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  • Question 1 - A victim of mob justice was brought to the A & E with...

    Incorrect

    • A victim of mob justice was brought to the A & E with a stab wound in the anterior chest 2 cm lateral to the left sternal border. He underwent an emergency thoracotomy that revealed clots in the pericardium, with a puncture wound in the right ventricle. To evacuate the clots from the pericardial cavity the surgeon slipped his hand behind the heart at its apex. He extended his finger upwards until its tip was stopped by a line of pericardial reflection which forms the:

      Your Answer: Hilar reflection

      Correct Answer: Oblique pericardial sinus

      Explanation:

      Transverse sinus: part of pericardial cavity that is behind the aorta and pulmonary trunk and in front of the superior vena cava separating the outflow vessels from the inflow vessels.
      Oblique pericardial sinus: is behind the left atrium where the visceral pericardium reflects onto the pulmonary veins and the inferior vena cava. Sliding a finger under the heart will take you to this space.
      Cardiac notch: indentation of the ‘of the heart’ on the superior lobe of the left lung.
      Hilar reflection: the reflection of the pleura onto the root of the lung to continue as mediastinal pleura.
      Costomediastinal recess: part of the pleural sac where the costal pleura transitions to become the mediastinal pleura.
      Sulcus terminalis: a groove between the right atrium and the vena cava

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      74
      Seconds

  • Question 2 - A patient is suspected to have a chromosomal abnormality. Which tumour and chromosomal...

    Incorrect

    • A patient is suspected to have a chromosomal abnormality. Which tumour and chromosomal association is correct?

      Your Answer: Wilm's tumour - chromosome 21

      Correct Answer: Neuroblastoma – chromosome 1

      Explanation:

      Neuroblastoma is associated with a deletion on chromosome 1 and inactivation of a suppressor gene. Neurofibromas and osteogenic sarcoma are associated with an abnormality on chromosome 17. Retinoblastoma (Rb) is associated with an abnormality on chromosome 13. Wilms’ tumours of the kidney are associated with an abnormality on chromosome 11.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      40.6
      Seconds

  • Question 3 - Injury to this nerve will result to the loss of general sensory innervation...

    Incorrect

    • Injury to this nerve will result to the loss of general sensory innervation of the lacrimal gland:

      Your Answer: Maxillary nerve

      Correct Answer: Ophthalmic nerve

      Explanation:

      The lacrimal glands are paired, almond-shaped exocrine glands, that secrete the aqueous layer of the tear film. The lacrimal nerve, derived from the ophthalmic nerve, supplies the sensory component of the lacrimal gland. The greater petrosal nerve, derived from the facial nerve, supplies the parasympathetic autonomic component of the lacrimal gland.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      12.6
      Seconds

  • Question 4 - A 30-year-old female was alarmed when she started to experience hair loss and...

    Incorrect

    • A 30-year-old female was alarmed when she started to experience hair loss and balding, however, she also noted increased hair on her face and body and developed an acne breakout. Deepening of her voice also became prominent. She was referred to an oncologist and was diagnosed with a hormone-producing tumour. What is the most likely diagnosis ?

      Your Answer:

      Correct Answer: Arrhenoblastoma

      Explanation:

      Arrhenoblastoma, known as ‘Sertoli–Leydig tumour’ is a rare ovarian stromal neoplasm that secretes testosterone. It is mostly seen in women in the reproductive years. The key clinical features of this tumour is due to excessive production of testosterone which leads to progressive masculinisation in a woman who was typical normal beforehand. The lesion tends to grow slowly and rarely metastasises. Treatment is surgical removal of the tumour and the prognosis is generally good.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 5 - What is correct regarding the obturator artery? ...

    Incorrect

    • What is correct regarding the obturator artery?

      Your Answer:

      Correct Answer: It is found in the medial compartment of the thigh

      Explanation:

      The obturator artery is a branch of the internal iliac artery, which passes antero-inferiorly on the lateral wall of the pelvis, to the upper part of the obturator foramen. The posterior branch follows the posterior margin of the foramen and turns forward on the inferior ramus of the ischium. It also supplies an articular branch, which enters the hip joint through the acetabular notch, sending a branch along the ligamentum teres to the head of the femur. It is the main source of arterial supply to the medial compartment of the thigh

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 6 - A elderly patient with bulbar palsy is bed ridden. While swallowing he aspirates...

    Incorrect

    • A elderly patient with bulbar palsy is bed ridden. While swallowing he aspirates one of his tablets into his lungs. In which bronchopulmonary segments is it most likely to end up?

      Your Answer:

      Correct Answer: Superior segmental bronchus of the right inferior lobe

      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 superior segmental bronchus branches posteriorly off the intermediate bronchus or the inferior lobe bronchus and is thus more likely to receive the foreign body that enters the right main bronchus. The lingula is only found on the left lung. The terminal bronchiole is a very small space almost impossible for the tablet to lodge here.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 7 - Which of the following muscles attaches to the pterygomandibular raphe? ...

    Incorrect

    • Which of the following muscles attaches to the pterygomandibular raphe?

      Your Answer:

      Correct Answer: Superior pharyngeal constrictor muscle

      Explanation:

      The pterygomandibular raphé (pterygomandibular ligament) provides attachment on its posterior border to the superior pharyngeal constrictor and on its anterior border to the buccinator muscle.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 8 - A 50-year-old female undergoes an ERCP for jaundice. 36 hours following the procedure...

    Incorrect

    • A 50-year-old female undergoes an ERCP for jaundice. 36 hours following the procedure she develops a fever and rigours. A blood culture is taken, which of the following organisms is most likely to be cultured?

      Your Answer:

      Correct Answer: Escherichia coli

      Explanation:

      One of the most serious post-ERCP complications is cholangitis leading to subsequent septicaemia. Enteric bacteria enter the biliary tree by the hematogenous route or following endoscopic or radiologic manipulation. Improperly disinfected endoscopes and accessories may also introduce infection into the biliary tree. The most common organisms responsible for infection after ERCP are the Enterobacteriaceae (especially Escherichia coli and Klebsiella species), alpha-haemolytic streptococci, Pseudomonas aeruginosa, Enterococcus, and Staphylococcus epidermidis. In most patients with acute cholangitis, a single organism is isolated from blood cultures.

      Acute cholangitis is a clinical syndrome characterized by fever, jaundice, and abdominal pain that develops as a result of stasis and infection in the biliary tract. It is also referred to as Charcot’s Triad. Cholangitis was first described by Charcot as a serious and life-threatening illness; however, it is now recognized that the severity can range from mild to life-threatening.

      Risk factors for post-ERCP infection include the use of combined percutaneous and endoscopic procedures, stent placement in malignant strictures, the presence of jaundice, low case volume, and incomplete or failed biliary drainage. Patients who are immunocompromised are more likely to experience an infectious complication.

      Prevention and/or reduction of the risk of post-ERCP infectious complications can be achieved by judicious use of preprocedural antibiotics and intraprocedural steps, such as minimizing or avoiding contrast injection in patients with known biliary obstruction or cholangitis, endoscopic decompression, including the placement of a biliary stent when complete drainage cannot be achieved, and prompt percutaneous drainage if endoscopic drainage is not possible or incomplete. Prophylactic preprocedural antibiotics should be given to patients with jaundice and suspected mechanical obstruction. In addition, patients with sclerosing cholangitis, pancreatic pseudocysts, and those who are immunocompromised should also receive preprocedural antibiotics

    • This question is part of the following fields:

      • Clinical Microbiology
      • Principles Of Surgery-in-General
      0
      Seconds

  • Question 9 - What is the basic chemical reaction that takes place in the breakdown of...

    Incorrect

    • What is the basic chemical reaction that takes place in the breakdown of complex foodstuffs?

      Your Answer:

      Correct Answer: Hydrolysis

      Explanation:

      Breakdown of complex food into simpler compounds is achieved by hydrolysis, with the help of different enzymes specific for different compounds.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 10 - Which is the CORRECT statement regarding the small intestine: ...

    Incorrect

    • Which is the CORRECT statement regarding the small intestine:

      Your Answer:

      Correct Answer: The superior mesenteric artery courses between the body and uncinate process of the pancreas before the artery supplies the jejunum and ileum

      Explanation:

      The small intestine extends from the pylorus to the ileocecal valve where It ends in the large intestine. It is surrounded on the sides and above by the large intestine. It is related anteriorly with the greater omentum and abdominal wall. Is connected to the vertebral column by a fold of peritoneum or otherwise known as the mesentery. Is divided into three portions: the duodenum, jejunum and ileum. The jejunum and ileum are supplied by the superior mesenteric artery that courses between the body and uncinate process of the pancreas before it gives off intestinal branches.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 11 - What is the normal glomerular filtration rate? ...

    Incorrect

    • What is the normal glomerular filtration rate?

      Your Answer:

      Correct Answer: 125 mL/min

      Explanation:

      The normal glomerular filtration rate (GFR) in humans is 125 mL/min. After the age of 40, GFR decreases progressively by about 0.4–1.2 mL/min per year.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 12 - 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:

      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
      0
      Seconds

  • Question 13 - A 15 year old girl presented to the emergency with a history of...

    Incorrect

    • A 15 year old girl presented to the emergency with a history of chronic cough, fever and weight loss. Her chest X-ray showed multiple nodules 1-4 cm in size and some of them with cavitation especially in the upper lobe. A sputum sample was positive for acid fast bacilli. Which of the following cells played a part in the development of the lung lesions?

      Your Answer:

      Correct Answer: Macrophage

      Explanation:

      The characteristic cells in granulomatous inflammation are giant cells, formed from merging macrophages and epithelioid cells elongated with granular eosinophilic cytoplasm. Granulomatous reactions are seen in patients with tuberculosis. A tuberculous/caseating granuloma is characterised by a zone of central necrosis lined with giant multinucleated giant cells (Langhans cells) and surrounded by epithelioid cells, lymphocytes and fibroblasts. The caseous zone is present due to the damaged and dead giant cells and epithelioid cells.
      Mast cells are only few in number and fibroblasts lay down collagen.
      Basophils are not present.
      The giant cell made up of macrophages are the most abundant cells in this inflammatory process.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 14 - 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 15 - A 30-year-old man sustains a severe facial fracture, and reconstruction is planned. Which...

    Incorrect

    • A 30-year-old man sustains a severe facial fracture, and reconstruction is planned. Which of the following investigations will facilitate preoperative planning?

      Your Answer:

      Correct Answer: Computerised tomography of the head

      Explanation:

      Significant facial fractures may have an intracranial effect. Computerised tomography (CT) scan of the head allows delineation of the injury extent, and a 3D reconstruction of images can be done. An Orthopantomogram (OPT) provides good images of mandible and surrounding bony structures but cannot give intracranial details. X-ray of the skull lacks the details important in modern practice.

      Craniomaxillofacial (CMF) injuries in the UK are due to:
      1. Interpersonal violence (52%)
      2. Motor vehicle accidents (16%)
      3. Sporting injuries (19%)
      4. Falls (11%)

    • This question is part of the following fields:

      • Emergency Medicine And Management Of Trauma
      • Principles Of Surgery-in-General
      0
      Seconds

  • Question 16 - A 26-year-old female patient had the following blood report: RBC count = 4....

    Incorrect

    • A 26-year-old female patient had the following blood report: RBC count = 4. 0 × 106/μl, haematocrit = 27% and haemoglobin = 11 g/dl, mean corpuscular volume (MCV) = 80–100 fl, mean corpuscular haemoglobin concentration (MCHC) = 31–37 g/dl. Which of the following is correct regarding this patient’s erythrocytes:

      Your Answer:

      Correct Answer: Normal MCV

      Explanation:

      MCV is the mean corpuscular volume and it is calculated from the haematocrit and the RBC count. It is normally 90 fl. Mean corpuscular haemoglobin concentration (MCHC) [g/dl] = haemoglobin [g/dl]/haematocrit = 11/0.27 = 41 g/dl and is higher than normal range (32 to 36 g/dL).

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 17 - A teacher had varicosities in the region of the small saphenous vein. Which...

    Incorrect

    • A teacher had varicosities in the region of the small saphenous vein. Which of the following is true about that vein?

      Your Answer:

      Correct Answer: Has nine to twelve valves

      Explanation:

      It is known that the small saphenous vein has nine to twelve valves along its course. This vein begins as a direct continuation of the lateral marginal vein posterior to the lateral malleolus. It is superficially situated but closer to its termination, perforates the deep fascia in the lower part of the popliteal fossa to end in the popliteal vein.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 18 - A 48 year old woman with episodes of recurrent urinary tract sepsis presents...

    Incorrect

    • A 48 year old woman with episodes of recurrent urinary tract sepsis presents with a staghorn calculus of the right kidney. Her urinary pH is 7.8. An abdominal x-ray shows a faint outline of the calculus. What would be the most likely composition of the stone?

      Your Answer:

      Correct Answer: Struvite

      Explanation:

      Staghorn calculi refer to branched stones that fill all or part of the renal pelvis and branch into several or all of the calyces. They are most often composed of struvite (magnesium ammonium phosphate) and/or calcium carbonate apatite. These stones are often referred to as ‘infection stones’ since they are strongly associated with urinary tract infections with urea splitting organisms. Small struvite and/or calcium carbonate apatite stones can grow rapidly over a period of weeks to months into large staghorn calculi involving the calyces and entire renal pelvis. If left untreated, this can lead to deterioration of kidney function and end-stage renal disease. In addition, since the stones often remain infected, there is a risk of developing sepsis. Thus, most patients require definitive surgical treatment.

      Struvite stones account for 15% of renal calculi. They are associated with chronic urinary tract infection (UTI) with gram-negative, urease-positive organisms that split urea into ammonia, which then combines with phosphate and magnesium to crystalize into a calculus. Usual organisms include Proteus, Pseudomonas, and Klebsiella species. Escherichia coli is not capable of splitting urea and, therefore, is not associated with struvite stones. Because ammonia, a base, is produced during the catalytic process, the urine pH is typically greater than 7.
      Underlying anatomical abnormalities that predispose patients to recurrent kidney infections should be sought and corrected. UTI does not resolve until the stone is removed entirely.
      This patient has a urine pH of 7.8 which is very alkaline.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Urology
      0
      Seconds

  • Question 19 - Which of the following two cerebral veins join up to form the great...

    Incorrect

    • Which of the following two cerebral veins join up to form the great cerebral vein, otherwise also known as the great vein of Galen?

      Your Answer:

      Correct Answer: Internal cerebral veins

      Explanation:

      The great vein of Galen or great cerebral vein, is formed by the union of the internal cerebral veins and the basal veins of Rosenthal. This vein curves upwards and backwards along the border of the splenium of the corpus callosum and eventually drains into the inferior sagittal sinus and straight sinus at its anterior extremity.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 20 - A 45-year-old woman was brought to the emergency department due to fever and...

    Incorrect

    • A 45-year-old woman was brought to the emergency department due to fever and chills. She has a history of recurrent UTI and complains of dysuria and urinary frequency. Urinary white blood cell count is >200 cell/high power field. If urine culture is performed, what is the most likely organism that will grow?

      Your Answer:

      Correct Answer: Escherichia coli

      Explanation:

      The pathogen that most likely causes recurrent urinary tract infection in young women are E. coli, Enterococcus and Staphylococcus saprophyticus.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 21 - 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 22 - Risk factors for hepatocellular carcinoma do NOT include: ...

    Incorrect

    • Risk factors for hepatocellular carcinoma do NOT include:

      Your Answer:

      Correct Answer: Heptitis E

      Explanation:

      Risk factors for hepatocellular carcinoma include hepatitis B and C, aflatoxin, anabolic steroids, alcohol cirrhosis and primary liver disease.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 23 - Which of the following is a likely cause of jaundice? ...

    Incorrect

    • Which of the following is a likely cause of jaundice?

      Your Answer:

      Correct Answer: Hepatic disease if plasma albumin is low and serum aminotransferase elevations > 500 units

      Explanation:

      Jaundice can occur due to any of the possible causes and treatment depends upon diagnosing the correct condition. Mild hyperbilirubinemia with normal levels of aminotransferase and alkaline phosphatase is often unconjugated (e.g., due to haemolysis or Gilbert’s syndrome rather than hepatobiliary disease). Moderate or severe hyperbilirubinemia along with increased urinary bilirubin (bilirubinuria), high alkaline phosphatase or aminotransferase levels suggest hepatobiliary disease. Hyperbilirubinemia produced by any hepatobiliary disease is largely conjugated. In this case, other blood tests include hepatitis serology for suspected hepatitis, prothrombin time (PT) or international normalised ratio (INR), albumin and globulin levels, and antimitochondrial antibody levels (suspected primary biliary cirrhosis). Low albumin and high globulin levels suggest chronic rather than acute liver disease. In cases where there is only a an elevation of alkaline phosphatase, γ-glutamyl transpeptidase (GGT) levels should be checked – the levels of which will be found high in hepatobiliary disease, but not in bone disorder which can also lead to elevated alkaline phosphatase levels. In diseases of hepatobiliary origin, aminotransferase elevations > 500 units suggest a hepatocellular cause, whereas disproportionate increases of alkaline phosphatase (e.g., alkaline phosphatase > 3 times normal and aminotransferase < 200 units) suggest cholestasis. Because hepatobiliary disease alone rarely causes bilirubin levels > 30 mg/dl, higher levels are suggestive of a combination of severe hepatobiliary disease and haemolysis or renal dysfunction. Imaging is best for diagnosing infiltrative and cholestatic causes of jaundice. Liver biopsy is rarely needed, but can be of use in intrahepatic cholestasis and in some types of hepatitis.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 24 - During an inguinal hernia repair, an incision is made parallel to and 5cm...

    Incorrect

    • During an inguinal hernia repair, an incision is made parallel to and 5cm above the inguinal ligament. The registrar is warned to look out for the inferior epigastric vessels to avoid damage. Between which layers of the abdominal wall is the registrar likely to find these vessels?

      Your Answer:

      Correct Answer: Transversus abdominis muscle and peritoneum

      Explanation:

      The inferior epigastric vessels lie on the inner surface of the transversus abdominis muscle covered by the parietal peritoneum. This layer of peritoneum lies over the inferior epigastric vessels to make the lateral umbilical fold. Camper’s and Scarpa’s fascia are two layers of the superficial fascia, the fatty layer and the membranous layer respectively.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 25 - A 6 week old baby who is developing well starts having profuse and...

    Incorrect

    • A 6 week old baby who is developing well starts having profuse and projectile vomiting after feeding. She has been losing weight and the vomit is non-bilious. Which of the following is the most likely cause?

      Your Answer:

      Correct Answer: Hypertrophy of the pyloric sphincter

      Explanation:

      Pyloric stenosis is a narrowing of the opening from the stomach to the first part of the small intestine (the pylorus). Symptoms include projectile vomiting without the presence of bile. This most often occurs after the baby is fed. The typical age that symptoms become obvious is two to twelve weeks old.

      The cause of pyloric stenosis is unclear. Risk factors in babies include birth by caesarean section, preterm birth, bottle feeding, and being first born. The diagnosis may be made by feeling an olive-shaped mass in the baby’s abdomen. This is often confirmed with ultrasound. It is four times more likely to occur in males, and is also more common in the first born. Rarely, infantile pyloric stenosis can occur as an autosomal dominant condition.

      It is uncertain whether it is a congenital anatomic narrowing or a functional hypertrophy of the pyloric sphincter muscle.
      Babies with this condition usually present any time in the first weeks to months of life with progressively worsening vomiting. The vomiting is often described as non-bile stained (non bilious) and projectile vomiting, because it is more forceful than the usual spitting up (gastroesophageal reflux) seen at this age. Some infants present with poor feeding and weight loss but others demonstrate normal weight gain. Dehydration may occur which causes a baby to cry without having tears and to produce less wet or dirty diapers due to not urinating for hours or for a few days. Symptoms usually begin between 3 to 12 weeks of age. Findings include epigastric fullness with visible peristalsis in the upper abdomen from the person’s left to right. Constant hunger, belching, and colic are other possible signs that the baby is unable to eat properly.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Paediatric Surgery
      0
      Seconds

  • Question 26 - The periphery of a haematoma is infiltrated by fibroblasts, collagen and new vasculature....

    Incorrect

    • The periphery of a haematoma is infiltrated by fibroblasts, collagen and new vasculature. This process is best described as?

      Your Answer:

      Correct Answer: Organisation of the haematoma

      Explanation:

      Formation of granulation tissue at the periphery of the hematoma is a normal process leading to resolution. This granulation tissue is composed of new capillaries, fibroblasts and collagen. Lysis of a blood clot can occur, but the actual process of this response is known as organization, wherein the scar tissue will become part of the vessels. This is followed by recanalization and embolization which can lead to eventual complications. Proliferation of a clot will occur due to an imbalance in the clotting and lysing systems. Thrombosis has nothing to do with the process described above.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

  • Question 27 - upon stroking the plantar surface of a patient's foot, extension of toes was...

    Incorrect

    • upon stroking the plantar surface of a patient's foot, extension of toes was noted. This is likely to be accompanied with:

      Your Answer:

      Correct Answer: Spasticity

      Explanation:

      An upper motor neuron lesion affects the neural pathway above the anterior horn cell or motor nuclei of the cranial nerves, whereas a lower motor neurone lesion affects nerve fibres travelling from the anterior horn of the spinal cord to the relevant muscles. An upper motor neurone lesions results in the following:
      – Spasticity in the extensor muscles (lower limbs) or flexor muscles (upper limbs).
      – ‘clasp-knife’ response where initial resistance to movement is followed by relaxation
      – Weakness in the flexors (lower limbs) or extensors (upper limbs) with no muscle wasting
      – Brisk tendon jerk reflexes
      – Positive Babinski sign (on stimulation of the sole of the foot, the big toe is raised rather than curled downwards)

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 28 - Which of these structures does NOT pass posterior to the medial malleolus? ...

    Incorrect

    • Which of these structures does NOT pass posterior to the medial malleolus?

      Your Answer:

      Correct Answer: Saphenous vein

      Explanation:

      The saphenous vein passes anterior to the medial malleolus. The structures passing posterior, from nearest to furthest include: tibial, posterior tendon, flexor digitorum longus tendon, posterior tibial artery, posterior tibial vein, posterior tibial nerve and the flexor hallucis longus tendon.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds

  • Question 29 - The renal tubule is the portion of the nephron that contains the fluid...

    Incorrect

    • The renal tubule is the portion of the nephron that contains the fluid that has been filtered by the glomerulus. Which of the following substances is actively secreted into the renal tubules?

      Your Answer:

      Correct Answer: Potassium

      Explanation:

      The renal corpuscle filters out solutes from the blood, delivering water and small solutes to the renal tubule for modification. In normal circumstances more than 90% of the filtered load of K is reabsorbed by the proximal tubules and loops of Henlé and almost all K appearing in the urine has been secreted by the late distal tubules and collecting tubules. So the rate of excretion is usually independent of the rate of filtration, but is closely tied to the rate of secretion and control of K excretion, largely accomplished by control of the secretion rate. Around 65–70% of the filtered potassium is reabsorbed along with water in the proximal tubule and the concentration of potassium in the tubular fluid varies little from that of the plasma.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds

  • Question 30 - Which cells are most commonly seen in a granulomatous lesion that suggests an...

    Incorrect

    • Which cells are most commonly seen in a granulomatous lesion that suggests an underlying chronic inflammation?

      Your Answer:

      Correct Answer: Lymphocytes

      Explanation:

      Lymphocytes and monocytes are commonly and characteristically recognised in a case of chronic inflammation.
      Eosinophils and neutrophils are seen with acute inflammation.
      Mast cells release histamine in early inflammation.
      Basophils are seen with allergies.
      Plasma cells are seen with viral infection.
      Platelets are not characteristic of any type of inflammation.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds

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