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  • Question 1 - Regarding ACE inhibitors, which of the following statements is CORRECT: ...

    Correct

    • Regarding ACE inhibitors, which of the following statements is CORRECT:

      Your Answer: Angiotensin-II receptor blockers are a useful alternative in patients who cannot tolerate ACE-inhibitors due a persistent cough.

      Explanation:

      ACE inhibitors should be used with caution in patients of Afro-Caribbean descent who may respond less well; calcium channel blockers are first line for hypertension in these patients. ACE inhibitors have a role in the management of diabetic nephropathy. ACE inhibitors are contraindicated in pregnant women. ACE inhibitors inhibit the breakdown of bradykinin; this is the cause of the persistent dry cough. Blocking ACE also diminishes the breakdown of the potent vasodilator bradykinin which is the cause of the persistent dry cough. Angiotensin-II receptor blockers do not have this effect, therefore they are useful alternative for patients who have to discontinue an ACE inhibitor because of persistent cough.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      32.9
      Seconds
  • Question 2 - A 35-year-old man, who was feeling unwell after his return from a business...

    Correct

    • A 35-year-old man, who was feeling unwell after his return from a business trip, was diagnosed with a disease that is known to be transmitted by a vector.

      Among the following microorganisms, which of the following has a mode of transmission of being vector-borne?

      Your Answer: Plasmodium falciparum

      Explanation:

      Plasmodium falciparum is a parasite that is vector-borne which is transmitted by the female Anopheles mosquito.

      Bordetella pertussis is transmitted through the respiratory tract, via respiratory droplets or direct contact with infectious secretions.

      Mycobacterium tuberculosis is transmitted via inhalation of infected respiratory droplets.

      HIV may be transmitted via sexual contact, vertical transmission from mothers to infants, and among injection drug users sharing infected needles, as well as through transfusion of infected blood products.

      Treponema pallidum transmission normally occurs during direct sexual contact with an individual who has an active primary or secondary syphilitic lesion.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      11.2
      Seconds
  • Question 3 - Which of the following is NOT a common myeloma laboratory finding: ...

    Correct

    • Which of the following is NOT a common myeloma laboratory finding:

      Your Answer: Elevated serum Bence-Jones protein

      Explanation:

      Myeloma laboratory findings include:
      – The presence of a paraprotein in serum or urine (the paraprotein is IgG in 60 percent of cases, IgA in 20 percent, and light chain only in almost all the rest),
      – Increased serum immunoglobulin-free light chain proteins generated by plasma cells but not coupled with heavy chains 
      – Reduced IgG, IgA, and IgM levels in the blood (immune paresis)
      – Anaemia, whether normochromic, normocytic, or macrocytic. 
      – On a blood film, a Rouleaux formation has been marked.
      – In advanced illness, neutropenia and thrombocytopenia are common.
      – ESR is high.
      – Plasma cells in the bone marrow are overabundant, typically in aberrant forms. – Hypercalcemia
      – Creatinine levels are high.
      – Serum albumin levels are low in advanced illness.
      60 percent of patients have osteolytic lesions, osteoporosis, or pathological fractures.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      7.6
      Seconds
  • Question 4 - The transport of oxygen from maternal to fetal circulation is made possible by...

    Incorrect

    • The transport of oxygen from maternal to fetal circulation is made possible by fetal haemoglobin. Which of the statements about fetal haemoglobin (HbF) is also correct?

      Your Answer: It is composed of two alpha and two beta subunits

      Correct Answer: The oxygen dissociation curve for foetal haemoglobin is shifted to the left of that of adult haemoglobin

      Explanation:

      Fetal haemoglobin is the most common type of haemoglobin found in the foetus during pregnancy. It transports oxygen from the maternal circulation to the fetal circulation. It can easily bind to oxygen from the maternal circulation because it has a high affinity for oxygen. From 10 to 12 weeks of pregnancy to the first six months after birth, the erythroid precursor cells produce fetal haemoglobin. In comparison to adult haemoglobin, fetal haemoglobin has two alpha and two gamma subunits, whereas adult haemoglobin has two alpha and two beta subunits in its major form.

      And, unlike adult haemoglobin, the oxygen dissociation curve of fetal haemoglobin is left-shifted. Myoglobin is an oxygen storage molecule with a very high affinity for oxygen. Only when the partial pressure of oxygen is exceeded does it release oxygen.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      23.9
      Seconds
  • Question 5 - Fatigue, dizziness upon standing, muscle weakness, weight loss, nausea, and sweating are all symptoms...

    Incorrect

    • Fatigue, dizziness upon standing, muscle weakness, weight loss, nausea, and sweating are all symptoms that a patient may experience in Addison's disease.

      Which of the following claims about Addison's disease is correct?

      Your Answer: Congenital adrenal hyperplasia is the commonest cause

      Correct Answer: ACTH levels are elevated in primary insufficiency

      Explanation:

      The adrenal glands produce too little steroid hormones, which causes Addison’s disease. The production of glucocorticoids, mineralocorticoids, and sex steroids are all altered. The most prevalent cause is autoimmune adrenalitis, which accounts for 70-80 percent of cases.

      It affects more women than males and occurs most frequently between the ages of 30 and 50.

      The following are some of the clinical signs and symptoms of Addison’s disease:

      Weakness and sluggishness
      Hypotension is a condition in which the blood pressure (notably orthostatic hypotension)
      Vomiting and nausea
      Loss of weight
      Axillary and pubic hair loss
      Depression
      Hyperpigmentation is a condition in which a person’s (palmar creases, buccal mucosa and exposed areas more commonly affected)
      The following are the classic biochemical hallmarks of Addison’s disease:
      Hyponatraemia
      Hyperkalaemia
      Hypercalcaemia
      Hypoglycaemia
      Acidosis metabolica
      When ACTH levels are combined with cortisol levels, it is possible to distinguish between primary and secondary adrenal insufficiency:
      In primary insufficiency, levels rise.
      In secondary insufficiency, levels are low or low normal.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      20.2
      Seconds
  • Question 6 - Regarding the intervertebral disc, which of the following statements is CORRECT: ...

    Correct

    • Regarding the intervertebral disc, which of the following statements is CORRECT:

      Your Answer: In L4 - L5 disc herniation, the L5 spinal nerve root is the most commonly affected.

      Explanation:

      A posterolateral herniation of the disc at the L4 – L5 level would be most likely to damage the fifth lumbar nerve root, not the fourth lumbar nerve root, due to more oblique descending of the fifth lumbar nerve root within the subarachnoid space.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      6.5
      Seconds
  • Question 7 - Which type of collagen is initially laid down in early wound healing: ...

    Correct

    • Which type of collagen is initially laid down in early wound healing:

      Your Answer: III

      Explanation:

      Fibroblasts migrate to the wound (about 2 – 5 days after wounding), proliferate and secrete extracellular matrix comprising mainly collagen (type III) and fibronectin to plug the gap.

    • This question is part of the following fields:

      • Pathology
      • Wound Healing
      9.8
      Seconds
  • Question 8 - In ventricular myocytes, the plateau phase of the action potential comes about through which...

    Incorrect

    • In ventricular myocytes, the plateau phase of the action potential comes about through which of the following:

      Your Answer: Opening of voltage-gated Na + channels

      Correct Answer: Opening of voltage-gated Ca 2+ channels

      Explanation:

      After the intial upstroke of the action potential, Na+channels and currents rapidly inactivate, but in cardiac myocytes, the initial depolarisation activates voltage-gated Ca2+channels (slow L-type channels, threshold approximately – 45 mV) through which Ca2+floods into the cell. The resulting influx of Ca2+prevents the cell from repolarising and causes a plateau phase, that is maintained for about 250 ms until the L-type channels inactivate. The cardiac AP is thus much longer than that in nerve or skeletal muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      26
      Seconds
  • Question 9 - Regarding diuretics, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding diuretics, which of the following statements is CORRECT:

      Your Answer: Loop diuretics act on the thin descending limb.

      Correct Answer: Carbonic anhydrase inhibitors have their effect by inhibiting bicarbonate reabsorption.

      Explanation:

      Carbonic anhydrase inhibitors e.g. acetazolamide block the reaction of carbon dioxide and water and so prevent Na+/H+exchange and bicarbonate reabsorption. The increased bicarbonate levels in the filtrate oppose water reabsorption. Proximal tubule sodium reabsorption is also reduced because it is partly dependent on bicarbonate reabsorption.

    • This question is part of the following fields:

      • Physiology
      • Renal
      67.6
      Seconds
  • Question 10 - The Auerbach's plexus is a set of ganglia that controls peristalsis and is...

    Correct

    • The Auerbach's plexus is a set of ganglia that controls peristalsis and is located in the gut wall.

      Auerbach's plexus is located in which layer of the gut wall?

      Your Answer: Muscular layer

      Explanation:

      The Auerbach’s plexus, also known as the myenteric plexus, is a collection of ganglia that controls peristalsis and is located in the gut wall.

      In the muscular layer of the wall, it is located between the circular and longitudinal muscle layers. It is a linear network of linked neurons that runs the length of the gastrointestinal system. The myenteric plexus generates an increase in gut wall tone and the strength of rhythmical contractions when stimulated.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      12.7
      Seconds
  • Question 11 - A 68-year-old man with multiple myeloma presents with complaints of abdominal pain and...

    Correct

    • A 68-year-old man with multiple myeloma presents with complaints of abdominal pain and malaise. A series of blood tests is done and his calcium level is 2.96 mmol/l.

      What effect will this blood test result have on gastric secretions?

      Your Answer: Stimulate the release of gastrin

      Explanation:

      Hypercalcaemia stimulates the release of gastrin from the G-cells in the pyloric antrum of the stomach, the duodenum and the pancreas.

      Gastrin is also released in response to:
      Stomach distension
      Vagal stimulation
      The presence of amino acids.

      Gastrin release is inhibited by the presence of acid and somatostatin.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      49
      Seconds
  • Question 12 - A patient presents with a rash for dermatological examination. A large area of...

    Correct

    • A patient presents with a rash for dermatological examination. A large area of purplish discolouration of the skin that measures 2 cm in diameter and does not blanch when pressure is applied is seen .

      What is the best description of this rash that you have found on examination?

      Your Answer: Ecchymoses

      Explanation:

      Ecchymosis are discolouration of the skin or mucous membranes caused by extravasation of blood. They are usually red or purple in colour and measure greater than 1 cm in diameter and do not blanch on applying pressure.

      A macule is a flat, well circumscribed area of discoloured skin less than 1 cm in diameter with no changes in the thickness or texture of the skin.

      Petechiae are discolouration of the skin measuring less than 3 mm in diameter

      Purpura are discolouration of the skin measuring between 0.3 cm and 1 cm in diameter.

      Erythema is redness of the skin or mucous membranes caused by hyperaemia of superficial capillaries caused by skin injury, infection or inflammation. Erythema blanches when pressure is applied whereas ecchymosis, purpura and petechiae do not.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      20.4
      Seconds
  • Question 13 - Which of the following virulence factors of E. coli is important for attachment...

    Incorrect

    • Which of the following virulence factors of E. coli is important for attachment to host epithelial cells in the pathogenesis of urinary tract infections:

      Your Answer: Alpha-haemolysin

      Correct Answer: Pili

      Explanation:

      Escherichia coli is the most common cause of urinary tract infection. Uropathic strains are characterised by pili with adhesion proteins that bind to specific receptors on the urinary tract epithelium. The motility of E. coli aids its ability to ascend the urethra into the bladder or ascend the ureter into the kidney.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      17.2
      Seconds
  • Question 14 - A 61-year-old woman returns to get the results of recent blood tests she...

    Incorrect

    • A 61-year-old woman returns to get the results of recent blood tests she had done for non-specific malaise, lethargy, and weight loss.

      The only abnormality discovered during the blood tests was a 580 x 10 9 /l increase in platelets. Her platelets were also elevated on a blood test taken 6 months earlier, according to her previous results. You're aware of the recent emergence of elevated platelet levels as a cancer risk marker and decide to look into it.

      Which of the following cancers is most likely to cause isolated thrombocytosis?

      Your Answer: Multiple myeloma

      Correct Answer: Colorectal cancer

      Explanation:

      Raised platelet levels have emerged as a cancer risk marker, according to a large population-based study published in 2017(link is external). According to the study, 12 percent of men and 6% of women with thrombocytosis were diagnosed with cancer within a year. These figures increased to 18% in men and 10% in women if a second platelet count was taken within 6 months of the first and showed an increased or stable elevated platelet count.

      The researchers discovered that thrombocytosis linked to cancer is most common in colorectal and lung cancers, and it is linked to a worse prognosis. Furthermore, one-third of the cancer patients in the study had no other symptoms that would have prompted an immediate cancer referral.

      The exact mechanism by which these cancers cause thrombocytosis is unknown, but one theory proposes the existence of pathogenic feedback loops between malignant cells and platelets, with a reciprocal interaction between tumour growth and metastasis, as well as thrombocytosis and platelet activation. Another hypothesis is that thrombocytosis occurs independently of cancer but aids in its spread and progression.

      The findings show that routinely testing for thrombocytosis could cut the time it takes to diagnose colorectal and lung cancer by at least two months. In the UK, this could result in around 5500 earlier cancer diagnoses per year.

      Because the positive predictive value of thrombocytosis in middle age for cancer (10%) is higher than the positive predictive value for a woman in her 50s presenting with a new breast lump (8.5%), this is clearly an important research paper that should be used to adjust future clinical practise. The current NICE guidelines predate these new research findings, so we’ll have to wait and see how they affect cancer referral guidelines in the UK.

      Because there are so many possible cancers associated with thrombocytosis, the treating clinician should take a thorough history and perform a thorough clinical examination if a patient is diagnosed with it. Further investigation and the most appropriate referral route should be aided by this information.

      It’s worth noting that the patients in the study had their blood tests done for a medical reason rather than as a random screening test.

      If there are no other symptoms to guide investigation and referral (one-third of the patients in the study had no other symptoms), keep in mind that the two most common cancers encountered were colorectal and lung cancer, so a chest X-ray and a faecal immunochemical test (FIT) for faecal blood may be reasonable initial investigations.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      36.6
      Seconds
  • Question 15 - Doxycycline is indicated first line for treatment of which of the following infections:...

    Correct

    • Doxycycline is indicated first line for treatment of which of the following infections:

      Your Answer: Chlamydia

      Explanation:

      Doxycycline may be used first line for chlamydia, pelvic inflammatory disease (with metronidazole and ceftriaxone), acute bacterial sinusitis, exacerbation of chronic bronchitis, moderate-severity community acquired pneumonia and high-severity community acquired pneumonia (with benzylpenicillin).

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      11.3
      Seconds
  • Question 16 - Which lobe of the prostate gland is most commonly affected in prostatic carcinoma?...

    Correct

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

      Your Answer: Posterior

      Explanation:

      The periurethral portion of the prostate gland increases in size during puberty and after the age of 55 years due to the growth of non-malignant cells in the transition zone of the prostate that surrounds the urethra. Most cancers develop in the posterior lobe, and cancers in this location may be palpated during a digital rectal examination (DRE).

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      17.9
      Seconds
  • Question 17 - Following a decrease in extracellular volume, which of the following is a reaction...

    Incorrect

    • Following a decrease in extracellular volume, which of the following is a reaction to enhanced sympathetic innervation of the kidney:

      Your Answer: Inhibit release of ADH

      Correct Answer: Release of renin

      Explanation:

      The RAS pathway begins with renin cleaving its substrate, angiotensinogen (AGT), to produce the inactive peptide, angiotensin I, which is then converted to angiotensin II by endothelial angiotensin-converting enzyme (ACE). ACE activation of angiotensin II occurs most extensively in the lung. Angiotensin II mediates vasoconstriction as well as aldosterone release from the adrenal gland, resulting in sodium retention and increased blood pressure.

    • This question is part of the following fields:

      • Physiology
      • Renal
      20.9
      Seconds
  • Question 18 - Common causes of exudates are infection, pericarditis, and malignancy.

    Which one statement about exudates...

    Correct

    • Common causes of exudates are infection, pericarditis, and malignancy.

      Which one statement about exudates is true?

      Your Answer: LDH levels are usually high

      Explanation:

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

      Exudates are cloudy. It has high LDH levels, serum protein ratio >0.5, protein content >2.9g/dl, specific gravity of >1.020 and a serum-ascites albumin gradient (SAAG) of <1.2g/dl.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      12.6
      Seconds
  • Question 19 - An 85-year-old woman is brought in from her nursing home. She arrives in...

    Correct

    • An 85-year-old woman is brought in from her nursing home. She arrives in the Emergency Department and appears confused. The staff member from the nursing home accompanying her informs you that she takes a water tablet.

      From her past medical history and records, you deduce that the water tablet is a loop diuretic.

      Which of the following parts of a nephron does a loop diuretic act on?

      Your Answer: Ascending loop of Henlé

      Explanation:

      Loop diuretics are drugs used to manage and treat fluid overload associated with CHF, liver cirrhosis, and renal disease. The drugs commonly used are:
      Furosemide
      Bumetanide
      Torsemide
      Ethacrynic Acid

      Loop diuretics act on the apical membrane of the thick ascending loop of Henle and inhibit the Na-K-Cl cotransporter. This blocks the reabsorption of sodium and chloride and results in salt-water excretion. This relieves congestion and reduces oedema.

      Other diuretics act on the following part of the nephron:
      1. Thiazide diuretics – Na/Cl co-transporter in the distal convoluted tubule
      2. Osmotic diuretics – PCT and the loop of Henle
      3. Aldosterone antagonists – distal convoluted tubule
      4. Carbonic anhydrase inhibitors – inhibit the carbonic anhydrase and act on proximal tubular cells

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      37.7
      Seconds
  • Question 20 - A 70-year-old patient diagnosed with Cushing's syndrome and has a history of weight...

    Correct

    • A 70-year-old patient diagnosed with Cushing's syndrome and has a history of weight gain, hypertension, and easy bruising.

      Which of these assertions about Cushing's syndrome is correct?

      Your Answer: Diagnosis can be confirmed by a dexamethasone suppression test

      Explanation:

      Cushing’s syndrome is a group of symptoms and signs brought on by long-term exposure to high amounts of endogenous or exogenous glucocorticoids.

      Iatrogenic corticosteroid injection is the most prevalent cause of Cushing’s syndrome. Cushing’s illness is the second most prevalent cause of Cushing’s syndrome. Cushing’s disease is distinct from Cushing’s syndrome in that it refers to a single cause of the illness, a pituitary adenoma that secretes high quantities of ACTH, which raises cortisol levels.

      Because cortisol enhances the vasoconstrictive impact of endogenous adrenaline, patients with Cushing’s syndrome are usually hypertensive.

      Hyperglycaemia (due to insulin resistance) rather than hypoglycaemia is a common symptom.
      Cortisol levels fluctuate throughout the day, with the greatest levels occurring around 0900 hours and the lowest occurring at 2400 hrs during sleep. The diurnal swing of cortisol levels is lost in Cushing’s syndrome, and levels are greater throughout the 24-hour period. In the morning, levels may be normal, but they may be high at night-time, when they are generally repressed.

      A dexamethasone suppression test or a 24-hour urine free cortisol collection can both be used to establish the existence of Cushing’s syndrome.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      32.5
      Seconds
  • Question 21 - Regarding the accessory nerve, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding the accessory nerve, which of the following statements is INCORRECT:

      Your Answer: The accessory nerve innervates the sternocleidomastoid and the trapezius muscle.

      Correct Answer: Accessory nerve palsy results in the inability to nod the head

      Explanation:

      Accessory nerve palsy results in inability to shrug the shoulders and to rotate the head to look at the opposite side to the lesion.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      26.1
      Seconds
  • Question 22 - A 60-year-old female is referred to the Oncology clinic due to the presence...

    Incorrect

    • A 60-year-old female is referred to the Oncology clinic due to the presence of lumps in her neck. There is a non-tender enlargement of several groups of cervical lymph nodes on examination. She is sent for a lymph node biopsy. The results show the presence of lymphoma cells, but there are no Reed-Sternberg cells.

      Which one is most appropriate for this case out of the following diagnoses?

      Your Answer: Hodgkin’s lymphoma

      Correct Answer: Non-Hodgkin’s lymphoma

      Explanation:

      Non-Hodgkin’s Lymphoma (NHL) causes neoplastic transformation of both B cell (85%) and T cell (15%) lines.

      The most common presentation is with enlarged, rubbery, painless lymph nodes. The patient may also have B symptoms which consist of night sweats, weight loss and fevers. Multiple myeloma most commonly presents with bone pain, especially in the back and ribs.

      The presence of Reed-Sternberg cells characterises Hodgkin’s lymphoma. Acute lymphoblastic leukaemia will present with features of anaemia, thrombocytopenia and leukopenia. The most common symptoms of chronic lymphocytic leukaemia are fatigue, night sweats and low-grade fever.

      The peak incidence of NHL is in the 50-70 years age group, it affects men and women equally, but affects the Caucasian population more commonly than black and Asian ethnic groups.
      The following are recognised risk factors for NHL:
      Chromosomal translocations and molecular rearrangements
      Epstein-Barr virus infection
      Human T-cell leukaemia virus type-1 (HTLV-1)
      Hepatitis C
      Congenital and acquired immunodeficiency states
      Autoimmune disorders, e.g. Sjogren’s syndrome and Hashimoto’s thyroiditis

    • This question is part of the following fields:

      • Haematology
      • Pathology
      35.8
      Seconds
  • Question 23 - Platelet alpha granules release which of the following? ...

    Incorrect

    • Platelet alpha granules release which of the following?

      Your Answer: Serotonin

      Correct Answer: Von Willebrand factor (VWF)

      Explanation:

      There are three types of storage granules contained in platelets. These are dense granules which contain the following:
      -ATP
      -ADP
      -serotonin and calcium alpha granules containing clotting factors
      -von Willebrand factor (VWF)
      -platelet-derived growth factor (PDGF)
      – other proteins lysosomes containing hydrolytic enzymes.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      436.9
      Seconds
  • Question 24 - Which of the following is NOT a typical feature of an abducens nerve...

    Incorrect

    • Which of the following is NOT a typical feature of an abducens nerve palsy:

      Your Answer: Convergent squint at rest

      Correct Answer: Inability to look up

      Explanation:

      CN VI palsies result in a convergent squint at rest (eye turned inwards) with inability to abduct the eye because of unopposed action of the rectus medialis. The patient complains of horizontal diplopia when looking towards the affected side. With complete paralysis, the eye cannot abduct past the midline.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      17.9
      Seconds
  • Question 25 - A 63-year-old man presents with severe abdominal pain and vomiting of blood. An...

    Correct

    • A 63-year-old man presents with severe abdominal pain and vomiting of blood. An endoscopy was performed and a peptic ulcer was found to have eroded into an artery nearby.

      Which of the following most likely describes the location of the ulcer?

      Your Answer: The posterior duodenum

      Explanation:

      The most common cause of upper gastrointestinal bleeding is peptic ulcer disease, particularly gastric and duodenal ulcers. Duodenal ulcers are most commonly associated with bleeding compared with gastric ulcers. Posterior duodenal ulcers are considered to be the most likely to cause severe bleeding because of its proximity to the branches of the gastroduodenal artery (GDA).

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      177.9
      Seconds
  • Question 26 - A patent has weakness of humeral flexion and extension. A CT scan reveals...

    Correct

    • A patent has weakness of humeral flexion and extension. A CT scan reveals that he has suffered damage to the nerve that innervates pectoralis major.
      Pectoralis major receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer: Lateral and medial pectoral nerves

      Explanation:

      Pectoralis major is a thick, fan-shaped muscle situated in the chest. It makes up the bulk of the chest musculature in the male and lies underneath the breast in the female. It overlies the thinner pectoralis minor muscle.
      Superficial muscles of the chest and arm showing pectoralis major (from Gray’s Anatomy)
      Pectoralis major has two heads; the clavicular head and the sternocostal head. The clavicular head originates from the anterior border and medial half of the clavicle. The sternocostal head originates from the anterior surface of the sternum, the superior six costal cartilages and the aponeurosis of the external oblique muscle. It inserts into the lateral lip of the bicipital groove of the humerus.
      Pectoralis major receives dual innervation from the medial pectoral nerve and the lateral pectoral nerve.
      Its main actions are as follows:
      Flexes humerus (clavicular head)
      Extends humerus (sternocostal head)
      Adducts and medially rotates the humerus
      Draws scapula anteriorly and inferiorly

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      207.2
      Seconds
  • Question 27 - At rest, saliva is produced predominantly by which of the following: ...

    Correct

    • At rest, saliva is produced predominantly by which of the following:

      Your Answer: Submandibular gland

      Explanation:

      At rest, most saliva is produced by the submandibular gland (65%). When stimulated by the autonomic nervous system, about 50% of saliva is produced by the parotid gland with only 30% produced by the submandibular gland.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      175.4
      Seconds
  • Question 28 - A 32-year old male patient has been diagnosed with meningococcal meningitis and was...

    Correct

    • A 32-year old male patient has been diagnosed with meningococcal meningitis and was given appropriate treatments. Because he is a family man, he fears that he might transmit the infection to the rest of his family members.

      The causative agent of meningococcal meningitis is spread via what mode of transmission?

      Your Answer: Respiratory droplet route

      Explanation:

      N. meningitidis, the causative agent of meningococcal meningitis, is considered both a commensal and a pathogen. It can be found in the surfaces of mucous membranes such as the nasopharynx and oropharynx. With this, it can be transmitted from a carrier to a new host via respiratory droplet secretions.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      15.1
      Seconds
  • Question 29 - Which of the following statements is false regarding the biceps brachii muscle? ...

    Correct

    • Which of the following statements is false regarding the biceps brachii muscle?

      Your Answer: It pronates the radioulnar joint in the forearm

      Explanation:

      The biceps brachii muscle is one of the chief muscles of the arm. The origin at the scapula and the insertion into the radius of the biceps brachii means it can act on both the shoulder joint and the elbow joint, which is why this muscle participates in a few movements of the arm. It derives its name from its two heads which merge in one unique distal body, defining the unusual structure of the muscle.

      The biceps brachii muscle is supplied by the musculocutaneous nerve (C5-C6), a branch of the brachial plexus.

      Arterial supply to the biceps brachii muscle varies considerably, coming from up to eight vessels originating from the brachial artery in the middle third of the arm.

      In the shoulder joint both muscle heads partially enforce opposite movements. The long head pulls the arm away from the trunk (abduction) and turns it inwards (inward rotation) whereas the short head pulls the arm back towards the trunk (adduction). When both heads contract simultaneously it leads to an arm bend (flexion). In the elbow joint the muscle bends the forearm (flexion) and rotates it outwards (supination). The supination is most powerful in a flexed elbow. In addition to the movement functions, the biceps has the important task to support the humeral head within the shoulder joint. Its antagonist is the triceps brachii in the posterior compartment of the arm.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      28.6
      Seconds
  • Question 30 - Coagulative necrosis is typically seen in which of the following: ...

    Incorrect

    • Coagulative necrosis is typically seen in which of the following:

      Your Answer: Ischaemic stroke

      Correct Answer: Myocardial infarction

      Explanation:

      Coagulative necrosis is the most common form of necrosis characterised by the loss of cell nuclei, but with general preservation of the underlying architecture. Dead tissue is macroscopically pale and firm. This is the classic pattern seen in myocardial infarction.Liquefactive necrosis leads to complete loss of cellular structure and conversion into a soft, semi-solid mass. This is typically seen in the brain following cerebral infarction.Caseous necrosis is most commonly seen in tuberculosis. Histologically, the complete loss of normal tissue architecture is replaced by amorphous, granular and eosinophilic tissue with a variable amount of fat and an appearance reminiscent of cottage cheese.Gangrenous necrosis is necrosis with putrefaction of tissues due to exposure to air (dry gangrene) or infection (wet gangrene).

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      5.3
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (1/2) 50%
Pharmacology (3/3) 100%
Microbiology (2/3) 67%
Principles Of Microbiology (1/1) 100%
Haematology (1/3) 33%
Pathology (4/7) 57%
Physiology (4/10) 40%
Respiratory Physiology (0/1) 0%
Endocrine Physiology (1/2) 50%
Anatomy (5/7) 71%
Head And Neck (1/1) 100%
Wound Healing (1/1) 100%
Renal (0/2) 0%
Gastrointestinal Physiology (2/2) 100%
General Pathology (2/2) 100%
Pathogens (1/2) 50%
Infections (1/1) 100%
Abdomen And Pelvis (2/2) 100%
Cardiovascular Pharmacology (1/1) 100%
Cranial Nerve Lesions (0/2) 0%
Basic Cellular (0/1) 0%
Upper Limb (2/2) 100%
Gastrointestinal (1/1) 100%
Inflammatory Responses (0/1) 0%
Passmed