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Question 1
Incorrect
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What is the function of the acute phase protein, C-reactive protein?
Your Answer: Activates complement
Correct Answer: Opsonises bacteria
Explanation:There are various immune reactions that become activated once the barrier between the body and environment has been compromised. There are certain opsonins that bind to the bacteria and facilitate phagocytosis. One of them is the acute phase protein: C protein. others include antibodies and complement.
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This question is part of the following fields:
- Immunology
- Physiology
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Question 2
Correct
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An 8 year old boy presents with bleeding from the nose. From which area did the bleeding most likely originate?
Your Answer: Kiesselbach's plexus
Explanation:Answer: Kiesselbach’s plexusEpistaxis is defined as acute haemorrhage from the nostril, nasal cavity, or nasopharynx. The source of 90% of anterior nosebleeds within the Kiesselbach’s plexus (also known as Little’s area) on the anterior nasal septum. Kiesselbach’s plexus (Kiesselbach’s area or Little’s area) is a vascular region of the anteroinferior nasal septum that comprises four arterial anastomoses:1)anterior ethmoidal artery – a branch of the ophthalmic artery2)sphenopalatine artery
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This question is part of the following fields:
- Head & Neck
- Pathology
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Question 3
Correct
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The following are all examples of type IV hypersensitivity EXCEPT for:
Your Answer: Extrinsic allergic alveolitis
Explanation:Examples of type IV reactions includes: Contact dermatitis Hashimoto’s thyroiditis Primary biliary cholangitis Tuberculin skin test (Mantoux test) Chronic transplant rejection Granulomatous inflammation (e.g. sarcoidosis, Crohn’s disease)
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This question is part of the following fields:
- Immunology
- Pathology
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Question 4
Incorrect
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The predominant site in the lymph node where B lymphocytes are found is:
Your Answer: It is found equally in all parts of the lymph node
Correct Answer: Cortex
Explanation:The cortex of the lymph node consists of the lymphoid nodules and sinusoids and posses a germinal centre from which B cells proliferate. The cortex of the lymph node predominately consists of B cells.
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This question is part of the following fields:
- Immunology
- Physiology
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Question 5
Correct
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A 33 year old woman presents with a history of recurrent infections and abscesses in the neck. Examination reveals a midline defect with an overlying scab which moves upwards on tongue protrusion. Which of the following is the most likely diagnosis?
Your Answer: Thyroglossal cyst
Explanation:Congenital neck masses are developmental anomalies typically seen in infants or children. Common conditions include thyroglossal duct cysts, branchial cleft cysts, and cystic hygromas. These malformations present as painless neck masses, which can cause dysphagia, respiratory distress, and neck pain due to compression of surrounding structures. The location of the mass depends on the embryological structure the cysts arise from. Diagnosis is made based on clinical findings and imaging results (ultrasound, CT, MRI), which also help in surgical planning. Treatment consists of complete surgical resection to prevent recurrence and complications such as infection or abscess formation. The thyroglossal cyst is present from birth and usually detected during early childhood. It presents as a painless, firm midline neck mass, usually near the hyoid bone, which elevates with swallowing and tongue protrusion. May cause dysphagia or neck/throat pain if the cyst enlarges.
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This question is part of the following fields:
- Head & Neck
- Pathology
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Question 6
Correct
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A 36 year old opera singer is admitted for a right thyroid lobectomy. Post operatively, he is unable to sing high notes. Which muscle is likely to demonstrate impaired function?
Your Answer: Cricothyroid
Explanation:Thyroidectomy has been reported as the most frequent cause of external branch of superior laryngeal nerve (EBSLN) injury. Diagnosis of EBSLN injury may be difficult because the symptoms are nonspecific in many cases. However, advanced diagnostic techniques have revealed the incidence to be relatively high, ranging from 5 to 28%. Paralysis of the EBSLN causes difficulty with high pitch phonation and decreased pitch range secondary to failure of cricothyroid muscle stimulation and lack of tension in the vocal cord. This symptom may be extremely serious for professional voice users. EBSLN injury can also cause vocal fatigue, hoarseness, breathy sounding voice, and vocal nodules.
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This question is part of the following fields:
- Head & Neck
- Pathology
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Question 7
Incorrect
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A 50-year-old man presents with unilateral facial paralysis after being hit on the head. On examination, he has a right-sided facial nerve palsy and watery discharge from the nose. What is the most likely underlying cause?
Your Answer: Occipital bone fracture
Correct Answer: Petrous temporal fracture
Explanation:Nasal discharge of clear fluid and a recent head injury makes basal skull fracture the most likely underlying cause for facial nerve palsy.Facial palsy is a neurological condition in which function of the facial nerve (cranial nerve VII) is partially or completely lost. It is often idiopathic (Bell’s palsy) but in some cases, specific causes such as trauma (e.g. temporal bone fracture), infections, or metabolic disorders can be identified. Two major types are distinguished: 1. Central facial palsy—lesion occurs between cortex and nuclei in the brainstem2. Peripheral facial palsy—lesion occurs between nuclei in the brainstem and peripheral organs Diagnosis can usually be made clinically while patient’s history often helps in evaluating the underlying aetiology.Patients with basal skull fracture following head injury (as in this case) exhibit Battle’s sign on examination. It is an indication of fracture of middle cranial fossa of the skull and consists of bruising over the mastoid process as a result of extravasation of blood along the path of the posterior auricular artery. Clinical presence of CSF leak further supports the diagnosis.Assessment options for basal skull fracture include CT and MRI scan. Idiopathic facial nerve palsy is treated with oral glucocorticoids and, in severe cases, with antivirals. Treatment of the other types depends on the underlying cause. Prophylactic antibiotics are given in cases of CSF leak.
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This question is part of the following fields:
- Head & Neck
- Pathology
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Question 8
Correct
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The following are all examples of type I hypersensitivity EXCEPT for:
Your Answer: Contact dermatitis
Explanation:Examples of type I reactions include: Allergic rhinitis Allergic conjunctivitis Allergic asthma Systemic anaphylaxis Angioedema Urticaria Penicillin allergy
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This question is part of the following fields:
- Immunology
- Pathology
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Question 9
Incorrect
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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: Haemorrhage
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.
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This question is part of the following fields:
- Inflammatory Responses
- Pathology
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Question 10
Incorrect
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Which cell type functions as the critical bridge between innate and adaptive immune systems, by activating naïve T lymphocytes?
Your Answer: Natural killer cells
Correct Answer: Dendritic cells
Explanation:Dendritic cells are antigen presenting cells. They express class II MHC and T cell co-stimulatory molecules. They bind antigens and present them to native T cells and in the process activate the specific T cell against that antigen.
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This question is part of the following fields:
- Immunology
- Physiology
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