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  • Question 1 - A 45-year-old-female is suspected to have a pulmonary mass. Supposing that she has...

    Incorrect

    • A 45-year-old-female is suspected to have a pulmonary mass. Supposing that she has a neoplasm, which of the following are most commonly found to involve the lung:

      Your Answer: Small-cell anaplastic carcinomas in smokers

      Correct Answer: Pulmonary metastases

      Explanation:

      Lung metastases occur when a cancer started in another part of the body (primary site) spreads to the lungs. The lungs are among the most common site where cancer can spread due to its rich systemic venous drainage, almost every type of cancer can spread to the lung. The most common types of cancer that spread to the lung are breast, colorectal, kidney, testicular, bladder, prostate, head and neck cancers.

    • This question is part of the following fields:

      • Pathology
      • Respiratory
      651
      Seconds

  • Question 2 - Which of the following conditions can present with multiple abscesses that may discharge...

    Incorrect

    • Which of the following conditions can present with multiple abscesses that may discharge sulphur granules?

      Your Answer: Histoplasmosis

      Correct Answer: Actinomycosis

      Explanation:

      Actinomycosis is primarily caused by any of the several members of the bacterial genus Actinomyces. These bacteria are generally anaerobes. And can cause multiple abscesses that may discharge sulphur granules.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      14.6
      Seconds

  • Question 3 - 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: Loop diuretic therapy

      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
      49.5
      Seconds

  • Question 4 - Which of the following morphological characteristic is a salient feature of a pure...

    Incorrect

    • Which of the following morphological characteristic is a salient feature of a pure apoptotic cell?

      Your Answer: Cellular swelling

      Correct Answer: Chromatin condensation

      Explanation:

      Apoptosis is the programmed death of cells which occurs as a normal and controlled part of an organism’s growth or development. The changes which occur in this process include blebbing, cell shrinkage, nuclear fragmentation, chromatin condensation, chromosomal DNA fragmentation, and global mRNA decay. The cell membrane however remains intact and the dead cells are phagocytosed prior to any content leakage and thus inflammatory response.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      13.6
      Seconds

  • Question 5 - The neurotransmitters adrenaline, noradrenaline and dopamine are derived from which amino acid? ...

    Correct

    • The neurotransmitters adrenaline, noradrenaline and dopamine are derived from which amino acid?

      Your Answer: Tyrosine

      Explanation:

      Tyrosine is the precursor to adrenaline, noradrenaline and dopamine. Tyrosine hydroxylase converts tyrosine to DOPA, which is in turn converted to dopamine, then to noradrenaline and finally adrenaline.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      4.9
      Seconds

  • Question 6 - 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
      8.1
      Seconds

  • Question 7 - 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: Ciprofloxacin

      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
      19.6
      Seconds

  • Question 8 - Which of the following conditions causes an elevation of the pH in the...

    Incorrect

    • Which of the following conditions causes an elevation of the pH in the tissues with elevated arterial CO2 content?

      Your Answer: Metabolic acidosis

      Correct Answer: Metabolic alkalosis

      Explanation:

      Metabolic alkalosis is a metabolic condition in which the pH of tissue is elevated beyond the normal range (7.35-7.45). This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate, or alternatively a direct result of increased bicarbonate concentrations. Normally, arterial pa(CO2) increases by 0.5–0.7 mmHg for every 1 mEq/l increase in plasma bicarbonate concentration, a compensatory response that is very quick. If the change in pa(CO2) is not within this range, then a mixed acid–base disturbance occurs.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      22.4
      Seconds

  • Question 9 - A 27 year old women works in a dry-cleaning shop. She was exposed...

    Incorrect

    • A 27 year old women works in a dry-cleaning shop. She was exposed to massive amounts of carbon tetrachloride on her skin as well as inhaled. Which of the following organs is most susceptible to damage?

      Your Answer: Stomach

      Correct Answer: Liver

      Explanation:

      Carbon tetrachloride (CCl4) is a common agent used in the dry cleaning industry and is thought to cause the formation of free radicals. It causes rapid breakdown of the endoplasmic reticulum due to decomposition of lipids and severe liver cell injury. Within less than 30 mins, hepatic protein synthesis declines, lipid export is reduced due to lack of apoprotein and there is an influx of calcium and cell death.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      13.1
      Seconds

  • Question 10 - A histology report of a cervical biopsy taken from a patient with tuberculosis...

    Incorrect

    • A histology report of a cervical biopsy taken from a patient with tuberculosis revealed the presence of epithelioid cells. What are these cells formed from?

      Your Answer: Epithelial cells

      Correct Answer: Macrophages

      Explanation:

      Granulomas formed in tuberculosis are called tubercles and are made up polynuclear phagocytes, Langhans cells and epithelioid cells. Macrophages when enlarged, consist of abundant cytoplasm and have a tendency of arranging themselves very closely to each other representing epithelial cells. These enlarged macrophages are therefore termed as epithelioid cells.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      11.5
      Seconds

  • Question 11 - A 70-year-old female who underwent coronary artery bypass graft developed post-operative acute renal...

    Correct

    • A 70-year-old female who underwent coronary artery bypass graft developed post-operative acute renal failure. Her urinary catheter was left in place to monitor urine output. 6 days later she developed fever and chills. She also complained of suprapubic and left flank pain. She is found to have developed acute ascending pyelonephritis. Which of the following organism was most likely isolated during urine culture?

      Your Answer: Escherichia coli with pili

      Explanation:

      The most common cause of urinary tract infection is Escherichia coli. Pilated strains of E. coli ascend the urethra to infect the kidney and the bladder. Catheters have been associated with an increased risk of UTIs.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      18.5
      Seconds

  • Question 12 - An ECG of a 30 year old woman revealed low voltage QRS complexes....

    Incorrect

    • An ECG of a 30 year old woman revealed low voltage QRS complexes. This patient is most probably suffering from?

      Your Answer: Ventricular tachycardia

      Correct Answer: Pericardial effusion

      Explanation:

      The QRS complex is associated with current that results in the contraction of both the ventricles. As ventricles have more muscle mass than the atria, they result in a greater deflection on the ECG. The normal duration of a QRS complex is 10s. A wide and deep Q wave depicts myocardial infarction. Abnormalities in the QRS complex maybe indicative of a bundle block, ventricular tachycardia or hypertrophy of the ventricles. Low voltage QRS complexes are characteristic of pericarditis or a pericardial effusion.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      25.8
      Seconds

  • Question 13 - A 5 year-old-child with fever complains of sore throat . She was brought...

    Incorrect

    • A 5 year-old-child with fever complains of sore throat . She was brought to her paediatrician for consult because she has also developed a rash and has swollen lymph nodes. Upon physical examination she cried when her liver was palpated and the tip of her spleen is slightly palpable. Full blood count shows haemoglobin 13 g/dL, Haematocrit 40%, white blood cell count 13x109/L with a WBC differential count of 45 neutrophils, 4 bands, 26 lymphocytes, 15 atypical lymphocytesm, 10 monocytes and 1 eosinophil. Whick is the most likely infectious agent that is responsible for the patient's condition?

      Your Answer: Rubella virus

      Correct Answer: Epstein–Barr virus

      Explanation:

      Epstein-Barr virus (EBV), also known as human herpes virus 4,is a member of the herpes virus family. EBV spreads most commonly through bodily fluids, primarily saliva. EBV can cause infectious mononucleosis. Symptoms of EBV can include fatigue, fever, inflamed throat, swollen lymph nodes in the neck, enlarged spleen, swollen liver and rash.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      43.7
      Seconds

  • Question 14 - A 68-year-old man underwent sigmoid resection with diverting colostomy for a ruptured sigmoid...

    Incorrect

    • A 68-year-old man underwent sigmoid resection with diverting colostomy for a ruptured sigmoid diverticulum 10 days ago. He received gentamicin and ampicillin post-op. 2 days after he was discharged from the hospital, he was readmitted because of high grade fever and chills. His blood culture grew Gram-negative bacilli. Which organism is most likely responsible for the patient's infection?

      Your Answer: Pseudomonas aeruginosa

      Correct Answer: Bacteroides fragilis

      Explanation:

      Bacteroides fragilis is an anaerobic, Gram-negative, rod-shaped bacterium. It is part of the normal flora of the human colon and is generally a commensal, but can cause infection if displaced into the bloodstream or surrounding tissue following surgery, disease, or trauma.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      23.9
      Seconds

  • Question 15 - Which tumour site is more commonly involved in adults than in children? ...

    Correct

    • Which tumour site is more commonly involved in adults than in children?

      Your Answer: Lung

      Explanation:

      In adults, the most common primary site of tumour is in the lungs, compared to children wherein the most common primary site is the blood.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      9
      Seconds

  • Question 16 - Which of the following is NOT a Gram-negative rod? ...

    Incorrect

    • Which of the following is NOT a Gram-negative rod?

      Your Answer: Escherichia coli

      Correct Answer: Clostridium tetani

      Explanation:

      Gram-positive rods include Clostridia, Listeria and diphtheroids.

      Gram-negative rods include Escherichia coli, Klebsiella, Yersinia, Haemohilus, Pseudomonas, Shigella, Legionella, proteus and Salmonella

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      4.5
      Seconds

  • Question 17 - The extent of cancer growth can be described through staging. What is taken...

    Correct

    • The extent of cancer growth can be described through staging. What is taken into consideration when staging a cancer?

      Your Answer: Local invasion

      Explanation:

      Cancer stage is based on four characteristics: the size of cancer, whether the cancer is invasive or non-invasive, whether the cancer has spread to the lymph nodes, and whether the cancer has spread to other parts of the body, in this case beyond the breast. Staging is important as it is often a good predictor of outcomes and treatment is adjusted accordingly.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      7
      Seconds

  • Question 18 - A 59-year old gentleman admitted for elective cholecystectomy was found to have a...

    Incorrect

    • A 59-year old gentleman admitted for elective cholecystectomy was found to have a haemoglobin 12.5 g/dl, haematocrit 37%, mean corpuscular volume 90 fl, platelet count 185 × 109/l, and white blood cell count 32 × 109/l; along with multiple, small mature lymphocytes on peripheral smear. The likely diagnosis is:

      Your Answer: Infectious mononucleosis

      Correct Answer: Chronic lymphocytic leukaemia

      Explanation:

      CLL or chronic lymphocytic leukaemia is the most common leukaemia seen in the Western world. Twice more common in men than women, the incidence of CLL increases with age. About 75% cases are seen in patients aged more than 60 years. The blood, marrow, spleen and lymph nodes all undergo infiltration, eventually leading to haematopoiesis (anaemia, neutropenia, thrombocytopenia), hepatomegaly, splenomegaly and decreased production of immunoglobulin. In 98% cases, CD+5 B cells undergo malignant transformation.

      Often diagnosed on blood tests while being evaluated for lymphadenopathy, CLL causes symptoms like fatigue, anorexia, weight loss, pallor, dyspnoea on exertion, abdominal fullness or distension. Findings include multiple lymphadenopathy with minimal-to- moderate hepatomegaly and splenomegaly. Increased susceptibility to infections is seen. Herpes Zoster is common. Diffuse or maculopapular skin infiltration can also be seen in T-cell CLL.

      Diagnosis is by examination of peripheral blood smear and marrow: hallmark being a sustained, absolute leucocytosis (>5 ×109/l) and increased lymphocytes in the marrow (>30%). Other findings can include hypogammaglobulinemia (<15% of cases) and, rarely, raised lactate dehydrogenase (LDH). Only 10% cases demonstrate moderate anaemia and/or thrombocytopenia.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      25.8
      Seconds

  • Question 19 - The ability of the bacteria to cause disease or its virulence is related...

    Correct

    • The ability of the bacteria to cause disease or its virulence is related to :

      Your Answer: Toxin and enzyme production

      Explanation:

      The pathogenicity of an organism or its ability to cause disease is determined by its virulence factors. Many bacteria produce virulence factors that inhibit the host’s immune system. The virulence factors of bacteria are typically proteins or other molecules that are synthesized by enzymes. These proteins are coded for by genes in chromosomal DNA, bacteriophage DNA or plasmids. The proteins made by the bacteria can poison the host cells and cause tissue damage.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      11.3
      Seconds

  • Question 20 - A patient is diagnosed with Conn’s syndrome. Aldosterone is secreted from where? ...

    Correct

    • A patient is diagnosed with Conn’s syndrome. Aldosterone is secreted from where?

      Your Answer: Zona glomerulosa of the adrenal cortex

      Explanation:

      The adrenal gland comprises an outer cortex and an inner medulla, which represent two developmentally and functionally independent endocrine glands.

      The adrenal medulla secretes adrenaline (70%) and noradrenaline (30%)

      The adrenal cortex consists of three layers (remembered by the mnemonic GFR):

      G = zona glomerulosa – secretes aldosterone

      F = zona fasciculata – secretes cortisol and sex steroids

      R = zona reticularis – secretes cortisol and sex steroids.

      Aldosterone facilitates the reabsorption of sodium and water and the excretion of potassium and hydrogen ions from the distal convoluted tubule and collecting ducts. Conn’s syndrome is characterized by increased aldosterone secretion from the adrenal glands.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      16.4
      Seconds

  • Question 21 - A 30-year-old woman is diagnosed with Hodgkin's lymphoma. Which of the following chemotherapy...

    Incorrect

    • A 30-year-old woman is diagnosed with Hodgkin's lymphoma. Which of the following chemotherapy regimens would be used in this case?

      Your Answer: CHOP

      Correct Answer: ABVD

      Explanation:

      ABVD is a chemotherapy regimen used in the first-line treatment of Hodgkin’s lymphoma. It consists of concurrent treatment with the chemotherapy drugs, adriamycin, bleomycin, vinblastine and dacarbazine. It supplanted the older MOPP protocol.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      6.6
      Seconds

  • Question 22 - What occurs during cellular atrophy? ...

    Correct

    • What occurs during cellular atrophy?

      Your Answer: Cell size decreases

      Explanation:

      Atrophy is the decrease in the size of cells, tissues, or organs. There are several causes including inadequate nutrition, poor circulation, loss of hormonal support or nerve supply, disuse, lack of exercise, or disease. An increase in cell size is termed hypertrophy which is distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Urology
      • Pathology
      11.1
      Seconds

  • Question 23 - If a patient takes long-term corticosteroid therapy, which of the following diseases is...

    Correct

    • If a patient takes long-term corticosteroid therapy, which of the following diseases is most likely to develop?

      Your Answer: Osteoporosis

      Explanation:

      One of the complications of long-term intake of corticosteroids is osteoporosis. Some guidelines recommend prophylactic calcium and vitamin D supplementation in patients who take more than 30 mg hydrocortisone or 7.5 mg of prednisolone daily.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      13.8
      Seconds

  • Question 24 - Hyperplastic arteriosclerosis with fibrinoid necrosis, petechial haemorrhages, microinfarcts in the kidneys and elevated...

    Correct

    • 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 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
      32.9
      Seconds

  • Question 25 - A medical student is told a substance is freely filtered but is not...

    Incorrect

    • A medical student is told a substance is freely filtered but is not metabolised, secreted, or stored in the kidney. It has a plasma concentration of 1000 mg/l and its urine excretion rate is 25 mg/min, and the inulin clearance is 100 ml/min. What is the rate of tubular reabsorption of the substance?

      Your Answer: 35 mg/min

      Correct Answer: 75 mg/min

      Explanation:

      Reabsorption or tubular reabsorption is the process by which the nephron removes water and solutes from the tubular fluid (pre-urine) and returns them to the circulating blood. To calculate the reabsorption rate of substance Z we use the following equation: excretion = (filtration + secretion) – reabsorption. As this substance is freely filtered, its filtration rate is equal to that of inulin. So 25 = (100 + 0) – reabsorption. Reabsorption = 100 – 25 therefore reabsorption = 75 mg/min.

    • This question is part of the following fields:

      • Physiology
      • Renal
      13
      Seconds

  • Question 26 - A 45 year-old male, with behavioural changes developed euvolemic hyponatraemia. Which of the...

    Incorrect

    • A 45 year-old male, with behavioural changes developed euvolemic hyponatraemia. Which of the following conditions most likely predisposed the patient to develop euvolemic hyponatraemia?

      Your Answer: Pancreatitis

      Correct Answer: Psychosis

      Explanation:

      In euvolemic hyponatraemia, there is volume expansion in the body, there is no oedema, but hyponatremia occurs. Causes include: state of severe pain or nausea, psychosis, brain trauma, SIADH, hypothyroidism and glucocorticoid deficiency.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      28.3
      Seconds

  • Question 27 - Which of these laboratory findings will indicate a fetal neural tube defect when...

    Incorrect

    • Which of these laboratory findings will indicate a fetal neural tube defect when done between 15 and 20 weeks of pregnancy?

      Your Answer: Hypochromic microcytic anaemia

      Correct Answer: Increased alpha-fetoprotein

      Explanation:

      Maternal serum screening during the second trimester is a non-invasive way of identifying women at increased risk of having children with a neural tube defect and should be offered to all pregnant women. The results are most accurate when the sample is taken between 15 and 20 weeks of gestation. Elevated levels of alpha-fetoprotein suggest open spina bifida, anencephaly, risk of pregnancy complications, or multiple pregnancy.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      10.9
      Seconds

  • Question 28 - A patient with this type of tumour is advised to follow up regularly...

    Incorrect

    • A patient with this type of tumour is advised to follow up regularly for monitoring of tumour size as there is a strong correlation with malignant potential and tumour size. Which of the following is the most likely tumour in this patient?

      Your Answer: Prostate adenocarcinoma

      Correct Answer: Renal adenocarcinoma

      Explanation:

      The distinction between a benign renal adenoma and renal adenocarcinoma is commonly made on the basis of size. Tumours less than 2 cm in size rarely become malignant as opposed to those greater than 3 cm.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      13.4
      Seconds

  • Question 29 - A 17-year-old boy, who had developed shortness of breath and a loss of...

    Correct

    • A 17-year-old boy, who had developed shortness of breath and a loss of appetite over the last month, was referred to a haematologist because he presented with easy bruising and petechiae. His prothrombin time, platelet count, partial thromboplastin and bleeding time were all normal. Which of the following would explain the presence of the petechiae and easy bruising tendency?

      Your Answer: Scurvy

      Explanation:

      Scurvy is a condition caused by a dietary deficiency of vitamin C, also known as ascorbic acid. Humans are unable to synthesize vitamin C, therefore the quantity of it that the body needs has to come from the diet. The presence of an adequate quantity of vitamin C is required for normal collagen synthesis. In scurvy bleeding tendency is due to capillary fragility and not coagulation defects, therefore blood tests are normal.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      21.3
      Seconds

  • Question 30 - In a cardiac cycle, what event does the closing of atrioventricular (AV) valves...

    Correct

    • In a cardiac cycle, what event does the closing of atrioventricular (AV) valves coincide with?

      Your Answer: First heart sound

      Explanation:

      In the cardiac cycle, the closing of the atrioventricular (AV) valves coincides with the onset of ventricular systole. This event marks the beginning of the isovolumetric contraction phase, where the ventricles begin to contract, but the volume of blood in the ventricles remains the same because both the AV valves and the semilunar valves (aortic and pulmonary valves) are closed. The closing of the AV valves produces the first heart sound, known as “S1” or “lub.”

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      10.2
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Pathology (8/23) 35%
Respiratory (0/1) 0%
Microbiology (2/6) 33%
Fluids & Electrolytes (0/3) 0%
Cell Injury & Wound Healing (0/3) 0%
Endocrine (2/2) 100%
Physiology (4/7) 57%
Renal (2/3) 67%
Pharmacology (0/2) 0%
Cardiovascular (1/2) 50%
Neoplasia (2/3) 67%
Haematology (1/2) 50%
Cell Injury & Wound Healing; Urology (1/1) 100%
Orthopaedics (1/1) 100%
Neurology (0/1) 0%
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