00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
Retry this test Dashboard

  • Question 1 - Which lymph nodes are most likely to enlarge due to the spread of...

    Correct

    • Which lymph nodes are most likely to enlarge due to the spread of infection through the lymphatic channels in a patient with a boil on his scrotum?

      Your Answer: Superficial inguinal nodes

      Explanation:

      The superficial inguinal nodes drain the perineum and the external genitalia which include the scrotum and the labia majora. The testes, however, drain to the lumbar nodes.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      26.5
      Seconds

  • Question 2 - What forms the pelvic diaphragm? ...

    Incorrect

    • What forms the pelvic diaphragm?

      Your Answer: Piriformis and internal obturator muscles

      Correct Answer: Levator ani and coccygeus muscles

      Explanation:

      The pelvic diaphragm is formed by the levator ani and the coccygeus muscles. The levator ani forms the greater part of the pelvic floor supporting the viscera in the pelvic cavity.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      16.2
      Seconds

  • Question 3 - A 35-year-old woman is in a comatose state following a traumatic head injury,...

    Incorrect

    • A 35-year-old woman is in a comatose state following a traumatic head injury, and is receiving intravenous (IV) antibiotics and IV fluids containing saline and 5% dextrose. A serum biochemistry analysis is performed five days later which shows a low serum potassium level. This is most likely to be due to:

      Your Answer:

      Correct Answer: Nothing per oral regimen

      Explanation:

      In this patient the cause for hypokalaemia is insufficient consumption of potassium as she is nil-per mouth with no intravenous supplementation. Parenteral nutrition has been used for comatose patients, although enteral feeding is usually preferable, and less prone to complications.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds

  • Question 4 - A 47 year-old woman was admitted for elective cholecystectomy, with a past...

    Incorrect

    • A 47 year-old woman was admitted for elective cholecystectomy, with a past history of easy bruising and heavy menstrual periods. The patient was also diagnosed with Willebrand's disease. Willebrand's disease is:

      Your Answer:

      Correct Answer: Autosomal dominant

      Explanation:

      von Willebrand disease is an autosomal dominant disorder marked by the deficiency of vWF, a large protein synthesized by the endothelial cells and megakaryocytes. It mediates adhesion of platelets to the subendothelium at site of vascular injury. Disease characteristics include impaired platelet adhesion, prolonged bleeding time and a functional deficiency of factor VIII (vWF is its carrier protein).

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 5 - 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 6 - A 28 years old women presents with a history of chronic cough with...

    Incorrect

    • A 28 years old women presents with a history of chronic cough with fever for the past 2 months. A chest x ray revealed a diffuse bilateral reticulonodular pattern. A transbronchial biopsy was performed and histological examination showed focal areas of inflammation with epithelioid macrophages, Langhans cells and lymphocytes. Which of the immune reaction is responsible for this?

      Your Answer:

      Correct Answer: Type IV hypersensitivity

      Explanation:

      A reactivated tuberculosis with granuloma formation is characteristic of type IV reaction. It is also called a delayed type of hypersensitivity reaction and takes around 2-8 days to deliver. It is a cell mediated response with the involvement of CD8 and CD4 cells and the release of IL-1 from macrophages that further activate these CD cells.

      Granulomatous reactions are mostly cell-mediated.

      Type I reactions are allergic and anaphylactic reactions and type II are complement-mediated immune reactions.

    • This question is part of the following fields:

      • Inflammation & Immunology; Respiratory
      • Pathology
      0
      Seconds

  • Question 7 - The vascular structure found on the right side of the fifth lumbar vertebra...

    Incorrect

    • The vascular structure found on the right side of the fifth lumbar vertebra is?

      Your Answer:

      Correct Answer: Inferior vena cava

      Explanation:

      The most likely vascular structure is the inferior vena cava. The inferior vena cava is formed by the joining of the two common iliac arteries, the right and the left iliac artery, at the level of the fifth lumbar vertebra( L5). The inferior vena cava passes along the right side of the vertebral column. It enters the thoracic cavity into the underside of the heart through the caval opening of the diaphragm at the level of the eight thoracic vertebra (T8).

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 8 - A patient who following 20 years of working in the asbestos industry develops...

    Incorrect

    • A patient who following 20 years of working in the asbestos industry develops malignant mesothelioma and is scheduled for pleuropneumonectomy to remove the entire pleura and lung on the affected side. Which layer would provide a natural cleavage plane for surgical separation of the costal pleura from the thoracic wall?

      Your Answer:

      Correct Answer: Endothoracic fascia

      Explanation:

      The endothoracic fascia is connective tissue that is between the costal parietal pleura and the inner aspect of the chest wall. Removing this layer of connective tissue would make it easy to separate the costal pleura from the thoracic wall.

      Deep fascia: is not found around the lungs. It is a layer of connective tissue that invests a muscle or a group of muscles.

      Parietal pleura: part of the pleura that lines the inner surface of the chest/thoracic cavity.

      Visceral pleura: is the serous membrane that lines the surface of the lungs.

      Transversus thoracis muscle fascia is associated only with the muscle transversus thoracis.

      Peritracheal fascia: a layer of connective tissue that invests the trachea. It is not associated with the thoracic wall or the costal pleura.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 9 - After having donated a unit of blood. The blood bank will prefer to...

    Incorrect

    • After having donated a unit of blood. The blood bank will prefer to use which of the following anticoagulants to store the blood?

      Your Answer:

      Correct Answer: Citrate

      Explanation:

      Calcium is necessary for coagulation to occur. Citrate being a chelator and combining with calcium ions to form un-ionised compound will prevent coagulation. Following transfusion the citrate is removed by the liver with in a few minutes. Oxalate also works on the same principle but it is toxic to the body.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 10 - A 14 year old girl suffers from haemophilia A and chronic knee pain...

    Incorrect

    • A 14 year old girl suffers from haemophilia A and chronic knee pain with progressive swelling and deformity over the last 4 years. Test results reveal a significantly reduced factor VIII activity. Which of the following is seen in the knee joint space after an acute painful episode?

      Your Answer:

      Correct Answer: Cholesterol crystals

      Explanation:

      Due to breakdown of the red blood cell membrane in haemophilic patients, cholesterol crystals are formed by the lipids. On the other hand lipofuscin deposition does not occur in haemolysis or haemorrhage. Neutrophil accumulation suggests acute inflammation. Anthracotic pigment is an exogenous carbon pigment that deposits in the lung from dust. Russell bodies are intracellular accumulations of immunoglobins in plasma cells. Curschmann’s spirals and Charcot Leyden crystals are pathognomonic of asthma.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Haematology
      • Pathology
      0
      Seconds

  • Question 11 - A 55-year-old woman died 3 years after a cardiac transplant due to worsening...

    Incorrect

    • A 55-year-old woman died 3 years after a cardiac transplant due to worsening congestive heart failure. Autopsy revealed diffuse hyperplasia of the vascular intima involving the entire length of the coronary arteries. The most probable cause of deterioration of the cardiac function is:

      Your Answer:

      Correct Answer: Coronary atherosclerosis

      Explanation:

      Allograft coronary artery disease (CAD) can begin right after the transplant and is the major cause of later death in cardiac transplant recipients. This form of atherosclerosis progresses quickly resulting in allograft failure. Due to lack of premonitory symptoms CAD may lead to sudden death.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      0
      Seconds

  • Question 12 - the action of the semimembranosus muscle is: ...

    Incorrect

    • the action of the semimembranosus muscle is:

      Your Answer:

      Correct Answer: Extension of the hip and flexion of the knee

      Explanation:

      the semimembranosus is situated at the back and medial side of the thigh. It arises from the upper and outer impression on the tuberosity of the ischium, above and lateral to the biceps femoris and semitendinosus. It is inserted mainly into the horizontal groove on the posterior medial aspect of the medial condyle of the tibia. it flexes the knee and assists in extension of the hip.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 13 - A 31 -year-old female patient had a blood gas done on presentation to...

    Incorrect

    • A 31 -year-old female patient had a blood gas done on presentation to the emergency department. She was found to have a metabolic acidosis and decreased anion gap. The most likely cause of these findings in this patient would be?

      Your Answer:

      Correct Answer: Hypoalbuminemia

      Explanation:

      A low anion gap might be caused by alterations in serum protein levels, primarily albumin (hypoalbuminemia), increased levels of calcium (hypercalcaemia) and magnesium (hypermagnesemia) or bromide and lithium intoxication. However, the commonest cause is hypoalbuminemia, thus if the albumin concentration falls, the anion gap will also be lower. The anion gap should be corrected upwards by 2.5 mmol/l for every 10g/l fall in the serum albumin.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      0
      Seconds

  • Question 14 - An old man was diagnosed with squamous cell carcinoma with axillary lymph node...

    Incorrect

    • An old man was diagnosed with squamous cell carcinoma with axillary lymph node metastasis. The doctor said he will excise the tumour and remove all axillary lymph nodes lateral to the edge of the pectoralis minor muscle. One of the following axillary lymph nodes won't be removed by this procedure. Which is it?

      Your Answer:

      Correct Answer: Apical

      Explanation:

      The apical lymph node group won’t be removed which include 20 to 30 lymph nodes.

      Axillary lymph nodes are grouped according to location. The lateral group, the anterior to pectoral group, the posterior or subscapular group, the central group, and the medial or apical group. The lateral, pectoral, and subscapular groups are found lateral to the pectoralis minor muscle. The central group is situated directly under that muscle. Thus, if all lymph nodes lateral to the medial edge of the pectoralis minor muscle are removed, all the above four groups will be removed. The apical group won’t be removed which is situated medial to the medial edge of the pectoralis minor muscle.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 15 - upon stroking the plantar surface of a patient's foot, extension of toes was...

    Incorrect

    • upon stroking the plantar surface of a patient's foot, extension of toes was noted. This is likely to be accompanied with:

      Your Answer:

      Correct Answer: Spasticity

      Explanation:

      An upper motor neuron lesion affects the neural pathway above the anterior horn cell or motor nuclei of the cranial nerves, whereas a lower motor neurone lesion affects nerve fibres travelling from the anterior horn of the spinal cord to the relevant muscles. An upper motor neurone lesions results in the following:

      – Spasticity in the extensor muscles (lower limbs) or flexor muscles (upper limbs).

      – ‘clasp-knife’ response where initial resistance to movement is followed by relaxation

      – Weakness in the flexors (lower limbs) or extensors (upper limbs) with no muscle wasting

      – Brisk tendon jerk reflexes

      – Positive Babinski sign (on stimulation of the sole of the foot, the big toe is raised rather than curled downwards)

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds

  • Question 16 - Pain in the epigastric region occurring typically 2-3 hours after meals and causing...

    Incorrect

    • Pain in the epigastric region occurring typically 2-3 hours after meals and causing the patient to wake up at night is characteristic of which of the following conditions?

      Your Answer:

      Correct Answer: Duodenal ulcer

      Explanation:

      The description is typical for duodenal ulcers. There is no pain upon waking in the morning however it appears around mid-morning and is relieved by ingestion of food. The pain also often causes the patient to wake up at night.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      0
      Seconds

  • Question 17 - During a radical mastectomy for advanced breast cancer, the surgeon injured the long...

    Incorrect

    • During a radical mastectomy for advanced breast cancer, the surgeon injured the long thoracic nerve. Which among the following muscles is likely to be affected?

      Your Answer:

      Correct Answer: Serratus anterior

      Explanation:

      The long thoracic nerve innervates the serratus anterior muscle which holds the scapula forward and balances the rhomboids and the trapezius muscles which retract the scapula. Injury to this nerve results in a ‘winged scapula’ with a posterior protrusion.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 18 - A 65-year-old smoker presents with painless haematuria, urinary frequency and urgency. He is...

    Incorrect

    • A 65-year-old smoker presents with painless haematuria, urinary frequency and urgency. He is diagnosed with bladder cancer. Which is the most likely type?

      Your Answer:

      Correct Answer: Transitional cell carcinoma

      Explanation:

      90% of bladder cancers are transitional cell carcinomas derived from the bladder urothelium. Risk factors include industrial chemicals, smoking and infection. Schistosomiasis and bladder stones predispose to the squamous cell variety.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds

  • Question 19 - A 18-year old girl presents to her doctor with an excessively enlarged left...

    Incorrect

    • A 18-year old girl presents to her doctor with an excessively enlarged left breast as compared to the right breast since puberty. The most likely cause for this is:

      Your Answer:

      Correct Answer: Virginal breast hypertrophy

      Explanation:

      Virginal breast hypertrophy’ is the term assigned to excessive growth of breasts during puberty and is a common phenomenon. It is also known as ‘juvenile macromastia’ or ‘ juvenile gigantomastia’. The breast hypertrophy often starts with menarche and occasionally occurs in growth spurts. These spurts can cause physical discomfort, red and itchy skin or pain in the breasts. The breasts can also grow continuously over several years and lead to overdevelopment of a normal breast. Nipples also undergo enlargement along with the breasts.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      0
      Seconds

  • Question 20 - A 45-year-old woman was brought to the emergency department due to fever and...

    Incorrect

    • A 45-year-old woman was brought to the emergency department due to fever and chills. She has a history of recurrent UTI and complains of dysuria and urinary frequency. Urinary white blood cell count is >200 cell/high power field. If urine culture is performed, what is the most likely organism that will grow?

      Your Answer:

      Correct Answer: Escherichia coli

      Explanation:

      The pathogen that most likely causes recurrent urinary tract infection in young women are E. coli, Enterococcus and Staphylococcus saprophyticus.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      0
      Seconds

  • Question 21 - 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:

      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
      0
      Seconds

  • Question 22 - Which of the following is most likely to cause hypovolaemic hypernatremia: ...

    Incorrect

    • Which of the following is most likely to cause hypovolaemic hypernatremia:

      Your Answer:

      Correct Answer: Hyperalimentation

      Explanation:

      Hypernatremia, characterised by a high serum sodium concentration, is rarely associated with volume overload (hypervolemia). A hypovolaemic hypernatremia may be seen during excessive administration of hypertonic sodium bicarbonate, hypertonic saline or hyperalimentation.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      0
      Seconds

  • Question 23 - A football player sustained an injury to his ankle. The wound went through...

    Incorrect

    • A football player sustained an injury to his ankle. The wound went through the skin, subcutaneous tissue and flexor retinaculum. Which other structure passing under the retinaculum may be injured?

      Your Answer:

      Correct Answer: Tibial nerve

      Explanation:

      The flexor retinaculum is immediately posterior to the medial malleolus. The structures that pass under the flexor retinaculum from anterior to posterior are: tendon of the tibialis posterior, flexor digitorum longus, posterior tibial artery (and vein), tibial nerve and tendon of flexor hallucis longus. The tibial nerve is the only one which lies behind the flexor retinaculum.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 24 - Which of these conditions causes haematuria, hypertension and proteinuria in children, usually after...

    Incorrect

    • Which of these conditions causes haematuria, hypertension and proteinuria in children, usually after a streptococcal infection?

      Your Answer:

      Correct Answer: Acute nephritic syndrome

      Explanation:

      Nephritic syndrome (or acute nephritic syndrome) is a syndrome comprising of signs of nephritis. Children between 2 and 12 are most commonly affected, but it may occur at any age. Predisposing factors/causes include:

      Infections with group A streptococcal bacteria (acute post-streptococcal glomerulonephritis).

      Primary renal diseases: immunoglobulin A nephropathy, membranoproliferative glomerulonephritis, idiopathic rapidly progressive crescentic glomerulonephritis.

      Secondary renal diseases: subacute bacterial endocarditis, infected ventriculo–peritoneal shunt, glomerulonephritis with visceral abscess, glomerulonephritis with bacterial, viral or parasitic infections.

      Multisystem diseases.

      By contrast, nephrotic syndrome is characterized by only proteins moving into the urine.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 25 - A 73-year-old woman goes to the doctor complaining of pain and stiffness in...

    Incorrect

    • A 73-year-old woman goes to the doctor complaining of pain and stiffness in her shoulders and hips for 4 months, which is worst in the mornings. She has also been suffering from fatigue, weight loss and depression. There were no abnormal findings on physical examination. The erythrocyte sedimentation rate was 110 mm/hour, and serum rheumatoid factor and antinuclear antibody assays were negative. Mild normochromic normocytic anaemia was also found. What is the most likely diagnosis in this case?

      Your Answer:

      Correct Answer: Polymyalgia rheumatica

      Explanation:

      Polymyalgia rheumatica (PMR) affects older adults, with an acute or subacute onset. Symptoms include severe pain and stiffness of the neck and pectoral or pelvic girdles, which is worse in the morning or after a period of inactivity and is usually bilateral. Other symptoms can include fatigue, weight loss, depression and fever. The erythrocyte sedimentation rate is usually elevated, and normochromic normocytic anaemia can occur. Other tests are usually normal in this disease.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      0
      Seconds

  • Question 26 - A 47 -year-old male was admitted due to a bleeding peptic ulcer. On...

    Incorrect

    • A 47 -year-old male was admitted due to a bleeding peptic ulcer. On his 3rd hospital day, he developed a cardiac arrhythmia. His serum potassium was markedly elevated. What is the most likely cause of hyperkalaemia in this patient?

      Your Answer:

      Correct Answer: Multiple blood transfusions

      Explanation:

      Patients with gastrointestinal bleeding often require blood transfusion. Among the various side effects of blood transfusions, is the increase of potassium levels. The use of stored blood for transfusions is followed by an increase of serum potassium levels. Potassium level increases are more pronounced in patients who receive blood stored for more than 12 d. Furthermore, the lysis and destruction of red blood cells, especially in the transfusion of older PRBCs, can further increase potassium levels. Excessive use of a PPi has been associated with hyperkaelemia however would be less likely in this acute setting.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      0
      Seconds

  • Question 27 - A 7-month-old abandoned baby with congenital non-communicating hydrocephalus is hosted by a clinic...

    Incorrect

    • A 7-month-old abandoned baby with congenital non-communicating hydrocephalus is hosted by a clinic at its new-born hostel. A CT scan of the baby's brain reveals what might be a blockage of the ventricular system between the third and the fourth ventricles. Which of the following is the most likely blocked structure?

      Your Answer:

      Correct Answer: Cerebral aqueduct

      Explanation:

      The drainage of cerebral spinal fluid from the third ventricle to the fourth ventricle is carried out by the cerebral aqueduct. The cerebral aqueduct is the narrowest passageway in the entire ventricular system and thus forms the most common site of blockage of flow of cerebrospinal fluid. The interventricular foramen allows passage of CSF to the third ventricle. The foramen of Luschka and Magendie are located on the fourth ventricle and allow passage of CSF to the subarachnoid space from the ventricular system. The pontine cistern is a space located on the ventral aspect of the pons. The cisterna magna is an opening on the subarachnoid space between the pia matter and the arachnoid.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 28 - A 55-year-old male chronic smoker is diagnosed with non-small-cell cancer. His right lung...

    Incorrect

    • A 55-year-old male chronic smoker is diagnosed with non-small-cell cancer. His right lung underwent complete atelectasis and he has a 7cm tumour involving the chest wall. What is the stage of the lung cancer of this patient?

      Your Answer:

      Correct Answer: T3

      Explanation:

      Non-small-cell lung cancer is staged through TNM classification. The stage of this patient is T3 because based on the TNM classification the tumour is staged T3 if > 7 cm or one that directly invades any of the following: Chest wall (including superior sulcus tumours), diaphragm, phrenic nerve, mediastinal pleura, or parietal pericardium; or the tumour is in the main bronchus < 2 cm distal to the carina but without involvement of the carina, Or it is associated with atelectasis/obstructive pneumonitis of the entire lung or separate tumour nodule(s) in the same lobe.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds

  • Question 29 - A biopsy is performed on a 67-year-old-man with testicular seminoma; it reveals that...

    Incorrect

    • A biopsy is performed on a 67-year-old-man with testicular seminoma; it reveals that the tumour affects the tunica vaginalis. The tumour stage in this case is:

      Your Answer:

      Correct Answer: T2

      Explanation:

      The primary tumour staging for testicular seminoma is as follows, according to AJCC guidelines:

      Tis: intratubular germ cell neoplasia (carcinoma in situ)

      T1: tumour limited to testis/epididymis without vascular or lymphatic invasion; the tumour can invade into the tunica albuginea but not the tunica vaginalis

      T2: tumour limited to testis/epididymis with vascular or lymphatic invasion or tumour extending through the tunica albuginea with involvement of the tunica vaginalis

      T3: tumour invading the spermatic cord, with or without vascular/lymphatic invasion

      T4: tumour invading the scrotum, with or without vascular/lymphatic invasion.

      According to these guidelines, the tumour in this case has a T2 stage.

    • This question is part of the following fields:

      • Pathology
      • Urology
      0
      Seconds

  • Question 30 - In the human body, veins often run a course parallel to the artery...

    Incorrect

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

      Your Answer:

      Correct Answer: Inferior mesenteric

      Explanation:

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

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

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

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

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

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 31 - The following structures DO NOT lie between the layers of the mesosalpinx except...

    Incorrect

    • The following structures DO NOT lie between the layers of the mesosalpinx except for the?

      Your Answer:

      Correct Answer: Fallopian tube

      Explanation:

      Mesosalpinx is the portion of the broad ligament that stretches from the fallopian tube to the ovary and contains the uterine tubes between it’s layers.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      0
      Seconds

  • Question 32 - While conducting a physical examination of a patient, the GP passed a finger...

    Incorrect

    • While conducting a physical examination of a patient, the GP passed a finger down the edge of the medial crus of the superficial inguinal ring and felt a bony prominence deep to the lateral edge of the spermatic cord. What was this bony prominence?

      Your Answer:

      Correct Answer: Pubic tubercle

      Explanation:

      At the superficial inguinal ring, the pubic tubercle would be felt as a bony prominence lateral to the edge of the spermatic cord. This tubercle is the point of attachment of the inguinal ligament that makes up the floor of the inguinal canal.

      Pecten pubis is the ridge on the superior surface of the superior pubic ramus and the point of attachment of the pectineal ligament.

      The pubic symphysis is the joint between the two pubic bones and the iliopubic eminence is a bony process on the pubis found near the articulation of the pubis and the ilium.

      The iliopectineal line is formed by the arcuate line of the ilium and the pectineal line of the pubis. It is the line that marks the transition between the abdominal and pelvic cavity.

      The sacral promontory is found on the posterior wall of the pelvis and would not be felt through the inguinal ring.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 33 - A 23-year-old woman decides to donate a kidney through a kidney chain. Which...

    Incorrect

    • A 23-year-old woman decides to donate a kidney through a kidney chain. Which of the following indices would be expected to be decreased in the donor after full recovery from the operation?

      Your Answer:

      Correct Answer: Creatinine clearance

      Explanation:

      Since medication to prevent rejection is so effective, donors do not need to be similar to their recipient. Most donated kidneys come from deceased donors; however, the utilisation of living donors is on the rise. Most problems encountered with live donation are associated with the donor. Firstly, there are the potentially harmful investigative procedures carried out in the assessment phase, the most hazardous being renal angiography, where there is cannulation of the artery and injection of a radio-opaque dye to determine the blood supply to the kidney. Secondly, there are the short-term risks of nephrectomy surgery. According to the literature, there is a mortality rate of between 1 in 1600 and 1 in 3000, but this is no more than is associated with any anaesthetic. In the initial postoperative period creatinine clearance may be decreased but this recovers fully over a few weeks to months. Long-term complications include prolonged wound pain.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 34 - Calculate the cardiac output in an adult male with the following parameters:

    Heart...

    Incorrect

    • Calculate the cardiac output in an adult male with the following parameters:

      Heart rate 70 beats/min

      Arterial [O2] 0.24 ml O2/min

      Venous [O2] 0.16 ml O2/mi

      Whole body O2 consumption 500 ml/min

      Pulmonary diastolic pressure 15 mmHg

      Pulmonary systolic pressure 25 mmHg

      Wedge pressure 5 mmHg.

      Your Answer:

      Correct Answer: 6.25 l/min

      Explanation:

      As per Fick’s principle, VO2 = (CO × CAO2) – (CO × CVO2) where VO2 = oxygen consumption, CO = cardiac output, CAO2 = oxygen concentration of arterial blood and CVO2 = oxygen concentration of venous blood. Thus, CO = VO2/CAO2– CVO2, CO = 500/0.24 – 0.16, CO = 500/0.8, CO = 6.25 l/min.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 35 - Which of the following diseases can cause paraesthesia along the distribution of the...

    Incorrect

    • Which of the following diseases can cause paraesthesia along the distribution of the median nerve of the hand, especially after activities which require flexion and extension of the wrist?

      Your Answer:

      Correct Answer: Carpal tunnel syndrome

      Explanation:

      Carpal tunnel syndrome tends to occur in women between the ages of 30-50. There are many risk factors, including diabetes, hypothyroidism, obesity, pregnancy, and repetitive wrist work. Symptoms include pain in the hand and wrist, tingling, and numbness distributed along the median nerve (the palmar side of the thumb, the index and middle fingers, and the radial half of the ring finger), which worsens at night.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      0
      Seconds

  • Question 36 - A 55-year-old woman complains of pain in the proximal and distal interphalangeal joins,...

    Incorrect

    • A 55-year-old woman complains of pain in the proximal and distal interphalangeal joins, and back pain which has increased over the last 4 years and worsens after activity. X-rays reveal Heberden’s and Bouchard’s nodes in her interphalangeal joints and the presence of osteophytes in her spine. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Osteoarthritis

      Explanation:

      Osteoarthritis is most common in older adults, predominating in women between the ages of 40 and 70; after this age, men and women are affected equally. It affects an entire joint, with disruption and potential loss of joint cartilage, along with other joint changes, including bone hypertrophy (osteophyte formation). The pain is usually gradual and is worse after activity, with occasional joint swelling. X-ray findings include marginal osteophytes, narrowing of the joint space, increased density of the subchondral bone, subchondral cyst formation, bony remodelling and joint effusions.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      0
      Seconds

  • Question 37 - A 29-year-old pregnant woman develops severe hypoxaemia with petechial rash and confusion following...

    Incorrect

    • A 29-year-old pregnant woman develops severe hypoxaemia with petechial rash and confusion following a fracture to her left femur. Which is the most probable cause of these symptoms in this patient?

      Your Answer:

      Correct Answer: Fat embolism

      Explanation:

      Fat embolism is a life-threatening form of embolism in which the embolus consists of fatty material or bone marrow particles that are introduced into the systemic venous system. It may be caused by long-bone fractures, orthopaedic procedures, sickle cell crisis, parenteral lipid infusion, burns and acute pancreatitis. Patients with fat embolism usually present with symptoms that include skin, brain, and lung dysfunction.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      0
      Seconds

  • Question 38 - The muscle that forms the posterior wall of the axilla along with the...

    Incorrect

    • The muscle that forms the posterior wall of the axilla along with the scapula, subscapularis muscle and teres major muscle is the?

      Your Answer:

      Correct Answer: Latissimus dorsi

      Explanation:

      The latissimus dorsi forms the posterior wall of the axilla along with the scapula. It is responsible for extension, adduction, transverse extension also known as horizontal abduction, flexion from an extended position, and (medial) internal rotation of the shoulder joint. It also has a synergistic role in extension and lateral flexion of the lumbar spine.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 39 - A woman that presented with dyspnoea, chest pain and cough was found to...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds

  • Question 40 - A 35 year-old woman is undergoing thyroidectomy. The external laryngeal nerve may be...

    Incorrect

    • A 35 year-old woman is undergoing thyroidectomy. The external laryngeal nerve may be injured whilst ligating this artery during the procedure due to its close relationship?

      Your Answer:

      Correct Answer: Superior thyroid artery

      Explanation:

      The superior thyroid artery arises from the external carotid artery just below the level of the greater cornu of the hyoid bone and ends in the thyroid gland. This artery must be ligated at the thyroid when conducting a thyroidectomy. If the artery is severed, but not ligated, it will bleed profusely. In order to gain control of the bleeding, the surgeon may need to extend the original incision laterally to ligate the artery at its origin at the external carotid artery. The external laryngeal branch of the superior laryngeal nerve courses in close proximity to the superior thyroid artery, making it at risk for injury during surgery.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 41 - 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 42 - Renin is secreted by pericytes in the vicinity of the afferent arterioles of the...

    Incorrect

    • Renin is secreted by pericytes in the vicinity of the afferent arterioles of the kidney from the juxtaglomerular cells. Plasma renin levels are decreased in patients with:

      Your Answer:

      Correct Answer: Primary aldosteronism

      Explanation:

      Primary aldosteronism, also known as primary hyperaldosteronism or Conn’s syndrome, is excess production of the hormone aldosterone by the adrenal glands resulting in low renin levels. Most patients with primary aldosteronism (Conn’s syndrome) have an adrenal adenoma. The increased plasma aldosterone concentration leads to increased renal Na+ reabsorption, which results in plasma volume expansion. The increase in plasma volume suppresses renin release from the juxtaglomerular apparatus and these patients usually have low plasma renin levels. Salt restriction and upright posture decrease renal perfusion pressure and therefore increases renin release from the juxtaglomerular apparatus. Secondary aldosteronism is due to elevated renin levels and may be caused by heart failure or renal artery stenosis.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 43 - A 30-year-old woman is diagnosed with Hodgkin's lymphoma. Which of the following chemotherapy...

    Incorrect

    • A 30-year-old woman is diagnosed with Hodgkin's lymphoma. Which of the following chemotherapy regimens would be used in this case?

      Your Answer:

      Correct Answer: ABVD

      Explanation:

      ABVD is a chemotherapy regimen used in the first-line treatment of Hodgkin’s lymphoma. It consists of concurrent treatment with the chemotherapy drugs, adriamycin, bleomycin, vinblastine and dacarbazine. It supplanted the older MOPP protocol.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds

  • Question 44 - If a 68-year-old man is diagnosed with a testicular seminoma that reaches the...

    Incorrect

    • If a 68-year-old man is diagnosed with a testicular seminoma that reaches the tunica albuginea and involves the tunica vaginalis, with retroperitoneal lymph nodes greater than 5cm, LDH 1.4 times the reference levels, β-hCG 4250 mIU/ml and AFP 780 ng/ml, what's the clinical stage in this case?

      Your Answer:

      Correct Answer: Stage IIC

      Explanation:

      According to the AJCC, the clinical staging for testicular seminoma is:
      Stage IA: T1 N0 M0 S0
      Stage IB: T2/3/4 N0 M0 S0
      Stage IC: any T N0 M0 S1/2/3
      Stage IIA: any T N1 M0 S0/1
      Stage IIB: any T N2 M0 S0/1
      Stage IIC: any T N3 M0 S0/1
      Stage IIIA: any T any N M1a S0/1
      Stage IIIB: any T any N M0/1a S2
      Stage IIIC: any T any N M1a/1b S3.
      The patient in this case has IIC stage

    • This question is part of the following fields:

      • Pathology
      • Urology
      0
      Seconds

  • Question 45 - A patient with this condition has extracellular fluid volume expansion: ...

    Incorrect

    • A patient with this condition has extracellular fluid volume expansion:

      Your Answer:

      Correct Answer: Nephrotic syndrome

      Explanation:

      Nephrotic syndrome is a syndrome comprising of signs of nephrosis, including proteinuria, hypoalbuminemia, and oedema. It is a component of glomerulonephritis, in which different degrees of proteinuria occur. Essentially, loss of protein through the kidneys leads to low protein levels in the blood , which causes water to be drawn into soft tissues (oedema). Severe hypoalbuminemia can also cause a variety of secondary problems, such as water in the abdominal cavity (ascites), around the heart or lung (pericardial effusion, pleural effusion), high cholesterol, loss of molecules regulating coagulation (hence increased risk of thrombosis). The most common sign is excess fluid in the body due to the serum hypoalbuminemia. Lower serum oncotic pressure causes fluid to accumulate in the interstitial tissues. Sodium and water retention aggravates the oedema.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      0
      Seconds

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

    Incorrect

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

      Your Answer:

      Correct Answer: Phyllodes tumour

      Explanation:

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

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      0
      Seconds

  • Question 47 - A 60-year old man with a left-sided indirect inguinal hernia underwent emergency surgery...

    Incorrect

    • A 60-year old man with a left-sided indirect inguinal hernia underwent emergency surgery to relieve large bowel obstruction resulting from a segment of the bowel being strangulated in the hernial sac. The most likely intestinal segment involved is:

      Your Answer:

      Correct Answer: Sigmoid colon

      Explanation:

      The sigmoid colon is the most likely segment involved as it is mobile due to the presence of the sigmoid mesocolon. The descending colon, although on the left side, is a bit superior and is also retroperitoneal. The ascending colon and caecum are on the right side of the abdomen. The rectum is too inferior to enter the deep inguinal ring and the transverse colon is too superior to be involved.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 48 - A 17-year-old female was given an antibiotic for a urinary tract infection. After...

    Incorrect

    • A 17-year-old female was given an antibiotic for a urinary tract infection. After taking the medication the patient developed Steven-Johnson syndrome. Which particular antibiotic usually causes Steven-Johnson syndrome?

      Your Answer:

      Correct Answer: Sulphonamides

      Explanation:

      Stevens–Johnson syndrome (SJS) is a type of severe skin reaction. The most common cause is certain medications such as lamotrigine, carbamazepine, allopurinol, sulphonamide antibiotics, and nevirapine.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      0
      Seconds

  • Question 49 - When exposing the right saphenofemoral junction for flush-ligation of the saphenous vein, which...

    Incorrect

    • When exposing the right saphenofemoral junction for flush-ligation of the saphenous vein, which of the following is the most likely to be seen passing through this opening?

      Your Answer:

      Correct Answer: Superficial external pudendal artery

      Explanation:

      The saphenous opening is an oval opening in the fascia lata. It is covered by the cribriform fascia and It is so called because it is perforated by the great saphenous vein and by numerous blood and lymphatic vessels and the superficial external pudendal artery pierces it.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 50 - Which of the following is NOT a Gram-negative rod? ...

    Incorrect

    • Which of the following is NOT a Gram-negative rod?

      Your Answer:

      Correct Answer: Clostridium tetani

      Explanation:

      Gram-positive rods include Clostridia, Listeria and diphtheroids.

      Gram-negative rods include Escherichia coli, Klebsiella, Yersinia, Haemohilus, Pseudomonas, Shigella, Legionella, proteus and Salmonella

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (1/2) 50%
Pelvis (1/2) 50%
Passmed
Retry this test Dashboard