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  • Question 1 - Regarding postural hypotension, which of the following statements is INCORRECT: ...

    Correct

    • Regarding postural hypotension, which of the following statements is INCORRECT:

      Your Answer: Postural hypotension usually causes a reflex bradycardia.

      Explanation:

      On standing from a prone position, gravity causes blood to pool in veins in the legs. Central venous pressure (CVP) falls, causing a fall in stroke volume and cardiac output (due to Starling’s law) and thus a fall in blood pressure. Normally this fall in BP is rapidly corrected by the baroreceptor reflex which causes venoconstriction (partially restoring CVP), and an increase in heart rate and contractility, so restoring cardiac output and blood pressure. Impaired autonomic nervous activity in the elderly accounts for the greater likelihood of postural hypotension. Any symptoms of dizziness, blurred vision or syncope is due to a transient fall in cerebral perfusion that occurs before cardiac output and mean arterial pressure (MAP) can be corrected.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      27.5
      Seconds
  • Question 2 - A patient with abdominal pain, vomiting and bloody diarrhoea develops a low platelet...

    Incorrect

    • A patient with abdominal pain, vomiting and bloody diarrhoea develops a low platelet count and deranged renal function. A diagnosis of haemolytic uraemic syndrome is made.
      Which of the following organisms is a recognised cause of haemolytic uraemic syndrome? Select ONE answer only.

      Your Answer: Salmonella typhi

      Correct Answer: Escherichia coli

      Explanation:

      E.Colistrain 0157 causes enterohaemorrhagic diarrhoea and can be followed by haemolytic uraemic syndrome (renal failure, haemolytic anaemia and thrombocytopenia).

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      33.4
      Seconds
  • Question 3 - Which coronary artery is mostly likely affected if an ECG shows ST segment...

    Incorrect

    • Which coronary artery is mostly likely affected if an ECG shows ST segment elevation in leads II, III and aVF, and ST segment depression in V1-V3?

      Your Answer: Left anterior descending artery

      Correct Answer: Right coronary artery

      Explanation:

      A posterior wall MI occurs when posterior myocardial tissue (now termed inferobasilar), usually supplied by the posterior descending artery — a branch of the right coronary artery in 80% of individuals — acutely loses blood supply due to intracoronary thrombosis in that vessel. This frequently coincides with an inferior wall MI due to the shared blood supply.

      The ECG findings of an acute posterior wall MI include the following:

      1. ST segment depression (not elevation) in the septal and anterior precordial leads (V1-V4). This occurs because these ECG leads will see the MI backwards; the leads are placed anteriorly, but the myocardial injury is posterior.
      2. A R/S wave ratio greater than 1 in leads V1 or V2.
      3. ST elevation in the posterior leads of a posterior ECG (leads V7-V9). Suspicion for a posterior MI must remain high, especially if inferior ST segment elevation is also present.
      4. ST segment elevation in the inferior leads (II, III and aVF) if an inferior MI is also present.

      The following ECG leads determine the location and vessels involved in myocardial infarction:

      ECG Leads Location Vessel involved
      V1-V2 Septal wall Left anterior descending
      V3-V4 Anterior wall Left anterior descending
      V5-V6 Lateral wall Left circumflex artery
      II, III, aVF Inferior wall Right coronary artery (80%) or Left circumflex artery (20%)
      I, aVL High lateral wall Left circumflex artery
      V1, V4R Right ventricle Right coronary artery
      V7-V9 Posterior wall Right coronary artery

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      48.4
      Seconds
  • Question 4 - Cryptococcus neoformans is primarily transmitted by which of the following routes: ...

    Incorrect

    • Cryptococcus neoformans is primarily transmitted by which of the following routes:

      Your Answer: Respiratory droplet spread

      Correct Answer: Inhalation of spores

      Explanation:

      Cryptococcus neoformans is found in bird droppings and transmission is by inhalation of spores, thus the lung is the primary site of infection.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      9.6
      Seconds
  • Question 5 - During quiet respiration, position of the right oblique fissure can be marked by...

    Incorrect

    • During quiet respiration, position of the right oblique fissure can be marked by a line drawn on the thoracic wall that:

      Your Answer: Begins at the spinous process of T6, crosses the fifth intercostal space laterally and follows the contour of rib 7 anteriorly.

      Correct Answer: Begins at the spinous process of T4, crosses the fifth intercostal space laterally and follows the contour of rib 6 anteriorly.

      Explanation:

      During quiet respiration, the approximate position of the right oblique fissure can be marked by a line on the thoracic wall that begins at the spinous process of vertebra T4, crosses the fifth intercostal space laterally and then follows the contour of rib 6 anteriorly.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      20.4
      Seconds
  • Question 6 - Blood flows from the left atrium into the left ventricle via: ...

    Correct

    • Blood flows from the left atrium into the left ventricle via:

      Your Answer: The mitral valve

      Explanation:

      Blood flows from the right atrium into the right ventricle via the tricuspid atrioventricular valve and from the left atrium into the left ventricle via the mitral atrioventricular valve. Blood is ejected from the right ventricle through the pulmonary semilunar valve into the pulmonary artery and from the left ventricle via the aortic semilunar valve into the aorta.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      53.9
      Seconds
  • Question 7 - An X-ray of a 24-year-old female hockey player who arrives at the hospital...

    Correct

    • An X-ray of a 24-year-old female hockey player who arrives at the hospital with a left foot injury reveals an avulsion fracture of the fifth metatarsal tuberosity. Which of the following muscles is most likely responsible for the movement of the fractured fragment?

      Your Answer: Fibularis brevis

      Explanation:

      An avulsion fracture of the base of the fifth metatarsal happens when the ankle is twisted inwards.

      When the ankle is twisted inwards a muscle called the fibularis brevis contracts to stop the movement and protect the ligaments of the ankle.

      The base of the fifth metatarsal is where this muscle is attached. The group of lateral leg muscles that function to plantarflex the foot includes the fibularis brevis and the fibularis longus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      127.8
      Seconds
  • Question 8 - You are about to perform an emergency pericardiocentesis on a 26-year-old male who...

    Correct

    • You are about to perform an emergency pericardiocentesis on a 26-year-old male who was involved in a car accident and is suspected of having cardiac tamponade due to signs of hypotension, muffled heart sounds, and distended neck veins. Where should you insert the needle to relieve tamponade?

      Your Answer: Inferior and to the left of the xiphochondral junction

      Explanation:

      Pericardiocentesis is a procedure that removes excess fluid from the pericardium. As a result, it’s used in cases of cardiac tamponade, which occurs when there’s too much fluid in the space around the heart.

      During the procedure, a needle and a small catheter are inserted 1 to 2 cm inferior and to the left of the xiphochondral junction into the pericardial cavity.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      29
      Seconds
  • Question 9 - For an action potential to occur, which of the following must be true:...

    Correct

    • For an action potential to occur, which of the following must be true:

      Your Answer: Depolarisation of the membrane must reach threshold potential

      Explanation:

      For an action potential to occur, the membrane must become more permeable to Na+and the Na+influx must be greater than the K+efflux. An action potential occurs when depolarisation of the membrane reaches threshold potential. The membrane must be out of the absolute refractory period, however an action potential can still occur in a relative refractory period but only in response to a larger than normal stimulus.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      30.9
      Seconds
  • Question 10 - Aplastic crises in sickle cell anaemia is classically precipitated by which of the...

    Incorrect

    • Aplastic crises in sickle cell anaemia is classically precipitated by which of the following infections:

      Your Answer: Epstein-Barr virus

      Correct Answer: Parvovirus B19

      Explanation:

      A serious complication in sickle cell disease (SCD) is the aplastic crisis. This may be caused by infection with Parvovirus B-19 (B19V). This virus causes fifth disease, a normally benign childhood disorder associated with fever, malaise, and a mild rash. This virus infects RBC progenitors in bone marrow, resulting in impaired cell division for a few days.
      Healthy people experience, at most, a slight drop in hematocrit, since the half-life of normal erythrocytes in the circulation is 40-60 days. In people with SCD, however, the RBC lifespan is greatly shortened (usually 10-20 days), and a very rapid drop in Hb occurs. The condition is self-limited, with bone marrow recovery occurring in 7-10 days, followed by brisk reticulocytosis.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      15.9
      Seconds
  • Question 11 - Calcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic...

    Incorrect

    • Calcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic chemical structure of these two classes differs, as does their relative selectivity for cardiac versus vascular L-type calcium channels. The phenylalkylamine class and the benzothiazepine class are two subgroups of non-dihydropyridines.

      A phenylalkylamine calcium-channel blocker is, for example, which of the following?

      Your Answer: Nimodipine

      Correct Answer: Verapamil

      Explanation:

      Calcium-channel blockers, also known as calcium antagonists, stop calcium from entering cells through the L-type calcium channel. This causes vascular smooth muscle in vessel walls to relax, resulting in a decrease in peripheral vascular resistance.
      They can be used for a variety of things, including:
      Hypertension
      Angina
      Atrial fibrillation
      Migraine

      Calcium-channel blockers can be divided into two categories: dihydropyridines and non-dihydropyridines. The basic chemical structure of these two classes differs, as does their relative selectivity for cardiac versus vascular L-type calcium channels.

      Dihydropyridines have a high vascular selectivity and lower systemic vascular resistance and blood pressure. As a result, they’re frequently used to treat hypertension. Modified release formulations are also used to treat angina, but their powerful systemic vasodilator and pressure-lowering effects can cause reflex cardiac stimulation, resulting in increased inotropy and tachycardia, which can counteract the beneficial effects of reduced afterload on myocardial oxygen demand.

      The suffix -dpine distinguishes dihydropyridines from other pyridines. Examples of dihydropyridines that are commonly prescribed include:
      Amlodipine
      Felodipine
      Nifedipine
      Nimodipine

      The phenylalkylamine class and the benzothiazepine class are two subgroups of non-dihydropyridines.

      Phenylalkylamines are less effective as systemic vasodilators because they are relatively selective for the myocardium. This group of drugs lowers myocardial oxygen demand and reverses coronary vasospasm, making them useful in the treatment of angina. They are also occasionally used to treat arrhythmias. A phenylalkylamine calcium-channel blocker like verapamil is an example.

      In terms of selectivity for vascular calcium channels, benzothiazepines fall somewhere between dihydropyridines and phenylalkylamines. They can lower arterial pressure without producing the same level of reflex cardiac stimulation as dihydropyridines because they have both cardiac depressant and vasodilator effects. Diltiazem is the only benzothiazepine currently in clinical use.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      37.8
      Seconds
  • Question 12 - You note that the prostate of a 60-year-old patient is enlarged during the...

    Incorrect

    • You note that the prostate of a 60-year-old patient is enlarged during the examination. You suspect BPH. Anatomically, the prostate has four main lobes. Which of the lobes is affected by benign prostatic hypertrophy?

      Your Answer: Posterior lobe

      Correct Answer: Median lobe

      Explanation:

      Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is characterized by an enlarged prostate gland.

      The prostate is divided into four major lobes. The median lobe is the most commonly affected by benign prostatic enlargement, resulting in urethral obstruction and urine symptoms.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      22.2
      Seconds
  • Question 13 - You are instructed by a senior to administer Mannitol to an RTA patient...

    Correct

    • You are instructed by a senior to administer Mannitol to an RTA patient with increased intracranial pressure.

      Mannitol is a low molecular weight compound that freely filters at the glomerulus and is not reabsorbed.
      Out of the following, which is a contraindication to the use of mannitol?

      Your Answer: Severe pulmonary oedema

      Explanation:

      Mannitol is the most widely used osmotic diuretic that is most commonly used to reduce cerebral oedema and intracranial pressure.
      It is recommended to use mannitol for the reduction of CSF pressure/cerebral oedema in a dose of 0.25-2 g/kg as an intravenous infusion over 30-60 minutes. This can be repeated 1-2 times after 4-8 hours if needed.

      Mannitol has several contraindications and some of them are listed below:
      1. Anuria due to renal disease
      2. Acute intracranial bleeding (except during craniotomy)
      3. Severe cardiac failure
      4. Severe dehydration
      5. Severe pulmonary oedema or congestion
      6. Known hypersensitivity to mannitol

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      25.2
      Seconds
  • Question 14 - A patient presents to ED complaining of a purulent discharge, urethral discomfort and...

    Correct

    • A patient presents to ED complaining of a purulent discharge, urethral discomfort and dysuria. You suspect gonorrhoea. Which of the following cell components produced by Neisseria gonorrhoeae is responsible for attachment to host cells:

      Your Answer: Pili

      Explanation:

      Infection of the genital mucosa by Neisseria gonorrhoeae involves attachment to and invasion of epithelial cells. Initial adherence of gonococci to columnar epithelial cells is mediated by type IV pili assembled from pilin subunit PilE proteins and pilus tip-associated PilC proteins, it then invades the epithelial layer, triggering a local acute inflammatory response.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      23.5
      Seconds
  • Question 15 - A 70-year old male is taken to the Emergency Room after suffering a...

    Correct

    • A 70-year old male is taken to the Emergency Room after suffering a traumatic fall while showering. Upon physical examination, the attending physician noted a hyperextended neck, 1/5 muscle strength in both upper extremities, 4/5 muscle strength in both lower extremities, and variable loss in sensation. The patient is placed in the wards for monitoring. For the next 24 hours, anuria is noted.

      Which of the following spinal cord injuries is the most likely diagnosis?

      Your Answer: Central cord syndrome

      Explanation:

      Central cord syndrome is the most common type of incomplete cord injury and almost always occurs due to a traumatic injury. It results in motor deficits that are worse in the upper extremities as compared to the lower extremities. It may also cause bladder dysfunction (retention) and variable sensory deficits below the level of injury.

      The majority of these patients will be older and present with symptoms after a fall with hyperextension of their neck. On examination, patients will have more significant strength impairments in the upper extremities (especially the hands) compared to the lower extremities. Patients often complain of sensory deficits below the level of injury, but this is variable. Pain and temperature sensations are typically affected, but the sensation of light touch can also be impaired. The most common sensory deficits are in a cape-like distribution across their upper back and down their posterior upper extremities. They will often have neck pain at the site of spinal cord impingement.

      Bladder dysfunction (most commonly urinary retention) and priapism can also be signs of upper motor neuron dysfunction. The sacral sensation is usually preserved, but the clinician should assess the rectal tone to evaluate the severity of the compression.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      75
      Seconds
  • Question 16 - Antidiuretic hormone (ADH) has which of the following effects: ...

    Correct

    • Antidiuretic hormone (ADH) has which of the following effects:

      Your Answer: Increases urine osmolality

      Explanation:

      ADH binds V2 receptors on renal principal cells in the late distal tubule and collecting ducts, raising cAMP levels and causing intracellular vesicles to fuse with the apical membrane. In their membrane these vesicles have water channels called aquaporins, which increase the water permeability allowing greater water reabsorption and concentration of urine. ADH also binds to V1 receptor receptors on vascular smooth muscle, causing vasoconstriction and enhancing the effect of aldosterone on sodium reabsorption in the distal tubule. ADH release is stimulated primarily by raised plasma osmolality detected by osmoreceptors in the anterior hypothalamus. Other factors that increase ADH release include: extracellular fluid volume depletion, angiotensin II, nausea, pain, stress, exercise, emotion, hypoglycaemia. ADH release is inhibited by low plasma osmolality, alcohol, caffeine, glucocorticoids and atrial natriuretic peptide (ANP). ADH deficiency (or an inadequate response to ADH) results in diabetes insipidus. Excess levels of ADH results in syndrome of inappropriate ADH secretion (SIADH).

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      12.5
      Seconds
  • Question 17 - A 18 year old male presents to the GP with painless asymmetrical cervical...

    Incorrect

    • A 18 year old male presents to the GP with painless asymmetrical cervical lymphadenopathy. Histological examination of a biopsied lymph node demonstrates Reed-Sternberg cells. What is the most likely diagnosis:

      Your Answer: Acute lymphoblastic leukaemia

      Correct Answer: Hodgkin lymphoma

      Explanation:

      Hodgkin’s lymphoma is a malignant tumour of the lymphatic system that is characterised histologically by the presence of Reed-Sternberg cells (multinucleated giant cells). The peak incidence is in young adults aged 20-35, and there is a slight male predominance.

      The following are recognised risk factors for Hodgkin’s lymphoma:
      Male gender
      Age 20-35
      Positive family history
      Epstein-Barr virus infection
      Immunosuppression including HIV infection
      Prolonged use of human growth hormone
      Most patients present with an enlarged, but otherwise asymptomatic lymph node. The most commonly affected lymph nodes are in the supraclavicular and lower cervical areas. Other common clinical features include shortness of breath and chest discomfort secondary to mediastinal mass. Mediastinal masses are sometimes discovered as incidental findings on routine chest X-rays. Approximately 30% of patients with Hodgkin’s lymphoma develop splenomegaly.
      ‘B’ symptoms occur in approximately 25% of patients. The ‘B’ symptoms of Hodgkin’s lymphoma are:
      Fever (>38ºC)
      Night sweats
      Weight loss (>10% over 6 months)
      Pain after alcohol consumption is a pathognomonic sign of Hodgkin’s lymphoma, it is, however, not a ‘B’ symptom. It is rare though, only occurring in 2-3% of patients with Hodgkin’s lymphoma.

      The Ann Arbour clinical staging is as follows:
      Stage I: one involved lymph node group
      Stage II two involved lymph node groups on one side of the diaphragm
      Stage III: lymph node groups involved on both sides of the diaphragm
      Stage IV: Involvement of extra-nodal tissues, such as the liver or bone marrow
      Diagnosis is made by lymph node biopsy, which should be taken from a sufficiently large specimen or excisional biopsy, as opposed to a fine needle biopsy. The Reed-Sternberg cell is the most useful diagnostic feature. This is a giant cell with twin mirror-image nuclei and prominent ‘owl’s eye’ nucleoli.
      The Reed-Sternberg cell of Hodgkin’s Lymphoma
      Histological typing depends upon the other cells within the diseased tissue. Nodular sclerosing is the most common type of Hodgkin’s lymphoma. Lymphocyte-depleted and lymphocyte-predominant are rare subtypes.
      The majority of cases can be successfully treated, and unlike many other malignancies even if the first-line treatment fails, a cure can often be achieved with second-line therapies. Stage 1 Hodgkin’s lymphoma is usually treated with radiotherapy alone, but more advanced stages require combination chemotherapy. In localised disease treated with irradiation, there is a 5-year survival rate of greater than 80%. In disseminated disease treated with chemotherapy, the 5-year survival falls to around 50%. Overall, a 5-year survival of >70% should be achieved.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      26.4
      Seconds
  • Question 18 - A 75-year-old man with rheumatoid arthritis had gained weight, developed resistant hypertension, muscle...

    Incorrect

    • A 75-year-old man with rheumatoid arthritis had gained weight, developed resistant hypertension, muscle weakness, and ankle oedema. This patient is most likely suffering from what condition?

      Your Answer: Renal artery stenosis

      Correct Answer: Cushing's syndrome

      Explanation:

      Overuse of cortisol medication, as seen in the treatment of patients with chronic asthma or rheumatoid arthritis, can cause Cushing’s syndrome.

      Weight gain, thin arms and legs, a round face, increased fat around the base of the neck, a fatty hump between the shoulders, easy bruising, wide purple stretch marks primarily on the abdomen, breasts, hips, and under the arms, weak muscles, hirsutism, hypertension, erectile dysfunction, osteoporosis, frontal alopecia, acne, depression, poor wound healing, and polycythaemia are all clinical features of Cushing’s syndrome.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      25.3
      Seconds
  • Question 19 - A 30-year old male is brought to the emergency room after a terrible...

    Incorrect

    • A 30-year old male is brought to the emergency room after a terrible fall during a photoshoot. The patient reported falling on his right forearm. There is evident swelling and tenderness on the affected area, with notable weakness of the flexor pollicis longus muscle. Radiographic imaging showed a fracture on the midshaft of the right radius.

      Which of the following nerves is most likely injured in the case above?

      Your Answer: The median nerve

      Correct Answer: The anterior interosseous nerve

      Explanation:

      Flexor pollicis longus receives nervous supply from the anterior interosseous branch of median nerve, derived from spinal roots C7 and C8.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      443.7
      Seconds
  • Question 20 - A 45-old woman is on several medications and being treated for epilepsy and...

    Incorrect

    • A 45-old woman is on several medications and being treated for epilepsy and bipolar disorder. In the ward rounds, you are asked to examine her in detail and discover she has a noticeable tremor. You believe that one of her medications may be responsible for this new onset tremor.

      Which of the following medications is least likely to be responsible for this tremor?

      Your Answer: Quetiapine

      Correct Answer: Carbamazepine

      Explanation:

      The only medication that does not commonly cause tremors is carbamazepine.

      The other drugs present with the following types of tremors as a side effect to their usage:
      1. Sodium valproate – Postural tremor is most common, but a resting tremor can also occur. Approximately 25% of patients taking sodium valproate are found to develop a tremor within 12 months of starting therapy.
      2. Lithium – fine hand tremor is very commonly seen and reported in as many as 50% of patients during the first week of therapy. The tremor tends to reduce with time and is only present in around 5% of patients taking the medication two years or longer.
      3. Atypical antipsychotics, such as olanzapine and quetiapine – tremor and limb shakiness.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      25.4
      Seconds
  • Question 21 - A 30-year-old carpenter presented to the emergency room with a laceration of his...

    Incorrect

    • A 30-year-old carpenter presented to the emergency room with a laceration of his upper volar forearm. Upon further exploration and observation, it was revealed that the nerve that innervates the pronator teres muscle has been damaged.

      Which of the following nerves is most likely damaged in the case?

      Your Answer: The anterior interosseous nerve

      Correct Answer: The median nerve

      Explanation:

      Pronator teres syndrome (PTS) is caused by a compression of the median nerve (MN) by the pronator teres (PT) muscle in the forearm.

      The median nerve, C6 and C7, innervates the pronator teres.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      62.4
      Seconds
  • Question 22 - A 30-year-old male presents with easy bruising and bleeding gums, feeling very tired...

    Incorrect

    • A 30-year-old male presents with easy bruising and bleeding gums, feeling very tired lately, and recurrent chest infections over the past few months. He had glandular fever approximately 6 months ago and feels that his symptoms started after that.

      His full blood count today is as follows:
      Hb 6.3 g/dl (11.5-14 g/dl)
      MCV 90 fl (80-100 fl)
      WCC 2.0 x 10 9 /l (4-11 x 10 9 /l)
      Platelets 15 x 10 9 /l (150-450 x 10 9 /l)

      The SINGLE most likely diagnosis is?

      Your Answer: Autoimmune haemolytic anaemia

      Correct Answer: Aplastic anaemia

      Explanation:

      Aplastic anaemia is a life-threatening failure of haemopoiesis characterised by pancytopenia and hypocellular bone marrow. It is rare and patients present with features of recurrent infections secondary to (leukocytopenia), increased bleeding tendency (secondary to thrombocytopenia) and anaemia. In aplastic anaemia, there is damage to the bone marrow and the haematopoietic stems cells leading to pancytopenia.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      29.8
      Seconds
  • Question 23 - The least likely feature expected to be seen in a lesion of the...

    Incorrect

    • The least likely feature expected to be seen in a lesion of the frontal lobe is which of the following?

      Your Answer: Personality change

      Correct Answer: Loss of two-point discrimination

      Explanation:

      Lesions in different areas give rise to different symptoms.
      Lesions of the parietal lobe give rise to loss of two-point discrimination.
      Lesions to Broca’s area give rise to expressive dysphasia results from damage
      Lesions to the primary motor cortex give rise to contralateral weakness of the face and arm.
      Lesions to the prefrontal cortex give rise to personality change.
      Lesions to the frontal eye field give rise to conjugate eye deviation towards side of lesion.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      17.6
      Seconds
  • Question 24 - Regarding haemophilia A, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding haemophilia A, which of the following statements is INCORRECT:

      Your Answer: Haemophilia A is the most common of the hereditary clotting factor deficiencies.

      Correct Answer: In haemophilia both the APTT and PT are prolonged.

      Explanation:

      Haemophilia A is the most common of the hereditary clotting factor deficiencies. The inheritance is sex-linked but up to one-third of patients have no family history and these cases result from recent mutation. The vast majority of cases are inherited in an X-linked recessive fashion, affecting males born to carrier mothers. Females born to affected fathers can also, rarely, be affected due to homozygosity for the gene, where there is marriage to close relatives.

      The defect is an absence or low level of plasma factor VIII. The APTT is prolonged but the PT is normal. Recurrent painful haemarthroses and muscle haematomas dominate the clinical course of severely affected patients and if inadequately treated, lead to progressive joint deformity and disability. Local pressure can cause entrapment neuropathy or ischaemic necrosis. Prolonged bleeding occurs after dental extractions or post-trauma. Spontaneous haematuria and gastrointestinal haemorrhage may occur. The clinical severity of the disease correlates inversely with the factor VIII level. Operative and post-traumatic haemorrhage are life-threatening both in severely and mildly affected patients.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      12.9
      Seconds
  • Question 25 - Which segment of the colon is most likely to be affected in diverticulitis?...

    Incorrect

    • Which segment of the colon is most likely to be affected in diverticulitis?

      Your Answer: Ascending colon

      Correct Answer: Sigmoid colon

      Explanation:

      Diverticulitis refers to inflammation and infection associated with a diverticulum and is estimated to occur in 10% to 25% of people with diverticulosis. Peridiverticular and pericolic infection results from a perforation (either macroscopic or microscopic) of a diverticulum, which leads to contamination, inflammation, and infection. The spectrum of disease ranges from mild, uncomplicated diverticulitis that can be treated in the outpatient setting, to free perforation and diffuse peritonitis that requires emergency laparotomy. Most patients present with left sided abdominal pain, with or without fever, and leucocytosis. The most common location for diverticulitis is the sigmoid colon.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      11.4
      Seconds
  • Question 26 - Detection of urinary Bence-Jones protein would be most suggestive of which of the...

    Incorrect

    • Detection of urinary Bence-Jones protein would be most suggestive of which of the following malignancies:

      Your Answer: Chronic lymphocytic leukaemia

      Correct Answer: Multiple myeloma

      Explanation:

      Bence Jones proteins are monoclonal immunoglobulin light chains found in urine (and plasma) of some patients with myeloma. Because of their relatively small size, light chains are readily excreted into the urine. The presence of significant amounts of Bence Jones proteins in urine is indicative of malignant B cell proliferation.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      5.8
      Seconds
  • Question 27 - Which of the following is an example of a non-parametric test: ...

    Incorrect

    • Which of the following is an example of a non-parametric test:

      Your Answer: Friedman's test

      Correct Answer: All of the above

      Explanation:

      All of the above answers are non-parametric tests.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      8.1
      Seconds
  • Question 28 - Regarding bronchiolitis, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding bronchiolitis, which of the following statements is CORRECT:

      Your Answer: It occurs most commonly from infection with parainfluenza virus.

      Correct Answer: Chest x-ray may show hyperinflation and increased peribronchial markings.

      Explanation:

      Acute bronchiolitis is caused most commonly by respiratory syncytial virus, occurring mostly in children aged 6 months to 2 years. Children with bronchiolitis are febrile and tachypnoeic with a dry cough and difficulty feeding. Examination may reveal chest hyperinflation, respiratory distress, wheezing and fine end-inspiratory crepitations. Chest x-ray may show hyperinflation and increased peribronchial markings (although CXR should only performed if there is diagnostic uncertainty or an atypical course). Treatment is usually supportive, aerosolized ribavirin is reserved for severely ill or immunocompromised patients.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      19.4
      Seconds
  • Question 29 - Elevation of the mandible is produced primarily by which of the following muscles:...

    Incorrect

    • Elevation of the mandible is produced primarily by which of the following muscles:

      Your Answer: Temporalis, geniohyoid and mylohyoid

      Correct Answer: Temporalis, masseter and medial pterygoid

      Explanation:

      Elevation of the mandible is generated by the temporalis, masseter and medial pterygoid muscles.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      12.9
      Seconds
  • Question 30 - One of the following pathogens is a conditional pathogen: ...

    Correct

    • One of the following pathogens is a conditional pathogen:

      Your Answer: Neisseria meningitidis

      Explanation:

      Obligate pathogens include Mycobacterium TB, HIV, Treponema pallidum, and Neisseria gonorrhoeae. Neisseria meningitidis, on the other hand, is a conditional pathogen.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      11.1
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (2/2) 100%
Physiology (4/5) 80%
Microbiology (2/5) 40%
Specific Pathogen Groups (0/1) 0%
Anatomy (3/11) 27%
Thorax (1/3) 33%
Pathogens (1/3) 33%
Lower Limb (1/1) 100%
Basic Cellular (1/1) 100%
Haematology (0/5) 0%
Pathology (0/5) 0%
Cardiovascular Pharmacology (1/2) 50%
Pharmacology (1/3) 33%
Abdomen (0/1) 0%
Central Nervous System (1/2) 50%
Endocrine (1/2) 50%
Upper Limb (0/2) 0%
CNS Pharmacology (0/1) 0%
Abdomen And Pelvis (0/1) 0%
Evidence Based Medicine (0/1) 0%
Statistics (0/1) 0%
Head And Neck (0/1) 0%
Principles (1/1) 100%
Passmed