00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - A 52 year old man undergoes a renal transplant from a living related...

    Correct

    • A 52 year old man undergoes a renal transplant from a living related donor. He is well for the first five months, but on review in the renal clinic, he is noted to have persistent hypertension and a slight deterioration in renal function. What is the best explanation for this?

      Your Answer: Renal artery stenosis

      Explanation:

      Transplant renal artery stenosis (TRAS) is a well-recognized vascular complication after kidney transplant. It occurs most frequently in the first 6 months after kidney transplant, and is one of the major causes of graft loss and premature death in transplant recipients. Transplant renal artery stenosis (TRAS) is the narrowing of the transplant renal artery, impeding blood flow to the allograft. It accounts for 1–5% cases of post-transplant hypertension. Patients with TRAS have activated RAAS and usually present with worsening or refractory hypertension, fluid retention and/or allograft dysfunction without evidence of rejection.
      Percutaneous transluminal angioplasty with stent placement is generally the first-line therapy to correct hemodynamically significant stenosis in TRAS, especially for lesions that are short, linear and distal to the anastomosis.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Organ Transplantation
      52.2
      Seconds
  • Question 2 - A 46 -year old patient diagnosed with chronic rhinosinusitis, was to undergo surgery...

    Correct

    • A 46 -year old patient diagnosed with chronic rhinosinusitis, was to undergo surgery to improve drainage from his frontal sinus to the nose. Which is a route that one would take to enter into the frontal sinus through the nasal cavity?

      Your Answer: Middle meatus

      Explanation:

      The middle meatus is a nasal passageway located inferior to the middle concha and superior to the inferior concha. On the superior aspect of this meatus is a bulge produced by the middle ethmoidal cells known as the bulla ethmoidalis. Below this bulge is a curved fissure, the hiatus semilunaris, which is also bordered inferiorly by the edge of the uncinate process of the ethmoid. It is through this curved fissure, hiatus semilunaris, that the middle meatus communicates with the frontal sinus. It first forms a communication with a curved passage way known as the infundibulum. The infundibulum anteriorly communicates with the anterior ethmoidal cells and continues upward as the frontonasal duct into the frontal sinus.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      80
      Seconds
  • Question 3 - A CT scan of 65 year old male patient at an outpatient clinic...

    Correct

    • A CT scan of 65 year old male patient at an outpatient clinic suggested a bone tumour at the stylomastoid foramen. Which of the following cranial nerves is likely to be affected with this tumour?

      Your Answer: VII

      Explanation:

      Cranial nerve VII, the facial nerve, is found in the internal acoustic canal and runs through this canal into the facial canal before exiting through the stylomastoid foramen. In the case of a bone tumour at the stylomastoid process, the facial nerve is the nerve that will most likely be affected.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      25.4
      Seconds
  • Question 4 - A 27-year old lady presented with dull, abdominal pain and some pain in...

    Incorrect

    • A 27-year old lady presented with dull, abdominal pain and some pain in her lower limbs. On enquiry, it was revealed that she has been suffering from depression for a few months. Physical examination and chest X-ray were normal. Further investigations revealed serum calcium 3.5 mmol/l, albumin 3.8 g/dl and phosphate 0.65 mmol/l. What is the diagnosis?

      Your Answer: Pituitary adenoma

      Correct Answer: Parathyroid adenoma

      Explanation:

      Hypercalcaemia with hypophosphatemia indicates parathyroid disorder and adenomas are more common than hyperplasia. In this young age group, metastatic disease is unlikely. Solitary adenomas are responsible for 80-85% cases of primary hyperparathyroidism. 10-15% cases are due to parathyroid hyperplasia and carcinomas account for 2-3% cases. Symptoms include bone pain (bones), nephrolithiasis (stones), muscular aches, peptic ulcer disease, pancreatitis (groans), depression (moans), anxiety and other mental disturbances.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      41.1
      Seconds
  • Question 5 - A 52-year-old male who is a known case of leukaemia visits the day...

    Correct

    • A 52-year-old male who is a known case of leukaemia visits the day unit for a blood transfusion. Five days later, he presents to the emergency department with a temperature of 38.5°C, and erythematous cutaneous eruptions.What is the most likely explanation?

      Your Answer: Graft-versus-host disease

      Explanation:

      This is transfusion-associated graft-versus-host disease (GvHD) occurring in an immunosuppressed patient. It can occur 4–30 days after a transfusion and follows a subacute pathway. Patients may also have diarrhoea and abnormal liver function tests. Management involves steroid therapy.

      Acute transfusion reactions present during or within 24 hours of a blood transfusion. The most frequent clinical features are fever, chills, pruritus, or urticaria, which typically resolve promptly without specific treatment or complications. Other signs occurring in temporal relationship with a blood transfusion such as severe dyspnoea, pyrexia, or loss of consciousness may be the first indication of a more severe, potentially fatal reaction.

      Transfusion reactions may be immune-mediated and non-immune-mediated. GvHD is a condition that might occur after an allogeneic transplant. The donated blood cells view the recipient’s body as foreign and attacks it. Immunosuppressed patients who receive white blood cells from another person are at increased risk of developing GvHD.

      There are two forms of the disease:
      1. Acute graft-versus-host disease (aGvHD): usually presents with skin and/or liver and/or gut involvement.
      2. Chronic graft-versus-host disease (cGvHD).

      The diagnosis is clinical and usually one of exclusion; however, biopsy of affected tissues may be helpful in unclear cases.

    • This question is part of the following fields:

      • Post-operative Management And Critical Care
      • Principles Of Surgery-in-General
      25.9
      Seconds
  • Question 6 - A 50-year-old man presents with bright red rectal bleeding that occurs post defecation...

    Incorrect

    • A 50-year-old man presents with bright red rectal bleeding that occurs post defecation and is noted on the toilet paper. It is also associated with severe pain. On external anal examination, a skin tag is identified at 6 o'clock position.Which of the following treatment options is most likely to be helpful?

      Your Answer: Injections of oily phenol

      Correct Answer: Topical GTN

      Explanation:

      Since the most likely diagnosis is anal fissure, the correct treatment is topical nitrates.

      Anal fissures are a common cause of painful, bright red rectal bleeding. Most fissures are idiopathic and present as a painful mucocutaneous defect in the posterior midline (90% cases). Fissures are more likely to be anteriorly located in females, particularly if they are multiparous. Diseases associated with fissure-in-ano include:
      1. Crohn’s disease
      2. Tuberculosis
      3. Internal rectal prolapse

      Diagnostic options are as follows:
      In most cases, the defect can be visualised as a posterior midline epithelial defect. Where symptoms are highly suggestive of the condition and examination findings are unclear, an examination under anaesthesia may be helpful. Atypical disease presentation should be investigated by colonoscopy and EUA, with biopsies of the area.

      For management of anal fissure:
      1. Stool softeners are important as hard stools may tear the epithelium and result in recurrent symptoms. The most effective first-line agents are topically applied GTN (0.2%) or Diltiazem (2%) paste.
      2. Resistant cases may benefit from injection of botulinum toxin or lateral internal sphincterotomy. Advancement flaps may be used to treat resistant cases.

    • This question is part of the following fields:

      • Colorectal Surgery
      • Generic Surgical Topics
      12.3
      Seconds
  • Question 7 - Bloody discharge from the nipple of a 40-year old woman with no obvious...

    Incorrect

    • Bloody discharge from the nipple of a 40-year old woman with no obvious lump or abnormality on mammography is suggestive of:

      Your Answer: Infiltrating ductal carcinoma

      Correct Answer: Intraductal papilloma

      Explanation:

      A small benign tumour, namely intraductal papilloma is most common in women between 35-55 years of age. It is also the commonest cause of spontaneous discharge from a single duct. A lump below the nipple may be sometimes palpable. Ultrasound and ductography are useful investigations., along with cytology of discharge to assess the presence of malignant cells. Confirmation is by breast biopsy.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      91.3
      Seconds
  • Question 8 - 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 9 - A 45 year old lady has been diagnosed with Friedreich's ataxia that has...

    Incorrect

    • A 45 year old lady has been diagnosed with Friedreich's ataxia that has affected her medial group of nuclei in the anterior horn of the spinal cord. Which of the following structures will have their muscles affected?

      Your Answer:

      Correct Answer: Axial muscles

      Explanation:

      The cells in the anterior horn can be arranged in the following three main groups: medial, lateral and central. The medial group of nuclei in the anterior horn of the spinal cord are located along the entire length of the spinal cord and are responsible for the innervation of the axial muscles of the body ( muscles of the head and neck region). Thus this disease will most likely affect the functioning of the muscles of the head and neck.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 10 - The chest X-ray of a 72 year old patient reveals the presence of...

    Incorrect

    • The chest X-ray of a 72 year old patient reveals the presence of a round lesion containing an air-fluid level in the left lung. These findings are most probably suggestive of:

      Your Answer:

      Correct Answer: Lung abscess

      Explanation:

      Lung abscesses are collections of pus within the lung that arise most commonly as a complication of aspiration pneumonia caused by oral anaerobes. Older patients are more at risk due to poor oral hygiene, gingivitis an inability to handle their oral secretions due to other diseases. Chest X-ray most commonly reveals the appearance of an irregularly shaped cavity with an air-fluid level.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 11 - A 35-year-old woman is in a comatose state following a traumatic head injury,...

    Incorrect

    • A 35-year-old woman is in a comatose state following a traumatic head injury, and is receiving intravenous (IV) antibiotics and IV fluids containing saline and 5% dextrose. A serum biochemistry analysis is performed five days later which shows a low serum potassium level. This is most likely to be due to:

      Your Answer:

      Correct Answer: Nothing per oral regimen

      Explanation:

      In this patient the cause for hypokalaemia is insufficient consumption of potassium as she is nil-per mouth with no intravenous supplementation. Parenteral nutrition has been used for comatose patients, although enteral feeding is usually preferable, and less prone to complications.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds
  • Question 12 - the action of the semimembranosus muscle is: ...

    Incorrect

    • the action of the semimembranosus muscle is:

      Your Answer:

      Correct Answer: Extension of the hip and flexion of the knee

      Explanation:

      the semimembranosus is situated at the back and medial side of the thigh. It arises from the upper and outer impression on the tuberosity of the ischium, above and lateral to the biceps femoris and semitendinosus. It is inserted mainly into the horizontal groove on the posterior medial aspect of the medial condyle of the tibia. it flexes the knee and assists in extension of the hip.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 13 - A 33 year old man with fulminant ulcerative colitis underwent a subtotal colectomy....

    Incorrect

    • A 33 year old man with fulminant ulcerative colitis underwent a subtotal colectomy. Which type of stoma would most likely be fashioned?

      Your Answer:

      Correct Answer: End ileostomy

      Explanation:

      Subtotal colectomy is resection of the entire right, transverse, left and part of the sigmoid colon. The rectal stump is closed and an end ileostomy fashioned in the right iliac fossa.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • The Abdomen
      0
      Seconds
  • Question 14 - The gradual depolarization in-between action potentials in pacemaker tissue is a result of?...

    Incorrect

    • The gradual depolarization in-between action potentials in pacemaker tissue is a result of?

      Your Answer:

      Correct Answer: A combination of gradual inactivation outward IK along with the presence of an inward ‘funny’ current (If) due to opening of channels permeable to both Na+ and K+ ions

      Explanation:

      One of the characteristic features of the pacemaker cell is the generation of a gradual diastolic depolarization also called the pacemaker potential. In phase 0, the upstroke of the action potential caused by an increase in the Ca2+ conductance, an influx of calcium occurs and a positive membrane potential is generated. The next is phase 3 which is repolarization caused by increased K+ conductance as a result of outwards K+ current. Phase 4 is a slow depolarization which accounts for the pacemaker activity, caused by increased conductance of Na+, inwards Na+ current called IF. it is turned on by repolarization.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds
  • Question 15 - A 32 year old woman who works as a teacher presents with a...

    Incorrect

    • A 32 year old woman who works as a teacher presents with a swollen, oedematous leg. She hails from Africa, from an area that is poorly sanitized and prevalent with mosquitoes. She travelled to England two weeks back. Which of the following is the most likely diagnosis?

      Your Answer:

      Correct Answer: Filariasis

      Explanation:

      Lymphatic filariasis, commonly known as elephantiasis, is a painful and profoundly disfiguring disease. In communities where filariasis is transmitted, all ages are affected. While the infection may be acquired during childhood its visible manifestations may occur later in life, causing temporary or permanent disability. The disease is caused by three species of thread-like nematode worms, known as filariae – Wuchereria bancrofti, Brugia malayi and Brugia timori. Male worms are about 3–4 centimetres in length, and female worms 8–10 centimetres. The male and female worms together form “nests” in the human lymphatic system.

      Filarial infection can cause a variety of clinical manifestations, including lymphoedema of the limbs, genital disease (hydrocele, chylocele, and swelling of the scrotum and penis) and recurrent acute attacks, which are extremely painful and are accompanied by fever. The vast majority of infected people are asymptomatic, but virtually all of them have subclinical lymphatic damage and as many as 40% have kidney damage, with proteinuria and haematuria.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Vascular
      0
      Seconds
  • Question 16 - Which of the following is not seen as a complication of wound healing?...

    Incorrect

    • Which of the following is not seen as a complication of wound healing?

      Your Answer:

      Correct Answer: Malignancy

      Explanation:

      Complications in wound healing can originate due to abnormalities in the repair process. These abnormalities are :
      1) Deficient scar formation: insufficient granulation tissue can lead to wound dehiscence and ulceration. Dehiscence or wound rupture is seen most commonly in abdominal surgery due to increased intraabdominal pressure. Ulcerations are common in extremity wounds due to inadequate vascularization.
      2) Excessive formation of repair components: collagen being laid down may begin normally however later lead to a raised scar also called a hypertrophic scar, which can extend beyond its boundaries to form a keloid and
      3) Formation of contractures.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 17 - An 8 year old boy presents with a history of repeated bacterial/pyogenic infections....

    Incorrect

    • An 8 year old boy presents with a history of repeated bacterial/pyogenic infections. He had a normal recovery from chickenpox and measles and shows normal antibody response. A decrease in which of the cell types can best explain this history of repeated pyogenic infections?

      Your Answer:

      Correct Answer: Neutrophils

      Explanation:

      A decrease in the number of granulocytes, particularly neutrophils is known as agranulocytosis and it increases the susceptibility of an individual towards recurrent infections. Neutropenia can be either due to decreased production or increased elimination of neutrophils.
      Ineffective agranulopoiesis is seen in: 1. myeloid stem cell suppression, 2. disease conditions associated with granulopoiesis such as megaloblastic anaemia and myelodysplastic syndromes, 3. rare genetic diseases, 4. splenic sequestration and 5. increased peripheral utilization.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 18 - A 40-year old Caucasian male came to the hospital with complaints of fatigue...

    Incorrect

    • A 40-year old Caucasian male came to the hospital with complaints of fatigue and lethargy. On examination, he was found to have raised blood pressure. Urine examination showed >300 mg/dl proteinuria (4+) and 24-hour urine protein 3.5g. No glucose, blood, nitrites, urobilinogen or casts were present in urine. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Membranous glomerulonephritis

      Explanation:

      Membranous glomerulonephritis or nephropathy, is a renal disorder with insidious course and usually affects people aged 30-50 years. 85% cases are primary (or idiopathic). The other 15% are secondary to autoimmune conditions like SLE, infections like malaria or hepatitis B, drugs like captopril and NSAIDs, or malignancies (particularly lung or colonic carcinoma). This disease is caused due to circulating immune complexes which are said to form by binding of antibodies to antigens in glomerular basement membrane. This antigens could be endogenous or derived from systemic circulation. This immune complex triggers the complement system, resulting in formation of membrane attack complex (MAC) on glomerular epithelial cells. This further results in release of proteases and oxidants which damage the capillaries making them ‘leaky’. Moreover, the epithelial cells also secrete a mediator to reduce nephron synthesis and distribution.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 19 - A 55-year-old male presents with an ulcerated mass at the anal verge. A...

    Incorrect

    • A 55-year-old male presents with an ulcerated mass at the anal verge. A biopsy is taken and the histology demonstrates as squamous cell carcinoma. Which of the following viral infection is most likely to have contributed to the development of the condition?

      Your Answer:

      Correct Answer: Human papillomavirus 16

      Explanation:

      Anal squamous cell cancer is believed to be directly linked to the presence of a complex inflammatory process most commonly caused by HPV infection (particularly with serotypes 16 and 18) in the histologically unique area of the anal squamocolumnar epithelium. In one Scandinavian study, serotype 16 HPV DNA was detected in 73% of anal cancer specimens, and serotype 16, 18, or both were detected in 84% of specimens. In contrast, no rectal cancer specimens contained HPV DNA.

    • This question is part of the following fields:

      • Clinical Microbiology
      • Principles Of Surgery-in-General
      0
      Seconds
  • Question 20 - After a car accident, a 30-year-old woman is alert and only has minor,...

    Incorrect

    • After a car accident, a 30-year-old woman is alert and only has minor, superficial injuries. 2 hours later, she becomes unconscious and a CT scan reveals a convex, lens-shaped haemorrhage over the right parietal region. The most likely diagnosis is:

      Your Answer:

      Correct Answer: Epidural haematoma

      Explanation:

      Epidural haematomas are usually caused by arterial bleeding, classically due to damage to the middle meningeal artery by a temporal bone fracture. Symptoms develop within minutes to several hours after the injury and consist of increasing headache, decreased level of consciousness, hemiparesis and pupillary dilation with loss of light reactivity. Around 15–20% of epidural hematomas are fatal.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 21 - The specialist registrar, while performing the repair of an infrarenal abdominal aortic aneurysm,...

    Incorrect

    • The specialist registrar, while performing the repair of an infrarenal abdominal aortic aneurysm, decides not to re-implant the inferior mesenteric artery into the repaired abdominal aorta. She says that an anastomotic artery running along the border of the large intestine is good enough to supply blood to the territory of the inferior mesenteric artery. Which vessel is she referring to?

      Your Answer:

      Correct Answer: Marginal

      Explanation:

      The marginal artery is a key anastomosis for the large intestine that runs around the border of the large intestine and is formed by the anastomosis of the branches of the ileocolic artery, right colic artery, middle colic artery, left colic artery and sigmoid artery. If a small artery is occluded, these branches allow blood to reach all segments of the colon.
      The arcades are anastomotic loops between the arteries that provide alternative pathways for blood flow. They are more prominent in the small intestine than the large intestine.
      Arteriae rectae are small branches that run from the marginal artery to reach the colon.
      The ileocolic artery is the branch of the superior mesenteric artery that supplies the caecum, appendix and terminal part of the ileum.
      The coronary arteries supply blood to the heart.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 22 - A 33 year old African woman presents with complaints of continuous dribbling of...

    Incorrect

    • A 33 year old African woman presents with complaints of continuous dribbling of urine after the birth of her second child. The woman denies any complications associated with her pregnancies except for prolonged labour. She is otherwise healthy and feels well. Which of the following is the most likely diagnosis?

      Your Answer:

      Correct Answer: Vesicovaginal fistula

      Explanation:

      Vesicovaginal fistula (VVF) is an abnormal opening between the bladder and the vagina that results in continuous and unremitting urinary incontinence. It is one of the most distressing complications of gynaecologic and obstetric procedures. Vesicovaginal fistulae should be suspected in patients with continuous dribbling incontinence after prolonged labour.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Urology
      0
      Seconds
  • Question 23 - A 65 year old man has colorectal cancer Duke C. What is his...

    Incorrect

    • A 65 year old man has colorectal cancer Duke C. What is his 5 year prognosis?

      Your Answer:

      Correct Answer: 50%

      Explanation:

      Dukes staging and 5 year survival:
      Dukes A – Tumour confined to the bowel but not extending beyond it, without nodal metastasis (95%)
      Dukes B – Tumour invading bowel wall, but without nodal metastasis (75%)
      Dukes C – Lymph node metastases (50%)
      Dukes D – Distant metastases (6%)

    • This question is part of the following fields:

      • Oncology
      • Principles Of Surgery-in-General
      0
      Seconds
  • Question 24 - A 29-year-old pregnant woman develops severe hypoxaemia with petechial rash and confusion following...

    Incorrect

    • A 29-year-old pregnant woman develops severe hypoxaemia with petechial rash and confusion following a fracture to her left femur. Which is the most probable cause of these symptoms in this patient?

      Your Answer:

      Correct Answer: Fat embolism

      Explanation:

      Fat embolism is a life-threatening form of embolism in which the embolus consists of fatty material or bone marrow particles that are introduced into the systemic venous system. It may be caused by long-bone fractures, orthopaedic procedures, sickle cell crisis, parenteral lipid infusion, burns and acute pancreatitis. Patients with fat embolism usually present with symptoms that include skin, brain, and lung dysfunction.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 25 - Which of the following brings about a reduction in gastric blood flow? ...

    Incorrect

    • Which of the following brings about a reduction in gastric blood flow?

      Your Answer:

      Correct Answer: Vasopressin

      Explanation:

      Gastric blood flow is increased by vagal stimulation, gastrin, histamine and acetylcholine as they stimulate gastric section and the production of vasodilator metabolites. Acetylcholine and histamine also have a direct action on the gastric arterioles. Similarly, gastric blood flow is reduced by inhibitors of secretion – catecholamines, secretin and vasopressin.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds
  • Question 26 - The lateral thoracic artery: ...

    Incorrect

    • The lateral thoracic artery:

      Your Answer:

      Correct Answer: Accompanies the long thoracic nerve to the serratus anterior muscle

      Explanation:

      The thoracic nerve, along with the lateral thoracic artery, follow the pectoralis minor to the side of the chest which supplies the serratus anterior and the pectoralis. It then sends branches across the axilla to the axillary glands and subscapularis. The pectoral branch of the thoraco-acromial anastomoses with the internal mammary, subscapular and intercostal arteries, which in women, supply an external mammary branch.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 27 - A 30-year-old male complains of pain and weakness in the shoulder. He has...

    Incorrect

    • A 30-year-old male complains of pain and weakness in the shoulder. He has recently been unwell with glandular fever from which he is fully recovered. On examination, there is some evidence of muscle wasting and a degree of winging of the scapula. Power during active movements is impaired. What is the most likely cause?

      Your Answer:

      Correct Answer: Parsonage-Turner syndrome

      Explanation:

      Parsonage-Turner Syndrome (PTS), also referred to as idiopathic brachial plexopathy or neuralgic amyotrophy, is a rare disorder consisting of a complex constellation of symptoms with abrupt onset of shoulder pain, usually unilaterally, followed by progressive neurologic deficits of motor weakness, dysesthesias, and numbness. Although the aetiology of the syndrome is unclear, it is reported in various clinical situations, including postoperatively, postinfectious, posttraumatic, and postvaccination.
      The most common associated risk factor is a recent viral illness.
      The pain is not positional and usually worse at night and may be associated with awakenings from sleep. There are typically no constitutional symptoms associated with the syndrome. The duration of pain is almost always self-limiting, lasting 1 to 2 weeks, but on rare occasion persisting for longer periods.
      In the earliest stages of this condition (the first few weeks), pain management with opiates, NSAIDs, and neuroleptics is the mainstay of treatment. Acupuncture and transcutaneous electrical nerve stimulation (TENS) can also be adjuncts to medications. Oral steroids have been recommended by some, but there is poor literature evidence to support its efficacy.
      Physical therapy plays an important role in the treatment of this condition. Modalities such as TENS can help in pain management.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Orthopaedics
      0
      Seconds
  • Question 28 - A 60-year old gentleman visited his general practitioner complaining of high grade fever...

    Incorrect

    • A 60-year old gentleman visited his general practitioner complaining of high grade fever for 7 days and a dull, aching pain in his left lumbar region. On enquiry, he admitted to having a burning sensation while passing urine. His blood results showed an elevated white blood cell count with a left shift. In his condition, which is the most characteristic finding on urine examination?

      Your Answer:

      Correct Answer: White blood cell casts

      Explanation:

      Tubulointerstitial nephritis is the term given to primary injury to renal tubules and the renal interstitium, which ultimately results in a decline in renal function. Acute tubulointerstitial nephritis (acute pyelonephritis) is often seen as a result of infection or drug reactions. The most characteristic feature of this condition on urine analysis is the presence of white blood cell casts.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 29 - A 70-year old man who is suspected to have a perforated colonic diverticulum...

    Incorrect

    • A 70-year old man who is suspected to have a perforated colonic diverticulum is explored in theatre through a midline incision. This incision will be through the:

      Your Answer:

      Correct Answer: Linea alba

      Explanation:

      The linea alba is the point where this incision was made. It is a tendinous raphe in the midline of the abdomen extending between the xiphoid process and the symphysis pubis. It is placed between the medial borders of the recti and is formed by the blending of the aponeuroses of the external and internal obliques and transversi.
      The linea aspera is a vertical ridge on the posterior surface of the femur.
      The arcuate line is the inferior border of the posterior rectus sheath behind the rectus abdominis muscle.
      The semilunar line is the lateral margin of the rectus abdominis.
      The iliopectineal line is a line on the pelvic bones formed by the arcuate line of the ilium and the pectineal line of the pubis.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 30 - A 48-year-old woman has a mass in her right breast and has right...

    Incorrect

    • A 48-year-old woman has a mass in her right breast and has right axillary node involvement. She underwent radical mastectomy of her right breast. The histopathology report described the tumour to be 4 cm in its maximum diameter with four axillary lymph nodes with evidence of tumour. The most likely stage of cancer in this patient is:

      Your Answer:

      Correct Answer: IIB

      Explanation:

      Stage IIB describes invasive breast cancer in which: the tumour is larger than 2 centimetres but no larger than 5 centimetres; small groups of breast cancer cells — larger than 0.2 millimetre but not larger than 2 millimetres — are found in the lymph nodes OR the tumour is larger than 2 centimetres but no larger than 5 centimetres; cancer has spread to 1 to 3 axillary lymph nodes or to lymph nodes near the breastbone (found during a sentinel node biopsy) OR the tumour is larger than 5 centimetres but has not spread to the axillary lymph nodes.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Generic Surgical Topics (2/3) 67%
Organ Transplantation (1/1) 100%
Anatomy (2/2) 100%
Basic Sciences (3/3) 100%
Post-operative Management And Critical Care (0/1) 0%
Principles Of Surgery-in-General (0/1) 0%
Colorectal Surgery (1/1) 100%
Pathology (1/1) 100%
Urology (0/1) 0%
Passmed