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Question 1
Correct
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Which organ is responsible for the secretion of enzymes that aid in digestion of complex starches?
Your Answer: Pancreas
Explanation:α-amylase is secreted by the pancreas, which is responsible for hydrolysis of starch, glycogen and other carbohydrates into simpler compounds.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 2
Correct
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Which of the following structures, is the area in which the superior cerebral veins drain into?
Your Answer: Superior sagittal sinus
Explanation:The superior cerebral veins are predominantly located on the superior aspect of the brain. They are 8 to 12 in number and they drain the lateral, medial and superior aspects of the cerebral hemispheres.
These veins drain into the superior sagittal sinus, also known as the superior longitudinal sinus – which is located along the attached margin of the falx cerebri. -
This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 3
Incorrect
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The cranial nerves of the brain provide motor and sensory innervation to the structures of the head and neck. Which of the following cranial nerves provide only motor innervation?
Your Answer: Oculomotor
Correct Answer: Abducens
Explanation:The cranial nerves emerge directly from the brain and the brain stem. They provide sensory, motor or both motor and sensory innervation. Here is a summary of the cranial nerves and their function:
Olfactory – Purely sensory
Optic – Sensory
Oculomotor – Mainly motor
Trochlear – Motor
Trigeminal – Both sensory and motor
Abducens – Mainly motor
Facial – Both sensory and motor
vestibulocochlear – Mostly sensory
Glossopharyngeal – Both sensory and motor
Vagus – Both sensory and motor
Accessory – Mainly motor
Hypoglossal – Mainly motor -
This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 4
Correct
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A 32-year-old lady presents with a six-month history of an offensive discharge from the anus. She is otherwise well but is annoyed at the need to wear pads. On examination, she has a small epithelial defect in the five o'clock position, approximately three centimetres from the anal verge. Out of the following, which is the most likely cause?
Your Answer: Fistula-in-ano
Explanation:This patient is a case of fistula-in-ano.
A fistula-in-ano is an abnormal hollow tract or cavity that is lined with granulation tissue and that connects a primary opening inside the anal canal to a secondary opening in the perianal skin; secondary tracts may be multiple and can extend from the same primary opening. Fistulae usually occur following previous ano-rectal sepsis. The discharge may be foul smelling and troublesome.
Fistula-in-ano is classified into two groups based on its anatomical location.
1. Low fistula: relatively close to the skin and passes through a few or no sphincter muscle fibres, crosses <30% external sphincter
2. High fistula: passes through a large amount of muscleAssessment of fistula-in-ano includes:
1. Examination of the perineum
2. Digital rectal examination (DRE)
Low, uncomplicated fistulas may not require any further assessment. Other groups will usually require more detailed investigation.
3. Endo-anal USS
4. Ano-rectal MRI scanTreatment options include:
1. Seton suture
2. Fistulotomy: Low fistulas that are simple should be treated by fistulotomy once the acute sepsis has been controlled. Fistulotomy (where safe) provides the highest healing rates.
3. Anal fistula plugs and fibrin glue
4. Ano-rectal advancement flaps: primarily for high fistulae -
This question is part of the following fields:
- Colorectal Surgery
- Generic Surgical Topics
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Question 5
Correct
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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: 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.
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This question is part of the following fields:
- Generic Surgical Topics
- Orthopaedics
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Question 6
Incorrect
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A 7 year old boy is taken to his family doctor for treatment of a painful limp. His mother states that the symptoms started 7 weeks ago. Two hip x-rays have been performed and they appear normal. What is the most appropriate course of action?
Your Answer: Arrange a further hip X-ray
Correct Answer: Arrange a hip MRI
Explanation:Legg-Calvé-Perthes (LCP) disease is a common cause of hip pain and limp in preadolescent children. Early in its course, this condition, a form of idiopathic osteonecrosis (or osteochondrosis), may be difficult to diagnose both clinically and radiographically. MRI is a useful tool for the evaluation of LCP disease that may assist with prompt diagnosis, staging, and evaluation of associated complications. In addition, a variety of MRI findings may provide valuable prognostic information. The MRI findings of LCP disease are quite variable depending on the different stages of the disease (avascular, revascularization, and healing phases).
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This question is part of the following fields:
- Generic Surgical Topics
- Orthopaedics
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Question 7
Correct
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A patient admitted for esophagectomy showed low levels of the lightest plasma protein in terms of weight. Which of the following is the lightest plasma protein:
Your Answer: Albumin
Explanation:Albumin is the most abundant and the lightest of all the plasma proteins. It maintains osmotic pressure, transports unconjugated bilirubin, thyroid hormones, fatty acids, drugs and acts as a buffer for pH.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 8
Correct
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A 45-year-old female is receiving chemotherapy for the treatment of metastatic breast cancer. You are called because it has become apparent that her doxorubicin infusion has extravasated. What is the most appropriate course of action?
Your Answer: Stop the infusion and apply a cold compress to the site
Explanation:Extravasation is the process by which any liquid (fluid or drug) accidentally leaks into the surrounding tissue. In terms of cancer therapy, extravasation refers to the inadvertent infiltration of chemotherapy into the subcutaneous or subdermal tissues surrounding the intravenous or intra-arterial administration site.
Extravasated drugs are classified according to their potential for causing damage as ‘vesicant’, ‘irritant’ and ‘non-vesicant’.
Doxorubicin is one of the vesicant drugs.
Regardless of the chemotherapy drug, early initiation of treatment is considered mandatory. In this context, patient education is crucial for prompt identification of the extravasation.
Step 1: Stop the infusion and leave the needle in place
Step 2: Identify the extravasated agent
Step 3: Leave the cannula in place, gently aspirate the agent and avoid manual compression, then remove the cannula
Step 4: Use a pen to outline the extravasated area
Step 5: Start Specific measures
Step 5A: For Anthracyclines (Doxorubicin), Apply cold compressions for 20 minutes, 4 times daily for 1-2 days.
Step 5B: Using Specific Antidotes as Topical Dimethyl sulfoxide (DMSO) or Dexrazoxane -
This question is part of the following fields:
- Oncology
- Principles Of Surgery-in-General
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Question 9
Incorrect
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A 13 month old baby was taken to the hospital after his father saw that he had periorbital oedema for two days. He is seen by the doctor and noted to have facial oedema and a tender distended abdomen. His temperature is 39.1 and his blood pressure is 91/46 mmHg. There is also clinical evidence of poor peripheral perfusion. What is the diagnosis?
Your Answer: Henoch Schönlein purpura
Correct Answer: Spontaneous bacterial peritonitis
Explanation:Answer: Spontaneous bacterial peritonitis
The presence of periorbital and facial oedema with normal blood pressure in this toddler indicates that he has nephrotic syndrome. Nephrotic syndrome can be associated with a series of complications that can affect an individual’s health and quality of life:
Spontaneous bacterial peritonitis can develop where there is ascites present. This is a frequent development in children but very rarely found in adults.Spontaneous bacterial peritonitis (SBP) is the development of a bacterial infection in the peritoneum, despite the absence of an obvious source for the infection. It is specifically an infection of the ascitic fluid – an increased volume of peritoneal fluid. Ascites is most commonly a complication of cirrhosis of the liver. It can also occur in patients with nephrotic syndrome. SBP has a high mortality rate.
The diagnosis of SBP requires paracentesis, a sampling of the peritoneal fluid taken from the peritoneal cavity. If the fluid contains large numbers of white blood cells known as neutrophils (>250 cells/µL), infection is confirmed and antibiotics will be given, without waiting for culture results. In addition to antibiotics, infusions of albumin are usually administered.
Signs and symptoms of spontaneous bacterial peritonitis (SBP) include fevers, chills, nausea, vomiting, abdominal pain and tenderness, general malaise, altered mental status, and worsening ascites. Thirteen percent of patients have no signs or symptoms. In cases of acute or chronic liver failure SBP is one of the main triggers for hepatic encephalopathy, and where there is no other clear causal indication for this, SBP may be suspected.
These symptoms can also be the same for a spontaneous fungal peritonitis (SFP) and therefore make a differentiation difficult. Delay of diagnosis can delay antifungal treatment and lead to a higher mortality rate.
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This question is part of the following fields:
- Generic Surgical Topics
- The Abdomen
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Question 10
Correct
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A 24-year-old rugby player sustains a fracture of the distal radius after falling on his outstretched right hand during the game. X-ray shows a dorsally angulated comminuted fracture. What is the most appropriate management?
Your Answer: Admit for open reduction and internal fixation
Explanation:This is a case of a high-velocity injury and, therefore, requires surgical fixation.
Bony injury resulting in a fracture may occur due to trauma (excessive force applied to bone), stress (repetitive low-velocity injury), or underlying pathology (abnormal bone which fractures during normal use or following minimal trauma).
Diagnosis involves not just evaluating the fracture, such as the site and type of injury, but also other associated injuries and distal neurovascular status. This may entail not just clinical examination but radiographs of proximal and distal joints. When assessing x-rays, it is important to assess for changes in the length of the bone, the angulation of the distal bone, rotational effects, and the presence of a foreign body such as glass.
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This question is part of the following fields:
- Generic Surgical Topics
- Orthopaedics
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Question 11
Correct
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An ECG of a 30 year old woman revealed low voltage QRS complexes. This patient is most probably suffering from?
Your Answer: Pericardial effusion
Explanation:The QRS complex is associated with current that results in the contraction of both the ventricles. As ventricles have more muscle mass than the atria, they result in a greater deflection on the ECG. The normal duration of a QRS complex is 10s. A wide and deep Q wave depicts myocardial infarction. Abnormalities in the QRS complex maybe indicative of a bundle block, ventricular tachycardia or hypertrophy of the ventricles. Low voltage QRS complexes are characteristic of pericarditis or a pericardial effusion.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 12
Incorrect
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A 55-year-old male presents with an ulcerated mass at the anal verge. A biopsy is taken and the histology demonstrates as squamous cell carcinoma. Which of the following viral infection is most likely to have contributed to the development of the condition?
Your Answer: Human papillomavirus 7
Correct Answer: Human papillomavirus 16
Explanation:Anal squamous cell cancer is believed to be directly linked to the presence of a complex inflammatory process most commonly caused by HPV infection (particularly with serotypes 16 and 18) in the histologically unique area of the anal squamocolumnar epithelium. In one Scandinavian study, serotype 16 HPV DNA was detected in 73% of anal cancer specimens, and serotype 16, 18, or both were detected in 84% of specimens. In contrast, no rectal cancer specimens contained HPV DNA.
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This question is part of the following fields:
- Clinical Microbiology
- Principles Of Surgery-in-General
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Question 13
Incorrect
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A 36 year old opera singer is admitted for a right thyroid lobectomy. Post operatively, he is unable to sing high notes. Which muscle is likely to demonstrate impaired function?
Your Answer:
Correct Answer: Cricothyroid
Explanation:Thyroidectomy has been reported as the most frequent cause of external branch of superior laryngeal nerve (EBSLN) injury.
Diagnosis of EBSLN injury may be difficult because the symptoms are nonspecific in many cases. However, advanced diagnostic techniques have revealed the incidence to be relatively high, ranging from 5 to 28%. Paralysis of the EBSLN causes difficulty with high pitch phonation and decreased pitch range secondary to failure of cricothyroid muscle stimulation and lack of tension in the vocal cord. This symptom may be extremely serious for professional voice users. EBSLN injury can also cause vocal fatigue, hoarseness, breathy sounding voice, and vocal nodules. -
This question is part of the following fields:
- Generic Surgical Topics
- Head And Neck Surgery
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Question 14
Incorrect
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A 3 year old boy is taken to the doctor by his mother who has noticed that he has been having rectal bleeding for a few months and a cherry red lesion appeared at the anal verge after defecation. Which of the following is most likely the diagnosis?
Your Answer:
Correct Answer: Juvenile polyp
Explanation:Juvenile polyps are benign hamartomas with neoplastic potential that are the most frequent gastrointestinal polyp of childhood, with the peak incidence between 3 and 5 years of age.. The presence of multiple juvenile polyps may indicate a premalignant condition commonly named juvenile polyposis coli or juvenile polyposis syndrome (JPS). In contrast, single or solitary juvenile polyps generally are considered benign sporadic lesions that confer little to no future risk of malignancy. Most frequent presentation is painless rectal bleeding. Other features include a prolapsing rectal mass and abdominal pain.
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This question is part of the following fields:
- Generic Surgical Topics
- Paediatric Surgery
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Question 15
Incorrect
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Intracellular shifting of hydrogen ions can generate a metabolic alkalosis. In which of the following conditions is metabolic alkalosis caused by this mechanism ?
Your Answer:
Correct Answer: Hypokalaemia
Explanation:Metabolic alkalosis is characterized by a primary increase in the concentration of serum bicarbonate ions. This may occur as a consequence of a loss of hydrogen ions or a gain in bicarbonate. Hydrogen ions may be lost through the kidneys or the GI tract, as for example during vomiting, nasogastric suction or use of diuretics. Intracellular shifting of hydrogen ions develops mainly during hypokalaemia to maintain neutrality. Gain in bicarbonate ions may develop during administration of sodium bicarbonate in high amounts or in amounts that exceed the capacity of excretion of the kidneys, as seen in renal failure. Fluid losses may be another cause of metabolic alkalosis, causing the reduction of extracellular fluid volume.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 16
Incorrect
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During routine laboratory tests, a 66-year-old man is found to be suffering from hypercholesterolaemia and is prescribed atorvastatin. What is the mechanism of action of atorvastatin?
Your Answer:
Correct Answer: Inhibits cholesterol synthesis
Explanation:Atorvastatin is a member of the drug class of statins, used for lowering cholesterol. The mode of action of statins is inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase. This enzyme is needed by the body to make cholesterol. The primary uses of atorvastatin is for the treatment of dyslipidaemia and the prevention of cardiovascular disease.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 17
Incorrect
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A 35 year old woman with dysphagia undergoes oesophageal manometry. She is found to have a hypertensive lower oesophageal sphincter that does not completely relax on swallowing. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Achalasia
Explanation:Achalasia is a failure of the lower oesophageal sphincter (LES) to relax that is caused by the degeneration of inhibitory neurons within the oesophageal wall. It is classified as either primary (idiopathic) or secondary (in the context of another disease). In patients with achalasia, the chief complaint is dysphagia to both solids and liquids, although regurgitation, retrosternal pain, and weight loss may also occur. Upper endoscopy, barium esophagram, and oesophageal manometry play complementary roles in the diagnosis of achalasia. While upper endoscopy and/or barium esophagram are often obtained initially, manometry usually confirms the diagnosis, and upper endoscopy is indicated to rule out a malignant underlying cause. In good surgical candidates, achalasia is usually treated with pneumatic dilation or myotomy. In most other cases, an injection of botulinum toxin is attempted. If these measures fail to provide relief, medical therapy (e.g., nifedipine) is indicated.
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This question is part of the following fields:
- Generic Surgical Topics
- Upper Gastrointestinal Surgery
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Question 18
Incorrect
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A 40 year old male presents with jaundice and is diagnosed as having a carcinoma of the head of the pancreas. Despite being deeply jaundiced, his staging investigations are negative for metastatic disease. What is the best method of biliary decompression in this case?
Your Answer:
Correct Answer: ERCP and placement of stent
Explanation:ERCP is a highly sensitive means of detecting pancreatic and/or biliary ductal abnormalities in pancreatic carcinoma. Among patients with pancreatic adenocarcinoma, 90-95% have abnormalities on ERCP findings.
ERCP is more invasive than the other diagnostic imaging modalities available for pancreatic carcinoma. ERCP also carries a 5-10% risk of significant complications. Because of this morbidity, it is usually reserved as a therapeutic procedure for biliary obstruction or for the diagnosis of unusual pancreatic neoplasms, such as intraductal pancreatic mucinous neoplasms (IPMN).
ERCP findings provide only limited staging information, but ERCP does have the advantage of allowing for therapeutic palliation of obstructive jaundice with either a plastic or metal biliary stent. -
This question is part of the following fields:
- Generic Surgical Topics
- Hepatobiliary And Pancreatic Surgery
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Question 19
Incorrect
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Question 20
Incorrect
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A 55-years-old man presented to the emergency department complaining of a squeezing sensation in his chest that has spread to his neck with associated worsening shortness of breath. Which of these laboratory tests would you ask for in this patient:
Your Answer:
Correct Answer: Creatine kinase-MB
Explanation:Creatine kinase-MB is a test that usually is ordered when the patient has chest pain as a cardiac marker. When a heart attack is suspected and a troponin test (which is more specific for heart damage), is not available CK-MB is ordered. There are 3 forms of CK: CK-MM, CK-BB and CK-MB. CK-MB is commonly found in heart tissue, therefore injured heart muscle cells release CK-MB into the blood. Elevated CK-MB levels indicate that it is probable that a person has recently had a heart attack.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 21
Incorrect
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A 50-year-old female undergoes an ERCP for jaundice. 36 hours following the procedure she develops a fever and rigours. A blood culture is taken, which of the following organisms is most likely to be cultured?
Your Answer:
Correct Answer: Escherichia coli
Explanation:One of the most serious post-ERCP complications is cholangitis leading to subsequent septicaemia. Enteric bacteria enter the biliary tree by the hematogenous route or following endoscopic or radiologic manipulation. Improperly disinfected endoscopes and accessories may also introduce infection into the biliary tree. The most common organisms responsible for infection after ERCP are the Enterobacteriaceae (especially Escherichia coli and Klebsiella species), alpha-haemolytic streptococci, Pseudomonas aeruginosa, Enterococcus, and Staphylococcus epidermidis. In most patients with acute cholangitis, a single organism is isolated from blood cultures.
Acute cholangitis is a clinical syndrome characterized by fever, jaundice, and abdominal pain that develops as a result of stasis and infection in the biliary tract. It is also referred to as Charcot’s Triad. Cholangitis was first described by Charcot as a serious and life-threatening illness; however, it is now recognized that the severity can range from mild to life-threatening.
Risk factors for post-ERCP infection include the use of combined percutaneous and endoscopic procedures, stent placement in malignant strictures, the presence of jaundice, low case volume, and incomplete or failed biliary drainage. Patients who are immunocompromised are more likely to experience an infectious complication.
Prevention and/or reduction of the risk of post-ERCP infectious complications can be achieved by judicious use of preprocedural antibiotics and intraprocedural steps, such as minimizing or avoiding contrast injection in patients with known biliary obstruction or cholangitis, endoscopic decompression, including the placement of a biliary stent when complete drainage cannot be achieved, and prompt percutaneous drainage if endoscopic drainage is not possible or incomplete. Prophylactic preprocedural antibiotics should be given to patients with jaundice and suspected mechanical obstruction. In addition, patients with sclerosing cholangitis, pancreatic pseudocysts, and those who are immunocompromised should also receive preprocedural antibiotics
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This question is part of the following fields:
- Clinical Microbiology
- Principles Of Surgery-in-General
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Question 22
Incorrect
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An experiment is carried out to observe engulfment and phagocytosis of microbes. Strep pneumoniae are added to a solution of leukocytes with a substance added to enhance the process of phagocytosis. What is this substance?
Your Answer:
Correct Answer: Complement C3b
Explanation:C3b is cleaved from C3 complement with the help of the enzyme C3- convertase. It binds to the cell surface of the offending substance and opsonizes it. This makes it easy for the phagocytes to detect and eliminate them.
IgM does not act as an opsonin but igG does.
Selectins aid leukocytes to bind to the endothelial surfaces.
C5a is a chemo-attractant and histamine a vasodilator.
NADPH oxidises offending substance after phagocytosis within the macrophage. -
This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 23
Incorrect
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When a young boy falls on his outstretched hand, he fractures one of the bones at his wrist joint. The doctors told his parents that the fractured bone has special importance as it is that bone that articulates with the distal end of the radius. Which one of the following is it?
Your Answer:
Correct Answer: Scaphoid
Explanation:It is the scaphoid bone that articulates with the radius at this level. It is located at the radial side of the wrist and is considered the largest bone in the proximal row of carpal bones. It articulates with the radius via its superior surface. This bone also articulates with trapezium and trapezoid bones via the inferior surface, capitate and lunate medially.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 24
Incorrect
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A patient underwent surgical excision of mass in the right carotid triangle. One day after the surgery patient complained of numbness of the skin over the right side of the neck. Injury to the cervical plexus of nerves is suspected. What is the possible nerve affected in this patient?
Your Answer:
Correct Answer: Transverse cervical
Explanation:The transverse cervical nerve (superficial cervical or cutaneous cervical) arises from the second and third spinal nerves, turns around the posterior border of the sternocleidomastoid and, passing obliquely forward beneath the external jugular vein to the anterior border of the muscle, it perforates the deep cervical fascia, and divides beneath the platysma into the ascending and descending branches. It provides cutaneous innervation to this area.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 25
Incorrect
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Which of the following is the most abundant WBC seen in a smear from a healthy person.
Your Answer:
Correct Answer: Neutrophils
Explanation:neutrophils are the most abundant cell type of the WBC. These phagocytes are found normally in the blood and increase in number are seen during an acute inflammation. These the percentages of WBC in blood Neutrophils: 40 to 60%
Lymphocytes: 20 to 40%
Monocytes: 2 to 8%
Eosinophils: 1 to 4%
Basophils: 0.5 to 1%
Band (young neutrophil): 0 to 3%. eosinophils, basophils, neutrophils are known as granulocytes and monocytes and lymphocytes as agranulocytes. -
This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 26
Incorrect
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A 32 year old woman presents to the ER with recurrent episodes of non specific abdominal pain. The labs including blood tests appear to be normal. Ct scan is done for further evaluation. The CT reveals a 1.5 cm nodule in the right adrenal gland that is associated with a lipid rich core. Urinary VMA is found to be within the normal range. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Benign non functional adenoma
Explanation:Adrenal adenomas are benign tumours of the adrenal glands, which can be either functioning or non-functioning. Though the majority are clinically silent, functional adenomas from the cortex of medulla can lead to overproduction of any of their associated hormones. Benign adenomas often have a lipid rich core that is readily identifiable on CT scanning. In addition the nodules are often well circumscribed.
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This question is part of the following fields:
- Breast And Endocrine Surgery
- Generic Surgical Topics
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Question 27
Incorrect
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The thoracic duct :
Your Answer:
Correct Answer: varies in length from 38 to 45 cm
Explanation:The thoracic duct is the main drainage of lymph in the body. It varies in length from 38 to 45 cm and extends from the second lumbar vertebra to the root of the neck.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 28
Incorrect
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Inside the palatoglossal arch is a muscle. Which nerve innervates this muscle?
Your Answer:
Correct Answer: X
Explanation:The palatoglossal arch contains the palatoglossal muscle which is innervated by the vagus nerve which is the tenth cranial nerve. So the correct answer is X
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 29
Incorrect
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A 30-year-old man sustains a severe facial fracture, and reconstruction is planned. Which of the following investigations will facilitate preoperative planning?
Your Answer:
Correct Answer: Computerised tomography of the head
Explanation:Significant facial fractures may have an intracranial effect. Computerised tomography (CT) scan of the head allows delineation of the injury extent, and a 3D reconstruction of images can be done. An Orthopantomogram (OPT) provides good images of mandible and surrounding bony structures but cannot give intracranial details. X-ray of the skull lacks the details important in modern practice.
Craniomaxillofacial (CMF) injuries in the UK are due to:
1. Interpersonal violence (52%)
2. Motor vehicle accidents (16%)
3. Sporting injuries (19%)
4. Falls (11%) -
This question is part of the following fields:
- Emergency Medicine And Management Of Trauma
- Principles Of Surgery-in-General
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Question 30
Incorrect
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The anatomical dead space in a patient with low oxygen saturation, is 125 ml, with a tidal volume of 500 ml and pa(CO2) of 40 mm Hg. The dead space was determined by Fowler's method. If we assume that the patient's lungs are healthy, what will his mixed expired CO2 tension [pE(CO2)] be?
Your Answer:
Correct Answer: 30 mmHg
Explanation:According to Bohr’s equation, VD/VT = (pA(CO2) − pE(CO2))/pA(CO2), where pE(CO2) is mixed expired CO2 and pA(CO2) is alveolar CO2pressure. Normally, the pa(CO2) is virtually identical to pA(CO2). Thus, VD/VT = (pa(CO2)) − pE(CO2)/pa(CO2). By Fowler’s method, VD/VT= 0.25. In the given problem, (pa(CO2) − pE(CO2)/pa(CO2) = (40 − pE(CO2)/40 = 0.25. Thus, pE(CO2) = 30 mmHg. If there is a great perfusion/ventilation inequality, pE(CO2) could be significantly lower than 30 mm Hg, and the patient’s physiological dead space would exceed the anatomical dead space.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
