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  • Question 1 - A 65-year old patient with altered bowl movement experienced the worsening of shortness...

    Correct

    • A 65-year old patient with altered bowl movement experienced the worsening of shortness of breath and exertional chest pains over the course of 8 weeks. Examination shows pallor and jugular venous distension. Furthermore, a test of the stool for occult blood is positive. Laboratory studies show: Haemoglobin 7.4 g/dl, Mean corpuscular volume 70 fl, Leukocyte count 5400/mm3, Platelet count 580 000/mm3, Erythrocyte sedimentation 33 mm/h.A blood smear shows hypochromic, microcytic RBCs with moderate poikilocytosis. Which of the following is the most likely diagnosis?

      Your Answer: Iron deficiency anaemia

      Explanation:

      Iron deficiency anaemia is the most common type of anaemia. It can occur due to deficiency of iron due to decreased intake or due to faulty absorption. An MCV less than 80 will indicated iron deficiency anaemia. On the smear the RBC will be microcytic hypochromic and will also show piokilocytosis. iron profiles tests are important to make a diagnosis. Clinically the patient will be pale and lethargic.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      31.9
      Seconds
  • Question 2 - The likely cause of a tender and swollen breast in a lactating mother...

    Correct

    • The likely cause of a tender and swollen breast in a lactating mother is:

      Your Answer: Acute mastitis

      Explanation:

      Acute mastitis results due to bacterial infection of the breast and results in signs of inflammation. It commonly occurs 2-3 weeks postpartum and common causative microorganisms are Staphylococcus aureus, Streptococcus species, and Escherichia coli. Complications like an abscess can be avoided by prompt treatment, which includes antibiotics and rest along with continued lactation.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      60.6
      Seconds
  • Question 3 - Which of the given options best describes the metabolic changes which occur following...

    Incorrect

    • Which of the given options best describes the metabolic changes which occur following a severe soft tissue injury sustained after a PVA?

      Your Answer: Protein anabolism

      Correct Answer: Mobilisation of fat stores

      Explanation:

      The following metabolic responses occur following trauma as part of a coping mechanism for the additional stress. These include acid base changes (metabolic acidosis or alkalosis), decrease urine output and osmolality, reduced basal metabolic rate (BMR), gluconeogenesis with amino acid breakdown and shunting, hyponatraemia as a result of impaired functioning of sodium pumps, hypoxic injury, coagulopathies, decreased immunity, increase extracellular fluid and hypovolemic shock, increase permeability leading to oedema, break down and mobilization of fat reserves, pyrexia and reduced circulating levels of albumin.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      115
      Seconds
  • Question 4 - What percentage of cardiac output is delivered to the skin? ...

    Correct

    • What percentage of cardiac output is delivered to the skin?

      Your Answer: 2%

      Explanation:

      Making up 4-5% of total body weight, the skin receives approximately 2% of cardiac output.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      4.1
      Seconds
  • Question 5 - A 66 year old retired judge has recently undergone a wide local excision...

    Correct

    • A 66 year old retired judge has recently undergone a wide local excision and sentinel lymph node biopsy for breast cancer. Which of the factors listed below will provide the most important prognostic information?

      Your Answer: Nodal status

      Explanation:

      Even in the era of gene-expression profiling, the nodal status still remains the primary prognostic discriminant in breast cancer patients. The exclusion of node involvement using non-invasive methods could reduce the rate of axillary surgery, thereby preventing from suffering complications.

      Lymph node status is highly related to prognosis (chances for survival).

    • This question is part of the following fields:

      • Breast And Endocrine Surgery
      • Generic Surgical Topics
      2.5
      Seconds
  • Question 6 - Which of the following arteries branches from the deep femoral artery and courses...

    Correct

    • Which of the following arteries branches from the deep femoral artery and courses between the pectineus and iliopsoas muscles?

      Your Answer: Medical femoral circumflex

      Explanation:

      The medial femoral circumflex artery is an artery in the upper thigh that supplies blood to the head and neck of the femur. It arises from the deep femoral artery and winds around the medial side of the femur. It passes first between pectineus and psoas major, and then between obturator externus and adductor brevis.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      12.9
      Seconds
  • Question 7 - Which of the following factors will not affect the wound healing process in...

    Correct

    • Which of the following factors will not affect the wound healing process in a young women who suffered serious burns to her chest and hands?

      Your Answer: Vitamin A deficiency

      Explanation:

      Healing can be sped-up or slowed down due to various reasons: 1. blood supply, 2. infection, 3. denervation, 4. collection of blood/hematoma, 5. mechanical stress, 6. foreign body, 7. techniques used during surgery and 8. dressing of the wound. Other systemic factors include 1. nutrition e.g. deficiency of zinc, vitamin C, protein deficiency, 2. metabolic status, 3. circulatory status and 4. hormonal influence

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      2.7
      Seconds
  • Question 8 - The gluteus medius muscle: ...

    Correct

    • The gluteus medius muscle:

      Your Answer: Is supplied by the superior gluteal nerve

      Explanation:

      The gluteus medius is situated on the outer surface of the pelvis. It arises from the outer surface of the ilium between the iliac crest and posterior gluteal line above and the anterior gluteal line below. The gluteus medius is supplied by the fourth and fifth lumbar and first sacral nerves through the superior gluteal nerve

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      4.1
      Seconds
  • Question 9 - A patient in the recovery ward after cardiac surgery is noticed to have...

    Correct

    • A patient in the recovery ward after cardiac surgery is noticed to have a small effusion in the lowest extent of the pleural cavity, into which no lung tissue extends. What is the name of this part of the pleural cavity?

      Your Answer: Costodiaphragmatic recess

      Explanation:

      The costodiaphragmatic recess is the part of the pleural cavity where the costal pleura is in continuity with the diaphragmatic pleura. It forms the lowest extent of the pleural cavity.
      Costomediastinal recess: a tiny recess that is anteriorly located, where the costal pleura becomes continuous with the mediastinal pleura.
      The cupola is the pleural cavity that extends above the first rib.
      The inferior mediastinum refers to the posterior, middle and anterior mediastinal divisions together.
      The pulmonary ligament on the other hand, is a pleural fold that is situated beneath the root of the lung on the medial aspect of the lung.
      Oblique pericardial sinus is not part of the pleural cavity.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      8.9
      Seconds
  • Question 10 - Out of the following options, which malignancy has the highest potential for multicentricity?...

    Correct

    • Out of the following options, which malignancy has the highest potential for multicentricity?

      Your Answer: Transitional cell carcinoma

      Explanation:

      Transitional cell carcinomas can arise anywhere in the urothelium lining the urinary tract; and hence are known to be multicentric and recur commonly. Prostatic adenocarcinoma most commonly involves the posterior lobe of the prostate gland. Although renal cell carcinomas occasionally show multicentricity, it is not common. Penile carcinomas are usually locally infiltrative lesions. Wilm’s tumours are usually solitary, but can be bilateral or multicentric in 10% cases. Small cell carcinoma of lung and teratomas are usually solitary.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      6.7
      Seconds
  • Question 11 - Destruction of the ventromedial nucleus of the hypothalamus will result in: ...

    Correct

    • Destruction of the ventromedial nucleus of the hypothalamus will result in:

      Your Answer: Loss of satiety

      Explanation:

      The ventromedial nucleus of the hypothalamus is divided into an anterior and a superior part. The anterior part controls the female sexual drive, whereas the superior part is responsible for satiety. Destruction of the superior part of the nucleus will result in overeating, as no signal tells the body that it is satisfied.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      8.9
      Seconds
  • Question 12 - A 46 year old female who was diagnosed with hypertension complains of numbness...

    Correct

    • A 46 year old female who was diagnosed with hypertension complains of numbness in her right arm and leg. She has no other neurological signs. What is the most likely cause?

      Your Answer: Lacunar infarct

      Explanation:

      Lacunar stroke or lacunar infarct (LACI) is the most common type of ischaemic stroke, and results from the occlusion of small penetrating arteries that provide blood to the brain’s deep structures.

      Types:
      Pure motor stroke/hemiparesis – It is marked by hemiparesis or hemiplegia that typically affects the face, arm, or leg of the side of the body opposite the location of the infarct. Dysarthria, dysphagia, and transient sensory symptoms may also be present.

      Ataxic hemiparesis – It displays a combination of cerebellar and motor symptoms, including weakness and clumsiness, on the ipsilateral side of the body. It usually affects the leg more than it does the arm; hence, it is known also as homolateral ataxia and crural paresis. The onset of symptoms is often over hours or days.

      Dysarthria/clumsy hand – The main symptoms are dysarthria and clumsiness (i.e., weakness) of the hand, which often are most prominent when the patient is writing.

      Pure sensory stroke – Marked by numbness (loss of sensation) on one side of the body; can later develop tingling, pain, burning, or another unpleasant sensation on one side of the body.

      Mixed sensorimotor stroke – This lacunar syndrome involves hemiparesis or hemiplegia (weakness) with sensory impairment in the contralateral side.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Surgical Disorders Of The Brain
      17.3
      Seconds
  • Question 13 - A 25 year-old male patient was brought to the hospital due to a...

    Correct

    • A 25 year-old male patient was brought to the hospital due to a vehicular accident. A skull x-ray was done which revealed a fracture along the base of the middle cranial fossa. The patient has no sense of touch over the skin over his cheek and chin. Injury to the maxillary and the mandibular nerves is suspected. In which foramina do these two affected sensory branches leave the cranial cavity.

      Your Answer: Foramen rotundum and foramen ovale

      Explanation:

      The patient’s clinical manifestations suggests an injury to the maxillary and mandibular nerves. The maxillary branch (V2) of the trigeminal nerve (CN V) passes through and exits the skull via the pterygopalatine fossa and the foramen rotundum. At the base of the skull the foramen ovale (Latin: oval window) is one of the larger of the several holes (the foramina) that transmit nerves through the skull. The foramen ovale is situated in the posterior part of the sphenoid bone, posterolateral to the foramen rotundum. The following structures pass through foramen ovale: mandibular nerve, motor root of the trigeminal nerve, accessory meningeal artery (small meningeal or paradural branch, sometimes derived from the middle meningeal artery), lesser petrosal nerve, a branch of the glossopharyngeal nerve and
      an emissary vein connecting the cavernous sinus with the pterygoid plexus of veins. Occasionally it will also carry the anterior trunk of the middle meningeal vein.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      16
      Seconds
  • Question 14 - The wound healing process is documented in patients undergoing laparoscopic procedures. The port...

    Incorrect

    • The wound healing process is documented in patients undergoing laparoscopic procedures. The port incisions are sutured closed and the wounds observed every few weeks for re-epithelialisation and tensile strength. Which substance is mostly likely to be found at a cellular level involved in wound healing?

      Your Answer: Collagen

      Correct Answer: Tyrosine kinase

      Explanation:

      Cell surface growth factor receptors require intercellular proteins such as tyrosine kinase which are necessary to initiate a series of events that eventually lead to cell division and growth. Tyrosine kinase is an enzyme that transfers a phosphate group to the tyrosine residue in a protein. This phosphorylation will lead to an up regulation of the enzyme activity.
      Fibronectin acts in the extracellular matrix to bind macromolecules (such as proteoglycans) via integrin receptors to aid attachment and migration of cells.
      Laminin is an extracellular matrix component that is abundant in basement membranes.
      Hyaluronic acid is one of the proteoglycans in the extracellular matrix.
      Collagen fibres are part of the extracellular matrix that gives strength and stability to connective tissues.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      48.4
      Seconds
  • Question 15 - The prostatic plexus of nerves contains nerve fibres that innervate penile tissue allowing...

    Correct

    • The prostatic plexus of nerves contains nerve fibres that innervate penile tissue allowing for erection. From which of the following nerves do these fibres originate?

      Your Answer: Pelvic splanchnics

      Explanation:

      Pelvic splanchnic nerves are examples of the parasympathetic nerves that innervate the smooth muscle and glands of the pelvic viscera. They are also the nerves contributing fibres to the prostatic plexus which innervate penile erectile tissue.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      10.2
      Seconds
  • Question 16 - During a clinical rotation in the ENT clinic, you observe a flexible bronchoscopy....

    Correct

    • During a clinical rotation in the ENT clinic, you observe a flexible bronchoscopy. As the scope is passed down the trachea, you see a cartilaginous structure that resembles a ship's keel and separates the right and the left main stem bronchi. This structure is the:

      Your Answer: Carina

      Explanation:

      The carina (a keel-like cartilage) is found at the bifurcation of the trachea separating the right from the left main stem bronchi. It is a little more to the left than to the right.
      The cricoid cartilage is the inferior and posterior cartilage of the larynx.
      The costal cartilage on the other hand elongates the ribs anteriorly and contribute to the elasticity of the thoracic cage.
      The pulmonary ligament is a fold of pleura located below the root of the lung.
      Tracheal rings are rings of cartilage that support the trachea.
      Peritracheal fascia is a layer of connective tissue that invests the trachea from the outside and is not visible on bronchoscopy.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      3.6
      Seconds
  • Question 17 - Which is a feature of the action of insulin? ...

    Correct

    • Which is a feature of the action of insulin?

      Your Answer: Promotes protein synthesis

      Explanation:

      Insulin is produced by the beta-cells of the islets of Langerhans in the pancreas. Its actions include:
      – promoting uptake of glucose into cells
      – glycogen synthesis (glycogenesis)
      – protein synthesis
      – stimulation of lipogenesis (fat formation).
      – driving potassium into cells – used to treat hyperkaelamia.
      Parathyroid hormone and activated vitamin D are the principal hormones involved in calcium/phosphate metabolism, rather than insulin.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      12.8
      Seconds
  • Question 18 - What is the normal duration of PR interval on an electrocardiogram of a...

    Correct

    • What is the normal duration of PR interval on an electrocardiogram of a healthy individual?

      Your Answer: 0.12–0.20 s

      Explanation:

      PR interval extends from the beginning of the P-wave until the beginning of the QRS complex. The normal duration of the PR interval is 0.12-0.20 s. It can be prolonged in first degree heart block, and reduced in Wolff-Parkinson-White syndrome.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      7.2
      Seconds
  • Question 19 - A 32-year-old motorist was involved in a road traffic accident in which he...

    Correct

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

      Your Answer: Aortic transection

      Explanation:

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

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

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

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

    • This question is part of the following fields:

      • Emergency Medicine And Management Of Trauma
      • Principles Of Surgery-in-General
      6.4
      Seconds
  • Question 20 - A 37 year old man is reported to have a left-sided renal mass....

    Correct

    • A 37 year old man is reported to have a left-sided renal mass. Imaging reveals a renal tumour measuring 5 cm that has invaded the left renal vein. Which of the following is the most appropriate step in the management of this patient?

      Your Answer: Radical nephrectomy

      Explanation:

      In a radical nephrectomy, the surgeon removes the whole kidney, the fatty tissues surrounding the kidney and a portion of the tube connecting the kidney to the bladder (ureter). The surgeon may remove the adrenal gland that sits atop the kidney if a tumour is close to or involves the adrenal gland. Radical nephrectomy is the treatment of choice for localized renal cell carcinoma (RCC). Biopsy should not be performed when a nephrectomy is planned but is mandatory before any ablative therapies are undertaken.

      Renal cell carcinoma comprise up to 85% of all renal malignancies. Males are more commonly affected than females and sporadic tumours typically affect patients in their sixth decade.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Urology
      17.5
      Seconds
  • Question 21 - In an anatomy demonstration, the instructor asked one of the medical students to...

    Correct

    • In an anatomy demonstration, the instructor asked one of the medical students to pass his index finger inferior to the root of the left lung. The student notices that his finger is blocked by a structure. Which structure do you think is responsible for this?

      Your Answer: Pulmonary ligament

      Explanation:

      The pulmonary ligament is dual layer of pleura stretching from the inferior part of the hilar reflection toward the diaphragm.
      The costodiaphragmatic recess is the cavity at the inferior border of the lung where the costal pleura becomes the diaphragmatic pleura.
      The cupola: is part of the pleura that extends superiorly above the first rib and has no association with the root of the lung.
      Inferior vena cava is located in the mediastinum, not near the root of the lung.
      Left pulmonary veins being part of the root of the lung, would not block access to behind the lung. Costomediastinal recess is the part of the pleura where the costal pleura become the mediastinal pleura.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      18.7
      Seconds
  • Question 22 - A 31 year old rugby player is brought to the ER after being...

    Correct

    • A 31 year old rugby player is brought to the ER after being crushed in a scrum. He briefly lost consciousness, regained it and collapsed again. On arrival, his GCS was noted to be 6/15 with dilatation of the left pupil. What would be the best definitive management in his case?

      Your Answer: Parietotemporal craniotomy

      Explanation:

      Epidural hematoma (EDH) is a traumatic accumulation of blood between the inner table of the skull and the stripped-off dural membrane. EDH results from a traumatic head injury, usually with an associated skull fracture and arterial laceration. The inciting event often is a focused blow to the head, such as that produced by a hammer or baseball bat. In 85-95% of patients, this type of trauma results in an overlying fracture of the skull. Blood vessels in close proximity to the fracture are the sources of the haemorrhage in the formation of an epidural hematoma. Because the underlying brain has usually been minimally injured, prognosis is excellent if treated aggressively. Outcome from surgical decompression and repair is related directly to patient’s preoperative neurologic condition.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Surgical Disorders Of The Brain
      12.5
      Seconds
  • Question 23 - A 35-year-old male presents to the urology department for investigation of pyelonephritis. He...

    Correct

    • A 35-year-old male presents to the urology department for investigation of pyelonephritis. He reports malaise, pyrexia, lymphadenopathy, and a maculopapular rash. The monospot test is negative. Due to a given history of recent high-risk sexual behaviour, you are asked to exclude HIV seroconversion illness in this patient. Which of the following should be the most appropriate investigation?

      Your Answer: p24 antigen test

      Explanation:

      P24 antigen test is used as one of the main investigations in diagnosing HIV seroconversion illness.

      Some people experience a short illness soon after they contract HIV. This is known as seroconversion illness, or primary or acute HIV infection. It is the period when someone with HIV is at their most infectious.

      HIV seroconversion is symptomatic in 60%–80% of the patients and typically presents as a glandular fever-type illness. Increased symptomatic severity is associated with poorer long-term prognosis. It typically occurs 2–3 weeks after contracting the virus.

      Signs and symptoms include:
      1. Sore throat
      2. Malaise, myalgia, and arthralgia
      3. Diarrhoea
      4. Maculopapular rash
      5. Oral ulcers
      6. Lymphadenopathy
      7. Meningoencephalitis (rarely)

      HIV PCR and p24 antigen test can confirm the diagnosis. The former is the most common and accurate test and consists of both a screening ELISA and a confirmatory western blot assay. P24 antigen test is also used as the mainstay of diagnosis and is usually positive from about 1 week to 3–4 weeks after an infection with HIV.

    • This question is part of the following fields:

      • Clinical Microbiology
      • Principles Of Surgery-in-General
      18.5
      Seconds
  • Question 24 - A 14 year old girl suffers from haemophilia A and chronic knee pain...

    Incorrect

    • A 14 year old girl suffers from haemophilia A and chronic knee pain with progressive swelling and deformity over the last 4 years. Test results reveal a significantly reduced factor VIII activity. Which of the following is seen in the knee joint space after an acute painful episode?

      Your Answer: Charcot Leyden crystals

      Correct Answer: Cholesterol crystals

      Explanation:

      Due to breakdown of the red blood cell membrane in haemophilic patients, cholesterol crystals are formed by the lipids. On the other hand lipofuscin deposition does not occur in haemolysis or haemorrhage. Neutrophil accumulation suggests acute inflammation. Anthracotic pigment is an exogenous carbon pigment that deposits in the lung from dust. Russell bodies are intracellular accumulations of immunoglobins in plasma cells. Curschmann’s spirals and Charcot Leyden crystals are pathognomonic of asthma.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      16.4
      Seconds
  • Question 25 - A 50-year-old male is due to undergo laparotomy for small bowel obstruction. What...

    Correct

    • A 50-year-old male is due to undergo laparotomy for small bowel obstruction. What is the best option for maintaining his airway?

      Your Answer: Insertion of cuffed endotracheal tube

      Explanation:

      Patients with bowel obstruction who have either been vomiting or at high risk of regurgitation of gastric contents on the induction of anaesthesia. Aspiration of stomach contents from the pharynx is prevented by sealing off the airway. This is achieved by passing a cuffed endotracheal tube and the patient is in considerable danger from the moment consciousness is lost until this has been done. All methods of inducing general anaesthesia in intestinal obstruction rely on the speedy insertion of such a tube, and the anaesthetist must ensure pre-operatively that the patient can be intubated.
      Cricoid pressure. As soon as the patient loses consciousness, an assistant exerts firm backwards pressure on the cricoid cartilage, obliterating the oesophageal lumen. This prevents regurgitated fluids from entering the pharynx from below, it prevents anaesthetic gases from entering (and distending) the stomach from above, and it facilitates intubation by pushing the larynx posteriorly.

    • This question is part of the following fields:

      • Post-operative Management And Critical Care
      • Principles Of Surgery-in-General
      4.9
      Seconds
  • Question 26 - The posterior cord contains nerve fibres from which of the following levels of...

    Incorrect

    • The posterior cord contains nerve fibres from which of the following levels of the spinal cord?

      Your Answer: C5, C6 and C7

      Correct Answer: C5, C6, C7, C8 and T1

      Explanation:

      THE correct answer is A. The posterior cord derives its fibres from the spinal nerves C5,C6,C7,C8,T1. This cord is formed from the fusion of the posterior divisions of the upper, lower, and middle trunks.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      8.1
      Seconds
  • Question 27 - A 19 year old female presents with a firm mobile mass in the...

    Correct

    • A 19 year old female presents with a firm mobile mass in the upper outer quadrant of her left breast. Which of the following could be the underlying disease process?

      Your Answer: Fibroadenoma

      Explanation:

      A fibroadenoma is a painless, unilateral, benign (non-cancerous) breast tumour that is a solid, not fluid-filled, lump. It occurs most commonly in women between the age of 14 to 35 years but can be found at any age. Fibroadenomas shrink after menopause, and therefore, are less common in post-menopausal women. Fibroadenomas are often referred to as a breast mouse due to their high mobility. Fibroadenomas are a marble-like mass comprising both epithelial and stromal tissues located under the skin of the breast. These firm, rubbery masses with regular borders are often variable in size.

      Duct ectasia, also known as mammary duct ectasia, is a benign (non-cancerous) breast condition that occurs when a milk duct in the breast widens and its walls thicken. This can cause the duct to become blocked and lead to fluid build-up. It’s more common in women who are getting close to menopause. But it can happen after menopause, too.

      Fat necrosis is a benign condition and does not increase the risk of developing breast cancer. It can occur anywhere in the breast and can affect women of any age. Men can also get fat necrosis, but this is very rare.

      Breast cysts are a benign condition. They’re one of the most common causes of a breast lump, and can develop in either one or both breasts. It’s thought they develop naturally as the breast changes with age due to normal changes in hormone levels. It’s common to have more than one cyst. Breast cysts can feel soft or hard and can be any size, ranging from a few millimetres to several centimetres. They’re usually oval or round in shape and can develop quickly.

      Atypical hyperplasia is a precancerous condition that affects cells in the breast. Atypical hyperplasia describes an accumulation of abnormal cells in the breast.

    • This question is part of the following fields:

      • Breast And Endocrine Surgery
      • Generic Surgical Topics
      5.8
      Seconds
  • Question 28 - A patient who following 20 years of working in the asbestos industry develops...

    Correct

    • A patient who following 20 years of working in the asbestos industry develops malignant mesothelioma and is scheduled for pleuropneumonectomy to remove the entire pleura and lung on the affected side. Which layer would provide a natural cleavage plane for surgical separation of the costal pleura from the thoracic wall?

      Your Answer: Endothoracic fascia

      Explanation:

      The endothoracic fascia is connective tissue that is between the costal parietal pleura and the inner aspect of the chest wall. Removing this layer of connective tissue would make it easy to separate the costal pleura from the thoracic wall.
      Deep fascia: is not found around the lungs. It is a layer of connective tissue that invests a muscle or a group of muscles.
      Parietal pleura: part of the pleura that lines the inner surface of the chest/thoracic cavity.
      Visceral pleura: is the serous membrane that lines the surface of the lungs.
      Transversus thoracis muscle fascia is associated only with the muscle transversus thoracis.
      Peritracheal fascia: a layer of connective tissue that invests the trachea. It is not associated with the thoracic wall or the costal pleura.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      33
      Seconds
  • Question 29 - Which of the following conditions is characterized by generalised oedema due to effusion...

    Correct

    • Which of the following conditions is characterized by generalised oedema due to effusion of fluid into the extracellular space?

      Your Answer: Anasarca

      Explanation:

      Anasarca (or ‘generalised oedema’) is a condition characterised by widespread swelling of the skin due to effusion of fluid into the extracellular space. It is usually caused by liver failure (cirrhosis of the liver), renal failure/disease, right-sided heart failure, as well as severe malnutrition/protein deficiency.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      18.9
      Seconds
  • Question 30 - A urologist makes a transverse suprapubic incision to retrieve a stone from the...

    Correct

    • 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: 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
      8.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Basic Sciences (18/22) 82%
Physiology (6/6) 100%
Pathology (3/6) 50%
Breast And Endocrine Surgery (2/2) 100%
Generic Surgical Topics (5/5) 100%
Anatomy (9/10) 90%
Surgical Disorders Of The Brain (2/2) 100%
Emergency Medicine And Management Of Trauma (1/1) 100%
Principles Of Surgery-in-General (3/3) 100%
Urology (1/1) 100%
Clinical Microbiology (1/1) 100%
Post-operative Management And Critical Care (1/1) 100%
Passmed