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Question 1
Incorrect
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Of the following, which is NOT a branch of the external carotid artery?
Your Answer:
Correct Answer: Mandibular artery
Explanation:The external carotid artery has eight important branches:
1. Superior thyroid artery
2. Ascending pharyngeal artery
3. Lingual artery
4. Facial artery
5. Occipital artery
6. Posterior auricular artery
7. Maxillary artery (terminal branch)
8. Superficial temporal artery (terminal branch)There is no mandibular artery but the first part of the maxillary artery is called the mandibular part as it is posterior to the lateral pterygoid muscle.
The maxillary artery is divided into three portions by its relation to the lateral pterygoid muscle:
first (mandibular) part: posterior to the lateral pterygoid muscle
second (pterygoid or muscular) part: within the lateral pterygoid muscle
third (pterygopalatine) part: anterior to the lateral pterygoid muscle. -
This question is part of the following fields:
- Anatomy
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Question 2
Incorrect
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What structure is most posterior at the porta hepatis?
Your Answer:
Correct Answer: Portal vein
Explanation:The structures in the porta hepatis from anterior to posterior are:
The ducts: Most anterior are the left and right hepatic ducts.
The arteries: Next are the left and right hepatic arteries
The veins: Next is the portal vein
The epiploic foramen of Winslow lies most posterior at the porta hepatis.
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This question is part of the following fields:
- Anatomy
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Question 3
Incorrect
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Which statement most accurately describes the action of increasing the gain in ultrasound imaging?
Your Answer:
Correct Answer: Amplifies the returning signal
Explanation:A higher frequency ultrasound comes with a better resolution of the digital image. Ultrasound with a frequency of 15 MHz is best used in imaging of superficial organs such as the thyroid gland, muscles, tendons and breasts whereas deep organs are better imaged using a lower frequency of 2-7MHz because of its ability for deeper penetration but lower resolution. These low frequency probes are also used to diagnose ascites, pleural effusions or can be used in echocardiography.
The US probe emits and then absorbs a reflected wave. Similar to brightness control, increasing the gain will amplify the return signal which is then attenuated by the tissue. This increases the signal to noise ratio.
A high frame rate, which basically means the number of times an image is updated onto the screen per second, improves the resolution of a moving 3D image which has become more accurate as the computing power has increased.Widening of the image field can be obtained by altering the penetration depth which is obtained by changing the frequency of the US beam.
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This question is part of the following fields:
- Anaesthesia Related Apparatus
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Question 4
Incorrect
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Which type of epithelium lines the luminal surface of the oesophagus?
Your Answer:
Correct Answer: Non keratinised stratified squamous epithelium
Explanation:Normally, the oesophagus is lined by non-keratinized stratified squamous epithelium. This epithelium can undergo metaplasia and convert to the columnar epithelium (stomach’s lining) in long-standing GERD that leads to Barret’s oesophagus.
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This question is part of the following fields:
- Anatomy
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Question 5
Incorrect
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You are preparing to anaesthetize a 27-year-old woman for an acute diagnostic laparoscopy to rule out appendicitis.
She has no medical history and does not take any medications on a regular basis. You're going to do a quick sequence induction.
Which method of preoxygenation is the most effective and efficient?Your Answer:
Correct Answer: Mapleson A circuit with a fresh gas flow of 100 ml/kg
Explanation:Professor Mapleson classified non-rebreathing circuits based on the position of the APL valve, which controls fresh gas flow.
The Mapleson A (Magill) circuit is most effective in spontaneous breathing, requiring only 70-100 ml/kg (the patient’s minute volume) of fresh gas flow. The patient inhales fresh gas from the reservoir bag and tubing during inspiration. During expiration, the patient adds dead space gas (gas that hasn’t been exchanged) to the tubing and reservoir bag in addition to the fresh gas flow. At the patient’s end, alveolar gas is vented through the APL valve. During the expiratory pause, the fresh gas flow causes more gas to be released.
The Mapleson A is inefficient during controlled ventilation. Venting occurs during inspiration rather than during the expiratory phase, as it does during spontaneous ventilation. As a result, unless a high fresh gas flow of >20 L/minute is used, alveolar gas is rebreathed.
During spontaneous ventilation, the Mapleson D circuit is inefficient.
The oxygen concentration in a Hudson mask is insufficient to allow for adequate pre-oxygenation.
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This question is part of the following fields:
- Anaesthesia Related Apparatus
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Question 6
Incorrect
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A new drug treatment has been developed for Crohn's disease. The pharmaceutical company behind this, is planning to conduct a trial and is looking for hiring around 200 individuals that are suffering from Crohn's disease. The aim would be to determine if there is any decline in the disease activity in response to the drug and compare it with a placebo.
What phase is the trial in?Your Answer:
Correct Answer: Phase 2
Explanation:The study is being conducted on a smaller level with only 200 participants and is determining the effectiveness of the drug in comparison to a placebo. These characteristics are in accordance with the second phase of trial.
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This question is part of the following fields:
- Statistical Methods
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Question 7
Incorrect
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The spinal cord tracts that transmits the sensations of pain, crude temperature, and light touch is?
Your Answer:
Correct Answer: Spinothalamic
Explanation:Dorsal column (ascending tract) – Proprioception, vibration, discriminative
Spinocerebellar (ascending tract) – Subconscious muscle position and tone
Corticospinal (descending tract) – Voluntary muscle
Rubrospinal (descending tract) – Flexor muscle tone
Vestibulospinal (descending tract) – Reflexes and muscle tone
Reticulospinal(descending tract) – Voluntary movements, head position.-
Autonomic – Descending tract.
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This question is part of the following fields:
- Anatomy
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Question 8
Incorrect
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Many of the processes we deal with in anaesthesia entail a relationship between two or more variables.
Which of the following relationships is a linear relationship?Your Answer:
Correct Answer: The relationship between the junction potential and temperature in a thermocouple
Explanation:Two bonded wires of dissimilar metals, iron/constantan or copper/constantan, make up a thermocouple (constantan is an alloy of copper and nickel). At the tip, a thermojunction voltage is generated that is proportional to temperature (Seebeck effect).
All of the other connections are non-linear.
For a single compartment model, the relationship between a decrease in plasma concentration of an intravenous bolus of a drug and time is a washout exponential.
A sine wave is the relationship between current and degrees or time from a mains power source.
A sigmoid curve represents the relationship between efficacy and log-dose of a pure agonist on mu receptors.
The pressure of a fixed mass of gas and its volume (Boyle’s law) at a fixed temperature are inversely proportional, resulting in a hyperbolic curve.
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This question is part of the following fields:
- Anaesthesia Related Apparatus
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Question 9
Incorrect
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The outer muscular layer of the oesophagus is covered by?
Your Answer:
Correct Answer: Loose connective tissue
Explanation:The oesophagus has four layers namely; 1. the mucosal layer, 2. the submucosal layer, 3. the muscular layer and 4. the layer of loose connective tissue which binds to the outer mucosal layer. The oesophagus lacks the serosal layer and therefore holds sutures poorly.
The mucosal layer consists of muscularis mucosa and the lamina propria and is made up of non keratinised stratified squamous epithelium. The mucosal layer is the innermost layer of the oesophagus.
The submucosal layer being the strongest layer of all has mucous glands which are called as the tuboalveolar mucous glands.
The outer muscular layer has two types of muscle layers of which one is the circular layer and the other the longitudinal layer. The Auerbach’s and Meissner’s nerve plexuses lie in between the longitudinal and circular muscle layers and submucosally. The muscle fibres present in the upper 1/3rd part of the oesophagus are skeletal muscle fibres, the middle 1/3rd layer has both smooth and skeletal muscle fibres, but the lower 1/3rd only has smooth muscle fibres.
The loose connective tissue layer or the adventitious layer has dense fibrous tissue.
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This question is part of the following fields:
- Anatomy
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Question 10
Incorrect
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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.
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This question is part of the following fields:
- Pathophysiology
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