00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - Which foramen contains the vertebral artery? ...

    Incorrect

    • Which foramen contains the vertebral artery?

      Your Answer: Foramen ovale

      Correct Answer: Foramen magnum

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      4.4
      Seconds
  • Question 2 - A 49-year-old man, smoker, complains of a persisting and worsening cough over the...

    Correct

    • A 49-year-old man, smoker, complains of a persisting and worsening cough over the past few months. He also has noted blood in his sputum. The patient has no other major health conditions. Which of the following investigative procedures should be done first?

      Your Answer: Sputum cytology

      Explanation:

      Sputum cytology is a diagnostic test used for the examination of sputum under a microscope to determine if abnormal cells are present. It may be used as the first diagnostic procedure to help detect a suspected lung cancer or certain non-cancerous lung conditions.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      8.1
      Seconds
  • Question 3 - The lateral thoracic artery: ...

    Correct

    • The lateral thoracic artery:

      Your Answer: Accompanies the long thoracic nerve to the serratus anterior muscle

      Explanation:

      The thoracic nerve, along with the lateral thoracic artery, follow the pectoralis minor to the side of the chest which supplies the serratus anterior and the pectoralis. It then sends branches across the axilla to the axillary glands and subscapularis. The pectoral branch of the thoraco-acromial anastomoses with the internal mammary, subscapular and intercostal arteries, which in women, supply an external mammary branch.

    • This question is part of the following fields:

      • Anatomy
      • Breast
      8.3
      Seconds
  • Question 4 - A TRUE statement regarding abolition of the cephalic phase of pancreatic secretion is...

    Correct

    • A TRUE statement regarding abolition of the cephalic phase of pancreatic secretion is that it:

      Your Answer: Will result after vagotomy

      Explanation:

      Recognition and integration of the sight, smell and taste of food triggers the cephalic phase of pancreatic secretion, causing an increase in pancreatic HCO3- and enzyme secretion. The degree of enzyme secretion in this phase is about 50% of the maximal response seen with exogenous CCK and secretin. The vagus nerve regulates the secretion through the cholinergic fibres innervating the acinar cells of the pancreas, and through peptidergic nerve fibres, which innervate ductal cells.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      4.7
      Seconds
  • Question 5 - Following a posterolateral thoracotomy, a surgeon may wish to infiltrate local anaesthetic above...

    Incorrect

    • Following a posterolateral thoracotomy, a surgeon may wish to infiltrate local anaesthetic above and below the incision to block the nerves supplying the thoracic wall. This wall is innervated by?

      Your Answer: Lateral pectoral nerves

      Correct Answer: Intercostal nerves

      Explanation:

      Intercostal nerves are the ventral primary rami of spinal nerves T1–T11. They give branches which supply the thoracic wall.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      11.9
      Seconds
  • Question 6 - A 58-year-old woman diagnosed with deep vein thrombosis had been using warfarin for...

    Correct

    • A 58-year-old woman diagnosed with deep vein thrombosis had been using warfarin for 10 days. When she presented to the doctor she had haemorrhagic bullae and necrotic lesions in her lower limbs and buttocks. Deficiency of which of the following proteins may have caused the necrotic skin lesions?

      Your Answer: Protein C

      Explanation:

      Warfarin-induced skin necrosis is a rare complication of anticoagulant therapy that requires immediate drug cessation. The most common cutaneous findings include petechiae that progress to ecchymoses and haemorrhagic bullae. Warfarin inactivates vitamin K-dependent clotting factors II, VII, IX, and X and vitamin K-dependent proteins C and S. The concentration of protein C falls more rapidly than other vitamin K-dependent factors because they have a shorter half-lives. Skin necrosis is seen mainly in patients with prior protein C deficiency.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      2.2
      Seconds
  • Question 7 - Where is the foramen ovale located? ...

    Correct

    • Where is the foramen ovale located?

      Your Answer: Sphenoid

      Explanation:

      The foramen ovale is an oval shaped opening in the middle cranial fossa located at the posterior base of the greater wing of the sphenoid bone, lateral to the lingula. It transmits the mandibular division of the trigeminal nerve (CN Vc), accessory meningeal artery, emissary veins between the cavernous sinuses and pterygoid plexus, otic ganglion, and occasionally the nervus spinosus and lesser petrosal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      2.7
      Seconds
  • Question 8 - Different portions of the renal tubule have varying degrees of water permeability. Which...

    Correct

    • Different portions of the renal tubule have varying degrees of water permeability. Which of the following renal sites is characterised by low water permeability under normal circumstances?

      Your Answer: Thick ascending limb of the loop of Henlé

      Explanation:

      Within the nephron of the kidney, the ascending limb of the loop of Henle is a segment of the loop of Henle downstream of the descending limb, after the sharp bend of the loop. Both the thin and the thick ascending limbs of the loop of Henlé have very low permeability to water. Since there are no regulatory mechanisms to alter its permeability, it remains poorly permeable to water under all circumstances. Sodium and chloride are transported out of the luminal fluid into the surrounding interstitial spaces, where they are reabsorbed. Water must remain behind because it is not reabsorbed, so the solute concentration becomes less and less (the luminal fluid becomes more dilute). This is one of the principal mechanisms (along with diminution of ADH secretion) for the production of a dilute, hypo-osmotic urine (water diuresis).

    • This question is part of the following fields:

      • Physiology
      • Renal
      7.8
      Seconds
  • Question 9 - A 56-year-old man undergoes tests to determine his renal function. His results over...

    Correct

    • 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: 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
      5
      Seconds
  • Question 10 - Which best describes the sartorius muscle? ...

    Correct

    • Which best describes the sartorius muscle?

      Your 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
      6.9
      Seconds
  • Question 11 - A week after a renal transplant the patient received antilymphocyte globulins. Shortly after...

    Correct

    • A week after a renal transplant the patient received antilymphocyte globulins. Shortly after she developed fever and hypotension. Which of the following mechanisms is involved in this response?

      Your Answer: Type III hypersensitivity

      Explanation:

      Type III hypersensitivity is characterized by soluble immune complexes which are aggregations of IgG and IgM antibodies with antigens that deposit in different tissues e.g. the skin, joints, kidneys. They can then trigger an immune response by activating the complement cascade. This reaction can take hours to develop and examples include: immuno-complex glomerulonephritis, rheumatoid arthritis, SLE, subacute bacterial endocarditis, arthus reaction and serum sickness.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      3
      Seconds
  • Question 12 - A histology report of a cervical biopsy taken from a patient with tuberculosis...

    Correct

    • A histology report of a cervical biopsy taken from a patient with tuberculosis revealed the presence of epithelioid cells. What are these cells formed from?

      Your Answer: Macrophages

      Explanation:

      Granulomas formed in tuberculosis are called tubercles and are made up polynuclear phagocytes, Langhans cells and epithelioid cells. Macrophages when enlarged, consist of abundant cytoplasm and have a tendency of arranging themselves very closely to each other representing epithelial cells. These enlarged macrophages are therefore termed as epithelioid cells.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      12.6
      Seconds
  • Question 13 - During a normal respiratory exhalation, what is the recoil alveolar pressure? ...

    Correct

    • During a normal respiratory exhalation, what is the recoil alveolar pressure?

      Your Answer: +10 cmH2O

      Explanation:

      To determine compliance of the respiratory system, changes in transmural pressures (in and out) immediately across the lung or chest cage (or both) are measured simultaneously with changes in lung or thoracic cavity volume. Changes in lung or thoracic cage volume are determined using a spirometer with transmural pressures measured by pressure transducers. For the lung alone, transmural pressure is calculated as the difference between alveolar (pA; inside) and intrapleural (ppl; outside) pressure. To calculate chest cage compliance, transmural pressure is ppl (inside) minus atmospheric pressure (pB; outside). For the combined lung–chest cage, transmural pressure or transpulmonary pressure is computed as pA – pB. pA pressure is determined by having the subject deeply inhale a measured volume of air from a spirometer. Under physiological conditions the transpulmonary or recoil pressure is always positive; intrapleural pressure is always negative and relatively large, while alveolar pressure moves from slightly negative to slightly positive as a person breathes.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      5.1
      Seconds
  • Question 14 - A 35 year-old woman is undergoing thyroidectomy. The external laryngeal nerve may be...

    Incorrect

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

      Your Answer: Inferior laryngeal artery

      Correct Answer: Superior thyroid artery

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      6.3
      Seconds
  • Question 15 - A mechanic sustained a deep laceration to his right cubital fossa which resulted...

    Correct

    • 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: 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
      4.3
      Seconds
  • Question 16 - Acute respiratory distress syndrome (ARDS) is a medical condition that occurs in critically...

    Correct

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

      Your Answer: Lung compliance

      Explanation:

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

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      2.6
      Seconds
  • Question 17 - Which of the following is the source of blood supply to the artery...

    Correct

    • Which of the following is the source of blood supply to the artery of the round ligament at the head of the femur?

      Your Answer: Obturator artery

      Explanation:

      The posterior branch of the obturator artery provides an articular branch to the head of the femur.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      3.9
      Seconds
  • Question 18 - Which of the following changes in the histology of the cell is most...

    Correct

    • Which of the following changes in the histology of the cell is most likely to be accompanied by disruption of the cell membrane following an injury?

      Your Answer: Coagulative necrosis

      Explanation:

      The process of necrosis ends with the rupture of the cell membrane and the consequent release of the cellular components into the surrounding tissue. Apoptosis, pyknosis and karyorrhexis are not reversible events but the cell membrane remains intact. Cloudy swelling and hydropic changes are also reversible but again the cell membrane remains intact and they are therefore different and distinct from necrosis.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      2
      Seconds
  • Question 19 - Which structure holds the duodenojejunal flexure in place? ...

    Correct

    • Which structure holds the duodenojejunal flexure in place?

      Your Answer: Suspensory ligament (of Treitz)

      Explanation:

      The duodenum is connected to the diaphragm by the suspensory ligament called the ligament of Treitz. It is a slip of skeletal muscle from the right crus of the diaphragm and a fibromuscular band of smooth muscle from the 3rd and 4th parts of the duodenum. It is an important landmark, used to divide the gastrointestinal tract into the upper and lower parts. Contraction of this ‘ligament’ leads to opening of the duodenojejunal flexure allowing the flow of chyme.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      1.9
      Seconds
  • Question 20 - A 35 year old man presented to the surgical OPD with a lump...

    Correct

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

      Your Answer: Giant cell

      Explanation:

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

      Mast cells are involved in allergic reactions.

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

      Plasma cells are typical of chronic inflammation.

      Lymphocytes are involved in viral infections.

      Macrophages combine together to form giant cells.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      2.3
      Seconds
  • Question 21 - Diuretics that act on the ascending limb of the loop of Henle produce:...

    Incorrect

    • Diuretics that act on the ascending limb of the loop of Henle produce:

      Your Answer: Reduced passive transport of sodium

      Correct Answer: Reduced active transport of sodium

      Explanation:

      The loop of Henlé leads from the proximal convoluted tubule to the distal convoluted tubule. Its primary function uses a counter current multiplier mechanism in the medulla to reabsorb water and ions from the urine. It can be divided into four parts:

      1. Descending limb of loop of Henlé – low permeability to ions and urea, while being highly permeable to water

      2. Thin ascending limb of loop of Henlé – not permeable to water, but it is permeable to ions

      3. Medullary thick ascending limb of loop of Henlé – sodium (Na+), potassium (K+) and chloride (Cl–) ions are reabsorbed by active transport. K+ is passively transported along its concentration gradient through a K+ channel in the basolateral aspect of the cells, back into the lumen of the ascending limb.

      4. The cortical thick ascending limb – the site of action where loop diuretics such as furosemide block the K+/Na+/2Cl− co-transporters = reduced active transport.

    • This question is part of the following fields:

      • Physiology
      • Renal
      10.4
      Seconds
  • Question 22 - A 39-year-old man, after radiological evaluation and thoracentesis, was found to have chylothorax....

    Correct

    • A 39-year-old man, after radiological evaluation and thoracentesis, was found to have chylothorax. What is the most probable cause of this diagnose?

      Your Answer: Mediastinal malignant lymphoma

      Explanation:

      Chylothorax is a potentially lethal condition characterized by fluid (chyle) accumulation in the pleural cavity, resulting from disruption of lymphatic drainage in the thoracic duct. Chyle is a fluid rich in triglycerides and chylomicrons and can originate from the thorax, the abdomen or both. Malignant tumours, especially lymphoma, are the most common causes of nontraumatic chylothorax. Bronchogenic carcinoma and trauma are the most common causes after lymphomas. Other rare causes of chylothorax are; granulomatous diseases, tuberculosis, congenital malformations, nephrotic syndrome, hypothyroidism, cirrhosis, decompensated heart failure and idiopathic chylothorax.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      5.3
      Seconds
  • Question 23 - During an operation to repair an aortic coarctation in a neonate, a surgeon...

    Correct

    • During an operation to repair an aortic coarctation in a neonate, a surgeon accidentally cuts the first aortic intercostal arteries as he mobilised the descending aorta. Which one of the following structure might be deprived of its primary source of blood supply following this injury?

      Your Answer: Right bronchus

      Explanation:

      The right bronchus is supplied by one right bronchial artery that may branch from one of the left bronchial arteries or from the right 3rd posterior intercostal artery (this is the first intercostal artery that arises from the aorta). Damage to this artery might stop blood supply to the main bronchus. Intercostal arteries that go to the first and the second interspaces originate from the highest intercostal artery such that blood supply to either of these spaces would not be interfered with.

      The left bronchus receives blood from 2 left bronchial arteries which are direct branches from the descending aorta.

      Fibrous pericardium is the sac that contains the heart. Its blood supply is not a major concern.

      Visceral pericardium receives its blood supply from the coronary vessels.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      8.1
      Seconds
  • Question 24 - Injury to the supraspinatus muscle will affect: ...

    Correct

    • Injury to the supraspinatus muscle will affect:

      Your Answer: Initiation of abduction of the humerus

      Explanation:

      This muscle arises from the medial two-thirds of the supraspinatus fossa and from the supraspinatus fascia. It is inserted into the highest impression on the greater tubercle of the humerus after passing over the upper part of the shoulder joint. It works with the deltoid to raise the arm from the side of the trunk and initiate abduction. It also assists in fixation of the head of the humerus in the glenoid cavity.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      6.5
      Seconds
  • Question 25 - The Carpal tunnel does NOT contain: ...

    Incorrect

    • The Carpal tunnel does NOT contain:

      Your Answer: Flexor digitorum profundus

      Correct Answer: Flexor carpi ulnaris

      Explanation:

      The contents of the carpal tunnel include:

      – Median nerve

      – Flexor digitorum supervicialis

      – Flexor digitorum profundus

      – Flexor policis longus

      – Flexor carpi radialis

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      8.1
      Seconds
  • Question 26 - In which of the following situations will fat necrosis occur? ...

    Correct

    • In which of the following situations will fat necrosis occur?

      Your Answer: Trauma to the breast

      Explanation:

      Fat necrosis is necrosis of adipose tissue with subsequent deposition of calcium, giving it a white chalky appearance. It is seen characteristically in trauma to the breast and the pancreas with subsequent involvement of the peripancreatic fat. In the breast it may present as a palpable mass with is usually painless or as an incidental finding on mammogram. Fatty acids are released from the traumatic tissue which combine with calcium in a process known as saponification, this is an example of dystrophic calcification in which calcium binds to dead tissue. The central focus is surrounded by macrophages and neutrophils initially, followed by proliferation of fibroblasts, neovascularization and lymphocytic migration to the site of the insult.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      2.6
      Seconds
  • Question 27 - What is the normal duration of PR interval on an electrocardiogram of a...

    Correct

    • What is the normal duration of PR interval on an electrocardiogram of a healthy individual?

      Your Answer: 0.12–0.20 s

      Explanation:

      PR interval extends from the beginning of the P-wave until the beginning of the QRS complex. The normal duration of the PR interval is 0.12-0.20 s. It can be prolonged in first degree heart block, and reduced in Wolff-Parkinson-White syndrome.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      4.5
      Seconds
  • Question 28 - A patient at the time of her second delivery opted for a bilateral...

    Correct

    • A patient at the time of her second delivery opted for a bilateral pudendal nerve block. In order to inject the anaesthetic agent near the pudendal nerve a anaesthetic consultant had to insert a finger into the vagina and press laterally to palpate which landmark?

      Your Answer: Ischial spine

      Explanation:

      The ischial spine is always palpated through the walls of the vagina when performing a transvaginal pudendal nerve block and can easily be palpated on the lateral wall of the vagina.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      3.4
      Seconds
  • Question 29 - A patient had sudden complete loss of vision of the right eye. Fundoscopy...

    Correct

    • A patient had sudden complete loss of vision of the right eye. Fundoscopy showed the distinct cherry red spot on the retina. Which of the following arteries was occluded?

      Your Answer: Central artery of the retina

      Explanation:

      The central retinal artery supplies all the nerve fibres that form the optic nerve, which carries the visual information to the lateral geniculate nucleus of the thalamus. Thus if the central retinal artery gets occluded, there is complete loss of vision in that eye and the entire retina (with the exception of the fovea) becomes pale, swollen and opaque while the central fovea still appears reddish (this is because the choroid colour shows through). This is the basis of the famous Cherry red spot seen on examination of the retina on fundoscopy of a central retinal artery occlusion (CRAO).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      2.3
      Seconds
  • Question 30 - Whipple's procedure involves mobilizing the head of the pancreas. As the surgeon does...

    Correct

    • Whipple's procedure involves mobilizing the head of the pancreas. As the surgeon does this, he must be careful to avoid injury to a key structure that is found lying behind the head of the pancreas. Which vital structure is this?

      Your Answer: Common bile duct

      Explanation:

      The posterior relations of the head of the pancreas include: the inferior vena cava, the common bile duct, the renal veins, the right crus of the diaphragm and the aorta.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      4.7
      Seconds
  • Question 31 - In a hypertensive patient with secondary hyperaldosteronism, aldosterone is released mainly in response...

    Correct

    • In a hypertensive patient with secondary hyperaldosteronism, aldosterone is released mainly in response to:

      Your Answer: Angiotensin II

      Explanation:

      Secondary hyperaldosteronism in hypertension is either due to primary renin overproduction by the kidneys or renin overproduction secondary to decreased renal blood flow. The main stimulus for aldosterone release are adrenocorticotrophic hormone (ACTH), angiotensin II and high plasma K+ levels. Low plasma Na+ might also stimulate the adrenal cortex. Fluid overload will reduce aldosterone secretion. Atrial natriuretic peptide is secreted under conditions of expanded extracellular volume and will not lead to aldosterone secretion.

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      2.5
      Seconds
  • Question 32 - A patient is suspected to have Blastomyces dermatidis infection. The patient contracted the...

    Correct

    • A patient is suspected to have Blastomyces dermatidis infection. The patient contracted the disease most likely through which port of entry?

      Your Answer: Respiratory tract

      Explanation:

      Blastomycosis disease is a fungal infection acquired through inhalation of the spores. It caused by the organism Blastomyces dermatitidis and manifests as a primary lung infection in about 70% of cases. The onset is relatively slow and symptoms are suggestive of pneumonia.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      3.2
      Seconds
  • Question 33 - A 16 year old girl fractured a bone in her left foot. Upon...

    Correct

    • 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: 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
      3.1
      Seconds
  • Question 34 - A 50 year old man was admitted to the surgical ICU following a...

    Correct

    • A 50 year old man was admitted to the surgical ICU following a hemicolectomy for carcinoma of the caecum. A full blood count revealed: haematocrit = 30%, erythrocytes = 4 × 106/μ, haemoglobin level = 8 g/dl. To determine the likely cause of his anaemia, red blood cell indices were calculated. Which RBC indices are correct?

      Your Answer: MCHC = haemoglobin concentration/haematocrit

      Explanation:

      Mean corpuscular haemoglobin concentration (MCHC) is calculated simply by dividing the haemoglobin concentration (8 g/dl) by the haematocrit (0.3). The normal range is 31–36 g/dl. This patient has a hypochromic anaemia (MCHC = 8/0.3 = 26.7 g/dl). Dividing the haemoglobin concentration × 10 by erythrocyte number yields mean corpuscular haemoglobin (MCH). Normal range is 25.4–34.6 pg/cell and this patient has a significantly reduced cellular haemoglobin content (MCH = 8 × 10/4 = 20 pg/cell). Mean corpuscular volume (MCV) is calculated by dividing haematocrit × 1000 by erythrocyte number (4 × 106/μl). Normal range is 80–100 fl and this patient has a microcytic anaemia (MCV = 0.3 × 1000/4 = 75 fl). Microcytic, hypochromic anaemia is characteristic for iron-deficiency.

    • This question is part of the following fields:

      • General
      • Physiology
      3.4
      Seconds
  • Question 35 - A 73-year-old woman goes to the doctor complaining of pain and stiffness in...

    Correct

    • A 73-year-old woman goes to the doctor complaining of pain and stiffness in her shoulders and hips for 4 months, which is worst in the mornings. She has also been suffering from fatigue, weight loss and depression. There were no abnormal findings on physical examination. The erythrocyte sedimentation rate was 110 mm/hour, and serum rheumatoid factor and antinuclear antibody assays were negative. Mild normochromic normocytic anaemia was also found. What is the most likely diagnosis in this case?

      Your Answer: Polymyalgia rheumatica

      Explanation:

      Polymyalgia rheumatica (PMR) affects older adults, with an acute or subacute onset. Symptoms include severe pain and stiffness of the neck and pectoral or pelvic girdles, which is worse in the morning or after a period of inactivity and is usually bilateral. Other symptoms can include fatigue, weight loss, depression and fever. The erythrocyte sedimentation rate is usually elevated, and normochromic normocytic anaemia can occur. Other tests are usually normal in this disease.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      2.1
      Seconds
  • Question 36 - The superior ulnar collateral artery is a direct branch of this artery: ...

    Correct

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

      Your 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
      4.8
      Seconds
  • Question 37 - A 55-year-old woman died 3 years after a cardiac transplant due to worsening...

    Correct

    • 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.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      3
      Seconds
  • Question 38 - A 27 year old women had developed a darker complexion following a vacation...

    Correct

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

      Your Answer: Tyrosine

      Explanation:

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

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

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

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

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      1.8
      Seconds
  • Question 39 - A 54 year old man fell off his bicycle. He felt a severe...

    Correct

    • A 54 year old man fell off his bicycle. He felt a severe pain in his hand and wasn't able to move it. It was found that a carpal bone in the distal row was fractured. Which is the most likely bone?

      Your Answer: Trapezium

      Explanation:

      There are eight carpal bones which are arranged in two rows, proximal and distal; scaphoid, lunate, triquetral and pisiform are of proximal row. Trapezium, trapezoid, capitate and hamate are of the distal row.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      1.5
      Seconds
  • Question 40 - During an exploratory laparotomy in a 22 year-old man shot in the abdomen,...

    Correct

    • During an exploratory laparotomy in a 22 year-old man shot in the abdomen, the operating doctor discovers the large bowel is perforated. Which of the following characteristics of the bowel enabled the surgeon to identify it as the large bowel?

      Your Answer: Epiploic appendages

      Explanation:

      The large intestine doesn’t have a continuous layer of longitudinal muscle. Instead, it has three strips of longitudinal muscle called taenia coli. The large intestine is covered with omental appendages that are fat filled. It is also folded into sacculations called haustrations. Serosa is a general term for the outermost coat or serous layer of a visceral structure that lies in the body cavities of the abdomen or thorax.

      Complete circular folds are only found in the small intestine.

      Valvulae conniventes or valves of Kerckring are the circular folds which are large valvular flaps projecting into the lumen of the small bowel.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      3.9
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (15/19) 79%
Head & Neck (2/4) 50%
Pathology (12/12) 100%
Respiratory (4/4) 100%
Breast (1/1) 100%
Gastroenterology (1/1) 100%
Physiology (8/9) 89%
Thorax (1/2) 50%
Haematology (1/1) 100%
Renal (1/2) 50%
Fluids & Electrolytes (1/1) 100%
Lower Limb (3/3) 100%
Inflammation & Immunology (2/2) 100%
Cell Injury & Wound Healing (4/4) 100%
Upper Limb (4/5) 80%
Abdomen (3/3) 100%
Cardiovascular (2/2) 100%
Pelvis (1/1) 100%
Endocrinology (1/1) 100%
Microbiology (1/1) 100%
General (1/1) 100%
Orthopaedics (1/1) 100%
Passmed