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  • Question 1 - The muscle that forms the posterior wall of the axilla along with the...

    Incorrect

    • The muscle that forms the posterior wall of the axilla along with the scapula, subscapularis muscle and teres major muscle is the?

      Your Answer: Serratus anterior

      Correct Answer: Latissimus dorsi

      Explanation:

      The latissimus dorsi forms the posterior wall of the axilla along with the scapula. It is responsible for extension, adduction, transverse extension also known as horizontal abduction, flexion from an extended position, and (medial) internal rotation of the shoulder joint. It also has a synergistic role in extension and lateral flexion of the lumbar spine.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      3
      Seconds

  • Question 2 - Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of...

    Incorrect

    • Gastrocnemius, semimembranosus and semitendinosus together with which other muscle form the boundaries of the popliteal fossa?

      Your Answer:

      Correct Answer: Biceps femoris

      Explanation:

      The popliteal fossa is located at the back of the knee. It is bounded laterally by the biceps femoris above and the plantaris and lateral head of the gastrocnemius below and medially by the semitendinosus and semimembranosus above and by the medial head of the gastrocnemius below.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 3 - A 1 week old baby boy is taken to the A&E department after...

    Incorrect

    • A 1 week old baby boy is taken to the A&E department after a right sided groin swelling had been noticed. An examination is done and the testes are correctly located but there is a right sided inguinal hernia that is soft and easily reduced. Which of the following is the most appropriate management?

      Your Answer:

      Correct Answer: Surgery over the next few days

      Explanation:

      Answer: Surgery over the next few days

      Inguinal hernia is a type of ventral hernia that occurs when an intra-abdominal structure, such as bowel or omentum, protrudes through a defect in the abdominal wall. Inguinal hernias do not spontaneously heal and must be surgically repaired because of the ever-present risk of incarceration. Generally, a surgical consultation should be made at the time of diagnosis, and repair (on an elective basis) should be performed very soon after the diagnosis is confirmed.

      The infant or child with an inguinal hernia generally presents with an obvious bulge at the internal or external ring or within the scrotum. The parents typically provide the history of a visible swelling or bulge, commonly intermittent, in the inguinoscrotal region in boys and inguinolabial region in girls.
      The swelling may or may not be associated with any pain or discomfort.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Paediatric Surgery
      0
      Seconds

  • Question 4 - A 6-year-old boy undergoes a closure of a loop colostomy. Which of the...

    Incorrect

    • A 6-year-old boy undergoes a closure of a loop colostomy. Which of the following should be used as a thromboprophylaxis?

      Your Answer:

      Correct Answer: None

      Explanation:

      Clinical characteristics associated with increased venous thromboembolism (VTE) risk in children (listed alphabetically, owing to the current lack of expert consensus or robust data regarding relative risk contributions)
      -Anticipated hospitalization > 72 h
      -Cancer (active, not in remission)
      -Central venous catheter presence
      -Oestrogen therapy started within the last 1 month
      -Inflammatory disease (newly diagnosed, poorly controlled, or flaring)
      -Intensive care unit admission
      -Mechanical ventilation
      -Mobility decreased from baseline (Braden Q‐score < 2)
      -Obesity (BMI > 99th percentile for age)
      -Post pubertal age
      -Severe dehydration, requiring intervention
      -Surgery > 90 min within last 14 days
      -Systemic or severe local infection (positive sputum/blood culture or viral test result, or empirical antibiotics)
      -Trauma as admitting diagnosis

      Pharmacological prophylaxis may be instituted in the following risk groups:
      Children in an ICU with a CVC and one other risk factor fit a high‐risk profile and may benefit from pharmacological thromboprophylaxis in the absence of strong contraindications.
      For children with either a CVC or admission to an ICU (but not both), two risk factors are recommended before the initiation of pharmacological thromboprophylaxis.
      For children with neither a CVC nor ICU admission, at least three risk factors should be present before the initiation of pharmacological thromboprophylaxis.

    • This question is part of the following fields:

      • Peri-operative Care
      • Principles Of Surgery-in-General
      0
      Seconds

  • Question 5 - A 3 month old baby boy is taken to the hospital for recurrent...

    Incorrect

    • A 3 month old baby boy is taken to the hospital for recurrent colicky abdominal pain and intermittent intestinal obstruction. The transverse colon is herniated into the thoracic cavity, through a mid line defect and this is shown when imaging is done. What is the cause of this defect?

      Your Answer:

      Correct Answer: Morgagni hernia

      Explanation:

      Morgagni hernias are one of the congenital diaphragmatic hernias (CDH), and are characterized by herniation through the foramen of Morgagni. When compared to Bochdalek hernias, Morgagni hernias are:
      -anterior
      -more often right-sided (,90%)
      -small
      -rare (,2% of CDH)
      -at low risk of prolapse

      Only ,30% of patients are symptomatic. Newborns may present with respiratory distress at birth similar to a Bochdalek hernia. Additionally, recurrent chest infections and gastrointestinal symptoms have been reported in those with previously undiagnosed Morgagni hernia.
      The image of the transverse colon is herniated into the thoracic cavity, through a mid line defect and this indicates that it is a Morgagni hernia since the foramen of a Morgagni hernia occurs in the anterior midline through the sternocostal hiatus of the diaphragm, with 90% of cases occurring on the right side.

      Clinical manifestations of congenital diaphragmatic hernia (CDH) include the following:
      Early diagnosis – Right-side heart; decreased breath sounds on the affected side; scaphoid abdomen; bowel sounds in the thorax, respiratory distress, and/or cyanosis on auscultation; CDH can often be diagnosed in utero with ultrasonography (US), magnetic resonance imaging (MRI), or both

      Late diagnosis – Chest mass on chest radiography, gastric volvulus, splenic volvulus, or large-bowel obstruction

      Congenital hernias (neonatal onset) – Respiratory distress and/or cyanosis occurs within the first 24 hours of life; CDH may not be diagnosed for several years if the defect is small enough that it does not cause significant pulmonary dysfunction

      Congenital hernias (childhood or adult onset) – Obstructive symptoms from protrusion of the colon, chest pain, tightness or fullness the in chest, sepsis following strangulation or perforation, and many respiratory symptoms occur.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • The Abdomen
      0
      Seconds

  • Question 6 - A 35 year old woman with jaundice is scheduled for ERCP. However, the...

    Incorrect

    • A 35 year old woman with jaundice is scheduled for ERCP. However, the procedure is complicated and she is returned to the ward, with signs of jaundice still present accompanied by severe abdominal pain that is generalized. What should be the next best step in management?

      Your Answer:

      Correct Answer: Arrange an abdominal CT scan

      Explanation:

      Complications of ERCP include pancreatitis, duodenal perforation, duodenal haemorrhage, infection, stent migration, and complications secondary to endoscopy. CT is performed if patients have severe abdominal pain, jaundice, elevated white blood cell count, and fever after ERCP.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Hepatobiliary And Pancreatic Surgery
      0
      Seconds

  • Question 7 - A 45-year-old male undergoes a distal gastrectomy for cancer. He is slightly anaemic...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds

  • Question 8 - A 26-year-old female patient had the following blood report: RBC count = 4....

    Incorrect

    • A 26-year-old female patient had the following blood report: RBC count = 4. 0 × 106/μl, haematocrit = 27% and haemoglobin = 11 g/dl, mean corpuscular volume (MCV) = 80–100 fl, mean corpuscular haemoglobin concentration (MCHC) = 31–37 g/dl. Which of the following is correct regarding this patient’s erythrocytes:

      Your Answer:

      Correct Answer: Normal MCV

      Explanation:

      MCV is the mean corpuscular volume and it is calculated from the haematocrit and the RBC count. It is normally 90 fl. Mean corpuscular haemoglobin concentration (MCHC) [g/dl] = haemoglobin [g/dl]/haematocrit = 11/0.27 = 41 g/dl and is higher than normal range (32 to 36 g/dL).

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 9 - A 31 year old detective has been having symptoms of post-defecation bleeding over...

    Incorrect

    • A 31 year old detective has been having symptoms of post-defecation bleeding over the past 6 years. She visits her doctor and on examination, large prolapsed haemorrhoids were seen. A colonoscopy was done and it showed no other disease. Which of the following options is the best course of action?

      Your Answer:

      Correct Answer: Excisional haemorrhoidectomy

      Explanation:

      The American Society of Colon and Rectal Surgeons (ASCRS) states that clinicians should typically offer haemorrhoidectomy to patients with symptomatic disease from external haemorrhoids or combined internal/external haemorrhoids with prolapse. For those who undergo surgical haemorrhoidectomy, a multimodality pain regimen is recommended to reduce use of narcotics and promote a faster recovery.

    • This question is part of the following fields:

      • Colorectal Surgery
      • Generic Surgical Topics
      0
      Seconds

  • Question 10 - The primary area involved in the pathology of Parkinson's disease is: ...

    Incorrect

    • The primary area involved in the pathology of Parkinson's disease is:

      Your Answer:

      Correct Answer: Substantia nigra

      Explanation:

      Parkinson’s disease is a degenerative, movement disorder of the central nervous system, and is typically characterized by muscle rigidity, tremor and bradykinesia (in extreme cases, akinesia). Secondary symptoms include high-level cognitive dysfunction and subtle language problems.
      Parkinson’s disease is also called ‘primary Parkinsonism’ or ‘idiopathic Parkinson’s disease and is the most common cause of Parkinsonism, a group of similar symptoms. The disorder is caused due to loss of pigmented dopaminergic cells in the pars compacta region of the substantia nigra.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 11 - Which of these substances is secreted by pericytes in the juxtaglomerular cells? ...

    Incorrect

    • Which of these substances is secreted by pericytes in the juxtaglomerular cells?

      Your Answer:

      Correct Answer: Renin

      Explanation:

      The juxtaglomerular cells synthesise, store and secrete the enzyme renin in the kidney. They are specialised smooth muscle cells in the wall of the afferent arteriole that delivers blood to the glomerulus and thus play a critical role in the renin– angiotensin system and so in renal autoregulation.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 12 - A 45-year-old man complains of shortness of breath, cough and chest pain. Chest...

    Incorrect

    • A 45-year-old man complains of shortness of breath, cough and chest pain. Chest X ray revealed a perihilar mass with bronchiectasis in the left mid-lung. Which of the following is most probably associated with these findings?

      Your Answer:

      Correct Answer: Bronchial carcinoid

      Explanation:

      Bronchial carcinoids are neuroendocrine tumours that arise from Kulchitsky’s cells of the bronchial epithelium. Kulchitsky’s cells belong to the diffuse endocrine system. Patients affected by this tumour may be asymptomatic or may present with symptoms of airway obstruction, like dyspnoea, wheezing, and cough. Other common findings are recurrent pneumonia, haemoptysis, chest pain and paraneoplastic syndromes. Chest radiographs are abnormal in the majority of cases. Peripheral carcinoids usually present as a solitary pulmonary nodule. For central lesions common findings include hilar or perihilar masses with or without atelectasis, bronchiectasis, or consolidation. Bronchial carcinoids most commonly arise in the large bronchi causing obstruction.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 13 - Which of the following structures is affected or damaged when the 'anterior drawer...

    Incorrect

    • Which of the following structures is affected or damaged when the 'anterior drawer test' is positive?

      Your Answer:

      Correct Answer: Anterior cruciate ligament

      Explanation:

      The anterior drawer test is an important orthopaedic test that is used to test weakness of the anterior cruciate ligament. The test is done by having the patient sit in a supine position with his/her knees flexed at 90 degrees. An examiner stabilises the patients feet and softly pulls or pushes on the proximal tibia. The test is positive if there is translational movement of the tibia in relation to the femur, indicating a weakened anterior cruciate ligament. The anterior cruciate ligament prevents the tibia from sliding out in front of the femur.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 14 - Renal function is an indication of the state of the kidney, measured by glomerular...

    Incorrect

    • Renal function is an indication of the state of the kidney, measured by glomerular filtration rate (GFR). In a healthy person, GFR would be greatly increased by: 

      Your Answer:

      Correct Answer: Substantial increases in renal blood flow

      Explanation:

      An increase in the rate of renal blood flow (RBF) greatly increases the glomerular filtration rate (GFR). The more plasma available (from increased RBF), the more filtrate is formed. Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal (kidney) glomerular capillaries into the Bowman’s capsule per unit time. Central to the physiologic maintenance of GFR is the differential basal tone of the afferent and efferent arterioles.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 15 - A 50-year-old woman goes to the doctor complaining of myalgia, muscle cramps, and...

    Incorrect

    • A 50-year-old woman goes to the doctor complaining of myalgia, muscle cramps, and weakness; she is diagnosed with severe hypokalaemia. Which of the following is the most common cause of hypokalaemia?

      Your Answer:

      Correct Answer: Prolonged vomiting

      Explanation:

      Potassium is one of the body’s major ions. Nearly 98% of the body’s potassium is intracellular. The ratio of intracellular to extracellular potassium is important in determining the cellular membrane potential. Small changes in the extracellular potassium level can have profound effects on the function of the cardiovascular and neuromuscular systems. Hypokalaemia may result from conditions as varied as renal or gastrointestinal (GI) losses, inadequate diet, transcellular shift (movement of potassium from serum into cells) and medications. The important causes of hypokalaemia are:
      Renal losses: renal tubular acidosis, hyperaldosteronism, magnesium depletion, leukaemia (mechanism uncertain).
      GI losses: vomiting or nasogastric suctioning, diarrhoea, enemas or laxative use, ileal loop.
      Medication effects: diuretics (most common cause), β-adrenergic agonists, steroids, theophylline, aminoglycosides.
      Transcellular shift: insulin, alkalosis.
      Severe hypokalaemia, with serum potassium concentrations of 2.5–3 meq/l, may cause muscle weakness, myalgia, tremor, muscle cramps and constipation.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 16 - The superior rectal artery is a continuation of the: ...

    Incorrect

    • The superior rectal artery is a continuation of the:

      Your Answer:

      Correct Answer: Inferior mesenteric artery

      Explanation:

      The superior rectal artery or superior haemorrhoidal artery is the continuation of the inferior mesenteric artery. It descends into the pelvis between the layers of the mesentery of the sigmoid colon, crossing the left common iliac artery and vein.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 17 - The oesophagus is an important part of the alimentary canal. It receives blood...

    Incorrect

    • The oesophagus is an important part of the alimentary canal. It receives blood from various arteries in the body. Which one of the following is an artery that will lead to some level of ischaemia to the oesophagus when ligated?

      Your Answer:

      Correct Answer: Left inferior phrenic

      Explanation:

      The oesophagus receives its blood supply from the following arteries: the inferior thyroid branch of the thyrocervical trunk, the descending thoracic aorta, the left gastric branch of the coeliac artery and the from the left inferior phrenic artery of the abdominal aorta. Hence ligation of the left inferior phrenic will lead to ischemia to some portions of the oesophagus.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 18 - A 34-year-old man with poorly controlled Crohn's disease is nutritionally compromised. A decision...

    Incorrect

    • A 34-year-old man with poorly controlled Crohn's disease is nutritionally compromised. A decision is made to start TPN.

      Which of the following routes should be the most appropriate for its administration?

      Your Answer:

      Correct Answer: Internal jugular vein via a central venous catheter

      Explanation:

      Since TPN solutions irritate the veins, they are best administered via a central line. The femoral route has a higher incidence of line-associated sepsis and is, thus, best avoided in this setting.

      The National Institute for Health and Care Excellence (NICE) has laid down guidelines for identifying patients as malnourished or at risk of malnourishment, in order to start oral, enteral, or parenteral nutrition support, alone or in combination.

      Following patients are identified as malnourished:
      1. BMI <18.5 kg/m2
      2. Unintentional weight loss of >10% within the last 3–6 months
      3. BMI <20 kg/m2 and unintentional weight loss of >5% within the last 3–6 months

      Following patients are at risk of malnutrition:
      1. Eaten nothing or little for >5 days and/or likely to eat little or nothing for the next 5 days or longer
      2. Poor absorptive capacity and/or
      3. High nutrient loss and/or
      4. High metabolic rate

      Considering the method of parenteral nutrition:
      1. For feeding <14 days, consider feeding via a peripheral venous catheter
      2. For feeding >30 days, use a tunnelled subclavian line,
      continuous administration in severely unwell patients
      3. If feed needed for >2 weeks, consider changing from continuous to cyclical feeding
      4. Do not give >50% of daily regime to unwell patients in the first 24–48 hours
      5. In surgical patients, if malnourished with unsafe swallow or a non-functional GI tract or perforation, consider perioperative parenteral feeding.

    • This question is part of the following fields:

      • Post-operative Management And Critical Care
      • Principles Of Surgery-in-General
      0
      Seconds

  • Question 19 - What percentage of cardiac output is delivered to the skin? ...

    Incorrect

    • What percentage of cardiac output is delivered to the skin?

      Your Answer:

      Correct Answer: 2%

      Explanation:

      Making up 4-5% of total body weight, the skin receives approximately 2% of cardiac output.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 20 - A 40-year old gentleman, who is a known with ulcerative colitis, complains of...

    Incorrect

    • A 40-year old gentleman, who is a known with ulcerative colitis, complains of recent-onset of itching and fatigue. On examination, his serum alkaline phosphatase level was found to be high. Barium radiography of the biliary tract showed a 'beaded' appearance. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Sclerosing cholangitis

      Explanation:

      Primary sclerosing cholangitis is characterised by patchy inflammation, fibrosis and strictures in intra- and extra-hepatic bile ducts. It is a chronic cholestatic condition with 80% patients having associated inflammatory bowel disease (likely to be ulcerative colitis). Symptoms include pruritus and fatigue. ERCP (endoscopic retrograde cholangiopancreatography) or MRCP (magnetic resonance cholangiopancreatography) are diagnostic. Disease can lead to complete obliteration of ducts, which can result in liver failure. Cholangiocarcinoma is also a recognised complication..

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 21 - A 65-year old gentleman presents to the clinic with chronic back pain and...

    Incorrect

    • A 65-year old gentleman presents to the clinic with chronic back pain and weight loss. His blood count shows a white blood cell count of 10 × 109/l, with a differential count of 66 polymorphonuclear leukocytes, 7 bands, 3 metamyelocytes, 3 myelocytes, 14 lymphocytes, 7 monocytes, and 5 nucleated red blood cells. The haemoglobin is 13 g/dl with a haematocrit of 38.1%, a mean corpuscular volume of 82 fl, and a platelet count of 126 × 109/l. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Metastatic carcinoma

      Explanation:

      The peripheral blood findings suggest a leucoerythroblastic picture, the common causes of which in a 65-year old gentleman includes prostatic or lung malignancy.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 22 - Hormones of the anterior pituitary include which of the following? ...

    Incorrect

    • Hormones of the anterior pituitary include which of the following?

      Your Answer:

      Correct Answer: Prolactin

      Explanation:

      The anterior pituitary gland (adenohypophysis or pars distalis) synthesizes and secretes:
      1. FSH (follicle-stimulating hormone)
      2. LH (luteinizing hormone)
      3. Growth hormone
      4. Prolactin
      5. ACTH (adrenocorticotropic hormone)
      6. TSH (thyroid-stimulating hormone).
      The posterior pituitary gland (neurohypophysis) stores and secretes 2 hormones produced by the hypothalamus:
      1. ADH (antidiuretic hormone or vasopressin)
      2. Oxytocin

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 23 - A 35 year old IV drug abuser arrives at the clinic with localized...

    Incorrect

    • A 35 year old IV drug abuser arrives at the clinic with localized spinal pain. It is worse on movement and has been occurring for the last 2 months. The pain is refractory to analgesic treatment and is felt excruciatingly at rest too. He has no history of tuberculosis. Which of the following is the most likely diagnosis?

      Your Answer:

      Correct Answer: Osteomyelitis

      Explanation:

      Complications of intravenous drug abuse, such as subcutaneous abscess, joint infections, osteomyelitis, overdose, hepatitis, and infective endocarditis, account for an increasing number of admissions in accident and emergency departments throughout the UK. The organisms that usually cause chronic osteomyelitis in intravenous drug users are Gram‐negative rods such as Pseudomonas aeruginosa and Gram‐positive cocci such as staphylococci. Early treatment is essential to prevent progressive bone destruction. TB tends to affect the thoracic spine and in other causes of osteomyelitis the lumbar spine is affected.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Orthopaedics
      0
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  • Question 24 - Which lymph nodes are most likely to enlarge due to the spread of...

    Incorrect

    • Which lymph nodes are most likely to enlarge due to the spread of infection through the lymphatic channels in a patient with a boil on his scrotum?

      Your Answer:

      Correct Answer: Superficial inguinal nodes

      Explanation:

      The superficial inguinal nodes drain the perineum and the external genitalia which include the scrotum and the labia majora. The testes, however, drain to the lumbar nodes.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
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  • Question 25 - What is correct regarding the obturator artery? ...

    Incorrect

    • What is correct regarding the obturator artery?

      Your Answer:

      Correct Answer: It is found in the medial compartment of the thigh

      Explanation:

      The obturator artery is a branch of the internal iliac artery, which passes antero-inferiorly on the lateral wall of the pelvis, to the upper part of the obturator foramen. The posterior branch follows the posterior margin of the foramen and turns forward on the inferior ramus of the ischium. It also supplies an articular branch, which enters the hip joint through the acetabular notch, sending a branch along the ligamentum teres to the head of the femur. It is the main source of arterial supply to the medial compartment of the thigh

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 26 - Which of these laboratory findings will indicate a fetal neural tube defect when...

    Incorrect

    • Which of these laboratory findings will indicate a fetal neural tube defect when done between 15 and 20 weeks of pregnancy?

      Your Answer:

      Correct Answer: Increased alpha-fetoprotein

      Explanation:

      Maternal serum screening during the second trimester is a non-invasive way of identifying women at increased risk of having children with a neural tube defect and should be offered to all pregnant women. The results are most accurate when the sample is taken between 15 and 20 weeks of gestation. Elevated levels of alpha-fetoprotein suggest open spina bifida, anencephaly, risk of pregnancy complications, or multiple pregnancy.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 27 - You observe a procedure to harvest the left internal thoracic (mammary) artery to...

    Incorrect

    • You observe a procedure to harvest the left internal thoracic (mammary) artery to be used as a graft for coronary artery bypass surgery. The left internal thoracic artery is mobilised from the inside of the chest wall and divided near the caudal end of the sternum. After dividing the internal thoracic artery at its distal end, the specialist registrar asks you to name the artery that will now have increased blood supply so that adequate blood flow is maintained to the rectus abdominis on the left side. What would your answer be?

      Your Answer:

      Correct Answer: Inferior epigastric artery

      Explanation:

      The rectus abdominis muscle is supplied by the superior epigastric artery which is a branch of the internal thoracic artery. If the internal thoracic artery is thus ligated, blood would no longer flow to it. However, the superior epigastric artery communicates with the inferior epigastric artery (a branch of the external iliac artery). This means that blood could flow from the external iliac, to the inferior epigastric, to the superior epigastric to the rectus abdominis.
      The superficial circumflex iliac artery and the superficial epigastric are two superficial branches of the femoral artery and do not supply the deep branches of the abdomen.
      The deep circumflex iliac artery travels along the iliac crest on the inner surface of the abdominal wall; being too lateral it doesn’t supply blood to the rectus abdominis.
      The distal portions of the umbilical arteries are obliterated in adults to form the medial umbilical folds.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 28 - Which of the following cytokines produced by the T cell induce MHC-II proteins?...

    Incorrect

    • Which of the following cytokines produced by the T cell induce MHC-II proteins?

      Your Answer:

      Correct Answer: γ-Interferon

      Explanation:

      Interferons elicit a non-specific antiviral activity by inducing specific RNA synthesis and expression of proteins in neighbouring cells. Common interferon inducers are viruses, double-stranded RNA and micro-organisms. INF-γ is produced mainly by CD4+, CD8+ T cells and less commonly by B cells and natural killer cells. INF-γ has antiviral and antiparasitic activity but its main biological activity appears to be immunomodulatory. Among its many functions are activation of macrophages and enhanced expression of MHC-II proteins or macrophages.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 29 - Which of the following arteries, that runs on the superior aspect of the...

    Incorrect

    • Which of the following arteries, that runs on the superior aspect of the first part of the duodenum, forms the lower boundary of the epiploic foramen (also known as the foramen of Winslow)?

      Your Answer:

      Correct Answer: Hepatic

      Explanation:

      The epiploic foramen is an important anatomical opening that allows for the communication between the greater peritoneal sac and the lesser peritoneal sac. Its boundaries are formed; superiorly by the caudate lobe of the liver, anteriorly by the hepatoduodenal ligament (containing the components of the portal triad), inferiorly by the first part of the duodenum and posteriorly by the peritoneum covering the inferior vena cava. The superior aspect of the first part of the duodenum, which forms the inferior boundary of the foramen of Winslow, forms the course of the hepatic artery before it ascends to the porta hepatis where it divides into its right and left branches.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
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  • Question 30 - Which best describes the suprascapular nerve? ...

    Incorrect

    • Which best describes the suprascapular nerve?

      Your Answer:

      Correct Answer: It contains nerve fibres from C5 and C6 spinal cord segments

      Explanation:

      The suprascapular nerve arises from the cervical spinal nerves 5 and 6 after coming together to form common trunk. This nerve supplies the supraspinatus and infraspinatus muscles giving off branches to the shoulder joint.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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