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  • Question 1 - A 17-year-old male presenting in the department has a history of C3 deficiency.C3...

    Correct

    • A 17-year-old male presenting in the department has a history of C3 deficiency.C3 deficiency is associated with all of the following EXCEPT?

      Your Answer: Hereditary angioedema

      Explanation:

      C1-inhibitor deficiency is the cause of hereditary angioedema not C3 deficiency,All the other statements are correct

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4.1
      Seconds

  • Question 2 - A 2nd-year medical student is solving an exam paper with questions about the...

    Correct

    • A 2nd-year medical student is solving an exam paper with questions about the immune system. She comes across a question regarding innate immunity. Innate immunity is the immunity naturally present within the body from birth. Which ONE of the following is not a part of this type of immunity?

      Your Answer: Antibody production

      Explanation:

      Innate immunity, also called non-specific immunity, refers to the components of the immune system naturally present in the body at birth. The components of innate immunity include: 1) Natural Killer Cells 2) Neutrophils 3) Macrophages 4) Mast Cells 5) Dendritic Cells 6) Basophils. Acquired or adaptive immunity is acquired in response to infection or vaccination. Although the response takes longer to develop, it is also a more long-lasting form of immunity. The components of this system include: 1) T lymphocytes 2) B lymphocytes 3) Antibodies

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      9.6
      Seconds

  • Question 3 - You review an 18-months-old child who seems to be having a reaction following...

    Correct

    • You review an 18-months-old child who seems to be having a reaction following an immunisation she took earlier in the day.Which statement concerning immunity and vaccination is true?

      Your Answer: The strongest immunological response is seen with natural immunity

      Explanation:

      Vaccination induces ACTIVE adaptive immunity. Actively acquired immunity involves the development of an immune response either due to vaccination or natural exposure to a pathogen and leads to long-lasting resistance to infection.Immediate protection is achieved with injection of immunoglobulin. The protection is transient lasting only a few weeks and is useful as post-exposure prophylaxis. Passively acquired immunity usually leads to short-lasting resistance to infection because it does not involve a host immune response. With inactivated bacteria, a series of primary vaccinations is usually required to induce an adequate immune response. In most cases, boosters are required to sustain adequate immunity.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      5.5
      Seconds

  • Question 4 - A 79-year-old male had a humeral shaft fracture during a road traffic accident...

    Correct

    • A 79-year-old male had a humeral shaft fracture during a road traffic accident and is being followed up in a fracture clinic. He complains of inability to use the limb 6 months after the injury. X-rays of that arm shows non union of his fracture.All the following are responsible for this non-union EXCEPT?

      Your Answer: Osteoporosis

      Explanation:

      An imbalance between bone resorption and formation is Osteoporosis. In normal bone, formation and resorption are roughly equal, and the density of bone matrix remains constant but there is more resorption in osteoporosis and the matrix density reduces and bones become weaker. Fractures are more likely to occur but healing is unaffected. Non-union of a fracture occurs when the two sides of a fracture fail to unite after 6 months. Causes include: infection, movement at the fracture site, avascular necrosis, tissue interposed between the fracture and gross misalignment.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      2.7
      Seconds

  • Question 5 - Antinuclear antibodies (ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that...

    Incorrect

    • Antinuclear antibodies (ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that bind to contents of the cell nucleus.Which ONE of these statements about ANAs is true?

      Your Answer: Anti-Ro antibodies are associated with CREST syndrome

      Correct Answer: They can be of any immunoglobulin class

      Explanation:

      Anti-nuclear antibodies(ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that bind to contents of the cell nucleus. They can be of any immunoglobulin class.CREST syndrome is usually associated with anti-centromere antibodies.ELISA testing is cheaper but not the most accurate means of testing for ANAs. Indirect immunofluorescence testing is the most reliable.Nucleolar staining is suggestive of scleroderma, while homogenous staining is suggestive of lupus.Anti-dsDNA antibodies are found in 80 – 90% of patients with SLE

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      10.1
      Seconds

  • Question 6 - A patient presents to your clinic with fever of unknown origin. His blood...

    Correct

    • A patient presents to your clinic with fever of unknown origin. His blood results shows a markedly elevated C-Reactive Protein (CRP) level.Which of these is responsible for mediating the release of CRP?

      Your Answer: IL-6

      Explanation:

      C-reactive protein (CRP) is an acute phase protein produced by the liver hepatocytes. Its production is regulated by cytokines, particularly interleukin 6 (IL-6) and it can be measured in the serum as a nonspecific marker of inflammation. Although a high CRP suggest an acute infection or inflammation, it does not identify the cause or location of infection.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      2.6
      Seconds

  • Question 7 - A 2-day-old male is referred to a tertiary care hospital by the community...

    Correct

    • A 2-day-old male is referred to a tertiary care hospital by the community midwife after a home visit due to jaundice and dyspnoea. After history and examination, the relevant blood work is performed, and the baby is found to have conjugated hyperbilirubinemia. The paediatric team suspects a hepatic origin for jaundice based on the findings. Which one of the following aetiologies is the most likely cause of jaundice in this case?

      Your Answer: Alpha 1-antitrypsin deficiency

      Explanation:

      The presence of dyspnoea makes alpha-1 antitrypsin deficiency the more likely diagnosis as biliary atresia does not cause respiratory symptoms. Deficiency of the enzyme alpha-1 antitrypsin causes uninhibited elastase activity and a decrease in elastic tissue. This causes liver cirrhosis leading to an elevation of conjugated bilirubin and emphysema in the lungs.Rhesus disease, hereditary spherocytosis and breast milk jaundice cause an elevation of unconjugated bilirubin thus ruling it out in this case. Breast milk jaundice occurs due to an inability of the newborn to metabolize the proteins in breast milk. Rhesus disease occurs when an Rh negative mother gives birth to an Rh positive baby. The jaundice would have been accompanied by anaemia and oedema. Hereditary spherocytosis occurs due to extravascular haemolysis as defective RBCs are removed by the spleen. The patient would present with jaundice, splenomegaly and possibly an aplastic crisis (if Parvovirus B19 infection).

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      7
      Seconds

  • Question 8 - A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited...

    Incorrect

    • A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited range of motion in the right elbow for the past two days. On examination, the right elbow is extremely tender with erythema and warmth of the overlying skin due to acute inflammation. Which ONE of the following statements is true with regards to acute inflammation?

      Your Answer: Increased intravascular osmotic pressure leads to oedema

      Correct Answer: Neutrophils are activated and adhere to the endothelium as a result of interaction with endothelial cell adhesion molecules

      Explanation:

      Acute inflammation is defined as inflammation occurring within minutes to hours in response to an injury lasting for less than two weeks. Acute inflammation Rapid onset (minutes to hours)Quick resolution (usually days)Chronic inflammationMay last weeks, months, or yearsThere are five cardinal signs of inflammation:1) Pain2) Redness3) Warmth4) Oedema5) Loss of functionDuring acute inflammation, neutrophils are activated and attracted to the site of inflammation in response to various interleukins and cytokines. This process takes place via the following mechanism:1) MarginationNeutrophils flow nearer the vessel wall rather than in the axial stream, which is referred to as margination2) Rolling along the surface of vascular endothelium3) Adhesion to the endothelium by interaction with adhesion molecules (ICAMS and VCAMS)4) Diapedesis is the movement of neutrophils from the endothelial cells into the interstitial space by squeezing through the gaps between adjacent endothelial cellsBradykinin and histamine are both responsible for vasodilation which causes oedema and decreases intravascular osmotic pressure.Neutrophils dominate early (2 days)- Live longer- Replicate in tissues

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      11.7
      Seconds

  • Question 9 - A 27-year-old female is brought to the Emergency Department by ambulance with extensive...

    Correct

    • A 27-year-old female is brought to the Emergency Department by ambulance with extensive bleeding from her upper arm following a fall from a bicycle onto a fence. On inspection her biceps brachii muscle has been lacerated.How will the muscle heal from this injury? Select ONE answer only.

      Your Answer: Satellite cells will produce a small number of regenerated myocytes

      Explanation:

      Muscle heals with fibrous tissue to form a scar. Once cut, it will never regain its previous bulk or power. Within the scar a small number of myocytes (muscle cells) may be seen, which are formed from satellite cells but they contribute little to the function of the muscle overall.In more widespread ischaemic injury, such as critical ischaemic limb due to arterial compromise, or in compartment syndrome, damaged myocytes are replaced diffusely with fibrous tissue. This fibrous tissue contracts and reduces movement, and in extreme cases can pull the limb into abnormal positions such as in Volkmann’s ischaemic contracture of the forearm.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4.8
      Seconds

  • Question 10 - A 30-year-old female presented to the Emergency Department after a fall during a...

    Correct

    • A 30-year-old female presented to the Emergency Department after a fall during a hiking expedition caused severe pain in her left arm and wrist drop. An X-ray revealed a mid-shaft fracture of the humerus, which most likely damaged the radial nerve. Which one of the following statements best describes the healing process of peripheral nerves?

      Your Answer: Peripheral nerve fibres regenerate at around 1mm per day

      Explanation:

      Peripheral nerves are nerves that lie outside the brain and spinal cord. Peripheral nerves readily regenerate, while central nervous system axonal injury does not spontaneously regenerate. If there is damage to the axons of peripheral nerves, the nerves will regenerate at a slow rate of 1 mm per day. The slow regeneration process may lead to muscle atrophy before regeneration is complete. Each peripheral nerve has a single cell body that supplies nutrients to the growing nerve fibre. The cell body does not undergo mitosis; only the axon is regenerated.Schwann cells of the peripheral nervous system provide support for this process, while the analogous oligodendrocytes of the central nervous system do not. Schwann cells themselves do not cause regeneration. Schwann cells provide myelin for myelinated fibres and surround non-myelinated fibres with their cytoplasm. If an axon is completely severed, as in the case of amputation, the axonal fibres regenerating from the cell body may never find their original route back to the muscle. Instead, they may form a traumatic neuroma, a painful collection of nerve fibres and myelin.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      6.9
      Seconds

  • Question 11 - A patient noticed ankle swelling and has passed very little urine over the...

    Correct

    • A patient noticed ankle swelling and has passed very little urine over the past 24 hours. He also has nausea and vomiting, reduced urine output and his blood results reveal a sudden rise in his creatinine levels over the past 48 hours. You make a diagnosis of acute kidney injury (AKI).Which one of these is a prerenal cause of AKI?

      Your Answer: Cardiac failure

      Explanation:

      The causes of AKI can be divided into pre-renal, intrinsic renal and post-renal causes. Majority of AKI developing in the community is due to a pre-renal causes (90% of cases).Pre-renal causes: Haemorrhage, severe vomiting or diarrhoea, burns, cardiac failure, liver cirrhosis, nephrotic syndrome, hypotension, severe cardiac failure, NSAIDs, COX-2 inhibitors, ACE inhibitors or ARBs, Abdominal aortic aneurysm, renal artery stenosis, hepatorenal syndrome, Intrinsic (renal) causes:Eclampsia, glomerulonephritis, thrombosis, haemolytic-uraemic syndrome, acute tubular necrosis (ATN), acute interstitial nephritis, drugs ( NSAIDs), infection or autoimmune diseases, vasculitis, polyarteritis nodosa, thrombotic microangiopathy, cholesterol emboli, renal vein thrombosis, malignant hypertensionPost-renal causes: Renal stones, Blood clot, Papillary necrosis, Urethral stricture, Prostatic hypertrophy or malignancy, Bladder tumour, Radiation fibrosis, Pelvic malignancy, Retroperitoneal fibrosis

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4.1
      Seconds

  • Question 12 - A 40-year-old man with reduced urine output, nausea, and confusion also has a...

    Correct

    • A 40-year-old man with reduced urine output, nausea, and confusion also has a 150% rise of creatinine from baseline over the past 7 days. A diagnosis of acute kidney injury (AKI) is made after more tests are done.His AKI stage is?

      Your Answer: Stage 2

      Explanation:

      This patient with a 150% rise of creatinine above baseline within 7 days has stage 2 Acute kidney injury (AKI).AKI stages are as follows:Stage 1Creatinine rise of 26 micromole/L or more within 48 hours, orCreatinine rise of 50-99% from baseline within 7 days (1.5-1.99 x baseline),orUrine output <0.5 mL/kg/hour for more than 6 hoursStage 2Creatinine rise of 100-199% from baseline within 7 days (2.0-2.99 x baseline),orUrine output <0.5 mL/kg/hour for more than 12 hoursStage 3Creatinine rise of 200% or more from baseline within 7 days (3.0 or more x baseline), orCreatinine rise to 354 micromole/L or more with acute rise of 26 micromole/L or more within 48 hours or 50% or more rise within 7 days, orUrine output <0.3 mL/kg/hour for 24 hours or anuria for 12 hours

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      2.4
      Seconds

  • Question 13 - A 40-year-old man with episodes of blood in urine and flank pain that...

    Correct

    • A 40-year-old man with episodes of blood in urine and flank pain that are recurrent presents for management. He has a history of hypertension that is difficult to control and recurrent urinary tract infections. Other findings are: bilateral masses in his flanks and haematuria (3+ on dipstick).What is the most likely diagnosis?

      Your Answer: Polycystic kidney disease

      Explanation:

      Autosomal dominant polycystic kidney disease (ADPKD) presents with abdominal or loin discomfort due to the increasing size of the kidneys, acute loin pain with or without haematuria, hypertension, and male infertility. It is the most common cause of serious renal disease and the most common inherited cause of renal failure in adults. Alport syndrome has hearing loss and eye abnormalities in addition to symptoms of kidney disease.Renal cell carcinoma presents with additional features of unexplained weight loss, loss of appetite, fever of unknown origin and anaemia.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4.1
      Seconds

  • Question 14 - A 62-year-old woman has reduced urine output, nausea, and confusion. Renal function tests...

    Correct

    • A 62-year-old woman has reduced urine output, nausea, and confusion. Renal function tests and other investigations done leads to a diagnosis of acute kidney injury (AKI).Which one of these is consistent with a diagnosis of AKI?

      Your Answer: A rise in serum creatinine of 30 μmol/L within 48 hours

      Explanation:

      AKI is diagnosed based on an acutely rising serum creatinine and/or reduction in urine output.

      AKI can often be non-oliguric.

      AKI is present if any one or more of the following criteria is met:

      • A rise in serum creatinine of ≥26 micromol/L (≥0.3 mg/dL) within 48 hours
      • A rise in serum creatinine to ≥1.5 times baseline, which is known or presumed to have occurred within the past 7 days (in practice you can use the lowest value from the past 3 months as the baseline for the patient)
      • Urine volume <0.5 ml/kg/hour for at least 6 hours.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4
      Seconds

  • Question 15 - A 66-year-old male was admitted from the Emergency Department due to severe pain...

    Correct

    • A 66-year-old male was admitted from the Emergency Department due to severe pain in the left forearm and hand, refractory to pain medication along with pallor and hypothermia of the affected limb. Ultrasound doppler showed an arterial embolism. Circulation was restored after vascular surgery, but there was extensive, irreversible muscle damage. How will the muscle heal from an injury of this type?

      Your Answer: Diffuse formation of fibrous tissue

      Explanation:

      Once muscle tissue is damaged, there will be healing via diffuse formation of fibrous tissue, especially due to the widespread ischemia. Callus formation takes place in the healing of bone, not muscle. Organised scar formation occurs when a lacerated wound is approximated by sutures so that primary intention wound healing can occur. Liquefaction degeneration occurs following ischemia in the brain. Volkmann’s ischemic contracture may occur, but it is not the primary type of healing that will take place but rather the effect of the fibrous scar formation.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      8.6
      Seconds

  • Question 16 - A dermatological examination of a patient presenting with a lump shows a visible...

    Incorrect

    • A dermatological examination of a patient presenting with a lump shows a visible collection of fluid measuring 0.3 cm in diameter.Which one of these best describes the lump you have found on examination?

      Your Answer: Pustule

      Correct Answer: Vesicle

      Explanation:

      A vesicle is a visible collection of fluid measuring less than 0.5 cm in diameter.A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus. A carbuncle is a collection of individual boils clustered together. A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter. A pustule is a small visible skin elevation containing an accumulation of pus.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4.5
      Seconds

  • Question 17 - A dermatological examination on a patient presenting with a lump shows a small...

    Correct

    • A dermatological examination on a patient presenting with a lump shows a small visible skin elevation containing an accumulation of pus.Which one of these best describes the lump you have found on examination?

      Your Answer: Pustule

      Explanation:

      A pustule is a small visible skin elevation containing an accumulation of pus. A carbuncle is a collection of individual boils clustered together. A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter. A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus. A vesicle is a visible collection of fluid measuring less than 0.5 cm in diameter.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4.9
      Seconds

  • Question 18 - A 20-year-old male has an anaphylactic reaction following a wasp sting.What type of...

    Correct

    • A 20-year-old male has an anaphylactic reaction following a wasp sting.What type of hypersensitivity reaction is this?

      Your Answer: Type I

      Explanation:

      Anaphylaxis is an example of a type I hypersensitivity reaction. It is IgE mediated. It requires a prior exposure to the antigen. The initial exposure sensitizes the body to the antigen and a second exposure to that antigen leads to an anaphylactic reaction.Massive calcium influx into the cells leads to mast cell degranulation. The Immunoglobulin antigen complex binds to Fc receptors on the surface of mast cells. The result is mast cell degranulation and release of histamine, proteoglycans and serum proteases from cytoplasmic granules.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      1.9
      Seconds

  • Question 19 - A 20-year-old male receives a small cut over his hand while climbing a...

    Correct

    • A 20-year-old male receives a small cut over his hand while climbing a fence causing it to bleed. Upon applying pressure for a few minutes, the bleeding stops. Which one of the following physiological components of the blood is responsible for the primary haemostasis reaction, such as in this case?

      Your Answer: Platelet plug formation

      Explanation:

      Haemostasis is your body’s defence against an injury that causes bleeding. It stops bleeding in three main steps: 1) Primary haemostasis – formation of a weak platelet plug- The primary reaction of the body is to cause local vasoconstriction at the site of injury and decrease blood flow to the affected area- the release of cytokines and inflammatory markers lead to adhesion of platelets and aggregation at the site of injury forming a platelet plug- the injured vessel wall has exposed subendothelial collagen that releases von Willebrand factor Any damage to the vessel wall causes the release of the Von Willebrand factor, which is necessary for platelet adhesion. Tissue Thromboplastin is also released, which activates the coagulation pathway, a component of secondary haemostasis. The coagulation cascade ultimately results in the conversion of fibrinogen to fibrin.2) Secondary haemostasis 3) Fibrinolysis

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      3.2
      Seconds

  • Question 20 - A 45-year-old African American male presents to your clinic complaining of swelling of...

    Correct

    • A 45-year-old African American male presents to your clinic complaining of swelling of his feet for the past six months. On examination, there is periorbital and pedal oedema. A 24-hour urine collection is ordered, which shows 8 g of protein. The serum cholesterol is ten mmol/L. You order a renal biopsy to confirm the diagnosis. Which one of the following findings are you most likely to see in this patient's biopsy?

      Your Answer: Focal segmental glomerulosclerosis

      Explanation:

      This patient has Nephrotic Syndrome confirmed by the presence of 1. Heavy proteinuria (greater than 3-3.5 g/24 hours)2. Hypoalbuminemia (serum albumin < 25 g/L)3. Generalised oedema (often with periorbital involvement)4. Severe hyperlipidaemia (total cholesterol is often > 10 mmol/L). Focal Segmental Glomerulosclerosis will be the most likely answer as it is the most common cause of Nephrotic Syndrome in African American adults. Minimal change disease is the most common cause of nephrotic syndrome in children. Membranous glomerulonephritis is the most common cause of Nephrotic Syndrome in Caucasian adults. In IgA nephropathy, patients will complain of cola-coloured urine. Mesangiocapillary glomerulonephritis presents with features of Nephritic Syndrome.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4.8
      Seconds

  • Question 21 - A 29-year-old woman with anaphylactic reaction to peanuts, had to use her EpiPen...

    Correct

    • A 29-year-old woman with anaphylactic reaction to peanuts, had to use her EpiPen on the way to hospital. What percentage of patients with anaphylactic reaction suffer a biphasic response?.

      Your Answer: 20%

      Explanation:

      About 20% of patients that suffer an anaphylactic reaction suffer a biphasic response 4-6 hours after the initial response (sometimes up to 72 hours after).

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4.5
      Seconds

  • Question 22 - A 67-year-old female presents with a history of morning stiffness and arthritis of...

    Correct

    • A 67-year-old female presents with a history of morning stiffness and arthritis of her hand joints. She is being investigated for rheumatoid arthritis.Which test is most sensitive and specific for this diagnosis?

      Your Answer: Anti-CCP

      Explanation:

      Anti-cyclic citrullinated peptide (anti-CCP) is an antibody present in 60-80% of rheumatoid arthritis patients. It is measured by enzyme-linked immunosorbent assay (ELISA). It may be present years before the onset of the disease and is associated with a more severe disease course.While most patients with anti-CCP antibodies are also positive for rheumatoid factor (RF), RF antibody is not specific for rheumatoid arthritis as it can occur in patients with other conditions such as infections and other autoimmune conditions.ESR, antinuclear antibodies(ANA) and Synovial fluid examination are not specific for rheumatoid arthritis.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      3.7
      Seconds

  • Question 23 - A 56-year-old male with a 10-year history of Diabetes Mellitus and Hypertension was...

    Correct

    • A 56-year-old male with a 10-year history of Diabetes Mellitus and Hypertension was rushed to the Emergency Department due to sudden onset crushing chest pain. ECG showed an ST-elevation myocardial infarct in the left anterior descending artery territory. The patient's condition was stabilised and managed with angioplasty, but he sustained significant myocardial damage. Which one of the following statements best agrees with the myocardial healing process?

      Your Answer: The left ventricle will likely hypertrophy first to maintain cardiac output

      Explanation:

      Following a myocardial infarction scar tissue formation will take place at the site of the damaged muscle. This places increased load on the rest of the myocardium causing it to hypertrophy. The left ventricle will hypertrophy first as it is pumping blood against a greater afterload as compared to the right ventricle. There are three types of cells in the body with regards to the cell cycle: 1. permanent2. labile3. stable cellsPermanent cells do not re-enter the cell cycle and remain in G0. If there is a pool of stem cells the stem cells will enter the cell cycle to form more cells. Myocardial cells are a type of permanent cell and there is no pool of stem cells in the heart muscle. The anterior wall will not hypertrophy as it is formed by the right atrium and ventricle and both of these hypertrophy after the left ventricle.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      5.8
      Seconds

  • Question 24 - A 58-year-old man with a traumatic brain injury is brought into the ER....

    Correct

    • A 58-year-old man with a traumatic brain injury is brought into the ER. A medical student asks you about the processes that occur in the brain following a traumatic injury.One of these best describes the central nervous systems response to injury.

      Your Answer: Degeneration of the axon occurs proximally before it occurs distally

      Explanation:

      Following neuronal injury, as seen in traumatic brain injury, the axon undergoes anterograde degeneration. Degradation starts from the cell body (proximally) and progresses distally. The axon becomes fragmented and degenerates. The brain shows no reactive changes to injury is incorrect. Following major injury such as stroke, the brain undergoes a process of liquefactive degeneration, which leaves cystic spaces within the brain.Axonal regeneration does not occur to any significant extent within the central nervous system unlike what is seen in the peripheral nervous system. Astrocytes undergo reactive gliosis, leaving behind a firm translucent tissue around sites of damage.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      7.6
      Seconds

  • Question 25 - A 40-year-old woman presents with a red, scaly, itchy rash around her navel...

    Incorrect

    • A 40-year-old woman presents with a red, scaly, itchy rash around her navel that occurred after contact with a nickel belt buckle. A diagnosis of allergic contact dermatitis is made. Which type of hypersensitivity reaction is this?

      Your Answer: Type III hypersensitivity reaction

      Correct Answer: Type IV hypersensitivity reaction

      Explanation:

      A type IV hypersensitivity reaction occurred in this patient. Allergic contact dermatitis is an inflammatory skin reaction occurring in response to an external stimulus, acting either as an allergen or an irritant, caused by a type IV or delayed hypersensitivity reaction. They usually take several days to develop.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      5
      Seconds

  • Question 26 - A patient presents to your Emergency Department with a laceration on their buttocks...

    Correct

    • A patient presents to your Emergency Department with a laceration on their buttocks requiring closure with sutures.What stage of wound healing is the first to reach completion?

      Your Answer: Haemostasis

      Explanation:

      The stages of wound healing are: haemostasis, inflammatory, proliferative and remodelling (maturation) phases in that order. The first stage in the healing process of a laceration is haemostasis. Haemostasis is the process of the wound being closed by clotting. The inflammatory phase occurs just after and up to 48 hours after injury– Blood vessels dilate to allow white blood cells, antibodies, growth factors, enzymes and nutrients to reach the wounded area leading to the characteristic signs of inflammation seen. Epithelialisation and angiogenesis are not phases of wound healing but occur during the proliferative phase. This ia after haemolysis and inflammation phases have occurred.The maturation phase is the final phase and occurs when the wound has closed. It involves remodelling of collagen from type III to type I. Apoptosis remove unwanted cells, cellular activity reduces and the number of blood vessels in the wounded area regresses and decreases. This can continues for up to 1 year after injury.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4.6
      Seconds

  • Question 27 - Innate, or non-specific, immunity is the immune system we are born with.Which of...

    Correct

    • Innate, or non-specific, immunity is the immune system we are born with.Which of the following is NOT an example of innate immunity? Select ONE answer only.

      Your Answer: T-lymphocytes

      Explanation:

      Innate, or non-specific, immunity is the immune system we are born with.There are three aspects of innate immunity:1. Anatomical barriers, such as:The cough reflexEnzymes in tears and skin oilsMucus – which traps bacteria and small particlesSkinStomach acid2. Humoral barriers, such as:The complement systemInterleukin-13. Cellular barriers, such as:NeutrophilsMacrophagesDendritic cellsNatural killer cellsAntibody production is part of the specific, or inducible immune response. T-lymphocytesare responsible for the cell mediated immune response which is part of specific, or inducible immunity.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4.4
      Seconds

  • Question 28 - A patient presents with a lump for a dermatological examination. There is a...

    Correct

    • A patient presents with a lump for a dermatological examination. There is a circumscribed skin elevation measuring 0.3 cm in diameter seen on examination.Which one of these best describes the lump you have found on examination?

      Your Answer: Papule

      Explanation:

      A papule is a solid, well circumscribed, skin elevation measuring less than 0.5 cm in diameter. A nodule is a solid, well circumscribed, raised area that lies in or under the skin and measures greater than 0.5 cm in diameter. They are usually painless. A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter. A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus. A pustule is a small visible skin elevation containing an accumulation of pus.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4
      Seconds

  • Question 29 - A dermatological examination on a patient presenting with a lump shows a solid,...

    Incorrect

    • A dermatological examination on a patient presenting with a lump shows a solid, well circumscribed, lump measuring 0.8 cm in diameter.Which one of these best describes the lump you have found on examination?

      Your Answer: Macule

      Correct Answer: Nodule

      Explanation:

      A nodule is a solid, well circumscribed, raised area that lies in or under the skin and measures greater than 0.5 cm in diameter. They are usually painless.A vesicle is a visible collection of fluid measuring less than 0.5 cm in diameter. A macule is a flat, well circumscribed area of discoloured skin less than 1 cm in diameter with no changes in the thickness or texture of the skin.A papule is a solid, well circumscribed, skin elevation measuring less than 0.5 cm in diameter.A plaque is a palpable skin lesion that is elevated and measures >1cm in diameter

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      5.1
      Seconds

  • Question 30 - A newborn baby is referred by the community midwife who is concerned the...

    Correct

    • A newborn baby is referred by the community midwife who is concerned the baby is jaundiced because of the yellow appearance of his eyes and skin following a postnatal home visit. The jaundice is visible in the baby’s feet making her worried.Jaundice are visible in the extremities of neonates at what approximate threshold bilirubin level?

      Your Answer: 255 μmol/L

      Explanation:

      Newborn babies have a higher concentration of red blood cells with shorter lifespan leading to higher bilirubin levels than in adults. This condition is short-lived and harmless but with potential serious causes that need to be assessed for if present. The most obvious physical sign of jaundice is a yellow discolouration of the sclera, skin and mucous membranes. At a bilirubin level of 35 μmol/L or higher, the eye is affected. The bilirubin level will need to be higher than 255 μmol/L for the feet and extremities to be affected.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      1.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

General Pathology (25/30) 83%
Pathology (25/30) 83%
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