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Question 1
Correct
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In the emergency room, a 28-year-old woman complains of wobbly and slurred speech, is unable to do the heel-shin test, and has nystagmus. The following signs are most likely related to damage to which of the following areas:
Your Answer: Cerebellum
Explanation:Cerebellar injury causes delayed and disorganized motions. When walking, people with cerebellar abnormalities sway and stagger.
Damage to the cerebellum can cause asynergia, the inability to judge distance and when to stop, dysmetria, the inability to perform rapid alternating movements or adiadochokinesia, movement tremors, staggering, wide-based walking or ataxic gait, a proclivity to fall, weak muscles or hypotonia, slurred speech or ataxic dysarthria, and abnormal eye movements or nystagmus.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 2
Incorrect
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A patient diagnosed with cranial nerve palsy exhibits asymmetrical movement of the palate, nasal regurgitation of food, and nasal quality to the voice.
Which of the following cranial nerves is most likely responsible for the aforementioned features?Your Answer: Accessory nerve
Correct Answer: Vagus nerve
Explanation:The vagus nerve, ‘the wanderer’, contains motor fibres (to the palate and vocal cords), sensory components (posterior and floor of external acoustic meatus) and visceral afferent and efferent fibres.
Palatal weakness can cause nasal speech and nasal regurgitation of food. The palate moves asymmetrically when the patient says ‘ahh’. Recurrent nerve palsy results in hoarseness, loss of volume and ‘bovine cough’.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 3
Incorrect
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Regarding hepatitis C, which of the following statements is INCORRECT:
Your Answer: Primary infection is often asymptomatic.
Correct Answer: Anti-HCV IgG antibodies are diagnostic of acute infection.
Explanation:Anti-HCV IgG antibodies indicate exposure to hepatitis C but this could be acute, chronic or resolved infection. If the antibody test is positive, HCV RNA should be tested for, which if positive indicates that a person has current infection with active hepatitis C.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 4
Incorrect
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Which of the following would you NOT expect from a deep fibular nerve palsy:
Your Answer:
Correct Answer: Loss of sensation over heel
Explanation:Damage to the deep fibular nerve results in loss of dorsiflexion of the ankle, with resultant foot drop with high-stepping gait, loss of toe extension, weakness of foot inversion and loss of sensation over the webspace between the 1st and 2nd toes.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 5
Incorrect
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Question 6
Incorrect
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If the afferent arteriole's diameter is smaller than the efferent arteriole's diameter in the glomerulus:
Your Answer:
Correct Answer: The net filtration pressure will decrease
Explanation:The relative resistance of the afferent and efferent arterioles substantially influences glomerular capillary hydrostatic pressure and consequently GFR. Filtration is forced through the filtration barrier due to high pressure in the glomerular capillaries. Afferent arteriolar constriction lowers this pressure while efferent arteriolar constriction raises it.
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This question is part of the following fields:
- Physiology
- Renal
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Question 7
Incorrect
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Regarding acute lymphoblastic leukaemia (ALL), which of the following statements is CORRECT:
Your Answer:
Correct Answer: ALL is the most common malignancy of childhood.
Explanation:Acute lymphoblastic leukaemia (ALL) is caused by an accumulation of lymphoblasts in the bone marrow and is the most common malignancy of childhood. The incidence of ALL is highest at 3 – 7 years, with 75% of cases occurring before the age of 6. 85% of cases are of B-cell lineage. Haematological investigations reveal a normochromic normocytic anaemia with thrombocytopenia in most cases. The total white cell count may be decreased, normal or increased. The blood film typically shows a variable number of blast cells. The bone marrow is hypercellular with >20% blast cells.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 8
Incorrect
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Regarding apoptosis, which of the following statements is INCORRECT:
Your Answer:
Correct Answer: Apoptosis leads to cell swelling and eventual cell lysis.
Explanation:Apoptosis is a controlled form of cell death in which no cellular contents are released from the dying cell, and thus no inflammatory reaction is seen. Apoptosis may occur physiologically or pathologically. Apoptosis may be induced in two main ways: by the engagement of surface death receptors e.g. TNF-alpha (extrinsic pathway) or through cellular injury (intrinsic pathway). The end result is the activation of proteases enzymes called caspases which dismantle the cell cytoplasm and nucleus. Apoptotic cells shrink down and fragment into apoptotic bodies, each of which retains an intact cell membrane; apoptotic bodies are then targeted or rapid removal by adjacent cells. Disordered apoptosis is thought to be central to a number of important disease processes, particularly carcinogenesis.
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This question is part of the following fields:
- Inflammatory Responses
- Pathology
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Question 9
Incorrect
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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:
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
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Question 10
Incorrect
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A 27-year-old man has been diagnosed with testicular cancer and has spread to the regional lymph nodes.
The lymph from the testes will drain to which of the following nodes?Your Answer:
Correct Answer: Para-aortic lymph nodes
Explanation:Testes are retroperitoneal organs and its lymphatic drainage is to the lumbar and para-aortic nodes along the lumbar vertebrae.
The scrotum is the one which drains into the nearby superficial inguinal nodes.
The glans penis and clitoris drains into the deep inguinal lymph nodes.
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This question is part of the following fields:
- Abdomen And Pelvis
- Anatomy
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