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  • Question 1 - 13 year old girl developed sun burnt cheeks after spending the day playing...

    Incorrect

    • 13 year old girl developed sun burnt cheeks after spending the day playing on the beach. What is the underlying mechanism to her injury?

      Your Answer: Antigen–antibody reaction

      Correct Answer: Free radical injury

      Explanation:

      Free radicals are a by-product of chemical reactions with an unpaired electron in their outer most shell. They are capable of causing wide spread damage to cells. They can cause autolytic reactions thereby converting the reactants into free radicals. By absorbing sun light, the energy is used to hydrolyse water into hydroxyl (OH) and hydrogen (H) free radicals which can cause injury by lipid peroxidation of membranes, oxidative modification of proteins and damage to the DNA structure.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Dermatology
      • Pathology
      14
      Seconds

  • Question 2 - A 62-year-old woman presented to the doctor complaining of spine pain, fatigue and...

    Incorrect

    • A 62-year-old woman presented to the doctor complaining of spine pain, fatigue and oliguria. She is diagnosed with chronic renal failure. Dipstick testing shows no protein, glucose, nitrite or ketones but a semi-quantitative sulphosalicylic acid test for urine protein is positive. Which of the following is the most probable cause of chronic renal failure in this patient.

      Your Answer: Systemic lupus erythematosus

      Correct Answer: Multiple myeloma

      Explanation:

      Dipstick results are negative because the proteins found in the urine of this patient are not albumin but Bence Jones proteins. A Bence Jones protein is a monoclonal globulin protein commonly detected in patients affected by multiple myeloma. Multiple myeloma is a malignancy of plasma cells characterised by the production of monoclonal immunoglobulin. Symptoms include bone pain, bone fractures, bleeding, neurologic symptoms, fatigue, frequent infections and weight loss.

    • This question is part of the following fields:

      • Pathology
      • Renal
      22.3
      Seconds

  • Question 3 - The glossopharyngeal nerve provides the parasympathetic innervation of the: ...

    Incorrect

    • The glossopharyngeal nerve provides the parasympathetic innervation of the:

      Your Answer: Sublingual salivary gland

      Correct Answer: Parotid salivary gland

      Explanation:

      The glossopharyngeal nerve provides parasympathetic innervation for the parotid salivary gland via the auriculotemporal nerve. The facial nerve supplies the parasympathetic innervation of the lacrimal, nasal, sublingual and submandibular glands.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck; Neurology
      14.5
      Seconds

  • Question 4 - A 5-year-old child presents with fever and otalgia. Greenish pustular discharge was seen...

    Correct

    • A 5-year-old child presents with fever and otalgia. Greenish pustular discharge was seen in his left ear during physical examination. The patient is diagnosed with otitis externa. Which of the following organisms most likely caused the infection?

      Your Answer: Pseudomonas aeruginosa

      Explanation:

      P. aeruginosa is a multidrug resistant pathogen recognised for its ubiquity, its advanced antibiotic resistance mechanisms and its association with serious illnesses – especially hospital-acquired infections such as ventilator-associated pneumonia and various septic syndromes. The species name aeruginosa is a Latin word meaning verdigris (copper rust), referring to the blue-green colour of laboratory cultures of the species. This blue-green pigment is a combination of two metabolites of P. aeruginosa, pyocyanin (blue) and pyoverdine (green), which impart the blue-green characteristic colour of cultures.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      29.3
      Seconds

  • Question 5 - Risk factors for hepatocellular carcinoma do NOT include: ...

    Correct

    • Risk factors for hepatocellular carcinoma do NOT include:

      Your Answer: Heptitis E

      Explanation:

      Risk factors for hepatocellular carcinoma include hepatitis B and C, aflatoxin, anabolic steroids, alcohol cirrhosis and primary liver disease.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      9.7
      Seconds

  • Question 6 - Blood investigations of a patient with vitamin K deficiency revealed a prolonged prothrombin...

    Correct

    • Blood investigations of a patient with vitamin K deficiency revealed a prolonged prothrombin time. This coagulation abnormality is most probably due to:

      Your Answer: Factor VII deficiency

      Explanation:

      Factor VII deficiency is a bleeding disorder caused by a deficiency or reduced activity of clotting factor VII. It may be inherited or acquired at some point during life. Inherited factor VII deficiency is an autosomal recessive disorder caused by mutations of the F7 gene. Factor VII is vitamin K-dependent, as are Factors II, IX and X and therefore lack of this vitamin can cause the development of acquired factor VII deficiency. Other causes of acquired deficiency of this factor include liver disease, sepsis and warfarin therapy.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      29.4
      Seconds

  • Question 7 - Which foramen contains the vertebral artery? ...

    Correct

    • Which foramen contains the vertebral artery?

      Your Answer: Foramen magnum

      Explanation:

      The foramen magnum is found in the most inferior part of the posterior cranial fossa. It is traversed by vital structures including the medulla oblongata. Its contents include the following: medulla oblongata, meninges, spinal root of the accessory nerve, vertebral arteries, anterior and posterior spinal arteries, tectorial membrane and alar ligaments.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      7.6
      Seconds

  • Question 8 - A 13-year-old girl has complained of pain in her left arm for 4...

    Incorrect

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

      Your Answer: Osteoblastoma

      Correct Answer: Ewing’s sarcoma

      Explanation:

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

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      14.1
      Seconds

  • Question 9 - A 62-year-old male patient in the intensive care unit was found to have...

    Incorrect

    • A 62-year-old male patient in the intensive care unit was found to have a low serum phosphate level. What is the serum level of phosphate which is considered as normal in adults?

      Your Answer: 1.50–3.0 mmol/l

      Correct Answer: 0.8–1.45 mmol/l

      Explanation:

      After calcium, phosphorus is the most plentiful mineral in the human body. It is an important and vital element which our body needs to complete many physiologic processes , such as filtering waste and repairing cells. Phosphorus helps with bone growth and approximately 85% of phosphate in the body is contained in bone. Phosphate is involved in energy storage, and nerve and muscle production. A normal range of plasma phosphate in adults teenagers generally from 0.8 mmol/l to 1.45 mmol/l. The normal range varies depending on age. Infants and children have higher phosphorus levels because more of this mineral is needed for their normal growth and bone development.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      12.3
      Seconds

  • Question 10 - Which lymph nodes are likely to be enlarged in a patient who has...

    Correct

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

      Your Answer: Superficial inguinal

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      8.1
      Seconds

  • Question 11 - Decreased velocity of impulse conduction through the atrioventricular node (AV node) in the...

    Incorrect

    • Decreased velocity of impulse conduction through the atrioventricular node (AV node) in the heart will lead to:

      Your Answer: Decreased PR interval

      Correct Answer: Increased PR interval

      Explanation:

      AV node damage may lead to an increase in the PR interval to as high as 0.25 – 0.40 s (normal = 0.12 – 0.20 s). In the case of severe impairment, there might be a complete failure of passage of impulses leading to complete block. In this case, the atria and ventricles will beat independently of each other.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      18
      Seconds

  • Question 12 - The gynaecologist suspects that her patient has a cervical cancer. What particular test...

    Correct

    • The gynaecologist suspects that her patient has a cervical cancer. What particular test should be done on this patient to screen for cervical cancer?

      Your Answer: Pap smear

      Explanation:

      Worldwide, approximately 500,000 new cases of cervical cancer and 274,000 deaths are attributable to cervical cancer yearly. This makes cervical cancer the second most common cause of death from cancer in women. The mainstay of cervical cancer screening has been the Papanicolaou test (Pap smear).

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      6.4
      Seconds

  • Question 13 - A 5-year-old child is rushed to the emergency department because of fever, erythema...

    Incorrect

    • A 5-year-old child is rushed to the emergency department because of fever, erythema and neck stiffness. The child is also hypotensive upon physical examination. Which is the most likely toxin responsible for this child's condition?

      Your Answer: Botulinum toxin

      Correct Answer: Endotoxin

      Explanation:

       An endotoxin is part of the bacterial outer membrane, and it is not released until the bacterium is killed by the immune system. The body’s response to an endotoxin can involve severe inflammation. In general, the inflammation process is usually considered beneficial to the infected host, but if the reaction is severe enough, it can lead to sepsis.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      19.3
      Seconds

  • Question 14 - 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
      4.3
      Seconds

  • Question 15 - What is the basic chemical reaction that takes place in the breakdown of...

    Incorrect

    • What is the basic chemical reaction that takes place in the breakdown of complex foodstuffs?

      Your Answer: Dehydration

      Correct Answer: Hydrolysis

      Explanation:

      Breakdown of complex food into simpler compounds is achieved by hydrolysis, with the help of different enzymes specific for different compounds.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      11.5
      Seconds

  • Question 16 - Following a bee sting, a women develops a 2cm red, raised, swollen lesion...

    Incorrect

    • Following a bee sting, a women develops a 2cm red, raised, swollen lesion at the site of the sting . Which of the following findings is likely to be seen in this lesion?

      Your Answer: Foreign body reaction

      Correct Answer: Vasodilation

      Explanation:

      Inflammation is the immediate response of the body towards infections or irritations. The cardinal signs of inflammation are 1. redness/rubor, 2. tumour/swelling, 3.dolar/pain, 4.calor/heat and organ dysfunction (function laesa). Inflammation has 2 components; vascular and cellular. Blood vessels dilate upstream of the inflamed area leading to the rubor and calor and constrict downstream, increasing pressure and causing fluid to leak out of the capillary, resulting in swelling. The cellular component includes infiltration by neutrophils. Leukocyte arrival and functions include; 1. margination: cells marginated 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 resulting in adhesion, 4. diapedesis and chemotaxis: diapedesis is the transmigration of the leukocyte across the endothelium of the capillary and towards a chemotactic product and 5. phagocytosis: engulfing the offending substance/cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      17.8
      Seconds

  • Question 17 - A cerebellar tremor can be differentiated from a Parkinsonian tremor in that: ...

    Incorrect

    • A cerebellar tremor can be differentiated from a Parkinsonian tremor in that:

      Your Answer: It is decreased during activity

      Correct Answer: It only occurs during voluntary movements

      Explanation:

      Cerebellar disease leads to intention tremors, which is absent at rest and appears at the onset of voluntary movements. In comparison, Parkinson’s tremor is present at rest. Frequency of tremor is a less reliable means to differentiate between the two as the oscillation amplitude of the tremor is not constant throughout a voluntary action.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      22.4
      Seconds

  • Question 18 - Which of the following organs of the abdominal cavity is completely covered by...

    Incorrect

    • Which of the following organs of the abdominal cavity is completely covered by the peritoneum?

      Your Answer: Pancreas

      Correct Answer: Spleen

      Explanation:

      Of the organs listed, the spleen is the only organ that is completely intraperitoneal, that is entirely in the peritoneum. Other completely intraperitoneal organs include the stomach, liver, appendix and the small intestines. The kidney, Inferior vena cava, aorta and the suprarenal glands are all retroperitoneal organs. The pancreas and the duodenum are partially retroperitoneal, with the tail of the pancreas in the peritoneum found in the splenorenal ligament while only the first part of the duodenum is intraperitoneal. For the intraperitoneal organs remember SALTD SPRSS
      S = Stomach
      A = Appendix
      L = Liver
      T = Transverse colon
      D = Duodenum (only the 1st part)
      S = Small intestines
      P = Pancreas (only the tail)
      R = Rectum (only the upper 3rd)
      S = Sigmoid colon
      S = Spleen
      For retroperitoneal, just remember SADPUCKER:
      S = suprarenal glands
      A = Aorta and IVC
      D = Duodenum (all but the 1st part)
      P = Pancreas (all but the tail)
      U = Ureter and bladder
      C = Colon (ascending and descending)
      K = Kidneys
      E = Oesophagus
      R = Rectum (Lower two-thirds)
      For secondarily retroperitoneal remember ‘Pussy Cat Dolls“:
      P = Pancreas
      C = Colon (only ascending and descending)
      D = Duodenum (only parts 2-4)

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      21.7
      Seconds

  • Question 19 - A sudden loud sound is more likely to result in cochlear damage than...

    Incorrect

    • A sudden loud sound is more likely to result in cochlear damage than a slowly developing loud sound. This is because:

      Your Answer: The tympanic membrane becomes flaccid as a sound becomes louder

      Correct Answer: There is a latent period before the attenuation reflex can occur

      Explanation:

      On transmission of a loud sound into the central nervous system, an attenuation reflex occurs after a latent period of 40-80 ms. This reflex contracts the two muscles that pull malleus and stapes closer, developing a high degree of rigidity in the entire ossicular chain. This reduces the ossicular conduction of low frequency sounds to the cochlea by 30-40 decibels. In this way, the cochlea is protected from damage due to loud sounds (these are low frequency sounds) when they develop slowly.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      22.1
      Seconds

  • Question 20 - Epstein-Barr virus (EBV) is known to be a carcinogen for: ...

    Incorrect

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

      Your Answer: Hepatocellular carcinoma

      Correct Answer: B-cell lymphoma

      Explanation:

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

    • This question is part of the following fields:

      • Microbiology; Neoplasia
      • Pathology
      4.9
      Seconds

  • Question 21 - A 50 year-old man, who sustained a head injury experienced sudden onset of...

    Incorrect

    • A 50 year-old man, who sustained a head injury experienced sudden onset of horizontal double vision. He is diagnosed with lateral rectus palsy. Which of the following nerves is affected in this condition?

      Your Answer: Oculomotor

      Correct Answer: Abducent

      Explanation:

      The lateral rectus muscle is one of the 6 extra-ocular muscles that control eye movements. It is responsible for abduction and is the only muscle that is innervated by the abducens nerve (CN VI).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      10.7
      Seconds

  • Question 22 - The thoracic duct : ...

    Incorrect

    • The thoracic duct :

      Your Answer: Enters the thorax through the vena caval hiatus of the thoracoabdominal diaphragm

      Correct Answer: varies in length from 38 to 45 cm

      Explanation:

      The thoracic duct is the main drainage of lymph in the body. It varies in length from 38 to 45 cm and extends from the second lumbar vertebra to the root of the neck.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      5.4
      Seconds

  • Question 23 - The inferior palpebral nerve ascends behind the orbicularis oculi. What is the terminal...

    Correct

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

      Your 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
      16.9
      Seconds

  • Question 24 - Perforin are present in the granules of which cell? ...

    Correct

    • Perforin are present in the granules of which cell?

      Your Answer: Natural killer cell

      Explanation:

      Perforins are characteristically found In the granules of CD8+ T cells and natural killer cells. They are cytolytic proteins that insert into the target plasma membrane forming a hole and resulting in lysis. They along with granzyme B induce apoptosis in the target cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      6.5
      Seconds

  • Question 25 - Painful erections along with deviation of the penis to one side when erect...

    Incorrect

    • Painful erections along with deviation of the penis to one side when erect are seen in which of the following conditions?

      Your Answer: Priapism

      Correct Answer: Peyronie’s disease

      Explanation:

      Peyronie’s disease leads to development of fibrous plaques in the penile soft tissue and occurs in 1% of men, most commonly affecting white males above 40 years age. It is a connective tissue disorder named after a French surgeon, François de la Peyronie who first described it. Symptoms include pain, hard lesions on the penis, abnormal curvature of erect penis, narrowing/shortening, painful sexual intercourse and in later stages, erectile dysfunction. 30% cases report fibrosis in other elastic tissues such as Dupuytren’s contractures of the hand. There is likely a genetic predisposition as increased incidence is noted among the male relatives of an affected individual.

    • This question is part of the following fields:

      • Pathology
      • Urology
      5.8
      Seconds

  • Question 26 - Etoposide is a chemotherapeutic agent used in the treatment of different types of...

    Incorrect

    • Etoposide is a chemotherapeutic agent used in the treatment of different types of cancer. Which of the following is the correct indication for this drug?

      Your Answer: Hairy cell leukaemia

      Correct Answer: Lung cancer

      Explanation:

      Etoposide phosphate is an inhibitor of the enzyme topoisomerase II. It is used as a form of chemotherapy for malignancies such as lung cancer, testicular cancer, lymphoma, non-lymphocytic leukaemia and glioblastoma multiforme. Side effects are very common and can include low blood cell counts, vomiting, loss of appetite, diarrhoea, hair loss, and fever.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      8.6
      Seconds

  • Question 27 - Which Statement is true of the brachial plexus? ...

    Incorrect

    • Which Statement is true of the brachial plexus?

      Your Answer: The lateral cord continues as the axillary nerve

      Correct Answer: The posterior cord continues as the axillary nerve

      Explanation:

      The lateral cord continues as the musculocutaeous nerve.

      The medial cord continues as the ulnar nerve.

      The posterior cord continues as the radial nerve and the axillary nerve.

      The nerve to subclavius muscle is a branch of the C6 root.

      The suprascapular nerve is a branch from the upper trunk.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      15
      Seconds

  • Question 28 - All the following arteries contribute to the blood supply of the hip joint...

    Incorrect

    • All the following arteries contribute to the blood supply of the hip joint except:

      Your Answer: Foveal artery

      Correct Answer: Pudendal

      Explanation:

      The blood supply to the hip joint is from two main arteries, the medial circumflex femoral and lateral circumflex femoral arteries. These are branches of the deep artery of the thigh, which itself is a branch of the femoral artery. There is contribution of blood supply from the inferior gluteals, foveal and obturator arteries.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      6.2
      Seconds

  • Question 29 - When does the heart rate decrease? ...

    Incorrect

    • When does the heart rate decrease?

      Your Answer: On inspiration

      Correct Answer: Pressure on the eyeball

      Explanation:

      Various vagotonic manoeuvres (e.g. Valsalva manoeuvre, carotid sinus massage, pressure on eyeballs, ice-water facial immersion, swallowing of ice-cold water) result in increased parasympathetic tone through the vagus nerve which results in a decrease in heart rate. These manoeuvres may be clinically useful in terminating supraventricular arrhythmias.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      3.7
      Seconds

  • Question 30 - Which of the following factors will not affect the wound healing process in...

    Correct

    • Which of the following factors will not affect the wound healing process in a young women who suffered serious burns to her chest and hands?

      Your Answer: Vitamin A deficiency

      Explanation:

      Healing can be sped-up or slowed down due to various reasons: 1. blood supply, 2. infection, 3. denervation, 4. collection of blood/hematoma, 5. mechanical stress, 6. foreign body, 7. techniques used during surgery and 8. dressing of the wound. Other systemic factors include 1. nutrition e.g. deficiency of zinc, vitamin C, protein deficiency, 2. metabolic status, 3. circulatory status and 4. hormonal influence

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      12.5
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cell Injury & Wound Healing; Dermatology (0/1) 0%
Pathology (6/15) 40%
Renal (0/1) 0%
Anatomy (4/10) 40%
Head & Neck; Neurology (0/1) 0%
Microbiology (1/2) 50%
Gastrointestinal; Hepatobiliary (1/1) 100%
Haematology (1/1) 100%
Head & Neck (3/4) 75%
Orthopaedics (0/1) 0%
Fluids & Electrolytes (0/1) 0%
Pelvis (1/1) 100%
Cardiovascular (0/2) 0%
Physiology (0/5) 0%
Neoplasia (1/1) 100%
Gastroenterology (0/1) 0%
Inflammation & Immunology (1/2) 50%
Neurology (0/2) 0%
Abdomen (0/1) 0%
Microbiology; Neoplasia (0/1) 0%
Thorax (0/1) 0%
Urology (0/1) 0%
Pharmacology (0/1) 0%
Upper Limb (0/1) 0%
Lower Limb (0/1) 0%
Cell Injury & Wound Healing (1/1) 100%
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