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  • Question 1 - Which of the following is the site of secretion of intrinsic factor: ...

    Incorrect

    • Which of the following is the site of secretion of intrinsic factor:

      Your Answer: Saliva

      Correct Answer: Stomach

      Explanation:

      Intrinsic factor is essential for the absorption of the small amounts of vitamin B12 normally present in the diet from the terminal ileum. The parietal cells of the stomach produce intrinsic factor, and following a gastrectomy, the absorption of vitamin B12 will be markedly reduced, and a deficiency state will exist.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      3
      Seconds

  • Question 2 - Regarding water and electrolyte absorption in the small intestine, which of the following statements...

    Incorrect

    • Regarding water and electrolyte absorption in the small intestine, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Na+ enters the cell across the apical membrane against its concentration gradient by both membrane channels and transporter protein mechanisms.

      Explanation:

      As the contents of the intestine are isotonic with body fluids and mostly have the same concentration of the major electrolytes, their absorption is active. Water cannot be moved directly, but follows osmotic gradients set up by the transport of ions, primarily mediated by the sodium pump.Na+/K+ ATPase located on the basolateral membrane of the epithelial cells pumps three Na+ ions from the cell in exchange for two K+ ions, against their respective concentration gradients. This leads to a low intracellular concentration of Na+ and a high intracellular concentration of K+. The low intracellular concentration of Na+ ensures a movement of Na+ from the intestinal contents into the cell down its concentration gradient by both membrane channels and transporter protein mechanisms. Na+ is then rapidly pumped again by the basolateral sodium pump. K+ leaves the cell across the basolateral membrane down its concentration gradient linked to an outward movement of Cl- against its concentration gradient (Cl- having entered the cell across the luminal membrane down its concentration gradient).

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
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  • Question 3 - Which of the following is considered an example of an observational study? ...

    Incorrect

    • Which of the following is considered an example of an observational study?

      Your Answer:

      Correct Answer: Cohort study

      Explanation:

      The two most common types of observational studies are cohort studies and case-control studies; a third type is cross-sectional studies.

    • This question is part of the following fields:

      • Evidence Based Medicine
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  • Question 4 - A 29-year-old woman with anaphylactic reaction to peanuts, had to use her EpiPen...

    Incorrect

    • A 29-year-old woman with anaphylactic reaction to peanuts, had to use her EpiPen on the way to hospital.

      What percentage of patients with anaphylactic reaction suffer a biphasic response?.

      Your Answer:

      Correct Answer: 20%

      Explanation:

      About 20% of patients that suffer an anaphylactic reaction suffer a biphasic response 4-6 hours after the initial response (sometimes up to 72 hours after).

    • This question is part of the following fields:

      • General Pathology
      • Pathology
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  • Question 5 - You are about to give an antimuscarinic agent to a 55 year-old male...

    Incorrect

    • You are about to give an antimuscarinic agent to a 55 year-old male patient. Which of the following conditions will make you with stop the administration, since it is a contraindication to antimuscarinic agents?

      Your Answer:

      Correct Answer: Prostatic enlargement

      Explanation:

      Antimuscarinic medications may impair the contractility of bladder smooth muscle, resulting in acute urine retention in men with BPH, and should be avoided or used with caution.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      0
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  • Question 6 - A 7-days-old neonate is taken to the emergency department. She's pyretic, lethargic, and unresponsive, and...

    Incorrect

    • A 7-days-old neonate is taken to the emergency department. She's pyretic, lethargic, and unresponsive, and her fontanelle has bulged.  Antibiotics are started, and a lumbar puncture reveals Gram-negative rods. Which pathogen is most likely to be the cause:

      Your Answer:

      Correct Answer: Escherichia coli

      Explanation:

      Among neonates, group B streptococci (GBS) are the most commonly identified causes of bacterial meningitis, implicated in roughly 50% of all cases. Escherichia coli(Gram-negative rods) accounts for another 20%. Thus, the identification and treatment of maternal genitourinary infections is an important prevention strategy.

    • This question is part of the following fields:

      • Infections
      • Microbiology
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  • Question 7 - Salivary glands produce saliva which is mostly water, but it also contains a...

    Incorrect

    • Salivary glands produce saliva which is mostly water, but it also contains a range of essential chemicals such as mucus, electrolytes, antibiotic agents, and enzymes.

      Which of the following is a carbohydrate-digesting enzyme found in saliva?

      Your Answer:

      Correct Answer: Amylase

      Explanation:

      The acinar cells of the parotid and submandibular glands release amylase. Amylase begins starch digestion before food is even eaten, and it works best at a pH of 7.4.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
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  • Question 8 - A 30-year-old man suffers from an open fracture of his forearm. As a...

    Incorrect

    • A 30-year-old man suffers from an open fracture of his forearm. As a consequence of his injury, the nerve that innervates the pronator quadratus muscle was severed.

      Which of the following statements regarding the pronator quadratus muscle is considered correct?

      Your Answer:

      Correct Answer: Its deep fibres bind the radius and ulna together

      Explanation:

      Pronator quadratus is a deep-seated, short, flat, and quadrilateral muscle with fibres running in a parallel direction.

      It arises from the oblique ridge on the anterior surface of the distal fourth of the Ulna. It is inserted in lateral border and anterior surface of the distal fourth of the radius. It is innervated by the anterior interosseous nerve, a branch of the median nerve (C8-T1). It is vascularized by the anterior interosseous artery.

      The action of the pronator quadratus muscle along with the pronator teres result in the pronation of the radioulnar joint. Contraction of this muscle pulls the distal end of the radius over the ulna, resulting in the pronation of the radioulnar joint

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 9 - Tiredness, night sweats, and easy bruising are symptoms of a 58-year-old woman. Splenomegaly...

    Incorrect

    • Tiredness, night sweats, and easy bruising are symptoms of a 58-year-old woman. Splenomegaly is observed during the examination.

      Which of the following diagnoses is the SINGLE MOST LIKELY?

      Your Answer:

      Correct Answer: Chronic myeloid leukaemia (CML)

      Explanation:

      CML is a myeloproliferative disorder characterised by an abnormal pluripotent haemopoietic stem cell. A cytogenetic abnormality known as the Philadelphia chromosome, which results from a reciprocal translocation between the long arms of chromosomes 9 and 22, causes more than 80% of cases of CML.

      CML is a disease that develops slowly over several years. This is known as the ‘chronic stage.’ This stage is usually asymptomatic, and 90 percent of patients are diagnosed at this point, with the disease being discovered frequently as a result of a routine blood test. During this stage, the bone marrow contains less than 10% immature white cells (blasts).

      When CML cells expand, symptoms typically begin to appear. The ‘accelerated stage’ is what it’s called. Approximately 10% of people are diagnosed at this point. During this stage, between 10% and 30% of blood cells in the bone marrow are blasts. During this stage, common clinical features include:
      Fatigue and exhaustion
      Night sweats and fever
      Distension of the abdomen
      Pain in the left upper quadrant (splenic infarction)
      Splenomegaly (commonest examination finding)
      Hepatomegaly
      Bruising is simple.
      Gout is a type of arthritis that affects (rapid cell turnover)
      Hyperviscosity is a condition in which the viscosity of (CVA, priapism)
      A small percentage of patients experience a ‘blast crisis’ (blast stage). More than 30% of the blood cells in the bone marrow are immature blast cells at this stage. Patients with severe constitutional symptoms (fever, weight loss, bone pain), infections, and bleeding diathesis typically present at this stage.

      In CML, laboratory findings include:
      White cell count is abnormally high (often greater than 100 x 109/l).
      Increased number of immature leukocytes causes a left shift.
      Anaemia that is mild to moderately normochromic and normocytic.
      Platelets can be low, normal, or elevated, and the Philadelphia chromosome can be found in > 80% of patients.
      Serum uric acid and ALP levels are frequently elevated.
      Tyrosine kinase inhibitors (TKIs), such as imatinib and dasatinib, are the current mainstay of CML treatment.
      Allogenic bone marrow transplantation is now only used in cases where TKIs have failed to work.

    • This question is part of the following fields:

      • Haematology
      • Pathology
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  • Question 10 - Despite taking the oral contraceptive pill, a 29-year-old woman becomes pregnant. During a...

    Incorrect

    • Despite taking the oral contraceptive pill, a 29-year-old woman becomes pregnant. During a medication review, you discover that she is epileptic and that her antiepileptic therapy has recently been changed.

      Which of the following antiepileptics is most likely to impair the oral contraceptive pill's effectiveness?

      Your Answer:

      Correct Answer: Carbamazepine

      Explanation:

      The metabolism of ethinyl oestradiol and progestogens has been shown to be increased by enzyme-inducing antiepileptics. The oral contraceptive pill (OCP) is less effective in preventing pregnancy as a result of this increased breakdown.

      Antiepileptic drugs that induce enzymes include:
      Carbamazepine
      Phenytoin
      Phenobarbital
      Topiramate

      Antiepileptics that do not induce enzymes are unlikely to affect contraception. Non-enzyme-inducing anticonvulsants include the following:
      Clonazepam
      Gabapentin
      Levetiracetam
      Piracetam
      Sodium valproate is a type of valproate that is used to

      Lamotrigine is an antiepileptic drug that does not cause the production of enzymes. It does, however, require special consideration, unlike other non-enzyme-inducing antiepileptics. The OCP does not appear to affect epilepsy directly, but it does appear to lower lamotrigine levels in the blood. This could result in a loss of seizure control and the occurrence of seizures.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
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  • Question 11 - What is the primary mode of action of Enoxaparin? ...

    Incorrect

    • What is the primary mode of action of Enoxaparin?

      Your Answer:

      Correct Answer: Inhibits factor Xa

      Explanation:

      Heparin acts as an anticoagulant by enhancing the inhibition rate of clotting proteases by antithrombin III impairing normal haemostasis and inhibition of factor Xa. Low molecular weight heparins have a small effect on the activated partial thromboplastin time and strongly inhibit factor Xa. Enoxaparin is derived from porcine heparin that undergoes benzylation followed by alkaline depolymerization.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 12 - In a VF arrest, a 6-year-old child is brought to your Emergency Department...

    Incorrect

    • In a VF arrest, a 6-year-old child is brought to your Emergency Department resuscitation area. He weighs 16 kilogrammes. He's had three DC shocks, but he's still in VF and doesn't have an output.

      What amiodarone dose should he get now, according to the most recent APLS guidelines?

      Your Answer:

      Correct Answer: 80 mg

      Explanation:

      In a shockable (Vf/pVT) paediatric cardiac arrest, amiodarone should be administered after the third and fifth shocks. The dose is 5 mg/kg (maximum 300 mg) and should be administered over a three-minute period. If at all possible, administration via a central line is recommended.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 13 - You are taking care of a 55-year-old male patient with a direct inguinal...

    Incorrect

    • You are taking care of a 55-year-old male patient with a direct inguinal hernia. In explaining his hernia, which of the following layers was compromised and had resulted in his condition?

      Your Answer:

      Correct Answer: Transversalis fascia

      Explanation:

      Direct inguinal hernias are most often caused by a weakness in the muscles of the abdominal wall that develops over time, or are due to straining or heavy lifting.

      A direct inguinal hernia protrudes through the Transversalis fascia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 14 - A 55-year-old female is urgently rushed into the Emergency Department as she complains...

    Incorrect

    • A 55-year-old female is urgently rushed into the Emergency Department as she complains of chest pain that is worse on breathing, shortness of breath, palpitations, and haemoptysis.

      She undergoes a CT pulmonary angiogram, which reveals a large pulmonary embolus. She is immediately started on heparin and shifted to the acute medical ward.

      Which of the following does heparin activate?

      Your Answer:

      Correct Answer: Antithrombin III

      Explanation:

      Heparin works by binding to and activating the enzyme inhibitor antithrombin III.

      Antithrombin III inactivates thrombin (factor IIa) by forming a 1:1 complex with thrombin. The heparin-antithrombin III complex also inhibits factor Xa and some other proteases involved with clotting. The heparin-ATIII complex can also inactivate IX, XI, XII, and plasmin.

      Heparin is a polymer of glycosaminoglycan. It occurs naturally and is found in mast cells. Clinically, it is used in two forms:
      1. Unfractionated: widely varying polymer chain lengths
      2. Low molecular weight: Smaller polymers only

      Heparin is not thrombolytic or fibrinolytic. It prevents the progression of existing clots by inhibiting further clotting. The lysis of existing clots relies on endogenous thrombolytics.

      Heparin is used for:
      1. Prevention and treatment of venous thromboembolism
      2. Treatment of disseminated intravascular coagulation
      3. Treatment of fat embolism
      4. Priming of haemodialysis and cardiopulmonary bypass machines

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 15 - A patient presents with a laceration on his hand and wrist that has...

    Incorrect

    • A patient presents with a laceration on his hand and wrist that has cut the nerve that innervates opponens pollicis.
      The opponens pollicis muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer:

      Correct Answer: The recurrent branch of the median nerve

      Explanation:

      Opponens pollicis is a small, triangular muscle that forms part of the thenar eminence. It originates from the flexor retinaculum and the tubercle of trapezium bone and inserts into the whole length of the first metacarpal bone on its radial side.
      Opponens pollicis is innervated by the recurrent branch of the median nerve and receives its blood supply from the superficial palmar arch.
      The main action of opponens pollicis is to flex the first metacarpal bone at the carpometacarpal joint, which opposes the thumb towards the centre of the palm. It also medially rotates the first metacarpal bone at the carpometacarpal joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 16 - After what time period should intravenous phenytoin be used as second-line treatment of...

    Incorrect

    • After what time period should intravenous phenytoin be used as second-line treatment of status epilepticus?

      Your Answer:

      Correct Answer: 25 minutes

      Explanation:

      If seizures recur or fail to respond after initial treatment with benzodiazepines within 25 minutes of onset, phenytoin sodium, fosphenytoin sodium, or phenobarbital sodium should be used.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 17 - After returning from Thailand two days ago, a 61-year-old man presents to the...

    Incorrect

    • After returning from Thailand two days ago, a 61-year-old man presents to the department with severe diarrhoea and vomiting. He has a history of hypertension and takes an ACE inhibitor to treat it.

      Which of the following statements about angiotensin-converting enzyme inhibitors is correct?

      Your Answer:

      Correct Answer: They have been shown to reduce mortality in heart failure

      Explanation:

      Angiotensin-converting enzyme (ACE) inhibitors prevent angiotensin I from being converted to angiotensin II. Angiotensin II has a variety of effects:
      Sympathetic activity has increased.
      Vasoconstriction in the arteries
      Secretion of Vasopressin
      Secretion of aldosterone

      The increase in systemic blood pressure is caused by arteriolar vasoconstriction. Vasopressin stimulates water reabsorption in the kidneys as well as the thirst sensation. In the distal convoluted tubules and collecting ducts, aldosterone causes the reabsorption of sodium and water from the urine in exchange for potassium secretion. As a result, ACE inhibitors lower systemic blood pressure while also causing hyperkalaemia.

      Angiotensin-converting enzyme inhibitors (ACE inhibitors) are used in a variety of clinical settings, including heart failure. According to a meta-analysis, ACE inhibitors reduce death, MI, and overall admission in patients with heart failure by 28%.
      ACE inhibitors are also used in the following clinical settings:
      Hypertension
      Chronic kidney disease
      Diabetic nephropathy 
      Following a myocardial infarction

      In the presence of renal artery stenosis, ACE inhibitors are contraindicated because they can cause or exacerbate renal failure.
      The most common side effect of ACE inhibitors is a dry cough caused by increased bradykinin production. There is, however, no known link to fibrosis of the lungs.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 18 - Which of the following drugs is first line treatment for a stable regular...

    Incorrect

    • Which of the following drugs is first line treatment for a stable regular broad-complex tachycardia:

      Your Answer:

      Correct Answer: Amiodarone

      Explanation:

      A regular broad-complex tachycardia is likely to be ventricular tachycardia or a regular supraventricular rhythm with bundle branch block. A ventricular tachycardia (or broad-complex tachycardia of uncertain origin) should be treated with amiodarone 300 mg IV over 10 – 60 min, followed by an infusion of 900 mg over the next 24 hours. If previously confirmed as SVT with bundle branch block, the patient should be treated as for narrow-complex tachycardia.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 19 - Which of the following is NOT a typical clinical feature of beta-thalassaemia major:...

    Incorrect

    • Which of the following is NOT a typical clinical feature of beta-thalassaemia major:

      Your Answer:

      Correct Answer: Increased bleeding tendency

      Explanation:

      Features include:
      – severe anaemia (becoming apparent at 3 – 6 months when the switch from gamma-chain to beta-chain production takes place)
      – failure to thrive
      – hepatosplenomegaly (due to excessive red cell destruction, extramedullary haemopoiesis and later due to transfusion related iron overload)
      – expansion of bones (due to marrow hyperplasia, resulting in bossing of the skull and cortical thinning with tendency to fracture)
      – increased susceptibility to infections (due to anaemia, iron overload, transfusion and splenectomy)
      – osteoporosis
      – hyperbilirubinaemia and gallstones
      – hyperuricaemia and gout
      – other features of haemolytic anaemia
      – liver damage and other features of iron overload

    • This question is part of the following fields:

      • Haematology
      • Pathology
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  • Question 20 - A 7-year-old girl is admitted to the hospital with a persistently high temperature....

    Incorrect

    • A 7-year-old girl is admitted to the hospital with a persistently high temperature. To help her reduce her fever, you decide to give her paracetamol and ibuprofen.

      What are the effects of paracetamol and ibuprofen on fever?

      Your Answer:

      Correct Answer: Reduction in prostaglandin synthesis

      Explanation:

      Interleukin-1, which is released by leukocytes and acts on the thermoregulatory centre of the hypothalamus, causes fever. Because prostaglandins mediate this process, antipyretics such as NSAIDs, paracetamol, and aspirin reduce prostaglandin levels by inhibiting cyclooxygenase enzymes. Malignant disease secretes interleukins, which cause the B-symptoms seen in lymphoma, for example. Bacterial toxins can also cause interleukins to be produced.

      Pyrexia of unknown origin (PUO) is defined as a fever of greater than 38.3 degrees Celsius that lasts for more than 2-3 weeks with no clear diagnosis despite extensive investigation.

      Investigation necessitates a thorough understanding of the conditions that can cause febrile illness, which may be missed during an initial investigation, as well as a thorough history, examination, and investigation centred on that list.

      Pyrexia of unknown origin has a wide differential diagnosis, which includes:
      Infection
      Bacterial
      Pyogenic abscess
      Tuberculosis
      Infective endocarditis
      Brucellosis
      Lyme disease
      Viral
      HIV
      Epstein Barr Virus
      Cytomegalovirus
      Parasite
      Toxoplasmosis
      Malignancy
      Leukaemia
      Lymphoma
      Renal cell carcinoma
      Hepatocellular carcinoma
      Vasculitides
      Still’s disease
      Granulomatosis with polyangiitis (formerly Wegener’s)
      Systemic lupus erythematosus
      Giant cell arteritis
      Rheumatoid arthritis
      Polymyalgia rheumatica
      Miscellaneous
      Drug induced fevers
      Familial Mediterranean fever
      Thyrotoxicosis
      Inflammatory bowel disease
      Sarcoidosis
      Factitious fever
      Exaggerated normal circadian fluctuation

      The patient might need to be admitted to the hospital for observation and further investigation. Because infection is still a possibility, blood cultures should be repeated on a regular basis, and inflammatory markers should be closely monitored. CT, PET, and MRI imaging have largely replaced diagnostic laparotomy as a diagnostic tool.

    • This question is part of the following fields:

      • Pathology
      • Pathology Of Infections
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  • Question 21 - An X-ray of a 24-year-old female hockey player who arrives at the hospital...

    Incorrect

    • An X-ray of a 24-year-old female hockey player who arrives at the hospital with a left foot injury reveals an avulsion fracture of the fifth metatarsal tuberosity. Which of the following muscles is most likely responsible for the movement of the fractured fragment?

      Your Answer:

      Correct Answer: Fibularis brevis

      Explanation:

      An avulsion fracture of the base of the fifth metatarsal happens when the ankle is twisted inwards.

      When the ankle is twisted inwards a muscle called the fibularis brevis contracts to stop the movement and protect the ligaments of the ankle.

      The base of the fifth metatarsal is where this muscle is attached. The group of lateral leg muscles that function to plantarflex the foot includes the fibularis brevis and the fibularis longus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 22 - Which of these is NOT a lithium side effect: ...

    Incorrect

    • Which of these is NOT a lithium side effect:

      Your Answer:

      Correct Answer: Peptic ulcer disease

      Explanation:

      Adverse Effects of lithium Include

      Leucocytosis (most patients)
      Polyuria/polydipsia (30-50%)
      Dry mouth (20-50%)
      Hand tremor (45% initially, 10% after 1 year of treatment)
      Confusion (40%)
      Decreased memory (40%)
      Headache (40%)
      Muscle weakness (30% initially, 1% after 1 year of treatment)
      Electrocardiographic (ECG) changes (20-30%)
      Nausea, vomiting, diarrhoea (10-30% initially, 1-10% after 1-2 years of treatment)
      Hyperreflexia (15%)
      Muscle twitch (15%)
      Vertigo (15%)
      Extrapyramidal symptoms, goitre (5%)
      Hypothyroidism (1-4%)
      Acne (1%)
      Hair thinning (1%)

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 23 - The tetanus vaccination contains inactivated tetanus toxoid, which induces the body to produce...

    Incorrect

    • The tetanus vaccination contains inactivated tetanus toxoid, which induces the body to produce protective antibodies. How do these antibodies protect the body from tetanus?

      Your Answer:

      Correct Answer: Neutralise the protein exotoxin of C. tetani

      Explanation:

      C. Tetanospasmin, an exotoxin produced by tetani, is responsible for the neurotoxic consequences of tetanus.

      The tetanus vaccination contains inactivated tetanus toxoid, which induces the body to produce protective antibodies that neutralize the tetanus toxin.

      It induces active immunization against Clostridium tetani exotoxin via toxoid-induced Ab generation.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
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  • Question 24 - A patient suffers a stab wound to the neck. The entry point of...

    Incorrect

    • A patient suffers a stab wound to the neck. The entry point of the blade is situated within the posterior triangle of the neck.
      Which of the following muscles is most likely to be involved? Select ONE answer only.

      Your Answer:

      Correct Answer: Anterior scalene

      Explanation:

      The anterior triangle is the triangular area of the neck found anteriorly to the sternocleidomastoid muscle. It is formed by the anterior border of sternocleidomastoid laterally, the median line of the neck medially and by the inferior border of the mandible superiorly. The apex of the anterior triangle extends towards the manubrium sterni. The anterior triangle contains:
      Muscles: thyrohyoid, sternothyroid, sternohyoid muscles
      Organs: thyroid gland, parathyroid glands, larynx, trachea, esophagus, submandibular gland, caudal part of the parotid gland
      Arteries: superior and inferior thyroid, common carotid, external carotid, internal carotid artery (and sinus), facial, submental, lingual arteries
      Veins: anterior jugular veins, internal jugular, common facial, lingual, superior thyroid, middle thyroid veins, facial vein, submental vein, lingual veins
      Nerves: vagus nerve (CN X), hypoglossal nerve (CN XII), part of sympathetic trunk, mylohyoid nerve

      The posterior triangle is a triangular area found posteriorly to the sternocleidomastoid muscle. It has three borders; anterior, posterior and inferior borders. The anterior border is the posterior margin of the sternocleidomastoid muscle. The posterior border is the anterior margin of the trapezius muscle, while the inferior border is the middle one-third of the clavicle. The investing layer of deep cervical fascia and integument forms the roof of the space, while the floor is covered with the prevertebral fascia along with levator scapulae, splenius capitis and the scalene muscles. The inferior belly of omohyoid subdivides the posterior triangle into a small supraclavicular, and a large occipital, triangle.
      Contents:
      Vessels: the third part of the subclavian artery, suprascapular and transverse cervical branches of the thyrocervical trunk, external jugular vein, lymph nodes
      Nerves: accessory nerve (CN XI), the trunks of the brachial plexus, fibers of the cervical plexus
      Of the muscles listed in the options, only the anterior scalene is situated within the posterior triangle of the neck.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
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  • Question 25 - A 45-year-old obese patient goes to the emergency department with a fever and...

    Incorrect

    • A 45-year-old obese patient goes to the emergency department with a fever and significant right upper quadrant pain. The pain radiates to her right shoulder tip.  Murphy's sign is positive and acute cholecystitis is diagnosed. The pain referred to the shoulder tip is caused by one of the following nerves:

      Your Answer:

      Correct Answer: Phrenic nerve

      Explanation:

      Gallbladder inflammation can cause pain in the right upper quadrant and right shoulder, which is caused by irritation of the diaphragmatic peritoneum. Pain from areas supplied by the phrenic nerve is often referred to other somatic regions served by spinal nerves C3-C5.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 26 - Regarding the flexor digitorum profundus muscle, which of the following is true? ...

    Incorrect

    • Regarding the flexor digitorum profundus muscle, which of the following is true?

      Your Answer:

      Correct Answer: The medial aspect of the muscle is innervated by the ulnar nerve

      Explanation:

      Flexor digitorum profundus is a fusiform muscle located deep within the anterior (flexor) compartment of the forearm. Along with the flexor pollicis longus and pronator quadratus muscles, it comprises the deep flexor compartment of the forearm.

      Flexor digitorum profundus has a dual innervation:

      (1) The medial part of the muscle, that inserts to the fourth and fifth digits, is innervated by the ulnar nerve (C8-T1);

      (2) The lateral part, that inserts to the second and third digits, is innervated by the median nerve, via anterior interosseous branch (C8-T1).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 27 - Normal saline (sodium chloride 0.9%) contains which of the following: ...

    Incorrect

    • Normal saline (sodium chloride 0.9%) contains which of the following:

      Your Answer:

      Correct Answer: Sodium and chloride

      Explanation:

      Normal saline (sodium chloride 0.9%) contains:
      Na+150 mmol/L
      Cl-150 mmol/L

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
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  • Question 28 - Regarding relationships between two variables, what does a negative correlation coefficient indicate: ...

    Incorrect

    • Regarding relationships between two variables, what does a negative correlation coefficient indicate:

      Your Answer:

      Correct Answer: The two variables are inversely related

      Explanation:

      A negative correlation coefficient means that the two variables are inversely related e.g. socio-economic class and mortality.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
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  • Question 29 - Which ONE statement about homeostasis is true? ...

    Incorrect

    • Which ONE statement about homeostasis is true?

      Your Answer:

      Correct Answer: Negative feedback occurs via receptors, comparators and effectors

      Explanation:

      Homeostasis is the property of a system in which variables are regulated so that internal conditions remain relatively constant and stable. Homeostasis is achieved by a negative feedback mechanism.

      Negative feedback occurs based upon a set point through receptors, comparators and effectors.

      The ‘set point’ is a NARROW range of values within which normal function occurs.

      The two body systems that regulate homeostasis are the Nervous system and the Endocrine system.

      The smooth muscle of the uterus becomes more active towards the end of pregnancy. This is a POSITIVE feedback.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
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  • Question 30 - The correct statement about the glomerular filtration barrier is which of the following?...

    Incorrect

    • The correct statement about the glomerular filtration barrier is which of the following?

      Your Answer:

      Correct Answer: The basement membrane is negatively charged, restricting filtration of negatively charged molecules.

      Explanation:

      The main factor in determining whether a substance is filtered or not is molecular weight. Molecules < 7 kDa in molecular weight e.g. glucose, amino acids, urea, ions are filtered freely, but larger molecules are increasingly restricted up to 70 kDa, and there is very little filtration for anything above this.
      There is further restriction of negatively charged molecules because they are repelled by negative charges, particularly in the basement membrane. Albumin, which has a molecular weight of 69 kDa and is negatively charged, is filtered but only in very small amounts. All of the filtered albumin is reabsorbed in the proximal tubule. Small molecules such as ions, glucose, amino acids and urea pass the filter without hindrance. Other than the ultrafiltrate being essentially protein free, it has an otherwise identical composition of plasma. Bowman’s capsule consists of:
      – an epithelial lining which consists of a single layer of cells called podocytes
      – endothelium which is perforated by pores or fenestrations – this allows plasma components with a molecular weight of < 70 kDa to pass freely.

    • This question is part of the following fields:

      • Physiology
      • Renal
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