00
Correct
00
Incorrect
00 : 00 : 0 00
Session Time
00 : 00
Average Question Time ( Secs)
Retry this test Dashboard

  • Question 1 - A 30 year old female suffered from mismatched transfusion induced haemolysis. Which substance...

    Correct

    • A 30 year old female suffered from mismatched transfusion induced haemolysis. Which substance will be raised in the plasma of this patient?

      Your Answer: Bilirubin

      Explanation:

      Bilirubin is a yellow pigment that is formed due to the break down of RBCs. Haemolysis results in haemoglobin that is broken down into a haem portion and globin which is converted into amino acids and used again. Haem is converted into unconjugated bilirubin in the macrophages and shunted to the liver. In the liver it is conjugated with glucuronic acid making it water soluble and thus excreted in the urine. Its normal levels are from 0.2-1 mg/dl. Increased bilirubin causes jaundice and yellowish discoloration of the skin.

    • This question is part of the following fields:

      • General
      • Physiology
      7.3
      Seconds

  • Question 2 - During an OSCE exam a medical student is asked to locate the sternal...

    Correct

    • During an OSCE exam a medical student is asked to locate the sternal angle. The sternal angle is a land mark for locating the level of the:

      Your Answer: Second costal cartilage

      Explanation:

      The sternal angle, a key landmark used in the clinic for auscultating for heart sounds, is the point of attachment of the costal cartilage of rib 2 to the sternum. It thus corresponds to the location of the second rib. A horizontal plane through the sternal angle traverses the T4/T5 intervertebral disc and marks the inferior boundary of the superior mediastinum.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      9.8
      Seconds

  • Question 3 - A 40 year old man suffered severe trauma following a MVA. His BP...

    Correct

    • A 40 year old man suffered severe trauma following a MVA. His BP is 72/30 mmhg, heart rate of 142 beats/mins and very feeble pulse. He was transfused 3 units of blood and his BP returned to 100/70 and his heart rate slowed to 90 beats/min. What decreased after transfusion?

      Your Answer: Total peripheral resistance

      Explanation:

      The patient is in hypovolemic shock, he is transfused with blood, this fluid resuscitation will result in a decreased sympathetic discharge and adequate ventricular filling which will result in the decreases TPR with an increased CO and cardiac filling pressures

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      9.2
      Seconds

  • Question 4 - A 49-year-old woman with acute renal failure has a total plasma [Ca2+] =...

    Incorrect

    • A 49-year-old woman with acute renal failure has a total plasma [Ca2+] = 2. 5 mmol/l and a glomerular filtration rate of 160 l/day. What is the estimated daily filtered load of calcium?

      Your Answer: 64 mmol/day

      Correct Answer: 240 mmol/day

      Explanation:

      Calcium is the most abundant mineral in the human body. The average adult body contains in total approximately 1 kg of calcium of which 99% is in the skeleton in the form of calcium phosphate salts. The extracellular fluid (ECF) contains approximately 22 mmol, of which about 9 mmol is in the plasma. About 40% of total plasma Ca2+ is bound to proteins and not filtered at the glomerular basement membrane. Therefore, the estimated daily filtered load is 1.5 mmol/l × 160 l/day = 240 mmol/day. The exact amount of free versus total Ca2+ depends on the blood pH: free Ca2+ increases during acidosis and decreases during alkalosis.

    • This question is part of the following fields:

      • Physiology
      • Renal
      20.2
      Seconds

  • Question 5 - 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
      6.4
      Seconds

  • Question 6 - After severe injury of the upper limb following an accident. The humerus is...

    Correct

    • After severe injury of the upper limb following an accident. The humerus is injured as well as the nerve which innervates the muscles of the anterior compartment of the arm. Which nerve is injured?

      Your Answer: Musculocutaneous

      Explanation:

      The musculoskeletal nerve supplies the muscles of the anterior compartment of the arm including the coracobrachialis, biceps brachii and the greater part of the brachialis. This nerve derives its fibres from the fifth, sixth and seventh cervical nerves and arises from the lateral cord of the brachial plexus. It also provides a branch to the elbow joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      18.6
      Seconds

  • Question 7 - Which of the following muscles attaches to the pterygomandibular raphe? ...

    Correct

    • Which of the following muscles attaches to the pterygomandibular raphe?

      Your Answer: Superior pharyngeal constrictor muscle

      Explanation:

      The pterygomandibular raphé (pterygomandibular ligament) provides attachment on its posterior border to the superior pharyngeal constrictor and on its anterior border to the buccinator muscle.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      16.8
      Seconds

  • Question 8 - A 45 year old lady has been diagnosed with Friedreich's ataxia that has...

    Incorrect

    • A 45 year old lady has been diagnosed with Friedreich's ataxia that has affected her medial group of nuclei in the anterior horn of the spinal cord. Which of the following structures will have their muscles affected?

      Your Answer: Feet

      Correct Answer: Axial muscles

      Explanation:

      The cells in the anterior horn can be arranged in the following three main groups: medial, lateral and central. The medial group of nuclei in the anterior horn of the spinal cord are located along the entire length of the spinal cord and are responsible for the innervation of the axial muscles of the body ( muscles of the head and neck region). Thus this disease will most likely affect the functioning of the muscles of the head and neck.

    • This question is part of the following fields:

      • Anatomy
      • Neurology
      38.2
      Seconds

  • Question 9 - A 45 -year-old female is recently diagnosed with breast cancer. She has a...

    Correct

    • A 45 -year-old female is recently diagnosed with breast cancer. She has a 8-cm-diameter mass in her left breast, with enlarged left axillary node. What is the most likely stage of her disease?

      Your Answer: IIIA

      Explanation:

      Stage IIIA breast cancer is T0–2 N2 M0 or T3 N1-2 M0 disease. It describes invasive breast cancer in which either: the tumour is smaller than 5 cm in diameter and has spread to 4 to 9 axillary lymph nodes; or it is found through imaging studies or clinical exam to have spread to internal mammary nodes (near the breastbone found during imaging tests or a physical exam); or the tumour is larger than 5 cm and has spread to 1 to 9 axillary nodes, or to internal mammary nodes. In this stage, the cancer has not metastasized (spread to distant sites).

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      7.8
      Seconds

  • Question 10 - A CT scan of 65 year old male patient at an outpatient clinic...

    Correct

    • A CT scan of 65 year old male patient at an outpatient clinic suggested a bone tumour at the stylomastoid foramen. Which of the following cranial nerves is likely to be affected with this tumour?

      Your Answer: VII

      Explanation:

      Cranial nerve VII, the facial nerve, is found in the internal acoustic canal and runs through this canal into the facial canal before exiting through the stylomastoid foramen. In the case of a bone tumour at the stylomastoid process, the facial nerve is the nerve that will most likely be affected.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      21.1
      Seconds

  • Question 11 - Which of the following structures is affected or damaged when the 'anterior drawer...

    Correct

    • Which of the following structures is affected or damaged when the 'anterior drawer test' is positive?

      Your Answer: Anterior cruciate ligament

      Explanation:

      The anterior drawer test is an important orthopaedic test that is used to test weakness of the anterior cruciate ligament. The test is done by having the patient sit in a supine position with his/her knees flexed at 90 degrees. An examiner stabilises the patients feet and softly pulls or pushes on the proximal tibia. The test is positive if there is translational movement of the tibia in relation to the femur, indicating a weakened anterior cruciate ligament. The anterior cruciate ligament prevents the tibia from sliding out in front of the femur.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      10.8
      Seconds

  • Question 12 - During a street fight a boy sustained a laceration below the elbow. It...

    Incorrect

    • During a street fight a boy sustained a laceration below the elbow. It was a deep cut that led to profuse bleeding from an artery situated on the supinator muscle immediately below the elbow. The vessel most likely to have been injured is?

      Your Answer: Anterior ulnar recurrent artery

      Correct Answer: Radial recurrent artery

      Explanation:

      The radial recurrent artery is situated on the supinator muscle then passing between the brachialis and the brachioradialis muscles. It originates from the radial artery and ends by anastomosing with the terminal part of the Profunda brachii.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      35.6
      Seconds

  • Question 13 - 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
      6.9
      Seconds

  • Question 14 - Regarding the long head of the biceps femoris, which of the following is...

    Incorrect

    • Regarding the long head of the biceps femoris, which of the following is correct?

      Your Answer: It will extend the leg at the knee

      Correct Answer: It crosses two joints

      Explanation:

      The long head of the biceps femoris arises from the lower and inner impression on the back of the tuberosity of the ischium. It inserts with the short head in an aponeurosis which becomes a tendon and this tendon is inserted into the lateral side of the head of the fibula and the lateral condyle of the tibia, thus crossing two joints.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      16.8
      Seconds

  • Question 15 - A 13-year-old girl has complained of pain in her left arm for 4...

    Incorrect

    • A 13-year-old girl has complained of pain in her left arm for 4 months. An X-ray reveals a mass along with erosion of the affected humerus. Histologically, the tumour is found to be formed by small, round, blue cells. What is the most likely diagnosis?

      Your Answer: Osteoblastoma

      Correct Answer: Ewing’s sarcoma

      Explanation:

      Ewing’s sarcoma is formed by small, round, blue cells, and is common in children. The usually develop in limbs, and clinical findings include pain and inflammation, with lytic destruction showing up on X-rays.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      31.5
      Seconds

  • Question 16 - A patient presents with loss of pain and temperature sensation in the left...

    Correct

    • A patient presents with loss of pain and temperature sensation in the left leg. He is likely to have a lesion involving:

      Your Answer: Right lateral spinothalamic tract

      Explanation:

      The spinothalamic tract is a sensory pathway originating in the spinal cord that transmits information to the thalamus. There are two main parts of the spinothalamic tract: the lateral spinothalamic tract transmits pain and temperature and the anterior spinothalamic tract transmits touch (crude touch). The decussation of this pathway occurs at the level of the spinal cord. Hence, a unilateral lesion of the lateral spinothalamic tract causes contralateral loss of pain and temperature.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      14.7
      Seconds

  • Question 17 - The normal location of the major duodenal papilla: ...

    Correct

    • The normal location of the major duodenal papilla:

      Your Answer: Descending part of the duodenum

      Explanation:

      The major duodenal papilla is on the descending portion of the duodenum on the medial side, about 7-10cm from the pylorus. The pancreatic ducts and the common bile ducts unite and open by a common orifice on the summit of the duodenal papilla.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      15
      Seconds

  • Question 18 - A medical intern wanting to perform her first thoracentesis (remove fluid from the...

    Correct

    • A medical intern wanting to perform her first thoracentesis (remove fluid from the pleural cavity) wishes to be reminded where to insert the needle to aspirate in order to avoid injuring the lung or neurovascular elements. Where is this place?

      Your Answer: The bottom of interspace 9 in the midaxillary line

      Explanation:

      Thoracentesis is performed in the costodiaphragmatic recess. The needle needs to be inserted below the level of the lungs to avoid injury to the lungs. At the paravertebral line, is between ribs 10 and 12, at the midaxillary line between ribs 8 and 10 and at the midclavicular line between interspaces 6 and 8. The needle should be inserted at the top of the rib (or the bottom of the interspace) to avoid damage to the neurovascular structures found below the rib running in the costal groove.

      The recommended location for the needle insertion varies depending upon the source. It is critical that the patient hold his or her breath to avoid piercing of the lung.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      15.8
      Seconds

  • Question 19 - Following a bee sting, a women develops a 2cm red, raised, swollen lesion...

    Correct

    • 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: 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
      19.6
      Seconds

  • Question 20 - Which statement is correct regarding secretions from the adrenal glands? ...

    Correct

    • Which statement is correct regarding secretions from the adrenal glands?

      Your Answer: Aldosterone is producd by the zona glomerulosa

      Explanation:

      The secretions of the adrenal glands by zone are:

      Zona glomerulosa – aldosterone

      Zona fasciculata – cortisol and testosterone

      Zona reticularis – oestradiol and progesterone

      Adrenal medulia – adrenaline, noradrenaline and dopamine.

    • This question is part of the following fields:

      • Physiology
      • Renal
      395.2
      Seconds

  • Question 21 - When a patient is standing erect, pleural fluid would tend to accumulate in...

    Correct

    • When a patient is standing erect, pleural fluid would tend to accumulate in which part of the pleural space?

      Your Answer: Costodiaphragmatic recess

      Explanation:

      The costo-diaphragmatic recess is the lowest extent of the pleural cavity or sac. Any fluid in the pleura will by gravity accumulate here when a patient is standing erect.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      6.2
      Seconds

  • Question 22 - Which of the following is a potential cause of a positive D-dimer assay?...

    Correct

    • Which of the following is a potential cause of a positive D-dimer assay?

      Your Answer: Deep venous thrombosis

      Explanation:

      A D-dimer test is performed to detect and diagnose thrombotic conditions and thrombosis. A negative result would rule out thrombosis and a positive result although not diagnostic, is highly suspicious of thrombotic conditions like a deep vein thrombosis, pulmonary embolism as well as DIC.

    • This question is part of the following fields:

      • General
      • Physiology
      5.7
      Seconds

  • Question 23 - Which of the following conditions of the breast is most often associated with...

    Correct

    • Which of the following conditions of the breast is most often associated with use of oral contraceptives?

      Your Answer: Cyst formation

      Explanation:

      Breast cysts are common and are smooth, firm, mobile lumps that can sometimes be tender. Cysts can also be bilateral and are known to recur in 10% of cases. They are more common in women in the third and fourth decades and most often disappear after menopause. Cysts are filled with fluid from the breast which occurs due to the normal menstrual cycle of a woman. The end of the menstrual cycle causes breast cells to swell. After the menses, the cells shrink and the released fluid disappears. However, in some cases this fluid forms a cyst. Incidence of cysts was also linked to use of oral contraceptives.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      5
      Seconds

  • Question 24 - A 14 year old girl suffers from haemophilia A and chronic knee pain...

    Correct

    • A 14 year old girl suffers from haemophilia A and chronic knee pain with progressive swelling and deformity over the last 4 years. Test results reveal a significantly reduced factor VIII activity. Which of the following is seen in the knee joint space after an acute painful episode?

      Your Answer: Cholesterol crystals

      Explanation:

      Due to breakdown of the red blood cell membrane in haemophilic patients, cholesterol crystals are formed by the lipids. On the other hand lipofuscin deposition does not occur in haemolysis or haemorrhage. Neutrophil accumulation suggests acute inflammation. Anthracotic pigment is an exogenous carbon pigment that deposits in the lung from dust. Russell bodies are intracellular accumulations of immunoglobins in plasma cells. Curschmann’s spirals and Charcot Leyden crystals are pathognomonic of asthma.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Haematology
      • Pathology
      23.8
      Seconds

  • Question 25 - Which portion of the renal tubule absorbs amino acids and glucose? ...

    Correct

    • Which portion of the renal tubule absorbs amino acids and glucose?

      Your Answer: Proximal convoluted tubule

      Explanation:

      In relation to the morphology of the kidney as a whole, the convoluted segments of the proximal tubules are confined entirely to the renal cortex. Glucose, amino acids, inorganic phosphate and some other solutes are reabsorbed via secondary active transport in the proximal renal tubule through co-transport channels driven by the sodium gradient.

    • This question is part of the following fields:

      • Physiology
      • Renal
      1498.4
      Seconds

  • Question 26 - A 16 year-old boy was stabbed in the right supraclavicular fossa. The sharp...

    Correct

    • A 16 year-old boy was stabbed in the right supraclavicular fossa. The sharp object punctured the portion of the parietal pleura that extends above the first rib. What is the name of this portion of the parietal pleura?

      Your Answer: Cupola

      Explanation:

      Endothoracic fascia: the connective tissue (fascia) that is between the costal parietal pleura and the inner wall of the chest wall.

      Costomediastinal recess: the point where the costal pleura becomes mediastinal pleura.

      Costodiaphragmatic recess: is the lowest point of the pleural sac where the costal pleura becomes diaphragmatic pleura.

      Cupola: the part of the parietal pleura that extends above the first rib level into the root of the neck.

      Costocervical recess: this is a made-up term.

      Peritracheal fascia: a layer of connective tissue that invests the trachea.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      11.5
      Seconds

  • Question 27 - Which of the following morphological features is most characteristic of hyaline degeneration? ...

    Incorrect

    • Which of the following morphological features is most characteristic of hyaline degeneration?

      Your Answer: Accumulation of lipids in cells

      Correct Answer: Homogeneous, ground-glass, pink-staining appearance of cells

      Explanation:

      The characteristic morphological features of hyaline degeneration is ground-glass, pinking staining cytoplasm with an intact cell membrane. The accumulation of lipids, calcium salts, lipofuscin and an amorphous cytoplasm with an intact cell membrane are all characteristically found in different situations.

      Pyknotic nucleus and orphan Annie eye nucleus are not seen in hyaline degeneration.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      16.2
      Seconds

  • Question 28 - What is the likely diagnosis in a 55-year old man presenting with jaundice,...

    Correct

    • What is the likely diagnosis in a 55-year old man presenting with jaundice, weight loss, pale coloured stools and elevated alkaline phosphatase?

      Your Answer: Pancreatic carcinoma

      Explanation:

      Increased alkaline phosphatase is indicative of cholestasis, with a 4x or greater increase seen 1-2 days after biliary obstruction. Its level can remain elevated several days after the obstruction is resolved due to the long half life (7 days). Increase up to three times the normal level can be seen in hepatitis, cirrhosis, space-occupying lesions and infiltrative disorders. Raised alkaline phosphatase with other liver function tests being normal can occur in focal hepatic lesions like abscesses or tumours, or in partial/intermittent biliary obstruction. However, alkaline phosphatase has several isoenzymes, which originate in different organs, particularly bone. An isolated rise can also be seen in malignancies (bronchogenic carcinoma, Hodgkin’s lymphoma), post-fatty meals (from the small intestine), in pregnancy (from the placenta), in growing children (from bone growth) and in chronic renal failure (from intestine and bone). One can differentiate between hepatic and non-hepatic cause by measurement of enzymes specific to the liver e.g. gamma-glutamyl transferase (GGT).

      In an elderly, asymptomatic patient, isolated rise of alkaline phosphatase usually points to bone disease (like Paget’s disease). Presence of other symptoms such as jaundice, pale stools, weight loss suggests obstructive jaundice, most probably due to pancreatic carcinoma.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      10.4
      Seconds

  • Question 29 - What is the normal duration of PR interval on an electrocardiogram of a...

    Correct

    • What is the normal duration of PR interval on an electrocardiogram of a healthy individual?

      Your Answer: 0.12–0.20 s

      Explanation:

      PR interval extends from the beginning of the P-wave until the beginning of the QRS complex. The normal duration of the PR interval is 0.12-0.20 s. It can be prolonged in first degree heart block, and reduced in Wolff-Parkinson-White syndrome.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      14.5
      Seconds

  • Question 30 - Which of the following muscles is innervated by the inferior branch of the...

    Incorrect

    • Which of the following muscles is innervated by the inferior branch of the right recurrent laryngeal nerve?

      Your Answer: Cricothyroid

      Correct Answer: Posterior cricoarytenoid

      Explanation:

      The posterior cricoarytenoid muscle, which is the sole abductor of the vocal folds, receives its innervation from the inferior laryngeal nerve which is a continuation of the recurrent laryngeal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      12.3
      Seconds

  • Question 31 - A 24 year old mother is breastfeeding her first child. Which of the...

    Correct

    • A 24 year old mother is breastfeeding her first child. Which of the following cellular adaptations occurred in her breast tissue to allow her to do this?

      Your Answer: Lobular hyperplasia

      Explanation:

      Under the influence of oestrogen in pregnancy, there is an increase in the number of lobules which will facilitate lactation.

      Steatocytes occur due to loss of weight and nutritional deficit.

      Metaplasia is a normal physiological process which is due to a change in normal epithelium with another type.

      Lobular atrophy will result in a decreased capacity to provide milk.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Female Health
      • Pathology
      26.5
      Seconds

  • Question 32 - Tumours derived from all three germ-cell layers in new-borns usually occur in which...

    Correct

    • Tumours derived from all three germ-cell layers in new-borns usually occur in which of the following sites?

      Your Answer: Sacrococcygeal area

      Explanation:

      A teratoma is a tumour with tissue or organ components resembling normal derivatives of more than one germ layer. It is derived from all three cell layers. The most common location of teratoma in new-born infants is in the sacrococcygeal area.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      5.5
      Seconds

  • Question 33 - A 57-year-old male smoker noted a lump on his inner lip. Upon physical...

    Correct

    • A 57-year-old male smoker noted a lump on his inner lip. Upon physical examination the lump measured more than 2 cm but less than 4 cm in its greatest dimension. He is diagnosed with squamous cell carcinoma of the lip. What is the stage of the patient's cancer according to the TNM staging for head and neck cancers?

      Your Answer: T2

      Explanation:

      Head and neck cancer is a group of cancers that starts within the mouth, nose, throat, larynx, sinuses, or salivary glands. The TNM staging system used for head and neck cancers is a clinical staging system that allows physicians to compare results across patients, assess prognosis, and design appropriate treatment regimens. The staging is as follows; Primary tumour (T): Tis: pre-invasive cancer (carcinoma in situ), T0: no evidence of primary tumour, T1: tumour 2 cm or less in its greatest dimension, T2: tumour more than 2 cm but not more than 4 cm, T3: tumour larger than 4 cm, T4: tumour with extension to bone, muscle, skin, antrum, neck, etc and TX: minimum requirements to assess primary tumour cannot be met. Regional lymph node involvement (N): N0: no evidence of regional lymph node involvement, N1: evidence of involvement of movable homolateral regional lymph nodes, N2: evidence of involvement of movable contralateral or bilateral regional lymph nodes, N3: evidence of involvement of fixed regional lymph nodes and NX: Minimum requirements to assess the regional nodes cannot be met. Distant metastases (M): M0: no evidence of distant metastases, M1: evidence of distant metastases and MX: minimum requirements to assess the presence of distant metastases cannot be met. Staging: Stage I: T1 N0 M0, Stage II: T2 N0 M0, Stage III: T2NOMO and T3N1MO, Stage IV: T4N1M0, any TN2M0, any TN3M0, any T and any NM1. The depth of infiltration is predictive of the prognosis. With increasing depth of invasion of the primary tumour, the risk of nodal metastasis increases and survival decreases. The patient in this scenario therefore has a T2 tumour.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      13.7
      Seconds

  • Question 34 - During cardiac catheterisation, if the blood sample from the catheter shows an oxygen...

    Incorrect

    • During cardiac catheterisation, if the blood sample from the catheter shows an oxygen saturation of 70%, and the pressure ranging from 12 to 24 mm Hg, it implies that the catheter tip is located in the:

      Your Answer: Right atrium

      Correct Answer: Pulmonary artery

      Explanation:

      Normal values for various parameters are as follows:

      Systolic arterial blood pressure (SBP): 90–140 mmHg.

      Diastolic arterial blood pressure: 60–90 mmHg.

      Mean arterial blood pressure (MAP): SBP + (2 × DBP)/3 (normal range: 70-105 mmHg).

      Right atrial pressure (RAP): 2–6 mmHg.

      Systolic right ventricular pressure (RVSP): 15–25 mmHg.

      Diastolic right ventricular pressure (RVDP): 0–8 mmHg.

      Pulmonary artery pressure (PAP): Systolic (PASP) is 15-25 mmHg and Diastolic (PADP) is 8–15 mmHg.

      Pulmonary artery wedge pressure (PAWP): 6–12 mmHg.

      Left atrial pressure (LAP): 6–12 mmHg.

      Thus, the given value indicates that the position of catheter tip is likely to be in the pulmonary artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      33
      Seconds

  • Question 35 - A 27-year-old female was admitted due to severe dehydration. The patient also complained...

    Correct

    • A 27-year-old female was admitted due to severe dehydration. The patient also complained of chest tightness, thus an ECG was requested. The ECG strip showed an isoelectric ST segment, upright T wave, with prominent U waves. What is the most likely electrolyte abnormality responsible for these ECG tracing?

      Your Answer: Hypokalaemia

      Explanation:

      U waves are prominent if it is >1-2mm or 25% of the height of the T wave. Abnormally prominent U waves are characteristically seen in severe hypokalaemia.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      15.6
      Seconds

  • Question 36 - The muscle that stabilizes the stapes is innervated by which of the following...

    Incorrect

    • The muscle that stabilizes the stapes is innervated by which of the following nerves?

      Your Answer: Chorda tympani nerve

      Correct Answer: Facial nerve

      Explanation:

      The stapedius is the smallest skeletal muscle in the human body. At just over one millimetre in length, its purpose is to stabilize the smallest bone in the body, the stapes and is innervated by a branch of the facial nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      14.1
      Seconds

  • Question 37 - A pedestrian sustained a left fibula fractured following a hit-and-run. X-rays showed that...

    Incorrect

    • A pedestrian sustained a left fibula fractured following a hit-and-run. X-rays showed that there was a transverse fracture of the upper end of the fibula. It was manifested clinically by inability to flex his foot at the ankle joint plus weak extension of the phalanges. What nerve is suspected to be injured in such a case?

      Your Answer: Superficial peroneal

      Correct Answer: Deep peroneal

      Explanation:

      The deep peroneal nerve supplies the muscles allowing for flexion of the foot at the ankle joint, namely the tibialis anterior and peroneus tertius muscles. The peroneus tertius, peroneus brevis, and peroneus longus evert the foot, whereas the tibialis anterior and tibialis posterior invert the foot. Fibres of the deep peroneal nerve originate from L4, L5, and S1.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      21.5
      Seconds

  • Question 38 - A surgeon ligates the left superior suprarenal artery whilst preforming a left adrenalectomy....

    Correct

    • A surgeon ligates the left superior suprarenal artery whilst preforming a left adrenalectomy. Where does the left superior suprarenal artery originate?

      Your Answer: Left inferior phrenic artery

      Explanation:

      The superior suprarenal arteries arises from the inferior phrenic artery on either side.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      24.7
      Seconds

  • Question 39 - Renin is secreted by pericytes in the vicinity of the afferent arterioles of the...

    Incorrect

    • Renin is secreted by pericytes in the vicinity of the afferent arterioles of the kidney from the juxtaglomerular cells. Plasma renin levels are decreased in patients with:

      Your Answer: Salt restriction

      Correct Answer: Primary aldosteronism

      Explanation:

      Primary aldosteronism, also known as primary hyperaldosteronism or Conn’s syndrome, is excess production of the hormone aldosterone by the adrenal glands resulting in low renin levels. Most patients with primary aldosteronism (Conn’s syndrome) have an adrenal adenoma. The increased plasma aldosterone concentration leads to increased renal Na+ reabsorption, which results in plasma volume expansion. The increase in plasma volume suppresses renin release from the juxtaglomerular apparatus and these patients usually have low plasma renin levels. Salt restriction and upright posture decrease renal perfusion pressure and therefore increases renin release from the juxtaglomerular apparatus. Secondary aldosteronism is due to elevated renin levels and may be caused by heart failure or renal artery stenosis.

    • This question is part of the following fields:

      • Physiology
      • Renal
      68.9
      Seconds

  • Question 40 - The dilator pupillae muscle is innervated by postganglionic sympathetic fibres. Where do the...

    Incorrect

    • The dilator pupillae muscle is innervated by postganglionic sympathetic fibres. Where do the postganglionic sympathetic fibres originate?

      Your Answer: Ciliary ganglion

      Correct Answer: Superior cervical ganglion

      Explanation:

      The postganglionic sympathetic axons are derived from the superior cervical ganglion and innervate the eye and lacrimal gland allowing for vasoconstriction of the iris and sclera, pupillary dilation, widening of the palpebral fissure, and a reduction in tear production.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      16
      Seconds

  • Question 41 - A sudden loud sound is more likely to result in cochlear damage than...

    Correct

    • A sudden loud sound is more likely to result in cochlear damage than a slowly developing loud sound. This is because:

      Your Answer: There is a latent period before the attenuation reflex can occur

      Explanation:

      On transmission of a loud sound into the central nervous system, an attenuation reflex occurs after a latent period of 40-80 ms. This reflex contracts the two muscles that pull malleus and stapes closer, developing a high degree of rigidity in the entire ossicular chain. This reduces the ossicular conduction of low frequency sounds to the cochlea by 30-40 decibels. In this way, the cochlea is protected from damage due to loud sounds (these are low frequency sounds) when they develop slowly.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      18.1
      Seconds

  • Question 42 - Which nodes are most likely to be enlarged in a patient complaining of...

    Correct

    • Which nodes are most likely to be enlarged in a patient complaining of a boil located on the labia majora?

      Your Answer: Superficial inguinal

      Explanation:

      The perineum, external genitalia, the labia majora and scrotum drain to the superficial inguinal lymph nodes. In a man, the testes do not drain to the superficial inguinal lymph nodes but rather travel in the spermatic cord and drain into the lumbar nodes. The lumbar nodes drain the internal pelvic organs. The sacral nodes drain the prostrate gland, uterus, vagina, rectum and posterior pelvic wall and the external iliac nodes in turn drain the lower limb. The internal iliac nodes drain the pelvis and gluteal region.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      15.9
      Seconds

  • Question 43 - The vascular structure found on the right side of the fifth lumbar vertebra...

    Incorrect

    • The vascular structure found on the right side of the fifth lumbar vertebra is?

      Your Answer: Right external iliac vein

      Correct Answer: Inferior vena cava

      Explanation:

      The most likely vascular structure is the inferior vena cava. The inferior vena cava is formed by the joining of the two common iliac arteries, the right and the left iliac artery, at the level of the fifth lumbar vertebra( L5). The inferior vena cava passes along the right side of the vertebral column. It enters the thoracic cavity into the underside of the heart through the caval opening of the diaphragm at the level of the eight thoracic vertebra (T8).

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      39.1
      Seconds

  • Question 44 - Skin infiltration by neoplastic T lymphocytes is seen in: ...

    Correct

    • Skin infiltration by neoplastic T lymphocytes is seen in:

      Your 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
      3.6
      Seconds

  • Question 45 - 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
      13.6
      Seconds

  • Question 46 - Which of these is secreted by both macrophages and muscle cells? ...

    Incorrect

    • Which of these is secreted by both macrophages and muscle cells?

      Your Answer: Interleukin-9

      Correct Answer: Interleukin-6

      Explanation:

      IL-6 is secreted by the T cells and macrophages and is a pro inflammatory cytokine. It is secreted in response to trauma e.g. burns and tissue damage that leads to inflammation. Apart from this its is also a myokine and is elevated due to muscle contraction. Other functions include: stimulate osteoclast formation when secreted by osteoblasts, mediate fever in acute phase response and are responsible for energy metabolism in muscle and fatty tissues. Inhibitors of IL-6 e.g. oestrogen are used as a treatment for postmenopausal osteoporosis.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      7.6
      Seconds

  • Question 47 - The pterygoid plexus receives tributaries from which of the following veins? ...

    Incorrect

    • The pterygoid plexus receives tributaries from which of the following veins?

      Your Answer: Internal jugular vein

      Correct Answer: Maxillary vein

      Explanation:

      The pterygoid plexus of veins is the main venous component associated with the infratemporal fossa. It receives tributaries corresponding to the branches of the internal maxillary artery. This plexus communicates freely with the anterior facial vein; it also communicates with the cavernous sinus, by branches through the foramen of Vesalius, foramen ovale and foramen lacerum. The (internal) maxillary vein is a short trunk which accompanies the first part of the (internal) maxillary artery. It is formed by a confluence of the veins of the pterygoid plexus and passes backward between the sphenomandibular ligament and the neck of the mandible and unites with the temporal vein to form the posterior facial vein. It carries blood away from the infratemporal fossa.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      9.9
      Seconds

  • Question 48 - During cardiac catheterisation in a 20-year old man, the following data is obtained:...

    Correct

    • During cardiac catheterisation in a 20-year old man, the following data is obtained: Pressure (mmHg), O2 saturation (%) Right atrium 7 (N = 5) 90 (N = 75), Right ventricle 35/7 (N = 25/5) 90 (N = 75), Pulmonary artery 35/8 (N = 25/15), 90 (N = 75), Left atrium 7 (N = 9) 95 (N = 95), Left ventricle 110/7 (N = 110/9) 95 (N = 95), Aorta 110/75 (N = 110/75) 95 (N = 95) where N = Normal value. What is the likely diagnosis?

      Your Answer: Atrial septal defect

      Explanation:

      A congenital heart disease, ASD or atrial septal defect leads to a communication between the right and left atria due to a defect in the interatrial septum. This leads to mixing of arterial and venous blood from the right and left side of the heart. The hemodynamic significance of this defect depends on the presence of shunting of blood. Normally, the left side of the heart has higher pressure than the right as the left side has to pump blood throughout the body. A large ASD (> 9 mm) will result in a clinically significant left-to-right shunt, causing volume overload of the right atrium and ventricle, eventually leading to heart failure. Cardiac catheterization would reveal very high oxygen saturation in the right atrium, right ventricle and pulmonary artery. Eventually, the left-to-right shunt will lead to pulmonary hypertension and increased afterload in the right ventricle, along with the increased preload due to the shunted blood. This will either cause right ventricular failure, or raise the pressure in the right side of the heart to equal or more than that in the left. Elevation of right atrial pressure to that of left atrial pressure would thus lead to diminishing or complete cessation of the shunt. If left uncorrected, there will be reversal of the shunt, known as Eisenmenger syndrome, resulting in clinical signs of cyanosis as the oxygen-poor blood form right side of the heart will mix with the blood in left side and reach the peripheral vascular system.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      8
      Seconds

  • Question 49 - After total thyroidectomy, which of the following investigations is recommended in the immediate...

    Correct

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

      Your 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
      29.5
      Seconds

  • Question 50 - During thymectomy the surgeon accidentally nicks a vein that lies just posterior to...

    Correct

    • During thymectomy the surgeon accidentally nicks a vein that lies just posterior to the thymus. Which of the following vessels is likely to be injured?

      Your Answer: Left brachiocephalic vein

      Explanation:

      The thymus is located superficially in the anterior mediastinum. The left brachiocephalic vein courses through the mediastinum to join the right brachiocephalic vein and form the superior vena cava on the right side of the thorax. The left brachiocephalic vein, being superficial, courses just deep to the thymus so that it may be susceptible to compression by an adjacent tumour. The left pulmonary vein, left bronchial vein and right pulmonary artery are deep, and enter and exit the lung at its root, thus are not near the thymus. The right superior intercostal vein drains the 2nd to the 4th intercostal spaces and drains into the arch of the azygos vein. It is not, therefore, closely related with the thymus.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      42.2
      Seconds

  • Question 51 - Glucose is not secreted by the kidneys, and is filtered without a limit....

    Correct

    • Glucose is not secreted by the kidneys, and is filtered without a limit. What is the transport maximum for glucose?

      Your Answer: 300 mg/dl

      Explanation:

      Transport maximum (or Tm) refers to the point at which increases in concentration do not result in an increase in movement of a substance across a membrane. Glucose is not secreted, thus excretion = filtration – reabsorption. Both filtration and reabsorption are directly proportional to the concentration of glucose in the plasma. However, reabsorption has a transport maximum of about 300 mg/dl in healthy nephrons, while filtration has effectively no limit (within reasonable physiological ranges). So, if the concentration rises above 300 mg/dl, the body cannot retain all the glucose, leading to glucosuria. Glucosuria is nearly always caused by elevated blood glucose levels, most commonly due to untreated diabetes mellitus.

    • This question is part of the following fields:

      • Physiology
      • Renal
      30.4
      Seconds

  • Question 52 - The left lateral pterygoid muscle is one of the muscles of mastication. When...

    Correct

    • The left lateral pterygoid muscle is one of the muscles of mastication. When acting alone, it will shift the mandible towards which direction?

      Your Answer: Laterally, to the right

      Explanation:

      The lateral pterygoid or external pterygoid is a muscle of mastication with two heads. It lies superiorly to the medial pterygoid. When acting alone, it will shift the mandible laterally and to the right.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      21
      Seconds

  • Question 53 - 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: Cholangiocarcinoma

      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
      15.8
      Seconds

  • Question 54 - An organ transplant patient may be at risk of developing which type of...

    Correct

    • An organ transplant patient may be at risk of developing which type of cancer?

      Your Answer: Skin cancer

      Explanation:

      The most common malignancies encountered in the post–solid organ transplant setting are non-melanoma skin cancers, post-transplant lymphoproliferative disorders and Kaposi’s sarcoma (KS). The pathogenesis of these tumours is likely related to the immunosuppressive drugs used post-transplantation and subsequent viral infection.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      9.9
      Seconds

  • Question 55 - Which of the following is the most likely cause of prolonged thrombin clotting...

    Incorrect

    • Which of the following is the most likely cause of prolonged thrombin clotting time?

      Your Answer: von Willebrand factor deficiency

      Correct Answer: Hypofibrinogenemia

      Explanation:

      Thrombin clotting time, also called thrombin time (TT), is test used for the investigation of possible bleeding or clotting disorders. TT reflects the conversion of fibrinogen to fibrin and it’s also very sensitive to the presence of the anticoagulant heparin. A prolonged thrombin time may indicate the presence of hypofibrinogenemia (decreased fibrinogen level ), dysfibrinogenaemia, disseminated intravascular coagulation (DIC), end stage liver disease or malnutrition.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      52.7
      Seconds

  • Question 56 - A 40-year-old woman is suspected to have an ovarian cancer. Which tumour marker...

    Correct

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

      Your 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
      9.7
      Seconds

  • Question 57 - Hyperplastic arteriosclerosis with fibrinoid necrosis, petechial haemorrhages, microinfarcts in the kidneys and elevated...

    Incorrect

    • Hyperplastic arteriosclerosis with fibrinoid necrosis, petechial haemorrhages, microinfarcts in the kidneys and elevated plasma renin are common findings in which of the following patients?

      Your Answer: A 3-year-old girl with Wilms' tumour

      Correct Answer: A 45-year-old woman with scleroderma

      Explanation:

      Scleroderma, also known as systemic sclerosis, is a chronic disease of the connective tissue. Involvement of the kidneys occurs in patients with diffuse scleroderma, causing rapid onset of high blood pressure with hyperreninemia, thrombotic microangiopathy, and progressive renal failure.

    • This question is part of the following fields:

      • Pathology
      • Renal
      36.7
      Seconds

  • Question 58 - 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: Superior orbital fissure

      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
      12.2
      Seconds

  • Question 59 - What causes a reduction in pulmonary functional residual capacity? ...

    Incorrect

    • What causes a reduction in pulmonary functional residual capacity?

      Your Answer: Asthma

      Correct Answer: Pulmonary fibrosis

      Explanation:

      Pulmonary functional residual capacity (FRC) is = volume of air present in the lungs at the end of passive expiration.

      Obstructive diseases (e.g. emphysema, chronic bronchitis, asthma) = an increase in FRC due to an increase in lung compliance and air trapping.

      Restrictive diseases (e.g. pulmonary fibrosis) result in stiffer, less compliant lungs and a reduction in FRC.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      14.8
      Seconds

  • Question 60 - A swimmer was struggling to finish his training following an injury to his...

    Correct

    • A swimmer was struggling to finish his training following an injury to his right arm. On further examination it was found that any movements involving adduction, medial rotation and extension of her arm were particularly weak. Which nerve in this case was damaged?

      Your Answer: Thoracodorsal

      Explanation:

      Weakness on these particular movements indicate that there is a problem with the latissimus dorsi muscle. This muscle is very important particularly in swimming movements and is supplied by the thoracodorsal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      15.1
      Seconds

  • Question 61 - Skeletal muscle fibres are divided into two basic types, type I (slow-twitch fibres)...

    Correct

    • Skeletal muscle fibres are divided into two basic types, type I (slow-twitch fibres) and type II (fast-twitch fibres). Fast muscle fibres do which of the following:

      Your Answer: Use anaerobic metabolism

      Explanation:

      Skeletal muscles are divided into two types:

      1) type I also known as the slow twitch fibres. They use oxygen for their metabolism and as a result they have a high endurance potential. To support this they have abundant mitochondria and myoglobin, so they appear red/dark.

      2) type II fibres also called fast twitch fibres, are low endurance fibres used during anaerobic metabolism. They are required for short bursts of strength and cannot sustain contractions for long periods of time.

    • This question is part of the following fields:

      • General
      • Physiology
      8.1
      Seconds

  • Question 62 - Which of the following organs is an ectoderm derivative? ...

    Incorrect

    • Which of the following organs is an ectoderm derivative?

      Your Answer: Mesothelium

      Correct Answer: Adrenal medulla

      Explanation:

      Ectoderm derivatives include the adrenal medulla, posterior pituitary, the epidermis of the skin, nails, hair, sweat glands, mammary glands, sebaceous glands, the central nervous system, the peripheral nervous system, the retina and lens of eye, the pupillary muscle of the iris, melanocytes, Schwann cells and odontoblasts.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      154.7
      Seconds

  • Question 63 - upon stroking the plantar surface of a patient's foot, extension of toes was...

    Correct

    • upon stroking the plantar surface of a patient's foot, extension of toes was noted. This is likely to be accompanied with:

      Your Answer: Spasticity

      Explanation:

      An upper motor neuron lesion affects the neural pathway above the anterior horn cell or motor nuclei of the cranial nerves, whereas a lower motor neurone lesion affects nerve fibres travelling from the anterior horn of the spinal cord to the relevant muscles. An upper motor neurone lesions results in the following:

      – Spasticity in the extensor muscles (lower limbs) or flexor muscles (upper limbs).

      – ‘clasp-knife’ response where initial resistance to movement is followed by relaxation

      – Weakness in the flexors (lower limbs) or extensors (upper limbs) with no muscle wasting

      – Brisk tendon jerk reflexes

      – Positive Babinski sign (on stimulation of the sole of the foot, the big toe is raised rather than curled downwards)

    • This question is part of the following fields:

      • Neurology
      • Physiology
      21.1
      Seconds

  • Question 64 - A patient is diagnosed with Brucellosis. What is the mode of transmission of...

    Correct

    • A patient is diagnosed with Brucellosis. What is the mode of transmission of this disease?

      Your Answer: Unpasteurised milk

      Explanation:

      Brucellosis is a highly contagious zoonosis caused by ingestion of unpasteurized milk or undercooked meat from infected animals, or close contact with their secretions.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      5.1
      Seconds

  • Question 65 - A 38 year-old man falls on an outstretched hand. X-rays indicate an anterior...

    Incorrect

    • A 38 year-old man falls on an outstretched hand. X-rays indicate an anterior dislocation of one of the carpal bones. Which carpal bone is most commonly dislocated?

      Your Answer: Scaphoid

      Correct Answer: Lunate

      Explanation:

      The scaphoid bone is the most commonly fractured carpal bone and has an increased risk of avascular necrosis.

      The lunate is the most commonly dislocated carpal bone. The displaced bone may compress the median nerve in the carpal tunnel.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      12.3
      Seconds

  • Question 66 - Following a lacerating injury along the anterior border of the trapezius muscle in...

    Correct

    • Following a lacerating injury along the anterior border of the trapezius muscle in the neck, a man has the point of his shoulder (scapula) sagging and he has difficulty with full abduction of his arm. Which nerve is most likely injured?

      Your Answer: Accessory (cranial nerve XI)

      Explanation:

      Injury to the accessory nerve denervates the trapezius muscle so that the person will no longer be able to raise the acromion of the shoulder. The dorsal scapular nerve supplies the rhomboids i.e. major and minor and the levator scapulae so that injury to this nerve weakens retraction of the scapula. The greater occipital nerve is responsible for sensation of the posterior scalp. The axillary nerve innervates the deltoid muscle which is responsible for abduction of the arm and the suprascapular nerve is responsible for rotating the humerus laterally. Cutaneous nerves supply the skin.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      24.4
      Seconds

  • Question 67 - A 38-year old lady presented to the hospital with abnormal passing of blood...

    Incorrect

    • A 38-year old lady presented to the hospital with abnormal passing of blood per vagina. On examination, she was found to have an endocervical polypoidal mass. On enquiry, she gave history of oral contraceptive usage for 3 years. What finding is expected on the histopathology report of biopsy of the mass?

      Your Answer: Submucosal fibroid

      Correct Answer: Microglandular hyperplasia

      Explanation:

      Endocervical polyps or microglandular hyperplasia are benign growths occurring in the endocervical canal, in about 2-5% women and occur secondary to use of oral contraceptives. They are usually < 1cm in size, friable and reddish-pink. Usually asymptomatic, they can cause bleeding or become infected, leading to leucorrhoea (purulent vaginal discharge). They are usually benign but need to be differentiated from adenocarcinomas by histology.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      34.9
      Seconds

  • Question 68 - A patient in the recovery ward after cardiac surgery is noticed to have...

    Correct

    • A patient in the recovery ward after cardiac surgery is noticed to have a small effusion in the lowest extent of the pleural cavity, into which no lung tissue extends. What is the name of this part of the pleural cavity?

      Your Answer: Costodiaphragmatic recess

      Explanation:

      The costodiaphragmatic recess is the part of the pleural cavity where the costal pleura is in continuity with the diaphragmatic pleura. It forms the lowest extent of the pleural cavity.

      Costomediastinal recess: a tiny recess that is anteriorly located, where the costal pleura becomes continuous with the mediastinal pleura.

      The cupola is the pleural cavity that extends above the first rib.

      The inferior mediastinum refers to the posterior, middle and anterior mediastinal divisions together.

      The pulmonary ligament on the other hand, is a pleural fold that is situated beneath the root of the lung on the medial aspect of the lung.

      Oblique pericardial sinus is not part of the pleural cavity.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      18
      Seconds

  • Question 69 - During thyroidectomy, the recurrent laryngeal nerves are vulnerable to injury. Which of the...

    Correct

    • During thyroidectomy, the recurrent laryngeal nerves are vulnerable to injury. Which of the following muscles will not be affected in cases where the recurrent laryngeal nerve is severed?

      Your Answer: Cricothyroid

      Explanation:

      All muscles of the larynx are supplied by the recurrent laryngeal nerve except for the cricothyroid which is supplied by the vagus nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      15.4
      Seconds

  • Question 70 - A 56-year old male with history of previous abdominal surgery presents to the...

    Correct

    • A 56-year old male with history of previous abdominal surgery presents to the emergency department with severe abdominal pain that is increasing in intensity. This pain is associated with abdominal distension and faint, high-pitched bowel sounds. An old scar is also noted on the abdomen. An erect abdominal X-ray shows multiple air-fluid levels in dilated bowel loops. No occult blood was found in stool sample. What is the most likely predisposing factor for his present condition?

      Your Answer: Adhesions from previous surgery

      Explanation:

      The described features suggest acute bowel obstruction. The scar described points toward previous surgery, which suggests development of peritoneal adhesions that could lead to obstruction. Hepatitis does not lead to dilated bowel loops. Amoebiasis could lead to inflammatory bowel disease, however, occult blood in stool is usually positive. Ileal adenocarcinoma is rare. Meckel’s diverticulum can possibly lea to obstruction but the findings described here are more consistent with obstruction due to peritoneal adhesions from a past surgery.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      16.5
      Seconds

  • Question 71 - Which of the following proteins acts as cofactor in the thrombin-induced activation of...

    Incorrect

    • Which of the following proteins acts as cofactor in the thrombin-induced activation of anticoagulant protein C?

      Your Answer: Alpha-2-antiplasmin

      Correct Answer: Thrombomodulin

      Explanation:

      Thrombomodulin is a protein cofactor expressed on the surface of endothelial cells. Thrombomodulin binds with thrombin forming a complex which activates protein C, initiating the anticoagulant pathway.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      27.8
      Seconds

  • Question 72 - A 77-year-old woman's renal function is tested. The following results were obtained during...

    Correct

    • A 77-year-old woman's renal function is tested. The following results were obtained during a 24-h period:

      Urine flow rate: 2. 0 ml/min

      Urine inulin: 0.5 mg/ml

      Plasma inulin: 0.02 mg/ml

      Urine urea: 220 mmol/l

      Plasma urea: 5 mmol/l.

      What is the urea clearance?

      Your Answer: 88 ml/min

      Explanation:

      Urea is reabsorbed in the inner medullary collecting ducts of the nephrons. The clearance (C) of any substance can be calculated as follows: C = (U × V)/P, where U and P are the urine and plasma concentrations of the substance, respectively and V is the urine flow rate. So, glomerular filtration rate = (0.220 × 2. 0)/0.005 = 88 ml/min.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      45.8
      Seconds

  • Question 73 - A patient is suspected to have a chromosomal abnormality. Which tumour and chromosomal...

    Incorrect

    • A patient is suspected to have a chromosomal abnormality. Which tumour and chromosomal association is correct?

      Your Answer: Retinoblastoma – chromosome 11

      Correct Answer: Neuroblastoma – chromosome 1

      Explanation:

      Neuroblastoma is associated with a deletion on chromosome 1 and inactivation of a suppressor gene. Neurofibromas and osteogenic sarcoma are associated with an abnormality on chromosome 17. Retinoblastoma (Rb) is associated with an abnormality on chromosome 13. Wilms’ tumours of the kidney are associated with an abnormality on chromosome 11.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      11.5
      Seconds

  • Question 74 - Following an accident, a man was unable to extend the wrist and metacarpophalangeal...

    Incorrect

    • Following an accident, a man was unable to extend the wrist and metacarpophalangeal joints, despite sensation being intact. Which nerve was likely damaged?

      Your Answer: Radial nerve

      Correct Answer: Posterior interosseous nerve

      Explanation:

      The posterior interosseous nerve which causes, what is known as the posterior interosseous nerve syndrome. The nerve is compressed before it bifurcates to form the medial and lateral branches. The compression is beyond the origin of the branches to the radial wrist extensors and the radial sensory nerve. The result of such a case is paralysis of the digital extensors and the extensor carpi ulnaris, resulting in dorsoradial deviation of the wrist.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      31.8
      Seconds

  • Question 75 - T lymphocytes that express the MCH type II antigen are most likely to...

    Correct

    • T lymphocytes that express the MCH type II antigen are most likely to produce which of the following cytokines?

      Your Answer: Gamma interferon

      Explanation:

      Interferon gamma is a soluble cytokine previously known as the macrophage activating factor. It is the only member belonging to the type II class of the interferons. It is secreted by a number of cells taking part in the immune reaction including: T-helper cells (CD-4), cells with immunological memory (CD45PA), killer cells (CD8), dendrite cells (CD23,35), natural killer cells (CD16) and B lymphocytes (CD22,CD23). It has both a defending as well as a pathological effect. It induces differentiation in the myeloid cell in the bone marrow. If macrophages are infected by parasites it activates the macrophages to destroy them. IFN-γ strengthens the anti-tumour activities of the cytotoxic lymphocytes. Together with CD4 or CD8 toxins, produced by lymphocytes, it suppresses the growth of the tumour cells. along with these functions it increases the non specific response of the natural killer cells, causing changes in the cell membrane surface to prevent adhesion and penetration of a virus. It can either increase or decrease B cell response and it activates osteoclasts which increases bone resorption.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      8.3
      Seconds

  • Question 76 - Which of the following statements is true regarding the umbilical cord? ...

    Incorrect

    • Which of the following statements is true regarding the umbilical cord?

      Your Answer: Is covered by a layer of endoderm

      Correct Answer: Is filled with jelly of Wharton

      Explanation:

      The umbilical cord that connects the fetus to the placenta is about 50cm long. This tissue consists of the body stalk and vitelline duct. The former containing the allantoic diverticulum and the umbilical vessels. The latter contains the connection linking the digestive tube and the yolk sac. This cord is wrapped by stratum of ectoderm and gelatinous tissue or jelly of Wharton. The right umbilical vein plus the vitelline vessels and ducts disappear and this at birth the cord has three vessels which are the umbilical vein and two umbilical arteries.

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      23.6
      Seconds

  • Question 77 - A 50-year-old man is diagnosed with emphysema and cirrhosis of the liver. Which...

    Incorrect

    • A 50-year-old man is diagnosed with emphysema and cirrhosis of the liver. Which of the following condition may be the cause of both cirrhosis and emphysema in this patient?

      Your Answer: Budd–Chiari syndrome

      Correct Answer: Alpha1-antitrypsin deficiency

      Explanation:

      Alpha-1 antitrypsin (A1AT) deficiency is a condition characterised by the lack of a protein that protects the lungs and liver from damage, called alpha1-antytripsin. The main complications of this condition are liver diseases such as cirrhosis and chronic hepatitis, due to accumulation of abnormal alpha 1-antytripsin and emphysema due to loss of the proteolytic protection of the lungs.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      8.2
      Seconds

  • Question 78 - A 46 -year old patient diagnosed with chronic rhinosinusitis, was to undergo surgery...

    Correct

    • 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: 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
      15.2
      Seconds

  • Question 79 - What is the action of the muscle of the orbit that originates on...

    Correct

    • What is the action of the muscle of the orbit that originates on the lesser wing of the sphenoid bone, just above the optic foramen?

      Your Answer: Elevation of the upper eyelid

      Explanation:

      The levator palpebrae superioris is the muscle in the orbit that elevates the superior (upper) eyelid. The levator palpebrae superioris originates on the lesser wing of the sphenoid bone, just above the optic foramen and receives somatic motor input from the ipsilateral superior division of the oculomotor nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      8.6
      Seconds

  • Question 80 - A diabetic 58-year-old man, after the injection of radiographic contrast, has a decreased...

    Incorrect

    • A diabetic 58-year-old man, after the injection of radiographic contrast, has a decreased urine output and decreased level of consciousness. Which of the following conditions has he most likely developed

      Your Answer: Chronic interstitial nephritis

      Correct Answer: Acute tubular necrosis

      Explanation:

      Acute tubular necrosis (ATN) involves damage to the tubule cells of the kidneys and is the most common cause of acute kidney injury. ATN in the majority of the cases is caused by ischaemia of the kidneys due to lack of perfusion and oxygenation but it may also occur due to poison or harmful substance. Contrast used for radiology may cause ATN in patients with several risk factors e.g. diabetic nephropathy. Symptoms may include oliguria, nausea, fluid retention, fatigue and decreased consciousness.

    • This question is part of the following fields:

      • Pathology
      • Renal
      30.4
      Seconds

  • Question 81 - During uterogrowth, the second pharyngeal arch gives rise to which structures? ...

    Incorrect

    • During uterogrowth, the second pharyngeal arch gives rise to which structures?

      Your Answer: Mylohyoid

      Correct Answer: Stylohyoid muscle

      Explanation:

      The second pharyngeal arch or hyoid arch, is the second of six pharyngeal arches that develops in fetal life during the fourth week of development and assists in forming the side and front of the neck. Derivatives:

      Skeletal – From the cartilage of the second arch arises:

      Stapes,

      Temporal styloid process,

      Stylohyoid ligament, and

      Lesser cornu of the hyoid bone.

      Muscles:

      Muscles of face

      Occipitofrontalis muscle

      Platysma

      Stylohyoid muscle

      Posterior belly of Digastric

      Stapedius muscle

      Auricular muscles

      Nerve supply: Facial nerve

    • This question is part of the following fields:

      • Anatomy
      • Embryology
      131.1
      Seconds

  • Question 82 - What is the innervation of the tensor tympani muscle? ...

    Incorrect

    • What is the innervation of the tensor tympani muscle?

      Your Answer: Chorda tympani nerve

      Correct Answer: Trigeminal nerve

      Explanation:

      The tensor veli palatini is innervated by the medial pterygoid nerve, a branch of mandibular nerve, the third branch of the trigeminal nerve (CN V3) – the only muscle of the palate not innervated by the pharyngeal plexus, which is formed by the vagal and glossopharyngeal nerves.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      11.8
      Seconds

  • Question 83 - Diuretics that act on the ascending limb of the loop of Henle produce:...

    Correct

    • Diuretics that act on the ascending limb of the loop of Henle produce:

      Your Answer: Reduced active transport of sodium

      Explanation:

      The loop of Henlé leads from the proximal convoluted tubule to the distal convoluted tubule. Its primary function uses a counter current multiplier mechanism in the medulla to reabsorb water and ions from the urine. It can be divided into four parts:

      1. Descending limb of loop of Henl̩ Рlow permeability to ions and urea, while being highly permeable to water

      2. Thin ascending limb of loop of Henl̩ Рnot permeable to water, but it is permeable to ions

      3. Medullary thick ascending limb of loop of Henlé – sodium (Na+), potassium (K+) and chloride (Cl–) ions are reabsorbed by active transport. K+ is passively transported along its concentration gradient through a K+ channel in the basolateral aspect of the cells, back into the lumen of the ascending limb.

      4. The cortical thick ascending limb – the site of action where loop diuretics such as furosemide block the K+/Na+/2Cl− co-transporters = reduced active transport.

    • This question is part of the following fields:

      • Physiology
      • Renal
      22.2
      Seconds

  • Question 84 - A 42 year old man presents with end stage renal failure and is...

    Incorrect

    • A 42 year old man presents with end stage renal failure and is prepared to receive a kidney from his best friend. HLA testing showed that they are not a 100% match and he is given immunosuppressant therapy for this. Three months later when his renal function is assessed, he showed signs of deteriorating renal function, with decreased renal output, proteinuria of +++ and RBCs in the urine. He was given antilymphocyte globulins and his condition reversed. During the crisis period the patient is likely to be suffering from?

      Your Answer: Graft-versus-host disease

      Correct Answer: Acute rejection

      Explanation:

      This patients is most likely experiencing an acute rejection. It is a cell mediated attack against the organ that has been transplanted. Antigens are either presented by blood borne cells with in the graft or antigen presenting cells in the body may be presenting class I and class II molecules that have been shed by the graft. Class I will activate CD8 and class II, CD4 cells, both of which will attack the graft.

      Chronic rejection is a slow process which occurs months to years after the transplant. The exact mechanism is not very well understood but it probably involves a combination of Type III and Type IV hypersensitivity directed against the foreign MHC molecules which look like self-MHC presenting a foreign antigen.

      Hyperacute Transplant Rejection occurs almost immediately and is often evident while you are still in surgery. It is caused by accidental ABO Blood type mismatching of the donor and recipient which almost never happens anymore. This means the host has preformed antibodies against the donated tissue.

    • This question is part of the following fields:

      • Inflammation & Immunology; Renal
      • Pathology
      67
      Seconds

  • Question 85 - Which of the following enzymes is secreted by the small intestinal mucosa? ...

    Correct

    • Which of the following enzymes is secreted by the small intestinal mucosa?

      Your Answer: Lactase

      Explanation:

      Lactase, an enzyme belonging to β-galactosidase family of enzymes, brings about the hydrolysis of the disaccharide lactose into galactose and glucose. In humans, it is present along the brush border membrane of the cells lining the small intestinal villi. Deficiency of lactase causes lactose intolerance.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      5.1
      Seconds

  • Question 86 - How are amino acids transported across the luminal surface of the small intestinal...

    Correct

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

      Your 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
      16.1
      Seconds

  • Question 87 - Which of the following muscles is solely contained in the anterior triangle of...

    Correct

    • Which of the following muscles is solely contained in the anterior triangle of the neck and divides the anterior triangle into three smaller triangles?

      Your Answer: Digastric

      Explanation:

      The digastric muscle is a small muscle located under the jaw. It lies below the body of the mandible, and extends, in a curved form, from the mastoid process to the symphysis menti. The digastric divides the anterior triangle of the neck into three smaller triangles:

      – The submaxillary triangle, bounded above by the lower border of the body of the mandible and a line drawn from its angle to the sternocleidomastoid, below by the posterior belly of the digastric and the stylohyoid and in front by the anterior belly of the digastric

      – The carotid triangle, bounded above by the posterior belly of the digastric and stylohyoid, behind by the sternocleidomastoid and below by the omohyoid

      – The suprahyoid or submental triangle, bounded laterally by the anterior belly of the digastric, medially by the midline of the neck from the hyoid bone to the symphysis menti and inferiorly by the body of the hyoid bone.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      24
      Seconds

  • Question 88 - Injury to this nerve will result to the loss of general sensory innervation...

    Incorrect

    • Injury to this nerve will result to the loss of general sensory innervation of the lacrimal gland:

      Your Answer: Maxillary nerve

      Correct Answer: Ophthalmic nerve

      Explanation:

      The lacrimal glands are paired, almond-shaped exocrine glands, that secrete the aqueous layer of the tear film. The lacrimal nerve, derived from the ophthalmic nerve, supplies the sensory component of the lacrimal gland. The greater petrosal nerve, derived from the facial nerve, supplies the parasympathetic autonomic component of the lacrimal gland.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      33.2
      Seconds

  • Question 89 - The primary motor cortex is located in the: ...

    Correct

    • The primary motor cortex is located in the:

      Your Answer: Precentral gyrus

      Explanation:

      The primary motor cortex is located in the dorsal part of the precentral gyrus and the anterior bank of the central sulcus. The precentral gyrus lies anterior to the postcentral gyrus and is separated from it by a central sulcus. Its anterior border is the precentral sulcus, while inferiorly it borders to the lateral fissure (Sylvian fissure).

    • This question is part of the following fields:

      • Neurology
      • Physiology
      8.4
      Seconds

  • Question 90 - A 45-year old male, who was a chronic smoker presented to the clinic...

    Incorrect

    • A 45-year old male, who was a chronic smoker presented to the clinic with backache and dry, incessant cough. On examination, he was found to have raised blood pressure, purplish striae on his abdomen, truncal obesity and tenderness over the lower thoracic spine. These findings are suggestive of which condition?

      Your Answer: Extra-adrenal paraganglioma

      Correct Answer: Small-cell anaplastic (oat cell) carcinoma

      Explanation:

      The symptoms suggest Cushing syndrome due to increased glucocorticoid levels. One cause of Cushing syndrome is ectopic production of adrenocorticotrophic hormone from oat cell carcinoma. As oat cell carcinoma is known to be highly metastatic, the tenderness in lower back could represent metastatic involvement.

    • This question is part of the following fields:

      • Endocrine
      • Pathology
      52.9
      Seconds

  • Question 91 - Cyclophosphamide is used as a chemotherapy and immunosuppressant agent and is indicated in...

    Correct

    • 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: 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
      7.1
      Seconds

  • Question 92 - 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
      28
      Seconds

  • Question 93 - A 26-year-old female sought consultation due to excessive vaginal discharge. Vaginal smear showed...

    Correct

    • A 26-year-old female sought consultation due to excessive vaginal discharge. Vaginal smear showed numerous bacilli under the microscope. The organism was non-pathogenic. What is the most likely organism:

      Your Answer: Lactobacillus species

      Explanation:

      Lactobacillus is a Gram-positive facultative bacteria. It is commonly present in the vagina and the gastrointestinal tract. Colonization of Lactobacillus is usually benign and it makes up a small portion of the gastrointestinal flora.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      33.2
      Seconds

  • Question 94 - After a cerebral infarction, which of these histopathogical findings is most likely to...

    Correct

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

      Your 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
      27.7
      Seconds

  • Question 95 - The nasolacrimal duct is a membranous canal. It extends from the lower part...

    Incorrect

    • The nasolacrimal duct is a membranous canal. It extends from the lower part of the lacrimal sac and drains into which structure?

      Your Answer: Middle meatus

      Correct Answer: Inferior meatus

      Explanation:

      The nasolacrimal duct carries tears from the lacrimal sac of the eye into the nasal cavity. The duct begins in the eye socket between the maxillary and lacrimal bones, from where it passes downwards and backwards. The opening of the nasolacrimal duct into the inferior nasal meatus of the nasal cavity is partially covered by a mucosal fold (valve of Hasner or plica lacrimalis). Excess tears flow through the nasolacrimal duct which drains into the inferior nasal meatus.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      13.7
      Seconds

  • Question 96 - Bile salt reuptake principally occurs where? ...

    Correct

    • Bile salt reuptake principally occurs where?

      Your Answer: In the ileum

      Explanation:

      90 – 95% of the bile salts are absorbed from the small intestine (mostly terminal ileum and then excreted again from the liver. This is known as the enterohepatic circulation. The entire pool recycles twice per meal and approximately 6 to 8 times per day.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      9.6
      Seconds

  • Question 97 - 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
      34.4
      Seconds

  • Question 98 - 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
      39.5
      Seconds

  • Question 99 - The primary area involved in the pathology of Parkinson's disease is: ...

    Correct

    • The primary area involved in the pathology of Parkinson's disease is:

      Your Answer: Substantia nigra

      Explanation:

      Parkinson’s disease is a degenerative, movement disorder of the central nervous system, and is typically characterized by muscle rigidity, tremor and bradykinesia (in extreme cases, akinesia). Secondary symptoms include high-level cognitive dysfunction and subtle language problems.

      Parkinson’s disease is also called ‘primary Parkinsonism’ or ‘idiopathic Parkinson’s disease and is the most common cause of Parkinsonism, a group of similar symptoms. The disorder is caused due to loss of pigmented dopaminergic cells in the pars compacta region of the substantia nigra.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      4.4
      Seconds

  • Question 100 - Severe abdominal pain radiating to the back, along with increased serum amylase levels,...

    Correct

    • Severe abdominal pain radiating to the back, along with increased serum amylase levels, is seen in which of the following conditions?

      Your Answer: Pancreatitis

      Explanation:

      The primary test for diagnosis and monitoring of pancreatitis is amylase. Increased plasma levels of amylase can be found in: salivary trauma (including anaesthetic intubation), mumps, pancreatitis and renal failure. However, a rise in the total amylase levels over 10 times the upper limit of normal (ULN) is suggestive of pancreatitis; 5–10 times the ULN may indicate ileus or duodenal disease or renal failure. Lower levels are commonly found in salivary gland disease.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      7.4
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

General (4/4) 100%
Physiology (21/25) 84%
Anatomy (22/41) 54%
Thorax (6/6) 100%
Cardiovascular (3/4) 75%
Renal (4/8) 50%
Pathology (21/34) 62%
Urology (1/1) 100%
Upper Limb (4/7) 57%
Head & Neck (7/16) 44%
Neurology (6/7) 86%
Neoplasia (5/6) 83%
Lower Limb (2/4) 50%
Orthopaedics (0/1) 0%
Abdomen (2/3) 67%
Inflammation & Immunology (3/4) 75%
Women's Health (1/2) 50%
Cell Injury & Wound Healing; Haematology (1/1) 100%
Cell Injury & Wound Healing (0/1) 0%
Gastrointestinal; Hepatobiliary (2/3) 67%
Cell Injury & Wound Healing; Female Health (1/1) 100%
Fluids & Electrolytes (2/2) 100%
Pelvis (1/1) 100%
Haematology (1/3) 33%
Endocrine (1/2) 50%
Respiratory (0/2) 0%
Embryology (0/3) 0%
Microbiology (2/2) 100%
Inflammation & Immunology; Renal (0/1) 0%
Gastroenterology (4/4) 100%
Pharmacology (1/1) 100%
Passmed
Retry this test Dashboard