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  • Question 1 - A 14-year old girl presented with a 2cm, mobile, cystic mass in the...

    Correct

    • A 14-year old girl presented with a 2cm, mobile, cystic mass in the midline of her neck. Fine needle aspiration of the mass revealed clear fluid. This is most likely a case of:

      Your Answer: Thyroglossal duct cyst

      Explanation:

      Thyroglossal cyst is the most common congenital thyroid anomaly which is clinically significant and affects women more than men. It is a vestigial remnant of developing thyroid. Although the thyroglossal cyst can develop anywhere along the thyroglossal duct, the most common site is in the midline between the isthmus of thyroid and hyoid bone, or just above the hyoid. Thyroglossal cysts are also associated with ectopic thyroid tissue. Clinically, the cyst moves upward with protrusion of the tongue. Rarely, the persistent duct can become malignant (thyroglossal duct carcinoma) where the cancerous cells arise in the ectopic thyroid tissue that are deposited along the duct. Exposure to radiation is a predisposing factor.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      13.8
      Seconds
  • Question 2 - Which of the following compensatory parameters is responsible for causing an increase in...

    Correct

    • Which of the following compensatory parameters is responsible for causing an increase in the blood pressure in a 30 year old patient with a BP of 40 mmHg?

      Your Answer: Baroreceptor reflex

      Explanation:

      The baroreflex or baroreceptor reflex is one of the body’s homeostatic mechanisms for regulating blood pressure. It provides a negative feedback response in which an elevated blood pressure will causes blood pressure to decrease; similarly, decreased blood pressure depresses the baroreflex, causing blood pressure to rise. The system relies on specialised neurones (baroreceptors) in the aortic arch, carotid sinuses and elsewhere to monitor changes in blood pressure and relay them to the brainstem. Subsequent changes in blood pressure are mediated by the autonomic nervous system. Baroreceptors include those in the auricles of the heart and vena cava, but the most sensitive baroreceptors are in the carotid sinuses and aortic arch. The carotid sinus baroreceptors are innervated by the glossopharyngeal nerve (CN IX); the aortic arch baroreceptors are innervated by the vagus nerve (CN X).

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      28
      Seconds
  • Question 3 - The chest X-ray of a 72 year old patient reveals the presence of...

    Correct

    • The chest X-ray of a 72 year old patient reveals the presence of a round lesion containing an air-fluid level in the left lung. These findings are most probably suggestive of:

      Your Answer: Lung abscess

      Explanation:

      Lung abscesses are collections of pus within the lung that arise most commonly as a complication of aspiration pneumonia caused by oral anaerobes. Older patients are more at risk due to poor oral hygiene, gingivitis an inability to handle their oral secretions due to other diseases. Chest X-ray most commonly reveals the appearance of an irregularly shaped cavity with an air-fluid level.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      11.4
      Seconds
  • Question 4 - If a catheter is placed in the main pulmonary artery of a healthy...

    Correct

    • If a catheter is placed in the main pulmonary artery of a healthy 30-year-old woman, which of the following will be its mean pulmonary arterial pressure?

      Your Answer: 15 mmHg

      Explanation:

      The pulmonary artery pressure (PA pressure) is a measure of the blood pressure found in the main pulmonary artery. The hydrostatic pressure of the pulmonary circulation refers to the actual pressure inside pulmonary vessels relative to atmospheric pressure. Hydrostatic (blood pressure) in the pulmonary vascular bed is low compared with that of similar systemic vessels. The mean pulmonary arterial pressure is about 15 mmHg (ranging from about 13 to 19 mmHg) and is much lower than the average systemic arterial pressure of 90 mmHg.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      19.1
      Seconds
  • Question 5 - A patient is diagnosed with lung cancer. His physician told him that his...

    Correct

    • A patient is diagnosed with lung cancer. His physician told him that his lung cancer type is aggressive. It can grow rapidly and may undergo early metastasis, however it is very sensitive to chemotherapy and radiotherapy. Which lung cancer type is most likely present

      Your Answer: Small-cell carcinoma

      Explanation:

      Small-cell lung carcinoma (SCLC) is a type of highly malignant cancer that most commonly arises within the lung. SCLC usually metastasizes widely very early on in the natural history of the tumour, and in nearly all cases responds dramatically to chemotherapy and/or radiotherapy. Surgery has no role in the treatment of this disease.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      22.7
      Seconds
  • Question 6 - A 45 year old man who complains of chronic post prandial, burning epigastric...

    Correct

    • A 45 year old man who complains of chronic post prandial, burning epigastric pain undergoes a gastrointestinal endoscopy. There is no apparent mass or haemorrhage and a biopsy is taken from the lower oesophageal mucosa just above the gastro-oesophageal junction. The results reveal the presence of columnar cells interspersed with goblet cells. Which change best explains the above mentioned histology?

      Your Answer: Metaplasia

      Explanation:

      Metaplasia is the transformation of one type of epithelium into another as a means to better cope with external stress on that epithelium. In this case metaplasia occurs due to the inflammation resulting from gastro-oesophageal reflux disease. Dysplasia is disordered cellular growth. Hyperplasia is an increase in cell number but not cell type i.e. transformation. Carcinoma is characterized by cellular atypia. Ischaemia would result in necrosis with ulceration. Carcinoma insitu involves dysplastic atypical cells with the basement membrane intact and atrophy would mean a decrease in number of cells.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Gastrointestinal
      • Pathology
      69.1
      Seconds
  • Question 7 - A 32-year-old man presents to the doctor complaining of pain in his left...

    Correct

    • A 32-year-old man presents to the doctor complaining of pain in his left calf whilst walking. He says that the pain goes away after a short period of rest but starts again during exercise or walking. The man reveals he has been a smoker for the last 15 years. His blood pressure, blood sugar and cholesterol level are normal. Artery biopsy shows intraluminal thrombosis and vasculitis. What's is the most likely cause of these findings?

      Your Answer: Buerger's disease

      Explanation:

      Thromboangiitis obliterans, also known as Buerger’s disease, is a rare type of occlusive peripheral arterial disease, usually seen in smokers, most commonly in men aged 20 to 40. Symptoms most often include intermittent claudication, skin changes, painful ulcers on extremities, pain in the extremities during rest and gangrene. Diagnosis is based on clinical findings, arteriography, echocardiography, and computed tomography angiography. A difference in blood pressure between arms, or between the arms and legs is a common finding. Electrocardiographic findings include nonspecific abnormality or normal results.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      119
      Seconds
  • Question 8 - A 7-year-old boy is diagnosed with metabolic acidosis as a result of severe...

    Correct

    • A 7-year-old boy is diagnosed with metabolic acidosis as a result of severe dehydration. Which of the following conditions is most likely to cause severe dehydration and metabolic acidosis?

      Your Answer: Severe diarrhoea

      Explanation:

      Diarrhoea is defined as having three or more loose or liquid stools per day, or as having more stools than is normal for that person. Severe diarrhoea, causing fluid loss and loss of bicarbonate, will result in marked dehydration and metabolic acidosis.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      49.9
      Seconds
  • Question 9 - A previously healthy 40-year-old housewife suddenly complains of a headache and loses consciousness....

    Correct

    • A previously healthy 40-year-old housewife suddenly complains of a headache and loses consciousness. A CT scan reveals subarachnoid haemorrhage. Which of the following is the most probable cause?

      Your Answer: Ruptured berry aneurysm

      Explanation:

      Saccular aneurysms, also known as berry aneurysms, appear as a round outpouching and are the most common form of cerebral aneurysm. They are a congenital intracranial defect, and haemorrhage can occur at any age, but is most common between the ages of 40-65 years. A second rupture (rebleeding) sometimes occurs, most often within about 7 days of the first bleed.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      38.8
      Seconds
  • Question 10 - Which condition presents with a positive urine dipstick test for blood, but no...

    Incorrect

    • Which condition presents with a positive urine dipstick test for blood, but no blood cells on urine microscopy?

      Your Answer: Post-streptococcal glomerulonephritis

      Correct Answer: Myoglobinuria

      Explanation:

      Myoglobinuria, or presence of myoglobulin in the urine is seen due to rhabdomyolysis (muscle destruction). Common causes of rhabdomyolysis include trauma, electrical injuries, burns, venom and drugs. Damaged muscle leads to release of myoglobin in the blood. Ideally, the released myoglobin gets filtered and excreted by the kidneys. However, excess myoglobin can occlude the renal filtration system leading to acute tubular necrosis and acute renal dysfunction.

    • This question is part of the following fields:

      • Pathology
      • Renal
      25.7
      Seconds
  • Question 11 - The pleural cavity is the space between the two pulmonary pleurae which cover...

    Correct

    • The pleural cavity is the space between the two pulmonary pleurae which cover the lungs. What is the normal amount of pleural fluid?

      Your Answer: 10 ml

      Explanation:

      Pleural fluid is a serous fluid produced by the serous membrane covering normal pleurae. Most fluid is produced by the parietal circulation (intercostal arteries) via bulk flow and reabsorbed by the lymphatic system. The total volume of fluid present in the intrapleural space is estimated to be only 2–10 ml. A small amount of protein is present in intrapleural fluid. Normally, the rate of reabsorption increases as a physiological response to accumulating fluid.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      37.2
      Seconds
  • Question 12 - Which of the following is an anion? ...

    Correct

    • Which of the following is an anion?

      Your Answer: Phosphate

      Explanation:

      Cations: sodium, magnesium, calcium and potassium

      Anions: chloride, phosphate, bicarbonate, lactate, sulphate and albumin

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      3.3
      Seconds
  • Question 13 - Which of the following mediators of inflammation requires arachidonic acid for synthesis? ...

    Incorrect

    • Which of the following mediators of inflammation requires arachidonic acid for synthesis?

      Your Answer: Interleukin-1

      Correct Answer: Prostaglandins

      Explanation:

      Arachidonic acid is normally present in the phospholipids that make up the cell membrane and is cleaved by phospholipase A2 from the phospholipid. Arachidonic acid is a precursor for the production of eicosanoids which include: 1) prostaglandins, prostacyclins and thromboxane, 2) leukotrienes and 3) anandamides. The production of these products along with their action on the body is called the arachidonic acid cascade.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      11.1
      Seconds
  • Question 14 -  A 45-year-old man presented to the doctor complaining of a flank pain and...

    Correct

    •  A 45-year-old man presented to the doctor complaining of a flank pain and episodes of haematuria. Abdominal ultrasound revealed a left renal mass and the patient underwent a nephrectomy. Histopathological pattern was triphasic with blastemal, epithelial, and stromal components. The pathologist suggested the tumour resulted from the lack of a tumour suppressor gene on chromosome 11. Which of the following tumours is the pathologist most likely suggesting?

      Your Answer: Wilms’ tumour

      Explanation:

      Wilms’ tumour is one of the most common malignant tumours of childhood but it can also rarely be found in adults. In biopsy, classical histopathological findings include the triphasic pattern composed by blastemal, epithelial, and stromal elements. First symptoms in children include an abdominal palpable mass, while in adults pain and haematuria are the most common complaints. Deletions of tumours’ suppressor genes on chromosome 11 are usually associated with Wilms’ tumour.

    • This question is part of the following fields:

      • Pathology
      • Renal
      18.9
      Seconds
  • Question 15 - A young lady visited a doctor with complaints of fever and a dull,...

    Incorrect

    • A young lady visited a doctor with complaints of fever and a dull, continuous pain in the right lumbar region for 6 days. On, enquiry, she recalled passing an increasing number of stools with occasional blood in last few months. Lower gastrointestinal endoscopic biopsy was taken 5 cm proximal to ileocaecal valve which showed transmural inflammation with several granulomas. Tissue section showed the absence of acid-fast bacillus. She denies any history of travel and her stool cultures were negative. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Crohn’s disease

      Explanation:

      Crohn’s disease is a chronic, inflammatory disease that can affect any part of the gastrointestinal tract but is usually seen in the distal ileum and colon. It is transmural and symptoms include chronic diarrhoea, abdominal pain, fever, anorexia and weight loss. On examination, there is usually abdominal tenderness with a palpable mass or fullness seen occasionally. Rectal bleeding is uncommon (except in isolated colonic involvement) which manifests like ulcerative colitis. Differential diagnosis includes acute appendicitis or intestinal obstruction. 25%-33% patients also have perianal disease in the form of fissure or fistulas.

      Extra intestinal manifestations predominate in children, and include: arthritis, pyrexia, anaemia or growth retardation. Histologically, the disease shows crypt inflammation and abscesses initially, which progress to aphthoid ulcers. These eventually develop into longitudinal and transverse ulcers with interspersed mucosal oedema, leading to the characteristic ‘cobblestoned appearance’. Transmural involvement leads to lymphoedema and thickening of bowel wall and mesentery, leading to extension of mesenteric fat on the serosal surface of bowel and enlargement of mesenteric nodes. There can also be hypertrophy of the muscularis mucosae, fibrosis and stricture formation, which can cause bowel obstruction.

      Abscesses are common and the disease can also leas to development of fistulas with various other organs, anterior abdominal wall and adjacent muscles. Pathognomonic non-caseating granulomas are seen in 50% cases and they can occur in nodes, peritoneum, liver, and in all layers of the bowel wall. The clinical course does not depend on the presence of granulomas. There is sharp demarcation between the diseased and the normal bowel (skip areas).

      35% cases show only the ileal involvement, whereas in 45% cases, both the ileum and colon are involved with a predilection for right side of colon. 20% cases show only colonic involvement, often sparing the rectum (unlike ulcerative colitis). In occasional cases, there is jejunoileitis – involvement of the entire small bowel. The stomach, duodenum and oesophagus are rarely involved, although there has been microscopic evidence of disease involving the gastric antrum in younger patients. The affected small bowel segments show increased rick of cancer. Moreover, patients with colonic disease show a long-term risk of cancer similar to that seen in ulcerative colitis.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      0
      Seconds
  • Question 16 - Which of these conditions is mithramycin used for? ...

    Incorrect

    • Which of these conditions is mithramycin used for?

      Your Answer:

      Correct Answer: Hypercalcaemia of malignancy

      Explanation:

      Mithramycin or Plicamycin is a tricyclic pentaglycosidic antibiotic derived from Streptomyces strains. It inhibits RNA and protein synthesis by adhering to DNA. It is used as a fluorescent dye and as an antineoplastic agent. It is also used to reduce hypercalcaemia, especially caused by malignancy. Plicamycin is currently used in multiple areas of research, including cancer cell apoptosis and as a metastasis inhibitor.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds
  • Question 17 - In a cardiac cycle, what event does the closing of atrioventricular (AV) valves...

    Incorrect

    • In a cardiac cycle, what event does the closing of atrioventricular (AV) valves coincide with?

      Your Answer:

      Correct Answer: First heart sound

      Explanation:

      In the cardiac cycle, the closing of the atrioventricular (AV) valves coincides with the onset of ventricular systole. This event marks the beginning of the isovolumetric contraction phase, where the ventricles begin to contract, but the volume of blood in the ventricles remains the same because both the AV valves and the semilunar valves (aortic and pulmonary valves) are closed. The closing of the AV valves produces the first heart sound, known as “S1” or “lub.”

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 18 - 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:

      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
      0
      Seconds
  • Question 19 - Which of the following will increase blood pressure and cause hypokalaemia? ...

    Incorrect

    • Which of the following will increase blood pressure and cause hypokalaemia?

      Your Answer:

      Correct Answer: Angiotensin II

      Explanation:

      Angiotensin is a peptide that is released in response to a decrease in blood volume and blood pressure. It has multiple functions but mainly acts to cause vasoconstriction, increase BP and release aldosterone from the adrenal cortex. It is a powerful vasoconstrictor and release of aldosterone causes increased retention of sodium and excretion of potassium.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 20 - A 40-year old Caucasian male came to the hospital with complaints of fatigue...

    Incorrect

    • A 40-year old Caucasian male came to the hospital with complaints of fatigue and lethargy. On examination, he was found to have raised blood pressure. Urine examination showed >300 mg/dl proteinuria (4+) and 24-hour urine protein 3.5g. No glucose, blood, nitrites, urobilinogen or casts were present in urine. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Membranous glomerulonephritis

      Explanation:

      Membranous glomerulonephritis or nephropathy, is a renal disorder with insidious course and usually affects people aged 30-50 years. 85% cases are primary (or idiopathic). The other 15% are secondary to autoimmune conditions like SLE, infections like malaria or hepatitis B, drugs like captopril and NSAIDs, or malignancies (particularly lung or colonic carcinoma). This disease is caused due to circulating immune complexes which are said to form by binding of antibodies to antigens in glomerular basement membrane. This antigens could be endogenous or derived from systemic circulation. This immune complex triggers the complement system, resulting in formation of membrane attack complex (MAC) on glomerular epithelial cells. This further results in release of proteases and oxidants which damage the capillaries making them ‘leaky’. Moreover, the epithelial cells also secrete a mediator to reduce nephron synthesis and distribution.

    • This question is part of the following fields:

      • Pathology
      • Renal
      0
      Seconds
  • Question 21 - A 48-year-old woman has a mass in her right breast and has right...

    Incorrect

    • A 48-year-old woman has a mass in her right breast and has right axillary node involvement. She underwent radical mastectomy of her right breast. The histopathology report described the tumour to be 4 cm in its maximum diameter with 3 axillary lymph nodes with evidence of tumour. The most likely stage of cancer in this patient is:

      Your Answer:

      Correct Answer: IIB

      Explanation:

      Stage IIB describes invasive breast cancer in which: the tumour is larger than 2 centimetres but no larger than 5 centimetres; small groups of breast cancer cells — larger than 0.2 millimetre but not larger than 2 millimetres — are found in the lymph nodes OR the tumour is larger than 2 centimetres but no larger than 5 centimetres; cancer has spread to 1 to 3 axillary lymph nodes or to lymph nodes near the breastbone (found during a sentinel node biopsy) OR the tumour is larger than 5 centimetres but has not spread to the axillary lymph nodes.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds
  • Question 22 - The most likely cause of a low p(O2) in arterial blood is: ...

    Incorrect

    • The most likely cause of a low p(O2) in arterial blood is:

      Your Answer:

      Correct Answer: Hypoxic hypoxia

      Explanation:

      Hypoxia is when the whole body or a region is deprived of adequate oxygen supply. Different types of hypoxia include the following:

      – Hypoxic hypoxia, which occurs due to poor oxygen supply, as a result of low partial pressure of oxygen in arterial blood. This could be due to low partial pressure of atmospheric oxygen (e.g., at high altitude), sleep apnoea, poor ventilation because of chronic obstructive pulmonary disease or respiratory arrest, or shunts. The other types of hypoxia have a normal partial pressure of oxygen.

      – Anaemic hypoxia occurs due to low total oxygen content of the blood, with a normal arterial oxygen pressure.

      – Hyperaemic hypoxia occurs due to poor delivery of oxygen to target tissues, such as in carbon monoxide poisoning or methemoglobinemia.

      – Histotoxic hypoxia results due to inability of the cells to use the delivered oxygen due to disabled oxidative phosphorylation enzymes.

      – Ischaemic (or stagnant) hypoxia occurs due to local flow restriction of well-oxygenated blood, seen in cases like cerebral ischaemia, ischaemic heart disease and intrauterine hypoxia.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 23 - The most important difference between interstitial fluid and plasma is the: ...

    Incorrect

    • The most important difference between interstitial fluid and plasma is the:

      Your Answer:

      Correct Answer: Protein concentration

      Explanation:

      Interstitial fluid (or tissue fluid or intercellular fluid) is a solution that surrounds the cells of multicellular animals. It is the main component of the extracellular fluid, which also includes plasma, lymph and transcellular fluid. Plasma, the major component in blood, communicates freely with interstitial fluid through pores and intercellular clefts in capillary endothelium. Interstitial fluid consists of a water solvent containing amino acids, sugars, fatty acids, coenzymes, hormones, neurotransmitters, salts, as well as waste products from the cells. Red blood cells, platelets and plasma proteins cannot pass through the walls of the capillaries. The resulting mixture that does pass through is essentially blood plasma without the plasma proteins. Tissue fluid also contains certain types of white blood cells. Once the extracellular fluid collects into small vessels it is considered to be lymph, and the vessels that carry it back to the blood are called the lymphatic vessels. The lymphatic system returns protein and excess interstitial fluid to the circulation.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 24 - A 50-year old lady presented to the clinic with chronic pain in the...

    Incorrect

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

      Your Answer:

      Correct Answer: Anaemia of chronic disease

      Explanation:

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

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 25 - A 42 year old man presents with end stage renal failure and is...

    Incorrect

    • A 42 year old man presents with end stage renal failure and is prepared to receive a kidney from his best friend. HLA testing showed that they are not a 100% match and he is given immunosuppressant therapy for this. Three months later when his renal function is assessed, he showed signs of deteriorating renal function, with decreased renal output, proteinuria of +++ and RBCs in the urine. He was given antilymphocyte globulins and his condition reversed. During the crisis period the patient is likely to be suffering from?

      Your Answer:

      Correct Answer: Acute rejection

      Explanation:

      This patients is most likely experiencing an acute rejection. It is a cell mediated attack against the organ that has been transplanted. Antigens are either presented by blood borne cells with in the graft or antigen presenting cells in the body may be presenting class I and class II molecules that have been shed by the graft. Class I will activate CD8 and class II, CD4 cells, both of which will attack the graft.

      Chronic rejection is a slow process which occurs months to years after the transplant. The exact mechanism is not very well understood but it probably involves a combination of Type III and Type IV hypersensitivity directed against the foreign MHC molecules which look like self-MHC presenting a foreign antigen.

      Hyperacute Transplant Rejection occurs almost immediately and is often evident while you are still in surgery. It is caused by accidental ABO Blood type mismatching of the donor and recipient which almost never happens anymore. This means the host has preformed antibodies against the donated tissue.

    • This question is part of the following fields:

      • Inflammation & Immunology; Renal
      • Pathology
      0
      Seconds
  • Question 26 - Which statement is correct regarding secretions from the adrenal glands? ...

    Incorrect

    • Which statement is correct regarding secretions from the adrenal glands?

      Your Answer:

      Correct Answer: Aldosterone is producd by the zona glomerulosa

      Explanation:

      The secretions of the adrenal glands by zone are:

      Zona glomerulosa – aldosterone

      Zona fasciculata – cortisol and testosterone

      Zona reticularis – oestradiol and progesterone

      Adrenal medulia – adrenaline, noradrenaline and dopamine.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 27 - Which of the following malignancies is likely to have the best prognosis? ...

    Incorrect

    • Which of the following malignancies is likely to have the best prognosis?

      Your Answer:

      Correct Answer: Papillary carcinoma of the thyroid

      Explanation:

      Papillary carcinoma accounts for 70-80% of all thyroid cancers and is seen commonly in people aged 30-60 years. It is more aggressive in elderly patients. 10-20% cases may have recurrence or persistent disease. More common in females with a female to male ratio of 3:1. Papillary carcinomas can also contain follicular carcinomas. The common route of spread is through lymphatics to regional nodes in one-third cases and pulmonary metastasis can also occur. Papillary carcinomas of the thyroid have the best prognosis, especially in patients less than 45 years of age with small tumours confined to the thyroid gland.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      0
      Seconds
  • Question 28 - Leukotrienes normally function during an asthma attack and work to sustain inflammation. Which...

    Incorrect

    • Leukotrienes normally function during an asthma attack and work to sustain inflammation. Which of the following enzymes would inhibit their synthesis?

      Your Answer:

      Correct Answer: 5-lipoxygenase

      Explanation:

      Leukotrienes are produced from arachidonic acid with the help of the enzyme 5-lipoxygenase. This takes place in the eosinophils, mast cells, neutrophils, monocytes and basophils. They are eicosanoid lipid mediators and take part in allergic and asthmatic attacks. They are both autocrine as well as paracrine signalling molecules to regulate the body’s response and include: LTA4, LTB4, LTC4, LTD4, LTE4 and LTF4.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      0
      Seconds
  • Question 29 - Which of these is secreted by both macrophages and muscle cells? ...

    Incorrect

    • Which of these is secreted by both macrophages and muscle cells?

      Your Answer:

      Correct Answer: Interleukin-6

      Explanation:

      IL-6 is secreted by the T cells and macrophages and is a pro inflammatory cytokine. It is secreted in response to trauma e.g. burns and tissue damage that leads to inflammation. Apart from this its is also a myokine and is elevated due to muscle contraction. Other functions include: stimulate osteoclast formation when secreted by osteoblasts, mediate fever in acute phase response and are responsible for energy metabolism in muscle and fatty tissues. Inhibitors of IL-6 e.g. oestrogen are used as a treatment for postmenopausal osteoporosis.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      0
      Seconds
  • Question 30 - What Is the mechanism behind rhesus incompatibility in a new born baby? ...

    Incorrect

    • What Is the mechanism behind rhesus incompatibility in a new born baby?

      Your Answer:

      Correct Answer: Type II hypersensitivity

      Explanation:

      In type II hypersensitivity the antibodies that are produced by the immune response bind to the patients own cell surface antigens. These antigens can be intrinsic or extrinsic. Destruction occurs due to antibody dependent cell mediated antibodies. Antibodies bind to the cell and opsonise the cell, activating phagocytes to destroy that cell e.g. autoimmune haemolytic anaemia, Goodpasture syndrome, erythroblastosis fetalis, pernicious anaemia, Graves’ disease, Myasthenia gravis and haemolytic disease of the new-born.

    • This question is part of the following fields:

      • Inflammation & Immunology; Haematology
      • Pathology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Endocrine (1/1) 100%
Pathology (7/9) 78%
Cardiovascular (2/2) 100%
Physiology (5/5) 100%
Respiratory (3/3) 100%
Neoplasia (1/1) 100%
Cell Injury & Wound Healing; Gastrointestinal (1/1) 100%
Fluids & Electrolytes (2/2) 100%
Neurology (1/1) 100%
Renal (1/2) 50%
Inflammation & Immunology (0/1) 0%
Passmed