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Question 1
Incorrect
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A 5 year old boy is taken to the family doctor following a history of difficult, painful defecation with bright red rectal bleeding. Which of the following would be the diagnosis?
Your Answer: Crohns disease
Correct Answer: Anal fissure
Explanation:An anal fissure is a painful linear tear or crack in the distal anal canal, which, in the short term, usually involves only the epithelium and, in the long term, involves the full thickness of the anal mucosa. Anal fissures develop with equal frequency in both sexes; they tend to occur in younger and middle-aged persons.
Treatment should include stool softeners and lifestyle advice. Failure of medical therapy is an indication for surgical therapy. Controversy mostly involves continued efforts to find a medical therapy for anal fissure that is as successful as the surgical therapy for the condition.
Typically, the patient reports severe pain during a bowel movement, with the pain lasting several minutes to hours afterward. The pain recurs with every bowel movement, and the patient commonly becomes afraid or unwilling to have a bowel movement, leading to a cycle of worsening constipation, harder stools, and more anal pain. Approximately 70% of patients note bright-red blood on the toilet paper or stool. Occasionally, a few drops may fall in the toilet bowl, but significant bleeding does not usually occur with an anal fissure.Children with intussceception usually present at a relatively young age with colicky abdominal pain, together with a mass on clinical examination. The often cited red current jelly type stool is a rare but classical feature.
Juvenile polyps may occur as part of the familial polyposis coli syndromes. The lesions, which are hamartomas, are often cherry red if they protrude externally.
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This question is part of the following fields:
- Generic Surgical Topics
- Paediatric Surgery
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Question 2
Incorrect
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A 24-year-old rugby player sustains a fracture of the distal radius after falling on his outstretched right hand during the game. X-ray shows a dorsally angulated comminuted fracture.
What is the most appropriate management?Your Answer:
Correct Answer: Admit for open reduction and internal fixation
Explanation:This is a case of a high-velocity injury and, therefore, requires surgical fixation.
Bony injury resulting in a fracture may occur due to trauma (excessive force applied to bone), stress (repetitive low-velocity injury), or underlying pathology (abnormal bone which fractures during normal use or following minimal trauma).
Diagnosis involves not just evaluating the fracture, such as the site and type of injury, but also other associated injuries and distal neurovascular status. This may entail not just clinical examination but radiographs of proximal and distal joints. When assessing x-rays, it is important to assess for changes in the length of the bone, the angulation of the distal bone, rotational effects, and the presence of a foreign body such as glass.
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This question is part of the following fields:
- Generic Surgical Topics
- Orthopaedics
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Question 3
Incorrect
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A 25-year-old woman complains of generalised swelling and particularly puffiness around the eyes which is worst in the morning. Laboratory studies showed:
Blood urea nitrogen (BUN) = 30 mg/dl,
Creatinine = 2. 8 mg/dl,
Albumin = 2. 0 mg/dl,
Alanine transaminase (ALT) = 25 U/l,
Bilirubin = 1 mg/dl.
Urine analysis shows 3+ albumin and no cells.
Which of the following is the most likely diagnosis?Your Answer:
Correct Answer: Nephrotic syndrome
Explanation:Nephrotic syndrome is a disorder in which the glomeruli have been damaged, characterized by:
– Proteinuria (>3.5 g per 1.73 m2 body surface area per day, or > 40 mg per square meter body surface area per hour in children)
– Hypoalbuminemia (< 2,5 g/dl)
– Hyperlipidaemia, and oedema (generalized anasarca). -
This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 4
Incorrect
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Which is a feature of the action of insulin?
Your Answer:
Correct Answer: Promotes protein synthesis
Explanation:Insulin is produced by the beta-cells of the islets of Langerhans in the pancreas. Its actions include:
– promoting uptake of glucose into cells
– glycogen synthesis (glycogenesis)
– protein synthesis
– stimulation of lipogenesis (fat formation).
– driving potassium into cells – used to treat hyperkaelamia.
Parathyroid hormone and activated vitamin D are the principal hormones involved in calcium/phosphate metabolism, rather than insulin. -
This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 5
Incorrect
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Regarding innervation to the peroneus brevis muscle:
Your Answer:
Correct Answer: Could be damaged by a fracture of the neck of the fibula
Explanation:The peroneus brevis is supplied by the fourth and fifth lumbar and first sacral nerves through the superficial peroneal nerve which is one of the two terminal branches of the common peroneal nerve. The common peroneal nerve winds around the neck of the fibula and can be injured in cases of fractured neck of fibula.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 6
Incorrect
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Which of the following muscles is solely contained in the anterior triangle of the neck and divides the anterior triangle into three smaller triangles?
Your Answer:
Correct Answer: Digastric
Explanation:The digastric muscle is a small muscle located under the jaw. It lies below the body of the mandible, and extends, in a curved form, from the mastoid process to the symphysis menti. The digastric divides the anterior triangle of the neck into three smaller triangles:
– The submaxillary triangle, bounded above by the lower border of the body of the mandible and a line drawn from its angle to the sternocleidomastoid, below by the posterior belly of the digastric and the stylohyoid and in front by the anterior belly of the digastric
– The carotid triangle, bounded above by the posterior belly of the digastric and stylohyoid, behind by the sternocleidomastoid and below by the omohyoid
– The suprahyoid or submental triangle, bounded laterally by the anterior belly of the digastric, medially by the midline of the neck from the hyoid bone to the symphysis menti and inferiorly by the body of the hyoid bone. -
This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 7
Incorrect
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The periphery of a haematoma is infiltrated by fibroblasts, collagen and new vasculature. This process is best described as?
Your Answer:
Correct Answer: Organisation of the haematoma
Explanation:Formation of granulation tissue at the periphery of the hematoma is a normal process leading to resolution. This granulation tissue is composed of new capillaries, fibroblasts and collagen. Lysis of a blood clot can occur, but the actual process of this response is known as organization, wherein the scar tissue will become part of the vessels. This is followed by recanalization and embolization which can lead to eventual complications. Proliferation of a clot will occur due to an imbalance in the clotting and lysing systems. Thrombosis has nothing to do with the process described above.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 8
Incorrect
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A 40-year old woman with portal hypertension has impaired venous drainage of the anal canal above the pectinate line. Thus, there might be an increase in blood flow downward to the systemic venous system via anastomoses with the inferior rectal vein. This is a tributary of?
Your Answer:
Correct Answer: Internal pudendal vein
Explanation:The inferior rectal vein drains into the internal pudendal vein. In addition the external iliac vein is one of the two branches of the common iliac vein however the internal iliac vein and it’s tributaries (including the pudendal vein) are much more important in draining the pelvic structures.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 9
Incorrect
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Which of the following structures, is the area in which the superior cerebral veins drain into?
Your Answer:
Correct Answer: Superior sagittal sinus
Explanation:The superior cerebral veins are predominantly located on the superior aspect of the brain. They are 8 to 12 in number and they drain the lateral, medial and superior aspects of the cerebral hemispheres.
These veins drain into the superior sagittal sinus, also known as the superior longitudinal sinus – which is located along the attached margin of the falx cerebri. -
This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 10
Incorrect
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Muscles and tendons in the planter region of the foot mainly take blood supply from:
Your Answer:
Correct Answer: Posterior tibial artery
Explanation:The posterior tibial artery is the main source of blood supply to the posterior compartment of the leg.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 11
Incorrect
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A 7-month-old abandoned baby with congenital non-communicating hydrocephalus is hosted by a clinic at its new-born hostel. A CT scan of the baby's brain reveals what might be a blockage of the ventricular system between the third and the fourth ventricles. Which of the following is the most likely blocked structure?
Your Answer:
Correct Answer: Cerebral aqueduct
Explanation:The drainage of cerebral spinal fluid from the third ventricle to the fourth ventricle is carried out by the cerebral aqueduct. The cerebral aqueduct is the narrowest passageway in the entire ventricular system and thus forms the most common site of blockage of flow of cerebrospinal fluid. The interventricular foramen allows passage of CSF to the third ventricle. The foramen of Luschka and Magendie are located on the fourth ventricle and allow passage of CSF to the subarachnoid space from the ventricular system. The pontine cistern is a space located on the ventral aspect of the pons. The cisterna magna is an opening on the subarachnoid space between the pia matter and the arachnoid.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 12
Incorrect
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In multiple myeloma, which of these cell types confirms the diagnosis when found in a smear of bone marrow aspirate?
Your Answer:
Correct Answer: Plasma cells
Explanation:A bone marrow aspiration is the diagnostic test for multiple myeloma, which is a malignant bone tumour that usually affects older adults. The smear reveals clusters of plasma cells, while X-rays tend to show circumscribed lytic lesions or diffuse demineralisation.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 13
Incorrect
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Glucose is the most important source of energy for cellular respiration. The transport of glucose in the renal tubular cells occurs via:
Your Answer:
Correct Answer: Secondary active transport with sodium
Explanation:In 1960, Robert K. Crane presented for the first time his discovery of the sodium-glucose cotransport as the mechanism for glucose absorption. Glucose transport through biological membranes requires specific transport proteins. Transport of glucose through the apical membrane of renal tubular as well as intestinal epithelial cells depends on the presence of secondary active Na+–glucose symporters, SGLT-1 and SGLT-2, which concentrate glucose inside the cells, using the energy provided by co-transport of Na+ ions down their electrochemical gradient.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 14
Incorrect
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A 59-year-old man was brought to the emergency department by his family after complaining of sudden, severe upper back pain and a ripping sensation, that radiated to his neck. On arrival, his pulse was weak in one arm compared with the other however his ECG result was normal. Which of the following is most probably the cause of these findings and symptoms?
Your Answer:
Correct Answer: Acute aortic dissection
Explanation:Acute aortic dissection is a serious condition in which the inner layer of the aorta tears and the blood flows in between the inner and middle layers of the aorta causing their separation (dissection). Aortic dissection can lead to rupture or decreased blood flow to organs. Clinical manifestations most often include the sudden onset of severe, tearing or ripping chest pain that can radiate to the shoulder, back or neck; syncope; altered mental status; dyspnoea; pale skin; stroke symptoms etc. The diagnosis of acute aortic dissection is based on clinical findings, imaging studies, electrocardiography and laboratory analysis.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 15
Incorrect
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After severe injury of the upper limb following an accident. The humerus is injured as well as the nerve which innervates the muscles of the anterior compartment of the arm. Which nerve is injured?
Your Answer:
Correct Answer: Musculocutaneous
Explanation:The musculoskeletal nerve supplies the muscles of the anterior compartment of the arm including the coracobrachialis, biceps brachii and the greater part of the brachialis. This nerve derives its fibres from the fifth, sixth and seventh cervical nerves and arises from the lateral cord of the brachial plexus. It also provides a branch to the elbow joint.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 16
Incorrect
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A 41 year old woman presents with discomfort in her left breast. On examination, she has a discrete, soft, fluctuant area in the upper outer quadrant of her left breast. A halo sign is observed on the mammogram. What is the most likely explanation for this process?
Your Answer:
Correct Answer: Breast cyst
Explanation:A breast cyst is a fluid-filled sac within the breast. They are often described as round or oval lumps with distinct edges. In texture, a breast cyst usually feels like a soft grape or a water-filled balloon, but can also feel firm.
Breast cysts can be painful and may be worrisome but are generally benign. They are most common in pre-menopausal women in their 30s or 40s. They usually disappear after menopause, but may persist or reappear when using hormone therapy. They are also common in adolescents. Breast cysts can be part of fibrocystic disease. The pain and swelling is usually worse in the second half of the menstrual cycle or during pregnancy.
The halo sign, described as a complete or partial radiolucent ring surrounding the periphery of a breast mass, has long been considered a mammographic sign indicating a benign process. The phenomenon is most frequently seen with cysts and fibroadenomas.
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This question is part of the following fields:
- Breast And Endocrine Surgery
- Generic Surgical Topics
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Question 17
Incorrect
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All the following statements are FALSE regarding the ophthalmic division of the trigeminal nerve, except:
Your Answer:
Correct Answer: The ophthalmic nerve is the smallest branch of the trigeminal nerve
Explanation:The ophthalmic nerve is the smallest of the three trigeminal divisions. The cutaneous branches of the ophthalmic nerve supply the conjunctiva, the skin over the forehead, the upper eyelid, and much of the external surface of the nose.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 18
Incorrect
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What is the pH of freshly formed saliva at ultimate stimulation?
Your Answer:
Correct Answer: 8
Explanation:Saliva has four major components: mucus (lubricant), α-amylase (enzyme that initiates digestion of starch), lingual lipase (enzyme that begins fat digestion), and a slightly alkaline electrolyte solution for moistening food. As the secretion rate of saliva increases, its osmolality increases. Moreover, the pH changes from slightly acidic (at rest) to basic (pH 8) at ultimate stimulation. This occurs due to increase of HCO3-. Amylase and mucus also increase in concentration after stimulation.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 19
Incorrect
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A 30-year-old male presents with a recurrent inguinal hernia on the left side of his abdomen and a newly diagnosed inguinal hernia on the right side. What is the best course of action?
Your Answer:
Correct Answer: Bilateral laparoscopic TEP repair
Explanation:Risk factors for Recurrent Inguinal Hernia with a moderate level of evidence include the presence of a sliding hernia, a diminished collagen type I/III ratio, increased systemic matrix metalloproteinase levels, obesity and open hernia repair under local anaesthesia by general surgeons.
The incorrect surgical technique is likely the most important reason for recurrence after primary IH repair.According to the guidelines:
– Laparo-endoscopic recurred inguinal hernia repair is strongly recommended after failed anterior tissue or Lichtenstein repair (evidence: moderate; recommendation: strong).
– Anterior repair is recommended after a failed posterior repair (evidence: moderate; recommendation: strong).
– An expert hernia surgeon should repair a recurrent Inguinal Hernia after failed anterior and posterior repair. Choice of technique depends on patient and surgeon specific factors (evidence: low; recommendation: strong upgraded).The EHS guidelines recommended for bilateral primary inguinal hernia repair, either a bilateral Lichtenstein or endoscopic approach.
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This question is part of the following fields:
- Generic Surgical Topics
- The Abdomen
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Question 20
Incorrect
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During an anatomy revision session, medical students are told that the posterior wall of the rectus sheath ends in a thin curved margin whose concavity is directed downwards. What is the name of this inferior border of the rectus sheath?
Your Answer:
Correct Answer: Arcuate line
Explanation:The rectus sheath is a tendinous sheath that encloses the rectus abdominis muscle. It covers the entire anterior surface however on the posterior surface of the muscle the sheath is incomplete ending inferiorly at the arcuate line. Below the arcuate line, the rectus abdominis is covered by the transversalis fascia. The linea alba is a band of aponeurosis on the midline of the anterior abdominal wall, which extends from the xiphoid process to the pubic symphysis. It is formed by the combined abdominal muscle aponeuroses. This is a useful site for midline incision during abdominal surgery because it does not carry many blood vessels. All of the other answer choices are related to the inguinal canal.
The falx inguinalis (sometimes called the inguinal falx or conjoint tendon), is the inferomedial attachment of the transversus abdominis with some fibres of the internal abdominal oblique – it contributes to the posterior wall of the inguinal canal.
The inguinal ligament is the ligament that connects the anterior superior iliac spine with the pubic tubercle – it makes the floor of the inguinal canal.
The internal (deep) inguinal ring is the entrance to the inguinal canal, where the transversalis fascia pouches out and creates an opening through which structures can leave the abdominal cavity. -
This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 21
Incorrect
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A 15-day old male baby was brought to the emergency department with sweating and his lips turning blue while feeding. He was born full term. On examination, his temperature was 37.9°C, blood pressure 75/45 mmHg, pulse was 175/min, and respiratory rate was 42/min. A harsh systolic ejection murmur could be heard at the left upper sternal border. X-ray chest showed small, boot-shaped heart with decreased pulmonary vascular markings. He most likely has:
Your Answer:
Correct Answer: Tetralogy of Fallot
Explanation:The most common congenital cyanotic heart disease and the most common cause of blue baby syndrome, Tetralogy of Fallot shows four cardiac malformations occurring together. These are ventricular septal defect (VSD), pulmonary stenosis (right ventricular outflow obstruction), overriding aorta (degree of which is variable), and right ventricular hypertrophy. The primary determinant of severity of disease is the degree of pulmonary stenosis. Tetralogy of Fallot is seen in 3-6 per 10,000 births and is responsible for 5-7% congenital heart defects, with slightly higher incidence in males. It has also been associated with chromosome 22 deletions and DiGeorge syndrome. It gives rise to right-to-left shunt leading to poor oxygenation of blood. Primary symptom is low oxygen saturation in the blood with or without cyanosis at birth of within first year of life. Affected children ay develop acute severe cyanosis or ‘tet spells’ (sudden, marked increase in cyanosis, with syncope, and may result in hypoxic brain injury and death). Other symptoms include heart murmur, failure to gain weight, poor development, clubbing, dyspnoea on exertion and polycythaemia. Chest X-ray reveals characteristic coeur-en-sabot (boot-shaped) appearance of the heart. Treatment consists of immediate care for cyanotic spells and Blalock–Taussig shunt (BT shunt) followed by corrective surgery.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 22
Incorrect
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A 58 year old man presents with complaints of recurrent episodes of diarrhoea over the past week that has resulted in marked exhaustion and fatigue. He underwent a successful cadaveric renal transplant last year and was able to return to his job as a swimming instructor. Stool microscopy is carried out and it shows evidence of cysts. Which of the following is the most likely source of infection?
Your Answer:
Correct Answer: Cryptosporidium
Explanation:Cryptosporidium infection occurs through the faecal-oral route of transmission. It usually lasts for 5–7 days. In immunocompetent patients it is self-limiting (nitazoxanide may be used to shorten the duration). In immunocompromised patients: Antiretroviral therapy to elevate the CD4 cell count/restore the immune system is essential prior to eradication with antiparasitic drugs. Diarrhoea is the main disease. The cysts are typically identified on stool microscopy.
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This question is part of the following fields:
- Clinical Microbiology
- Principles Of Surgery-in-General
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Question 23
Incorrect
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A 60-year-old male is suspected to have pancreatic cancer. What particular tumour marker should be requested to aid in the confirmation of the diagnosis of pancreatic cancer?
Your Answer:
Correct Answer: Carcinoembryonic antigen (CEA)
Explanation:Carcinoembryonic antigen (CEA) is used as a tumour marker. CEA test measures the amount of this protein that may appear in the blood of some people who have certain types of cancers especially cancer of the colon and rectal cancer. It may also be present in the pancreas, breast, ovary or lung.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 24
Incorrect
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A 27-year-old cyclist is hit by a bus travelling at 30mph. He was not wearing a helmet. He arrives with a GCS of 3/15 and is intubated. A CT scan shows evidence of cerebral contusion but no localising clinical signs are present. What is the most appropriate course of action?
Your Answer:
Correct Answer: Insertion of intra cranial pressure monitoring device
Explanation:This patient may well develop raised ICP over the next few days and intracranial pressure monitoring will help with the
management.Summary of guidelines:
For adults who have sustained a head injury and have any of the following risk factors, perform a CT head scan within 1 hour of the risk factor being identified:
– GCS less than 13 on initial assessment in the emergency department.
– GCS less than 15 at 2 hours after the injury on assessment in the emergency department.
– Suspected open or depressed skull fracture.
– Any sign of basal skull fracture (haemotympanum, ‘panda’ eyes, cerebrospinal fluid leakage from the ear or nose, Battle’s sign).
– Post-traumatic seizure.
– Focal neurological deficit.
– More than 1 episode of vomiting.
A provisional written radiology report should be made available within 1 hour of the scan being performedFor adults with any of the following risk factors who have experienced some loss of consciousness or amnesia since the injury, perform a CT head scan within 8 hours of the head injury:
– Age 65 years or older.
– Any history of bleeding or clotting disorders.
– Dangerous mechanism of injury (a pedestrian or cyclist struck by a motor vehicle, an occupant ejected from a motor vehicle or a fall from a height of greater than 1 metre or 5 stairs).
– More than 30 minutes’ retrograde amnesia of events immediately before the head injury.
A provisional written radiology report should be made available within 1 hour of the scan being performed.– Intubate and ventilate all patients with GCS 8 or less requiring transfer to a neuroscience unit.
Intubate and ventilate the patient immediately in the following circumstances:
– Coma – not obeying commands, not speaking, not eye opening (that is, GCS 8 or less).
– Loss of protective laryngeal reflexes.
– Ventilatory insufficiency as judged by blood gases: hypoxaemia (PaO2 < 13 kPa on oxygen) or hypercarbia (PaCO2 > 6 kPa).
– Spontaneous hyperventilation causing PaCO2 < 4 kPa.
– Irregular respirations.Use the criteria below for admitting patients to hospital following a head injury:
– Patients with new, clinically significant abnormalities on imaging.
– Patients whose GCS has not returned to 15 after imaging, regardless of the imaging results.
– When a patient has indications for CT scanning but this cannot be done within the appropriate period, either because CT is not available or because the patient is not sufficiently cooperative to allow scanning.
– Continuing worrying signs (for example, persistent vomiting, severe headaches) of concern to the clinician.
– Other sources of concern to the clinician (for example, drug or alcohol intoxication, other injuries, shock, suspected non-accidental injury, meningism, cerebrospinal fluid leak).
– Perform and record observations on a half-hourly basis until GCS equal to 15 has been achieved.
– Do not discharge patients presenting with head injury until they have achieved GCS equal to 15 -
This question is part of the following fields:
- Generic Surgical Topics
- Surgical Disorders Of The Brain
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Question 25
Incorrect
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A 17-year-old female was given an antibiotic for a urinary tract infection. After taking the medication the patient developed Steven-Johnson syndrome. Which particular antibiotic usually causes Steven-Johnson syndrome?
Your Answer:
Correct Answer: Sulphonamides
Explanation:Stevens–Johnson syndrome (SJS) is a type of severe skin reaction. The most common cause is certain medications such as lamotrigine, carbamazepine, allopurinol, sulphonamide antibiotics, and nevirapine.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 26
Incorrect
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A 7-year-old boy is diagnosed with metabolic acidosis as a result of severe dehydration. Which of the following conditions is most likely to cause severe dehydration and metabolic acidosis?
Your Answer:
Correct Answer: Severe diarrhoea
Explanation:Diarrhoea is defined as having three or more loose or liquid stools per day, or as having more stools than is normal for that person. Severe diarrhoea, causing fluid loss and loss of bicarbonate, will result in marked dehydration and metabolic acidosis.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 27
Incorrect
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A 56-year-old woman weighs 75 kg. In this patient, total body water, intracellular fluid and extracellular fluid are respectively:
Your Answer:
Correct Answer: 45 l, 30 l, 15 l
Explanation:The percentages of body water contained in various fluid compartments add up to total body water (TBW). This water makes up a significant fraction of the human body, both by weight and by volume. The total body water (TBW) content of humans is approximately 60% of body weight. Two-thirds is located in the intracellular and one-third in the extracellular compartment. So, in a 75-kg individual, TBW = 60 × 75/100 = 45 l. Intracellular content = 2/3 × 45 = 30 l and extracellular content = 1/3 × 45 = 15 l.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 28
Incorrect
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A woman that presented with dyspnoea, chest pain and cough was found to have a serous pleural effusion. This finding is most likely to be associated with which of the following conditions?
Your Answer:
Correct Answer: Congestive heart failure
Explanation:A pleural effusion is defined as an abnormal collection of fluid in the pleural space. Pleural effusion can result from excess fluid production or decreased absorption or both. Thoracentesis and laboratory testing help determine the origin of the accumulated fluid. Serous fluid accumulation in the pleural space indicates the presence of a hydrothorax and is most likely to develop secondary to congestive heart failure.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 29
Incorrect
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Blood investigations of a patient with vitamin K deficiency revealed a prolonged prothrombin time. This coagulation abnormality is most probably due to:
Your Answer:
Correct Answer: Factor VII deficiency
Explanation:Factor VII deficiency is a bleeding disorder caused by a deficiency or reduced activity of clotting factor VII. It may be inherited or acquired at some point during life. Inherited factor VII deficiency is an autosomal recessive disorder caused by mutations of the F7 gene. Factor VII is vitamin K-dependent, as are Factors II, IX and X and therefore lack of this vitamin can cause the development of acquired factor VII deficiency. Other causes of acquired deficiency of this factor include liver disease, sepsis and warfarin therapy.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 30
Incorrect
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What is the correct order of structures a needle must pass before it enters the pleural cavity?
Your Answer:
Correct Answer: External intercostals – internal intercostals – innermost intercostals – parietal pleura
Explanation:The correct order of structures from superficial to deep are: the skin and subcutaneous tissue, the external intercostals followed by internal intercostals, innermost intercostals and finally parietal pleura.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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