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  • Question 1 - An 80-year-old man has a swelling in his left groin with moderate pain...

    Incorrect

    • An 80-year-old man has a swelling in his left groin with moderate pain and discomfort complaints. Diagnosed with an inguinal hernia, he is scheduled for elective surgery to repair the defect. Of the following, which nerve runs in the inguinal canal and is at risk of being damaged during surgery?

      Your Answer: Femoral nerve

      Correct Answer: Ilioinguinal nerve

      Explanation:

      The inguinal canal is a passage in the lower anterior abdominal wall just above the inguinal ligament. It transmits the following structures:
      1. genital branch of genitofemoral nerve
      2. ilioinguinal nerve
      3. spermatic cord (males only)
      4. round ligament of the uterus (females only)

      The ilioinguinal is a direct branch of the first lumbar nerve. The ilioinguinal nerve enters the inguinal canal via the abdominal musculature (and not through the deep (internal) inguinal ring) and exits through the superficial (or external) inguinal ring.

      The openings for the other nerves in the answer options are:
      Sciatic nerve – exits the pelvis via the greater sciatic foramen
      Obturator nerve – descends into pelvis via the obturator foramen
      Femoral nerve – descends from the abdomen through the pelvis behind the inguinal canal

      The Iliohypogastric nerve also arises from the first lumbar root with the ilioinguinal nerve but pierces the transversus abdominis muscle posteriorly, just above the iliac crest, and continues anteriorly between the transversus abdominis and the internal abdominal oblique muscles.

    • This question is part of the following fields:

      • Anatomy
      41.9
      Seconds
  • Question 2 - Which of the following statements is true regarding sucralfate? ...

    Incorrect

    • Which of the following statements is true regarding sucralfate?

      Your Answer: Is a simple compound formed from sulphated sucrose

      Correct Answer: Has very few side effects

      Explanation:

      Sucralfate is an octasulfate of glucose to which Al(OH)3 has been added. It undergoes extensive cross-linking in an acidic environment and forms a polymer which adheres to the ulcer base for up to 6 hours and protects it from further erosion. Since it is not systemically absorbed it is virtually devoid of side effects. However, it may cause constipation in about 2% of cases due to the Aluminium component in it.

      Sucralfate does not have antibacterial action against Helicobacter pylori. However, Bismuth has antibacterial action due to its oligodynamic effect.

    • This question is part of the following fields:

      • Pharmacology
      28.7
      Seconds
  • Question 3 - A new proton pump inhibitor (PPI) is being evaluated in elderly patients who...

    Incorrect

    • A new proton pump inhibitor (PPI) is being evaluated in elderly patients who are taking aspiring. Study designed has 120 patients receiving the PPI, while a control group of 240 individuals is given the standard PPI. Over a span of 6 years, 24 of the group receiving the new PPI had an upper GI bleed compared to 60 individuals who received the standard PPI. How would you calculate the absolute risk reduction?

      Your Answer:

      Correct Answer: 5%

      Explanation:

      Absolute risk reduction = (Control event rate) – (Experimental event rate)

      Experimental event rate = 24 / 120 = 0.2

      Control event rate = 60 / 240 = 0.25

      Absolute risk reduction = 0.25 – 0.2 = 0.05 = 5% reduction

    • This question is part of the following fields:

      • Statistical Methods
      0
      Seconds
  • Question 4 - The following foetal anatomical features functionally closes earliest at birth? ...

    Incorrect

    • The following foetal anatomical features functionally closes earliest at birth?

      Your Answer:

      Correct Answer: Foramen ovale

      Explanation:

      Foramen ovale, ductus arteriosus (DA) and ductus venosus (DV) are the three important cardiac shunts in-utero.

      At birth the umbilical vessels constrict in response to stretch as they are clamped. Blood flow through the ductus venosus (DV) decreases but the DV closes passively in 3-10 days.

      As the pulmonary circulation is established, there is a drastic fall in pulmonary vascular resistance and an increased pulmonary blood flow. This increases flow and pressure in the Left Atrium that exceeds that of the right atrium. The difference in pressure usually leads to the IMMEDIATE closure of the foramen ovale.

      The DA is functionally closed within the first 36-hours of birth in a healthy full-term newborn. Subsequent endothelial and fibroblast proliferation leads to permanent anatomical closure within 2 – 3 weeks.

      Oxygenated blood from the placenta passes via the umbilical vein to the liver. Blood also bypasses the liver via the ductus venosus into the inferior vena cava (IVC). The Crista dividens is a tissue flap situated at the junction of the IVC and the right atrium (RA). This flap directs the oxygen-rich blood, along the posterior aspect of the IVC, through the foramen ovale into the left atrium (LA).

      The Eustachian valve also known as the valve of The IVC is a remnant of the crista dividens.

    • This question is part of the following fields:

      • Anatomy
      0
      Seconds
  • Question 5 - Iron is one of the most important micronutrients in the body. Out of...

    Incorrect

    • Iron is one of the most important micronutrients in the body. Out of the following, which one has the most abundant storage of iron in the body?

      Your Answer:

      Correct Answer: Haemoglobin

      Explanation:

      Iron is a necessary micronutrient for proper erythropoietic function, oxidative metabolism, and cellular immune responses. Although dietary iron absorption (1-2 mg/d) is tightly controlled, it is only just balanced by losses.

      The adult body contains 35-45 mg/kg iron (about 4-5 g)

      Iron can be found in a variety of forms, including haemoglobin, ferritin, haemosiderin, myoglobin, haem enzymes, and transferrin bound proteins.

    • This question is part of the following fields:

      • Pathophysiology
      0
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  • Question 6 - Obeying Boyle's law and Charles's law is a characteristic feature of an ideal...

    Incorrect

    • Obeying Boyle's law and Charles's law is a characteristic feature of an ideal gas. The gas which is most ideal out of the following options is?

      Your Answer:

      Correct Answer: Helium

      Explanation:

      The ideal gas equation makes the following assumptions:

      The gas particles have a small volume in comparison to the volume occupied by the gas.
      Between the gas particles, there are no forces of interaction.
      Individual gas particle collisions, as well as gas particle collisions with container walls, are elastic, meaning momentum is conserved.
      PV = nRT
      Where:

      P = pressure
      V = volume
      n = moles of gas
      T = temperature
      R = universal gas constant

      Helium is a monoatomic gas with a small helium atom. The attractive forces between helium atoms are small because the helium atom is spherical and has no dipole moment. Because helium atoms are spherical, collisions between them approach the ideal state of elasticity.

      Most real gases behave qualitatively like ideal gases at standard temperatures and pressures. When intermolecular forces and molecular size become important, the ideal gas model tends to fail at lower temperatures or higher pressures. It also fails to work with the majority of heavy gases.

      Helium, argon, neon, and xenon are noble or inert gases that behave the most like an ideal gas. Xenon is a noble gas with a much larger atomic size than helium.

    • This question is part of the following fields:

      • Pharmacology
      0
      Seconds
  • Question 7 - When the volume of gas is measured, its value should be supported by...

    Incorrect

    • When the volume of gas is measured, its value should be supported by a suitable abbreviation. From the following options, what does the STPD stand for?

      Your Answer:

      Correct Answer: Standard Temperature and Pressure, Dry

      Explanation:

      Gas is composed of large numbers of molecules moving in random directions, separated by distances. They undergo perfectly elastic collisions with each other and the walls of a container and transfer kinetic energy in form of heat. These assumptions bring the characteristics of gases within the range and reasonable approximation to a real gas, particularly how any change in temperature and pressure affect the behaviour of gas. According to different theories and laws proposed, mathematical equations are derived to calculate the volume of gas, also different abbreviations are being used according to given conditions. The abbreviations used are ATP, BTPS, and STPD.
      ATP stands for ambient temperature and barometric pressure, it is used to describe the conditions under which volume of gas is measured.
      BTPS stands for body temperature and pressure saturated with water vapor. These are conditions under which volume of gas exist and all results of lung volume determination should be quoted at BTPS.
      STPD stands for standard temperature and pressure, dry (0C and 760 mm Hg). These are the conditions that are used to describe quantities of individual gases exchanged in the lungs.

    • This question is part of the following fields:

      • Anaesthesia Related Apparatus
      0
      Seconds
  • Question 8 - A 42-year-old man presented with a bitemporal hemianopia with enlarged hands and feet....

    Incorrect

    • A 42-year-old man presented with a bitemporal hemianopia with enlarged hands and feet. On examination, he was found to be hypertensive. Which of the following correctly explains the cause of his visual field defect?

      Your Answer:

      Correct Answer: Pituitary macroadenoma secreting growth hormone (GH)

      Explanation:

      Pituitary macroadenoma is a benign tumour with growth larger than 10mm (those under 10mm are called microadenoma)

      Compression of optic chiasm by pituitary adenoma is responsible for causing visual field defects like bitemporal hemianopia, optic neuropathy.

    • This question is part of the following fields:

      • Pathophysiology
      0
      Seconds
  • Question 9 - A study designed to examine the benefits of adding a new antiplatelet to...

    Incorrect

    • A study designed to examine the benefits of adding a new antiplatelet to aspirin after a myocardial infraction. The recorded results give us the percentage of patients that reported myocardial infraction within a three month period. The percentage was 4% and 3% for aspirin and the combination of drugs respectively. How many further patients needed to be treated in order for one patient to avoid any more heart attacks during 3 months?

      Your Answer:

      Correct Answer: 100

      Explanation:

      Number needed to treat can be defined as the number of patients who need to be treated to prevent one additional bad outcome.

      It can be found as:

      NNT=1/Absolute Risk Reduction (rounded to the next integer since number of patients can be integer only).

      where ARR= (Risk factor associated with the new drug group) — (Risk factor associated with the currently available drug)

      So,

      ARR= (0.04-0.03)

      ARR= 0.01

      NNT= 1/0.01

      NNT=100

    • This question is part of the following fields:

      • Statistical Methods
      0
      Seconds
  • Question 10 - Which of the following correctly explains the mechanism of lowering blood pressure by...

    Incorrect

    • Which of the following correctly explains the mechanism of lowering blood pressure by nitroglycerine?

      Your Answer:

      Correct Answer: Acetylcholine

      Explanation:

      Nitroglycerine is rapidly denitrated enzymatically in the smooth muscle cell to release the free radical nitric oxide (NO).
      Released NO activated cytosolic guanylyl cyclase which increases cGMP (cyclin guanosine monophosphate) which causes dephosphorylation of myosin light chain kinase (MLCK) through a cGMP-dependent protein kinase.
      Reduced availability of phosphorylated (active) MLCK interferes with activation of myosin and in turn, it fails to interact with actin to cause contraction. Consequently, relaxation occurs.

    • This question is part of the following fields:

      • Pharmacology
      0
      Seconds

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