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  • Question 1 - The passage of leukocytes through the wall of the blood vessels is best...

    Correct

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

      Your Answer: Diapedesis

      Explanation:

      The steps involved in leukocyte arrival and function are:

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

      2. rolling: selectins are upregulated on the vessel walls

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

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

      5. phagocytosis: engulfing the offending substance/cell.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      16.6
      Seconds
  • Question 2 - A 50-year old lady presented to the clinic with chronic pain in the...

    Correct

    • A 50-year old lady presented to the clinic with chronic pain in the abdomen. On physical examination, she was found to be pale. Further investigations revealed a decrease in both serum iron and total iron-binding capacity, along with an increase in serum ferritin. These findings are seen in:

      Your Answer: Anaemia of chronic disease

      Explanation:

      Anaemia of chronic disease is characterized by low serum iron, iron-binding capacity and saturation with increased ferritin (storage iron). Haemolytic anaemia is characterized by normal iron levels as the haemoglobin released from the haemolysed red blood cells is recycled. Anaemia due to chronic blood loss leads to low serum iron, low ferritin and high total iron-binding capacity (TIBC). Malabsorption, especially with duodenal involvement can also lead to iron deficiency anaemia with low ferritin and high TIBC. Megaloblastic anaemia due to vitamin B12 and folate deficiency is not associated with abnormalities in metabolism of iron.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      21.3
      Seconds
  • Question 3 - Macrolides are a group of antibiotics commonly used to treat respiratory tract and...

    Correct

    • Macrolides are a group of antibiotics commonly used to treat respiratory tract and soft-tissue infections. Which of the following antibiotics is a macrolide?

      Your Answer: Erythromycin

      Explanation:

      Erythromycin is a macrolide antibiotic used in the treatment of several bacterial infections, including respiratory tract infections, skin infections, chlamydia infections, pelvic inflammatory disease, and syphilis. It may also be used during pregnancy to prevent Group B streptococcal infection in the new-born.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      16.2
      Seconds
  • Question 4 - Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal...

    Correct

    • Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal volume of 550 ml and an effective anatomical dead space of 250 ml. What is his alveolar ventilation?

      Your Answer: 3000 ml/min

      Explanation:

      Alveolar ventilation is the amount of air reaching the alveoli per minute. Alveolar ventilation = respiratory rate × (tidal volume – anatomical dead space volume). Thus, alveolar ventilation = 10 × (550 − 250) = 3000 ml/min.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      84.4
      Seconds
  • Question 5 - When does the heart rate decrease? ...

    Correct

    • When does the heart rate decrease?

      Your Answer: Pressure on the eyeball

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      20.9
      Seconds
  • Question 6 - Which tumour occurs in young adults, affecting the epiphyses of the bones and...

    Incorrect

    • Which tumour occurs in young adults, affecting the epiphyses of the bones and sometimes extending to the soft tissues?

      Your Answer: Osteoid osteoma

      Correct Answer: Benign giant-cell tumour

      Explanation:

      Benign giant-cell tumours tend to affect adults in their twenties and thirties, occur in the epiphyses and can erode the bone and extend into the soft tissues. These tumours have a strong tendency to recur.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      20.4
      Seconds
  • Question 7 - A 60-year-old female has sudden onset of high-grade fever associated with cough with...

    Correct

    • A 60-year-old female has sudden onset of high-grade fever associated with cough with productive rusty-coloured sputum. Chest x-ray showed left-sided consolidation. What is the most accurate test for the diagnosis of this patient?

      Your Answer: Sputum culture

      Explanation:

      Sputum culture is used to detect and identify the organism that are infecting the lungs or breathing passages.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      91
      Seconds
  • Question 8 - A histological examination of a lump showed an abnormal amount and arrangement of...

    Correct

    • A histological examination of a lump showed an abnormal amount and arrangement of normal tissue in an otherwise normal area. This condition is known as?

      Your Answer: Hamartoma

      Explanation:

      A hamartoma is a condition best described as tissue normally present in an area arranged haphazardly in an disorganized, abnormal fashion. They are never malignant and do not metastasis.

      All the neoplastic, cancerous lesions comprise of a mixture of different cells that are not normal to that area.

      Metaplasia is a change in the type of the epithelium.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      42.3
      Seconds
  • Question 9 - Which portion of the renal tubule absorbs amino acids and glucose? ...

    Incorrect

    • Which portion of the renal tubule absorbs amino acids and glucose?

      Your Answer: Distal convoluted tubule

      Correct Answer: Proximal convoluted tubule

      Explanation:

      In relation to the morphology of the kidney as a whole, the convoluted segments of the proximal tubules are confined entirely to the renal cortex. Glucose, amino acids, inorganic phosphate and some other solutes are reabsorbed via secondary active transport in the proximal renal tubule through co-transport channels driven by the sodium gradient.

    • This question is part of the following fields:

      • Physiology
      • Renal
      20
      Seconds
  • Question 10 - What percentage of cardiac output is delivered to the skin? ...

    Correct

    • What percentage of cardiac output is delivered to the skin?

      Your Answer: 2%

      Explanation:

      Making up 4-5% of total body weight, the skin receives approximately 2% of cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      4.3
      Seconds
  • Question 11 - In multiple myeloma, which of these cell types confirms the diagnosis when found...

    Correct

    • In multiple myeloma, which of these cell types confirms the diagnosis when found in a smear of bone marrow aspirate?

      Your Answer: Plasma cells

      Explanation:

      A bone marrow aspiration is the diagnostic test for multiple myeloma, which is a malignant bone tumour that usually affects older adults. The smear reveals clusters of plasma cells, while X-rays tend to show circumscribed lytic lesions or diffuse demineralisation.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      187.2
      Seconds
  • Question 12 - A 40 year old man suffered severe trauma following an MVA. His BP...

    Correct

    • A 40 year old man suffered severe trauma following an MVA. His BP is 70/33 mmhg, heart rate of 140 beats/mins and very feeble pulse. He was transfused 3 units of blood resulting in his BP returning to 100/70 and his heart rate to 90 beats/min. What decreased following transfusion?

      Your Answer: Total peripheral resistance

      Explanation:

      The patient is in hypovolemic shock, he is transfused with blood to replace the volume lost. It is important not only to replace fluids but stop active bleeding in resuscitation. Fluid replacement will result in a decreased sympathetic discharge and adequate ventricular filling thus reducing total peripheral resistance and increasing cardiac output and cardiac filling pressures.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      20.6
      Seconds
  • Question 13 - A woman that presented with dyspnoea, chest pain and cough was found to...

    Incorrect

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

      Your Answer: Metastatic carcinoma

      Correct Answer: Congestive heart failure

      Explanation:

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

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      33.9
      Seconds
  • Question 14 - Which tumour marker is associated with medullary carcinoma of thyroid? ...

    Incorrect

    • Which tumour marker is associated with medullary carcinoma of thyroid?

      Your Answer: Alpha-fetoprotein

      Correct Answer: Calcitonin

      Explanation:

      Medullary carcinoma of thyroid accounts for 3% of thyroid cancers. It arises from the parafollicular cells (C cells) of the thyroid gland that produce calcitonin. It is often familial and caused by mutation of ret proto-oncogene, but can occasionally be sporadic. The familial cases can also occur as part of MEN syndromes IIA and IIB. The high calcitonin leads to down-regulation of the receptors, which does not affect the calcium levels significantly. Medullary carcinoma of thyroid shows characteristic amyloid deposits that stain positively with Congo red. The initial presentation consists of an asymptomatic thyroid nodule. Many cases are diagnosed due to routine screening of relatives of patients with MEN IIA and IIB. Medullary carcinoma can also cause ectopic production of other hormones/peptides such as adrenocorticotrophic hormone, vasoactive intestinal polypeptide, kallikreins and serotonin.

      Metastasis from medullary carcinoma spread via the lymphatics to cervical and mediastinal nodes, and can also affect the liver, lungs and bone. Diagnosis is by raised serum calcitonin levels. A provocative test with calcium (15 mg/kg intravenously over 4 hours) also aids in diagnosis by leading to excessive secretion of calcitonin. X-ray might also show dense, conglomerate calcification.

      CA-125 is frequently elevated in ovarian carcinomas. CA 15-3 is often associated with breast carcinomas. Alpha-fetoprotein is seen raised in hepatomas and gonadal tumours. Elevated HCG is associated with normal pregnancies, gonadal tumours, and choriocarcinomas. Thyroglobulin is used for surveillance in papillary carcinoma of thyroid. CA 19-9 is used in the management of pancreatic cancer.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      7.2
      Seconds
  • Question 15 - A 35 year-old man presents with high grade fever for 7 days after...

    Correct

    • A 35 year-old man presents with high grade fever for 7 days after returning from a trip to India. He tested positive for widal test. What is the most likely organism that caused his fever?

      Your Answer: Salmonella typhi

      Explanation:

      Typhoid fever is caused by virulent bacteria called Salmonella typhi. Salmonella typhi spread through contaminated food or water and occasionally through direct contact with someone who is infected.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      20.7
      Seconds
  • Question 16 - The renal tubule is the portion of the nephron that contains the fluid...

    Incorrect

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

      Your Answer: Sodium

      Correct Answer: Potassium

      Explanation:

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

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      75.5
      Seconds
  • Question 17 - A 40-year old gentleman underwent a computed tomographic scan for the abdomen to...

    Incorrect

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

      Your Answer: Haematoma

      Correct Answer: Non-functioning adrenal adenoma

      Explanation:

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

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

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      211.9
      Seconds
  • Question 18 - Which of the following is the cause of flattened (notched) T waves on...

    Correct

    • Which of the following is the cause of flattened (notched) T waves on electrocardiogram (ECG)?

      Your Answer: Hypokalaemia

      Explanation:

      The T-wave is formed due to ventricular repolarisation. Normally, it is seen as a positive wave. It can be normally inverted (negative) in V1 (occasionally in V2-3 in African-Americans/Afro-Caribbeans). Hyperacute T-waves are the earliest ECG change of acute myocardial infarction. ECG findings of hyperkalaemia include high, tent-shaped T-waves, a small P-wave and a wide QRS complex. Hypokalaemia results in flattened (notched) T-waves, U-waves, ST-segment depression and prolonged QT interval.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      9.4
      Seconds
  • Question 19 - A 56-year-old man undergoes tests to determine his renal function. His results over...

    Incorrect

    • A 56-year-old man undergoes tests to determine his renal function. His results over a period of 24 hours were:

      Urine flow rate: 2. 0 ml/min

      Urine inulin: 1.0 mg/ml

      Plasma inulin: 0.01 mg/ml

      Urine urea: 260 mmol/l

      Plasma urea: 7 mmol/l

      What is the glomerular filtration rate?

      Your Answer: 100 ml/min

      Correct Answer: 200 ml/min

      Explanation:

      Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal (kidney) glomerular capillaries into the Bowman’s capsule per unit time. GFR is equal to the inulin clearance because inulin is freely filtered into Bowman’s capsule but is not reabsorbed or secreted. 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. Thus, glomerular filtration rate = (1.0 × 2. 0)/0.01 = 200 ml/min.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      20.5
      Seconds
  • Question 20 - A 4-year-old child was brought to a paediatrician for consult due to a...

    Correct

    • 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: 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
      126.4
      Seconds
  • Question 21 - Which of the following diseases affects young adults, causing pain in any bone...

    Correct

    • Which of the following diseases affects young adults, causing pain in any bone -particularly long bones- which worsens at night, and is typically relieved by common analgesics, such as aspirin?

      Your Answer: Osteoid osteoma

      Explanation:

      Osteoid osteoma, which tends to affect young adults, can occur in any bone but is most common in long bones. It can cause pain (usually worse at night) that is typically relieved by mild analgesics, such as non-steroidal anti-inflammatory drugs. X-ray findings include a small radiolucent zone surrounded by a larger sclerotic zone.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      40.7
      Seconds
  • Question 22 - Which of the following chemotherapy regimens is most likely to be used in...

    Incorrect

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

      Your Answer: ABVD

      Correct Answer: FOLFOX

      Explanation:

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

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      17.8
      Seconds
  • Question 23 - Which of the following is likely to result in hematocolpos in a 12-year...

    Incorrect

    • Which of the following is likely to result in hematocolpos in a 12-year old girl?

      Your Answer: Turner syndrome

      Correct Answer: Imperforate hymen

      Explanation:

      Hematocolpos means accumulation of blood in vagina and hematometra is accumulation of blood in the uterus. These are most likely seen with an imperforate hymen; which is seen I 1 in 2000 females. If spontaneous resolution does not occur, treatment involves making a hole in the hymen to allow discharge of menstrual blood.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      18.7
      Seconds
  • Question 24 - A patient with Paget's disease of the bone is predisposed to developing which...

    Incorrect

    • A patient with Paget's disease of the bone is predisposed to developing which type of cancer?

      Your Answer: Ewing’s sarcoma

      Correct Answer: Osteosarcoma

      Explanation:

      Paget’s disease of bone (PDB) is a focal disorder of bone. It is presumed benign in nature and mediated by abnormal osteoclast function. However osteosarcomas may occur in <1% of patients with Paget's disease of the bone. Osteosarcomas are osteogenic in origin, and consistently arise in sites of pagetic bone. This is not to be confused with Paget's disease of the breast.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      22
      Seconds
  • Question 25 - Renal function is an indication of the state of the kidney, measured by glomerular...

    Incorrect

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

      Your Answer: An increase in mean arterial pressure from 90 mmHg to 140 mmHg

      Correct Answer: Substantial increases in renal blood flow

      Explanation:

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

    • This question is part of the following fields:

      • Physiology
      • Renal
      27.2
      Seconds
  • Question 26 - What is the 5 year survival rate of a patient who is diagnosed...

    Correct

    • What is the 5 year survival rate of a patient who is diagnosed with stage III colon cancer, who underwent successful resection and completed the prescribed session of adjuvant chemotherapy?

      Your Answer: 30%–60%

      Explanation:

      In this patient who has stage III colon cancer, the survival rate is 30-60%. For stage I or Dukes’ stage A disease, the 5-year survival rate after surgical resection exceeds 90%. For stage II or Dukes’ stage B disease, the 5-year survival rate is 70%–85% after resection, with or without adjuvant therapy. For stage III or Dukes’ stage C disease, the 5-year survival rate is 30%– 60% after resection and adjuvant chemotherapy and for stage IV or Dukes’ stage D disease, the 5-year survival rate is poor (approximately 5%).

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      42.4
      Seconds
  • Question 27 - A 62-year-old male patient in the intensive care unit was found to have...

    Correct

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

      Your Answer: 0.8–1.45 mmol/l

      Explanation:

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

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      14.5
      Seconds
  • Question 28 - Which of the following is the most likely cause of prolonged thrombin clotting...

    Incorrect

    • Which of the following is the most likely cause of prolonged thrombin clotting time?

      Your Answer: Warfarin therapy

      Correct Answer: Hypofibrinogenemia

      Explanation:

      Thrombin clotting time, also called thrombin time (TT), is test used for the investigation of possible bleeding or clotting disorders. TT reflects the conversion of fibrinogen to fibrin and it’s also very sensitive to the presence of the anticoagulant heparin. A prolonged thrombin time may indicate the presence of hypofibrinogenemia (decreased fibrinogen level ), dysfibrinogenaemia, disseminated intravascular coagulation (DIC), end stage liver disease or malnutrition.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      30.3
      Seconds
  • Question 29 - What is the normal glomerular filtration rate? ...

    Correct

    • What is the normal glomerular filtration rate?

      Your Answer: 125 mL/min

      Explanation:

      The normal glomerular filtration rate (GFR) in humans is 125 mL/min. After the age of 40, GFR decreases progressively by about 0.4–1.2 mL/min per year.

    • This question is part of the following fields:

      • Physiology
      • Renal
      5
      Seconds
  • Question 30 - A 63-year old lady presents with pain in multiple bones and renal failure....

    Incorrect

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

      Your Answer: Reed–Sternberg cells

      Correct Answer: Plasma cells

      Explanation:

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

    • This question is part of the following fields:

      • Haematology
      • Pathology
      13.4
      Seconds
  • Question 31 - A 35 year-old female developed food poisoning 24H after eating canned food. She...

    Correct

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

      Your Answer: Clostridium botulinum

      Explanation:

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

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      26
      Seconds
  • Question 32 - 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: 12%

      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
      13.5
      Seconds
  • Question 33 - Cancer of the testis most likely metastases to which set of lymph nodes?...

    Incorrect

    • Cancer of the testis most likely metastases to which set of lymph nodes?

      Your Answer: Superficial inguinal

      Correct Answer: Aortic

      Explanation:

      The lymphatic drainage of an organ is related to its blood supply. The lymphatic drainage of the testis drains along the testicular artery to reach the lymph nodes along the aorta.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      9.9
      Seconds
  • Question 34 - A 55-year-old male has a mass on the right lung with involvement of...

    Correct

    • A 55-year-old male has a mass on the right lung with involvement of the right mediastinal lymph nodes. What is the nodal staging according to the TNM staging?

      Your Answer: N2

      Explanation:

      The N stages for lung cancer are from NO to N3 : NO, there is no lung cancer in any lymph nodes: N1, there is lung cancer in the proximal lymph nodes: N2, there is lung cancer in the mediastinal hilar lymph nodes, but on the same side as the affected lung or there is lung cancer in the carinal lymph nodes: N3, there is metastatic lung cancer in lymph nodes on the opposite side of the chest, in the cervical or apical lymph nodes. In this patient the ipsilateral mediastinal node is involved, thus it is classified as N2.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      15.5
      Seconds
  • Question 35 - A 5-year-old child is rushed to the emergency department because of fever, erythema...

    Incorrect

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

      Your Answer: Neurotoxin

      Correct Answer: Endotoxin

      Explanation:

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

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      19.6
      Seconds
  • Question 36 - A 45 year old man who complains of chronic post prandial, burning epigastric...

    Correct

    • 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: 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
      33.4
      Seconds
  • Question 37 - A 40 year old woman, who is under anaesthesia for an elective procedure,...

    Incorrect

    • A 40 year old woman, who is under anaesthesia for an elective procedure, received an antibiotic injection. She immediately developed a rash and her airway constricted raising the airway pressure. Which mechanism is responsible for this reaction?

      Your Answer: Type IV hypersensitivity

      Correct Answer: Type I hypersensitivity

      Explanation:

      Type I hypersensitivity reaction is an immediate reaction that occurs due to binding of the antigen with antibodies attached to mast cells in a previously sensitized person. It has an immediate phase, which is characterised by vasodilation, leakage of plasma, smooth muscle spasm, or glandular secretions. This manifests in about 5-30 min and usually resolves within 60 mins. The delayed phase follows after 24 hours and can persist up to several days. It is due to infiltration of eosinophils, neutrophils, basophils and CD4+ cells and leads to tissue destruction. The nature of the reaction varies according to the site. It can take the form of skin allergy, hives, allergic rhinitis, conjunctivitis, bronchial asthma or food allergy.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      35.7
      Seconds
  • Question 38 - Dicloxacillin is an antibiotic; the subclass that dicloxacillin belongs to is: ...

    Incorrect

    • Dicloxacillin is an antibiotic; the subclass that dicloxacillin belongs to is:

      Your Answer: Quinolone

      Correct Answer: Penicillin

      Explanation:

      Dicloxacillin is a narrow-spectrum beta-lactam antibiotic. It is used to treat infections caused by susceptible Gram-positive bacteria and most effective against beta-lactamase-producing organisms such as Staphylococcus aureus. To decrease the development of resistance, dicloxacillin is recommended to treat infections that are suspected or proven to be caused by beta-lactamase-producing bacteria.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      22.8
      Seconds
  • Question 39 - A 24 year old mother is breastfeeding her first child. Which of the...

    Correct

    • A 24 year old mother is breastfeeding her first child. Which of the following cellular adaptations occurred in her breast tissue to allow her to do this?

      Your Answer: Lobular hyperplasia

      Explanation:

      Under the influence of oestrogen in pregnancy, there is an increase in the number of lobules which will facilitate lactation.

      Steatocytes occur due to loss of weight and nutritional deficit.

      Metaplasia is a normal physiological process which is due to a change in normal epithelium with another type.

      Lobular atrophy will result in a decreased capacity to provide milk.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Female Health
      • Pathology
      19.4
      Seconds
  • Question 40 - Which of the following morphological features is most characteristic of hyaline degeneration? ...

    Incorrect

    • Which of the following morphological features is most characteristic of hyaline degeneration?

      Your Answer: Accumulation of lipofuscin

      Correct Answer: Homogeneous, ground-glass, pink-staining appearance of cells

      Explanation:

      The characteristic morphological features of hyaline degeneration is ground-glass, pinking staining cytoplasm with an intact cell membrane. The accumulation of lipids, calcium salts, lipofuscin and an amorphous cytoplasm with an intact cell membrane are all characteristically found in different situations.

      Pyknotic nucleus and orphan Annie eye nucleus are not seen in hyaline degeneration.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      12.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cell Injury & Wound Healing (2/3) 67%
Pathology (15/29) 52%
Haematology (1/3) 33%
Pharmacology (1/3) 33%
Physiology (6/11) 55%
Respiratory (1/3) 33%
Cardiovascular (4/4) 100%
Orthopaedics (2/3) 67%
Microbiology (3/4) 75%
Renal (1/3) 33%
Endocrine (0/3) 0%
Fluids & Electrolytes (1/3) 33%
Neoplasia (3/4) 75%
Women's Health (0/1) 0%
Cell Injury & Wound Healing; Gastrointestinal (1/1) 100%
Inflammation & Immunology (0/1) 0%
Cell Injury & Wound Healing; Female Health (1/1) 100%
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