    Incorrect

    • A 50-year-old man is diagnosed with emphysema and cirrhosis of the liver. Which of the following condition may be the cause of both cirrhosis and emphysema in this patient?

      Your Answer:

      Correct Answer: Alpha1-antitrypsin deficiency

      Explanation:

      Alpha-1 antitrypsin (A1AT) deficiency is a condition characterised by the lack of a protein that protects the lungs and liver from damage, called alpha1-antytripsin. The main complications of this condition are liver diseases such as cirrhosis and chronic hepatitis, due to accumulation of abnormal alpha 1-antytripsin and emphysema due to loss of the proteolytic protection of the lungs.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      0
      Seconds

  • Question 30 - Which of the following features is indicative of poor prognosis in a case...

    Incorrect

    • Which of the following features is indicative of poor prognosis in a case of breast carcinoma?

      Your Answer:

      Correct Answer: Axillary lymph node metastases

      Explanation:

      Lymphatic spread indicates poor prognosis. Presence of family history is not a prognostic factor despite being linked to higher incidence. Aneuploidy is a poor prognostic factor. A breast tumour positive for oestrogen receptors is a good prognostic factor as it increases the responsiveness of the tumour to certain therapies. In-situ tumours carry the best prognosis.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      0
      Seconds

  • Question 31 - If the blood flow is constant, oxygen extraction by tissues will show the...

    Incorrect

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

      Your Answer:

      Correct Answer: Tissue cooling

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 32 - The absence of which of the following components characterizes the grey platelet syndrome...

    Incorrect

    • The absence of which of the following components characterizes the grey platelet syndrome (GPS)?

      Your Answer:

      Correct Answer: Alpha granules

      Explanation:

      Grey platelet syndrome (GPS) is a rare inherited bleeding disorder associated with an almost total absence of α-granules and their contents. The syndrome is characterised by thrombocytopenia, enlarged platelets that have a grey appearance, myelofibrosis, and splenomegaly. Alpha granules store proteins and growth factors that promote platelet adhesiveness and wound healing. Patients with GPS develop symptoms and signs such as easy bruising, prolonged bleeding, and nose bleeds.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

  • Question 33 - The tensor villi palatini muscle is a broad thin, ribbon-like muscle in the...

    Incorrect

    • The tensor villi palatini muscle is a broad thin, ribbon-like muscle in the head that tenses the soft palate. Which of the following structures is associated with the tensor villi palatini muscle?

      Your Answer:

      Correct Answer: The hamulus of the medial pterygoid plate

      Explanation:

      The pterygoid hamulus is a hook-like process at the lower extremity of the medial pterygoid plate of the sphenoid bone around which the tendon of the tensor veli palatini passes.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 34 - A 34-year-old woman with pelvic inflammatory disease is administered ceftriaxone. The subclass of...

    Incorrect

    • A 34-year-old woman with pelvic inflammatory disease is administered ceftriaxone. The subclass of antibiotics that ceftriaxone belongs to is:

      Your Answer:

      Correct Answer: Third-generation cephalosporins

      Explanation:

      Ceftriaxone is a third-generation cephalosporin antibiotic. It has a broad spectrum of activity against Gram-positive and Gram-negative bacteria. Its indications include middle ear infections, endocarditis, meningitis, pneumonia, bone and joint infections, intra-abdominal infections, skin infections, urinary tract infections, gonorrhoea, and pelvic inflammatory disease.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds

  • Question 35 - Which of the following will increase blood pressure and cause hypokalaemia? ...

    Incorrect

    • Which of the following will increase blood pressure and cause hypokalaemia?

      Your Answer:

      Correct Answer: Angiotensin II

      Explanation:

      Angiotensin is a peptide that is released in response to a decrease in blood volume and blood pressure. It has multiple functions but mainly acts to cause vasoconstriction, increase BP and release aldosterone from the adrenal cortex. It is a powerful vasoconstrictor and release of aldosterone causes increased retention of sodium and excretion of potassium.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 36 - Elevated mean corpuscular volume with hypersegmented neutrophils and low reticulocyte index is seen...

    Incorrect

    • Elevated mean corpuscular volume with hypersegmented neutrophils and low reticulocyte index is seen in on the blood count of a middle-aged lady about to undergo elective surgery. On enquiry, she mentions feeling tired for a few months. Which of the following investigations should be carried out in her to reach a diagnosis?

      Your Answer:

      Correct Answer: Serum vitamin B12 and folate

      Explanation:

      Elevated levels of MCV indicates megaloblastic anaemia, which are associated with hypersegmented neutrophils. Likely causes include vitamin B12 or folate deficiency. Megaloblastic anaemia results from defective synthesis of DNA. As RNA production continues, the cells enlarge with a large nucleus. The cytoplasmic maturity becomes greater than nuclear maturity. Megaloblasts are produced initially in the marrow, before blood. Dyspoiesis makes erythropoiesis ineffective, causing direct hyperbilirubinemia and hyperuricemia. As all cell lines are affected, reticulocytopenia, thrombocytopenia and leukopenia develop. Large, oval blood cells (macro-ovalocytes) are released in the circulation, along with presence of hypersegmented neutrophils.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

  • Question 37 - A 42 - year old male patient with an acute onset headache was...

    Incorrect

    • A 42 - year old male patient with an acute onset headache was brought in to the emergency department with suspicion of a subarachnoid haemorrhage (SAH). The SHO on call decided to have a diagnostic lumbar puncture after computed topography scan failed to support the suspicion. To perform a successful lumbar puncture without causing injury to the spine, which anatomical landmark should guide the SHO to locate the fourth vertebra for insertion of the spinal needle?

      Your Answer:

      Correct Answer: Iliac crest

      Explanation:

      The safest spinal level for conducting a lumbar puncture, is at the level of the fourth lumbar vertebra. The anatomical landmark used to locate the fourth lumbar vertebra (L4), is the iliac crest. The needle can safely be inserted either above or below L4. The conus medullaris is at the level of the border of L1 and L2 so L4 is safely distant from it.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 38 - During a procedure to treat an ulcer in the first part of the...

    Incorrect

    • During a procedure to treat an ulcer in the first part of the duodenum, the most appropriate site to make the incision on the anterior abdominal wall to approach this ulcer would be the:

      Your Answer:

      Correct Answer: Epigastric region

      Explanation:

      The abdomen is divided into nine regions for descriptive purposes. The epigastric region contains the first part of the duodenum, part of the stomach, part of the liver and pancreas. This would be the region that the surgeon would need to enter to access the ulcer.

      Typically, a midline incision in the epigastric region, extending from just below the xiphoid process down to the umbilicus, provides excellent access to the first part of the duodenum.

      The left inguinal region contains the sigmoid colon.

      The left lumbar region contains the descending colon and kidney.

      The right lumbar region contains the right kidney and descending colon.

      The right hypochondrial region contains part of the liver and gall bladder.

      The hypogastric region contains the urinary bladder and the rectum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 39 - The left lateral pterygoid muscle is one of the muscles of mastication. When...

    Incorrect

    • The left lateral pterygoid muscle is one of the muscles of mastication. When acting alone, it will shift the mandible towards which direction?

      Your Answer:

      Correct Answer: Laterally, to the right

      Explanation:

      The lateral pterygoid or external pterygoid is a muscle of mastication with two heads. It lies superiorly to the medial pterygoid. When acting alone, it will shift the mandible laterally and to the right.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 40 - A 30-year-old man is brought to the emergency department suffering from extreme dehydration,...

    Incorrect

    • A 30-year-old man is brought to the emergency department suffering from extreme dehydration, and subsequent hypotension and tachycardia. Which part of the kidney will compensate for this loss?

      Your Answer:

      Correct Answer: Collecting ducts

      Explanation:

      The collecting duct system of the kidney consists of a series of tubules and ducts that physically connect nephrons to a minor calyx or directly to the renal pelvis. The collecting duct system is the last component of the kidney to influence the body’s electrolyte and fluid balance. In humans, the system accounts for 4–5% of the kidney’s reabsorption of sodium and 5% of the kidney’s reabsorption of water. At times of extreme dehydration, over 24% of the filtered water may be reabsorbed in the collecting duct system.

    • This question is part of the following fields:

      • Physiology
      • Renal
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  • Question 41 - A 65-year-old female is taking different medications for various medical conditions. Which medication...

    Incorrect

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

      Your Answer:

      Correct Answer: Spironolactone

      Explanation:

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

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
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  • Question 42 - 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 43 - If a 55-year old gentleman who has suffered a stroke, develops a tremor...

    Incorrect

    • If a 55-year old gentleman who has suffered a stroke, develops a tremor in his fingers that worsens on reaching for an object, what part of his brain is likely to be involved?

      Your Answer:

      Correct Answer: Cerebellum

      Explanation:

      The cerebellum plays an important role in the integration of sensory perception and motor output. Multiple neural pathways link the cerebellum with the motor cortex and the spinocerebellar tract. The cerebellum uses the constant feedback on body position to fine-tune the movements and integrates these pathways. The patient described here has a characteristic cerebellar tremor that is a slow, broad tremor of the extremities and occurs at the end of a purposeful movement.

    • This question is part of the following fields:

      • Neurology
      • Physiology
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  • Question 44 - An 80 year-old quadriplegic man has been lying supine for 7 weeks in...

    Incorrect

    • An 80 year-old quadriplegic man has been lying supine for 7 weeks in a critical care ward. He develops a right lung abscess that is draining by gravity to a particular region of the lung. Which is the most likely site of pus collection?

      Your Answer:

      Correct Answer: Superior segment of the lower lobe

      Explanation:

      The superior segmental bronchus of the lower lobe of the right lung branches posteriorly off the intermediate bronchus or the inferior lobe bronchus. It is therefore more likely to receive fluid or foreign bodies that enter the right main bronchus especially when the patient is supine.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 45 - During pregnancy the uterus enlarges however after delivery it regresses to its original...

    Incorrect

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

      Your Answer:

      Correct Answer: Lysosomes

      Explanation:

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

    • This question is part of the following fields:

      • General
      • Physiology
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  • Question 46 - What is the role of ICAM-1 and VCAM-1 in the inflammatory process? ...

    Incorrect

    • What is the role of ICAM-1 and VCAM-1 in the inflammatory process?

      Your Answer:

      Correct Answer: Leukocyte adhesion

      Explanation:

      Steps involved in leukocyte arrival and function include:

      1. margination: cells migrate from the centre to the periphery of the vessel.

      2. rolling: selectins are upregulated on the vessel walls.

      3. adhesion: upregulation of the adhesion molecules ICAM and VCAM on the endothelium interact with integrins on the leukocytes. Interaction of these results in adhesion.

      4. diapedesis and chemotaxis: diapedesis is the transmigration of the leukocyte across the endothelium of the capillary and towards a chemotactic product.

      5. phagocytosis: engulfing the offending substance/cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
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  • Question 47 - 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:

      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
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      Seconds

  • Question 48 - What is the innervation of the tensor tympani muscle? ...

    Incorrect

    • What is the innervation of the tensor tympani muscle?

      Your Answer:

      Correct Answer: Trigeminal nerve

      Explanation:

      The tensor veli palatini is innervated by the medial pterygoid nerve, a branch of mandibular nerve, the third branch of the trigeminal nerve (CN V3) – the only muscle of the palate not innervated by the pharyngeal plexus, which is formed by the vagal and glossopharyngeal nerves.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 49 - 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:

      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
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  • Question 50 - The posterior boundary of the carotid triangle is bounded by which of the...

    Incorrect

    • The posterior boundary of the carotid triangle is bounded by which of the following muscles?

      Your Answer:

      Correct Answer: Sternocleidomastoid

      Explanation:

      The carotid triangle is a portion of the anterior triangle of the neck. It is bounded superiorly by the posterior belly of the digastric muscle, antero-inferiorly by the superior belly of omohyoid and posteriorly by the sternocleidomastoid. The floor is formed by the thyrohyoid, hyoglossus, middle and inferior pharyngeal constrictors and the roof is formed by the skin, superficial fascia, platysma and deep fascia.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

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Pathology (1/1) 100%
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