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  • Question 1 - During a splenectomy procedure of a 45-year old male patient with a bleeding...

    Incorrect

    • During a splenectomy procedure of a 45-year old male patient with a bleeding ruptured spleen, the surgeon decided to clamp the splenic artery near the coeliac trunk to stop the bleeding. Which of the following organ/s parts will be least affected by the clamping?

      Your Answer: Greater omentum

      Correct Answer: Duodenum

      Explanation:

      The duodenum is the only organ in the list that would not be affect by the clumping of the splenic artery as it is supplied by common hepatic artery (through the gastroduodenal artery) and the superior mesenteric artery (through the inferior pancreaticoduodenal artery). The splenic artery is the artery that supplies the spleen with oxygenated blood. The splenic artery before reaching the spleen also gives off branches that supply the stomach and the pancreas. The greater curvature and the fundus of the stomach is supplied the short gastric artery which branches off from the splenic artery. The left portion of the greater curvature of the stomach together with the greater omentum is supplied by the left gastro-omental artery of the splenic artery. The body and tail of the pancreas is supplied by branches of the splenic artery through the dorsal and superior pancreatic arteries and the caudal pancreatic arteries respectively.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      359.2
      Seconds
  • Question 2 - A 3 year old boy is taken to the doctor by his mother...

    Incorrect

    • 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: Anal fissure

      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.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Paediatric Surgery
      84.1
      Seconds
  • Question 3 - The Brunner glands secrete an alkaline product that helps maintain an optimal pH...

    Correct

    • The Brunner glands secrete an alkaline product that helps maintain an optimal pH for pancreatic enzyme activity. Where are these glands located?

      Your Answer: Submucosa of the duodeneum

      Explanation:

      The Brunner glands are located in the submucosa of the duodenum. These glands are connected to the interstitial lumen by ducts that open into certain crypts. They secrete an alkaline product that protects the duodenal mucosa from the acidic chyme and helps achieve an optimal pH for the enzymes.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      89.3
      Seconds
  • Question 4 - A blood sample of a 58 year old male patient, who underwent an...

    Incorrect

    • A blood sample of a 58 year old male patient, who underwent an abdominal aortic aneurysm repair, was sent to the laboratory. The laboratory technician said that the patient’s blood agglutinates with antisera anti-A and anti-D, while the patient’s serum agglutinates cells of blood group B. What is the blood group of this patient?

      Your Answer: A negative D

      Correct Answer: A positive

      Explanation:

      Group A – has only the A antigen on red cells (and B antibody in the plasma)
      Group B – has only the B antigen on red cells (and A antibody in the plasma)
      Group AB – has both A and B antigens on red cells (but neither A nor B antibody in the plasma)
      Group O – has neither A nor B antigens on red cells (but both A and B antibody are in the plasma). Many people also have a so-called Rh factor on the red blood cell’s surface. This is also an antigen and those who have it are called Rh+. A person with Rh– blood does not have Rh antibodies naturally in the blood plasma (as one can have A or B antibodies, for instance) but they can develop Rh antibodies in the blood plasma if they receive blood from a person with Rh+ blood, whose Rh antigens can trigger the production of Rh antibodies. A person with Rh+ blood can receive blood from a person with Rh– blood without any problems. In this scenario the person has blood group A+ as he has A antigen, anti B antibody and Rh antigen

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      385.4
      Seconds
  • Question 5 - A 25-year-old man is involved in vigorous intercourse and suddenly feels a snap....

    Correct

    • A 25-year-old man is involved in vigorous intercourse and suddenly feels a snap. His penis becomes swollen and painful immediately after. The admitting surgeon suspects a penile fracture. Which of the following is the most appropriate initial management?

      Your Answer: Immediate surgical exploration

      Explanation:

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

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

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

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Urology
      40.1
      Seconds
  • Question 6 - Which of the following bones was most likely fractured following an injury in...

    Correct

    • Which of the following bones was most likely fractured following an injury in the medial side of the foot between the navicular behind and base of the first metatarsal in front?

      Your Answer: First cuneiform

      Explanation:

      The first cuneiform bone is the largest of the three cuneiforms. It is situated at the medial side of the foot, between the navicular behind and the base of the first metatarsal in front.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      98.9
      Seconds
  • Question 7 - A 60-year old patient having a history of cholelithiasis that led to recurrent...

    Incorrect

    • A 60-year old patient having a history of cholelithiasis that led to recurrent pain, bloating, nausea and vomiting, was scheduled for surgery to have the gallbladder removed. During the cholecystectomy, the SHO conducting the procedure accidentally punctured a blood vessel that lied immediately posterior to the omental foramen and blood filled the operating field. Which of the following blood vessels was the one likely punctured?

      Your Answer: Aorta

      Correct Answer: Inferior vena cava

      Explanation:

      The omental foramen is the pathway that connects the greater peritoneal sac and the lesser peritoneal sac. The omental foramen is bordered posteriorly by the inferior vena cava. This is the blood vessel that would most likely be punctured. The aorta and its branch, the renal artery, lie postero-lateral to the omental foramen and are deeper than the inferior vena cava hence making them less likely to be injured. The hepatic portal vein, the hepatic artery and the superior mesenteric vein borders the omental foramen anteriorly and would not be injured by a jab on the posterior border of the omental foramen. Finally, the splenic artery is found in the splenorenal ligament that borders the omental foramen laterally to the left.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      2066.6
      Seconds
  • Question 8 - A patient is diagnosed with a tumour of the parotid gland. During surgical...

    Incorrect

    • A patient is diagnosed with a tumour of the parotid gland. During surgical removal of the gland, which artery is vulnerable to injury?

      Your Answer: Main trunk of cranial nerve VIII

      Correct Answer: External carotid artery

      Explanation:

      The external carotid artery is a major artery of the head and neck. It arises from the common carotid artery when it splits into the external and internal carotid artery. It supplies blood to the face and neck. The external carotid artery begins opposite the upper border of the thyroid cartilage and, taking a slightly curved course, passes upward and forward and then inclines backward to the space behind the neck of the mandible, where it divides into the superficial temporal and internal maxillary arteries. It rapidly diminishes in size in its course up the neck, owing to the number and large size of the branches given off from it. At its origin, this artery is more superficial and placed nearer the midline than the internal carotid and is contained within the carotid triangle. The external carotid artery is covered by the skin, superficial fascia, platysma, deep fascia and anterior margin of the sternocleidomastoid. It is crossed by the hypoglossal nerve, by the lingual, ranine, common facial and superior thyroid veins; and by the digastric and stylohyoid; higher up it passes deeply into the substance of the parotid gland, where it lies deep to the facial nerve and the junction of the temporal and internal maxillary veins. It is here that it is in danger during surgery of the parotid gland.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      15.6
      Seconds
  • Question 9 - The mechanism of action of streptokinase involves: ...

    Correct

    • The mechanism of action of streptokinase involves:

      Your Answer: Direct conversion of plasminogen to plasmin

      Explanation:

      Streptokinase is an enzyme that is produced by group A beta haemolytic streptococcus and is an effective and cost efficient method for the dissolution of a clot used in cases of MI and pulmonary embolism. It works by directly converting plasminogen to plasmin which breaks down the blood components in the clot and fibrin, dissolving the clot. Streptokinase is a bacterial product and thus the body will develop immunity against it.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      56.1
      Seconds
  • Question 10 - A 53-year-old woman is diagnosed with cellulitis surrounding her leg ulcer. A swab...

    Incorrect

    • A 53-year-old woman is diagnosed with cellulitis surrounding her leg ulcer. A swab is taken and oral flucloxacillin is started. The following result is obtained:

      Your Answer:

      Correct Answer: Add penicillin

      Explanation:

      Streptococci may be divided into alpha and beta haemolytic types

      Alpha haemolytic streptococci

      The most important alpha haemolytic streptococcus is Streptococcus pneumoniae (pneumococcus). Pneumococcus is a common cause of pneumonia, meningitis and otitis media. Another clinical example is Streptococcus viridans

      Beta haemolytic streptococci

      These can be subdivided into group A and B

      Group A

      most important organism is Streptococcus pyogenes
      responsible for erysipelas, impetigo, cellulitis, type 2 necrotizing fasciitis and pharyngitis/tonsillitis
      immunological reactions can cause rheumatic fever or post-streptococcal glomerulonephritis
      erythrogenic toxins cause scarlet fever

      Group B

      Streptococcus agalactiae may lead to neonatal meningitis and septicaemia

    • This question is part of the following fields:

      • Clinical Microbiology
      • Principles Of Surgery-in-General
      0
      Seconds
  • Question 11 - A 39-year-old woman who is a known case of acute myeloid leukaemia requires...

    Incorrect

    • A 39-year-old woman who is a known case of acute myeloid leukaemia requires venous access for chemotherapy. Which of the following is the best option?

      Your Answer:

      Correct Answer: Groshong line

      Explanation:

      Chemotherapy for acute myeloid leukaemia (AML) requires long-term therapy and multiple blood tests. Therefore, an indwelling device, such as Groshong line, is preferable.

      Tunnelled lines such as Groshong and Hickman lines are popular devices for patients with long-term therapeutic requirements. These devices are usually inserted, using ultrasound guidance, into the internal jugular vein and then tunnelled under the skin. A cuff of woven material is sited near the end and helps to anchor the device into the tissues. These cuffs require formal dissection to allow the device to be removed.

    • This question is part of the following fields:

      • Peri-operative Care
      • Principles Of Surgery-in-General
      0
      Seconds
  • Question 12 - A 45-year old with sarcoidosis has enlarged tracheobronchial lymph nodes. Which nerve is...

    Incorrect

    • A 45-year old with sarcoidosis has enlarged tracheobronchial lymph nodes. Which nerve is most likely to be irritated in this patient?

      Your Answer:

      Correct Answer: Left recurrent laryngeal

      Explanation:

      Tracheobronchial lymph nodes are located at the bifurcation of the trachea and are in three groups i.e. the right superior, left superior and inferior. The aorta arches over the left bronchus near the point of tracheal bifurcation. Thus, the nerves that are closely associated with the aorta might be irritated if these nodes become inflamed. The left recurrent laryngeal nerve is such a nerve. The phrenic nerves, both the left and the right, are lateral and thus would not be affected. The right recurrent nerve loops around the right subclavian artery and is distant from this area. The right vagus artery is not associated with the aorta and the sympathetic chain is located in the posterior chest parallel to the vertebra, also not associated with the tracheobronchial tree.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 13 - What is the normal duration of the ST segment? ...

    Incorrect

    • What is the normal duration of the ST segment?

      Your Answer:

      Correct Answer: 0.08 s

      Explanation:

      The ST segment lies between the QRS complex and the T-wave. The normal duration of the ST segment is 0.08 s. ST-segment elevation or depression may indicate myocardial ischaemia or infarction.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds
  • Question 14 - A patient presents with loss of fine touch and sense of proprioception in...

    Incorrect

    • A patient presents with loss of fine touch and sense of proprioception in the lower part of the body (below T6). He is likely to have a lesion involving:

      Your Answer:

      Correct Answer: Gracile nucleus

      Explanation:

      The gracile nucleus is located in the medulla oblongata and is one of the dorsal column nuclei involved in the sensation of fine touch and proprioception. It contains second-order neurons of the dorsal column–medial lemniscus system, that receive inputs from sensory neurones of the dorsal root ganglia and send axons that synapse in the thalamus.
      The gracile nucleus and fasciculus carry epicritic, kinaesthetic and conscious proprioceptive information from the lower part of the body (below the level of T6 in the spinal cord). Similar information from the upper part of body (above T6, except for face and ear) is carried by the cuneate nucleus and fasciculus. The information from face and ear is carried by the primary sensory trigeminal nucleus.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds
  • Question 15 - After surgery, a patient developed a stitch granuloma . Which leukocyte in the...

    Incorrect

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

      Your Answer:

      Correct Answer: Monocyte

      Explanation:

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

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds
  • Question 16 - Regarding the posterior compartment of the leg, which is correct? ...

    Incorrect

    • Regarding the posterior compartment of the leg, which is correct?

      Your Answer:

      Correct Answer: The muscles plantarflex the foot and are innervated by the tibial nerve

      Explanation:

      The muscles of the back of the leg are subdivided into two groups: superficial and deep. Superficial muscles include gastrocnemius, soleus and plantaris. Deep muscles include tibialis posterior, flexor hallucis longus, flexor digitorum longus and popliteus. The superficial ( calf muscles) which are responsible for plantarflexion of the foot are supplied by the tibial nerve as follows: the gastrocnemius and soleus muscles are supplied by the first and second sacral nerves and the plantaris by the fourth and fifth lumbar and first sacral nerve (the tibial nerve).

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 17 - A patient who has used NSAIDS for many years presents to the A&E...

    Incorrect

    • A patient who has used NSAIDS for many years presents to the A&E with symptoms of acute haemorrhagic shock. An emergency endoscopy is done that shows that a duodenal ulcer has perforated the posterior wall of the first part of the duodenum. Which artery is most likely to be the cause of the haemorrhage?

      Your Answer:

      Correct Answer: Gastroduodenal

      Explanation:

      The gastroduodenal artery is a branch of the hepatic artery and descends near the pylorus between the first part of the duodenum and the neck of the pancreas to divide at the lower border of the duodenum into the right gastroepiploic and pancreaticoduodenal arteries. Before it divides, it gives off a few branches to the pyloric end of the stomach and to the pancreas. The artery that is most likely involved in this situation is the gastroduodenal artery since it is posterior to the first part of the duodenum.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 18 - A 24-year old patient diagnosed with a direct inguinal hernia was scheduled for...

    Incorrect

    • A 24-year old patient diagnosed with a direct inguinal hernia was scheduled for surgery to have the hernia repaired. The hernia was discovered to be protruding through the Hesselbach's triangle (inguinal triangle). Which of the following blood vessels that is a branch of the external iliac artery forms the lateral border of this triangle?

      Your Answer:

      Correct Answer: Inferior epigastric

      Explanation:

      The inguinal triangle is formed by the following structures; inguinal ligament at the base; inferior epigastric vessels laterally and the lateral border of the rectus sheath medially. This triangle (also known as Hesselebach’s triangle) is where direct inguinal hernias protrude. The inferior epigastric artery is this the branch of the external iliac artery being referred to. All the other blood vessels are branches of the internal iliac artery.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 19 - Which muscle would be affected most following injury to the transverse cervical artery?...

    Incorrect

    • Which muscle would be affected most following injury to the transverse cervical artery?

      Your Answer:

      Correct Answer: Trapezius

      Explanation:

      The latissimus dorsi receives blood from the thoracodorsal artery, the supraspinatus receives its blood from the suprascapular artery, the levator scapulae and the rhomboids are supplied by the dorsal scapular artery and the transverse cervical artery supplies blood to the trapezius.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 20 - The transverse colon has two curvatures known as the colic flexures on each...

    Incorrect

    • The transverse colon has two curvatures known as the colic flexures on each side of its lateral ends, the right and left. The left colic flexure found on the side of the descending colon is attached to an organ superiorly by a mesenteric ligament. Which organ is this?

      Your Answer:

      Correct Answer: Spleen

      Explanation:

      The left colic flexure is the bend of the transverse colon as it continues to form the descending colon on the left upper quadrant. The spleen is located on the superior aspect of the left colic flexure. It is commonly referred to as the splenic flexure because of its relation o the spleen superiorly.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 21 - Which of the following accumulates within a cell due to the aging process?...

    Incorrect

    • Which of the following accumulates within a cell due to the aging process?

      Your Answer:

      Correct Answer: Lipofuscin

      Explanation:

      Lipofuscin , also known as lipochrome, is a wear and tear pigment or an aging pigment. It represents free radical injury or lipid peroxidation. On microscopic examination is appears as a yellowish brown pigment around the nucleus (perinuclear pigment). It is often seen in cells which are undergoing regressive changes, commonly in the liver and heart of old patients or patients with cancer, cachexia or severe malnutrition.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 22 - A 21-year-old woman presents with intermittent diarrhoea for the past eight months and...

    Incorrect

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

      Your Answer:

      Correct Answer: Laxative abuse

      Explanation:

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

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

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

    • This question is part of the following fields:

      • Colorectal Surgery
      • Generic Surgical Topics
      0
      Seconds
  • Question 23 - A 53 year old male presents with generalised right upper quadrant pain which...

    Incorrect

    • A 53 year old male presents with generalised right upper quadrant pain which started from the previous day. On admission, he is septic and jaundiced and there is tenderness in the right upper quadrant. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Cholangitis

      Explanation:

      Acute cholangitis is a bacterial infection superimposed on an obstruction of the biliary tree most commonly from a gallstone, but it may be associated with neoplasm or stricture. The classic triad of findings is right upper quadrant (RUQ) pain, fever, and jaundice. A pentad may also be seen, in which mental status changes and sepsis are added to the triad.

      A spectrum of cholangitis exists, ranging from mild symptoms to fulminant overwhelming sepsis. Thus, therapeutic options for patient management include broad-spectrum antibiotics and, potentially, emergency decompression of the biliary tree.
      The main factors in the pathogenesis of acute cholangitis are biliary tract obstruction, elevated intraluminal pressure, and infection of bile. A biliary system that is colonized by bacteria but is unobstructed, typically does not result in cholangitis. It is believed that biliary obstruction diminishes host antibacterial defences, causes immune dysfunction, and subsequently increases small bowel bacterial colonization. Although the exact mechanism is unclear, it is believed that bacteria gain access to the biliary tree by retrograde ascent from the duodenum or from portal venous blood. As a result, infection ascends into the hepatic ducts, causing serious infection. Increased biliary pressure pushes the infection into the biliary canaliculi, hepatic veins, and perihepatic lymphatics, leading to bacteraemia (25-40%). The infection can be suppurative in the biliary tract.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Hepatobiliary And Pancreatic Surgery
      0
      Seconds
  • Question 24 - What's the nodal stage of a testicular seminoma if several lymph nodes between...

    Incorrect

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

      Your Answer:

      Correct Answer: N2

      Explanation:

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

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 25 - A 32-year-old man presents with aching pain and discomfort in his right testicle....

    Incorrect

    • A 32-year-old man presents with aching pain and discomfort in his right testicle. He has generally been feeling unwell for the past 48 hours as well. On examination, tenderness of the right testicle and an exaggerated cremasteric reflex has been found. What should be the appropriate course of action?

      Your Answer:

      Correct Answer: Administration of antibiotics

      Explanation:

      This is likely a case of epididymo-orchitis which usually occurs due to infection with gonorrhoea or chlamydia in this age group (<35 years). Epididymo-orchitis is an acute inflammation of the epididymis and often involves the testis. It is usually caused by bacterial infection which spreads from the urethra or bladder. Amiodarone is a recognised non-infective cause of epididymitis, which resolves on stopping the drug. On examination, tenderness is usually confined to the epididymis, which may facilitate differentiating it from torsion where pain usually affects the entire testis.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Urology
      0
      Seconds
  • Question 26 - A child presents with hypertension. Serum potassium analysis shows hypokalaemia. What is the...

    Incorrect

    • A child presents with hypertension. Serum potassium analysis shows hypokalaemia. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Liddle syndrome

      Explanation:

      Liddle’s syndrome,  is an autosomal dominant disorder, that is characterized by early, and frequently severe, high blood pressure associated with low plasma renin activity, metabolic alkalosis, low blood potassium, and normal to low levels of aldosterone. Liddle syndrome involves abnormal kidney function, with excess reabsorption of sodium and loss of potassium from the renal tubule. Bartter Syndrome also presents with hypokalaemia, however blood pressure of these patients is usually low or normal.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 27 - A Jewish man was diagnosed with haemophilia C. Which of the following factors...

    Incorrect

    • A Jewish man was diagnosed with haemophilia C. Which of the following factors is deficient in this form of haemophilia?

      Your Answer:

      Correct Answer: Factor XI

      Explanation:

      Haemophilia C, also known as plasma thromboplastin antecedent (PTA) deficiency or Rosenthal syndrome, is a condition caused by the deficiency of the coagulation factor XI. The condition is rare and it is usually found in Ashkenazi Jews.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 28 - A 6 year-old boy is brought to you coughing. He is suspected to...

    Incorrect

    • A 6 year-old boy is brought to you coughing. He is suspected to have aspirated a Lego piece which he was seen playing with. Where would you expect the piece to be?

      Your Answer:

      Correct Answer: Right main bronchus

      Explanation:

      Inhaled objects are more likely to enter the right lung for several reasons. First the right bronchus is shorter, wider and more vertical than the left bronchus. Also, the carina (a ridge-like structure at the point of tracheal bifurcation) is set a little towards the left. The terminal bronchiole is a very small space and impossible for the seed to lodge here.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 29 - A 70-year old man had had a large indirect inguinal hernia for 3...

    Incorrect

    • A 70-year old man had had a large indirect inguinal hernia for 3 years. He presents at the out patient clinic complaining of pain in the scrotum. There is, however, no evidence of obstruction or inflammation. You conclude that the hernial sac is most probably compressing the:

      Your Answer:

      Correct Answer: Ilioinguinal nerve

      Explanation:

      The ilioinguinal nerve arises together with the iliohypogastric nerve from the first lumbar nerve to emerge from the lateral border of the psoas major muscle just below the iliohypogastric and passing obliquely across the quadratus lumborum and iliacus muscles. It perforates the transversus abdominis, near the anterior part of the iliac crest and communicates with the iliohypogastric nerve between the internal oblique and the transversus. It then pierces the internal oblique to distribute filaments to it and accompanying the spermatic cord through the subcutaneous inguinal ring, is distributed to the skin of the upper and medial parts of the thigh, the skin over the root of the penis and the upper part of the scrotum in man and to the skin covering the mons pubis and labium majus in the woman. As the ilioinguinal nerve runs through the inguinal canal, it could easily be compressed by a hernial sac.
      The femoral branch of genitofemoral nerve provides sensory innervation of the upper medial thigh.
      The femoral nerve innervates the compartment of the thigh and also has some cutaneous sensory branches to the thigh.
      The iliohypogastric nerve innervates the skin of the lower abdominal wall, upper hip and upper thigh. The subcostal nerve innervates the skin of the anterolateral abdominal wall and the anterior scrotal nerve is a terminal branch of the ilioinguinal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 30 - A 65-year old gentleman presents to the clinic with chronic back pain and...

    Incorrect

    • A 65-year old gentleman presents to the clinic with chronic back pain and weight loss. His blood count shows a white blood cell count of 10 × 109/l, with a differential count of 66 polymorphonuclear leukocytes, 7 bands, 3 metamyelocytes, 3 myelocytes, 14 lymphocytes, 7 monocytes, and 5 nucleated red blood cells. The haemoglobin is 13 g/dl with a haematocrit of 38.1%, a mean corpuscular volume of 82 fl, and a platelet count of 126 × 109/l. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Metastatic carcinoma

      Explanation:

      The peripheral blood findings suggest a leucoerythroblastic picture, the common causes of which in a 65-year old gentleman includes prostatic or lung malignancy.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
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SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (2/5) 40%
Basic Sciences (3/7) 43%
Generic Surgical Topics (1/2) 50%
Paediatric Surgery (0/1) 0%
Physiology (1/2) 50%
Urology (1/1) 100%
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