00
Correct
00
Incorrect
00 : 00 : 0 00
Session Time
00 : 00
Average Question Time ( Mins)
  • Question 1 - A 21 year old female presents to the clinic with axillary lymphadenopathy and...

    Correct

    • A 21 year old female presents to the clinic with axillary lymphadenopathy and symptoms suggestive of Hodgkin's lymphoma. Which of the following tests should be done?

      Your Answer: Excision biopsy of a lymph node

      Explanation:

      Answer: Excision biopsy of a lymph node

      Hodgkin lymphoma is an uncommon cancer that develops in the lymphatic system, which is a network of vessels and glands spread throughout your body. In Hodgkin lymphoma, B-lymphocytes (a particular type of lymphocyte) start to multiply in an abnormal way and begin to collect in certain parts of the lymphatic system, such as the lymph nodes (glands). The affected lymphocytes lose their infection-fighting properties, making you more vulnerable to infection. The most common symptom of Hodgkin lymphoma is a painless swelling in a lymph node, usually in the neck, armpit or groin.
      A histologic diagnosis of Hodgkin lymphoma is always required. An excisional lymph node biopsy is recommended because the lymph node architecture is important for histologic classification.

      Features of Hodgkin lymphoma include the following:

      Asymptomatic lymphadenopathy may be present (above the diaphragm in 80% of patients)

      Constitutional symptoms (unexplained weight loss [>10% of total body weight] within the past 6 months, unexplained fever >38º C, or drenching night sweats) are present in 40% of patients; collectively, these are known as B symptoms

      Intermittent fever is observed in approximately 35% of cases; infrequently, the classic Pel-Ebstein fever is observed (high fever for 1-2 week, followed by an afebrile period of 1-2 week)

      Chest pain, cough, shortness of breath, or a combination of those may be present due to a large mediastinal mass or lung involvement; rarely, haemoptysis occurs

      Pruritus may be present

      Pain at sites of nodal disease, precipitated by drinking alcohol, occurs in fewer than 10% of patients but is specific for Hodgkin lymphoma

      Back or bone pain may rarely occur

      A family history is also helpful; in particular, nodular sclerosis Hodgkin lymphoma (NSHL) has a strong genetic component and has often previously been diagnosed in the family.

    • This question is part of the following fields:

      • Principles Of Surgery-in-General
      • Surgical Technique And Technology
      2
      Seconds
  • Question 2 - Difficulty in retracting the foreskin of the penis in an uncircumcised male is...

    Incorrect

    • Difficulty in retracting the foreskin of the penis in an uncircumcised male is known as:

      Your Answer:

      Correct Answer: Phimosis

      Explanation:

      Phimosis is the inability to fully retract the foreskin of the penis in an uncircumcised male. It can be physiological in infancy, in which it could be referred to as ‘developmental non-retractility of the foreskin. However, it is almost always pathological in older children and men. Causes include chronic inflammation (e.g. balanoposthitis), multiple catheterisations, or forceful foreskin retraction. One of the causes is chronic balanitis xerotica obliterans. It leads to development of a ring of indurated tissue near the tip of the prepuce, which prevents retraction. Contributory factors include infections, hormonal and inflammatory factors. The recommended treatment includes circumcision.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      9
      Seconds
  • Question 3 - A 39 year old man with a long standing inguinal hernia inquires about...

    Incorrect

    • A 39 year old man with a long standing inguinal hernia inquires about the risk of strangulation over the next year if he decides not to have surgery done. He is seen with a small, direct inguinal hernia. Which percentage matches with the likely risk of strangulation over the year?

      Your Answer:

      Correct Answer:

      Explanation:

      Indirect inguinal hernias have a higher risk of strangulation. The risk of strangulation and obstruction is lowest for direct inguinal hernias as they have a wide neck, which can often be monitored and managed conservatively. A study conducted showed that the cumulative probability of strangulation for inguinal hernias was 2.8 per cent, rising to 4.5 per cent after 2 years.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • The Abdomen
      0
      Seconds
  • Question 4 - A 32-year-old motorist was involved in a road traffic accident in which he...

    Incorrect

    • A 32-year-old motorist was involved in a road traffic accident in which he collided head-on with another car at high speed. He was wearing a seatbelt and the airbags were deployed. When rescuers arrived, he was conscious and lucid but died immediately after.

      What could have explained his death?

      Your Answer:

      Correct Answer: Aortic transection

      Explanation:

      Aortic transection was the underlying cause of death in this patient.

      Aortic transection, or traumatic aortic rupture, is typically the result of a blunt aortic injury in the context of rapid deceleration. This condition is commonly fatal as blood in the aorta is under great pressure and can quickly escape the vessel through a tear, resulting in rapid haemorrhagic shock and death. A temporary haematoma may prevent the immediate death. Injury to the aorta during a sudden deceleration commonly originates near the terminal section of the aortic arch, also known as the isthmus. This portion lies just distal to the take-off of the left subclavian artery at the intersection of the mobile and fixed portions of the aorta. As many as 80% of the patients with aortic transection die at the scene before reaching a trauma centre for treatment.

      A widened mediastinum may be seen on the X-ray of a person with aortic rupture.

      Other types of thoracic trauma include:
      1. Tension pneumothorax and pneumothorax
      2. Haemothorax
      3. Flail chest
      4. Cardiac tamponade
      5. Blunt cardiac injury
      6. Pulmonary contusion
      7. Diaphragm disruption
      8. Mediastinal traversing wounds

    • This question is part of the following fields:

      • Emergency Medicine And Management Of Trauma
      • Principles Of Surgery-in-General
      0
      Seconds
  • Question 5 - A 45-year-old man has a long history of ulcerative colitis. His symptoms are...

    Incorrect

    • A 45-year-old man has a long history of ulcerative colitis. His symptoms are well-controlled with steroids. However, attempts at steroid weaning and use of steroid-sparing drugs have repeatedly failed. He wishes to avoid a permanent stoma.

      Which of the following should be the best operative strategy?

      Your Answer:

      Correct Answer:

      Explanation:

      In patients with ulcerative colitis (UC) where medical management is not successful, surgical resection (pan-proctocolectomy) may offer a chance of cure. Those patients wishing to avoid a permanent stoma may be considered for an ileoanal pouch. However, this procedure is only offered in the elective setting.

      Patients with inflammatory bowel disease (UC and Crohn’s disease) frequently present in surgical practice. Elective indications for surgery in UC include disease that requires maximal therapy or prolonged courses of steroids.

      Long-standing UC is associated with a risk of malignant transformation. Dysplastic transformation of the colonic epithelium with associated mass lesions is an absolute indication for a proctocolectomy. Restorative options in UC include an ileoanal pouch. Complications of such a pouch include anastomotic dehiscence, pouchitis, and poor physiological function with seepage and soiling.
      .
      Emergency presentation of poorly-controlled colitis that fails to respond to medical therapy should usually be managed with a subtotal colectomy. Excision of the rectum is a procedure with a higher morbidity and is not generally performed in the emergency setting.

    • This question is part of the following fields:

      • Colorectal Surgery
      • Generic Surgical Topics
      0
      Seconds
  • Question 6 - A neonate is diagnosed with cryptorchidism of the right side (undescended testis). Which...

    Incorrect

    • A neonate is diagnosed with cryptorchidism of the right side (undescended testis). Which is the LEAST likely place to find the testis?

      Your Answer:

      Correct Answer: Perineum

      Explanation:

      Embryologically the testes are retroperitoneal structures in the posterior abdominal wall, attached to the anterolateral abdominal wall by the gubernaculum. The gubernaculum ‘pulls’ the testes through the deep inguinal ring, inguinal canal and superficial inguinal ring and over the pelvic brim. The gubernaculum is preceded by the processus vaginalis that is derived from the peritoneum anterior to the testes. The processus vaginalis pushes the muscle and fascial layers. These eventually make up the canal and the spermatic cord, into the scrotum. The gubernaculum persists as the scrotal ligament while part of the processus vaginalis remains as a bursa-like sac i.e. the tunica vaginalis testes. The testes therefore could be caught in any one of these places along its path of descending. The testes are never in the perineum.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 7 - The vascular structure found on the right side of the fifth lumbar vertebra...

    Incorrect

    • The vascular structure found on the right side of the fifth lumbar vertebra is?

      Your Answer:

      Correct Answer: Inferior vena cava

      Explanation:

      The most likely vascular structure is the inferior vena cava. The inferior vena cava is formed by the joining of the two common iliac arteries, the right and the left iliac artery, at the level of the fifth lumbar vertebra( L5). The inferior vena cava passes along the right side of the vertebral column. It enters the thoracic cavity into the underside of the heart through the caval opening of the diaphragm at the level of the eight thoracic vertebra (T8).

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 8 - 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
      0
      Seconds
  • Question 9 - A 53-year-old male undergoes an elective right hemicolectomy. A stapled ileocolic anastomosis is...

    Incorrect

    • A 53-year-old male undergoes an elective right hemicolectomy. A stapled ileocolic anastomosis is constructed. Eight hours later he becomes tachycardic and passes approximately 600ml of dark red blood per rectum. Which of the following processes is the most likely explanation for what happened?

      Your Answer:

      Correct Answer: Anastomotic staple line bleeding

      Explanation:

      Complications related to stapled anastomoses include bleeding, device failure, and anastomotic failure, which include stricture or leak.
      Stricture: Patient discomfort, need for additional procedures
      Bleeding: Hemodynamic implications, difficult intraoperative visualization
      Anastomotic leak: Increase in local recurrence, decreased overall survival, sepsis, need for diverting ostomy, increased hospital cost, increased use of hospital resources, decreased quality of life.
      Anastomotic bleeding is a common complication of stapled anastomoses, and it can lead to hemodynamic instability and anaemia, sometimes requiring transfusion or additional procedures. To this end, there are efforts aimed at reducing staple line haemorrhage by using buttressing techniques.

    • This question is part of the following fields:

      • Principles Of Surgery-in-General
      • Surgical Technique And Technology
      0
      Seconds
  • Question 10 - A 33 year old man presents with an injured forearm after falling from...

    Incorrect

    • A 33 year old man presents with an injured forearm after falling from a scaffolding. Examination reveals a radial fracture and dislocated distal radio-ulnar joint. Which of the following options is synonymous with this presentation?

      Your Answer:

      Correct Answer: Galeazzi

      Explanation:

      The Galeazzi fracture is a fracture of the middle to distal one-third of the radius associated with dislocation or subluxation of the distal radioulnar joint. It presents with pain, swelling and deformity. Physical examination reveals point tenderness over the fracture site. Isolated fracture of radius is rare and there usually is an associated injury.

      Other fractures:
      – Colles’ fracture (dinner fork deformity): fall onto extended outstretched hand. Classical Colles’ fractures have 3 features:
      1. Transverse fracture of the radius
      2. 1 inch proximal to the radio-carpal joint
      3. Dorsal displacement and angulation

      – Smith’s fracture (reverse Colles’ fracture): volar angulation of distal radius fragment (Garden spade deformity). Caused by falling backwards onto the palm of an outstretched hand or falling with wrists flexed

      – Bennett’s fracture: Intra-articular fracture of the first carpometacarpal joint. Impact on flexed metacarpal, caused by fist fights

      – Monteggia’s fracture: dislocation of the proximal radioulnar joint in association with an ulna fracture. Caused by a fall on outstretched hand with forced pronation.

      – Pott’s fracture: Bimalleolar ankle fracture from forced foot eversion

      – Barton’s fracture: Distal radius fracture (Colles’/Smith’s) with associated radiocarpal dislocation from a fall onto extended and pronated wrist

      – Holstein Lewis Fracture: fracture of the distal third of the humerus resulting in entrapment of the radial nerve.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Orthopaedics
      0
      Seconds
  • Question 11 - A 58 year old woman is scheduled for the exploration of the common...

    Incorrect

    • A 58 year old woman is scheduled for the exploration of the common bile duct and insertion of a T tube. Which of the following devices would be most appropriately used in this patient?

      Your Answer:

      Correct Answer: Latex T tube on passive drainage

      Explanation:

      The special part of the equipment is the T tube itself. As the name refers, it is a special tube in the shape of T with a shorter transverse part (20 cm) that stays inside the CBD (after trimming) and a long longitudinal part (60 cm) that extends from the middle of the transverse part to an end that connects with a drainage bag. This portion extends from the CBD to outside the abdominal cavity when applied. It comes with different circumference sizes (10, 12, 14, 16, 18 Fr). T tube can be made of different materials like latex, silicone, red rubber and polyvinyl chloride (PVC). PVC is very inert causing the least tissue reaction with lack of tissue tract formation making it the least favourable material for T tube placement purposes. Silicon has many favourable physical properties, but it can disintegrate with poor handling making it not a practical option for long-term placement. Latex has the desired properties to be the most commonly used. Red rubber is an alternative if latex can not be used or is not available.

    • This question is part of the following fields:

      • Principles Of Surgery-in-General
      • Surgical Technique And Technology
      0
      Seconds
  • Question 12 - Chest X-ray of a 45-year old gentleman with a week history of pleurisy...

    Incorrect

    • Chest X-ray of a 45-year old gentleman with a week history of pleurisy showed a small pneumothorax with moderate-sized pleural effusion. Arterial blood gas analysis showed p(CO2) = 23 mmHg, p(O2) = 234.5 mmHg, standard bicarbonate = 16 mmol/l. What are we most likely dealing with?

      Your Answer:

      Correct Answer: Compensated respiratory alkalosis

      Explanation:

      Normal pH with low p(CO2) and low standard bicarbonate could indicate either compensated respiratory alkalosis or a compensated metabolic acidosis. However, the history of hyperventilation for 5 days (pleurisy) favours compensated respiratory alkalosis. Compensated metabolic acidosis would have been likely in a diabetic patient with fever, vomiting and high glucose (diabetic ketoacidosis).

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds
  • Question 13 - A 20 year old is brought to the A&E after he fell from...

    Incorrect

    • A 20 year old is brought to the A&E after he fell from a moving cart. The boy has sustained blunt abdominal injury, and the there is a possibility of internal bleeding as the boy is in shock. An urgent exploratory laparotomy is done in the A&E theatre. On opening the peritoneal cavity, the operating surgeon notices a torn gastrosplenic ligament with a large clot around the spleen. Which artery is most likely to have been injured in this case?

      Your Answer:

      Correct Answer: Short gastric

      Explanation:

      The short gastric arteries branch from the splenic artery near the splenic hilum to travel back in the gastrosplenic ligament to supply the fundus of the stomach. Therefore, these may be injured in this case.
      The splenic artery courses deep to the stomach to reach the hilum of the spleen. It doesn’t travel in the gastrosplenic ligament although it does give off branches that do.
      The middle colic artery is a branch of the superior mesenteric artery that supplies the transverse colon.
      Gastroepiploic artery is the largest branch of the splenic artery that courses between the layers of the greater omentum to anastomose with the right gastroepiploic.
      Left gastric artery, a branch of the coeliac trunk. It supplies the left half of the lesser curvature.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 14 - Laboratory findings in a patient with dark urine and yellowish skin revealed a...

    Incorrect

    • Laboratory findings in a patient with dark urine and yellowish skin revealed a prolonged prothrombin time. Which of the following is the most likely cause of this finding?

      Your Answer:

      Correct Answer: Liver damage

      Explanation:

      Various conditions may prolong the prothrombin time (PT), including: warfarin use, vitamin K deficiency, liver disease, disseminated intravascular coagulopathy, hypofibrinogenemia, heparin infusion, massive blood transfusion and hypothermia. Liver disease causes prolonging of PT due to diminished synthesis of clotting factors. Dark urine colour and jaundice are indicators of the presence of a liver disease in this patient.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 15 - 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
      Seconds
  • Question 16 - A 5-year-old child diagnosed with nephrotic syndrome developed generalised oedema. What is the...

    Incorrect

    • A 5-year-old child diagnosed with nephrotic syndrome developed generalised oedema. What is the mechanism for the development of oedema in patients with nephrotic syndrome?

      Your Answer:

      Correct Answer: Decreased colloid osmotic pressure

      Explanation:

      The development of oedema in nephrotic syndrome has traditionally been viewed as an underfill mechanism. According to this view, urinary loss of protein results in hypoalbuminemia and decreased plasma oncotic pressure. As a result, plasma water translocates out of the intravascular space and results in a decrease in intravascular volume. In response to the underfilled circulation, effector mechanisms are then activated that signal the kidney to secondarily retain salt and water. While an underfill mechanism may be responsible for oedema formation in a minority of patients, recent clinical and experimental findings would suggest that oedema formation in most nephrotic patients is the result of primary salt retention. Direct measurements of blood and plasma volume or measurement of neurohumoral markers that indirectly reflect effective circulatory volume are mostly consistent with either euvolemia or a volume expanded state. The ability to maintain plasma volume in the setting of a decreased plasma oncotic pressure is achieved by alterations in transcapillary exchange mechanisms known to occur in the setting of hypoalbuminemia that limit excessive capillary fluid filtration.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 17 - The physician suggested lifestyle modification for his patient because his present condition could...

    Incorrect

    • The physician suggested lifestyle modification for his patient because his present condition could increase his risk for the development of adenocarcinoma of the oesophagus. What is the most common predisposing factor for the development of adenocarcinoma of the oesophagus?

      Your Answer:

      Correct Answer: Gastro-oesophageal reflux disease

      Explanation:

      Barret’s oesophagus is attributed primarily to gastro-oesophageal reflux disease. The chronic acidic environment damages the squamous epithelial lining of the oesophagus, and subsequently undifferentiated pluripotent stem cells develop into columnar epithelium, this is then known as Barret’s oesophagitis.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 18 - Mallory bodies are characteristic of which of the following conditions? ...

    Incorrect

    • Mallory bodies are characteristic of which of the following conditions?

      Your Answer:

      Correct Answer: Alcoholic hepatitis

      Explanation:

      Mallory bodies (or ‘alcoholic hyaline’) are inclusion bodies in the cytoplasm of liver cells, seen in patients of alcoholic hepatitis; and also in Wilson’s disease. These pathological bodies are made of intermediate keratin filament proteins that are ubiquinated or bound by proteins like heat chock protein. Being highly eosinophilic, they appear pink on haematoxylin and eosin staining.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 19 - A 25-year-old woman is undergoing an appendicectomy for perforated appendicitis. What is the...

    Incorrect

    • A 25-year-old woman is undergoing an appendicectomy for perforated appendicitis. What is the single most important modality for reducing the risks of postoperative wound infection?

      Your Answer:

      Correct Answer: Perioperative administration of antibiotics

      Explanation:

      Perioperative administration of antibiotics is very important for reducing the risks of postoperative wound infection. Clips make infections easier to manage but do not reduce the risks. Drains have no effect on the skin wounds in these cases.

      Surgical site infections (SSI) comprise up to 20% of all healthcare-associated infections and at least 5% of patients undergoing surgery will develop an SSI as a result. SSIs may occur following a breach in tissue surfaces and allow normal commensals and other pathogens to initiate infection. The organisms are mostly derived from the patient’s own body.

      SSIs are a major cause of morbidity and mortality.
      Some preoperative measures that may increase the risk of SSI include:
      1. Shaving the wound using a razor (disposable clipper preferred)
      2. Tissue hypoxia
      3. Delayed administration of prophylactic antibiotics in tourniquet surgery

      SSIs can be prevented by taking certain precautionary steps pre-, intra-, and postoperatively.

      1. Preoperatively:
      a. Do not remove body hair routinely
      b. If hair needs removal, use electrical clippers (razors increase the risk of infection)
      c. Antibiotic prophylaxis if:
      – placement of prosthesis or valve
      – clean-contaminated surgery
      – contaminated surgery

      2. Intraoperatively:
      a. Prepare the skin with alcoholic chlorhexidine (Lowest incidence of SSI)
      b. Cover surgical site with dressing

      3. Postoperatively:
      a. Prevention of incisional infection by appropriate cleansing, skin care, and moisture management
      b.Tissue viability advice for management of surgical wound healing by secondary intention

    • This question is part of the following fields:

      • Principles Of Surgery-in-General
      • Surgical Technique And Technology
      0
      Seconds
  • Question 20 - A 40-year-old motorcyclist is involved in a road traffic accident. A FAST scan...

    Incorrect

    • A 40-year-old motorcyclist is involved in a road traffic accident. A FAST scan in the emergency department shows free intrabdominal fluid.
      A laparotomy is performed during which there is evidence of small liver laceration that has stopped bleeding and a tear to the inferior pole of the spleen. What is the best course of action?

      Your Answer:

      Correct Answer: Attempt measures to conserve the spleen

      Explanation:

      Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should take into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management.

      The trend in the management of splenic injury continues to favour nonoperative or conservative management. This varies from institution to institution but usually includes patients with stable hemodynamic signs, stable haemoglobin levels over 12-48 hours, minimal transfusion requirements (2 U or less), CT scan injury scale grade of 1 or 2 without a blush, and patients younger than 55 years.
      Surgical therapy is usually reserved for patients with signs of ongoing bleeding or hemodynamic instability. In some institutions, CT scan–assessed grade V splenic injuries with stable vitals may be observed closely without operative intervention, but most patients with these injuries will undergo exploratory laparotomy for more precise staging, repair, or removal.

      A retrospective analysis by Scarborough et al compared the effectiveness of nonoperative management with immediate splenectomy for adult patients with grade IV or V blunt splenic injury. The study found that both approaches had similar rates of in-hospital mortality (11.5% in the splenectomy group vs 10.0%), however, there was a higher incidence of infectious complications in the immediate splenectomy group. The rate of failure in the nonoperative management was 20.1% and symptoms of a bleeding disorder, the need for an early blood transfusion, and grade V injury were all early predictors of nonoperative management failure.

    • This question is part of the following fields:

      • Emergency Medicine And Management Of Trauma
      • Principles Of Surgery-in-General
      0
      Seconds
  • Question 21 - Which of the following statements regarding the arteries in the neck are TRUE?...

    Incorrect

    • Which of the following statements regarding the arteries in the neck are TRUE?

      Your Answer:

      Correct Answer: The thyrocervical trunk typically gives rise to the inferior thyroid artery, transverse cervical artery and suprascapular artery

      Explanation:

      The thyrocervical trunk is one of the three branches of the first part of the subclavian artery and gives numerous branches which supply viscera of the neck, the brachial plexus, neck muscles and scapular anastomoses. The vertebral arteries are major arteries of the neck. They arise as branches from the subclavian arteries and merge to form the single midline basilar artery. The carotid sinus is a dilated area at the base of the internal carotid artery just superior to the bifurcation of the internal carotid and external carotid at the level of the superior border of thyroid cartilage.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 22 - Glucose is the most important source of energy for cellular respiration. The transport...

    Incorrect

    • Glucose is the most important source of energy for cellular respiration. The transport of glucose in the renal tubular cells occurs via:

      Your Answer:

      Correct Answer: Secondary active transport with sodium

      Explanation:

      In 1960, Robert K. Crane presented for the first time his discovery of the sodium-glucose cotransport as the mechanism for glucose absorption. Glucose transport through biological membranes requires specific transport proteins. Transport of glucose through the apical membrane of renal tubular as well as intestinal epithelial cells depends on the presence of secondary active Na+–glucose symporters, SGLT-1 and SGLT-2, which concentrate glucose inside the cells, using the energy provided by co-transport of Na+ ions down their electrochemical gradient.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds
  • Question 23 - A 20 year lady is brought to the A&E following a road accident....

    Incorrect

    • A 20 year lady is brought to the A&E following a road accident. She is hypotensive and a CT scan of the abdomen reveals a shattered spleen. An emergency splenectomy is performed where the splenic artery is ligated right at its origin. Which of the following arteries will have a diminished blood flow owing to ligation of the splenic artery at its origin?

      Your Answer:

      Correct Answer: Left gastroepiploic

      Explanation:

      Ligation of the splenic artery right at its point of origin should cut off blood flow in its branches. The following are the branches of the splenic artery: pancreatic branches, short gastric branches and left gastroepiploic arteries.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 24 - What is correct regarding the obturator artery? ...

    Incorrect

    • What is correct regarding the obturator artery?

      Your Answer:

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

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 25 - A 46 year old politician with chronic hepatitis for several years visits the...

    Incorrect

    • A 46 year old politician with chronic hepatitis for several years visits the clinic for a review. Recently, his AFP is noted to be increased and an abdominal ultrasound demonstrates a 2.2cm lesion in segment V of the liver. What is the most appropriate course of action?

      Your Answer:

      Correct Answer: Liver MRI

      Explanation:

      In patients with liver tumours, it is crucial to detect and stage the tumours at an early stage (to select patients who will benefit from curative liver resection, and avoid unnecessary surgery). Therefore, an optimal preoperative evaluation of the liver is necessary, and a contrast-enhanced MRI is widely considered the state-of-the-art method. Liver MRI without contrast administration is appropriate for cholelithiasis but not sufficient for most liver tumour diagnoses.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Hepatobiliary And Pancreatic Surgery
      0
      Seconds
  • Question 26 - Which of the following diseases causes abrupt vertigo, nausea, vomiting, tinnitus, and nystagmus?...

    Incorrect

    • Which of the following diseases causes abrupt vertigo, nausea, vomiting, tinnitus, and nystagmus?

      Your Answer:

      Correct Answer: Vestibular neuronitis

      Explanation:

      Vestibular neuronitis or labyrinthitis causes a self-limited episode of vertigo, presumably due to inflammation of the vestibular division of cranial nerve VIII. Its causes are unknown, It may be due to a virus, but it can be related to a bacterial infection, head injury, stress, allergy, or as a reaction to medication. Symptoms can last up to 7-10 days.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 27 - A 26-year old man is brought to the A&E with a stab wound...

    Incorrect

    • A 26-year old man is brought to the A&E with a stab wound to the chest. The wound is in a part of the left lung that might partially fill the costomediastinal recess in full respiration. Where did the weapon strike this man?

      Your Answer:

      Correct Answer: Lingula

      Explanation:

      During full inspiration, the lingual-of the left lung partially fills the costomediastinal recess. If the apex of the lung is fully filled with air, it would occupy the copula (the part of the pleura that extends above the first rib). The hilum is part of the lung where the neurovascular structures that form the root of the lung enter and leave the lung and doesn’t expand on inspiration. The middle lobe can expand to fill the costomediastinal recess, however, the middle lobe is on the right lung. The inferior lobe, during full inspiration, might fill the costodiaphragmatic recess.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 28 - A 63-year-old woman complains of a new, persisting headache. She is diagnosed with...

    Incorrect

    • A 63-year-old woman complains of a new, persisting headache. She is diagnosed with vasculitis and the histopathological sample revealed giant-cell arteritis. What is the most probable diagnose?

      Your Answer:

      Correct Answer: Temporal arteritis

      Explanation:

      Giant cell arteritis (GCA), also known as temporal arteritis, is the most common systemic inflammatory vasculitis that occurs in adults. It is of unknown aetiology and affects arteries large to small however the involvement of the superficial temporal arteries is almost always present. Other commonly affected arteries include the ophthalmic, occipital and vertebral arteries, therefore GCA can result in systemic, neurologic, and ophthalmologic complications. GCA usually is found in patients older than 50 years of age and should always be considered in the differential diagnosis of a new-onset headache accompanied by an elevated erythrocyte sedimentation rate. Diagnosis depends on the results of artery biopsy.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 29 - A glycogen storage disorder is characterised by increased liver glycogen with a normal...

    Incorrect

    • A glycogen storage disorder is characterised by increased liver glycogen with a normal structure and no increase in serum glucose after oral intake of a protein-rich diet. Deficiency of which of the following enzymes is responsible for this disorder?

      Your Answer:

      Correct Answer: Glucose-6-phosphatase

      Explanation:

      The most common glycogen storage disorder is von Gierke’s disease or glycogen storage disease type I. It results from a deficiency of enzyme glucose-6-phosphatase which affects the ability of liver to produce free glucose from glycogen and gluconeogenesis; leading to severe hypoglycaemia. There is also increased glycogen storage in the liver and kidneys causing enlargement and various problems in their functioning. The disease also causes lactic acidosis and hyperlipidaemia. The main treatment includes frequent or continuous feedings of corn-starch or other carbohydrates.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds
  • Question 30 - For calculation of cardiac output by Fick's principle, which of the following vessels...

    Incorrect

    • For calculation of cardiac output by Fick's principle, which of the following vessels is the best source of venous blood to determine the arterial-to-venous oxygen tension difference?

      Your Answer:

      Correct Answer: Pulmonary artery

      Explanation:

      Fick’s principle states that the total uptake (or release) of a substance by peripheral tissues is equal to the product of the blood flow to the peripheral tissues and the arterial– venous concentration difference (gradient) of the substance. It is used to measure the cardiac output, and the formula is Cardiac output = oxygen consumption divided by arteriovenous oxygen difference. Assuming there are no shunts across the pulmonary system, the pulmonary blood flow equals the systemic blood flow. The arterial and venous blood oxygen content is measured by sampling from the pulmonary artery (low oxygen content) and pulmonary vein (high oxygen content). Peripheral arterial blood is used as a surrogate for the pulmonary vein.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Passmed