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  • Question 1 - Cranial nerve XII, the hypoglossal nerve, innervates which one of the following muscles...

    Correct

    • Cranial nerve XII, the hypoglossal nerve, innervates which one of the following muscles in the list?

      Your Answer: Hyoglossus

      Explanation:

      The cranial nerve XII, hypoglossal nerve, innervates all the intrinsic and extrinsic muscles of the tongue except the palatoglossus. The muscles of the tongue innervated by this nerve include the extrinsic muscles; hyoglossus, styloglossus, genioglossus and the intrinsic muscles; superior longitudinal, inferior longitudinal, vertical and transverse muscles. The salpingopharyngeus, palatoglossus and the palatopharyngeus muscles are innervated by the vagus nerve. The stylopharyngeus muscle is innervated by the glossopharyngeal nerve (CN IX). The mylohyoid muscle is innervated by the inferior alveolar nerve, a branch of the mandibular nerve. Finally, the geniohyoid muscle is innervated by the olfactory nerve (CN I) via the hypoglossal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      23.1
      Seconds
  • Question 2 - After a prolonged coronary artery bypass surgery, a 60-year old gentleman was transfused...

    Correct

    • After a prolonged coronary artery bypass surgery, a 60-year old gentleman was transfused 3 units of fresh-frozen plasma and 2 units of packed red cells. Two days later, the nurse noticed that he was tachypnoeic and chest X-ray showed signs consistent with adult respiratory distress syndrome. Which of the following variables will be low in this patient?

      Your Answer: Compliance of the lung

      Explanation:

      Acute or adult respiratory distress syndrome (ARDS) is a reaction to several forms of lung injuries and is commonly associated with sepsis and SIRS (systemic inflammatory response syndrome), severe traumatic injury, severe head injury, narcotics overdose, drowning, pulmonary contusion, and multiple blood transfusions. There is an increase in risk due to pre-existing liver disease or coagulation abnormalities. It results due to indirect toxic effects of neutrophil-derived inflammatory mediators in the lungs. ARDS is defined by the 1994 American–European Consensus Committee as the acute onset of bilateral infiltrates on chest X-ray, a partial pressure of arterial oxygen (pa(O2)) to fraction of inspired oxygen Fi(O2) ratio of less than 200 mmHg and a pulmonary artery occlusion pressure of less than 18 or the absence of clinical evidence of left arterial hypertension. ARDS is basically pulmonary oedema in the absence of volume overload or poor left ventricular function. This is different from acute lung injury, which shows a pa(O2)/Fi(O2) ratio of less than 300 mmHg. Pathogenesis of ARDS starts from damage to alveolar epithelium and vascular endothelium, causing increased permeability. Damage to surfactant-producing type II cells disrupts the production and function of pulmonary surfactant, causing micro atelectasis and poor gas exchange. There is a decrease in lung compliance and increase in work of breathing. Eventually, there is resorption of alveolar oedema, regeneration of epithelial cells, proliferation and differentiation of type II alveolar cells and alveolar remodelling. Some show resolution and some progress to fibrosing alveolitis, which involves the deposition of collagen in alveolar, vascular and interstitial spaces.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      51.3
      Seconds
  • Question 3 - During an exploratory laparotomy a herniation of bowel is identified between the lateral...

    Correct

    • 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: 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
      14.9
      Seconds
  • Question 4 - Difficulty in retracting the foreskin of the penis in an uncircumcised male is...

    Correct

    • Difficulty in retracting the foreskin of the penis in an uncircumcised male is known as:

      Your Answer: Phimosis

      Explanation:

      Phimosis is the inability to fully retract the foreskin of the penis in an uncircumcised male. It can be physiological in infancy, in which it could be referred to as ‘developmental non-retractility of the foreskin. However, it is almost always pathological in older children and men. Causes include chronic inflammation (e.g. balanoposthitis), multiple catheterisations, or forceful foreskin retraction. One of the causes is chronic balanitis xerotica obliterans. It leads to development of a ring of indurated tissue near the tip of the prepuce, which prevents retraction. Contributory factors include infections, hormonal and inflammatory factors. The recommended treatment includes circumcision.

    • This question is part of the following fields:

      • Pathology
      • Urology
      8.5
      Seconds
  • Question 5 - A biopsy taken from the respiratory passage of a 37 year old male,...

    Correct

    • A biopsy taken from the respiratory passage of a 37 year old male, chronic smoker will mostly likely show which cellular adaptation?

      Your Answer: Stratified squamous metaplasia

      Explanation:

      Metaplasia is a change in the cell type caused in part due to an extrinsic stress on the organ. It involves a change in the surface epithelium from one cell type to the another, most commonly squamous to columnar. This is a reversible process, and removal of the stress should theoretically reverse the surface epithelium back to normal morphology. Respiratory tract metaplasia is a classic example, in which the normal pseudostratified columnar epithelium is replaced by stratified squamous epithelium to better cope with the stress. Under continuous stress metaplasia can progress to dysplasia which is a disordered growth of cells eventually leading to the development of carcinoma.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Respiratory
      • Pathology
      22.9
      Seconds
  • Question 6 - A 50-year-old gentleman was recently diagnosed with hypertension, with no other abnormalities on...

    Incorrect

    • A 50-year-old gentleman was recently diagnosed with hypertension, with no other abnormalities on physical examination. Further investigations revealed the following :
      Na+ 144 mmol/l
      K+ 3.0 mmol/l
      Cl- 107 mmol/l
      Bicarbonate 25 mmol/l.
      Blood glucose 5.8 mmol/l.
      What is the likely diagnosis?

      Your Answer: Renal artery stenosis

      Correct Answer: Conn syndrome

      Explanation:

      Overproduction of aldosterone (a mineralocorticoid) by the adrenal glands is known as Conn’s syndrome. It can be either due to an aldosterone-secreting adrenal adenoma (50-60% cases) or adrenal gland hyperplasia (40-50% cases). Excess aldosterone leads to sodium and water retention, along with potassium excretion. This leads to arterial (non-essential) hypertension. Conn’s syndrome is the commonest cause of primary hyperaldosteronism. Other symptoms include muscle cramps, headache (due to hypokalaemia) and metabolic alkalosis, which occurs due to increased secretion of H+ ions by the kidney. The raised pH of the blood traps calcium leading to symptoms of hypocalcaemia, which can be mimicked by liquorice ingestion and Liddle syndrome. To diagnose Conn’s syndrome, the ratio of renin and aldosterone is measured. Due to suppression of renin secretion, there is low renin to aldosterone ratio (<0.05). However, anti-hypertensives may affect the test results and should be withdrawn for 6 weeks. Computed tomography can also be done to detect the presence of adrenal adenoma. Cushing’s syndrome does not cause hypokalaemia with normal serum glucose levels. Nelson’s syndrome refers to increased ACTH secretion due to pituitary adenoma. Pheochromocytoma will not lead to hypokalaemia even though hypertension can be seen.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      65.5
      Seconds
  • Question 7 - Normally, the O2 transfer in the lungs from alveolar to capillary is perfusion-limited....

    Incorrect

    • Normally, the O2 transfer in the lungs from alveolar to capillary is perfusion-limited. In which of the following situations does it become a diffusion-limited process?

      Your Answer: Breathing hyperbaric gas mixture

      Correct Answer: Pulmonary oedema

      Explanation:

      Normally, the transfer of oxygen from air spaces to blood takes place across the alveolar-capillary membrane by simple diffusion and depends entirely on the amount of blood flow (perfusion-limited process). Diseases that affect this diffusion will transform the normal process to a diffusion limited process. Thus, the diseases which cause a thickened barrier (such as pulmonary oedema due to increased extravascular lung water or asbestosis) will limit the diffusion of oxygen. Chronic obstructive lung diseases will have little effect on diffusion. Inhaling hyperbaric gas mixtures might overcome the diffusion limitation in patients with mild asbestosis or interstitial oedema, by increasing the driving force. Strenuous (not mild) exercise might also favour diffusion limitation and decrease passage time. Increasing the rate of ventilation will not have this affect but will only maintain a high oxygen gradient from air to blood.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      19.6
      Seconds
  • Question 8 - From which of the following cells is heparin produced? ...

    Incorrect

    • From which of the following cells is heparin produced?

      Your Answer: Endothelial cells

      Correct Answer: Mast cells

      Explanation:

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

    • This question is part of the following fields:

      • Haematology
      • Pathology
      19.1
      Seconds
  • Question 9 - A 20-year old college student was diagnosed with meningitis that had developed due...

    Correct

    • A 20-year old college student was diagnosed with meningitis that had developed due to an acute cavernous sinus thrombosis from an ear infection. Which of the following superficial venous routes is the usual path that an infected blood clot takes to reach the cavernous sinus?

      Your Answer: Facial vein

      Explanation:

      The facial vein is the usual communication between the cavernous sinus and the pterygoid sinus. It is through this vein that an infected clot can travel to the cavernous sinus and cause infection. The pterygoid plexus is a venous plexus that is situated between the temporalis muscle and lateral pterygoid muscle, and partly between the two pterygoid muscles. The pterygoid plexus is connected to the facial vein by the deep facial vein. This connection is what makes this area where this sinus and the facial vein are located a danger zone. The danger zone or triangle of the face is the area from the corners of the mouth to the nose bridge. The sinus connection in this area makes it possible for infection to reach the cavernous sinus and at times cause meningitis.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      48.4
      Seconds
  • Question 10 - A surgeon trainee is assisting in an operation to ligate the ductus arteriosus....

    Correct

    • A surgeon trainee is assisting in an operation to ligate the ductus arteriosus. The consultant supervising explains that caution is required when placing a clamp on the ductus to avoid injury to an important structure immediately dorsal to it. To which structure is the consultant referring?

      Your Answer: Left recurrent laryngeal nerve

      Explanation:

      The left recurrent laryngeal nerve branches off the vagus and wraps around the aorta, posterior to the ductus arteriosus/ligamentum arteriosum from whence it courses superiorly to innervate the laryngeal muscles.

      Accessory Hemiazygous vein is on the left side of the body draining the posterolateral chest wall and emptying blood into the azygos vein.

      The left internal thoracic artery is branch of the left subclavian artery supplying blood to the anterior wall of the thorax.

      Left phrenic nerve is lateral to the vagus nerve.

      Thoracic duct: is behind the oesophagus, coursing between the aorta and the azygos vein in the posterior chest.

      Right recurrent laryngeal nerve: loops around the right subclavian artery and is not in danger in this procedure.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      17.1
      Seconds
  • Question 11 - A 34-year-old man is receiving chemotherapy for non-Hodgkin's lymphoma. Which of the following...

    Correct

    • A 34-year-old man is receiving chemotherapy for non-Hodgkin's lymphoma. Which of the following chemotherapy regimens would be used in this case?

      Your Answer: CHOP

      Explanation:

      CHOP is the acronym for a chemotherapy regimen used in the treatment of non-Hodgkin’s lymphoma, comprising cyclophosphamide, hydroxyrubicin (adriamycin), vincristine and prednisone. This regimen can also be combined with the monoclonal antibody rituximab if the lymphoma is of B cell origin; this combination is called R-CHOP.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      11
      Seconds
  • Question 12 - What class of drugs does buspirone belong to? ...

    Correct

    • What class of drugs does buspirone belong to?

      Your Answer: Anxiolytic

      Explanation:

      Buspirone is an anxiolytic agent and a serotonin-receptor agonist that belongs to the azaspirodecanedione class of compounds. It shows no potential for addiction compared with other drugs commonly prescribed for anxiety, especially the benzodiazepines. The development of tolerance has not been noted. It is primarily used to treat generalized anxiety disorders. It is also commonly used to augment antidepressants in the treatment of major depressive disorder.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      48.4
      Seconds
  • Question 13 - Calculate the total peripheral resistance for a patient with a blood pressure of...

    Incorrect

    • Calculate the total peripheral resistance for a patient with a blood pressure of 130/70 mm HG and cardiac output of 5 litres / min?

      Your Answer: 20 mmHg × min/l

      Correct Answer: 18 mmHg × min/l

      Explanation:

      Total peripheral resistance = Mean arterial pressure/Cardiac output. And the mean arterial pressure = Diastolic pressure + 1/3 (Systolic pressure – Diastolic pressure), i.e., 70 + 1/3 (130-70) = 90 mmHg. Therefore, total peripheral resistance = 90 mmHg/5 l per min = 18 mmHg × min/l.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      24.7
      Seconds
  • Question 14 - Which of the following structure contains the parasympathetic pre-ganglionic nucleus that innervates the...

    Correct

    • Which of the following structure contains the parasympathetic pre-ganglionic nucleus that innervates the iris sphincter muscle and the ciliary muscle?

      Your Answer: Edinger–Westphal nucleus

      Explanation:

      The Edinger–Westphal nucleus (accessory oculomotor nucleus) is the parasympathetic pre-ganglionic nucleus that innervates the iris sphincter muscle and the ciliary muscle.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      14
      Seconds
  • Question 15 - 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
      36.4
      Seconds
  • Question 16 - An infant, 5 weeks and 6 days old born with a large sub-aortic...

    Incorrect

    • An infant, 5 weeks and 6 days old born with a large sub-aortic ventricular septal defect, is prepared for pulmonary artery banding through a left thoracotomy (the child is not fit for a surgical closure). The surgeon initially passes his index finger immediately behind two great arteries in the pericardial sac to mobilise the great arteries in order to pass the tape around the pulmonary artery. Into which space is the surgeon's finger inserted?

      Your Answer: Oblique pericardial sinus

      Correct Answer: Transverse pericardial sinus

      Explanation:

      Cardiac notch: is an indentation on the left lung of the heart.

      Coronary sinus: a venous sinus on the surface of the heart (the posterior aspect) that receives blood from the smaller veins that drain the heart.

      Coronary sulcus: a groove on the heart between the atria and ventricles.

      Transverse pericardial sinus: located behind the aorta and pulmonary trunk and anterior to the superior vena cava.

      Oblique pericardial sinus: located behind the left atrium. Accessed from the inferior side (or the apex) of the heart upwards.

      Horizontal pericardial sinus: this is a made-up term.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      23
      Seconds
  • Question 17 - Which muscle extends to form the cremasteric muscle? ...

    Incorrect

    • Which muscle extends to form the cremasteric muscle?

      Your Answer: External abdominal oblique muscle

      Correct Answer: Internal abdominal oblique muscle

      Explanation:

      The cremasteric muscle is a thin layer of muscle composed of several fasciculi that originate from the middle of the inguinal ligament. At its point of origin the fibres are continuous with the fibres of internal oblique and sometimes with the transversus abdominis. It then passes along the lateral side of the spermatic cord and descends with it through the superficial inguinal ring on the front and sides of the cord.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      207.8
      Seconds
  • Question 18 - A 34-year-old woman is diagnosed with cerebral oedema after suffering a severe head...

    Incorrect

    • A 34-year-old woman is diagnosed with cerebral oedema after suffering a severe head trauma. Which of the following conditions is not likely to be associated with the extracellular oedema?

      Your Answer: All answers are correct

      Correct Answer: Increased plasma colloid osmotic pressure

      Explanation:

      Cerebral oedema is extracellular fluid accumulation in the brain. Increased capillary permeability, increased capillary pressure, increased interstitial fluid colloid osmotic pressure and lymphatic blockage would increase fluid movement into the interstitial spaces. Increased plasma colloid osmotic pressure, however, would oppose fluid movement from the capillaries into the interstitial compartment.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      36.1
      Seconds
  • Question 19 - A previously healthy 40-year-old housewife suddenly complains of a headache and loses consciousness....

    Correct

    • A previously healthy 40-year-old housewife suddenly complains of a headache and loses consciousness. A CT scan reveals subarachnoid haemorrhage. Which of the following is the most probable cause?

      Your Answer: Ruptured berry aneurysm

      Explanation:

      Saccular aneurysms, also known as berry aneurysms, appear as a round outpouching and are the most common form of cerebral aneurysm. They are a congenital intracranial defect, and haemorrhage can occur at any age, but is most common between the ages of 40-65 years. A second rupture (rebleeding) sometimes occurs, most often within about 7 days of the first bleed.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      48
      Seconds
  • Question 20 - Multiple cells were labelled using a fluorescent dye that doesn’t cross the cell...

    Incorrect

    • Multiple cells were labelled using a fluorescent dye that doesn’t cross the cell membrane. One cell in the middle was bleached with a light that destroys the dye, but the cell soon recovers its stain. The presence of which structures best explains this?

      Your Answer: Tight junctions

      Correct Answer: Gap junctions

      Explanation:

      Gap junctions are attachments between cells that permit intercellular communication e.g. they permit current flow and electrical coupling between myocardial cells. They allow direct electrical transmission among cells and also permit certain substance to pass through as well. They are either homotypic, formed by two identical hemichannels or heterotypic, formed by different hemichannels.

    • This question is part of the following fields:

      • General
      • Physiology
      10.7
      Seconds
  • Question 21 - A 65 year old man with a history of diabetes and hypertension presented...

    Correct

    • A 65 year old man with a history of diabetes and hypertension presented with a stroke a few months ago severely affecting his speech and movement in the right arm and leg. A cerebral angiogram revealed a middle cerebral artery occlusion. A recent CT scan was done which revealed a 5 cm cystic space in his left parietal lobe. This lesion is a result of which of the following forms of resolution?

      Your Answer: Liquefactive necrosis

      Explanation:

      Characteristically, the brain will undergo liquefactive necrosis following ischaemic injury. This leaves a cystic space in that region which would show up on a CT scan. Atrophy would result in a generalized decrease in the brain size. Coagulative necrosis typically occurs in parenchymal organs e.g. the spleen or kidney which have a lower lipid content. Caseous necrosis is typical in granulomatous tuberculosis infection. Apoptosis will not form a cystic area as it is programmed cell death involving a individual cells. Gangrenous necrosis is characteristic of ischaemic injury of the lower limb and GI tract. Fibrinous necrosis results from necrotic damage to the blood vessels with the leaking of proteins into the vessel, appearing bright pink on H & E staining.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Neurology
      • Pathology
      18.7
      Seconds
  • Question 22 - What is the role of factor VII in coagulation? ...

    Correct

    • What is the role of factor VII in coagulation?

      Your Answer: Initiates the process of coagulation in conjunction with tissue factor

      Explanation:

      The main role of factor VII is to initiate the process of coagulation along with tissue factor (TF). TF is found in the blood vessels and is not normally exposed to the bloodstream. When a vessel is injured tissue factor is exposed to blood and circulating factor VII. Factor VII is converted to VIIa by TF.

    • This question is part of the following fields:

      • General
      • Physiology
      17.3
      Seconds
  • Question 23 - When does the heart rate decrease? ...

    Incorrect

    • When does the heart rate decrease?

      Your Answer: On inspiration

      Correct Answer: Pressure on the eyeball

      Explanation:

      Various vagotonic manoeuvres (e.g. Valsalva manoeuvre, carotid sinus massage, pressure on eyeballs, ice-water facial immersion, swallowing of ice-cold water) result in increased parasympathetic tone through the vagus nerve which results in a decrease in heart rate. These manoeuvres may be clinically useful in terminating supraventricular arrhythmias.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      7.2
      Seconds
  • Question 24 - A 40 year old woman, who is under anaesthesia for an elective procedure,...

    Correct

    • A 40 year old woman, who is under anaesthesia for an elective procedure, received an antibiotic injection. She immediately developed a rash and her airway constricted raising the airway pressure. Which mechanism is responsible for this reaction?

      Your Answer: Type I hypersensitivity

      Explanation:

      Type I hypersensitivity reaction is an immediate reaction that occurs due to binding of the antigen with antibodies attached to mast cells in a previously sensitized person. It has an immediate phase, which is characterised by vasodilation, leakage of plasma, smooth muscle spasm, or glandular secretions. This manifests in about 5-30 min and usually resolves within 60 mins. The delayed phase follows after 24 hours and can persist up to several days. It is due to infiltration of eosinophils, neutrophils, basophils and CD4+ cells and leads to tissue destruction. The nature of the reaction varies according to the site. It can take the form of skin allergy, hives, allergic rhinitis, conjunctivitis, bronchial asthma or food allergy.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      28.1
      Seconds
  • Question 25 - Inside the palatoglossal arch is a muscle. Which nerve innervates this muscle? ...

    Incorrect

    • Inside the palatoglossal arch is a muscle. Which nerve innervates this muscle?

      Your Answer: VII

      Correct Answer: X

      Explanation:

      The palatoglossal arch contains the palatoglossal muscle which is innervated by the vagus nerve which is the tenth cranial nerve. So the correct answer is X

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      12.1
      Seconds
  • Question 26 - Which of the following will be a likely sequelae of complete ileal resection?...

    Incorrect

    • Which of the following will be a likely sequelae of complete ileal resection?

      Your Answer: Decreased calcium absorption

      Correct Answer: Vitamin B12 deficiency

      Explanation:

      The ileum is a part of the small intestine and has a pH of around 7-8 (neutral or slightly alkaline). Its main function is absorption of products of digestion. The ileal wall has multiple villi, which in turn have numerous microvilli. This increases the surface area available for absorption significantly. The cells lining the ileum contain multiple enzymes such as protease and carbohydrase, which aid in the final stages of digestion. Villi contain lacteals which absorb the products of fat digestion, fatty acids and glycerol. Thus, ileal resection will lead to their decreased absorption and increased fat content in the stool. The ileum is also responsible for absorption of vitamin B12.

      Maximum water absorption occurs in the colon followed by the jejunum. Hence, ileal resection is less likely to lead to fluid volume deficiency. Also, most minerals (like calcium, iron etc.) are absorbed in the duodenum, and thus will not be affected by ileal resection.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      17.4
      Seconds
  • Question 27 - A 22-year old man presented with a mass in his left scrotum which...

    Incorrect

    • A 22-year old man presented with a mass in his left scrotum which was more prominent when standing and felt like a 'bag of worms'. Examination revealed a non-tender mass along the spermatic cord. Also, the right testis was larger than the left testis. What is the likely diagnosis?

      Your Answer: Spermatocoele

      Correct Answer: Varicocele

      Explanation:

      Varicocele refers to dilatation and increased tortuosity of the pampiniform plexus – which is a network of veins found in spermatic cord that drain the testicle. Defective valves or extrinsic compression can result in outflow obstruction and cause dilatation near the testis. Normal diameter of the small vessels ranges from 0.5 – 1.5mm. A varicocele is a dilatation more than 2mm.

      The plexus travels from the posterior aspect of testis into the inguinal canal with other structures forming the spermatic cord. They then form the testicular veins out of which the right testicular vein drains into the inferior vena cava and the left into the left renal vein.

      It affects 15-20% men, and 40% of infertile males. Usually diagnosed in 15-25 years of age, they are rarely seen after 40 years of age. Because of the vertical path taken by the left testicular vein to drain into left renal vein, 98% idiopathic varicoceles occur on the left side. It is bilateral in 70% cases. Right-sided varicoceles are rare.

      Symptoms include pain or heaviness in the testis, infertility, testicular atrophy, a palpable mass, which is non-tender and along the spermatic cord (resembling a ‘bag of worms’). The testis on the affected side might be smaller.

      Diagnosis can be made by ultrasound. Provocative measures such as Valsalva manoeuvre or making the patient stand up to increase the dilatation by increasing the intra-abdominal venous pressure.

    • This question is part of the following fields:

      • Pathology
      • Urology
      46.4
      Seconds
  • Question 28 - The thyrocervical trunk branches into which artery that passes upward and in front...

    Incorrect

    • The thyrocervical trunk branches into which artery that passes upward and in front of the vertebral artery and longus colli muscle:

      Your Answer: Deep cervical

      Correct Answer: Inferior thyroid

      Explanation:

      The inferior thyroid artery is an artery in the neck. It arises from the thyrocervical trunk and passes upward, in front of the vertebral artery and longus colli muscle.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      43.4
      Seconds
  • Question 29 - A 68-year-old woman complains of headaches, dizziness, and memory loss. About a month...

    Correct

    • 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: 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
      21.1
      Seconds
  • Question 30 - Which of these substances is secreted by pericytes in the juxtaglomerular cells? ...

    Correct

    • Which of these substances is secreted by pericytes in the juxtaglomerular cells?

      Your Answer: Renin

      Explanation:

      The juxtaglomerular cells synthesise, store and secrete the enzyme renin in the kidney. They are specialised smooth muscle cells in the wall of the afferent arteriole that delivers blood to the glomerulus and thus play a critical role in the renin– angiotensin system and so in renal autoregulation.

    • This question is part of the following fields:

      • Physiology
      • Renal
      5.1
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (5/9) 56%
Head & Neck (3/5) 60%
Physiology (4/10) 40%
Respiratory (1/2) 50%
Abdomen (1/2) 50%
Pathology (8/11) 73%
Urology (1/2) 50%
Cell Injury & Wound Healing; Respiratory (1/1) 100%
Endocrine (0/1) 0%
Haematology (0/1) 0%
Thorax (1/2) 50%
Pharmacology (2/2) 100%
Cardiovascular (0/2) 0%
Gastroenterology (1/2) 50%
Fluids & Electrolytes (0/1) 0%
Neurology (2/2) 100%
General (1/2) 50%
Cell Injury & Wound Healing; Neurology (1/1) 100%
Inflammation & Immunology (1/1) 100%
Renal (1/1) 100%
Passmed