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Question 1
Correct
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A 55-year-old woman died 3 years after a cardiac transplant due to worsening congestive heart failure. Autopsy revealed diffuse hyperplasia of the vascular intima involving the entire length of the coronary arteries. The most probable cause of deterioration of the cardiac function is:
Your Answer: Coronary atherosclerosis
Explanation:Allograft coronary artery disease (CAD) can begin right after the transplant and is the major cause of later death in cardiac transplant recipients. This form of atherosclerosis progresses quickly resulting in allograft failure. Due to lack of premonitory symptoms CAD may lead to sudden death.
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This question is part of the following fields:
- Cardiovascular
- Pathology
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Question 2
Correct
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A 55-year old lady underwent a major surgery for repair of an aortic aneurysm. Her blood pressure was low throughout the intra-operative and the post-operative period, along with increasing serum creatinine and urea. Microscopic examination of her urine showed multiple granular and hyaline casts. What is the likely condition the patient is suffering from?
Your Answer: Acute tubular necrosis
Explanation:The most common predisposing factor leading to acute tubular necrosis is ischemia, typically seen in hospitalized patients with low blood pressure.
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This question is part of the following fields:
- Pathology
- Renal
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Question 3
Incorrect
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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.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 4
Incorrect
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Loperamide is a drug used to treat diarrhoea. What is the mechanism of action of loperamide?
Your Answer:
Correct Answer: Opiate agonist
Explanation:Loperamide is an opioid-receptor agonist and acts on the mu opioid receptors in the myenteric plexus of large intestine. It works by decreasing the motility of the circular and longitudinal smooth muscles of the intestinal wall. It is often used for this purpose in gastroenteritis, inflammatory bowel disease, and short bowel syndrome.
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This question is part of the following fields:
- Pathology
- Pharmacology
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Question 5
Incorrect
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What is the most likely cause of bitemporal hemianopia?
Your Answer:
Correct Answer: Prolactinoma
Explanation:Prolactinoma is the mot common pituitary adenoma; leading to hyperprolactinaemia. By virtue of their size, macroprolactinomas press on the adjacent structures leading to headaches and loss of vision due to the pressure effect on optic chiasm. Women notice a change in their menstrual cycle due to raised prolactin levels. In comparison, the problem goes unnoticed in men in the initial stages. Craniopharyngioma is a less common space-occupying lesions affecting children and young adults.
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This question is part of the following fields:
- Endocrine
- Pathology
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Question 6
Incorrect
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Perforin are present in the granules of which cell?
Your Answer:
Correct Answer: Natural killer cell
Explanation:Perforins are characteristically found In the granules of CD8+ T cells and natural killer cells. They are cytolytic proteins that insert into the target plasma membrane forming a hole and resulting in lysis. They along with granzyme B induce apoptosis in the target cell.
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This question is part of the following fields:
- Inflammation & Immunology
- Pathology
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Question 7
Incorrect
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Which of these infectious agents tends to affect people under 20 and over 40 years old, can cause acute encephalitis with cerebral oedema and petechial haemorrhages, along with haemorrhagic lesions of the temporal lobe. A lumbar puncture will reveal clear cerebrospinal fluid with an elevated lymphocyte count?
Your Answer:
Correct Answer: Herpes simplex virus
Explanation:Haemorrhagic lesions of the temporal lobe are typical of Herpes simplex encephalitis (HSE). It tends to affect patients aged under 20 or over 40 years, and is often fatal if left untreated. In acute encephalitis, cerebral oedema and petechial haemorrhages occur and direct viral invasion of the brain usually damages neurones. The majority of cases of herpes encephalitis are caused by herpes simplex virus-1 (HSV-1), and about 10% of cases of herpes encephalitis are due to HSV-2, which is typically spread through sexual contact.
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This question is part of the following fields:
- Neurology
- Pathology
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Question 8
Incorrect
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What is the correct order of structures a needle must pass before it enters the pleural cavity?
Your Answer:
Correct Answer: External intercostals – internal intercostals – innermost intercostals – parietal pleura
Explanation:The correct order of structures from superficial to deep are: the skin and subcutaneous tissue, the external intercostals followed by internal intercostals, innermost intercostals and finally parietal pleura.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 9
Incorrect
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What is the result of maltase deficiency in the brush border of the small intestine?
Your Answer:
Correct Answer: Results in increased passage of maltose in stool
Explanation:Maltase is an enzyme produced from the surface cells of the villi, lining the small intestine and aids in hydrolysing the disaccharide maltose, which splits into two molecules of α-glucose. It is done by breaking the glycosidic bond between the ‘first’ carbon of one glucose and the ‘fourth’ carbon of the other (a 1–4 bond). Hence, a deficiency of enzyme maltase will result in the increased passage of maltose in the stool.
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This question is part of the following fields:
- Gastroenterology
- Physiology
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Question 10
Incorrect
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During work up for a 29 year-old lady who complained of chest pain, a computed tomography showed a large mass in the posterior mediastinum. Which among the following structures could be involved?
Your Answer:
Correct Answer: Lymph nodes
Explanation:Boundaries of the posterior mediastinum include:
Superior: a plane through the sternal angle and T4/5
Inferior: the diaphragm
Anterior: the middle mediastinal structures
Posterior the spinal cord.
Structures in the posterior mediastinum include the descending thoracic aorta, the azygos system, oesophagus, thoracic duct and lymph nodes. The great vessels and structures at the root of the lung are part of the middle mediastinum. In this case, the lymph nodes is the correct answer.
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This question is part of the following fields:
- Anatomy
- Thorax
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