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Question 1
Correct
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Which of the following structures is not easily palpable?
Your Answer: Styloid process of the temporal bone
Explanation:The styloid process is a thin, pointed process that projects antero-inferiorly from the base of the petrous temporal bone. It can vary in length from a short, stubby process to a slender, four to five centimetre rod. It forms from the cranial elements of the second pharyngeal arch. The tympanic plate of the temporal bone ensheathes the base of this process. The pointed, projecting portion of the process provides attachment to the stylohyoid and stylomandibular ligaments, and to three muscles – the styloglossus, stylohyoid, and stylopharyngeus. As the styloid process is covered by the various muscles, it is not easily palpable in live subjects.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 2
Correct
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A 38 year old man is to undergo excision of the base of the prostate for malignant growth, which of the following structures is directly related to the base of the prostate?
Your Answer: Urinary bladder
Explanation:The prostate is situated in the pelvic cavity and is also located immediately below the internal urethral orifice at the commencement of the urethra. It is held in position by the puboprostatic ligaments, the superior fascia of the urogenital diaphragm and the anterior portions of the levatores ani. The base of the prostate is directed upward and is attached to the inferior surface of the urinary bladder while the apex is directed downward and is in contact with the superior fascia of the urogenital diaphragm.
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This question is part of the following fields:
- Anatomy
- Pelvis
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Question 3
Incorrect
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An excision of a mass in the right parietal area of the head will be performed. In which layer of the scalp are the nerves and blood vessels located?
Your Answer: Aponeurosis
Correct Answer: Connective tissue
Explanation:The scalp is the anatomical area bordered by the face at the front, and by the neck at the sides and back. The scalp is usually described as having five layers:
1. The skin which contains numerous sebaceous glands and hair follicles.
2. The connective tissue, a dense subcutaneous layer of fat and fibrous tissue that lies beneath the skin, containing the nerves and vessels of the scalp.
3. The aponeurosis or galea aponeurotica, a tough layer of dense fibrous tissue which runs from the frontalis muscle anteriorly to the occipitalis posteriorly.
4. The loose areolar connective tissue layer provides an easy plane of separation between the upper three layers and the pericranium.
5. The pericranium is the periosteum of the skull bones and provides nutrition to the bone and the capacity for repair.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 4
Correct
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Blood supply to the posterior compartment of the thigh is supplied by which artery?
Your Answer: Perforating
Explanation:There are usually 3 perforating arteries:
The first gives branches to the adductor brevis and magnus, biceps femoris and gluteus maximus and anastomoses with the inferior gluteal, medial and lateral femoral circumflex.
The second artery supplies the posterior femoral muscles and anastomose with the first and third perforating vessels.
The third supplies the posterior femoral muscles.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 5
Incorrect
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A woman that presented with dyspnoea, chest pain and cough was found to have a serous pleural effusion. This finding is most likely to be associated with which of the following conditions?
Your Answer: Tuberculosis
Correct Answer: Congestive heart failure
Explanation:A pleural effusion is defined as an abnormal collection of fluid in the pleural space. Pleural effusion can result from excess fluid production or decreased absorption or both. Thoracentesis and laboratory testing help determine the origin of the accumulated fluid. Serous fluid accumulation in the pleural space indicates the presence of a hydrothorax and is most likely to develop secondary to congestive heart failure.
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This question is part of the following fields:
- Pathology
- Respiratory
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Question 6
Incorrect
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An operation to resect a tumour of the right lung was stopped as the chest surgeon said that the tumour was crossing the oblique fissure. Which structures are separated by the oblique fissure of the right lung?
Your Answer: Lower lobe from middle lobe only
Correct Answer: Lower lobe from both upper and middle lobes
Explanation:The oblique fissure on the right lung separates the lower lobe from both the middle and upper lobe. The lingual is only found on the left lung and is part of the upper lobe.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 7
Incorrect
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A lesion involving the suprachiasmatic nucleus of hypothalamus is likely to affect:
Your Answer: Temperature regulation
Correct Answer: Regulation of circadian rhythm
Explanation:The suprachiasmatic nucleus (SCN) in the hypothalamus is responsible for controlling endogenous circadian rhythms and destruction of the SCN leads to a loss of circadian rhythm.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 8
Incorrect
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A patient is diagnosed with Brucellosis. What is the mode of transmission of this disease?
Your Answer: Cats
Correct 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.
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This question is part of the following fields:
- Microbiology
- Pathology
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Question 9
Incorrect
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A lad involved in a road traffic accident is rushed to casualty where physical examination reveals that he has limited extension of his right humerus. Which of the following nerves is most likely to have been injured?
Your Answer: Medial pectoral nerve
Correct Answer: Thoracodorsal nerve
Explanation:Extension of the humerus is a function of the latissimus dorsi. This muscle is supplied by the thoracodorsal nerve which is a branch of the posterior cord of the plexus whose fibres are derived from cranial nerves V, VI and VII.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 10
Incorrect
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Which of the following causes the maximum increase in the secretion of antidiuretic hormone (ADH)?
Your Answer: Decreased plasma osmolarity
Correct Answer: Increased plasma osmolarity
Explanation:The most potent stimulus for ADH release is increased plasma osmolarity. Decreased plasma volume is a less potent stimulus in comparison. However, decrease blood volume and arterial pressure due to severe haemorrhage does lead to ADH secretion. Hypothalamic releasing factors do not control the release of posterior pituitary hormones ADH and oxytocin.
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This question is part of the following fields:
- Endocrinology
- Physiology
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Question 11
Incorrect
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The inferior palpebral nerve ascends behind the orbicularis oculi. What is the terminal branch of the inferior palpebral nerve?
Your Answer: Lacrimal nerve
Correct Answer: Infraorbital nerve
Explanation:The inferior palpebral nerve is a branch of the maxillary nerve. It supplies the skin and conjunctiva of the lower eyelid.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 12
Incorrect
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A 29-year-old pregnant woman suffering from hyperemesis gravidarum is prescribed metoclopramide. What is the mechanism of action of metoclopramide?
Your Answer: Irreversibly inhibits H+/K+-ATPase
Correct Answer: Dopamine antagonist
Explanation:Metoclopramide is a potent dopamine-receptor antagonist with anti-emetic and prokinetic properties. It is therefore commonly used to treat nausea and vomiting, and to facilitate gastric emptying in patients with gastric stasis. The anti-emetic action of metoclopramide is due to its antagonist activity at D2 receptors in the chemoreceptor trigger zone (CTZ) in the central nervous system. Common adverse drug reactions associated with metoclopramide include restlessness (akathisia), and focal dystonia.
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This question is part of the following fields:
- Pathology
- Pharmacology
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Question 13
Incorrect
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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: Thyroarytenoid
Correct 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.
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This question is part of the following fields:
- Anatomy
- Head & Neck
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Question 14
Incorrect
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A child defecates a few minutes after being fed by the mother. This is most likely due to:
Your Answer: Vasovagal reflex
Correct Answer: Gastrocolic reflex
Explanation:The gastrocolic reflex is a physiological reflex that involves increase in colonic motility in response to stretch in the stomach and by-products of digestion in the small intestine. It is shown to be uneven in its distribution throughout the colon, with the sigmoid colon affected more than the right side of the colon in terms of a phasic response. Various neuropeptides have been proposed as mediators of this reflex, such as serotonin, neurotensin, cholecystokinin and gastrin.
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This question is part of the following fields:
- Gastroenterology
- Physiology
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Question 15
Correct
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Vincristine is a chemotherapy agent used to treat a number of types of cancer. Which of the following is a recognised major side-effect of vincristine?
Your Answer: Peripheral neuropathy
Explanation:Vincristine is an alkaloid chemotherapeutic agent. It is used to treat a number of types of cancer including acute lymphocytic leukaemia, acute myeloid leukaemia, Hodgkin’s disease, neuroblastoma, and small cell lung cancer among others. The main side-effects of vincristine are peripheral neuropathy and constipation.
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This question is part of the following fields:
- Pathology
- Pharmacology
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Question 16
Incorrect
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A 30 year old female presented in the emergency with an irregular pulse. Her ECG showed absent P-waves with irregular RR interval. What is the most likely diagnosis?
Your Answer: Atrial tachycardia
Correct Answer: Atrial fibrillation
Explanation:Atrial fibrillation is one of the most common cardiac arrhythmias. It is often asymptomatic but may present with symptoms of palpitations, fainting, chest pain and heart failure. Characteristic findings are: absence of P-waves, unorganised electrical activity in their place, irregularity of RR interval due to irregular conduction of impulses to the ventricles and if paroxysmal AF is suspected, episodes may be documented with the use of Holter monitoring
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 17
Incorrect
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13 year old girl developed sun burnt cheeks after spending the day playing on the beach. What is the underlying mechanism to her injury?
Your Answer: Damage to DNA
Correct Answer: Free radical injury
Explanation:Free radicals are a by-product of chemical reactions with an unpaired electron in their outer most shell. They are capable of causing wide spread damage to cells. They can cause autolytic reactions thereby converting the reactants into free radicals. By absorbing sun light, the energy is used to hydrolyse water into hydroxyl (OH) and hydrogen (H) free radicals which can cause injury by lipid peroxidation of membranes, oxidative modification of proteins and damage to the DNA structure.
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This question is part of the following fields:
- Cell Injury & Wound Healing; Dermatology
- Pathology
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Question 18
Correct
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Causes of metabolic acidosis with a normal anion gap include:
Your Answer: Diarrhoea
Explanation:Excess acid intake and excess bicarbonate loss as in diarrhoea, are causes of metabolic acidosis with a normal anion gap. The other conditions all result in an increased anion gap.
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This question is part of the following fields:
- Fluids & Electrolytes
- Physiology
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Question 19
Correct
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The bronchial circulation is a part of the circulatory system that supplies nutrients and oxygen to the pulmonary parenchyma. What percentage of cardiac output is received by bronchial circulation?
Your Answer: 2%
Explanation:The bronchial circulation is part of the systemic circulation and receives about 2% of the cardiac output from the left heart. Bronchial arteries arise from branches of the aorta, intercostal, subclavian or internal mammary arteries. The bronchial arteries supply the tracheobronchial tree with both nutrients and O2. It is complementary to the pulmonary circulation that brings deoxygenated blood to the lungs and carries oxygenated blood away from them in order to oxygenate the rest of the body.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 20
Correct
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A 20 year old is brought to the A&E after he fell from a moving cart. The boy has sustained blunt abdominal injury, and the there is a possibility of internal bleeding as the boy is in shock. An urgent exploratory laparotomy is done in the A&E theatre. On opening the peritoneal cavity, the operating surgeon notices a torn gastrosplenic ligament with a large clot around the spleen. Which artery is most likely to have been injured in this case?
Your Answer: Short gastric
Explanation:The short gastric arteries branch from the splenic artery near the splenic hilum to travel back in the gastrosplenic ligament to supply the fundus of the stomach. Therefore, these may be injured in this case.
The splenic artery courses deep to the stomach to reach the hilum of the spleen. It doesn’t travel in the gastrosplenic ligament although it does give off branches that do.
The middle colic artery is a branch of the superior mesenteric artery that supplies the transverse colon.
Gastroepiploic artery is the largest branch of the splenic artery that courses between the layers of the greater omentum to anastomose with the right gastroepiploic.
Left gastric artery, a branch of the coeliac trunk. It supplies the left half of the lesser curvature.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 21
Incorrect
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A machine worker fractured the medial epicondyle of his right humerus resulting in damage to an artery running with the ulnar nerve posterior to the medial epicondyle. The artery injured is the?
Your Answer: Interosseous recurrent
Correct Answer: Superior ulnar collateral
Explanation:The superior ulnar collateral artery runs posterior to the medial epicondyle of the humerus, accompanied by the ulnar nerve. This artery arises from the brachial artery near the middle of the arm and ends under the flexor carpi ulnaris muscle by anastomosing with two arteries: the posterior ulnar recurrent and inferior ulnar collateral.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 22
Incorrect
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During pregnancy the uterus enlarges however after delivery it regresses to its original size. Which of the following organelles is responsible for this regression?
Your Answer: Golgi apparatus
Correct Answer: Lysosomes
Explanation:Lysosomes are formed by budding of the Golgi apparatus and contain enzymes which digest macromolecules. They are found in both plants and animals and are active in autophagic cell death, digestion after phagocytosis and for the cells own recycling process. They fuse with the molecules and release their content resulting in digestion.
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This question is part of the following fields:
- General
- Physiology
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Question 23
Incorrect
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Which of the following cytokines produced by the T cell induce MHC-II proteins?
Your Answer: Tumour necrosis factor
Correct Answer: γ-Interferon
Explanation:Interferons elicit a non-specific antiviral activity by inducing specific RNA synthesis and expression of proteins in neighbouring cells. Common interferon inducers are viruses, double-stranded RNA and micro-organisms. INF-γ is produced mainly by CD4+, CD8+ T cells and less commonly by B cells and natural killer cells. INF-γ has antiviral and antiparasitic activity but its main biological activity appears to be immunomodulatory. Among its many functions are activation of macrophages and enhanced expression of MHC-II proteins or macrophages.
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This question is part of the following fields:
- General
- Physiology
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Question 24
Incorrect
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A man in his sixties underwent surgery to remove a lump from his axilla. During removal, a nerve originating from the lateral cord of the brachial plexus was damaged. Which nerve is this referring to?
Your Answer: Suprascapular
Correct Answer: Lateral pectoral
Explanation:The only branch of the lateral cord of brachial plexus in the options given, is the lateral pectoral nerve. It supplies the pectoralis major muscle and sends a branch to join the medial pectoral nerve forming a loop in front of the first part of the axillary artery.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 25
Incorrect
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The rotator cuff surrounds the shoulder joint and consists of the supraspinatus, infraspinatus, subscapularis and which one other muscle?
Your Answer: Deltoid
Correct Answer: Teres minor
Explanation:The correct answer is the teres minor muscle. These group of muscles play an important role in protecting the shoulder joint and keeping the head of the humerus in the glenoid fossa of the scapula. This fossa is somehow shallow and needs support to allow for the full mobility that the shoulder joint has.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 26
Incorrect
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Which muscle is most likely to be affected following an injury to the thoracodorsal nerve (C6-C8)?
Your Answer: Serratus posterior inferior
Correct Answer: Latissimus dorsi
Explanation:Latissimus dorsi is a triangular, flat muscle that covers the lumbar region and the lower half of the thoracic region. It is supplied by the sixth, seventh and eighth cervical nerves through the thoracodorsal (long subscapular) nerve.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 27
Incorrect
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A 34-year-old woman with severe burns, presented to casualty with a blood pressure of 75/40 mmHg and pulse of 172/minute. Obviously the patient is in shock. Which type of shock is it more likely to be?
Your Answer: Septic shock
Correct Answer: Hypovolaemic shock
Explanation:Shock is a life-threatening condition that occurs when the organs and tissues of the body are not receiving a sufficient flow of blood. Lack of blood flow, oxygen and nutrients results in the inability to function properly and damage to many organs. Shock requires immediate treatment because, if left untreated the impaired tissue perfusion and cellular hypoxia can cause irreversible tissue injury, collapse, coma or even death. There are various types of physiological shock, including: cardiogenic (due to heart damage), hypovolaemic (due to low total volume of blood or plasma), neurogenic (due to nervous system damage), septic (due to infections) and anaphylactic shock (due to allergic reactions). Hypovolaemic shock can be caused by blood loss due to trauma, internal bleeding or other fluid loss due to severe burns, prolonged diarrhoea, vomiting and sweating.
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This question is part of the following fields:
- Cardiovascular
- Pathology
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Question 28
Incorrect
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Normally, the O2 transfer in the lungs from alveolar to capillary is perfusion-limited. In which of the following situations does it become a diffusion-limited process?
Your Answer: Increased ventilatory rate
Correct Answer: Pulmonary oedema
Explanation:Normally, the transfer of oxygen from air spaces to blood takes place across the alveolar-capillary membrane by simple diffusion and depends entirely on the amount of blood flow (perfusion-limited process). Diseases that affect this diffusion will transform the normal process to a diffusion limited process. Thus, the diseases which cause a thickened barrier (such as pulmonary oedema due to increased extravascular lung water or asbestosis) will limit the diffusion of oxygen. Chronic obstructive lung diseases will have little effect on diffusion. Inhaling hyperbaric gas mixtures might overcome the diffusion limitation in patients with mild asbestosis or interstitial oedema, by increasing the driving force. Strenuous (not mild) exercise might also favour diffusion limitation and decrease passage time. Increasing the rate of ventilation will not have this affect but will only maintain a high oxygen gradient from air to blood.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 29
Incorrect
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In a splenectomy procedure, special care is emphasized on the preservation of the tail of the pancreas that is closely associated with the spleen to avoid post operative pancreatic fistula. As a general surgeon conducting a splenectomy where are you most likely to find the tail of the pancreas in the abdominal cavity?
Your Answer: Falciform ligament
Correct Answer: Splenorenal ligament
Explanation:The tail of the pancreas is the only intraperitoneal part of the pancreas and is found contained in the splenorenal ligament of the peritoneal cavity. The splenorenal ligament is derived from the peritoneum where the wall of the general peritoneal cavity connects to the omental bursa between the spleen and the left kidney. This ligament contains the splenic vessels and the tail of the pancreas.
The gastrocolic ligament stretches from the greater curvature of the stomach to the transverse colon, connecting the two.
The gastrosplenic ligament is derived from the greater omentum and is the structure that connects the stomach to the hilum of the spleen. The gastrosplenic ligament continues from the splenic flexure of the colon to the diaphragm and acts as a support to the spleen.
The transverse colon is connected to the abdominal wall by the mesocolon ligament.
The falciform ligament on the other hand, attaches the liver to the ventral wall of the abdomen.
The hepatoduodenal ligament connects the porta hepatis of the liver to the superior part of the duodenum.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 30
Incorrect
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Urine specific gravity allows the assessment of which of the following renal functions?
Your Answer:
Correct Answer: Concentration
Explanation:Concentrating ability of kidneys is assessed by measuring the urine specific gravity. Normal values of urine specific gravity fall between 1.002 and 1.030 g/ml.
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This question is part of the following fields:
- Pathology
- Renal
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SESSION STATS - PERFORMANCE PER SPECIALTY
