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  • Question 1 - Chronic obstructive pulmonary disease (COPD) is likely to result in: ...

    Incorrect

    • Chronic obstructive pulmonary disease (COPD) is likely to result in:

      Your Answer: Metabolic alkalosis

      Correct Answer: Respiratory acidosis

      Explanation:

      COPD leads to respiratory acidosis (chronic). This occurs due to hypoventilation which involves multiple causes, such as poor responsiveness to hypoxia and hypercapnia, increased ventilation/perfusion mismatch leading to increased dead space ventilation and decreased diaphragm function.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      3
      Seconds
  • Question 2 - An excision of a mass in the right parietal area of the head...

    Incorrect

    • An excision of a mass in the right parietal area of the head will be performed. In which layer of the scalp are the nerves and blood vessels located?

      Your Answer:

      Correct Answer: Connective tissue

      Explanation:

      The scalp is the anatomical area bordered by the face at the front, and by the neck at the sides and back. The scalp is usually described as having five layers:
      1. The skin which contains numerous sebaceous glands and hair follicles.
      2. The connective tissue, a dense subcutaneous layer of fat and fibrous tissue that lies beneath the skin, containing the nerves and vessels of the scalp.
      3. The aponeurosis or galea aponeurotica, a tough layer of dense fibrous tissue which runs from the frontalis muscle anteriorly to the occipitalis posteriorly.
      4. The loose areolar connective tissue layer provides an easy plane of separation between the upper three layers and the pericranium.
      5. The pericranium is the periosteum of the skull bones and provides nutrition to the bone and the capacity for repair.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
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  • Question 3 - A 58 year old man has recently undergone a successful coronary artery bypass...

    Incorrect

    • A 58 year old man has recently undergone a successful coronary artery bypass procedure and is coming off the cardiac bypass circuit. Which of the following drugs should be administered to him to normalize his clotting prior to decannulation and chest closure?

      Your Answer:

      Correct Answer: Protamine sulphate

      Explanation:

      Protamine is used in patients undergoing off-pump coronary artery bypass (OPCAB) surgery to reverse the anticoagulant effects of heparin and restore coagulation. FFP may be effective but would carry a significant risk of fluid overload.

    • This question is part of the following fields:

      • Peri-operative Care
      • Principles Of Surgery-in-General
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  • Question 4 - After surgery, a patient developed a stitch granuloma . Which leukocyte in the...

    Incorrect

    • After surgery, a patient developed a stitch granuloma . Which leukocyte in the peripheral blood will become an activated macrophage in this granuloma?

      Your Answer:

      Correct Answer: Monocyte

      Explanation:

      Monocytes are leukocytes that protect the body against infections and move to the site of infection within 8-12 hours to deal with it. They are produced in the bone marrow and shortly after being produced are released into the blood stream where they circulate until an infection is detected. When called upon they leave the circulation and transform into macrophages within the tissue fluid and thus gain the capability to phagocytose the offending substance. Monocyte count is part of a complete blood picture. Monocytosis is the state of excess monocytes in the peripheral blood and may be indicative of various disease states. Examples of processes that can increase a monocyte count include: • chronic inflammation • stress response • hyperadrenocorticism • immune-mediated disease • pyogranulomatous disease • necrosis • red cell regeneration.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
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  • Question 5 - The uterine artery arises from the? ...

    Incorrect

    • The uterine artery arises from the?

      Your Answer:

      Correct Answer: Internal iliac artery

      Explanation:

      The uterine artery arises from the anterior division of the internal iliac artery and runs medially on the levator ani towards the uterine cervix.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
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  • Question 6 - Carbon dioxide is principally transported in the blood in which form? ...

    Incorrect

    • Carbon dioxide is principally transported in the blood in which form?

      Your Answer:

      Correct Answer: Bicarbonate

      Explanation:

      Carbon dioxide is transported in the blood in various forms:
      – Bicarbonate (80–90%)
      – Carbamino compounds (5–10%)
      – Physically dissolved in solution (5%).
      Carbon dioxide is carried on the haemoglobin molecule as carbamino-haemoglobin; carboxyhaemoglobin is the combination of haemoglobin with carbon monoxide.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
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  • Question 7 - A 54 year old man with end stage renal failure is undergoing a...

    Incorrect

    • A 54 year old man with end stage renal failure is undergoing a live donor renal transplant. The surgeon decides to implant the kidney in the left iliac fossa via a Rutherford Morrison incision. To which vessels should the transplanted kidney be anastomosed?

      Your Answer:

      Correct Answer: External iliac artery and vein

      Explanation:

      For this procedure:
      Following the preparation of the patient, a Rutherford-Morison incision was made at the right or left iliac fossa to access to the iliac vessels. Heparin (2500-4000 IU bolus) was given intravenously prior to the clamping of the iliac vessels. The renal artery was first anastomosed in an end-to-side fashion to the external iliac artery. The corner sutures (6/0 Prolene) were placed while the kidney allograft was first placed at the medial side of the incision. The lateral side of the renal artery was anastomosed by continuous suture using the 6/0 Prolene suture. The kidney allograft was then flipped to the lateral side and the medial side of the renal artery was anastomosed to the external iliac artery. The anastomosis was checked by placing a small vascular bulldog to the renal artery and the vascular clamp was released over the external iliac artery.

      Following the renal artery anastomosis, the renal vein was anastomosed in an end-to-side fashion to the external iliac vein. Two corner sutures (5/0 Prolene) were placed first, then the lateral side of renal vein anastomosis was performed with continuous sutures from inside the lumen, and then a medial side anastomosis was performed by continuous sutures from the outside of the lumen (Figure ​(Figure2).2). Similarly, the anastomosis was checked by placing a vascular clamp over the renal vein and then releasing the vascular clamp on the external iliac vein.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Organ Transplantation
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  • Question 8 - The rotator cuff surrounds the shoulder joint and consists of the supraspinatus, infraspinatus,...

    Incorrect

    • The rotator cuff surrounds the shoulder joint and consists of the supraspinatus, infraspinatus, subscapularis and which one other muscle?

      Your Answer:

      Correct Answer: Teres minor

      Explanation:

      The correct answer is the teres minor muscle. These group of muscles play an important role in protecting the shoulder joint and keeping the head of the humerus in the glenoid fossa of the scapula. This fossa is somehow shallow and needs support to allow for the full mobility that the shoulder joint has.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 9 - A 48-year-old female with haematemesis is admitted to accident and emergency in hypovolaemic...

    Incorrect

    • A 48-year-old female with haematemesis is admitted to accident and emergency in hypovolaemic shock. She undergoes resuscitation including administration of packed red cells. The blood transfusion centre will not release certain blood products unless a ‘massive bleeding’ protocol is initiated. Which of the following is not a definition of massive bleeding?

      Your Answer:

      Correct Answer: Ongoing blood loss of 100 mL/min

      Explanation:

      Various definitions of massive blood transfusion (MBT) have been published in the medical literature such as:

      – Replacement of one entire blood volume within 24 h

      – Transfusion of >10 units of packed red blood cells (PRBCs) in 24 h

      – Transfusion of >20 units of PRBCs in 24 h

      – Transfusion of >4 units of PRBCs in 1 h when on-going need is foreseeable

      – Replacement of 50% of total blood volume (TBV) within 3 h.

    • This question is part of the following fields:

      • Emergency Medicine And Management Of Trauma
      • Principles Of Surgery-in-General
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  • Question 10 - While conducting a physical examination of a patient, the GP passed a finger...

    Incorrect

    • While conducting a physical examination of a patient, the GP passed a finger down the edge of the medial crus of the superficial inguinal ring and felt a bony prominence deep to the lateral edge of the spermatic cord. What was this bony prominence?

      Your Answer:

      Correct Answer: Pubic tubercle

      Explanation:

      At the superficial inguinal ring, the pubic tubercle would be felt as a bony prominence lateral to the edge of the spermatic cord. This tubercle is the point of attachment of the inguinal ligament that makes up the floor of the inguinal canal.
      Pecten pubis is the ridge on the superior surface of the superior pubic ramus and the point of attachment of the pectineal ligament.
      The pubic symphysis is the joint between the two pubic bones and the iliopubic eminence is a bony process on the pubis found near the articulation of the pubis and the ilium.
      The iliopectineal line is formed by the arcuate line of the ilium and the pectineal line of the pubis. It is the line that marks the transition between the abdominal and pelvic cavity.
      The sacral promontory is found on the posterior wall of the pelvis and would not be felt through the inguinal ring.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 11 - A 40 year old man suffered severe trauma following an MVA. His BP...

    Incorrect

    • A 40 year old man suffered severe trauma following an MVA. His BP is 70/33 mmhg, heart rate of 140 beats/mins and very feeble pulse. He was transfused 3 units of blood resulting in his BP returning to 100/70 and his heart rate to 90 beats/min. What decreased following transfusion?

      Your Answer:

      Correct Answer: Total peripheral resistance

      Explanation:

      The patient is in hypovolemic shock, he is transfused with blood to replace the volume lost. It is important not only to replace fluids but stop active bleeding in resuscitation. Fluid replacement will result in a decreased sympathetic discharge and adequate ventricular filling thus reducing total peripheral resistance and increasing cardiac output and cardiac filling pressures.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
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  • Question 12 - A 36 year old female presents to the clinic with a 6 week...

    Incorrect

    • A 36 year old female presents to the clinic with a 6 week history of discomfort just below her ribcage which is relieved by eating. She develops haematemesis and undergoes an upper GI endoscopy. An actively bleeding ulcer is noted in the first part of the duodenum. What is the best course of action?

      Your Answer:

      Correct Answer: Injection with adrenaline

      Explanation:

      Upper gastrointestinal (GI) bleeding is usually defined by a bleeding source proximal to the ligament of Treitz although some may also include a bleeding source in the proximal jejunum. Upper GI bleeding emergencies are characterized by hematemesis, melena, haematochezia (if the bleeding is massive and brisk) and evidence of hemodynamic compromise such as dizziness, syncope episodes and shock. The most commonly used endoscopic haemostatic interventions include epinephrine (adrenaline) injection, thermal coagulation and endoscopic clipping at the ulcer site to constrict, compress and/or destroy the bleeding vessel. Injection of 30 mL diluted epinephrine (1:10 000) can effectively prevent recurrent bleeding with a low rate of complications. The optimal injection volume of epinephrine for endoscopic treatment of an actively bleeding ulcer (spurting or oozing) is 30 mL.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Upper Gastrointestinal Surgery
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  • Question 13 - Biopsy of a neoplastic mass was performed. Histologic examination of the specimen showed...

    Incorrect

    • Biopsy of a neoplastic mass was performed. Histologic examination of the specimen showed spindle shaped cells with high nuclear/cytoplasm ratio on immunohisto chemical staining. These pleomorphic cells were vimentin positive, cytokeratin negative and cd45 negative. This type of neoplasm is most commonly found in which patient?

      Your Answer:

      Correct Answer: A 15-year-old boy with a mass in the left femur and lung metastases

      Explanation:

      A histology report that describes spindle shaped cells which are vimentin positive suggests osteosarcoma and hematogenous spread to the lungs.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 14 - A 43 year old detective undergoes a vasectomy at the local hospital. He...

    Incorrect

    • A 43 year old detective undergoes a vasectomy at the local hospital. He is reviewed at the request of his general practitioner.
      On examination, he has a small rounded nodule adjacent to the vas. Which of the following is the most likely underlying diagnosis?

      Your Answer:

      Correct Answer: Sperm granuloma

      Explanation:

      A sperm granuloma is a lump of extravasated sperm that appears along the vasa deferentia or epididymides in vasectomized men.
      Sperm granulomas are rounded or irregular in shape, one millimetre to one centimetre or more, with a central mass of degenerating sperm surrounded by tissue containing blood vessels and immune system cells. Sperm granulomas can be either asymptomatic or symptomatic (i.e., either not painful or painful, respectively). If it is painful, it can be treated using over-the-counter anti-inflammatory /pain medication. If it causes unbearable discomfort, it may need to be surgically removed. However, they generally heal by themselves. Statistics suggest that between 15-40% of men may develop a granuloma post-vasectomy.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Urology
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  • Question 15 - Which of the following causes the maximum increase in the secretion of antidiuretic...

    Incorrect

    • Which of the following causes the maximum increase in the secretion of antidiuretic hormone (ADH)?

      Your Answer:

      Correct Answer: Increased plasma osmolarity

      Explanation:

      The most potent stimulus for ADH release is increased plasma osmolarity. Decreased plasma volume is a less potent stimulus in comparison. However, decrease blood volume and arterial pressure due to severe haemorrhage does lead to ADH secretion. Hypothalamic releasing factors do not control the release of posterior pituitary hormones ADH and oxytocin.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
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  • Question 16 - Which of the following is responsible for the maximum increase in total peripheral...

    Incorrect

    • Which of the following is responsible for the maximum increase in total peripheral resistance on sympathetic stimulation?

      Your Answer:

      Correct Answer: Arterioles

      Explanation:

      Arterioles are also known as the resistance vessels as they are responsible for approximately half the resistance of the entire systemic circulation. They are richly innervated by the autonomic nervous system and hence, will bring about the maximum increase in peripheral resistance on sympathetic stimulation.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
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  • Question 17 - A 55-year-old man is recovering following an elective right hemicolectomy for carcinoma of...

    Incorrect

    • A 55-year-old man is recovering following an elective right hemicolectomy for carcinoma of the caecum. His surgery is uncomplicated, when should oral intake resume?

      Your Answer:

      Correct Answer: Within 24 hours of surgery

      Explanation:

      It has been well established that any delay in the resumption of normal oral diet after major surgery is associated with increased rates of infectious complications and delayed recovery. Early oral diet is safe 4 h after surgery in patients with a new non-diverted colorectal anastomosis. Some report that low residue diet, rather than a clear liquid diet, after colorectal surgery is associated with less nausea, faster return of bowel function, and a shorter hospital stay without increasing postoperative morbidity when administered in association with prevention of postoperative ileus. Spontaneous food intake rarely exceeds 1200–1500 kcal/day. To reach energy and protein requirements, additional oral nutritional supplements are useful.

    • This question is part of the following fields:

      • Post-operative Management And Critical Care
      • Principles Of Surgery-in-General
      0
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  • Question 18 - Which muscles are attached to the tibial tuberosity? ...

    Incorrect

    • Which muscles are attached to the tibial tuberosity?

      Your Answer:

      Correct Answer: Vastus intermedius

      Explanation:

      The tuberosity of the tibia is the site of attachment to the ligamentum patella (the tendon of the quadriceps femoris muscle which include four heads: rectus femoris, vastus medialis, intermedius and lateralis).

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
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  • Question 19 - Lung compliance is increased by: ...

    Incorrect

    • Lung compliance is increased by:

      Your Answer:

      Correct Answer: Emphysema

      Explanation:

      Lung compliance is increased by emphysema, acute asthma and increasing age and decreased by alveolar oedema, pulmonary hypertension, atelectasis and pulmonary fibrosis.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
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  • Question 20 - A 25-year-old man is involved in vigorous intercourse and suddenly feels a snap....

    Incorrect

    • A 25-year-old man is involved in vigorous intercourse and suddenly feels a snap. His penis becomes swollen and painful immediately after. The admitting surgeon suspects a penile fracture.

      Which of the following is the most appropriate initial management?

      Your Answer:

      Correct Answer: Immediate surgical exploration

      Explanation:

      Suspected penile fractures should be surgically explored and the injury repaired.

      Penile fractures are a rare type of urological trauma. The injury is usually in the proximal part of the penile shaft and may involve the urethra. A classical history of a snapping sensation followed by immediate pain is usually given by the patient (usually during vigorous intercourse). On examination, a tense haematoma is most commonly noted, and if the urethra is injured, blood may be seen at the meatus.

      The correct management involves surgical exploration and repair of the injury. A circumferential incision is made immediately inferior to the glans and the penile shaft is inspected. Injuries are usually sutured and the urethra is repaired over a catheter.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Urology
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  • Question 21 - A 15 year old girl presented to the emergency with a history of...

    Incorrect

    • A 15 year old girl presented to the emergency with a history of chronic cough, fever and weight loss. Her chest X-ray showed multiple nodules 1-4 cm in size and some of them with cavitation especially in the upper lobe. A sputum sample was positive for acid fast bacilli. Which of the following cells played a part in the development of the lung lesions?

      Your Answer:

      Correct Answer: Macrophage

      Explanation:

      The characteristic cells in granulomatous inflammation are giant cells, formed from merging macrophages and epithelioid cells elongated with granular eosinophilic cytoplasm. Granulomatous reactions are seen in patients with tuberculosis. A tuberculous/caseating granuloma is characterised by a zone of central necrosis lined with giant multinucleated giant cells (Langhans cells) and surrounded by epithelioid cells, lymphocytes and fibroblasts. The caseous zone is present due to the damaged and dead giant cells and epithelioid cells.
      Mast cells are only few in number and fibroblasts lay down collagen.
      Basophils are not present.
      The giant cell made up of macrophages are the most abundant cells in this inflammatory process.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 22 - A urologist makes a transverse suprapubic incision to retrieve a stone from the...

    Incorrect

    • A urologist makes a transverse suprapubic incision to retrieve a stone from the urinary bladder. Which of the following abdominal wall layers will the surgeon NOT traverse?

      Your Answer:

      Correct Answer: Posterior rectus sheath

      Explanation:

      Pfannenstiel incision (a transverse suprapubic incision) is made below the arcuate line. Thus, there is no posterior layer of the rectus sheath here, only the transversalis fascia lines the inner layer of the rectus abdominis. The layers traversed include: skin, superficial fascia (fatty and membranous), deep fascia, anterior rectus sheath, rectus abdominis muscle, transversalis fascia, extraperitoneal connective tissue and peritoneum.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
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  • Question 23 - 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
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  • Question 24 - What's the nodal stage of a testicular seminoma if several lymph nodes between...

    Incorrect

    • What's the nodal stage of a testicular seminoma if several lymph nodes between 2cm and 5cm are found?

      Your Answer:

      Correct Answer: N2

      Explanation:

      According to the American Joint Committee on Cancer (AJCC) 2002 guidelines, the nodal staging of testicular seminoma is the following:
      N0: no regional lymph node metastases
      N1: metastasis with lymph nodes 2 cm or less in their greatest dimension or multiple lymph nodes, none more than 2 cm
      N2: metastasis with lymph nodes greater than 2 cm but not greater than 5 cm in their greatest dimension, or multiple lymph nodes, any one mass greater than 2 cm, but not more than 5 cm
      N3: metastasis with lymph nodes greater than 5 cm in their greatest dimension.
      The patient in this case has N2 testicular seminoma. This TNM staging is extremely important because treatment options are decided depending on this classification.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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  • Question 25 - A 21-year-old woman presents with intermittent diarrhoea for the past eight months and...

    Incorrect

    • A 21-year-old woman presents with intermittent diarrhoea for the past eight months and loss in weight of about two kilograms. Colonoscopy is carried out in which appearances of melanosis coli are identified. This is confirmed on biopsy.

      What could be the most likely cause of melanosis coli in this patient?

      Your Answer:

      Correct Answer: Laxative abuse

      Explanation:

      Melanosis coli may have occurred as a result of laxative abuse in this patient.

      Melanosis coli, also pseudomelanosis coli, is a disorder of pigmentation of the wall of the colon, often identified at the time of colonoscopy. It is benign, and may have no significant correlation with the disease. The brown pigment seen is lipofuscin in macrophages, not melanin.

      According to the World Health Organisation (WHO), chronic diarrhoea is defined as lasting for more than 14 days. It is very common in irritable bowel syndrome (IBS). Patients may be divided into those with diarrhoea-predominant IBS and those with constipation-predominant IBS. Along with diarrhoea/constipation, clinical features such as abdominal pain, bloating, weight loss, change in bowel habit, lethargy, nausea, backache, and bladder symptoms are also seen. Bloody diarrhoea is more common in ulcerative colitis than in Crohn’s disease.

    • This question is part of the following fields:

      • Colorectal Surgery
      • Generic Surgical Topics
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  • Question 26 - In a splenectomy procedure, special care is emphasized on the preservation of the...

    Incorrect

    • In a splenectomy procedure, special care is emphasized on the preservation of the tail of the pancreas that is closely associated with the spleen to avoid post operative pancreatic fistula. As a general surgeon conducting a splenectomy where are you most likely to find the tail of the pancreas in the abdominal cavity?

      Your Answer:

      Correct Answer: Splenorenal ligament

      Explanation:

      The tail of the pancreas is the only intraperitoneal part of the pancreas and is found contained in the splenorenal ligament of the peritoneal cavity. The splenorenal ligament is derived from the peritoneum where the wall of the general peritoneal cavity connects to the omental bursa between the spleen and the left kidney. This ligament contains the splenic vessels and the tail of the pancreas.
      The gastrocolic ligament stretches from the greater curvature of the stomach to the transverse colon, connecting the two.
      The gastrosplenic ligament is derived from the greater omentum and is the structure that connects the stomach to the hilum of the spleen. The gastrosplenic ligament continues from the splenic flexure of the colon to the diaphragm and acts as a support to the spleen.
      The transverse colon is connected to the abdominal wall by the mesocolon ligament.
      The falciform ligament on the other hand, attaches the liver to the ventral wall of the abdomen.
      The hepatoduodenal ligament connects the porta hepatis of the liver to the superior part of the duodenum.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 27 - In a neurological exam on a robbery with violence victim, it was discovered...

    Incorrect

    • In a neurological exam on a robbery with violence victim, it was discovered that the victim had lost sense of touch to the skin over her cheek and chin (maxilla and mandible region). Where are the cell bodies of the nerve that is responsible for touch sensations of this region located?

      Your Answer:

      Correct Answer: Cranial nerve V ganglion

      Explanation:

      The skin over the cheek and the maxilla are innervated by the trigeminal nerve (CN V). The trigeminal nerve has three major branches and it is the largest cranial nerve. The three branches of the trigeminal nerve are; the ophthalmic nerve, the maxillary nerve and the mandibular nerve. The trigeminal nerves ganglion is a sensory nerve ganglion know as the trigeminal ganglion (also referred to as the Gasser’s ganglion or the semilunar ganglion). It is contained in the dura matter in a cavity known as the Meckel’s cave, which covers the trigeminal impression near the apex of the petrous part of the temporal bone.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 28 - A 68 year old woman has undergone surgical repair of her femoral hernia....

    Incorrect

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

      Your Answer:

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

      Explanation:

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

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

    • This question is part of the following fields:

      • Principles Of Surgery-in-General
      • Surgical Technique And Technology
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  • Question 29 - The pudendal nerve is derived from? ...

    Incorrect

    • The pudendal nerve is derived from?

      Your Answer:

      Correct Answer: S2, S3, S4

      Explanation:

      The pudendal nerve derives it’s fibres from the ventral branches of the second, third and fourth sacral nerves (S2,3,4)

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
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  • Question 30 - A 25 year old lady visits her regular doctor to have a skin...

    Incorrect

    • A 25 year old lady visits her regular doctor to have a skin lesion excised from her thigh. At her 3 month follow-up appointment, the doctor notes that the scar is contracting. Which of the following allows this process to happen?

      Your Answer:

      Correct Answer: Myofibroblasts

      Explanation:

      Answer: Myofibroblasts

      Fibroblasts are a type of cell which have mesenchymal origin and can exhibit either non-contractile or highly contractile phenotype. Under normal conditions, fibroblasts function to maintain tissue homeostasis by regulating the turnover of extracellular matrix (ECM). When tissues are injured, however, fibroblasts around the injured region differentiate into myofibroblasts, a type of highly contractile cells that produce abundant ECM proteins. While the mechanisms of wound healing are not completely understood, it has become clear that both fibroblasts and myofibroblasts play a critical role in the wound healing process. Specifically, the traction forces of fibroblasts and coordinated contraction of myofibroblasts are believed to be responsible for wound contraction and closure. However, excessive myofibroblast activity, accompanied by elevated levels of mechanical stress in the healing region, often causes scar tissue formation, and in the worst case, contracture of tissues (e.g. Dupuytren’s contracture), leading to local immobilization and loss of function.

    • This question is part of the following fields:

      • Peri-operative Care
      • Principles Of Surgery-in-General
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SESSION STATS - PERFORMANCE PER SPECIALTY

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