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  • Question 1 - The functional residual capacity (FRC) will be decreased in which of the following:...

    Incorrect

    • The functional residual capacity (FRC) will be decreased in which of the following:

      Your Answer: Asthma

      Correct Answer: Pulmonary fibrosis

      Explanation:

      Factors decreasing FRC:Restrictive ventilatory defects e.g. pulmonary fibrosisPosture – lying supineIncreased intra-abdominal pressure (e.g. obesity, pregnancy, ascites)Reduced muscle tone of diaphragm e.g. muscle relaxants in anaesthesia, neuromuscular disease

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      26.1
      Seconds
  • Question 2 - Regarding renal clearance, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding renal clearance, which of the following statements is CORRECT:

      Your Answer: Creatinine clearance is the gold standard for measurement of GFR.

      Correct Answer: The MDRD equation uses plasma creatinine to estimate the GFR making an adjustment for age, sex and race.

      Explanation:

      Clearance is defined as the volume of plasma that is cleared of a substance per unit time. Inulin clearance is the gold standard for measurement of GFR but creatinine clearance is typically used instead. Creatinine is freely filtered and not reabsorbed, but there is a little creatinine tubular secretion. In practice, GFR is usually estimated from the plasma creatinine using a formula e.g. the MDRD equation making an adjustment for age, sex and race.

    • This question is part of the following fields:

      • Physiology
      • Renal
      53.5
      Seconds
  • Question 3 - A 35-year-old man presents with haemoptysis, night sweats, and weight loss. Further examinations...

    Incorrect

    • A 35-year-old man presents with haemoptysis, night sweats, and weight loss. Further examinations were done and a diagnosis of tuberculosis is suspected. Which of the following statements is considered correct regarding Mycobacterium tuberculosis?

      Your Answer: It Gram stains red

      Correct Answer: It is impervious to decolourisation with acid

      Explanation:

      Mycobacterium tuberculosis are part of the Mycobacteriaceae family. They are described to have the characteristics of a Gram-positive cell wall but they are not easily stained with Gram stain. This is because their cell wall contains a high lipid content, and this lipid allows the Mycobacteria to bind to alkaline stains with the application and help of heat. Once stained, they are able to resist decolorization even with the use of acid alcohol as the decolourizer, making them very difficult to decolorize, that is why they are known to be acid-fast.The Ghon complex is a non-pathognomonic radiographic finding on a chest x-ray that is significant for pulmonary infection of tuberculosis. The location of the Ghon’s focus is usually subpleural and predominantly in the upper part of the lower lobe and lower part of the middle or upper lobe. Skeletal tuberculosis of the spine is referred to as Pott disease.The risk of reactivation TB is about 3.3% during the first year after a positive PPD skin test and a total of 5% to 15% thereafter in the person’s lifetime. Progression from infection to active disease varies with age and the intensity and duration of exposure. Reactivation TB occurs when there is an alteration or suppression of the cellular immune system in the infected host that favoursreplication of the bacilli and progression to disease.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      9.7
      Seconds
  • Question 4 - Regarding the accessory nerve, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding the accessory nerve, which of the following statements is INCORRECT:

      Your Answer: The nerve originates from cervical segments C1 - C5.

      Correct Answer: Accessory nerve palsy results in the inability to nod the head.

      Explanation:

      Accessory nerve palsy results in inability to shrug the shoulders and to rotate the head to look at the opposite side to the lesion.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      26.7
      Seconds
  • Question 5 - About what percentage of filtered Na+is reabsorbed in the proximal tubule: ...

    Incorrect

    • About what percentage of filtered Na+is reabsorbed in the proximal tubule:

      Your Answer: 50 - 60%

      Correct Answer: 65 - 70%

      Explanation:

      Of the filtered sodium, about 65% is reabsorbed in the proximal tubule.

    • This question is part of the following fields:

      • Physiology
      • Renal
      32.9
      Seconds
  • Question 6 - A 19-year-old woman presents with dysuria and vaginal discharge. A swab was taken...

    Incorrect

    • A 19-year-old woman presents with dysuria and vaginal discharge. A swab was taken for culture. Culture results showed the presence of Neisseria gonorrhoeae infection. Treatment of azithromycin and doxycycline was started.Which of the following statements is considered correct regarding Neisseria gonorrhoeae?

      Your Answer: Pelvic tenderness is usually present in women

      Correct Answer: Throat swabs can be used for diagnosis

      Explanation:

      Neisseria gonorrhoeae is a Gram-negative diplococcus that causes gonorrhoea. Gonorrhoea is an acute pyogenic infection of nonciliated columnar and transitional epithelium; infection can be established at any site where these cells are found. Gonococcal infections are primarily acquired by sexual contact and occur primarily in the urethra, endocervix, anal canal, pharynx, and conjunctiva.In men, acute urethritis, usually resulting in purulent discharge and dysuria (painful urination), is the most common manifestation. The endocervix is the most common site of infection in women. Symptoms of infection, when present, include dysuria, cervical discharge, and lower abdominal pain. Some cases in women may be asymptomatic leading to complications such as pelvic inflammatory disease. Blood-borne dissemination occurs in less than 1% of all infections, resulting in purulent arthritis and rarely septicaemia. Fever and a rash on the extremities can also be present. Other conditions associated with N. gonorrhoeae include anorectal and oropharyngeal infections. Infections in these sites are more common in men who have sex with men but can also occur in women. Pharyngitis is the chief complaint in symptomatic oropharyngeal infections, whereas discharge, rectal pain, or bloody stools may be seen in rectal gonorrhoea. Approximately 30% to 60% of women with genital gonorrhoea have concurrent rectal infection. Newborns can acquire ophthalmia neonatorum, a gonococcal eye infection, during vaginal delivery through an infected birth canal. Specimens collected for the recovery of N. gonorrhoeae may come from genital sources or from other sites, such as the rectum, pharynx, and jointfluid. According to the 2010 STD Treatment guidelines, cephalosporins (e.g., ceftriaxone, cefixime) are currently recommended treatments.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      11.5
      Seconds
  • Question 7 - A 45-year-old woman presents with persistent palpitations for the past two days. She...

    Incorrect

    • A 45-year-old woman presents with persistent palpitations for the past two days. She has a good haemodynamic balance. An ECG is performed, which reveals that she has atrial flutter. The patient is examined by a cardiology registrar, who recommends using a 'rate control' strategy while she waits for cardioversion.Which of the drugs listed below is the best fit for this strategy?

      Your Answer: Lidocaine

      Correct Answer: Bisoprolol

      Explanation:

      In atrial flutter, ventricular rate control is usually used as a stopgap measure until sinus rhythm can be restored. A beta-blocker (such as bisoprolol), diltiazem, or verapamil can be used to lower the heart rate.Electrical cardioversion, pharmacological cardioversion, or catheter ablation can all be used to restore sinus rhythm. Cardioversion should not be attempted until the patient has been fully anticoagulated for at least three weeks if the duration of atrial flutter is unknown or has lasted for more than 48 hours. Emergency electrical cardioversion is the treatment of choice when there is an acute presentation with haemodynamic compromise. For the treatment of recurrent atrial flutter, catheter ablation is preferred.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      49.7
      Seconds
  • Question 8 - Which of the following is an example of a non-parametric test: ...

    Correct

    • Which of the following is an example of a non-parametric test:

      Your Answer: All of the above

      Explanation:

      All of the above answers are non-parametric tests.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      18.5
      Seconds
  • Question 9 - A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited...

    Incorrect

    • A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited range of motion in the right elbow for the past two days. On examination, the right elbow is extremely tender with erythema and warmth of the overlying skin due to acute inflammation. Which ONE of the following statements is true with regards to acute inflammation?

      Your Answer: Bradykinin and histamine cause vasoconstriction

      Correct Answer: Neutrophils are activated and adhere to the endothelium as a result of interaction with endothelial cell adhesion molecules

      Explanation:

      Acute inflammation is defined as inflammation occurring within minutes to hours in response to an injury lasting for less than two weeks. Acute inflammation Rapid onset (minutes to hours)Quick resolution (usually days)Chronic inflammationMay last weeks, months, or yearsThere are five cardinal signs of inflammation:1) Pain2) Redness3) Warmth4) Oedema5) Loss of functionDuring acute inflammation, neutrophils are activated and attracted to the site of inflammation in response to various interleukins and cytokines. This process takes place via the following mechanism:1) MarginationNeutrophils flow nearer the vessel wall rather than in the axial stream, which is referred to as margination2) Rolling along the surface of vascular endothelium3) Adhesion to the endothelium by interaction with adhesion molecules (ICAMS and VCAMS)4) Diapedesis is the movement of neutrophils from the endothelial cells into the interstitial space by squeezing through the gaps between adjacent endothelial cellsBradykinin and histamine are both responsible for vasodilation which causes oedema and decreases intravascular osmotic pressure.Neutrophils dominate early (2 days)- Live longer- Replicate in tissues

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      57.5
      Seconds
  • Question 10 - A newborn baby is born by vaginal delivery to a mother who has...

    Incorrect

    • A newborn baby is born by vaginal delivery to a mother who has a Chlamydia infection and who is started on treatment after the delivery. The neonate subsequently develops an infection also.Which one of these is the most common neonatal manifestation of Chlamydia trachomatis infection?

      Your Answer: Meningitis

      Correct Answer: Conjunctivitis

      Explanation:

      Conjunctivitis is the most common neonatal manifestation of Chlamydia trachomatis infection. The second commonest neonatal manifestation is pneumoniaOphthalmia neonatorum refers to any conjunctivitis in the newborn period, irrespective of causative organism. Presently, chlamydia is the single most common cause, accounting for up to 40% of cases. Ophthalmia neonatorum caused by chlamydia typically presents 5 to 14 days after birth with unilateral or bilateral watery discharge that progressively becomes more copious and purulent. There is no associated risk of ulceration and perforation, and the eyes are less inflamed.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      25.8
      Seconds
  • Question 11 - A 45-year-old African American male presents to your clinic complaining of swelling of...

    Correct

    • A 45-year-old African American male presents to your clinic complaining of swelling of his feet for the past six months. On examination, there is periorbital and pedal oedema. A 24-hour urine collection is ordered, which shows 8 g of protein. The serum cholesterol is ten mmol/L. You order a renal biopsy to confirm the diagnosis. Which one of the following findings are you most likely to see in this patient's biopsy?

      Your Answer: Focal segmental glomerulosclerosis

      Explanation:

      This patient has Nephrotic Syndrome confirmed by the presence of 1. Heavy proteinuria (greater than 3-3.5 g/24 hours)2. Hypoalbuminemia (serum albumin < 25 g/L)3. Generalised oedema (often with periorbital involvement)4. Severe hyperlipidaemia (total cholesterol is often > 10 mmol/L). Focal Segmental Glomerulosclerosis will be the most likely answer as it is the most common cause of Nephrotic Syndrome in African American adults. Minimal change disease is the most common cause of nephrotic syndrome in children. Membranous glomerulonephritis is the most common cause of Nephrotic Syndrome in Caucasian adults. In IgA nephropathy, patients will complain of cola-coloured urine. Mesangiocapillary glomerulonephritis presents with features of Nephritic Syndrome.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      18.9
      Seconds
  • Question 12 - You're evaluating a male patient who's having a lung function test done. In...

    Incorrect

    • You're evaluating a male patient who's having a lung function test done. In calculating the patient’s functional residual capacity, what parameters should you add to derive the functional residual capacity volume?

      Your Answer: Inspiratory reserve volume + tidal volume

      Correct Answer: Expiratory reserve volume + residual volume

      Explanation:

      The volume of air that remains in the lungs after a single breath is known as functional residual capacity (FRC). It is calculated by combining the expiratory reserve volume and residual volume.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      71.3
      Seconds
  • Question 13 - Injury to which nerve can lead to weakness or paralysis of the brachialis...

    Incorrect

    • Injury to which nerve can lead to weakness or paralysis of the brachialis muscle?

      Your Answer: The median nerve

      Correct Answer: The musculocutaneous nerve

      Explanation:

      The brachialis muscle is a prime flexor of the forearm at the elbow joint. It is fusiform in shape and located in the anterior (flexor) compartment of the arm, deep to the biceps brachii. The brachialis is a broad muscle, with its broadest part located in the middle rather than at either of its extremities. It is sometimes divided into two parts, and may fuse with the fibres of the biceps brachii, coracobrachialis, or pronator teres muscles. It also functions to form part of the floor of the cubital fossa.The brachialis is primarily supplied by the musculocutaneous nerve (C5, C6). In addition, a small lateral portion of the muscle is innervated by the radial nerve (C7).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      18.2
      Seconds
  • Question 14 - A patient with a recent diagnosis of Hepatitis B would like to find...

    Incorrect

    • A patient with a recent diagnosis of Hepatitis B would like to find out further information regarding his diagnosis and prognosis. Which among the following statements is considered true regarding Hepatitis B?

      Your Answer: Less than 50% of patients that contract hepatitis B make a full recovery

      Correct Answer: 60-65% of patients that contract hepatitis B show subclinical disease

      Explanation:

      As the immune response is activated, the virus is slowly cleared from the system, and most patients become non-infectious. In adults, about 50% of infections are asymptomatic; 20% to 30% of patients exhibit clinical jaundice but have a benign resolution of the infection. Therefore, about 80% of infections do not cause serious sequelae. The risk for chronic infection is inversely proportional to age at time of infection, with approximately 90% of infants and only 3% of adults developing a chronic infection. Individuals with a chronic infection have a higher risk of liver disease, such as cirrhosis or hepatic carcinoma.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      61.7
      Seconds
  • Question 15 - In ventricular myocytes, the plateau phase of the action potential comes about through which...

    Correct

    • In ventricular myocytes, the plateau phase of the action potential comes about through which of the following:

      Your Answer: Opening of voltage-gated Ca 2+ channels

      Explanation:

      After the intial upstroke of the action potential, Na+channels and currents rapidly inactivate, but in cardiac myocytes, the initial depolarisation activates voltage-gated Ca2+channels (slow L-type channels, threshold approximately – 45 mV) through which Ca2+floods into the cell. The resulting influx of Ca2+prevents the cell from repolarising and causes a plateau phase, that is maintained for about 250 ms until the L-type channels inactivate. The cardiac AP is thus much longer than that in nerve or skeletal muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      12.4
      Seconds
  • Question 16 - A patient suffers a lower limb fracture that causes damage to the nerve...

    Incorrect

    • A patient suffers a lower limb fracture that causes damage to the nerve that innervates peroneus brevis.Peroneus brevis receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer: Obturator nerve

      Correct Answer: Superficial peroneal nerve

      Explanation:

      Peroneus brevis is innervated by the superficial peroneal nerve.Peroneus longus is innervated by the superficial peroneal nerve.Peroneus tertius is innervated by the deep peroneal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      7.7
      Seconds
  • Question 17 - All of the following are actions of insulin except: ...

    Incorrect

    • All of the following are actions of insulin except:

      Your Answer: Decreased glycogenolysis

      Correct Answer: Increased gluconeogenesis

      Explanation:

      Major Actions of Insulin:↑ Glucose uptake into cells↑ Glycogenesis↓ Glycogenolysis↓ Gluconeogenesis↑ Protein synthesis↓ Protein degradation↑ Fat deposition↓ Lipolysis↓ Ketoacid production↑ K+ uptake into cellsMajor Actions of Glucagon:↓ Glycogenesis↑ Glycogenolysis↑ Gluconeogenesis↓ Fatty acid synthesis↑ Lipolysis↑ Ketoacid production

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      40.1
      Seconds
  • Question 18 - Where in the nephron is most K+reabsorbed: ...

    Incorrect

    • Where in the nephron is most K+reabsorbed:

      Your Answer: Descending loop of Henle

      Correct Answer: Proximal tubule

      Explanation:

      Approximately 65 – 70% of filtered K+is reabsorbed in the proximal tubule. Potassium reabsorption is tightly linked to that of sodium and water. The reabsorption of sodium drives that of water, which may carry some potassium with it. The potassium gradient resulting from the reabsorption of water from the tubular lumen drives the paracellular reabsorption of potassium and may be enhanced by the removal of potassium from the paracellular space via the Na+/K+ATPase pump. In the later proximal tubule, the positive potential in the lumen also drives the potassium reabsorption through the paracellular route.

    • This question is part of the following fields:

      • Physiology
      • Renal
      11.7
      Seconds
  • Question 19 - A 30-year-old man bought into the ED with increased thirst, confusion, abdominal pain...

    Incorrect

    • A 30-year-old man bought into the ED with increased thirst, confusion, abdominal pain and constipation is suspected to have hypercalcaemia.What is the commonest cause of hypercalcaemia in the UK?

      Your Answer: Secondary hyperparathyroidism

      Correct Answer: Primary hyperparathyroidism

      Explanation:

      The commonest cause of hypercalcaemia in the UK is primary hyperparathyroidism, which accounts for around 70-80% of cases. It is commoner in younger patients and in community setting.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      27.3
      Seconds
  • Question 20 - By the third day of wound healing, which sort of inflammatory cell has...

    Incorrect

    • By the third day of wound healing, which sort of inflammatory cell has predominated:

      Your Answer: Monocytes

      Correct Answer: Macrophages

      Explanation:

      The inflammatory phase of healing is sometimes called the lag phase because wound strength does not begin to return immediately. The inflammatory phase is completed within three days except in the presence of infection or other factors associated with impaired wound healing. Mononuclear leukocytes accumulate and are transformed into macrophages. The maturation of blood-derived monocytes into macrophages is heralded by several events, including secretion of vimentin, which is a structural filament protein involved in wound healing.

    • This question is part of the following fields:

      • Pathology
      • Wound Healing
      36.5
      Seconds
  • Question 21 - A patient noticed ankle swelling and has passed very little urine over the...

    Incorrect

    • A patient noticed ankle swelling and has passed very little urine over the past 24 hours. He also has nausea and vomiting, reduced urine output and his blood results reveal a sudden rise in his creatinine levels over the past 48 hours. You make a diagnosis of acute kidney injury (AKI).Which one of these is a prerenal cause of AKI?

      Your Answer: Eclampsia

      Correct Answer: Cardiac failure

      Explanation:

      The causes of AKI can be divided into pre-renal, intrinsic renal and post-renal causes. Majority of AKI developing in the community is due to a pre-renal causes (90% of cases).Pre-renal causes: Haemorrhage, severe vomiting or diarrhoea, burns, cardiac failure, liver cirrhosis, nephrotic syndrome, hypotension, severe cardiac failure, NSAIDs, COX-2 inhibitors, ACE inhibitors or ARBs, Abdominal aortic aneurysm, renal artery stenosis, hepatorenal syndrome, Intrinsic (renal) causes:Eclampsia, glomerulonephritis, thrombosis, haemolytic-uraemic syndrome, acute tubular necrosis (ATN), acute interstitial nephritis, drugs ( NSAIDs), infection or autoimmune diseases, vasculitis, polyarteritis nodosa, thrombotic microangiopathy, cholesterol emboli, renal vein thrombosis, malignant hypertensionPost-renal causes: Renal stones, Blood clot, Papillary necrosis, Urethral stricture, Prostatic hypertrophy or malignancy, Bladder tumour, Radiation fibrosis, Pelvic malignancy, Retroperitoneal fibrosis

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      14.6
      Seconds
  • Question 22 - Regarding benzylpenicillin, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding benzylpenicillin, which of the following statements is CORRECT:

      Your Answer: Benzylpenicillin is first line in treatment of tetanus.

      Correct Answer: If meningococcal disease is suspected, benzylpenicillin should be given before transfer to hospital.

      Explanation:

      Benzylpenicillin (although inactivated by bacterial beta-lactamases) is effective for many streptococcal (including pneumococcal), gonococcal, and meningococcal infections and also for anthrax, diphtheria, gas gangrene, leptospirosis, and treatment of Lyme disease. If meningococcal disease (meningitis with non-blanching rash or meningococcal septicaemia) is suspected, benzylpenicillin should be given before transfer to hospital, so long as this does not delay the transfer; benzylpenicillin is no longer the drug of first choice for pneumococcal meningitis. Although benzylpenicillin is effective in the treatment of tetanus, metronidazole is preferred. Benzylpenicillin is inactivated by gastric acid and absorption from the gastrointestinal tract is poor and therefore it must be given by injection.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      27
      Seconds
  • Question 23 - Which of the following neurotransmitter and receptor combinations is present at the neuromuscular...

    Incorrect

    • Which of the following neurotransmitter and receptor combinations is present at the neuromuscular junction:

      Your Answer: Noradrenaline acting at beta receptors

      Correct Answer: Acetylcholine acting at nicotinic receptors

      Explanation:

      At the neuromuscular junction, acetylcholine is released from the prejunctional membrane which acts on cholinergic nicotinic receptors on the postjunctional membrane.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      8.6
      Seconds
  • Question 24 - A 52-year old male comes to the out-patient department for a groin mass...

    Incorrect

    • A 52-year old male comes to the out-patient department for a groin mass that protrudes when standing. The patient notes that it is reducible when lying down. On physical examination, there is presence of a cough impulse. The initial assessment is hernia. Further investigation reveals that the mass lies lateral to the epigastric vessels.Among the types of hernia, which is the most likely diagnosis of the case above?

      Your Answer: Direct inguinal hernia

      Correct Answer: Indirect inguinal hernia

      Explanation:

      Inguinal hernias can present with an array of different symptoms. Most patients present with a bulge in the groin area, or pain in the groin. Some will describe the pain or bulge that gets worse with physical activity or coughing. Symptoms may include a burning or pinching sensation in the groin. These sensations can radiate into the scrotum or down the leg. It is important to perform a thorough physical and history to rule out other causes of groin pain. At times an inguinal hernia can present with severe pain or obstructive symptoms caused by incarceration or strangulation of the hernia sac contents. A proper physical exam is essential in the diagnosis of an inguinal hernia. Physical examination is the best way to diagnose a hernia. The exam is best performed with the patient standing. Visual inspection of the inguinal area is conducted first to rule out obvious bulges or asymmetry in groin or scrotum. Next, the examiner palpates over the groin and scrotum to detect the presence of a hernia. The palpation of the inguinal canal is completed last. The examiner palpates through the scrotum and towards the external inguinal ring. The patient is then instructed to cough or perform a Valsalva manoeuvre. If a hernia is present, the examiner will be able to palpate a bulge that moves in and out as the patient increases intra abdominal pressure through coughing or Valsalva.Groin hernias are categorized into 2 main categories: inguinal and femoral.Inguinal hernias are further subdivided into direct and indirect. An indirect hernia occurs when abdominal contents protrude through the internal inguinal ring and into the inguinal canal. This occurs lateral to the inferior epigastric vessels. The hernia contents may extend into the scrotum, and can be reduced superiorly then superolaterally. A direct inguinal hernia is protrusion of abdominal contents through the transversalis fascia within Hesselbach’s triangle. The borders of Hesselbach’s triangle are the inferior epigastric vessels superolaterally, the rectus sheath medially, and inguinal ligament inferiorly.A femoral hernia is a protrusion into the femoral ring. The borders of the femoral ring are the femoral vein laterally, Cooper’s ligament posteriorly, the iliopubic tract/inguinal ligament anteriorly and lacunar ligament medially.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      20.1
      Seconds
  • Question 25 - The following are all examples of type II hypersensitivity EXCEPT for: ...

    Correct

    • The following are all examples of type II hypersensitivity EXCEPT for:

      Your Answer: Post-streptococcal glomerulonephritis

      Explanation:

      Examples of type II reactions include: Incompatible blood transfusionsHaemolytic disease of the newbornAutoimmune haemolytic anaemiasGoodpasture’s syndromeRheumatic heart diseaseBullous pemphigoid

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      15.1
      Seconds
  • Question 26 - A somatostatinoma is diagnosed in a 74-year-old patient who has recently developed diabetes...

    Incorrect

    • A somatostatinoma is diagnosed in a 74-year-old patient who has recently developed diabetes mellitus, recurrent episodes of gallstones, and Steatorrhoea. She also  has a tumour in the head of her pancreas.Which of the following is the most likely effect of this tumour? 

      Your Answer: Increase insulin release

      Correct Answer: Inhibit gastric acid secretion

      Explanation:

      Somatostatin-producing cells present in the pyloric antrum, duodenum, and pancreatic islets are known as D-cells or delta-cells. Somatostatin inhibits gastric acid secretion by acting directly on acid-producing parietal cells in the stomach via a G-protein coupled receptor.Somatostatin affects hormones in the following ways:Inhibits the anterior pituitary’s secretion of growth hormone.Inhibits the anterior pituitary’s secretion of thyroid-stimulating hormone.The secretion of various gastrointestinal hormones is inhibited (including gastrin, CCK, secretin, motilin, VIP and GIP) Reduces the rate at which the stomach empties.Inhibits the release of insulin and glucagon from the pancreas.The pancreas’ exocrine secretory activity is inhibited.Somatostatin can also slow the digestive process by suppressing the production of hormones such gastrin, secretin, and histamine, which reduces gastric acid secretion.A somatostatinoma is a cancerous tumour of the endocrine pancreas’ D-cells, which make somatostatin. Somatostatin inhibits pancreatic and gastrointestinal hormones when levels are high. The following clinical characteristics are related with somatostatinomas:Insulin secretion blockage causes diabetes mellitus.Gallstones by inhibition of CCK and secretin Steatorrhoea via inhibition of CCK and secretinHypochlorhydria is caused by the suppression of gastrin, a hormone that increases gastric acid output regularly.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      14.7
      Seconds
  • Question 27 - You assess a patient that has suffered a nerve injury that has paralysed...

    Incorrect

    • You assess a patient that has suffered a nerve injury that has paralysed her left latissimus dorsi muscle.Latissimus dorsi receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer: Spinal root of accessory nerve

      Correct Answer: Thoracodorsal nerve

      Explanation:

      Latissimus dorsi originates from the lower part of the back, where it covers a wide area. It lies underneath the inferior fibres of trapezius superiorly, and trapezius is the most superficial back muscle.Superficial muscles of the back showing latissimus dorsi (from Gray’s Anatomy)Latissimus dorsi has a broad origin, arising from the spinous processes of T6-T12, the thoracolumbar fascia, the iliac crest and the inferior 3 or 4 ribs. The fibres converge into a tendon that inserts into the intertubercular groove of the humerus.Latissimus dorsi is innervated by the thoracodorsal nerve.Latissimus dorsi acts to extend, adduct and medially rotate the humerus. It, therefore, raises the body towards the arm during climbing.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      14.4
      Seconds
  • Question 28 - Which of the following pathogens is most likely to cause an infection in...

    Incorrect

    • Which of the following pathogens is most likely to cause an infection in a chemo patient with significant neutropenia?

      Your Answer: Herpes varicella

      Correct Answer: Candida

      Explanation:

      Chemotherapy that is too aggressive weakens your immune system, putting you at risk for a fungal and many other infection. Neutropenia is a condition in which a person’s neutrophil count is abnormally low. Neutrophils are an infection-fighting type of white blood cell. Neutrophils fight infection by killing bacteria and fungi (yeast) that infiltrate the body. Fungal organisms are significant pathogens in the setting of neutropenia.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      5.4
      Seconds
  • Question 29 - The role of the juxtaglomerular (granular) cells of the juxtaglomerular apparatus is: ...

    Incorrect

    • The role of the juxtaglomerular (granular) cells of the juxtaglomerular apparatus is:

      Your Answer:

      Correct Answer: Production of renin

      Explanation:

      Juxtaglomerular cells synthesise renin. These cells are specialised smooth muscle cells that are located in the walls of the afferent arterioles, and there are some in the efferent arterioles.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
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  • Question 30 - Regarding iron handling, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding iron handling, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Iron is taken across the enterocyte apical membrane by the divalent metal transporter (DMT1).

      Explanation:

      Dietary iron may be in the form of haem or non-haem iron. Haem iron is degraded after absorption through the cell surface to release Fe2+. Most non-haem iron is in the form Fe3+, which is reduced at the luminal surface to the more soluble Fe2+, facilitated by hydrochloric acid in gastric secretions (and enhanced by ascorbic acid). Fe2+is taken across the enterocyte apical membrane by the divalent metal transporter (DMT1). In the enterocyte, Fe2+is then either stored in enterocyte epithelial cells as ferritin, or released into portal plasma via the molecule ferroportin at the basolateral membrane.

    • This question is part of the following fields:

      • Haematology
      • Pathology
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SESSION STATS - PERFORMANCE PER SPECIALTY

Physiology (4/11) 36%
Respiratory (0/1) 0%
Renal (0/4) 0%
Microbiology (1/3) 33%
Specific Pathogen Groups (1/3) 33%
Cardiovascular Pharmacology (0/1) 0%
Pharmacology (0/2) 0%
Evidence Based Medicine (0/1) 0%
Statistics (0/1) 0%
General Pathology (2/3) 67%
Pathology (4/7) 57%
Respiratory Physiology (1/1) 100%
Anatomy (0/4) 0%
Upper Limb (0/2) 0%
Cardiovascular (1/1) 100%
Lower Limb (0/1) 0%
Endocrine (1/1) 100%
Endocrine Physiology (0/1) 0%
Wound Healing (1/1) 100%
Infections (0/1) 0%
Basic Cellular (1/1) 100%
Abdomen And Pelvis (0/1) 0%
Immune Responses (1/2) 50%
Gastrointestinal Physiology (0/1) 0%
Haematology (0/1) 0%
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