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  • Question 1 - A 13-year-old girl has complained of pain in her left arm for 4...

    Incorrect

    • A 13-year-old girl has complained of pain in her left arm for 4 months. An X-ray reveals a mass along with erosion of the affected humerus. Histologically, the tumour is found to be formed by small, round, blue cells. What is the most likely diagnosis?

      Your Answer: Chondroblastoma

      Correct Answer: Ewing’s sarcoma

      Explanation:

      Ewing’s sarcoma is formed by small, round, blue cells, and is common in children. The usually develop in limbs, and clinical findings include pain and inflammation, with lytic destruction showing up on X-rays.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      28.2
      Seconds
  • Question 2 - A 58-year-old woman diagnosed with deep vein thrombosis had been using warfarin for...

    Correct

    • A 58-year-old woman diagnosed with deep vein thrombosis had been using warfarin for 10 days. When she presented to the doctor she had haemorrhagic bullae and necrotic lesions in her lower limbs and buttocks. Deficiency of which of the following proteins may have caused the necrotic skin lesions?

      Your Answer: Protein C

      Explanation:

      Warfarin-induced skin necrosis is a rare complication of anticoagulant therapy that requires immediate drug cessation. The most common cutaneous findings include petechiae that progress to ecchymoses and haemorrhagic bullae. Warfarin inactivates vitamin K-dependent clotting factors II, VII, IX, and X and vitamin K-dependent proteins C and S. The concentration of protein C falls more rapidly than other vitamin K-dependent factors because they have a shorter half-lives. Skin necrosis is seen mainly in patients with prior protein C deficiency.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      18.7
      Seconds
  • Question 3 - The chest X-ray of an 10-year-old boy, that presented with low-grade fever and...

    Incorrect

    • The chest X-ray of an 10-year-old boy, that presented with low-grade fever and cough, revealed hilar enlargement and parenchymal consolidation in the middle lobes. These X-ray findings are more typical for which of the following diagnoses?

      Your Answer: Secondary tuberculosis

      Correct Answer: Pulmonary tuberculosis

      Explanation:

      Primary pulmonary tuberculosis is seen in patients exposed to Mycobacterium tuberculosis for the firs time. The main radiographic findings in primary pulmonary tuberculosis include homogeneous parenchymal consolidation typically in the lower and middle lobes, lymphadenopathy, miliary opacities and pleural effusion.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      31.2
      Seconds
  • Question 4 - The transmembrane proteins responsible for resting membrane potential of vascular smooth muscle cells...

    Correct

    • The transmembrane proteins responsible for resting membrane potential of vascular smooth muscle cells was blocked by a drug. Which of the following transmembrane proteins were blocked by this drug?

      Your Answer: K+ channels

      Explanation:

      The resting membrane potential is due to selective permeability of the membrane to potassium ions. The Na/K pump is responsible for the generation of a gradient across the membrane and it is due to the inherent ability of the K channels to allow diffusion back into the nerve at rest which charges the cells. In reality, the resting membrane potential is more positive because of small contributions by Na+ channels, Cl− channels and non-selective cation channels.

    • This question is part of the following fields:

      • General
      • Physiology
      14.4
      Seconds
  • Question 5 - In a splenectomy procedure, special care is emphasized on the preservation of the...

    Incorrect

    • In a splenectomy procedure, special care is emphasized on the preservation of the tail of the pancreas that is closely associated with the spleen to avoid post operative pancreatic fistula. As a general surgeon conducting a splenectomy where are you most likely to find the tail of the pancreas in the abdominal cavity?

      Your Answer: Gastrocolic ligament

      Correct Answer: Splenorenal ligament

      Explanation:

      The tail of the pancreas is the only intraperitoneal part of the pancreas and is found contained in the splenorenal ligament of the peritoneal cavity. The splenorenal ligament is derived from the peritoneum where the wall of the general peritoneal cavity connects to the omental bursa between the spleen and the left kidney. This ligament contains the splenic vessels and the tail of the pancreas.

      The gastrocolic ligament stretches from the greater curvature of the stomach to the transverse colon, connecting the two.

      The gastrosplenic ligament is derived from the greater omentum and is the structure that connects the stomach to the hilum of the spleen. The gastrosplenic ligament continues from the splenic flexure of the colon to the diaphragm and acts as a support to the spleen.

      The transverse colon is connected to the abdominal wall by the mesocolon ligament.

      The falciform ligament on the other hand, attaches the liver to the ventral wall of the abdomen.

      The hepatoduodenal ligament connects the porta hepatis of the liver to the superior part of the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      52.9
      Seconds
  • Question 6 - While conducting a physical examination of a patient, the GP passed a finger...

    Correct

    • While conducting a physical examination of a patient, the GP passed a finger down the edge of the medial crus of the superficial inguinal ring and felt a bony prominence deep to the lateral edge of the spermatic cord. What was this bony prominence?

      Your Answer: Pubic tubercle

      Explanation:

      At the superficial inguinal ring, the pubic tubercle would be felt as a bony prominence lateral to the edge of the spermatic cord. This tubercle is the point of attachment of the inguinal ligament that makes up the floor of the inguinal canal.

      Pecten pubis is the ridge on the superior surface of the superior pubic ramus and the point of attachment of the pectineal ligament.

      The pubic symphysis is the joint between the two pubic bones and the iliopubic eminence is a bony process on the pubis found near the articulation of the pubis and the ilium.

      The iliopectineal line is formed by the arcuate line of the ilium and the pectineal line of the pubis. It is the line that marks the transition between the abdominal and pelvic cavity.

      The sacral promontory is found on the posterior wall of the pelvis and would not be felt through the inguinal ring.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      12.2
      Seconds
  • Question 7 - Which lymph nodes are likely to be enlarged in a patient who has...

    Correct

    • Which lymph nodes are likely to be enlarged in a patient who has malignant growth involving the anus?

      Your Answer: Superficial inguinal

      Explanation:

      The lymphatics from the anus, skin of the perineum and the scrotum end in the superficial inguinal nodes. In case of a malignant growth of the anus, the superficial inguinal lymph nodes would most likely be enlarge.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      12.3
      Seconds
  • Question 8 - A pedestrian sustained a left fibula fractured following a hit-and-run. X-rays showed that...

    Correct

    • A pedestrian sustained a left fibula fractured following a hit-and-run. X-rays showed that there was a transverse fracture of the upper end of the fibula. It was manifested clinically by inability to flex his foot at the ankle joint plus weak extension of the phalanges. What nerve is suspected to be injured in such a case?

      Your Answer: Deep peroneal

      Explanation:

      The deep peroneal nerve supplies the muscles allowing for flexion of the foot at the ankle joint, namely the tibialis anterior and peroneus tertius muscles. The peroneus tertius, peroneus brevis, and peroneus longus evert the foot, whereas the tibialis anterior and tibialis posterior invert the foot. Fibres of the deep peroneal nerve originate from L4, L5, and S1.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      18.5
      Seconds
  • Question 9 - Dysarthria, nystagmus and a tremor worsening with directed movement are likely to be...

    Incorrect

    • Dysarthria, nystagmus and a tremor worsening with directed movement are likely to be seen in:

      Your Answer: Damage to pontine and caudate nuclei

      Correct Answer: Cerebellar disease

      Explanation:

      The given symptoms are seen in diseases affecting the cerebellum. A cerebellar tremor is a slow tremor that occurs at the end of a purposeful movement. It is seen in cerebellar disease, such as multiple sclerosis or some inherited degenerative disorders and chronic alcoholism. Classically, tremors are produced in the same side of the body as a one-sided lesion. Cerebellar disease can also result in a wing-beating’ type of tremor called rubral or Holmes’ tremor – a combination of rest, action and postural tremors. Other signs of cerebellar disease include dysarthria (speech problems), nystagmus (rapid, involuntary rolling of the eyes), gait problems and postural tremor of the trunk and neck.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      19.6
      Seconds
  • Question 10 - A 65-year old patient with altered bowl movement experienced the worsening of...

    Correct

    • A 65-year old patient with altered bowl movement experienced the worsening of shortness of breath and exertional chest pains over the course of 8 weeks. Examination shows pallor and jugular venous distension. Furthermore, a test of the stool for occult blood is positive. Laboratory studies show:

      Haemoglobin 7.4 g/dl

      Mean corpuscular volume 70 fl Leukocyte count 5400/mm3

      Platelet count 580 000/mm3 Erythrocyte sedimentation 33 mm/h

      A blood smear shows hypochromic, microcytic RBCs with moderate poikilocytosis. Which of the following is the most likely diagnosis?

      Your Answer: Iron deficiency anaemia

      Explanation:

      Iron deficiency anaemia is the most common type of anaemia. It can occur due to deficiency of iron due to decreased intake or due to faulty absorption. An MCV less than 80 will indicated iron deficiency anaemia. On the smear the RBC will be microcytic hypochromic and will also show piokilocytosis. iron profiles tests are important to make a diagnosis. Clinically the patient will be pale and lethargic.

    • This question is part of the following fields:

      • General
      • Physiology
      23.5
      Seconds
  • Question 11 - A 26-year-old female patient had the following blood report: RBC count =...

    Correct

    • A 26-year-old female patient had the following blood report: RBC count = 4. 0 × 106/μl, haematocrit = 27% and haemoglobin = 11 g/dl, mean corpuscular volume (MCV) = 90 fl, mean corpuscular haemoglobin concentration (MCHC) = 41 g/dl. Further examination of blood sample revealed increased osmotic fragility of the erythrocytes. Which of the following is the most likely cause of this patient’s findings?

      Your Answer: Spherocytosis

      Explanation:

      Spherocytes are small rounded RBCs. It is due to an inherited defect of the RBC cytoskeleton membrane tethering proteins. Membrane blebs form that are lost over time and cells become round instead of biconcave. As it is a normochromic anaemia, the MCV is normal. it is diagnosed by osmotic fragility test which reveals increased fragility in a hypotonic solution.

    • This question is part of the following fields:

      • General
      • Physiology
      9.7
      Seconds
  • Question 12 - A patient admitted for esophagectomy showed low levels of the lightest plasma protein...

    Correct

    • A patient admitted for esophagectomy showed low levels of the lightest plasma protein in terms of weight. Which of the following is the lightest plasma protein:

      Your Answer: Albumin

      Explanation:

      Albumin is the most abundant and the lightest of all the plasma proteins. It maintains osmotic pressure, transports unconjugated bilirubin, thyroid hormones, fatty acids, drugs and acts as a buffer for pH.

    • This question is part of the following fields:

      • General
      • Physiology
      22
      Seconds
  • Question 13 - A teenage Somalian boy presents with a complaint of an enlarged lower jaw....

    Incorrect

    • A teenage Somalian boy presents with a complaint of an enlarged lower jaw. His blood film shows blast cells and macrophages. Which virus is responsible for this?

      Your Answer: Cytomegalovirus

      Correct Answer: Epstein–Barr virus

      Explanation:

      Burkitt’s lymphoma is a type of non-Hodgkin’s lymphoma. Histologically it is characterised by a starry sky appearance due to numerous neoplastic macrophages which are required to clear the rapidly dividing tumour cells/blast cells. Burkitt’s lymphoma commonly affects the jaw bone, forming a huge tumour mass. It is associated with translocation of c-myc gene and has three types: 1) endemic/African type, 2)sporadic and 3)immunodeficiency-associated. The first type is strongly associated with EBV.

    • This question is part of the following fields:

      • General
      • Physiology
      12
      Seconds
  • Question 14 - The mechanism of action of streptokinase involves: ...

    Correct

    • The mechanism of action of streptokinase involves:

      Your Answer: Direct conversion of plasminogen to plasmin

      Explanation:

      Streptokinase is an enzyme that is produced by group A beta haemolytic streptococcus and is an effective and cost efficient method for the dissolution of a clot used in cases of MI and pulmonary embolism. It works by directly converting plasminogen to plasmin which breaks down the blood components in the clot and fibrin, dissolving the clot. Streptokinase is a bacterial product and thus the body will develop immunity against it.

    • This question is part of the following fields:

      • General
      • Physiology
      31.4
      Seconds
  • Question 15 - How much blood can the pulmonary vessels of a 45-year-old healthy man accommodate...

    Incorrect

    • How much blood can the pulmonary vessels of a 45-year-old healthy man accommodate when he is at rest?

      Your Answer: 2000 ml

      Correct Answer: 500 ml

      Explanation:

      Pulmonary circulation is the portion of the cardiovascular system which carries deoxygenated blood away from the heart, to the lungs, and returns oxygenated blood back to the heart. The vessels of the pulmonary circulation are very compliant (easily distensible) and so typically accommodate about 500 ml of blood in an adult man. This large lung blood volume can serve as a reservoir for the left ventricle, particularly during periods when left ventricular output momentarily exceeds venous return.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      546.5
      Seconds
  • Question 16 - What will the destruction of endoplasmic reticulum stop? ...

    Incorrect

    • What will the destruction of endoplasmic reticulum stop?

      Your Answer: Synthesis of glycogen

      Correct Answer: Synthesis of proteins

      Explanation:

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

    • This question is part of the following fields:

      • General
      • Physiology
      10.9
      Seconds
  • Question 17 - 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
      12.7
      Seconds
  • Question 18 - 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: T complex in the electrocardiogram

      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
      19.9
      Seconds
  • Question 19 - In relation to the muscles of facial expression, It is true to say:...

    Incorrect

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

      Your Answer: The digastric muscle is a muscle of facial expression

      Correct 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
      7.5
      Seconds
  • Question 20 - During strenuous exercise, what else occurs besides tachycardia? ...

    Incorrect

    • During strenuous exercise, what else occurs besides tachycardia?

      Your Answer: Rise in Paco2

      Correct Answer: Increased stroke volume

      Explanation:

      During strenuous exercise there is an increase in:

      – Heart rate, stroke volume and therefore cardiac output. (CO = HR x SV)

      – Respiratory rate (hyperventilation) which will lead to a reduction in Paco2.

      – Oxygen demand of skeletal muscle, therefore leading to a reduction in mixed venous blood oxygen concentration.

      Renal blood flow is autoregulated, so renal blood flow is preserved and will tend to remain the same. Mean arterial blood pressure is a function of cardiac output and total peripheral resistance and will increase with exercise, mainly as a result of the increase in cardiac output that occurs.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      8.4
      Seconds
  • Question 21 - 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
      18.4
      Seconds
  • Question 22 - A patient underwent surgical excision of mass in the right carotid triangle. One...

    Incorrect

    • A patient underwent surgical excision of mass in the right carotid triangle. One day after the surgery patient complained of numbness of the skin over the right side of the neck. Injury to the cervical plexus of nerves is suspected. What is the possible nerve affected in this patient?

      Your Answer: Spinal accessory

      Correct Answer: Transverse cervical

      Explanation:

      The transverse cervical nerve (superficial cervical or cutaneous cervical) arises from the second and third spinal nerves, turns around the posterior border of the sternocleidomastoid and, passing obliquely forward beneath the external jugular vein to the anterior border of the muscle, it perforates the deep cervical fascia, and divides beneath the platysma into the ascending and descending branches. It provides cutaneous innervation to this area.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      4.2
      Seconds
  • Question 23 - The petrous part of the internal carotid artery is located inside of which...

    Incorrect

    • The petrous part of the internal carotid artery is located inside of which cranial bone?

      Your Answer: Frontal

      Correct Answer: Temporal

      Explanation:

      The petrous segment, or C2, of the internal carotid is that which is inside the petrous part of the temporal bone. This segment extends until the foramen lacerum. The petrous portion classically has three sections: an ascending, or vertical portion; the genu, or bend; and the horizontal portion.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      5.8
      Seconds
  • Question 24 - The primary area involved in the pathology of Parkinson's disease is: ...

    Correct

    • The primary area involved in the pathology of Parkinson's disease is:

      Your Answer: Substantia nigra

      Explanation:

      Parkinson’s disease is a degenerative, movement disorder of the central nervous system, and is typically characterized by muscle rigidity, tremor and bradykinesia (in extreme cases, akinesia). Secondary symptoms include high-level cognitive dysfunction and subtle language problems.

      Parkinson’s disease is also called ‘primary Parkinsonism’ or ‘idiopathic Parkinson’s disease and is the most common cause of Parkinsonism, a group of similar symptoms. The disorder is caused due to loss of pigmented dopaminergic cells in the pars compacta region of the substantia nigra.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      12.2
      Seconds
  • Question 25 - the action of the semimembranosus muscle is: ...

    Incorrect

    • the action of the semimembranosus muscle is:

      Your Answer: Extension of the hip and extension of the knee

      Correct Answer: Extension of the hip and flexion of the knee

      Explanation:

      the semimembranosus is situated at the back and medial side of the thigh. It arises from the upper and outer impression on the tuberosity of the ischium, above and lateral to the biceps femoris and semitendinosus. It is inserted mainly into the horizontal groove on the posterior medial aspect of the medial condyle of the tibia. it flexes the knee and assists in extension of the hip.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      9.4
      Seconds
  • Question 26 - Which of the following mediators of inflammation requires arachidonic acid for synthesis? ...

    Incorrect

    • Which of the following mediators of inflammation requires arachidonic acid for synthesis?

      Your Answer: Interferon-gamma

      Correct Answer: Prostaglandins

      Explanation:

      Arachidonic acid is normally present in the phospholipids that make up the cell membrane and is cleaved by phospholipase A2 from the phospholipid. Arachidonic acid is a precursor for the production of eicosanoids which include: 1) prostaglandins, prostacyclins and thromboxane, 2) leukotrienes and 3) anandamides. The production of these products along with their action on the body is called the arachidonic acid cascade.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      13.7
      Seconds
  • Question 27 - What occurs during cellular atrophy? ...

    Correct

    • What occurs during cellular atrophy?

      Your Answer: Cell size decreases

      Explanation:

      Atrophy is the decrease in the size of cells, tissues, or organs. There are several causes including inadequate nutrition, poor circulation, loss of hormonal support or nerve supply, disuse, lack of exercise, or disease. An increase in cell size is termed hypertrophy which is distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Urology
      • Pathology
      13.1
      Seconds
  • Question 28 - You are asked to help a junior medical student studying anatomy to identify...

    Correct

    • You are asked to help a junior medical student studying anatomy to identify the left lung. Which of the following features found only in the left lung will you use the identify it?

      Your Answer: Cardiac notch

      Explanation:

      Oblique fissure: is found on both the left and the right lungs. It separates the upper from the lower lobes in both lungs and the middle lobe from the lower lobe in the right lung(which has three lobes.)

      The superior lobar bronchus is found in both lungs.

      Cardiac notch: found only on the left lung.

      Horizontal fissure: a deep groove separating the middle lobe from the upper lobe of the right lung is absent on the left lung.

      Diaphragmatic surface: refers to the part of the lung, both the left and the right, that is in contact with the diaphragm.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      13.7
      Seconds
  • Question 29 - Which of the following is not seen as a complication of wound healing?...

    Incorrect

    • Which of the following is not seen as a complication of wound healing?

      Your Answer: Proud flesh

      Correct Answer: Malignancy

      Explanation:

      Complications in wound healing can originate due to abnormalities in the repair process. These abnormalities are :

      1) Deficient scar formation: insufficient granulation tissue can lead to wound dehiscence and ulceration. Dehiscence or wound rupture is seen most commonly in abdominal surgery due to increased intraabdominal pressure. Ulcerations are common in extremity wounds due to inadequate vascularization.

      2) Excessive formation of repair components: collagen being laid down may begin normally however later lead to a raised scar also called a hypertrophic scar, which can extend beyond its boundaries to form a keloid and

      3) Formation of contractures.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      6.3
      Seconds
  • Question 30 - Pseudomonas aeruginosa is a multidrug resistant pathogen that causes hospital-acquired infections. It is...

    Incorrect

    • Pseudomonas aeruginosa is a multidrug resistant pathogen that causes hospital-acquired infections. It is usually treated with piperacillin or another antibiotic. Which of the following is the other antibiotic?

      Your Answer:

      Correct Answer: Azlocillin

      Explanation:

      Azlocillin, like piperacillin, is an acylampicillin antibiotic with an extended spectrum of activity and greater in vitro potency than the carboxypenicillins. Azlocillin is similar to mezlocillin and piperacillin. It demonstrates antibacterial activity against a broad spectrum of bacteria, including Pseudomonas aeruginosa.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Orthopaedics (0/2) 0%
Pathology (5/8) 63%
Haematology (1/1) 100%
Respiratory (0/1) 0%
General (5/7) 71%
Physiology (7/12) 58%
Abdomen (1/2) 50%
Anatomy (6/9) 67%
Pelvis (1/1) 100%
Lower Limb (2/2) 100%
Neurology (1/2) 50%
Cardiovascular (1/2) 50%
Head & Neck (1/3) 33%
Gastroenterology (0/1) 0%
Inflammation & Immunology (1/1) 100%
Cell Injury & Wound Healing; Urology (1/1) 100%
Thorax (1/1) 100%
Cell Injury & Wound Healing (1/1) 100%
Pharmacology (1/1) 100%
Passmed