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  • Question 1 - Point of entry of the vagal trunk into the abdomen: ...

    Incorrect

    • Point of entry of the vagal trunk into the abdomen:

      Your Answer: Aortic hiatus

      Correct Answer: Oesophageal hiatus

      Explanation:

      The oesophageal hiatus is located in the muscular part of the diaphragm a T10 and is above, in front and a little to the left of the aortic hiatus. It transmits the oesophagus, the vagus nerves and some small oesophageal arteries.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      11.5
      Seconds
  • Question 2 - A new-born was found to have an undeveloped spiral septum in the heart....

    Incorrect

    • A new-born was found to have an undeveloped spiral septum in the heart. This is characteristic of which of the following?

      Your Answer: Atrioventricular septal defect

      Correct Answer: Persistent truncus arteriosus

      Explanation:

      Persistent truncus arteriosus is a congenital heart disease that occurs when the primitive truncus does not divide into the pulmonary artery and aorta, resulting in a single arterial trunk. The spiral septum is created by fusion of a truncal septum and the aorticopulmonary spiral septum. Incomplete development of these septa results in incomplete separation of the common tube of the truncus arteriosus and the aorticopulmonary trunk.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      9
      Seconds
  • Question 3 - The annular ligament in the forearm: ...

    Incorrect

    • The annular ligament in the forearm:

      Your Answer: Encircles the styloid process of the radius

      Correct Answer: Encircles the head of the radius

      Explanation:

      The annular ligament forms about four-fifths of the osseofibrous ring and is attached to the anterior and posterior margins of the radial notch. It is a strong band of fibres which encircles the head of the radius retaining it in contact with the radial notch of the ulna. When it comes to its upper border, it blends with the anterior and posterior ligament of the elbow.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      7.7
      Seconds
  • Question 4 - A 65-year old man, known with Type 2 diabetes and chronic renal failure,...

    Incorrect

    • A 65-year old man, known with Type 2 diabetes and chronic renal failure, is likely to eventually present with which of the following conditions?

      Your Answer: Primary hyperparathyroidism

      Correct Answer: Secondary hyperparathyroidism

      Explanation:

      When the parathyroid glands secrete excess parathyroid hormone (PTH) in response to hypocalcaemia, it is known as Secondary hyperparathyroidism and is often seen in patients with renal failure. In chronic renal failure, the kidneys fail to excrete adequate phosphorus and also fail to convert enough vitamin D to its active form. This leads to formation of insoluble calcium phosphate in the body which ultimately causes hypocalcaemia. The glands then undergo hyperplasia and hypertrophy leading to secondary hyperparathyroidism. Symptoms include bone and joint pains, along with limb deformities. The raised PTH also results in pleiotropic effects on blood, the immune system and nervous system.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      16.3
      Seconds
  • Question 5 - Renal function is an indication of the state of the kidney, measured by glomerular...

    Correct

    • 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: 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
      7.7
      Seconds
  • Question 6 - The surgical registrar is doing an exploratory laparotomy on a 35 year old...

    Correct

    • The surgical registrar is doing an exploratory laparotomy on a 35 year old lady of African descent with tuberculous of the abdomen and suspected perforation. The small bowel is matted due to adhesions and it is difficult to differentiate the ileum from the jejunum. Which of the following features is typical of the jejunum?

      Your Answer: It has sparse aggregated lymph nodules

      Explanation:

      The jejunum has a wider diameter, is thicker and more vascularized, hence of a deeper colour compared to the ileum. The valvulae conniventes (circular folds) of its mucous membranes are large and thick and its villi are larger than those in the ileum. The jejunum also has sparse aggregates of lymph nodules and most of its part occupies the umbilical and left iliac regions whilst the ileum is mostly in the umbilical, hypogastric, right iliac and pelvic regions.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      16.6
      Seconds
  • Question 7 - An ECG of a 30 year old woman revealed low voltage QRS complexes....

    Correct

    • An ECG of a 30 year old woman revealed low voltage QRS complexes. This patient is most probably suffering from?

      Your Answer: Pericardial effusion

      Explanation:

      The QRS complex is associated with current that results in the contraction of both the ventricles. As ventricles have more muscle mass than the atria, they result in a greater deflection on the ECG. The normal duration of a QRS complex is 10s. A wide and deep Q wave depicts myocardial infarction. Abnormalities in the QRS complex maybe indicative of a bundle block, ventricular tachycardia or hypertrophy of the ventricles. Low voltage QRS complexes are characteristic of pericarditis or a pericardial effusion.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      14.7
      Seconds
  • Question 8 - Which of the following physiological changes will you see in a young man...

    Correct

    • Which of the following physiological changes will you see in a young man who has been trekking in the Himalayas for 3 years?

      Your Answer: Increased renal excretion of HCO3 –

      Explanation:

      The atmospheric pressure is lower at high altitudes as compared with sea level. This leads to a decrease in the partial pressure of oxygen. Once 2100 m (7000 feet) of altitude is reached, there is a drop in saturation of oxyhaemoglobin. The oxygen saturation of haemoglobin determines the oxygen content in the blood. The body physiological tries to adapt to high altitude by acclimatization. Immediate effects include hyperventilation, fluid loss (due to a decreased thirst drive), increase in heart rate and slightly lowered stroke volume. Long term effects include lower lactate production, compensatory alkali loss in urine, decrease in plasma volume, increased erythropoietin release and red cell mass, increased haematocrit, higher concentration of capillaries in striated muscle tissue, increase in myoglobin, increase in mitochondria, increase in aerobic enzyme concentration such as 2,3-DPG and pulmonary vasoconstriction.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      7.2
      Seconds
  • Question 9 - What is formed when the ductus deferens unites with the duct of the...

    Correct

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

      Your Answer: Ejaculatory duct

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      8.8
      Seconds
  • Question 10 - During an exploratory laparotomy a herniation of bowel is identified between the lateral...

    Incorrect

    • During an exploratory laparotomy a herniation of bowel is identified between the lateral edge of the rectus abdominis, the inguinal ligament and the inferior epigastric vessels. These boundaries define the hernia as being a:

      Your Answer: Indirect inguinal hernia

      Correct Answer: Direct inguinal hernia

      Explanation:

      The boundaries given define the inguinal triangle which is the site for direct inguinal hernias. Indirect inguinal hernias occur lateral to the inferior epigastric vessels.

      Femoral hernias protrude through the femoral ring, into the femoral canal.

      Umbilical hernias protrude through a defect in the umbilical area.

      Obturator hernias, occur through the obturator foramen. These are very rare.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      15.4
      Seconds
  • Question 11 - A 13-year-old boy's mother notices he has a lump in his arm, near...

    Correct

    • A 13-year-old boy's mother notices he has a lump in his arm, near his right shoulder. An X-ray reveals a lateral projection in the metaphyseal region of his humerus. The lesion is removed and it is found to be composed of bony cortex, capped by cartilage. What's the most likely diagnosis in this case?

      Your Answer: Osteochondroma

      Explanation:

      Osteochondromas, or osteocartilaginous exostoses, are the most common benign bone tumours, and tend to appear near the ends of long bones. The overgrowth can occur in any bone where cartilage forms bone, and they are capped by cartilage. They are most common in people between the ages of 10-20 years old.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      30.3
      Seconds
  • Question 12 - During routine laboratory tests, a 66-year-old man is found to be suffering from...

    Correct

    • During routine laboratory tests, a 66-year-old man is found to be suffering from hypercholesterolaemia and is prescribed atorvastatin. What is the mechanism of action of atorvastatin?

      Your Answer: Inhibits cholesterol synthesis

      Explanation:

      Atorvastatin is a member of the drug class of statins, used for lowering cholesterol. The mode of action of statins is inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase. This enzyme is needed by the body to make cholesterol. The primary uses of atorvastatin is for the treatment of dyslipidaemia and the prevention of cardiovascular disease.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      7.8
      Seconds
  • Question 13 - What intrinsic muscle of the larynx is responsible for the tensing of the...

    Correct

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

      Your Answer: Cricothyroid muscle

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      8.4
      Seconds
  • Question 14 - A patient under went repair of a lingual artery aneurysm in the floor...

    Correct

    • A patient under went repair of a lingual artery aneurysm in the floor of the mouth. During surgical dissection from the inside of the mouth which muscle would you have to pass through to reach the main portion of the lingual artery?

      Your Answer: Hyoglossus

      Explanation:

      The lingual artery first runs obliquely upward and medialward to the greater horns of the hyoid bone. It then curves downward and forward, forming a loop which is crossed by the hypoglossal nerve, and passing beneath the digastric muscle and stylohyoid muscle it runs horizontally forward, beneath the hyoglossus, and finally, ascending almost perpendicularly to the tongue, turns forward on its lower surface as far as the tip, to become the deep lingual artery.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      17.9
      Seconds
  • Question 15 - The muscle which has an antagonistic action to the serratus anterior muscle and...

    Correct

    • The muscle which has an antagonistic action to the serratus anterior muscle and is the primary protractor of the scapula is the?

      Your Answer: Rhomboid major

      Explanation:

      The rhomboid major arises from the second, third, fourth and fifth thoracic vertebrae. It is inserted into a narrow tendinous arch attached to the root of the spine of the scapula and the inferior angle. By its insertion in the inferior angle of the scapula, it acts on this angle and produces a slight rotation of the scapula on the side of the chest. It also retracts the scapula by working with the trapezius muscle.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      8.7
      Seconds
  • Question 16 - A child presents with hypertension. Serum potassium analysis shows hypokalaemia. What is the...

    Incorrect

    • A child presents with hypertension. Serum potassium analysis shows hypokalaemia. What is the most likely diagnosis?

      Your Answer: Rhabdomyolysis

      Correct Answer: Liddle syndrome

      Explanation:

      Liddle’s syndrome,  is an autosomal dominant disorder, that is characterized by early, and frequently severe, high blood pressure associated with low plasma renin activity, metabolic alkalosis, low blood potassium, and normal to low levels of aldosterone. Liddle syndrome involves abnormal kidney function, with excess reabsorption of sodium and loss of potassium from the renal tubule. Bartter Syndrome also presents with hypokalaemia, however blood pressure of these patients is usually low or normal.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      26.2
      Seconds
  • Question 17 - Pain in the right upper quadrant of the abdomen on ingestion of a...

    Correct

    • Pain in the right upper quadrant of the abdomen on ingestion of a fatty meal is seen in a condition which involves which of the following substances?

      Your Answer: Cholecystokinin

      Explanation:

      The clinical scenario described here favours the presence of gallstones. During food ingestion, vagal discharges stimulate gallbladder contraction. Moreover, presence of fat and amino acids in the intestinal lumen stimulates the release of cholecystokinin (CCK) in the duodenum. This causes sustained gallbladder contraction and relaxation of the sphincter of Oddi. If gallstones are present, there will be inflammation in the gallbladder and CCK will aggravate it due to contractions.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      10.9
      Seconds
  • Question 18 - A 35 year-old woman is undergoing thyroidectomy. The external laryngeal nerve may be...

    Incorrect

    • A 35 year-old woman is undergoing thyroidectomy. The external laryngeal nerve may be injured whilst ligating this artery during the procedure due to its close relationship?

      Your Answer: Inferior laryngeal artery

      Correct Answer: Superior thyroid artery

      Explanation:

      The superior thyroid artery arises from the external carotid artery just below the level of the greater cornu of the hyoid bone and ends in the thyroid gland. This artery must be ligated at the thyroid when conducting a thyroidectomy. If the artery is severed, but not ligated, it will bleed profusely. In order to gain control of the bleeding, the surgeon may need to extend the original incision laterally to ligate the artery at its origin at the external carotid artery. The external laryngeal branch of the superior laryngeal nerve courses in close proximity to the superior thyroid artery, making it at risk for injury during surgery.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      13.7
      Seconds
  • Question 19 - The operating surgeon notices a structure lying alongside a herniated mass whilst repairing...

    Correct

    • The operating surgeon notices a structure lying alongside a herniated mass whilst repairing an indirect inguinal hernia in a female patient. Which structure could this be?

      Your Answer: Round ligament of the uterus

      Explanation:

      The main structure traversing the inguinal canal in women is the round ligament. In men, it is the spermatic cord.

      The iliohypogastric nerve innervates the abdominal wall and runs between the transversus abdominis and internal oblique muscles before piercing the internal oblique at the anterior superior iliac spine to run between the internal and external obliques.

      The inferior epigastric artery is between the peritoneum and the transversus abdominis creating the lateral umbilical fold.

      The ovarian artery and the ovarian vein are branches from the descending aorta and inferior vena cava that supply the ovary in the pelvic cavity.

      The pectineal ligament is a thick fascial layer over the pectineal line of the pubis. It doesn’t traverse the canal.

      The broad ligament if found on the lateral sides of the uterus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      16.1
      Seconds
  • Question 20 - A 48-year-old woman has a mass in her right breast and has right...

    Incorrect

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

      Your Answer: IIIA

      Correct Answer: IIB

      Explanation:

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

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      4.3
      Seconds
  • Question 21 - A 25 year old male patient who had sustained a stab wound in...

    Incorrect

    • A 25 year old male patient who had sustained a stab wound in the middle of the posterior aspect of the left thigh, was discharged from hospital after dressing and antibiotic prophylaxis. Later on the patient developed bleeding through the wound and upon review, the source was discovered to be an artery that is the direct source of the medial and lateral circumflex arteries. Which is this artery that was injured?

      Your Answer: External iliac artery

      Correct Answer: Profunda femoris artery

      Explanation:

      The medial and lateral circumflex arteries are direct branches of the Profunda femoris artery otherwise also known as the deep artery of the thigh. The Profunda femoris artery arises from the femoral artery just below the inguinal ligament (approximately 2-5cm below it).

      The following are the branches of the deep artery of the thigh:

      Lateral circumflex femoral artery

      Medial circumflex femoral artery

      Perforating arteries

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      23.1
      Seconds
  • Question 22 - A 50-year-old gentleman was recently diagnosed with hypertension, with no other abnormalities on...

    Incorrect

    • A 50-year-old gentleman was recently diagnosed with hypertension, with no other abnormalities on physical examination. Further investigations revealed the following :
      Na+ 144 mmol/l
      K+ 3.0 mmol/l
      Cl- 107 mmol/l
      Bicarbonate 25 mmol/l.
      Blood glucose 5.8 mmol/l.
      What is the likely diagnosis?

      Your Answer: Renal artery stenosis

      Correct Answer: Conn syndrome

      Explanation:

      Overproduction of aldosterone (a mineralocorticoid) by the adrenal glands is known as Conn’s syndrome. It can be either due to an aldosterone-secreting adrenal adenoma (50-60% cases) or adrenal gland hyperplasia (40-50% cases). Excess aldosterone leads to sodium and water retention, along with potassium excretion. This leads to arterial (non-essential) hypertension. Conn’s syndrome is the commonest cause of primary hyperaldosteronism. Other symptoms include muscle cramps, headache (due to hypokalaemia) and metabolic alkalosis, which occurs due to increased secretion of H+ ions by the kidney. The raised pH of the blood traps calcium leading to symptoms of hypocalcaemia, which can be mimicked by liquorice ingestion and Liddle syndrome. To diagnose Conn’s syndrome, the ratio of renin and aldosterone is measured. Due to suppression of renin secretion, there is low renin to aldosterone ratio (<0.05). However, anti-hypertensives may affect the test results and should be withdrawn for 6 weeks. Computed tomography can also be done to detect the presence of adrenal adenoma. Cushing’s syndrome does not cause hypokalaemia with normal serum glucose levels. Nelson’s syndrome refers to increased ACTH secretion due to pituitary adenoma. Pheochromocytoma will not lead to hypokalaemia even though hypertension can be seen.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      21.7
      Seconds
  • Question 23 - What are some of the derivatives of the second pharyngeal arch? ...

    Incorrect

    • What are some of the derivatives of the second pharyngeal arch?

      Your Answer: Anterior belly of the digastric

      Correct Answer: Stylohyoid muscle

      Explanation:

      Also known as the hyoid arch, it forms the side and front of the neck. From its cartilage develops the styloid process, stylohyoid ligament and lesser cornu of the hyoid bone. The muscular derivatives include the muscles of facial expression, stapedius, stylohyoid and the posterior belly of the digastric. All these are innervated by cranial nerve VII but migrate into the area of the mandibular arch.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      10.4
      Seconds
  • Question 24 - Which of the following is a likely consequence of severe diarrhoea? ...

    Correct

    • Which of the following is a likely consequence of severe diarrhoea?

      Your Answer: A decrease in the sodium content of the body

      Explanation:

      Diarrhoea can occur due to any of the numerous aetiologies, which include infectious, drug-induced, food related, surgical, inflammatory, transit-related or malabsorption. Four mechanisms have been implicated in diarrhoea: increased osmotic load, increased secretion, inflammation and decreased absorption time. Diarrhoea can result in fluid loss with consequent dehydration, electrolyte loss (Na+, K+, Mg2+, Cl–) and even vascular collapse. Loss of bicarbonate ions can lead to a metabolic acidosis.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      14.4
      Seconds
  • Question 25 - Which name is given to the inferior fascia of the urogenital diaphragm? ...

    Correct

    • Which name is given to the inferior fascia of the urogenital diaphragm?

      Your Answer: Perineal membrane

      Explanation:

      The urogenital fascia is mostly commonly referred to as the perineal membrane. This term refers to an anatomical fibrous membrane in the perineum. It is triangular in shape, and thus at times referred to as the triangular ligament. It is about 4 cm in depth. Its The perineal membrane’s apex is anterior and is separated from the arcuate pubic ligament by an oval opening for the passage of the deep dorsal vein of the penis. The lateral marginas of this triangular ligament are attached on either side to the inferior rami of the pubis and ischium, above the crus penis. Its base faces the rectum, and connects to the central tendinous point of the perineum. The pelvic fascia and Colle’s fascia is fused to the base of this triangle.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      8.5
      Seconds
  • Question 26 - A 14-year old girl presented with a 2cm, mobile, cystic mass in the...

    Correct

    • A 14-year old girl presented with a 2cm, mobile, cystic mass in the midline of her neck. Fine needle aspiration of the mass revealed clear fluid. This is most likely a case of:

      Your Answer: Thyroglossal duct cyst

      Explanation:

      Thyroglossal cyst is the most common congenital thyroid anomaly which is clinically significant and affects women more than men. It is a vestigial remnant of developing thyroid. Although the thyroglossal cyst can develop anywhere along the thyroglossal duct, the most common site is in the midline between the isthmus of thyroid and hyoid bone, or just above the hyoid. Thyroglossal cysts are also associated with ectopic thyroid tissue. Clinically, the cyst moves upward with protrusion of the tongue. Rarely, the persistent duct can become malignant (thyroglossal duct carcinoma) where the cancerous cells arise in the ectopic thyroid tissue that are deposited along the duct. Exposure to radiation is a predisposing factor.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      15.3
      Seconds
  • Question 27 - Muscles and tendons in the planter region of the foot mainly take blood...

    Incorrect

    • Muscles and tendons in the planter region of the foot mainly take blood supply from:

      Your Answer: Popliteal artery

      Correct Answer: Posterior tibial artery

      Explanation:

      The posterior tibial artery is the main source of blood supply to the posterior compartment of the leg.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      17.3
      Seconds
  • Question 28 - What is the mostly likely cause of prolonged activated partial thromboplastin time (aPPT)...

    Correct

    • What is the mostly likely cause of prolonged activated partial thromboplastin time (aPPT) ?

      Your Answer: Heparin therapy

      Explanation:

      The partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT) is an indicator for measuring the efficacy of both the intrinsic and common coagulation pathway. Prolonged aPTT may indicate: use of heparin, antiphospholipid antibody and coagulation factor deficiency (e.g., haemophilia). Deficiencies of factors VIII, IX, XI and XII and rarely von Willebrand factor (if causing a low factor VIII level) may lead to a prolonged aPTT correcting on mixing studies.

    • This question is part of the following fields:

      • General
      • Physiology
      6.9
      Seconds
  • Question 29 - Which of the following diseases causes abrupt vertigo, nausea, vomiting, tinnitus, and nystagmus?...

    Incorrect

    • Which of the following diseases causes abrupt vertigo, nausea, vomiting, tinnitus, and nystagmus?

      Your Answer: Cerebral abscess

      Correct Answer: Vestibular neuronitis

      Explanation:

      Vestibular neuronitis or labyrinthitis causes a self-limited episode of vertigo, presumably due to inflammation of the vestibular division of cranial nerve VIII. Its causes are unknown, It may be due to a virus, but it can be related to a bacterial infection, head injury, stress, allergy, or as a reaction to medication. Symptoms can last up to 7-10 days.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      9.6
      Seconds
  • Question 30 - Ventricular filling follows a delay caused by? ...

    Correct

    • Ventricular filling follows a delay caused by?

      Your Answer: AV node

      Explanation:

      The AV node is a conducting tissue found between the atria and the ventricles of the heart. It conducts electrical signal from the atria to the ventricles and acts a delaying mechanism preventing the atria and the ventricles from contracting at the same time. This decremental conduction prevents premature ventricular contraction in cases such as atrial fibrillation. A delay in the AV node is the reason for the PR segment seen on the ECG. In certain types of supraventricular tachycardia, a person could have two AV nodes; this will cause a loop in electrical current and uncontrollably rapid heart beat. When this electricity catches up with itself, it will dissipate and return to a normal heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      6.4
      Seconds
  • Question 31 - An 80 year-old quadriplegic man has been lying supine for 7 weeks in...

    Incorrect

    • An 80 year-old quadriplegic man has been lying supine for 7 weeks in a critical care ward. He develops a right lung abscess that is draining by gravity to a particular region of the lung. Which is the most likely site of pus collection?

      Your Answer: Lingula

      Correct Answer: Superior segment of the lower lobe

      Explanation:

      The superior segmental bronchus of the lower lobe of the right lung branches posteriorly off the intermediate bronchus or the inferior lobe bronchus. It is therefore more likely to receive fluid or foreign bodies that enter the right main bronchus especially when the patient is supine.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      15.5
      Seconds
  • Question 32 - A 16 year-old boy was stabbed in the right supraclavicular fossa. The sharp...

    Correct

    • A 16 year-old boy was stabbed in the right supraclavicular fossa. The sharp object punctured the portion of the parietal pleura that extends above the first rib. What is the name of this portion of the parietal pleura?

      Your Answer: Cupola

      Explanation:

      Endothoracic fascia: the connective tissue (fascia) that is between the costal parietal pleura and the inner wall of the chest wall.

      Costomediastinal recess: the point where the costal pleura becomes mediastinal pleura.

      Costodiaphragmatic recess: is the lowest point of the pleural sac where the costal pleura becomes diaphragmatic pleura.

      Cupola: the part of the parietal pleura that extends above the first rib level into the root of the neck.

      Costocervical recess: this is a made-up term.

      Peritracheal fascia: a layer of connective tissue that invests the trachea.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      8.8
      Seconds
  • Question 33 - The collaborative effort of the lateral pterygoid muscles produces which action on the...

    Correct

    • The collaborative effort of the lateral pterygoid muscles produces which action on the jaw?

      Your Answer: Protrude the mandible

      Explanation:

      The combined effort of the lateral pterygoid muscles results in the protrusion of the mandible. The lateral pterygoid muscle is a muscle of mastication located superiorly to the medial pterygoid muscle and has two heads. The superior head originates on the infratemporal surface and infratemporal crest of the greater wing of the sphenoid bone, and the inferior head on the lateral surface of the lateral pterygoid plate. The insertion of this muscle is on the front margin of the articular disc of the temporomandibular joint. The unilateral contraction of the pterygoid muscle results in the laterotrusion of the mandible. It is important to note that the lateral pterygoid muscle is the only muscle of mastication that can open the jaw.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      17.5
      Seconds
  • Question 34 - The primary somatosensory cortex is located in the: ...

    Incorrect

    • The primary somatosensory cortex is located in the:

      Your Answer: Occipital lobe

      Correct Answer: Postcentral gyrus

      Explanation:

      The primary somatic sensory cortex is located in the postcentral gyrus and is the largest cortical receiving area for information from somatosensory receptors. Through corticocortical fibres, it then sends the information to other areas of the neocortex and further analysis takes place in the posterior parietal association cortex.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      6.2
      Seconds
  • Question 35 - A 68-year-old woman complains of headaches, dizziness, and memory loss. About a month...

    Incorrect

    • A 68-year-old woman complains of headaches, dizziness, and memory loss. About a month ago, she fell from a staircase but only suffered mild head trauma. What is the most likely diagnosis in this case?

      Your Answer: Epidural haematoma

      Correct Answer: Chronic subdural haematoma

      Explanation:

      A quarter to a half of patients with chronic subdural haematoma have no identifiable history of head trauma. If a patient does have a history of head trauma, it usually is mild. The average time between head trauma and chronic subdural haematoma diagnosis is 4–5 weeks. Symptoms include decreased level of consciousness, balance problems, cognitive dysfunction and memory loss, motor deficit (e.g. hemiparesis), headache or aphasia. Some patients present acutely. They usually result from tears in bridging veins which cross the subdural space, and may cause an increase in intracranial pressure (ICP).

    • This question is part of the following fields:

      • Neurology
      • Pathology
      13.1
      Seconds
  • Question 36 - Which of the following is likely to induce secretion of glucagon? ...

    Correct

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

      Your Answer: Low serum concentration of glucose

      Explanation:

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

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      5.7
      Seconds
  • Question 37 - After being admitted to the hospital, a 60-year-old man is administered sodium nitroprusside....

    Correct

    • After being admitted to the hospital, a 60-year-old man is administered sodium nitroprusside. Which class of drugs does nitroprusside belong to?

      Your Answer: Vasodilators

      Explanation:

      Sodium nitroprusside is a potent peripheral vasodilator that affects both arterioles and venules. It is often administered intravenously to patients who are experiencing a hypertensive emergency. It reduces both total peripheral resistance as well as venous return, so decreasing both preload and afterload. For this reason it can be used in severe cardiogenic heart failure where this combination of effects can act to increase cardiac output. It is administered by intravenous infusion. Onset is typically immediate and effects last for up to ten minutes. The duration of treatment should not exceed 72 hours.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      20.3
      Seconds
  • Question 38 - Some substances, such as Chromium-51 and Technetium-99, are freely filtered but not secreted...

    Incorrect

    • Some substances, such as Chromium-51 and Technetium-99, are freely filtered but not secreted or absorbed by the kidney. In these cases, their clearance rate is equal to:

      Your Answer: Renal plasma flow

      Correct Answer: Glomerular filtration rate

      Explanation:

      If a substance passes through the glomerular membrane with perfect ease, the glomerular filtrate contains virtually the same concentration of the substance as does the plasma and if the substance is neither secreted nor reabsorbed by the tubules, all of the filtered substance continues on into the urine. Glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidney.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      13
      Seconds
  • Question 39 - An operation to resect a tumour of the right lung was stopped as...

    Incorrect

    • An operation to resect a tumour of the right lung was stopped as the chest surgeon said that the tumour was crossing the oblique fissure. Which structures are separated by the oblique fissure of the right lung?

      Your Answer: Lower lobe from upper lobe only

      Correct Answer: Lower lobe from both upper and middle lobes

      Explanation:

      The oblique fissure on the right lung separates the lower lobe from both the middle and upper lobe. The lingual is only found on the left lung and is part of the upper lobe.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      15.2
      Seconds
  • Question 40 - A 20-year-old woman had profuse watery diarrhoea for 2 days. She felt dizzy...

    Incorrect

    • A 20-year-old woman had profuse watery diarrhoea for 2 days. She felt dizzy and weak, and thus decided to seek medical attention. At the emergency room her BP was 80/60 mmHg with a pulse of 118/min. What is the most appropriate intravenous treatment that should be given?

      Your Answer: 5% dextrose in water

      Correct Answer: Isotonic saline

      Explanation:

      Normal saline is typically the first fluid used when hypovolemia is severe enough to threaten the adequacy of blood circulation. It is isotonic and has long been believed to be the safest fluid to give quickly in large volumes.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      15.2
      Seconds
  • Question 41 - A 34-year-old Asian male presents with cervical lymphadenopathy. The patient is suspected to...

    Incorrect

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

      Your Answer: Liquefactive necrosis

      Correct Answer: Caseation necrosis

      Explanation:

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

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      13.4
      Seconds
  • Question 42 - A teacher had varicosities in the region of the small saphenous vein. Which...

    Correct

    • A teacher had varicosities in the region of the small saphenous vein. Which of the following is true about that vein?

      Your Answer: Has nine to twelve valves

      Explanation:

      It is known that the small saphenous vein has nine to twelve valves along its course. This vein begins as a direct continuation of the lateral marginal vein posterior to the lateral malleolus. It is superficially situated but closer to its termination, perforates the deep fascia in the lower part of the popliteal fossa to end in the popliteal vein.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      10.2
      Seconds
  • Question 43 - Which of the following structures carry part of the right bundle branch of...

    Incorrect

    • Which of the following structures carry part of the right bundle branch of the AV bundle?

      Your Answer: Pectinate muscles

      Correct Answer: Moderator band (septomarginal trabecula)

      Explanation:

      The moderator band extends from the base of the anterior papillary muscle to the ventricular septum. It is the structure which carries part of the right AV bundle. Its role it to prevent overdistention of the ventricle.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      9.8
      Seconds
  • Question 44 - The inferior palpebral nerve ascends behind the orbicularis oculi. What is the terminal...

    Incorrect

    • The inferior palpebral nerve ascends behind the orbicularis oculi. What is the terminal branch of the inferior palpebral nerve?

      Your Answer: Lacrimal nerve

      Correct Answer: Infraorbital nerve

      Explanation:

      The inferior palpebral nerve is a branch of the maxillary nerve. It supplies the skin and conjunctiva of the lower eyelid.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      7.4
      Seconds
  • Question 45 - Which of the following has the highest content of triglycerides? ...

    Correct

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

      Your Answer: Chylomicron

      Explanation:

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

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      6.2
      Seconds
  • Question 46 - Which of the following statements is true regarding the umbilical cord? ...

    Correct

    • Which of the following statements is true regarding the umbilical cord?

      Your Answer: Is filled with jelly of Wharton

      Explanation:

      The umbilical cord that connects the fetus to the placenta is about 50cm long. This tissue consists of the body stalk and vitelline duct. The former containing the allantoic diverticulum and the umbilical vessels. The latter contains the connection linking the digestive tube and the yolk sac. This cord is wrapped by stratum of ectoderm and gelatinous tissue or jelly of Wharton. The right umbilical vein plus the vitelline vessels and ducts disappear and this at birth the cord has three vessels which are the umbilical vein and two umbilical arteries.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      4.7
      Seconds
  • Question 47 - Which of the following organs is an ectoderm derivative? ...

    Incorrect

    • Which of the following organs is an ectoderm derivative?

      Your Answer: Adrenal cortex

      Correct Answer: Adrenal medulla

      Explanation:

      Ectoderm derivatives include the adrenal medulla, posterior pituitary, the epidermis of the skin, nails, hair, sweat glands, mammary glands, sebaceous glands, the central nervous system, the peripheral nervous system, the retina and lens of eye, the pupillary muscle of the iris, melanocytes, Schwann cells and odontoblasts.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      10
      Seconds
  • Question 48 - What is the nerve supply to the muscles of the lateral compartment of...

    Correct

    • What is the nerve supply to the muscles of the lateral compartment of the leg ?

      Your Answer: Superficial peroneal nerve

      Explanation:

      The peroneus longus and peroneus brevis in the lateral compartment of the leg take nerve supply from the superficial peroneal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      6.8
      Seconds
  • Question 49 - When a young boy falls on his outstretched hand, he fractures one of...

    Correct

    • When a young boy falls on his outstretched hand, he fractures one of the bones at his wrist joint. The doctors told his parents that the fractured bone has special importance as it is that bone that articulates with the distal end of the radius. Which one of the following is it?

      Your Answer: Scaphoid

      Explanation:

      It is the scaphoid bone that articulates with the radius at this level. It is located at the radial side of the wrist and is considered the largest bone in the proximal row of carpal bones. It articulates with the radius via its superior surface. This bone also articulates with trapezium and trapezoid bones via the inferior surface, capitate and lunate medially.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      12.3
      Seconds
  • Question 50 - The renal cortex and medulla, if seen under the microscope, is lacking one...

    Incorrect

    • The renal cortex and medulla, if seen under the microscope, is lacking one of the following:

      Your Answer: A basement membrane

      Correct Answer: Squamous epithelium

      Explanation:

      Capillaries, Henle’s loop, collecting ducts, Bertin columns and type IV collagen in glomerular basement membrane are all structures present in the renal cortex or medulla. The squamous epithelium is the only one that is lacking in both the renal cortex and medulla, because normally it is not found above the outer urethra.

    • This question is part of the following fields:

      • Pathology
      • Renal
      9.3
      Seconds
  • Question 51 - A patient with a long standing lower motor neuron lesion will have: ...

    Incorrect

    • A patient with a long standing lower motor neuron lesion will have:

      Your Answer: Hyperaesthesia

      Correct Answer: Muscle wasting

      Explanation:

      Lower motor neurons (LMNs) connect the brainstem and spinal cord to muscle fibres. Damage to lower motor neurons is indicated by abnormal electromyographic potentials, fasciculations, paralysis, weakening and wasting of skeletal muscles.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      6.2
      Seconds
  • Question 52 - Basal Metabolic Rate (BMR) will most likely be reduced by which of the...

    Correct

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

      Your Answer: Decrease in body temperature

      Explanation:

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

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      10.3
      Seconds
  • Question 53 - An 18 -year-old female is diagnosed with folliculitis in the left axilla. What...

    Correct

    • An 18 -year-old female is diagnosed with folliculitis in the left axilla. What is the most likely organism that could cause this condition?

      Your Answer: Staphylococcus aureus

      Explanation:

      Folliculitis is the inflammation of the hair follicles. It is usually caused by Staphylococcus infection.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      9.4
      Seconds
  • Question 54 - What is the most likely cause of prolonged bleeding time in a 40...

    Correct

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

      Your 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
      10
      Seconds
  • Question 55 - Which of the following conditions is likely to result in splenomegaly, hypochromic anaemia...

    Correct

    • Which of the following conditions is likely to result in splenomegaly, hypochromic anaemia and hemochromatosis in a young male?

      Your Answer: β-Thalassaemia

      Explanation:

      Beta-thalassaemia is due to decreased production of β-polypeptide chains, with an autosomal inheritance pattern. Carrier patients (heterozygotes) are asymptomatic and have mild to moderate microcytic anaemia. This is known as thalassaemia minor. Homozygotes (β-thalassaemia major, or Cooley’s anaemia) develop severe anaemia and marrow hyperactivity. The disease presents at 1-2 years of age with severe anaemia and transfusional and absorptive iron overload. Patients also present with jaundice, leg ulcers, massive splenomegaly and cholelithiasis. The disease can also lead to splenic sequestration leading to faster destruction of transfused red blood cells. Increased marrow activity causes thickening of cranial bones. Involvement of long bones is also seen, which can cause pathological fractures and growth impairment. There is iron deposition in various organs, which can lead to heart failure or hepatic failure (leading to cirrhosis). Thalassaemias are suspected in presence of family history, or signs suggesting microcytic haemolytic anaemia. Further test and quantitative haemoglobin studies are useful. In beta-thalassaemia, there is an increase in serum bilirubin, iron and ferritin levels. There is severe anaemia, often with haemoglobin < 6 g/dl. There is an elevated red blood cell count, which are microcytic. Peripheral blood smear is diagnostic with nucleated erythroblasts, target cells, small pale red blood cells, and punctate basophilia.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      8.5
      Seconds
  • Question 56 - A woman that presented with dyspnoea, chest pain and cough was found to...

    Incorrect

    • A woman that presented with dyspnoea, chest pain and cough was found to have a serous pleural effusion. This finding is most likely to be associated with which of the following conditions?

      Your Answer: Metastatic carcinoma

      Correct Answer: Congestive heart failure

      Explanation:

      A pleural effusion is defined as an abnormal collection of fluid in the pleural space. Pleural effusion can result from excess fluid production or decreased absorption or both. Thoracentesis and laboratory testing help determine the origin of the accumulated fluid. Serous fluid accumulation in the pleural space indicates the presence of a hydrothorax and is most likely to develop secondary to congestive heart failure.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      14.4
      Seconds
  • Question 57 - A 34-year old gentleman presented with acute pancreatitis to the emergency department. On...

    Incorrect

    • A 34-year old gentleman presented with acute pancreatitis to the emergency department. On enquiry, there was found to be a history of recurrent pancreatitis, eruptive xanthomas and raised plasma triglyceride levels associated with chylomicrons. Which of the following will be found deficient in this patient?

      Your Answer: High-density lipoprotein (HDL)

      Correct Answer: Lipoprotein lipase

      Explanation:

      The clinical features mentioned here suggest the diagnosis of hypertriglyceridemia due to lipoprotein lipase (LPL) deficiency. LPL aids in hydrolysing the lipids in lipoproteins into free fatty acids and glycerol. Apo-CII acts as a co-factor. Deficiency of this enzyme leads to hypertriglyceridemia.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      4.3
      Seconds
  • Question 58 - When you rest your elbows on a desk, what bony landmark of the...

    Correct

    • When you rest your elbows on a desk, what bony landmark of the upper limb are you resting on?

      Your Answer: Olecranon process of the ulna

      Explanation:

      At the upper and back part of the ulna, there exists a curved eminence which is the olecranon process. This process lodges in the olecranon fossa of the humerus. It’s posterior surface is subcutaneous and this triangular area is what you rest your elbow upon.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      7.3
      Seconds
  • Question 59 - A 63-year old lady presents with pain in multiple bones and renal failure....

    Incorrect

    • A 63-year old lady presents with pain in multiple bones and renal failure. On enquiry, there is history of recurrent pneumonia in the past. What will be the likely finding on her bone marrow biopsy?

      Your Answer: Reed–Sternberg cells

      Correct Answer: Plasma cells

      Explanation:

      Multiple myeloma is a plasma cell malignancy that produce excessive monoclonal immunoglobulins. The disease presents with bone pains, renal dysfunction, increased calcium, anaemia and recurrent infections. Diagnosis is by demonstrating the presence of M-protein in urine or serum, lytic bone lesions, light chain proteinuria or excessive plasma cells on marrow biopsy.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      15.3
      Seconds
  • Question 60 - Post-total gastrectomy, there will be a decreased production of which of the following...

    Incorrect

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

      Your Answer: Trypsin

      Correct Answer: Pepsin

      Explanation:

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

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      7.1
      Seconds
  • Question 61 - A surgeon performing a Whipple's procedure, that involves mobilizing the head of the...

    Correct

    • A surgeon performing a Whipple's procedure, that involves mobilizing the head of the pancreases, accidentally injured a structure immediately posterior to the neck of the pancreases which bled out. Which structure is most likely to have been injured?

      Your Answer: Superior mesenteric artery

      Explanation:

      The splenic vein runs behind the pancreas, receives the inferior mesenteric vein and joins the superior mesenteric vein to form the portal vein behind the pancreatic neck.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      3.8
      Seconds
  • Question 62 - Dysarthria, nystagmus and a tremor worsening with directed movement are likely to be...

    Correct

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

      Your 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
      2.6
      Seconds
  • Question 63 - Which muscle in the neck divides the neck into two large triangles? ...

    Correct

    • Which muscle in the neck divides the neck into two large triangles?

      Your Answer: Sternocleidomastoid

      Explanation:

      The sternocleidomastoid muscle is an important landmark in the neck as it divides the neck into two; anterior and posterior triangles. These triangles help in the location of the structures of the neck including the carotid artery, head and neck lymph nodes, accessory nerve and the brachial plexus. It originates from the manubrium and medial portion of the clavicle and inserts on the mastoid process of the temporal bone, superior nuchal line. The sternocleidomastoid receives blood supply from the occipital artery and the superior thyroid artery. It is innervated by the accessory nerve (motor) and cervical plexus (sensory).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      6.8
      Seconds
  • Question 64 - Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal...

    Correct

    • Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal volume of 550 ml and an effective anatomical dead space of 250 ml. Which of the following will bring about a maximum increase in his alveolar ventilation?

      Your Answer: A 2x increase in tidal volume and a shorter snorkel

      Explanation:

      Alveolar ventilation = respiratory rate × (tidal volume − anatomical dead space volume). Increase in respiratory rate simply causes movement of air in the anatomical dead space, with no contribution to the alveolar ventilation. By use of a shorter snorkel, the effective anatomical dead space will decrease and will cause a maximum rise in alveolar ventilation along with doubling of tidal volume.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      7
      Seconds
  • Question 65 - A 29-year-old pregnant woman suffering from hyperemesis gravidarum is prescribed metoclopramide. What is...

    Correct

    • A 29-year-old pregnant woman suffering from hyperemesis gravidarum is prescribed metoclopramide. What is the mechanism of action of metoclopramide?

      Your Answer: Dopamine antagonist

      Explanation:

      Metoclopramide is a potent dopamine-receptor antagonist with anti-emetic and prokinetic properties. It is therefore commonly used to treat nausea and vomiting, and to facilitate gastric emptying in patients with gastric stasis. The anti-emetic action of metoclopramide is due to its antagonist activity at D2 receptors in the chemoreceptor trigger zone (CTZ) in the central nervous system. Common adverse drug reactions associated with metoclopramide include restlessness (akathisia), and focal dystonia.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      14.3
      Seconds
  • Question 66 - Blood supply to the posterior compartment of the thigh is supplied by which...

    Incorrect

    • Blood supply to the posterior compartment of the thigh is supplied by which artery?

      Your Answer: Peroneal

      Correct Answer: Perforating

      Explanation:

      There are usually 3 perforating arteries:

      The first gives branches to the adductor brevis and magnus, biceps femoris and gluteus maximus and anastomoses with the inferior gluteal, medial and lateral femoral circumflex.

      The second artery supplies the posterior femoral muscles and anastomose with the first and third perforating vessels.

      The third supplies the posterior femoral muscles.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      9.9
      Seconds
  • Question 67 - If a catheter is placed in the main pulmonary artery of a healthy...

    Incorrect

    • If a catheter is placed in the main pulmonary artery of a healthy 30-year-old woman, which of the following will be its mean pulmonary arterial pressure?

      Your Answer: 10 mmHg

      Correct Answer: 15 mmHg

      Explanation:

      The pulmonary artery pressure (PA pressure) is a measure of the blood pressure found in the main pulmonary artery. The hydrostatic pressure of the pulmonary circulation refers to the actual pressure inside pulmonary vessels relative to atmospheric pressure. Hydrostatic (blood pressure) in the pulmonary vascular bed is low compared with that of similar systemic vessels. The mean pulmonary arterial pressure is about 15 mmHg (ranging from about 13 to 19 mmHg) and is much lower than the average systemic arterial pressure of 90 mmHg.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      10.1
      Seconds
  • Question 68 - 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
      6.2
      Seconds
  • Question 69 - Which of the following cells would be increased in a patient suffering from...

    Incorrect

    • Which of the following cells would be increased in a patient suffering from a hydatid cyst in the liver?

      Your Answer: Lymphocytes

      Correct Answer: Eosinophils

      Explanation:

      Eosinophils are granulocytes that respond to parasitic infections. They are also involved in allergy response and asthma. They contain granules which stain red with Romanowsky’s method and contain peroxidase, Rnase, Dnase, histamine, lipase and major basic proteins that are toxic to the parasite as well as the hosts tissue. They are about 1-5% of the total WBC population and persist in the blood for 6-12 hours.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      8.8
      Seconds
  • Question 70 - A 25 year-old female medical student presents with fever, lack of appetite, rashes,...

    Incorrect

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

      Your Answer: Herpes simplex virus

      Correct Answer: Epstein–Barr virus

      Explanation:

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

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      10
      Seconds
  • Question 71 - A man was stabbed in the thigh following a bar brawl. A superficial...

    Incorrect

    • A man was stabbed in the thigh following a bar brawl. A superficial vein was injured which terminates in the femoral vein. This superficial vein is?

      Your Answer: Obturator

      Correct Answer: Great saphenous

      Explanation:

      The great saphenous vein is considered the longest vein in the body. It terminates in the femoral vein nearly 3cm below the inguinal ligament. It begins at the dorsum of the foot in the medial marginal vein and ascends at the medial side of the leg in relation with the saphenous nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      9.5
      Seconds
  • Question 72 - A neonate with failure to pass meconium is being evaluated. His abdomen is...

    Incorrect

    • A neonate with failure to pass meconium is being evaluated. His abdomen is distended and X-ray films of the abdomen show markedly dilated small bowel and colon loops. The likely diagnosis is:

      Your Answer: Meckel’s diverticulum

      Correct Answer: Aganglionosis in the rectum

      Explanation:

      Hirschsprung’s disease (also known as aganglionic megacolon) leads to colon enlargement due to bowel obstruction by an aganglionic section of bowel that starts at the anus. A blockage is created by a lack of ganglion cells needed for peristalsis that move the stool. 1 in 5000 children suffer from this disease, with boys affected four times more commonly than girls. It develops in the fetus in early stages of pregnancy. Symptoms include not having a first bowel movement (meconium) within 48 hours of birth, repeated vomiting and a swollen abdomen. Two-third of cases are diagnosed within 3 months of birth. Some children may present with delayed toilet training and some might not show symptoms till early childhood. Diagnosis is by barium enema and rectal biopsy (showing lack of ganglion cells).

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      10.4
      Seconds
  • Question 73 - Which of the following is the most common germ cell tumour of the...

    Correct

    • Which of the following is the most common germ cell tumour of the testis affecting an adult male?

      Your Answer: Seminoma

      Explanation:

      Germ cell tumours represent 90% of primary tumours arising in the testis. They are broadly divided into seminomas and non-seminomas. Seminomas are the most common testicular germ cell tumour seen in 40% cases. The other non-seminomatous histological subtypes include embryonal (25%), teratocarcinoma (25%), teratoma (5%) and pure choriocarcinoma (1%).

    • This question is part of the following fields:

      • Pathology
      • Urology
      6.1
      Seconds
  • Question 74 - Which of the following accumulates within a cell due to the aging process?...

    Incorrect

    • Which of the following accumulates within a cell due to the aging process?

      Your Answer: Bilirubin

      Correct Answer: Lipofuscin

      Explanation:

      Lipofuscin , also known as lipochrome, is a wear and tear pigment or an aging pigment. It represents free radical injury or lipid peroxidation. On microscopic examination is appears as a yellowish brown pigment around the nucleus (perinuclear pigment). It is often seen in cells which are undergoing regressive changes, commonly in the liver and heart of old patients or patients with cancer, cachexia or severe malnutrition.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      7.7
      Seconds
  • Question 75 - Which of the following muscles is solely contained in the anterior triangle of...

    Incorrect

    • Which of the following muscles is solely contained in the anterior triangle of the neck and divides the anterior triangle into three smaller triangles?

      Your Answer: Omohyoid

      Correct Answer: Digastric

      Explanation:

      The digastric muscle is a small muscle located under the jaw. It lies below the body of the mandible, and extends, in a curved form, from the mastoid process to the symphysis menti. The digastric divides the anterior triangle of the neck into three smaller triangles:

      – The submaxillary triangle, bounded above by the lower border of the body of the mandible and a line drawn from its angle to the sternocleidomastoid, below by the posterior belly of the digastric and the stylohyoid and in front by the anterior belly of the digastric

      – The carotid triangle, bounded above by the posterior belly of the digastric and stylohyoid, behind by the sternocleidomastoid and below by the omohyoid

      – The suprahyoid or submental triangle, bounded laterally by the anterior belly of the digastric, medially by the midline of the neck from the hyoid bone to the symphysis menti and inferiorly by the body of the hyoid bone.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      10.1
      Seconds
  • Question 76 - A 27 year old women had developed a darker complexion following a vacation...

    Incorrect

    • A 27 year old women had developed a darker complexion following a vacation to India. She had no erythema or tenderness. Her skin colour returned to normal over a period of 1 month. Which of the these substances is related to the biochemical change mentioned above?

      Your Answer: Hemosiderin

      Correct Answer: Tyrosine

      Explanation:

      The tanning process can occur due to UV light exposure as a result of oxidation of tyrosine to dihydrophenylalanine with the help of the tyrosinase enzyme within the melanocytes. Hemosiderin can impart a brown colour due to breakdown of RBC but its usually due to a trauma and is known as haemochromatosis.

      Lipofuscin gives a golden brown colour to the cell granules not the skin.

      Homogentisic acid is part of a rare disease alkaptonuria, with characteristic black pigment deposition within the connective tissue.

      Copper can impart a brown golden colour, but is not related to UV light exposure.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      17.5
      Seconds
  • Question 77 - The dilator pupillae muscle is innervated by postganglionic sympathetic fibres. Where do the...

    Correct

    • The dilator pupillae muscle is innervated by postganglionic sympathetic fibres. Where do the postganglionic sympathetic fibres originate?

      Your Answer: Superior cervical ganglion

      Explanation:

      The postganglionic sympathetic axons are derived from the superior cervical ganglion and innervate the eye and lacrimal gland allowing for vasoconstriction of the iris and sclera, pupillary dilation, widening of the palpebral fissure, and a reduction in tear production.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      8.3
      Seconds
  • Question 78 - In what form are fats primarily transported in the body? ...

    Correct

    • In what form are fats primarily transported in the body?

      Your Answer: Free fatty acids

      Explanation:

      Fat is mainly transported in the body as free fatty acids. Once out of the adipose cell, the free fatty acids get ionized and combine with albumin.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      15.1
      Seconds
  • Question 79 - A man in his sixties underwent surgery to remove a lump from his...

    Correct

    • A man in his sixties underwent surgery to remove a lump from his axilla. During removal, a nerve originating from the lateral cord of the brachial plexus was damaged. Which nerve is this referring to?

      Your Answer: Lateral pectoral

      Explanation:

      The only branch of the lateral cord of brachial plexus in the options given, is the lateral pectoral nerve. It supplies the pectoralis major muscle and sends a branch to join the medial pectoral nerve forming a loop in front of the first part of the axillary artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      9.2
      Seconds
  • Question 80 - What is the most likely cause of bitemporal hemianopia? ...

    Correct

    • What is the most likely cause of bitemporal hemianopia?

      Your Answer: Prolactinoma

      Explanation:

      Prolactinoma is the mot common pituitary adenoma; leading to hyperprolactinaemia. By virtue of their size, macroprolactinomas press on the adjacent structures leading to headaches and loss of vision due to the pressure effect on optic chiasm. Women notice a change in their menstrual cycle due to raised prolactin levels. In comparison, the problem goes unnoticed in men in the initial stages. Craniopharyngioma is a less common space-occupying lesions affecting children and young adults.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      5.6
      Seconds
  • Question 81 - A 35 year old man presented to the surgical OPD with a lump...

    Incorrect

    • A 35 year old man presented to the surgical OPD with a lump on his right forearm which appeared 3 weeks ago and was tender on examination. He gave a history was being in a car accident with pieces of glass from the windshield piercing his forearm removed manually and on further elective surgery. Which of these cells are characteristically found during inflammation in this situation?

      Your Answer: Mast cell

      Correct Answer: Giant cell

      Explanation:

      A foreign body reaction Is characteristic of giant cells. Glass being the foreign object initiates an inflammatory response in this condition.

      Mast cells are involved in allergic reactions.

      Eosinophils are characteristic of a parasitic infection and allergic inflammatory process but are not due to foreign bodies.

      Plasma cells are typical of chronic inflammation.

      Lymphocytes are involved in viral infections.

      Macrophages combine together to form giant cells.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      35.6
      Seconds
  • Question 82 - Acute respiratory distress syndrome (ARDS) is a medical condition that occurs in critically...

    Correct

    • Acute respiratory distress syndrome (ARDS) is a medical condition that occurs in critically ill patients, and can be triggered by events such as trauma and sepsis. Which of the following variables is most likely to be lower than normal in a patient with ARDS?

      Your Answer: Lung compliance

      Explanation:

      Acute (or Adult) respiratory distress syndrome (ARDS) is a medical condition occurring in critically ill patients characterized by widespread inflammation in the lungs. The development of acute respiratory distress syndrome (ARDS) starts with damage to the alveolar epithelium and vascular endothelium, resulting in increased permeability to plasma and inflammatory cells. These cells pass into the interstitium and alveolar space, resulting in pulmonary oedema. Damage to the surfactant-producing type II cells and the presence of protein-rich fluid in the alveolar space disrupt the production and function of pulmonary surfactant, leading to micro atelectasis and impaired gas exchange. The pathophysiological consequences of lung oedema in ARDS include a decrease in lung volumes, compliance and large intrapulmonary shunts. ARDS may be seen in the setting of pneumonia, sepsis, following trauma, multiple blood transfusions, severe burns, severe pancreatitis, near-drowning, drug reactions, or inhalation injuries.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      10
      Seconds
  • Question 83 - Calculate the pulmonary vascular resistance in an adult male with the following parameters:...

    Correct

    • Calculate the pulmonary vascular resistance in an adult male with the following parameters:

      Heart rate 70 beats/min

      Arterial [O2] 0.24 ml O2/min

      Venous [O2] 0.16 ml O2/mi

      Whole body O2 consumption 500 ml/min

      Pulmonary diastolic pressure 15 mmHg

      Pulmonary systolic pressure 25 mmHg

      Wedge pressure 5 mmHg.

      Your Answer: 2.0 resistance units (mmHg/l per min)

      Explanation:

      Pulmonary vascular resistance (PVR) = (Mean pulmonary artery pressure – Pulmonary capillary wedge pressure) divided by Cardiac output. To get cardiac output, Fick’s principle needs to be applied which states that VO2 = (CO × CAO2) – (CO × CVO2) where VO2 = oxygen consumption, CO = cardiac output, CA = oxygen concentration of arterial blood and CVO2 = oxygen concentration of venous blood. Thus, CO = VO2/CAO2– CVO2, CO = 500/0.24–0.16, CO = 500/0.8, CO = 6.25 l/min. To calculate mean pulmonary artery pressure, we use the formula: Mean pulmonary artery pressure = Diastolic pressure + 1/3(Systolic pressure – Diastolic pressure). Thus, Mean pulmonary artery pressure = 15 + 1/3(25 – 15) = 15 + 3. 33 = 18.33. Substituting these values in the first formula, PVR = 18.3–5/6.25 = 13.5/5.25 = 2.0 resistance units (mmHg/l per min) approximately.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      7.6
      Seconds
  • Question 84 - The histological exam of a tuberculous granuloma shows a periphery of multinuclear giant...

    Correct

    • The histological exam of a tuberculous granuloma shows a periphery of multinuclear giant cells, with a central area of:

      Your Answer: Caseous necrosis

      Explanation:

      Granulomas with necrosis tend to have an infectious cause. The chronic infective lesion in this case typically presents with a central area of caseous (cheese-like) necrosis. Foam cells are the fat-laden M2 macrophages seen in atherosclerosis

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Dermatology
      • Pathology
      7.2
      Seconds
  • Question 85 - What best describes the muscles of the posterior compartment of the leg? ...

    Correct

    • What best describes the muscles of the posterior compartment of the leg?

      Your Answer: One of the posterior compartment leg muscles laterally rotates the femur

      Explanation:

      The muscles of the back of the leg are subdivided into two groups: superficial and deep. Superficial muscles include gastrocnemius, soleus and plantaris and are the chief extensors of the foot at the ankle joint. Deep muscles include the tibialis posterior, flexor hallucis longus, flexor digitorum longus and popliteus

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      10
      Seconds
  • Question 86 - A 28 year gang member was shot in the chest. The bullet hit...

    Incorrect

    • A 28 year gang member was shot in the chest. The bullet hit a vessel that courses horizontally across the mediastinum. Which of the following vessels is it likely to be?

      Your Answer: Left internal jugular vein

      Correct Answer: Left brachiocephalic vein

      Explanation:

      The superior vena cava that empties blood into the right atrium is formed by the right and the left brachiocephalic veins. Hence, the left brachiocephalic has to course across the mediastinum horizontally to join with its right ‘counterpart’. The left subclavian artery and vein being lateral to the mediastinum do not cross the mediastinum while the left jugular and the common carotid artery course vertically.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      26.7
      Seconds
  • Question 87 - A 45 year old lady has been diagnosed with Friedreich's ataxia that has...

    Correct

    • A 45 year old lady has been diagnosed with Friedreich's ataxia that has affected her medial group of nuclei in the anterior horn of the spinal cord. Which of the following structures will have their muscles affected?

      Your Answer: Axial muscles

      Explanation:

      The cells in the anterior horn can be arranged in the following three main groups: medial, lateral and central. The medial group of nuclei in the anterior horn of the spinal cord are located along the entire length of the spinal cord and are responsible for the innervation of the axial muscles of the body ( muscles of the head and neck region). Thus this disease will most likely affect the functioning of the muscles of the head and neck.

    • This question is part of the following fields:

      • Anatomy
      • Neurology
      19.3
      Seconds
  • Question 88 - An experiment is carried out to observe engulfment and phagocytosis of microbes. Strep...

    Incorrect

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

      Your Answer: Histamine

      Correct Answer: Complement C3b

      Explanation:

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

      IgM does not act as an opsonin but igG does.

      Selectins aid leukocytes to bind to the endothelial surfaces.

      C5a is a chemo-attractant and histamine a vasodilator.

      NADPH oxidises offending substance after phagocytosis within the macrophage.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      17.9
      Seconds
  • Question 89 - 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: At the base of the villi throughout the small intestine

      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
      16.4
      Seconds
  • Question 90 - Hormones of the anterior pituitary include which of the following? ...

    Incorrect

    • Hormones of the anterior pituitary include which of the following?

      Your Answer: Oxytocin

      Correct Answer: Prolactin

      Explanation:

      The anterior pituitary gland (adenohypophysis or pars distalis) synthesizes and secretes:

      1. FSH (follicle-stimulating hormone)

      2. LH (luteinizing hormone)

      3. Growth hormone

      4. Prolactin

      5. ACTH (adrenocorticotropic hormone)

      6. TSH (thyroid-stimulating hormone).

      The posterior pituitary gland (neurohypophysis) stores and secretes 2 hormones produced by the hypothalamus:

      1. ADH (antidiuretic hormone or vasopressin)

      2. Oxytocin

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      5.1
      Seconds
  • Question 91 - A 30 year old male has a painless and transilluminant swelling at the...

    Incorrect

    • A 30 year old male has a painless and transilluminant swelling at the upper pole of his left testi. There is a negative cough test. Which of the following is the likely diagnosis?

      Your Answer: Varicocele

      Correct Answer: Spermatocoele

      Explanation:

      Spermatocele, also known as a spermatic cyst is a cystic mass usually occurring at the upper pole of the testis. Differential diagnosis included hydrocele as both are cystic, painless and transilluminant. Ultrasound is a useful modality. If symptomatic or large, surgical excision can be done.

    • This question is part of the following fields:

      • Pathology
      • Urology
      9.5
      Seconds
  • Question 92 - Which of the following nerves has its terminal branch at the supratrochlear nerve?...

    Incorrect

    • Which of the following nerves has its terminal branch at the supratrochlear nerve?

      Your Answer: Maxillary

      Correct Answer: Frontal

      Explanation:

      The supratrochlear nerve is a branch of the frontal nerve which comes from the ophthalmic division of cranial nerve V (trigeminal nerve). It passes above the superior oblique nerve and its descending filaments join the infratrochlear branch of the nasociliary nerve. From the orbit, it exits between the supraorbital foramen and the pulley of the superior oblique. It then curves up to the forehead beneath the corrugator supercilli and frontalis muscle. It further divides into branches that supply sensory innervation to the bridge of the nose, medial part of the upper eyelid and medial forehead.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      12.5
      Seconds
  • Question 93 - An 80 year-old lady presents to the out patient clinic complaining of chest...

    Incorrect

    • An 80 year-old lady presents to the out patient clinic complaining of chest pain of 2 months' duration with a normal electrocardiogram and cardiac enzymes. A computed tomographic scan is done which reveals a mass lesion involving a structure in the middle mediastinum. Which among the following structures could be involved?

      Your Answer: Aortic arch

      Correct Answer: Ascending aorta

      Explanation:

      The middle mediastinum is the broadest part of the mediastinal cavity containing the heart enclosed in the pericardium, ascending aorta, lower half of the superior vena cava with the azygos vein opening into it, the bifurcation of the trachea and the two bronchi, the pulmonary artery with its branches, pulmonary veins, phrenic nerves and bronchial lymph nodes. The most likely structure involved is the ascending aorta, perhaps with an aneurysm.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      19.6
      Seconds
  • Question 94 - A 39-year old female patient was diagnosed with a tumour of the left...

    Incorrect

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

      Your Answer: Inferior mesenteric vein

      Correct Answer: Left renal vein

      Explanation:

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

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      3
      Seconds
  • Question 95 - The passage of leukocytes through the wall of the blood vessels is best...

    Correct

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

      Your Answer: Diapedesis

      Explanation:

      The steps involved in leukocyte arrival and function are:

      1. margination: cells migrate from the centre to the periphery of the vessel

      2. rolling: selectins are upregulated on the vessel walls

      3. adhesion: upregulation of the adhesion molecules ICAM and VCAM on the endothelium interact with integrins on the leukocytes, interaction of these results in adhesion

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

      5. phagocytosis: engulfing the offending substance/cell.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      4.7
      Seconds
  • Question 96 - During an inguinal hernia repair, an incision is made parallel to and 5cm...

    Correct

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

      Your Answer: Transversus abdominis muscle and peritoneum

      Explanation:

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

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      11.5
      Seconds
  • Question 97 - What is the pH of freshly formed saliva at ultimate stimulation? ...

    Correct

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

      Your Answer: 8

      Explanation:

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

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      1.5
      Seconds
  • Question 98 - An intern is attempting to put in an arterial line in an ICU...

    Incorrect

    • An intern is attempting to put in an arterial line in an ICU patients left foot. Which is the best site to feel for the pulsation of the dorsalis pedis artery in the foot?

      Your Answer: Just behind the medial malleolus

      Correct Answer: Just lateral to the tendon of extensor hallucis longus

      Explanation:

      The dorsalis pedis artery is the continuation of the anterior tibial artery. The pulse of the posterior tibial artery, which comes from the posterior compartment of the leg, may be felt behind the medial malleolus just lateral to the tendon of the extensor hallucis longus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      15
      Seconds
  • Question 99 - During an operation to repair an indirect inguinal hernia, you are asked to...

    Incorrect

    • During an operation to repair an indirect inguinal hernia, you are asked to indicate the position of the deep inguinal ring. You indicate this as being:

      Your Answer: Above the pubic tubercle

      Correct Answer: Above the midpoint of the inguinal ligament

      Explanation:

      The deep inguinal ring is near the midpoint of the inguinal ligament, below the anterior superior iliac spine. It is lateral to the inferior epigastric artery. The superficial ring, however, is found above the pubic tubercle. The supravesical fossa is the space between the median and medial umbilical folds.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      14.2
      Seconds
  • Question 100 - A ‘claw hand’ is usually associated with injury to which of the following...

    Correct

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

      Your Answer: Ulnar nerve

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      4
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Abdomen (4/9) 44%
Anatomy (22/44) 50%
Cardiovascular (3/4) 75%
Pathology (12/31) 39%
Upper Limb (5/6) 83%
Endocrine (2/5) 40%
Physiology (17/25) 68%
Renal (1/2) 50%
Respiratory (3/5) 60%
Pelvis (2/2) 100%
Orthopaedics (1/1) 100%
Pharmacology (3/3) 100%
Head & Neck (5/9) 56%
Fluids & Electrolytes (0/3) 0%
Gastroenterology (6/9) 67%
Neoplasia (0/1) 0%
Lower Limb (3/8) 38%
Embryology (1/3) 33%
General (2/2) 100%
Neurology (2/6) 33%
Thorax (1/6) 17%
Endocrinology (1/1) 100%
Microbiology (2/4) 50%
Haematology (1/2) 50%
Inflammation & Immunology (0/3) 0%
Urology (1/2) 50%
Cell Injury & Wound Healing (1/3) 33%
Cell Injury & Wound Healing; Dermatology (1/1) 100%
Passmed