00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
Retry this test Dashboard

  • Question 1 - Where is factor VIII predominantly synthesised? ...

    Incorrect

    • Where is factor VIII predominantly synthesised?

      Your Answer: Bone marrow

      Correct Answer: Vascular endothelium

      Explanation:

      Factor VIII is an important part of the coagulation cascade. Deficiency causes haemophilia A. It is synthesised predominantly by the vascular endothelium and is not affected by liver disease. In the circulation it is bound to von Willebrand factor and it forms a stable complex with it. It is activated by thrombin or factor Xa and acts as a co factor to factor IXa to activate factor X which is a co factor to factor Va. Thrombin cleaves fibrinogen in fibrin and forms a meshwork to trap RBC and platelets to form a clot.

    • This question is part of the following fields:

      • General
      • Physiology
      13.8
      Seconds

  • Question 2 - An 80 year-old lady presents to the out patient clinic complaining of chest...

    Incorrect

    • An 80 year-old lady presents to the out patient clinic complaining of chest pain of 2 months' duration with a normal electrocardiogram and cardiac enzymes. A computed tomographic scan is done which reveals a mass lesion involving a structure in the middle mediastinum. Which among the following structures could be involved?

      Your Answer:

      Correct Answer: Ascending aorta

      Explanation:

      The middle mediastinum is the broadest part of the mediastinal cavity containing the heart enclosed in the pericardium, ascending aorta, lower half of the superior vena cava with the azygos vein opening into it, the bifurcation of the trachea and the two bronchi, the pulmonary artery with its branches, pulmonary veins, phrenic nerves and bronchial lymph nodes. The most likely structure involved is the ascending aorta, perhaps with an aneurysm.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 3 - After having donated a unit of blood. The blood bank will prefer to...

    Incorrect

    • After having donated a unit of blood. The blood bank will prefer to use which of the following anticoagulants to store the blood?

      Your Answer:

      Correct Answer: Citrate

      Explanation:

      Calcium is necessary for coagulation to occur. Citrate being a chelator and combining with calcium ions to form un-ionised compound will prevent coagulation. Following transfusion the citrate is removed by the liver with in a few minutes. Oxalate also works on the same principle but it is toxic to the body.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 4 - Which of these substances is secreted by pericytes in the juxtaglomerular cells? ...

    Incorrect

    • Which of these substances is secreted by pericytes in the juxtaglomerular cells?

      Your Answer:

      Correct Answer: Renin

      Explanation:

      The juxtaglomerular cells synthesise, store and secrete the enzyme renin in the kidney. They are specialised smooth muscle cells in the wall of the afferent arteriole that delivers blood to the glomerulus and thus play a critical role in the renin– angiotensin system and so in renal autoregulation.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 5 - A 45-year old with sarcoidosis has enlarged tracheobronchial lymph nodes. Which nerve is...

    Incorrect

    • A 45-year old with sarcoidosis has enlarged tracheobronchial lymph nodes. Which nerve is most likely to be irritated in this patient?

      Your Answer:

      Correct Answer: Left recurrent laryngeal

      Explanation:

      Tracheobronchial lymph nodes are located at the bifurcation of the trachea and are in three groups i.e. the right superior, left superior and inferior. The aorta arches over the left bronchus near the point of tracheal bifurcation. Thus, the nerves that are closely associated with the aorta might be irritated if these nodes become inflamed. The left recurrent laryngeal nerve is such a nerve. The phrenic nerves, both the left and the right, are lateral and thus would not be affected. The right recurrent nerve loops around the right subclavian artery and is distant from this area. The right vagus artery is not associated with the aorta and the sympathetic chain is located in the posterior chest parallel to the vertebra, also not associated with the tracheobronchial tree.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 6 - Which nuclei of the posterior grey column of the spinal cord are likely...

    Incorrect

    • Which nuclei of the posterior grey column of the spinal cord are likely affected in a patient who has lost the sensation of pain and temperature?

      Your Answer:

      Correct Answer: Substantia gelatinosa

      Explanation:

      Substantia gelatinosa is one of the nuclei in the posterior grey column along side other posterior grey column nuclei like the nucleus dorsalis, nucleus proprius, and posteromarginal nucleus. These nuclei are a collection of cells in the posterior grey area found in throughout the spinal cord. The substantia gelatinosa receives direct input from the dorsal nerve roots (sensory), especially from thermoreceptors and nociceptors (receptors for temperature and pain).

    • This question is part of the following fields:

      • Anatomy
      • Neurology
      0
      Seconds

  • Question 7 - A 26-year-old female patient had the following blood report: RBC count =...

    Incorrect

    • A 26-year-old female patient had the following blood report: RBC count = 4. 0 × 106/μl, haematocrit = 27% and haemoglobin = 11 g/dl, mean corpuscular volume (MCV) = 90 fl, mean corpuscular haemoglobin concentration (MCHC) = 41 g/dl. Further examination of blood sample revealed increased osmotic fragility of the erythrocytes. Which of the following is the most likely cause of this patient’s findings?

      Your Answer:

      Correct Answer: Spherocytosis

      Explanation:

      Spherocytes are small rounded RBCs. It is due to an inherited defect of the RBC cytoskeleton membrane tethering proteins. Membrane blebs form that are lost over time and cells become round instead of biconcave. As it is a normochromic anaemia, the MCV is normal. it is diagnosed by osmotic fragility test which reveals increased fragility in a hypotonic solution.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 8 - Which lymph nodes are likely to be enlarged in a patient who has...

    Incorrect

    • Which lymph nodes are likely to be enlarged in a patient who has malignant growth involving the anus?

      Your Answer:

      Correct Answer: Superficial inguinal

      Explanation:

      The lymphatics from the anus, skin of the perineum and the scrotum end in the superficial inguinal nodes. In case of a malignant growth of the anus, the superficial inguinal lymph nodes would most likely be enlarge.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      0
      Seconds

  • Question 9 - Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of...

    Incorrect

    • Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of the popliteal fossa?

      Your Answer:

      Correct Answer: Biceps femoris

      Explanation:

      The popliteal fossa is located at the back of the knee. It is bounded laterally by the biceps femoris above and the plantaris and lateral head of the gastrocnemius below and medially by the semitendinosus and semimembranosus above and by the medial head of the gastrocnemius below.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 10 - A 38-year old woman presents to the clinic with a 2 cm eczema-like...

    Incorrect

    • A 38-year old woman presents to the clinic with a 2 cm eczema-like lesion on the areolar region of her left breast, for 5 months. Biopsy of the lesion showed large cells at the dermal-epidermal junction with positive staining for mucin. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Paget’s disease of the breast

      Explanation:

      Paget’s disease of the breast or nipple resembles eczema in appearance with an underlying carcinoma typically. The disease is usually unilateral and presents with inflammation, oozing and crusting along with a non-healing ulcer. Treatment is often delayed due to the innocuous appearance but can be fatal. It results due to spread of neoplastic cells from the ducts of the mammary gland to the epithelium.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      0
      Seconds

  • Question 11 - Under normal conditions, what is the major source of energy of cardiac muscles?...

    Incorrect

    • Under normal conditions, what is the major source of energy of cardiac muscles?

      Your Answer:

      Correct Answer: Fatty acids

      Explanation:

      Under basal conditions, most of the energy needed by cardiac muscle for metabolism is derived from fats (60%), 35% by carbohydrates, and 5% by ketones and amino acids. However, after intake of large amounts of glucose, lactate and pyruvate are mainly used. During prolonged starvation, fat acts as the primary source. 50% of the used lipids are sourced from circulating fatty acids.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 12 - During an operation for a sigmoid colectomy the surgeon ligates the sigmoid arteries....

    Incorrect

    • During an operation for a sigmoid colectomy the surgeon ligates the sigmoid arteries. From which artery do the sigmoid arteries branch?

      Your Answer:

      Correct Answer: Inferior mesenteric artery

      Explanation:

      Sigmoid arteries are branches of the inferior mesenteric artery (IMA). Sigmoid artery gives off branches that supply the lower descending colon, the iliac colon and the sigmoid colon.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 13 - The most likely cause of prominent U waves on the electrocardiogram (ECG) of...

    Incorrect

    • The most likely cause of prominent U waves on the electrocardiogram (ECG) of a patient is:

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 14 - The occipital artery is accompanied by which nerve as it arises from the...

    Incorrect

    • The occipital artery is accompanied by which nerve as it arises from the external carotid artery?

      Your Answer:

      Correct Answer: Hypoglossal nerve (CN XII)

      Explanation:

      Three main types of variations in the relations of the occipital artery and the hypoglossal nerve are found according to the level at which the nerve crosses the external carotid artery and the point of origin of the occipital artery. In Type I, the hypoglossal nerve crosses the external carotid artery inferior to the origin of the occipital artery; in Type II, the nerve crosses the external carotid artery at the level of origin of the occipital artery; and in Type III, it crosses superior to that level. In Type III the occipital artery makes a loop around the hypoglossal nerve and is in a position to pull and exert pressure on the nerve. This possibility should be taken into consideration in the diagnosis of peripheral paresis or paralysis of the tongue and during surgery in this area.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 15 - The operating surgeon notices a structure lying alongside a herniated mass whilst repairing...

    Incorrect

    • The operating surgeon notices a structure lying alongside a herniated mass whilst repairing an indirect inguinal hernia in a female patient. Which structure could this be?

      Your Answer:

      Correct Answer: Round ligament of the uterus

      Explanation:

      The main structure traversing the inguinal canal in women is the round ligament. In men, it is the spermatic cord.

      The iliohypogastric nerve innervates the abdominal wall and runs between the transversus abdominis and internal oblique muscles before piercing the internal oblique at the anterior superior iliac spine to run between the internal and external obliques.

      The inferior epigastric artery is between the peritoneum and the transversus abdominis creating the lateral umbilical fold.

      The ovarian artery and the ovarian vein are branches from the descending aorta and inferior vena cava that supply the ovary in the pelvic cavity.

      The pectineal ligament is a thick fascial layer over the pectineal line of the pubis. It doesn’t traverse the canal.

      The broad ligament if found on the lateral sides of the uterus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 16 - The transmembrane proteins responsible for resting membrane potential of vascular smooth muscle cells...

    Incorrect

    • The transmembrane proteins responsible for resting membrane potential of vascular smooth muscle cells was blocked by a drug. Which of the following transmembrane proteins were blocked by this drug?

      Your Answer:

      Correct Answer: K+ channels

      Explanation:

      The resting membrane potential is due to selective permeability of the membrane to potassium ions. The Na/K pump is responsible for the generation of a gradient across the membrane and it is due to the inherent ability of the K channels to allow diffusion back into the nerve at rest which charges the cells. In reality, the resting membrane potential is more positive because of small contributions by Na+ channels, Cl− channels and non-selective cation channels.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 17 - A 49-year-old man, smoker, complains of a persisting and worsening cough over the...

    Incorrect

    • A 49-year-old man, smoker, complains of a persisting and worsening cough over the past few months. He also has noted blood in his sputum. The patient has no other major health conditions. Which of the following investigative procedures should be done first?

      Your Answer:

      Correct Answer: Sputum cytology

      Explanation:

      Sputum cytology is a diagnostic test used for the examination of sputum under a microscope to determine if abnormal cells are present. It may be used as the first diagnostic procedure to help detect a suspected lung cancer or certain non-cancerous lung conditions.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      0
      Seconds

  • Question 18 - Fine-needle aspiration is a type of biopsy procedure. When performing a fine-needle aspiration...

    Incorrect

    • Fine-needle aspiration is a type of biopsy procedure. When performing a fine-needle aspiration of the lungs, which is the most common complication of the procedure?

      Your Answer:

      Correct Answer: Pneumothorax

      Explanation:

      Pneumothorax is the most common complication of a fine-needle aspiration procedure. Various factors, such as lesion size, have been associated with increased risk of pneumothorax .

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      0
      Seconds

  • Question 19 - Which one of the following is a derivative of the midgut? ...

    Incorrect

    • Which one of the following is a derivative of the midgut?

      Your Answer:

      Correct Answer: Caecum

      Explanation:

      The primary intestinal loop is formed from the midgut which gives rise to the distal half of the duodenum, the jejunum, ascending colon, proximal two thirds of the transverse colon and the ileum.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      0
      Seconds

  • Question 20 - A child defecates a few minutes after being fed by the mother. This...

    Incorrect

    • A child defecates a few minutes after being fed by the mother. This is most likely due to:

      Your Answer:

      Correct Answer: Gastrocolic reflex

      Explanation:

      The gastrocolic reflex is a physiological reflex that involves increase in colonic motility in response to stretch in the stomach and by-products of digestion in the small intestine. It is shown to be uneven in its distribution throughout the colon, with the sigmoid colon affected more than the right side of the colon in terms of a phasic response. Various neuropeptides have been proposed as mediators of this reflex, such as serotonin, neurotensin, cholecystokinin and gastrin.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds

  • Question 21 - A lad involved in a road traffic accident is rushed to casualty where...

    Incorrect

    • A lad involved in a road traffic accident is rushed to casualty where physical examination reveals that he has limited extension of his right humerus. Which of the following nerves is most likely to have been injured?

      Your Answer:

      Correct Answer: Thoracodorsal nerve

      Explanation:

      Extension of the humerus is a function of the latissimus dorsi. This muscle is supplied by the thoracodorsal nerve which is a branch of the posterior cord of the plexus whose fibres are derived from cranial nerves V, VI and VII.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 22 - Which muscle in the neck divides the neck into two large triangles? ...

    Incorrect

    • Which muscle in the neck divides the neck into two large triangles?

      Your Answer:

      Correct Answer: Sternocleidomastoid

      Explanation:

      The sternocleidomastoid muscle is an important landmark in the neck as it divides the neck into two; anterior and posterior triangles. These triangles help in the location of the structures of the neck including the carotid artery, head and neck lymph nodes, accessory nerve and the brachial plexus. It originates from the manubrium and medial portion of the clavicle and inserts on the mastoid process of the temporal bone, superior nuchal line. The sternocleidomastoid receives blood supply from the occipital artery and the superior thyroid artery. It is innervated by the accessory nerve (motor) and cervical plexus (sensory).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      0
      Seconds

  • Question 23 - A 55-year old lady underwent a major surgery for repair of an aortic...

    Incorrect

    • A 55-year old lady underwent a major surgery for repair of an aortic aneurysm. Her blood pressure was low throughout the intra-operative and the post-operative period, along with increasing serum creatinine and urea. Microscopic examination of her urine showed multiple granular and hyaline casts. What is the likely condition the patient is suffering from?

      Your Answer:

      Correct Answer: Acute tubular necrosis

      Explanation:

      The most common predisposing factor leading to acute tubular necrosis is ischemia, typically seen in hospitalized patients with low blood pressure.

    • This question is part of the following fields:

      • Pathology
      • Renal
      0
      Seconds

  • Question 24 - A 4-year-old child was brought to a paediatrician for consult due to a...

    Incorrect

    • A 4-year-old child was brought to a paediatrician for consult due to a palpable mass in his abdomen. The child has poor appetite and regularly complains of abdominal pain. The child was worked up and diagnosed with a tumour. What is the most likely diagnosis ?

      Your Answer:

      Correct Answer: Nephroblastoma

      Explanation:

      Nephroblastoma is also known as Wilms’ tumour. It is a cancer of the kidneys that typically occurs in children. The median age of diagnose is approximately 3.5 years. With the current treatment, approximately 80-90% of children with Wilms’ tumour survive.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds

  • Question 25 - A 20-year-old woman had profuse watery diarrhoea for 2 days. She felt dizzy...

    Incorrect

    • A 20-year-old woman had profuse watery diarrhoea for 2 days. She felt dizzy and weak, and thus decided to seek medical attention. At the emergency room her BP was 80/60 mmHg with a pulse of 118/min. What is the most appropriate intravenous treatment that should be given?

      Your Answer:

      Correct Answer: Isotonic saline

      Explanation:

      Normal saline is typically the first fluid used when hypovolemia is severe enough to threaten the adequacy of blood circulation. It is isotonic and has long been believed to be the safest fluid to give quickly in large volumes.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      0
      Seconds

  • Question 26 - A middle aged man presented in OPD with a low grade fever and...

    Incorrect

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

      Your Answer:

      Correct Answer: Monocytes

      Explanation:

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

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      0
      Seconds

  • Question 27 - Prostatectomy carries a risk of loss of penile erection due to injury to...

    Incorrect

    • Prostatectomy carries a risk of loss of penile erection due to injury to the prostatic plexus responsible for an erection. From which nerves do these fibres originate?

      Your Answer:

      Correct Answer: Pelvic splanchnics

      Explanation:

      Erection is a function of the parasympathetic nerves. Of the nerves listed, only the pelvic splanchnic nerves have parasympathetic fibres that innervate the smooth muscles and glands of the pelvic viscera.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      0
      Seconds

  • Question 28 - A 25-year-old football player suffers severe head trauma during a game. Physical examination...

    Incorrect

    • A 25-year-old football player suffers severe head trauma during a game. Physical examination reveals a decerebrate posture and bilateral papilledema. A CT scan reveals marked diffuse cerebral oedema. This condition will be most severe in which component of the brain?

      Your Answer:

      Correct Answer: White matter

      Explanation:

      The greatest amount of salt and water increase with cerebral oedema occurs within the white matter. Any swelling from oedema, haemorrhage or haematoma increases the intracranial pressure (ICP). As the ICP increases, the cerebral perfusion decreases and brain tissue can become ischaemic, even leading to brain death.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      0
      Seconds

  • Question 29 - Which of the following conditions of the breast is most often associated with...

    Incorrect

    • Which of the following conditions of the breast is most often associated with use of oral contraceptives?

      Your Answer:

      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.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      0
      Seconds

  • Question 30 - Calculate the stroke volume in an adult male with the following parameters:

    Heart...

    Incorrect

    • Calculate the stroke volume in an adult male with the following parameters:

      Heart rate 70 beats/min

      Arterial [O2] 0.24 ml O2/min

      Venous [O2] 0.16 ml O2/mi

      Whole body O2 consumption 500 ml/min

      Pulmonary diastolic pressure 15 mmHg

      Pulmonary systolic pressure 25 mmHg

      Wedge pressure 5 mmHg.

      Your Answer:

      Correct Answer: 90 ml

      Explanation:

      Fick’s principle states that, VO2 = (CO × CAO2) – (CO × CVO2) where VO2 = oxygen consumption, CO = cardiac output, CAO2 = oxygen concentration of arterial blood and CVO2 = oxygen concentration of venous blood. Thus, CO = VO2/CAO2– CVO2, CO = 500/0.24–0.16, CO = 500/0.8, CO = 6.25 l/min. Cardiac output is also given by product of stroke volume and heart rate. Thus, stroke volume = cardiac output / heart rate = 6.25/70 × 1000 stroke volume = 90 ml approximately.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

General (0/1) 0%
Physiology (0/1) 0%
Passmed
Retry this test Dashboard