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  • Question 1 - What is the most likely cause of prolonged bleeding time in a 40...

    Correct

    • What is the most likely cause of prolonged bleeding time in a 40 year old women admitted for a laparoscopic cholecystectomy?

      Your Answer: Thrombocytopaenia

      Explanation:

      Bleeding time is related to platelet function, thus a decrease in platelet function, as seen in thrombocytopenia, DIC and von Willebrand disease in which platelet aggregation is defective, leads to an increase in bleeding time. It is not affected by a decrease or deficiency of any other clotting factors. Aspirin and other COX inhibitors prolong bleeding time along with warfarin and heparin.

    • This question is part of the following fields:

      • General
      • Physiology
      23.7
      Seconds

  • Question 2 - A 50 year old man was admitted to the surgical ICU following a...

    Correct

    • A 50 year old man was admitted to the surgical ICU following a hemicolectomy for carcinoma of the caecum. A full blood count revealed: haematocrit = 30%, erythrocytes = 4 × 106/μ, haemoglobin level = 8 g/dl. To determine the likely cause of his anaemia, red blood cell indices were calculated. Which RBC indices are correct?

      Your Answer: MCHC = haemoglobin concentration/haematocrit

      Explanation:

      Mean corpuscular haemoglobin concentration (MCHC) is calculated simply by dividing the haemoglobin concentration (8 g/dl) by the haematocrit (0.3). The normal range is 31–36 g/dl. This patient has a hypochromic anaemia (MCHC = 8/0.3 = 26.7 g/dl). Dividing the haemoglobin concentration × 10 by erythrocyte number yields mean corpuscular haemoglobin (MCH). Normal range is 25.4–34.6 pg/cell and this patient has a significantly reduced cellular haemoglobin content (MCH = 8 × 10/4 = 20 pg/cell). Mean corpuscular volume (MCV) is calculated by dividing haematocrit × 1000 by erythrocyte number (4 × 106/μl). Normal range is 80–100 fl and this patient has a microcytic anaemia (MCV = 0.3 × 1000/4 = 75 fl). Microcytic, hypochromic anaemia is characteristic for iron-deficiency.

    • This question is part of the following fields:

      • General
      • Physiology
      81.4
      Seconds

  • Question 3 - What is the mostly likely cause of prolonged activated partial thromboplastin time (aPPT)...

    Correct

    • What is the mostly likely cause of prolonged activated partial thromboplastin time (aPPT) ?

      Your Answer: Heparin therapy

      Explanation:

      The partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT) is an indicator for measuring the efficacy of both the intrinsic and common coagulation pathway. Prolonged aPTT may indicate: use of heparin, antiphospholipid antibody and coagulation factor deficiency (e.g., haemophilia). Deficiencies of factors VIII, IX, XI and XII and rarely von Willebrand factor (if causing a low factor VIII level) may lead to a prolonged aPTT correcting on mixing studies.

    • This question is part of the following fields:

      • General
      • Physiology
      12.7
      Seconds

  • Question 4 - Myoglobin is released as a result of rhabdomyolysis from damaged skeletal muscles. What...

    Correct

    • Myoglobin is released as a result of rhabdomyolysis from damaged skeletal muscles. What function do they perform in the muscle?

      Your Answer: Acts like haemoglobin and binds with O2

      Explanation:

      Myoglobin is a pigmented globular protein made up of 153 amino acids with a prosthetic group containing haem around which the apoprotein folds. It is the primary oxygen carrying protein of the muscles. The binding of oxygen to myoglobin is unaffected by the oxygen pressure as it has an instant tendency to bind given its hyperbolic oxygen curve. It releases oxygen at very low pO2 levels.

    • This question is part of the following fields:

      • General
      • Physiology
      17.5
      Seconds

  • Question 5 - A 60 year old patient with a history of carcinoma of the head...

    Correct

    • A 60 year old patient with a history of carcinoma of the head of the pancreas, and obstructive jaundice presents with a spontaneous nose bleed and easy bruising. What is the most likely reason for this?

      Your Answer: Vitamin-K-dependent clotting factors deficiency

      Explanation:

      Vitamin K is a fat soluble vitamin requiring fat metabolism to function properly to allow for its absorption. People with obstructive jaundice develop vitamin k deficiency as fat digestion is impaired. Vit K causes carboxylation of glutamate residue and hence regulates blood coagulation including: prothrombin (factor II), factors VII, IX, X, protein C, protein S and protein Z.

    • This question is part of the following fields:

      • General
      • Physiology
      22.5
      Seconds

  • Question 6 - A 23 year old woman is Rh -ve and she delivered a baby...

    Correct

    • A 23 year old woman is Rh -ve and she delivered a baby with a Rh+ blood group. What measure can be performed to prevent Rh incompatibility in the next pregnancy?

      Your Answer: Immunoglobulin D

      Explanation:

      Rh disease is also known as erythroblastosis fetalis and is a disease of the new-born. In mild states it can cause anaemia with reticulocytosis and in severe forms causes severe anaemia, morbus hemolytcus new-born and hydrops fetalis. RBCs of the Rh+ baby can cross the placenta and enter into the maternal blood. As she is Rh- her body will form antibodies against the D antigen which will pass through the placenta in subsequent pregnancies.

    • This question is part of the following fields:

      • General
      • Physiology
      23.6
      Seconds

  • Question 7 - C5a (a complement component) is a potent? ...

    Incorrect

    • C5a (a complement component) is a potent?

      Your Answer: Kinin

      Correct Answer: Anaphylotoxin

      Explanation:

      C5a is a strong chemoattractant as well as an anaphylotoxin and is involved in the recruitment of inflammatory cells such as neutrophils, eosinophils, monocytes, and T lymphocytes. It is also involved in activation of phagocytic cells, release of granule-based enzymes and generation of oxidants. All of which contribute to innate immune functions.

    • This question is part of the following fields:

      • General
      • Physiology
      19.1
      Seconds

  • Question 8 - What will the destruction of endoplasmic reticulum stop? ...

    Correct

    • What will the destruction of endoplasmic reticulum stop?

      Your Answer: Synthesis of proteins

      Explanation:

      The rough endoplasmic reticulum is the factory for the manufacturing of proteins. It contains ribosomes attached to it and transports proteins that are destined for membranes and secretions. The rough ER is connected to the nuclear envelope and to the cisternae of the Golgi apparatus by vesicles that shuttle between the two compartments.

    • This question is part of the following fields:

      • General
      • Physiology
      10.1
      Seconds

  • Question 9 - A 50 year old woman presented with excessive bleeding after an inguinal hernia...

    Correct

    • A 50 year old woman presented with excessive bleeding after an inguinal hernia repair. Labs are suggestive of a primary haemostasis defect. Deficiency of which of the following is most likely to cause it?

      Your Answer: Platelets

      Explanation:

      Primary haemostatic control means the first line of defence against immediate bleeding. This is carried out by the platelets. They immediately form a haemostatic plug at the site of injury. Coagulation starts within 20s after an injury to the blood vessel which damage the endothelial cells. Secondary haemostasis follows which includes activation of the coagulation factors to form fibrin strands which mesh together forming the platelet plug. Platelets interact with platelet collagen receptor, glycoprotein Ia/IIa and to collagen fibres in the vascular endothelium. This adhesion is mediated by von Willebrand factor (vWF), which forms links between the platelet glycoprotein Ib/IX/V and collagen fibrils. The platelets are then activated and release the contents of their granules into the plasma, in turn activating other platelets and white blood cells.

    • This question is part of the following fields:

      • General
      • Physiology
      21.3
      Seconds

  • Question 10 - During pregnancy the uterus enlarges however after delivery it regresses to its original...

    Correct

    • 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: 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
      8.5
      Seconds

  • Question 11 - An 18 year-old with an iron deficient diet was prescribed an iron supplement...

    Incorrect

    • An 18 year-old with an iron deficient diet was prescribed an iron supplement by her GP. Lack of iron often results in:

      Your Answer: Megaloblastic anaemia

      Correct Answer: Hypochromic anaemia

      Explanation:

      Iron deficiency anaemia is the most common type of anaemia. It can occur due to deficiency of iron from decreased intake, increased loss or inadequate absorption. An MCV less than 80 will indicated iron deficiency anaemia. On the smear the RBCs will be microcytic hypochromic and will also show poikilocytosis. Iron profile tests are important to make a diagnosis. Clinically the patient will be pale and lethargic.

    • This question is part of the following fields:

      • General
      • Physiology
      26.9
      Seconds

  • Question 12 - Which of the following organelles have the capacity to regenerate and spontaneously replicate?...

    Correct

    • Which of the following organelles have the capacity to regenerate and spontaneously replicate?

      Your Answer: Mitochondrion

      Explanation:

      A mitochondria is a membrane bound organelle found in eukaryotic cells. They are called the powerhouse of the cell and are the place where ATP is formed from energy generated through metabolism. They are capable of replication as well as repair and regeneration.

    • This question is part of the following fields:

      • General
      • Physiology
      14.4
      Seconds

  • Question 13 - What is the reason for a deranged thrombin clotting time? ...

    Correct

    • What is the reason for a deranged thrombin clotting time?

      Your Answer: Heparin therapy

      Explanation:

      Thrombic clotting time is also known as thrombin time. It is clinically performed to determine the therapeutic levels of heparin. After plasma is isolated from the blood, bovine thrombin is added to it and the time it takes from the addition to clot is recorded. The reference interval is usually <21s. deranged results are indicative of heparin therapy, hypofibrinogenemia, hyperfibrinogenaemia or lupus anticoagulant.

    • This question is part of the following fields:

      • General
      • Physiology
      15.6
      Seconds

  • Question 14 - Which of the following is a potential cause of a positive D-dimer assay?...

    Correct

    • Which of the following is a potential cause of a positive D-dimer assay?

      Your Answer: Deep venous thrombosis

      Explanation:

      A D-dimer test is performed to detect and diagnose thrombotic conditions and thrombosis. A negative result would rule out thrombosis and a positive result although not diagnostic, is highly suspicious of thrombotic conditions like a deep vein thrombosis, pulmonary embolism as well as DIC.

    • This question is part of the following fields:

      • General
      • Physiology
      10
      Seconds

  • Question 15 - A blood sample from a patient with polycythaemia vera will show which of...

    Correct

    • A blood sample from a patient with polycythaemia vera will show which of the following abnormalities?

      Your Answer: High platelet count

      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 a myeloproliferative syndrome, 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 increased RBCs, white blood cells (WBCs) and platelets. In secondary polycythaemia the increase occurs due to high levels of erythropoietin either artificially or naturally. The increase is about 6-8 million/cm3 of blood. A type of secondary polycythaemia is physiological polycythaemia where people living in high altitudes who are exposed to hypoxic conditions produce more erythropoietin as a compensatory mechanism for thin oxygen and low oxygen partial pressure.

    • This question is part of the following fields:

      • General
      • Physiology
      25.2
      Seconds

  • Question 16 - Which of the following can lead to haemolytic anaemia? ...

    Correct

    • Which of the following can lead to haemolytic anaemia?

      Your Answer: Presence of haemoglobin S

      Explanation:

      Haemoglobin S is an abnormal type of haemoglobin seen in sickle cell anaemia. This allows for the haemoglobin to crystalize within the RBC upon exposure to low partial pressures of oxygen. This results in rupture of the RBCs as they pass through microcirculation, especially in the spleen. This can cause blockage of the vessel down stream and ischaemic death of tissues, accompanied by severe pain.

    • This question is part of the following fields:

      • General
      • Physiology
      15.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

General (14/16) 88%
Physiology (14/16) 88%
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