00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - A 5-year-old child presents with fever and otalgia. Greenish pustular discharge was seen...

    Correct

    • A 5-year-old child presents with fever and otalgia. Greenish pustular discharge was seen in his left ear during physical examination. The patient is diagnosed with otitis externa. Which of the following organisms most likely caused the infection?

      Your Answer: Pseudomonas aeruginosa

      Explanation:

      P. aeruginosa is a multidrug resistant pathogen recognised for its ubiquity, its advanced antibiotic resistance mechanisms and its association with serious illnesses – especially hospital-acquired infections such as ventilator-associated pneumonia and various septic syndromes. The species name aeruginosa is a Latin word meaning verdigris (copper rust), referring to the blue-green colour of laboratory cultures of the species. This blue-green pigment is a combination of two metabolites of P. aeruginosa, pyocyanin (blue) and pyoverdine (green), which impart the blue-green characteristic colour of cultures.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      14.3
      Seconds
  • Question 2 - An 11 year old boy is referred to the clinic with pain in...

    Correct

    • An 11 year old boy is referred to the clinic with pain in the left knee. He has been experiencing the pain for the past four months and it usually lasts for a few hours. He is seen to be walking with an antalgic gait and has apparent left leg shortening. The left knee is normal but the left hip reveals pain on internal and external rotation. Flattening of the femoral head is shown on imaging. Which of the following is the most likely underlying diagnosis?

      Your Answer: Perthes disease

      Explanation:

      Answer: Perthes disease

      Perthes’ disease is a condition affecting the hip joint in children. It is rare (1 in 9,000 children are affected) and we do not clearly understand why it occurs.

      Part or all of the femoral head (top of the thigh bone: the ball part of the ball-and-socket hip joint) loses its blood supply and may become misshapen. This may lead to arthritis of the hip in later years.

      The earliest sign of Legg-Calvé-Perthes disease (LCPD) is an intermittent limp (abductor lurch), especially after exertion, with mild or intermittent pain in the anterior part of the thigh. LCPD is the most common cause of a limp in the 4- to 10-year-old age group, and the classic presentation has been described as a painless limp.
      The patient may present with limited range of motion of the affected extremity. The most common symptom is persistent pain.

      Hip pain may develop and is a result of necrosis of the involved bone. This pain may be referred to the medial aspect of the ipsilateral knee or to the lateral thigh. The quadriceps muscles and adjacent thigh soft tissues may atrophy, and the hip may develop adduction flexion contracture. The patient may have an antalgic gait with limited hip motion.
      Early radiographic changes may reveal only a nonspecific effusion of the joint associated with slight widening of the joint space, metaphyseal demineralization (decreased bone density around the joint), and periarticular swelling (bulging capsule). This is the acute phase, and it may last 1-2 weeks. Decreasing bone density in and around the joint is noted after a few weeks. Eventually, the disease may progress to collapse of the femoral head, increase in the width of the neck, and demineralization of the femoral head. The final shape of this area depends on the extent of necrosis and the degree of collapse.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Orthopaedics
      21.7
      Seconds
  • Question 3 - Which of the following diseases can cause paraesthesia along the distribution of the...

    Correct

    • Which of the following diseases can cause paraesthesia along the distribution of the median nerve of the hand, especially after activities which require flexion and extension of the wrist?

      Your Answer: Carpal tunnel syndrome

      Explanation:

      Carpal tunnel syndrome tends to occur in women between the ages of 30-50. There are many risk factors, including diabetes, hypothyroidism, obesity, pregnancy, and repetitive wrist work. Symptoms include pain in the hand and wrist, tingling, and numbness distributed along the median nerve (the palmar side of the thumb, the index and middle fingers, and the radial half of the ring finger), which worsens at night.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      5.3
      Seconds
  • Question 4 - A 40-year-old male pedestrian is brought to the A&E department after being hit...

    Correct

    • A 40-year-old male pedestrian is brought to the A&E department after being hit by a car. On examination, he is found to be dyspnoeic and hypoxic despite administration of high flow oxygen therapy. Moreover, his pulse is 115bpm and blood pressure is 110/70 mmHg. The right side of his chest is hyper-resonant on percussion and has decreased breath sounds. His trachea is deviated to the left. What is the most likely underlying diagnosis?

      Your Answer: Tension pneumothorax

      Explanation:

      This patient has developed a tension pneumothorax following a blunt trauma.

      Tension pneumothorax is a life-threatening condition that develops when air is trapped in the pleural cavity under positive pressure, displacing mediastinal structures and compromising cardiopulmonary function. Blunt or penetrating chest trauma that creates a flap-type defect on the surface of the lung can result in this life-threatening condition.

      Signs and symptoms of tension pneumothorax include:
      1. Chest pain that usually has a sudden onset, is sharp, and may lead to feeling of tightness in the chest
      2. Dyspnoea and progressive hypoxia
      3. Tachycardia
      4. Hyperventilation
      5. Cough
      6. Fatigue

      On examination, hyper-resonant percussion note and tracheal deviation are typically found. Treatment is immediate without waiting for the CXR result and includes needle decompression and chest tube insertion.

    • This question is part of the following fields:

      • Emergency Medicine And Management Of Trauma
      • Principles Of Surgery-in-General
      12.7
      Seconds
  • Question 5 - A 62 year old retired teacher is diagnosed as having a malignant lesion...

    Incorrect

    • A 62 year old retired teacher is diagnosed as having a malignant lesion in the inferior aspect of her left breast. On examination, there is palpable axillary lymphadenopathy. Which of the following is the best course of action?

      Your Answer: Wide local excision and sentinel lymph node biopsy

      Correct Answer: Image guided fine needle aspiration of the axillary nodes

      Explanation:

      Fine-needle aspiration (FNA) cytology of axillary lymph nodes is a simple, minimally invasive technique that can be used to improve preoperative determination of the status of the axillary lymph nodes in patients with breast cancer, thereby serving as a tool with which to triage patients for sentinel versus full lymph node dissection procedures. FNA of axillary lymph nodes is a sensitive and very specific method with which to detect metastasis in breast cancer patients. Because of its excellent positive predictive value, full axillary lymph node dissection can be planned safely instead of a sentinel lymph node dissection when a preoperative positive FNA result is rendered.

    • This question is part of the following fields:

      • Breast And Endocrine Surgery
      • Generic Surgical Topics
      22.9
      Seconds
  • Question 6 - A 49-year-old man, smoker, complains of a persisting and worsening cough over the...

    Correct

    • A 49-year-old man, smoker, complains of a persisting and worsening cough over the past few months. He also has noted blood in his sputum. The patient has no other major health conditions. Which of the following investigative procedures should be done first?

      Your Answer: Sputum cytology

      Explanation:

      Sputum cytology is a diagnostic test used for the examination of sputum under a microscope to determine if abnormal cells are present. It may be used as the first diagnostic procedure to help detect a suspected lung cancer or certain non-cancerous lung conditions.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      15.6
      Seconds
  • Question 7 - Medulloblastoma usually occurs in children between 5 to 9 years old. Where does...

    Incorrect

    • Medulloblastoma usually occurs in children between 5 to 9 years old. Where does medulloblastoma commonly originate from?

      Your Answer: Pons

      Correct Answer: Cerebellar vermis

      Explanation:

      Medulloblastoma is the most common malignant brain tumour in children, accounting for 10-20% of primary CNS neoplasms. Most of the tumours originate in the cerebellar vermis.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      20.3
      Seconds
  • Question 8 - A young man in a motor vehicle accident sustained a spinal injury at...

    Incorrect

    • A young man in a motor vehicle accident sustained a spinal injury at C8 level. What would likely be seen in this patient?

      Your Answer: The muscles innervated by the radial nerve that would most likely be affected would be the most proximal ones

      Correct Answer: The hypothenar muscles would be completely paralysed

      Explanation:

      The eighth cervical nerve is one of the contributors of the ulnar nerve. The ulnar nerve supplies the hypothenar muscles which include the opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis, and palmaris brevis.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      18.7
      Seconds
  • Question 9 - A 32 year old man has had a total pancreatectomy done. He has...

    Incorrect

    • A 32 year old man has had a total pancreatectomy done. He has severe necrotizing pancreatitis that is unresponsive to conservative therapy. Which statement regarding the physiological effects of a total pancreatectomy on this patient is false?

      Your Answer: The patient is likely to develop diabetes mellitus

      Correct Answer: Loss of fat emulsification will result in the malabsorption of vitamins A, C, D, and K

      Explanation:

      Answer: Loss of fat emulsification will result in the malabsorption of vitamins A, C, D, and K

      Vitamins are classified as either fat soluble (vitamins A, D, E and K) or water soluble (vitamins B and C). This difference between the two groups is very important. It determines how each vitamin acts within the body. The fat soluble vitamins are soluble in lipids (fats). These vitamins are usually absorbed in fat globules (called chylomicrons) that travel through the lymphatic system of the small intestines and into the general blood circulation within the body. These fat soluble vitamins, especially vitamins A and E, are then stored in body tissues.
      Vitamin C is a water soluble vitamin which makes the statement false.
      Primary pancreatic maldigestion of carbohydrate, protein, and fat is caused by decreased activity of amylase, trypsin, and lipase. Pancreatic lipase is an enzyme secreted from the pancreas. As the primary lipase enzyme that hydrolyses dietary fat molecules in the human digestive system, it is one of the main digestive enzymes, converting triglyceride substrates found in ingested oils to monoglycerides and free fatty acids.
      The duodenum plays a key role in absorption of vitamins and minerals, and is removed in PD resections. This, in combination with malabsorption and increased metabolic demand, results in increased risk of micronutrient deficiencies. Routine supplementation of fat soluble vitamin and trace elements are recommended following resection.

    • This question is part of the following fields:

      • Peri-operative Care
      • Principles Of Surgery-in-General
      41.9
      Seconds
  • Question 10 - A 30-year-old man is admitted to the hospital with an embolus in the...

    Incorrect

    • A 30-year-old man is admitted to the hospital with an embolus in the brachial artery. A cervical rib is suspected as being the underlying cause. From which of the following vertebral levels does the cervical rib arise?

      Your Answer: C2

      Correct Answer: C7

      Explanation:

      A cervical rib in humans is an extra rib which arises from the C7 vertebra. Its presence is a congenital abnormality located above the normal first rib, and it consists of an anomalous fibrous band that often originates from C7 and may arc towards but rarely reaches the sternum. It is estimated to occur in 0.2% to 0.5% of the population. People may have a cervical rib on the right, left, or both sides.

      Most cases of cervical ribs are not clinically relevant and do not have symptoms; cervical ribs are generally discovered incidentally. However, they vary widely in size and shape, and in rare cases, they may cause problems such as contributing to thoracic outlet syndrome due to compression of the lower trunk of the brachial plexus or subclavian artery.

      Compression of the brachial plexus may be identified by weakness of the muscles near the base of the thumb. Compression of the subclavian artery is often diagnosed by finding a positive Adson’s sign on examination, where the radial pulse in the arm is lost during abduction and external rotation of the shoulder.

      Treatment is most commonly undertaken when there is evidence of neurovascular compromise. A transaxillary approach is the traditional operative method for excision of the cervical rib.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Vascular
      5.3
      Seconds
  • Question 11 - Regarding abduction of the digits of the hand, which of the following is...

    Incorrect

    • Regarding abduction of the digits of the hand, which of the following is correct?

      Your Answer: The palmar interosseous muscles are the sole adductors of the digits

      Correct Answer: All of the adductors of the digits take at least part of their attachments from metacarpal bones

      Explanation:

      Lying on the palmer surfaces of the metacarpal bones are four palmar interossei which are smaller than the dorsal interossei. Arising from the entire length of the metacarpal bone of one finger, is a palmar interosseous, which is inserted into the side of the base of the first phalanx and the aponeurotic expansion of the extensor digitorum communis tendon to the same finger. All the interossei are innervated by the eighth cervical nerve, through the deep palmar branch of the ulnar nerve. The palmar interossei adducts the fingers to an imaginary line drawn longitudinally through the centre of the middle finger.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      46.2
      Seconds
  • Question 12 - A 34-year-old woman is diagnosed with cerebral oedema after suffering a severe head...

    Incorrect

    • A 34-year-old woman is diagnosed with cerebral oedema after suffering a severe head trauma. Which of the following conditions is not likely to be associated with the extracellular oedema?

      Your Answer: All answers are associated

      Correct Answer: Increased plasma colloid osmotic pressure

      Explanation:

      Cerebral oedema is extracellular fluid accumulation in the brain. Increased capillary permeability, increased capillary pressure, increased interstitial fluid colloid osmotic pressure and lymphatic blockage would increase fluid movement into the interstitial spaces. Increased plasma colloid osmotic pressure, however, would oppose fluid movement from the capillaries into the interstitial compartment.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      32.4
      Seconds
  • Question 13 - Which of these HLA alleles is most likely to be present in ankylosing...

    Correct

    • Which of these HLA alleles is most likely to be present in ankylosing spondylitis?

      Your Answer: HLA-B27

      Explanation:

      Ankylosing spondylitis usually appears between the ages of 20-40 years old and is more frequent in men. It is strongly associated with HLA-B27, along with other spondyloarthropathies, which can be remembered through the mnemonic PAIR (Psoriasis, Ankylosing spondylitis, Inflammatory bowel disease, and Reactive arthritis).

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      6
      Seconds
  • Question 14 - From which of the following cells is heparin produced? ...

    Incorrect

    • From which of the following cells is heparin produced?

      Your Answer: Endothelial cells

      Correct Answer: Mast cells

      Explanation:

      Heparin is a natural highly-sulphated glycosaminoglycan that has anticoagulant functions. It is produced by the body basophils and mast cells.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      59.1
      Seconds
  • Question 15 - A 22-year-old woman is involved in a road traffic accident. After a transient...

    Correct

    • A 22-year-old woman is involved in a road traffic accident. After a transient period of concussion, she is found to have a GCS of 15, by the paramedics. She is next observed on her arrival at the A&E department of the hospital and is found to have a GCS of 3 and a blown right pupil. Out of the following, which condition best accounts for this deterioration?

      Your Answer: Transtentorial herniation

      Explanation:

      The presence of blown right pupil is a sign of the third cranial nerve compression. The most likely cause is an extradural bleed. However, since this option is not listed, transtentorial herniation would be the most applicable answer. Intraventricular bleeds are typically more common in premature neonates and deterioration due to hydrocephalus is more chronic. Subdural haematoma has a slower onset of symptoms.

      Transtentorial herniation is a type of cerebral herniaton. It is further divided into two types with the uncal herniation being the most common.
      1. Descending transtentorial herniation: more frequently known as uncal herniation
      2. Ascending transtentorial herniation: less common than uncal herniation

      Uncal (transtentorial) herniation is herniation of the medial temporal lobe from the middle into the posterior fossa, across the tentorial opening. The cardinal signs are an acute loss of consciousness associated with ipsilateral oculomotor nerve palsy with a fixed and dilated pupil (blown pupil) and contralateral hemiparesis.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Surgical Disorders Of The Brain
      10.7
      Seconds
  • Question 16 - A 45-year-old female with a metallic heart valve has just undergone an elective...

    Incorrect

    • A 45-year-old female with a metallic heart valve has just undergone an elective paraumbilical hernia repair. In view of her metallic valve, she is given unfractionated heparin perioperatively. How should the therapeutic efficacy be monitored, assuming her renal function is normal?

      Your Answer: Measurement of Prothrombin time

      Correct Answer: Measurement of APTT

      Explanation:

      Because of the substantial risk of thromboembolism early after valve replacement, perioperative initiation of anticoagulation is necessary, despite the increased risk for bleeding. Anticoagulation should be initiated within 24 h after the procedure with unfractionated heparin or low-molecular-weight heparin (LMWH).
      Heparin is monitored by checking the activated partial thromboplastin time or anti-Xa activity.
      Oral anticoagulants are monitored by INR.

    • This question is part of the following fields:

      • Peri-operative Care
      • Principles Of Surgery-in-General
      44.5
      Seconds
  • Question 17 - The neurotransmitters adrenaline, noradrenaline and dopamine are derived from which amino acid? ...

    Incorrect

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

      Your Answer: Tryptophan

      Correct 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:

      • Basic Sciences
      • Physiology
      18.2
      Seconds
  • Question 18 - A 68-year-old woman complains of headaches, dizziness, and memory loss. About a month...

    Correct

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

      Your Answer: Chronic subdural haematoma

      Explanation:

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

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      42.5
      Seconds
  • Question 19 - The left lateral pterygoid muscle is one of the muscles of mastication. When...

    Incorrect

    • The left lateral pterygoid muscle is one of the muscles of mastication. When acting alone, it will shift the mandible towards which direction?

      Your Answer: Laterally, to the left

      Correct Answer: Laterally, to the right

      Explanation:

      The lateral pterygoid or external pterygoid is a muscle of mastication with two heads. It lies superiorly to the medial pterygoid. When acting alone, it will shift the mandible laterally and to the right.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      9.7
      Seconds
  • Question 20 - An 11 year old girl undergoes a delayed open reduction and fixation of...

    Correct

    • An 11 year old girl undergoes a delayed open reduction and fixation of a significantly displaced supracondylar fracture. She complains of paraesthesia of the hand and significant forearm pain. The radial pulse is normal. What is the best course of action?

      Your Answer: Fasciotomy

      Explanation:

      Answer: Fasciotomy

      Fasciotomy is a surgical procedure where the fascia is cut to relieve tension or pressure commonly to treat the resulting loss of circulation to an area of tissue or muscle. Fasciotomy is a limb-saving procedure when used to treat acute compartment syndrome. A delay in performing the procedure can lead to neurovascular complications or lead to the need for amputation of a limb. Complications can also involve the formation of scar tissue after the operation. A thickening of the surgical scars can result in the loss of mobility of the joint involved. This can be addressed through occupational or physical therapy.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Orthopaedics
      13.5
      Seconds
  • Question 21 - A 35 year old man arrives at the ED with abdominal pain. He...

    Correct

    • A 35 year old man arrives at the ED with abdominal pain. He is from Zimbabwe. Radiological scan of the abdomen reveals calcification of the urinary bladder. Which of the following is the most likely cause of his condition?

      Your Answer: Schistosoma haematobium

      Explanation:

      The ova of Schistosoma haematobium are deposited in the wall of the bladder and ureters, where they evoke a granulomatous inflammatory reaction with eventual calcification of the bladder wall. The typical presentation is painful terminal haematuria. Secondary bacterial infection may occur, particularly with Pseudomonas, Proteus or Salmonella, especially following instrumentation of the bladder.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Urology
      9.7
      Seconds
  • Question 22 - A 45-year-old male undergoes a distal gastrectomy for cancer. He is slightly anaemic...

    Correct

    • A 45-year-old male undergoes a distal gastrectomy for cancer. He is slightly anaemic and therefore receives a transfusion of 4 units of packed red cells to cover both the existing anaemia and associated perioperative blood loss. He is noted to develop ECG changes that are not consistent with ischaemia. What is the most likely cause?

      Your Answer: Hyperkalaemia

      Explanation:

      The patient suffers from hyperkalaemia as an adverse effect of RBCs transfusion, which causes his ECG changes.
      The potassium concentration of blood increases during storage, by as much as 5–10 mmol u−1. After the transfusion, the RBC membrane Na+–K+ ATPase pumping mechanism is re-established and cellular potassium reuptake occurs rapidly. Hyperkalaemia rarely occurs during massive transfusions unless the patient is also hypothermic and acidotic.
      The total extracellular potassium load, which is <0.5 mmol for fresh RBC units and only 5-7 mmol for units at expiration, rarely causes problems in the recipient because of rapid dilution, redistribution into cells, and excretion. An abnormally high potassium level (>5 mmol/l or ≥1.5 mmol/l net increase) within an hour of transfusion is classified as transfusion-associated hyperkalaemia.
      Irradiation enhances potassium leakage.

    • This question is part of the following fields:

      • Post-operative Management And Critical Care
      • Principles Of Surgery-in-General
      26
      Seconds
  • Question 23 - A young lady is rushed to the A&E department after being stabbed on...

    Incorrect

    • A young lady is rushed to the A&E department after being stabbed on her way home. She coughs up blood and a drain is placed into the left chest which removes 750ml of frank blood. She fails to improve and has been given 4 units of blood. Her CVP is now 13. What is the best course of action?

      Your Answer: Thoracotomy in ED

      Correct Answer: Thoracotomy in theatre

      Explanation:

      Answer: Thoracotomy in theatre

      A high CVP of 13 indicates cardiac tamponade. Cardiac tamponade is a clinical syndrome caused by the accumulation of fluid in the pericardial space, resulting in reduced ventricular filling and subsequent hemodynamic compromise. The condition is a medical emergency, the complications of which include pulmonary oedema, shock, and death.
      A pericardiotomy via a thoracotomy is mandatory for lifesaving cardiac decompression in acute traumatic cardiac tamponade in cases of ineffective drainage due to clot formation within the pericardial space. Wherever possible a patient needing surgery for penetrating chest trauma should be moved to an operating theatre where optimal surgical expertise and facilities are available.

    • This question is part of the following fields:

      • Emergency Medicine And Management Of Trauma
      • Principles Of Surgery-in-General
      16
      Seconds
  • Question 24 - A 32 year old presents with symptoms of an anal fistula. The clinician...

    Correct

    • A 32 year old presents with symptoms of an anal fistula. The clinician examines him in the lithotomy position and the external opening of the fistula is identified in the 7 o'clock position. At which of the following locations is the internal opening most likely to be found?

      Your Answer: 6 o'clock

      Explanation:

      Goodsall’s rule can be used to clinically predict the course of an anorectal fistula tract. Imagine a line that bisects the anus in the coronal plane (transverse anal line). Any fistula that originates anterior to the line will course anteriorly in a direct route. Fistulae that originate posterior to the line will have a curved path. An exception to the rule are anterior fistulas lying more than 3 cm from the anus, which may open into the anterior midline of the anal canal.

    • This question is part of the following fields:

      • Colorectal Surgery
      • Generic Surgical Topics
      42.8
      Seconds
  • Question 25 - The muscle that stabilizes the stapes is innervated by which of the following...

    Correct

    • The muscle that stabilizes the stapes is innervated by which of the following nerves?

      Your Answer: Facial nerve

      Explanation:

      The stapedius is the smallest skeletal muscle in the human body. At just over one millimetre in length, its purpose is to stabilize the smallest bone in the body, the stapes and is innervated by a branch of the facial nerve.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      5.9
      Seconds
  • Question 26 - A 39 year old woman returns from a holiday trip in Nepal and...

    Incorrect

    • A 39 year old woman returns from a holiday trip in Nepal and presents to her doctor with painless jaundice. On examination there is no organomegaly and she is not deeply jaundiced. What is most likely cause of her illness?

      Your Answer: Gilberts syndrome

      Correct Answer: Hepatitis A infection

      Explanation:

      Hepatitis A is a viral liver disease that can cause mild to severe illness. The hepatitis A virus (HAV) is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person.
      The risk of hepatitis A infection is associated with a lack of safe water, and poor sanitation and hygiene (such as dirty hands). Unlike hepatitis B and C, hepatitis A does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms and fulminant hepatitis (acute liver failure), which is often fatal.
      Prodrome
      In the prodrome, patients may have mild flulike symptoms of anorexia, nausea and vomiting, fatigue, malaise, low-grade fever (usually < 39.5°C), myalgia, and mild headache. Smokers often lose their taste for tobacco, like persons presenting with appendicitis. Icteric phase
      In the icteric phase, dark urine appears first (bilirubinuria). Pale stool soon follows, although this is not universal. Jaundice occurs in most (70%-85%) adults with acute HAV infection; it is less likely in children and is uncommon in infants. The degree of icterus also increases with age. Abdominal pain occurs in approximately 40% of patients. Itching (pruritus), although less common than jaundice, is generally accompanied by jaundice.

      Arthralgias and skin rash, although also associated with acute HAV infection, are less frequent than the above symptoms. Rash more often occurs on the lower limbs and may have a vasculitic appearance.

      Relapsing hepatitis A
      Relapsing hepatitis A is an uncommon sequela of acute infection, is more common in elderly persons, and is characterized by a protracted course of symptoms of the disease and a relapse of symptoms and signs following apparent resolution.

    • This question is part of the following fields:

      • Clinical Microbiology
      • Principles Of Surgery-in-General
      5.8
      Seconds
  • Question 27 - 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:

      • Basic Sciences
      • Physiology
      20.9
      Seconds
  • Question 28 - Macrolides are a group of antibiotics commonly used to treat respiratory tract and...

    Incorrect

    • Macrolides are a group of antibiotics commonly used to treat respiratory tract and soft-tissue infections. Which of the following antibiotics is a macrolide?

      Your Answer: Ciprofloxacin

      Correct Answer: Erythromycin

      Explanation:

      Erythromycin is a macrolide antibiotic used in the treatment of several bacterial infections, including respiratory tract infections, skin infections, chlamydia infections, pelvic inflammatory disease, and syphilis. It may also be used during pregnancy to prevent Group B streptococcal infection in the new-born.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      3.8
      Seconds
  • Question 29 - The optic foramen, superior orbital fissure, foramen ovale, foramen rotundum and foramen sinosum...

    Correct

    • The optic foramen, superior orbital fissure, foramen ovale, foramen rotundum and foramen sinosum are all located on which bone at the base of the skull?

      Your Answer: Sphenoid

      Explanation:

      The sphenoid bone consists of two parts, a central part and two wing-like structures that extend sideways towards each side of the skull. It forms the base of the skull, and floor and sides of the orbit. On its central part lies the optic foramen. The foramen ovale, foramen spinosum and foramen rotundum lie on its great wing while the superior orbital fissure lies on its lesser wing.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      3.5
      Seconds
  • Question 30 - What is the innervation of the tensor tympani muscle? ...

    Incorrect

    • What is the innervation of the tensor tympani muscle?

      Your Answer: Facial nerve

      Correct Answer: Trigeminal nerve

      Explanation:

      The tensor veli palatini is innervated by the medial pterygoid nerve, a branch of mandibular nerve, the third branch of the trigeminal nerve (CN V3) – the only muscle of the palate not innervated by the pharyngeal plexus, which is formed by the vagal and glossopharyngeal nerves.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      2.5
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Basic Sciences (8/17) 47%
Pathology (5/8) 63%
Generic Surgical Topics (5/7) 71%
Orthopaedics (2/2) 100%
Emergency Medicine And Management Of Trauma (1/2) 50%
Principles Of Surgery-in-General (2/6) 33%
Breast And Endocrine Surgery (0/1) 0%
Anatomy (2/6) 33%
Peri-operative Care (0/2) 0%
Vascular (0/1) 0%
Physiology (1/3) 33%
Surgical Disorders Of The Brain (1/1) 100%
Urology (1/1) 100%
Post-operative Management And Critical Care (1/1) 100%
Colorectal Surgery (1/1) 100%
Clinical Microbiology (0/1) 0%
Passmed