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Question 1
Incorrect
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Which of the following is responsible for the maximum increase in total peripheral resistance on sympathetic stimulation?
Your Answer: Capillaries
Correct Answer: Arterioles
Explanation:Arterioles are also known as the resistance vessels as they are responsible for approximately half the resistance of the entire systemic circulation. They are richly innervated by the autonomic nervous system and hence, will bring about the maximum increase in peripheral resistance on sympathetic stimulation.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 2
Correct
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When the pitch of a sound increases, what is the physiological response seen in the listener?
Your Answer: The location of maximal basilar membrane displacement moves toward the base of the cochlea
Explanation:An increase in the frequency of sound waves results in a change in the position of maximal displacement of the basilar membrane in the cochlea. Low pitch sound produces maximal displacement towards the cochlear apex and greatest activation of hair cells there. With an increasing pitch, the site of greatest displacement moves towards the cochlear base. However, increased amplitude of displacement, increase in the number of activated hair cells, increased frequency of discharge of units in the auditory nerve and increase in the range of frequencies to which such units respond, are all seen in increases in the intensity or a sound stimulus.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 3
Correct
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A 17-year-old female was given an antibiotic for a urinary tract infection. After taking the medication the patient developed Steven-Johnson syndrome. Which particular antibiotic usually causes Steven-Johnson syndrome?
Your Answer: Sulphonamides
Explanation:Stevens–Johnson syndrome (SJS) is a type of severe skin reaction. The most common cause is certain medications such as lamotrigine, carbamazepine, allopurinol, sulphonamide antibiotics, and nevirapine.
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This question is part of the following fields:
- Microbiology
- Pathology
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Question 4
Correct
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When a young boy falls on his outstretched hand, he fractures one of the bones at his wrist joint. The doctors told his parents that the fractured bone has special importance as it is that bone that articulates with the distal end of the radius. Which one of the following is it?
Your Answer: Scaphoid
Explanation:It is the scaphoid bone that articulates with the radius at this level. It is located at the radial side of the wrist and is considered the largest bone in the proximal row of carpal bones. It articulates with the radius via its superior surface. This bone also articulates with trapezium and trapezoid bones via the inferior surface, capitate and lunate medially.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 5
Correct
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The proximal tubule is the portion of the ductal system of the nephron of the kidney which leads from Bowman's capsule to the loop of Henle. Which of the following is most likely to be seen in a sample of fluid leaving the proximal tubule?
Your Answer: It will have no amino acids
Explanation:The proximal tubule is the portion of the duct system of the nephron leading from Bowman’s capsule to the loop of Henlé. The most distinctive characteristic of the proximal tubule is its brush border (or ‘striated border’). The luminal surface of the epithelial cells of this segment of the nephron is covered with densely packed microvilli forming a border which greatly increases the luminal surface area of the cells, presumably facilitating their reabsorptive function. Glucose, amino acids, inorganic phosphate, and some other solutes are100% reabsorbed via secondary active transport through co-transporters driven by the sodium gradient out of the nephron.
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This question is part of the following fields:
- Physiology
- Renal
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Question 6
Correct
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A 60-year-old man complains of pain in his left thigh. An X-ray reveals bowing of the affected femur, increased bone density, bony enlargement, abnormal bone architecture with coarse cortical trabeculations, and stress microfractures. Which is the most likely diagnosis in this case?
Your Answer: Paget’s disease of bone
Explanation:Paget’s disease of bone is a chronic disorder of the adult skeleton in which bone turnover is accelerated in localised areas, replacing normal matrix with softened and enlarged bone and causing gradual pain and deformity in some cases. It is more predominant in men over the age of 40. Characteristic X-ray findings include increased bone density, abnormal architecture with coarse cortical trabeculation or cortical thickening, bowing and bony enlargement; there might also be stress microfractures of the tibia or femur.
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This question is part of the following fields:
- Orthopaedics
- Pathology
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Question 7
Correct
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Which tumour site is more commonly involved in adults than in children?
Your Answer: Lung
Explanation:In adults, the most common primary site of tumour is in the lungs, compared to children wherein the most common primary site is the blood.
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This question is part of the following fields:
- Neoplasia
- Pathology
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Question 8
Correct
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Which of the following toxins most likely results in continuous cAMP production, which pumps H2O, sodium, potassium, chloride and bicarbonate into the lumen of the small intestine and results in rapid dehydration?
Your Answer: Cholera toxin
Explanation:The cholera toxin (CTX or CT) is an oligomeric complex made up of six protein subunits: a single copy of the A subunit (part A), and five copies of the B subunit (part B), connected by a disulphide bond. The five B subunits form a five-membered ring that binds to GM1 gangliosides on the surface of the intestinal epithelium cells. The A1 portion of the A subunit is an enzyme that ADP-ribosylates G proteins, while the A2 chain fits into the central pore of the B subunit ring. Upon binding, the complex is taken into the cell via receptor-mediated endocytosis. Once inside the cell, the disulphide bond is reduced, and the A1 subunit is freed to bind with a human partner protein called ADP-ribosylation factor 6 (Arf6). Binding exposes its active site, allowing it to permanently ribosylate the Gs alpha subunit of the heterotrimeric G protein. This results in constitutive cAMP production, which in turn leads to secretion of H2O, Na+, K+, Cl−, and HCO3− into the lumen of the small intestine and rapid dehydration. The gene encoding the cholera toxin was introduced into V. cholerae by horizontal gene transfer.
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This question is part of the following fields:
- Microbiology
- Pathology
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Question 9
Correct
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The chest X-ray of an 10-year-old boy, that presented with low-grade fever and cough, revealed hilar enlargement and parenchymal consolidation in the middle lobes. These X-ray findings are more typical for which of the following diagnoses?
Your Answer: Pulmonary tuberculosis
Explanation:Primary pulmonary tuberculosis is seen in patients exposed to Mycobacterium tuberculosis for the firs time. The main radiographic findings in primary pulmonary tuberculosis include homogeneous parenchymal consolidation typically in the lower and middle lobes, lymphadenopathy, miliary opacities and pleural effusion.
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This question is part of the following fields:
- Pathology
- Respiratory
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Question 10
Correct
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The most likely cause of prominent U waves on the electrocardiogram (ECG) of a patient is:
Your Answer: Hypokalaemia
Explanation:The U-wave, not always visible in ECGs, is thought to represent repolarisation of papillary muscles or Purkinje fibres. When seen, it is very small and occurs after the T-wave. Inverted U-waves indicate myocardial ischaemia or left ventricular volume overload. Prominent U-waves are most commonly seen in hypokalaemia. Other causes include hypercalcaemia, thyrotoxicosis, digitalis exposure, adrenaline and class 1A and 3 anti-arrhythmic agents. It can also be seen in congenital long-QT syndrome and in intracranial haemorrhage.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 11
Correct
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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: 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.
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This question is part of the following fields:
- Pathology
- Renal
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Question 12
Incorrect
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Which is the CORRECT statement regarding the small intestine:
Your Answer: The proximal jejunum has more arterial arcades than the distal ileum
Correct Answer: The superior mesenteric artery courses between the body and uncinate process of the pancreas before the artery supplies the jejunum and ileum
Explanation:The small intestine extends from the pylorus to the ileocecal valve where It ends in the large intestine. It is surrounded on the sides and above by the large intestine. It is related anteriorly with the greater omentum and abdominal wall. Is connected to the vertebral column by a fold of peritoneum or otherwise known as the mesentery. Is divided into three portions: the duodenum, jejunum and ileum. The jejunum and ileum are supplied by the superior mesenteric artery that courses between the body and uncinate process of the pancreas before it gives off intestinal branches.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 13
Correct
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A lesion involving the lateral portion of the dorsal columns at the level of the nape of the neck will most likely affect:
Your Answer: Vibratory sensations from the ipsilateral arm
Explanation:At the level mentioned in the question, the lateral portion of dorsal columns comprises of the fasciculus cuneatus. Axons carrying the sensations of touch, vibration and proprioception from the ipsilateral arm enter the spinal cord and ascend in the fasciculus cuneatus, synapsing in the nucleus cuneatus of the caudal medulla. Secondary neurons from this nucleus give rise to internal arcuate fibres, which decussate and ascend to the thalamus as the medial lemniscus. Tertiary neurons from there project to the ipsilateral somatosensory cortex. Thus, any damage to the fasciculus cuneatus will result in a deficit in tactile, proprioceptive and vibratory sensations in the ipsilateral arm, and not the contralateral arm.
Fine motor control of the fingers is mainly carried by the ipsilateral lateral corticospinal tract in the lateral funiculus of the cord. Motor control of the contralateral foot is carried by the ipsilateral corticospinal tract in the lateral funiculus of the cord. Lack of sweating of the face could be produced by interruption of sympathetic innervation. Proprioception from the ipsilateral leg is carried by the fasciculus gracilis in the medial part of the dorsal columns.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 14
Correct
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What forms the pelvic diaphragm?
Your Answer: Levator ani and coccygeus muscles
Explanation:The pelvic diaphragm is formed by the levator ani and the coccygeus muscles. The levator ani forms the greater part of the pelvic floor supporting the viscera in the pelvic cavity.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 15
Correct
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A 45-year-old pregnant woman develops high blood pressure at 20 weeks. She complains of headaches and swollen feet, and a test reveals proteinuria (350 mg/day). Which of the following is the most likely diagnosis?
Your Answer: Pre-eclampsia
Explanation:Pre-eclampsia (PE) is a disorder of pregnancy characterized by the onset of high blood pressure (two separate readings taken at least 6 h apart of 140/90 or more) and often a significant amount of protein in the urine (>300 mg of protein in a 24-h urine sample). While blood pressure elevation is the most visible sign of the disease, it involves generalised damage to the maternal endothelium of the kidneys and liver, with the release of vasopressive factors only secondary to the original damage. Pre-eclampsia may develop at varying times within pregnancy and its progress differs among patients; most cases present pre-term. It has no known cure apart from ending the pregnancy (induction of labour or abortion). It may also present up to 6 weeks post partum. Risk factors for pre-eclampsia include obesity, prior hypertension, older age, and diabetes mellitus.
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This question is part of the following fields:
- Physiology
- Renal
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Question 16
Incorrect
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Which of the following conditions of the breast is most often associated with use of oral contraceptives?
Your Answer: Galactocele
Correct Answer: Cyst formation
Explanation:Breast cysts are common and are smooth, firm, mobile lumps that can sometimes be tender. Cysts can also be bilateral and are known to recur in 10% of cases. They are more common in women in the third and fourth decades and most often disappear after menopause. Cysts are filled with fluid from the breast which occurs due to the normal menstrual cycle of a woman. The end of the menstrual cycle causes breast cells to swell. After the menses, the cells shrink and the released fluid disappears. However, in some cases this fluid forms a cyst. Incidence of cysts was also linked to use of oral contraceptives.
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This question is part of the following fields:
- Pathology
- Women's Health
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Question 17
Correct
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A 38 year old man is to undergo excision of the base of the prostate for malignant growth, which of the following structures is directly related to the base of the prostate?
Your Answer: Urinary bladder
Explanation:The prostate is situated in the pelvic cavity and is also located immediately below the internal urethral orifice at the commencement of the urethra. It is held in position by the puboprostatic ligaments, the superior fascia of the urogenital diaphragm and the anterior portions of the levatores ani. The base of the prostate is directed upward and is attached to the inferior surface of the urinary bladder while the apex is directed downward and is in contact with the superior fascia of the urogenital diaphragm.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 18
Correct
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Biopsy of a neoplastic mass was performed. Histologic examination of the specimen showed spindle shaped cells with high nuclear/cytoplasm ratio on immunohisto chemical staining. These pleomorphic cells were vimentin positive, cytokeratin negative and cd45 negative. This type of neoplasm is most commonly found in which patient?
Your Answer: A 15-year-old boy with a mass in the left femur and lung metastases
Explanation:A histology report that describes spindle shaped cells which are vimentin positive suggests osteosarcoma and hematogenous spread to the lungs.
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This question is part of the following fields:
- Neoplasia; Orthopaedics
- Pathology
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Question 19
Incorrect
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During an operation to repair an aortic coarctation in a neonate, a surgeon accidentally cuts the first aortic intercostal arteries as he mobilised the descending aorta. Which one of the following structure might be deprived of its primary source of blood supply following this injury?
Your Answer: First posterior intercostal space
Correct Answer: Right bronchus
Explanation:The right bronchus is supplied by one right bronchial artery that may branch from one of the left bronchial arteries or from the right 3rd posterior intercostal artery (this is the first intercostal artery that arises from the aorta). Damage to this artery might stop blood supply to the main bronchus. Intercostal arteries that go to the first and the second interspaces originate from the highest intercostal artery such that blood supply to either of these spaces would not be interfered with.
The left bronchus receives blood from 2 left bronchial arteries which are direct branches from the descending aorta.
Fibrous pericardium is the sac that contains the heart. Its blood supply is not a major concern.
Visceral pericardium receives its blood supply from the coronary vessels.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 20
Incorrect
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An 80 year-old quadriplegic man has been lying supine for 7 weeks in a critical care ward. He develops a right lung abscess that is draining by gravity to a particular region of the lung. Which is the most likely site of pus collection?
Your Answer: Middle lobe
Correct Answer: Superior segment of the lower lobe
Explanation:The superior segmental bronchus of the lower lobe of the right lung branches posteriorly off the intermediate bronchus or the inferior lobe bronchus. It is therefore more likely to receive fluid or foreign bodies that enter the right main bronchus especially when the patient is supine.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 21
Correct
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A 36-year-old female was advised to undergo genetic testing of BRCA1 and BRCA2. BRCA1 and BRCA2 are tumour markers specifically for which organ?
Your Answer: Breast
Explanation:Women with harmful mutations in either BRCA1 or BRCA2 have a risk of breast cancer that is about five times the normal risk.
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This question is part of the following fields:
- Neoplasia
- Pathology
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Question 22
Correct
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Injury to this nerve may result in loss of sensation of the mandibular teeth and bone:
Your Answer: Inferior alveolar nerve
Explanation:The inferior alveolar nerve (sometimes called the inferior dental nerve) is a branch of the mandibular nerve, which is itself the third branch of the trigeminal nerve. The inferior alveolar nerves supply sensation to the lower teeth of the mandible.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 23
Correct
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A 59-year-old man was brought to the emergency department by his family after complaining of sudden, severe upper back pain and a ripping sensation, that radiated to his neck. On arrival, his pulse was weak in one arm compared with the other however his ECG result was normal. Which of the following is most probably the cause of these findings and symptoms?
Your Answer: Acute aortic dissection
Explanation:Acute aortic dissection is a serious condition in which the inner layer of the aorta tears and the blood flows in between the inner and middle layers of the aorta causing their separation (dissection). Aortic dissection can lead to rupture or decreased blood flow to organs. Clinical manifestations most often include the sudden onset of severe, tearing or ripping chest pain that can radiate to the shoulder, back or neck; syncope; altered mental status; dyspnoea; pale skin; stroke symptoms etc. The diagnosis of acute aortic dissection is based on clinical findings, imaging studies, electrocardiography and laboratory analysis.
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This question is part of the following fields:
- Cardiovascular
- Pathology
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Question 24
Correct
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Evaluation of a 60-year old gentleman, who has been a coal miner all his life and is suspected to have pulmonary fibrosis reveals the following: normal FEV1, arterial oxygen saturation 92%, alveolar ventilation 6000 ml/min at a tidal volume of 600 ml and a breathing rate of 12 breaths/min. There are also pathological changes in lung compliance and residual volume. Which of the following is most accurate about his residual volume?
Your Answer: Cannot be measured directly with a spirometer
Explanation:Residual volume is the air left in the lungs after maximal expiration is done. Thus, this is not a part of vital capacity and cannot be measured with a spirometer directly. It can be measured by the methods such as body plethysmography or inert gas dilution. Expiratory reserve volume is vital capacity minus inspiratory capacity. Resting volume of lungs is he sum of residual volume and expiratory reserve volume. Lungs recoil inward until the recoil pressure becomes zero, which corresponds to a volume significantly lower than residual volume.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 25
Correct
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Routine evaluation of a 38 year old gentleman showed a slightly lower arterial oxygen [pa(O2)] than the alveolar oxygen [pA(O2)]. This difference is:
Your Answer: Is normal and due to shunted blood
Explanation:Blood that bypasses the ventilated parts of lung and enters the arterial circulation directly is known as shunted blood. It happens in normal people due to mixing of arterial blood with bronchial and some myocardial venous blood (which drains into the left heart). Diffusion limitation and reaction velocity with haemoglobin are immeasurably small. CO2 unloading will not affect the difference between alveolar and arterial p(O2). A large VSD will result in much lower arterial O2 as compared to alveolar O2.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 26
Correct
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A football player sustained an injury to his ankle. The wound went through the skin, subcutaneous tissue and flexor retinaculum. Which other structure passing under the retinaculum may be injured?
Your Answer: Tibial nerve
Explanation:The flexor retinaculum is immediately posterior to the medial malleolus. The structures that pass under the flexor retinaculum from anterior to posterior are: tendon of the tibialis posterior, flexor digitorum longus, posterior tibial artery (and vein), tibial nerve and tendon of flexor hallucis longus. The tibial nerve is the only one which lies behind the flexor retinaculum.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 27
Correct
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What is the reason for a deranged thrombin clotting time?
Your Answer: Heparin therapy
Explanation:Thrombic clotting time is also known as thrombin time. It is clinically performed to determine the therapeutic levels of heparin. After plasma is isolated from the blood, bovine thrombin is added to it and the time it takes from the addition to clot is recorded. The reference interval is usually <21s. deranged results are indicative of heparin therapy, hypofibrinogenemia, hyperfibrinogenaemia or lupus anticoagulant.
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This question is part of the following fields:
- General
- Physiology
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Question 28
Incorrect
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Which of the following causes the maximum increase in the secretion of antidiuretic hormone (ADH)?
Your Answer: Decreased plasma volume
Correct Answer: Increased plasma osmolarity
Explanation:The most potent stimulus for ADH release is increased plasma osmolarity. Decreased plasma volume is a less potent stimulus in comparison. However, decrease blood volume and arterial pressure due to severe haemorrhage does lead to ADH secretion. Hypothalamic releasing factors do not control the release of posterior pituitary hormones ADH and oxytocin.
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This question is part of the following fields:
- Endocrinology
- Physiology
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Question 29
Correct
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QT interval in the electrocardiogram of a healthy individual is normally:
Your Answer: 0.40 s
Explanation:QT interval extends from beginning of the QRS complex till the end of he T-wave and normally lasts for 0.40 s. It is important in the diagnosis of long-QT and short-QT syndrome. The QT interval varies on the basis of heart rate and may need to be corrected.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 30
Incorrect
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A surgeon ligates the left superior suprarenal artery whilst preforming a left adrenalectomy. Where does the left superior suprarenal artery originate?
Your Answer: Renal artery
Correct Answer: Left inferior phrenic artery
Explanation:The superior suprarenal arteries arises from the inferior phrenic artery on either side.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 31
Incorrect
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Which of the following is the most likely cause of prolonged thrombin clotting time?
Your Answer: Warfarin therapy
Correct Answer: Hypofibrinogenemia
Explanation:Thrombin clotting time, also called thrombin time (TT), is test used for the investigation of possible bleeding or clotting disorders. TT reflects the conversion of fibrinogen to fibrin and it’s also very sensitive to the presence of the anticoagulant heparin. A prolonged thrombin time may indicate the presence of hypofibrinogenemia (decreased fibrinogen level ), dysfibrinogenaemia, disseminated intravascular coagulation (DIC), end stage liver disease or malnutrition.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 32
Correct
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A 90-year-old man is prescribed spironolactone after his family notices his legs are swollen. What class of drugs does spironolactone belong to?
Your Answer: Potassium-sparing diuretics
Explanation:Spironolactone is a renal competitive aldosterone antagonist in a class of drugs called ‘potassium-sparing diuretics’, that is primarily used to treat fluid build-up due to heart failure, liver scarring, or kidney disease. It is also used in the treatment of high blood pressure, low blood potassium, early-onset puberty, and acne and excessive hair growth in women. Spironolactone inhibits the effect of aldosterone by competing for intracellular aldosterone receptors in the distal tubule cells. This increases the secretion of water and sodium, while decreasing the excretion of potassium.
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This question is part of the following fields:
- Pathology
- Pharmacology
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Question 33
Incorrect
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After a prolonged coronary artery bypass surgery, a 60-year old gentleman was transfused 3 units of fresh-frozen plasma and 2 units of packed red cells. Two days later, the nurse noticed that he was tachypnoeic and chest X-ray showed signs consistent with adult respiratory distress syndrome. Which of the following variables will be low in this patient?
Your Answer: Surface tension of alveolar fluid
Correct Answer: Compliance of the lung
Explanation:Acute or adult respiratory distress syndrome (ARDS) is a reaction to several forms of lung injuries and is commonly associated with sepsis and SIRS (systemic inflammatory response syndrome), severe traumatic injury, severe head injury, narcotics overdose, drowning, pulmonary contusion, and multiple blood transfusions. There is an increase in risk due to pre-existing liver disease or coagulation abnormalities. It results due to indirect toxic effects of neutrophil-derived inflammatory mediators in the lungs. ARDS is defined by the 1994 American–European Consensus Committee as the acute onset of bilateral infiltrates on chest X-ray, a partial pressure of arterial oxygen (pa(O2)) to fraction of inspired oxygen Fi(O2) ratio of less than 200 mmHg and a pulmonary artery occlusion pressure of less than 18 or the absence of clinical evidence of left arterial hypertension. ARDS is basically pulmonary oedema in the absence of volume overload or poor left ventricular function. This is different from acute lung injury, which shows a pa(O2)/Fi(O2) ratio of less than 300 mmHg. Pathogenesis of ARDS starts from damage to alveolar epithelium and vascular endothelium, causing increased permeability. Damage to surfactant-producing type II cells disrupts the production and function of pulmonary surfactant, causing micro atelectasis and poor gas exchange. There is a decrease in lung compliance and increase in work of breathing. Eventually, there is resorption of alveolar oedema, regeneration of epithelial cells, proliferation and differentiation of type II alveolar cells and alveolar remodelling. Some show resolution and some progress to fibrosing alveolitis, which involves the deposition of collagen in alveolar, vascular and interstitial spaces.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 34
Incorrect
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In an anatomy demonstration, the instructor asked one of the medical students to pass his index finger inferior to the root of the left lung. The student notices that his finger is blocked by a structure. Which structure do you think is responsible for this?
Your Answer: Cupola
Correct Answer: Pulmonary ligament
Explanation:The pulmonary ligament is dual layer of pleura stretching from the inferior part of the hilar reflection toward the diaphragm.
The costodiaphragmatic recess is the cavity at the inferior border of the lung where the costal pleura becomes the diaphragmatic pleura.
The cupola: is part of the pleura that extends superiorly above the first rib and has no association with the root of the lung.
Inferior vena cava is located in the mediastinum, not near the root of the lung.
Left pulmonary veins being part of the root of the lung, would not block access to behind the lung. Costomediastinal recess is the part of the pleura where the costal pleura become the mediastinal pleura.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 35
Correct
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A 50-year old gentleman who was admitted for elective surgery was found to have haemoglobin 9.5 g/dl, white blood cell count of 1.4 × 109/l and a mean corpuscular volume (MCV) of 134 fl. Which of the following is the likely finding on his peripheral blood smear?
Your Answer: Hypersegmented neutrophils
Explanation:The likely diagnosis is megaloblastic anaemia, which also shows the presence of hypersegmented neutrophils.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 36
Correct
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A 40 year old man suffered severe trauma following an MVA. His BP is 70/33 mmhg, heart rate of 140 beats/mins and very feeble pulse. He was transfused 3 units of blood resulting in his BP returning to 100/70 and his heart rate to 90 beats/min. What decreased following transfusion?
Your Answer: Total peripheral resistance
Explanation:The patient is in hypovolemic shock, he is transfused with blood to replace the volume lost. It is important not only to replace fluids but stop active bleeding in resuscitation. Fluid replacement will result in a decreased sympathetic discharge and adequate ventricular filling thus reducing total peripheral resistance and increasing cardiac output and cardiac filling pressures.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 37
Incorrect
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Which of the following muscles is innervated by the inferior branch of the right recurrent laryngeal nerve?
Your Answer: Cricothyroid
Correct Answer: Posterior cricoarytenoid
Explanation:The posterior cricoarytenoid muscle, which is the sole abductor of the vocal folds, receives its innervation from the inferior laryngeal nerve which is a continuation of the recurrent laryngeal nerve.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 38
Correct
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If the blood flow is constant, oxygen extraction by tissues will show the greatest decrease due to which of the following interventions?
Your Answer: Tissue cooling
Explanation:With a constant blood flow to a given tissue bed, there will be an increase in oxygen extraction by the tissue with the following; an increase in tissue metabolism and oxygen requirements: warming (or fever), exercise, catecholamines and thyroxine. With cooling, the demand for oxygen decreases, leading to decreased oxygen extraction.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 39
Incorrect
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An 26-year-old man sought admission due to persistent non-bloody diarrhoea. The patient is HIV-positive. Examination of stool sample showed numerous acid-fast cysts. Which of the following organism is the most likely cause of diarrhoea?
Your Answer: Mycobacterium avium-intracellular complex
Correct Answer: Cryptosporidium parvum
Explanation:Cryptosporidium parvum is one of several species that causes cryptosporidiosis, a parasitic disease of the mammalian intestinal tract. Primary symptoms of C. parvum infection are acute, watery, and non-bloody diarrhoea. C. parvum infection is of particular concern in immunocompromised patients, where diarrhoea can reach 10–15 l per day.
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This question is part of the following fields:
- Microbiology
- Pathology
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Question 40
Correct
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Which of the following morphological features is most characteristic of hyaline degeneration?
Your Answer: Homogeneous, ground-glass, pink-staining appearance of cells
Explanation:The characteristic morphological features of hyaline degeneration is ground-glass, pinking staining cytoplasm with an intact cell membrane. The accumulation of lipids, calcium salts, lipofuscin and an amorphous cytoplasm with an intact cell membrane are all characteristically found in different situations.
Pyknotic nucleus and orphan Annie eye nucleus are not seen in hyaline degeneration.
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This question is part of the following fields:
- Cell Injury & Wound Healing
- Pathology
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SESSION STATS - PERFORMANCE PER SPECIALTY
