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  • Question 1 - Which is the site of action of the drug omeprazole? ...

    Incorrect

    • Which is the site of action of the drug omeprazole?

      Your Answer: Na+/K+ pump

      Correct Answer: H+/K+ ATPase

      Explanation:

      H+/K+-ATPase or ‘proton pump’ located in the canalicular membrane plays a major role in acid secretion. The ATPase here is magnesium-dependent. Omeprazole is a proton pump inhibitor and blocks H+/K+- ATPase.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      2
      Seconds
  • Question 2 - Which among the following vertebrae marks the lowest extent of the superior mediastinum?...

    Incorrect

    • Which among the following vertebrae marks the lowest extent of the superior mediastinum?

      Your Answer:

      Correct Answer: Fourth thoracic

      Explanation:

      The superior mediastinum lies between the manubrium anteriorly and the upper vertebrae of the thorax posteriorly. Below, it is bound by a slightly oblique plane that passes backward from the sternal angle to the lower part of the body of T4 and laterally by the pleura.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 3 - A 30 year old male has a painless and transilluminant swelling at the...

    Incorrect

    • A 30 year old male has a painless and transilluminant swelling at the upper pole of his left testi. There is a negative cough test. Which of the following is the likely diagnosis?

      Your Answer:

      Correct Answer: Spermatocoele

      Explanation:

      Spermatocele, also known as a spermatic cyst is a cystic mass usually occurring at the upper pole of the testis. Differential diagnosis included hydrocele as both are cystic, painless and transilluminant. Ultrasound is a useful modality. If symptomatic or large, surgical excision can be done.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 4 - The thyrocervical trunk branches into which artery that passes upward and in front...

    Incorrect

    • The thyrocervical trunk branches into which artery that passes upward and in front of the vertebral artery and longus colli muscle:

      Your Answer:

      Correct Answer: Inferior thyroid

      Explanation:

      The inferior thyroid artery is an artery in the neck. It arises from the thyrocervical trunk and passes upward, in front of the vertebral artery and longus colli muscle.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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      Seconds
  • Question 5 - A 36-year old gentleman with a history of cough for 4 weeks came...

    Incorrect

    • A 36-year old gentleman with a history of cough for 4 weeks came to the hospital. Examination revealed multiple lymphadenopathy with splenomegaly. Investigations revealed haemoglobin 11 g/dl, haematocrit 32.4%, mean corpuscular volume (MCV) 93 fl, white blood cell count 63 × 109/l, and platelet count 39 × 109/l; along with characteristic Auer rods on peripheral blood smear. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Acute myelogenous leukaemia (AML)

      Explanation:

      AML, or acute myeloid leukaemia is the commonest acute leukaemia affecting adults. increasing in incidence with age. It is a malignancy of the myeloid line of white blood cells. It results in rapid proliferation of abnormal cells, which accumulate in the marrow. Interference with normal cell production leads to a drop in red blood cells, white blood cells and platelets. This causes symptoms such as tiredness, shortness of breath, tendency to bleed or bruise easily and recurrent infections. AML is known to progress quickly and can lead to death in weeks and months if not treated. Leukemic blasts of AML show presence of Auer rods. These are clumps of azurophilic granular material that form needles in the cytoplasm. Composed of fused lysosomes, these contain peroxidase, lysosomal enzymes and crystalline inclusions. Auer rods are classically present in myeloid blasts of M1, M2, M3 and M4 acute leukaemia. They also help to distinguish the preleukemia myelodysplastic syndromes.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
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  • Question 6 - The pterygoid plexus receives tributaries from which of the following veins? ...

    Incorrect

    • The pterygoid plexus receives tributaries from which of the following veins?

      Your Answer:

      Correct Answer: Maxillary vein

      Explanation:

      The pterygoid plexus of veins is the main venous component associated with the infratemporal fossa. It receives tributaries corresponding to the branches of the internal maxillary artery. This plexus communicates freely with the anterior facial vein; it also communicates with the cavernous sinus, by branches through the foramen of Vesalius, foramen ovale and foramen lacerum. The (internal) maxillary vein is a short trunk which accompanies the first part of the (internal) maxillary artery. It is formed by a confluence of the veins of the pterygoid plexus and passes backward between the sphenomandibular ligament and the neck of the mandible and unites with the temporal vein to form the posterior facial vein. It carries blood away from the infratemporal fossa.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 7 - A 30 year old man suffered severe blood loss, approx. 20-30% of his...

    Incorrect

    • A 30 year old man suffered severe blood loss, approx. 20-30% of his blood volume. What changes are most likely seen in the pulmonary vascular resistance (PVR) and pulmonary artery pressure (PAP) respectively following this decrease in cardiac output?

      Your Answer:

      Correct Answer: Increase Decrease

      Explanation:

      Hypovolemia will result in the activation of the sympathetic adrenal discharge resulting is a decrease pulmonary artery pressure and an elevated pulmonary vascular resistance.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
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  • Question 8 - A 46-year old lady presents with chief complaints of a large mass in...

    Incorrect

    • A 46-year old lady presents with chief complaints of a large mass in the left breast. Histopathology of the mass revealed a stromal component with an epithelial component. What is the likely lesion?

      Your Answer:

      Correct Answer: Phyllodes tumour

      Explanation:

      Phyllodes tumours are large, quickly growing tumours which arise from the periductal stroma of the breast. These are fibroepithelial tumours and account for less than 1% of breast cancers. These tumours can be benign, borderline or malignant based on the histology. The tumour usually affects adult women, mostly between the age of 40 to 50 years. It can be confused with fibroadenoma, which however affects much younger patients.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 9 - In the glomerulus of the kidney, the mesangium is a structure associated with the capillaries. It has extraglomerular mesangial...

    Incorrect

    • In the glomerulus of the kidney, the mesangium is a structure associated with the capillaries. It has extraglomerular mesangial cells that:

      Your Answer:

      Correct Answer: Form the juxtaglomerular apparatus in combination with the macula densa and juxtaglomerular cells

      Explanation:

      The mesangium is an inner layer of the glomerulus, within the basement membrane surrounding the glomerular capillaries. The mesangial cells are phagocytic and secrete the amorphous basement membrane-like material known as the mesangial matrix. They are typically separated from the lumen of the capillaries by endothelial cells. The other type of cells in the mesangium are the extraglomerular mesangial cells which form the juxtaglomerular apparatus in combination with two other types of cells: the macula densa of the distal convoluted tubule and juxtaglomerular cells of the afferent arteriole. This apparatus controls blood pressure through the renin–angiotensin–aldosterone system.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
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  • Question 10 - A significantly elevated white cell count of 50 x 109/l with 5% blasts...

    Incorrect

    • A significantly elevated white cell count of 50 x 109/l with 5% blasts and raised leucocyte alkaline phosphatase is seen in which of the following conditions?

      Your Answer:

      Correct Answer: Leukaemoid reaction

      Explanation:

      Non-neoplastic proliferation of leucocytes causes an increase in leukocyte alkaline phosphatase (LAP). This is referred to as ‘leukemoid reaction’ because of the similarity to leukaemia with an increased white cell count (>50 × 109/l) with immature forms. Causes of leukemoid reaction includes haemorrhage, drugs (glucocorticoids, all-trans retinoic acid etc), infections such as tuberculosis and pertussis, and as a paraneoplastic phenomenon. Leukemoid reaction can also be seen in infancy as a feature of trisomy 21. This is usually a benign condition, but can be a response to a disease state. Differential diagnosis include chronic myelogenous leukaemia (CML).

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 11 - Which nuclei of the posterior grey column of the spinal cord are likely...

    Incorrect

    • Which nuclei of the posterior grey column of the spinal cord are likely affected in a patient who has lost the sensation of pain and temperature?

      Your Answer:

      Correct Answer: Substantia gelatinosa

      Explanation:

      Substantia gelatinosa is one of the nuclei in the posterior grey column along side other posterior grey column nuclei like the nucleus dorsalis, nucleus proprius, and posteromarginal nucleus. These nuclei are a collection of cells in the posterior grey area found in throughout the spinal cord. The substantia gelatinosa receives direct input from the dorsal nerve roots (sensory), especially from thermoreceptors and nociceptors (receptors for temperature and pain).

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 12 - The prostatic plexus of nerves contains nerve fibres that innervate penile tissue allowing...

    Incorrect

    • The prostatic plexus of nerves contains nerve fibres that innervate penile tissue allowing for erection. From which of the following nerves do these fibres originate?

      Your Answer:

      Correct Answer: Pelvic splanchnics

      Explanation:

      Pelvic splanchnic nerves are examples of the parasympathetic nerves that innervate the smooth muscle and glands of the pelvic viscera. They are also the nerves contributing fibres to the prostatic plexus which innervate penile erectile tissue.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 13 - During strenuous exercise, what else occurs besides tachycardia? ...

    Incorrect

    • During strenuous exercise, what else occurs besides tachycardia?

      Your Answer:

      Correct Answer: Increased stroke volume

      Explanation:

      During strenuous exercise there is an increase in:
      – Heart rate, stroke volume and therefore cardiac output. (CO = HR x SV)
      – Respiratory rate (hyperventilation) which will lead to a reduction in Paco2.
      – Oxygen demand of skeletal muscle, therefore leading to a reduction in mixed venous blood oxygen concentration.
      Renal blood flow is autoregulated, so renal blood flow is preserved and will tend to remain the same. Mean arterial blood pressure is a function of cardiac output and total peripheral resistance and will increase with exercise, mainly as a result of the increase in cardiac output that occurs.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
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  • Question 14 - A 7-year-old boys undergoes a testicular biopsy after a tumour is found in...

    Incorrect

    • A 7-year-old boys undergoes a testicular biopsy after a tumour is found in his right testis. Elements similar to hair and teeth are found in it. What kind of tumour is this?

      Your Answer:

      Correct Answer: Teratoma

      Explanation:

      A teratoma is a tumour containing tissue elements that are similar to normal derivatives of more than one germ layer. They usually contain skin, hair, teeth and bone tissue and are more common in children, behaving as a benign tumour. After puberty, they are regarded as malignant and can metastasise.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
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  • Question 15 - A 73-year-old woman goes to the doctor complaining of pain and stiffness in...

    Incorrect

    • A 73-year-old woman goes to the doctor complaining of pain and stiffness in her shoulders and hips for 4 months, which is worst in the mornings. She has also been suffering from fatigue, weight loss and depression. There were no abnormal findings on physical examination. The erythrocyte sedimentation rate was 110 mm/hour, and serum rheumatoid factor and antinuclear antibody assays were negative. Mild normochromic normocytic anaemia was also found. What is the most likely diagnosis in this case?

      Your Answer:

      Correct Answer: Polymyalgia rheumatica

      Explanation:

      Polymyalgia rheumatica (PMR) affects older adults, with an acute or subacute onset. Symptoms include severe pain and stiffness of the neck and pectoral or pelvic girdles, which is worse in the morning or after a period of inactivity and is usually bilateral. Other symptoms can include fatigue, weight loss, depression and fever. The erythrocyte sedimentation rate is usually elevated, and normochromic normocytic anaemia can occur. Other tests are usually normal in this disease.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 16 - An old man presented with atrophy of the thenar eminence despite the sensation...

    Incorrect

    • An old man presented with atrophy of the thenar eminence despite the sensation over it still being intact. What is the injured nerve in this case?

      Your Answer:

      Correct Answer: Median nerve

      Explanation:

      Atrophy of the thenar muscles means injury to the motor supply of these muscles. The nerve that sends innervation to it is the median nerve. But the median nerve does not provide sensory innervation to the overlying skin so sensation is spared.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 17 - Which of the following structure forms the floor of the posterior triangle of...

    Incorrect

    • Which of the following structure forms the floor of the posterior triangle of the neck:

      Your Answer:

      Correct Answer: Prevertebral fascia

      Explanation:

      The posterior triangle (or lateral cervical region) is a region of the neck which has the following boundaries:
      Apex: Union of the sternocleidomastoid and the trapezius muscles at the superior nuchal line of the occipital bone
      Anterior: Posterior border of the sternocleidomastoid muscle
      Posterior: Anterior border of the trapezius
      Base: Middle one third of the clavicle
      Roof: Investing layer of the deep cervical fascia
      Floor: The anterolateral portion of prevertebral fascia

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
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  • Question 18 - Which of the following statements is true of Colles’ fracture? ...

    Incorrect

    • Which of the following statements is true of Colles’ fracture?

      Your Answer:

      Correct Answer: Is a cause of carpal tunnel syndrome

      Explanation:

      Colles’ fracture is a distal fracture of the radius that is a known cause of carpal tunnel syndrome (compression of the median nerve in the carpal tunnel). It rarely results in ulnar nerve compression. A Colles’ fracture is extra-articular and does not extend into the wrist joint, otherwise this would make it an intra-articular fracture (Barton’s fracture). The distal fragment in a Colles’ fracture is displaced dorsally, unlike in a Smith’s fracture where the distal fragment is displaced volarly (ventrally). Associated fracture of the ulnar styloid process may occur and is a common associated injury.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
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  • Question 19 - A 40-year old gentleman, known with past peptic ulcer disease, was brought to...

    Incorrect

    • A 40-year old gentleman, known with past peptic ulcer disease, was brought to the clinic in a dehydrated state with persistent vomiting. His blood investigations revealed sodium = 142 mmol/l, potassium = 2.6 mmol/l, chloride = 85 mmol/l, pH = 7.55, p(CO2) = 50 mmHg, p(O2) = 107 mmHg and standard bicarbonate = 40 mmol/l. This patient had:

      Your Answer:

      Correct Answer: Metabolic alkalosis

      Explanation:

      High pH with high standard bicarbonate indicates metabolic alkalosis. The pa(CO2) was appropriately low in compensation. This is hypokalaemia hypochloraemic metabolic acidosis due to prolonged vomiting. Treatment includes treating the cause and intravenous sodium chloride with potassium.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
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  • Question 20 - A chest x ray is ordered for a 39 year old man who...

    Incorrect

    • A chest x ray is ordered for a 39 year old man who presents with a history of a cough and weight loss for over a month. It shows a rounded opacity in the pleural cavity near the cardiac notch. The opacity is most likely to be in the:

      Your Answer:

      Correct Answer: Costomediastinal recess

      Explanation:

      The costomediastinal recess is the point where the costal pleura becomes the mediastinal pleura, located right next to the cardiac notch.
      The cupola: part of the parietal pleura that extends above the first rib to the root of the lung.
      Hilum: located on the medial surface of the lung where neurovascular structures enter and leave the lung.
      Pulmonary ligament: pleural fold found below the root of the lung, is a point of continuity between the visceral and mediastinal pleura.
      Costodiaphragmatic recess: the lowest extent of the pleural cavity.
      Superior mediastinum: part of the mediastinum that contains the great vessels leaving and entering the heart.
      The cardiac notch is in the inferior mediastinum.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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