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  • Question 1 - Intracellular shifting of hydrogen ions can generate a metabolic alkalosis. In which of...

    Incorrect

    • Intracellular shifting of hydrogen ions can generate a metabolic alkalosis. In which of the following conditions is metabolic alkalosis caused by this mechanism ?

      Your Answer: Vomiting

      Correct Answer: Hypokalaemia

      Explanation:

      Metabolic alkalosis is characterized by a primary increase in the concentration of serum bicarbonate ions. This may occur as a consequence of a loss of hydrogen ions or a gain in bicarbonate. Hydrogen ions may be lost through the kidneys or the GI tract, as for example during vomiting, nasogastric suction or use of diuretics. Intracellular shifting of hydrogen ions develops mainly during hypokalaemia to maintain neutrality. Gain in bicarbonate ions may develop during administration of sodium bicarbonate in high amounts or in amounts that exceed the capacity of excretion of the kidneys, as seen in renal failure. Fluid losses may be another cause of metabolic alkalosis, causing the reduction of extracellular fluid volume.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      23.7
      Seconds
  • Question 2 - A 40-year old Caucasian male came to the hospital with complaints of fatigue...

    Incorrect

    • A 40-year old Caucasian male came to the hospital with complaints of fatigue and lethargy. On examination, he was found to have raised blood pressure. Urine examination showed >300 mg/dl proteinuria (4+) and 24-hour urine protein 3.5g. No glucose, blood, nitrites, urobilinogen or casts were present in urine. What is the most likely diagnosis?

      Your Answer: Minimal-change disease

      Correct Answer: Membranous glomerulonephritis

      Explanation:

      Membranous glomerulonephritis or nephropathy, is a renal disorder with insidious course and usually affects people aged 30-50 years. 85% cases are primary (or idiopathic). The other 15% are secondary to autoimmune conditions like SLE, infections like malaria or hepatitis B, drugs like captopril and NSAIDs, or malignancies (particularly lung or colonic carcinoma). This disease is caused due to circulating immune complexes which are said to form by binding of antibodies to antigens in glomerular basement membrane. This antigens could be endogenous or derived from systemic circulation. This immune complex triggers the complement system, resulting in formation of membrane attack complex (MAC) on glomerular epithelial cells. This further results in release of proteases and oxidants which damage the capillaries making them ‘leaky’. Moreover, the epithelial cells also secrete a mediator to reduce nephron synthesis and distribution.

    • This question is part of the following fields:

      • Pathology
      • Renal
      47.1
      Seconds
  • Question 3 - A 68-year-old woman complains of headaches, dizziness, and memory loss. About a month...

    Correct

    • A 68-year-old woman complains of headaches, dizziness, and memory loss. About a month ago, she fell from a staircase but only suffered mild head trauma. What is the most likely diagnosis in this case?

      Your Answer: Chronic subdural haematoma

      Explanation:

      A quarter to a half of patients with chronic subdural haematoma have no identifiable history of head trauma. If a patient does have a history of head trauma, it usually is mild. The average time between head trauma and chronic subdural haematoma diagnosis is 4–5 weeks. Symptoms include decreased level of consciousness, balance problems, cognitive dysfunction and memory loss, motor deficit (e.g. hemiparesis), headache or aphasia. Some patients present acutely. They usually result from tears in bridging veins which cross the subdural space, and may cause an increase in intracranial pressure (ICP).

    • This question is part of the following fields:

      • Neurology
      • Pathology
      545.4
      Seconds
  • Question 4 - Hormones of the anterior pituitary include which of the following? ...

    Incorrect

    • Hormones of the anterior pituitary include which of the following?

      Your Answer: Antidiuretic hormone (ADH)

      Correct Answer: Prolactin

      Explanation:

      The anterior pituitary gland (adenohypophysis or pars distalis) synthesizes and secretes:

      1. FSH (follicle-stimulating hormone)

      2. LH (luteinizing hormone)

      3. Growth hormone

      4. Prolactin

      5. ACTH (adrenocorticotropic hormone)

      6. TSH (thyroid-stimulating hormone).

      The posterior pituitary gland (neurohypophysis) stores and secretes 2 hormones produced by the hypothalamus:

      1. ADH (antidiuretic hormone or vasopressin)

      2. Oxytocin

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      650076
      Seconds
  • Question 5 - What is the normal amount of oxygen that is carried in the blood?...

    Incorrect

    • What is the normal amount of oxygen that is carried in the blood?

      Your Answer: 5 ml oxygen/100 ml blood

      Correct Answer: 20 ml oxygen/100 ml blood

      Explanation:

      Normally, 100 ml of blood contains 15g haemoglobin and a single gram of haemoglobin can bind to 1.34 ml oxygen when 100% saturated. Thus, 15 × 1.34 = 20 ml O2/100 ml blood. The haemoglobin in venous blood that is leaving the tissues is about 75% saturated with oxygen, and hence it carries about 15 ml O2/100 ml venous blood. This implies that for each 10 ml of blood, 5 ml oxygen is transported to the tissues. With a p(O2) > 100 mm Hg, only 3 ml of oxygen is dissolved in every one litre of plasma. By increasing the pA(O2) by breathing 100% oxygen, one can add an extra amount of oxygen in the plasma, but the amount of oxygen carried by haemoglobin will not increase significantly as it is already > 95% saturated.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      15.3
      Seconds
  • Question 6 - A 56-year-old man undergoes tests to determine his renal function. His results over...

    Incorrect

    • A 56-year-old man undergoes tests to determine his renal function. His results over a period of 24 hours were:

      Urine flow rate: 2. 0 ml/min

      Urine inulin: 1.0 mg/ml

      Plasma inulin: 0.01 mg/ml

      Urine urea: 260 mmol/l

      Plasma urea: 7 mmol/l

      What is the glomerular filtration rate?

      Your Answer:

      Correct Answer: 200 ml/min

      Explanation:

      Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal (kidney) glomerular capillaries into the Bowman’s capsule per unit time. GFR is equal to the inulin clearance because inulin is freely filtered into Bowman’s capsule but is not reabsorbed or secreted. 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. Thus, glomerular filtration rate = (1.0 × 2. 0)/0.01 = 200 ml/min.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 7 - A 45-year old farmer was referred to the surgical clinic with complaints of...

    Incorrect

    • A 45-year old farmer was referred to the surgical clinic with complaints of pain in his right hypochondrium. Investigations confirmed the diagnosis of hepatocellular carcinoma with malignant ascites. According to you, what is the most likely cause of HCC in this patient?

      Your Answer:

      Correct Answer: Aflatoxin

      Explanation:

      Aflatoxins are naturally occurring toxins produced by the Aspergillus fungus (most often, A. flavus and A. parasiticus). These organisms are common and their native habitat is soil, decaying vegetation and grains. They can contaminate the grain before harvest or after storage, more likely in high-humidity (at least 7%) or high temperature environment of after stressful conditions like drought. Aflatoxins are mycotoxins and also carcinogenic. They get metabolized in the liver to an epoxide, aflatoxin M1. High exposure can lead to acute necrosis, cirrhosis or liver carcinoma. These substances can cause haemorrhage, acute liver damage, oedema, and alteration in digestion, absorption and/or metabolism of nutrients. Although humans are susceptible to these toxins like all other animals, they have a high tolerance level and hence, rarely develop acute aflatoxicosis. However, children are particularly susceptible to exposure leading to growth impairment and delayed development. Chronic exposure carries a high risk of hepatic cancer, due to intercalation of its metabolite aflatoxin M1 into the DNA and alkylation of the bases because of its epoxide moiety.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      0
      Seconds
  • Question 8 - A 50-year-old woman goes to the doctor complaining of myalgia, muscle cramps, and...

    Incorrect

    • A 50-year-old woman goes to the doctor complaining of myalgia, muscle cramps, and weakness; she is diagnosed with severe hypokalaemia. Which of the following is the most common cause of hypokalaemia?

      Your Answer:

      Correct Answer: Prolonged vomiting

      Explanation:

      Potassium is one of the body’s major ions. Nearly 98% of the body’s potassium is intracellular. The ratio of intracellular to extracellular potassium is important in determining the cellular membrane potential. Small changes in the extracellular potassium level can have profound effects on the function of the cardiovascular and neuromuscular systems. Hypokalaemia may result from conditions as varied as renal or gastrointestinal (GI) losses, inadequate diet, transcellular shift (movement of potassium from serum into cells) and medications. The important causes of hypokalaemia are:

      Renal losses: renal tubular acidosis, hyperaldosteronism, magnesium depletion, leukaemia (mechanism uncertain).

      GI losses: vomiting or nasogastric suctioning, diarrhoea, enemas or laxative use, ileal loop.

      Medication effects: diuretics (most common cause), β-adrenergic agonists, steroids, theophylline, aminoglycosides.

      Transcellular shift: insulin, alkalosis.

      Severe hypokalaemia, with serum potassium concentrations of 2.5–3 meq/l, may cause muscle weakness, myalgia, tremor, muscle cramps and constipation.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 9 - Calculate the total peripheral resistance for a patient with a blood pressure of...

    Incorrect

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

      Your Answer:

      Correct Answer: 18 mmHg × min/l

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 10 - A 50-year old gentleman who was admitted for elective surgery was found to...

    Incorrect

    • A 50-year old gentleman who was admitted for elective surgery was found to have haemoglobin 9.5 g/dl, white blood cell count of 1.4 × 109/l and a mean corpuscular volume (MCV) of 134 fl. Which of the following is the likely finding on his peripheral blood smear?

      Your Answer:

      Correct Answer: Hypersegmented neutrophils

      Explanation:

      The likely diagnosis is megaloblastic anaemia, which also shows the presence of hypersegmented neutrophils.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 11 - The passage of leukocytes through the wall of the blood vessels is best...

    Incorrect

    • The passage of leukocytes through the wall of the blood vessels is best described by which of the following terms?

      Your Answer:

      Correct Answer: Diapedesis

      Explanation:

      The steps involved in leukocyte arrival and function are:

      1. margination: cells migrate 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, interaction of these results in adhesion

      4. diapedesis and chemotaxis: diapedesis is the transmigration of the leukocyte across the endothelium of the capillary and towards a chemotactic product

      5. phagocytosis: engulfing the offending substance/cell.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      0
      Seconds
  • Question 12 - Which of the following is found to be elevated in a case of...

    Incorrect

    • Which of the following is found to be elevated in a case of hepatocellular carcinoma?

      Your Answer:

      Correct Answer: AFP

      Explanation:

      Alpha-fetoprotein (AFP) is a glycoprotein that is normally produced by the yolk sac of the embryo, and then the fetal liver. It is elevated in the new-born and thus, also in the pregnant women. Eventually, it decreases in the first year of life to reach the adult normal value of < 20 ng/ml by 1 year of age. Markedly elevated levels (>500 ng/ml) in a high-risk patient is considered diagnostic for primary hepatocellular carcinoma (HCC). Moreover, due to smaller tumours secreting less quantities of AFP, rising levels can be a better indication. However, not all hepatocellular carcinomas produce AFP. Also, the level of AFP is not a prognostic factor. Populations where hepatitis B and HCC are common (e.g.: sub-Saharan Africans, ethnic Chinese) can see AFP levels as high as 100,000 ng/ml, whereas levels are low (about 3000 ng/ml) in regions with lesser incidences of HCC.

      AFP can also be elevated up to 500 ng/ml in conditions like embryonic teratocarcinomas, hepatoblastomas, fulminant hepatitis, hepatic metastases from gastrointestinal tract cancers, some cholangiocarcinomas). Lesser values are seen in acute and chronic hepatitis.

      Overall, the sensitivity of AFP value ≥20 ng/ml is 39-64% and the specificity is 76%–91%. Value of 500 ng/ml is considered as the diagnostic cut-off level for HCC.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      0
      Seconds
  • Question 13 - Evaluation of a 60-year old gentleman, who has been a coal miner all...

    Incorrect

    • Evaluation of a 60-year old gentleman, who has been a coal miner all his life and is suspected to have pulmonary fibrosis reveals the following: normal FEV1, arterial oxygen saturation 92%, alveolar ventilation 6000 ml/min at a tidal volume of 600 ml and a breathing rate of 12 breaths/min. There are also pathological changes in lung compliance and residual volume. Which of the following is most accurate about his residual volume?

      Your Answer:

      Correct Answer: Cannot be measured directly with a spirometer

      Explanation:

      Residual volume is the air left in the lungs after maximal expiration is done. Thus, this is not a part of vital capacity and cannot be measured with a spirometer directly. It can be measured by the methods such as body plethysmography or inert gas dilution. Expiratory reserve volume is vital capacity minus inspiratory capacity. Resting volume of lungs is he sum of residual volume and expiratory reserve volume. Lungs recoil inward until the recoil pressure becomes zero, which corresponds to a volume significantly lower than residual volume.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 14 - Pseudomonas aeruginosa is a multidrug resistant pathogen that causes hospital-acquired infections. It is...

    Incorrect

    • Pseudomonas aeruginosa is a multidrug resistant pathogen that causes hospital-acquired infections. It is usually treated with piperacillin or another antibiotic. Which of the following is the other antibiotic?

      Your Answer:

      Correct Answer: Azlocillin

      Explanation:

      Azlocillin, like piperacillin, is an acylampicillin antibiotic with an extended spectrum of activity and greater in vitro potency than the carboxypenicillins. Azlocillin is similar to mezlocillin and piperacillin. It demonstrates antibacterial activity against a broad spectrum of bacteria, including Pseudomonas aeruginosa.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      0
      Seconds
  • Question 15 - A middle aged man presented in OPD with a low grade fever and...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds
  • Question 16 - 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:

      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
      0
      Seconds
  • Question 17 - A 55 year-old construction worker is diagnosed with malignant mesothelioma. Exposure to which...

    Incorrect

    • A 55 year-old construction worker is diagnosed with malignant mesothelioma. Exposure to which substance increased his risk in developing mesothelioma?

      Your Answer:

      Correct Answer: Asbestos

      Explanation:

      Mesothelioma is a rare, aggressive form of cancer that develops in the lining of the lungs, abdomen or heart. It is linked to inhalation of asbestos commonly used in ship building and the insulation industry. It has no known cure and has a very poor prognosis.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds
  • Question 18 - Diuretics that act on the ascending limb of the loop of Henle produce:...

    Incorrect

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

      Your Answer:

      Correct 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 Henlé – low permeability to ions and urea, while being highly permeable to water

      2. Thin ascending limb of loop of Henlé – not 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
      0
      Seconds
  • Question 19 - A 65 year old man with a history of diabetes and hypertension presented...

    Incorrect

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

      Your Answer:

      Correct Answer: Liquefactive necrosis

      Explanation:

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

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Neurology
      • Pathology
      0
      Seconds
  • Question 20 - A 24 year old mother is breastfeeding her first child. Which of the...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds
  • Question 21 - A patient in the intensive care unit developed hyperphosphatemia. The phosphate level is...

    Incorrect

    • A patient in the intensive care unit developed hyperphosphatemia. The phosphate level is 160 mmol/L. Which of the following is most likely responsible for this abnormality?

      Your Answer:

      Correct Answer: Renal insufficiency

      Explanation:

      Hyperphosphatemia is an electrolyte disturbance in which there is an abnormally elevated level of phosphate in the blood. It is caused by conditions that impair renal phosphate excretion (ex: renal insufficiency, hypoparathyroidism, parathyroid suppression) and conditions with massive extracellular fluid phosphate loads (ex: rapid administration of exogenous phosphate, extensive cellular injury or necrosis, transcellular phosphate shifts).

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      0
      Seconds
  • Question 22 - Perforin are present in the granules of which cell? ...

    Incorrect

    • Perforin are present in the granules of which cell?

      Your Answer:

      Correct Answer: Natural killer cell

      Explanation:

      Perforins are characteristically found In the granules of CD8+ T cells and natural killer cells. They are cytolytic proteins that insert into the target plasma membrane forming a hole and resulting in lysis. They along with granzyme B induce apoptosis in the target cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      0
      Seconds
  • Question 23 - Which of the following key features will be seen in an organ undergoing...

    Incorrect

    • Which of the following key features will be seen in an organ undergoing atrophy?

      Your Answer:

      Correct Answer: A greater number of autophagic vacuoles

      Explanation:

      Atrophy is characterised by the breakdown of intracellular components along with organelles and packing them into vacuoles known as autophagic vacuoles. This is an adaptive response that separates the damaged cellular structures from the rest of the cells.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      0
      Seconds
  • Question 24 - The blood investigations of a 30-year old man with jaundice revealed the following...

    Incorrect

    • The blood investigations of a 30-year old man with jaundice revealed the following : total bilirubin 6.5 mg/dl, direct bilirubin 1.1 mg/dl, indirect bilirubin 5.4 mg/dl and haemoglobin 7.3 mg/dl. What is the most likely diagnosis out of the following?

      Your Answer:

      Correct Answer: Haemolysis

      Explanation:

      Hyperbilirubinemia can be caused due to increased bilirubin production, decreased liver uptake or conjugation, or decreased biliary excretion. Normal bilirubin level is less than 1.2 mg/dl (<20 μmol/l), with most of it unconjugated. Elevated unconjugated bilirubin (indirect bilirubin fraction >85%) can occur due to haemolysis (increased bilirubin production) or defective liver uptake/conjugation (Gilbert syndrome). Such increases are less than five-fold usually (<6 mg/dl or <100 μmol/l) unless there is coexistent liver disease.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      0
      Seconds
  • Question 25 - A 7-year-old boy is diagnosed with metabolic acidosis as a result of severe...

    Incorrect

    • A 7-year-old boy is diagnosed with metabolic acidosis as a result of severe dehydration. Which of the following conditions is most likely to cause severe dehydration and metabolic acidosis?

      Your Answer:

      Correct Answer: Severe diarrhoea

      Explanation:

      Diarrhoea is defined as having three or more loose or liquid stools per day, or as having more stools than is normal for that person. Severe diarrhoea, causing fluid loss and loss of bicarbonate, will result in marked dehydration and metabolic acidosis.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 26 - The anatomical dead space in a patient with low oxygen saturation, is 125...

    Incorrect

    • The anatomical dead space in a patient with low oxygen saturation, is 125 ml, with a tidal volume of 500 ml and pa(CO2) of 40 mm Hg. The dead space was determined by Fowler's method. If we assume that the patient's lungs are healthy, what will his mixed expired CO2 tension [pE(CO2)] be?

      Your Answer:

      Correct Answer: 30 mmHg

      Explanation:

      According to Bohr’s equation, VD/VT = (pA(CO2) − pE(CO2))/pA(CO2), where pE(CO2) is mixed expired CO2 and pA(CO2) is alveolar CO2pressure. Normally, the pa(CO2) is virtually identical to pA(CO2). Thus, VD/VT = (pa(CO2)) − pE(CO2)/pa(CO2). By Fowler’s method, VD/VT= 0.25. In the given problem, (pa(CO2) − pE(CO2)/pa(CO2) = (40 − pE(CO2)/40 = 0.25. Thus, pE(CO2) = 30 mmHg. If there is a great perfusion/ventilation inequality, pE(CO2) could be significantly lower than 30 mm Hg, and the patient’s physiological dead space would exceed the anatomical dead space.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 27 - An electronic manufacturing engineer had abdominal distension and underwent a CT scan of...

    Incorrect

    • An electronic manufacturing engineer had abdominal distension and underwent a CT scan of the abdomen. Thereafter he was diagnosed with hepatic angiosarcoma. Exposure to what agent is responsible for the development of this neoplasm?

      Your Answer:

      Correct Answer: Arsenic

      Explanation:

      Hepatic angiosarcomas are associated with particular carcinogens which includes: arsenic , thorotrast, and polyvinyl chloride. With exposure to this three agents, there is a very long latent period of many years between exposure and the development of tumours.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      0
      Seconds
  • Question 28 - A 55-years-old man presented to the emergency department complaining of a squeezing sensation...

    Incorrect

    • A 55-years-old man presented to the emergency department complaining of a squeezing sensation in his chest that has spread to his neck with associated worsening shortness of breath. Which of these laboratory tests would you ask for in this patient:

      Your Answer:

      Correct Answer: Creatine kinase-MB

      Explanation:

      Creatine kinase-MB is a test that usually is ordered when the patient has chest pain as a cardiac marker. When a heart attack is suspected and a troponin test (which is more specific for heart damage), is not available CK-MB is ordered. There are 3 forms of CK: CK-MM, CK-BB and CK-MB. CK-MB is commonly found in heart tissue, therefore injured heart muscle cells release CK-MB into the blood. Elevated CK-MB levels indicate that it is probable that a person has recently had a heart attack.

    • This question is part of the following fields:

      • Cardiovascular
      • Pathology
      0
      Seconds
  • Question 29 - The likely cause of a tender and swollen breast in a lactating mother...

    Incorrect

    • The likely cause of a tender and swollen breast in a lactating mother is:

      Your Answer:

      Correct Answer: Acute mastitis

      Explanation:

      Acute mastitis results due to bacterial infection of the breast and results in signs of inflammation. It commonly occurs 2-3 weeks postpartum and common causative microorganisms are Staphylococcus aureus, Streptococcus species, and Escherichia coli. Complications like an abscess can be avoided by prompt treatment, which includes antibiotics and rest along with continued lactation.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      0
      Seconds
  • Question 30 - 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:

      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
      0
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SESSION STATS - PERFORMANCE PER SPECIALTY

Fluids & Electrolytes (0/1) 0%
Pathology (1/3) 33%
Renal (0/1) 0%
Neurology (1/1) 100%
Endocrine (0/1) 0%
Physiology (0/2) 0%
Respiratory (0/1) 0%
Passmed