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  • Question 1 - Intravenous diazepam was administered to a man who was brought to the emergency...

    Correct

    • Intravenous diazepam was administered to a man who was brought to the emergency department with status epilepticus. He was administered 15 l/min oxygen via a reservoir bag mask. Blood investigations showed sodium = 140 mmol/l, potassium = 4 mmol/l and chloride = 98 mmol/l. His arterial blood gas analysis revealed pH 7.08, p(CO2)= 61.5 mmHg, p(O2) = 111 mmHg and standard bicarbonate = 17 mmol/l. This patient had:

      Your Answer: Mixed acidosis

      Explanation:

      Acidosis with high p(CO2) and low standard bicarbonate indicates mixed acidosis. Lower p(O2) is due to breathing of 70% oxygen. The prolonged seizures lead to lactic acidosis and the intravenous diazepam is responsible for the respiratory acidosis. Treatment includes airway manoeuvres and oxygen, assisted ventilation if needed, and treatment with fluids.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      34.1
      Seconds
  • Question 2 - A cyclist fell and sustained a laceration to his elbow which was shortly...

    Correct

    • A cyclist fell and sustained a laceration to his elbow which was shortly sutured in the emergency department. Which of the following factors will aid in the wound healing process?

      Your Answer: Presence of sutures

      Explanation:

      Foreign bodies including sutures will delay wound healing, however due to the net affect being helpful they are used. Secondary wound infection will delay healing and is a potential post op complication. Corticosteroids depresses the wound healing ability of the body. Poor nutrition will also delay healing leading to decreased albumin, vit D and vit C. Diabetic patients with atherosclerosis with poor perfusion of tissues have notoriously delayed/poor healing.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      20.8
      Seconds
  • Question 3 - During a splenectomy procedure of a 45-year old male patient with a bleeding...

    Correct

    • During a splenectomy procedure of a 45-year old male patient with a bleeding ruptured spleen, the surgeon decided to clamp the splenic artery near the coeliac trunk to stop the bleeding. Which of the following organ/s parts will be least affected by the clamping?

      Your Answer: Duodenum

      Explanation:

      The duodenum is the only organ in the list that would not be affect by the clumping of the splenic artery as it is supplied by common hepatic artery (through the gastroduodenal artery) and the superior mesenteric artery (through the inferior pancreaticoduodenal artery). The splenic artery is the artery that supplies the spleen with oxygenated blood. The splenic artery before reaching the spleen also gives off branches that supply the stomach and the pancreas. The greater curvature and the fundus of the stomach is supplied the short gastric artery which branches off from the splenic artery. The left portion of the greater curvature of the stomach together with the greater omentum is supplied by the left gastro-omental artery of the splenic artery. The body and tail of the pancreas is supplied by branches of the splenic artery through the dorsal and superior pancreatic arteries and the caudal pancreatic arteries respectively.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      94
      Seconds
  • Question 4 - If a tumour is found in both lobes of the prostate, without nodal...

    Incorrect

    • If a tumour is found in both lobes of the prostate, without nodal involvement or metastases, a histological grade of G2 and elevated PSA, what is the overall prostatic cancer stage?

      Your Answer: Stage III

      Correct Answer: Stage II

      Explanation:

      The AJCC uses the TNM, Gleason score and PSA levels to determine the overall stage of prostatic cancer. This staging is as follows:

      Stage I: T1, N0, M0, Gleason score 6 or less, PSA less than 10; or T2a, N0, M0, Gleason score 6 or less, PSA less than 10

      Stage IIa: T1, N0, M0, Gleason score of 7, PSA less than 20; or T1, N0, M0, Gleason score of 6 or less, PSA at least 10 but less than 20; or T2a or T2b, N0, M0, Gleason score of 7 or less, PSA less than 20

      Stage IIb: T2c, N0, M0, any Gleason score, any PSA; or T1 or T2, N0, M0, any Gleason score PSA of 20 or more; or T1 or T2, N0, M0, Gleason score of 8 or higher, any PSA

      Stage III: T3, N0, M0, any Gleason score, any PSA Stage IV: T4, N0, M0,any Gleason score, any PSA; or any T, N1, M0,any Gleason score, any PSA; or Any T, any N, M1, any Gleason score, any PSA.

      The patient in this case has a T2 N0 M0 G2 tumour, meaning it belongs in stage II

    • This question is part of the following fields:

      • Pathology
      • Urology
      135.3
      Seconds
  • Question 5 - The muscle that depresses the glenoid fossa directly is the: ...

    Incorrect

    • The muscle that depresses the glenoid fossa directly is the:

      Your Answer:

      Correct Answer: Pectoralis minor

      Explanation:

      Situated at the upper part of the thorax beneath the pectoralis major, is a thin pectoralis minor, triangular muscle. It originates from the third, fourth and fifth ribs, near the cartilage and from the aponeurosis which covers the intercostals. These fibres move upwards and laterally to join and form a flat tendon. This is inserted into the medial border and upper surface of the coracoid process of the scapula. Through this medial anterior thoracic nerve, fibres from the pectoralis minor are received from the eighth cervical and first thoracic nerves. This pectoralis minor pushes down on the point of the shoulder (glenoid fossa), drawing the scapula downward and medially towards the thorax which throws the inferior angle backwards.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 6 - During hysterectomy, the ureter is most likely to be ligated when a surgeon...

    Incorrect

    • During hysterectomy, the ureter is most likely to be ligated when a surgeon is clamping the?

      Your Answer:

      Correct Answer: Uterine arteries

      Explanation:

      The ureter forms the posterior boundary of a shallow depression which lodges the ovary and then runs medially and forward on the lateral aspect of the uterine cervix and upper part of the vagina to reach the fundus of the bladder. It is also situated about 2cm from the side of the cervix of the uterus. The relationship of the ureters and uterine arteries is of clinical significance because the arteries are at risk of iatrogenic injury during hysterectomy.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      0
      Seconds
  • Question 7 - A 44-year old man, who was euthyroid underwent thyroidectomy following neoplastic cells found...

    Incorrect

    • A 44-year old man, who was euthyroid underwent thyroidectomy following neoplastic cells found on fine-needle aspiration. Frozen section of multiple thyroid masses showed malignant neoplasm of polygonal cells in nests. The neoplasm also showed presence of amyloid which was positive with Congo-red staining. Immunoperoxidase staining for calcitonin was also positive. Chest X-ray revealed no abnormality. However, his blood pressure was found to be raised, and his serum ionised calcium was high. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Multiple endocrine neoplasia type IIA

      Explanation:

      MEN (Multiple Endocrine Neoplasia) syndromes are a group of three separate familial disease which consists of adenomatous hyperplasia and neoplasia in several endocrine glands. All three conditions are inherited as an autosomal dominant trait, with a single gene producing multiple effects. MEN IIA is characterized by medullary carcinoma of the thyroid, pheochromocytoma and hyperparathyroidism. It should be suspected in patients with bilateral pheochromocytoma, a familial history of MEN, or at least two characteristic endocrine manifestations. Genetic testing is used to confirm the diagnosis. Early diagnosis is crucial to aid in complete excision of the localized tumour. Pheochromocytomas can be detected by plasma free metanephrines and fractionated urinary catecholamines, particularly adrenaline (epinephrine).

      Imaging studies such as computed tomography or magnetic resonance imaging might also prove useful. Hyperparathyroidism is diagnosed by the standard finding of hypercalcaemia, hypophosphatemia and an increased parathyroid hormone level. Once MEN IIA syndrome is identified in any patient, it is recommended that his or her first-degree relatives and any other symptomatic also undergo genetic testing. Relatives should be subjected to annual screening for hyperparathyroidism and pheochromocytoma beginning in early childhood and continue indefinitely. Serum calcium levels help in screening for hyperparathyroidism. Similarly, screening for pheochromocytoma is by history, measurement of the blood pressure and laboratory testing.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      0
      Seconds
  • Question 8 - A 30-year-old woman known with Von Willebrand disease (vWD) has to undergo surgery....

    Incorrect

    • A 30-year-old woman known with Von Willebrand disease (vWD) has to undergo surgery. Which of these complications is most unlikely in this patient?

      Your Answer:

      Correct Answer: Hemarthrosis

      Explanation:

      Von Willebrand disease (vWD) is an inherited haemorrhagic disorder characterised by the impairment of primary haemostasis. It is caused by the deficiency or dysfunction of a protein named von Willebrand factor. The most common manifestation due to the condition is abnormal bleeding. Complications include easy bruising, hematomas, epistaxis, menorrhagia, prolonged bleeding and severe haemorrhage. Hemarthrosis is a complication that is more commonly found in haemophilia.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 9 - A 7-month-old abandoned baby with congenital non-communicating hydrocephalus is hosted by a clinic...

    Incorrect

    • A 7-month-old abandoned baby with congenital non-communicating hydrocephalus is hosted by a clinic at its new-born hostel. A CT scan of the baby's brain reveals what might be a blockage of the ventricular system between the third and the fourth ventricles. Which of the following is the most likely blocked structure?

      Your Answer:

      Correct Answer: Cerebral aqueduct

      Explanation:

      The drainage of cerebral spinal fluid from the third ventricle to the fourth ventricle is carried out by the cerebral aqueduct. The cerebral aqueduct is the narrowest passageway in the entire ventricular system and thus forms the most common site of blockage of flow of cerebrospinal fluid. The interventricular foramen allows passage of CSF to the third ventricle. The foramen of Luschka and Magendie are located on the fourth ventricle and allow passage of CSF to the subarachnoid space from the ventricular system. The pontine cistern is a space located on the ventral aspect of the pons. The cisterna magna is an opening on the subarachnoid space between the pia matter and the arachnoid.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds
  • Question 10 - A 47 -year-old male was admitted due to a bleeding peptic ulcer. On...

    Incorrect

    • A 47 -year-old male was admitted due to a bleeding peptic ulcer. On his 3rd hospital day, he developed a cardiac arrhythmia. His serum potassium was markedly elevated. What is the most likely cause of hyperkalaemia in this patient?

      Your Answer:

      Correct Answer: Multiple blood transfusions

      Explanation:

      Patients with gastrointestinal bleeding often require blood transfusion. Among the various side effects of blood transfusions, is the increase of potassium levels. The use of stored blood for transfusions is followed by an increase of serum potassium levels. Potassium level increases are more pronounced in patients who receive blood stored for more than 12 d. Furthermore, the lysis and destruction of red blood cells, especially in the transfusion of older PRBCs, can further increase potassium levels. Excessive use of a PPi has been associated with hyperkaelemia however would be less likely in this acute setting.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      0
      Seconds
  • Question 11 - A 56-year-old man undergoes tests to determine his renal function. His results over...

    Incorrect

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

      Urine flow rate: 2. 0 ml/min

      Urine inulin: 1.0 mg/ml

      Plasma inulin: 0.01 mg/ml

      Urine urea: 260 mmol/l

      Plasma urea: 7 mmol/l

      What is the glomerular filtration rate?

      Your Answer:

      Correct Answer: 200 ml/min

      Explanation:

      Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal (kidney) glomerular capillaries into the Bowman’s capsule per unit time. GFR is equal to the inulin clearance because inulin is freely filtered into Bowman’s capsule but is not reabsorbed or secreted. The clearance (C) of any substance can be calculated as follows: C = (U × V)/P, where U and P are the urine and plasma concentrations of the substance, respectively and V is the urine flow rate. Thus, glomerular filtration rate = (1.0 × 2. 0)/0.01 = 200 ml/min.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 12 - Choose the most correct answer regarding the obturator internus muscle. ...

    Incorrect

    • Choose the most correct answer regarding the obturator internus muscle.

      Your Answer:

      Correct Answer: It emerges from the pelvis through the lesser sciatic foramen

      Explanation:

      The obturator internus arises from the inner surface of the anterolateral wall of the pelvis and the pelvic surface of the obturator membrane. The fibres converge rapidly towards the lesser sciatic foramen and end in four or five tendinous bands and leave the pelvis through the lesser sciatic foramen.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 13 - Calculate the cardiac output of a patient with the following measurements: oxygen uptake...

    Incorrect

    • Calculate the cardiac output of a patient with the following measurements: oxygen uptake 200 ml/min, oxygen concentration in the peripheral vein 7 vol%, oxygen concentration in the pulmonary artery 10 vol% and oxygen concentration in the aorta 15 vol%.

      Your Answer:

      Correct Answer: 4000 ml/min

      Explanation:

      The Fick’s principle states that the uptake of a substance by an organ equals the arteriovenous difference of the substance multiplied by the blood flowing through the organ. We can thus calculate the pulmonary blood flow with pulmonary arterial (i.e., mixed venous) oxygen content, aortic oxygen content and oxygen uptake. The pulmonary blood flow, systemic blood flow and cardiac output can be considered the same assuming there are no intracardiac shunts. Thus, we can calculate the cardiac output. Cardiac output = oxygen uptake/(aortic − mixed venous oxygen content) = 200 ml/min/(15 ml O2/100 ml − 10 ml O2/100 ml) = 200 ml/min/(5 ml O2/100 ml) = 200 ml/min/0.05 = 4000 ml/min.

      It is crucial to remember to use pulmonary arterial oxygen content and not peripheral vein oxygen content, when calculating the cardiac output by Fick’s method.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 14 - Mallory bodies are characteristic of which of the following conditions? ...

    Incorrect

    • Mallory bodies are characteristic of which of the following conditions?

      Your Answer:

      Correct Answer: Alcoholic hepatitis

      Explanation:

      Mallory bodies (or ‘alcoholic hyaline’) are inclusion bodies in the cytoplasm of liver cells, seen in patients of alcoholic hepatitis; and also in Wilson’s disease. These pathological bodies are made of intermediate keratin filament proteins that are ubiquinated or bound by proteins like heat chock protein. Being highly eosinophilic, they appear pink on haematoxylin and eosin staining.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      0
      Seconds
  • Question 15 - A 45-year-old man with short bowel syndrome requires parenteral nutrition. The solution of...

    Incorrect

    • A 45-year-old man with short bowel syndrome requires parenteral nutrition. The solution of choice for parenteral nutrition is:

      Your Answer:

      Correct Answer: Crystalline amino acids

      Explanation:

      Total parenteral nutrition (TPN), is the practice of feeding a person intravenously, circumventing the gut. It is normally used in the following situations: surgery, when feeding by mouth is not possible, when a person’s digestive system cannot absorb nutrients due to chronic disease or if a person’s nutrient requirement cannot be met by enteral feeding and supplementation. A sterile bag of nutrient solution, between 500 ml and 4L, is provided. The pump infuses a small amount (0.1–10 ml/h) continuously to keep the vein open. The nutrient solution consists of water, glucose, salts, amino acids, vitamins and sometimes emulsified fats. Ideally each patient is assessed individually before commencing on parenteral nutrition, and a team consisting of doctors, nurses, clinical pharmacists and dietitians evaluate the patient’s individual data and decide what formula to use and at what rate.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 16 - Which of the following organs of the abdominal cavity is completely covered by...

    Incorrect

    • Which of the following organs of the abdominal cavity is completely covered by the peritoneum?

      Your Answer:

      Correct Answer: Spleen

      Explanation:

      Of the organs listed, the spleen is the only organ that is completely intraperitoneal, that is entirely in the peritoneum. Other completely intraperitoneal organs include the stomach, liver, appendix and the small intestines. The kidney, Inferior vena cava, aorta and the suprarenal glands are all retroperitoneal organs. The pancreas and the duodenum are partially retroperitoneal, with the tail of the pancreas in the peritoneum found in the splenorenal ligament while only the first part of the duodenum is intraperitoneal. For the intraperitoneal organs remember SALTD SPRSS
      S = Stomach
      A = Appendix
      L = Liver
      T = Transverse colon
      D = Duodenum (only the 1st part)
      S = Small intestines
      P = Pancreas (only the tail)
      R = Rectum (only the upper 3rd)
      S = Sigmoid colon
      S = Spleen
      For retroperitoneal, just remember SADPUCKER:
      S = suprarenal glands
      A = Aorta and IVC
      D = Duodenum (all but the 1st part)
      P = Pancreas (all but the tail)
      U = Ureter and bladder
      C = Colon (ascending and descending)
      K = Kidneys
      E = Oesophagus
      R = Rectum (Lower two-thirds)
      For secondarily retroperitoneal remember ‘Pussy Cat Dolls“:
      P = Pancreas
      C = Colon (only ascending and descending)
      D = Duodenum (only parts 2-4)

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 17 - The primary somatosensory cortex is located in the: ...

    Incorrect

    • The primary somatosensory cortex is located in the:

      Your Answer:

      Correct Answer: Postcentral gyrus

      Explanation:

      The primary somatic sensory cortex is located in the postcentral gyrus and is the largest cortical receiving area for information from somatosensory receptors. Through corticocortical fibres, it then sends the information to other areas of the neocortex and further analysis takes place in the posterior parietal association cortex.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 18 - What is the nerve supply to the muscles of the lateral compartment of...

    Incorrect

    • What is the nerve supply to the muscles of the lateral compartment of the leg ?

      Your Answer:

      Correct Answer: Superficial peroneal nerve

      Explanation:

      The peroneus longus and peroneus brevis in the lateral compartment of the leg take nerve supply from the superficial peroneal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 19 - Endometrial hyperplasia is most likely to be associated with which of the following...

    Incorrect

    • Endometrial hyperplasia is most likely to be associated with which of the following conditions?

      Your Answer:

      Correct Answer: Fibrothecoma

      Explanation:

      A benign tumour arising from the ovarian stroma, fibrothecoma are bilateral in 10% cases. The thecoma component of the tumour can produce oestrogen leading to endometrial hyperplasia. The thecoma is rich in lipid content and is responsible for the yellowish appearance of the tumour. Meig’s syndrome is the presence of fibrothecoma with a right-sided hydrothorax.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      0
      Seconds
  • Question 20 - Out of the following options, which malignancy has the highest potential for multicentricity?...

    Incorrect

    • Out of the following options, which malignancy has the highest potential for multicentricity?

      Your Answer:

      Correct Answer: Transitional cell carcinoma

      Explanation:

      Transitional cell carcinomas can arise anywhere in the urothelium lining the urinary tract; and hence are known to be multicentric and recur commonly. Prostatic adenocarcinoma most commonly involves the posterior lobe of the prostate gland. Although renal cell carcinomas occasionally show multicentricity, it is not common. Penile carcinomas are usually locally infiltrative lesions. Wilm’s tumours are usually solitary, but can be bilateral or multicentric in 10% cases. Small cell carcinoma of lung and teratomas are usually solitary.

    • This question is part of the following fields:

      • Pathology
      • Renal
      0
      Seconds
  • Question 21 - Regarding the extensor retinaculum of the wrist, which of these is CORRECT? ...

    Incorrect

    • Regarding the extensor retinaculum of the wrist, which of these is CORRECT?

      Your Answer:

      Correct Answer: It prevents the tendons of the posterior compartment of the forearm from ‘bowstringing’ when the hand is extended at the wrist

      Explanation:

      This extensor retinaculum, as the name indicates, holds the tendons of the extensors against the dorsal surface of the distal radius and ulna. Therefore, the correct answer is that it prevents bowstringing of the extensor tendons with wrist extension. It forms compartments between it and its bony attachment, and these compartments guide and hold the tendons.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 22 - 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 23 - A 44-year old gentleman presented to the hospital in congestive cardiac failure. On...

    Incorrect

    • A 44-year old gentleman presented to the hospital in congestive cardiac failure. On further investigation, he was found to have a right-sided retroperitoneal mass. On enquiry, he gave a history of intermittent hypertensive attacks. 24-hour urine specimen revealed raised metanephrine and vanillylmandelic acid levels. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Pheochromocytoma

      Explanation:

      A neuroendocrine tumour of the chromaffin cells in adrenal medulla, pheochromocytoma secretes excessive catecholamines – adrenaline (epinephrine) and noradrenaline (norepinephrine). Pheochromocytomas are also known as the ‘10% tumour’. This is because 10% of them are bilateral, 10% are malignant, and 10% are extra-adrenal. Extra-adrenal paragangliomas (also known as extra-adrenal pheochromocytomas) are less common than pheochromocytomas and arise in the ganglia of sympathetic nervous system. Around 25% of pheochromocytomas are familial. Symptoms are described as feeling of ‘impending doom’, and include tachycardia, hypertension, palpitations, anxiety, headaches and pallor. Orthostatic hypertension is typically seen where there is a more than 100 mmHg fall in systolic pressure when the patient stands up. Pheochromocytomas can also lead to malignant hypertension. Diagnosis is by measurement of catecholamines and metanephrines in blood or in 24-hour urine, after exclusion of other possible causes such as stress, hypoglycaemia and drugs (methyldopa, dopamine agonists, ganglion-blocking antihypertensive). Imaging is also needed to localize the tumour. Localization of the tumour can also be done by Iodine-131 meta-iodobenzylguanidine (I131-MIBG) imaging.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      0
      Seconds
  • Question 24 - A middle aged man presented in OPD with a low grade fever and...

    Incorrect

    • A middle aged man presented in OPD with a low grade fever and a persistent cough. His blood smear showed an increase in cells with large bi-lobed nuclei. Which of these cells represent the one seen on the smear?

      Your Answer:

      Correct Answer: Monocytes

      Explanation:

      Monocytes are white cells that protect the body against harmful pathogens. They are mobile and are produced in the bone marrow, mature there and circulate in the blood for about 1-3 days, where they enter the tissues and transform into macrophages. They are characteristically identified by their large bi-lobed nuclei.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      0
      Seconds
  • Question 25 - A 65-year-old smoker presents with painless haematuria, urinary frequency and urgency. He is...

    Incorrect

    • A 65-year-old smoker presents with painless haematuria, urinary frequency and urgency. He is diagnosed with bladder cancer. Which is the most likely type?

      Your Answer:

      Correct Answer: Transitional cell carcinoma

      Explanation:

      90% of bladder cancers are transitional cell carcinomas derived from the bladder urothelium. Risk factors include industrial chemicals, smoking and infection. Schistosomiasis and bladder stones predispose to the squamous cell variety.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds
  • Question 26 - A man in his sixties underwent surgery to remove a lump from his...

    Incorrect

    • A man in his sixties underwent surgery to remove a lump from his axilla. During removal, a nerve originating from the lateral cord of the brachial plexus was damaged. Which nerve is this referring to?

      Your Answer:

      Correct Answer: Lateral pectoral

      Explanation:

      The only branch of the lateral cord of brachial plexus in the options given, is the lateral pectoral nerve. It supplies the pectoralis major muscle and sends a branch to join the medial pectoral nerve forming a loop in front of the first part of the axillary artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 27 - Which of the following is a likely cause of jaundice? ...

    Incorrect

    • Which of the following is a likely cause of jaundice?

      Your Answer:

      Correct Answer: Hepatic disease if plasma albumin is low and serum aminotransferase elevations > 500 units

      Explanation:

      Jaundice can occur due to any of the possible causes and treatment depends upon diagnosing the correct condition. Mild hyperbilirubinemia with normal levels of aminotransferase and alkaline phosphatase is often unconjugated (e.g., due to haemolysis or Gilbert’s syndrome rather than hepatobiliary disease). Moderate or severe hyperbilirubinemia along with increased urinary bilirubin (bilirubinuria), high alkaline phosphatase or aminotransferase levels suggest hepatobiliary disease. Hyperbilirubinemia produced by any hepatobiliary disease is largely conjugated. In this case, other blood tests include hepatitis serology for suspected hepatitis, prothrombin time (PT) or international normalised ratio (INR), albumin and globulin levels, and antimitochondrial antibody levels (suspected primary biliary cirrhosis). Low albumin and high globulin levels suggest chronic rather than acute liver disease. In cases where there is only a an elevation of alkaline phosphatase, γ-glutamyl transpeptidase (GGT) levels should be checked – the levels of which will be found high in hepatobiliary disease, but not in bone disorder which can also lead to elevated alkaline phosphatase levels. In diseases of hepatobiliary origin, aminotransferase elevations > 500 units suggest a hepatocellular cause, whereas disproportionate increases of alkaline phosphatase (e.g., alkaline phosphatase > 3 times normal and aminotransferase < 200 units) suggest cholestasis. Because hepatobiliary disease alone rarely causes bilirubin levels > 30 mg/dl, higher levels are suggestive of a combination of severe hepatobiliary disease and haemolysis or renal dysfunction. Imaging is best for diagnosing infiltrative and cholestatic causes of jaundice. Liver biopsy is rarely needed, but can be of use in intrahepatic cholestasis and in some types of hepatitis.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 28 - A swimmer was struggling to finish his training following an injury to his...

    Incorrect

    • A swimmer was struggling to finish his training following an injury to his right arm. On further examination it was found that any movements involving adduction, medial rotation and extension of her arm were particularly weak. Which nerve in this case was damaged?

      Your Answer:

      Correct Answer: Thoracodorsal

      Explanation:

      Weakness on these particular movements indicate that there is a problem with the latissimus dorsi muscle. This muscle is very important particularly in swimming movements and is supplied by the thoracodorsal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 29 - In the case of an injury to the sub sartorial canal, which of...

    Incorrect

    • In the case of an injury to the sub sartorial canal, which of the following structures is most likely to be injured?

      Your Answer:

      Correct Answer: Nerve to vastus medialis

      Explanation:

      The adductor canal (sub sartorial canal) is situated in the middle third of the thigh.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 30 - A 5-year-old child presents with fever and otalgia. Greenish pustular discharge was seen...

    Incorrect

    • A 5-year-old child presents with fever and otalgia. Greenish pustular discharge was seen in his left ear during physical examination. The patient is diagnosed with otitis externa. Which of the following organisms most likely caused the infection?

      Your Answer:

      Correct Answer: Pseudomonas aeruginosa

      Explanation:

      P. aeruginosa is a multidrug resistant pathogen recognised for its ubiquity, its advanced antibiotic resistance mechanisms and its association with serious illnesses – especially hospital-acquired infections such as ventilator-associated pneumonia and various septic syndromes. The species name aeruginosa is a Latin word meaning verdigris (copper rust), referring to the blue-green colour of laboratory cultures of the species. This blue-green pigment is a combination of two metabolites of P. aeruginosa, pyocyanin (blue) and pyoverdine (green), which impart the blue-green characteristic colour of cultures.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
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