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  • Question 1 - A patient who has used NSAIDS for many years presents to the A&E...

    Correct

    • A patient who has used NSAIDS for many years presents to the A&E with symptoms of acute haemorrhagic shock. An emergency endoscopy is done that shows that a duodenal ulcer has perforated the posterior wall of the first part of the duodenum. Which artery is most likely to be the cause of the haemorrhage?

      Your Answer: Gastroduodenal

      Explanation:

      The gastroduodenal artery is a branch of the hepatic artery and descends near the pylorus between the first part of the duodenum and the neck of the pancreas to divide at the lower border of the duodenum into the right gastroepiploic and pancreaticoduodenal arteries. Before it divides, it gives off a few branches to the pyloric end of the stomach and to the pancreas. The artery that is most likely involved in this situation is the gastroduodenal artery since it is posterior to the first part of the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      16
      Seconds

  • Question 2 - The majority of gallstones are mainly composed of: ...

    Correct

    • The majority of gallstones are mainly composed of:

      Your Answer: Cholesterol

      Explanation:

      Bile salts are formed out of cholesterol in the liver cells. Occasionally, precipitation of cholesterol occurs resulting into cholesterol stones developing in the gall bladder.

      These cholesterol gallstones are the most common type and account for 80% of all gallstones. Another type, accounting for 20% gallstones is pigment stones which are composed of bilirubin and calcium salts. Occasionally, stones of mixed origin are also seen.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      7.1
      Seconds

  • Question 3 - A cancer patient was found to have a radio resistant tumour. Which tumour...

    Incorrect

    • A cancer patient was found to have a radio resistant tumour. Which tumour does the patient most likely have?

      Your Answer: Lymphoma

      Correct Answer: Liposarcoma

      Explanation:

      Liposarcoma is a cancer that arises in fat cells in deep soft tissue. Commonly it occurs inside the thigh or retroperitoneum. It usually affects middle-aged and older adults, over 40 years. Liposarcoma is the most common soft-tissue sarcoma. It is very radio resistant. Five-year survival rates vary from 100% to 56% based on histological subtype.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      47.6
      Seconds

  • Question 4 - A 47-year-old male smoker, who had been self-medicating with oral steroids for the...

    Correct

    • A 47-year-old male smoker, who had been self-medicating with oral steroids for the last two years due to persistent breathlessness presented to the doctor complaining of a productive cough, fever and chest pain. A chest X-ray revealed bilateral patchy opacities. He was diagnosed with bilateral bronchopneumonia. Which of these organisms is most probably causing these findings?

      Your Answer: Nocardia asteroides

      Explanation:

      Nocardia is a Gram-positive aerobic actinomycete. Several species have been identified but the most common human pathogen is Nocardia asteroides. The predominant clinical finding in the majority of patients affected by nocardiosis is pulmonary disease. Predisposing factors for pulmonary nocardiosis include leukaemia, human immunodeficiency virus (HIV) infection, organ transplantation, diabetes and receiving prolonged corticosteroids.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      37.5
      Seconds

  • Question 5 - Which of the following is NOT true regarding malignant hyperpyrexia ...

    Correct

    • Which of the following is NOT true regarding malignant hyperpyrexia

      Your Answer: It can be caused by nitrous oxide

      Explanation:

      Malignant hyerpyrexia occurs in 1 in 150,000. All inhalational anaesthetic agents and suxamethonium, except nitrous oxide can cause malignant hyperpyrexia.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      23.8
      Seconds

  • Question 6 - C5a (a complement component) is a potent? ...

    Incorrect

    • C5a (a complement component) is a potent?

      Your Answer: Cytokine

      Correct Answer: Anaphylotoxin

      Explanation:

      C5a is a strong chemoattractant as well as an anaphylotoxin and is involved in the recruitment of inflammatory cells such as neutrophils, eosinophils, monocytes, and T lymphocytes. It is also involved in activation of phagocytic cells, release of granule-based enzymes and generation of oxidants. All of which contribute to innate immune functions.

    • This question is part of the following fields:

      • General
      • Physiology
      52.4
      Seconds

  • Question 7 - A man had an injury to his right brachial plexus. After examination by...

    Correct

    • A man had an injury to his right brachial plexus. After examination by the doctor they found that the diaphragm and the scapula were unaffected however the patient could not abduct his arm. When helped with abducting his arm to 45 degrees he was able to continue the movement. This means that he was unable to initiate abduction. Where is the likely site of injury?

      Your Answer: Suprascapular nerve

      Explanation:

      The loss of ability to initiate abduction means paralysis of the supraspinatus muscle. This muscle is supplied by the supraclavicular nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      29.3
      Seconds

  • Question 8 - The dura mater is a thick membrane that is the outermost of the...

    Correct

    • The dura mater is a thick membrane that is the outermost of the three layers of the meninges. Which of the following foramen transmits the dura mater?

      Your Answer: Foramen magnum

      Explanation:

      The foramen magnum is found in the most inferior part of the posterior cranial fossa . It is traversed by vital structures including the medulla oblongata . Its contents include the following: medulla oblongata, meninges (arachnoid, dura and pia mater), 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
      5.7
      Seconds

  • Question 9 - 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
      85.7
      Seconds

  • Question 10 - Which organ is most vulnerable to haemorrhagic shock? ...

    Correct

    • Which organ is most vulnerable to haemorrhagic shock?

      Your Answer: Kidneys

      Explanation:

      At rest, the brain receives 15% cardiac output, muscles 15%, gastrointestinal tract 30% and kidneys receive 20%. However, if normalised by weight, the largest specific blood flow is received by the kidneys at rest (400 ml/min x 100g), making them highly vulnerable in the case of a haemorrhagic shock.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      3.2
      Seconds

  • Question 11 - 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
      27.8
      Seconds

  • Question 12 - Which of the following substances brings about a dilatation of the gastrointestinal resistance...

    Correct

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

      Your 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
      31.6
      Seconds

  • Question 13 - Which of these structures is most likely to be damaged if a patient...

    Correct

    • Which of these structures is most likely to be damaged if a patient loses consciousness days or weeks after an otherwise insignificant head trauma, especially in elderly patients?

      Your Answer: Dural bridging vein

      Explanation:

      A subdural haematoma is a type of hematoma, usually associated with traumatic brain injury, in which blood collects between the dura mater and the pia-arachnoid mater. Symptoms of subdural haemorrhage have a slower onset than those of epidural haemorrhages because the lower pressure veins bleed more slowly than arteries. These injuries are more common in elderly patients, especially those taking antiplatelet or anticoagulant drugs. Oedema and increased intracranial pressure are unusual.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      7.1
      Seconds

  • Question 14 - A drug abuser developed an infection which spread from the dorsum of the...

    Correct

    • A drug abuser developed an infection which spread from the dorsum of the hand to the medial side of the arm along the course of the large cutaneous vein. Which vein is involved?

      Your Answer: Basilic

      Explanation:

      The basilic vein is one of two veins found in the forearm, the other is the cephalic vein. These veins originate from the deep venous arch of the hand. The cephalic vein ascends along the lateral side of the forearm, and the basilic vein runs up the medial side of the forearm.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      30.1
      Seconds

  • Question 15 - 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: Pseudomonas aeruginosa

      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
      25.2
      Seconds

  • Question 16 - A 55-year-old woman complains of pain in the proximal and distal interphalangeal joins,...

    Correct

    • A 55-year-old woman complains of pain in the proximal and distal interphalangeal joins, and back pain which has increased over the last 4 years and worsens after activity. X-rays reveal Heberden’s and Bouchard’s nodes in her interphalangeal joints and the presence of osteophytes in her spine. What is the most likely diagnosis?

      Your Answer: Osteoarthritis

      Explanation:

      Osteoarthritis is most common in older adults, predominating in women between the ages of 40 and 70; after this age, men and women are affected equally. It affects an entire joint, with disruption and potential loss of joint cartilage, along with other joint changes, including bone hypertrophy (osteophyte formation). The pain is usually gradual and is worse after activity, with occasional joint swelling. X-ray findings include marginal osteophytes, narrowing of the joint space, increased density of the subchondral bone, subchondral cyst formation, bony remodelling and joint effusions.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      44.5
      Seconds

  • Question 17 - Which of these antibiotics is the first choice treatment for infections caused by...

    Correct

    • Which of these antibiotics is the first choice treatment for infections caused by Pseudomonas aeruginosa?

      Your Answer: Piperacillin

      Explanation:

      Piperacillin is an extended-spectrum beta-lactam antibiotic of the ureidopenicillin class. It is normally used with a beta-lactamase inhibitor such as tazobactam. The combination has activity against many Gram-positive and Gram-negative pathogens and anaerobes, including Pseudomonas aeruginosa. Piperacillin is sometimes referred to as an anti-pseudomonal penicillin.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      75.5
      Seconds

  • Question 18 - A 34-year-old woman with pelvic inflammatory disease is administered ceftriaxone. The subclass of...

    Correct

    • A 34-year-old woman with pelvic inflammatory disease is administered ceftriaxone. The subclass of antibiotics that ceftriaxone belongs to is:

      Your Answer: Third-generation cephalosporins

      Explanation:

      Ceftriaxone is a third-generation cephalosporin antibiotic. It has a broad spectrum of activity against Gram-positive and Gram-negative bacteria. Its indications include middle ear infections, endocarditis, meningitis, pneumonia, bone and joint infections, intra-abdominal infections, skin infections, urinary tract infections, gonorrhoea, and pelvic inflammatory disease.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      17.6
      Seconds

  • Question 19 - Carbon dioxide is principally transported in the blood in which form? ...

    Correct

    • Carbon dioxide is principally transported in the blood in which form?

      Your Answer: Bicarbonate

      Explanation:

      Carbon dioxide is transported in the blood in various forms:

      – Bicarbonate (80–90%)

      – Carbamino compounds (5–10%)

      – Physically dissolved in solution (5%).

      Carbon dioxide is carried on the haemoglobin molecule as carbamino-haemoglobin; carboxyhaemoglobin is the combination of haemoglobin with carbon monoxide.

    • This question is part of the following fields:

      • Physiology
      • Respiratory; Cardiovascular
      7.1
      Seconds

  • Question 20 - Staphylococcus aureus can be identified in the laboratory based on the clotting of...

    Correct

    • Staphylococcus aureus can be identified in the laboratory based on the clotting of plasma. Which microbial product is responsible for this activity?

      Your Answer: Coagulase

      Explanation:

      Staphylococcus aureus is the most pathogenic species and is implicated in a variety of infections.  S. aureus can be identified due to its production of coagulase. The staphylococcal enzyme coagulase will cause inoculated citrated rabbit plasma to gel or coagulate. The coagulase converts soluble fibrinogen in the plasma into insoluble fibrin.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      10.3
      Seconds

  • Question 21 - Driving pressure is considered to be a strong predictor of mortality in patients...

    Correct

    • Driving pressure is considered to be a strong predictor of mortality in patients with ARDS. What is the normal mean intravascular driving pressure for the respiratory circulation?

      Your Answer: 10 mmHg

      Explanation:

      Driving pressure is the difference between inflow and outflow pressure. For the pulmonary circulation, this is the difference between pulmonary arterial (pa) and left atrial pressure (pLA). Normally, mean driving pressure is about 10 mmHg, computed by subtracting pLA (5 mmHg) from pA (15 mmHg). This is in contrast to a mean driving pressure of nearly 100 mmHg in the systemic circulation.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      12
      Seconds

  • Question 22 - During uterogrowth, the second pharyngeal arch gives rise to which structures? ...

    Correct

    • During uterogrowth, the second pharyngeal arch gives rise to which structures?

      Your Answer: Stylohyoid muscle

      Explanation:

      The second pharyngeal arch or hyoid arch, is the second of six pharyngeal arches that develops in fetal life during the fourth week of development and assists in forming the side and front of the neck. Derivatives:

      Skeletal – From the cartilage of the second arch arises:

      Stapes,

      Temporal styloid process,

      Stylohyoid ligament, and

      Lesser cornu of the hyoid bone.

      Muscles:

      Muscles of face

      Occipitofrontalis muscle

      Platysma

      Stylohyoid muscle

      Posterior belly of Digastric

      Stapedius muscle

      Auricular muscles

      Nerve supply: Facial nerve

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      36.2
      Seconds

  • Question 23 - A 45-year old with sarcoidosis has enlarged tracheobronchial lymph nodes. Which nerve is...

    Correct

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

      Your 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
      28.4
      Seconds

  • Question 24 - 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: Collecting 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
      14
      Seconds

  • Question 25 - What causes a reduction in pulmonary functional residual capacity? ...

    Incorrect

    • What causes a reduction in pulmonary functional residual capacity?

      Your Answer: Pneumonia

      Correct Answer: Pulmonary fibrosis

      Explanation:

      Pulmonary functional residual capacity (FRC) is = volume of air present in the lungs at the end of passive expiration.

      Obstructive diseases (e.g. emphysema, chronic bronchitis, asthma) = an increase in FRC due to an increase in lung compliance and air trapping.

      Restrictive diseases (e.g. pulmonary fibrosis) result in stiffer, less compliant lungs and a reduction in FRC.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      47.3
      Seconds

  • Question 26 - The tensor villi palatini muscle is a broad thin, ribbon-like muscle in the...

    Correct

    • The tensor villi palatini muscle is a broad thin, ribbon-like muscle in the head that tenses the soft palate. Which of the following structures is associated with the tensor villi palatini muscle?

      Your Answer: The hamulus of the medial pterygoid plate

      Explanation:

      The pterygoid hamulus is a hook-like process at the lower extremity of the medial pterygoid plate of the sphenoid bone around which the tendon of the tensor veli palatini passes.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      27.3
      Seconds

  • Question 27 - Which of the following is a true statement regarding secretion of gastric acid?...

    Correct

    • Which of the following is a true statement regarding secretion of gastric acid?

      Your Answer: Acetylcholine increases gastric acid secretion

      Explanation:

      Gastric acid secretion is increased by acetylcholine, histamine and gastrin, with the help of cAMP as a secondary messenger. They increase H+ and Cl- secretion by increasing the number of H+/K+ ATPase molecules and Cl- channels. In contrast, gastric acid secretion is decreased by somatostatin, epidermal growth factor and prostaglandins.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      80.1
      Seconds

  • Question 28 - Different substances have different renal clearance rates. Which of the following substances should...

    Correct

    • Different substances have different renal clearance rates. Which of the following substances should have the lowest renal clearance rate in a healthy patient?

      Your Answer: Glucose

      Explanation:

      Under normal conditions the renal clearance of glucose is zero, since glucose is completely reabsorbed in the renal tubules and not excreted. Glycosuria – the excretion of glucose into the urine- is nearly always caused by elevated blood glucose levels, most commonly due to untreated diabetes mellitus.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      28.5
      Seconds

  • Question 29 - Which of the following is most likely to cause hypovolaemic hypernatremia: ...

    Incorrect

    • Which of the following is most likely to cause hypovolaemic hypernatremia:

      Your Answer: Diarrhoea

      Correct Answer: Hyperalimentation

      Explanation:

      Hypernatremia, characterised by a high serum sodium concentration, is rarely associated with volume overload (hypervolemia). A hypovolaemic hypernatremia may be seen during excessive administration of hypertonic sodium bicarbonate, hypertonic saline or hyperalimentation.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      40.2
      Seconds

  • Question 30 - Which of the following muscles is solely contained in the anterior triangle of...

    Correct

    • 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: 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
      32.9
      Seconds

  • Question 31 - Where do the seminal vesicles lie? ...

    Correct

    • Where do the seminal vesicles lie?

      Your Answer: Base of the bladder and rectum

      Explanation:

      The seminal vesicles are two lobulated membranous pouches situated between the fundus of the bladder and rectum and act as a reservoir for the semen and secrete a fluid that is added to the seminal fluid. Each sac is pyramidal in shape but they all vary in size not only in different individuals but also in the same individuals. The anterior surface is in contact with the fundus of the bladder, extending from near the termination of the ureter to the base of the prostate. Each vesicle consist of single tube, which gives off several irregular caecal diverticula. These separate coils and the diverticula are connected by fibrous tissue.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      39.9
      Seconds

  • Question 32 - A 20 year old is brought to the A&E after he fell from...

    Correct

    • 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: 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
      90.4
      Seconds

  • Question 33 - 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
      103.6
      Seconds

  • Question 34 - Which of the following conditions is likely to result in splenomegaly, hypochromic anaemia...

    Incorrect

    • Which of the following conditions is likely to result in splenomegaly, hypochromic anaemia and hemochromatosis in a young male?

      Your Answer: Sickle cell anaemia

      Correct Answer: β-Thalassaemia

      Explanation:

      Beta-thalassaemia is due to decreased production of β-polypeptide chains, with an autosomal inheritance pattern. Carrier patients (heterozygotes) are asymptomatic and have mild to moderate microcytic anaemia. This is known as thalassaemia minor. Homozygotes (β-thalassaemia major, or Cooley’s anaemia) develop severe anaemia and marrow hyperactivity. The disease presents at 1-2 years of age with severe anaemia and transfusional and absorptive iron overload. Patients also present with jaundice, leg ulcers, massive splenomegaly and cholelithiasis. The disease can also lead to splenic sequestration leading to faster destruction of transfused red blood cells. Increased marrow activity causes thickening of cranial bones. Involvement of long bones is also seen, which can cause pathological fractures and growth impairment. There is iron deposition in various organs, which can lead to heart failure or hepatic failure (leading to cirrhosis). Thalassaemias are suspected in presence of family history, or signs suggesting microcytic haemolytic anaemia. Further test and quantitative haemoglobin studies are useful. In beta-thalassaemia, there is an increase in serum bilirubin, iron and ferritin levels. There is severe anaemia, often with haemoglobin < 6 g/dl. There is an elevated red blood cell count, which are microcytic. Peripheral blood smear is diagnostic with nucleated erythroblasts, target cells, small pale red blood cells, and punctate basophilia.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      26.8
      Seconds

  • Question 35 - During a street fight a boy sustained a laceration below the elbow. It...

    Incorrect

    • 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: Anterior ulnar recurrent artery

      Correct 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
      1461.7
      Seconds

  • Question 36 - An enlarged lymph node which shows well-defined, prominent paracortical follicles with germinal centres...

    Correct

    • An enlarged lymph node which shows well-defined, prominent paracortical follicles with germinal centres is most likely from which of the following patients?

      Your Answer: A 5-year-old boy with a sore throat and runny nose

      Explanation:

      Lymphadenopathy is common in children and is usually reactive in nature. The description fits that of a benign, reactive lymph node.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      11
      Seconds

  • Question 37 - Which of the following features is indicative of poor prognosis in a case...

    Correct

    • Which of the following features is indicative of poor prognosis in a case of breast carcinoma?

      Your Answer: Axillary lymph node metastases

      Explanation:

      Lymphatic spread indicates poor prognosis. Presence of family history is not a prognostic factor despite being linked to higher incidence. Aneuploidy is a poor prognostic factor. A breast tumour positive for oestrogen receptors is a good prognostic factor as it increases the responsiveness of the tumour to certain therapies. In-situ tumours carry the best prognosis.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      6
      Seconds

  • Question 38 - In which of the following compartments of the femoral sheath is the femoral...

    Correct

    • In which of the following compartments of the femoral sheath is the femoral artery located?

      Your Answer: Lateral compartment

      Explanation:

      The femoral sheath also known as the crural sheath is made up of three compartments; lateral, intermediate and the medial. The femoral artery is contained in the lateral compartment of the femoral sheath while the femoral vein is in the intermediate compartment.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      12.2
      Seconds

  • Question 39 - Which of the following is the most common germ cell tumour of the...

    Incorrect

    • Which of the following is the most common germ cell tumour of the testis affecting an adult male?

      Your Answer: Embryonal carcinoma

      Correct Answer: Seminoma

      Explanation:

      Germ cell tumours represent 90% of primary tumours arising in the testis. They are broadly divided into seminomas and non-seminomas. Seminomas are the most common testicular germ cell tumour seen in 40% cases. The other non-seminomatous histological subtypes include embryonal (25%), teratocarcinoma (25%), teratoma (5%) and pure choriocarcinoma (1%).

    • This question is part of the following fields:

      • Pathology
      • Urology
      11.3
      Seconds

  • Question 40 - The ability of the bacteria to cause disease or its virulence is related...

    Correct

    • The ability of the bacteria to cause disease or its virulence is related to :

      Your Answer: Toxin and enzyme production

      Explanation:

      The pathogenicity of an organism or its ability to cause disease is determined by its virulence factors. Many bacteria produce virulence factors that inhibit the host’s immune system. The virulence factors of bacteria are typically proteins or other molecules that are synthesized by enzymes. These proteins are coded for by genes in chromosomal DNA, bacteriophage DNA or plasmids. The proteins made by the bacteria can poison the host cells and cause tissue damage.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      5.5
      Seconds

  • Question 41 - A 40-year old lady presented to the hospital with fever and mental confusion...

    Correct

    • A 40-year old lady presented to the hospital with fever and mental confusion for 1 week. On examination, she was found to have multiple petechiae all over her skin and mucosal surfaces. Blood investigations revealed low platelet count and raised urea and creatinine. A platelet transfusion was carried out, following which she succumbed to death. Autopsy revealed pink hyaline thrombi in myocardial arteries. What is the likely diagnosis?

      Your Answer: Thrombotic thrombocytopenic purpura

      Explanation:

      Hyaline thrombi are typically associated with thrombotic thrombocytopenic purpura (TTP), which is caused by non-immunological destruction of platelets. Platelet transfusion is contraindicated in TTP. Platelets and red blood cells also get damaged by loose strands of fibrin deposited in small vessels. Multiple organs start developing platelet-fibrin thrombi (bland thrombi with no vasculitis) typically at arteriocapillary junctions. This is known as ‘thrombotic microangiopathy’. Treatment consists of plasma exchange.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      18
      Seconds

  • Question 42 - Which statement is true regarding the diaphragmatic openings: ...

    Correct

    • Which statement is true regarding the diaphragmatic openings:

      Your Answer: The thoracic duct passes through the opening at T12

      Explanation:

      The diaphragmatic openings are:

      T8 – opening for the inferior vena cavaand the right phrenic nerve

      T10 – opening for the oesophagusand the left gastric artery and vein

      T12 – opening for the aorta, the thoracic duct and azygos vein.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      13.4
      Seconds

  • Question 43 - The chest X-ray of an 10-year-old boy, that presented with low-grade fever and...

    Correct

    • The chest X-ray of an 10-year-old boy, that presented with low-grade fever and cough, revealed hilar enlargement and parenchymal consolidation in the middle lobes. These X-ray findings are more typical for which of the following diagnoses?

      Your Answer: Pulmonary tuberculosis

      Explanation:

      Primary pulmonary tuberculosis is seen in patients exposed to Mycobacterium tuberculosis for the firs time. The main radiographic findings in primary pulmonary tuberculosis include homogeneous parenchymal consolidation typically in the lower and middle lobes, lymphadenopathy, miliary opacities and pleural effusion.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      22.3
      Seconds

  • Question 44 - What principal artery that supplies the meninges is susceptible to rupture following trauma...

    Correct

    • What principal artery that supplies the meninges is susceptible to rupture following trauma to the side of the head over the temporal region:

      Your Answer: Middle meningeal artery

      Explanation:

      The middle meningeal artery normally arises from the first or mandibular segment of the maxillary artery. The artery runs in a groove on the inside of the cranium, this can clearly be seen on a lateral skull X-ray. An injured middle meningeal artery is the most common cause of an epidural hematoma.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      7.9
      Seconds

  • Question 45 - 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: Metastatic duct carcinoma of the breast

      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
      9.1
      Seconds

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

    Correct

    • Which of the following has the least malignant potential?

      Your 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
      11.7
      Seconds

  • Question 47 - A patient gives a history of dull discomfort in her abdomen associated with...

    Correct

    • A patient gives a history of dull discomfort in her abdomen associated with pain that she points to be on her right shoulder and right scapula. The following organs are most likely to be source of her pain:

      Your Answer: Liver, duodenum and gallbladder

      Explanation:

      Referred pain is felt at a point away from the source of the pain or the unpleasant sensation. It arises when a nerve is damaged or compressed at a point but the pain is felt at another site that is the territory of that nerve. Common abdominal causes of referred pain to the shoulder and the shoulder blade are the liver, duodenum and gall bladder.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      9.9
      Seconds

  • Question 48 - A football player sustained an injury to his ankle. The wound went through...

    Correct

    • A football player sustained an injury to his ankle. The wound went through the skin, subcutaneous tissue and flexor retinaculum. Which other structure passing under the retinaculum may be injured?

      Your Answer: Tibial nerve

      Explanation:

      The flexor retinaculum is immediately posterior to the medial malleolus. The structures that pass under the flexor retinaculum from anterior to posterior are: tendon of the tibialis posterior, flexor digitorum longus, posterior tibial artery (and vein), tibial nerve and tendon of flexor hallucis longus. The tibial nerve is the only one which lies behind the flexor retinaculum.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      20.8
      Seconds

  • Question 49 - Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of...

    Correct

    • Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of the popliteal fossa?

      Your Answer: Biceps femoris

      Explanation:

      The popliteal fossa is located at the back of the knee. It is bounded laterally by the biceps femoris above and the plantaris and lateral head of the gastrocnemius below and medially by the semitendinosus and semimembranosus above and by the medial head of the gastrocnemius below.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      14.8
      Seconds

  • Question 50 - A 46-year old female patient experienced a stroke that affected her glossopharyngeal nerve....

    Correct

    • A 46-year old female patient experienced a stroke that affected her glossopharyngeal nerve. Damage to the glossopharyngeal nerve would most likely:

      Your Answer: Result in general sensory deficit to the pharynx

      Explanation:

      The glossopharyngeal nerve (CN IX) has many functions which include:

      – Contributes to the pharyngeal plexus

      – Receiving general somatic sensory fibres from the tonsils, pharynx, the middle ear and the posterior third of the tongue.

      – supplies motor fibres to only one muscle; the stylopharyngeus muscle.

      – provides parasympathetic fibres to the parotid gland via the otic ganglion.

      – Receives visceral sensory fibres from the carotid bodies & carotid sinus.

      – Receives special visceral sensory fibres from the posterior third of the tongue.

      The above functions will directly be affected by the damage of the glossopharyngeal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      29.3
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Abdomen (4/4) 100%
Anatomy (18/19) 95%
Gastroenterology (3/3) 100%
Physiology (7/11) 64%
Neoplasia (0/2) 0%
Pathology (13/20) 65%
Respiratory (3/4) 75%
Pharmacology (3/3) 100%
General (0/1) 0%
Upper Limb (2/3) 67%
Head & Neck (6/6) 100%
Fluids & Electrolytes (1/3) 33%
Cardiovascular (1/1) 100%
Haematology (2/4) 50%
Neurology (1/1) 100%
Microbiology (2/3) 67%
Orthopaedics (1/1) 100%
Respiratory; Cardiovascular (1/1) 100%
Embryology (1/1) 100%
Thorax (1/1) 100%
Renal (0/1) 0%
Pelvis (1/1) 100%
Women's Health (1/1) 100%
Lower Limb (3/3) 100%
Urology (0/1) 0%
Gastrointestinal; Hepatobiliary (1/1) 100%
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