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  • Question 1 - A 76 year old man who presented with lower back pain is diagnosed...

    Correct

    • A 76 year old man who presented with lower back pain is diagnosed with prostatic carcinoma that has metastasized to his lumber spine. Which of the following markers is characteristically elevated?

      Your Answer: PSA

      Explanation:

      Spread of prostatic carcinoma is common to the lumbar spine and pelvis. This results in osteoblastic metastases that will present as lower back pain with increased alkaline phosphatase, prostatic acid phosphates and PSA. PSA is more specific and a PSA > 10 ng/ml for any age is worrisome.

    • This question is part of the following fields:

      • Neoplasia; Urology
      • Pathology
      16.6
      Seconds

  • Question 2 - An electronic manufacturing engineer had abdominal distension and underwent a CT scan of...

    Correct

    • An electronic manufacturing engineer had abdominal distension and underwent a CT scan of the abdomen. Thereafter he was diagnosed with hepatic angiosarcoma. Exposure to what agent is responsible for the development of this neoplasm?

      Your Answer: Arsenic

      Explanation:

      Hepatic angiosarcomas are associated with particular carcinogens which includes: arsenic , thorotrast, and polyvinyl chloride. With exposure to this three agents, there is a very long latent period of many years between exposure and the development of tumours.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      18.1
      Seconds

  • Question 3 - The superior pancreaticoduodenal artery, the artery that supplies blood to the pancreas and...

    Correct

    • The superior pancreaticoduodenal artery, the artery that supplies blood to the pancreas and the duodenum, is a branch of the:

      Your Answer: Gastroduodenal artery

      Explanation:

      The superior pancreaticoduodenal artery together with the right gastroepiploic artery form the two branches of the gastroduodenal artery which divides at the lower border of the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      34.8
      Seconds

  • Question 4 - The following joint has an anastomotic circulation that is provided by branches of...

    Correct

    • The following joint has an anastomotic circulation that is provided by branches of the brachial artery:

      Your Answer: Elbow joint

      Explanation:

      The arterial anastomoses of the elbow joint is contributed by branches of the brachial artery and the Profunda brachii artery. The brachial artery gives off the superior ulnar collateral artery and the inferior collateral artery. On the other hand, the Profunda brachii gives off the radial and medial recurrent arteries.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      17.9
      Seconds

  • Question 5 - What is the nerve supply to the muscles of the lateral compartment of...

    Correct

    • What is the nerve supply to the muscles of the lateral compartment of the leg ?

      Your Answer: Superficial peroneal nerve

      Explanation:

      The peroneus longus and peroneus brevis in the lateral compartment of the leg take nerve supply from the superficial peroneal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      6.4
      Seconds

  • Question 6 - Which of the following is a true statement regarding secretion of gastric acid?...

    Correct

    • Which of the following is a true statement regarding secretion of gastric acid?

      Your Answer: Acetylcholine increases gastric acid secretion

      Explanation:

      Gastric acid secretion is increased by acetylcholine, histamine and gastrin, with the help of cAMP as a secondary messenger. They increase H+ and Cl- secretion by increasing the number of H+/K+ ATPase molecules and Cl- channels. In contrast, gastric acid secretion is decreased by somatostatin, epidermal growth factor and prostaglandins.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      22.8
      Seconds

  • Question 7 - During an operation to repair an aortic coarctation in a neonate, a surgeon...

    Incorrect

    • During an operation to repair an aortic coarctation in a neonate, a surgeon accidentally cuts the first aortic intercostal arteries as he mobilised the descending aorta. Which one of the following structure might be deprived of its primary source of blood supply following this injury?

      Your Answer: Left bronchus

      Correct Answer: Right bronchus

      Explanation:

      The right bronchus is supplied by one right bronchial artery that may branch from one of the left bronchial arteries or from the right 3rd posterior intercostal artery (this is the first intercostal artery that arises from the aorta). Damage to this artery might stop blood supply to the main bronchus. Intercostal arteries that go to the first and the second interspaces originate from the highest intercostal artery such that blood supply to either of these spaces would not be interfered with.

      The left bronchus receives blood from 2 left bronchial arteries which are direct branches from the descending aorta.

      Fibrous pericardium is the sac that contains the heart. Its blood supply is not a major concern.

      Visceral pericardium receives its blood supply from the coronary vessels.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      1394.2
      Seconds

  • Question 8 - Which lymph nodes are likely to be enlarged in a patient who has...

    Incorrect

    • Which lymph nodes are likely to be enlarged in a patient who has malignant growth involving the anus?

      Your Answer: Internal iliac

      Correct Answer: Superficial inguinal

      Explanation:

      The lymphatics from the anus, skin of the perineum and the scrotum end in the superficial inguinal nodes. In case of a malignant growth of the anus, the superficial inguinal lymph nodes would most likely be enlarge.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      30.8
      Seconds

  • Question 9 - A 42-year old woman presents to the doctor with jaundice. Her investigations show...

    Correct

    • A 42-year old woman presents to the doctor with jaundice. Her investigations show conjugated hyperbilirubinemia, raised urine bilirubin levels and low urine urobilinogen levels. What is the likely cause of her jaundice?

      Your Answer: Blockage of the common bile duct

      Explanation:

      The description of the patient here fits the diagnosis of obstructive jaundice or cholestasis, which results in conjugated hyperbilirubinemia. Cholestasis occurs due to impairment of bile flow, which can be anywhere from the liver cell canaliculus to the ampulla of Vater. Causes can be divided into intrahepatic and extrahepatic.

      – Intrahepatic causes include hepatitis, drug toxicity, alcoholic liver disease, primary biliary cirrhosis, cholestasis of pregnancy and metastatic cancer.

      – Extrahepatic causes include common duct stone, pancreatic cancer, benign stricture of the common duct, ductal carcinoma, pancreatitis and sclerosing cholangitis.

      There is absence of bile constituents in the intestine, which causes spillage in the systemic circulation. Symptoms include pale stools, dark urine, pruritus, malabsorption leading to steatorrhea and deficiency of fat-soluble vitamins. Chronic cases can result in osteoporosis or osteomalacia due to vitamin D deficiency and Ca2+ malabsorption. Cholesterol and phospholipid retention produces hyperlipidaemia despite fat malabsorption (although increased liver synthesis and decreased plasma esterification of cholesterol also contribute); triglyceride levels are largely unaffected. The lipids circulate as a unique, low-density lipoprotein called lipoprotein X.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      43.9
      Seconds

  • Question 10 - In what form are fats primarily transported in the body? ...

    Incorrect

    • In what form are fats primarily transported in the body?

      Your Answer: Triglycerides

      Correct Answer: Free fatty acids

      Explanation:

      Fat is mainly transported in the body as free fatty acids. Once out of the adipose cell, the free fatty acids get ionized and combine with albumin.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      14.5
      Seconds

  • Question 11 - A patient in the intensive care unit developed hyperphosphatemia. The phosphate level is...

    Correct

    • A patient in the intensive care unit developed hyperphosphatemia. The phosphate level is 160 mmol/L. Which of the following is most likely responsible for this abnormality?

      Your Answer: Renal insufficiency

      Explanation:

      Hyperphosphatemia is an electrolyte disturbance in which there is an abnormally elevated level of phosphate in the blood. It is caused by conditions that impair renal phosphate excretion (ex: renal insufficiency, hypoparathyroidism, parathyroid suppression) and conditions with massive extracellular fluid phosphate loads (ex: rapid administration of exogenous phosphate, extensive cellular injury or necrosis, transcellular phosphate shifts).

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      7.8
      Seconds

  • Question 12 - How are amino acids transported across the luminal surface of the small intestinal...

    Incorrect

    • How are amino acids transported across the luminal surface of the small intestinal epithelium?

      Your Answer: Co-transport with glucose

      Correct Answer: Co-transport with sodium ions

      Explanation:

      Once complex peptides are broken down into amino acids by the peptidases present in the brush border of small intestine, they are ready for absorption by at least four sodium-dependent amino acid co-transporters – one each for acidic, basic, neutral and amino acids, present on the luminal plasma membrane. These transporters first bind sodium and can then bind the amino acids. Thus, amino acid absorption is totally dependent on the electrochemical gradient of sodium across the epithelium. The basolateral membrane in contrast, possesses additional transporters to carry amino acids from the cell into the blood, but these are sodium-independent.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      19.7
      Seconds

  • Question 13 - A correct statement about the RECTUM: ...

    Correct

    • A correct statement about the RECTUM:

      Your Answer: It is an important anastomotic site for the portal and caval (systemic) venous systems

      Explanation:

      The rectum is part of the gastrointestinal tract that is continuous above with the sigmoid colon and below with the anal canal. It contains both longitudinal and circular smooth muscles. These are supplied by the enteric nervous system. It is about 12 cm long. It has no sacculations comparable with those of the colon. It has three permanent transverse folds called the valves of Houston. The peritoneum is related to the upper two thirds of the rectum only whereas the lower part is not covered by peritoneum. It is supplied by the superior rectal (hemorrhoidal) branch of the inferior mesenteric artery and the median sacral artery that is a direct branch from the abdominal aorta. It is drained by veins that begin as a plexus that surround the anus. These veins form anastomoses with the portal system (portocaval anastomoses).

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      23.9
      Seconds

  • Question 14 - A sexually active 21 year old man presents with the history of dysuria...

    Correct

    • A sexually active 21 year old man presents with the history of dysuria for the past 3 days. Urine culture confirmed Neisseria gonorrhoeae and smear showed abundant neutrophils. Which of the following mediators is responsible for causing diapedesis of the neutrophils to reach the site of infection?

      Your Answer: Complement C5a

      Explanation:

      C5a is part of the complement cascade and is released frim the complement C5. It acts as a chemotactic factor for neutrophils. Other chemotactic mediators are TNF, leukotrienes and bacterial products.

      Bradykinin is associated with the production of pain and vasodilation.

      Hageman factor is a clotting factor.

      Histamine causes vasodilation.

      C3B causes opsonisation.

      IL-6 and IL-12 are inflammatory mediators causing B cell maturation and mediating inflammation and prostaglandins are involved with pain, increasing cell permeability and vasodilation.

    • This question is part of the following fields:

      • Inflammation & Immunology; Urology
      • Pathology
      16.1
      Seconds

  • Question 15 - A Jewish man was diagnosed with haemophilia C. Which of the following factors...

    Correct

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

      Your 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
      7.9
      Seconds

  • Question 16 - A patient admitted for esophagectomy showed low levels of the lightest plasma protein...

    Correct

    • A patient admitted for esophagectomy showed low levels of the lightest plasma protein in terms of weight. Which of the following is the lightest plasma protein:

      Your Answer: Albumin

      Explanation:

      Albumin is the most abundant and the lightest of all the plasma proteins. It maintains osmotic pressure, transports unconjugated bilirubin, thyroid hormones, fatty acids, drugs and acts as a buffer for pH.

    • This question is part of the following fields:

      • General
      • Physiology
      24
      Seconds

  • Question 17 - Coagulation in the body (in vivo) is a process in which several proteins...

    Correct

    • Coagulation in the body (in vivo) is a process in which several proteins known as coagulation factors are activated in a cascade effect to stop bleeding. Which of the following initiates this cascade effect?

      Your Answer: Tissue factor

      Explanation:

      Tissue factor (TF), also known as ‘factor III’ or ‘thromboplastin’, is an anti-coagulation protein that initiates the extrinsic coagulation. TF acts as a transmembrane receptor for Factor VII/VIIa . It is expressed by endothelial cells but also certain tissues, such as the heart and brain.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      28.1
      Seconds

  • Question 18 - A lesion involving the lateral geniculate nucleus of the thalamus is likely to...

    Incorrect

    • A lesion involving the lateral geniculate nucleus of the thalamus is likely to affect:

      Your Answer: Taste

      Correct Answer: Vision

      Explanation:

      The lateral geniculate nucleus (LGN) of the thalamus is the primary processor of visual information in the central nervous system. The LGN receives information directly from the retina and sends projections directly to the primary visual cortex. The LGN likely helps the visual system focus its attention on the most important information.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      30.2
      Seconds

  • Question 19 - The accumulation of eosinophils within tissues is mostly regulated by which of the...

    Correct

    • The accumulation of eosinophils within tissues is mostly regulated by which of the following cytokines?

      Your Answer: Interleukin-5

      Explanation:

      IL-5 is produced by TH2 helper cells and by mast cells. They stimulate increased secretion of immunoglobulins and stimulate B cell growth. They are the major regulators in eosinophil activation and control. They are also released from eosinophils and mast cells in asthmatic patients and are associate with a many other allergic conditions.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      10.2
      Seconds

  • Question 20 - A syndrome responsible for failure to absorb vitamin B12 from the GIT is...

    Correct

    • A syndrome responsible for failure to absorb vitamin B12 from the GIT is called?

      Your Answer: Pernicious anaemia

      Explanation:

      Pernicious anaemia is a type of autoimmune disease in which antibodies form against the parietal cells or intrinsic factor. Intrinsic factor is required for the absorption of vitamin B12. Blood testing typically shows a macrocytic, normochromic anaemia and low levels of serum vitamin B12. A Schilling test can then be used to distinguish between pernicious anaemia, vitamin B12 malabsorption and vitamin B12 deficiency. Symptoms include shortness of breath, pallor and diarrhoea etc.

    • This question is part of the following fields:

      • General
      • Physiology
      6.4
      Seconds

  • Question 21 - Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal...

    Incorrect

    • Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal volume of 550 ml and an effective anatomical dead space of 250 ml. What is his alveolar ventilation?

      Your Answer: 5000 ml/min

      Correct Answer: 3000 ml/min

      Explanation:

      Alveolar ventilation is the amount of air reaching the alveoli per minute. Alveolar ventilation = respiratory rate × (tidal volume – anatomical dead space volume). Thus, alveolar ventilation = 10 × (550 − 250) = 3000 ml/min.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      11.5
      Seconds

  • Question 22 - Skin infiltration by neoplastic T lymphocytes is seen in: ...

    Incorrect

    • Skin infiltration by neoplastic T lymphocytes is seen in:

      Your Answer: Chronic lymphocytic leukaemia

      Correct Answer: Mycosis fungoides

      Explanation:

      Mycosis fungoides is a chronic T-cell lymphoma that involves the skin and less commonly, the internal organs such as nodes, liver, spleen and lungs. It is usually diagnosed in patients above 50 years and the average life expectancy is 7-10 years. It is insidious in onset and presents as a chronic, itchy rash, eventually spreading to involve most of the skin. Lesions are commonly plaque-like, but can be nodular or ulcerated. Symptoms include fever, night sweats and weight loss. Skin biopsy is diagnostic. However, early cases may pose a challenge due to fewer lymphoma cells. The malignant cells are mature T cells (T4+, T11+, T12+). The epidermis shows presence of characteristic Pautrier’s micro abscesses are present in the epidermis.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      19.9
      Seconds

  • Question 23 - Which of the following malignancies is likely to have the best prognosis? ...

    Correct

    • Which of the following malignancies is likely to have the best prognosis?

      Your Answer: Papillary carcinoma of the thyroid

      Explanation:

      Papillary carcinoma accounts for 70-80% of all thyroid cancers and is seen commonly in people aged 30-60 years. It is more aggressive in elderly patients. 10-20% cases may have recurrence or persistent disease. More common in females with a female to male ratio of 3:1. Papillary carcinomas can also contain follicular carcinomas. The common route of spread is through lymphatics to regional nodes in one-third cases and pulmonary metastasis can also occur. Papillary carcinomas of the thyroid have the best prognosis, especially in patients less than 45 years of age with small tumours confined to the thyroid gland.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      7.5
      Seconds

  • Question 24 - Pain in the right upper quadrant of the abdomen on ingestion of a...

    Correct

    • Pain in the right upper quadrant of the abdomen on ingestion of a fatty meal is seen in a condition which involves which of the following substances?

      Your Answer: Cholecystokinin

      Explanation:

      The clinical scenario described here favours the presence of gallstones. During food ingestion, vagal discharges stimulate gallbladder contraction. Moreover, presence of fat and amino acids in the intestinal lumen stimulates the release of cholecystokinin (CCK) in the duodenum. This causes sustained gallbladder contraction and relaxation of the sphincter of Oddi. If gallstones are present, there will be inflammation in the gallbladder and CCK will aggravate it due to contractions.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      8.7
      Seconds

  • Question 25 - After a car accident, a 30-year-old woman is alert and only has minor,...

    Correct

    • After a car accident, a 30-year-old woman is alert and only has minor, superficial injuries. 2 hours later, she becomes unconscious and a CT scan reveals a convex, lens-shaped haemorrhage over the right parietal region. The most likely diagnosis is:

      Your Answer: Epidural haematoma

      Explanation:

      Epidural haematomas are usually caused by arterial bleeding, classically due to damage to the middle meningeal artery by a temporal bone fracture. Symptoms develop within minutes to several hours after the injury and consist of increasing headache, decreased level of consciousness, hemiparesis and pupillary dilation with loss of light reactivity. Around 15–20% of epidural hematomas are fatal.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      12.2
      Seconds

  • Question 26 - During a radical mastectomy for advanced breast cancer, the surgeon injured the long...

    Correct

    • During a radical mastectomy for advanced breast cancer, the surgeon injured the long thoracic nerve. Which among the following muscles is likely to be affected?

      Your Answer: Serratus anterior

      Explanation:

      The long thoracic nerve innervates the serratus anterior muscle which holds the scapula forward and balances the rhomboids and the trapezius muscles which retract the scapula. Injury to this nerve results in a ‘winged scapula’ with a posterior protrusion.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      8.8
      Seconds

  • Question 27 - An 26-year-old man sought admission due to persistent non-bloody diarrhoea. The patient is...

    Correct

    • An 26-year-old man sought admission due to persistent non-bloody diarrhoea. The patient is HIV-positive. Examination of stool sample showed numerous acid-fast cysts. Which of the following organism is the most likely cause of diarrhoea?

      Your Answer: Cryptosporidium parvum

      Explanation:

      Cryptosporidium parvum is one of several species that causes cryptosporidiosis, a parasitic disease of the mammalian intestinal tract. Primary symptoms of C. parvum infection are acute, watery, and non-bloody diarrhoea. C. parvum infection is of particular concern in immunocompromised patients, where diarrhoea can reach 10–15 l per day.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      14
      Seconds

  • Question 28 - Depression of the normal coagulation system and excessive bleeding after surgery can occur...

    Correct

    • Depression of the normal coagulation system and excessive bleeding after surgery can occur in which of the following medical conditions?

      Your Answer: Liver disease

      Explanation:

      As most of the coagulation factors are synthesized in the liver, liver diseases like hepatitis or cirrhosis will depress the coagulation system. Vitamin K deficiency can also decrease the production of vitamin K dependent coagulation factors VII, XI, X and prothrombin.

    • This question is part of the following fields:

      • General
      • Physiology
      12.5
      Seconds

  • Question 29 - A 40-year old lady presented to the hospital with fever and mental confusion...

    Correct

    • A 40-year old lady presented to the hospital with fever and mental confusion for 1 week. On examination, she was found to have multiple petechiae all over her skin and mucosal surfaces. Blood investigations revealed low platelet count and raised urea and creatinine. A platelet transfusion was carried out, following which she succumbed to death. Autopsy revealed pink hyaline thrombi in myocardial arteries. What is the likely diagnosis?

      Your Answer: Thrombotic thrombocytopenic purpura

      Explanation:

      Hyaline thrombi are typically associated with thrombotic thrombocytopenic purpura (TTP), which is caused by non-immunological destruction of platelets. Platelet transfusion is contraindicated in TTP. Platelets and red blood cells also get damaged by loose strands of fibrin deposited in small vessels. Multiple organs start developing platelet-fibrin thrombi (bland thrombi with no vasculitis) typically at arteriocapillary junctions. This is known as ‘thrombotic microangiopathy’. Treatment consists of plasma exchange.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      35.3
      Seconds

  • Question 30 - What occurs during cellular atrophy? ...

    Correct

    • What occurs during cellular atrophy?

      Your Answer: Cell size decreases

      Explanation:

      Atrophy is the decrease in the size of cells, tissues, or organs. There are several causes including inadequate nutrition, poor circulation, loss of hormonal support or nerve supply, disuse, lack of exercise, or disease. An increase in cell size is termed hypertrophy which is distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Urology
      • Pathology
      8.5
      Seconds

  • Question 31 - A 46 -year old patient diagnosed with chronic rhinosinusitis, was to undergo surgery...

    Incorrect

    • A 46 -year old patient diagnosed with chronic rhinosinusitis, was to undergo surgery to improve drainage from his frontal sinus to the nose. Which is a route that one would take to enter into the frontal sinus through the nasal cavity?

      Your Answer: Superior meatus

      Correct Answer: Middle meatus

      Explanation:

      The middle meatus is a nasal passageway located inferior to the middle concha and superior to the inferior concha. On the superior aspect of this meatus is a bulge produced by the middle ethmoidal cells known as the bulla ethmoidalis. Below this bulge is a curved fissure, the hiatus semilunaris, which is also bordered inferiorly by the edge of the uncinate process of the ethmoid. It is through this curved fissure, hiatus semilunaris, that the middle meatus communicates with the frontal sinus. It first forms a communication with a curved passage way known as the infundibulum. The infundibulum anteriorly communicates with the anterior ethmoidal cells and continues upward as the frontonasal duct into the frontal sinus.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      21.2
      Seconds

  • Question 32 - A lad involved in a road traffic accident is rushed to casualty where...

    Incorrect

    • A lad involved in a road traffic accident is rushed to casualty where physical examination reveals that he has limited extension of his right humerus. Which of the following nerves is most likely to have been injured?

      Your Answer: Suprascapular nerve

      Correct Answer: Thoracodorsal nerve

      Explanation:

      Extension of the humerus is a function of the latissimus dorsi. This muscle is supplied by the thoracodorsal nerve which is a branch of the posterior cord of the plexus whose fibres are derived from cranial nerves V, VI and VII.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      18.7
      Seconds

  • Question 33 - 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
      120.8
      Seconds

  • Question 34 - Lung compliance is increased by: ...

    Incorrect

    • Lung compliance is increased by:

      Your Answer: Pulmonary fibrosis

      Correct Answer: Emphysema

      Explanation:

      Lung compliance is increased by emphysema, acute asthma and increasing age and decreased by alveolar oedema, pulmonary hypertension, atelectasis and pulmonary fibrosis.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      13.3
      Seconds

  • Question 35 - A patient who complained of pain on the lower left side of the...

    Correct

    • A patient who complained of pain on the lower left side of the back had an x-ray done which confirmed a hernia passing posterolaterally, just superior to the iliac crest. Where is this hernia passing through?

      Your Answer: Lumbar triangle

      Explanation:

      The lumber triangle is bound medially by the border of the latissimus dorsi, laterally by the external abdominal oblique and by the iliac crest inferiorly. This is exactly where the hernia that is described is located.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      20.7
      Seconds

  • Question 36 - A young man was thrown from a vehicle in a collision. He landed...

    Correct

    • A young man was thrown from a vehicle in a collision. He landed on his head and shoulder tip, stretching the left side of his neck. A neurological examination revealed that the fifth and sixth cervical nerves had been torn from the spinal cord. What is the most obvious clinical manifestation of this?

      Your Answer: Abduction

      Explanation:

      In the case of injuries to the upper roots of the brachial plexus there is complete loss of abduction. The muscle performing this movement is the supraspinatus. This initiates the movement, followed by the deltoid muscle, which allows for complete abduction. Both these muscles are innervated by nerves originating from C5 and C6. The injury to these roots results in a condition named Erb-Duchenne’s palsy.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      88.5
      Seconds

  • Question 37 - A 60-year-old male is suspected to have pancreatic cancer. What particular tumour marker...

    Correct

    • A 60-year-old male is suspected to have pancreatic cancer. What particular tumour marker should be requested to aid in the confirmation of the diagnosis of pancreatic cancer?

      Your Answer: Carcinoembryonic antigen (CEA)

      Explanation:

      Carcinoembryonic antigen (CEA) is used as a tumour marker. CEA test measures the amount of this protein that may appear in the blood of some people who have certain types of cancers especially cancer of the colon and rectal cancer. It may also be present in the pancreas, breast, ovary or lung.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      18.2
      Seconds

  • Question 38 - A 65-year old man, known with Type 2 diabetes and chronic renal failure,...

    Incorrect

    • A 65-year old man, known with Type 2 diabetes and chronic renal failure, is likely to eventually present with which of the following conditions?

      Your Answer: Primary hyperparathyroidism

      Correct Answer: Secondary hyperparathyroidism

      Explanation:

      When the parathyroid glands secrete excess parathyroid hormone (PTH) in response to hypocalcaemia, it is known as Secondary hyperparathyroidism and is often seen in patients with renal failure. In chronic renal failure, the kidneys fail to excrete adequate phosphorus and also fail to convert enough vitamin D to its active form. This leads to formation of insoluble calcium phosphate in the body which ultimately causes hypocalcaemia. The glands then undergo hyperplasia and hypertrophy leading to secondary hyperparathyroidism. Symptoms include bone and joint pains, along with limb deformities. The raised PTH also results in pleiotropic effects on blood, the immune system and nervous system.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      19450.9
      Seconds

  • Question 39 - Langhans giant cells are characteristically seen in which type of inflammation? ...

    Correct

    • Langhans giant cells are characteristically seen in which type of inflammation?

      Your Answer: Granulomatous inflammation

      Explanation:

      Langhans giant cells are characteristically seen in granulomatous inflammation. They form when epithelioid cells fuse together. They usually contain a nuclei with a horseshoe-shaped pattern in the periphery of the cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      13.5
      Seconds

  • Question 40 - Which of the following is the most accurate test for the diagnosis of...

    Correct

    • Which of the following is the most accurate test for the diagnosis of primary syphilis?

      Your Answer: Dark-field microscopy

      Explanation:

      Primary syphilis is transmitted via sexual contact. Lesions on genitalia, called a chancre occur after an asymptomatic incubation period of 10-90 days (average 21 days) after exposure. This chancre is a typically solitary (can be multiple), firm, painless, ulceration over the skin at the point of exposure to spirochete, seen on penis, vagina or rectum. It heals spontaneously after 4-6 weeks. Local lymphadenopathy can be seen.

      Diagnosis is made by microscopy of fluid from lesion using dark-field illumination, taking care to not confuse with other treponemal disease. Screening tests include rapid plasma regain (RPR) and Venereal Diseases Research Laboratory (VDRL) tests. False positives are known to occur with these tests and can be seen in viral infections like hepatitis, varicella, Epstein-Barr virus, tuberculosis, lymphoma, pregnancy and IV drug use. More specific tests should therefore be carried out in case these screening tests are positive.

      The Treponema pallidum hemagglutination assay (TPHA) and the fluorescent treponemal antibody absorption (FTAABS) test are based on monoclonal antibodies and immunofluorescence and are more specific. However, they can too show false positives with other treponemal diseases like yaws or pinta. Other confirmatory tests include those based on enzyme-linked immunoassays.

    • This question is part of the following fields:

      • Pathology
      • Urology
      11.3
      Seconds

  • Question 41 - 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
      50.5
      Seconds

  • Question 42 - Which of the following conditions is likely to result in splenomegaly, hypochromic anaemia...

    Correct

    • Which of the following conditions is likely to result in splenomegaly, hypochromic anaemia and hemochromatosis in a young male?

      Your Answer: β-Thalassaemia

      Explanation:

      Beta-thalassaemia is due to decreased production of β-polypeptide chains, with an autosomal inheritance pattern. Carrier patients (heterozygotes) are asymptomatic and have mild to moderate microcytic anaemia. This is known as thalassaemia minor. Homozygotes (β-thalassaemia major, or Cooley’s anaemia) develop severe anaemia and marrow hyperactivity. The disease presents at 1-2 years of age with severe anaemia and transfusional and absorptive iron overload. Patients also present with jaundice, leg ulcers, massive splenomegaly and cholelithiasis. The disease can also lead to splenic sequestration leading to faster destruction of transfused red blood cells. Increased marrow activity causes thickening of cranial bones. Involvement of long bones is also seen, which can cause pathological fractures and growth impairment. There is iron deposition in various organs, which can lead to heart failure or hepatic failure (leading to cirrhosis). Thalassaemias are suspected in presence of family history, or signs suggesting microcytic haemolytic anaemia. Further test and quantitative haemoglobin studies are useful. In beta-thalassaemia, there is an increase in serum bilirubin, iron and ferritin levels. There is severe anaemia, often with haemoglobin < 6 g/dl. There is an elevated red blood cell count, which are microcytic. Peripheral blood smear is diagnostic with nucleated erythroblasts, target cells, small pale red blood cells, and punctate basophilia.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      33.3
      Seconds

  • Question 43 - A cancer patient was found to have a radio resistant tumour. Which tumour...

    Correct

    • A cancer patient was found to have a radio resistant tumour. Which tumour does the patient most likely have?

      Your Answer: Liposarcoma

      Explanation:

      Liposarcoma is a cancer that arises in fat cells in deep soft tissue. Commonly it occurs inside the thigh or retroperitoneum. It usually affects middle-aged and older adults, over 40 years. Liposarcoma is the most common soft-tissue sarcoma. It is very radio resistant. Five-year survival rates vary from 100% to 56% based on histological subtype.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      8.2
      Seconds

  • Question 44 - Which of the given options best describes the metabolic changes which occur following...

    Correct

    • Which of the given options best describes the metabolic changes which occur following a severe soft tissue injury sustained after a PVA?

      Your Answer: Mobilisation of fat stores

      Explanation:

      The following metabolic responses occur following trauma as part of a coping mechanism for the additional stress. These include acid base changes (metabolic acidosis or alkalosis), decrease urine output and osmolality, reduced basal metabolic rate (BMR), gluconeogenesis with amino acid breakdown and shunting, hyponatraemia as a result of impaired functioning of sodium pumps, hypoxic injury, coagulopathies, decreased immunity, increase extracellular fluid and hypovolemic shock, increase permeability leading to oedema, break down and mobilization of fat reserves, pyrexia and reduced circulating levels of albumin.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      46.5
      Seconds

  • Question 45 - Which of the following diseases can cause paraesthesia along the distribution of the...

    Correct

    • Which of the following diseases can cause paraesthesia along the distribution of the median nerve of the hand, especially after activities which require flexion and extension of the wrist?

      Your Answer: Carpal tunnel syndrome

      Explanation:

      Carpal tunnel syndrome tends to occur in women between the ages of 30-50. There are many risk factors, including diabetes, hypothyroidism, obesity, pregnancy, and repetitive wrist work. Symptoms include pain in the hand and wrist, tingling, and numbness distributed along the median nerve (the palmar side of the thumb, the index and middle fingers, and the radial half of the ring finger), which worsens at night.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      19.8
      Seconds

  • Question 46 - Which of the following is an anion? ...

    Correct

    • Which of the following is an anion?

      Your Answer: Phosphate

      Explanation:

      Cations: sodium, magnesium, calcium and potassium

      Anions: chloride, phosphate, bicarbonate, lactate, sulphate and albumin

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      19.5
      Seconds

  • Question 47 - A young man in a motor vehicle accident sustained a spinal injury at...

    Correct

    • A young man in a motor vehicle accident sustained a spinal injury at C8 level. What would likely be seen in this patient?

      Your Answer: The hypothenar muscles would be completely paralysed

      Explanation:

      The eighth cervical nerve is one of the contributors of the ulnar nerve. The ulnar nerve supplies the hypothenar muscles which include the opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis, and palmaris brevis.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      37.5
      Seconds

  • Question 48 - Which of the following veins empties into the left renal vein? ...

    Correct

    • Which of the following veins empties into the left renal vein?

      Your Answer: Left suprarenal

      Explanation:

      The left suprarenal vein empties into the left renal vein which crosses the vertebral column to reach the inferior vena cava. The left renal vein also receives the left gonadal vein.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      17.1
      Seconds

  • Question 49 - A 55-year-old woman died 3 years after a cardiac transplant due to worsening...

    Correct

    • A 55-year-old woman died 3 years after a cardiac transplant due to worsening congestive heart failure. Autopsy revealed diffuse hyperplasia of the vascular intima involving the entire length of the coronary arteries. The most probable cause of deterioration of the cardiac function is:

      Your Answer: Coronary atherosclerosis

      Explanation:

      Allograft coronary artery disease (CAD) can begin right after the transplant and is the major cause of later death in cardiac transplant recipients. This form of atherosclerosis progresses quickly resulting in allograft failure. Due to lack of premonitory symptoms CAD may lead to sudden death.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      20.5
      Seconds

  • Question 50 - A TRUE statement regarding abolition of the cephalic phase of pancreatic secretion is...

    Correct

    • A TRUE statement regarding abolition of the cephalic phase of pancreatic secretion is that it:

      Your Answer: Will result after vagotomy

      Explanation:

      Recognition and integration of the sight, smell and taste of food triggers the cephalic phase of pancreatic secretion, causing an increase in pancreatic HCO3- and enzyme secretion. The degree of enzyme secretion in this phase is about 50% of the maximal response seen with exogenous CCK and secretin. The vagus nerve regulates the secretion through the cholinergic fibres innervating the acinar cells of the pancreas, and through peptidergic nerve fibres, which innervate ductal cells.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      12.5
      Seconds

  • Question 51 - Which of the following arteries, if ligated, will most likely affect blood supply...

    Incorrect

    • Which of the following arteries, if ligated, will most likely affect blood supply to the pancreas?

      Your Answer: Common hepatic

      Correct Answer: Superior mesenteric

      Explanation:

      The pancreas is a glandular organ in the body that produces important hormones such as insulin and glucagon. Its blood supply is from branches of the coeliac artery, superior mesenteric artery and the splenic artery. These are the arteries that if ligated, would affect blood supply to the pancreas.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      14.4
      Seconds

  • Question 52 - Bloody discharge from the nipple of a 40-year old woman with no obvious...

    Correct

    • Bloody discharge from the nipple of a 40-year old woman with no obvious lump or abnormality on mammography is suggestive of:

      Your Answer: Intraductal papilloma

      Explanation:

      A small benign tumour, namely intraductal papilloma is most common in women between 35-55 years of age. It is also the commonest cause of spontaneous discharge from a single duct. A lump below the nipple may be sometimes palpable. Ultrasound and ductography are useful investigations., along with cytology of discharge to assess the presence of malignant cells. Confirmation is by breast biopsy.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      10.4
      Seconds

  • Question 53 - The gradual depolarization in-between action potentials in pacemaker tissue is a result of?...

    Incorrect

    • The gradual depolarization in-between action potentials in pacemaker tissue is a result of?

      Your Answer: A gradual increase in inward Na+ (INa) channels current through fast Na+ channels

      Correct Answer: A combination of gradual inactivation outward IK along with the presence of an inward ‘funny’ current (If) due to opening of channels permeable to both Na+ and K+ ions

      Explanation:

      One of the characteristic features of the pacemaker cell is the generation of a gradual diastolic depolarization also called the pacemaker potential. In phase 0, the upstroke of the action potential caused by an increase in the Ca2+ conductance, an influx of calcium occurs and a positive membrane potential is generated. The next is phase 3 which is repolarization caused by increased K+ conductance as a result of outwards K+ current. Phase 4 is a slow depolarization which accounts for the pacemaker activity, caused by increased conductance of Na+, inwards Na+ current called IF. it is turned on by repolarization.

    • This question is part of the following fields:

      • General
      • Physiology
      152.4
      Seconds

  • Question 54 - During an exploratory laparotomy a herniation of bowel is identified between the lateral...

    Incorrect

    • During an exploratory laparotomy a herniation of bowel is identified between the lateral edge of the rectus abdominis, the inguinal ligament and the inferior epigastric vessels. These boundaries define the hernia as being a:

      Your Answer: Indirect inguinal hernia

      Correct Answer: Direct inguinal hernia

      Explanation:

      The boundaries given define the inguinal triangle which is the site for direct inguinal hernias. Indirect inguinal hernias occur lateral to the inferior epigastric vessels.

      Femoral hernias protrude through the femoral ring, into the femoral canal.

      Umbilical hernias protrude through a defect in the umbilical area.

      Obturator hernias, occur through the obturator foramen. These are very rare.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      55.6
      Seconds

  • Question 55 - A middle aged man presented in OPD with a low grade fever and...

    Correct

    • A middle aged man presented in OPD with a low grade fever and a persistent cough. His blood smear showed an increase in cells with large bi-lobed nuclei. Which of these cells represent the one seen on the smear?

      Your Answer: Monocytes

      Explanation:

      Monocytes are white cells that protect the body against harmful pathogens. They are mobile and are produced in the bone marrow, mature there and circulate in the blood for about 1-3 days, where they enter the tissues and transform into macrophages. They are characteristically identified by their large bi-lobed nuclei.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      14.2
      Seconds

  • Question 56 - What principal artery that supplies the meninges is susceptible to rupture following trauma...

    Correct

    • What principal artery that supplies the meninges is susceptible to rupture following trauma to the side of the head over the temporal region:

      Your Answer: Middle meningeal artery

      Explanation:

      The middle meningeal artery normally arises from the first or mandibular segment of the maxillary artery. The artery runs in a groove on the inside of the cranium, this can clearly be seen on a lateral skull X-ray. An injured middle meningeal artery is the most common cause of an epidural hematoma.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      5
      Seconds

  • Question 57 - Which of the following substances brings about a dilatation of the gastrointestinal resistance...

    Correct

    • Which of the following substances brings about a dilatation of the gastrointestinal resistance vessels?

      Your Answer: Vasoactive intestinal peptide

      Explanation:

      Gastric vasoconstrictors include catecholamines, angiotensin II and vasopressin. Vasodilators include vasoactive intestinal peptide and the hormones; gastrin, cholecystokinin and glucagon.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      16.5
      Seconds

  • Question 58 - A patient had sudden complete loss of vision of the right eye. Fundoscopy...

    Correct

    • A patient had sudden complete loss of vision of the right eye. Fundoscopy showed the distinct cherry red spot on the retina. Which of the following arteries was occluded?

      Your Answer: Central artery of the retina

      Explanation:

      The central retinal artery supplies all the nerve fibres that form the optic nerve, which carries the visual information to the lateral geniculate nucleus of the thalamus. Thus if the central retinal artery gets occluded, there is complete loss of vision in that eye and the entire retina (with the exception of the fovea) becomes pale, swollen and opaque while the central fovea still appears reddish (this is because the choroid colour shows through). This is the basis of the famous Cherry red spot seen on examination of the retina on fundoscopy of a central retinal artery occlusion (CRAO).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      10.2
      Seconds

  • Question 59 - Which name is given to the inferior fascia of the urogenital diaphragm? ...

    Correct

    • Which name is given to the inferior fascia of the urogenital diaphragm?

      Your Answer: Perineal membrane

      Explanation:

      The urogenital fascia is mostly commonly referred to as the perineal membrane. This term refers to an anatomical fibrous membrane in the perineum. It is triangular in shape, and thus at times referred to as the triangular ligament. It is about 4 cm in depth. Its The perineal membrane’s apex is anterior and is separated from the arcuate pubic ligament by an oval opening for the passage of the deep dorsal vein of the penis. The lateral marginas of this triangular ligament are attached on either side to the inferior rami of the pubis and ischium, above the crus penis. Its base faces the rectum, and connects to the central tendinous point of the perineum. The pelvic fascia and Colle’s fascia is fused to the base of this triangle.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      6.3
      Seconds

  • Question 60 - After a total colectomy and ileotomy, a 50-year old diabetic man who was...

    Correct

    • After a total colectomy and ileotomy, a 50-year old diabetic man who was a known case of diabetic nephropathy had persistent metabolic acidosis. The patient appeared well perfused, with normal vital signs and normal fluid balance. Investigations revealed:

      Sodium = 132 mmol/l

      Potassium = 6.6 mmol/l

      Creatinine = 185 μmol/l (2.16 mg/dl)

      Chloride = 109 μmol/l

      8am cortisol = 500 nmol/l (18 μg/dl)

      pH = 7.29, p(CO2) = 27 mmHg

      p(O2) = 107 mmHg

      standard bicarbonate = 12 mmol/l.

      What is the likely causes of his acidosis?

      Your Answer: Renal tubular acidosis

      Explanation:

      Acidosis here is due to low bicarbonate. The low p(CO2) is seen in compensation. The anion gap is normal, ruling out intra-abdominal ischaemia (which leads to metabolic acidosis). If it was a gastrointestinal aetiology, low potassium would be seen. The history of diabetic nephropathy predisposes to renal tubular acidosis. Type 4 (hyporeninaemic hypoaldosteronism) is associated with high potassium and is found in diabetic and hypertensive renal disease.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      35
      Seconds

  • Question 61 - A 25 year old primi gravida lady was scheduled for a regular antenatal...

    Incorrect

    • A 25 year old primi gravida lady was scheduled for a regular antenatal check up. During the vaginal exam of this lady, the registrar discovered a malignant growth on the anterior wall of her vagina. Which of the following structures, adjacent to the vagina, is likely to be involved as well?

      Your Answer:

      Correct Answer: Fundus of the bladder

      Explanation:

      The fundus of the bladder is related anatomically to the anterior surface of the vagina and the urethra as well. If there was a malignant growth in the anterior surface of the vagina, then most likely the fundus of the bladder would be involved as well aspotentially the urethra.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      0
      Seconds

  • Question 62 - Which of the following diseases causes abrupt vertigo, nausea, vomiting, tinnitus, and nystagmus?...

    Incorrect

    • Which of the following diseases causes abrupt vertigo, nausea, vomiting, tinnitus, and nystagmus?

      Your Answer:

      Correct Answer: Vestibular neuronitis

      Explanation:

      Vestibular neuronitis or labyrinthitis causes a self-limited episode of vertigo, presumably due to inflammation of the vestibular division of cranial nerve VIII. Its causes are unknown, It may be due to a virus, but it can be related to a bacterial infection, head injury, stress, allergy, or as a reaction to medication. Symptoms can last up to 7-10 days.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      0
      Seconds

  • Question 63 - Chronic obstructive pulmonary disease (COPD) is likely to result in: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Respiratory acidosis

      Explanation:

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

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds

  • Question 64 - Which of the following foramina provides a passage through which the vestibulocochlear nerve,...

    Incorrect

    • Which of the following foramina provides a passage through which the vestibulocochlear nerve, passes?

      Your Answer:

      Correct Answer: Internal acoustic meatus

      Explanation:

      The internal auditory meatus is a canal within the petrous part of the temporal bone of the skull between the posterior cranial fossa and the inner ear. It 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
      0
      Seconds

  • Question 65 - A 23-year-old woman decides to donate a kidney through a kidney chain. Which...

    Incorrect

    • A 23-year-old woman decides to donate a kidney through a kidney chain. Which of the following indices would be expected to be decreased in the donor after full recovery from the operation?

      Your Answer:

      Correct Answer: Creatinine clearance

      Explanation:

      Since medication to prevent rejection is so effective, donors do not need to be similar to their recipient. Most donated kidneys come from deceased donors; however, the utilisation of living donors is on the rise. Most problems encountered with live donation are associated with the donor. Firstly, there are the potentially harmful investigative procedures carried out in the assessment phase, the most hazardous being renal angiography, where there is cannulation of the artery and injection of a radio-opaque dye to determine the blood supply to the kidney. Secondly, there are the short-term risks of nephrectomy surgery. According to the literature, there is a mortality rate of between 1 in 1600 and 1 in 3000, but this is no more than is associated with any anaesthetic. In the initial postoperative period creatinine clearance may be decreased but this recovers fully over a few weeks to months. Long-term complications include prolonged wound pain.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 66 - A 55-year-old woman complains of pain in the proximal and distal interphalangeal joins,...

    Incorrect

    • A 55-year-old woman complains of pain in the proximal and distal interphalangeal joins, and back pain which has increased over the last 4 years and worsens after activity. X-rays reveal Heberden’s and Bouchard’s nodes in her interphalangeal joints and the presence of osteophytes in her spine. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Osteoarthritis

      Explanation:

      Osteoarthritis is most common in older adults, predominating in women between the ages of 40 and 70; after this age, men and women are affected equally. It affects an entire joint, with disruption and potential loss of joint cartilage, along with other joint changes, including bone hypertrophy (osteophyte formation). The pain is usually gradual and is worse after activity, with occasional joint swelling. X-ray findings include marginal osteophytes, narrowing of the joint space, increased density of the subchondral bone, subchondral cyst formation, bony remodelling and joint effusions.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      0
      Seconds

  • Question 67 - Cyclophosphamide is used as a chemotherapy and immunosuppressant agent and is indicated in...

    Incorrect

    • Cyclophosphamide is used as a chemotherapy and immunosuppressant agent and is indicated in various diseases. One of the most severe complications of its use is cancer of the:

      Your Answer:

      Correct Answer: Urinary bladder

      Explanation:

      Cyclophosphamide is used to treat various types of cancer and autoimmune disorders. The main use of cyclophosphamide is in combination with other chemotherapy agents in the treatment of lymphomas, some forms of leukaemia and some solid tumours. Side-effects include nausea and vomiting, bone marrow suppression, stomach ache, diarrhoea, darkening of the skin/nails, alopecia, lethargy, and haemorrhagic cystitis. Cyclophosphamide is itself carcinogenic, potentially causing transitional cell carcinoma of the bladder as a long-term complication.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds

  • Question 68 - 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:

      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
      0
      Seconds

  • Question 69 - A elderly patient with bulbar palsy is bed ridden. While swallowing he aspirates...

    Incorrect

    • A elderly patient with bulbar palsy is bed ridden. While swallowing he aspirates one of his tablets into his lungs. In which bronchopulmonary segments is it most likely to end up?

      Your Answer:

      Correct Answer: Superior segmental bronchus of the right inferior lobe

      Explanation:

      Inhaled objects are more likely to enter the right lung for several reasons. First the right bronchus is shorter, wider and more vertical than the left bronchus. Also, the carina (a ridge-like structure at the point of tracheal bifurcation) is set a little towards the left. The superior segmental bronchus branches posteriorly off the intermediate bronchus or the inferior lobe bronchus and is thus more likely to receive the foreign body that enters the right main bronchus. The lingula is only found on the left lung. The terminal bronchiole is a very small space almost impossible for the tablet to lodge here.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 70 - An anatomy instructor is giving a demonstration of the right lung. Which of...

    Incorrect

    • An anatomy instructor is giving a demonstration of the right lung. Which of the statements about the right lung made by the demonstrator is correct?

      Your Answer:

      Correct Answer: Its upper lobar bronchus lies behind and above the right pulmonary artery

      Explanation:

      The root of the lungs on both sides are similar in that the pulmonary veins are anterior and inferior while the bronchus is posterior. However, on the right side, the pulmonary arteries are anterior to the bronchus while on the left side the pulmonary arteries are superior to the bronchus. The lingual is only found on the left lung. The mediastinum is the space in the thorax between the two pleural sacs and does not contain any lung. The right lung, having three lobes, is slightly larger than the left lung. On both sides, the phrenic nerves passes in front of the root of the lung.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 71 - Atrial septal defect (ASD) is most likely to be due to incomplete closure...

    Incorrect

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

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 72 - Where is the foramen ovale located? ...

    Incorrect

    • Where is the foramen ovale located?

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 73 - Regarding the coagulation cascade, Factor VII: ...

    Incorrect

    • Regarding the coagulation cascade, Factor VII:

      Your Answer:

      Correct Answer: Is a serine protease

      Explanation:

      Factor VII (FVII) is a zymogen for a vitamin K-dependent serine protease essential for the initiation of blood coagulation. It is synthesized primarily in the liver and circulates in plasma. Within the liver, hepatocytes are involved in the synthesis of most blood coagulation factors, such as fibrinogen, prothrombin, factor V, VII, IX, X, XI, XII, as well as protein C and S, and antithrombin, whereas liver sinusoidal endothelial cells produce factor VIII and von Willebrand factor.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 74 - Signals pass through neuromuscular junctions via the neurotransmitter acetylcholine. After release from the...

    Incorrect

    • Signals pass through neuromuscular junctions via the neurotransmitter acetylcholine. After release from the skeletal neuromuscular junction, acetylcholine:

      Your Answer:

      Correct Answer: Causes postsynaptic depolarisation

      Explanation:

      Acetylcholine is released from the presynaptic membrane into the cleft where it binds to the ion gated channels on the post synaptic membrane, causing them to open. This results in sodium entering into the fibre and further depolarizing it, creating an action potential.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

  • Question 75 - Which cells are most commonly seen in a granulomatous lesion that suggests an...

    Incorrect

    • Which cells are most commonly seen in a granulomatous lesion that suggests an underlying chronic inflammation?

      Your Answer:

      Correct Answer: Lymphocytes

      Explanation:

      Lymphocytes and monocytes are commonly and characteristically recognised in a case of chronic inflammation.

      Eosinophils and neutrophils are seen with acute inflammation.

      Mast cells release histamine in early inflammation.

      Basophils are seen with allergies.

      Plasma cells are seen with viral infection.

      Platelets are not characteristic of any type of inflammation.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      0
      Seconds

  • Question 76 - The posterior cord contains nerve fibres from which of the following levels of...

    Incorrect

    • The posterior cord contains nerve fibres from which of the following levels of the spinal cord?

      Your Answer:

      Correct Answer: C5, C6, C7, C8 and T1

      Explanation:

      THE correct answer is A. The posterior cord derives its fibres from the spinal nerves C5,C6,C7,C8,T1. This cord is formed from the fusion of the posterior divisions of the upper, lower, and middle trunks.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 77 - A 68-year-old woman complains of headaches, dizziness, and memory loss. About a month...

    Incorrect

    • A 68-year-old woman complains of headaches, dizziness, and memory loss. About a month ago, she fell from a staircase but only suffered mild head trauma. What is the most likely diagnosis in this case?

      Your Answer:

      Correct Answer: Chronic subdural haematoma

      Explanation:

      A quarter to a half of patients with chronic subdural haematoma have no identifiable history of head trauma. If a patient does have a history of head trauma, it usually is mild. The average time between head trauma and chronic subdural haematoma diagnosis is 4–5 weeks. Symptoms include decreased level of consciousness, balance problems, cognitive dysfunction and memory loss, motor deficit (e.g. hemiparesis), headache or aphasia. Some patients present acutely. They usually result from tears in bridging veins which cross the subdural space, and may cause an increase in intracranial pressure (ICP).

    • This question is part of the following fields:

      • Neurology
      • Pathology
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      Seconds

  • Question 78 - A growing tumour is impinging on the lingual artery in the floor of...

    Incorrect

    • A growing tumour is impinging on the lingual artery in the floor of the mouth. Which structure will experience decreased blood flow?

      Your Answer:

      Correct Answer: The sublingual gland

      Explanation:

      The paired sublingual glands are major salivary glands in the mouth. They are the smallest, most diffuse, and the only unencapsulated major salivary glands. They provide only 3-5% of the total salivary volume. The gland receives its blood supply from the sublingual and submental arteries. The sublingual artery is a branch of the lingual artery, thus damage to the lingual artery will decrease the blood flow to the sublingual gland.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 79 - Which Statement is true of the brachial plexus? ...

    Incorrect

    • Which Statement is true of the brachial plexus?

      Your Answer:

      Correct Answer: The posterior cord continues as the axillary nerve

      Explanation:

      The lateral cord continues as the musculocutaeous nerve.

      The medial cord continues as the ulnar nerve.

      The posterior cord continues as the radial nerve and the axillary nerve.

      The nerve to subclavius muscle is a branch of the C6 root.

      The suprascapular nerve is a branch from the upper trunk.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 80 - The renal tubule is the portion of the nephron that contains the fluid...

    Incorrect

    • The renal tubule is the portion of the nephron that contains the fluid that has been filtered by the glomerulus. Which of the following substances is actively secreted into the renal tubules?

      Your Answer:

      Correct Answer: Potassium

      Explanation:

      The renal corpuscle filters out solutes from the blood, delivering water and small solutes to the renal tubule for modification. In normal circumstances more than 90% of the filtered load of K is reabsorbed by the proximal tubules and loops of Henlé and almost all K appearing in the urine has been secreted by the late distal tubules and collecting tubules. So the rate of excretion is usually independent of the rate of filtration, but is closely tied to the rate of secretion and control of K excretion, largely accomplished by control of the secretion rate. Around 65–70% of the filtered potassium is reabsorbed along with water in the proximal tubule and the concentration of potassium in the tubular fluid varies little from that of the plasma.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
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  • Question 81 - Which of the following toxins most likely results in continuous cAMP production, which...

    Incorrect

    • Which of the following toxins most likely results in continuous cAMP production, which pumps H2O, sodium, potassium, chloride and bicarbonate into the lumen of the small intestine and results in rapid dehydration?

      Your Answer:

      Correct Answer: Cholera toxin

      Explanation:

      The cholera toxin (CTX or CT) is an oligomeric complex made up of six protein subunits: a single copy of the A subunit (part A), and five copies of the B subunit (part B), connected by a disulphide bond. The five B subunits form a five-membered ring that binds to GM1 gangliosides on the surface of the intestinal epithelium cells. The A1 portion of the A subunit is an enzyme that ADP-ribosylates G proteins, while the A2 chain fits into the central pore of the B subunit ring. Upon binding, the complex is taken into the cell via receptor-mediated endocytosis. Once inside the cell, the disulphide bond is reduced, and the A1 subunit is freed to bind with a human partner protein called ADP-ribosylation factor 6 (Arf6). Binding exposes its active site, allowing it to permanently ribosylate the Gs alpha subunit of the heterotrimeric G protein. This results in constitutive cAMP production, which in turn leads to secretion of H2O, Na+, K+, Cl−, and HCO3− into the lumen of the small intestine and rapid dehydration. The gene encoding the cholera toxin was introduced into V. cholerae by horizontal gene transfer.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
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  • Question 82 - After total thyroidectomy, which of the following investigations is recommended in the immediate...

    Incorrect

    • After total thyroidectomy, which of the following investigations is recommended in the immediate post-operative period?

      Your Answer:

      Correct Answer: Serum calcium

      Explanation:

      Total thyroidectomy might sometimes result in inadvertent excision or damage of parathyroid glands, leading to hypoparathyroidism. Monitoring serum calcium levels in the post-operative period to detect hypocalcaemia is essential to diagnose and prevent this condition.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
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  • Question 83 - An ECG of a 30 year old woman revealed low voltage QRS complexes....

    Incorrect

    • An ECG of a 30 year old woman revealed low voltage QRS complexes. This patient is most probably suffering from?

      Your Answer:

      Correct Answer: Pericardial effusion

      Explanation:

      The QRS complex is associated with current that results in the contraction of both the ventricles. As ventricles have more muscle mass than the atria, they result in a greater deflection on the ECG. The normal duration of a QRS complex is 10s. A wide and deep Q wave depicts myocardial infarction. Abnormalities in the QRS complex maybe indicative of a bundle block, ventricular tachycardia or hypertrophy of the ventricles. Low voltage QRS complexes are characteristic of pericarditis or a pericardial effusion.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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  • Question 84 - Which of the following organelles have the capacity to regenerate and spontaneously replicate?...

    Incorrect

    • Which of the following organelles have the capacity to regenerate and spontaneously replicate?

      Your Answer:

      Correct Answer: Mitochondrion

      Explanation:

      A mitochondria is a membrane bound organelle found in eukaryotic cells. They are called the powerhouse of the cell and are the place where ATP is formed from energy generated through metabolism. They are capable of replication as well as repair and regeneration.

    • This question is part of the following fields:

      • General
      • Physiology
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  • Question 85 - When a penile tumour invades the subepithelial connective tissue of the penis, what...

    Incorrect

    • When a penile tumour invades the subepithelial connective tissue of the penis, what is its stage?

      Your Answer:

      Correct Answer: T1

      Explanation:

      The TNM staging used for penile cancer is as follows:

      TX: primary tumour cannot be assessed

      T0: primary tumour is not evident

      Tis: carcinoma in situ is present

      Ta: non-invasive verrucous carcinoma is present

      T1: tumour is invading subepithelial connective tissue

      T2: tumour is invading the corpora spongiosum or cavernosum

      T3: tumour invading the urethra or prostate

      T4: tumour invading other adjacent structures.

      In this case, the patient has a T1 tumour.

    • This question is part of the following fields:

      • Pathology
      • Urology
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  • Question 86 - After a cerebral infarction, which of these histopathogical findings is most likely to...

    Incorrect

    • After a cerebral infarction, which of these histopathogical findings is most likely to be found?

      Your Answer:

      Correct Answer: Liquefactive necrosis

      Explanation:

      The brain has a high lipid content and typically undergoes liquefaction with ischaemic injury, because it contains little connective tissue but high amounts of digestive enzymes.

    • This question is part of the following fields:

      • Neurology
      • Pathology
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  • Question 87 - Following a bee sting, a women develops a 2cm red, raised, swollen lesion...

    Incorrect

    • Following a bee sting, a women develops a 2cm red, raised, swollen lesion at the site of the sting . Which of the following findings is likely to be seen in this lesion?

      Your Answer:

      Correct Answer: Vasodilation

      Explanation:

      Inflammation is the immediate response of the body towards infections or irritations. The cardinal signs of inflammation are 1. redness/rubor, 2. tumour/swelling, 3.dolar/pain, 4.calor/heat and organ dysfunction (function laesa). Inflammation has 2 components; vascular and cellular. Blood vessels dilate upstream of the inflamed area leading to the rubor and calor and constrict downstream, increasing pressure and causing fluid to leak out of the capillary, resulting in swelling. The cellular component includes infiltration by neutrophils. Leukocyte arrival and functions include; 1. margination: cells marginated from the centre to the periphery of the vessel, 2. rolling: selectins are upregulated on the vessel walls, 3. adhesion: upregulation of the adhesion molecules ICAM and VCAM on the endothelium interact with integrins on the leukocytes resulting in adhesion, 4. diapedesis and chemotaxis: diapedesis is the transmigration of the leukocyte across the endothelium of the capillary and towards a chemotactic product and 5. phagocytosis: engulfing the offending substance/cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
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  • Question 88 - Which of the following foramina will the ophthalmic artery pass through in order...

    Incorrect

    • Which of the following foramina will the ophthalmic artery pass through in order to reach the eye?

      Your Answer:

      Correct Answer: Optic canal

      Explanation:

      The optic foramen is the opening to the optic canal. The canal is located in the sphenoid bone; it is bounded medially by the body of the sphenoid and laterally by the lesser wing of the sphenoid. The superior surface of the sphenoid bone is bounded behind by a ridge, which forms the anterior border of a narrow, transverse groove, the chiasmatic groove (optic groove). The groove ends on either side in the optic foramen, which transmits the optic nerve and ophthalmic artery into the orbital cavity. Compared to the optic nerve, the ophthalmic artery is located inferolaterally within the canal.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 89 - A 40-year-old woman is suspected to have an ovarian cancer. Which tumour marker...

    Incorrect

    • A 40-year-old woman is suspected to have an ovarian cancer. Which tumour marker should be requested to confirm the diagnosis?

      Your Answer:

      Correct Answer: CA-125

      Explanation:

      CA-125 is a protein that is used as a tumour marker. This substance is found in high concentration in patients with ovarian cancer. It is the only tumour marker recommended for clinical use in the diagnosis and management of ovarian cancer.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
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  • Question 90 - Endometrial hyperplasia is most likely to be associated with which of the following...

    Incorrect

    • Endometrial hyperplasia is most likely to be associated with which of the following conditions?

      Your Answer:

      Correct Answer: Fibrothecoma

      Explanation:

      A benign tumour arising from the ovarian stroma, fibrothecoma are bilateral in 10% cases. The thecoma component of the tumour can produce oestrogen leading to endometrial hyperplasia. The thecoma is rich in lipid content and is responsible for the yellowish appearance of the tumour. Meig’s syndrome is the presence of fibrothecoma with a right-sided hydrothorax.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
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  • Question 91 - What is the innervation of the laryngeal mucosa inferior to the true vocal...

    Incorrect

    • What is the innervation of the laryngeal mucosa inferior to the true vocal cord?

      Your Answer:

      Correct Answer: Recurrent laryngeal nerve

      Explanation:

      Motor innervation to all other muscles of the larynx and sensory innervation to the subglottis is by the recurrent laryngeal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 92 - A 25-year-old female had a painful abdomen and several episodes of vomiting. She...

    Incorrect

    • 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:

      Correct 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
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  • Question 93 - Hepatomegaly with greatly increased serum alpha-fetoprotein is seen in which of the following...

    Incorrect

    • Hepatomegaly with greatly increased serum alpha-fetoprotein is seen in which of the following conditions?

      Your Answer:

      Correct Answer: Hepatocellular carcinoma

      Explanation:

      Hepatocellular carcinoma or hepatoma affects people with pre-existing cirrhosis and is more common in areas with higher prevalence of hepatitis B and C. Diagnosis include raise alpha-fetoprotein levels, imaging and liver biopsy if needed. Patients at high-risk for developing this disease can undergo screening by periodic AFP measurement and abdominal ultrasonography. The malignancy carries poor prognosis (see also Answer to 10.4).

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
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  • Question 94 - In a splenectomy procedure, special care is emphasized on the preservation of the...

    Incorrect

    • In a splenectomy procedure, special care is emphasized on the preservation of the tail of the pancreas that is closely associated with the spleen to avoid post operative pancreatic fistula. As a general surgeon conducting a splenectomy where are you most likely to find the tail of the pancreas in the abdominal cavity?

      Your Answer:

      Correct Answer: Splenorenal ligament

      Explanation:

      The tail of the pancreas is the only intraperitoneal part of the pancreas and is found contained in the splenorenal ligament of the peritoneal cavity. The splenorenal ligament is derived from the peritoneum where the wall of the general peritoneal cavity connects to the omental bursa between the spleen and the left kidney. This ligament contains the splenic vessels and the tail of the pancreas.

      The gastrocolic ligament stretches from the greater curvature of the stomach to the transverse colon, connecting the two.

      The gastrosplenic ligament is derived from the greater omentum and is the structure that connects the stomach to the hilum of the spleen. The gastrosplenic ligament continues from the splenic flexure of the colon to the diaphragm and acts as a support to the spleen.

      The transverse colon is connected to the abdominal wall by the mesocolon ligament.

      The falciform ligament on the other hand, attaches the liver to the ventral wall of the abdomen.

      The hepatoduodenal ligament connects the porta hepatis of the liver to the superior part of the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 95 - Which best describes the sartorius muscle? ...

    Incorrect

    • Which best describes the sartorius muscle?

      Your Answer:

      Correct Answer: Will flex the leg at the knee joint

      Explanation:

      The sartorius muscle arises from tendinous fibres from the superior iliac spine. It passes obliquely across the thigh from lateral to medial and is inserted into the upper part of the medial side of the tibia. When the sartorius muscle contracts it will flex the leg at the knee joint.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 96 - Which of the following structures, is the area in which the superior cerebral...

    Incorrect

    • Which of the following structures, is the area in which the superior cerebral veins drain into?

      Your Answer:

      Correct Answer: Superior sagittal sinus

      Explanation:

      The superior cerebral veins are predominantly located on the superior aspect of the brain. They are 8 to 12 in number and they drain the lateral, medial and superior aspects of the cerebral hemispheres.

      These veins drain into the superior sagittal sinus, also known as the superior longitudinal sinus – which is located along the attached margin of the falx cerebri.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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  • Question 97 - A 55-year-old male chronic smoker is diagnosed with non-small-cell cancer. His right lung...

    Incorrect

    • A 55-year-old male chronic smoker is diagnosed with non-small-cell cancer. His right lung underwent complete atelectasis and he has a 7cm tumour involving the chest wall. What is the stage of the lung cancer of this patient?

      Your Answer:

      Correct Answer: T3

      Explanation:

      Non-small-cell lung cancer is staged through TNM classification. The stage of this patient is T3 because based on the TNM classification the tumour is staged T3 if > 7 cm or one that directly invades any of the following: Chest wall (including superior sulcus tumours), diaphragm, phrenic nerve, mediastinal pleura, or parietal pericardium; or the tumour is in the main bronchus < 2 cm distal to the carina but without involvement of the carina, Or it is associated with atelectasis/obstructive pneumonitis of the entire lung or separate tumour nodule(s) in the same lobe.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
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  • Question 98 - What is the 5-year survival rate of carcinoma of the pancreas? ...

    Incorrect

    • What is the 5-year survival rate of carcinoma of the pancreas?

      Your Answer:

      Correct Answer: 30 per cent

      Explanation:

      Pancreatic cancer typically has a poor prognosis, partly because the cancer usually initially remains symptomless, leading to locally advanced or metastatic disease at the time of diagnosis. Median survival from diagnosis is around 3–6 months. Even in those suitable for resectional surgery, 5-year survival rates are still only 30 per cent.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
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  • Question 99 - A histological examination of a lump showed an abnormal amount and arrangement of...

    Incorrect

    • A histological examination of a lump showed an abnormal amount and arrangement of normal tissue in an otherwise normal area. This condition is known as?

      Your Answer:

      Correct Answer: Hamartoma

      Explanation:

      A hamartoma is a condition best described as tissue normally present in an area arranged haphazardly in an disorganized, abnormal fashion. They are never malignant and do not metastasis.

      All the neoplastic, cancerous lesions comprise of a mixture of different cells that are not normal to that area.

      Metaplasia is a change in the type of the epithelium.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
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  • Question 100 - A 46-year old female patient experienced a stroke that affected her glossopharyngeal nerve....

    Incorrect

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

      Your Answer:

      Correct Answer: Result in general sensory deficit to the pharynx

      Explanation:

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

      – Contributes to the pharyngeal plexus

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

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

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

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

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

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

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
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SESSION STATS - PERFORMANCE PER SPECIALTY

Neoplasia; Urology (1/1) 100%
Pathology (23/25) 92%
Neoplasia (3/3) 100%
Abdomen (3/5) 60%
Anatomy (13/19) 68%
Upper Limb (5/6) 83%
Lower Limb (2/2) 100%
Gastroenterology (5/7) 71%
Physiology (10/16) 63%
Thorax (0/1) 0%
Pelvis (1/2) 50%
Fluids & Electrolytes (2/2) 100%
Inflammation & Immunology; Urology (1/1) 100%
Haematology (4/5) 80%
General (3/4) 75%
Neurology (1/2) 50%
Inflammation & Immunology (3/3) 100%
Respiratory (1/3) 33%
Endocrine (1/2) 50%
Microbiology (1/1) 100%
Cell Injury & Wound Healing; Urology (1/1) 100%
Head & Neck (2/3) 67%
Urology (1/1) 100%
Renal (1/1) 100%
Cell Injury & Wound Healing (1/1) 100%
Orthopaedics (1/1) 100%
Cardiovascular (1/1) 100%
Women's Health (1/1) 100%
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