00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Mins)
Retry this test Dashboard

  • Question 1 - A 70-year old man presents to the surgical out patient clinic with a...

    Incorrect

    • A 70-year old man presents to the surgical out patient clinic with a direct inguinal hernia on the right side. He had undergone and appendicectomy 6 months prior. The examining doctor correlated the development of the hernia to iatrogenic nerve injury that happened during the operation. Which nerve had been injured?

      Your Answer: Genital branch of the genitofemoral

      Correct Answer: Ilioinguinal

      Explanation:

      Direct inguinal hernias occur because of weakness in the abdominal muscles. The ilioinguinal nerve is important for innervating the muscles of the lower abdominal wall and damage during appendicectomy therefore prevents the man from being able to contract abdominal muscles to pull the falx inguinalis over the weak fascia.
      The genitofemoral nerve innervates the cremaster muscle and injury to it would cause inability to elevate the testes.
      The subcostal nerve and the ventral primary ramus of T10 innervate the muscles, skin and fascia of the upper abdominal wall.
      The iliohypogastric nerve supplies the skin over the upper part of the buttock behind the area supplied by the subcostal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      3
      Seconds

  • Question 2 - A gymnast was admitted to hospital for investigation of a weakness in the...

    Incorrect

    • A gymnast was admitted to hospital for investigation of a weakness in the extension and adduction of his arm. He had a previous penetrating wound in the area of the posterior axillary fold. Which of these muscles is the likely cause?

      Your Answer:

      Correct Answer: Latissimus dorsi

      Explanation:

      All the criteria of this case points towards the latissimus dorsi. This muscle is greatly involved in extension, adduction and medial rotation of the arm and forms the posterior axillary fold which in this case was injured.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 3 - During work up for a 29 year-old lady who complained of chest pain,...

    Incorrect

    • During work up for a 29 year-old lady who complained of chest pain, a computed tomography showed a large mass in the posterior mediastinum. Which among the following structures could be involved?

      Your Answer:

      Correct Answer: Lymph glands

      Explanation:

      Boundaries of the posterior mediastinum include:
      Superior: a plane through the sternal angle and T4/5
      Inferior: the diaphragm
      Anterior: the middle mediastinal structures
      Posterior the spinal cord.
      Structures in the posterior mediastinum include the descending thoracic aorta, the azygos system, oesophagus, thoracic duct and lymph nodes. The great vessels and structures at the root of the lung are part of the middle mediastinum. In this case, the lymph nodes is the correct answer.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 4 - A 31 year old woman arrives at the clinic due to a tender...

    Incorrect

    • A 31 year old woman arrives at the clinic due to a tender breast lump. On examination, there is a fluctuant and tender mass. She has a 2 month old child. Which of the following most likely caused her breast lump?

      Your Answer:

      Correct Answer: Breast abscess

      Explanation:

      A breast abscess is a localised collection of pus in the breast tissue. It is usually caused by a bacterial infection. Breast infections, including mastitis and breast abscesses, are most often seen in women aged 15 to 45 years. Mastitis can occur as a result of breastfeeding and if left untreated it can progress to an abscess. The bacteria most commonly associated with this is staphylococcus aureus.

    • This question is part of the following fields:

      • Breast And Endocrine Surgery
      • Generic Surgical Topics
      0
      Seconds

  • Question 5 - A 30-year-old man who is a known case of von Willebrand disease has...

    Incorrect

    • A 30-year-old man who is a known case of von Willebrand disease has started bleeding following the excision of a sebaceous cyst.

      Administration of which of the following agents is most likely to be beneficial?

      Your Answer:

      Correct Answer: Desmopressin

      Explanation:

      Desmopressin is useful in managing mild to moderate episodes of bleeding in von Willebrand disease (vWD).

      vWD is the most common hereditary coagulopathy resulting from the deficiency or abnormal function of von Willebrand factor (vWF). vWF promotes platelet adhesion to damaged endothelium and other platelets and is also involved in the transport and stabilization of factor VIII.

      There are seven subtypes of vWD. Type 1 vWD (autosomal dominant) is the most common and accounts for 80% of the cases. Type 2 vWD (autosomal dominant or recessive) accounts for 15% of the cases. There is a significant spectrum of severity ranging from spontaneous bleeding and epistaxis through to troublesome excessive bleeding following minor procedures.

      Bleeding time is mostly used as a diagnostic test for vWD. Treatment options include administration of tranexamic acid for minor cases undergoing minor procedures. More significant bleeding or procedures respond well to desmopressin (DDAVP). It is most effective in type 1 vWD, less effective in type 2 and contraindicated in type 2B. Individuals who cannot have desmopressin or in whom it is contraindicated usually receive factor VIII concentrates containing vWF.

    • This question is part of the following fields:

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

  • Question 6 - A 50 year old lawyer is admitted to the medical ward for an...

    Incorrect

    • A 50 year old lawyer is admitted to the medical ward for an endarterectomy. His CT report confirms a left temporal lobe infarct. Which visual defect is most likely to be encountered?

      Your Answer:

      Correct Answer: Right superior quadranopia

      Explanation:

      Quadrantanopia refers to an anopia affecting a quarter of the field of vision. While quadrantanopia can be caused by lesions in the temporal and parietal lobes, it is most commonly associated with lesions in the occipital lobe.
      A lesion affecting one side of the temporal lobe may cause damage to the inferior optic radiations (known as the temporal pathway or Meyer’s loop) which can lead to superior quadrantanopia on the contralateral side of both eyes (colloquially referred to as pie in the sky).

      Therefore, a left temporal lobe infarct will affect the right superior quadrantanopia.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Surgical Disorders Of The Brain
      0
      Seconds

  • Question 7 - A 39 year old hiker slips down a slope and injures her hand...

    Incorrect

    • A 39 year old hiker slips down a slope and injures her hand on an oak tree. On examination, she is tender in the anatomical snuffbox and on bimanual palpation. X-rays with scaphoid views show no evidence of fracture. What is the most appropriate course of action?

      Your Answer:

      Correct Answer: Application of futura splint and fracture clinic review

      Explanation:

      A scaphoid fracture is a break of the scaphoid bone in the wrist. Symptoms generally include pain at the base of the thumb which is worse with use of the hand. The anatomic snuffbox is generally tender and swelling may occur. Complications may include non-union of the fracture, avascular necrosis, and arthritis.

      Scaphoid fractures are most commonly caused by a fall on an outstretched hand. Diagnosis is generally based on examination and medical imaging. Some fractures may not be visible on plain X-rays. In such cases a person may be casted with repeat X-rays in two weeks or an MRI or bone scan may be done.
      Scaphoid fractures are often diagnosed by PA and lateral X-rays. However, not all fractures are apparent initially. Therefore, people with tenderness over the scaphoid (those who exhibit pain to pressure in the anatomic snuff box) are often splinted in a thumb spica for 7–10 days at which point a second set of X-rays is taken. If there was a hairline fracture, healing may now be apparent. Even then a fracture may not be apparent. A CT Scan can then be used to evaluate the scaphoid with greater resolution. The use of MRI, if available, is preferred over CT and can give one an immediate diagnosis. Bone scintigraphy is also an effective method for diagnosing a fracture which does not appear on x-ray.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Orthopaedics
      0
      Seconds

  • Question 8 - A 32 year old man is suffering from recurrent bouts of severe pain...

    Incorrect

    • A 32 year old man is suffering from recurrent bouts of severe pain that is localized to the anus. The pain lasts momentarily for a few seconds and completely resolves between attacks. Which of the following would be the most suitable approach to this patient's management?

      Your Answer:

      Correct Answer: Reassurance

      Explanation:

      Proctalgia fugax (PF) is a benign painful rectal condition that is defined as intermittent, recurring, and self-limiting pain in the anorectal region in the absence of organic pathology. The pain of proctalgia fugax is sharp or gripping and severe. Similar to other urogenital focal pain syndromes, such as vulvodynia and proctodynia, the causes remain obscure. Stress and sitting for prolonged periods often increase the frequency and intensity of attacks of proctalgia fugax. Patients often feel an urge to defecate with the onset of the paroxysms of pain . Depression often accompanies the pain of proctalgia fugax but is not thought to be the primary cause. The symptoms of proctalgia fugax can be so severe as to limit the patient’s ability to perform activities of daily living. Reassurance has proven to help in many cases as the condition has been linked to stress.

    • This question is part of the following fields:

      • Colorectal Surgery
      • Generic Surgical Topics
      0
      Seconds

  • Question 9 - A 40-year-old chef presents to the hospital with profuse bloody diarrhoea. He also...

    Incorrect

    • A 40-year-old chef presents to the hospital with profuse bloody diarrhoea. He also complains of frequent urge to defecate and pain before and during defecation. A sigmoidoscopy is arranged which reveals necrosis and ulceration of the descending colon mucosa.

      What is the most likely underlying cause?

      Your Answer:

      Correct Answer: Infection with enteroinvasive E. coli

      Explanation:

      Necrosis and ulcers of the colon are a feature of infection with enteroinvasive E. coli (EIEC). It presents with a dysentery-type illness similar to shigellosis.

      E. coli have different strains that cause a wide range of conditions. The four main types are:

      1. Enteropathogenic E. coli—cause watery diarrhoea, vomiting, and low-grade fever

      2. Enteroinvasive E. coli—cause dysentery, large bowel necrosis, and ulcers

      3. Enterotoxigenic E. coli—cause traveller’s diarrhoea

      4. Enterohaemorrhagic E. coli 0157:H7—cause haemorrhagic colitis, haemolytic uremic syndrome, and thrombotic thrombocytopenic purpura

    • This question is part of the following fields:

      • Clinical Microbiology
      • Principles Of Surgery-in-General
      0
      Seconds

  • Question 10 - 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 11 - A 39-year-old man, after radiological evaluation and thoracentesis, was found to have chylothorax....

    Incorrect

    • A 39-year-old man, after radiological evaluation and thoracentesis, was found to have chylothorax. What is the most probable cause of this diagnose?

      Your Answer:

      Correct Answer: Mediastinal malignant lymphoma

      Explanation:

      Chylothorax is a potentially lethal condition characterized by fluid (chyle) accumulation in the pleural cavity, resulting from disruption of lymphatic drainage in the thoracic duct. Chyle is a fluid rich in triglycerides and chylomicrons and can originate from the thorax, the abdomen or both. Malignant tumours, especially lymphoma, are the most common causes of nontraumatic chylothorax. Bronchogenic carcinoma and trauma are the most common causes after lymphomas. Other rare causes of chylothorax are; granulomatous diseases, tuberculosis, congenital malformations, nephrotic syndrome, hypothyroidism, cirrhosis, decompensated heart failure and idiopathic chylothorax.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 12 - A 6 year old boy previously diagnosed with a rare genetic disorder requires...

    Incorrect

    • A 6 year old boy previously diagnosed with a rare genetic disorder requires long term drug therapy for his condition. The drug needs to be administered intravenously. Lately, the child has been pulling at the current system of Hickman line and the parents are requesting an alternate. Which of the following would be the best alternative method?

      Your Answer:

      Correct Answer: Portacath device

      Explanation:

      Portacaths are usually inserted when there is a need for long term access to a vein. This might be to provide medication, special intravenous feeding, fluids, blood and blood product transfusion and blood tests. Broviacs would pose the same core problems as a Hickman.

    • This question is part of the following fields:

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

  • Question 13 - QT interval in the electrocardiogram of a healthy individual is normally: ...

    Incorrect

    • QT interval in the electrocardiogram of a healthy individual is normally:

      Your Answer:

      Correct Answer: 0.40 s

      Explanation:

      QT interval extends from beginning of the QRS complex till the end of he T-wave and normally lasts for 0.40 s. It is important in the diagnosis of long-QT and short-QT syndrome. The QT interval varies on the basis of heart rate and may need to be corrected.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 14 - In which situation is a stretch reflex such as knee jerk likely to...

    Incorrect

    • In which situation is a stretch reflex such as knee jerk likely to be exaggerated?

      Your Answer:

      Correct Answer: In upper motor neuron lesion

      Explanation:

      A stretch reflex is a monosynaptic reflex that causes muscle contraction in response to stretching within that muscle. The sensory apparatus in a muscle that are sensitive to stretch are the muscle spindles. The patellar (knee jerk) reflex is an example. In upper motor neuron lesions, the stretch reflexes tend to be brisk due to loss of inhibitory signals on gamma neurons through the lateral reticulospinal tract.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 15 - Which of the following is a true statement regarding secretion of gastric acid?...

    Incorrect

    • Which of the following is a true statement regarding secretion of gastric acid?

      Your Answer:

      Correct Answer: Acetylcholine increases gastric acid secretion

      Explanation:

      Gastric acid secretion is increased by acetylcholine, histamine and gastrin, with the help of cAMP as a secondary messenger. They increase H+ and Cl- secretion by increasing the number of H+/K+ ATPase molecules and Cl- channels. In contrast, gastric acid secretion is decreased by somatostatin, epidermal growth factor and prostaglandins.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 16 - A 40-year-old man presents to the acute surgical unit with acute pancreatitis. Over...

    Incorrect

    • A 40-year-old man presents to the acute surgical unit with acute pancreatitis. Over the next few days, he becomes dyspnoeic and his saturations are 89% on air and CVP is 16 mmHg. CXR shows bilateral pulmonary infiltrates.

      What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Acute respiratory distress syndrome

      Explanation:

      Acute pancreatitis is known to precipitate acute respiratory distress syndrome (ARDS) which is characterised by bilateral pulmonary infiltrates and severe hypoxaemia in the absence of evidence for cardiogenic pulmonary oedema. Pulmonary oedema is excluded by the CVP reading of <18 mmHg in this scenario. ARDS is subdivided into two stages. Early stage consists of an exudative phase of injury with associated oedema. The later stage is one of repair and consists of fibroproliferative changes. Subsequent scarring may result in poor lung function. ARDS can also lead to multiple organ failure. Various causes of ARDS include:
      1. Sepsis
      2. Direct lung injury
      3. Trauma
      4. Acute pancreatitis
      5. Long bone fracture or multiple fractures (through fat embolism)
      6. Head injury (sympathetic nervous stimulation which leads to acute pulmonary hypertension)

      Management options are:
      1. Treat the underlying cause
      2. Antibiotics (if signs of sepsis)
      3. Negative fluid balance, i.e. diuretics
      4. Recruitment manoeuvres such as prone ventilation and use of positive end-expiratory pressure (PEEP)
      5. Mechanical ventilation strategy using low tidal volumes, as conventional tidal volumes may cause lung injury (only treatment found to improve survival rates)

    • This question is part of the following fields:

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

  • Question 17 - A 41 year old librarian undergoes a gastric bypass surgery and she returns...

    Incorrect

    • A 41 year old librarian undergoes a gastric bypass surgery and she returns to the clinic complaining that she develops vertigo and crampy abdominal pain after eating. Which of the following is the underlying cause?

      Your Answer:

      Correct Answer: Dumping syndrome

      Explanation:

      Dumping syndrome is the effect of altered gastric reservoir function, abnormal postoperative gastric motor function, and/or pyloric emptying mechanism. Clinically significant dumping syndrome occurs in approximately 10% of patients after any type of gastric surgery and in up to 50% of patients after laparoscopic Roux-en-Y gastric bypass. Dumping syndrome has characteristic alimentary and systemic manifestations. It is a frequent complication observed after a variety of gastric surgical procedures, such as vagotomy, pyloroplasty, gastrojejunostomy, and laparoscopic Nissan fundoplication. Dumping syndrome can be separated into early and late forms, depending on the occurrence of symptoms in relation to the time elapsed after a meal.
      Postprandially, the function of the body of the stomach is to store food and to allow the initial chemical digestion by acid and proteases before transferring food to the gastric antrum. In the antrum, high-amplitude contractions triturate the solids, reducing the particle size to 1-2 mm. Once solids have been reduced to this desired size, they are able to pass through the pylorus. An intact pylorus prevents the passage of larger particles into the duodenum. Gastric emptying is controlled by the fundic tone, antropyloric mechanisms, and duodenal feedback. Gastric surgery alters each of these mechanisms in several ways.

      The late dumping syndrome is suspected in the person who has symptoms of hypoglycaemia in the setting of previous gastric surgery, and this late dumping can be proven with an oral glucose tolerance test (hyperinsulinemic hypoglycaemia), as well as gastric emptying scintigraphy, which shows the abnormal pattern of initially delayed and then accelerated gastric emptying.

      The clinical presentation of dumping syndrome can be divided into GI symptoms and vasomotor symptoms. GI symptoms include early satiety, crampy abdominal pain, nausea, vomiting, and explosive diarrhoea. Vasomotor symptoms include diaphoresis, flushing, dizziness, palpitations, and an intense desire to lie down.

      The expression of these symptoms varies in different individuals. Most patients with early dumping have both GI and vasomotor symptoms, while patients with late dumping have mostly vasomotor symptoms. Patients with severe dumping often limit their food intake to avoid symptoms. This leads to weight loss and, over time, malnutrition.

      Early dumping syndrome generally occurs within 15 minutes of ingesting a meal and is attributable to the rapid transit of food into the small intestine, whereas late dumping syndrome occurs later and may be attributed to hypoglycaemia with tremors, cold sweats, difficulty in concentrating, and loss of consciousness.

      Early dumping systemic symptoms are as follows:
      Desire to lie down
      Palpitations
      Fatigue
      Faintness
      Syncope
      Diaphoresis
      Headache
      Flushing

      Early dumping abdominal symptoms are as follows:
      Epigastric fullness
      Diarrhoea
      Nausea
      Abdominal cramps
      Borborygmi

      Late dumping symptoms are as follows:
      Perspiration
      Shakiness
      Difficulty to concentrate
      Decreased consciousness
      Hunger

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Upper Gastrointestinal Surgery
      0
      Seconds

  • Question 18 - A 60-year-old male is suspected to have pancreatic cancer. What particular tumour marker...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 19 - If a catheter is placed in the main pulmonary artery of a healthy...

    Incorrect

    • If a catheter is placed in the main pulmonary artery of a healthy 30-year-old woman, which of the following will be its mean pulmonary arterial pressure?

      Your Answer:

      Correct Answer: 15 mmHg

      Explanation:

      The pulmonary artery pressure (PA pressure) is a measure of the blood pressure found in the main pulmonary artery. The hydrostatic pressure of the pulmonary circulation refers to the actual pressure inside pulmonary vessels relative to atmospheric pressure. Hydrostatic (blood pressure) in the pulmonary vascular bed is low compared with that of similar systemic vessels. The mean pulmonary arterial pressure is about 15 mmHg (ranging from about 13 to 19 mmHg) and is much lower than the average systemic arterial pressure of 90 mmHg.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 20 - Which of the following is true regarding factor XI? ...

    Incorrect

    • Which of the following is true regarding factor XI?

      Your Answer:

      Correct Answer: Deficiency causes haemophilia C

      Explanation:

      Factor XI is also known as plasma thromboplastin and is one of the enzymes of the coagulation cascade. It is produced in the liver and is a serine protease. It is activated by factor XIIa, thrombin and by itself. Deficiency of factor XI causes the rare type of haemophilia C. Low levels of factor XI also occur in other disease states, including Noonan syndrome. High levels of factor XI have been seen in thrombosis.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 21 - A 39 year old decides to donate one of her kidneys to her...

    Incorrect

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

      Your Answer:

      Correct Answer: Allograft

      Explanation:

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

      Isograft Graft – tissue between two individuals who are genetically identical

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

      Xenograft – tissue transplanted from another species

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Organ Transplantation
      0
      Seconds

  • Question 22 - A 62-year-old woman presented to the doctor complaining of spine pain, fatigue and...

    Incorrect

    • A 62-year-old woman presented to the doctor complaining of spine pain, fatigue and oliguria. She is diagnosed with chronic renal failure. Dipstick testing shows no protein, glucose, nitrite or ketones but a semi-quantitative sulphosalicylic acid test for urine protein is positive. Which of the following is the most probable cause of chronic renal failure in this patient.

      Your Answer:

      Correct Answer: Multiple myeloma

      Explanation:

      Dipstick results are negative because the proteins found in the urine of this patient are not albumin but Bence Jones proteins. A Bence Jones protein is a monoclonal globulin protein commonly detected in patients affected by multiple myeloma. Multiple myeloma is a malignancy of plasma cells characterised by the production of monoclonal immunoglobulin. Symptoms include bone pain, bone fractures, bleeding, neurologic symptoms, fatigue, frequent infections and weight loss.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 23 - An intern is attempting to put in an arterial line in an ICU...

    Incorrect

    • An intern is attempting to put in an arterial line in an ICU patients left foot. Which is the best site to feel for the pulsation of the dorsalis pedis artery in the foot?

      Your Answer:

      Correct Answer: Just lateral to the tendon of extensor hallucis longus

      Explanation:

      The dorsalis pedis artery is the continuation of the anterior tibial artery. The pulse of the posterior tibial artery, which comes from the posterior compartment of the leg, may be felt behind the medial malleolus just lateral to the tendon of the extensor hallucis longus.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 24 - The midgut loop, also called the primary intestinal loop in a developing embryo,...

    Incorrect

    • The midgut loop, also called the primary intestinal loop in a developing embryo, is formed when the midgut bends around which of the following arteries?

      Your Answer:

      Correct Answer: Superior mesenteric

      Explanation:

      In a developing foetus, the midgut develops to form most of the intestines. During this development process, the midgut usually bends around the superior mesenteric artery and forms what is referred to as the midgut loop.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 25 - A 33 year old morbidly obese women is considered for bariatric surgery. Which...

    Incorrect

    • A 33 year old morbidly obese women is considered for bariatric surgery. Which of the options provided below would most likely be associated with the highest long term failure rates?

      Your Answer:

      Correct Answer: Intra gastric balloon

      Explanation:

      The intragastric balloon aids weight loss by slowing the rate at which food enters the stomach and by stimulating gastric stretch receptors. But lifestyle changes, including behaviour modification, exercise and a healthy diet, are crucial for maintaining weight loss once the device is removed. Intragastric balloon is really only suitable as a bridge to a more definitive surgical solution and is associated with a high failure rates and complications.

      Gastric banding: band applied to upper stomach which can be inflated or deflated with normal saline. This affects satiety. Over a 5 year period complications requiring further surgery occur in up to 15% cases.

      Roux-en-Y gastric bypass: a gastric pouch is formed and connected to the jejunum. Patients achieve greater and more long-term weight loss than gastric banding.

      Sleeve gastrectomy: body and fundus resected to leave a small section of stomach

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Upper Gastrointestinal Surgery
      0
      Seconds

  • Question 26 - The pterion is clinically significant as it marks an area of weakness on...

    Incorrect

    • The pterion is clinically significant as it marks an area of weakness on the skull. What structure lies beneath it?

      Your Answer:

      Correct Answer: Anterior branches of the middle meningeal artery

      Explanation:

      The pterion is the area where four bones, the parietal, frontal, greater wing of sphenoid and the squamous part of the temporal bone meet. It overlies the anterior branch of the middle meningeal artery on the internal aspect of the skull. The pterion is the weakest part of the skull. Slight trauma to this region can cause extradural hematoma.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 27 - A 9 year old girl is admitted to the A&E department after having...

    Incorrect

    • A 9 year old girl is admitted to the A&E department after having a fall. Her blood pressure is 101/56 mmHg, pulse is 91 and her abdomen is soft but tender on the left side. Imaging shows that there is a grade III splenic laceration. What is the best course of action?

      Your Answer:

      Correct Answer: Admit the child to the high dependency unit for close monitoring

      Explanation:

      Answer: Admit the child to the high dependency unit for close monitoring.

      Grade 3: This mid-stage rupture is a tear more than 3 cm deep. It can also involve the splenic artery or a hematoma that covers over half of the surface area. A grade 3 rupture can also mean that a hematoma is present in the organ tissue that is greater than 5 cm or expanding.
      The trend in management of splenic injury continues to favour nonoperative or conservative management.
      Most haemodynamically stable injuries can be managed non-operatively (especially Grades I to III).

    • This question is part of the following fields:

      • Emergency Medicine And Management Of Trauma
      • Principles Of Surgery-in-General
      0
      Seconds

  • Question 28 - What causes a reduction in pulmonary functional residual capacity? ...

    Incorrect

    • What causes a reduction in pulmonary functional residual capacity?

      Your Answer:

      Correct Answer: Pulmonary fibrosis

      Explanation:

      Pulmonary functional residual capacity (FRC) is = volume of air present in the lungs at the end of passive expiration.
      Obstructive diseases (e.g. emphysema, chronic bronchitis, asthma) = an increase in FRC due to an increase in lung compliance and air trapping.
      Restrictive diseases (e.g. pulmonary fibrosis) result in stiffer, less compliant lungs and a reduction in FRC.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 29 - A 13-year-old boy's mother notices he has a lump in his arm, near...

    Incorrect

    • A 13-year-old boy's mother notices he has a lump in his arm, near his right shoulder. An X-ray reveals a lateral projection in the metaphyseal region of his humerus. The lesion is removed and it is found to be composed of bony cortex, capped by cartilage. What's the most likely diagnosis in this case?

      Your Answer:

      Correct Answer: Osteochondroma

      Explanation:

      Osteochondromas, or osteocartilaginous exostoses, are the most common benign bone tumours, and tend to appear near the ends of long bones. The overgrowth can occur in any bone where cartilage forms bone, and they are capped by cartilage. They are most common in people between the ages of 10-20 years old.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 30 - Which of the following will be affected by a lesion in the posterior...

    Incorrect

    • Which of the following will be affected by a lesion in the posterior column-medial lemniscus system?

      Your Answer:

      Correct Answer: Fine touch

      Explanation:

      The posterior column–medial lemniscus (PCML) pathway is a sensory pathway that transmits fine touch and conscious proprioceptive information from the body to the brain. As the posterior columns are also known as dorsal columns, the pathway is also called the dorsal column–medial lemniscus system or DCML.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Passmed
Retry this test Dashboard