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  • Question 1 - A histopathological analysis of a specimen showed loss of individual cell structure with...

    Incorrect

    • A histopathological analysis of a specimen showed loss of individual cell structure with karyorrhexis and fragmentation. The overall integrity of the tissue structure is preserved. This is typical of which of the following pathologies?

      Your Answer: Renal transplant rejection

      Correct Answer: Viral hepatitis

      Explanation:

      Viral infections will cause necrosis of the hepatocytes with characteristic changes of karyorrhexis and cell fragmentation.

      Brown atrophy of the heart is due to accumulation of lipofuscin in the myocardium.

      Tissue destruction associated with transplant rejection leads to widespread loss of structural integrity.

      Single cell necrosis is not characteristically seen in chronic alcoholic liver.

      Barbiturate overdose will result in hypertrophy of the smooth endoplasmic reticulum.

      Carcinoma insitu will cause dysplastic cells without the overall structural integrity being disrupted.

      Atrophy is due to apoptosis with ordered cellular fragmentation and phagocytosis and will not induce an inflammatory process unlike necrosis.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      21.2
      Seconds
  • Question 2 - Injury to which of the following arteries is likely to affect the blood...

    Correct

    • Injury to which of the following arteries is likely to affect the blood supply to the seminal vesicles?

      Your Answer: Middle rectal

      Explanation:

      Ligation of middle rectal artery is most likely to affect the blood supply of seminal vesicles since arteries supplying the seminal vesicles are derived from the middle and inferior vesical and middle rectal arteries.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      12.8
      Seconds
  • Question 3 - Which organs would cause pain in a patient who complains of dull pain...

    Correct

    • Which organs would cause pain in a patient who complains of dull pain in her pelvis, along the midline starting from the pubic bone in the front to the sacrum at the back?

      Your Answer: Urinary bladder, uterus/cervix/vagina, rectum

      Explanation:

      The pain could have been caused by the urinary bladder, uterus/cervix/vagina or rectum as it involves the pelvic viscera.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      11.6
      Seconds
  • Question 4 - A 34-year-old Asian male presents with cervical lymphadenopathy. The patient is suspected to...

    Correct

    • A 34-year-old Asian male presents with cervical lymphadenopathy. The patient is suspected to have tuberculous lymphadenopathy. Excision biopsy of one of the nodes showed granulomatous inflammation. Which histopathologic feature is most likely consistent with the diagnosis of tuberculosis?

      Your Answer: Caseation necrosis

      Explanation:

      The granulomas of tuberculosis tend to contain necrosis (caseating tubercles), but non-necrotizing granulomas may also be present. Multinucleated giant cells with nuclei arranged like a horseshoe (Langhans giant cells) and foreign body giant cells are often present, but are not specific for tuberculosis. A definitive diagnosis of tuberculosis requires identification of the causative organism by microbiological cultures.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      14.6
      Seconds
  • Question 5 - What is a major source of fuel being oxidised by the skeletal muscles...

    Correct

    • What is a major source of fuel being oxidised by the skeletal muscles of a man who has undergone starvation for 7 days?

      Your Answer: Serum fatty acids

      Explanation:

      Starvation is the most extreme form of malnutrition. Prolonged starvation can lead to permanent organ damage and can be fatal. Starved individuals eventually lose significant fat and muscle mass as the body uses these for energy.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      10.9
      Seconds
  • Question 6 - A cell is classified on the basis of its regenerative ability. Which of...

    Incorrect

    • A cell is classified on the basis of its regenerative ability. Which of the following cells represent a permanent cell?

      Your Answer: Osteocyte

      Correct Answer: Erythrocyte

      Explanation:

      An erythrocyte is the last cell in the progeny of RBC cell division and is not capable of further division and regeneration. Hepatocytes, osteocytes and epithelium of kidney tubules are all stable cells. Colonic mucosa and pluripotent hematopoietic stem cells are all labile cells.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      11.6
      Seconds
  • Question 7 - The passage of leukocytes through the wall of the blood vessels is best...

    Correct

    • The passage of leukocytes through the wall of the blood vessels is best described by which of the following terms?

      Your Answer: Diapedesis

      Explanation:

      The steps involved in leukocyte arrival and function are:

      1. margination: cells migrate 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, interaction of these results in adhesion

      4. diapedesis and chemotaxis: diapedesis is the transmigration of the leukocyte across the endothelium of the capillary and towards a chemotactic product

      5. phagocytosis: engulfing the offending substance/cell.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      9.2
      Seconds
  • Question 8 - A ‘claw hand’ is usually associated with injury to which of the following...

    Correct

    • A ‘claw hand’ is usually associated with injury to which of the following nerves?

      Your Answer: Ulnar nerve

      Explanation:

      A ‘claw hand’ is associated with injury to the ulnar nerve at the wrist affecting the interossei, lumbricals and hypothenar muscles of the hand. It is characterized by hypothenar eminence wasting, hyperextended metacarpophalangeal joints and flexed interphalangeal joints.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      3.6
      Seconds
  • Question 9 - Which of these conditions causes haematuria, hypertension and proteinuria in children, usually after...

    Incorrect

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

      Your Answer: Nephrotic syndrome

      Correct Answer: Acute nephritic syndrome

      Explanation:

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

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

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

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

      Multisystem diseases.

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

    • This question is part of the following fields:

      • Physiology
      • Renal
      13.2
      Seconds
  • Question 10 - The circle of Willis is one of the cerebrovascular safeguards comprised of the...

    Correct

    • The circle of Willis is one of the cerebrovascular safeguards comprised of the left and the right posterior communicating artery. Which of the following arteries in the brain is connected to the posterior cerebral artery by these posterior communicating arteries?

      Your Answer: Internal carotid artery

      Explanation:

      The Circle of Willis is an anastomosis of cerebral arteries that are located at the base of the brain. The Circle of Willis is one of the important safeguards that ensure back up of blood supply to parts of the brain in case of any cerebrovascular accident. The Circle of Willis is made up of an anterior portion of arteries including; the anterior cerebral arteries. The anterior cerebral arteries are connected to the posterior portion of the circle of Willis by the anterior communicating artery. The posterior portion is made up of the posterior cerebral artery which branch off from the basilar artery. The posterior cerebral artery are connected to the anterior portion of the circle of Willis by the posterior communicating artery. The posterior communicating artery connects the posterior cerebral artery to the internal carotid artery. The circle of Willis receives blood supply from the left and right internal carotid arteries that continues as the middle cerebral artery and posteriorly from the two vertebral arteries that join to form the basilar artery.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      16.6
      Seconds
  • Question 11 - Intravenous diazepam was administered to a man who was brought to the emergency...

    Incorrect

    • Intravenous diazepam was administered to a man who was brought to the emergency department with status epilepticus. He was administered 15 l/min oxygen via a reservoir bag mask. Blood investigations showed sodium = 140 mmol/l, potassium = 4 mmol/l and chloride = 98 mmol/l. His arterial blood gas analysis revealed pH 7.08, p(CO2)= 61.5 mmHg, p(O2) = 111 mmHg and standard bicarbonate = 17 mmol/l. This patient had:

      Your Answer: Metabolic acidosis

      Correct Answer: Mixed acidosis

      Explanation:

      Acidosis with high p(CO2) and low standard bicarbonate indicates mixed acidosis. Lower p(O2) is due to breathing of 70% oxygen. The prolonged seizures lead to lactic acidosis and the intravenous diazepam is responsible for the respiratory acidosis. Treatment includes airway manoeuvres and oxygen, assisted ventilation if needed, and treatment with fluids.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      89.4
      Seconds
  • Question 12 - The superior ulnar collateral artery is a direct branch of this artery: ...

    Correct

    • The superior ulnar collateral artery is a direct branch of this artery:

      Your Answer: Brachial

      Explanation:

      The brachial artery gives rise to a small branch at the middle of the arm, which is the superior collateral artery. It descends accompanied by the ulnar nerve and anastomoses with the posterior ulnar recurrent and inferior ulnar collateral.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      13.2
      Seconds
  • Question 13 - A 38-year old woman presents to the clinic with a 2 cm eczema-like...

    Incorrect

    • A 38-year old woman presents to the clinic with a 2 cm eczema-like lesion on the areolar region of her left breast, for 5 months. Biopsy of the lesion showed large cells at the dermal-epidermal junction with positive staining for mucin. What is the likely diagnosis?

      Your Answer: Acute mastitis

      Correct Answer: Paget’s disease of the breast

      Explanation:

      Paget’s disease of the breast or nipple resembles eczema in appearance with an underlying carcinoma typically. The disease is usually unilateral and presents with inflammation, oozing and crusting along with a non-healing ulcer. Treatment is often delayed due to the innocuous appearance but can be fatal. It results due to spread of neoplastic cells from the ducts of the mammary gland to the epithelium.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      15.3
      Seconds
  • Question 14 - The oesophagus is an important part of the alimentary canal. It receives blood...

    Incorrect

    • The oesophagus is an important part of the alimentary canal. It receives blood from various arteries in the body. Which one of the following is an artery that will lead to some level of ischaemia to the oesophagus when ligated?

      Your Answer: Right gastric

      Correct Answer: Left inferior phrenic

      Explanation:

      The oesophagus receives its blood supply from the following arteries: the inferior thyroid branch of the thyrocervical trunk, the descending thoracic aorta, the left gastric branch of the coeliac artery and the from the left inferior phrenic artery of the abdominal aorta. Hence ligation of the left inferior phrenic will lead to ischemia to some portions of the oesophagus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      25.4
      Seconds
  • Question 15 - Which of the following is most likely to cause hypovolaemic hypernatremia: ...

    Incorrect

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

      Your Answer: Nephrogenic diabetes insipidus

      Correct Answer: Hyperalimentation

      Explanation:

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

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      23.9
      Seconds
  • Question 16 - During an inguinal hernia repair, an incision is made parallel to and 5cm...

    Incorrect

    • 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: Internal abdominal oblique and transversus abdominis muscles

      Correct 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
      25.9
      Seconds
  • Question 17 - A patient is diagnosed with lung cancer. His physician told him that his...

    Incorrect

    • A patient is diagnosed with lung cancer. His physician told him that his lung cancer type is aggressive. It can grow rapidly and may undergo early metastasis, however it is very sensitive to chemotherapy and radiotherapy. Which lung cancer type is most likely present

      Your Answer: Squamous cell carcinoma

      Correct Answer: Small-cell carcinoma

      Explanation:

      Small-cell lung carcinoma (SCLC) is a type of highly malignant cancer that most commonly arises within the lung. SCLC usually metastasizes widely very early on in the natural history of the tumour, and in nearly all cases responds dramatically to chemotherapy and/or radiotherapy. Surgery has no role in the treatment of this disease.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      23.9
      Seconds
  • Question 18 - Which of the following variables are needed to calculate inspiratory reserve volume of...

    Incorrect

    • Which of the following variables are needed to calculate inspiratory reserve volume of a patient?

      Your Answer: Vital capacity and expiratory reserve volume

      Correct Answer: Tidal volume, vital capacity and expiratory reserve volume

      Explanation:

      Vital capacity = inspiratory reserve volume + tidal volume + expiratory reserve volume. Thus, inspiratory reserve volume can be calculated if tidal volume, vital capacity and expiratory reserve volume are known.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      12.7
      Seconds
  • Question 19 - The periphery of a haematoma is infiltrated by fibroblasts, collagen and new vasculature....

    Incorrect

    • The periphery of a haematoma is infiltrated by fibroblasts, collagen and new vasculature. This process is best described as?

      Your Answer: Recanalization

      Correct Answer: Organisation of the haematoma

      Explanation:

      Formation of granulation tissue at the periphery of the hematoma is a normal process leading to resolution. This granulation tissue is composed of new capillaries, fibroblasts and collagen. Lysis of a blood clot can occur, but the actual process of this response is known as organization, wherein the scar tissue will become part of the vessels. This is followed by recanalization and embolization which can lead to eventual complications. Proliferation of a clot will occur due to an imbalance in the clotting and lysing systems. Thrombosis has nothing to do with the process described above.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      9
      Seconds
  • Question 20 - What is the pH of freshly formed saliva at ultimate stimulation? ...

    Correct

    • What is the pH of freshly formed saliva at ultimate stimulation?

      Your Answer: 8

      Explanation:

      Saliva has four major components: mucus (lubricant), α-amylase (enzyme that initiates digestion of starch), lingual lipase (enzyme that begins fat digestion), and a slightly alkaline electrolyte solution for moistening food. As the secretion rate of saliva increases, its osmolality increases. Moreover, the pH changes from slightly acidic (at rest) to basic (pH 8) at ultimate stimulation. This occurs due to increase of HCO3-. Amylase and mucus also increase in concentration after stimulation.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      5.7
      Seconds
  • Question 21 - The following structures DO NOT lie between the layers of the mesosalpinx except...

    Incorrect

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

      Your Answer: Vaginal artery

      Correct Answer: Fallopian tube

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      13.1
      Seconds
  • Question 22 - Inside the palatoglossal arch is a muscle. Which nerve innervates this muscle? ...

    Incorrect

    • Inside the palatoglossal arch is a muscle. Which nerve innervates this muscle?

      Your Answer: XII

      Correct Answer: X

      Explanation:

      The palatoglossal arch contains the palatoglossal muscle which is innervated by the vagus nerve which is the tenth cranial nerve. So the correct answer is X

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      11.4
      Seconds
  • Question 23 - A 73-year-old woman goes to the doctor complaining of pain and stiffness in...

    Incorrect

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

      Your Answer: Fibromyositis

      Correct Answer: Polymyalgia rheumatica

      Explanation:

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

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      2.9
      Seconds
  • Question 24 - A 60 year old patient with a history of carcinoma of the head...

    Incorrect

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

      Your Answer: Vitamin B12 deficiency

      Correct Answer: Vitamin-K-dependent clotting factors deficiency

      Explanation:

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

    • This question is part of the following fields:

      • General
      • Physiology
      9.7
      Seconds
  • Question 25 - Following nerve injury, paralysis of the quadriceps femoris muscle occurs. Which of the...

    Correct

    • Following nerve injury, paralysis of the quadriceps femoris muscle occurs. Which of the following movements will be affected?

      Your Answer: Extension of the leg

      Explanation:

      The quadriceps muscle is a great extensor of the thigh. Therefore, following nerve injury or cutting nerve supply to the quadriceps will affect extension of the thigh

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      13.5
      Seconds
  • Question 26 - Which of the following has the highest content of triglycerides? ...

    Incorrect

    • Which of the following has the highest content of triglycerides?

      Your Answer: LDL

      Correct Answer: Chylomicron

      Explanation:

      Created by the small intestinal cells, chylomicrons are large lipoprotein molecules which transport lipids to the liver, adipose, cardiac and skeletal tissue. Chylomicrons are mainly composed of triglycerides (,85%) along with some cholesterol and cholesteryl esters. Apo B-48 is the main apolipoprotein content.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      9.6
      Seconds
  • Question 27 - Which nerve lies immediately medial to the psoas major muscle? ...

    Correct

    • Which nerve lies immediately medial to the psoas major muscle?

      Your Answer: Obturator

      Explanation:

      The obturator nerve is formed from the ventral divisions of the 2nd, 3rd and 4th lumbar nerves. It courses through the fibres of the psoas major and emerges from the medial border near the pelvic brim.

      The iliohypogastric nerve comes from the first lumbar nerve and emerges from the upper part of the lateral border of psoas major.

      The ilioinguinal nerve arises with the iliohypogastric nerve from the first lumbar nerve and also emerges from the lateral border of the psoas major muscle.

      The lateral femoral cutaneous nerve comes from the posterior division of the 2nd and 3rd lumbar nerves to emerge from the lateral border of the psoas major muscle near its middle.

      The femoral nerve also arises from the dorsal divisions, but of the 2nd, 3rd and 4th lumbar nerves and courses through the muscle fibres to emerge at the lower part of the lateral border.

      The coccygeal nerve doesn’t arise from the lumbar plexus but from the sacral plexus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      9.7
      Seconds
  • Question 28 - What is the role of ICAM-1 and VCAM-1 in the inflammatory process? ...

    Incorrect

    • What is the role of ICAM-1 and VCAM-1 in the inflammatory process?

      Your Answer: Leukocyte transmigration

      Correct Answer: Leukocyte adhesion

      Explanation:

      Steps involved in leukocyte arrival and function include:

      1. margination: cells migrate 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. Interaction of these results in adhesion.

      4. diapedesis and chemotaxis: diapedesis is the transmigration of the leukocyte across the endothelium of the capillary and towards a chemotactic product.

      5. phagocytosis: engulfing the offending substance/cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      3.1
      Seconds
  • Question 29 - Bile salt reuptake principally occurs where? ...

    Correct

    • Bile salt reuptake principally occurs where?

      Your Answer: In the ileum

      Explanation:

      90 – 95% of the bile salts are absorbed from the small intestine (mostly terminal ileum and then excreted again from the liver. This is known as the enterohepatic circulation. The entire pool recycles twice per meal and approximately 6 to 8 times per day.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      9.3
      Seconds
  • Question 30 - A 50 year old female patient with an history of chronic headache was...

    Incorrect

    • A 50 year old female patient with an history of chronic headache was scheduled for CT scan. If the CT scan revealed a tumour at the horn of the lateral ventricle, which of the following structures is most likely to be compressed by this tumour?

      Your Answer: Frontal lobe

      Correct Answer: Fibres of the corpus callosum

      Explanation:

      The ventricular system of the brain is made up of four ventricles namely; two lateral and a third and forth ventricle. The ventricles are the site of the development of the cerebrospinal fluid. The left and right lateral ventricles are located in each of the brain’s hemispheres. The roof of the lateral ventricles are made up of the fibres of the corpus callosum. This is the structure that would be compressed by the a tumour on the roof of the lateral ventricles.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      17.3
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cell Injury & Wound Healing (1/4) 25%
Pathology (2/10) 20%
Anatomy (7/12) 58%
Pelvis (2/3) 67%
Microbiology (1/1) 100%
Gastroenterology (3/4) 75%
Physiology (3/8) 38%
Upper Limb (2/2) 100%
Renal (0/1) 0%
Head & Neck (1/3) 33%
Respiratory (0/2) 0%
Women's Health (0/1) 0%
Abdomen (1/3) 33%
Fluids & Electrolytes (0/1) 0%
Neoplasia (0/1) 0%
Orthopaedics (0/1) 0%
General (0/1) 0%
Lower Limb (1/1) 100%
Inflammation & Immunology (0/1) 0%
Passmed