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Question 1
Correct
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While studying fluid homeostasis in the body, you encounter the term exudate. Exudate is a fluid that leaks out of the intravascular space due to changes in the permeability of the microcirculation secondary to inflammation.
Which ONE of the following conditions would not be listed among the causes of an exudate?Your Answer: Myxoedema
Explanation:An exudate is an inflammatory fluid that leaks out of the intravascular space due to increased vascular permeability and intravascular pressure. It is mostly caused by local processes and can occur in the following conditions:
1) Infection (e.g. pneumonia)
2) Malignancy
3) Pericarditis
4) Collagen vascular diseases, e.g., Rheumatoid ArthritisMyxoedema is a state of severe hypothyroidism in which deposition of mucopolysaccharides occurs in the dermis. This causes a transudative effusion, typically in the pretibial region.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 2
Correct
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You examine a 78-year-old man who has been diagnosed with chronic lymphocytic leukaemia (CLL).
What is the MAIN contributory factor in this condition's immunodeficiency?Your Answer: Hypogammaglobulinemia
Explanation:Immunodeficiency is present in all patients with chronic lymphocytic leukaemia (CLL), though it is often mild and not clinically significant. Infections are the leading cause of death in 25-50 percent of CLL patients, with respiratory tract, skin, and urinary tract infections being the most common.
Hypogammaglobulinemia is the most common cause of immunodeficiency in CLL patients, accounting for about 85 percent of all cases.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 3
Correct
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A 1-year-old male is brought to the paediatrician by his mother due to swelling of the right knee after a minor fall. On examination, the right knee is swollen, fluctuant and tender. Ultrasound-guided aspiration reveals a massive hemarthrosis. Family history shows that his older brother also has a bleeding disorder.
Which one of the following conditions does the patient most likely have?Your Answer: Haemophilia A
Explanation:A diagnosis of Haemophilia is supported in this patient by the family history and the presence of hemarthrosis-both characteristics of Haemophilia. Haemophilia A is caused by Factor VIII deficiency, leading to impaired coagulation. This disease typically presents after six months when the child starts crawling.
Von Willebrand disease presents with nosebleeds and hematomas. Idiopathic thrombocytopenic purpura presents with bruises that resemble a rash.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency presents with haemolytic anaemia induced by specific drugs or foods.
Factor V Leiden mutation causes blood clotting rather than bleeding.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 4
Incorrect
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A 79-year-old male had a humeral shaft fracture during a road traffic accident and is being followed up in a fracture clinic. He complains of inability to use the limb 6 months after the injury. X-rays of that arm shows non union of his fracture.
All the following are responsible for this non-union EXCEPT?Your Answer: Movement at fracture site
Correct Answer: Osteoporosis
Explanation:An imbalance between bone resorption and formation is Osteoporosis. In normal bone, formation and resorption are roughly equal, and the density of bone matrix remains constant but there is more resorption in osteoporosis and the matrix density reduces and bones become weaker. Fractures are more likely to occur but healing is unaffected.
Non-union of a fracture occurs when the two sides of a fracture fail to unite after 6 months. Causes include: infection, movement at the fracture site, avascular necrosis, tissue interposed between the fracture and gross misalignment.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 5
Correct
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Which of the following is NOT a typical clinical feature of sickle cell disease:
Your Answer: Neutropaenia
Explanation:Features of sickle cell disease include:
Anaemia (symptoms are usually mild because the O2 dissociation curve of Hb S is shifted to the right)
Vaso-occlusive crisis
Visceral sequestration crisis
Aplastic crisisIncreased susceptibility to infection
Other clinical features: Pigment gallstones with cholecystitis
Chronic leg ulcers
Avascular necrosis of the femoral and humeral heads or other bones
Cardiomyopathy
Pulmonary hypertension
Proliferative retinopathy
Priapism
Renal papillary necrosis
Stroke -
This question is part of the following fields:
- Haematology
- Pathology
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Question 6
Correct
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In which of the following would you NOT typically see a neutropaenia:
Your Answer: Asplenism
Explanation:Causes of neutropaenia:
Drug-induced (e.g. chemotherapy, chloramphenicol, co-trimoxazole, phenytoin, carbamazepine, carbimazole, furosemide, chloroquine, clozapine, some DMARDs)
Benign (racial or familial)
Cyclical
Immune (e.g. SLE, Felty’s syndrome, hypersensitivity and anaphylaxis)
Leukaemia
Infections (e.g. HIV, hepatitis, fulminant bacterial infection)
General Pancytopaenia
Hypersplenism, aplastic anaemia, malignant infiltration of bone marrow, megaloblastic anaemia, chemotherapy, myelodysplasia -
This question is part of the following fields:
- Immune Responses
- Pathology
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Question 7
Correct
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Which of the following best describes a natural killer cell:
Your Answer: A large granular lymphocyte that kills by inducing target cell apoptosis.
Explanation:Natural killer (NK) cells are cytotoxic CD8 positive cells that lack the T-cell receptor. They are large cells with cytoplasmic granules. NK cells are designed to kill target cells that have a low level of expression of HLA class I molecules, such as may occur during viral infection or on a malignant cell. NK cells do this by displaying several receptors for HLA molecules on their surface. When HLA is expressed on the target cell these deliver an inhibitory signal into the NK cell. When HLA molecules are absent on the target cell this inhibitory signal is lost and the NK cell can then kill its target. In addition, NK cells display antibody-dependent cell-mediated cytotoxicity. In this, antibody binds to antigen on the surface of the target cell and then NK cells bind to the Fc portion of the bound antibody and kill the target cell.
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This question is part of the following fields:
- Immune Responses
- Pathology
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Question 8
Incorrect
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The blood test reports of a 56-year-old female are sent for your review. She seems acutely sick and has had multiple infections over the past few months. Her complete blood count report shows neutropenia.
Which one of the following options is true with regards to neutropenia?Your Answer: It is defined as a total neutrophil count of < 0.5 x 10 9 /l
Correct Answer: It can be caused by both radiotherapy and chemotherapy
Explanation:A total neutrophil count of less than 2 x 109/L is defined as neutropenia. It can be caused by the following:
1. viral infections
2. SLE
3. RA
4. hypersplenism
5. chemo- and radiotherapy
6. vitamin B12 and folate deficiency
7. drug reactions -
This question is part of the following fields:
- Haematology
- Pathology
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Question 9
Correct
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One of the following statements about acute lymphoblastic leukaemia(ALL) is true.
Your Answer: It is classified using the FAB classification
Explanation:ALL affects children predominantly.
The CNS is commonly involved in ALL.
The Philadelphia chromosome is present in 25% of adult ALL and 5% of childhood ALL cases.
The cure rate in children is approximately 80% in children and 50% in adults.
ALL is classified into 3 groups using the French-American-British (FAB) classification:
ALL-L1: small uniform cells
ALL-L2: large varied cells
ALL-L3: large varied cells with vacuoles. -
This question is part of the following fields:
- Haematology
- Pathology
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Question 10
Incorrect
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One of the benefits of wound healing through first intention is:
Your Answer: Decreased risk of anaerobic infection
Correct Answer: Minimisation of scar tissue formation
Explanation:Primary wound healing, or healing by first intention, occurs within hours of repairing a full-thickness surgical incision. This surgical insult results in the mortality of a minimal number of cellular constituents. Healing by first intention can occur when the wound edges are opposed, the wound is clean and uninfected and there is minimal loss of cells and tissue i.e. surgical incision wound. The wound margins are joined by fibrin deposition, which is subsequently replaced by collagen and covered by epidermal growth.
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This question is part of the following fields:
- Pathology
- Wound Healing
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SESSION STATS - PERFORMANCE PER SPECIALTY
