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  • Question 1 - Through which of the following anatomical structures does an indirect inguinal hernia pass?...

    Incorrect

    • Through which of the following anatomical structures does an indirect inguinal hernia pass?

      Your Answer:

      Correct Answer: External oblique

      Explanation:

      Inguinal hernias are subdivided into direct and indirect.An indirect hernia occurs when abdominal contents protrude through the internal inguinal ring and into the inguinal canal. This occurs lateral to the inferior epigastric vessels. The hernia contents may extend into the scrotum.A direct inguinal hernia is protrusion of abdominal contents through the transversalis fascia within Hesselbachā€™s triangle. The borders of Hesselbachā€™s triangle are the inferior epigastric vessels superolaterally, the rectus sheath medially, and inguinal ligament inferiorly.The deep (internal) inguinal ring is located above and halfway between the pubic tubercle and the anterior superior iliac spine. This serves as the entrance to the inguinal canal. The superficial (external) inguinal ring lies immediately above and medial to the pubic tubercle. This triangular opening is a defect in the external oblique aponeurosis, and forms the exit of the inguinal canal.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
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  • Question 2 - Injury to which nerve can lead to weakness or paralysis of the brachialis...

    Incorrect

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

      Your Answer:

      Correct Answer: The musculocutaneous nerve

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 3 - A patient suffers from an injury to his hip and thigh. As a...

    Incorrect

    • A patient suffers from an injury to his hip and thigh. As a consequence of his injury, the nerve that was damaged innervates the obturator externus muscle.In which of the following nerves is the obturator externus muscle innervated by?

      Your Answer:

      Correct Answer: Posterior branch of the obturator nerve

      Explanation:

      The obturator externus is innervated by the posterior branch of the obturator nerve, L2-L4.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds
  • Question 4 - Regarding the penis, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: The corpus spongiosum is ventral in the erect penis.

      Explanation:

      Because the anatomical position of the penis is erect, the paired corpora cavernosa are defined as dorsal in the body of the penis and the single corpus spongiosum as ventral. The nerves and vessels lie superficial to the corpus cavernosum. The urethra lies within the corpus spongiosum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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      Seconds
  • Question 5 - DepressionĀ of the eyeball is primarily produced by which of the following muscles: ...

    Incorrect

    • DepressionĀ of the eyeball is primarily produced by which of the following muscles:

      Your Answer:

      Correct Answer: Inferior rectus and superior oblique

      Explanation:

      DepressionĀ of the eyeball is produced by the inferiorĀ rectus and the superiorĀ oblique muscles.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
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      Seconds
  • Question 6 - Which of the following is NOT a typical feature of lithium toxicity: ...

    Incorrect

    • Which of the following is NOT a typical feature of lithium toxicity:

      Your Answer:

      Correct Answer: Miosis

      Explanation:

      Features of toxicity include:Increasing gastrointestinal disturbances (vomiting, diarrhoea, anorexia)Visual disturbancesPolyuria and incontinenceMuscle weakness and tremorTinnitusCNS disturbances (dizziness, confusion and drowsiness increasing to lack of coordination, restlessness, stupor)Abnormal reflexes and myoclonusHypernatraemiaWith severe overdosage (serum-lithium concentration > 2 mmol/L) seizures, cardiac arrhythmias (including sinoatrial block, bradycardia and first-degree heart block), blood pressure changes, electrolyte imbalance, circulatory failure, renal failure, coma and sudden death may occur.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 7 - A lesion to which part of the optic radiation will result in contralateral...

    Incorrect

    • A lesion to which part of the optic radiation will result in contralateral homonymous inferior quadrantanopia?

      Your Answer:

      Correct Answer: Right parietal lobe

      Explanation:

      A visual loss in the lower left quadrant in both visual fields is an indication of an inferior homonymous. This is due to a lesion of the superior fibres of the optic radiation in the parietal lobe on the contralateral side of the visual pathway.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
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  • Question 8 - A 68-year-old man with BPH presents to the emergency department in significant pain...

    Incorrect

    • A 68-year-old man with BPH presents to the emergency department in significant pain secondary to urinary retention. What is the location of the neuronal cell bodies that are responsible for urinary bladder discomfort sensation?

      Your Answer:

      Correct Answer: Dorsal root ganglia of spinal cord levels S2, S3 and S4

      Explanation:

      The activation of stretch receptors with visceral afferents relayed through the pelvic nerve plexus and into the pelvic splanchnic nerves causes bladder pain. The sensory fibres of spinal nerves S2 – S4 enter the dorsal root ganglia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
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  • Question 9 - The 'pump handle' movement of the thoracic wallĀ describes which of the following movements:...

    Incorrect

    • The 'pump handle' movement of the thoracic wallĀ describes which of the following movements:

      Your Answer:

      Correct Answer: The anterior ends of the ribs moving upwards and forwards

      Explanation:

      Because the anterior ends of the ribs are inferior to the posterior ends, when the ribs are elevated, the anterior end moves upwards and forwards, moving the sternum upwards and forwards in turn. This ‘pump handle’ upwards and forwards movement changes the anteroposterior (AP) dimension of the thorax.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 10 - Which of the following muscles acts as an extensor of the shoulder joint?...

    Incorrect

    • Which of the following muscles acts as an extensor of the shoulder joint?

      Your Answer:

      Correct Answer: Teres major

      Explanation:

      The glenohumeral joint possesses the capability of allowing an extreme range of motion in multiple planes.Flexion ā€“ Defined as bringing the upper limb anterior in the sagittal plane. The usual range of motion is 180 degrees. The main flexors of the shoulder are the anterior deltoid, coracobrachialis, and pectoralis major. Biceps brachii also weakly assists in this action.Extensionā€”Defined as bringing the upper limb posterior in a sagittal plane. The normal range of motion is 45 to 60 degrees. The main extensors of the shoulder are the posterior deltoid, latissimus dorsi, and teres major.Internal rotationā€”Defined as rotation toward the midline along a vertical axis. The normal range of motion is 70 to 90 degrees. The internal rotation muscles are the subscapularis, pectoralis major, latissimus dorsi, teres major, and the anterior aspect of the deltoid.External rotation – Defined as rotation away from the midline along a vertical axis. The normal range of motion is 90 degrees. Primarily infraspinatus and teres minor are responsible for the motion.Adduction ā€“ Defined as bringing the upper limb towards the midline in the coronal plane. Pectoralis major, latissimus dorsi, and teres major are the muscles primarily responsible for shoulder adduction.Abduction – Defined as bringing the upper limb away from the midline in the coronal plane. The normal range of motion is 150 degrees. Due to the ability to differentiate several pathologies by the range of motion of the glenohumeral joint in this plane of motion, it is essential to understand how different muscles contribute to this action.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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      Seconds
  • Question 11 - Which of the following is an adverse effect of carbamazepine: ...

    Incorrect

    • Which of the following is an adverse effect of carbamazepine:

      Your Answer:

      Correct Answer: Aplastic anaemia

      Explanation:

      Common adverse effects include nausea and vomiting, sedation, dizziness, headache, blurred vision and ataxia. TheseĀ adverse effects are dose related and are most common at the start of treatment.Other adverse effects include:Allergic skin reactions (and rarely, more serious dermatological conditions)Hyponatraemia (avoid concomitant use with diuretics)Leucopenia, thrombocytopenia and other blood disorders including aplastic anaemiaHepatic impairment

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 12 - A patient who has a nerve injury has sparing of the upper half...

    Incorrect

    • A patient who has a nerve injury has sparing of the upper half of the orbicularis oculi muscle but not the lower half. Which branch of the facial nerve supplies the lower half of the orbicularis oculi?

      Your Answer:

      Correct Answer: Zygomatic branch

      Explanation:

      The facial nerve divides into five terminal branches once in the parotid gland. 1. The temporal branch innervates muscles in the temple, forehead and supraorbital areas.2. The zygomatic branch innervates muscles in the infraorbital area, the lateral nasal area and the upper lip.3. The buccal branch innervates muscles in the cheek, the upper lip and the corner of the mouth. 4. The marginal mandibular branch innervates muscles of the lower lip and chin. 5. The cervical branch innervates the platysma muscle.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
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  • Question 13 - Which of the following clinical features is most suggestive of a lesion of...

    Incorrect

    • Which of the following clinical features is most suggestive of a lesion of the occipital lobe:

      Your Answer:

      Correct Answer: Homonymous hemianopia

      Explanation:

      Homonymous hemianopia is a visual field defect involving either the two right or the two left halves of the visual fields of both eyes. It is caused by lesions of the retrochiasmal visual pathways, ie, lesions of the optic tract, the lateral geniculate nucleus, the optic radiations, and the cerebral visual (occipital) cortex

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
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      Seconds
  • Question 14 - A patient suffers an injury to his thigh that damages the nerve that...

    Incorrect

    • A patient suffers an injury to his thigh that damages the nerve that innervates pectineus.Which of the following nerves has been damaged in this case? Select ONE answer only.

      Your Answer:

      Correct Answer: Femoral nerve

      Explanation:

      Pectineus is innervated by the femoral nerve. It may also receive a branch from the obturator nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds
  • Question 15 - You are reviewing a patient following a fall from a horse. You suspect...

    Incorrect

    • You are reviewing a patient following a fall from a horse. You suspect they may have an Erb's palsy as a result of a brachial plexus injury. Regarding Erb's palsy, which one of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Erb's palsy may result in loss of sensation of the regimental badge area.

      Explanation:

      Erb’s palsy is caused by damage to the C5 and C6 nerve rootsĀ and thus primarily involves the musculocutaneous, suprascapular and axillary nerves.Ā It commonly result from an excessive increase in the angle between the neck and the shoulder e.g. a person thrown from a motorbike or horseback or during a difficult birth. There is loss or weakness of abduction, lateral rotation and flexion of the arm and flexion and supination of the forearm andĀ loss of sensation on the lateral arm. A characteristic ‘Waiter’s tip’ deformity may be present where the limb hangs limply by the side, medially rotated by the unopposed action of pectoralis major with the forearm pronated due to paralysis of theĀ biceps brachii.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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      Seconds
  • Question 16 - Regarding the lacrimal apparatus, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the lacrimal apparatus, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Lacrimal fluid is drained from the eyeball through the lacrimal punctum.

      Explanation:

      Lacrimal fluid is drained from the eyeball through the lacrimal punctum.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
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      Seconds
  • Question 17 - The most important nerves for inversion of the foot are: ...

    Incorrect

    • The most important nerves for inversion of the foot are:

      Your Answer:

      Correct Answer: Tibial and deep fibular nerve

      Explanation:

      Inversion of the foot is achieved by the tibialis anterior which is innervated by the deep fibular nerves, and the tibialis posterior muscles which is innervated by the tibial nerve respectively.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 18 - A 45-year-old man had a painless superficial inguinal lymphadenopathy. It was later found...

    Incorrect

    • A 45-year-old man had a painless superficial inguinal lymphadenopathy. It was later found to be malignant. Which of the following parts of the body is most likely the origin of this cancerous lymph node?

      Your Answer:

      Correct Answer: Anal canal

      Explanation:

      A cancer of the anal canal below the pectinate line would spread to the superficial inguinal lymph nodes. Anal cancer often spreads through lymphatic drainage to the internal iliac lymph nodes in lesions above the pectinate line and to the superficial inguinal lymph nodes in lesions below the pectinate line.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 19 - Which of the following best describes the mechanism of action of aspirin: ...

    Incorrect

    • Which of the following best describes the mechanism of action of aspirin:

      Your Answer:

      Correct Answer: Cyclo-oxygenase (COX) inhibitor

      Explanation:

      Aspirin is a non-steroidal anti-inflammatory drug (NSAID). Aspirin irreversibly inhibits cyclooxygenase (COX) enzymes and the resulting inhibition of prostaglandin synthesis results in analgesic, antipyretic and to a lesser extent anti-inflammatory actions.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 20 - The sensory innervation of the oropharynx is provided by which of the following...

    Incorrect

    • The sensory innervation of the oropharynx is provided by which of the following nerves:

      Your Answer:

      Correct Answer: Glossopharyngeal nerve

      Explanation:

      Each subdivision of the pharynx has a different sensory innervation:the nasopharynx is innervated by the maxillary nervethe oropharynx is innervated by the glossopharyngeal nervethe laryngopharynx is innervated by the vagus nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
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  • Question 21 - Which of the following best describes the popliteal artery's course? ...

    Incorrect

    • Which of the following best describes the popliteal artery's course?

      Your Answer:

      Correct Answer: After exiting the popliteal fossa terminates at the lower border of the popliteus muscle

      Explanation:

      The popliteal artery divides into the anterior and posterior tibial arteries at the lower border of the popliteus after exiting the popliteal fossa between the gastrocnemius and popliteus muscles.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 22 - After a work-related accident, a 33-year old male is taken to the emergency...

    Incorrect

    • After a work-related accident, a 33-year old male is taken to the emergency room with difficulty in adduction and flexion of his left arm at the glenohumeral joint. The attending physician is suspects involvement of the coracobrachialis muscle.The nerve injured in the case above is?

      Your Answer:

      Correct Answer: The musculocutaneous nerve

      Explanation:

      The coracobrachialis muscle is innervated by the musculocutaneous nerve (C5-C7) a branch of the lateral cord of the brachial plexus.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 23 - Which of the following is NOT a typical cerebellar sign: ...

    Incorrect

    • Which of the following is NOT a typical cerebellar sign:

      Your Answer:

      Correct Answer: Resting tremor

      Explanation:

      An intention tremor is characteristic of cerebellar dysfunction. Resting tremor may be seen in Parkinsonism.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
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  • Question 24 - A patient suffers from an injury and as a consequence, the nerve that...

    Incorrect

    • A patient suffers from an injury and as a consequence, the nerve that was damaged innervates the obturator internus muscle.In which of the following nerves is the obturator internus muscle innervated by?

      Your Answer:

      Correct Answer: Nerve to obturator internus

      Explanation:

      The obturator internus is innervated by the obturator internus nerve (L5ā€“S2), a branch of sacral plexus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds
  • Question 25 - A 62 year old man has sustained a penetrating injury to the submandibular...

    Incorrect

    • A 62 year old man has sustained a penetrating injury to the submandibular triangle. On examination, his tongue is weak and when protruded deviates to the left. Which of the following nerves has most likely been injured:

      Your Answer:

      Correct Answer: Left hypoglossal nerve

      Explanation:

      Damage to the hypoglossal nerve results in weakness of the tongue, with deviation of the tongue towards the weak side on protrusion.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
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  • Question 26 - Which of the following muscles is least likely to beĀ involved in forceful expiration:...

    Incorrect

    • Which of the following muscles is least likely to beĀ involved in forceful expiration:

      Your Answer:

      Correct Answer: External intercostal muscles

      Explanation:

      Forceful expiration is primarily produced by the deeper thoracic muscles (internal and innermost intercostal muscles, subcostals and transversus thoracis) aided by contraction of the abdominal wall muscles which increase intra-abdominal pressure thus further reducing the volume of the thorax.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
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  • Question 27 - Which of the following ligaments supports the head of the talus? ...

    Incorrect

    • Which of the following ligaments supports the head of the talus?

      Your Answer:

      Correct Answer: Spring ligament

      Explanation:

      The spring-ligament complex is a significant medial arch stabilizer. The two important functions of this ligament include promoting the stability of the talonavicular joint by acting as a support for the talus head and by acting as a static support to maintain the medial longitudinal arch.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 28 - If a patient dislocated his right shoulder and has been referred to the...

    Incorrect

    • If a patient dislocated his right shoulder and has been referred to the orthopaedic outpatient department for a follow-up after a successful reduction, which of the following is the most important position for him to avoid holding his arm in until he is seen in the clinic?

      Your Answer:

      Correct Answer: Arm at 90 degrees to side with palm up

      Explanation:

      The arm should be placed in a poly-sling that should be worn for about two weeks. A physiotherapist may give gentle movements for the arm to help in reducing stiffness and in relieving the pain. It is important that the patient must avoid positions that could cause re-dislocation.The most important position to avoid is the arm being held out at 90 degrees to the side with the palm facing upwards, especially if a force is being applied.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 29 - Which of the following would you NOT expect from a deep fibular nerve...

    Incorrect

    • Which of the following would you NOT expect from a deep fibular nerve palsy:

      Your Answer:

      Correct Answer: Loss of sensation over heel

      Explanation:

      Damage to the deep fibular nerve results in loss of dorsiflexion of the ankle, with resultant foot drop with high-stepping gait, loss of toe extension, weakness of foot inversion and loss of sensation over the webspace between the 1st and 2nd toes.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 30 - Which of the following muscles is most responsible for thigh extension at the...

    Incorrect

    • Which of the following muscles is most responsible for thigh extension at the hip joint?

      Your Answer:

      Correct Answer: Hamstrings and gluteus maximus

      Explanation:

      For hip extension, the gluteus maximus and hamstring muscles work together. To compensate for gluteus maximus weakness, the hamstring frequently acts as the primary hip extensor.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

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