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  • Question 1 - A surgeon performing a Whipple's procedure, that involves mobilizing the head of the...

    Incorrect

    • A surgeon performing a Whipple's procedure, that involves mobilizing the head of the pancreases, accidentally injured a structure immediately posterior to the neck of the pancreases which bled out. Which structure is most likely to have been injured?

      Your Answer:

      Correct Answer: Superior mesenteric artery

      Explanation:

      The splenic vein runs behind the pancreas, receives the inferior mesenteric vein and joins the superior mesenteric vein to form the portal vein behind the pancreatic neck.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      8
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  • Question 2 - A 68 year old woman has undergone surgical repair of her femoral hernia....

    Incorrect

    • A 68 year old woman has undergone surgical repair of her femoral hernia. The surgeon used bipolar diathermy for haemostasis. Which of the following options would be regarded as the greatest risk with the usage of bipolar diathermy?

      Your Answer:

      Correct Answer: Fires when used near alcoholic skin preparations that have pooled

      Explanation:

      An operating room fire is rare but a well-known hazard that can result in significant patient morbidity. When it comes to the disposal of surgical spirits, the SPC for chlorhexidine states: ‘The solution is flammable. The risk of surgical fires due to spirit-based skin preparation fluid should be actively reduced. Data from the US show that up to 650 surgical fires occur each year, with up to 5% causing death or serious harm.

      Diathermy use electric currents to produce local heat and thereby facilitate haemostasis or surgical dissection. There are two major types of diathermy:
      1. Monopolar – current flows through a handheld device, from the tip of the device into the patient. The earth electrode is located some distance away.
      2. Bipolar – current flows from one electrode to another however, both electrodes are usually contained within the same device e.g. a pair of forceps. The result is that heating is localised to the area between the two electrodes and surrounding tissue damage is minimised. However this may create a spark and ignite flammable solutions.

    • This question is part of the following fields:

      • Principles Of Surgery-in-General
      • Surgical Technique And Technology
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  • Question 3 - An 26-year-old man sought admission due to persistent non-bloody diarrhoea. The patient is...

    Incorrect

    • An 26-year-old man sought admission due to persistent non-bloody diarrhoea. The patient is HIV-positive. Examination of stool sample showed numerous acid-fast cysts. Which of the following organism is the most likely cause of diarrhoea?

      Your Answer:

      Correct Answer: Cryptosporidium parvum

      Explanation:

      Cryptosporidium parvum is one of several species that causes cryptosporidiosis, a parasitic disease of the mammalian intestinal tract. Primary symptoms of C. parvum infection are acute, watery, and non-bloody diarrhoea. C. parvum infection is of particular concern in immunocompromised patients, where diarrhoea can reach 10–15 l per day.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
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  • Question 4 - An enlarged lymph node excised from a patient and submitted for histopathological evaluation...

    Incorrect

    • An enlarged lymph node excised from a patient and submitted for histopathological evaluation showed well-defined, prominent paracortical follicles with germinal centres? Which of the following patients are we likely talking about?

      Your Answer:

      Correct Answer: A 5-year-old boy with a sore throat and runny nose

      Explanation:

      Lymphadenopathy is common in children and is usually reactive in nature. The description fits that of a benign, reactive lymph node.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
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  • Question 5 - A 41 year old lecturer is admitted with abdominal pain. He has suffered...

    Incorrect

    • A 41 year old lecturer is admitted with abdominal pain. He has suffered from repeated episodes of this colicky right upper quadrant pain. On examination, he has a fever with right upper quadrant peritonism. His blood tests show a white cell count of 22. An abdominal ultrasound scan shows multiple gallstones in a thick walled gallbladder, the bile duct measures 4mm. Tests show that his liver function is normal. What is the best course of action?

      Your Answer:

      Correct Answer: Undertake a laparoscopic cholecystectomy

      Explanation:

      This individual has acute cholecystitis. This is demonstrated by well-localized pain in the right upper quadrant, usually with rebound and guarding; frequent presence of fever and peritonism. Ultrasonography is the procedure of choice in suspected gallbladder or biliary disease. A bile duct measuring 4mm is usually normal.
      Once gallstones become symptomatic, definitive surgical intervention with cholecystectomy is usually indicated (typically, laparoscopic cholecystectomy is the first-line therapy at centres with experience in this procedure).

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Hepatobiliary And Pancreatic Surgery
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  • Question 6 - Which of the following is not seen as a complication of wound healing?...

    Incorrect

    • Which of the following is not seen as a complication of wound healing?

      Your Answer:

      Correct Answer: Malignancy

      Explanation:

      Complications in wound healing can originate due to abnormalities in the repair process. These abnormalities are :
      1) Deficient scar formation: insufficient granulation tissue can lead to wound dehiscence and ulceration. Dehiscence or wound rupture is seen most commonly in abdominal surgery due to increased intraabdominal pressure. Ulcerations are common in extremity wounds due to inadequate vascularization.
      2) Excessive formation of repair components: collagen being laid down may begin normally however later lead to a raised scar also called a hypertrophic scar, which can extend beyond its boundaries to form a keloid and
      3) Formation of contractures.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 7 - 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 8 - A CT-scan of the lung shows a tumour crossing the minor (horizontal) fissure....

    Incorrect

    • A CT-scan of the lung shows a tumour crossing the minor (horizontal) fissure. This fissure separates:

      Your Answer:

      Correct Answer: The middle lobe from the upper lobe

      Explanation:

      The horizontal fissure separates the upper lobe from the middle lobe. The oblique fissure on the other hand separates the lower lobe from both the middle and upper lobes. The lingula is found only on the left lung.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 9 - Which is the correct order of tendons passing from medial to lateral-posterior to...

    Incorrect

    • Which is the correct order of tendons passing from medial to lateral-posterior to the medial malleolus?

      Your Answer:

      Correct Answer: Posterior tibial, flexor digitorum longus, flexor hallucis longus

      Explanation:

      The correct order of structures is the tendon of tibialis posterior, tendon of flexor digitorum longus, posterior tibial artery (and vein), tibial nerve and tendon of flexor hallucis longus.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 10 - In the case of an injury to the sub sartorial canal, which of...

    Incorrect

    • In the case of an injury to the sub sartorial canal, which of the following structures is most likely to be injured?

      Your Answer:

      Correct Answer: Nerve to vastus medialis

      Explanation:

      The adductor canal (sub sartorial canal) is situated in the middle third of the thigh.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 11 - Inside the palatoglossal arch is a muscle. Which nerve innervates this muscle? ...

    Incorrect

    • Inside the palatoglossal arch is a muscle. Which nerve innervates this muscle?

      Your Answer:

      Correct Answer: X

      Explanation:

      The palatoglossal arch contains the palatoglossal muscle which is innervated by the vagus nerve which is the tenth cranial nerve. So the correct answer is X

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 12 - Which of the following structures lying posterior to the ovary are at risk...

    Incorrect

    • Which of the following structures lying posterior to the ovary are at risk of injury in excision of a malignant tumour in the right ovary?

      Your Answer:

      Correct Answer: Ureter

      Explanation:

      The ovaries are two nodular structures situated one on either side of the uterus in relation to the lateral wall of the pelvis and attached to the back of the broad ligament of the uterus, lying posteroinferiorly to the fallopian tubes. Each ovary has a lateral and medial surface. The ureter is at greater risk of iatrogenic injury at this location.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 13 - A 39 year old lady presents with a mass in the upper outer...

    Incorrect

    • A 39 year old lady presents with a mass in the upper outer quadrant of her left breast. Imaging, histology and clinical examination confirm a 1.4cm malignant mass lesion with no clinical evidence of axillary nodal disease. Which treatment would be the most appropriate?

      Your Answer:

      Correct Answer: Wide local excision and sentinel node biopsy

      Explanation:

      Sentinel lymph node biopsy has become the gold standard for axillary staging for patients with clinically and radiologically node negative axilla. The recommended technique is the dual technique of blue dye/radioisotope and this is associated with high sentinel node identification rates (> 95 %). However, in centres where radioisotope is not available, blue dye guided four node sampling appears to be a reasonable alternative. Sentinel node biopsy was shown to be an accurate technique for axillary node staging in the ALMANAC Trial with less associated morbidity and strong health economic arguments for its use.

      The tumour in this patient is small so a wide local excision should be done.
      Lumpectomy or breast wide local excision is a surgical removal of a discrete portion or lump of breast tissue, usually in the treatment of a malignant tumour or breast cancer. It is considered a viable breast conservation therapy, as the amount of tissue removed is limited compared to a full-breast mastectomy, and thus may have physical and emotional advantages over more disfiguring treatment. Sometimes a lumpectomy may be used to either confirm or rule out that cancer has actually been detected. A lumpectomy is usually recommended to patients whose cancer has been detected early and who do not have enlarged tumours.

    • This question is part of the following fields:

      • Breast And Endocrine Surgery
      • Generic Surgical Topics
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  • Question 14 - Out of the following options, which malignancy has the highest potential for multicentricity?...

    Incorrect

    • Out of the following options, which malignancy has the highest potential for multicentricity?

      Your Answer:

      Correct Answer: Transitional cell carcinoma

      Explanation:

      Transitional cell carcinomas can arise anywhere in the urothelium lining the urinary tract; and hence are known to be multicentric and recur commonly. Prostatic adenocarcinoma most commonly involves the posterior lobe of the prostate gland. Although renal cell carcinomas occasionally show multicentricity, it is not common. Penile carcinomas are usually locally infiltrative lesions. Wilm’s tumours are usually solitary, but can be bilateral or multicentric in 10% cases. Small cell carcinoma of lung and teratomas are usually solitary.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 15 - A 50-year-old female is being prepared for a Whipple's procedure. A right-sided subclavian...

    Incorrect

    • A 50-year-old female is being prepared for a Whipple's procedure. A right-sided subclavian line is inserted and anaesthesia is induced. Following intubation, the patient becomes progressively hypoxic and haemodynamically unstable. What is the most likely underlying explanation?

      Your Answer:

      Correct Answer: Tension pneumothorax

      Explanation:

      The complications of central vein catheterization (CVC) include infection, thrombosis, occlusion, and, in particular, mechanical complications which usually occur during insertion and are closely related to the anatomic location of the central veins. Infectious complications are reported to occur in 5% to 26% of patients, mechanical complications in 5% to 19%, and thrombotic complications in 2% to 26%. Mechanical complications associated with the insertion of central lines include arterial puncture, hematoma, haemothorax, pneumothorax, arterial-venous fistula, venous air embolism, nerve injury, thoracic duct injury (left side only), intraluminal dissection, and puncture of the aorta
      Pneumothorax is one of the most common CVC insertion complications, reportedly representing up to 30% of all mechanical adverse events of CVC insertion.
      Clinician-performed bedside US allows the diagnosis of pneumothorax to be made immediately, with a high degree of sensitivity and with better accuracy than supine chest films and equal to that of CT scan.
      Tension pneumothorax is classically characterized by hypotension and hypoxia. On examination, breath sounds are absent on the affected haemothorax and the trachea deviates away from the affected side. The thorax may also be hyper resonant; jugular venous distention and tachycardia may be present.
      If a pneumothorax is diagnosed the treatment strategy should be determined by the following factors: (I) size; (II) symptoms; (III) spontaneous breathing or use of mechanical ventilation; (IV) clinical diagnosis of a tension pneumothorax.

      Treatment consisted of: (I) observation; (II) outpatient insertion of a Heimlich valve; (III) inpatient tube thoracostomy.

    • This question is part of the following fields:

      • Peri-operative Care
      • Principles Of Surgery-in-General
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  • Question 16 - Which of the following substances will enhance the activity of antithrombin III? ...

    Incorrect

    • Which of the following substances will enhance the activity of antithrombin III?

      Your Answer:

      Correct Answer: Heparin

      Explanation:

      Antithrombin III is a glycoprotein that inactivates multiple enzymes involved in the coagulation system. It inactivates factor X, factor IX, factor II, factor VII, factor XI and factor XII. Its activity is greatly increased by the action of heparin.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
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  • Question 17 - A victim of assault in a domestic violence is stabbed in the left...

    Incorrect

    • A victim of assault in a domestic violence is stabbed in the left chest. The tip of the pen knife entered the pleural space just above the cardiac notch. Luckily the lung was spared as it would only occupy this space during deep inspiration. Which of these structures was pierced by the knife?

      Your Answer:

      Correct Answer: Costomediastinal recess

      Explanation:

      The costomediastinal recess is located immediately next to the cardiac notch. The medial aspect of the superior lobe of the left lung, when fully inflated expands to this place. The lung wouldn’t enter the anterior or the posterior mediastinum which are found between the two pleural cavities.
      The costodiaphragmatic recess is the lowest extent of the pleural cavity where the inferior lobes of the lungs would expand into in deep inhalation.
      The cupola, is the part of the pleural cavity that extends above the first rib into the root of the neck. The superior most part of the superior lobe of the lung might extend into this part.
      Pulmonary ligament: pleural fold that is located below the root of the lung where the visceral pleura and the mediastinal pleura are in continuity.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 18 - A significantly elevated white cell count of 50 x 109/l with 5% blasts...

    Incorrect

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

      Your Answer:

      Correct Answer: Leukaemoid reaction

      Explanation:

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

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 19 - A 40-year-old man is due to undergo excision of a sebaceous cyst on...

    Incorrect

    • A 40-year-old man is due to undergo excision of a sebaceous cyst on his scalp. Which of the following agents should be used for local anaesthesia?

      Your Answer:

      Correct Answer: 1% lignocaine with 1 in 200,000 adrenaline

      Explanation:

      Scalp wounds often bleed and the addition of adrenaline is, therefore, desirable. Lignocaine is fast acting and the preferred agent for local anaesthesia.

      Lignocaine, also called lidocaine, is a local anaesthetic and a less commonly used antiarrhythmic. Its increased doses may be used when combined with adrenaline to limit systemic absorption. Adrenaline may be added to local anaesthetic drugs. It prolongs the duration of action at the site of injection and permits usage of higher doses. It is, however, contraindicated in patients taking monoamine oxidase inhibitors or tricyclic antidepressants.

      Other listed options are ruled out in this case because:
      1. Bupivacaine: has a much longer duration of action than lignocaine and, thus, may be used for topical wound infiltration at the conclusion of surgical procedures.
      2. Prilocaine: the agent of choice for intravenous regional anaesthesia.

    • This question is part of the following fields:

      • Principles Of Surgery-in-General
      • Surgical Technique And Technology
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  • Question 20 - Etoposide is a chemotherapeutic agent used in the treatment of different types of...

    Incorrect

    • Etoposide is a chemotherapeutic agent used in the treatment of different types of cancer. Which of the following is the correct indication for this drug?

      Your Answer:

      Correct Answer: Lung cancer

      Explanation:

      Etoposide phosphate is an inhibitor of the enzyme topoisomerase II. It is used as a form of chemotherapy for malignancies such as lung cancer, testicular cancer, lymphoma, non-lymphocytic leukaemia and glioblastoma multiforme. Side effects are very common and can include low blood cell counts, vomiting, loss of appetite, diarrhoea, hair loss, and fever.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 21 - A 27 year old lady presents with bright red rectal bleeding that occurs...

    Incorrect

    • A 27 year old lady presents with bright red rectal bleeding that occurs after defecation and is seen in the toilet bowl and on the tissue. She is constipated but her bowel habit is otherwise normal. A digital rectal examination is done which is also normal. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Haemorrhoidal disease

      Explanation:

      Answer: Haemorrhoidal disease

      Haemorrhoids are a normal part of the anatomy of the anorectum. They are vascular cushions that serve to protect the anal sphincter, aid closure of the anal canal during increased abdominal pressure, and provide sensory information that helps differentiate among stool, liquid and gas. Because of their high vascularity and sensitive location, they are also a frequent cause of pathology. Contributing factors include pregnancy, chronic constipation, diarrhoea or prolonged straining, weight lifting, and weakening of supporting tissue as a result of aging or genetics.
      Haemorrhoids are classified according to their position relative to the dentate line. External haemorrhoids lie below the dentate line, are covered by squamous epithelium and innervated by cutaneous nerves. If symptomatic, the only definitive therapy is surgical excision.
      Internal haemorrhoids arise above the dentate line, are covered by columnar cells and have a visceral nerve supply. They are further categorized — and treated — according to their degree of prolapse:
      -Grade I haemorrhoids bleed but do not prolapse; on colonoscopy, they are seen as small bulges into the lumen.
      -Grade II haemorrhoids prolapse outside the anal canal but reduce spontaneously.
      -Grade III haemorrhoids protrude outside the anal canal and usually require manual reduction.
      -Grade IV haemorrhoids are irreducible and constantly prolapsed. Acutely thrombosed haemorrhoids and those involving rectal mucosal prolapse are also grade IV.

      Most gastrointestinal and surgical societies advocate anoscopy and/or flexible sigmoidoscopy to evaluate any bright-red rectal bleeding. Colonoscopy should be considered in the evaluation of any rectal bleeding that is not typical of haemorrhoids such as in the presence of strong risk factors for colonic malignancy or in the setting of rectal bleeding with a negative anorectal examination.

      Anal fissures are tears of the sensitive mucosal lining of the anus. Anal fissures often cause pain during and after a bowel movement, sometimes followed by throbbing pain for several hours. They are also often associated with itching and blood on toilet tissue, in the bowl, or on the surface of the stool. Anal fissures are caused by
      trauma to the anal canal usually during bowel movements. Anal fissures are also sometimes caused by inflammatory bowel disease or infection.

    • This question is part of the following fields:

      • Colorectal Surgery
      • Generic Surgical Topics
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  • Question 22 - Identify which of the following muscles acts on two joints? ...

    Incorrect

    • Identify which of the following muscles acts on two joints?

      Your Answer:

      Correct Answer: Sartorius

      Explanation:

      The sartorius muscle, the longest muscle in the body, is one of the two jointed or biarticular muscles. It originates from the anterior superior iliac spine and part of the notch between the anterior superior iliac spine and anterior inferior iliac spine and crosses both the hip joint and the knee joint. At the hip joint the sartorius flexes and rotates the thigh at the hip joint and flexes the leg at the knee joint.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 23 - A 36 year old female who is admitted in the intensive care unit...

    Incorrect

    • A 36 year old female who is admitted in the intensive care unit after being involved in a motor vehicle accident is being considered as an organ donor following discussion with her family. What is not a precondition for the diagnosis of brainstem death?

      Your Answer:

      Correct Answer: A PaCO2 of > 7 kPa has been documented

      Explanation:

      In adults 50% of the cases of brain death follow severe head injury, 30% are due to subarachnoid haemorrhage and 20% are due to a severe hypoxic-ischaemic event. Thus supra-tentorial catastrophes lead to pressure effect which cause the irretrievable death of the brain-stem.

      The Criteria for Diagnosis of Brain-Stem Death

      All the pre-conditions must be satisfied and
      there should be demonstrably no pharmacological or
      metabolic reason for the coma before formally testing the
      integrity of the brain-stem reflexes.

      Pre Conditions
      1. The patient is comatose and mechanically ventilated
      for apnoea.
      2. The diagnosis of structural brain damage has been
      established or the immediate cause of coma is known.
      3. A period of observation is essential.

      Exclusions
      1. Drugs are not the cause of coma e.g. barbiturates.
      Neuromuscular blockade has been demonstrably reversed.
      2. Hypothermia does not exist.
      3. There is no endocrine or metabolic disturbance.

      Testing for Brain-Stem Death
      Reflexes involving brain-stem function.
      1. No pupillary response to light.
      2. No corneal reflex.
      3. No vestibulo ocular reflex (Caloric test).
      4. Doll’s eye reflex
      5. No motor response to pain – in the Vth nerve distribution.
      6. No gag reflex in response to suction through endotracheal tube or tracheostomy.
      7. Apnoea persists despite a rise in PaCO2 to greater than 50 mmHg (6.6kPa) against a background of a normal PaO2.

      Diagnosis is to be made by two doctors who have been registered for more than five years and are competent in the procedure. At least one should be a consultant. Testing should be undertaken by the doctors together and must always be performed completely and successfully on two occasions in total.

    • This question is part of the following fields:

      • Emergency Medicine And Management Of Trauma
      • Principles Of Surgery-in-General
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  • Question 24 - A machine worker fractured the medial epicondyle of his right humerus resulting in...

    Incorrect

    • A machine worker fractured the medial epicondyle of his right humerus resulting in damage to an artery running with the ulnar nerve posterior to the medial epicondyle. The artery injured is the?

      Your Answer:

      Correct Answer: Superior ulnar collateral

      Explanation:

      The superior ulnar collateral artery runs posterior to the medial epicondyle of the humerus, accompanied by the ulnar nerve. This artery arises from the brachial artery near the middle of the arm and ends under the flexor carpi ulnaris muscle by anastomosing with two arteries: the posterior ulnar recurrent and inferior ulnar collateral.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 25 - A new-born was found to have an undeveloped spiral septum in the heart....

    Incorrect

    • A new-born was found to have an undeveloped spiral septum in the heart. This is characteristic of which of the following?

      Your Answer:

      Correct Answer: Persistent truncus arteriosus

      Explanation:

      Persistent truncus arteriosus is a congenital heart disease that occurs when the primitive truncus does not divide into the pulmonary artery and aorta, resulting in a single arterial trunk. The spiral septum is created by fusion of a truncal septum and the aorticopulmonary spiral septum. Incomplete development of these septa results in incomplete separation of the common tube of the truncus arteriosus and the aorticopulmonary trunk.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 26 - The optic foramen, superior orbital fissure, foramen ovale, foramen rotundum and foramen sinosum...

    Incorrect

    • The optic foramen, superior orbital fissure, foramen ovale, foramen rotundum and foramen sinosum are all located on which bone at the base of the skull?

      Your Answer:

      Correct Answer: Sphenoid

      Explanation:

      The sphenoid bone consists of two parts, a central part and two wing-like structures that extend sideways towards each side of the skull. It forms the base of the skull, and floor and sides of the orbit. On its central part lies the optic foramen. The foramen ovale, foramen spinosum and foramen rotundum lie on its great wing while the superior orbital fissure lies on its lesser wing.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 27 - Endometrial hyperplasia is most likely to be associated with which of the following...

    Incorrect

    • Endometrial hyperplasia is most likely to be associated with which of the following conditions?

      Your Answer:

      Correct Answer: Fibrothecoma

      Explanation:

      A benign tumour arising from the ovarian stroma, fibrothecoma are bilateral in 10% cases. The thecoma component of the tumour can produce oestrogen leading to endometrial hyperplasia. The thecoma is rich in lipid content and is responsible for the yellowish appearance of the tumour. Meig’s syndrome is the presence of fibrothecoma with a right-sided hydrothorax.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 28 - A 78-year-old diabetic man undergoes renal function tests. Which of the following substances...

    Incorrect

    • A 78-year-old diabetic man undergoes renal function tests. Which of the following substances will be the most accurate for measuring glomerular filtration rate (GFR)?

      Your Answer:

      Correct Answer: Inulin

      Explanation:

      Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal glomerular capillaries into the Bowman’s capsule per unit time. Clinically, this is often measured to determine renal function. Inulin was originally used as it is not reabsorbed by the kidney after glomerular filtration, therefore its rate of excretion is directly proportional to the rate of filtration of water and solutes across the glomerular filter. However, in clinical practice, creatinine clearance is used to measure GFR. Creatinine is an endogenous molecule, synthesised in the body, that is freely filtered by the glomerulus (but also secreted by the renal tubules in very small amounts). Creatinine clearance exceeds GFR due to creatinine secretion, and is therefore a close approximation of the GFR.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
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  • Question 29 - A cerebellar tremor can be differentiated from a Parkinsonian tremor in that: ...

    Incorrect

    • A cerebellar tremor can be differentiated from a Parkinsonian tremor in that:

      Your Answer:

      Correct Answer: It only occurs during voluntary movements

      Explanation:

      Cerebellar disease leads to intention tremors, which is absent at rest and appears at the onset of voluntary movements. In comparison, Parkinson’s tremor is present at rest. Frequency of tremor is a less reliable means to differentiate between the two as the oscillation amplitude of the tremor is not constant throughout a voluntary action.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
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  • Question 30 - A patient presents with loss of pain and temperature sensation in the left...

    Incorrect

    • A patient presents with loss of pain and temperature sensation in the left leg. He is likely to have a lesion involving:

      Your Answer:

      Correct Answer: Right lateral spinothalamic tract

      Explanation:

      The spinothalamic tract is a sensory pathway originating in the spinal cord that transmits information to the thalamus. There are two main parts of the spinothalamic tract: the lateral spinothalamic tract transmits pain and temperature and the anterior spinothalamic tract transmits touch (crude touch). The decussation of this pathway occurs at the level of the spinal cord. Hence, a unilateral lesion of the lateral spinothalamic tract causes contralateral loss of pain and temperature.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY

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