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  • Question 1 - A 60 year old patient with a history of carcinoma of the head...

    Incorrect

    • A 60 year old patient with a history of carcinoma of the head of the pancreas, and obstructive jaundice presents with a spontaneous nose bleed and easy bruising. What is the most likely reason for this?

      Your Answer: Vitamin C deficiency

      Correct Answer: Vitamin-K-dependent clotting factors deficiency

      Explanation:

      Vitamin K is a fat soluble vitamin requiring fat metabolism to function properly to allow for its absorption. People with obstructive jaundice develop vitamin k deficiency as fat digestion is impaired. Vit K causes carboxylation of glutamate residue and hence regulates blood coagulation including: prothrombin (factor II), factors VII, IX, X, protein C, protein S and protein Z.

    • This question is part of the following fields:

      • General
      • Physiology
      28.5
      Seconds

  • Question 2 - A 50 year old man was admitted to the surgical ICU following a...

    Incorrect

    • A 50 year old man was admitted to the surgical ICU following a hemicolectomy for carcinoma of the caecum. A full blood count revealed: haematocrit = 30%, erythrocytes = 4 × 106/μ, haemoglobin level = 8 g/dl. To determine the likely cause of his anaemia, red blood cell indices were calculated. Which RBC indices are correct?

      Your Answer: MCV = haemoglobin concentration/haematocrit

      Correct Answer: MCHC = haemoglobin concentration/haematocrit

      Explanation:

      Mean corpuscular haemoglobin concentration (MCHC) is calculated simply by dividing the haemoglobin concentration (8 g/dl) by the haematocrit (0.3). The normal range is 31–36 g/dl. This patient has a hypochromic anaemia (MCHC = 8/0.3 = 26.7 g/dl). Dividing the haemoglobin concentration × 10 by erythrocyte number yields mean corpuscular haemoglobin (MCH). Normal range is 25.4–34.6 pg/cell and this patient has a significantly reduced cellular haemoglobin content (MCH = 8 × 10/4 = 20 pg/cell). Mean corpuscular volume (MCV) is calculated by dividing haematocrit × 1000 by erythrocyte number (4 × 106/μl). Normal range is 80–100 fl and this patient has a microcytic anaemia (MCV = 0.3 × 1000/4 = 75 fl). Microcytic, hypochromic anaemia is characteristic for iron-deficiency.

    • This question is part of the following fields:

      • General
      • Physiology
      40.8
      Seconds

  • Question 3 - An 18 year-old with an iron deficient diet was prescribed an iron supplement...

    Incorrect

    • An 18 year-old with an iron deficient diet was prescribed an iron supplement by her GP. Lack of iron often results in:

      Your Answer: Pernicious anaemia

      Correct Answer: Hypochromic anaemia

      Explanation:

      Iron deficiency anaemia is the most common type of anaemia. It can occur due to deficiency of iron from decreased intake, increased loss or inadequate absorption. An MCV less than 80 will indicated iron deficiency anaemia. On the smear the RBCs will be microcytic hypochromic and will also show poikilocytosis. Iron profile tests are important to make a diagnosis. Clinically the patient will be pale and lethargic.

    • This question is part of the following fields:

      • General
      • Physiology
      13.3
      Seconds

  • Question 4 - What is the most likely cause of prolonged bleeding time in a 40...

    Correct

    • What is the most likely cause of prolonged bleeding time in a 40 year old women admitted for a laparoscopic cholecystectomy?

      Your Answer: Thrombocytopaenia

      Explanation:

      Bleeding time is related to platelet function, thus a decrease in platelet function, as seen in thrombocytopenia, DIC and von Willebrand disease in which platelet aggregation is defective, leads to an increase in bleeding time. It is not affected by a decrease or deficiency of any other clotting factors. Aspirin and other COX inhibitors prolong bleeding time along with warfarin and heparin.

    • This question is part of the following fields:

      • General
      • Physiology
      8.7
      Seconds

  • Question 5 - Myoglobin is released as a result of rhabdomyolysis from damaged skeletal muscles. What...

    Incorrect

    • Myoglobin is released as a result of rhabdomyolysis from damaged skeletal muscles. What function do they perform in the muscle?

      Your Answer: Acts as a cytochrome

      Correct Answer: Acts like haemoglobin and binds with O2

      Explanation:

      Myoglobin is a pigmented globular protein made up of 153 amino acids with a prosthetic group containing haem around which the apoprotein folds. It is the primary oxygen carrying protein of the muscles. The binding of oxygen to myoglobin is unaffected by the oxygen pressure as it has an instant tendency to bind given its hyperbolic oxygen curve. It releases oxygen at very low pO2 levels.

    • This question is part of the following fields:

      • General
      • Physiology
      25.6
      Seconds

  • Question 6 - A blood sample from a patient with polycythaemia vera will show which of...

    Correct

    • A blood sample from a patient with polycythaemia vera will show which of the following abnormalities?

      Your Answer: High platelet count

      Explanation:

      Polycythaemia is a condition that results in an increase in the total number of red blood cells (RBCs) in the blood. It can be due to a myeloproliferative syndrome, chronically low oxygen levels or rarely malignancy. In primary polycythaemia/ polycythaemia vera the increase is due to an abnormality in the bone marrow, resulting in increased RBCs, white blood cells (WBCs) and platelets. In secondary polycythaemia the increase occurs due to high levels of erythropoietin either artificially or naturally. The increase is about 6-8 million/cm3 of blood. A type of secondary polycythaemia is physiological polycythaemia where people living in high altitudes who are exposed to hypoxic conditions produce more erythropoietin as a compensatory mechanism for thin oxygen and low oxygen partial pressure.

    • This question is part of the following fields:

      • General
      • Physiology
      18.5
      Seconds

  • Question 7 - Which of the following organelles have the capacity to regenerate and spontaneously replicate?...

    Correct

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

      Your 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
      10.2
      Seconds

  • Question 8 - A 23 year old woman is Rh -ve and she delivered a baby...

    Correct

    • A 23 year old woman is Rh -ve and she delivered a baby with a Rh+ blood group. What measure can be performed to prevent Rh incompatibility in the next pregnancy?

      Your Answer: Immunoglobulin D

      Explanation:

      Rh disease is also known as erythroblastosis fetalis and is a disease of the new-born. In mild states it can cause anaemia with reticulocytosis and in severe forms causes severe anaemia, morbus hemolytcus new-born and hydrops fetalis. RBCs of the Rh+ baby can cross the placenta and enter into the maternal blood. As she is Rh- her body will form antibodies against the D antigen which will pass through the placenta in subsequent pregnancies.

    • This question is part of the following fields:

      • General
      • Physiology
      19.9
      Seconds

  • Question 9 - C5a (a complement component) is a potent? ...

    Incorrect

    • C5a (a complement component) is a potent?

      Your Answer: Neurotransmitter

      Correct Answer: Anaphylotoxin

      Explanation:

      C5a is a strong chemoattractant as well as an anaphylotoxin and is involved in the recruitment of inflammatory cells such as neutrophils, eosinophils, monocytes, and T lymphocytes. It is also involved in activation of phagocytic cells, release of granule-based enzymes and generation of oxidants. All of which contribute to innate immune functions.

    • This question is part of the following fields:

      • General
      • Physiology
      11.9
      Seconds

  • Question 10 - A 50 year old woman presented with excessive bleeding after an inguinal hernia...

    Incorrect

    • A 50 year old woman presented with excessive bleeding after an inguinal hernia repair. Labs are suggestive of a primary haemostasis defect. Deficiency of which of the following is most likely to cause it?

      Your Answer: Factor VI

      Correct Answer: Platelets

      Explanation:

      Primary haemostatic control means the first line of defence against immediate bleeding. This is carried out by the platelets. They immediately form a haemostatic plug at the site of injury. Coagulation starts within 20s after an injury to the blood vessel which damage the endothelial cells. Secondary haemostasis follows which includes activation of the coagulation factors to form fibrin strands which mesh together forming the platelet plug. Platelets interact with platelet collagen receptor, glycoprotein Ia/IIa and to collagen fibres in the vascular endothelium. This adhesion is mediated by von Willebrand factor (vWF), which forms links between the platelet glycoprotein Ib/IX/V and collagen fibrils. The platelets are then activated and release the contents of their granules into the plasma, in turn activating other platelets and white blood cells.

    • This question is part of the following fields:

      • General
      • Physiology
      27.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

General (4/10) 40%
Physiology (4/10) 40%
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