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  • Question 1 - Risk factors for hepatocellular carcinoma do NOT include: ...

    Correct

    • Risk factors for hepatocellular carcinoma do NOT include:

      Your Answer: Heptitis E

      Explanation:

      Risk factors for hepatocellular carcinoma include hepatitis B and C, aflatoxin, anabolic steroids, alcohol cirrhosis and primary liver disease.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      15.2
      Seconds

  • Question 2 - Due to a plantarflexion–inversion ankle sprain, which is the first ligament to rupture?...

    Incorrect

    • Due to a plantarflexion–inversion ankle sprain, which is the first ligament to rupture?

      Your Answer: Posterior talofibular ligament

      Correct Answer: Anterior talofibular ligament

      Explanation:

      The anterior talofibular ligament passes from the anterior margin of the fibular malleolus. It is the most commonly injured ligament, as part of the lateral ligament of the ankle.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      14.5
      Seconds

  • Question 3 - Which of the following morphological features is most characteristic of hyaline degeneration? ...

    Correct

    • 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.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      13.2
      Seconds

  • Question 4 - A 34-year-old woman has been suffering from headaches, fever, vomiting, and confusion for...

    Correct

    • A 34-year-old woman has been suffering from headaches, fever, vomiting, and confusion for the last 5 days. A CT scan reveals an oedematous mass with ring enhancement in the left temporal region. It is biopsied, revealing glial cells, necrosis, neutrophils and lymphocytes. What is the most likely diagnosis?

      Your Answer: Cerebral abscess

      Explanation:

      A cerebral abscess can result from direct extension of cranial infections, penetrating head trauma, haematogenous spread, or for unknown causes. An abscess forms when an area of cerebral inflammation becomes necrotic and encapsulated by glial cells and fibroblasts. Oedema around the abscess can increase the intracranial pressure. Symptoms result from increased intracranial pressure and mass effects. It is most frequent in the third decade of life, and when it occurs in children, it is usually associated with congenital heart disease.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      9.2
      Seconds

  • Question 5 - Osteomyelitis is most commonly caused by which microbe in adults? ...

    Incorrect

    • Osteomyelitis is most commonly caused by which microbe in adults?

      Your Answer: Streptococcus viridans

      Correct Answer: Staphylococcus aureus

      Explanation:

      Osteomyelitis is most commonly caused by S. aureus in all age groups.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      10.7
      Seconds

  • Question 6 - Which of the following chemotherapy regimens is most likely to be used in...

    Incorrect

    • Which of the following chemotherapy regimens is most likely to be used in colorectal cancer?

      Your Answer: ADOC

      Correct Answer: FOLFOX

      Explanation:

      Chemotherapy regimens are often identified by acronyms, identifying the agents used in the drug combination. However, the letters used are not consistent across regimens. FOLFOX is a chemotherapy regimen used for the treatment of colorectal cancer, made up of the following drugs: • FOL: fluorouracil (5-fluorouracil or 5-FU) • F: folinic acid (leucovorin) • OX: oxaliplatin (Eloxatin®).

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      9.8
      Seconds

  • Question 7 - The muscles of the superficial posterior compartment of the leg insert into the:...

    Correct

    • The muscles of the superficial posterior compartment of the leg insert into the:

      Your Answer: Calcaneus

      Explanation:

      The muscles of the superficial posterior compartment of the leg form the characteristic ‘calf’ shape of the posterior leg and include the gastrocnemius, soleus and plantaris. The gastrocnemius and soleus together form a muscular mass which is occasionally described as the triceps surae; its tendon of insertion is the tendo calcaneus. The tendo calcaneus is the thickest and strongest in the body and together with the tendon of the plantaris muscle is inserted into the posterior part of the calcaneus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      9
      Seconds

  • Question 8 - Vincristine is a chemotherapy agent used to treat a number of types of...

    Incorrect

    • Vincristine is a chemotherapy agent used to treat a number of types of cancer. Which of the following is a recognised major side-effect of vincristine?

      Your Answer: Myelosuppression

      Correct Answer: Peripheral neuropathy

      Explanation:

      Vincristine is an alkaloid chemotherapeutic agent. It is used to treat a number of types of cancer including acute lymphocytic leukaemia, acute myeloid leukaemia, Hodgkin’s disease, neuroblastoma, and small cell lung cancer among others. The main side-effects of vincristine are peripheral neuropathy and constipation.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      14.2
      Seconds

  • Question 9 - In the kidney, the macula densa is an area of closely packed specialized cells lining the wall of...

    Incorrect

    • In the kidney, the macula densa is an area of closely packed specialized cells lining the wall of the:

      Your Answer: Juxtaglomerular cells

      Correct Answer: Distal convoluted tubule

      Explanation:

      In the kidney, the macula densa is an area of closely packed specialised cells lining the region of the distal convoluted tubule (DCT) lying next to the glomerular vascular pole. The cells of the macula densa are sensitive to the ionic content and water volume of the fluid in the DCT, producing signals that promote renin secretion by other cells of the juxtaglomerular apparatus.

    • This question is part of the following fields:

      • Physiology
      • Renal
      13.9
      Seconds

  • Question 10 - The normal location of the major duodenal papilla: ...

    Incorrect

    • The normal location of the major duodenal papilla:

      Your Answer: Ascending part of the duodenum

      Correct Answer: Descending part of the duodenum

      Explanation:

      The major duodenal papilla is on the descending portion of the duodenum on the medial side, about 7-10cm from the pylorus. The pancreatic ducts and the common bile ducts unite and open by a common orifice on the summit of the duodenal papilla.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      20.7
      Seconds

  • Question 11 - A medical student is asked to calculate the net pressure difference in a...

    Correct

    • A medical student is asked to calculate the net pressure difference in a capillary wall, considering: Interstitial fluid hydrostatic pressure = –3 mmHg, Plasma colloid osmotic pressure = 28 mmHg, Capillary hydrostatic pressure = 17 mmHg, Interstitial fluid colloid osmotic pressure = 8 mmHg, and Filtration coefficient = 1. Which is the correct answer?

      Your Answer: 0 mmHg

      Explanation:

      The rate of filtration at any point along a capillary depends on a balance of forces sometimes called Starling’s forces after the physiologist who first described their operation in detail. The Starling principle of fluid exchange is key to understanding how plasma fluid (solvent) within the bloodstream (intravascular fluid) moves to the space outside the bloodstream (extravascular space). Fluid movement = k[(pc– pi)–(Πc– Πi)] where k = capillary filtration coefficient, pc = capillary hydrostatic pressure, pi= interstitial hydrostatic pressure, Πc = capillary colloid osmotic pressure, Πi = interstitial colloid osmotic pressure. Therefore: 1 × [capillary hydrostatic pressure (17) – interstitial fluid hydrostatic pressure (–3)] – [plasma colloid osmotic pressure (28) – interstitial fluid colloid osmotic pressure (8)] = 0 mmHg

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      6.3
      Seconds

  • Question 12 - From which fascia of the pelvic wall muscle does the levator ani muscle...

    Correct

    • From which fascia of the pelvic wall muscle does the levator ani muscle arise?

      Your Answer: Obturator internus

      Explanation:

      The levator ani muscle arises from the posterior surface of the superior ramus of the pubis lateral to the symphysis, behind the inner surface of the spine of the ischium and between these points from the obturator internus fascia. It is attached to the inner surface of the side of the lesser pelvic cavity, supports the viscera in the cavity and surrounds the various structures that pass through it.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      13.8
      Seconds

  • Question 13 - A 65-year-old man with no history of smoking complains of shortness of breath...

    Correct

    • A 65-year-old man with no history of smoking complains of shortness of breath and persistent cough over the past 8 months. He reveals that in the 1960s he worked for several years as a boiler operator. Chest X-ray shows diffuse lung infiltrates. Which of the following is the most probable cause of these findings?

      Your Answer: Asbestosis

      Explanation:

      Asbestosis is a chronic lung disease which leads to long-term respiratory complications and is caused by the inhalation of asbestos fibres. Symptoms due to long exposure to asbestos usually appear 10 to 40 years after initial exposure and include shortness of breath, cough, weight loss, clubbing of the fingers and chest pain. Typical chest X-ray findings include diffuse lung infiltrates that cause the appearance of shaggy heart borders.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      12.2
      Seconds

  • Question 14 - A brain tumour causing blockage of the hypophyseal portal system is likely to...

    Correct

    • A brain tumour causing blockage of the hypophyseal portal system is likely to result in an increased secretion of which of the following hormones?

      Your Answer: Prolactin

      Explanation:

      The hypophyseal portal system links the hypothalamus and the anterior pituitary. With the help of this system, the anterior pituitary receives releasing and inhibitory hormones from the hypothalamus and regulates the action of other endocrine glands. One of the inhibitory hormones carried by this system is the prolactin-inhibitory hormone. In the absence of this hormone which might occur in case of a blockage of the system, prolactin secretion increases to about three times normal levels.

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      9.3
      Seconds

  • Question 15 - A 46-year old female patient experienced a stroke that affected her glossopharyngeal nerve....

    Incorrect

    • A 46-year old female patient experienced a stroke that affected her glossopharyngeal nerve. Damage to the glossopharyngeal nerve would most likely:

      Your Answer: Affect taste of the anterior 2 thirds of the tongue

      Correct Answer: Result in general sensory deficit to the pharynx

      Explanation:

      The glossopharyngeal nerve (CN IX) has many functions which include:

      – Contributes to the pharyngeal plexus

      – Receiving general somatic sensory fibres from the tonsils, pharynx, the middle ear and the posterior third of the tongue.

      – supplies motor fibres to only one muscle; the stylopharyngeus muscle.

      – provides parasympathetic fibres to the parotid gland via the otic ganglion.

      – Receives visceral sensory fibres from the carotid bodies & carotid sinus.

      – Receives special visceral sensory fibres from the posterior third of the tongue.

      The above functions will directly be affected by the damage of the glossopharyngeal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      12.8
      Seconds

  • Question 16 - A 38-year old woman presents to the clinic with a 2 cm eczema-like...

    Correct

    • 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: 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
      27.8
      Seconds

  • Question 17 - In the emergency room, a nurse was introducing a catheter into the patients...

    Incorrect

    • In the emergency room, a nurse was introducing a catheter into the patients femoral vein for rapid fluid therapy. The femoral vein is situated inside the femoral sheath. Which of the following is true about that sheath?

      Your Answer: The femoral sheath is formed by a prolongation downward of the pelvic fasciae

      Correct Answer: The medial compartment is called the femoral canal

      Explanation:

      The femoral sheath is situated ,4cm below the inguinal ligament. It is a prolongation of the abdominal fascia. The anterior wall is a prolongation of the transversalis fascia and the posterior wall, the iliac fascia. It is divided by two vertical septa into 3 compartments, lateral, intermediate, and medial. The medial compartment is known as the femoral canal and contains some lymphatic vessels. The lateral one contains the femoral artery and the intermediate one contains the femoral vein.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      66.3
      Seconds

  • Question 18 - A 7-year-old boys undergoes a testicular biopsy after a tumour is found in...

    Correct

    • A 7-year-old boys undergoes a testicular biopsy after a tumour is found in his right testis. Elements similar to hair and teeth are found in it. What kind of tumour is this?

      Your Answer: Teratoma

      Explanation:

      A teratoma is a tumour containing tissue elements that are similar to normal derivatives of more than one germ layer. They usually contain skin, hair, teeth and bone tissue and are more common in children, behaving as a benign tumour. After puberty, they are regarded as malignant and can metastasise.

    • This question is part of the following fields:

      • Pathology
      • Urology
      14
      Seconds

  • Question 19 - Chronic obstructive pulmonary disease (COPD) is likely to result in: ...

    Correct

    • Chronic obstructive pulmonary disease (COPD) is likely to result in:

      Your Answer: Respiratory acidosis

      Explanation:

      COPD leads to respiratory acidosis (chronic). This occurs due to hypoventilation which involves multiple causes, such as poor responsiveness to hypoxia and hypercapnia, increased ventilation/perfusion mismatch leading to increased dead space ventilation and decreased diaphragm function.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      3.7
      Seconds

  • Question 20 - A 54 year old man fell off his bicycle. He felt a severe...

    Correct

    • A 54 year old man fell off his bicycle. He felt a severe pain in his hand and wasn't able to move it. It was found that a carpal bone in the distal row was fractured. Which is the most likely bone?

      Your Answer: Trapezium

      Explanation:

      There are eight carpal bones which are arranged in two rows, proximal and distal; scaphoid, lunate, triquetral and pisiform are of proximal row. Trapezium, trapezoid, capitate and hamate are of the distal row.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      14.6
      Seconds

  • Question 21 - A 62-year-old male smoker, presented with shortness of breath, chronic cough and haemoptysis...

    Incorrect

    • A 62-year-old male smoker, presented with shortness of breath, chronic cough and haemoptysis over the last three months. He has developed a fat pad in the base of his neck, rounded face, acne and osteoporosis. Which of the following is the most likely pulmonary disease that is causing these symptoms and findings?

      Your Answer: Bronchial carcinoid

      Correct Answer: Small-cell anaplastic carcinoma

      Explanation:

      Small cell lung cancer is a highly aggressive form of lung cancer. It is thought to originate from neuroendocrine cells in the bronchus called Feyrter cells and is often associated to ectopic production of hormones like ADH and ACTH that result in paraneoplastic syndromes and Cushing’s syndrome.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      16.5
      Seconds

  • Question 22 - A ‘claw hand’ is usually associated with injury to which of the following...

    Correct

    • A ‘claw hand’ is usually associated with injury to which of the following nerves?

      Your Answer: Ulnar nerve

      Explanation:

      A ‘claw hand’ is associated with injury to the ulnar nerve at the wrist affecting the interossei, lumbricals and hypothenar muscles of the hand. It is characterized by hypothenar eminence wasting, hyperextended metacarpophalangeal joints and flexed interphalangeal joints.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      4.4
      Seconds

  • Question 23 - Which of the following is a likely consequence of severe diarrhoea? ...

    Incorrect

    • Which of the following is a likely consequence of severe diarrhoea?

      Your Answer: A metabolic alkalosis

      Correct Answer: A decrease in the sodium content of the body

      Explanation:

      Diarrhoea can occur due to any of the numerous aetiologies, which include infectious, drug-induced, food related, surgical, inflammatory, transit-related or malabsorption. Four mechanisms have been implicated in diarrhoea: increased osmotic load, increased secretion, inflammation and decreased absorption time. Diarrhoea can result in fluid loss with consequent dehydration, electrolyte loss (Na+, K+, Mg2+, Cl–) and even vascular collapse. Loss of bicarbonate ions can lead to a metabolic acidosis.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      18.3
      Seconds

  • Question 24 - Where does the ejaculatory duct open into? ...

    Correct

    • Where does the ejaculatory duct open into?

      Your Answer: Prostatic urethra

      Explanation:

      There are two ejaculatory ducts, one on either side of the midline. Each ejaculatory duct is formed by the union of the duct from the seminal vesicles with the ductus deferens. They start at the base of the prostate and run forward and downward between the middle and lateral lobes and along the side of the prostatic utricle to end in the prostatic urethra.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      3.7
      Seconds

  • Question 25 - A child defecates a few minutes after being fed by the mother. This...

    Correct

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

      Your 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
      14
      Seconds

  • Question 26 - A 50-year old gentleman who suffered a stroke was brought to the emergency...

    Correct

    • A 50-year old gentleman who suffered a stroke was brought to the emergency department by his relatives. The patient however denied the presence of paralysis of his left upper and lower limbs. What is the most likely site of the lesion in this patient?

      Your Answer: Right posterior parietal cortex

      Explanation:

      A large injury to the non-dominant parietal cortex can make the patient neglect or refuse to acknowledge the presence of paralysis on the contralateral side. This can also involve the perception of the external world. Smaller injuries in this area which involve the precentral gyrus (primary motor cortex) or postcentral gyrus (primary sensory cortex) cause contralateral spastic paralysis or contralateral loss of tactile sensation respectively. A lesion in posterior inferior gyrus of the dominant frontal lobe results in motor aphasia. Involvement of the posterior superior gyrus of the dominant frontal lobe produces sensory aphasia.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      43.7
      Seconds

  • Question 27 - A patient with Paget's disease of the bone is predisposed to developing which...

    Incorrect

    • A patient with Paget's disease of the bone is predisposed to developing which type of cancer?

      Your Answer: Ewing’s sarcoma

      Correct Answer: Osteosarcoma

      Explanation:

      Paget’s disease of bone (PDB) is a focal disorder of bone. It is presumed benign in nature and mediated by abnormal osteoclast function. However osteosarcomas may occur in <1% of patients with Paget's disease of the bone. Osteosarcomas are osteogenic in origin, and consistently arise in sites of pagetic bone. This is not to be confused with Paget's disease of the breast.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      10.5
      Seconds

  • Question 28 - A 4-year-old child was brought to a paediatrician for consult due to a...

    Correct

    • 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: 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
      10.5
      Seconds

  • Question 29 - Some substances, such as Chromium-51 and Technetium-99, are freely filtered but not secreted...

    Correct

    • Some substances, such as Chromium-51 and Technetium-99, are freely filtered but not secreted or absorbed by the kidney. In these cases, their clearance rate is equal to:

      Your Answer: Glomerular filtration rate

      Explanation:

      If a substance passes through the glomerular membrane with perfect ease, the glomerular filtrate contains virtually the same concentration of the substance as does the plasma and if the substance is neither secreted nor reabsorbed by the tubules, all of the filtered substance continues on into the urine. Glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidney.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      13.5
      Seconds

  • Question 30 - Most of the coagulation factors are serine proteases. Which of the following is...

    Correct

    • Most of the coagulation factors are serine proteases. Which of the following is not one of them?

      Your Answer: Factor XIII

      Explanation:

      Serine protease coagulation factors include: thrombin, plasmin, Factors X, XI and XII. Factor VIII and factor V are glycoproteins and factor XIII is a transglutaminase.

    • This question is part of the following fields:

      • General
      • Physiology
      22.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Gastrointestinal; Hepatobiliary (1/1) 100%
Pathology (7/12) 58%
Anatomy (5/9) 56%
Lower Limb (1/3) 33%
Cell Injury & Wound Healing (1/1) 100%
Neurology (2/2) 100%
Orthopaedics (0/1) 0%
Pharmacology (0/2) 0%
Physiology (7/9) 78%
Renal (0/1) 0%
Abdomen (1/2) 50%
Fluids & Electrolytes (2/2) 100%
Pelvis (1/1) 100%
Respiratory (2/3) 67%
Endocrinology (1/1) 100%
Head & Neck (0/1) 0%
Women's Health (1/1) 100%
Urology (1/1) 100%
Upper Limb (2/2) 100%
Gastroenterology (1/2) 50%
Neoplasia (1/2) 50%
General (1/1) 100%
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