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  • Question 1 - With respect to far accommodation, which of the following is a TRUE statement?...

    Incorrect

    • With respect to far accommodation, which of the following is a TRUE statement?

      Your Answer: The pupils are constricted (accommodation response)

      Correct Answer: The ciliary muscles are relaxed

      Explanation:

      Myopia or near-sightedness is a disease due to elongated eyeballs or too strong a lens. For far accommodation (focus of a distant object onto the retina), the lens needs to decrease its refractive power, or in other words, increase its focal length. This is done by relaxation of ciliary muscles which tightens the zonular fibres and flattening of the lens. Relaxation of the zonular fibres, rounding of the lens, shortening of the focal length and constriction of the pupil occurs during near accommodation.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      13.2
      Seconds
  • Question 2 - 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
      9.7
      Seconds
  • Question 3 - Etoposide is a chemotherapeutic agent used in the treatment of different types of...

    Correct

    • 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: 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
      13.6
      Seconds
  • Question 4 - A young female in the 15th week of pregnancy presented to the emergency...

    Correct

    • 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 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
      18.5
      Seconds
  • Question 5 - Which of these structures does NOT pass posterior to the medial malleolus? ...

    Correct

    • Which of these structures does NOT pass posterior to the medial malleolus?

      Your Answer: Saphenous vein

      Explanation:

      The saphenous vein passes anterior to the medial malleolus. The structures passing posterior, from nearest to furthest include: tibial, posterior tendon, flexor digitorum longus tendon, posterior tibial artery, posterior tibial vein, posterior tibial nerve and the flexor hallucis longus tendon.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      27.9
      Seconds
  • Question 6 - 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
      20.4
      Seconds
  • Question 7 - A significantly elevated white cell count of 50 x 109/l with 5% blasts...

    Incorrect

    • A significantly elevated white cell count of 50 x 109/l with 5% blasts and raised leucocyte alkaline phosphatase is seen in which of the following conditions?

      Your Answer: HIV infection

      Correct Answer: Leukaemoid reaction

      Explanation:

      Non-neoplastic proliferation of leucocytes causes an increase in leukocyte alkaline phosphatase (LAP). This is referred to as ‘leukemoid reaction’ because of the similarity to leukaemia with an increased white cell count (>50 × 109/l) with immature forms. Causes of leukemoid reaction includes haemorrhage, drugs (glucocorticoids, all-trans retinoic acid etc), infections such as tuberculosis and pertussis, and as a paraneoplastic phenomenon. Leukemoid reaction can also be seen in infancy as a feature of trisomy 21. This is usually a benign condition, but can be a response to a disease state. Differential diagnosis include chronic myelogenous leukaemia (CML).

    • This question is part of the following fields:

      • Haematology
      • Pathology
      15.8
      Seconds
  • Question 8 - A 29-year-old pregnant woman develops severe hypoxaemia with petechial rash and confusion following...

    Correct

    • A 29-year-old pregnant woman develops severe hypoxaemia with petechial rash and confusion following a fracture to her left femur. Which is the most probable cause of these symptoms in this patient?

      Your Answer: Fat embolism

      Explanation:

      Fat embolism is a life-threatening form of embolism in which the embolus consists of fatty material or bone marrow particles that are introduced into the systemic venous system. It may be caused by long-bone fractures, orthopaedic procedures, sickle cell crisis, parenteral lipid infusion, burns and acute pancreatitis. Patients with fat embolism usually present with symptoms that include skin, brain, and lung dysfunction.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      21
      Seconds
  • Question 9 - From which source does the lingual artery originate? ...

    Incorrect

    • From which source does the lingual artery originate?

      Your Answer: Maxillary

      Correct Answer: External carotid

      Explanation:

      The lingual artery arises from the external carotid between the superior thyroid artery and facial artery. It can be located easily on the lower surface of the tongue. The terminal branch of the lingual artery is the deep lingual artery. On its course the lingual artery gives off side branches: dorsal lingual branches that supply the dorsum of the tongue till the epiglottis; sublingual artery that supplies the sublingual gland.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      12
      Seconds
  • Question 10 - Which of the following conditions can present with multiple abscesses that may discharge...

    Incorrect

    • Which of the following conditions can present with multiple abscesses that may discharge sulphur granules?

      Your Answer: Brucellosis

      Correct Answer: Actinomycosis

      Explanation:

      Actinomycosis is primarily caused by any of the several members of the bacterial genus Actinomyces. These bacteria are generally anaerobes. And can cause multiple abscesses that may discharge sulphur granules.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      8.4
      Seconds
  • Question 11 - A 40-year old gentleman underwent a computed tomographic scan for the abdomen to...

    Incorrect

    • A 40-year old gentleman underwent a computed tomographic scan for the abdomen to rule out blunt abdominal trauma, after a vehicular accident. The scan revealed no abnormal finding except for a 1 cm-sized cortical mass in the left adrenal gland. The doctor-on-call decided to not intervene for this mass because it was likely to be a:

      Your Answer: Adrenocortical carcinoma

      Correct Answer: Non-functioning adrenal adenoma

      Explanation:

      Adrenal adenomas are common, benign lesions which are asymptomatic and seen in 10% of population. Usually detected incidentally on Computed tomography (‘incidentaloma’), only around 1 in 10,000 are malignant (adenocarcinoma). Adrenal adenomas rarely need to be investigated, especially if they are homogenous and less than 3 cm in diameter. Follow-up imaging can be done after an interval of 3-6 months to assess any change in size. Some adenomas can secrete cortisol (leading to Cushing syndrome), or aldosterone (leads to Conn syndrome) or androgens (leading to hyperandrogenism).

      Haematomas and simple cysts are not usually seen in adrenal gland. Infection due to Histoplasma capsulatum is usually bilateral and leads to multiple granulomas. Adrenal metastasis will usually demonstrate a lung primary and the adrenal lesions will be often multiple and larger than 1 cm.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      19.1
      Seconds
  • Question 12 - A 27 year-old male patient was admitted to the hospital due to recurrent...

    Incorrect

    • 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: Pseudomonas aeruginosa

      Correct 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
      25.8
      Seconds
  • Question 13 - A 49-year-old woman with acute renal failure has a total plasma [Ca2+] =...

    Incorrect

    • A 49-year-old woman with acute renal failure has a total plasma [Ca2+] = 2. 5 mmol/l and a glomerular filtration rate of 160 l/day. What is the estimated daily filtered load of calcium?

      Your Answer: 120 mmol/day

      Correct Answer: 240 mmol/day

      Explanation:

      Calcium is the most abundant mineral in the human body. The average adult body contains in total approximately 1 kg of calcium of which 99% is in the skeleton in the form of calcium phosphate salts. The extracellular fluid (ECF) contains approximately 22 mmol, of which about 9 mmol is in the plasma. About 40% of total plasma Ca2+ is bound to proteins and not filtered at the glomerular basement membrane. Therefore, the estimated daily filtered load is 1.5 mmol/l × 160 l/day = 240 mmol/day. The exact amount of free versus total Ca2+ depends on the blood pH: free Ca2+ increases during acidosis and decreases during alkalosis.

    • This question is part of the following fields:

      • Physiology
      • Renal
      7.5
      Seconds
  • Question 14 - Which of the following will show decreased hearing when tested by air conduction...

    Incorrect

    • Which of the following will show decreased hearing when tested by air conduction but normal hearing when tested by bone conduction?

      Your Answer: Lesion of the auditory nerve

      Correct Answer: Fibrosis causing fixation of the ossicles

      Explanation:

      As the cochlea is embedded into bone, the vibrations from the bone are transmitted directly to the fluid in the cochlea. Hence, any damage to the ossicles or tympanic membrane will not show an abnormal result on bone conduction test.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      15.2
      Seconds
  • Question 15 - Whipple's procedure involves mobilizing the head of the pancreas. As the surgeon does...

    Incorrect

    • 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: Gastroduodenal artery

      Correct 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
      22.8
      Seconds
  • Question 16 - The Brunner glands secrete an alkaline product that helps maintain an optimal pH...

    Incorrect

    • The Brunner glands secrete an alkaline product that helps maintain an optimal pH for pancreatic enzyme activity. Where are these glands located?

      Your Answer: Submucosa of the jejunum

      Correct Answer: Submucosa of the duodeneum

      Explanation:

      The Brunner glands are located in the submucosa of the duodenum. These glands are connected to the interstitial lumen by ducts that open into certain crypts. They secrete an alkaline product that protects the duodenal mucosa from the acidic chyme and helps achieve an optimal pH for the enzymes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      5.3
      Seconds
  • Question 17 - The tensor villi palatini muscle is a broad thin, ribbon-like muscle in the...

    Incorrect

    • The tensor villi palatini muscle is a broad thin, ribbon-like muscle in the head that tenses the soft palate. Which of the following structures is associated with the tensor villi palatini muscle?

      Your Answer: The middle pharyngeal constrictor

      Correct Answer: The hamulus of the medial pterygoid plate

      Explanation:

      The pterygoid hamulus is a hook-like process at the lower extremity of the medial pterygoid plate of the sphenoid bone around which the tendon of the tensor veli palatini passes.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      13.4
      Seconds
  • Question 18 - A surgical registrar performing an adrenalectomy procedure on the left suprarenal gland of...

    Correct

    • A surgical registrar performing an adrenalectomy procedure on the left suprarenal gland of a 25 - year old male patient, accidentally jabbed and injured a vital structure that lies anterior to the left suprarenal organ. Which of the following was the structure most likely injured?

      Your Answer: Pancreas

      Explanation:

      The adrenal (suprarenal) glands are organs of the endocrine system located on top of each of the kidneys. The left suprarenal gland, in question, is crescent in shape and slightly larger than the right suprarenal gland. It is posteriorly located to the lateral aspect of the head of the pancreas which is thus the most likely to be injured. The other organs like the duodenum, liver and the inferior vena cava are related to the right suprarenal gland. The spleen and the colon are not in close proximity with the left suprarenal gland and are not likely to be the organs injured.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      15.8
      Seconds
  • Question 19 - Biopsy of a neoplastic mass was performed. Histologic examination of the specimen showed...

    Incorrect

    • Biopsy of a neoplastic mass was performed. Histologic examination of the specimen showed spindle shaped cells with high nuclear/cytoplasm ratio on immunohisto chemical staining. These pleomorphic cells were vimentin positive, cytokeratin negative and cd45 negative. This type of neoplasm is most commonly found in which patient?

      Your Answer: A 45-year-old woman with massive ascites and peritoneal metastases

      Correct Answer: A 15-year-old boy with a mass in the left femur and lung metastases

      Explanation:

      A histology report that describes spindle shaped cells which are vimentin positive suggests osteosarcoma and hematogenous spread to the lungs.

    • This question is part of the following fields:

      • Neoplasia; Orthopaedics
      • Pathology
      12.8
      Seconds
  • Question 20 - An electronic manufacturing engineer had abdominal distension and underwent a CT scan of...

    Correct

    • An electronic manufacturing engineer had abdominal distension and underwent a CT scan of the abdomen. Thereafter he was diagnosed with hepatic angiosarcoma. Exposure to what agent is responsible for the development of this neoplasm?

      Your Answer: Arsenic

      Explanation:

      Hepatic angiosarcomas are associated with particular carcinogens which includes: arsenic , thorotrast, and polyvinyl chloride. With exposure to this three agents, there is a very long latent period of many years between exposure and the development of tumours.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      8.2
      Seconds
  • Question 21 - Which of the following is not seen as a complication of wound healing?...

    Correct

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

      Your 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
      2.4
      Seconds
  • Question 22 - The pudendal nerve is derived from? ...

    Correct

    • The pudendal nerve is derived from?

      Your Answer: S2, S3, S4

      Explanation:

      The pudendal nerve derives it’s fibres from the ventral branches of the second, third and fourth sacral nerves (S2,3,4)

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      3.2
      Seconds
  • Question 23 - 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: Embolization

      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
      9.5
      Seconds
  • Question 24 - A surgeon performing a laparoscopic repair of an inguinal hernia visualizes a loop...

    Incorrect

    • A surgeon performing a laparoscopic repair of an inguinal hernia visualizes a loop of bowel protruding through the abdominal wall to form a direct inguinal hernia. When this is viewed from the side of the abdomen with a laparoscope, in which region would the hernial sac be?

      Your Answer: Lateral inguinal fossa

      Correct Answer: Medial inguinal fossa

      Explanation:

      In a direct inguinal hernia, visceral contents exit the abdomen through a weak point in the fascia in the medial inguinal fossa i.e. the area between the medial and lateral umbilical folds. Such a hernia doesn’t pass through the deep inguinal ring or the lateral inguinal fossa. Note that direct hernias can go through the superficial inguinal ring, although rarely. The supravesical fossa, between the median and medial umbilical folds, is formed by a peritoneal reflection from the anterior abdominal wall onto the bladder and the retrovesical fossa is the region behind the urinary bladder.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      20.7
      Seconds
  • Question 25 - A 36-year-old female was advised to undergo genetic testing of BRCA1 and BRCA2....

    Incorrect

    • 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: Lung

      Correct 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
      4.9
      Seconds
  • Question 26 - A 26-year-old female patient had the following blood report: RBC count = 4....

    Incorrect

    • 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) = 80–100 fl, mean corpuscular haemoglobin concentration (MCHC) = 31–37 g/dl. Which of the following is correct regarding this patient’s erythrocytes:

      Your Answer: Decreased MCV

      Correct Answer: Normal MCV

      Explanation:

      MCV is the mean corpuscular volume and it is calculated from the haematocrit and the RBC count. It is normally 90 fl. Mean corpuscular haemoglobin concentration (MCHC) [g/dl] = haemoglobin [g/dl]/haematocrit = 11/0.27 = 41 g/dl and is higher than normal range (32 to 36 g/dL).

    • This question is part of the following fields:

      • General
      • Physiology
      5.6
      Seconds
  • Question 27 - Which of the given options best describes the metabolic changes which occur following...

    Incorrect

    • Which of the given options best describes the metabolic changes which occur following a severe soft tissue injury sustained after a PVA?

      Your Answer: Inhibition of gluconeogenesis

      Correct Answer: Mobilisation of fat stores

      Explanation:

      The following metabolic responses occur following trauma as part of a coping mechanism for the additional stress. These include acid base changes (metabolic acidosis or alkalosis), decrease urine output and osmolality, reduced basal metabolic rate (BMR), gluconeogenesis with amino acid breakdown and shunting, hyponatraemia as a result of impaired functioning of sodium pumps, hypoxic injury, coagulopathies, decreased immunity, increase extracellular fluid and hypovolemic shock, increase permeability leading to oedema, break down and mobilization of fat reserves, pyrexia and reduced circulating levels of albumin.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      14
      Seconds
  • Question 28 - A 54 year old man fell off his bicycle. He felt a severe...

    Incorrect

    • A 54 year old man fell off his bicycle. He felt a severe pain in his hand and wasn't able to move it. It was found that a carpal bone in the distal row was fractured. Which is the most likely bone?

      Your Answer: Lunate

      Correct Answer: Trapezium

      Explanation:

      There are eight carpal bones which are arranged in two rows, proximal and distal; scaphoid, lunate, triquetral and pisiform are of proximal row. Trapezium, trapezoid, capitate and hamate are of the distal row.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      27.1
      Seconds
  • Question 29 - The renal tubule is the portion of the nephron that contains the fluid...

    Correct

    • The renal tubule is the portion of the nephron that contains the fluid that has been filtered by the glomerulus. Which of the following substances is actively secreted into the renal tubules?

      Your Answer: Potassium

      Explanation:

      The renal corpuscle filters out solutes from the blood, delivering water and small solutes to the renal tubule for modification. In normal circumstances more than 90% of the filtered load of K is reabsorbed by the proximal tubules and loops of Henlé and almost all K appearing in the urine has been secreted by the late distal tubules and collecting tubules. So the rate of excretion is usually independent of the rate of filtration, but is closely tied to the rate of secretion and control of K excretion, largely accomplished by control of the secretion rate. Around 65–70% of the filtered potassium is reabsorbed along with water in the proximal tubule and the concentration of potassium in the tubular fluid varies little from that of the plasma.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      7.1
      Seconds
  • Question 30 - 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
      11.9
      Seconds
  • Question 31 - A growing tumour is impinging on the lingual artery in the floor of...

    Correct

    • A growing tumour is impinging on the lingual artery in the floor of the mouth. Which structure will experience decreased blood flow?

      Your Answer: The sublingual gland

      Explanation:

      The paired sublingual glands are major salivary glands in the mouth. They are the smallest, most diffuse, and the only unencapsulated major salivary glands. They provide only 3-5% of the total salivary volume. The gland receives its blood supply from the sublingual and submental arteries. The sublingual artery is a branch of the lingual artery, thus damage to the lingual artery will decrease the blood flow to the sublingual gland.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      13.1
      Seconds
  • Question 32 - One of the following structures is contained in the anterior compartment of the...

    Incorrect

    • One of the following structures is contained in the anterior compartment of the lower leg. Which is it?

      Your Answer: Superficial peroneal nerve

      Correct Answer: Extensor hallucis muscle

      Explanation:

      The lower leg is made up of four fascial compartments separated from one another by septa that contain the muscles of the lower leg. The four compartments are ; anterior, lateral, deep posterior and superficial posterior compartments.

      These are the compartments and there contents:

      i) Anterior compartment: Tibialis anterior muscle, extensor hallucis longus muscle, extensor digitorum longus muscle, peroneus tertius muscles, deep fibular nerve and anterior tibial blood vessels

      ii) Lateral compartment: Fibularis longus muscle, brevis muscles and superficial fibular nerve

      iii) Deep posterior compartment: Tibialis posterior m., flexor hallucis longus m., flexor digitorum longus m. ,popliteus m. , tibial nerve, posterior tibial artery and posterior tibial vessels such as the fibular artery.

      iv) Superficial posterior compartment: Gastrocnemius m., soleus m., plantaris m., medial sural cutaneous nerve

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      20.5
      Seconds
  • Question 33 - Which of the following chemotherapy regimens is most likely to be used in...

    Incorrect

    • Which of the following chemotherapy regimens is most likely to be used in colorectal cancer?

      Your Answer: ABVD

      Correct Answer: FOLFOX

      Explanation:

      Chemotherapy regimens are often identified by acronyms, identifying the agents used in the drug combination. However, the letters used are not consistent across regimens. FOLFOX is a chemotherapy regimen used for the treatment of colorectal cancer, made up of the following drugs: • FOL: fluorouracil (5-fluorouracil or 5-FU) • F: folinic acid (leucovorin) • OX: oxaliplatin (Eloxatin®).

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      4.9
      Seconds
  • Question 34 - The gradual depolarization in-between action potentials in pacemaker tissue is a result of?...

    Correct

    • The gradual depolarization in-between action potentials in pacemaker tissue is a result of?

      Your Answer: A combination of gradual inactivation outward IK along with the presence of an inward ‘funny’ current (If) due to opening of channels permeable to both Na+ and K+ ions

      Explanation:

      One of the characteristic features of the pacemaker cell is the generation of a gradual diastolic depolarization also called the pacemaker potential. In phase 0, the upstroke of the action potential caused by an increase in the Ca2+ conductance, an influx of calcium occurs and a positive membrane potential is generated. The next is phase 3 which is repolarization caused by increased K+ conductance as a result of outwards K+ current. Phase 4 is a slow depolarization which accounts for the pacemaker activity, caused by increased conductance of Na+, inwards Na+ current called IF. it is turned on by repolarization.

    • This question is part of the following fields:

      • General
      • Physiology
      17.4
      Seconds
  • Question 35 - Epstein-Barr virus (EBV) is known to be a carcinogen for: ...

    Incorrect

    • Epstein-Barr virus (EBV) is known to be a carcinogen for:

      Your Answer: Leukaemia

      Correct Answer: B-cell lymphoma

      Explanation:

      EBV is known to be carcinogenic for B-cell lymphoma, nasopharyngel carcinoma and Hodgkin’s lymphoma.

    • This question is part of the following fields:

      • Microbiology; Neoplasia
      • Pathology
      10.8
      Seconds
  • Question 36 - A young man came to the emergency room after an accident. The anterior...

    Incorrect

    • A young man came to the emergency room after an accident. The anterior surface of his wrist was lacerated with loss of sensation over the thumb side of his palm. Which nerves have been damaged?

      Your Answer: Medial antebrachial cutaneous

      Correct Answer: Median

      Explanation:

      The median nerve provides cutaneous innervation to the skin of the palmar radial three and a half fingers. Also the site of injury indicates that the medial nerve may have been injured as it passes into the hand by crossing over the anterior wrist.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      26.1
      Seconds
  • Question 37 - Bloody discharge from the nipple of a 40-year old woman with no obvious...

    Correct

    • Bloody discharge from the nipple of a 40-year old woman with no obvious lump or abnormality on mammography is suggestive of:

      Your Answer: Intraductal papilloma

      Explanation:

      A small benign tumour, namely intraductal papilloma is most common in women between 35-55 years of age. It is also the commonest cause of spontaneous discharge from a single duct. A lump below the nipple may be sometimes palpable. Ultrasound and ductography are useful investigations., along with cytology of discharge to assess the presence of malignant cells. Confirmation is by breast biopsy.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      13.7
      Seconds
  • Question 38 - What is the innervation of the laryngeal mucosa inferior to the true vocal...

    Correct

    • What is the innervation of the laryngeal mucosa inferior to the true vocal cord?

      Your Answer: Recurrent laryngeal nerve

      Explanation:

      Motor innervation to all other muscles of the larynx and sensory innervation to the subglottis is by the recurrent laryngeal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      6.4
      Seconds
  • Question 39 - The nutcracker effect of the alimentary canal is described as a nutcracker-like compression...

    Correct

    • The nutcracker effect of the alimentary canal is described as a nutcracker-like compression caused by the aorta and the superior mesenteric arteries on a certain section of the alimentary canal leading to bowel obstruction. Which of the following parts of the alimentary canal is usually obstructed by this nutcracker compression of the two arteries?

      Your Answer: Duodenum

      Explanation:

      The ‘nutcracker effect’ is only seen in one part of the alimentary canal, and that is in the third part of the duodenum. This can happen when the superior mesenteric artery that passes across the duodenum and the aorta, posteriorly to the third part of the duodenum enlarges and starts compressing the duodenum. The result is an obstructed duodenum that inhibits passage of food.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      18.4
      Seconds
  • Question 40 - 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
      12.6
      Seconds
  • Question 41 - The superior rectal artery is a continuation of the: ...

    Correct

    • The superior rectal artery is a continuation of the:

      Your Answer: Inferior mesenteric artery

      Explanation:

      The superior rectal artery or superior haemorrhoidal artery is the continuation of the inferior mesenteric artery. It descends into the pelvis between the layers of the mesentery of the sigmoid colon, crossing the left common iliac artery and vein.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      8.1
      Seconds
  • Question 42 - Following nerve injury, paralysis of the quadriceps femoris muscle occurs. Which of the...

    Incorrect

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

      Your Answer: Flexion of the leg

      Correct 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
      14.9
      Seconds
  • Question 43 - 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
      4.3
      Seconds
  • Question 44 - A medical student is asked to calculate the net pressure difference in a...

    Correct

    • A medical student is asked to calculate the net pressure difference in a capillary wall, considering: Interstitial fluid hydrostatic pressure = –3 mmHg, Plasma colloid osmotic pressure = 28 mmHg, Capillary hydrostatic pressure = 17 mmHg, Interstitial fluid colloid osmotic pressure = 8 mmHg, and Filtration coefficient = 1. Which is the correct answer?

      Your Answer: 0 mmHg

      Explanation:

      The rate of filtration at any point along a capillary depends on a balance of forces sometimes called Starling’s forces after the physiologist who first described their operation in detail. The Starling principle of fluid exchange is key to understanding how plasma fluid (solvent) within the bloodstream (intravascular fluid) moves to the space outside the bloodstream (extravascular space). Fluid movement = k[(pc– pi)–(Πc– Πi)] where k = capillary filtration coefficient, pc = capillary hydrostatic pressure, pi= interstitial hydrostatic pressure, Πc = capillary colloid osmotic pressure, Πi = interstitial colloid osmotic pressure. Therefore: 1 × [capillary hydrostatic pressure (17) – interstitial fluid hydrostatic pressure (–3)] – [plasma colloid osmotic pressure (28) – interstitial fluid colloid osmotic pressure (8)] = 0 mmHg

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      16.3
      Seconds
  • Question 45 - 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
      14
      Seconds
  • Question 46 - Glucose is not secreted by the kidneys, and is filtered without a limit....

    Correct

    • Glucose is not secreted by the kidneys, and is filtered without a limit. What is the transport maximum for glucose?

      Your Answer: 300 mg/dl

      Explanation:

      Transport maximum (or Tm) refers to the point at which increases in concentration do not result in an increase in movement of a substance across a membrane. Glucose is not secreted, thus excretion = filtration – reabsorption. Both filtration and reabsorption are directly proportional to the concentration of glucose in the plasma. However, reabsorption has a transport maximum of about 300 mg/dl in healthy nephrons, while filtration has effectively no limit (within reasonable physiological ranges). So, if the concentration rises above 300 mg/dl, the body cannot retain all the glucose, leading to glucosuria. Glucosuria is nearly always caused by elevated blood glucose levels, most commonly due to untreated diabetes mellitus.

    • This question is part of the following fields:

      • Physiology
      • Renal
      15.3
      Seconds
  • Question 47 - A 55-year-old man underwent CT scan of the whole abdomen. The result showed...

    Correct

    • A 55-year-old man underwent CT scan of the whole abdomen. The result showed renal cell carcinoma with a tumour size of 7cm and extension into the regional lymph. What is the clinical stage of his renal cell cancer?

      Your Answer: Stage III

      Explanation:

      Renal cell carcinoma is a kidney cancer that originates in the lining of the proximal convoluted tubule. It is the most common type of kidney cancer in adults, responsible for approximately 90–95% of cases. Renal cell carcinomas can be staged by using the American Joint Committee on Cancer (AJCC) TNM (tumour-node-metastasis) classification, as follows: Stage I: tumours that are 7 cm or smaller and confined to the kidney, Stage II: tumours that are larger than 7 cm but still confined to the kidney, Stage III: tumours extending into the renal vein or vena cava, involving the ipsilateral adrenal gland and/or perinephric fat, or which have spread to one local lymph node and Stage IV: tumours extending beyond Gerota’s fascia, to more than one local node, or with distant metastases Recent literature has questioned whether the cut-off in size between stage I and stage II tumours should be 5 cm instead of 7 cm. The patient’s cancer in this case is stage III.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      12
      Seconds
  • Question 48 - 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
      2.7
      Seconds
  • Question 49 - A pedestrian sustained a left fibula fractured following a hit-and-run. X-rays showed that...

    Incorrect

    • 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: Tibial

      Correct 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
      20.7
      Seconds
  • Question 50 - Which of the following two cerebral veins join up to form the great...

    Incorrect

    • 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: Middle cerebral veins

      Correct 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
      9.8
      Seconds
  • Question 51 - Renal function is an indication of the state of the kidney, measured by glomerular...

    Incorrect

    • Renal function is an indication of the state of the kidney, measured by glomerular filtration rate (GFR). In a healthy person, GFR would be greatly increased by: 

      Your Answer: Strong, acute sympathetic stimulation to kidney

      Correct Answer: Substantial increases in renal blood flow

      Explanation:

      An increase in the rate of renal blood flow (RBF) greatly increases the glomerular filtration rate (GFR). The more plasma available (from increased RBF), the more filtrate is formed. Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal (kidney) glomerular capillaries into the Bowman’s capsule per unit time. Central to the physiologic maintenance of GFR is the differential basal tone of the afferent and efferent arterioles.

    • This question is part of the following fields:

      • Physiology
      • Renal
      17
      Seconds
  • Question 52 - Which of the following is a large artery that runs immediately posterior to...

    Correct

    • Which of the following is a large artery that runs immediately posterior to the stomach?

      Your Answer: Splenic

      Explanation:

      The splenic artery is the large artery that would be found running off the posterior wall of the stomach. It is a branch of the coeliac trunk and sends off branches to the pancreas before reaching the spleen. The gastroduodenal artery on the other hand is found inferior to the stomach, posterior to the first portion of the duodenum. The left gastroepiploic artery runs from the left to the right of the greater curvature of the stomach. The common hepatic artery runs on the superior aspect of the lesser curvature of the stomach, and is a branch of the coeliac trunk. The superior mesenteric artery arises from the abdominal aorta just below the junction of the coeliac trunk.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      9.9
      Seconds
  • Question 53 - A 35-year-old woman is in a comatose state following a traumatic head injury,...

    Incorrect

    • A 35-year-old woman is in a comatose state following a traumatic head injury, and is receiving intravenous (IV) antibiotics and IV fluids containing saline and 5% dextrose. A serum biochemistry analysis is performed five days later which shows a low serum potassium level. This is most likely to be due to:

      Your Answer: Aldosterone deficiency

      Correct Answer: Nothing per oral regimen

      Explanation:

      In this patient the cause for hypokalaemia is insufficient consumption of potassium as she is nil-per mouth with no intravenous supplementation. Parenteral nutrition has been used for comatose patients, although enteral feeding is usually preferable, and less prone to complications.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      27.4
      Seconds
  • Question 54 - 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
      13.2
      Seconds
  • Question 55 - Regarding the long head of the biceps femoris, which of the following is...

    Correct

    • Regarding the long head of the biceps femoris, which of the following is correct?

      Your Answer: It crosses two joints

      Explanation:

      The long head of the biceps femoris arises from the lower and inner impression on the back of the tuberosity of the ischium. It inserts with the short head in an aponeurosis which becomes a tendon and this tendon is inserted into the lateral side of the head of the fibula and the lateral condyle of the tibia, thus crossing two joints.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      37.9
      Seconds
  • Question 56 - A 7-year-old boys undergoes a testicular biopsy after a tumour is found in...

    Incorrect

    • A 7-year-old boys undergoes a testicular biopsy after a tumour is found in his right testis. Elements similar to hair and teeth are found in it. What kind of tumour is this?

      Your Answer: Seminoma

      Correct Answer: Teratoma

      Explanation:

      A teratoma is a tumour containing tissue elements that are similar to normal derivatives of more than one germ layer. They usually contain skin, hair, teeth and bone tissue and are more common in children, behaving as a benign tumour. After puberty, they are regarded as malignant and can metastasise.

    • This question is part of the following fields:

      • Pathology
      • Urology
      6.7
      Seconds
  • Question 57 - A chest x ray of a patient reveals loculated fluid in the right...

    Correct

    • A chest x ray of a patient reveals loculated fluid in the right chest, which can be easily aspirated if the needle is inserted through the body wall just above the 9th rib in the midaxillary line. Where is this fluid located?

      Your Answer: Costodiaphragmatic recess

      Explanation:

      The costodiaphragmatic recess is the lowest point of the pleural sac where the costal pleura becomes the diaphragmatic pleura. At the midclavicular line, this is found between ribs 6 and 8; at the paravertebral lines, between ribs 10 and 12 and between ribs 8 and 10 at the midaxillary line.

      The cardiac notch: is an indentation of the heart on the left lung, located on the anterior surface of the lung.

      Cupola: part of the parietal pleura that extends above the first rib.

      Oblique pericardial sinus: part of the pericardial sac located posterior to the heart behind the left atrium.

      Costomediastinal recess: a reflection of the pleura from the costal surface to the mediastinal surface, is on the anterior surface of the chest.

      The inferior mediastinum: is the space in the chest occupied by the heart.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      16.2
      Seconds
  • Question 58 - A 42 year old women presents with end stage renal failure and is...

    Correct

    • A 42 year old women presents with end stage renal failure and is prepared to receive a kidney from her husband. HLA testing showed that they are not a 100% match and she is given immunosuppressant therapy for this. Three months later when her renal function tests were performed she showed signs of deteriorating renal function, with decreased renal output, proteinuria of +++ and RBCs in the urine. She was given antilymphocyte globulins and her condition reversed. What type of graft did this patient receive?

      Your Answer: Allograft

      Explanation:

      Allograft describes a graft between two of the same species. As the donor and the recipients are history-incompatible, rejection of the graft is common and is controlled by immunosuppressive drug therapy. Isograft and syngraft are synonymous and referred to a graft transferred between genetically identical individuals e.g. identical twins. In this case rejection is rare as they are history-compatible.

      Autograft refers to transfer of one part of the body to another location.

      Xenograft is transfer of tissue from another species e.g. pig to human in valve replacement surgeries and rejection is very high.

    • This question is part of the following fields:

      • Inflammation & Immunology; Renal
      • Pathology
      5
      Seconds
  • Question 59 - What's the nodal stage of a testicular seminoma if several lymph nodes between...

    Incorrect

    • What's the nodal stage of a testicular seminoma if several lymph nodes between 2cm and 5cm are found?

      Your Answer: N3

      Correct Answer: N2

      Explanation:

      According to the American Joint Committee on Cancer (AJCC) 2002 guidelines, the nodal staging of testicular seminoma is the following:

      N0: no regional lymph node metastases

      N1: metastasis with lymph nodes 2 cm or less in their greatest dimension or multiple lymph nodes, none more than 2 cm

      N2: metastasis with lymph nodes greater than 2 cm but not greater than 5 cm in their greatest dimension, or multiple lymph nodes, any one mass greater than 2 cm, but not more than 5 cm

      N3: metastasis with lymph nodes greater than 5 cm in their greatest dimension.

      The patient in this case has N2 testicular seminoma. This TNM staging is extremely important because treatment options are decided depending on this classification.

    • This question is part of the following fields:

      • Pathology
      • Urology
      5
      Seconds
  • Question 60 - Which of the following statements regarding aqueous humour is correct? ...

    Incorrect

    • Which of the following statements regarding aqueous humour is correct?

      Your Answer: Is the only source of nutrients for the iris

      Correct Answer: Is the only source of nutrients for the lens of the eye

      Explanation:

      The aqueous humour is a transparent, watery fluid similar to plasma, but containing low protein concentrations. It is secreted from the ciliary epithelium and fills both the anterior and the posterior chambers of the eye. It maintains the intraocular pressure and inflates the globe of the eye. It is this hydrostatic pressure which keeps the eyeball in a roughly spherical shape and keeps the walls of the eyeball taut. It provides nutrition (e.g. amino acids and glucose) for the avascular ocular tissues; posterior cornea, trabecular meshwork, lens, and anterior vitreous. It may serve to transport ascorbate into the anterior segment to act as an antioxidant agent. The presence of immunoglobulins indicate its role in immune response to defend against pathogens.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      8.7
      Seconds
  • Question 61 - Which of the following muscles are involved in abduction of the wrist? ...

    Correct

    • Which of the following muscles are involved in abduction of the wrist?

      Your Answer: Extensor carpi radialis brevis and flexor carpi radialis

      Explanation:

      The muscle of the wrist that cause abduction of the wrist otherwise also know as radial flexion of the wrist are the following:

      -Abductor Pollicis Longus

      -Flexor Carpi Radialis

      -Extensor Carpi Radialis Longus

      -Extensor Carpi Radialis Brevis

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      20.4
      Seconds
  • Question 62 - A 35 year-old female developed food poisoning 24H after eating canned food. She...

    Correct

    • A 35 year-old female developed food poisoning 24H after eating canned food. She complained of abdominal cramps, with nausea and vomiting. Shortly after she suddenly developed weakness, blurring of vision, difficulty in swallowing and breathing. Which of the following organisms is most likely associated with fatal food poisoning?

      Your Answer: Clostridium botulinum

      Explanation:

      C. botulinum is a Gram-positive, rod-shaped, spore-forming bacterium. It is an obligate anaerobe, meaning that oxygen is poisonous to the cells. Only botulinum toxin types A, B, E, and F cause disease in humans. Types A, B, and E are associated with foodborne illness. Botulism poisoning can occur due to preserved or home-canned, low-acid food that was not processed using correct preservation times and/or pressure. Signs and symptoms of foodborne botulism typically begin between 18 and 36 hours after the toxin gets into the body, but can range from a few hours to several days, depending on the amount of toxin ingested. Botulinum that is produced by Clostridium botulinum can cause respiratory and muscular paralysis.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      4.7
      Seconds
  • Question 63 - 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: Osteoarthritis

      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
      28.5
      Seconds
  • Question 64 - Atrial septal defect (ASD) is most likely to be due to incomplete closure...

    Incorrect

    • Atrial septal defect (ASD) is most likely to be due to incomplete closure of which one of the following structures:

      Your Answer: Ductus arteriosus

      Correct Answer: Foramen ovale

      Explanation:

      Atrial septal defect is a congenital heart defect that results in a communication between the right and left atria of the heart and may involve the interatrial septum. It results from incomplete closure of the foramen ovale which is normally open during fetal life and closes just after birth.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      9.4
      Seconds
  • Question 65 - A 24-year-old patient with recurrent episodes of deep vein thrombosis presents again to...

    Correct

    • A 24-year-old patient with recurrent episodes of deep vein thrombosis presents again to the clinic. Deficiency of which of the following blood proteins is the most probable cause of this episode?

      Your Answer: Antithrombin III

      Explanation:

      Antithrombin III (ATIII) is a blood protein that acts by inhibiting blood coagulation by neutralizing the enzymatic activity of thrombin.

      Antithrombin III deficiency is an autosomal dominant disorder that leads to an increased risk of venous and arterial thrombosis. Clinical manifestations typically appear in young adulthood.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      15
      Seconds
  • Question 66 - In a hypertensive patient with secondary hyperaldosteronism, aldosterone is released mainly in response...

    Correct

    • In a hypertensive patient with secondary hyperaldosteronism, aldosterone is released mainly in response to:

      Your Answer: Angiotensin II

      Explanation:

      Secondary hyperaldosteronism in hypertension is either due to primary renin overproduction by the kidneys or renin overproduction secondary to decreased renal blood flow. The main stimulus for aldosterone release are adrenocorticotrophic hormone (ACTH), angiotensin II and high plasma K+ levels. Low plasma Na+ might also stimulate the adrenal cortex. Fluid overload will reduce aldosterone secretion. Atrial natriuretic peptide is secreted under conditions of expanded extracellular volume and will not lead to aldosterone secretion.

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      12.5
      Seconds
  • Question 67 - Under normal conditions, what is the major source of energy of cardiac muscles?...

    Correct

    • Under normal conditions, what is the major source of energy of cardiac muscles?

      Your Answer: Fatty acids

      Explanation:

      Under basal conditions, most of the energy needed by cardiac muscle for metabolism is derived from fats (60%), 35% by carbohydrates, and 5% by ketones and amino acids. However, after intake of large amounts of glucose, lactate and pyruvate are mainly used. During prolonged starvation, fat acts as the primary source. 50% of the used lipids are sourced from circulating fatty acids.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      6.7
      Seconds
  • Question 68 - Where do the cells belonging to the mononuclear phagocyte system originate? ...

    Incorrect

    • Where do the cells belonging to the mononuclear phagocyte system originate?

      Your Answer: Lymph nodes

      Correct Answer: Bone marrow

      Explanation:

      The macrophage originates from a committed bone marrow stem cell. It is called the pluripotent hematopoietic stem cell. This differentiates into a monoblast and then into a promonocyte and finally matures into a monocyte. When called upon they leave the bone marrow and enter into the circulation. Upon entering the tissue they transform into macrophages. Tissue macrophages include: Kupffer cells (liver), alveolar macrophages (lung), osteoclasts (bone), Langerhans cells (skin), microglial cells (central nervous system), and possibly the dendritic immunocytes of the dermis, spleen and lymph nodes.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      7.9
      Seconds
  • Question 69 - 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
      10.1
      Seconds
  • Question 70 - What is the most likely cause of prolonged bleeding time in a 40...

    Incorrect

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

      Your Answer: Haemophilia

      Correct Answer: Thrombocytopaenia

      Explanation:

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

    • This question is part of the following fields:

      • General
      • Physiology
      9.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Neurology (0/2) 0%
Physiology (7/15) 47%
General (1/4) 25%
Pathology (12/27) 44%
Pharmacology (1/2) 50%
Women's Health (2/2) 100%
Anatomy (14/28) 50%
Lower Limb (2/6) 33%
Inflammation & Immunology; Respiratory (1/1) 100%
Haematology (1/2) 50%
Cardiovascular (2/2) 100%
Head & Neck (3/7) 43%
Microbiology (1/3) 33%
Endocrine (0/1) 0%
Renal (1/4) 25%
Abdomen (5/8) 63%
Neoplasia; Orthopaedics (0/1) 0%
Neoplasia (3/4) 75%
Cell Injury & Wound Healing (1/3) 33%
Pelvis (1/1) 100%
Upper Limb (2/4) 50%
Fluids & Electrolytes (2/3) 67%
Microbiology; Neoplasia (0/1) 0%
Respiratory (1/1) 100%
Urology (0/2) 0%
Thorax (1/2) 50%
Inflammation & Immunology; Renal (1/1) 100%
Orthopaedics (0/1) 0%
Endocrinology (1/1) 100%
Inflammation & Immunology (0/1) 0%
Passmed