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

  • Question 1 - Laboratory findings in a patient with dark urine and yellowish skin revealed a...

    Correct

    • Laboratory findings in a patient with dark urine and yellowish skin revealed a prolonged prothrombin time. Which of the following is the most likely cause of this finding?

      Your Answer: Liver damage

      Explanation:

      Various conditions may prolong the prothrombin time (PT), including: warfarin use, vitamin K deficiency, liver disease, disseminated intravascular coagulopathy, hypofibrinogenemia, heparin infusion, massive blood transfusion and hypothermia. Liver disease causes prolonging of PT due to diminished synthesis of clotting factors. Dark urine colour and jaundice are indicators of the presence of a liver disease in this patient.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      33
      Seconds

  • Question 2 - 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: Changes in permeability of cells to the principal extracellular anions, Cl− and HCO3 −

      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
      133.9
      Seconds

  • Question 3 - Which one of the following groups of lymph nodes is most likely to...

    Incorrect

    • Which one of the following groups of lymph nodes is most likely to be inflamed due to paronychia involving the big toe?

      Your Answer: Medial group of superficial inguinal lymph nodes

      Correct Answer: Vertical group of superficial inguinal lymph nodes

      Explanation:

      Paronychia affecting the big toe will result in inflammation of the superficial inguinal lymph nodes as it drains lymph from the big toe.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      62.3
      Seconds

  • Question 4 - During an operation to repair an indirect inguinal hernia, you are asked to...

    Correct

    • During an operation to repair an indirect inguinal hernia, you are asked to indicate the position of the deep inguinal ring. You indicate this as being:

      Your Answer: Above the midpoint of the inguinal ligament

      Explanation:

      The deep inguinal ring is near the midpoint of the inguinal ligament, below the anterior superior iliac spine. It is lateral to the inferior epigastric artery. The superficial ring, however, is found above the pubic tubercle. The supravesical fossa is the space between the median and medial umbilical folds.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      52.1
      Seconds

  • Question 5 - Which of the following is true about a patient who has undergone total...

    Correct

    • Which of the following is true about a patient who has undergone total colectomy and ileostomy?

      Your Answer: Following total colectomy and ileostomy, the volume and water content of ileal discharge decreases over time

      Explanation:

      After a patient has undergone total colectomy and ileostomy, the volume of ileal discharge, along with its water content gradually decreases over time. Post surgery, most patients can live a normal life. Iron and vitamin B12 absorption do not take place in the colon and hence are not affected significantly by a colectomy.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      33.8
      Seconds

  • Question 6 - Where do the seminal vesicles lie? ...

    Correct

    • Where do the seminal vesicles lie?

      Your 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
      23.3
      Seconds

  • Question 7 - A 42 - year old male patient with an acute onset headache was...

    Correct

    • 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: 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
      70.9
      Seconds

  • Question 8 - A 55 year old man presented with a 4 day history of cough...

    Correct

    • A 55 year old man presented with a 4 day history of cough and fever. His sputum culture showed the presence of Strep pneumoniae. Which of the following substances produced by the inflammatory cells will result in effective clearance of this organism from the lung parenchyma?

      Your Answer: Hydrogen peroxide

      Explanation:

      Hydrogen peroxide is produced by myeloperoxidase to form a potent oxidant that eliminates bacteria, but is not effective in chronic granulomatous diseases.

      Platelet activating factor will lead to the activation, adhesion and aggregation of platelets but will not directly kill bacteria.

      Prostaglandins cause vasodilation but do not activate neutrophils.

      Kallikrein promotes formation of bradykinin that leads to vasodilation.

      Leukreines increase vascular permeability.

      Cytokines are communicating molecules between immune cells but directly will not kill bacteria.

      Interleukins will regulate the immune response.

    • This question is part of the following fields:

      • Inflammation & Immunology; Respiratory
      • Pathology
      31.3
      Seconds

  • Question 9 - The dilator pupillae muscle is innervated by postganglionic sympathetic fibres. Where do the...

    Incorrect

    • The dilator pupillae muscle is innervated by postganglionic sympathetic fibres. Where do the postganglionic sympathetic fibres originate?

      Your Answer: Ciliary ganglion

      Correct Answer: Superior cervical ganglion

      Explanation:

      The postganglionic sympathetic axons are derived from the superior cervical ganglion and innervate the eye and lacrimal gland allowing for vasoconstriction of the iris and sclera, pupillary dilation, widening of the palpebral fissure, and a reduction in tear production.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      41.1
      Seconds

  • Question 10 - 13 year old girl developed sun burnt cheeks after spending the day playing...

    Correct

    • 13 year old girl developed sun burnt cheeks after spending the day playing on the beach. What is the underlying mechanism to her injury?

      Your Answer: Free radical injury

      Explanation:

      Free radicals are a by-product of chemical reactions with an unpaired electron in their outer most shell. They are capable of causing wide spread damage to cells. They can cause autolytic reactions thereby converting the reactants into free radicals. By absorbing sun light, the energy is used to hydrolyse water into hydroxyl (OH) and hydrogen (H) free radicals which can cause injury by lipid peroxidation of membranes, oxidative modification of proteins and damage to the DNA structure.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Dermatology
      • Pathology
      25.6
      Seconds

  • Question 11 - A patient with testicular seminoma has the following tumour markers: LDH 1.3 times...

    Incorrect

    • A patient with testicular seminoma has the following tumour markers: LDH 1.3 times the reference levels, β-hCG 4500 mIU/ml and AFP 875 ng/ml. What's the serum tumour marker stage in this case?

      Your Answer: S3

      Correct Answer: S1

      Explanation:

      According to AJCC guidelines, the serum tumour marker staging is the following:

      S0: marker studies within normal limits

      S1: lactate dehydrogenase (LDH) less than 1.5 times the reference range, beta-human chorionic gonadotrophin (β-hCG) <5000 mIU/ml, and alpha-fetoprotein (AFP) <1000 ng/ml S2: LDH 1.5–10 times the reference range, β-hCG 5000–50,000 mIU/ml or AFP 1000–10,000 ng/ml S3: LDH greater than 10 times the reference range, β-hCG >50,000 mIU/ml or AFP >10,000 ng/ml.

      According to this, the patient’s tumour belongs to the S1 stage.

    • This question is part of the following fields:

      • Pathology
      • Urology
      37.9
      Seconds

  • Question 12 - A retroperitoneal structure is: ...

    Incorrect

    • A retroperitoneal structure is:

      Your Answer: Sigmoid colon

      Correct Answer: Pancreas

      Explanation:

      Retroperitoneal structures are those that are found behind the peritoneum. They include: kidneys, suprarenal glands, bladder, ureter, inferior vena cava, rectum, oesophagus (part of it), part of the pancreas, 2nd, 3rd and 4th parts of the duodenum and ascending and descending parts of the colon.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      23.5
      Seconds

  • Question 13 - Pain in the right upper quadrant of the abdomen on ingestion of a...

    Correct

    • 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: 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
      56.1
      Seconds

  • Question 14 - A 15-year-old girl was diagnosed with bacterial meningitis. Gram staining of the spinal...

    Incorrect

    • A 15-year-old girl was diagnosed with bacterial meningitis. Gram staining of the spinal fluid shows numerous polymorphonuclear neutrophils and Gram-positive cocci. Which is the empiric drug of choice to be given to the patient until the antibiotic sensitivity report is available?

      Your Answer: Methicillin

      Correct Answer: Ceftriaxone

      Explanation:

      Acute meningitis is a medical emergency. All suspects should receive their first dose of antibiotics immediately and be transferred to hospital as soon as possible. If facilities for blood culture and/or lumbar puncture (LP) are immediately available, they should be performed before administration
      of the first dose of antibiotics (see contraindications to LP below). Neither procedure should lead to a significant delay in antibiotic administration.
      Administer ceftriaxone 80-100 mg/kg (maximum 2 g, 12 hourly) intravenously. The intramuscular or intraosseous route can be used if there is no vascular access. Penicillin allergy is not a contraindication to ceftriaxone in acute meningitis (C-1). Omit ceftriaxone only if there has been documented ceftriaxone anaphylaxis. Give chloramphenicol 25 mg/kg (maximum 500 mg) intravenously instead, if available. Administer adequate analgesia and transfer the patient immediately to hospital, detailing all administered
      medication in the referral letter.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      29.7
      Seconds

  • Question 15 - An 8 year old boy presents with a history of repeated bacterial/pyogenic infections....

    Correct

    • An 8 year old boy presents with a history of repeated bacterial/pyogenic infections. He had a normal recovery from chickenpox and measles and shows normal antibody response. A decrease in which of the cell types can best explain this history of repeated pyogenic infections?

      Your Answer: Neutrophils

      Explanation:

      A decrease in the number of granulocytes, particularly neutrophils is known as agranulocytosis and it increases the susceptibility of an individual towards recurrent infections. Neutropenia can be either due to decreased production or increased elimination of neutrophils.

      Ineffective agranulopoiesis is seen in: 1. myeloid stem cell suppression, 2. disease conditions associated with granulopoiesis such as megaloblastic anaemia and myelodysplastic syndromes, 3. rare genetic diseases, 4. splenic sequestration and 5. increased peripheral utilization.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      9.7
      Seconds

  • Question 16 - A man in his sixties underwent surgery to remove a lump from his...

    Correct

    • A man in his sixties underwent surgery to remove a lump from his axilla. During removal, a nerve originating from the lateral cord of the brachial plexus was damaged. Which nerve is this referring to?

      Your Answer: Lateral pectoral

      Explanation:

      The only branch of the lateral cord of brachial plexus in the options given, is the lateral pectoral nerve. It supplies the pectoralis major muscle and sends a branch to join the medial pectoral nerve forming a loop in front of the first part of the axillary artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      715.9
      Seconds

  • Question 17 - 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: CHOP

      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
      12.7
      Seconds

  • Question 18 - Tumours derived from all three germ-cell layers in new-borns usually occur in which...

    Correct

    • Tumours derived from all three germ-cell layers in new-borns usually occur in which of the following sites?

      Your Answer: Sacrococcygeal area

      Explanation:

      A teratoma is a tumour with tissue or organ components resembling normal derivatives of more than one germ layer. It is derived from all three cell layers. The most common location of teratoma in new-born infants is in the sacrococcygeal area.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      12.4
      Seconds

  • Question 19 - In an anatomy demonstration, the instructor asked one of the medical students to...

    Correct

    • In an anatomy demonstration, the instructor asked one of the medical students to pass his index finger inferior to the root of the left lung. The student notices that his finger is blocked by a structure. Which structure do you think is responsible for this?

      Your Answer: Pulmonary ligament

      Explanation:

      The pulmonary ligament is dual layer of pleura stretching from the inferior part of the hilar reflection toward the diaphragm.

      The costodiaphragmatic recess is the cavity at the inferior border of the lung where the costal pleura becomes the diaphragmatic pleura.

      The cupola: is part of the pleura that extends superiorly above the first rib and has no association with the root of the lung.

      Inferior vena cava is located in the mediastinum, not near the root of the lung.

      Left pulmonary veins being part of the root of the lung, would not block access to behind the lung. Costomediastinal recess is the part of the pleura where the costal pleura become the mediastinal pleura.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      36.7
      Seconds

  • Question 20 - 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
      12.3
      Seconds

  • Question 21 - Thalamic syndrome will most likely result in: ...

    Incorrect

    • Thalamic syndrome will most likely result in:

      Your Answer: Thirst

      Correct Answer: Hyperaesthesia

      Explanation:

      Signs and symptoms of thalamic syndrome include contralateral hemi anaesthesia, burning or aching sensation in one half of a body (hyperaesthesia), often accompanied by mood swings.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      18.9
      Seconds

  • Question 22 - Different portions of the renal tubule have varying degrees of water permeability. Which...

    Incorrect

    • Different portions of the renal tubule have varying degrees of water permeability. Which of the following renal sites is characterised by low water permeability under normal circumstances?

      Your Answer: Collecting duct

      Correct Answer: Thick ascending limb of the loop of Henlé

      Explanation:

      Within the nephron of the kidney, the ascending limb of the loop of Henle is a segment of the loop of Henle downstream of the descending limb, after the sharp bend of the loop. Both the thin and the thick ascending limbs of the loop of Henlé have very low permeability to water. Since there are no regulatory mechanisms to alter its permeability, it remains poorly permeable to water under all circumstances. Sodium and chloride are transported out of the luminal fluid into the surrounding interstitial spaces, where they are reabsorbed. Water must remain behind because it is not reabsorbed, so the solute concentration becomes less and less (the luminal fluid becomes more dilute). This is one of the principal mechanisms (along with diminution of ADH secretion) for the production of a dilute, hypo-osmotic urine (water diuresis).

    • This question is part of the following fields:

      • Physiology
      • Renal
      67
      Seconds

  • Question 23 - An old woman complains of a lack of sensation halfway down the anterior...

    Incorrect

    • An old woman complains of a lack of sensation halfway down the anterior surface of the thigh. The cause of this:

      Your Answer:

      Correct Answer: Would result from damage to the nerve that innervates the pectineus muscle

      Explanation:

      The pectineus is supplied by the second, third and fourth lumbar nerves through the femoral nerve and by the third lumbar through the accessory obturator when it exists. The anterior surface of the thigh receives its innervation from the femoral nerve as well, thus this is the nerve most likely to be injured

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 24 - A 76 year old man who presented with lower back pain is diagnosed...

    Incorrect

    • A 76 year old man who presented with lower back pain is diagnosed with prostatic carcinoma that has metastasized to his lumber spine. Which of the following markers is characteristically elevated?

      Your Answer:

      Correct Answer: PSA

      Explanation:

      Spread of prostatic carcinoma is common to the lumbar spine and pelvis. This results in osteoblastic metastases that will present as lower back pain with increased alkaline phosphatase, prostatic acid phosphates and PSA. PSA is more specific and a PSA > 10 ng/ml for any age is worrisome.

    • This question is part of the following fields:

      • Neoplasia; Urology
      • Pathology
      0
      Seconds

  • Question 25 - A 7-year-old boy is diagnosed with metabolic acidosis as a result of severe...

    Incorrect

    • A 7-year-old boy is diagnosed with metabolic acidosis as a result of severe dehydration. Which of the following conditions is most likely to cause severe dehydration and metabolic acidosis?

      Your Answer:

      Correct Answer: Severe diarrhoea

      Explanation:

      Diarrhoea is defined as having three or more loose or liquid stools per day, or as having more stools than is normal for that person. Severe diarrhoea, causing fluid loss and loss of bicarbonate, will result in marked dehydration and metabolic acidosis.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds

  • Question 26 - QT interval in the electrocardiogram of a healthy individual is normally: ...

    Incorrect

    • QT interval in the electrocardiogram of a healthy individual is normally:

      Your Answer:

      Correct Answer: 0.40 s

      Explanation:

      QT interval extends from beginning of the QRS complex till the end of he T-wave and normally lasts for 0.40 s. It is important in the diagnosis of long-QT and short-QT syndrome. The QT interval varies on the basis of heart rate and may need to be corrected.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 27 - When inserting a chest drain anteriorly into the second intercostal space, one must...

    Incorrect

    • When inserting a chest drain anteriorly into the second intercostal space, one must identify the second costal cartilage by palpating which landmark?

      Your Answer:

      Correct Answer: Sternal angle

      Explanation:

      The sternal angle is the site for identification of the second rib as the second rib is attached to the sternum at this point.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 28 - A 55 year-old construction worker is diagnosed with malignant mesothelioma. Exposure to which...

    Incorrect

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

      Your Answer:

      Correct Answer: Asbestos

      Explanation:

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

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds

  • Question 29 - A 35 year old patient presenting with haematemesis, heart burn and bloody stool...

    Incorrect

    • A 35 year old patient presenting with haematemesis, heart burn and bloody stool was diagnosed with a duodenal ulcer that had eroded the gastroduodenal artery. The patient was then rushed into theatre for an emergency procedure to control the haemorrhage. If the surgeon decided to ligate the gastroduodenal artery at its origin, which of the following arteries would most likely experience retrograde blood flow from collateral sources as a result of the ligation?

      Your Answer:

      Correct Answer: Right gastroepiploic

      Explanation:

      In the stomach and around the duodenum, there are many arterial anastomoses. Ligation of the gastroduodenal artery would result in the retrograde flow of blood from the left gastroepiploic artery to the right gastroepiploic artery. The blood flows into the right gastroepiploic artery, a branch of the gastroduodenal artery from the left gastroepiploic artery that branches from the splenic artery. This retrograde blood flow is aimed at providing alternate blood flow to the greater curvature of the stomach.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 30 - Which of the following muscles aid in inspiration? ...

    Incorrect

    • Which of the following muscles aid in inspiration?

      Your Answer:

      Correct Answer: Diaphragm and external intercostals

      Explanation:

      The diaphragm and external intercostals are muscles of inspiration as they increase the volume of thoracic cavity and reduce the intrathoracic pressure. Muscles of expiration include abdominal muscles and internal intercostals.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Haematology (1/1) 100%
Pathology (5/8) 63%
General (0/1) 0%
Physiology (2/5) 40%
Anatomy (6/9) 67%
Lower Limb (0/1) 0%
Abdomen (1/2) 50%
Gastroenterology (2/2) 100%
Pelvis (2/2) 100%
Head & Neck (1/2) 50%
Inflammation & Immunology; Respiratory (1/1) 100%
Cell Injury & Wound Healing; Dermatology (1/1) 100%
Urology (0/1) 0%
Microbiology (0/1) 0%
Inflammation & Immunology (1/1) 100%
Upper Limb (1/1) 100%
Pharmacology (0/1) 0%
Neoplasia (1/1) 100%
Thorax (1/1) 100%
Neurology (0/1) 0%
Renal (0/1) 0%
Passmed
Retry this test Dashboard