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  • Question 1 - A patient is unable to move their mandible to the left. Which muscle...

    Correct

    • A patient is unable to move their mandible to the left. Which muscle is affected in this case?

      Your Answer: Right lateral pterygoid muscle

      Explanation:

      Patients with paralysis of the right pterygoid muscle are unable to move their mandible laterally to the left.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      14.5
      Seconds

  • Question 2 - A man had noticed weakness in his left arm causing flexion of the...

    Correct

    • A man had noticed weakness in his left arm causing flexion of the elbow and supination of the forearm. Which nerve in this case was injured?

      Your Answer: Musculocutaneous

      Explanation:

      The musculocutaneous nerve supplies the biceps brachii and the brachialis muscles. The first one flexes the elbow and the shoulder. It is also involved in supination. The brachialis muscle flexes the forearm. The injury to the musculocutaneous nerve results in paralysis of these muscles.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      35.6
      Seconds

  • Question 3 - The primary somatosensory cortex is located in the: ...

    Correct

    • The primary somatosensory cortex is located in the:

      Your Answer: Postcentral gyrus

      Explanation:

      The primary somatic sensory cortex is located in the postcentral gyrus and is the largest cortical receiving area for information from somatosensory receptors. Through corticocortical fibres, it then sends the information to other areas of the neocortex and further analysis takes place in the posterior parietal association cortex.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      15.2
      Seconds

  • Question 4 - Regarding the coagulation cascade, Factor VII: ...

    Correct

    • Regarding the coagulation cascade, Factor VII:

      Your 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
      23.7
      Seconds

  • Question 5 - A 7-year-old girl is given cephalexin to treat an infection and develops hives,...

    Correct

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

      Your Answer: Angio-oedema

      Explanation:

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

    • This question is part of the following fields:

      • Physiology
      • Renal
      62.5
      Seconds

  • Question 6 - The Brunner glands secrete an alkaline product that helps maintain an optimal pH...

    Incorrect

    • The Brunner glands secrete an alkaline product that helps maintain an optimal pH for pancreatic enzyme activity. Where are these glands located?

      Your Answer: Epithelium of the Ampulla of Vater

      Correct Answer: Submucosa of the duodeneum

      Explanation:

      The Brunner glands are located in the submucosa of the duodenum. These glands are connected to the interstitial lumen by ducts that open into certain crypts. They secrete an alkaline product that protects the duodenal mucosa from the acidic chyme and helps achieve an optimal pH for the enzymes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      25.7
      Seconds

  • Question 7 - A patient with this condition has extracellular fluid volume expansion: ...

    Incorrect

    • A patient with this condition has extracellular fluid volume expansion:

      Your Answer: Burns

      Correct Answer: Nephrotic syndrome

      Explanation:

      Nephrotic syndrome is a syndrome comprising of signs of nephrosis, including proteinuria, hypoalbuminemia, and oedema. It is a component of glomerulonephritis, in which different degrees of proteinuria occur. Essentially, loss of protein through the kidneys leads to low protein levels in the blood , which causes water to be drawn into soft tissues (oedema). Severe hypoalbuminemia can also cause a variety of secondary problems, such as water in the abdominal cavity (ascites), around the heart or lung (pericardial effusion, pleural effusion), high cholesterol, loss of molecules regulating coagulation (hence increased risk of thrombosis). The most common sign is excess fluid in the body due to the serum hypoalbuminemia. Lower serum oncotic pressure causes fluid to accumulate in the interstitial tissues. Sodium and water retention aggravates the oedema.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      82.2
      Seconds

  • Question 8 - The gradual depolarization in-between action potentials in pacemaker tissue is a result of?...

    Correct

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

      Your 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
      13.4
      Seconds

  • Question 9 - Loperamide is a drug used to treat diarrhoea. What is the mechanism of...

    Incorrect

    • Loperamide is a drug used to treat diarrhoea. What is the mechanism of action of loperamide?

      Your Answer: Irreversibly inhibits H+/K+-ATPase

      Correct Answer: Opiate agonist

      Explanation:

      Loperamide is an opioid-receptor agonist and acts on the mu opioid receptors in the myenteric plexus of large intestine. It works by decreasing the motility of the circular and longitudinal smooth muscles of the intestinal wall. It is often used for this purpose in gastroenteritis, inflammatory bowel disease, and short bowel syndrome.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      20.2
      Seconds

  • Question 10 - A 34-year-old woman with pelvic inflammatory disease is administered ceftriaxone. The subclass of...

    Incorrect

    • A 34-year-old woman with pelvic inflammatory disease is administered ceftriaxone. The subclass of antibiotics that ceftriaxone belongs to is:

      Your Answer: Fourth-generation cephalosporins

      Correct Answer: Third-generation cephalosporins

      Explanation:

      Ceftriaxone is a third-generation cephalosporin antibiotic. It has a broad spectrum of activity against Gram-positive and Gram-negative bacteria. Its indications include middle ear infections, endocarditis, meningitis, pneumonia, bone and joint infections, intra-abdominal infections, skin infections, urinary tract infections, gonorrhoea, and pelvic inflammatory disease.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      52.2
      Seconds

  • Question 11 - Increased resistance to flow of blood in cerebral vessels is most likely seen...

    Incorrect

    • Increased resistance to flow of blood in cerebral vessels is most likely seen in:

      Your Answer: Reduction in systemic arterial pressure

      Correct Answer: Elevation in systemic arterial pressure from 100 to 130 mmHg

      Explanation:

      Constant cerebral blood flow is maintained by autoregulation in the brain, which causes an increase in local vascular resistance to offset an increase in blood pressure. There will be an increase in cerebral blood flow (and decrease in resistance to cerebral blood flow) with a decrease in arterial oxygen or an increase in arterial CO2. Similarly, a decrease in viscosity will also increase the blood flow. Due to increased brain metabolism and activity during a seizure, there will also be an increase in the cerebral blood flow.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      54.5
      Seconds

  • Question 12 - Which muscle would be affected most following injury to the transverse cervical artery?...

    Correct

    • Which muscle would be affected most following injury to the transverse cervical artery?

      Your Answer: Trapezius

      Explanation:

      The latissimus dorsi receives blood from the thoracodorsal artery, the supraspinatus receives its blood from the suprascapular artery, the levator scapulae and the rhomboids are supplied by the dorsal scapular artery and the transverse cervical artery supplies blood to the trapezius.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      51.6
      Seconds

  • Question 13 - A victim of assault in a domestic violence is stabbed in the left...

    Incorrect

    • A victim of assault in a domestic violence is stabbed in the left chest. The tip of the pen knife entered the pleural space just above the cardiac notch. Luckily the lung was spared as it would only occupy this space during deep inspiration. Which of these structures was pierced by the knife?

      Your Answer: Cupola

      Correct Answer: Costomediastinal recess

      Explanation:

      The costomediastinal recess is located immediately next to the cardiac notch. The medial aspect of the superior lobe of the left lung, when fully inflated expands to this place. The lung wouldn’t enter the anterior or the posterior mediastinum which are found between the two pleural cavities.

      The costodiaphragmatic recess is the lowest extent of the pleural cavity where the inferior lobes of the lungs would expand into in deep inhalation.

      The cupola, is the part of the pleural cavity that extends above the first rib into the root of the neck. The superior most part of the superior lobe of the lung might extend into this part.

      Pulmonary ligament: pleural fold that is located below the root of the lung where the visceral pleura and the mediastinal pleura are in continuity.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      108.4
      Seconds

  • Question 14 - Which of the following factors will not affect the wound healing process in...

    Incorrect

    • Which of the following factors will not affect the wound healing process in a young women who suffered serious burns to her chest and hands?

      Your Answer: Blood supply

      Correct Answer: Vitamin A deficiency

      Explanation:

      Healing can be sped-up or slowed down due to various reasons: 1. blood supply, 2. infection, 3. denervation, 4. collection of blood/hematoma, 5. mechanical stress, 6. foreign body, 7. techniques used during surgery and 8. dressing of the wound. Other systemic factors include 1. nutrition e.g. deficiency of zinc, vitamin C, protein deficiency, 2. metabolic status, 3. circulatory status and 4. hormonal influence

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      69.8
      Seconds

  • Question 15 - A 50 year-old man, who sustained a head injury experienced sudden onset of...

    Incorrect

    • A 50 year-old man, who sustained a head injury experienced sudden onset of horizontal double vision. He is diagnosed with lateral rectus palsy. Which of the following nerves is affected in this condition?

      Your Answer: Oculomotor

      Correct Answer: Abducent

      Explanation:

      The lateral rectus muscle is one of the 6 extra-ocular muscles that control eye movements. It is responsible for abduction and is the only muscle that is innervated by the abducens nerve (CN VI).

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      65.8
      Seconds

  • Question 16 - An old woman complains of a lack of sensation halfway down the anterior...

    Correct

    • An old woman complains of a lack of sensation halfway down the anterior surface of the thigh. The cause of this:

      Your Answer: Would result from damage to the nerve that innervates the pectineus muscle

      Explanation:

      The pectineus is supplied by the second, third and fourth lumbar nerves through the femoral nerve and by the third lumbar through the accessory obturator when it exists. The anterior surface of the thigh receives its innervation from the femoral nerve as well, thus this is the nerve most likely to be injured

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      60.8
      Seconds

  • Question 17 - Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of...

    Incorrect

    • Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of the popliteal fossa?

      Your Answer: Sartorius

      Correct Answer: Biceps femoris

      Explanation:

      The popliteal fossa is located at the back of the knee. It is bounded laterally by the biceps femoris above and the plantaris and lateral head of the gastrocnemius below and medially by the semitendinosus and semimembranosus above and by the medial head of the gastrocnemius below.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      12.5
      Seconds

  • Question 18 - What is the linea aspera: ...

    Incorrect

    • What is the linea aspera:

      Your Answer: Is inferior to the medial epicondyle of the femur

      Correct Answer: Serves as an attachment for adductors of the thigh

      Explanation:

      The linea aspera is a prominent longitudinal ridge or crest on the middle third of the femur. It has a medial and a lateral lip and a narrow, rough, intermediate line. The vastus medialis arises from the medial lip of the linea aspera and has superior and inferior prolongations. The vastus lateralis takes origin from the lateral lip . The adductor magnus is inserted into the linea aspera. Two muscles are attached between the vastus lateralis and the adductor magnus: the gluteus maximus is inserted above and the short head of the biceps femoris arises below. Four muscles are inserted between the adductor magnus and the vastus medialis: the iliacus and pectineus superiorly, and the adductor brevis and adductor longus inferiorly.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      25
      Seconds

  • Question 19 - A 35-year-old ultra marathon runner becomes severely dehydrated and collapses. This patient most...

    Incorrect

    • A 35-year-old ultra marathon runner becomes severely dehydrated and collapses. This patient most likely has:

      Your Answer: High renal water excretion

      Correct Answer: Decreased baroreceptor firing rate

      Explanation:

      Baroreceptors are sensors located in the blood vessels of all vertebrate animals. They sense the blood pressure and relay the information to the brain, so that a proper blood pressure can be maintained. Acute dehydration results in decreased plasma volume and increased plasma osmolarity, since more water than salt is lost in sweat. The decrease in plasma volume leads to an inhibition of the baroreceptors and a lower firing rate. The increase in plasma osmolarity leads to increased ADH secretion and high plasma ADH levels, which increases water permeability of collecting duct cells. Therefore more water is reabsorbed by the kidneys and renal water excretion is low.

    • This question is part of the following fields:

      • Physiology
      • Renal
      77.3
      Seconds

  • Question 20 - An 80 year-old lady presents to the out patient clinic complaining of chest...

    Incorrect

    • An 80 year-old lady presents to the out patient clinic complaining of chest pain of 2 months' duration with a normal electrocardiogram and cardiac enzymes. A computed tomographic scan is done which reveals a mass lesion involving a structure in the middle mediastinum. Which among the following structures could be involved?

      Your Answer: Thoracic duct

      Correct Answer: Ascending aorta

      Explanation:

      The middle mediastinum is the broadest part of the mediastinal cavity containing the heart enclosed in the pericardium, ascending aorta, lower half of the superior vena cava with the azygos vein opening into it, the bifurcation of the trachea and the two bronchi, the pulmonary artery with its branches, pulmonary veins, phrenic nerves and bronchial lymph nodes. The most likely structure involved is the ascending aorta, perhaps with an aneurysm.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      40.9
      Seconds

  • Question 21 - Epstein-Barr virus (EBV) is known to be a carcinogen for: ...

    Incorrect

    • Epstein-Barr virus (EBV) is known to be a carcinogen for:

      Your Answer: Leukaemia

      Correct Answer: B-cell lymphoma

      Explanation:

      EBV is known to be carcinogenic for B-cell lymphoma, nasopharyngel carcinoma and Hodgkin’s lymphoma.

    • This question is part of the following fields:

      • Microbiology; Neoplasia
      • Pathology
      29.5
      Seconds

  • Question 22 - A 78-year-old diabetic man undergoes renal function tests. Which of the following substances...

    Incorrect

    • A 78-year-old diabetic man undergoes renal function tests. Which of the following substances will be the most accurate for measuring glomerular filtration rate (GFR)?

      Your Answer: Creatinine

      Correct Answer: Inulin

      Explanation:

      Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal glomerular capillaries into the Bowman’s capsule per unit time. Clinically, this is often measured to determine renal function. Inulin was originally used as it is not reabsorbed by the kidney after glomerular filtration, therefore its rate of excretion is directly proportional to the rate of filtration of water and solutes across the glomerular filter. However, in clinical practice, creatinine clearance is used to measure GFR. Creatinine is an endogenous molecule, synthesised in the body, that is freely filtered by the glomerulus (but also secreted by the renal tubules in very small amounts). Creatinine clearance exceeds GFR due to creatinine secretion, and is therefore a close approximation of the GFR.

    • This question is part of the following fields:

      • Physiology
      • Renal
      18.8
      Seconds

  • Question 23 - Which of the following is likely to induce secretion of glucagon? ...

    Incorrect

    • Which of the following is likely to induce secretion of glucagon?

      Your Answer: High serum concentration of glucose

      Correct Answer: Low serum concentration of glucose

      Explanation:

      The most potent stimulus for secretion of glucagon is hypoglycaemia whereas hyperglycaemia is a stimulus for insulin release. Glucagon secretion also occurs in response to high levels of amino acids. Somatostatin inhibits glucagon secretion. Parasympathetic stimulation increases pancreatic acinar secretion, but not of α-cells.

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      31.8
      Seconds

  • Question 24 - A 45-year old male patient with a long history of alcoholism developed liver...

    Incorrect

    • A 45-year old male patient with a long history of alcoholism developed liver cirrhosis that has led to portal hypertension. Which of the following plexuses of veins is most likely dilated in this patient?

      Your Answer: Vesical plexus

      Correct Answer: Haemorrhoidal plexus

      Explanation:

      The haemorrhoidal plexus or also known as the rectal plexus is a venous plexus that surrounds the rectum. This venous plexus in males communicates anteriorly with the vesical plexus and uterovaginal plexus in females. This venous plexus forms a site of free communication between the portal and systemic venous systems. In the case of portal hypertension this plexus would most likely dilate due to the increased pressure.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      47.9
      Seconds

  • Question 25 - A week after a renal transplant the patient received antilymphocyte globulins. Shortly after...

    Incorrect

    • A week after a renal transplant the patient received antilymphocyte globulins. Shortly after she developed fever and hypotension. Which of the following mechanisms is involved in this response?

      Your Answer: Type II hypersensitivity

      Correct Answer: Type III hypersensitivity

      Explanation:

      Type III hypersensitivity is characterized by soluble immune complexes which are aggregations of IgG and IgM antibodies with antigens that deposit in different tissues e.g. the skin, joints, kidneys. They can then trigger an immune response by activating the complement cascade. This reaction can take hours to develop and examples include: immuno-complex glomerulonephritis, rheumatoid arthritis, SLE, subacute bacterial endocarditis, arthus reaction and serum sickness.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      9.6
      Seconds

  • Question 26 - Which of the following muscles aid in inspiration? ...

    Incorrect

    • Which of the following muscles aid in inspiration?

      Your Answer: Abdominal muscles and external intercostals

      Correct Answer: Diaphragm and external intercostals

      Explanation:

      The diaphragm and external intercostals are muscles of inspiration as they increase the volume of thoracic cavity and reduce the intrathoracic pressure. Muscles of expiration include abdominal muscles and internal intercostals.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      6
      Seconds

  • Question 27 - When one is silently counting, what part of his brain will show increased...

    Incorrect

    • When one is silently counting, what part of his brain will show increased regional cerebral blood flow (rCBF)?

      Your Answer: Broca’s area

      Correct Answer: Supplementary motor area

      Explanation:

      Regional cerebral blood flow (rCBF) increases in the superior speech cortex (supplementary motor area) during periods of silent counting, whereas speaking aloud will do so in the motor cortex and medial temporal lobe, along with the superior speech cortex.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      36.7
      Seconds

  • Question 28 - A 55 year old lady underwent an uneventful appendicectomy. Two hours later, her...

    Incorrect

    • A 55 year old lady underwent an uneventful appendicectomy. Two hours later, her arterial blood gas analysis on room revealed pH: 7.30, p(CO2): 53 mmHg and p(O2): 79 mmHg. What is the most likely cause of these findings?

      Your Answer: Occult haemorrhage

      Correct Answer: Alveolar hypoventilation

      Explanation:

      In the given problem, there is respiratory acidosis due to hypercapnia from a low respiratory rate and/or volume (hypoventilation). Causes of hypoventilation include conditions impairing the central nervous system (CNS) respiratory drive, impaired neuromuscular transmission and other causes of muscular weakness (drugs and sedatives), along with obstructive, restrictive and parenchymal pulmonary disorders. Hypoventilation leads to hypoxia and hypercapnia reduces the arterial pH. Severe acidosis leads to pulmonary arteriolar vasoconstriction, systemic vascular dilatation, reduced myocardial contractility, hyperkalaemia, hypotension and cardiac irritability resulting in arrhythmias. Raised carbon dioxide concentration also causes cerebral vasodilatation and raised intracranial pressure. Over time, buffering and renal compensation occurs. However, this might not be seen in acute scenarios where the rise in p(CO2) occurs rapidly.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      26.9
      Seconds

  • Question 29 - Which of the following accumulates within a cell due to the aging process?...

    Incorrect

    • Which of the following accumulates within a cell due to the aging process?

      Your Answer: Beta carotene

      Correct Answer: Lipofuscin

      Explanation:

      Lipofuscin , also known as lipochrome, is a wear and tear pigment or an aging pigment. It represents free radical injury or lipid peroxidation. On microscopic examination is appears as a yellowish brown pigment around the nucleus (perinuclear pigment). It is often seen in cells which are undergoing regressive changes, commonly in the liver and heart of old patients or patients with cancer, cachexia or severe malnutrition.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      36
      Seconds

  • Question 30 - Which of the following is NOT true regarding malignant hyperpyrexia ...

    Incorrect

    • Which of the following is NOT true regarding malignant hyperpyrexia

      Your Answer:

      Correct Answer: It can be caused by nitrous oxide

      Explanation:

      Malignant hyerpyrexia occurs in 1 in 150,000. All inhalational anaesthetic agents and suxamethonium, except nitrous oxide can cause malignant hyperpyrexia.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (8/10) 80%
Head & Neck (2/2) 100%
Upper Limb (2/2) 100%
Neurology (2/2) 100%
Physiology (11/11) 100%
General (2/2) 100%
Renal (3/3) 100%
Fluids & Electrolytes (1/1) 100%
Pathology (3/8) 38%
Pharmacology (2/3) 67%
Cardiovascular (1/1) 100%
Thorax (2/2) 100%
Cell Injury & Wound Healing (0/2) 0%
Lower Limb (1/3) 33%
Microbiology; Neoplasia (0/1) 0%
Endocrinology (1/1) 100%
Pelvis (1/1) 100%
Inflammation & Immunology (0/1) 0%
Respiratory (2/2) 100%
Passmed
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