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  • Question 1 - Which of the following is a potential cause of a positive D-dimer assay?...

    Correct

    • Which of the following is a potential cause of a positive D-dimer assay?

      Your Answer: Deep venous thrombosis

      Explanation:

      A D-dimer test is performed to detect and diagnose thrombotic conditions and thrombosis. A negative result would rule out thrombosis and a positive result although not diagnostic, is highly suspicious of thrombotic conditions like a deep vein thrombosis, pulmonary embolism as well as DIC.

    • This question is part of the following fields:

      • General
      • Physiology
      7.1
      Seconds

  • Question 2 - A 45-year-old man complains of shortness of breath, cough and chest pain. Chest...

    Incorrect

    • A 45-year-old man complains of shortness of breath, cough and chest pain. Chest X ray revealed a perihilar mass with bronchiectasis in the left mid-lung. Which of the following is most probably associated with these findings?

      Your Answer: Metastatic adenocarcinoma

      Correct Answer: Bronchial carcinoid

      Explanation:

      Bronchial carcinoids are neuroendocrine tumours that arise from Kulchitsky’s cells of the bronchial epithelium. Kulchitsky’s cells belong to the diffuse endocrine system. Patients affected by this tumour may be asymptomatic or may present with symptoms of airway obstruction, like dyspnoea, wheezing, and cough. Other common findings are recurrent pneumonia, haemoptysis, chest pain and paraneoplastic syndromes. Chest radiographs are abnormal in the majority of cases. Peripheral carcinoids usually present as a solitary pulmonary nodule. For central lesions common findings include hilar or perihilar masses with or without atelectasis, bronchiectasis, or consolidation. Bronchial carcinoids most commonly arise in the large bronchi causing obstruction.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      107.3
      Seconds

  • Question 3 - The rotator cuff surrounds the shoulder joint and consists of the supraspinatus, infraspinatus,...

    Correct

    • The rotator cuff surrounds the shoulder joint and consists of the supraspinatus, infraspinatus, subscapularis and which one other muscle?

      Your Answer: Teres minor

      Explanation:

      The correct answer is the teres minor muscle. These group of muscles play an important role in protecting the shoulder joint and keeping the head of the humerus in the glenoid fossa of the scapula. This fossa is somehow shallow and needs support to allow for the full mobility that the shoulder joint has.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      9.3
      Seconds

  • Question 4 - Macrolides are a group of antibiotics commonly used to treat respiratory tract and...

    Correct

    • Macrolides are a group of antibiotics commonly used to treat respiratory tract and soft-tissue infections. Which of the following antibiotics is a macrolide?

      Your Answer: Erythromycin

      Explanation:

      Erythromycin is a macrolide antibiotic used in the treatment of several bacterial infections, including respiratory tract infections, skin infections, chlamydia infections, pelvic inflammatory disease, and syphilis. It may also be used during pregnancy to prevent Group B streptococcal infection in the new-born.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      52.5
      Seconds

  • Question 5 - A new-born was found to have an undeveloped spiral septum in the heart....

    Correct

    • A new-born was found to have an undeveloped spiral septum in the heart. This is characteristic of which of the following?

      Your Answer: Persistent truncus arteriosus

      Explanation:

      Persistent truncus arteriosus is a congenital heart disease that occurs when the primitive truncus does not divide into the pulmonary artery and aorta, resulting in a single arterial trunk. The spiral septum is created by fusion of a truncal septum and the aorticopulmonary spiral septum. Incomplete development of these septa results in incomplete separation of the common tube of the truncus arteriosus and the aorticopulmonary trunk.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      29.6
      Seconds

  • Question 6 - A 48-year-old woman has a mass in her right breast and has right...

    Incorrect

    • A 48-year-old woman has a mass in her right breast and has right axillary node involvement. She underwent radical mastectomy of her right breast. The histopathology report described the tumour to be 4 cm in its maximum diameter with 3 axillary lymph nodes with evidence of tumour. The most likely stage of cancer in this patient is:

      Your Answer: IIIB

      Correct Answer: IIB

      Explanation:

      Stage IIB describes invasive breast cancer in which: the tumour is larger than 2 centimetres but no larger than 5 centimetres; small groups of breast cancer cells — larger than 0.2 millimetre but not larger than 2 millimetres — are found in the lymph nodes OR the tumour is larger than 2 centimetres but no larger than 5 centimetres; cancer has spread to 1 to 3 axillary lymph nodes or to lymph nodes near the breastbone (found during a sentinel node biopsy) OR the tumour is larger than 5 centimetres but has not spread to the axillary lymph nodes.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      49.3
      Seconds

  • Question 7 - After surgery, a patient developed a stitch granuloma . Which leukocyte in the...

    Correct

    • After surgery, a patient developed a stitch granuloma . Which leukocyte in the peripheral blood will become an activated macrophage in this granuloma?

      Your Answer: Monocyte

      Explanation:

      Monocytes are leukocytes that protect the body against infections and move to the site of infection within 8-12 hours to deal with it. They are produced in the bone marrow and shortly after being produced are released into the blood stream where they circulate until an infection is detected. When called upon they leave the circulation and transform into macrophages within the tissue fluid and thus gain the capability to phagocytose the offending substance. Monocyte count is part of a complete blood picture. Monocytosis is the state of excess monocytes in the peripheral blood and may be indicative of various disease states. Examples of processes that can increase a monocyte count include: • chronic inflammation • stress response • hyperadrenocorticism • immune-mediated disease • pyogranulomatous disease • necrosis • red cell regeneration.

    • This question is part of the following fields:

      • General
      • Physiology
      18.4
      Seconds

  • Question 8 - A teenager presents with pain and swelling in a limb which increases after...

    Incorrect

    • 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: Ewing’s sarcoma

      Correct 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
      119.6
      Seconds

  • Question 9 - A 30 year old female suffered from mismatched transfusion induced haemolysis. Which substance...

    Correct

    • A 30 year old female suffered from mismatched transfusion induced haemolysis. Which substance will be raised in the plasma of this patient?

      Your Answer: Bilirubin

      Explanation:

      Bilirubin is a yellow pigment that is formed due to the break down of RBCs. Haemolysis results in haemoglobin that is broken down into a haem portion and globin which is converted into amino acids and used again. Haem is converted into unconjugated bilirubin in the macrophages and shunted to the liver. In the liver it is conjugated with glucuronic acid making it water soluble and thus excreted in the urine. Its normal levels are from 0.2-1 mg/dl. Increased bilirubin causes jaundice and yellowish discoloration of the skin.

    • This question is part of the following fields:

      • General
      • Physiology
      14
      Seconds

  • Question 10 - Atrial septal defect (ASD) is most likely to be due to incomplete closure...

    Correct

    • Atrial septal defect (ASD) is most likely to be due to incomplete closure of which one of the following structures:

      Your Answer: Foramen ovale

      Explanation:

      Atrial septal defect is a congenital heart defect that results in a communication between the right and left atria of the heart and may involve the interatrial septum. It results from incomplete closure of the foramen ovale which is normally open during fetal life and closes just after birth.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      86.7
      Seconds

  • Question 11 - Which of the following arteries, that runs on the superior aspect of the...

    Correct

    • Which of the following arteries, that runs on the superior aspect of the first part of the duodenum, forms the lower boundary of the epiploic foramen (also known as the foramen of Winslow)?

      Your Answer: Hepatic

      Explanation:

      The epiploic foramen is an important anatomical opening that allows for the communication between the greater peritoneal sac and the lesser peritoneal sac. Its boundaries are formed; superiorly by the caudate lobe of the liver, anteriorly by the hepatoduodenal ligament (containing the components of the portal triad), inferiorly by the first part of the duodenum and posteriorly by the peritoneum covering the inferior vena cava. The superior aspect of the first part of the duodenum, which forms the inferior boundary of the foramen of Winslow, forms the course of the hepatic artery before it ascends to the porta hepatis where it divides into its right and left branches.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      35
      Seconds

  • Question 12 - A 17-year-old boy, who had developed shortness of breath and a loss of...

    Correct

    • A 17-year-old boy, who had developed shortness of breath and a loss of appetite over the last month, was referred to a haematologist because he presented with easy bruising and petechiae. His prothrombin time, platelet count, partial thromboplastin and bleeding time were all normal. Which of the following would explain the presence of the petechiae and easy bruising tendency?

      Your Answer: Scurvy

      Explanation:

      Scurvy is a condition caused by a dietary deficiency of vitamin C, also known as ascorbic acid. Humans are unable to synthesize vitamin C, therefore the quantity of it that the body needs has to come from the diet. The presence of an adequate quantity of vitamin C is required for normal collagen synthesis. In scurvy bleeding tendency is due to capillary fragility and not coagulation defects, therefore blood tests are normal.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      245.1
      Seconds

  • Question 13 - Which of the following nerves has its terminal branch at the supratrochlear nerve?...

    Incorrect

    • Which of the following nerves has its terminal branch at the supratrochlear nerve?

      Your Answer: Nasociliary

      Correct Answer: Frontal

      Explanation:

      The supratrochlear nerve is a branch of the frontal nerve which comes from the ophthalmic division of cranial nerve V (trigeminal nerve). It passes above the superior oblique nerve and its descending filaments join the infratrochlear branch of the nasociliary nerve. From the orbit, it exits between the supraorbital foramen and the pulley of the superior oblique. It then curves up to the forehead beneath the corrugator supercilli and frontalis muscle. It further divides into branches that supply sensory innervation to the bridge of the nose, medial part of the upper eyelid and medial forehead.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      24.6
      Seconds

  • Question 14 - Which of the following morphological features is most characteristic of hyaline degeneration? ...

    Correct

    • Which of the following morphological features is most characteristic of hyaline degeneration?

      Your Answer: Homogeneous, ground-glass, pink-staining appearance of cells

      Explanation:

      The characteristic morphological features of hyaline degeneration is ground-glass, pinking staining cytoplasm with an intact cell membrane. The accumulation of lipids, calcium salts, lipofuscin and an amorphous cytoplasm with an intact cell membrane are all characteristically found in different situations.

      Pyknotic nucleus and orphan Annie eye nucleus are not seen in hyaline degeneration.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      13.9
      Seconds

  • Question 15 - Which of the following foramen provides passage of the facial nerve? ...

    Correct

    • Which of the following foramen provides passage of the facial nerve?

      Your Answer: Internal acoustic meatus

      Explanation:

      The internal auditory meatus provides a passage through which the vestibulocochlear nerve, the facial nerve, and the labyrinthine artery (an internal auditory branch of the basilar artery) can pass from inside the skull to structures of the inner ear and face.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      5.5
      Seconds

  • Question 16 - A 7-year-old girl is given cephalexin to treat an infection and develops hives,...

    Correct

    • A 7-year-old girl is given cephalexin to treat an infection and develops hives, with localised facial oedema. Which of the following conditions will cause localised oedema?

      Your Answer: Angio-oedema

      Explanation:

      Angio-oedema, is the rapid swelling of the skin, mucosa and submucosal tissues. The underlying mechanism typically involves histamine or bradykinin. The version related to histamine is to due an allergic reaction to agents such as insect bites, food, or medications. The version related to bradykinin may occur due to an inherited C1 esterase inhibitor deficiency, medications e.g. angiotensin converting enzyme inhibitors, or a lymphoproliferative disorder.

    • This question is part of the following fields:

      • Physiology
      • Renal
      13.1
      Seconds

  • Question 17 - The pterion is clinically significant as it marks an area of weakness on...

    Correct

    • The pterion is clinically significant as it marks an area of weakness on the skull. What structure lies beneath it?

      Your Answer: Anterior branches of the middle meningeal artery

      Explanation:

      The pterion is the area where four bones, the parietal, frontal, greater wing of sphenoid and the squamous part of the temporal bone meet. It overlies the anterior branch of the middle meningeal artery on the internal aspect of the skull. The pterion is the weakest part of the skull. Slight trauma to this region can cause extradural hematoma.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      8.5
      Seconds

  • Question 18 - The pattern of drainage of the lymphatic and venous systems of the anterior...

    Correct

    • The pattern of drainage of the lymphatic and venous systems of the anterior abdominal wall is arranged around a horizontal plane above which drainage is in a cranial direction and below which drainage is in a caudal direction. Which horizontal plane is being referred to?

      Your Answer: Level of the umbilicus

      Explanation:

      The umbilicus is a key landmark for the lymphatic and venous drainage of the abdominal wall. Above it, lymphatics drain into the axillary lymph nodes and the venous blood drains into the superior epigastric vein, into the internal thoracic vein. Below it, lymphatics drain into the superficial inguinal lymph nodes while venous blood drains into the inferior epigastric vein and the external iliac vein.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      13.4
      Seconds

  • Question 19 - A 55-year-old male has a mass on the right lung with involvement of...

    Incorrect

    • A 55-year-old male has a mass on the right lung with involvement of the right mediastinal lymph nodes. What is the nodal staging according to the TNM staging?

      Your Answer: N3

      Correct Answer: N2

      Explanation:

      The N stages for lung cancer are from NO to N3 : NO, there is no lung cancer in any lymph nodes: N1, there is lung cancer in the proximal lymph nodes: N2, there is lung cancer in the mediastinal hilar lymph nodes, but on the same side as the affected lung or there is lung cancer in the carinal lymph nodes: N3, there is metastatic lung cancer in lymph nodes on the opposite side of the chest, in the cervical or apical lymph nodes. In this patient the ipsilateral mediastinal node is involved, thus it is classified as N2.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      95.9
      Seconds

  • Question 20 - What are some of the derivatives of the second pharyngeal arch? ...

    Correct

    • What are some of the derivatives of the second pharyngeal arch?

      Your Answer: Stylohyoid muscle

      Explanation:

      Also known as the hyoid arch, it forms the side and front of the neck. From its cartilage develops the styloid process, stylohyoid ligament and lesser cornu of the hyoid bone. The muscular derivatives include the muscles of facial expression, stapedius, stylohyoid and the posterior belly of the digastric. All these are innervated by cranial nerve VII but migrate into the area of the mandibular arch.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      10.3
      Seconds

  • Question 21 - During an appendicectomy in a 16 year old girl, the registrar initially did...

    Correct

    • During an appendicectomy in a 16 year old girl, the registrar initially did not find the appendix on entering the peritoneal cavity. She, however, remained calm as she knew she could find it by:

      Your Answer: Looking at the confluence of the taenia coli

      Explanation:

      The vermiform appendix arises from the apex of the caecum. Although it has a constant base, it can pass in one of several directions such as upward behind the caecum, to the left behind the ileum and mesentery or downward into the lesser pelvis. It is retained in place by a peritoneal fold, the mesoenteriole derived from the left leaf of the mesentery. Taenia coli meet at the appendix which is the terminal portion of the caecum. The appendix is below the ileocecal valve, not above. It is not near the right colic artery (which supplies the ascending colon). It would not be found by removing a layer of the jejuno-ileum and is not in the pelvic brim.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      16.2
      Seconds

  • Question 22 - Where is the foramen ovale located? ...

    Correct

    • Where is the foramen ovale located?

      Your Answer: Sphenoid

      Explanation:

      The foramen ovale is an oval shaped opening in the middle cranial fossa located at the posterior base of the greater wing of the sphenoid bone, lateral to the lingula. It transmits the mandibular division of the trigeminal nerve (CN Vc), accessory meningeal artery, emissary veins between the cavernous sinuses and pterygoid plexus, otic ganglion, and occasionally the nervus spinosus and lesser petrosal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      7.3
      Seconds

  • Question 23 - A 49-year-old man, smoker, complains of a persisting and worsening cough over the...

    Correct

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

      Your Answer: Sputum cytology

      Explanation:

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

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      79.4
      Seconds

  • Question 24 - A brain tumour causing blockage of the hypophyseal portal system is likely to...

    Correct

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

      Your Answer: Prolactin

      Explanation:

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

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      14.2
      Seconds

  • Question 25 - A Jewish man was diagnosed with haemophilia C. Which of the following factors...

    Incorrect

    • A Jewish man was diagnosed with haemophilia C. Which of the following factors is deficient in this form of haemophilia?

      Your Answer: Factor IX

      Correct Answer: Factor XI

      Explanation:

      Haemophilia C, also known as plasma thromboplastin antecedent (PTA) deficiency or Rosenthal syndrome, is a condition caused by the deficiency of the coagulation factor XI. The condition is rare and it is usually found in Ashkenazi Jews.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      8.9
      Seconds

  • Question 26 - Injury to which of the following arteries is likely to affect the blood...

    Correct

    • Injury to which of the following arteries is likely to affect the blood supply to the seminal vesicles?

      Your Answer: Middle rectal

      Explanation:

      Ligation of middle rectal artery is most likely to affect the blood supply of seminal vesicles since arteries supplying the seminal vesicles are derived from the middle and inferior vesical and middle rectal arteries.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      8.3
      Seconds

  • Question 27 - A gymnast was admitted to hospital for investigation of a weakness in the...

    Correct

    • A gymnast was admitted to hospital for investigation of a weakness in the extension and adduction of his arm. He had a previous penetrating wound in the area of the posterior axillary fold. Which of these muscles is the likely cause?

      Your Answer: Latissimus dorsi

      Explanation:

      All the criteria of this case points towards the latissimus dorsi. This muscle is greatly involved in extension, adduction and medial rotation of the arm and forms the posterior axillary fold which in this case was injured.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      16.2
      Seconds

  • Question 28 - A surgeon ligates the left superior suprarenal artery whilst preforming a left adrenalectomy....

    Correct

    • A surgeon ligates the left superior suprarenal artery whilst preforming a left adrenalectomy. Where does the left superior suprarenal artery originate?

      Your Answer: Left inferior phrenic artery

      Explanation:

      The superior suprarenal arteries arises from the inferior phrenic artery on either side.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      8.9
      Seconds

  • Question 29 - After finding elevated PSA levels, a 69-year-old man undergoes a needle biopsy and...

    Incorrect

    • After finding elevated PSA levels, a 69-year-old man undergoes a needle biopsy and is diagnosed with prostatic cancer. What is the stage of this primary tumour?

      Your Answer: T1a

      Correct Answer: T1c

      Explanation:

      The AJCC uses a TNM system to stage prostatic cancer, with categories for the primary tumour, regional lymph nodes and distant metastases:

      TX: cannot evaluate the primary tumour T0: no evidence of tumour

      T1: tumour present, but not detectable clinically or with imaging T1a: tumour was incidentally found in less than 5% of prostate tissue resected (for other reasons)

      T1b: tumour was incidentally found in more than 5% of prostate tissue resected

      T1c: tumour was found in a needle biopsy performed due to an elevated serum prostate-specific antigen

      T2: the tumour can be felt (palpated) on examination, but has not spread outside the prostate

      T2a: the tumour is in half or less than half of one of the prostate gland’s two lobes

      T2b: the tumour is in more than half of one lobe, but not both

      T2c: the tumour is in both lobes

      T3: the tumour has spread through the prostatic capsule (if it is only part-way through, it is still T2)

      T3a: the tumour has spread through the capsule on one or both sides

      T3b: the tumour has invaded one or both seminal vesicles

      T4: the tumour has invaded other nearby structures.

      In this case, the tumour has a T1c stage.

    • This question is part of the following fields:

      • Pathology
      • Urology
      12.8
      Seconds

  • Question 30 - The gluteus medius muscle: ...

    Correct

    • The gluteus medius muscle:

      Your Answer: Is supplied by the superior gluteal nerve

      Explanation:

      The gluteus medius is situated on the outer surface of the pelvis. It arises from the outer surface of the ilium between the iliac crest and posterior gluteal line above and the anterior gluteal line below. The gluteus medius is supplied by the fourth and fifth lumbar and first sacral nerves through the superior gluteal nerve

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      17.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

General (3/3) 100%
Physiology (5/5) 100%
Pathology (5/11) 45%
Respiratory (1/2) 50%
Anatomy (13/14) 93%
Upper Limb (2/2) 100%
Pharmacology (1/1) 100%
Cardiovascular (1/1) 100%
Neoplasia (0/2) 0%
Orthopaedics (0/1) 0%
Thorax (1/1) 100%
Abdomen (4/4) 100%
Haematology (1/2) 50%
Head & Neck (3/4) 75%
Cell Injury & Wound Healing (1/1) 100%
Renal (1/1) 100%
Embryology (1/1) 100%
Endocrinology (1/1) 100%
Pelvis (1/1) 100%
Urology (0/1) 0%
Lower Limb (1/1) 100%
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