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  • Question 1 - Choose the most correct answer regarding the obturator internus muscle. ...

    Incorrect

    • Choose the most correct answer regarding the obturator internus muscle.

      Your Answer: It adducts the thigh

      Correct Answer: It emerges from the pelvis through the lesser sciatic foramen

      Explanation:

      The obturator internus arises from the inner surface of the anterolateral wall of the pelvis and the pelvic surface of the obturator membrane. The fibres converge rapidly towards the lesser sciatic foramen and end in four or five tendinous bands and leave the pelvis through the lesser sciatic foramen.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      21.8
      Seconds
  • Question 2 - Which muscle is most likely to be affected following an injury to the...

    Correct

    • Which muscle is most likely to be affected following an injury to the thoracodorsal nerve (C6-C8)?

      Your Answer: Latissimus dorsi

      Explanation:

      Latissimus dorsi is a triangular, flat muscle that covers the lumbar region and the lower half of the thoracic region. It is supplied by the sixth, seventh and eighth cervical nerves through the thoracodorsal (long subscapular) nerve.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      5.4
      Seconds
  • Question 3 - A 14 year old girl suffers from haemophilia A and chronic knee pain...

    Incorrect

    • A 14 year old girl suffers from haemophilia A and chronic knee pain with progressive swelling and deformity over the last 4 years. Test results reveal a significantly reduced factor VIII activity. Which of the following is seen in the knee joint space after an acute painful episode?

      Your Answer: Neutrophils

      Correct Answer: Cholesterol crystals

      Explanation:

      Due to breakdown of the red blood cell membrane in haemophilic patients, cholesterol crystals are formed by the lipids. On the other hand lipofuscin deposition does not occur in haemolysis or haemorrhage. Neutrophil accumulation suggests acute inflammation. Anthracotic pigment is an exogenous carbon pigment that deposits in the lung from dust. Russell bodies are intracellular accumulations of immunoglobins in plasma cells. Curschmann’s spirals and Charcot Leyden crystals are pathognomonic of asthma.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Haematology
      • Pathology
      17.1
      Seconds
  • Question 4 - A retroperitoneal structure is: ...

    Correct

    • A retroperitoneal structure is:

      Your Answer: Pancreas

      Explanation:

      Retroperitoneal structures are those that are found behind the peritoneum. They include: kidneys, suprarenal glands, bladder, ureter, inferior vena cava, rectum, oesophagus (part of it), part of the pancreas, 2nd, 3rd and 4th parts of the duodenum and ascending and descending parts of the colon.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      10.3
      Seconds
  • Question 5 - Acute respiratory distress syndrome (ARDS) is a medical condition that occurs in critically...

    Correct

    • Acute respiratory distress syndrome (ARDS) is a medical condition that occurs in critically ill patients, and can be triggered by events such as trauma and sepsis. Which of the following variables is most likely to be lower than normal in a patient with ARDS?

      Your Answer: Lung compliance

      Explanation:

      Acute (or Adult) respiratory distress syndrome (ARDS) is a medical condition occurring in critically ill patients characterized by widespread inflammation in the lungs. The development of acute respiratory distress syndrome (ARDS) starts with damage to the alveolar epithelium and vascular endothelium, resulting in increased permeability to plasma and inflammatory cells. These cells pass into the interstitium and alveolar space, resulting in pulmonary oedema. Damage to the surfactant-producing type II cells and the presence of protein-rich fluid in the alveolar space disrupt the production and function of pulmonary surfactant, leading to micro atelectasis and impaired gas exchange. The pathophysiological consequences of lung oedema in ARDS include a decrease in lung volumes, compliance and large intrapulmonary shunts. ARDS may be seen in the setting of pneumonia, sepsis, following trauma, multiple blood transfusions, severe burns, severe pancreatitis, near-drowning, drug reactions, or inhalation injuries.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      44
      Seconds
  • Question 6 - A 65 year old man with a history of diabetes and hypertension presented...

    Correct

    • A 65 year old man with a history of diabetes and hypertension presented with a stroke a few months ago severely affecting his speech and movement in the right arm and leg. A cerebral angiogram revealed a middle cerebral artery occlusion. A recent CT scan was done which revealed a 5 cm cystic space in his left parietal lobe. This lesion is a result of which of the following forms of resolution?

      Your Answer: Liquefactive necrosis

      Explanation:

      Characteristically, the brain will undergo liquefactive necrosis following ischaemic injury. This leaves a cystic space in that region which would show up on a CT scan. Atrophy would result in a generalized decrease in the brain size. Coagulative necrosis typically occurs in parenchymal organs e.g. the spleen or kidney which have a lower lipid content. Caseous necrosis is typical in granulomatous tuberculosis infection. Apoptosis will not form a cystic area as it is programmed cell death involving a individual cells. Gangrenous necrosis is characteristic of ischaemic injury of the lower limb and GI tract. Fibrinous necrosis results from necrotic damage to the blood vessels with the leaking of proteins into the vessel, appearing bright pink on H & E staining.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Neurology
      • Pathology
      21.1
      Seconds
  • Question 7 - Intracellular shifting of hydrogen ions can generate a metabolic alkalosis. In which of...

    Incorrect

    • Intracellular shifting of hydrogen ions can generate a metabolic alkalosis. In which of the following conditions is metabolic alkalosis caused by this mechanism ?

      Your Answer: Vomiting

      Correct Answer: Hypokalaemia

      Explanation:

      Metabolic alkalosis is characterized by a primary increase in the concentration of serum bicarbonate ions. This may occur as a consequence of a loss of hydrogen ions or a gain in bicarbonate. Hydrogen ions may be lost through the kidneys or the GI tract, as for example during vomiting, nasogastric suction or use of diuretics. Intracellular shifting of hydrogen ions develops mainly during hypokalaemia to maintain neutrality. Gain in bicarbonate ions may develop during administration of sodium bicarbonate in high amounts or in amounts that exceed the capacity of excretion of the kidneys, as seen in renal failure. Fluid losses may be another cause of metabolic alkalosis, causing the reduction of extracellular fluid volume.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      20.5
      Seconds
  • Question 8 - Ventricular filling follows a delay caused by? ...

    Correct

    • Ventricular filling follows a delay caused by?

      Your Answer: AV node

      Explanation:

      The AV node is a conducting tissue found between the atria and the ventricles of the heart. It conducts electrical signal from the atria to the ventricles and acts a delaying mechanism preventing the atria and the ventricles from contracting at the same time. This decremental conduction prevents premature ventricular contraction in cases such as atrial fibrillation. A delay in the AV node is the reason for the PR segment seen on the ECG. In certain types of supraventricular tachycardia, a person could have two AV nodes; this will cause a loop in electrical current and uncontrollably rapid heart beat. When this electricity catches up with itself, it will dissipate and return to a normal heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      10.3
      Seconds
  • Question 9 - When a patient is standing erect, pleural fluid would tend to accumulate in...

    Correct

    • When a patient is standing erect, pleural fluid would tend to accumulate in which part of the pleural space?

      Your Answer: Costodiaphragmatic recess

      Explanation:

      The costo-diaphragmatic recess is the lowest extent of the pleural cavity or sac. Any fluid in the pleura will by gravity accumulate here when a patient is standing erect.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      9.8
      Seconds
  • Question 10 - The most important difference between interstitial fluid and plasma is the: ...

    Correct

    • The most important difference between interstitial fluid and plasma is the:

      Your Answer: Protein concentration

      Explanation:

      Interstitial fluid (or tissue fluid or intercellular fluid) is a solution that surrounds the cells of multicellular animals. It is the main component of the extracellular fluid, which also includes plasma, lymph and transcellular fluid. Plasma, the major component in blood, communicates freely with interstitial fluid through pores and intercellular clefts in capillary endothelium. Interstitial fluid consists of a water solvent containing amino acids, sugars, fatty acids, coenzymes, hormones, neurotransmitters, salts, as well as waste products from the cells. Red blood cells, platelets and plasma proteins cannot pass through the walls of the capillaries. The resulting mixture that does pass through is essentially blood plasma without the plasma proteins. Tissue fluid also contains certain types of white blood cells. Once the extracellular fluid collects into small vessels it is considered to be lymph, and the vessels that carry it back to the blood are called the lymphatic vessels. The lymphatic system returns protein and excess interstitial fluid to the circulation.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      17.3
      Seconds
  • Question 11 - A 15-day old baby was brought to the emergency department with constipation for...

    Correct

    • A 15-day old baby was brought to the emergency department with constipation for 4 days. On examination, the abdomen of the baby was found to be distended and tender all over. No bowel sounds were heard. A sigmoid colon biopsy was carried out, which showed absent ganglion cells. What is the diagnosis?

      Your Answer: Hirschsprung’s disease

      Explanation:

      Hirschsprung’s disease is characterized by congenital absence of the autonomic plexus (Meissner’s and Auerbach’s plexus) in the intestinal wall. Usually limited to the distal colon, it can occasionally involve the entire colon or even the small bowel. There is abnormal or absent peristalsis in the affected segment, resulting in continuous spasm of smooth muscle and partial/complete obstruction. This causes accumulation of intestinal contents and dilatation of proximal segment. Skip lesions are highly uncommon. This disease is seen early in life with 15% patients presenting in first month, 60% by 1 year of age and 85% by the age of 4 years. Symptoms include severe and complete constipation, abdominal distension and vomiting. Patients with involvement of ultra-short segments might have mild constipation with intervening diarrhoea. In older children, symptoms include failure to thrive, anorexia, and lack of an urge to defecate. On examination, an empty rectum is revealed with stool palpable high up in the colon. If not diagnosed in time, it can lead to Hirschsprung’s enterocolitis (toxic megacolon), which can be fulminant and lead to death. Diagnosis involves a barium enema or a rectal suction biopsy. Barium enema shows a transition in diameter between the dilated, normal colon proximal to the narrowed, affected distal segment. It is to be noted that barium enema should be done without prior preparation, which can dilate the abnormal segment, leading to a false-negative result. A 24-hour post-evacuation film can be obtained in the neonatal period – if the colon is still filled with barium, there is a high likelihood of Hirschsprung’s disease. Full-thickness rectal biopsy is diagnostic by showing the absence of ganglion cells. Acetylcholinesterase staining can be done to highlight the enlarged nerve trunks. Abnormal innervation can also be demonstrated by rectal manometry.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      33.5
      Seconds
  • Question 12 - A 32-year old gentleman came to the emergency department, complaining of progressively increasing...

    Correct

    • A 32-year old gentleman came to the emergency department, complaining of progressively increasing weakness in his arms and legs over 5 days. On examination, there is symmetrical weakness on both sides of his face, along with weakness of the proximal and distal muscles of all four limbs. No loss of sensation noted. Deep tendon reflexes could not be elicited and plantar responses were downward. On enquiry, it was revealed that he had an upper respiratory tract infection 10 days ago. The likely diagnosis is:

      Your Answer: Guillain–Barré syndrome

      Explanation:

      Guillain–Barré syndrome (GBS) is an acute, autoimmune polyradiculoneuropathy which affects the peripheral nervous system and is usually triggered by an acute infectious process. 75% patients have a history of acute infection within the past 1–4 weeks, usually respiratory or gastrointestinal. immunisations have also been implicated. The most common form is acute inflammatory demyelinating polyneuropathy. It results in an ascending paralysis with complete loss of deep tendon reflexes. Treatment includes immunoglobulins and supportive care. However, the disease may be fatal due to severe pulmonary complications and dysautonomia.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      49.9
      Seconds
  • Question 13 - Which of the following malignancies is associated with the development of Lambert-Eaton myasthenic...

    Incorrect

    • Which of the following malignancies is associated with the development of Lambert-Eaton myasthenic syndrome?

      Your Answer: Pheochromocytoma

      Correct Answer: Lung cancer

      Explanation:

      Lambert–Eaton myasthenic syndrome is a rare disorder of the neuromuscular junction. It can occur as a solitary diagnosis but it can also occur as a paraneoplastic syndrome associated with lung cancer, particularly small-cell histology. It can also be associated with other cancers such as lymphoma, non-Hodgkin’s lymphoma, T-cell leukaemia, non-small-cell lung cancer, prostate cancer and thymoma.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      10.8
      Seconds
  • Question 14 - Injury to this nerve will result to the loss of general sensory innervation...

    Incorrect

    • Injury to this nerve will result to the loss of general sensory innervation of the lacrimal gland:

      Your Answer: Abducens nerve

      Correct Answer: Ophthalmic nerve

      Explanation:

      The lacrimal glands are paired, almond-shaped exocrine glands, that secrete the aqueous layer of the tear film. The lacrimal nerve, derived from the ophthalmic nerve, supplies the sensory component of the lacrimal gland. The greater petrosal nerve, derived from the facial nerve, supplies the parasympathetic autonomic component of the lacrimal gland.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      9.2
      Seconds
  • Question 15 - After a prolonged coronary artery bypass surgery, a 60-year old gentleman was transfused...

    Correct

    • After a prolonged coronary artery bypass surgery, a 60-year old gentleman was transfused 3 units of fresh-frozen plasma and 2 units of packed red cells. Two days later, the nurse noticed that he was tachypnoeic and chest X-ray showed signs consistent with adult respiratory distress syndrome. Which of the following variables will be low in this patient?

      Your Answer: Compliance of the lung

      Explanation:

      Acute or adult respiratory distress syndrome (ARDS) is a reaction to several forms of lung injuries and is commonly associated with sepsis and SIRS (systemic inflammatory response syndrome), severe traumatic injury, severe head injury, narcotics overdose, drowning, pulmonary contusion, and multiple blood transfusions. There is an increase in risk due to pre-existing liver disease or coagulation abnormalities. It results due to indirect toxic effects of neutrophil-derived inflammatory mediators in the lungs. ARDS is defined by the 1994 American–European Consensus Committee as the acute onset of bilateral infiltrates on chest X-ray, a partial pressure of arterial oxygen (pa(O2)) to fraction of inspired oxygen Fi(O2) ratio of less than 200 mmHg and a pulmonary artery occlusion pressure of less than 18 or the absence of clinical evidence of left arterial hypertension. ARDS is basically pulmonary oedema in the absence of volume overload or poor left ventricular function. This is different from acute lung injury, which shows a pa(O2)/Fi(O2) ratio of less than 300 mmHg. Pathogenesis of ARDS starts from damage to alveolar epithelium and vascular endothelium, causing increased permeability. Damage to surfactant-producing type II cells disrupts the production and function of pulmonary surfactant, causing micro atelectasis and poor gas exchange. There is a decrease in lung compliance and increase in work of breathing. Eventually, there is resorption of alveolar oedema, regeneration of epithelial cells, proliferation and differentiation of type II alveolar cells and alveolar remodelling. Some show resolution and some progress to fibrosing alveolitis, which involves the deposition of collagen in alveolar, vascular and interstitial spaces.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      9.5
      Seconds
  • Question 16 - A 47 -year-old male was admitted due to a bleeding peptic ulcer. On...

    Correct

    • A 47 -year-old male was admitted due to a bleeding peptic ulcer. On his 3rd hospital day, he developed a cardiac arrhythmia. His serum potassium was markedly elevated. What is the most likely cause of hyperkalaemia in this patient?

      Your Answer: Multiple blood transfusions

      Explanation:

      Patients with gastrointestinal bleeding often require blood transfusion. Among the various side effects of blood transfusions, is the increase of potassium levels. The use of stored blood for transfusions is followed by an increase of serum potassium levels. Potassium level increases are more pronounced in patients who receive blood stored for more than 12 d. Furthermore, the lysis and destruction of red blood cells, especially in the transfusion of older PRBCs, can further increase potassium levels. Excessive use of a PPi has been associated with hyperkaelemia however would be less likely in this acute setting.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      39.8
      Seconds
  • Question 17 - Injury of the ventral rami at this cervical spinal level will result in...

    Correct

    • Injury of the ventral rami at this cervical spinal level will result in paralysis of the rectus capitis anterior muscle:

      Your Answer: C1, C2

      Explanation:

      The rectus capitis anterior is a short, flat muscle, situated immediately behind the upper part of the longus capitis. It is also known as the obliquus capitis superior. It aids in flexion of the head and the neck. Nerve supple is from C1 and C2.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      6.3
      Seconds
  • Question 18 - Which lymph nodes are most likely to enlarge due to the spread of...

    Correct

    • Which lymph nodes are most likely to enlarge due to the spread of infection through the lymphatic channels in a patient with a boil on his scrotum?

      Your Answer: Superficial inguinal nodes

      Explanation:

      The superficial inguinal nodes drain the perineum and the external genitalia which include the scrotum and the labia majora. The testes, however, drain to the lumbar nodes.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      15.1
      Seconds
  • Question 19 - A 25-year-old woman complains of generalised swelling and particularly puffiness around the eyes...

    Correct

    • A 25-year-old woman complains of generalised swelling and particularly puffiness around the eyes which is worst in the morning. Laboratory studies showed:

      Blood urea nitrogen (BUN) = 30 mg/dl

      Creatinine = 2. 8 mg/dl

      Albumin = 2. 0 mg/dl

      Alanine transaminase (ALT) = 25 U/l

      Bilirubin = 1 mg/dl

      Urine analysis shows 3+ albumin and no cells.

      Which of the following is the most likely diagnosis?

      Your Answer: Nephrotic syndrome

      Explanation:

      Nephrotic syndrome is a disorder in which the glomeruli have been damaged, characterized by:

      – Proteinuria (>3.5 g per 1.73 m2 body surface area per day, or > 40 mg per square meter body surface area per hour in children)

      – Hypoalbuminemia (< 2,5 g/dl) – Hyperlipidaemia, and oedema (generalized anasarca).

    • This question is part of the following fields:

      • Physiology
      • Renal
      25.1
      Seconds
  • Question 20 - In the case of an injury to the sub sartorial canal, which of...

    Incorrect

    • In the case of an injury to the sub sartorial canal, which of the following structures is most likely to be injured?

      Your Answer: Nerve to sartorius

      Correct Answer: Nerve to vastus medialis

      Explanation:

      The adductor canal (sub sartorial canal) is situated in the middle third of the thigh.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      20.1
      Seconds
  • Question 21 - A 45-year old farmer was referred to the surgical clinic with complaints of...

    Correct

    • A 45-year old farmer was referred to the surgical clinic with complaints of pain in his right hypochondrium. Investigations confirmed the diagnosis of hepatocellular carcinoma with malignant ascites. According to you, what is the most likely cause of HCC in this patient?

      Your Answer: Aflatoxin

      Explanation:

      Aflatoxins are naturally occurring toxins produced by the Aspergillus fungus (most often, A. flavus and A. parasiticus). These organisms are common and their native habitat is soil, decaying vegetation and grains. They can contaminate the grain before harvest or after storage, more likely in high-humidity (at least 7%) or high temperature environment of after stressful conditions like drought. Aflatoxins are mycotoxins and also carcinogenic. They get metabolized in the liver to an epoxide, aflatoxin M1. High exposure can lead to acute necrosis, cirrhosis or liver carcinoma. These substances can cause haemorrhage, acute liver damage, oedema, and alteration in digestion, absorption and/or metabolism of nutrients. Although humans are susceptible to these toxins like all other animals, they have a high tolerance level and hence, rarely develop acute aflatoxicosis. However, children are particularly susceptible to exposure leading to growth impairment and delayed development. Chronic exposure carries a high risk of hepatic cancer, due to intercalation of its metabolite aflatoxin M1 into the DNA and alkylation of the bases because of its epoxide moiety.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      18.8
      Seconds
  • Question 22 - A teenager presents with pain and swelling in a limb which increases after...

    Correct

    • A teenager presents with pain and swelling in a limb which increases after activity. X-rays reveal an expansible, eccentric, lytic lesion in the metaphysis distally in the affected bone surrounded by new bone. What is the most likely diagnosis?

      Your Answer: Aneurysmal bone cyst

      Explanation:

      Aneurysmal bone cysts tend to develop in patients younger than 20 years old. They usually occur in the metaphyseal region of long bones, and are cystic lesions composed of numerous blood filled channels that grow slowly. In X-rays, they show up as circumscribed lesions, sometimes surrounded by new bone.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      23.7
      Seconds
  • Question 23 - When inserting a chest drain anteriorly into the second intercostal space, one must...

    Incorrect

    • When inserting a chest drain anteriorly into the second intercostal space, one must identify the second costal cartilage by palpating which landmark?

      Your Answer: Sternal notch

      Correct Answer: Sternal angle

      Explanation:

      The sternal angle is the site for identification of the second rib as the second rib is attached to the sternum at this point.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      25.1
      Seconds
  • Question 24 - The tympanic membrane is a thin semi-transparent membrane that separates the tympanic cavity...

    Incorrect

    • The tympanic membrane is a thin semi-transparent membrane that separates the tympanic cavity from the bottom of the external acoustic meatus. The interior of the tympanic membrane is innervated by which of the following cranial nerves?

      Your Answer: Facial

      Correct Answer: Glossopharyngeal

      Explanation:

      The glossopharyngeal nerve, known as the ninth cranial nerve (CN IX), is a mixed nerve that carries afferent sensory and efferent motor information. The glossopharyngeal nerve has five distinct general functions:

      – The branchial motor (special visceral efferent), supplies the stylopharyngeus muscle.

      – The visceral motor (general visceral efferent), provides parasympathetic innervation of the parotid gland via the otic ganglion.

      – The visceral sensory (general visceral afferent), carries visceral sensory information from the carotid sinus and carotid body.

      – The general sensory (general somatic afferent), provides general sensory information from the inner surface of the tympanic membrane, upper pharynx (GVA), and the posterior one-third of the tongue.

      – The visceral afferent (special visceral afferent), provides taste sensation from the posterior one-third of the tongue, including the circumvallate papillae.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      15.1
      Seconds
  • Question 25 - During an anatomy revision session, medical students are told that the posterior wall...

    Incorrect

    • During an anatomy revision session, medical students are told that the posterior wall of the rectus sheath ends in a thin curved margin whose concavity is directed downwards. What is the name of this inferior border of the rectus sheath?

      Your Answer: Inguinal ligament

      Correct Answer: Arcuate line

      Explanation:

      The rectus sheath is a tendinous sheath that encloses the rectus abdominis muscle. It covers the entire anterior surface however on the posterior surface of the muscle the sheath is incomplete ending inferiorly at the arcuate line. Below the arcuate line, the rectus abdominis is covered by the transversalis fascia. The linea alba is a band of aponeurosis on the midline of the anterior abdominal wall, which extends from the xiphoid process to the pubic symphysis. It is formed by the combined abdominal muscle aponeuroses. This is a useful site for midline incision during abdominal surgery because it does not carry many blood vessels. All of the other answer choices are related to the inguinal canal.

      The falx inguinalis (sometimes called the inguinal falx or conjoint tendon), is the inferomedial attachment of the transversus abdominis with some fibres of the internal abdominal oblique – it contributes to the posterior wall of the inguinal canal.

      The inguinal ligament is the ligament that connects the anterior superior iliac spine with the pubic tubercle – it makes the floor of the inguinal canal.

      The internal (deep) inguinal ring is the entrance to the inguinal canal, where the transversalis fascia pouches out and creates an opening through which structures can leave the abdominal cavity.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      19
      Seconds
  • Question 26 - Cancer of the testis most likely metastases to which set of lymph nodes?...

    Incorrect

    • Cancer of the testis most likely metastases to which set of lymph nodes?

      Your Answer: Superficial inguinal

      Correct Answer: Aortic

      Explanation:

      The lymphatic drainage of an organ is related to its blood supply. The lymphatic drainage of the testis drains along the testicular artery to reach the lymph nodes along the aorta.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      12.3
      Seconds
  • Question 27 - A 40-year old woman presents with tightening of the skin over her fingers...

    Incorrect

    • A 40-year old woman presents with tightening of the skin over her fingers which makes movement of her fingers difficult.. She also gives a history of her fingers turning blue on exposure to low temperatures. She admits to gradual weight loss. Investigations reveal negative rheumatoid factor, negative antinuclear antibody and a positive anticentromere body. Which of the following conditions is she likely to have?

      Your Answer: Zollinger-Ellison syndrome

      Correct Answer: Oesophageal stricture

      Explanation:

      Scleroderma is a connective tissue disorder that ranges in severity and progression. The disease could show generalised skin thickening with rapid, fatal, visceral involvement; or only cutaneous involvement (typically fingers and face). The slow progressive form is also known as ‘limited cutaneous scleroderma’ or CREST syndrome (calcinosis cutis, Raynaud’s phenomenon, (o)oesophageal dysmotility, sclerodactyly, and telangiectasia).

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      25.5
      Seconds
  • Question 28 - Different portions of the renal tubule have varying degrees of water permeability. Which...

    Incorrect

    • Different portions of the renal tubule have varying degrees of water permeability. Which of the following renal sites is characterised by low water permeability under normal circumstances?

      Your Answer: Collecting duct

      Correct Answer: Thick ascending limb of the loop of Henlé

      Explanation:

      Within the nephron of the kidney, the ascending limb of the loop of Henle is a segment of the loop of Henle downstream of the descending limb, after the sharp bend of the loop. Both the thin and the thick ascending limbs of the loop of Henlé have very low permeability to water. Since there are no regulatory mechanisms to alter its permeability, it remains poorly permeable to water under all circumstances. Sodium and chloride are transported out of the luminal fluid into the surrounding interstitial spaces, where they are reabsorbed. Water must remain behind because it is not reabsorbed, so the solute concentration becomes less and less (the luminal fluid becomes more dilute). This is one of the principal mechanisms (along with diminution of ADH secretion) for the production of a dilute, hypo-osmotic urine (water diuresis).

    • This question is part of the following fields:

      • Physiology
      • Renal
      19.5
      Seconds
  • Question 29 - A drug abuser developed an infection which spread from the dorsum of the...

    Incorrect

    • A drug abuser developed an infection which spread from the dorsum of the hand to the medial side of the arm along the course of the large cutaneous vein. Which vein is involved?

      Your Answer: Cephalic

      Correct Answer: Basilic

      Explanation:

      The basilic vein is one of two veins found in the forearm, the other is the cephalic vein. These veins originate from the deep venous arch of the hand. The cephalic vein ascends along the lateral side of the forearm, and the basilic vein runs up the medial side of the forearm.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      15.9
      Seconds
  • Question 30 - A 78-year-old diabetic man undergoes renal function tests. Which of the following substances...

    Correct

    • A 78-year-old diabetic man undergoes renal function tests. Which of the following substances will be the most accurate for measuring glomerular filtration rate (GFR)?

      Your Answer: Inulin

      Explanation:

      Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal glomerular capillaries into the Bowman’s capsule per unit time. Clinically, this is often measured to determine renal function. Inulin was originally used as it is not reabsorbed by the kidney after glomerular filtration, therefore its rate of excretion is directly proportional to the rate of filtration of water and solutes across the glomerular filter. However, in clinical practice, creatinine clearance is used to measure GFR. Creatinine is an endogenous molecule, synthesised in the body, that is freely filtered by the glomerulus (but also secreted by the renal tubules in very small amounts). Creatinine clearance exceeds GFR due to creatinine secretion, and is therefore a close approximation of the GFR.

    • This question is part of the following fields:

      • Physiology
      • Renal
      9.1
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (5/12) 42%
Lower Limb (0/2) 0%
Thorax (2/3) 67%
Cell Injury & Wound Healing; Haematology (0/1) 0%
Pathology (5/10) 50%
Abdomen (1/2) 50%
Physiology (7/8) 88%
Respiratory (2/2) 100%
Cell Injury & Wound Healing; Neurology (1/1) 100%
Fluids & Electrolytes (2/3) 67%
Cardiovascular (1/1) 100%
Gastrointestinal; Hepatobiliary (2/3) 67%
Neurology (1/1) 100%
Neoplasia (0/1) 0%
Head & Neck (1/3) 33%
Pelvis (1/1) 100%
Renal (2/3) 67%
Orthopaedics (1/1) 100%
Endocrine (0/1) 0%
Upper Limb (0/1) 0%
Passmed