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  • Question 1 - A 50-year-old woman goes to the doctor complaining of myalgia, muscle cramps, and...

    Correct

    • A 50-year-old woman goes to the doctor complaining of myalgia, muscle cramps, and weakness; she is diagnosed with severe hypokalaemia. Which of the following is the most common cause of hypokalaemia?

      Your Answer: Prolonged vomiting

      Explanation:

      Potassium is one of the body’s major ions. Nearly 98% of the body’s potassium is intracellular. The ratio of intracellular to extracellular potassium is important in determining the cellular membrane potential. Small changes in the extracellular potassium level can have profound effects on the function of the cardiovascular and neuromuscular systems. Hypokalaemia may result from conditions as varied as renal or gastrointestinal (GI) losses, inadequate diet, transcellular shift (movement of potassium from serum into cells) and medications. The important causes of hypokalaemia are:

      Renal losses: renal tubular acidosis, hyperaldosteronism, magnesium depletion, leukaemia (mechanism uncertain).

      GI losses: vomiting or nasogastric suctioning, diarrhoea, enemas or laxative use, ileal loop.

      Medication effects: diuretics (most common cause), β-adrenergic agonists, steroids, theophylline, aminoglycosides.

      Transcellular shift: insulin, alkalosis.

      Severe hypokalaemia, with serum potassium concentrations of 2.5–3 meq/l, may cause muscle weakness, myalgia, tremor, muscle cramps and constipation.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      41.3
      Seconds
  • Question 2 - The oesophagus is an important part of the alimentary canal. It receives blood...

    Incorrect

    • The oesophagus is an important part of the alimentary canal. It receives blood from various arteries in the body. Which one of the following is an artery that will lead to some level of ischaemia to the oesophagus when ligated?

      Your Answer: Superior mesenteric

      Correct Answer: Left inferior phrenic

      Explanation:

      The oesophagus receives its blood supply from the following arteries: the inferior thyroid branch of the thyrocervical trunk, the descending thoracic aorta, the left gastric branch of the coeliac artery and the from the left inferior phrenic artery of the abdominal aorta. Hence ligation of the left inferior phrenic will lead to ischemia to some portions of the oesophagus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      36.8
      Seconds
  • Question 3 - Cervical intraepithelial neoplasia on Pap smear of a 34-year old lady is most...

    Correct

    • Cervical intraepithelial neoplasia on Pap smear of a 34-year old lady is most likely associated with which of the following?

      Your Answer: Human papillomavirus infection

      Explanation:

      CIN (Cervical intraepithelial neoplasia) is considered a precursor of cervical cancer and is likely caused due to infection with human papillomavirus (HPV) types 16, 18, 31, 33, 35 or 39. The risk factors for cervical cancer include multiple sex partners, young age at the time of first intercourse, intercourse with men whose previous partners had cervical cancer. Also, smoking and immunodeficient states are considered contributory. CIN is graded as mild (grade I), moderate (grade II) and severe dysplasia or carcinoma in situ (grade III). CIN III rarely regresses spontaneously and can lead to invasive carcinoma by invading the basement membrane. Squamous cell carcinomas are the commonest cervical cancer seen in 80-85% of all cases. Others are commonly adenocarcinomas. Cervical cancer can spread by direct extension, lymphatic spread to pelvic and para-aortic nodes or by hematogenous route.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      12.9
      Seconds
  • Question 4 - During a surgical procedure involving the carotid artery, which nerve in the cervical...

    Correct

    • During a surgical procedure involving the carotid artery, which nerve in the cervical plexus of nerves that is embedded in the carotid sheath is most susceptible to injury?

      Your Answer: Ansa cervicalis

      Explanation:

      The ansa cervicalis is a loop of nerves that are part of the cervical plexus. They lie superficial to the internal jugular vein in the carotid triangle. Branches from the ansa cervicalis innervate the sternohyoid, sternothyroid and the inferior belly of the omohyoid. The superior root of the ansa cervicalis is formed by a branch of spinal nerve C1. These nerve fibres travel in the hypoglossal nerve before leaving to form the superior root. The superior root goes around the occipital artery and then descends embedded in the carotid sheath. It sends a branch off to the superior belly of the omohyoid muscle and is then joined by the inferior root. The inferior root is formed by fibres from spinal nerves C2 and C3.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      8.6
      Seconds
  • Question 5 - A young women following a road traffic accident suffered heavy blood loss and...

    Correct

    • A young women following a road traffic accident suffered heavy blood loss and developed subsequent anaemia. Which of the following is a consequence of this?

      Your Answer: A high reticulocyte count

      Explanation:

      Anaemia refers to a decrease in the circulating levels of haemoglobin in the blood resulting in a reduced ability of the body to transport oxygen effectively. Anaemia from blood loss results in the body further compensating by releasing stored RBCs and immature RBCs from the bone marrow. Thus resulting in a high reticulocyte count.

    • This question is part of the following fields:

      • General
      • Physiology
      16.2
      Seconds
  • Question 6 - Which of the following substances is most likely to cause pulmonary vasodilatation? ...

    Correct

    • Which of the following substances is most likely to cause pulmonary vasodilatation?

      Your Answer: Nitric oxide

      Explanation:

      In the body, nitric oxide is synthesised from arginine and oxygen by various nitric oxide synthase (NOS) enzymes and by sequential reduction of inorganic nitrate. The endothelium of blood vessels uses nitric oxide to signal the surrounding smooth muscle to relax, so dilating the artery and increasing blood flow. Nitric oxide/oxygen blends are used in critical care to promote capillary and pulmonary dilation to treat primary pulmonary hypertension in neonatal patients post-meconium aspiration and related to birth defects.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      8.2
      Seconds
  • Question 7 - A 42 year old women presents with end stage renal failure and is...

    Correct

    • A 42 year old women presents with end stage renal failure and is prepared to receive a kidney from her husband. HLA testing showed that they are not a 100% match and she is given immunosuppressant therapy for this. Three months later when her renal function tests were performed she showed signs of deteriorating renal function, with decreased renal output, proteinuria of +++ and RBCs in the urine. She was given antilymphocyte globulins and her condition reversed. What type of graft did this patient receive?

      Your Answer: Allograft

      Explanation:

      Allograft describes a graft between two of the same species. As the donor and the recipients are history-incompatible, rejection of the graft is common and is controlled by immunosuppressive drug therapy. Isograft and syngraft are synonymous and referred to a graft transferred between genetically identical individuals e.g. identical twins. In this case rejection is rare as they are history-compatible.

      Autograft refers to transfer of one part of the body to another location.

      Xenograft is transfer of tissue from another species e.g. pig to human in valve replacement surgeries and rejection is very high.

    • This question is part of the following fields:

      • Inflammation & Immunology; Renal
      • Pathology
      27.6
      Seconds
  • Question 8 - Which of these is secreted by both macrophages and muscle cells? ...

    Incorrect

    • Which of these is secreted by both macrophages and muscle cells?

      Your Answer: Interleukin 1

      Correct Answer: Interleukin-6

      Explanation:

      IL-6 is secreted by the T cells and macrophages and is a pro inflammatory cytokine. It is secreted in response to trauma e.g. burns and tissue damage that leads to inflammation. Apart from this its is also a myokine and is elevated due to muscle contraction. Other functions include: stimulate osteoclast formation when secreted by osteoblasts, mediate fever in acute phase response and are responsible for energy metabolism in muscle and fatty tissues. Inhibitors of IL-6 e.g. oestrogen are used as a treatment for postmenopausal osteoporosis.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      7.5
      Seconds
  • Question 9 - Which of the following clinical signs will be demonstrated in a case of...

    Incorrect

    • Which of the following clinical signs will be demonstrated in a case of Brown-Séquard syndrome due to hemisection of the spinal cord at mid-thoracic level?

      Your Answer: Ipsilateral spastic paralysis, contralateral loss of vibration and proprioception (position sense) and ipsilateral loss of pain and temperature sensation beginning one or two segments below the lesion

      Correct Answer: Ipsilateral spastic paralysis, ipsilateral loss of vibration and proprioception (position sense) and contralateral loss of pain and temperature sensation beginning one or two segments below the lesion

      Explanation:

      Brown–Séquard syndrome results due to lateral hemisection of the spinal cord and results in a loss of motricity (paralysis and ataxia) and sensation. The hemisection of the cord results in a lesion of each of the three main neural systems: the principal upper motor neurone pathway of the corticospinal tract, one or both dorsal columns and the spinothalamic tract. As a result of the injury to these three main brain pathways the patient will present with three lesions. The corticospinal lesion produces spastic paralysis on the same side of the body (the loss of moderation by the upper motor neurons). The lesion to fasciculus gracilis or fasciculus cuneatus results in ipsilateral loss of vibration and proprioception (position sense). The loss of the spinothalamic tract leads to pain and temperature sensation being lost from the contralateral side beginning one or two segments below the lesion. At the lesion site, all sensory modalities are lost on the same side, and an ipsilateral flaccid paralysis.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      9.9
      Seconds
  • Question 10 - A 25 year-old female medical student presents with fever, lack of appetite, rashes,...

    Correct

    • A 25 year-old female medical student presents with fever, lack of appetite, rashes, sore throat and lymphadenopathy. Peripheral smear shows atypical lymphocytes. Which is the most likely organism responsible for this patient's condition?

      Your Answer: Epstein–Barr virus

      Explanation:

      Epstein-Barr virus is in the herpes family of viruses and most people will become infected with EBV sometime during their lives. EBV commonly causes infectious mononucleosis, or mono, a contagious viral illness that initially attacks the lymph nodes in the neck and throat. When these tissues become less effective in fighting infection, sore throats, swelling of the nodes and fever may result.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      39.6
      Seconds
  • Question 11 - A 45 year old women has a 4 cm non tender mass in...

    Correct

    • A 45 year old women has a 4 cm non tender mass in her right breast which is fixed to the chest wall. Another 2cm non-tender mass is palpable in the left axilla. Chest x ray reveals multiple nodules ranging from 0.5 - 0.2 cm in both the lungs. What is the stage of her disease?

      Your Answer: T4 N1 M1

      Explanation:

      This woman has an invasive primary tumour mass with axillary node and lung metastases, making this stage T4 N1 M1. Looking at the other stems, T1 N1 M0 signifies a small primary cancer with nodal metastases but no distant metastases; T1 N0 M1 signifies a small primary cancer with no lymph node metastases but with distant metastases; T2 N1 M0 signifies a larger primary cancer with nodal metastases but no distant metastases; and T3 N0 M0 indicates a larger primary cancer with no metastases to either lymph nodes or to distant sites.

    • This question is part of the following fields:

      • Neoplasia; Female Health
      • Pathology
      39.3
      Seconds
  • Question 12 - Which is the CORRECT statement regarding the small intestine: ...

    Incorrect

    • Which is the CORRECT statement regarding the small intestine:

      Your Answer: Postganglionic sympathetic fibres to the jejunum and ileum arise from synapses with preganglionic sympathetic fibres located in the coeliac ganglion

      Correct Answer: The superior mesenteric artery courses between the body and uncinate process of the pancreas before the artery supplies the jejunum and ileum

      Explanation:

      The small intestine extends from the pylorus to the ileocecal valve where It ends in the large intestine. It is surrounded on the sides and above by the large intestine. It is related anteriorly with the greater omentum and abdominal wall. Is connected to the vertebral column by a fold of peritoneum or otherwise known as the mesentery. Is divided into three portions: the duodenum, jejunum and ileum. The jejunum and ileum are supplied by the superior mesenteric artery that courses between the body and uncinate process of the pancreas before it gives off intestinal branches.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      38.5
      Seconds
  • Question 13 - A 50 year old male point was diagnosed with tennis elbow that became...

    Correct

    • A 50 year old male point was diagnosed with tennis elbow that became worse after he started playing basket ball over the last three months. He was admitted to the orthopaedic ward to have elbow braces fitted. What type of synovial joint is the elbow joint?

      Your Answer: Hinge

      Explanation:

      The elbow joint is one of the many synovial joints in the body. This joint is an example of the hinge joint as the humerus is received into the semilunar notch of the ulna and the capitulum of the humerus articulates with the fovea on the head of the radius, together acting as a hinge in one plane.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      11.8
      Seconds
  • Question 14 - A computer tomography guided needle biopsy is done on a patient with a...

    Correct

    • A computer tomography guided needle biopsy is done on a patient with a cystic swelling in the left chest. The radiologist inserted the biopsy needle into the 9th intercostal space along the mid axillary line to aspirate the swelling and obtain tissue for histological diagnosis. In which space is the swelling most likely to be?

      Your Answer: Costodiaphragmatic recess

      Explanation:

      The costodiaphragmatic recess is the lowest point of the pleural sac where the costal pleura becomes the diaphragmatic pleura. At the midclavicular line, this is found between ribs 6 and 8; at the paravertebral lines, between ribs 10 and 12 and between ribs 8 and 10 at the midaxillary line.

      The cardiac notch: is an indentation of the heart on the left lung, located on the anterior surface of the lung.

      Cupola: part of the parietal pleura that extends above the first rib.

      Oblique pericardial sinus: part of the pericardial sac located posterior to the heart behind the left atrium.

      Costomediastinal recess: a reflection of the pleura from the costal surface to the mediastinal surface, is on the anterior surface of the chest.

      The inferior mediastinum: is the space in the chest occupied by the heart.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      24.6
      Seconds
  • Question 15 - During an anatomy revision session, medical students are told that the posterior wall...

    Correct

    • 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: 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
      11.3
      Seconds
  • Question 16 - During a street fight a boy sustained a laceration below the elbow. It...

    Correct

    • During a street fight a boy sustained a laceration below the elbow. It was a deep cut that led to profuse bleeding from an artery situated on the supinator muscle immediately below the elbow. The vessel most likely to have been injured is?

      Your Answer: Radial recurrent artery

      Explanation:

      The radial recurrent artery is situated on the supinator muscle then passing between the brachialis and the brachioradialis muscles. It originates from the radial artery and ends by anastomosing with the terminal part of the Profunda brachii.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      36.7
      Seconds
  • Question 17 - What is the arterial sequence for an analgesic to reach the latissimus dorsi...

    Incorrect

    • What is the arterial sequence for an analgesic to reach the latissimus dorsi muscle assuming that your starting point is at the subclavian vein?

      Your Answer: Subclavian – axillary – acromioclavicular – acromial

      Correct Answer: Subclavian – axillary – subscapular – thoracodorsal

      Explanation:

      Assuming our starting point is the subclavian artery, the analgesic continues in the same vessel into the axillary artery, as it passes into the axilla. The axillary artery at the lower border of the subscapularis gives rise to the subcapsular artery which is considered the largest branch of the axillary artery. This circumflex scapular branch distributes a serratus branch before entering the substance of the muscle as the thoracodorsal artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      35.3
      Seconds
  • Question 18 - A patient is admitted to the ICU, and is prescribed tazobactam, amongst other...

    Correct

    • A patient is admitted to the ICU, and is prescribed tazobactam, amongst other drugs. What is the mechanism of action of tazobactam?

      Your Answer: Inhibits beta-lactamase

      Explanation:

      Tazobactam is a compound which inhibits the action of bacterial beta-lactamases. It is added to the extended-spectrum beta-lactam antibiotic piperacillin to broaden the spectrum of piperacillin by making it effective against organisms that express beta-lactamase and would normally degrade piperacillin.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      9.6
      Seconds
  • Question 19 - A 25-year-old female had a painful abdomen and several episodes of vomiting. She...

    Correct

    • A 25-year-old female had a painful abdomen and several episodes of vomiting. She was severely dehydrated when she was brought to the hospital. Her ABG showed a pH 7.7, p(O2) 75 mmHg, p(CO2) 46 mmHg and bicarbonate 48 mmol/l. The most likely interpretation of this ABG report would be:

      Your Answer: Metabolic alkalosis

      Explanation:

      Metabolic alkalosis is a primary increase in bicarbonate (HCO3−) with or without compensatory increase in carbon dioxide partial pressure (Pco2); pH may be high or nearly normal. Metabolic alkalosis occurs as a consequence of a loss of H+ from the body or a gain in HCO3 -. In its pure form, it manifests as alkalemia (pH >7.40). As a compensatory mechanism, metabolic alkalosis leads to alveolar hypoventilation with a rise in arterial carbon dioxide tension p(CO2), which diminishes the change in pH that would otherwise occur. Normally, arterial p(CO2) increases by 0.5–0.7 mmHg for every 1 mmol/l increase in plasma bicarbonate concentration, a compensatory response that occurs very rapidly. If the change in p(CO2) is not within this range, then a mixed acid–base disturbance occurs. Likewise, if the increase in p(CO2) is less than the expected change, then a primary respiratory alkalosis is also present. However an elevated serum bicarbonate concentration can also occur due to a compensatory response to primary respiratory acidosis. A bicarbonate concentration greater than 35 mmol/l is almost always caused by metabolic alkalosis (as is the case in this clinical scenario). Calculation of the serum anion gap can also help to differentiate between primary metabolic alkalosis and the metabolic compensation for respiratory acidosis. The anion gap is frequently elevated to a modest degree in metabolic alkalosis because of the increase in the negative charge of albumin and the enhanced production of lactate. However, the only definitive way to diagnose metabolic alkalosis is by performing a simultaneous blood gases analysis, which reveals elevation of both pH and arterial p(CO2) and increased calculated bicarbonate.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      59.3
      Seconds
  • Question 20 - A 13-year-old boy's mother notices he has a lump in his arm, near...

    Correct

    • A 13-year-old boy's mother notices he has a lump in his arm, near his right shoulder. An X-ray reveals a lateral projection in the metaphyseal region of his humerus. The lesion is removed and it is found to be composed of bony cortex, capped by cartilage. What's the most likely diagnosis in this case?

      Your Answer: Osteochondroma

      Explanation:

      Osteochondromas, or osteocartilaginous exostoses, are the most common benign bone tumours, and tend to appear near the ends of long bones. The overgrowth can occur in any bone where cartilage forms bone, and they are capped by cartilage. They are most common in people between the ages of 10-20 years old.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      25.8
      Seconds
  • Question 21 - A chest X-ray in a healthy, non-smoker, asymptomatic 48-year-old woman reveals a 2cm...

    Incorrect

    • A chest X-ray in a healthy, non-smoker, asymptomatic 48-year-old woman reveals a 2cm left lower lobe well-defined round opacity. Which of the following conditions is most probably responsible for this finding?

      Your Answer: Mesothelioma

      Correct Answer: Pulmonary hamartoma

      Explanation:

      An asymptomatic healthy patient with no history of smoking and a lesion of small size most probably has a benign lung lesion. Hamartomas are one of the most common benign tumours of the lung that accounts for approximately 6% of all solitary pulmonary nodules. Pulmonary hamartomas are usually asymptomatic and therefore are found incidentally when performing an imaging test for other reasons.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      21
      Seconds
  • Question 22 - During an operation to repair an indirect inguinal hernia, you are asked to...

    Correct

    • During an operation to repair an indirect inguinal hernia, you are asked to indicate the position of the deep inguinal ring. You indicate this as being:

      Your Answer: Above the midpoint of the inguinal ligament

      Explanation:

      The deep inguinal ring is near the midpoint of the inguinal ligament, below the anterior superior iliac spine. It is lateral to the inferior epigastric artery. The superficial ring, however, is found above the pubic tubercle. The supravesical fossa is the space between the median and medial umbilical folds.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      100.2
      Seconds
  • Question 23 - 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
      6.7
      Seconds
  • Question 24 - the action of the semimembranosus muscle is: ...

    Correct

    • the action of the semimembranosus muscle is:

      Your Answer: Extension of the hip and flexion of the knee

      Explanation:

      the semimembranosus is situated at the back and medial side of the thigh. It arises from the upper and outer impression on the tuberosity of the ischium, above and lateral to the biceps femoris and semitendinosus. It is inserted mainly into the horizontal groove on the posterior medial aspect of the medial condyle of the tibia. it flexes the knee and assists in extension of the hip.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      33.3
      Seconds
  • Question 25 - Which of the cranial nerves is responsible for touch sensation on the skin...

    Correct

    • Which of the cranial nerves is responsible for touch sensation on the skin over the maxilla region and the mandible?

      Your Answer: Trigeminal

      Explanation:

      The sensation of the face is provided by the trigeminal nerve which is cranial nerve V. It is also responsible for other motor functions such as biting and chewing. The trigeminal nerve has three branches; the ophthalmic nerve (V1), the maxillary nerve((V2) and the mandibular nerve (V3). These three branches exit the skull through separate foramina, namely; the superior orbital fissure, the foramen rotundum and the foramen ovale respectively. The mnemonic for this is ‘Standing room only’. The sensory fibres of the maxillary nerve are distributed to the lower eyelid and cheek, the nares and upper lip, the upper teeth and gums, the nasal mucosa, the palate and roof of the pharynx, the maxillary, ethmoid and sphenoid sinuses, and parts of the meninges. The sensory fibres of the mandibular nerve are distributed to the lower lip, the lower teeth and gums, the floor of the mouth, the anterior two-thirds of the tongue, the chin and jaw (except the angle of the jaw, which is supplied by C2–C3), parts of the external ear, and parts of the meninges. The mandibular nerve carries touch/ position and pain/temperature sensation from the mouth. The sensory fibres of the ophthalmic nerve are distributed to the scalp and forehead, the upper eyelid, the conjunctiva and cornea of the eye, the nose (including the tip of the nose), the nasal mucosa, the frontal sinuses and parts of the meninges (the dura and blood vessels). The sensory fibres of the maxillary nerve are distributed to the lower eyelid and cheek, the nares and upper lip, the upper teeth and gums, the nasal mucosa, the palate and roof of the pharynx, the maxillary, ethmoid and sphenoid sinuses, and parts of the meninges.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      22
      Seconds
  • Question 26 - A 56 year old gentleman, who is a chronic smoker presents to the...

    Incorrect

    • A 56 year old gentleman, who is a chronic smoker presents to the clinic with dyspnoea. His Chest X-ray shows intercostal space widening with increased blackening bilaterally. What is the most likely finding on his pulmonary function test?

      Your Answer: Decreased total lung capacity

      Correct Answer: Increased total lung capacity

      Explanation:

      In patients suspected of having chronic obstructive pulmonary disease, pulmonary function testing (PFT) is useful to confirm airway obstruction, to quantify its severity and reversibility, for following disease progression and monitoring response to treatment. These tests include:

      FEV1 – volume of air forcefully expired during the first second after a full breath

      Forced vital capacity (FVC) – total volume of air expired with maximal force and flow-volume loops. The hallmark of airway obstruction is reduction of FEV1, FVC and the ratio of FEV1/FVC, with a concave pattern in expiratory tracing on the flow-volume loop. FEV1 and forced vital capacity (FVC) are easily measured with office spirometry and are useful to assess the severity of disease. Other parameters include increased total lung capacity, functional residual capacity and residual volume, which can help distinguish chronic obstructive pulmonary disease (COPD) from restrictive pulmonary disease where these values are lower than normal. Along with these, other tests are decreased vital capacity; and decreased diffusing capacity for carbon monoxide (DLCO). DLCO is non-specific and can be low in other disorders that affect the pulmonary vascular bed, such as interstitial lung disease. DLCO is however useful to distinguish COPD from asthma, in which DLCO is normal or elevated.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      20.1
      Seconds
  • Question 27 - From which of the following cells is heparin produced? ...

    Incorrect

    • From which of the following cells is heparin produced?

      Your Answer: Endothelial cells

      Correct Answer: Mast cells

      Explanation:

      Heparin is a natural highly-sulphated glycosaminoglycan that has anticoagulant functions. It is produced by the body basophils and mast cells.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      17
      Seconds
  • Question 28 - A 60 year old patient with a history of carcinoma of the head...

    Correct

    • A 60 year old patient with a history of carcinoma of the head of the pancreas, and obstructive jaundice presents with a spontaneous nose bleed and easy bruising. What is the most likely reason for this?

      Your Answer: Vitamin-K-dependent clotting factors deficiency

      Explanation:

      Vitamin K is a fat soluble vitamin requiring fat metabolism to function properly to allow for its absorption. People with obstructive jaundice develop vitamin k deficiency as fat digestion is impaired. Vit K causes carboxylation of glutamate residue and hence regulates blood coagulation including: prothrombin (factor II), factors VII, IX, X, protein C, protein S and protein Z.

    • This question is part of the following fields:

      • General
      • Physiology
      9.7
      Seconds
  • Question 29 - A 55-year old lady underwent a major surgery for repair of an aortic...

    Correct

    • 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: 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
      15
      Seconds
  • Question 30 - Which of the following conditions is characterized by generalised oedema due to effusion...

    Correct

    • Which of the following conditions is characterized by generalised oedema due to effusion of fluid into the extracellular space?

      Your Answer: Anasarca

      Explanation:

      Anasarca (or ‘generalised oedema’) is a condition characterised by widespread swelling of the skin due to effusion of fluid into the extracellular space. It is usually caused by liver failure (cirrhosis of the liver), renal failure/disease, right-sided heart failure, as well as severe malnutrition/protein deficiency.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      14.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Fluids & Electrolytes (3/3) 100%
Physiology (5/7) 71%
Abdomen (2/4) 50%
Anatomy (8/11) 73%
Pathology (9/12) 75%
Women's Health (1/1) 100%
Head & Neck (2/2) 100%
General (2/2) 100%
Respiratory (1/3) 33%
Inflammation & Immunology; Renal (1/1) 100%
Inflammation & Immunology (0/1) 0%
Neurology (0/1) 0%
Microbiology (1/1) 100%
Neoplasia; Female Health (1/1) 100%
Upper Limb (2/3) 67%
Thorax (1/1) 100%
Pharmacology (1/1) 100%
Orthopaedics (1/1) 100%
Urology (1/1) 100%
Lower Limb (1/1) 100%
Haematology (0/1) 0%
Renal (1/1) 100%
Passmed