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  • Question 1 - A 70-year-old man suffers an ischaemic stroke and develops a left homonymous hemianopia....

    Correct

    • 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.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      6.7
      Seconds

  • Question 2 - Below which level of the spinal cord will the inferior gluteal nerve be...

    Correct

    • Below which level of the spinal cord will the inferior gluteal nerve be unaffected?

      Your Answer: S3

      Explanation:

      The inferior gluteal nerve arises from the dorsal divisions of the fifth lumbar and first and second sacral nerves. According to this fact any lesion at or below the S3 will not affect the inferior gluteal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      3.4
      Seconds

  • Question 3 - A 25 year-old female medical student presents with fever, lack of appetite, rashes,...

    Correct

    • A 25 year-old female medical student presents with fever, lack of appetite, rashes, sore throat and lymphadenopathy. Peripheral smear shows atypical lymphocytes. Which is the most likely organism responsible for this patient's condition?

      Your Answer: Epstein–Barr virus

      Explanation:

      Epstein-Barr virus is in the herpes family of viruses and most people will become infected with EBV sometime during their lives. EBV commonly causes infectious mononucleosis, or mono, a contagious viral illness that initially attacks the lymph nodes in the neck and throat. When these tissues become less effective in fighting infection, sore throats, swelling of the nodes and fever may result.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      8.1
      Seconds

  • Question 4 - A 48-year-old woman has a mass in her right breast and has right...

    Correct

    • A 48-year-old woman has a mass in her right breast and has right axillary node involvement. She underwent radical mastectomy of her right breast. The histopathology report described the tumour to be 4 cm in its maximum diameter with 3 axillary lymph nodes with evidence of tumour. The most likely stage of cancer in this patient is:

      Your Answer: IIB

      Explanation:

      Stage IIB describes invasive breast cancer in which: the tumour is larger than 2 centimetres but no larger than 5 centimetres; small groups of breast cancer cells — larger than 0.2 millimetre but not larger than 2 millimetres — are found in the lymph nodes OR the tumour is larger than 2 centimetres but no larger than 5 centimetres; cancer has spread to 1 to 3 axillary lymph nodes or to lymph nodes near the breastbone (found during a sentinel node biopsy) OR the tumour is larger than 5 centimetres but has not spread to the axillary lymph nodes.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      8.9
      Seconds

  • Question 5 - Dicloxacillin is an antibiotic; the subclass that dicloxacillin belongs to is: ...

    Correct

    • Dicloxacillin is an antibiotic; the subclass that dicloxacillin belongs to is:

      Your Answer: Penicillin

      Explanation:

      Dicloxacillin is a narrow-spectrum beta-lactam antibiotic. It is used to treat infections caused by susceptible Gram-positive bacteria and most effective against beta-lactamase-producing organisms such as Staphylococcus aureus. To decrease the development of resistance, dicloxacillin is recommended to treat infections that are suspected or proven to be caused by beta-lactamase-producing bacteria.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      5.5
      Seconds

  • Question 6 - After a cerebral infarction, which of these histopathogical findings is most likely to...

    Correct

    • After a cerebral infarction, which of these histopathogical findings is most likely to be found?

      Your Answer: Liquefactive necrosis

      Explanation:

      The brain has a high lipid content and typically undergoes liquefaction with ischaemic injury, because it contains little connective tissue but high amounts of digestive enzymes.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      13.5
      Seconds

  • Question 7 - During a procedure in the mediastinum, the surgeon accidentally injured a key structure...

    Incorrect

    • During a procedure in the mediastinum, the surgeon accidentally injured a key structure that lies immediately anterior to the thoracic duct. Which structure is likely to be injured?

      Your Answer: Aorta

      Correct Answer: Oesophagus

      Explanation:

      In the mid-thorax, the azygos vein, thoracic duct and aorta (in this order from right to the left) are all located posterior to the oesophagus. The superior vena cava, left internal jugular vein and trachea are not found in the mid thorax.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      18.6
      Seconds

  • Question 8 - A 34-year-old woman has been suffering from headaches, fever, vomiting, and confusion for...

    Correct

    • A 34-year-old woman has been suffering from headaches, fever, vomiting, and confusion for the last 5 days. A CT scan reveals an oedematous mass with ring enhancement in the left temporal region. It is biopsied, revealing glial cells, necrosis, neutrophils and lymphocytes. What is the most likely diagnosis?

      Your Answer: Cerebral abscess

      Explanation:

      A cerebral abscess can result from direct extension of cranial infections, penetrating head trauma, haematogenous spread, or for unknown causes. An abscess forms when an area of cerebral inflammation becomes necrotic and encapsulated by glial cells and fibroblasts. Oedema around the abscess can increase the intracranial pressure. Symptoms result from increased intracranial pressure and mass effects. It is most frequent in the third decade of life, and when it occurs in children, it is usually associated with congenital heart disease.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      8.2
      Seconds

  • Question 9 - Which of these substances is secreted by pericytes in the juxtaglomerular cells? ...

    Correct

    • Which of these substances is secreted by pericytes in the juxtaglomerular cells?

      Your Answer: Renin

      Explanation:

      The juxtaglomerular cells synthesise, store and secrete the enzyme renin in the kidney. They are specialised smooth muscle cells in the wall of the afferent arteriole that delivers blood to the glomerulus and thus play a critical role in the renin– angiotensin system and so in renal autoregulation.

    • This question is part of the following fields:

      • Physiology
      • Renal
      3.3
      Seconds

  • Question 10 - Which is the most common benign germ-cell tumour that could occur in a...

    Correct

    • Which is the most common benign germ-cell tumour that could occur in a premenopausal woman?

      Your Answer: Dermoid cyst

      Explanation:

      A dermoid cyst is a teratoma of a cystic nature that contains an array of developmentally mature and solid tissues. Dermoid cysts grow slowly and this type of cystic teratoma is nearly always benign.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      14.2
      Seconds

  • Question 11 - 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
      13.6
      Seconds

  • Question 12 - Which is the correct order of tendons passing from medial to lateral-posterior to...

    Correct

    • Which is the correct order of tendons passing from medial to lateral-posterior to the medial malleolus?

      Your Answer: Posterior tibial, flexor digitorum longus, flexor hallucis longus

      Explanation:

      The correct order of structures is the tendon of tibialis posterior, tendon of flexor digitorum longus, posterior tibial artery (and vein), tibial nerve and tendon of flexor hallucis longus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      12.5
      Seconds

  • Question 13 - What percentage of cardiac output is delivered to the skin? ...

    Correct

    • What percentage of cardiac output is delivered to the skin?

      Your Answer: 2%

      Explanation:

      Making up 4-5% of total body weight, the skin receives approximately 2% of cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      2.3
      Seconds

  • Question 14 - A 75-year old patient is in atrial fibrallation but has never been on...

    Correct

    • A 75-year old patient is in atrial fibrallation but has never been on anticoagulation therapy. To reduce the risk of future emboli, she would benefit from starting on long-term warfarin. Arterial emboli leading to acute limb ischaemia most commonly lodge at which one of the following sites?

      Your Answer: Common femoral artery

      Explanation:

      The common femoral artery is the commonest site of arterial emboli causing acute limb ischemia. The treatment of choice is urgent femoral embolectomy.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      13.6
      Seconds

  • Question 15 - Lateral medullary syndrome, also known as Wallenberg's syndrome is a neurological condition caused...

    Correct

    • Lateral medullary syndrome, also known as Wallenberg's syndrome is a neurological condition caused by ischaemia in the lateral part of the medulla oblongata and is commonly associated with numerous neurological symptoms. Which of the following arteries when occluded leads to this condition?

      Your Answer: Posterior inferior cerebellar

      Explanation:

      The lateral medullary syndrome or Wallenberg’s disease is also known as posterior inferior cerebellar artery syndrome (PICA). This syndrome is a clinical manifestation of the occlusion of the posterior cerebellar artery that results in symptoms of infarction of the lateral medullary oblongata. Other arteries that contribute to blood flow in to this region such are the vertebral artery, superior middle cerebellar and inferior medullary arteries can also result to this syndrome when occluded.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      18
      Seconds

  • Question 16 - A 50-year old gentleman who was admitted for elective surgery was found to...

    Incorrect

    • A 50-year old gentleman who was admitted for elective surgery was found to have haemoglobin 9.5 g/dl, white blood cell count of 1.4 × 109/l and a mean corpuscular volume (MCV) of 134 fl. Which of the following is the likely finding on his peripheral blood smear?

      Your Answer: Schistocytes

      Correct Answer: Hypersegmented neutrophils

      Explanation:

      The likely diagnosis is megaloblastic anaemia, which also shows the presence of hypersegmented neutrophils.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      10
      Seconds

  • Question 17 - A 60-year-old woman complains of left sided headaches which have been recurring for...

    Incorrect

    • A 60-year-old woman complains of left sided headaches which have been recurring for several years. She recently suffered from a focal seizure for the first time a few days ago. A CT scan shows a mass in the left hemisphere of the brain. The most likely diagnosis is:

      Your Answer: Glioblastoma multiforme

      Correct Answer: Meningioma

      Explanation:

      Meningiomas are a common benign intracranial tumour, and their incidence is higher in women between the ages of 40-60 years old. Many of these tumours are asymptomatic and are diagnosed incidentally, although some of them may have malignant presentations (less than 2% of cases). These benign tumours can develop wherever there is dura, over the convexities near the venous sinuses, along the base of the skull, in the posterior fossa and, within the ventricles.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      13.2
      Seconds

  • Question 18 - What intrinsic muscle of the larynx is responsible for the tensing of the...

    Incorrect

    • What intrinsic muscle of the larynx is responsible for the tensing of the vocal cords?

      Your Answer: Posterior cricoarytenoid

      Correct Answer: Cricothyroid muscle

      Explanation:

      The cricothyroid muscle is the only tensor muscle of the larynx aiding with phonation. It attaches to the anterolateral aspect of the cricoid and the inferior cornu and lower lamina of the thyroid cartilage. Its action tilts the thyroid forward to help tense the vocal cords.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      16.4
      Seconds

  • Question 19 - Which of the following has the least malignant potential? ...

    Correct

    • Which of the following has the least malignant potential?

      Your Answer: Hyperplastic polyp

      Explanation:

      Non-neoplastic (non-adenomatous) colonic polyps include hyperplastic polyps, hamartomas, juvenile polyps, pseudopolyps, lipomas, leiomyomas and others.

      An autosomal dominant condition, Peutz–Jeghers syndrome is a disease that is characterized by multiple hamartomatous polyps in the stomach, small bowel and colon. Symptoms of this syndrome include hyperpigmentation of the skin and mucous membranes, especially of the lips and gums.

      Juvenile polyps develop in children, and once they outgrow their blood supply, they autoamputate around puberty. In cases of uncontrolled bleeding or intussusception, treatment is needed.

      Inflammatory polyps and pseudopolyps occur in chronic ulcerative colitis and Crohn’s disease. There is an increased risk of cancer with multiple juvenile polyps (not with sporadic polyps).

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      8.4
      Seconds

  • Question 20 - Basal Metabolic Rate (BMR) will most likely be reduced by which of the...

    Correct

    • Basal Metabolic Rate (BMR) will most likely be reduced by which of the following?

      Your Answer: Decrease in body temperature

      Explanation:

      The basal metabolic rate (BMR) is defined as the rate of calorie consumption after an overnight fast, in the absence of any muscular activity, with the patient in a restful state. Various factors affect the BMR including weight, body surface area and age. The BMR is 30 kcal/m2 per hour at birth; at age 2, the rate is 57 kcal/m2 per hour; and at age 20, 41 kcal/m2 per hour. After this, the BMR decreases by 10% between 20-60 years of age. Women are known to have a 10% lower BMR than men (due to higher fat content). A one-degree change in body temperature leads to a 10% change in BMR in the same direction. However, shivering and increasing ambient temperature brings about a rise in BMR, and so does stress, physical activity, caffeine, theophylline and hyperthyroidism. Also, thermogenesis induced by diet results in increased metabolic rate and hence, BMR should be ideally measured after overnight fasting.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      2.9
      Seconds

  • Question 21 - After severe injury of the upper limb following an accident. The humerus is...

    Correct

    • After severe injury of the upper limb following an accident. The humerus is injured as well as the nerve which innervates the muscles of the anterior compartment of the arm. Which nerve is injured?

      Your Answer: Musculocutaneous

      Explanation:

      The musculoskeletal nerve supplies the muscles of the anterior compartment of the arm including the coracobrachialis, biceps brachii and the greater part of the brachialis. This nerve derives its fibres from the fifth, sixth and seventh cervical nerves and arises from the lateral cord of the brachial plexus. It also provides a branch to the elbow joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      12.4
      Seconds

  • Question 22 - A 40-year old woman with portal hypertension has impaired venous drainage of the...

    Incorrect

    • A 40-year old woman with portal hypertension has impaired venous drainage of the anal canal above the pectinate line. Thus, there might be an increase in blood flow downward to the systemic venous system via anastomoses with the inferior rectal vein. This is a tributary of?

      Your Answer: Internal iliac vein

      Correct Answer: Internal pudendal vein

      Explanation:

      The inferior rectal vein drains into the internal pudendal vein. In addition the external iliac vein is one of the two branches of the common iliac vein however the internal iliac vein and it’s tributaries (including the pudendal vein) are much more important in draining the pelvic structures.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      28.6
      Seconds

  • Question 23 - 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
      6
      Seconds

  • Question 24 - A chloride sweat test was performed on a 13-year-old boy. Results indicated a...

    Correct

    • A chloride sweat test was performed on a 13-year-old boy. Results indicated a high likelihood of cystic fibrosis. This diagnosis is associated with a higher risk of developing which of the following?

      Your Answer: Bronchiectasis

      Explanation:

      Cystic fibrosis is a life-threatening disorder that causes the build up of thick mucus in the lungs, digestive tract, and other areas of the body. It is a hereditary autosomal-recessive disease caused by mutations of the CFTR gene. Cystic fibrosis eventually results in bronchiectasis which is defined as a permanent dilatation and obstruction of bronchi or bronchioles.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      4.9
      Seconds

  • Question 25 - A 66-year-old man complains of constant headaches. On physical examination, the only relevant...

    Correct

    • 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.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      13.2
      Seconds

  • Question 26 - 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
      9.3
      Seconds

  • Question 27 - Which of the following can occur even in the absence of brainstem co-ordination?...

    Incorrect

    • Which of the following can occur even in the absence of brainstem co-ordination?

      Your Answer: Swallowing

      Correct Answer: Gastric emptying

      Explanation:

      Although gastric emptying is under both neural and hormonal control, it does not require brainstem co-ordination. Increased motility of the orad stomach (decreased distensibility) or of the distal stomach (increased peristalsis), decreased pyloric tone, decreased duodenal motility or a combination of these, all increase the rate of gastric emptying. The major control mechanism for gastric emptying is through duodenal gastric feedback. The duodenum has receptors for the presence of acid, carbohydrate, fat and protein digestion products, osmolarity different from that of plasma, and distension. Activating these receptors decreases the rate of gastric emptying. Neural mechanisms involve both enteric and vagal pathways and a vagotomy impairs the gastric emptying regulation. CCK (cholecystokinin) slows gastric emptying at physiological levels of the hormone. Gastrin, secretin and glucose-1-phosphate also slow gastric emptying, but require higher doses.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      11
      Seconds

  • Question 28 - Which of the following compensatory parameters is responsible for causing an increase in...

    Correct

    • Which of the following compensatory parameters is responsible for causing an increase in the blood pressure in a 30 year old patient with a BP of 40 mmHg?

      Your Answer: Baroreceptor reflex

      Explanation:

      The baroreflex or baroreceptor reflex is one of the body’s homeostatic mechanisms for regulating blood pressure. It provides a negative feedback response in which an elevated blood pressure will causes blood pressure to decrease; similarly, decreased blood pressure depresses the baroreflex, causing blood pressure to rise. The system relies on specialised neurones (baroreceptors) in the aortic arch, carotid sinuses and elsewhere to monitor changes in blood pressure and relay them to the brainstem. Subsequent changes in blood pressure are mediated by the autonomic nervous system. Baroreceptors include those in the auricles of the heart and vena cava, but the most sensitive baroreceptors are in the carotid sinuses and aortic arch. The carotid sinus baroreceptors are innervated by the glossopharyngeal nerve (CN IX); the aortic arch baroreceptors are innervated by the vagus nerve (CN X).

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      8.1
      Seconds

  • Question 29 - A 51-year old woman after undergoing a barium swallowing was discovered to be...

    Correct

    • A 51-year old woman after undergoing a barium swallowing was discovered to be suffering from an oesophageal hiatal hernia. Which muscle fibres of the diaphragm border this hernia directly if the stomach herniates through an enlarged oesophageal hiatus?

      Your Answer: Right crus

      Explanation:

      The oesophageal hiatus is a natural fissure on the thoracic diaphragm that allows passage of the oesophagus and the vagal nerve. The oesophageal hiatus is located in one of the tendinous structures of the diaphragm that connect it to the spine which is known as the right crus. In case of an hiatal hernia, this diaphragmatic structure would be the one bordering the hernia as it is the structure that encircles the oesophageal hiatus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      17.3
      Seconds

  • Question 30 - A CT scan of 65 year old male patient at an outpatient clinic...

    Correct

    • 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: 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
      8.8
      Seconds

  • Question 31 - Which of the following proteins prevents red blood cells (RBCs) from bursting when...

    Correct

    • Which of the following proteins prevents red blood cells (RBCs) from bursting when they pass through capillaries?

      Your Answer: Spectrin

      Explanation:

      Spectrin is a structural protein found in the cytoskeleton that lines the intercellular side of the membrane of cells which include RBCs. They maintain the integrity and structure of the cell. It is arranged into a hexagonal arrangement formed from tetramers of spectrin and associated with short actin filaments that form junctions allowing the RBC to distort its shape.

    • This question is part of the following fields:

      • General
      • Physiology
      10.5
      Seconds

  • Question 32 - Which of these nerves controls adduction of hand? ...

    Incorrect

    • Which of these nerves controls adduction of hand?

      Your Answer: Musculocutaneous nerve

      Correct Answer: Ulnar nerve

      Explanation:

      The adductors of the fingers are the palmer interossei. They are supplied by the ulnar nerve, which is a branch of the medical cord of the brachial plexus.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      12.5
      Seconds

  • Question 33 - Raised alkaline phosphatase and positive antimitochondrial antibody indicates which of the following conditions...

    Correct

    • Raised alkaline phosphatase and positive antimitochondrial antibody indicates which of the following conditions presenting with pruritus?

      Your Answer: Primary biliary cirrhosis

      Explanation:

      An autoimmune disease, primary biliary cirrhosis results in destruction of intrahepatic bile ducts. This leads to cholestasis, cirrhosis and eventually, hepatic failure. Symptoms includes fatigue, pruritus and steatorrhea. Increased IgM levels, along with antimitochondrial antibodies are seen in the serum. Liver biopsy is diagnostic, and also aids in staging of disease.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      5.7
      Seconds

  • Question 34 - After a car accident, a 30-year-old woman is alert and only has minor,...

    Correct

    • After a car accident, a 30-year-old woman is alert and only has minor, superficial injuries. 2 hours later, she becomes unconscious and a CT scan reveals a convex, lens-shaped haemorrhage over the right parietal region. The most likely diagnosis is:

      Your Answer: Epidural haematoma

      Explanation:

      Epidural haematomas are usually caused by arterial bleeding, classically due to damage to the middle meningeal artery by a temporal bone fracture. Symptoms develop within minutes to several hours after the injury and consist of increasing headache, decreased level of consciousness, hemiparesis and pupillary dilation with loss of light reactivity. Around 15–20% of epidural hematomas are fatal.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      49.1
      Seconds

  • Question 35 - A 55-year-old male chronic smoker is diagnosed with non-small-cell cancer. His right lung...

    Correct

    • 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: 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
      9.6
      Seconds

  • Question 36 - Which of the following two cerebral veins join up to form the great...

    Correct

    • Which of the following two cerebral veins join up to form the great cerebral vein, otherwise also known as the great vein of Galen?

      Your Answer: Internal cerebral veins

      Explanation:

      The great vein of Galen or great cerebral vein, is formed by the union of the internal cerebral veins and the basal veins of Rosenthal. This vein curves upwards and backwards along the border of the splenium of the corpus callosum and eventually drains into the inferior sagittal sinus and straight sinus at its anterior extremity.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      7.5
      Seconds

  • Question 37 - What is the likely diagnosis in a 55-year old man presenting with jaundice,...

    Correct

    • What is the likely diagnosis in a 55-year old man presenting with jaundice, weight loss, pale coloured stools and elevated alkaline phosphatase?

      Your Answer: Pancreatic carcinoma

      Explanation:

      Increased alkaline phosphatase is indicative of cholestasis, with a 4x or greater increase seen 1-2 days after biliary obstruction. Its level can remain elevated several days after the obstruction is resolved due to the long half life (7 days). Increase up to three times the normal level can be seen in hepatitis, cirrhosis, space-occupying lesions and infiltrative disorders. Raised alkaline phosphatase with other liver function tests being normal can occur in focal hepatic lesions like abscesses or tumours, or in partial/intermittent biliary obstruction. However, alkaline phosphatase has several isoenzymes, which originate in different organs, particularly bone. An isolated rise can also be seen in malignancies (bronchogenic carcinoma, Hodgkin’s lymphoma), post-fatty meals (from the small intestine), in pregnancy (from the placenta), in growing children (from bone growth) and in chronic renal failure (from intestine and bone). One can differentiate between hepatic and non-hepatic cause by measurement of enzymes specific to the liver e.g. gamma-glutamyl transferase (GGT).

      In an elderly, asymptomatic patient, isolated rise of alkaline phosphatase usually points to bone disease (like Paget’s disease). Presence of other symptoms such as jaundice, pale stools, weight loss suggests obstructive jaundice, most probably due to pancreatic carcinoma.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      15.3
      Seconds

  • Question 38 - The most important difference between interstitial fluid and plasma is the: ...

    Correct

    • The most important difference between interstitial fluid and plasma is the:

      Your Answer: Protein concentration

      Explanation:

      Interstitial fluid (or tissue fluid or intercellular fluid) is a solution that surrounds the cells of multicellular animals. It is the main component of the extracellular fluid, which also includes plasma, lymph and transcellular fluid. Plasma, the major component in blood, communicates freely with interstitial fluid through pores and intercellular clefts in capillary endothelium. Interstitial fluid consists of a water solvent containing amino acids, sugars, fatty acids, coenzymes, hormones, neurotransmitters, salts, as well as waste products from the cells. Red blood cells, platelets and plasma proteins cannot pass through the walls of the capillaries. The resulting mixture that does pass through is essentially blood plasma without the plasma proteins. Tissue fluid also contains certain types of white blood cells. Once the extracellular fluid collects into small vessels it is considered to be lymph, and the vessels that carry it back to the blood are called the lymphatic vessels. The lymphatic system returns protein and excess interstitial fluid to the circulation.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      4.2
      Seconds

  • Question 39 - Which of the following structures lying posterior to the ovary are at risk...

    Correct

    • Which of the following structures lying posterior to the ovary are at risk of injury in excision of a malignant tumour in the right ovary?

      Your Answer: Ureter

      Explanation:

      The ovaries are two nodular structures situated one on either side of the uterus in relation to the lateral wall of the pelvis and attached to the back of the broad ligament of the uterus, lying posteroinferiorly to the fallopian tubes. Each ovary has a lateral and medial surface. The ureter is at greater risk of iatrogenic injury at this location.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      3.9
      Seconds

  • Question 40 - Following a lacerating injury along the anterior border of the trapezius muscle in...

    Correct

    • Following a lacerating injury along the anterior border of the trapezius muscle in the neck, a man has the point of his shoulder (scapula) sagging and he has difficulty with full abduction of his arm. Which nerve is most likely injured?

      Your Answer: Accessory (cranial nerve XI)

      Explanation:

      Injury to the accessory nerve denervates the trapezius muscle so that the person will no longer be able to raise the acromion of the shoulder. The dorsal scapular nerve supplies the rhomboids i.e. major and minor and the levator scapulae so that injury to this nerve weakens retraction of the scapula. The greater occipital nerve is responsible for sensation of the posterior scalp. The axillary nerve innervates the deltoid muscle which is responsible for abduction of the arm and the suprascapular nerve is responsible for rotating the humerus laterally. Cutaneous nerves supply the skin.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      7
      Seconds

  • Question 41 - A 39-year old female patient was diagnosed with a tumour of the left...

    Correct

    • A 39-year old female patient was diagnosed with a tumour of the left adrenal gland. The tumour, which is metastasizing to the adjacent tissues, has already extended to the left suprarenal vein. If the tumour is still spreading, which of the following veins will most likely be affected after the involvement of the left suprarenal vein?

      Your Answer: Left renal vein

      Explanation:

      The suprarenal veins or also known as the veins of Warshaw, are the veins that receive blood from the suprarenal glands. These veins receive blood from the medullary venous plexus and the cortex of the adrenal glands (suprarenal glands). They are two in number – the left and the right suprarenal veins. The right suprarenal vein drains into the inferior vena cava while the left suprarenal vein drains into the left renal vein. This therefore means that in the case of a metastasizing tumour involving the left suprarenal vein, the tumour will most likely extend from the left suprarenal vein to the left renal vein into which it drains.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      11.7
      Seconds

  • Question 42 - A specialist registrar was performing the bi-lateral surgical removal of the adrenal glands....

    Correct

    • A specialist registrar was performing the bi-lateral surgical removal of the adrenal glands. He first removed the left adrenal gland before moving on to the right one. However, the registrar noticed that the removal of the right adrenal gland would be a challenge because of an overlying structure. What was this structure that overlies the right suprarenal glad?

      Your Answer: Inferior vena cava

      Explanation:

      The adrenal glands or the suprarenal glands are small glands that are found on top of each of the kidneys. They are retroperitoneal glands. The right adrenal gland is found on top of the right kidney and is closely associated with the inferior vena cava as it directly drains into this large vein. In the case where the right adrenal gland is to be surgically removed, the inferior vena cava might prove a problem to manoeuvre as it overlies the right suprarenal gland. The other blood vessels such as the aorta, right renal, superior mesenteric, splenic artery and the hepatic vein as well as the right crus are not closely associated with either of the suprarenal glands.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      11.5
      Seconds

  • Question 43 - Which of the following is the most likely cause of prolonged thrombin clotting...

    Correct

    • Which of the following is the most likely cause of prolonged thrombin clotting time?

      Your Answer: Hypofibrinogenemia

      Explanation:

      Thrombin clotting time, also called thrombin time (TT), is test used for the investigation of possible bleeding or clotting disorders. TT reflects the conversion of fibrinogen to fibrin and it’s also very sensitive to the presence of the anticoagulant heparin. A prolonged thrombin time may indicate the presence of hypofibrinogenemia (decreased fibrinogen level ), dysfibrinogenaemia, disseminated intravascular coagulation (DIC), end stage liver disease or malnutrition.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      21.7
      Seconds

  • Question 44 - Following a bee sting, a women develops a 2cm red, raised, swollen lesion...

    Correct

    • Following a bee sting, a women develops a 2cm red, raised, swollen lesion at the site of the sting . Which of the following findings is likely to be seen in this lesion?

      Your Answer: Vasodilation

      Explanation:

      Inflammation is the immediate response of the body towards infections or irritations. The cardinal signs of inflammation are 1. redness/rubor, 2. tumour/swelling, 3.dolar/pain, 4.calor/heat and organ dysfunction (function laesa). Inflammation has 2 components; vascular and cellular. Blood vessels dilate upstream of the inflamed area leading to the rubor and calor and constrict downstream, increasing pressure and causing fluid to leak out of the capillary, resulting in swelling. The cellular component includes infiltration by neutrophils. Leukocyte arrival and functions include; 1. margination: cells marginated from the centre to the periphery of the vessel, 2. rolling: selectins are upregulated on the vessel walls, 3. adhesion: upregulation of the adhesion molecules ICAM and VCAM on the endothelium interact with integrins on the leukocytes resulting in adhesion, 4. diapedesis and chemotaxis: diapedesis is the transmigration of the leukocyte across the endothelium of the capillary and towards a chemotactic product and 5. phagocytosis: engulfing the offending substance/cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      8
      Seconds

  • Question 45 - 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
      4.8
      Seconds

  • Question 46 - The principal motor and sensory nerve of the perineum is the? ...

    Correct

    • The principal motor and sensory nerve of the perineum is the?

      Your Answer: Pudendal

      Explanation:

      The pudendal nerve is formed by S1,2,4 anterior branches. It gives off the inferior haemorrhoid nerve before dividing terminally into the perineal nerve and the dorsal nerve of the clitoris or the penis. Thus, it is the principal motor and sensory nerve of the perineum.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      6.5
      Seconds

  • Question 47 - An organ transplant patient may be at risk of developing which type of...

    Correct

    • An organ transplant patient may be at risk of developing which type of cancer?

      Your Answer: Skin cancer

      Explanation:

      The most common malignancies encountered in the post–solid organ transplant setting are non-melanoma skin cancers, post-transplant lymphoproliferative disorders and Kaposi’s sarcoma (KS). The pathogenesis of these tumours is likely related to the immunosuppressive drugs used post-transplantation and subsequent viral infection.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      4.8
      Seconds

  • Question 48 - The gastrosplenic ligament also known as the gastrolienal ligament is the structure that...

    Correct

    • The gastrosplenic ligament also known as the gastrolienal ligament is the structure that connects the greater curvature of the stomach to the hilum of the spleen. Which of the following arteries would most likely be injured if a surgeon accidentally tore this ligament?

      Your Answer: Short gastric

      Explanation:

      The short gastric arteries arise from the end of the splenic arteries and form five to seven branches. The short gastric arteries inside the gastrosplenic ligament from the left to the right, supply the greater curvature of the stomach. The hepatic artery proper runs inside the hepatoduodenal ligament. The right gastric artery and the left gastric artery are contained in the hepatogastric ligament. The caudal pancreatic artery branches off from the splenic artery and supplies the tail of the pancreas. The middle colic artery supplies the transverse colon. The splenic artery does not travel in the gastrosplenic ligament and so it would not be damaged by a tear to this ligament.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      11.8
      Seconds

  • Question 49 - A 25 year old women is pregnant with her second child. She is...

    Correct

    • A 25 year old women is pregnant with her second child. She is A- blood group. Her first child was Rh+ and the father is also Rh+. The second child is at a risk of developing which condition?

      Your Answer: Haemolytic disease of the new-born

      Explanation:

      This infant is at risk for haemolytic disease of the new born also known as erythroblastosis fetalis. In the pregnancy, Rh-positive RBC’s cross the placenta and enter the mothers blood system. She then becomes sensitised and forms IgG antibodies/anti-Rh antibodies against them. The second child is at a greater risk for this disease than the first child with Rh-positive blood group as during the second pregnancy, a more powerful response is produced. IgG has the ability to cross the placenta and bind to the fetal RBCs (type II hypersensitivity reaction) which are phagocytosed by the macrophages.

    • This question is part of the following fields:

      • Inflammation & Immunology; Haematology
      • Pathology
      13
      Seconds

  • Question 50 - A 16 year old girl fractured a bone in her left foot. Upon...

    Correct

    • A 16 year old girl fractured a bone in her left foot. Upon examination the clinician discovered that the fracture affected the insertion of the peroneus brevis muscle. Which of the following bones was most likely affected?

      Your Answer: Base of the fifth metatarsal

      Explanation:

      The peroneus brevis muscle originates from the lower two-thirds of the lateral body of the fibula and has inserts at the base of the fifth metatarsal. Fractures to this bone are common and can be due to infection, trauma, overuse and repetitive use.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      17.8
      Seconds

  • Question 51 - Action potentials are used extensively by the nervous system to communicate between neurones...

    Correct

    • Action potentials are used extensively by the nervous system to communicate between neurones and muscles or glands. What happens during the activation of a nerve cell membrane?

      Your Answer: Sodium ions flow inward

      Explanation:

      During the generation of an action potential, the membrane gets depolarized which cause the voltage gated sodium channels to open and sodium diffuses inside the neuron, resulting in the membrane potential moving towards a positive value. This positive potential will then open the voltage gated potassium channels and cause more K+ to move out decreasing the membrane potential and restoring the membrane potential to its resting value.

    • This question is part of the following fields:

      • General
      • Physiology
      10.3
      Seconds

  • Question 52 - Which of the following diseases affects young adults, causing pain in any bone...

    Correct

    • Which of the following diseases affects young adults, causing pain in any bone -particularly long bones- which worsens at night, and is typically relieved by common analgesics, such as aspirin?

      Your Answer: Osteoid osteoma

      Explanation:

      Osteoid osteoma, which tends to affect young adults, can occur in any bone but is most common in long bones. It can cause pain (usually worse at night) that is typically relieved by mild analgesics, such as non-steroidal anti-inflammatory drugs. X-ray findings include a small radiolucent zone surrounded by a larger sclerotic zone.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      5.6
      Seconds

  • Question 53 - Paracentesis of ascetic fluid in a 45-year old woman revealed the following :...

    Correct

    • Paracentesis of ascetic fluid in a 45-year old woman revealed the following : clear, yellow fluid with protein 2.0 g/dl and a few mesothelial and mononuclear cells seen. No malignant cells seen. What is the likely diagnosis?

      Your Answer: Cirrhosis

      Explanation:

      Ascites develops either from:

        • Increased  accumulation
          • Increased capillary permeability
          • Increased venous pressure
          • Decreased protein (oncotic pressure)
        • Decreased clearance
          • Increased lymphatic obstruction

      Cause

      • Transudate (<30g/L protein) (Systemic disease)
        • Liver (Cirrhosis)
        • Cardiac e.g. RHF, CCF, SBE right heart valve disease and constrictive Pericarditis
        • Renal failure
        • Hypoalbuminaemia (nephrosis)
      • Exudate (>30g/L protein) (Local disease)
        • Malignancy
        • Venous obstruction e.g. Budd-Chiari, Schistosomiasis
        • Pancreatitis
        • Lymphatic obstruction
        • Infection (especially TB)

      Cirrhosis is disease of the liver that is characterized by fibrosis leading to disorganization of the hepatic architecture. It shows the development of regenerative nodules surrounded by dense fibrotic tissue. Cirrhosis shows non-specific symptoms initially, which include fatigue, anorexia and weight loss. It can later progress to portal hypertension, ascites and liver failure.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      5.2
      Seconds

  • Question 54 - A biopsy is performed on a 67-year-old-man with testicular seminoma; it reveals that...

    Correct

    • 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: 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
      11.2
      Seconds

  • Question 55 - A neonate is diagnosed with cryptorchidism of the right side (undescended testis). Which...

    Incorrect

    • A neonate is diagnosed with cryptorchidism of the right side (undescended testis). Which is the LEAST likely place to find the testis?

      Your Answer: Somewhere in the inguinal canal

      Correct Answer: Perineum

      Explanation:

      Embryologically the testes are retroperitoneal structures in the posterior abdominal wall, attached to the anterolateral abdominal wall by the gubernaculum. The gubernaculum ‘pulls’ the testes through the deep inguinal ring, inguinal canal and superficial inguinal ring and over the pelvic brim. The gubernaculum is preceded by the processus vaginalis that is derived from the peritoneum anterior to the testes. The processus vaginalis pushes the muscle and fascial layers. These eventually make up the canal and the spermatic cord, into the scrotum. The gubernaculum persists as the scrotal ligament while part of the processus vaginalis remains as a bursa-like sac i.e. the tunica vaginalis testes. The testes therefore could be caught in any one of these places along its path of descending. The testes are never in the perineum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      6.3
      Seconds

  • Question 56 - Whipple's procedure involves mobilizing the head of the pancreas. As the surgeon does...

    Correct

    • Whipple's procedure involves mobilizing the head of the pancreas. As the surgeon does this, he must be careful to avoid injury to a key structure that is found lying behind the head of the pancreas. Which vital structure is this?

      Your Answer: Common bile duct

      Explanation:

      The posterior relations of the head of the pancreas include: the inferior vena cava, the common bile duct, the renal veins, the right crus of the diaphragm and the aorta.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      7.4
      Seconds

  • Question 57 - What causes a reduction in pulmonary functional residual capacity? ...

    Incorrect

    • What causes a reduction in pulmonary functional residual capacity?

      Your Answer: Emphysema

      Correct Answer: Pulmonary fibrosis

      Explanation:

      Pulmonary functional residual capacity (FRC) is = volume of air present in the lungs at the end of passive expiration.

      Obstructive diseases (e.g. emphysema, chronic bronchitis, asthma) = an increase in FRC due to an increase in lung compliance and air trapping.

      Restrictive diseases (e.g. pulmonary fibrosis) result in stiffer, less compliant lungs and a reduction in FRC.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      8.4
      Seconds

  • Question 58 - A 55-years-old man presented to the emergency department complaining of a squeezing sensation...

    Correct

    • A 55-years-old man presented to the emergency department complaining of a squeezing sensation in his chest that has spread to his neck with associated worsening shortness of breath. Which of these laboratory tests would you ask for in this patient:

      Your Answer: Creatine kinase-MB

      Explanation:

      Creatine kinase-MB is a test that usually is ordered when the patient has chest pain as a cardiac marker. When a heart attack is suspected and a troponin test (which is more specific for heart damage), is not available CK-MB is ordered. There are 3 forms of CK: CK-MM, CK-BB and CK-MB. CK-MB is commonly found in heart tissue, therefore injured heart muscle cells release CK-MB into the blood. Elevated CK-MB levels indicate that it is probable that a person has recently had a heart attack.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      5.6
      Seconds

  • Question 59 - A 17-year-old boy, who had developed shortness of breath and a loss of...

    Correct

    • A 17-year-old boy, who had developed shortness of breath and a loss of appetite over the last month, was referred to a haematologist because he presented with easy bruising and petechiae. His prothrombin time, platelet count, partial thromboplastin and bleeding time were all normal. Which of the following would explain the presence of the petechiae and easy bruising tendency?

      Your Answer: Scurvy

      Explanation:

      Scurvy is a condition caused by a dietary deficiency of vitamin C, also known as ascorbic acid. Humans are unable to synthesize vitamin C, therefore the quantity of it that the body needs has to come from the diet. The presence of an adequate quantity of vitamin C is required for normal collagen synthesis. In scurvy bleeding tendency is due to capillary fragility and not coagulation defects, therefore blood tests are normal.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      33.4
      Seconds

  • Question 60 - A 69 Year old lady presented to the emergency department following a massive...

    Correct

    • A 69 Year old lady presented to the emergency department following a massive myocardial infarction. She was found to be in hypotensive shock with focal neurological signs. Unfortunately the patient demised. What would be the expected findings on the brain biopsy?

      Your Answer: Liquefactive necrosis

      Explanation:

      Liquefactive necrosis is often associated with bacterial or fungal infections. However, hypoxic death of cells within the central nervous system can also result in liquefactive necrosis. The focal area is soft with a liquefied centre containing necrotic debris and dead white cells. This may later be enclosed by a cystic wall

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Neurology
      • Pathology
      8.2
      Seconds

  • Question 61 - Following an accident, a man was unable to extend the wrist and metacarpophalangeal...

    Incorrect

    • Following an accident, a man was unable to extend the wrist and metacarpophalangeal joints, despite sensation being intact. Which nerve was likely damaged?

      Your Answer: Median nerve

      Correct Answer: Posterior interosseous nerve

      Explanation:

      The posterior interosseous nerve which causes, what is known as the posterior interosseous nerve syndrome. The nerve is compressed before it bifurcates to form the medial and lateral branches. The compression is beyond the origin of the branches to the radial wrist extensors and the radial sensory nerve. The result of such a case is paralysis of the digital extensors and the extensor carpi ulnaris, resulting in dorsoradial deviation of the wrist.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      10.8
      Seconds

  • Question 62 - The thyroid gland is a large ductless gland located in which part of...

    Correct

    • The thyroid gland is a large ductless gland located in which part of the neck?

      Your Answer: Visceral space

      Explanation:

      The thyroid gland is an endocrine gland in the neck, consisting of two lobes connected by an isthmus. It is situated at the front and sides of the neck in the visceral space.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      8
      Seconds

  • Question 63 - The following branch of the aorta is unpaired: ...

    Correct

    • The following branch of the aorta is unpaired:

      Your Answer: Coeliac artery

      Explanation:

      Branches that stem from the abdominal aorta can be divided into three: the visceral branches, parietal branches and terminal branches. Of the visceral branches, the suprarenal, renal, testicular and ovarian arteries are paired while the coeliac artery and superior and inferior mesenteric arteries are unpaired. Of the parietal branches the inferior phrenic and lumbar arteries are paired while the middle sacral artery is unpaired. The terminal branches i.e. the common iliac arteries are paired.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      8.8
      Seconds

  • Question 64 - During an inguinal hernia repair, an incision is made parallel to and 5cm...

    Correct

    • During an inguinal hernia repair, an incision is made parallel to and 5cm above the inguinal ligament. The registrar is warned to look out for the inferior epigastric vessels to avoid damage. Between which layers of the abdominal wall is the registrar likely to find these vessels?

      Your Answer: Transversus abdominis muscle and peritoneum

      Explanation:

      The inferior epigastric vessels lie on the inner surface of the transversus abdominis muscle covered by the parietal peritoneum. This layer of peritoneum lies over the inferior epigastric vessels to make the lateral umbilical fold. Camper’s and Scarpa’s fascia are two layers of the superficial fascia, the fatty layer and the membranous layer respectively.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      7.9
      Seconds

  • Question 65 - A 36-year-old female was advised to undergo genetic testing of BRCA1 and BRCA2....

    Correct

    • A 36-year-old female was advised to undergo genetic testing of BRCA1 and BRCA2. BRCA1 and BRCA2 are tumour markers specifically for which organ?

      Your Answer: Breast

      Explanation:

      Women with harmful mutations in either BRCA1 or BRCA2 have a risk of breast cancer that is about five times the normal risk.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      2.7
      Seconds

  • Question 66 - A 7-month-old abandoned baby with congenital non-communicating hydrocephalus is hosted by a clinic...

    Correct

    • 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: 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
      19.2
      Seconds

  • Question 67 - A 45-year old gentleman presents with diarrhoea for two weeks. He has no...

    Correct

    • A 45-year old gentleman presents with diarrhoea for two weeks. He has no history of fever and the diarrhoea stops on fasting. Which is the most likely type of diarrhoea that he is suffering from?

      Your Answer: Osmotic

      Explanation:

      The different types of diarrhoea are:

      1. Secretory diarrhoea – Due to increased secretion or decreased absorption. There is minimal to no structural damage in this type. The most common cause is cholera toxin which stimulates secretion of anions (especially chloride), with sodium and water.

      2. Osmotic diarrhoea – Due to increased osmotic load, there is water loss. This occurs in cases of maldigestion syndromes, such as coeliac or pancreatic disease.

      3. Motility-related diarrhoea – Occurs in cases of abnormal gastrointestinal motility. Due to increased motility, there is poor absorption and this leads to diarrhoea. This is seen post-vagotomy or in diabetic neuropathy.

      4. Inflammatory diarrhoea – Due to damage to the mucosa or brush border, there is a loss of protein-rich fluids and poor absorption. Features of all the above three types can be seen in this type. Aetiology includes bacterial, viral, parasitic infections or autoimmune problems including inflammatory bowel disease.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      9.2
      Seconds

  • Question 68 - Risk factors for hepatocellular carcinoma do NOT include: ...

    Correct

    • Risk factors for hepatocellular carcinoma do NOT include:

      Your Answer: Heptitis E

      Explanation:

      Risk factors for hepatocellular carcinoma include hepatitis B and C, aflatoxin, anabolic steroids, alcohol cirrhosis and primary liver disease.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      4.9
      Seconds

  • Question 69 - A 34-year-old man is receiving chemotherapy for non-Hodgkin's lymphoma. Which of the following...

    Correct

    • A 34-year-old man is receiving chemotherapy for non-Hodgkin's lymphoma. Which of the following chemotherapy regimens would be used in this case?

      Your Answer: CHOP

      Explanation:

      CHOP is the acronym for a chemotherapy regimen used in the treatment of non-Hodgkin’s lymphoma, comprising cyclophosphamide, hydroxyrubicin (adriamycin), vincristine and prednisone. This regimen can also be combined with the monoclonal antibody rituximab if the lymphoma is of B cell origin; this combination is called R-CHOP.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      6
      Seconds

  • Question 70 - A 24-year old, lactating mother presents to the clinic with a tender, 1.5cm...

    Correct

    • A 24-year old, lactating mother presents to the clinic with a tender, 1.5cm mass just below the right nipple, which shows multiple fissures. What finding is likely associated with her condition?

      Your Answer: Staphylococcus aureus infection

      Explanation:

      Breast abscess occur commonly in lactating mothers in the postpartum period due to cracking of the nipple. It is commonly caused due to Staphylococcus aureus infection. Fat necrosis usually results from trauma wherein an ill-defined mass is formed. Ductal carcinomas are malignant masses which are not tender usually, and rare in the young age group. Plasma cell mastitis affect women in an older age group. Sclerosing adenosis is a type of fibrocystic disease which can lead to a tender, cystic mass but no fissuring or cracks are seen in the nipple. Fibroadenoma and lipomas are non-tender, well-defined masses.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      9.6
      Seconds

  • Question 71 - A 17-year-old female was given an antibiotic for a urinary tract infection. After...

    Correct

    • 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: 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
      7.1
      Seconds

  • Question 72 - A 60-year-old man complains of pain in his left thigh. An X-ray reveals...

    Correct

    • A 60-year-old man complains of pain in his left thigh. An X-ray reveals bowing of the affected femur, increased bone density, bony enlargement, abnormal bone architecture with coarse cortical trabeculations, and stress microfractures. Which is the most likely diagnosis in this case?

      Your Answer: Paget’s disease of bone

      Explanation:

      Paget’s disease of bone is a chronic disorder of the adult skeleton in which bone turnover is accelerated in localised areas, replacing normal matrix with softened and enlarged bone and causing gradual pain and deformity in some cases. It is more predominant in men over the age of 40. Characteristic X-ray findings include increased bone density, abnormal architecture with coarse cortical trabeculation or cortical thickening, bowing and bony enlargement; there might also be stress microfractures of the tibia or femur.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      7.4
      Seconds

  • Question 73 - Which of these laboratory findings will indicate a fetal neural tube defect when...

    Correct

    • Which of these laboratory findings will indicate a fetal neural tube defect when done between 15 and 20 weeks of pregnancy?

      Your Answer: Increased alpha-fetoprotein

      Explanation:

      Maternal serum screening during the second trimester is a non-invasive way of identifying women at increased risk of having children with a neural tube defect and should be offered to all pregnant women. The results are most accurate when the sample is taken between 15 and 20 weeks of gestation. Elevated levels of alpha-fetoprotein suggest open spina bifida, anencephaly, risk of pregnancy complications, or multiple pregnancy.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      10.6
      Seconds

  • Question 74 - Severe abdominal pain radiating to the back, along with increased serum amylase levels,...

    Correct

    • Severe abdominal pain radiating to the back, along with increased serum amylase levels, is seen in which of the following conditions?

      Your Answer: Pancreatitis

      Explanation:

      The primary test for diagnosis and monitoring of pancreatitis is amylase. Increased plasma levels of amylase can be found in: salivary trauma (including anaesthetic intubation), mumps, pancreatitis and renal failure. However, a rise in the total amylase levels over 10 times the upper limit of normal (ULN) is suggestive of pancreatitis; 5–10 times the ULN may indicate ileus or duodenal disease or renal failure. Lower levels are commonly found in salivary gland disease.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      20.7
      Seconds

  • Question 75 - Both the arytenoid muscles and the lateral cricoarytenoid muscles perform this action on...

    Incorrect

    • Both the arytenoid muscles and the lateral cricoarytenoid muscles perform this action on the glottis:

      Your Answer: Abduction

      Correct Answer: Adduction

      Explanation:

      Both the arytenoid and the cricoartenoid muscles close the glottis. The lateral cricoarytenoid muscles extend from the lateral cricoid cartilage to the muscular process of the arytenoid cartilage. By rotating the arytenoid cartilages medially, these muscles adduct the vocal cords and thereby close the rima glottidis. The arytenoid muscle adducts or approximates the arytenoid cartilages, and thus closes the aperture of the glottis.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      10.4
      Seconds

  • Question 76 - A young 16 year old boy presented to the ENT clinic with a...

    Correct

    • A young 16 year old boy presented to the ENT clinic with a history of sore throat for the past 1 day. On examination there was a pharyngeal purulent discharge. Which of the following types of inflammation is seen in this boy?

      Your Answer: Acute inflammation

      Explanation:

      A 1 day history suggests the purulent discharge is due to acute inflammation. Acute inflammation has 3 features:

      1) the affected area is occupied by a purulent discharge composed of proteins, fluids and cells from local blood vessels

      2) the infective agent i.e. bacteria is present in the affected area

      3) the damaged tissue can be liquified and the debris removed from the site.

      If the inflammation lasts over weeks or months, then it is termed as chronic inflammation.

      Granulomatous inflammation is characterised by the presence and formation of granulomas.

      Exudate is not a feature of resolution or a complication of inflammation.

      Abscess formation takes more than 1 day to form and is usually within a capsule/cavity.

    • This question is part of the following fields:

      • Inflammation & Immunology; Respiratory
      • Pathology
      9.5
      Seconds

  • Question 77 - What is the normal amount of oxygen that is carried in the blood?...

    Correct

    • What is the normal amount of oxygen that is carried in the blood?

      Your Answer: 20 ml oxygen/100 ml blood

      Explanation:

      Normally, 100 ml of blood contains 15g haemoglobin and a single gram of haemoglobin can bind to 1.34 ml oxygen when 100% saturated. Thus, 15 × 1.34 = 20 ml O2/100 ml blood. The haemoglobin in venous blood that is leaving the tissues is about 75% saturated with oxygen, and hence it carries about 15 ml O2/100 ml venous blood. This implies that for each 10 ml of blood, 5 ml oxygen is transported to the tissues. With a p(O2) > 100 mm Hg, only 3 ml of oxygen is dissolved in every one litre of plasma. By increasing the pA(O2) by breathing 100% oxygen, one can add an extra amount of oxygen in the plasma, but the amount of oxygen carried by haemoglobin will not increase significantly as it is already > 95% saturated.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      3.4
      Seconds

  • Question 78 - Staphylococcus aureus can be identified in the laboratory based on the clotting of...

    Correct

    • Staphylococcus aureus can be identified in the laboratory based on the clotting of plasma. Which microbial product is responsible for this activity?

      Your Answer: Coagulase

      Explanation:

      Staphylococcus aureus is the most pathogenic species and is implicated in a variety of infections.  S. aureus can be identified due to its production of coagulase. The staphylococcal enzyme coagulase will cause inoculated citrated rabbit plasma to gel or coagulate. The coagulase converts soluble fibrinogen in the plasma into insoluble fibrin.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      6.9
      Seconds

  • Question 79 - Which type of thyroid tumour represents 75 - 80% of thyroid cancer cases?...

    Correct

    • Which type of thyroid tumour represents 75 - 80% of thyroid cancer cases? This type is predominant in children and in patients who have had a previous history of head or neck radiation.

      Your Answer: Papillary carcinoma

      Explanation:

      Papillary thyroid carcinoma is the most common thyroid cancer. This cancer has a high cure rate with 10-year survival rates for all patients with papillary thyroid cancer estimated at 80% to 90%.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      19.9
      Seconds

  • Question 80 - A 27-yeaar-old woman is diagnosed with candidiasis and prescribed fluconazole. What is the...

    Correct

    • A 27-yeaar-old woman is diagnosed with candidiasis and prescribed fluconazole. What is the mechanism of action of fluconazole?

      Your Answer: Inhibits cytochrome P450

      Explanation:

      Fluconazole is a triazole antifungal drug used in the treatment and prevention of superficial and systemic fungal infections. Like other imidazole- and triazole-class antifungals, fluconazole inhibits the fungal cytochrome P450 enzyme, 14-demethylase. It is used to treat candidiasis, blastomycosis, coccidioidomycosis, cryptococcosis, histoplasmosis, dermatophytosis, and pityriasis versicolor.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      7.3
      Seconds

  • Question 81 - 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
      38.1
      Seconds

  • Question 82 - An abnormal opening of the urethra on the under surface of the penis...

    Correct

    • An abnormal opening of the urethra on the under surface of the penis (ventral surface) is known as:

      Your Answer: Hypospadias

      Explanation:

      Hypospadias is the condition where the urethra opens along the underside or ventral aspect of penile shaft. First-degree hypospadias is seen in 50-75% cases, where the urethra open on the glans penis. Second-degree hypospadias is seen in 20% cases where the urethra opens on the shaft, and third-degree in 30% cases with the urethra opening on the perineum. The severe cases are usually associated with undescended testis (cryptorchidism) or chordee, where the penis is tethered downwards and not completely separated from the perineum.

      It is a common male genital birth defect but varying incidences are noted in different countries. There is no obvious inheritance pattern noted. No exact cause has been determined, however several hypotheses include poor response to androgen, or interference by environmental factors.

    • This question is part of the following fields:

      • Pathology
      • Urology
      10.5
      Seconds

  • Question 83 - A 31-year-old woman is diagnosed with adrenal hyperplasia, and laboratory samples are taken...

    Correct

    • A 31-year-old woman is diagnosed with adrenal hyperplasia, and laboratory samples are taken to measure serum aldosterone and another substance. Which is most likely to be the other test that was prescribed to this patient?

      Your Answer: Plasma renin

      Explanation:

      The evaluation of a patient in whom hyperaldosteronism is first to determine that hyperaldosteronism is present (serum aldosterone) and, if it is present, to differentiate primary from secondary causes of hyperaldosteronism. The aldosterone-to-renin ratio (ARR) is the most sensitive means of differentiating primary from secondary causes of hyperaldosteronism as it is abnormally increased in primary hyperaldosteronism, and decreased or normal but with high renin levels in secondary hyperaldosteronism.

    • This question is part of the following fields:

      • Physiology
      • Renal
      20.4
      Seconds

  • Question 84 - A 27 year-old male patient was admitted to the hospital due to recurrent...

    Correct

    • A 27 year-old male patient was admitted to the hospital due to recurrent fever for the past 2 weeks. The patient claimed that he is an intravenous drug user. Following work up, the patient was diagnosed with infective endocarditis. Which is the most likely organism responsible for this diagnosis?

      Your Answer: Staphylococcus aureus

      Explanation:

      Acute bacterial endocarditis is a fulminant illness lasting over days to weeks (<2weeks). It is most likely due to Staphylococcus aureus especially in intravenous drug abusers.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      39.9
      Seconds

  • Question 85 - Which of the following is NOT a Gram-negative rod? ...

    Correct

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

      Your 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
      2.6
      Seconds

  • Question 86 - 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
      4.4
      Seconds

  • Question 87 - A mechanic sustained a deep laceration to his right cubital fossa which resulted...

    Correct

    • A mechanic sustained a deep laceration to his right cubital fossa which resulted in him unable to move the proximal radioulnar joint of his right arm. Which muscles was affected?

      Your Answer: Pronator teres

      Explanation:

      The correct answer is the pronator teres muscle. This muscle arises from 2 heads of origin: the humerus and ulnar. Between the 2 heads is the site of entrance of median nerve to the forearm. This muscle acts on the proximal radio-ulnar joint to rotate the radius on the ulna, otherwise known as pronation. It also assists in forearm flexion if the radius is fixed.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      10.8
      Seconds

  • Question 88 - A 76 year old man who presented with lower back pain is diagnosed...

    Correct

    • 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: 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
      16
      Seconds

  • Question 89 - After a total colectomy and ileotomy, a 50-year old diabetic man who was...

    Correct

    • After a total colectomy and ileotomy, a 50-year old diabetic man who was a known case of diabetic nephropathy had persistent metabolic acidosis. The patient appeared well perfused, with normal vital signs and normal fluid balance. Investigations revealed:

      Sodium = 132 mmol/l

      Potassium = 6.6 mmol/l

      Creatinine = 185 μmol/l (2.16 mg/dl)

      Chloride = 109 μmol/l

      8am cortisol = 500 nmol/l (18 μg/dl)

      pH = 7.29, p(CO2) = 27 mmHg

      p(O2) = 107 mmHg

      standard bicarbonate = 12 mmol/l.

      What is the likely causes of his acidosis?

      Your Answer: Renal tubular acidosis

      Explanation:

      Acidosis here is due to low bicarbonate. The low p(CO2) is seen in compensation. The anion gap is normal, ruling out intra-abdominal ischaemia (which leads to metabolic acidosis). If it was a gastrointestinal aetiology, low potassium would be seen. The history of diabetic nephropathy predisposes to renal tubular acidosis. Type 4 (hyporeninaemic hypoaldosteronism) is associated with high potassium and is found in diabetic and hypertensive renal disease.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      11.9
      Seconds

  • Question 90 - In relation to the muscles of facial expression, It is true to say:...

    Correct

    • In relation to the muscles of facial expression, It is true to say:

      Your Answer: They are in the same subcutaneous plane as the platysma muscle

      Explanation:

      The facial muscles generally originate from the facial bones and attach to the skin, in the same plane as the platysma muscle. They are all innervated by cranial nerve VII (the facial nerve). The occipitofrontalis muscle consists of two parts: The occipital belly, near the occipital bone, and the frontal belly, near the frontal bone.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      12.8
      Seconds

  • Question 91 - A 65-year-old female is taking different medications for various medical conditions. Which medication...

    Correct

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

      Your Answer: Spironolactone

      Explanation:

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

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      10.2
      Seconds

  • Question 92 - A 50-year-old man is diagnosed with emphysema and cirrhosis of the liver. Which...

    Correct

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

      Your Answer: Alpha1-antitrypsin deficiency

      Explanation:

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

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      5.3
      Seconds

  • Question 93 - Etoposide is a chemotherapeutic agent used in the treatment of different types of...

    Incorrect

    • Etoposide is a chemotherapeutic agent used in the treatment of different types of cancer. Which of the following is the correct indication for this drug?

      Your Answer: Colon cancer

      Correct Answer: Lung cancer

      Explanation:

      Etoposide phosphate is an inhibitor of the enzyme topoisomerase II. It is used as a form of chemotherapy for malignancies such as lung cancer, testicular cancer, lymphoma, non-lymphocytic leukaemia and glioblastoma multiforme. Side effects are very common and can include low blood cell counts, vomiting, loss of appetite, diarrhoea, hair loss, and fever.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      16.8
      Seconds

  • Question 94 - Which ectopic tissue is usually contained in the Meckel's diverticulum? ...

    Correct

    • Which ectopic tissue is usually contained in the Meckel's diverticulum?

      Your Answer: Gastric

      Explanation:

      The Meckel’s diverticulum is a vestigial remnant of the omphalomesenteric duct. This structure is also referred to as the vitelline and contains two types of ectopic tissue, namely; gastric and pancreatic.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      3.7
      Seconds

  • Question 95 - A young girl injured her arm following a fall down the steps On...

    Correct

    • A young girl injured her arm following a fall down the steps On examination, it was found that her left proximal radioulnar joint had dislocated and the annular ligament was stretched. This will make which movement extremely painful?

      Your Answer: Supination

      Explanation:

      Supination is the rotation of the forearm so that the palm of the hand faces anteriorly. This is performed by the biceps brachii and supinator of the extensor muscles of the thumb. The opposite action of moving the palm from an anterior-facing position to a posterior-facing position is called pronation. Pronation is performed by the pronator teres and pronator quadratus.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      14.1
      Seconds

  • Question 96 - What is the 5 year survival rate of a patient who is diagnosed...

    Correct

    • What is the 5 year survival rate of a patient who is diagnosed with stage III colon cancer, who underwent successful resection and completed the prescribed session of adjuvant chemotherapy?

      Your Answer: 30%–60%

      Explanation:

      In this patient who has stage III colon cancer, the survival rate is 30-60%. For stage I or Dukes’ stage A disease, the 5-year survival rate after surgical resection exceeds 90%. For stage II or Dukes’ stage B disease, the 5-year survival rate is 70%–85% after resection, with or without adjuvant therapy. For stage III or Dukes’ stage C disease, the 5-year survival rate is 30%– 60% after resection and adjuvant chemotherapy and for stage IV or Dukes’ stage D disease, the 5-year survival rate is poor (approximately 5%).

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      2.9
      Seconds

  • Question 97 - In the case of an injury to the sub sartorial canal, which of...

    Incorrect

    • In the case of an injury to the sub sartorial canal, which of the following structures is most likely to be injured?

      Your Answer: Obturator nerve

      Correct Answer: Nerve to vastus medialis

      Explanation:

      The adductor canal (sub sartorial canal) is situated in the middle third of the thigh.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      8.7
      Seconds

  • Question 98 - In the emergency room, a nurse was introducing a catheter into the patients...

    Correct

    • In the emergency room, a nurse was introducing a catheter into the patients femoral vein for rapid fluid therapy. The femoral vein is situated inside the femoral sheath. Which of the following is true about that sheath?

      Your Answer: The medial compartment is called the femoral canal

      Explanation:

      The femoral sheath is situated ,4cm below the inguinal ligament. It is a prolongation of the abdominal fascia. The anterior wall is a prolongation of the transversalis fascia and the posterior wall, the iliac fascia. It is divided by two vertical septa into 3 compartments, lateral, intermediate, and medial. The medial compartment is known as the femoral canal and contains some lymphatic vessels. The lateral one contains the femoral artery and the intermediate one contains the femoral vein.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      23.6
      Seconds

  • Question 99 - A construction worker is brought to the A&E after a fall on site....

    Correct

    • A construction worker is brought to the A&E after a fall on site. The patient is conscious but complains of inability to feel his legs. A neurological examination reveals that he has no cutaneous sensation from his umbilicus to his toes. What is the likely level of the spinal cord that is injured?

      Your Answer: T10

      Explanation:

      The umbilicus has a relatively consistent position in humans and thus serves as an important land mark. The skin around the waist at the level of the umbilicus is supplied by the tenth thoracic spinal nerve (T10 dermatome).

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      10.8
      Seconds

  • Question 100 - Which of the following is likely to induce secretion of glucagon? ...

    Correct

    • Which of the following is likely to induce secretion of glucagon?

      Your Answer: Low serum concentration of glucose

      Explanation:

      The most potent stimulus for secretion of glucagon is hypoglycaemia whereas hyperglycaemia is a stimulus for insulin release. Glucagon secretion also occurs in response to high levels of amino acids. Somatostatin inhibits glucagon secretion. Parasympathetic stimulation increases pancreatic acinar secretion, but not of α-cells.

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      21.4
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Neurology (7/14) 50%
Pathology (51/94) 54%
Anatomy (35/68) 51%
Lower Limb (4/10) 40%
Microbiology (6/10) 60%
Neoplasia (9/14) 64%
Pharmacology (4/8) 50%
Thorax (0/2) 0%
Physiology (23/38) 61%
Renal (2/4) 50%
General (6/10) 60%
Cardiovascular (5/8) 63%
Head & Neck (9/18) 50%
Haematology (2/6) 33%
Gastrointestinal; Hepatobiliary (5/10) 50%
Gastroenterology (6/10) 60%
Upper Limb (5/12) 42%
Pelvis (3/6) 50%
Respiratory (6/10) 60%
Abdomen (13/18) 72%
Fluids & Electrolytes (2/4) 50%
Inflammation & Immunology (1/2) 50%
Inflammation & Immunology; Haematology (2/2) 100%
Orthopaedics (3/4) 75%
Urology (2/4) 50%
Cell Injury & Wound Healing; Neurology (1/2) 50%
Women's Health (1/2) 50%
Inflammation & Immunology; Respiratory (2/4) 50%
Neoplasia; Urology (1/2) 50%
Embryology (1/2) 50%
Endocrinology (1/2) 50%
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