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  • Question 1 - Lateral medullary syndrome, also known as Wallenberg's syndrome is a neurological condition caused...

    Incorrect

    • 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: Superior cerebellar

      Correct 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
      17.5
      Seconds
  • Question 2 - Carbachol is a cholinergic agonist. In which of these cases should carbachol be...

    Incorrect

    • Carbachol is a cholinergic agonist. In which of these cases should carbachol be administered?

      Your Answer: Paroxysmal atrial tachycardia provoked by emotion or exercise

      Correct Answer: Cataract surgery

      Explanation:

      Carbachol (carbamylcholine) is a cholinergic agent, a choline ester and a positively charged quaternary ammonium compound. It is primarily used for various ophthalmic purposes, such as for treating glaucoma, or for use during ophthalmic surgery. It is usually administered topically to the eye or through intraocular injection. It is not well absorbed in the gastro-intestinal tract and does not cross the blood–brain barrier.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      11.3
      Seconds
  • Question 3 - An experiment is carried out to observe engulfment and phagocytosis of microbes. Strep...

    Incorrect

    • An experiment is carried out to observe engulfment and phagocytosis of microbes. Strep pneumoniae are added to a solution of leukocytes with a substance added to enhance the process of phagocytosis. What is this substance?

      Your Answer: NADPH oxidase

      Correct Answer: Complement C3b

      Explanation:

      C3b is cleaved from C3 complement with the help of the enzyme C3- convertase. It binds to the cell surface of the offending substance and opsonizes it. This makes it easy for the phagocytes to detect and eliminate them.

      IgM does not act as an opsonin but igG does.

      Selectins aid leukocytes to bind to the endothelial surfaces.

      C5a is a chemo-attractant and histamine a vasodilator.

      NADPH oxidises offending substance after phagocytosis within the macrophage.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      17.2
      Seconds
  • Question 4 - Calculate the total peripheral resistance for a patient with a blood pressure of...

    Incorrect

    • Calculate the total peripheral resistance for a patient with a blood pressure of 130/70 mm HG and cardiac output of 5 litres / min?

      Your Answer: 20 mmHg × min/l

      Correct Answer: 18 mmHg × min/l

      Explanation:

      Total peripheral resistance = Mean arterial pressure/Cardiac output. And the mean arterial pressure = Diastolic pressure + 1/3 (Systolic pressure – Diastolic pressure), i.e., 70 + 1/3 (130-70) = 90 mmHg. Therefore, total peripheral resistance = 90 mmHg/5 l per min = 18 mmHg × min/l.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      9.7
      Seconds
  • Question 5 - Which condition presents with a positive urine dipstick test for blood, but no...

    Incorrect

    • Which condition presents with a positive urine dipstick test for blood, but no blood cells on urine microscopy?

      Your Answer: Renal papillary necrosis

      Correct Answer: Myoglobinuria

      Explanation:

      Myoglobinuria, or presence of myoglobulin in the urine is seen due to rhabdomyolysis (muscle destruction). Common causes of rhabdomyolysis include trauma, electrical injuries, burns, venom and drugs. Damaged muscle leads to release of myoglobin in the blood. Ideally, the released myoglobin gets filtered and excreted by the kidneys. However, excess myoglobin can occlude the renal filtration system leading to acute tubular necrosis and acute renal dysfunction.

    • This question is part of the following fields:

      • Pathology
      • Renal
      8.3
      Seconds
  • Question 6 - A young female in the 15th week of pregnancy presented to the emergency...

    Incorrect

    • A young female in the 15th week of pregnancy presented to the emergency department with the passage of grape-like masses per vagina. Dilatation and curettage was done and microscopy revealed large avascular villi with trophoblastic proliferation. Which one of the following investigations is best recommended for her follow-up?

      Your Answer: Serum oestrogen level

      Correct Answer: Serum β-hCG

      Explanation:

      Trophoblast is the layer of cells surrounding the blastocyst and that later develops into the chorion and amnion. Gestational trophoblastic disease is a tumour arising from this trophoblast. It can occur during or after either an intrauterine or ectopic pregnancy. If it occurs in a pregnant woman, it usually leads to spontaneous abortion, eclampsia or fetal death. It can be either malignant or benign.

      In suspected cases, investigations include measurement of serum beta subunit of human chorionic gonadotrophin (β-hCG) and pelvic ultrasound. Confirmatory test is a biopsy. Post-removal, the disease is classified clinically to assess further treatment. To assess the presence of metastases, further work-up includes computed tomography of the brain, chest, abdomen and pelvis. Chemotherapy is usually needed for persistent disease. If at least three consecutive, weekly serum β-hCG measurements are normal, treatment is considered successful. Follow-up is also done by measuring β-hCG.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      17.3
      Seconds
  • Question 7 - A 25-year-old woman complains of generalised swelling and particularly puffiness around the eyes...

    Incorrect

    • A 25-year-old woman complains of generalised swelling and particularly puffiness around the eyes which is worst in the morning. Laboratory studies showed:

      Blood urea nitrogen (BUN) = 30 mg/dl

      Creatinine = 2. 8 mg/dl

      Albumin = 2. 0 mg/dl

      Alanine transaminase (ALT) = 25 U/l

      Bilirubin = 1 mg/dl

      Urine analysis shows 3+ albumin and no cells.

      Which of the following is the most likely diagnosis?

      Your Answer: Acute tubular necrosis

      Correct Answer: Nephrotic syndrome

      Explanation:

      Nephrotic syndrome is a disorder in which the glomeruli have been damaged, characterized by:

      – Proteinuria (>3.5 g per 1.73 m2 body surface area per day, or > 40 mg per square meter body surface area per hour in children)

      – Hypoalbuminemia (< 2,5 g/dl) – Hyperlipidaemia, and oedema (generalized anasarca).

    • This question is part of the following fields:

      • Physiology
      • Renal
      11.8
      Seconds
  • Question 8 - 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: Inferior mesenteric 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
      19.5
      Seconds
  • Question 9 - Which of the following structure contains the parasympathetic pre-ganglionic nucleus that innervates the...

    Correct

    • Which of the following structure contains the parasympathetic pre-ganglionic nucleus that innervates the iris sphincter muscle and the ciliary muscle?

      Your Answer: Edinger–Westphal nucleus

      Explanation:

      The Edinger–Westphal nucleus (accessory oculomotor nucleus) is the parasympathetic pre-ganglionic nucleus that innervates the iris sphincter muscle and the ciliary muscle.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      7.6
      Seconds
  • Question 10 - A 13 year old girl presented with signs of shortness of breath, chest...

    Incorrect

    • A 13 year old girl presented with signs of shortness of breath, chest pain, non-productive cough, oedema of the lower extremities and cyanosis of the fingertips. She has a history of a ventricular septal defect not surgically corrected. The most probable cause of these symptoms is:

      Your Answer: Left atrial thrombosis

      Correct Answer: Shunt reversal

      Explanation:

      A ventricular septal defect (VSD) is a common form of congenital heart defects and is characterised by the presence of a hole in the wall that separates the right from the left ventricle. Medium or large defects can cause many complications. One of these complication is Eisenmenger syndrome, characterised by reversal of the shunt (from left-to-right shunt into a right-to-left) ,cyanosis and pulmonary hypertension.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      16
      Seconds
  • Question 11 - A 70-year-old male who has smoked since his teens complains of progressive shortness...

    Incorrect

    • A 70-year-old male who has smoked since his teens complains of progressive shortness of breath and a persistent cough. Which of the following abnormalities is most likely to be present in his pulmonary function tests?

      Your Answer: Increased forced vital capacity (FVC)

      Correct Answer: Increased residual volume

      Explanation:

      Chronic obstructive pulmonary disease (COPD) is a type of obstructive lung disease characterized by long-term poor airflow. The main symptoms include shortness of breath and cough with sputum production. The best diagnostic test for evaluating patients with suspected chronic obstructive pulmonary disease (COPD) is lung function measured with spirometry. Key spirometrical measures may be obtained with a portable office spirometer and should include forced vital capacity (FVC) and the normal forced expiratory volume in the first second of expiration (FEV1). The ratio of FEV1 to forced vital capacity (FEV1/FVC) normally exceeds 0.75. Patients with COPD typically present with obstructive airflow. Complete pulmonary function testing may show increased total lung capacity, functional residual capacity and residual volume. A substantial loss of lung surface area available for effective oxygen exchange causes diminished carbon monoxide diffusion in the lung (DLco) in patients with emphysema. Tobacco smoking is the most common cause of COPD, with factors such as air pollution and genetics playing a smaller role.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      9.1
      Seconds
  • Question 12 - Which of the deep fasciae located in the anterolateral abdominal wall form the...

    Incorrect

    • Which of the deep fasciae located in the anterolateral abdominal wall form the inguinal ligament?

      Your Answer: Transverse abdominal aponeurosis

      Correct Answer: External abdominal oblique aponeurosis

      Explanation:

      The inguinal ligament is the inferior border of the aponeurosis of the external oblique abdominis and extends from the anterior superior iliac spine to the pubic tubercle from whence it is reflected backward and laterally to attach to the pectineal line and form the lacunar ligament.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      9.4
      Seconds
  • Question 13 - In a cardiac cycle, what event does the closing of atrioventricular (AV) valves...

    Incorrect

    • In a cardiac cycle, what event does the closing of atrioventricular (AV) valves coincide with?

      Your Answer: End of isovolumic relaxation

      Correct Answer: Second heart sound

      Explanation:

      The beginning of ventricular systole corresponds to the beginning of the QRS complex in the ECG. The beginning of the ventricular systole also corresponds to the closure of the atrioventricular valves, causing the first heart sound (S1). S2, the second heart sound is due to closure of the aortic and pulmonary valves at the end of ventricular systole.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      8.1
      Seconds
  • Question 14 - A 10-year-old boy was sent for an x-ray of the leg because he...

    Correct

    • A 10-year-old boy was sent for an x-ray of the leg because he was complaining of pain and swelling. The x-ray showed the classic sign of Codman's triangle. What is the most likely diagnosis of this patient?

      Your Answer: Osteosarcoma

      Explanation:

      Codman’s triangle is the triangular area of new subperiosteal bone that is created when a lesion, often a tumour, raises the periosteum away from the bone. The main causes for this sign are osteosarcoma, Ewing’s sarcoma, eumycetoma, and a subperiosteal abscess.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      12.3
      Seconds
  • Question 15 - A 56 year old gentleman, who is a chronic smoker presents to the...

    Incorrect

    • A 56 year old gentleman, who is a chronic smoker presents to the clinic with dyspnoea. His Chest X-ray shows intercostal space widening with increased blackening bilaterally. What is the most likely finding on his pulmonary function test?

      Your Answer: Increased FEV1/FVC

      Correct Answer: Increased total lung capacity

      Explanation:

      In patients suspected of having chronic obstructive pulmonary disease, pulmonary function testing (PFT) is useful to confirm airway obstruction, to quantify its severity and reversibility, for following disease progression and monitoring response to treatment. These tests include:

      FEV1 – volume of air forcefully expired during the first second after a full breath

      Forced vital capacity (FVC) – total volume of air expired with maximal force and flow-volume loops. The hallmark of airway obstruction is reduction of FEV1, FVC and the ratio of FEV1/FVC, with a concave pattern in expiratory tracing on the flow-volume loop. FEV1 and forced vital capacity (FVC) are easily measured with office spirometry and are useful to assess the severity of disease. Other parameters include increased total lung capacity, functional residual capacity and residual volume, which can help distinguish chronic obstructive pulmonary disease (COPD) from restrictive pulmonary disease where these values are lower than normal. Along with these, other tests are decreased vital capacity; and decreased diffusing capacity for carbon monoxide (DLCO). DLCO is non-specific and can be low in other disorders that affect the pulmonary vascular bed, such as interstitial lung disease. DLCO is however useful to distinguish COPD from asthma, in which DLCO is normal or elevated.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      13.7
      Seconds
  • Question 16 - Lung compliance is increased by: ...

    Correct

    • Lung compliance is increased by:

      Your Answer: Emphysema

      Explanation:

      Lung compliance is increased by emphysema, acute asthma and increasing age and decreased by alveolar oedema, pulmonary hypertension, atelectasis and pulmonary fibrosis.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      9.3
      Seconds
  • Question 17 - Post-total gastrectomy, there will be a decreased production of which of the following...

    Incorrect

    • Post-total gastrectomy, there will be a decreased production of which of the following enzymes?

      Your Answer: Cholecystokinin

      Correct Answer: Pepsin

      Explanation:

      Pepsin is a protease that is released from the gastric chief cells and acts to degrade proteins into peptides. Released as pepsinogen, it is activated by hydrochloric acid and into pepsin itself. Gastrin and the vagus nerve trigger the release of pepsinogen and HCl when a meal is ingested. Pepsin functions optimally in an acidic environment, especially at a pH of 2.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      10.4
      Seconds
  • Question 18 - A 4-year-old child was brought to a paediatrician for consult due to a...

    Correct

    • A 4-year-old child was brought to a paediatrician for consult due to a palpable mass in his abdomen. The child has poor appetite and regularly complains of abdominal pain. The child was worked up and diagnosed with a tumour. What is the most likely diagnosis ?

      Your Answer: Nephroblastoma

      Explanation:

      Nephroblastoma is also known as Wilms’ tumour. It is a cancer of the kidneys that typically occurs in children. The median age of diagnose is approximately 3.5 years. With the current treatment, approximately 80-90% of children with Wilms’ tumour survive.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      8
      Seconds
  • Question 19 - A 66-year-old man complains of constant headaches. On physical examination, the only relevant...

    Incorrect

    • 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: Cerebral abscess

      Correct 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
      8.3
      Seconds
  • Question 20 - Calculate the cardiac stroke volume of a patient whose oxygen consumption (measured by...

    Incorrect

    • Calculate the cardiac stroke volume of a patient whose oxygen consumption (measured by analysis of mixed expired gas) is 300 ml/min, arterial O2 content is 20 ml/100 ml blood, pulmonary arterial O2 content is 15 ml/100 ml blood and heart rate is 60/min.

      Your Answer: 1 ml

      Correct Answer: 100 ml

      Explanation:

      By Fick’s principle, VO2 = Q × (CA (O2) − CV (O2)) where VO2 = O2 consumption, Q = cardiac output and CA(O2) and CV(O2) are arterial and mixed venous O2 content respectively. Thus, in the given problem, 300 ml O2/min = Q × (20−15) ml O2/100 ml. Thus, Q = 6000 ml blood/min. Then, we can calculate stroke volume by dividing the cardiac output with heart rate. Thus, stroke volume = 6000 ml/min divided by 60/min stroke volume = 100 ml.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      3.5
      Seconds
  • Question 21 - An X ray of a 60 year old male brought to the accident...

    Correct

    • An X ray of a 60 year old male brought to the accident and emergency following a fall down stairs shows a fractured olecranon process of the right ulna with the line of fracture passing through the superior surface, disrupting a muscle. Which among the following muscles was most likely injured?

      Your Answer: Triceps brachii

      Explanation:

      The superior surface of the olecranon process forms an attachment for the insertion of the triceps brachii on the posterior aspect. It also has a minor transverse groove for the attachment of part of the posterior ligament of the elbow on the anterior aspect.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      1.8
      Seconds
  • Question 22 - Urine specific gravity allows the assessment of which of the following renal functions?...

    Correct

    • Urine specific gravity allows the assessment of which of the following renal functions?

      Your Answer: Concentration

      Explanation:

      Concentrating ability of kidneys is assessed by measuring the urine specific gravity. Normal values of urine specific gravity fall between 1.002 and 1.030 g/ml.

    • This question is part of the following fields:

      • Pathology
      • Renal
      2.6
      Seconds
  • Question 23 - A 38-year-old woman with end-stage renal disease, is undergoing haemodialysis. She has normocytic...

    Incorrect

    • A 38-year-old woman with end-stage renal disease, is undergoing haemodialysis. She has normocytic normochromic anaemia. What is the best treatment for her?

      Your Answer: Vitamin B12

      Correct Answer: Erythropoietin

      Explanation:

      E erythropoietin (EPO) is a hormone that is released by the kidney. It is responsible for the regulation of red blood cell production in the body. It can be made using recombinant technology and is used in the treatment of anaemia of chronic renal failure and in patients under going chemotherapy

    • This question is part of the following fields:

      • General
      • Physiology
      11.5
      Seconds
  • Question 24 - The Henderson–Hasselbalch equation describes the derivation of pH as a measure of acidity. According to this equation,...

    Correct

    • The Henderson–Hasselbalch equation describes the derivation of pH as a measure of acidity. According to this equation, the buffering capacity of the system is at maximum when the number of free anions compared with undissociated acid is:

      Your Answer: Equal

      Explanation:

      In 1908, Lawrence Joseph Henderson wrote an equation describing the use of carbonic acid as a buffer solution. Later, Karl Albert Hasselbalch re-expressed that formula in logarithmic terms, resulting in the Henderson–Hasselbalch equation. The equation is also useful for estimating the pH of a buffer solution and finding the equilibrium pH in acid–base reactions. Two equivalent forms of the equation are: pH = pKa + log10 [A–]/[HA] or pH = pKa + log10 [base]/[acid]. Here, pKa is − log10(Ka) where Ka is the acid dissociation constant, that is: pKa = –log10(Ka) = –log10 ([H3 O+][A–]/[HA]) for the reaction: HA + H2 O ≈ A– + H3 O+ In these equations, A– denotes the ionic form of the relevant acid. Bracketed quantities such as [base] and [acid] denote the molar concentration of the quantity enclosed. Maximum buffering capacity is found when pH = pKa or when the number of free anions to undissociated acid is equal and buffer range is considered to be at a pH = pKa ± 1.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      3.7
      Seconds
  • Question 25 - A 57-year-old male smoker noted a lump on his inner lip. Upon physical...

    Incorrect

    • A 57-year-old male smoker noted a lump on his inner lip. Upon physical examination the lump measured more than 2 cm but less than 4 cm in its greatest dimension. He is diagnosed with squamous cell carcinoma of the lip. What is the stage of the patient's cancer according to the TNM staging for head and neck cancers?

      Your Answer: T1

      Correct Answer: T2

      Explanation:

      Head and neck cancer is a group of cancers that starts within the mouth, nose, throat, larynx, sinuses, or salivary glands. The TNM staging system used for head and neck cancers is a clinical staging system that allows physicians to compare results across patients, assess prognosis, and design appropriate treatment regimens. The staging is as follows; Primary tumour (T): Tis: pre-invasive cancer (carcinoma in situ), T0: no evidence of primary tumour, T1: tumour 2 cm or less in its greatest dimension, T2: tumour more than 2 cm but not more than 4 cm, T3: tumour larger than 4 cm, T4: tumour with extension to bone, muscle, skin, antrum, neck, etc and TX: minimum requirements to assess primary tumour cannot be met. Regional lymph node involvement (N): N0: no evidence of regional lymph node involvement, N1: evidence of involvement of movable homolateral regional lymph nodes, N2: evidence of involvement of movable contralateral or bilateral regional lymph nodes, N3: evidence of involvement of fixed regional lymph nodes and NX: Minimum requirements to assess the regional nodes cannot be met. Distant metastases (M): M0: no evidence of distant metastases, M1: evidence of distant metastases and MX: minimum requirements to assess the presence of distant metastases cannot be met. Staging: Stage I: T1 N0 M0, Stage II: T2 N0 M0, Stage III: T2NOMO and T3N1MO, Stage IV: T4N1M0, any TN2M0, any TN3M0, any T and any NM1. The depth of infiltration is predictive of the prognosis. With increasing depth of invasion of the primary tumour, the risk of nodal metastasis increases and survival decreases. The patient in this scenario therefore has a T2 tumour.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      2.3
      Seconds
  • Question 26 - A 32-year-old man presented with a metabolic acidosis and increased anion gap. What...

    Incorrect

    • A 32-year-old man presented with a metabolic acidosis and increased anion gap. What is the most likely cause of the changes of the anion gap in this patient?

      Your Answer: Hypergammaglobulinemia

      Correct Answer: Lactic acidosis

      Explanation:

      High anion gap in metabolic acidosis is caused generally by the elevation of the levels of acids like ketones, lactate, sulphates in the body, which consume the bicarbonate ions. Other causes of a high anion gap include overdosing on salicylates, uraemia, rhabdomyolysis, hypocalcaemia, hypomagnesaemia, or ingestion of toxins such as ethylene glycol, methanol, propyl alcohol, cyanide and iron.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      3.5
      Seconds
  • Question 27 - A 39-year-old man, after radiological evaluation and thoracentesis, was found to have chylothorax....

    Incorrect

    • A 39-year-old man, after radiological evaluation and thoracentesis, was found to have chylothorax. What is the most probable cause of this diagnose?

      Your Answer: Congestive heart failure

      Correct Answer: Mediastinal malignant lymphoma

      Explanation:

      Chylothorax is a potentially lethal condition characterized by fluid (chyle) accumulation in the pleural cavity, resulting from disruption of lymphatic drainage in the thoracic duct. Chyle is a fluid rich in triglycerides and chylomicrons and can originate from the thorax, the abdomen or both. Malignant tumours, especially lymphoma, are the most common causes of nontraumatic chylothorax. Bronchogenic carcinoma and trauma are the most common causes after lymphomas. Other rare causes of chylothorax are; granulomatous diseases, tuberculosis, congenital malformations, nephrotic syndrome, hypothyroidism, cirrhosis, decompensated heart failure and idiopathic chylothorax.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      2.6
      Seconds
  • Question 28 - A 25-year-old female had a painful abdomen and several episodes of vomiting. She...

    Correct

    • A 25-year-old female had a painful abdomen and several episodes of vomiting. She was severely dehydrated when she was brought to the hospital. Her ABG showed a pH 7.7, p(O2) 75 mmHg, p(CO2) 46 mmHg and bicarbonate 48 mmol/l. The most likely interpretation of this ABG report would be:

      Your Answer: Metabolic alkalosis

      Explanation:

      Metabolic alkalosis is a primary increase in bicarbonate (HCO3−) with or without compensatory increase in carbon dioxide partial pressure (Pco2); pH may be high or nearly normal. Metabolic alkalosis occurs as a consequence of a loss of H+ from the body or a gain in HCO3 -. In its pure form, it manifests as alkalemia (pH >7.40). As a compensatory mechanism, metabolic alkalosis leads to alveolar hypoventilation with a rise in arterial carbon dioxide tension p(CO2), which diminishes the change in pH that would otherwise occur. Normally, arterial p(CO2) increases by 0.5–0.7 mmHg for every 1 mmol/l increase in plasma bicarbonate concentration, a compensatory response that occurs very rapidly. If the change in p(CO2) is not within this range, then a mixed acid–base disturbance occurs. Likewise, if the increase in p(CO2) is less than the expected change, then a primary respiratory alkalosis is also present. However an elevated serum bicarbonate concentration can also occur due to a compensatory response to primary respiratory acidosis. A bicarbonate concentration greater than 35 mmol/l is almost always caused by metabolic alkalosis (as is the case in this clinical scenario). Calculation of the serum anion gap can also help to differentiate between primary metabolic alkalosis and the metabolic compensation for respiratory acidosis. The anion gap is frequently elevated to a modest degree in metabolic alkalosis because of the increase in the negative charge of albumin and the enhanced production of lactate. However, the only definitive way to diagnose metabolic alkalosis is by performing a simultaneous blood gases analysis, which reveals elevation of both pH and arterial p(CO2) and increased calculated bicarbonate.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      23.9
      Seconds
  • Question 29 - What is formed when the ductus deferens unites with the duct of the...

    Incorrect

    • What is formed when the ductus deferens unites with the duct of the seminal vesicle?

      Your Answer: Aberrant ductules

      Correct Answer: Ejaculatory duct

      Explanation:

      The deferens is a cylindrical structure​ with dense walls and an extremely small lumen It is joined at an acute angle by the duct of the seminal vesicles to form the ejaculatory duct, which traverses the prostate behind it’s middle lobe and opens into the prostatic portion of the urethra, close to the orifice of the prostatic utricle.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      10
      Seconds
  • Question 30 - When exposing the right saphenofemoral junction for flush-ligation of the saphenous vein, which...

    Incorrect

    • When exposing the right saphenofemoral junction for flush-ligation of the saphenous vein, which of the following is the most likely to be seen passing through this opening?

      Your Answer: Superficial circumflex iliac artery

      Correct Answer: Superficial external pudendal artery

      Explanation:

      The saphenous opening is an oval opening in the fascia lata. It is covered by the cribriform fascia and It is so called because it is perforated by the great saphenous vein and by numerous blood and lymphatic vessels and the superficial external pudendal artery pierces it.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      8.3
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (2/7) 29%
Head & Neck (1/2) 50%
Pathology (4/13) 31%
Pharmacology (0/1) 0%
Inflammation & Immunology (0/1) 0%
Cardiovascular (0/4) 0%
Physiology (2/10) 20%
Renal (1/3) 33%
Women's Health (0/1) 0%
Pelvis (0/2) 0%
Respiratory (1/4) 25%
Abdomen (0/1) 0%
Neoplasia (2/3) 67%
Gastroenterology (0/1) 0%
Neurology (0/1) 0%
Upper Limb (1/1) 100%
General (0/1) 0%
Fluids & Electrolytes (2/3) 67%
Lower Limb (0/1) 0%
Passmed