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Question 1
Incorrect
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A 67-year-old man is scheduled for open surgery to treat a popliteal artery aneurysm. What is the structure that forms the supero-lateral boundary of the popliteal fossa?
Your Answer: Medial head of gastrocnemius
Correct Answer: Tendon of biceps femoris
Explanation:The Polpiteal Fossa and Sartorius Muscle
The area behind the knee is known as the polpiteal fossa. It is bordered by the tenodon of biceps femoris on the superolateral side, and the tendons of semimembranous and semitendinosus on the superomedial side. The medial head of gastrocnemius forms the inferomedial border, while the lateral head of gastrocnemius forms the inferolateral border.
The sartorius muscle is attached to the medial surface of the tibia. This muscle is located in the thigh and runs from the hip to the knee. It is responsible for flexing and rotating the hip joint, as well as flexing the knee joint. The sartorius muscle is one of the longest muscles in the body and is important for maintaining proper posture and movement. the anatomy of the polpiteal fossa and the sartorius muscle can be helpful in diagnosing and treating injuries or conditions in this area.
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This question is part of the following fields:
- Clinical Sciences
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Question 2
Correct
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What is the most accurate definition of evidence-based medicine (EBM)?
Your Answer: EBM is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients
Explanation:Evidence-Based Medicine
Evidence-based medicine (EBM) is a widely accepted approach to healthcare decision-making that involves the conscientious, explicit, and judicious use of current best evidence. This approach integrates the best available evidence with individual patient preferences to make informed decisions about patient care. While economic analyses can help allocate resources in a cost-effective manner, critical appraisal of clinical research is also an essential element of EBM.
EBM recognizes that high-quality randomized controlled trials and systematic reviews are valuable sources of evidence, but they are not the only sources. Practicing according to guidelines can be beneficial if the guidelines are evidence-based, but this is not always the case. Ultimately, the goal of EBM is to provide patients with the best possible care by using the most current and reliable evidence available while taking into account individual patient preferences and characteristics. By doing so, healthcare providers can make informed decisions that lead to better patient outcomes.
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This question is part of the following fields:
- Clinical Sciences
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Question 3
Incorrect
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A 67-year-old woman is scheduled for a total hip replacement on her right side. The surgeon plans to use the lateral approach to access the hip joint, which involves dividing the tensor fascia lata, as well as the gluteus medius and minimus muscles. However, this approach poses a risk to the nerve supply of these muscles. Can you identify the nerve that innervates the tensor fascia lata and gluteus medius muscles?
Your Answer: Sciatic nerve
Correct Answer: Superior gluteal nerve
Explanation:Nerves and Approaches to the Hip Joint
The superior gluteal nerve originates from L4-S1 and exits the pelvis through the greater sciatic foramen. It provides innervation to the gluteus medius, gluteus minimus, and tensor fascia lata muscles. However, the nerves in danger depend on the approach used to access the hip joint.
The posterior approach involves an incision through the deep fascia and gluteus maximus, followed by division of the external rotators. This approach puts the sciatic nerve at risk. On the other hand, the anterior approach involves the planes between tensor fascia lata and sartorius, and then rectus femoris and gluteus medius. This approach endangers the lateral femoral cutaneous nerve of the thigh.
In summary, the nerves at risk during hip joint access depend on the approach used. The posterior approach puts the sciatic nerve in danger, while the anterior approach endangers the lateral femoral cutaneous nerve of the thigh. It is important for medical professionals to be aware of these potential risks to minimize complications during hip joint procedures.
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This question is part of the following fields:
- Clinical Sciences
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Question 4
Incorrect
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What is the main role of cholecystokinin?
Your Answer: Increases gastric emptying
Correct Answer: Triggers gallbladder contraction
Explanation:Hormones and their Functions in Digestion
Cholecystokinin is a hormone that helps in digestion by neutralizing the partially digested food. It does this by stimulating the gallbladder to contract and the pancreas to release alkaline pancreatic fluid. This fluid helps to neutralize the acidic food and aids in the digestion process.
Gastrin is another hormone that plays a crucial role in digestion. It increases the production of stomach acid and also increases the rate of gastric emptying. This helps to break down the food more efficiently and move it through the digestive system.
Secretin is a hormone that reduces the production of stomach acid. It is released by the small intestine in response to the acidic food passing through it. This helps to prevent the stomach from becoming too acidic and causing discomfort.
Leptin is a hormone that helps to regulate appetite. It is produced by fat cells and acts on the brain to suppress appetite. This helps to maintain a healthy weight and prevent overeating.
In summary, hormones play a vital role in digestion by regulating the production of stomach acid, neutralizing acidic food, and suppressing appetite.
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This question is part of the following fields:
- Clinical Sciences
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Question 5
Incorrect
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Which type of antibody plays a crucial role in inhibiting the attachment of viruses to the apical membrane of enterocytes?
Your Answer: D
Correct Answer: A
Explanation:The Functions of Different Types of Antibodies
There are various types of B cells in the gut’s mucosa, collectively known as GALT. These B cells produce IgA dimers that attach to the basal aspect of enterocytes. Using their J chain, IgA dimers pass through epithelial cells and become sIgA, which is more resistant to intraluminal enzymatic breakdown. sIgA then enters the GIT lumen, where it helps to prevent viruses from binding to epithelial cells.
The function of IgD is currently unknown, while IgE is crucial in responding to fungi, worms, and type I hypersensitivity reactions. IgG is the most specific antibody type, capable of crossing the placenta and forming antibody-antigen complexes. IgM forms pentamers and aids in activating complement.
In summary, different types of antibodies have distinct functions in the body. IgA helps to block viruses in the gut, while IgE responds to certain allergens. IgG is highly specific and can cross the placenta, while IgM activates complement. The function of IgD remains a mystery.
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This question is part of the following fields:
- Clinical Sciences
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Question 6
Correct
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You are in a nutrition clinic reviewing a 16-year-old boy with anorexia nervosa. He has a BMI of 15.5 kg/m2 and his weight is 70% the expected weight for height.
How would you classify his level of malnutrition?Your Answer: Severe undernutrition
Explanation:Malnutrition
Malnutrition is a clinical condition that occurs when there is an imbalance in the energy, protein, or other components of the diet, leading to adverse effects on the body’s health. This condition encompasses undernutrition, overnutrition, and vitamin and mineral deficiencies. Undernutrition is the most common form of malnutrition and is classified based on different grading systems used worldwide. Severe undernutrition is characterized by a weight of less than 70-75% of the expected weight for age and a BMI of less than 16 kg/m2.
To grade the severity of protein-energy malnutrition (PEM), a scale is commonly used. This scale considers the expected weight for age and BMI. A normal weight is between 90-110% of the expected weight for age and a BMI of 19-24 kg/m2. Mild undernutrition is between 85-90% of the expected weight for age and a BMI of 18-18.9 kg/m2. Moderate undernutrition is between 75-85% of the expected weight for age and a BMI of 16-17.9 kg/m2. Severe undernutrition is less than 75% of the expected weight for age and a BMI of less than 16 kg/m2.
In summary, malnutrition is a serious condition that affects many people worldwide. the different types of malnutrition and their severity can help healthcare professionals provide appropriate treatment and interventions to improve the health outcomes of those affected.
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This question is part of the following fields:
- Clinical Sciences
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Question 7
Incorrect
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After a carbohydrate-rich meal, what triggers the liver to produce glycogen?
Your Answer: Glucagon
Correct Answer: Insulin
Explanation:Glycogen Formation and Degradation
Glycogen is a complex carbohydrate that is stored in the liver and muscles. It is formed from glucose and serves as a source of energy when glucose levels in the blood are low. Insulin, which is released by pancreatic beta cells after a carbohydrate load, promotes glycogen synthesis. This process requires several enzymes, including phosphoglucomutase, glucose-1-phosphate uridyltransferase, glycogen synthase, and branching enzyme. Conversely, when glucose is scarce, glycogen must be broken down to release glucose into the blood. The hormone glucagon stimulates glycogen degradation, which requires the enzymes glycogen phosphorylase and debranching enzyme. Defects in either the formation or degradation of glycogen can cause fasting hypoglycemia, which is a common feature of many glycogen storage disorders (GSDs).
One example of a GSD is glycogen synthase deficiency (GSD type 0), which typically presents in childhood with symptoms of hypoglycemia after an overnight fast. Symptoms can be improved by administering glucose, and patients can be given corn starch to prevent symptoms in the morning. A liver biopsy will show very little glycogen, and the disease is inherited as an autosomal recessive trait. Overall, glycogen formation and degradation are important processes that help regulate glucose levels in the body.
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This question is part of the following fields:
- Clinical Sciences
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Question 8
Incorrect
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Ms. Johnson is a 35-year-old asthmatic woman with severe community acquired pneumonia. She has been admitted to the intensive care unit for cardiovascular support. Currently, her blood pressure is 80/64 mmHg, heart rate is 128 bpm, and cardiac output is 3.2 L/min. Ms. Johnson is receiving 15 L/min of oxygen through a facemask and has oxygen saturations of 88% with a respiratory rate of 16. Her temperature is 39.6°C. What is the estimated stroke volume for Ms. Johnson?
Your Answer:
Correct Answer: 25 ml
Explanation:Cardiac Output and its Relationship to Health Conditions
Cardiac output is the product of heart rate and stroke volume. Stroke volume can be calculated by dividing cardiac output by heart rate. The average cardiac output is 5 liters per minute, with a normal stroke volume ranging from 50-85 milliliters per beat, depending on heart rate.
When a person experiences poor oxygen saturation and a normal respiratory rate, it may indicate that they are becoming exhausted and unable to breathe rapidly. This, combined with low blood pressure, tachycardia, and a failure to maintain cardiac output, can be indicative of shock. Additionally, a high temperature may suggest severe sepsis secondary to pneumonia.
cardiac output and its relationship to various health conditions can help medical professionals diagnose and treat patients more effectively. By monitoring heart rate, stroke volume, and other vital signs, healthcare providers can identify potential issues and intervene before they become life-threatening. Proper management of cardiac output is crucial for maintaining overall health and preventing serious complications.
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This question is part of the following fields:
- Clinical Sciences
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Question 9
Incorrect
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What blood test result indicates hypoglycaemia?
Your Answer:
Correct Answer: A young child with a plasma glucose concentration of 2.2 mmol/L
Explanation:Hypoglycaemia
Hypoglycaemia occurs when the blood glucose level falls below the typical fasting level. This condition is common and may not always require treatment, especially if it is mild and asymptomatic. However, the diagnosis of true hypoglycaemia requires the satisfaction of Whipple’s triad, which includes the presence of hypoglycaemia, symptoms/signs consistent with hypoglycaemia, and resolution of symptoms/signs when blood glucose level normalises.
Symptoms of hypoglycaemia are caused by sympathetic activity and disrupted central nervous system function due to inadequate glucose. Infants may experience hypotonia, jitteriness, seizures, poor feeding, apnoea, and lethargy. On the other hand, adults and older children may experience tremor, sweating, nausea, lightheadedness, hunger, and disorientation. Severe hypoglycaemia can cause confusion, aggressive behaviour, and reduced consciousness.
In summary, hypoglycaemia is important to recognise its symptoms and provide appropriate treatment. While mild hypoglycaemia may not always require intervention, true hypoglycaemia should be diagnosed based on Whipple’s triad. Symptoms of hypoglycaemia vary depending on age, and severe hypoglycaemia can cause serious complications.
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This question is part of the following fields:
- Clinical Sciences
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Question 10
Incorrect
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A 78-year-old man is diagnosed with a vitamin B1 deficiency. What food is known to be a rich source of thiamine?
Your Answer:
Correct Answer: Wheat germ
Explanation:Thiamine Deficiency and Dietary Sources
Thiamine, also known as vitamin B1, is an essential nutrient that the body cannot store in large amounts and must be obtained through the diet. Wholegrain cereals, oatmeal, yeast, pork, sunflower seeds, and certain vegetables such as potatoes, asparagus, and cauliflower are good dietary sources of thiamine. However, refined cereals and white flour typically contain low levels of thiamine, and processing, boiling, and overcooking vegetables can remove a significant amount of the vitamin.
Thiamine plays a crucial role in energy production, nervous transmission, and collagen synthesis. A deficiency in thiamine can lead to impairment of these processes, resulting in various signs and symptoms such as muscle tenderness, weakness, and reduced reflexes, confusion, memory impairment, impaired wound healing, poor balance, falls, constipation, and reduced appetite. Therefore, it is important to ensure adequate intake of thiamine through a balanced diet to prevent deficiency and maintain optimal health.
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This question is part of the following fields:
- Clinical Sciences
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