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  • Question 1 - Following the administration of a medication for a heart condition, a 69-year-old man...

    Correct

    • Following the administration of a medication for a heart condition, a 69-year-old man develops hypothyroidism.

      Which of the following drugs is most likely to be the cause?

      Your Answer: Amiodarone

      Explanation:

      Amiodarone has a chemical structure that is similar to that of thyroxine and can bind to the nuclear thyroid receptor. It can cause both hypothyroidism and hyperthyroidism, though hypothyroidism is far more common, with 5-10% of patients suffering from it.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      30.4
      Seconds
  • Question 2 - In adults in the United Kingdom, which of the following pathogens is the...

    Correct

    • In adults in the United Kingdom, which of the following pathogens is the most likely cause of viral infectious gastroenteritis:

      Your Answer: Norovirus

      Explanation:

      Norovirus is the most common viral cause of epidemic gastroenteritis worldwide; it is also a common cause of endemic diarrhoea in community settings. In the United Kingdom, norovirus has become the most common cause of gastroenteritis in adults and children since the introduction of rotavirus vaccination.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      18.3
      Seconds
  • Question 3 - A 50-year-old man managed by the renal team for stage 4 chronic kidney...

    Incorrect

    • A 50-year-old man managed by the renal team for stage 4 chronic kidney disease which appears to be deteriorating presents with a history of shortness of breath and ankle oedema. His most recent blood tests shows low calcium levels.

      Which of these increases the renal reabsorption of calcium?

      Your Answer: Calcitonin

      Correct Answer: Parathyroid hormone

      Explanation:

      Parathyroid hormone (PTH), a polypeptide containing 84 amino acids, is the principal hormone that controls free calcium in the body.

      Its main actions are:
      Increases osteoclastic activity
      Increases plasma calcium concentration
      Decreases renal phosphate reabsorption
      Decreases plasma phosphate concentration
      Increases renal tubular reabsorption of calcium
      Increases calcium and phosphate absorption in the small intestine
      Increases renal conversion of 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      36.6
      Seconds
  • Question 4 - A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited...

    Correct

    • A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited range of motion in the right elbow for the past two days. On examination, the right elbow is extremely tender with erythema and warmth of the overlying skin due to acute inflammation.

      Which ONE of the following statements is true with regards to acute inflammation?

      Your Answer: Neutrophils are activated and adhere to the endothelium as a result of interaction with endothelial cell adhesion molecules

      Explanation:

      Acute inflammation is defined as inflammation occurring within minutes to hours in response to an injury lasting for less than two weeks.

      Acute inflammation
      Rapid onset (minutes to hours)
      Quick resolution (usually days)

      Chronic inflammation
      May last weeks, months, or years

      There are five cardinal signs of inflammation:
      1) Pain
      2) Redness
      3) Warmth
      4) Oedema
      5) Loss of function

      During acute inflammation, neutrophils are activated and attracted to the site of inflammation in response to various interleukins and cytokines. This process takes place via the following mechanism:
      1) Margination
      Neutrophils flow nearer the vessel wall rather than in the axial stream, which is referred to as margination
      2) Rolling along the surface of vascular endothelium
      3) Adhesion to the endothelium by interaction with adhesion molecules (ICAMS and VCAMS)
      4) Diapedesis is the movement of neutrophils from the endothelial cells into the interstitial space by squeezing through the gaps between adjacent endothelial cells

      Bradykinin and histamine are both responsible for vasodilation which causes oedema and decreases intravascular osmotic pressure.

      Neutrophils dominate early (<2 days)
      – Many in the bloodstream
      – Attach firmly to adhesion molecules
      – Apoptosis after 24-48hrs
      Monocytes/macrophages dominate late (>2 days)
      – Live longer
      – Replicate in tissues

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      122.5
      Seconds
  • Question 5 - When a child has mumps, how long should he or she be off...

    Correct

    • When a child has mumps, how long should he or she be off from school?

      Your Answer: 5 days from onset of swelling

      Explanation:

      To avoid the spread of infection, infected patients should be isolated. Patients should avoid going to school, childcare, or job for five days after the swelling has occurred.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      29.3
      Seconds
  • Question 6 - A patient presents with a lump for a dermatological examination. There is a...

    Incorrect

    • A patient presents with a lump for a dermatological examination. There is a circumscribed skin elevation measuring 0.3 cm in diameter seen on examination.

      Which one of these best describes the lump you have found on examination?

      Your Answer: Nodule

      Correct Answer: Papule

      Explanation:

      A papule is a solid, well circumscribed, skin elevation measuring less than 0.5 cm in diameter.

      A nodule is a solid, well circumscribed, raised area that lies in or under the skin and measures greater than 0.5 cm in diameter. They are usually painless.

      A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter.

      A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus.

      A pustule is a small visible skin elevation containing an accumulation of pus.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      38.2
      Seconds
  • Question 7 - Regarding Campylobacter gastroenteritis, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding Campylobacter gastroenteritis, which of the following statements is INCORRECT:

      Your Answer: It is associated with the subsequent development of Reiter's syndrome.

      Correct Answer: Infection usually requires antibiotic treatment.

      Explanation:

      Campylobacter jejuni is the primary human pathogen, typically causing dysentery (bloody diarrhoea illness) following ingestion of contaminated meat, especially poultry. Infection is typically self-limiting and does not require antibiotic therapy. Campylobacter gastroenteritis is associated with the immune-mediated complications of Guillain-Barre syndrome, reactive arthritis and Reiter’s syndrome.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      67.8
      Seconds
  • Question 8 - A 43 year old lady who has a previous medical history of hyperthyroidism...

    Incorrect

    • A 43 year old lady who has a previous medical history of hyperthyroidism presents to the emergency room with sweating, palpitations and agitation. On examination, she is tachycardic, hypertensive and hyperpyrexic. She recently had a stomach bug and has not been able to take her medication regularly. The best medication to immediately treat her symptoms is which of the following?

      Your Answer: Carbimazole

      Correct Answer: Propranolol

      Explanation:

      There is a high suspicion of a thyroid crisis in this patient and emergent treatment should be initiated even before the results of TFT’s have returned. Antiadrenergic drugs like IV propranolol should be administered immediately to minimise sympathomimetic symptoms. Antithyroid medications like propylthiouracil or carbimazole should be administered to block further synthesis of thyroid hormones. After thionamide therapy has been started to prevent stimulation of new hormone synthesis, there should then be delayed administration of oral iodine solution. Hydrocortisone administration is also recommended as it treats possible relative adrenal insufficiency while also decreases peripheral conversion of T4 to T3.

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
      28.1
      Seconds
  • Question 9 - What is the interquartile range of the following data set: 5, 10, 15,...

    Incorrect

    • What is the interquartile range of the following data set: 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 60, 70

      Your Answer:

      Correct Answer: 30

      Explanation:

      5, 10, 15 /20, 25, 30 /35, 40, 45 /50, 60, 70
      Sample size (n) = 12
      Median = [(n+1)/2]th value
      = (12+1)/2 = 6.5
      = halfway between 6th and 7th value
      = (30 +35)/2 = 32.5
      The lower (first) quartile = halfway between 15 and 20
      = 17.5
      The upper (third) quartile = halfway between 45 and 50
      = 47.5
      The interquartile range is the difference between the upper quartile and lower quartile
      = 47.5 – 17.5 = 30

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      0
      Seconds
  • Question 10 - Your consultant decides to use ketamine for a patient requiring procedural sedation in...

    Incorrect

    • Your consultant decides to use ketamine for a patient requiring procedural sedation in the Emergency Department. At what receptor does ketamine primarily act:

      Your Answer:

      Correct Answer: NMDA receptor

      Explanation:

      In contrast to most other anaesthetic agents, ketamine is a NMDA (N-methyl-D-aspartate) receptor antagonist. It is a non-competitive antagonist of the calcium-ion channel in the NMDA receptor. It further inhibits the NMDA-receptor by binding to its phencyclidine binding site. Ketamine also acts at other receptors as an opioid receptor agonist (analgesic effects), as an muscarinic anticholinergic receptor antagonist (antimuscarinic effects) and by blocking fast sodium channels (local anaesthetic effect).

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      0
      Seconds
  • Question 11 - For which of the following infections is phenoxymethylpenicillin (penicillin V) primarily used? ...

    Incorrect

    • For which of the following infections is phenoxymethylpenicillin (penicillin V) primarily used?

      Your Answer:

      Correct Answer: Streptococcal tonsillitis

      Explanation:

      Phenoxymethylpenicillin (penicillin V) is less active than benzylpenicillin but both have similar antibacterial spectrum. Because penicillin V is gastric-acid stable, it is suitable for oral administration, but should not be used for serious infections as absorption can be unpredictable and plasma concentrations can be variable.
      Its uses are:
      1. mainly for respiratory tract infections in children
      2. for streptococcal tonsillitis
      3. for continuing treatment after one or more injections of benzylpenicillin when clinical response has begun.
      4. for prophylaxis against streptococcal infections following rheumatic fever and against pneumococcal infections following splenectomy or in sickle-cell disease.

      It should not be used for meningococcal or gonococcal infections.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds
  • Question 12 - Due to a traffic accident, a male patient was unable to lift his...

    Incorrect

    • Due to a traffic accident, a male patient was unable to lift his arm, indicating an injury at the glenohumeral joint. Based on the patient’s current condition, which nerve or nerves are may likely damaged?

      Your Answer:

      Correct Answer: Axillary and suprascapular nerve

      Explanation:

      A suprascapular nerve injury causes numbness in the shoulder, as well as weakness in abduction and external rotation.

      Damage to the axillary nerve can result in shoulder or arm muscle weakness, as well as difficulty lifting the arm. This is because the deltoid and supraspinatus muscles, which are innervated by the axillary and suprascapular nerves, are responsible for abduction of the arm at the shoulder joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 13 - Regarding pressures and airflow during the normal breathing cycle, which of the following...

    Incorrect

    • Regarding pressures and airflow during the normal breathing cycle, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Negative intrapleural pressure causes dynamic compression of the airways.

      Explanation:

      Dynamic compression occurs during forced expiration, when as the expiratory muscles contract, all the structures within the lungs, including the airways, are compressed by the positive intrapleural pressure. Consequently the smaller airways collapse before the alveoli empty completely and some air remains within the lungs (the residual volume).

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 14 - Which lobe of the prostate gland is most commonly affected in benign prostatic...

    Incorrect

    • Which lobe of the prostate gland is most commonly affected in benign prostatic hypertrophy?

      Your Answer:

      Correct Answer: Median

      Explanation:

      Benign enlargement of the prostate is common in men older than 50 years. The cause is possibly an imbalance in the hormonal control of the gland. The median lobe of the gland enlarges upward and encroaches within the sphincter vesicae, located at the neck of the bladder. The leakage of urine into the prostatic urethra causes an intense reflex desire to micturate. The enlargement of the median and lateral lobes of the gland produces elongation and lateral compression and distortion of the urethra so that the patient experiences difficulty in passing urine and the stream is weak. Back-pressure effects on the ureters and both kidneys are a common complication. The enlargement of the uvula vesicae (owing to the enlarged median lobe) results in the formation of a pouch of stagnant urine behind the urethral orifice within the bladder. The stagnant urine frequently becomes infected, and the inflamed bladder (cystitis) adds to the patient’s symptoms.

      In all operations on the prostate, the surgeon regards the prostatic venous plexus with respect. The veins have thin walls, are valveless, and are drained by several large trunks directly into the internal iliac veins. Damage to these veins can result in a severe haemorrhage.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      0
      Seconds
  • Question 15 - Oedema can occur as a result of any of the following WITH THE...

    Incorrect

    • Oedema can occur as a result of any of the following WITH THE EXCEPTION OF:

      Your Answer:

      Correct Answer: Increased interstitial hydrostatic pressure

      Explanation:

      Oedema is defined as a palpable swelling produced by the expansion of the interstitial fluid volume. A variety of clinical conditions are associated with the development of oedema, including heart failure, cirrhosis, and nephrotic syndrome. The development of oedema requires an alteration in capillary dynamics in a direction that favours an increase in net filtration and also inadequate removal of the additional filtered fluid by lymphatic drainage. Oedema may form in response to an elevation in capillary hydraulic pressure (which increases the delta hydraulic pressure) or increased capillary permeability, or it can be due to disruption of the endothelial glycocalyx, decreased interstitial compliance, a lower plasma oncotic pressure (which reduces the delta oncotic pressure), or a combination of these changes. Oedema can also be induced by lymphatic obstruction since the fluid that is normally filtered is not returned to the systemic circulation.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 16 - Which one these is an example of a cause of an exudate? ...

    Incorrect

    • Which one these is an example of a cause of an exudate?

      Your Answer:

      Correct Answer: Subphrenic abscess

      Explanation:

      An exudate is an inflammatory fluid emanating from the intravascular space due to changes in the permeability of the surrounding microcirculation.

      Some common causes of exudates are: pneumonia, empyema, lung cancer, breast cancer, cancer of the pleura, SLE, rheumatoid arthritis, pericarditis, subphrenic abscess, chylothorax.

      Myxoedema, nephrotic syndrome, congestive cardiac failure, and liver cirrhosis all cause TRANSUDATE.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds
  • Question 17 - A patient with history of weight loss and diarrhoea was found out to...

    Incorrect

    • A patient with history of weight loss and diarrhoea was found out to have Giardia lamblia in her stool since returning from a holiday to Nepal.

      Which of the following statements is considered true regarding the life cycle of Giardia lamblia?

      Your Answer:

      Correct Answer: Trophozoites attach to the intestinal wall via a specialised sucking disc

      Explanation:

      Cysts are resistant forms and are responsible for transmission of giardiasis. Both cysts and trophozoites can be found in the faeces (diagnostic stages). The cysts are hardy and can survive several months in cold water. Infection occurs by the ingestion of cysts in contaminated water, food, or by the faecal-oral route (hands or fomites).
      In the small intestine, excystation releases trophozoites (each cyst produces two trophozoites).
      Trophozoites multiply by longitudinal binary fission, remaining in the lumen of the proximal small bowel where they can be free or attached to the mucosa by a ventral sucking disk.
      Encystation occurs as the parasites transit toward the colon. The cyst is the stage found most commonly in non diarrheal faeces.
      Because the cysts are infectious when passed in the stool or shortly afterward, person-to-person transmission is possible. While animals are infected with Giardia, their importance as a reservoir is unclear.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
      Seconds
  • Question 18 - Hartmann's solution contains how much sodium: ...

    Incorrect

    • Hartmann's solution contains how much sodium:

      Your Answer:

      Correct Answer: 131 mmol/L

      Explanation:

      Hartmann’s solution (compound sodium lactate) contains: Na+131 mmol/L, K+5 mmol/L, HCO3-29 mmol/L (as lactate), Cl-111 mmol/L, Ca2+2 mmol/L. It can be used instead of isotonic sodium chloride solution during or after surgery, or in the initial management of the injured or wounded; it may reduce the risk of hyperchloraemic acidosis.

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
      0
      Seconds
  • Question 19 - A 36-year-old woman is 22-weeks pregnant and is investigated for a possible thyroid...

    Incorrect

    • A 36-year-old woman is 22-weeks pregnant and is investigated for a possible thyroid disorder. When her total thyroid hormone levels does not correlate with her thyrometabolic status, her thyroid-binding globulin levels are checked.

      What percentage of circulating thyroid hormones is bound to thyroid-binding globulin?

      Your Answer:

      Correct Answer: 70%

      Explanation:

      Only a very small fraction of the thyroid hormones circulating in the blood are free. The majority is bound to transport proteins. Only the free thyroid hormones are biologically active, and measurement of total thyroid hormone levels can be misleading.

      The relative percentages of bound and unbound thyroid hormones are:
      Bound to thyroid-binding globulin -70%
      Bound to albumin -15-20%
      Bound to transthyretin -10-15%
      Free T3 -0.3%
      Free T4 -0.03%

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds
  • Question 20 - A 78-year-old woman visits the emergency room with dizziness and nausea. She claims...

    Incorrect

    • A 78-year-old woman visits the emergency room with dizziness and nausea. She claims that her doctor gave her cinnarizine two days prior, but that it didn't seem to help.

      Cinnarizine's mechanism of action is which of the following?

      Your Answer:

      Correct Answer: Antihistamine action

      Explanation:

      Cinnarizine is a piperazine derivative with an antihistamine effect that makes it anti-emetic. Motion sickness and vestibular disorders, such as Méniéres disease, are the most common conditions for which it is prescribed.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 21 - Campylobacter jejuni is primarily spread via which of the following routes: ...

    Incorrect

    • Campylobacter jejuni is primarily spread via which of the following routes:

      Your Answer:

      Correct Answer: Faecal-oral route

      Explanation:

      Campylobacter spp. are a common cause of acute infective gastroenteritis, particularly in children, with Campylobacter jejuni responsible for 90% of Campylobacter gastroenteritis. Infection typically follows ingestion of contaminated meat (most frequently undercooked poultry), unpasteurised milk or contaminated water, following which the microorganism invades and colonises the mucosa of the small intestine.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds
  • Question 22 - The syndrome of inappropriate antidiuresis due to excessive antidiuretic hormone (ADH) secretion is...

    Incorrect

    • The syndrome of inappropriate antidiuresis due to excessive antidiuretic hormone (ADH) secretion is diagnosed in a male patient with a history of recurrent hyponatraemia.

      Which of the following produces ADH?

      Your Answer:

      Correct Answer: Hypothalamus

      Explanation:

      Antidiuretic hormone (ADH), commonly known as vasopressin, is a peptide hormone that controls how much water the body retains.

      It is produced in the magnocellular and parvocellular neurosecretory cells of the paraventricular nucleus and supraoptic nucleus in the hypothalamus from a prohormone precursor. It is subsequently carried to the posterior pituitary via axons and stored in vesicles.

      The secretion of ADH from the posterior pituitary is regulated by numerous mechanisms:
      Increased plasma osmolality: Osmoreceptors in the hypothalamus detect an increase in osmolality and trigger ADH release.

      Stretch receptors in the atrial walls and big veins detect a decrease in atrial pressure as a result of this (cardiopulmonary baroreceptors). ADH release is generally inhibited by atrial receptor firing, but when the atrial receptors are stretched, the firing reduces and ADH release is promoted.
      Hypotension causes baroreceptor firing to diminish, resulting in increased sympathetic activity and ADH release.
      An increase in angiotensin II stimulates angiotensin II receptors in the hypothalamus, causing ADH production to increase.

      The main sites of action for ADH are:
      The kidney is made up of two parts. ADH’s main job is to keep the extracellular fluid volume under control. It increases permeability to water by acting on the renal collecting ducts via V2 Receptors (via a camp-dependent mechanism). This leads to a decrease in urine production, an increase in blood volume, and an increase in arterial pressure as a result.

      Vascular system: Vasoconstriction is a secondary function of ADH. ADH causes vasoconstriction via binding to V1 Receptors on vascular smooth muscle (via the IP3 signal transduction pathway). An increase in arterial pressure occurs as a result of this.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      0
      Seconds
  • Question 23 - While studying fluid homeostasis in the body, you encounter the term exudate. Exudate...

    Incorrect

    • While studying fluid homeostasis in the body, you encounter the term exudate. Exudate is a fluid that leaks out of the intravascular space due to changes in the permeability of the microcirculation secondary to inflammation.

      Which ONE of the following conditions would not be listed among the causes of an exudate?

      Your Answer:

      Correct Answer: Myxoedema

      Explanation:

      An exudate is an inflammatory fluid that leaks out of the intravascular space due to increased vascular permeability and intravascular pressure. It is mostly caused by local processes and can occur in the following conditions:
      1) Infection (e.g. pneumonia)
      2) Malignancy
      3) Pericarditis
      4) Collagen vascular diseases, e.g., Rheumatoid Arthritis

      Myxoedema is a state of severe hypothyroidism in which deposition of mucopolysaccharides occurs in the dermis. This causes a transudative effusion, typically in the pretibial region.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds
  • Question 24 - A 7-year-old girl is admitted to the hospital with a persistently high temperature....

    Incorrect

    • A 7-year-old girl is admitted to the hospital with a persistently high temperature. To help her reduce her fever, you decide to give her paracetamol and ibuprofen.

      What are the effects of paracetamol and ibuprofen on fever?

      Your Answer:

      Correct Answer: Reduction in prostaglandin synthesis

      Explanation:

      Interleukin-1, which is released by leukocytes and acts on the thermoregulatory centre of the hypothalamus, causes fever. Because prostaglandins mediate this process, antipyretics such as NSAIDs, paracetamol, and aspirin reduce prostaglandin levels by inhibiting cyclooxygenase enzymes. Malignant disease secretes interleukins, which cause the B-symptoms seen in lymphoma, for example. Bacterial toxins can also cause interleukins to be produced.

      Pyrexia of unknown origin (PUO) is defined as a fever of greater than 38.3 degrees Celsius that lasts for more than 2-3 weeks with no clear diagnosis despite extensive investigation.

      Investigation necessitates a thorough understanding of the conditions that can cause febrile illness, which may be missed during an initial investigation, as well as a thorough history, examination, and investigation centred on that list.

      Pyrexia of unknown origin has a wide differential diagnosis, which includes:
      Infection
      Bacterial
      Pyogenic abscess
      Tuberculosis
      Infective endocarditis
      Brucellosis
      Lyme disease
      Viral
      HIV
      Epstein Barr Virus
      Cytomegalovirus
      Parasite
      Toxoplasmosis
      Malignancy
      Leukaemia
      Lymphoma
      Renal cell carcinoma
      Hepatocellular carcinoma
      Vasculitides
      Still’s disease
      Granulomatosis with polyangiitis (formerly Wegener’s)
      Systemic lupus erythematosus
      Giant cell arteritis
      Rheumatoid arthritis
      Polymyalgia rheumatica
      Miscellaneous
      Drug induced fevers
      Familial Mediterranean fever
      Thyrotoxicosis
      Inflammatory bowel disease
      Sarcoidosis
      Factitious fever
      Exaggerated normal circadian fluctuation

      The patient might need to be admitted to the hospital for observation and further investigation. Because infection is still a possibility, blood cultures should be repeated on a regular basis, and inflammatory markers should be closely monitored. CT, PET, and MRI imaging have largely replaced diagnostic laparotomy as a diagnostic tool.

    • This question is part of the following fields:

      • Pathology
      • Pathology Of Infections
      0
      Seconds
  • Question 25 - A 43-year old male is taken to the Emergency Room for a lacerated...

    Incorrect

    • A 43-year old male is taken to the Emergency Room for a lacerated wound on the abdomen, situated above the umbilicus. A short segment of the small bowel has herniated through the wound.

      Which of these anatomic structures is the deepest structure injured in the case above?

      Your Answer:

      Correct Answer: Transversalis fascia

      Explanation:

      The following structures are the layers of the anterior abdominal wall from the most superficial to the deepest layer:

      Skin
      Fatty layer of the superficial fascia (Camper’s fascia)
      Membranous layer of the superficial fascia (Scarpa’s fascia)
      Aponeurosis of the external and internal oblique muscles
      Rectus abdominis muscle
      Aponeurosis of the internal oblique and transversus abdominis
      Fascia transversalis
      Extraperitoneal fat
      Parietal peritoneum

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      0
      Seconds
  • Question 26 - What is the pathophysiology of Cushing's syndrome: ...

    Incorrect

    • What is the pathophysiology of Cushing's syndrome:

      Your Answer:

      Correct Answer: Glucocorticoid excess

      Explanation:

      Cushing’s syndrome is the name given to the clinical symptoms and signs induced by chronic glucocorticoid excess.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds
  • Question 27 - Which of the following laboratory findings is NOT typical of Hodgkin lymphoma: ...

    Incorrect

    • Which of the following laboratory findings is NOT typical of Hodgkin lymphoma:

      Your Answer:

      Correct Answer: Basophilia

      Explanation:

      Features may include:Normochromic normocytic anaemia is most common; bone marrow failure involvement is unusual in early disease, but if it occurs bone marrow failure may develop with leucoerythroblastic anaemiaOne-third of patients have a neutrophilia; eosinophilia is frequentAdvanced disease is associated with lymphopenia and loss of cell-mediated immunityPlatelet count is normal or increased in early disease and reduced in later stagesESR and CRP are usually raised (ESR is useful in monitoring disease progress)Serum LDH is raised initially in 30-40% of casesDiagnosis is made by histological examination of an excised lymph nodeThe distinctive multinucleate polypoid RS cell is central to the diagnosis of the four classic types of HL (95% of cases)

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 28 - A patient complains of stomach ache. You see a midline scar in the...

    Incorrect

    • A patient complains of stomach ache. You see a midline scar in the epigastric area when you examine the abdomen. Upon further interrogation, the patient reveals that she had a subtotal gastrectomy for recurring stomach ulcers several years ago. The stomach mucosa secretes a variety of vital compounds, and her ability to secrete some of these molecules has been harmed as a result of his surgery.

      The stomach mucous neck cells secrete which of the following substances?

      Your Answer:

      Correct Answer: Bicarbonate

      Explanation:

      Foveolar cells, also known as gastric mucous-neck cells, are cells that line the stomach mucosa and are found in the necks of the gastric pits. Mucus and bicarbonate are produced by these cells, which prevent the stomach from digesting itself. At pH 4, the mucous allows the acid to penetrate the lining, while below pH 4, the acid is unable to do so. Viscous fingering is the term for this procedure.

      The table below summarizes the many cell types found in the stomach, as well as the substances secreted by each cell type and the function of the secretion:

      Cell type/ Substance secreted/ Function of secretion
      Parietal cells/ Hydrochloric acid/ Kills microbes and activates pepsinogen
      Parietal cells/ Intrinsic factor/Binds to vitamin B12 and facilitates its absorption
      Chief cells/ Pepsinogen/ Protein digestion
      Chief cells/ Gastric lipase/ Fat digestion
      G-cells/ Gastrin/ Stimulates gastric acid secretion
      Enterochromaffin-like cells (ECL cells) /Histamine/ Stimulates gastric acid secretion
      Mucous-neck cells/ Mucous and bicarbonate/ Protects stomach epithelium from acid
      D-cells/ Somatostatin/ Inhibits gastric acid secretion

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      0
      Seconds
  • Question 29 - Normal human immunoglobulin is mostly used to protect against which of the following...

    Incorrect

    • Normal human immunoglobulin is mostly used to protect against which of the following infectious diseases?

      Your Answer:

      Correct Answer: Measles and hepatitis A

      Explanation:

      Immune globulin IM is indicated for prophylaxis following exposure
      to hepatitis A, to prevent or modify measles (rubeola) in a
      susceptible person exposed fewer than 6 days previously,
      for susceptible household contacts of measles patients,
      particularly contacts <1 year and pregnant women without
      evidence of immunity, and to modify rubella in exposed pregnant
      women who will not consider a therapeutic abortion.

    • This question is part of the following fields:

      • Immunoglobulins And Vaccines
      • Pharmacology
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  • Question 30 - Which of the following best describes a natural killer cell: ...

    Incorrect

    • Which of the following best describes a natural killer cell:

      Your Answer:

      Correct Answer: A large granular lymphocyte that kills by inducing target cell apoptosis.

      Explanation:

      Natural killer (NK) cells are cytotoxic CD8 positive cells that lack the T-cell receptor. They are large cells with cytoplasmic granules. NK cells are designed to kill target cells that have a low level of expression of HLA class I molecules, such as may occur during viral infection or on a malignant cell. NK cells do this by displaying several receptors for HLA molecules on their surface. When HLA is expressed on the target cell these deliver an inhibitory signal into the NK cell. When HLA molecules are absent on the target cell this inhibitory signal is lost and the NK cell can then kill its target. In addition, NK cells display antibody-dependent cell-mediated cytotoxicity. In this, antibody binds to antigen on the surface of the target cell and then NK cells bind to the Fc portion of the bound antibody and kill the target cell.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
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SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular Pharmacology (1/1) 100%
Pharmacology (1/2) 50%
Microbiology (2/3) 67%
Pathogens (2/3) 67%
Endocrine Physiology (0/1) 0%
Physiology (0/1) 0%
General Pathology (1/2) 50%
Pathology (1/2) 50%
Endocrine (0/1) 0%
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