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  • Question 1 - A child defecates a few minutes after being fed by the mother. This...

    Incorrect

    • A child defecates a few minutes after being fed by the mother. This is most likely due to:

      Your Answer: Enterogastric reflex

      Correct Answer: Gastrocolic reflex

      Explanation:

      The gastrocolic reflex is a physiological reflex that involves increase in colonic motility in response to stretch in the stomach and by-products of digestion in the small intestine. It is shown to be uneven in its distribution throughout the colon, with the sigmoid colon affected more than the right side of the colon in terms of a phasic response. Various neuropeptides have been proposed as mediators of this reflex, such as serotonin, neurotensin, cholecystokinin and gastrin.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      3
      Seconds

  • Question 2 - Which organ is responsible for the secretion of enzymes that aid in digestion...

    Incorrect

    • Which organ is responsible for the secretion of enzymes that aid in digestion of complex starches?

      Your Answer:

      Correct Answer: Pancreas

      Explanation:

      α-amylase is secreted by the pancreas, which is responsible for hydrolysis of starch, glycogen and other carbohydrates into simpler compounds.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 3 - A 45-year old male, who was a chronic smoker presented to the clinic...

    Incorrect

    • A 45-year old male, who was a chronic smoker presented to the clinic with backache and dry, incessant cough. On examination, he was found to have raised blood pressure, purplish striae on his abdomen, truncal obesity and tenderness over the lower thoracic spine. These findings are suggestive of which condition?

      Your Answer:

      Correct Answer: Small-cell anaplastic (oat cell) carcinoma

      Explanation:

      The symptoms suggest Cushing syndrome due to increased glucocorticoid levels. One cause of Cushing syndrome is ectopic production of adrenocorticotrophic hormone from oat cell carcinoma. As oat cell carcinoma is known to be highly metastatic, the tenderness in lower back could represent metastatic involvement.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
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  • Question 4 - A young man came to the emergency room after an accident. The anterior...

    Incorrect

    • A young man came to the emergency room after an accident. The anterior surface of his wrist was lacerated with loss of sensation over the thumb side of his palm. Which nerves have been damaged?

      Your Answer:

      Correct Answer: Median

      Explanation:

      The median nerve provides cutaneous innervation to the skin of the palmar radial three and a half fingers. Also the site of injury indicates that the medial nerve may have been injured as it passes into the hand by crossing over the anterior wrist.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 5 - A premenopausal woman has an ovarian tumour. Which is the most common benign...

    Incorrect

    • A premenopausal woman has an ovarian tumour. Which is the most common benign germ-cell tumour that could occur in a premenopausal woman?

      Your Answer:

      Correct Answer: Dermoid cyst

      Explanation:

      A dermoid cyst is a teratoma of a cystic nature that contains an array of developmentally mature and solid tissues. Dermoid cysts grow slowly and this type of cystic teratoma is nearly always benign.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 6 - Which of the following muscles aid in inspiration? ...

    Incorrect

    • Which of the following muscles aid in inspiration?

      Your Answer:

      Correct Answer: Diaphragm and external intercostals

      Explanation:

      The diaphragm and external intercostals are muscles of inspiration as they increase the volume of thoracic cavity and reduce the intrathoracic pressure. Muscles of expiration include abdominal muscles and internal intercostals.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
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  • Question 7 - A 30-year-old male presents with pain in the testis and scrotum. It began...

    Incorrect

    • A 30-year-old male presents with pain in the testis and scrotum. It began 10 hours previously and has worsened during that time. On examination, he has pyrexia, the testis is swollen and tender and there is an associated hydrocele. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Acute epididymo-orchitis

      Explanation:

      The following history findings are associated with acute epididymitis and orchitis:
      – Gradual onset of scrotal pain and swelling, usually unilateral, often developing over several days (as opposed to hours for testicular torsion)
      – Dysuria, frequency, or urgency
      – Fever and chills (in only 25% of adults with acute epididymitis but in up to 71% of children with the condition)
      Usually, no nausea or vomiting (in contrast to testicular torsion)
      – Urethral discharge preceding the onset of acute epididymitis (in some cases)

      Physical examination findings may fail to distinguish acute epididymitis from testicular torsion. Physical findings associated with acute epididymitis may include the following:
      – Tenderness and induration occurring first in the epididymal tail and then spreading
      – Elevation of the affected hemiscrotum
      – Normal cremasteric reflex
      – Erythema and mild scrotal cellulitis
      – Reactive hydrocele (in patients with advanced epididymo-orchitis)
      – Bacterial prostatitis or seminal vesiculitis (in post pubertal individuals)
      – With tuberculosis, focal epididymitis, a draining sinus, or beading of the vas deferens
      – In children, an underlying congenital anomaly of the urogenital tract
      Findings associated with orchitis may include the following:
      – Testicular enlargement, induration, and a reactive hydrocele (common)
      – Non-tender epididymis
      In 20-40% of cases, association with acute epididymitis

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Urology
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  • Question 8 - A 10-year-old boy was sent for an x-ray of the leg because he...

    Incorrect

    • A 10-year-old boy was sent for an x-ray of the leg because he was complaining of pain and swelling. The x-ray showed the classic sign of Codman's triangle. What is the most likely diagnosis of this patient?

      Your Answer:

      Correct Answer: Osteosarcoma

      Explanation:

      Codman’s triangle is the triangular area of new subperiosteal bone that is created when a lesion, often a tumour, raises the periosteum away from the bone. The main causes for this sign are osteosarcoma, Ewing’s sarcoma, eumycetoma, and a subperiosteal abscess.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 9 - Which type of contractions are responsible for the propulsion of chyme along the...

    Incorrect

    • Which type of contractions are responsible for the propulsion of chyme along the small intestine?

      Your Answer:

      Correct Answer: Segmentation

      Explanation:

      Two major types of intestinal contractions are segmentation and peristalsis:
      Segmentation occurs most frequently and primarily involves circular muscle. It is essentially a contraction of 2- or 3-cm long intestinal segments while the muscle on either side of it relaxes. Chyme in the segment is displaced in both orad and aborad directions. As the contracted segment relaxes, the previously relaxed segments on either side may contract. This efficiently mixes the chyme with the digestive secretions and exposes the mucosal absorptive surface to the luminal contents. It also serves a propulsive function and contributes to the aborad movement of chyme.
      Peristalsis is a propulsive wave of contraction that is initiated by intestinal distension. It is short lived and travels only a few centimetres before dying out. The combined effects of intestinal peristalsis and segmentation provide for both adequate mixing of the intestinal contents and slow, steady movement of chyme.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
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  • Question 10 - A terrorist running away from the police was shot in the back. The...

    Incorrect

    • A terrorist running away from the police was shot in the back. The bullet hit his left lung halfway between its apex and the diaphragmatic surface. Which part of the lung was most likely to be injured?

      Your Answer:

      Correct Answer: Inferior lobe

      Explanation:

      The oblique fissure of the left lung is so sharp that the posterior surface of the left lung is mostly composed of the inferior lobe so that the point halfway between the apex and the diaphragmatic surface of the lung would result in injury to the inferior lobe.
      The hilum is the point on the medial surface of the lung where the structures that form the root of the lung enter and leave the lung.
      The lingual on the other hand is part of the superior lobe of the left lung and it is part of the anterior and superior sides of the lung.
      The middle lobe is only found on the right lung.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 11 - Coagulation in the body (in vivo) is a process in which several proteins...

    Incorrect

    • Coagulation in the body (in vivo) is a process in which several proteins known as coagulation factors are activated in a cascade effect to stop bleeding. Which of the following initiates this cascade effect?

      Your Answer:

      Correct Answer: Tissue factor

      Explanation:

      Tissue factor (TF), also known as ‘factor III’ or ‘thromboplastin’, is an anti-coagulation protein that initiates the extrinsic coagulation. TF acts as a transmembrane receptor for Factor VII/VIIa . It is expressed by endothelial cells but also certain tissues, such as the heart and brain.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 12 - What will the destruction of endoplasmic reticulum stop? ...

    Incorrect

    • What will the destruction of endoplasmic reticulum stop?

      Your Answer:

      Correct Answer: Synthesis of proteins

      Explanation:

      The rough endoplasmic reticulum is the factory for the manufacturing of proteins. It contains ribosomes attached to it and transports proteins that are destined for membranes and secretions. The rough ER is connected to the nuclear envelope and to the cisternae of the Golgi apparatus by vesicles that shuttle between the two compartments.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
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  • Question 13 - Which of the following statements regarding the femoral artery is CORRECT? ...

    Incorrect

    • Which of the following statements regarding the femoral artery is CORRECT?

      Your Answer:

      Correct Answer: It has the femoral nerve lying lateral to it

      Explanation:

      The femoral artery begins immediately behind the inguinal ligament, midway between the anterior superior spine of the ilium and the symphysis pubis. The first 4 cm of the vessel is enclosed, together with the femoral vein, in a fibrous sheath (the femoral sheath). The femoral nerve lies lateral to this.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 14 - Which of the following variables are needed to calculate inspiratory reserve volume of...

    Incorrect

    • Which of the following variables are needed to calculate inspiratory reserve volume of a patient?

      Your Answer:

      Correct Answer: Tidal volume, vital capacity and expiratory reserve volume

      Explanation:

      Vital capacity = inspiratory reserve volume + tidal volume + expiratory reserve volume. Thus, inspiratory reserve volume can be calculated if tidal volume, vital capacity and expiratory reserve volume are known.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
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  • Question 15 - Ventricular filling follows a delay caused by? ...

    Incorrect

    • Ventricular filling follows a delay caused by?

      Your Answer:

      Correct Answer: AV node

      Explanation:

      The AV node is a conducting tissue found between the atria and the ventricles of the heart. It conducts electrical signal from the atria to the ventricles and acts a delaying mechanism preventing the atria and the ventricles from contracting at the same time. This decremental conduction prevents premature ventricular contraction in cases such as atrial fibrillation. A delay in the AV node is the reason for the PR segment seen on the ECG. In certain types of supraventricular tachycardia, a person could have two AV nodes; this will cause a loop in electrical current and uncontrollably rapid heart beat. When this electricity catches up with itself, it will dissipate and return to a normal heart rate.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
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  • Question 16 - 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:

      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
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  • Question 17 - A 30 year-old male patient sustained a sharp blow to the right side...

    Incorrect

    • A 30 year-old male patient sustained a sharp blow to the right side of the head, over the temporal region during a vehicular accident. This resulted to the rupture of the principal artery that supplies the meninges. Which artery is affected?

      Your Answer:

      Correct Answer: Middle meningeal artery

      Explanation:

      The middle meningeal artery is typically the third branch of the first part of the maxillary artery, one of the two terminal branches of the external carotid artery. After branching off the maxillary artery in the infratemporal fossa, it runs through the foramen spinosum to supply the dura mater and the calvaria. The middle meningeal artery is the largest of the three (paired) arteries that supply the meninges, the others being the anterior meningeal artery and the posterior meningeal artery. The anterior branch of the middle meningeal artery runs beneath the pterion. It is vulnerable to injury at this point, where the skull is thin. Rupture of the artery may give rise to an epidural hematoma .An injured middle meningeal artery is the most common cause of an epidural hematoma.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 18 - Which of the following key features will be seen in an organ undergoing...

    Incorrect

    • Which of the following key features will be seen in an organ undergoing atrophy?

      Your Answer:

      Correct Answer: A greater number of autophagic vacuoles

      Explanation:

      Atrophy is characterised by the breakdown of intracellular components along with organelles and packing them into vacuoles known as autophagic vacuoles. This is an adaptive response that separates the damaged cellular structures from the rest of the cells.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 19 - The dilator pupillae muscle is innervated by postganglionic sympathetic fibres. Where do the...

    Incorrect

    • The dilator pupillae muscle is innervated by postganglionic sympathetic fibres. Where do the postganglionic sympathetic fibres originate?

      Your Answer:

      Correct Answer: Superior cervical ganglion

      Explanation:

      The postganglionic sympathetic axons are derived from the superior cervical ganglion and innervate the eye and lacrimal gland allowing for vasoconstriction of the iris and sclera, pupillary dilation, widening of the palpebral fissure, and a reduction in tear production.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 20 - Which of the following cells would be increased in a patient suffering from...

    Incorrect

    • Which of the following cells would be increased in a patient suffering from a hydatid cyst in the liver?

      Your Answer:

      Correct Answer: Eosinophils

      Explanation:

      Eosinophils are granulocytes that respond to parasitic infections. They are also involved in allergy response and asthma. They contain granules which stain red with Romanowsky’s method and contain peroxidase, Rnase, Dnase, histamine, lipase and major basic proteins that are toxic to the parasite as well as the hosts tissue. They are about 1-5% of the total WBC population and persist in the blood for 6-12 hours.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 21 - 13 year old girl developed sun burnt cheeks after spending the day playing...

    Incorrect

    • 13 year old girl developed sun burnt cheeks after spending the day playing on the beach. What is the underlying mechanism to her injury?

      Your Answer:

      Correct Answer: Free radical injury

      Explanation:

      Free radicals are a by-product of chemical reactions with an unpaired electron in their outer most shell. They are capable of causing wide spread damage to cells. They can cause autolytic reactions thereby converting the reactants into free radicals. By absorbing sun light, the energy is used to hydrolyse water into hydroxyl (OH) and hydrogen (H) free radicals which can cause injury by lipid peroxidation of membranes, oxidative modification of proteins and damage to the DNA structure.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
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  • Question 22 - A patient who following 20 years of working in the asbestos industry develops...

    Incorrect

    • A patient who following 20 years of working in the asbestos industry develops malignant mesothelioma and is scheduled for pleuropneumonectomy to remove the entire pleura and lung on the affected side. Which layer would provide a natural cleavage plane for surgical separation of the costal pleura from the thoracic wall?

      Your Answer:

      Correct Answer: Endothoracic fascia

      Explanation:

      The endothoracic fascia is connective tissue that is between the costal parietal pleura and the inner aspect of the chest wall. Removing this layer of connective tissue would make it easy to separate the costal pleura from the thoracic wall.
      Deep fascia: is not found around the lungs. It is a layer of connective tissue that invests a muscle or a group of muscles.
      Parietal pleura: part of the pleura that lines the inner surface of the chest/thoracic cavity.
      Visceral pleura: is the serous membrane that lines the surface of the lungs.
      Transversus thoracis muscle fascia is associated only with the muscle transversus thoracis.
      Peritracheal fascia: a layer of connective tissue that invests the trachea. It is not associated with the thoracic wall or the costal pleura.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 23 - Chest X-ray of a 45-year old gentleman with a week history of pleurisy...

    Incorrect

    • Chest X-ray of a 45-year old gentleman with a week history of pleurisy showed a small pneumothorax with moderate-sized pleural effusion. Arterial blood gas analysis showed p(CO2) = 23 mmHg, p(O2) = 234.5 mmHg, standard bicarbonate = 16 mmol/l. What are we most likely dealing with?

      Your Answer:

      Correct Answer: Compensated respiratory alkalosis

      Explanation:

      Normal pH with low p(CO2) and low standard bicarbonate could indicate either compensated respiratory alkalosis or a compensated metabolic acidosis. However, the history of hyperventilation for 5 days (pleurisy) favours compensated respiratory alkalosis. Compensated metabolic acidosis would have been likely in a diabetic patient with fever, vomiting and high glucose (diabetic ketoacidosis).

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
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  • Question 24 - A 3 year old boy is awaiting surgery for a ruptured appendix and...

    Incorrect

    • A 3 year old boy is awaiting surgery for a ruptured appendix and the nurse wants to give him an infusion of intravenous fluid whilst waiting for theatre. Given that his electrolytes are normal, which of the following infusion fluid would be appropriate?

      Your Answer:

      Correct Answer: 0.9% Saline solution

      Explanation:

      Indications for IV fluids include:
      – Resuscitation and circulatory support
      – Replacing on-going fluid losses
      – Maintenance fluids for children for whom oral fluids are not appropriate
      – Correction of electrolyte disturbances

      According to the NICE guidelines, if children and young people need IV fluid resuscitation, use glucose‑free crystalloids that contain sodium in the range 131–154 mmol/litre, with a bolus of 20 ml/kg over less than 10 minutes. Take into account pre‑existing conditions (for example, cardiac disease or kidney disease), as smaller fluid volumes may be needed.

      All the others are contraindicated according to the guidelines as they are either made of glucose or are colloids.
      Gelofusine is a 4% w/v solution of succinylated gelatine (also known as modified fluid gelatine) used as an intravenous colloid, and behaves much like blood filled with albumins.
      Dextrose solution is a mixture of dextrose (glucose) and water. It is used to treat low blood sugar or water loss without electrolyte loss. Intravenous sugar solutions are in the crystalloid family of medications. They come in a number of strengths including 5%, 10%, and 50% dextrose.
      0.45% saline/ 5% glucose solution also contains glucose hence it is contraindicated.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Paediatric Surgery
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  • Question 25 - The specimen sent to the pathologist for examination was found to be benign....

    Incorrect

    • The specimen sent to the pathologist for examination was found to be benign. Which one of the following is most likely a benign tumour?

      Your Answer:

      Correct Answer: Warthin’s tumour

      Explanation:

      Warthin’s tumour is also known as papillary cystadenoma lymphomatosum. It is a benign cystic tumour of the salivary glands containing abundant lymphocytes and germinal centres. It has a slightly higher incidence in males and most likely occur in older adults aged between 60 to 70 years. This tumour is also associated with smoking. Smokers have an eight-fold greater risk in developing the tumour compared to non-smokers.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
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  • Question 26 - A 39-year-old woman is involved in a road traffic accident and sustains a...

    Incorrect

    • A 39-year-old woman is involved in a road traffic accident and sustains a significant laceration to the lateral aspect of the nose, associated with tissue loss.

      What should be the best management option?

      Your Answer:

      Correct Answer: Rotational skin flap

      Explanation:

      Nasal injuries can be challenging to manage and where there is tissue loss, it can be difficult to primarily close them and obtain a satisfactory aesthetic result. Debridement together with a rotational skin flap would produce the best results.

      A rotation flap is a semi-circular skin flap that is rotated into the defect on a fulcrum point. It provides the ability to mobilize large areas of tissue with a wide vascular base for reconstruction. Rotation flaps may be pedicled or free. Pedicled flaps are more reliable but are limited in the range of movement. Free flaps have increased range but carry greater risk of breakdown as they require vascular anastomosis.

    • This question is part of the following fields:

      • Emergency Medicine And Management Of Trauma
      • Principles Of Surgery-in-General
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  • Question 27 - A 30 year old lawyer presented with a history of pleural effusions, pericarditis,...

    Incorrect

    • A 30 year old lawyer presented with a history of pleural effusions, pericarditis, arthralgia without joint deformity and episodes of myalgia for the past 12 months. Blood tests reveal a normocytic anaemia. Which of the following tests should be performed to investigate this condition further?

      Your Answer:

      Correct Answer: Antinuclear antibody test

      Explanation:

      These non specific findings are suggestive of autoimmune disease. Antinuclear antibody (ANA) is the first test that should be performed when autoimmune diseases are suspected and later on more specific tests should be performed. This tests aids in the diagnosis of SLE, scleroderma, Sjogren’s syndrome, Raynaud’s disease, juvenile chronic arthritis, rheumatoid arthritis and antiphospholipid antibody syndrome etc. To confirm the disease a history, physical examination along with specific tests are required.
      CPK is more specific for acute conditions.
      ESR is a non specific test for inflammation.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 28 - A 39 year old decides to donate one of her kidneys to her...

    Incorrect

    • A 39 year old decides to donate one of her kidneys to her niece. Which of the following types of transplants would this be?

      Your Answer:

      Correct Answer: Allograft

      Explanation:

      Allograft is a tissue graft from a donor of the same species as the recipient but not genetically identical.

      Isograft Graft – tissue between two individuals who are genetically identical

      Autograft – transplantation of organs or tissues from one part of the body to another in the same individual

      Xenograft – tissue transplanted from another species

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Organ Transplantation
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  • Question 29 - A 31 year old woman presents to the clinic for assessment of varicose...

    Incorrect

    • A 31 year old woman presents to the clinic for assessment of varicose veins that she developed several years ago. Examination reveals marked truncal varicosities with a long tortuous saphenous vein. Which of the following would be the next most appropriate step in her management?

      Your Answer:

      Correct Answer: Arrange a venous duplex scan

      Explanation:

      Deep vein thrombosis (DVT) is the formation of a blood clot in a deep vein of the legs, thigh, or pelvis. Thrombosis is most often seen in individuals with a history of immobilization, obesity, malignancy, or hereditary thrombophilia. Vascular endothelial damage, venous stasis, and hypercoagulability, collectively referred to as the Virchow triad, are the main factors contributing to the development of DVT.
      Symptoms usually occur unilaterally and include swelling, tenderness, and redness or discoloration. Pulmonary embolism (PE), a severe complication of DVT, should be suspected in patients with dizziness, dyspnoea, and fever. The diagnostic test of choice for DVT is compression ultrasound. In most cases, a negative D-dimer test allows thrombosis or PE to be ruled out, but a positive test is nonspecific.
      Initial acute treatment of DVT consists of anticoagulation with heparin and, if the thrombus is large or unresponsive to anticoagulation, may also include thrombolysis or thrombectomy. Secondary prophylaxis is achieved with oral warfarin or direct factor Xa inhibitors and supportive measures such as regular exercise and compression stockings.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Vascular
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  • Question 30 - A patient with testicular seminoma has the following tumour markers: LDH 1.3 times...

    Incorrect

    • A patient with testicular seminoma has the following tumour markers: LDH 1.3 times the reference levels, β-hCG 4500 mIU/ml and AFP 875 ng/ml. What's the serum tumour marker stage in this case?

      Your Answer:

      Correct Answer: S1

      Explanation:

      According to AJCC guidelines, the serum tumour marker staging is the following:
      S0: marker studies within normal limits
      S1: lactate dehydrogenase (LDH) less than 1.5 times the reference range, beta-human chorionic gonadotrophin (β-hCG) <5000 mIU/ml, and alpha-fetoprotein (AFP) <1000 ng/ml
      S2: LDH 1.5–10 times the reference range, β-hCG 5000–50,000 mIU/ml or AFP 1000–10,000 ng/ml
      S3: LDH greater than 10 times the reference range, β-hCG >50,000 mIU/ml or AFP >10,000 ng/ml.
      According to this, the patient’s tumour belongs to the S1 stage.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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