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Question 1
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A 25 year old man presented with a history of headache and peripheral cyanosis. He had been living in the Himalayas for 6 months prior to this. What is the reason for his condition?
Your Answer: Physiological polycythaemia
Explanation:Polycythaemia is a condition that results in an increase in the total number of red blood cells (RBCs) in the blood. It can be due to myeloproliferative syndrome or due to chronically low oxygen levels or rarely malignancy. In primary polycythaemia/polycythaemia vera the increase is due to an abnormality in the bone marrow, resulting in increases RBCs, white blood cells (WBCs) and platelets. In secondary polycythaemia the increase occurs due to high levels of erythropoietin either artificially or naturally. The increase is about 6-8 million/cm3 of blood. A type of secondary polycythaemia is physiological polycythaemia where people living in high altitudes who are exposed to hypoxic conditions produce more erythropoietin as a compensatory mechanism for thin oxygen and low oxygen partial pressure.
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This question is part of the following fields:
- General
- Physiology
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Question 2
Correct
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A 70-year-old man suffers an ischaemic stroke and develops a left homonymous hemianopia. Where is the likely infarct?
Your Answer: Right occipital lobe
Explanation:The man has a left homonymous hemianopia which means he is unable to view objects in the left visual field. This information is processed by the right primary visual cortex which lies in the right occipital lobe.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 3
Correct
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A 35 year old man presented to the surgical OPD with a lump on his right forearm which appeared 3 weeks ago and was tender on examination. He gave a history was being in a car accident with pieces of glass from the windshield piercing his forearm removed manually and on further elective surgery. Which of these cells are characteristically found during inflammation in this situation?
Your Answer: Giant cell
Explanation:A foreign body reaction Is characteristic of giant cells. Glass being the foreign object initiates an inflammatory response in this condition.
Mast cells are involved in allergic reactions.
Eosinophils are characteristic of a parasitic infection and allergic inflammatory process but are not due to foreign bodies.
Plasma cells are typical of chronic inflammation.
Lymphocytes are involved in viral infections.
Macrophages combine together to form giant cells.
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This question is part of the following fields:
- Inflammation & Immunology
- Pathology
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Question 4
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A 66-year-old man complains of constant headaches. On physical examination, the only relevant sign is a dark brown mole located on left his arm which has grown in size over the years and is itchy and painful. A MRI of the brain revealed a solitary lesion at the grey-white junction in the right frontal lobe, without ring enhancement. This lesion is most likely to be:
Your Answer: Metastatic carcinoma
Explanation:The location of the mass at the grey–white junction is typical of a metastasis. The most frequent types of metastatic brain tumours originate in the lung, skin, kidney, breast and colon. These tumour cells reach the brain via the bloodstream. This patient is likely to have skin cancer, which caused the metastatic brain tumour.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 5
Correct
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Leakage from a silicone breast implant can lead to:
Your Answer: Pain and contracture
Explanation:Breast implants are mainly: saline-filled and silicone gel-filled. Complications include haematoma, fluid collections, infection at the surgical site, pain, wrinkling, asymmetric appearance, wound dehiscence and thinning of the breast tissue.
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This question is part of the following fields:
- Pathology
- Women's Health
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Question 6
Correct
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The muscle that stabilizes the stapes is innervated by which of the following nerves?
Your Answer: Facial nerve
Explanation:The stapedius is the smallest skeletal muscle in the human body. At just over one millimetre in length, its purpose is to stabilize the smallest bone in the body, the stapes and is innervated by a branch of the facial nerve.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 7
Correct
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An enlarged lymph node which shows well-defined, prominent paracortical follicles with germinal centres is most likely from which of the following patients?
Your Answer: A 5-year-old boy with a sore throat and runny nose
Explanation:Lymphadenopathy is common in children and is usually reactive in nature. The description fits that of a benign, reactive lymph node.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 8
Correct
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Question 9
Correct
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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: 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.
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This question is part of the following fields:
- Fluids & Electrolytes
- Pathology
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Question 10
Correct
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Regarding abduction of the digits of the hand, which of the following is correct?
Your 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.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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