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  • Question 1 - A 60-year-old male is suspected to have pancreatic cancer. What particular tumour marker...

    Incorrect

    • A 60-year-old male is suspected to have pancreatic cancer. What particular tumour marker should be requested to aid in the confirmation of the diagnosis of pancreatic cancer?

      Your Answer: CA-125

      Correct Answer: Carcinoembryonic antigen (CEA)

      Explanation:

      Carcinoembryonic antigen (CEA) is used as a tumour marker. CEA test measures the amount of this protein that may appear in the blood of some people who have certain types of cancers especially cancer of the colon and rectal cancer. It may also be present in the pancreas, breast, ovary or lung.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      16.5
      Seconds
  • Question 2 - A 45-year old farmer was referred to the surgical clinic with complaints of...

    Correct

    • A 45-year old farmer was referred to the surgical clinic with complaints of pain in his right hypochondrium. Investigations confirmed the diagnosis of hepatocellular carcinoma with malignant ascites. According to you, what is the most likely cause of HCC in this patient?

      Your Answer: Aflatoxin

      Explanation:

      Aflatoxins are naturally occurring toxins produced by the Aspergillus fungus (most often, A. flavus and A. parasiticus). These organisms are common and their native habitat is soil, decaying vegetation and grains. They can contaminate the grain before harvest or after storage, more likely in high-humidity (at least 7%) or high temperature environment of after stressful conditions like drought. Aflatoxins are mycotoxins and also carcinogenic. They get metabolized in the liver to an epoxide, aflatoxin M1. High exposure can lead to acute necrosis, cirrhosis or liver carcinoma. These substances can cause haemorrhage, acute liver damage, oedema, and alteration in digestion, absorption and/or metabolism of nutrients. Although humans are susceptible to these toxins like all other animals, they have a high tolerance level and hence, rarely develop acute aflatoxicosis. However, children are particularly susceptible to exposure leading to growth impairment and delayed development. Chronic exposure carries a high risk of hepatic cancer, due to intercalation of its metabolite aflatoxin M1 into the DNA and alkylation of the bases because of its epoxide moiety.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      32.6
      Seconds
  • Question 3 - During a street fight a boy sustained a laceration below the elbow. It...

    Correct

    • During a street fight a boy sustained a laceration below the elbow. It was a deep cut that led to profuse bleeding from an artery situated on the supinator muscle immediately below the elbow. The vessel most likely to have been injured is?

      Your Answer: Radial recurrent artery

      Explanation:

      The radial recurrent artery is situated on the supinator muscle then passing between the brachialis and the brachioradialis muscles. It originates from the radial artery and ends by anastomosing with the terminal part of the Profunda brachii.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      29.9
      Seconds
  • Question 4 - A patient came into the emergency in a state of shock. His blood...

    Correct

    • A patient came into the emergency in a state of shock. His blood group is not known, but on testing it clotted with anti B antibodies when mixed with A +ve blood. Which blood should be transfused?

      Your Answer: B +ve

      Explanation:

      Group A – has only the A antigen on red cells (and B antibody in the plasma)

      Group B – has only the B antigen on red cells (and A antibody in the plasma)

      Group AB – has both A and B antigens on red cells (but neither A nor B antibody in the plasma)

      Group O – has neither A nor B antigens on red cells (but both A and B antibody are in the plasma). Many people also have a Rh factor on the red blood cell’s surface. This is also an antigen and those who have it are called Rh+. Those who have not are called Rh–. A person with Rh– blood does not have Rh antibodies naturally in the blood plasma (as one can have A or B antibodies, for instance) but they can develop Rh antibodies in the blood plasma if they receive blood from a person with Rh+ blood, whose Rh antigens can trigger the production of Rh antibodies. A person with Rh+ blood can receive blood from a person with Rh– blood without any problems. The patient’s blood group is B positive as he has antigen B, antibody A and Rh antigens

    • This question is part of the following fields:

      • General
      • Physiology
      4
      Seconds
  • Question 5 - Which of the following over-the-counter drugs can cause a prolonged bleeding time? ...

    Correct

    • Which of the following over-the-counter drugs can cause a prolonged bleeding time?

      Your Answer: Acetylsalicylic acid

      Explanation:

      Acetylsalicylic acid, or aspirin, is a nonsteroidal anti-inflammatory drug that is widely used as an analgesic and antipyretic. Aspirin is as a cyclo-oxygenase inhibitor that leads to decreased prostaglandin production. Decreased platelet aggregation is another effect of this drug, achieved by long-lasting use of aspirin.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      4.7
      Seconds
  • Question 6 - Which of the following is NOT a nutritional factor involved in wound healing:...

    Correct

    • Which of the following is NOT a nutritional factor involved in wound healing:

      Your Answer: Vitamin B3

      Explanation:

      Vitamin B6 is required for collagen cross-links.

      Vitamin A is required for epithelial cell proliferation.

      Zinc is required for RNA and DNA synthesis.

      Copper is required for cross-linking of collagen.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Physiology
      8.9
      Seconds
  • Question 7 - A 35-year old lady presents to her GP with vague abdominal symptoms. Examination...

    Incorrect

    • A 35-year old lady presents to her GP with vague abdominal symptoms. Examination reveals a normal size spleen. Which of the following is the likely diagnosis?

      Your Answer:

      Correct Answer: Idiopathic thrombocytopenic purpura

      Explanation:

      Idiopathic thrombocytopenic purpura (ITP) is a disease caused due to development of an antibody against a platelet antigen (autoantibody). In childhood disease, the autoantibody gets triggered by binding of viral antigen to the megakaryocytes. Presentation includes unexplained thrombocytopenia, petechiae and bleeding from mucosal surfaces. The spleen usually does not enlarge in size. However, splenomegaly can occur due to coexisting viral infection. Marrow examination reveals normal or increased number of megakaryocytes. Diagnosis is by exclusion of other thrombocytopenic disorders.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 8 - Which of the following statements is true of Colles’ fracture? ...

    Incorrect

    • Which of the following statements is true of Colles’ fracture?

      Your Answer:

      Correct Answer: Is a cause of carpal tunnel syndrome

      Explanation:

      Colles’ fracture is a distal fracture of the radius that is a known cause of carpal tunnel syndrome (compression of the median nerve in the carpal tunnel). It rarely results in ulnar nerve compression. A Colles’ fracture is extra-articular and does not extend into the wrist joint, otherwise this would make it an intra-articular fracture (Barton’s fracture). The distal fragment in a Colles’ fracture is displaced dorsally, unlike in a Smith’s fracture where the distal fragment is displaced volarly (ventrally). Associated fracture of the ulnar styloid process may occur and is a common associated injury.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      0
      Seconds
  • Question 9 - Which of the following muscles attaches to the pterygomandibular raphe? ...

    Incorrect

    • Which of the following muscles attaches to the pterygomandibular raphe?

      Your Answer:

      Correct Answer: Superior pharyngeal constrictor muscle

      Explanation:

      The pterygomandibular raphé (pterygomandibular ligament) provides attachment on its posterior border to the superior pharyngeal constrictor and on its anterior border to the buccinator muscle.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 10 - Which one of the following is a derivative of the midgut? ...

    Incorrect

    • Which one of the following is a derivative of the midgut?

      Your Answer:

      Correct Answer: Caecum

      Explanation:

      The primary intestinal loop is formed from the midgut which gives rise to the distal half of the duodenum, the jejunum, ascending colon, proximal two thirds of the transverse colon and the ileum.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      0
      Seconds
  • Question 11 - A 68-year-old man underwent sigmoid resection with diverting colostomy for a ruptured sigmoid...

    Incorrect

    • A 68-year-old man underwent sigmoid resection with diverting colostomy for a ruptured sigmoid diverticulum 10 days ago. He received gentamicin and ampicillin post-op. 2 days after he was discharged from the hospital, he was readmitted because of high grade fever and chills. His blood culture grew Gram-negative bacilli. Which organism is most likely responsible for the patient's infection?

      Your Answer:

      Correct Answer: Bacteroides fragilis

      Explanation:

      Bacteroides fragilis is an anaerobic, Gram-negative, rod-shaped bacterium. It is part of the normal flora of the human colon and is generally a commensal, but can cause infection if displaced into the bloodstream or surrounding tissue following surgery, disease, or trauma.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      0
      Seconds
  • Question 12 - A 27-yeaar-old woman is diagnosed with candidiasis and prescribed fluconazole. What is the...

    Incorrect

    • A 27-yeaar-old woman is diagnosed with candidiasis and prescribed fluconazole. What is the mechanism of action of fluconazole?

      Your Answer:

      Correct Answer: Inhibits cytochrome P450

      Explanation:

      Fluconazole is a triazole antifungal drug used in the treatment and prevention of superficial and systemic fungal infections. Like other imidazole- and triazole-class antifungals, fluconazole inhibits the fungal cytochrome P450 enzyme, 14-demethylase. It is used to treat candidiasis, blastomycosis, coccidioidomycosis, cryptococcosis, histoplasmosis, dermatophytosis, and pityriasis versicolor.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds
  • Question 13 - A 78-year-old diabetic man undergoes renal function tests. Which of the following substances...

    Incorrect

    • A 78-year-old diabetic man undergoes renal function tests. Which of the following substances will be the most accurate for measuring glomerular filtration rate (GFR)?

      Your Answer:

      Correct Answer: Inulin

      Explanation:

      Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal glomerular capillaries into the Bowman’s capsule per unit time. Clinically, this is often measured to determine renal function. Inulin was originally used as it is not reabsorbed by the kidney after glomerular filtration, therefore its rate of excretion is directly proportional to the rate of filtration of water and solutes across the glomerular filter. However, in clinical practice, creatinine clearance is used to measure GFR. Creatinine is an endogenous molecule, synthesised in the body, that is freely filtered by the glomerulus (but also secreted by the renal tubules in very small amounts). Creatinine clearance exceeds GFR due to creatinine secretion, and is therefore a close approximation of the GFR.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 14 - upon stroking the plantar surface of a patient's foot, extension of toes was...

    Incorrect

    • upon stroking the plantar surface of a patient's foot, extension of toes was noted. This is likely to be accompanied with:

      Your Answer:

      Correct Answer: Spasticity

      Explanation:

      An upper motor neuron lesion affects the neural pathway above the anterior horn cell or motor nuclei of the cranial nerves, whereas a lower motor neurone lesion affects nerve fibres travelling from the anterior horn of the spinal cord to the relevant muscles. An upper motor neurone lesions results in the following:

      – Spasticity in the extensor muscles (lower limbs) or flexor muscles (upper limbs).

      – ‘clasp-knife’ response where initial resistance to movement is followed by relaxation

      – Weakness in the flexors (lower limbs) or extensors (upper limbs) with no muscle wasting

      – Brisk tendon jerk reflexes

      – Positive Babinski sign (on stimulation of the sole of the foot, the big toe is raised rather than curled downwards)

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 15 - Which of the following substances brings about a dilatation of the gastrointestinal resistance...

    Incorrect

    • Which of the following substances brings about a dilatation of the gastrointestinal resistance vessels?

      Your Answer:

      Correct Answer: Vasoactive intestinal peptide

      Explanation:

      Gastric vasoconstrictors include catecholamines, angiotensin II and vasopressin. Vasodilators include vasoactive intestinal peptide and the hormones; gastrin, cholecystokinin and glucagon.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 16 - Which of the following is responsible for the maximum increase in total peripheral...

    Incorrect

    • Which of the following is responsible for the maximum increase in total peripheral resistance on sympathetic stimulation?

      Your Answer:

      Correct Answer: Arterioles

      Explanation:

      Arterioles are also known as the resistance vessels as they are responsible for approximately half the resistance of the entire systemic circulation. They are richly innervated by the autonomic nervous system and hence, will bring about the maximum increase in peripheral resistance on sympathetic stimulation.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 17 - The superior ulnar collateral artery is a direct branch of this artery: ...

    Incorrect

    • The superior ulnar collateral artery is a direct branch of this artery:

      Your Answer:

      Correct Answer: Brachial

      Explanation:

      The brachial artery gives rise to a small branch at the middle of the arm, which is the superior collateral artery. It descends accompanied by the ulnar nerve and anastomoses with the posterior ulnar recurrent and inferior ulnar collateral.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 18 - In a splenectomy procedure, special care is emphasized on the preservation of the...

    Incorrect

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

      Your Answer:

      Correct Answer: Splenorenal ligament

      Explanation:

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

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

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

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

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

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

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 19 - A patient who complained of pain on the lower left side of the...

    Incorrect

    • A patient who complained of pain on the lower left side of the back had an x-ray done which confirmed a hernia passing posterolaterally, just superior to the iliac crest. Where is this hernia passing through?

      Your Answer:

      Correct Answer: Lumbar triangle

      Explanation:

      The lumber triangle is bound medially by the border of the latissimus dorsi, laterally by the external abdominal oblique and by the iliac crest inferiorly. This is exactly where the hernia that is described is located.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 20 - The circle of Willis is one of the cerebrovascular safeguards comprised of the...

    Incorrect

    • The circle of Willis is one of the cerebrovascular safeguards comprised of the left and the right posterior communicating artery. Which of the following arteries in the brain is connected to the posterior cerebral artery by these posterior communicating arteries?

      Your Answer:

      Correct Answer: Internal carotid artery

      Explanation:

      The Circle of Willis is an anastomosis of cerebral arteries that are located at the base of the brain. The Circle of Willis is one of the important safeguards that ensure back up of blood supply to parts of the brain in case of any cerebrovascular accident. The Circle of Willis is made up of an anterior portion of arteries including; the anterior cerebral arteries. The anterior cerebral arteries are connected to the posterior portion of the circle of Willis by the anterior communicating artery. The posterior portion is made up of the posterior cerebral artery which branch off from the basilar artery. The posterior cerebral artery are connected to the anterior portion of the circle of Willis by the posterior communicating artery. The posterior communicating artery connects the posterior cerebral artery to the internal carotid artery. The circle of Willis receives blood supply from the left and right internal carotid arteries that continues as the middle cerebral artery and posteriorly from the two vertebral arteries that join to form the basilar artery.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 21 - A 50 year old man on warfarin therapy following insertion of a pacemaker...

    Incorrect

    • A 50 year old man on warfarin therapy following insertion of a pacemaker presented with epistaxis. Which of the following is true regarding blood coagulation?

      Your Answer:

      Correct Answer: Patients with haemophilia A usually have a normal bleeding time

      Explanation:

      A prolonged bleeding time is seen in platelet disorders like thrombocytopenia. Patients with haemophilia A or B have a prolonged PTT but not a prolonged bleeding time.

      Ca2+ is necessary for coagulation.

      von Willebrand factor is an important part of the factor VIII complex and promotes platelet adhesion and aggregation.

      DIC results in depleted coagulation factors and accumulation of fibrin.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 22 - An elderly, diabetic man has firm, tender nodules at the base of his...

    Incorrect

    • An elderly, diabetic man has firm, tender nodules at the base of his left middle and ring fingers, which he can't extend fully. What's the most likely diagnosis?

      Your Answer:

      Correct Answer: Fibromatosis

      Explanation:

      This case is suggestive of Dupuytren’s contracture due to palmar fibromatosis. Its incidence is higher in men over the age of 45 years, and it increases in patients with diabetes, alcoholism, or epilepsy. These nodules are benign, usually appearing as a tender nodule in the palm which becomes painless. The disease has an aggressive clinical behaviour and recurs frequently.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      0
      Seconds
  • Question 23 - The otic ganglion receives its preganglionic sympathetic fibres from which of the following...

    Incorrect

    • The otic ganglion receives its preganglionic sympathetic fibres from which of the following nerves?

      Your Answer:

      Correct Answer: Glossopharyngeal nerve

      Explanation:

      The otic ganglion is a small (2–3 mm), oval shaped, flattened parasympathetic ganglion of a reddish-grey colour, located immediately below the foramen ovale in the infratemporal fossa and on the medial surface of the mandibular nerve. The preganglionic parasympathetic fibres originate in the inferior salivatory nucleus of the glossopharyngeal nerve. They leave the glossopharyngeal nerve by its tympanic branch and then pass via the tympanic plexus and the lesser petrosal nerve to the otic ganglion. Here, the fibres synapse, and the postganglionic fibres pass by communicating branches to the auriculotemporal nerve, which conveys them to the parotid gland. They produce vasodilator and secretomotor effects.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 24 - The patient who is diagnosed with bladder cancer asked his physician, what could...

    Incorrect

    • The patient who is diagnosed with bladder cancer asked his physician, what could have been the contributing factor in the development of his bladder cancer?

      Your Answer:

      Correct Answer: Smoking

      Explanation:

      Tobacco smoking is the main known contributor to urinary bladder cancer. In most populations, smoking is associated with over half of bladder cancer cases in men and one-third of cases among women.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds
  • Question 25 - A 54-year-old woman with amyotrophic lateral sclerosis is diagnosed with respiratory acidosis. The...

    Incorrect

    • A 54-year-old woman with amyotrophic lateral sclerosis is diagnosed with respiratory acidosis. The patient’s renal excretion of potassium would be expected to:

      Your Answer:

      Correct Answer: Fall, since tubular secretion of potassium is inversely coupled to acid secretion

      Explanation:

      Respiratory acidosis is a medical emergency in which decreased ventilation (hypoventilation) increases the concentration of carbon dioxide in the blood and decreases the blood’s pH (a condition generally called acidosis). Secretion of acid and potassium by the renal tubule are inversely related. So, increased excretion of H+ during renal compensation for respiratory acidosis will result in decreased secretion (or increased retention) of potassium ions, with the result that the body’s potassium store rises. An increase in K+ excretion would be associated with renal compensation for respiratory alkalosis. The filtered load of K+depends only on K+ plasma concentration and glomerular filtration rate, not on plasma pH.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 26 - A 77-year-old woman's renal function is tested. The following results were obtained during...

    Incorrect

    • A 77-year-old woman's renal function is tested. The following results were obtained during a 24-h period:

      Urine flow rate: 2. 0 ml/min

      Urine inulin: 0.5 mg/ml

      Plasma inulin: 0.02 mg/ml

      Urine urea: 220 mmol/l

      Plasma urea: 5 mmol/l.

      What is the urea clearance?

      Your Answer:

      Correct Answer: 88 ml/min

      Explanation:

      Urea is reabsorbed in the inner medullary collecting ducts of the nephrons. The clearance (C) of any substance can be calculated as follows: C = (U × V)/P, where U and P are the urine and plasma concentrations of the substance, respectively and V is the urine flow rate. So, glomerular filtration rate = (0.220 × 2. 0)/0.005 = 88 ml/min.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 27 - Rapid Eye Movement (REM) sleep is typically associated with: ...

    Incorrect

    • Rapid Eye Movement (REM) sleep is typically associated with:

      Your Answer:

      Correct Answer: Penile erections

      Explanation:

      Normal sleep comprises of alternate cycles between slow-wave sleep (non-REM sleep) and REM sleep. REM sleep is characterized by increased metabolic brain activity and EEG desynchronization. Somnambulism (sleepwalking), enuresis (bedwetting) and night terrors all occur during slow-wave sleep or during arousal from slow-wave sleep. In comparison, REM sleep is characterized by hypotonia of major muscle groups (excluding ocular muscles), dreams, nightmares and penile erection.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 28 - The primary area involved in the pathology of Parkinson's disease is: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Substantia nigra

      Explanation:

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

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

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 29 - Pain in the epigastric region occurring typically 2-3 hours after meals and causing...

    Incorrect

    • Pain in the epigastric region occurring typically 2-3 hours after meals and causing the patient to wake up at night is characteristic of which of the following conditions?

      Your Answer:

      Correct Answer: Duodenal ulcer

      Explanation:

      The description is typical for duodenal ulcers. There is no pain upon waking in the morning however it appears around mid-morning and is relieved by ingestion of food. The pain also often causes the patient to wake up at night.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      0
      Seconds
  • Question 30 - A 50 year old male point was diagnosed with tennis elbow that became...

    Incorrect

    • A 50 year old male point was diagnosed with tennis elbow that became worse after he started playing basket ball over the last three months. He was admitted to the orthopaedic ward to have elbow braces fitted. What type of synovial joint is the elbow joint?

      Your Answer:

      Correct Answer: Hinge

      Explanation:

      The elbow joint is one of the many synovial joints in the body. This joint is an example of the hinge joint as the humerus is received into the semilunar notch of the ulna and the capitulum of the humerus articulates with the fovea on the head of the radius, together acting as a hinge in one plane.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 31 - A 15-day old baby was brought to the emergency department with constipation for...

    Incorrect

    • A 15-day old baby was brought to the emergency department with constipation for 4 days. On examination, the abdomen of the baby was found to be distended and tender all over. No bowel sounds were heard. A sigmoid colon biopsy was carried out, which showed absent ganglion cells. What is the diagnosis?

      Your Answer:

      Correct Answer: Hirschsprung’s disease

      Explanation:

      Hirschsprung’s disease is characterized by congenital absence of the autonomic plexus (Meissner’s and Auerbach’s plexus) in the intestinal wall. Usually limited to the distal colon, it can occasionally involve the entire colon or even the small bowel. There is abnormal or absent peristalsis in the affected segment, resulting in continuous spasm of smooth muscle and partial/complete obstruction. This causes accumulation of intestinal contents and dilatation of proximal segment. Skip lesions are highly uncommon. This disease is seen early in life with 15% patients presenting in first month, 60% by 1 year of age and 85% by the age of 4 years. Symptoms include severe and complete constipation, abdominal distension and vomiting. Patients with involvement of ultra-short segments might have mild constipation with intervening diarrhoea. In older children, symptoms include failure to thrive, anorexia, and lack of an urge to defecate. On examination, an empty rectum is revealed with stool palpable high up in the colon. If not diagnosed in time, it can lead to Hirschsprung’s enterocolitis (toxic megacolon), which can be fulminant and lead to death. Diagnosis involves a barium enema or a rectal suction biopsy. Barium enema shows a transition in diameter between the dilated, normal colon proximal to the narrowed, affected distal segment. It is to be noted that barium enema should be done without prior preparation, which can dilate the abnormal segment, leading to a false-negative result. A 24-hour post-evacuation film can be obtained in the neonatal period – if the colon is still filled with barium, there is a high likelihood of Hirschsprung’s disease. Full-thickness rectal biopsy is diagnostic by showing the absence of ganglion cells. Acetylcholinesterase staining can be done to highlight the enlarged nerve trunks. Abnormal innervation can also be demonstrated by rectal manometry.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      0
      Seconds
  • Question 32 - A young man in a motor vehicle accident sustained a spinal injury at...

    Incorrect

    • A young man in a motor vehicle accident sustained a spinal injury at C8 level. What would likely be seen in this patient?

      Your Answer:

      Correct Answer: The hypothenar muscles would be completely paralysed

      Explanation:

      The eighth cervical nerve is one of the contributors of the ulnar nerve. The ulnar nerve supplies the hypothenar muscles which include the opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis, and palmaris brevis.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 33 - The muscle that forms the posterior wall of the axilla along with the...

    Incorrect

    • The muscle that forms the posterior wall of the axilla along with the scapula, subscapularis muscle and teres major muscle is the?

      Your Answer:

      Correct Answer: Latissimus dorsi

      Explanation:

      The latissimus dorsi forms the posterior wall of the axilla along with the scapula. It is responsible for extension, adduction, transverse extension also known as horizontal abduction, flexion from an extended position, and (medial) internal rotation of the shoulder joint. It also has a synergistic role in extension and lateral flexion of the lumbar spine.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 34 - A 27-year old lady is shot in the chest. The bullet enters superior...

    Incorrect

    • A 27-year old lady is shot in the chest. The bullet enters superior to the upper edge of the clavicle. She had difficulty in breathing which is interpreted by the A&E physician as a likely indicator of a collapsed lung. If that is the case, what portion of the pleura is most likely to have been punctured?

      Your Answer:

      Correct Answer: Cupola

      Explanation:

      The cupola is part of the pleura that extends above the first rib into the root of the lung. Most likely to injured in a stab above the level of the clavicle.

      Costodiaphragmatic recess: the lowest extent of the pleural sac.

      Pulmonary ligament: is a fold of pleura located below the root of the lung.

      Mediastinal pleura: part of the pleura that lines the mediastinal cavity.

      Hilar reflection is the part of the pleura where the visceral pleura of the lung reflects to become continuous with the parietal pleura.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 35 - A medical officer was shown an X ray with barium contrast and was...

    Incorrect

    • A medical officer was shown an X ray with barium contrast and was asked to distinguish the small from the large bowel. Which of the following features listed is CORRECT?

      Your Answer:

      Correct Answer: Circular folds of the mucosa

      Explanation:

      Distinguishing features include:

      1. Three strips of longitudinal muscle-taenia coli- on the wall instead of a continuous surrounding longitudinal muscle that is seen in the small intestine

      2. The colon has bulges called haustra that are not on the small bowel.

      3. The surface of the colon is covered with fatty omental appendages. Both the colon and the small intestine have similar circular smooth muscle layer, serosa. Peyer’s patches are lymphoid tissues that are not visible on X ray with barium contrast.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 36 - What Is the mechanism behind rhesus incompatibility in a new born baby? ...

    Incorrect

    • What Is the mechanism behind rhesus incompatibility in a new born baby?

      Your Answer:

      Correct Answer: Type II hypersensitivity

      Explanation:

      In type II hypersensitivity the antibodies that are produced by the immune response bind to the patients own cell surface antigens. These antigens can be intrinsic or extrinsic. Destruction occurs due to antibody dependent cell mediated antibodies. Antibodies bind to the cell and opsonise the cell, activating phagocytes to destroy that cell e.g. autoimmune haemolytic anaemia, Goodpasture syndrome, erythroblastosis fetalis, pernicious anaemia, Graves’ disease, Myasthenia gravis and haemolytic disease of the new-born.

    • This question is part of the following fields:

      • Inflammation & Immunology; Haematology
      • Pathology
      0
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  • Question 37 - Pseudomonas aeruginosa is a multidrug resistant pathogen that causes hospital-acquired infections. It is...

    Incorrect

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

      Your Answer:

      Correct Answer: Azlocillin

      Explanation:

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

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds
  • Question 38 - A patient with this condition has extracellular fluid volume expansion: ...

    Incorrect

    • A patient with this condition has extracellular fluid volume expansion:

      Your Answer:

      Correct Answer: Nephrotic syndrome

      Explanation:

      Nephrotic syndrome is a syndrome comprising of signs of nephrosis, including proteinuria, hypoalbuminemia, and oedema. It is a component of glomerulonephritis, in which different degrees of proteinuria occur. Essentially, loss of protein through the kidneys leads to low protein levels in the blood , which causes water to be drawn into soft tissues (oedema). Severe hypoalbuminemia can also cause a variety of secondary problems, such as water in the abdominal cavity (ascites), around the heart or lung (pericardial effusion, pleural effusion), high cholesterol, loss of molecules regulating coagulation (hence increased risk of thrombosis). The most common sign is excess fluid in the body due to the serum hypoalbuminemia. Lower serum oncotic pressure causes fluid to accumulate in the interstitial tissues. Sodium and water retention aggravates the oedema.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      0
      Seconds
  • Question 39 - A 28-year old lady comes to the surgical clinic with a recently detected...

    Incorrect

    • A 28-year old lady comes to the surgical clinic with a recently detected lump in her right breast. On examination, the lump is found to be 1cm, rubbery, mobile with no palpable axillary nodes. Mammography reveals no microcalcifications and the opposite breast appears normal. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Fibroadenoma

      Explanation:

      A benign breast tumour, fibroadenoma is common below the age of 30 years and occurs due to oestrogenic excess. It is characterised by proliferation of both glandular and stromal elements. Fibroadenomas are usually solitary and are mobile, not fixed to surrounding structures. The tumour is elastic, nodular and encapsulated with a grey-white cut surface. The two main histological types include intracanalicular and pericanalicular types, with both types often present in the same tumour. In the intracanalicular type, the stromal proliferation component predominates causing compression of ducts making them appear slit-like. In pericanalicular type, the fibrous stroma dominates around the ductal spaces so that they remain oval on cross section.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      0
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  • Question 40 - The histological exam of a tuberculous granuloma shows a periphery of multinuclear giant...

    Incorrect

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

      Your Answer:

      Correct 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
      0
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  • Question 41 - A 25 year old man presented with a history of headache and peripheral...

    Incorrect

    • A 25 year old man presented with a history of headache and peripheral cyanosis. He had been living in the Himalayas for 6 months prior to this. What is the reason for his condition?

      Your Answer:

      Correct Answer: Physiological polycythaemia

      Explanation:

      Polycythaemia is a condition that results in an increase in the total number of red blood cells (RBCs) in the blood. It can be due to myeloproliferative syndrome or due to chronically low oxygen levels or rarely malignancy. In primary polycythaemia/polycythaemia vera the increase is due to an abnormality in the bone marrow, resulting in increases RBCs, white blood cells (WBCs) and platelets. In secondary polycythaemia the increase occurs due to high levels of erythropoietin either artificially or naturally. The increase is about 6-8 million/cm3 of blood. A type of secondary polycythaemia is physiological polycythaemia where people living in high altitudes who are exposed to hypoxic conditions produce more erythropoietin as a compensatory mechanism for thin oxygen and low oxygen partial pressure.

    • This question is part of the following fields:

      • General
      • Physiology
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  • Question 42 - A 70-year-old female who underwent coronary artery bypass graft developed post-operative acute renal...

    Incorrect

    • A 70-year-old female who underwent coronary artery bypass graft developed post-operative acute renal failure. Her urinary catheter was left in place to monitor urine output. 6 days later she developed fever and chills. She also complained of suprapubic and left flank pain. She is found to have developed acute ascending pyelonephritis. Which of the following organism was most likely isolated during urine culture?

      Your Answer:

      Correct Answer: Escherichia coli with pili

      Explanation:

      The most common cause of urinary tract infection is Escherichia coli. Pilated strains of E. coli ascend the urethra to infect the kidney and the bladder. Catheters have been associated with an increased risk of UTIs.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      0
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  • Question 43 - A patient who underwent emergency appendicectomy complains of having numbness (paraesthesia) of the...

    Incorrect

    • A patient who underwent emergency appendicectomy complains of having numbness (paraesthesia) of the skin at the pubic region. Which nerve was most likely injured in the operation?

      Your Answer:

      Correct Answer: Iliohypogastric

      Explanation:

      The iliohypogastric nerve comes from L1 and emerges from the upper part of the lateral border of the psoas major. It then crosses obliquely in front of the quadratus lumborum to the iliac crest where it perforates the posterior part of transversus abdominis and divides between that muscle and the internal oblique into a lateral and an anterior cutaneous branch. This provides sensory innervation to the skin of the lower abdominal wall, upper hip and upper thigh.

      The genitofemoral nerve also comes from the lumbar plexus that innervates the skin of the anterior scrotum or labia majora and upper medial thigh.

      The subcostal nerve is the ventral primary ramus of T12 providing sensory innervation to the anterolateral abdominal wall in an area superior to the pubic region.

      A spinal nerve owing to their deep location would not have been injured in the procedure.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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      Seconds
  • Question 44 - A 60-year-old woman complains of left sided headaches which have been recurring for...

    Incorrect

    • A 60-year-old woman complains of left sided headaches which have been recurring for several years. She recently suffered from a focal seizure for the first time a few days ago. A CT scan shows a mass in the left hemisphere of the brain. The most likely diagnosis is:

      Your Answer:

      Correct Answer: Meningioma

      Explanation:

      Meningiomas are a common benign intracranial tumour, and their incidence is higher in women between the ages of 40-60 years old. Many of these tumours are asymptomatic and are diagnosed incidentally, although some of them may have malignant presentations (less than 2% of cases). These benign tumours can develop wherever there is dura, over the convexities near the venous sinuses, along the base of the skull, in the posterior fossa and, within the ventricles.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      0
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  • Question 45 - Which of the following malignancies is associated with the development of Lambert-Eaton myasthenic...

    Incorrect

    • Which of the following malignancies is associated with the development of Lambert-Eaton myasthenic syndrome?

      Your Answer:

      Correct Answer: Lung cancer

      Explanation:

      Lambert–Eaton myasthenic syndrome is a rare disorder of the neuromuscular junction. It can occur as a solitary diagnosis but it can also occur as a paraneoplastic syndrome associated with lung cancer, particularly small-cell histology. It can also be associated with other cancers such as lymphoma, non-Hodgkin’s lymphoma, T-cell leukaemia, non-small-cell lung cancer, prostate cancer and thymoma.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
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  • Question 46 - Which of the following has the least malignant potential? ...

    Incorrect

    • Which of the following has the least malignant potential?

      Your Answer:

      Correct Answer: Hyperplastic polyp

      Explanation:

      Non-neoplastic (non-adenomatous) colonic polyps include hyperplastic polyps, hamartomas, juvenile polyps, pseudopolyps, lipomas, leiomyomas and others.

      An autosomal dominant condition, Peutz–Jeghers syndrome is a disease that is characterized by multiple hamartomatous polyps in the stomach, small bowel and colon. Symptoms of this syndrome include hyperpigmentation of the skin and mucous membranes, especially of the lips and gums.

      Juvenile polyps develop in children, and once they outgrow their blood supply, they autoamputate around puberty. In cases of uncontrolled bleeding or intussusception, treatment is needed.

      Inflammatory polyps and pseudopolyps occur in chronic ulcerative colitis and Crohn’s disease. There is an increased risk of cancer with multiple juvenile polyps (not with sporadic polyps).

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
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  • Question 47 - 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:

      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
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  • Question 48 - A 60 year old female patient who has suffered an embolic stroke that...

    Incorrect

    • A 60 year old female patient who has suffered an embolic stroke that affected her middle cerebral artery as revealed by a CT scan is likely to exhibit which of the following neurologic conditions?

      Your Answer:

      Correct Answer: Contralateral hemiplegia

      Explanation:

      The middle cerebral artery is a major artery that supplies blood to the cerebrum. It continues from the internal carotid artery up into the lateral sulcus. The middle cerebral artery mainly supplies the lateral aspect of the cerebral cortex, anterior aspect of the temporal lobes and the insular cortices.

      Functional areas supplied by this vein are as follows:

      The motor and pre-motor areas

      The somato-sensory

      Auditory areas

      Motor speech

      Sensory speech

      Pre-frontal area

      Occlusion of the middle cerebral artery results in:

      i) A severe contralateral hemiplegia, most marked in the upper extremity and face

      ii) A contralateral sensory impairment worse in the upper part of the body.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 49 - A chest X-ray in a healthy, non-smoker, asymptomatic 48-year-old woman reveals a 2cm...

    Incorrect

    • A chest X-ray in a healthy, non-smoker, asymptomatic 48-year-old woman reveals a 2cm left lower lobe well-defined round opacity. Which of the following conditions is most probably responsible for this finding?

      Your Answer:

      Correct Answer: Pulmonary hamartoma

      Explanation:

      An asymptomatic healthy patient with no history of smoking and a lesion of small size most probably has a benign lung lesion. Hamartomas are one of the most common benign tumours of the lung that accounts for approximately 6% of all solitary pulmonary nodules. Pulmonary hamartomas are usually asymptomatic and therefore are found incidentally when performing an imaging test for other reasons.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      0
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  • Question 50 - What is the likely diagnosis in a 55-year old man presenting with jaundice,...

    Incorrect

    • What is the likely diagnosis in a 55-year old man presenting with jaundice, weight loss, pale coloured stools and elevated alkaline phosphatase?

      Your Answer:

      Correct Answer: Pancreatic carcinoma

      Explanation:

      Increased alkaline phosphatase is indicative of cholestasis, with a 4x or greater increase seen 1-2 days after biliary obstruction. Its level can remain elevated several days after the obstruction is resolved due to the long half life (7 days). Increase up to three times the normal level can be seen in hepatitis, cirrhosis, space-occupying lesions and infiltrative disorders. Raised alkaline phosphatase with other liver function tests being normal can occur in focal hepatic lesions like abscesses or tumours, or in partial/intermittent biliary obstruction. However, alkaline phosphatase has several isoenzymes, which originate in different organs, particularly bone. An isolated rise can also be seen in malignancies (bronchogenic carcinoma, Hodgkin’s lymphoma), post-fatty meals (from the small intestine), in pregnancy (from the placenta), in growing children (from bone growth) and in chronic renal failure (from intestine and bone). One can differentiate between hepatic and non-hepatic cause by measurement of enzymes specific to the liver e.g. gamma-glutamyl transferase (GGT).

      In an elderly, asymptomatic patient, isolated rise of alkaline phosphatase usually points to bone disease (like Paget’s disease). Presence of other symptoms such as jaundice, pale stools, weight loss suggests obstructive jaundice, most probably due to pancreatic carcinoma.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      0
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  • Question 51 - A 16 year old girl fractured a bone in her left foot. Upon...

    Incorrect

    • A 16 year old girl fractured a bone in her left foot. Upon examination the clinician discovered that the fracture affected the insertion of the peroneus brevis muscle. Which of the following bones was most likely affected?

      Your Answer:

      Correct Answer: Base of the fifth metatarsal

      Explanation:

      The peroneus brevis muscle originates from the lower two-thirds of the lateral body of the fibula and has inserts at the base of the fifth metatarsal. Fractures to this bone are common and can be due to infection, trauma, overuse and repetitive use.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 52 - Which best describes the sartorius muscle? ...

    Incorrect

    • Which best describes the sartorius muscle?

      Your Answer:

      Correct Answer: Will flex the leg at the knee joint

      Explanation:

      The sartorius muscle arises from tendinous fibres from the superior iliac spine. It passes obliquely across the thigh from lateral to medial and is inserted into the upper part of the medial side of the tibia. When the sartorius muscle contracts it will flex the leg at the knee joint.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 53 - A 23 year old woman is Rh -ve and she delivered a baby...

    Incorrect

    • A 23 year old woman is Rh -ve and she delivered a baby with a Rh+ blood group. What measure can be performed to prevent Rh incompatibility in the next pregnancy?

      Your Answer:

      Correct Answer: Immunoglobulin D

      Explanation:

      Rh disease is also known as erythroblastosis fetalis and is a disease of the new-born. In mild states it can cause anaemia with reticulocytosis and in severe forms causes severe anaemia, morbus hemolytcus new-born and hydrops fetalis. RBCs of the Rh+ baby can cross the placenta and enter into the maternal blood. As she is Rh- her body will form antibodies against the D antigen which will pass through the placenta in subsequent pregnancies.

    • This question is part of the following fields:

      • General
      • Physiology
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  • Question 54 - After finding elevated PSA levels, a 69-year-old man undergoes a needle biopsy and...

    Incorrect

    • After finding elevated PSA levels, a 69-year-old man undergoes a needle biopsy and is diagnosed with prostatic cancer. What is the stage of this primary tumour?

      Your Answer:

      Correct Answer: T1c

      Explanation:

      The AJCC uses a TNM system to stage prostatic cancer, with categories for the primary tumour, regional lymph nodes and distant metastases:

      TX: cannot evaluate the primary tumour T0: no evidence of tumour

      T1: tumour present, but not detectable clinically or with imaging T1a: tumour was incidentally found in less than 5% of prostate tissue resected (for other reasons)

      T1b: tumour was incidentally found in more than 5% of prostate tissue resected

      T1c: tumour was found in a needle biopsy performed due to an elevated serum prostate-specific antigen

      T2: the tumour can be felt (palpated) on examination, but has not spread outside the prostate

      T2a: the tumour is in half or less than half of one of the prostate gland’s two lobes

      T2b: the tumour is in more than half of one lobe, but not both

      T2c: the tumour is in both lobes

      T3: the tumour has spread through the prostatic capsule (if it is only part-way through, it is still T2)

      T3a: the tumour has spread through the capsule on one or both sides

      T3b: the tumour has invaded one or both seminal vesicles

      T4: the tumour has invaded other nearby structures.

      In this case, the tumour has a T1c stage.

    • This question is part of the following fields:

      • Pathology
      • Urology
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  • Question 55 - A 56-year-old woman weighs 75 kg. In this patient, total body water, intracellular...

    Incorrect

    • A 56-year-old woman weighs 75 kg. In this patient, total body water, intracellular fluid and extracellular fluid are respectively:

      Your Answer:

      Correct Answer: 45 l, 30 l, 15 l

      Explanation:

      The percentages of body water contained in various fluid compartments add up to total body water (TBW). This water makes up a significant fraction of the human body, both by weight and by volume. The total body water (TBW) content of humans is approximately 60% of body weight. Two-thirds is located in the intracellular and one-third in the extracellular compartment. So, in a 75-kg individual, TBW = 60 × 75/100 = 45 l. Intracellular content = 2/3 × 45 = 30 l and extracellular content = 1/3 × 45 = 15 l.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
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  • Question 56 - Where is factor VIII predominantly synthesised? ...

    Incorrect

    • Where is factor VIII predominantly synthesised?

      Your Answer:

      Correct Answer: Vascular endothelium

      Explanation:

      Factor VIII is an important part of the coagulation cascade. Deficiency causes haemophilia A. It is synthesised predominantly by the vascular endothelium and is not affected by liver disease. In the circulation it is bound to von Willebrand factor and it forms a stable complex with it. It is activated by thrombin or factor Xa and acts as a co factor to factor IXa to activate factor X which is a co factor to factor Va. Thrombin cleaves fibrinogen in fibrin and forms a meshwork to trap RBC and platelets to form a clot.

    • This question is part of the following fields:

      • General
      • Physiology
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  • Question 57 - The orbicularis oculi us a muscle that closes the eyelids. What is the...

    Incorrect

    • The orbicularis oculi us a muscle that closes the eyelids. What is the motor innervation of this muscle?

      Your Answer:

      Correct Answer: A branch of a nerve that exits through the stylomastoid foramen

      Explanation:

      The orbicularis oculi is a muscle in the face that closes the eyelids. It is supplied by zygomatic branch of the facial nerve (cranial nerve VII), which exits through the stylomastoid foramen.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 58 - A 16 year-old boy was stabbed in the right supraclavicular fossa. The sharp...

    Incorrect

    • 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:

      Correct 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
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  • Question 59 - A mechanic sustained a deep laceration to his right cubital fossa which resulted...

    Incorrect

    • A mechanic sustained a deep laceration to his right cubital fossa which resulted in him unable to move the proximal radioulnar joint of his right arm. Which muscles was affected?

      Your Answer:

      Correct Answer: Pronator teres

      Explanation:

      The correct answer is the pronator teres muscle. This muscle arises from 2 heads of origin: the humerus and ulnar. Between the 2 heads is the site of entrance of median nerve to the forearm. This muscle acts on the proximal radio-ulnar joint to rotate the radius on the ulna, otherwise known as pronation. It also assists in forearm flexion if the radius is fixed.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 60 - A chest x ray is ordered for a 39 year old man who...

    Incorrect

    • A chest x ray is ordered for a 39 year old man who presents with a history of a cough and weight loss for over a month. It shows a rounded opacity in the pleural cavity near the cardiac notch. The opacity is most likely to be in the:

      Your Answer:

      Correct Answer: Costomediastinal recess

      Explanation:

      The costomediastinal recess is the point where the costal pleura becomes the mediastinal pleura, located right next to the cardiac notch.

      The cupola: part of the parietal pleura that extends above the first rib to the root of the lung.

      Hilum: located on the medial surface of the lung where neurovascular structures enter and leave the lung.

      Pulmonary ligament: pleural fold found below the root of the lung, is a point of continuity between the visceral and mediastinal pleura.

      Costodiaphragmatic recess: the lowest extent of the pleural cavity.

      Superior mediastinum: part of the mediastinum that contains the great vessels leaving and entering the heart.

      The cardiac notch is in the inferior mediastinum.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 61 - A space defined by the teres major muscle, the teres minor muscle, long...

    Incorrect

    • A space defined by the teres major muscle, the teres minor muscle, long head of the triceps brachii muscle and surgical neck of the humerus contains the axillary nerve and the?

      Your Answer:

      Correct Answer: Posterior circumflex humeral artery

      Explanation:

      This quadrangular space transmits the posterior circumflex humeral vessels and the axillary nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
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  • Question 62 - Congenital anomalies of genitourinary tract are more common than any other system. Which...

    Incorrect

    • Congenital anomalies of genitourinary tract are more common than any other system. Which of the following anomalies carries the greatest risk of morbidity?

      Your Answer:

      Correct Answer: Bladder exstrophy

      Explanation:

      Bladder exstrophy is the condition where the urinary bladder opens from the anterior aspect suprapubically. The mucosa of the bladder is continuous with the abdominal skin and there is separation of the pubic bones. The function of the upper urinary tract remains normal usually. Treatment consists of surgical reconstruction of the bladder and returning it to the pelvis. There can be a need for continent urinary diversion along with reconstruction of the genitals.

    • This question is part of the following fields:

      • Pathology
      • Renal
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  • Question 63 - A 32-year-old man presents to the doctor complaining of pain in his left...

    Incorrect

    • A 32-year-old man presents to the doctor complaining of pain in his left calf whilst walking. He says that the pain goes away after a short period of rest but starts again during exercise or walking. The man reveals he has been a smoker for the last 15 years. His blood pressure, blood sugar and cholesterol level are normal. Artery biopsy shows intraluminal thrombosis and vasculitis. What's is the most likely cause of these findings?

      Your Answer:

      Correct Answer: Buerger's disease

      Explanation:

      Thromboangiitis obliterans, also known as Buerger’s disease, is a rare type of occlusive peripheral arterial disease, usually seen in smokers, most commonly in men aged 20 to 40. Symptoms most often include intermittent claudication, skin changes, painful ulcers on extremities, pain in the extremities during rest and gangrene. Diagnosis is based on clinical findings, arteriography, echocardiography, and computed tomography angiography. A difference in blood pressure between arms, or between the arms and legs is a common finding. Electrocardiographic findings include nonspecific abnormality or normal results.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      0
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  • Question 64 - A Jewish man was diagnosed with haemophilia C. Which of the following factors...

    Incorrect

    • A Jewish man was diagnosed with haemophilia C. Which of the following factors is deficient in this form of haemophilia?

      Your Answer:

      Correct Answer: Factor XI

      Explanation:

      Haemophilia C, also known as plasma thromboplastin antecedent (PTA) deficiency or Rosenthal syndrome, is a condition caused by the deficiency of the coagulation factor XI. The condition is rare and it is usually found in Ashkenazi Jews.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
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  • Question 65 - Lateral medullary syndrome, also known as Wallenberg's syndrome is a neurological condition caused...

    Incorrect

    • Lateral medullary syndrome, also known as Wallenberg's syndrome is a neurological condition caused by ischaemia in the lateral part of the medulla oblongata and is commonly associated with numerous neurological symptoms. Which of the following arteries when occluded leads to this condition?

      Your Answer:

      Correct Answer: Posterior inferior cerebellar

      Explanation:

      The lateral medullary syndrome or Wallenberg’s disease is also known as posterior inferior cerebellar artery syndrome (PICA). This syndrome is a clinical manifestation of the occlusion of the posterior cerebellar artery that results in symptoms of infarction of the lateral medullary oblongata. Other arteries that contribute to blood flow in to this region such are the vertebral artery, superior middle cerebellar and inferior medullary arteries can also result to this syndrome when occluded.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 66 - Which organ is responsible for the secretion of enzymes that aid in digestion...

    Incorrect

    • Which organ is responsible for the secretion of enzymes that aid in digestion of complex starches?

      Your Answer:

      Correct Answer: Pancreas

      Explanation:

      α-amylase is secreted by the pancreas, which is responsible for hydrolysis of starch, glycogen and other carbohydrates into simpler compounds.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
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  • Question 67 - A 45 year old man who complains of chronic post prandial, burning epigastric...

    Incorrect

    • A 45 year old man who complains of chronic post prandial, burning epigastric pain undergoes a gastrointestinal endoscopy. There is no apparent mass or haemorrhage and a biopsy is taken from the lower oesophageal mucosa just above the gastro-oesophageal junction. The results reveal the presence of columnar cells interspersed with goblet cells. Which change best explains the above mentioned histology?

      Your Answer:

      Correct Answer: Metaplasia

      Explanation:

      Metaplasia is the transformation of one type of epithelium into another as a means to better cope with external stress on that epithelium. In this case metaplasia occurs due to the inflammation resulting from gastro-oesophageal reflux disease. Dysplasia is disordered cellular growth. Hyperplasia is an increase in cell number but not cell type i.e. transformation. Carcinoma is characterized by cellular atypia. Ischaemia would result in necrosis with ulceration. Carcinoma insitu involves dysplastic atypical cells with the basement membrane intact and atrophy would mean a decrease in number of cells.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Gastrointestinal
      • Pathology
      0
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  • Question 68 - Which of the following muscles winds around the pterygoid hamulus? ...

    Incorrect

    • Which of the following muscles winds around the pterygoid hamulus?

      Your Answer:

      Correct Answer: Tensor veli palatini

      Explanation:

      The tensor veli palatini tenses the soft palate and by doing so, assists the levator veli palatini in elevating the palate to occlude and prevent entry of food into the nasopharynx during swallowing. It arises by a flat lamella from the scaphoid fossa at the base of the medial pterygoid plate, from the spina angularis of the sphenoid and from the lateral wall of the cartilage of the auditory tube. Descending vertically between the medial pterygoid plate and the medial pterygoid muscle, it ends in a tendon which winds around the pterygoid hamulus, being retained in this situation by some of the fibres of origin of the medial pterygoid muscle. Between the tendon and the hamulus is a small bursa. The tendon then passes medialward and is inserted onto the palatine aponeurosis and the surface behind the transverse ridge on the horizontal part of the palatine bone.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 69 - A young female in the 15th week of pregnancy presented to the emergency...

    Incorrect

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

      Your Answer:

      Correct Answer: Serum β-hCG

      Explanation:

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

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

    • This question is part of the following fields:

      • Pathology
      • Women's Health
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  • Question 70 - The bronchial circulation is a part of the circulatory system that supplies nutrients and oxygen to the pulmonary...

    Incorrect

    • The bronchial circulation is a part of the circulatory system that supplies nutrients and oxygen to the pulmonary parenchyma. What percentage of cardiac output is received by bronchial circulation?

      Your Answer:

      Correct Answer: 2%

      Explanation:

      The bronchial circulation is part of the systemic circulation and receives about 2% of the cardiac output from the left heart. Bronchial arteries arise from branches of the aorta, intercostal, subclavian or internal mammary arteries. The bronchial arteries supply the tracheobronchial tree with both nutrients and O2. It is complementary to the pulmonary circulation that brings deoxygenated blood to the lungs and carries oxygenated blood away from them in order to oxygenate the rest of the body.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
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  • Question 71 - Action potentials are used extensively by the nervous system to communicate between neurones...

    Incorrect

    • Action potentials are used extensively by the nervous system to communicate between neurones and muscles or glands. What happens during the activation of a nerve cell membrane?

      Your Answer:

      Correct Answer: Sodium ions flow inward

      Explanation:

      During the generation of an action potential, the membrane gets depolarized which cause the voltage gated sodium channels to open and sodium diffuses inside the neuron, resulting in the membrane potential moving towards a positive value. This positive potential will then open the voltage gated potassium channels and cause more K+ to move out decreasing the membrane potential and restoring the membrane potential to its resting value.

    • This question is part of the following fields:

      • General
      • Physiology
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  • Question 72 - A 22-year old man presented with a mass in his left scrotum which...

    Incorrect

    • A 22-year old man presented with a mass in his left scrotum which was more prominent when standing and felt like a 'bag of worms'. Examination revealed a non-tender mass along the spermatic cord. Also, the right testis was larger than the left testis. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Varicocele

      Explanation:

      Varicocele refers to dilatation and increased tortuosity of the pampiniform plexus – which is a network of veins found in spermatic cord that drain the testicle. Defective valves or extrinsic compression can result in outflow obstruction and cause dilatation near the testis. Normal diameter of the small vessels ranges from 0.5 – 1.5mm. A varicocele is a dilatation more than 2mm.

      The plexus travels from the posterior aspect of testis into the inguinal canal with other structures forming the spermatic cord. They then form the testicular veins out of which the right testicular vein drains into the inferior vena cava and the left into the left renal vein.

      It affects 15-20% men, and 40% of infertile males. Usually diagnosed in 15-25 years of age, they are rarely seen after 40 years of age. Because of the vertical path taken by the left testicular vein to drain into left renal vein, 98% idiopathic varicoceles occur on the left side. It is bilateral in 70% cases. Right-sided varicoceles are rare.

      Symptoms include pain or heaviness in the testis, infertility, testicular atrophy, a palpable mass, which is non-tender and along the spermatic cord (resembling a ‘bag of worms’). The testis on the affected side might be smaller.

      Diagnosis can be made by ultrasound. Provocative measures such as Valsalva manoeuvre or making the patient stand up to increase the dilatation by increasing the intra-abdominal venous pressure.

    • This question is part of the following fields:

      • Pathology
      • Urology
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  • Question 73 - Identify which of the following muscles acts on two joints? ...

    Incorrect

    • Identify which of the following muscles acts on two joints?

      Your Answer:

      Correct Answer: Sartorius

      Explanation:

      The sartorius muscle, the longest muscle in the body, is one of the two jointed or biarticular muscles. It originates from the anterior superior iliac spine and part of the notch between the anterior superior iliac spine and anterior inferior iliac spine and crosses both the hip joint and the knee joint. At the hip joint the sartorius flexes and rotates the thigh at the hip joint and flexes the leg at the knee joint.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 74 - A butcher accidentally cut himself on his right index finger. Which of the...

    Incorrect

    • A butcher accidentally cut himself on his right index finger. Which of the following substances when in contact with the basement membrane of the injured vasculature will activate the coagulation cascade as well as the kinin system in a first response to this injury?

      Your Answer:

      Correct Answer: Hageman factor

      Explanation:

      Hageman factor/factor XII in the intrinsic pathway activates prekallikrein and factor XI. Deficiency will not cause excessive bleeding as other coagulation factors will be utilized but the PTT will be greater than 200 seconds.

      Thromboxane promotes platelet aggregation and causes vasoconstriction.

      Plasmin, which is cleaved from plasminogen acts as an anticoagulant which breaks down thrombi.

      Platelet activating factor promotes platelet aggregation and is also chemotactic to neutrophils.

      Histamine acts as a vasodilator.

      Platelet inhibiting factor acts an anticoagulant.

      Renin is a hormone released from the kidney that causes vasoconstriction and water retention.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
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  • Question 75 - A 20 year old is brought to the A&E after he fell from...

    Incorrect

    • A 20 year old is brought to the A&E after he fell from a moving cart. The boy has sustained blunt abdominal injury, and the there is a possibility of internal bleeding as the boy is in shock. An urgent exploratory laparotomy is done in the A&E theatre. On opening the peritoneal cavity, the operating surgeon notices a torn gastrosplenic ligament with a large clot around the spleen. Which artery is most likely to have been injured in this case?

      Your Answer:

      Correct Answer: Short gastric

      Explanation:

      The short gastric arteries branch from the splenic artery near the splenic hilum to travel back in the gastrosplenic ligament to supply the fundus of the stomach. Therefore, these may be injured in this case.

      The splenic artery courses deep to the stomach to reach the hilum of the spleen. It doesn’t travel in the gastrosplenic ligament although it does give off branches that do.

      The middle colic artery is a branch of the superior mesenteric artery that supplies the transverse colon.

      Gastroepiploic artery is the largest branch of the splenic artery that courses between the layers of the greater omentum to anastomose with the right gastroepiploic.

      Left gastric artery, a branch of the coeliac trunk. It supplies the left half of the lesser curvature.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
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  • Question 76 - An ultrasound report of a 35-year old female patient revealed that she had...

    Incorrect

    • An ultrasound report of a 35-year old female patient revealed that she had cancer of the pancreas and presented with subsequent severe obstructive jaundice. In which part of this was woman's pancreas was the tumour most likely located?

      Your Answer:

      Correct Answer: Head

      Explanation:

      The pancreas is divided into five parts; the head, body, neck, tail, and the uncinate process. Of the five parts, tumours located at the head of the pancreas in most instances cause obstruction of the common bile duct more often than tumours in the other parts of the pancreas. This is because the common bile duct passes through the head of the pancreas from the gallbladder and the liver (it is formed where the cystic and the hepatic bile duct join) to empty bile into the duodenum. This biliary obstruction leads to accumulation of bile in the liver and a consequent bilirubinaemia (raised levels of blood bilirubin). This results in jaundice. The pancreas is not divided into lobes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
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  • Question 77 - A 4-year-old child was brought to a paediatrician for consult due to a...

    Incorrect

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

      Your Answer:

      Correct Answer: Nephroblastoma

      Explanation:

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

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
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  • Question 78 - A 25-year old man presented to the clinic with swelling of the penis....

    Incorrect

    • A 25-year old man presented to the clinic with swelling of the penis. His uncircumcised penis was erythematous and oedematous. The foreskin could not be retracted over the glans. Which of the following agents is the likely cause of his condition?

      Your Answer:

      Correct Answer: Staphylococcus aureus

      Explanation:

      Inflammation of the glans penis is known as balanitis. Associated involvement of the foreskin is then known as balanoposthitis. More likely to occur in men who have a tight foreskin that is difficult to pull back, or poor hygiene.

    • This question is part of the following fields:

      • Pathology
      • Urology
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  • Question 79 - Which of the following is not seen as a complication of wound healing?...

    Incorrect

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

      Your Answer:

      Correct Answer: Malignancy

      Explanation:

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

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

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

      3) Formation of contractures.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      0
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  • Question 80 - A 45 -year-old female is recently diagnosed with breast cancer. She has a...

    Incorrect

    • A 45 -year-old female is recently diagnosed with breast cancer. She has a 8-cm-diameter mass in her left breast, with enlarged left axillary node. What is the most likely stage of her disease?

      Your Answer:

      Correct Answer: IIIA

      Explanation:

      Stage IIIA breast cancer is T0–2 N2 M0 or T3 N1-2 M0 disease. It describes invasive breast cancer in which either: the tumour is smaller than 5 cm in diameter and has spread to 4 to 9 axillary lymph nodes; or it is found through imaging studies or clinical exam to have spread to internal mammary nodes (near the breastbone found during imaging tests or a physical exam); or the tumour is larger than 5 cm and has spread to 1 to 9 axillary nodes, or to internal mammary nodes. In this stage, the cancer has not metastasized (spread to distant sites).

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
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  • Question 81 - A 25-year-old football player suffers severe head trauma during a game. Physical examination...

    Incorrect

    • A 25-year-old football player suffers severe head trauma during a game. Physical examination reveals a decerebrate posture and bilateral papilledema. A CT scan reveals marked diffuse cerebral oedema. This condition will be most severe in which component of the brain?

      Your Answer:

      Correct Answer: White matter

      Explanation:

      The greatest amount of salt and water increase with cerebral oedema occurs within the white matter. Any swelling from oedema, haemorrhage or haematoma increases the intracranial pressure (ICP). As the ICP increases, the cerebral perfusion decreases and brain tissue can become ischaemic, even leading to brain death.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      0
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  • Question 82 - During an anatomy revision session, medical students are told that the posterior wall...

    Incorrect

    • During an anatomy revision session, medical students are told that the posterior wall of the rectus sheath ends in a thin curved margin whose concavity is directed downwards. What is the name of this inferior border of the rectus sheath?

      Your Answer:

      Correct Answer: Arcuate line

      Explanation:

      The rectus sheath is a tendinous sheath that encloses the rectus abdominis muscle. It covers the entire anterior surface however on the posterior surface of the muscle the sheath is incomplete ending inferiorly at the arcuate line. Below the arcuate line, the rectus abdominis is covered by the transversalis fascia. The linea alba is a band of aponeurosis on the midline of the anterior abdominal wall, which extends from the xiphoid process to the pubic symphysis. It is formed by the combined abdominal muscle aponeuroses. This is a useful site for midline incision during abdominal surgery because it does not carry many blood vessels. All of the other answer choices are related to the inguinal canal.

      The falx inguinalis (sometimes called the inguinal falx or conjoint tendon), is the inferomedial attachment of the transversus abdominis with some fibres of the internal abdominal oblique – it contributes to the posterior wall of the inguinal canal.

      The inguinal ligament is the ligament that connects the anterior superior iliac spine with the pubic tubercle – it makes the floor of the inguinal canal.

      The internal (deep) inguinal ring is the entrance to the inguinal canal, where the transversalis fascia pouches out and creates an opening through which structures can leave the abdominal cavity.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 83 - Which of the following is likely to induce secretion of glucagon? ...

    Incorrect

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

      Your Answer:

      Correct 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
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  • Question 84 - 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:

      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
      0
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  • Question 85 - 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:

      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
      0
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  • Question 86 - 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:

      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
      0
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  • Question 87 - During an OSCE exam a medical student is asked to locate the sternal...

    Incorrect

    • During an OSCE exam a medical student is asked to locate the sternal angle. The sternal angle is a land mark for locating the level of the:

      Your Answer:

      Correct Answer: Second costal cartilage

      Explanation:

      The sternal angle, a key landmark used in the clinic for auscultating for heart sounds, is the point of attachment of the costal cartilage of rib 2 to the sternum. It thus corresponds to the location of the second rib. A horizontal plane through the sternal angle traverses the T4/T5 intervertebral disc and marks the inferior boundary of the superior mediastinum.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 88 - 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:

      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
      0
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  • Question 89 - A swimmer was struggling to finish his training following an injury to his...

    Incorrect

    • A swimmer was struggling to finish his training following an injury to his right arm. On further examination it was found that any movements involving adduction, medial rotation and extension of her arm were particularly weak. Which nerve in this case was damaged?

      Your Answer:

      Correct Answer: Thoracodorsal

      Explanation:

      Weakness on these particular movements indicate that there is a problem with the latissimus dorsi muscle. This muscle is very important particularly in swimming movements and is supplied by the thoracodorsal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 90 - In a neurological exam on a robbery with violence victim, it was discovered...

    Incorrect

    • In a neurological exam on a robbery with violence victim, it was discovered that the victim had lost sense of touch to the skin over her cheek and chin (maxilla and mandible region). Where are the cell bodies of the nerve that is responsible for touch sensations of this region located?

      Your Answer:

      Correct Answer: Cranial nerve V ganglion

      Explanation:

      The skin over the cheek and the maxilla are innervated by the trigeminal nerve (CN V). The trigeminal nerve has three major branches and it is the largest cranial nerve. The three branches of the trigeminal nerve are; the ophthalmic nerve, the maxillary nerve and the mandibular nerve. The trigeminal nerves ganglion is a sensory nerve ganglion know as the trigeminal ganglion (also referred to as the Gasser’s ganglion or the semilunar ganglion). It is contained in the dura matter in a cavity known as the Meckel’s cave, which covers the trigeminal impression near the apex of the petrous part of the temporal bone.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
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  • Question 91 - Chronic obstructive pulmonary disease (COPD) is likely to result in: ...

    Incorrect

    • Chronic obstructive pulmonary disease (COPD) is likely to result in:

      Your Answer:

      Correct Answer: Respiratory acidosis

      Explanation:

      COPD leads to respiratory acidosis (chronic). This occurs due to hypoventilation which involves multiple causes, such as poor responsiveness to hypoxia and hypercapnia, increased ventilation/perfusion mismatch leading to increased dead space ventilation and decreased diaphragm function.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 92 - A 75-year old patient is in atrial fibrallation but has never been on...

    Incorrect

    • A 75-year old patient is in atrial fibrallation but has never been on anticoagulation therapy. To reduce the risk of future emboli, she would benefit from starting on long-term warfarin. Arterial emboli leading to acute limb ischaemia most commonly lodge at which one of the following sites?

      Your Answer:

      Correct Answer: Common femoral artery

      Explanation:

      The common femoral artery is the commonest site of arterial emboli causing acute limb ischemia. The treatment of choice is urgent femoral embolectomy.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      0
      Seconds
  • Question 93 - A 45-year old with sarcoidosis has enlarged tracheobronchial lymph nodes. Which nerve is...

    Incorrect

    • A 45-year old with sarcoidosis has enlarged tracheobronchial lymph nodes. Which nerve is most likely to be irritated in this patient?

      Your Answer:

      Correct Answer: Left recurrent laryngeal

      Explanation:

      Tracheobronchial lymph nodes are located at the bifurcation of the trachea and are in three groups i.e. the right superior, left superior and inferior. The aorta arches over the left bronchus near the point of tracheal bifurcation. Thus, the nerves that are closely associated with the aorta might be irritated if these nodes become inflamed. The left recurrent laryngeal nerve is such a nerve. The phrenic nerves, both the left and the right, are lateral and thus would not be affected. The right recurrent nerve loops around the right subclavian artery and is distant from this area. The right vagus artery is not associated with the aorta and the sympathetic chain is located in the posterior chest parallel to the vertebra, also not associated with the tracheobronchial tree.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 94 - Regarding the posterior compartment of the leg, which is correct? ...

    Incorrect

    • Regarding the posterior compartment of the leg, which is correct?

      Your Answer:

      Correct Answer: The muscles plantarflex the foot and are innervated by the tibial nerve

      Explanation:

      The muscles of the back of the leg are subdivided into two groups: superficial and deep. Superficial muscles include gastrocnemius, soleus and plantaris. Deep muscles include tibialis posterior, flexor hallucis longus, flexor digitorum longus and popliteus. The superficial ( calf muscles) which are responsible for plantarflexion of the foot are supplied by the tibial nerve as follows: the gastrocnemius and soleus muscles are supplied by the first and second sacral nerves and the plantaris by the fourth and fifth lumbar and first sacral nerve (the tibial nerve).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 95 - Which statement is correct regarding secretions from the adrenal glands? ...

    Incorrect

    • Which statement is correct regarding secretions from the adrenal glands?

      Your Answer:

      Correct Answer: Aldosterone is producd by the zona glomerulosa

      Explanation:

      The secretions of the adrenal glands by zone are:

      Zona glomerulosa – aldosterone

      Zona fasciculata – cortisol and testosterone

      Zona reticularis – oestradiol and progesterone

      Adrenal medulia – adrenaline, noradrenaline and dopamine.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
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  • Question 96 - Which of the following substances will enhance the activity of antithrombin III? ...

    Incorrect

    • Which of the following substances will enhance the activity of antithrombin III?

      Your Answer:

      Correct Answer: Heparin

      Explanation:

      Antithrombin III is a glycoprotein that inactivates multiple enzymes involved in the coagulation system. It inactivates factor X, factor IX, factor II, factor VII, factor XI and factor XII. Its activity is greatly increased by the action of heparin.

    • This question is part of the following fields:

      • General
      • Physiology
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  • Question 97 - A patient under went repair of a lingual artery aneurysm in the floor...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds
  • Question 98 - Which of these conditions causes haematuria, hypertension and proteinuria in children, usually after...

    Incorrect

    • Which of these conditions causes haematuria, hypertension and proteinuria in children, usually after a streptococcal infection?

      Your Answer:

      Correct Answer: Acute nephritic syndrome

      Explanation:

      Nephritic syndrome (or acute nephritic syndrome) is a syndrome comprising of signs of nephritis. Children between 2 and 12 are most commonly affected, but it may occur at any age. Predisposing factors/causes include:

      Infections with group A streptococcal bacteria (acute post-streptococcal glomerulonephritis).

      Primary renal diseases: immunoglobulin A nephropathy, membranoproliferative glomerulonephritis, idiopathic rapidly progressive crescentic glomerulonephritis.

      Secondary renal diseases: subacute bacterial endocarditis, infected ventriculo–peritoneal shunt, glomerulonephritis with visceral abscess, glomerulonephritis with bacterial, viral or parasitic infections.

      Multisystem diseases.

      By contrast, nephrotic syndrome is characterized by only proteins moving into the urine.

    • This question is part of the following fields:

      • Physiology
      • Renal
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  • Question 99 - A 17-year-old boy, who had developed shortness of breath and a loss of...

    Incorrect

    • A 17-year-old boy, who had developed shortness of breath and a loss of appetite over the last month, was referred to a haematologist because he presented with easy bruising and petechiae. His prothrombin time, platelet count, partial thromboplastin and bleeding time were all normal. Which of the following would explain the presence of the petechiae and easy bruising tendency?

      Your Answer:

      Correct Answer: Scurvy

      Explanation:

      Scurvy is a condition caused by a dietary deficiency of vitamin C, also known as ascorbic acid. Humans are unable to synthesize vitamin C, therefore the quantity of it that the body needs has to come from the diet. The presence of an adequate quantity of vitamin C is required for normal collagen synthesis. In scurvy bleeding tendency is due to capillary fragility and not coagulation defects, therefore blood tests are normal.

    • This question is part of the following fields:

      • Haematology
      • Pathology
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      Seconds
  • Question 100 - Where would you insert the needle when drawing blood from a patient's median...

    Incorrect

    • Where would you insert the needle when drawing blood from a patient's median cubital vein?

      Your Answer:

      Correct Answer: Anterior aspect of the elbow

      Explanation:

      The correct answer is to insert it into the anterior aspect of the elbow. If you look at the venous drainage of the upper limb, you will find that there are two main veins, the basilic and the cephalic vein; the connecting branch between these two veins is the median cubital vein. and this vein passes via the cubital fossa which is on the anterior aspect of the forearm.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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Neoplasia (0/1) 0%
Pathology (2/3) 67%
Gastrointestinal; Hepatobiliary (1/1) 100%
Anatomy (1/1) 100%
Upper Limb (1/1) 100%
General (1/1) 100%
Physiology (2/2) 100%
Haematology (1/1) 100%
Cell Injury & Wound Healing (1/1) 100%
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