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  • Question 1 - Staphylococcus aureus can be identified in the laboratory based on the clotting of...

    Incorrect

    • Staphylococcus aureus can be identified in the laboratory based on the clotting of plasma. Which microbial product is responsible for this activity?

      Your Answer: Plasminogen

      Correct Answer: Coagulase

      Explanation:

      Staphylococcus aureus is the most pathogenic species and is implicated in a variety of infections.  S. aureus can be identified due to its production of coagulase. The staphylococcal enzyme coagulase will cause inoculated citrated rabbit plasma to gel or coagulate. The coagulase converts soluble fibrinogen in the plasma into insoluble fibrin.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      10.5
      Seconds
  • Question 2 - A 33 year old woman presents with a complaint of dysphagia. She has...

    Incorrect

    • A 33 year old woman presents with a complaint of dysphagia. She has a ten year history of treatment refractory anaemia secondary to menorrhagia. Which of the following is the most likely underlying cause?

      Your Answer: Adenocarcinoma of the oesophagus

      Correct Answer: Plummer Vinson syndrome

      Explanation:

      Iron deficiency anaemia (IDA) is the most common form of anaemia worldwide and can be due to inadequate intake, decreased absorption (e.g., atrophic gastritis, inflammatory bowel disease), increased demand (e.g., during pregnancy), or increased loss (e.g., gastrointestinal bleeding, menorrhagia) of iron. Prolonged deficiency depletes the iron stores in the body, resulting in decreased erythropoiesis and anaemia.
      Symptoms are nonspecific and include fatigue, pallor, lethargy, hair loss, brittle nails, and pica. Diagnostic lab values include low haemoglobin, microcytic, hypochromic red blood cells on peripheral smear, and low ferritin and iron levels. Once diagnosed, the underlying cause should be determined. Patients at risk for underlying gastrointestinal malignancy should also undergo a colonoscopy.
      Iron deficiency anaemia is treated with oral (most common) or parenteral iron supplementation. Severe anaemia or those with concomitant cardiac conditions may also require blood transfusions. The underlying cause of IDA should also be corrected. IDA may manifest as Plummer-Vinson syndrome (PVS): triad of postcricoid dysphagia, upper oesophageal webs, and iron deficiency anaemia

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Upper Gastrointestinal Surgery
      0.4
      Seconds
  • Question 3 - What is the most likely condition a new born infant is likely to...

    Incorrect

    • What is the most likely condition a new born infant is likely to suffer from, if he/she was born with incomplete fusion of the embryonic endocardial cushions?

      Your Answer: Transposition of the great arteries

      Correct Answer: An atrioventricular septal defect

      Explanation:

      The endocardial cushions in the heart are the mesenchymal tissue that make up the part of the atrioventricular valves, atrial septum and ventricular septum. An incomplete fusion of these mesenchymal cells can cause an atrioventricular septal defect. The terms endocardial cushion defect, atrioventricular septal defect and common atrioventricular canal defect can be used interchangeably with one another.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0.6
      Seconds
  • Question 4 - When you rest your elbows on a desk, what bony landmark of the...

    Incorrect

    • When you rest your elbows on a desk, what bony landmark of the upper limb are you resting on?

      Your Answer:

      Correct Answer: Olecranon process of the ulna

      Explanation:

      At the upper and back part of the ulna, there exists a curved eminence which is the olecranon process. This process lodges in the olecranon fossa of the humerus. It’s posterior surface is subcutaneous and this triangular area is what you rest your elbow upon.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 5 - Which nerve mediates the sensation to itch from the skin that is just...

    Incorrect

    • Which nerve mediates the sensation to itch from the skin that is just over the base of the spine of your scapula?

      Your Answer:

      Correct Answer: Dorsal primary ramus of C7

      Explanation:

      The first branches off spinal nerves are called the dorsal and ventral rami. The dorsal rami mediate sensation of the skin over the back and motor supply to the true muscles of the back whilst the ventral rami gives sensation to the skin over the limbs and the skin that is over the ventral side of the trunk. It also gives motor supply to the skeletal muscles of the neck, the trunk and extremities. Hence, itchiness of the part of the skin that is over the spine of the scapula would be mediated by the primary ramus of C7. Accessory nerve doesn’t have any sensory innervation.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 6 - A 43 year old housewife is admitted with colicky right upper quadrant pain....

    Incorrect

    • A 43 year old housewife is admitted with colicky right upper quadrant pain. On clinical examination she has a mild fever and jaundice. An ultrasound scan shows gallstones and she is taken to theatre for an open cholecystectomy. During operation, Calots triangle is almost completely impossible to delineate. What is the most likely explanation?

      Your Answer:

      Correct Answer: Mirizzi syndrome

      Explanation:

      Mirizzi syndrome is defined as common hepatic duct obstruction caused by extrinsic compression from an impacted stone in the cystic duct or infundibulum of the gallbladder. Patients with Mirizzi syndrome can present with jaundice, fever, and right upper quadrant pain. Mirizzi syndrome is often not recognized preoperatively in patients undergoing cholecystectomy and can lead to significant morbidity and biliary injury, particularly with laparoscopic surgery. Acute presentations of the syndrome include symptoms consistent with cholecystitis.
      Surgery is extremely difficult as Calot’s triangle is often completely obliterated and the risks of causing injury to the common bile duct (CBD) are high.
      Multiple and large gallstones can become impacted in the Hartmann’s pouch of the gallbladder, leading to chronic inflammation – which leads to compression of the CBD, necrosis, fibrosis, and ultimately fistula formation into the adjacent common hepatic duct (CHD). As a result, the CHD/CBD becomes obstructed by either scar or stone, resulting in obstructive jaundice. It can be divided into four types.
      Type I – No fistula present
      Type IA – Presence of the cystic duct
      Type IB – Obliteration of the cystic duct
      Types II–IV – Fistula present
      Type II – Defect smaller than 33% of the CHD diameter
      Type III – Defect 33–66% of the CHD diameter
      Type IV – Defect larger than 66% of the CHD diameter

      Simple cholecystectomy is suitable for type I patients. For types II–IV, subtotal cholecystectomy can be performed to avoid damage to the main bile ducts. Cholecystectomy and bilioenteric anastomosis may be required. Roux-en-Y hepaticojejunostomy has shown good outcome in some studies.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Hepatobiliary And Pancreatic Surgery
      0
      Seconds
  • Question 7 - A 33 year old woman presents to the ER after being involved in...

    Incorrect

    • A 33 year old woman presents to the ER after being involved in a road traffic accident. Her knee has hit the dashboard. Examination reveals a posteriorly displaced tibia. Injury to which of the following structures has resulted in this presentation?

      Your Answer:

      Correct Answer: Posterior cruciate ligament

      Explanation:

      The posterior drawer test is a physical exam technique that is done to assess the integrity of the posterior cruciate ligament (PCL). The PCL is attached to the posterior intercondylar area of the tibia and passes anteriorly, medially, and upward to attach to the lateral side of the medial femoral condyle.
      This ligament prevents backward displacement of the tibia or forward sliding of the femur. Injury to the ligament allows displacement of the tibia

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Orthopaedics
      0
      Seconds
  • Question 8 - A 60-year-old male is suspected to have pancreatic cancer. What particular tumour marker...

    Incorrect

    • A 60-year-old male is suspected to have pancreatic cancer. What particular tumour marker should be requested to aid in the confirmation of the diagnosis of pancreatic cancer?

      Your Answer:

      Correct Answer: Carcinoembryonic antigen (CEA)

      Explanation:

      Carcinoembryonic antigen (CEA) is used as a tumour marker. CEA test measures the amount of this protein that may appear in the blood of some people who have certain types of cancers especially cancer of the colon and rectal cancer. It may also be present in the pancreas, breast, ovary or lung.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 9 - There are several mechanisms involved in the transport of sodium ions from blood...

    Incorrect

    • There are several mechanisms involved in the transport of sodium ions from blood to interstitial fluid of the muscle cells. Which of the following mechanisms best describes this phenomenon?

      Your Answer:

      Correct Answer: Diffusion through channels between endothelial cells

      Explanation:

      Capillaries are the smallest of the body’s blood vessels, measuring 5–10 μm and they help to enable the exchange of water, oxygen, carbon dioxide, and many other nutrients and waste substances between the blood and the tissues surrounding them. The walls of capillaries are composed of only a single layer of cells, the endothelium. Ion channels are pore-forming proteins that help to establish and control the small voltage gradient that exists across the plasma membrane of all living cells by allowing the flow of ions down their electrochemical gradient. An ion channel is an integral membrane protein or more typically an assembly of several proteins. The archetypal channel pore is just one or two atoms wide at its narrowest point. It conducts a specific ion such as sodium or potassium and conveys them through the membrane in single file.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds
  • Question 10 - A teenage Somalian boy presents with a complaint of an enlarged lower jaw....

    Incorrect

    • A teenage Somalian boy presents with a complaint of an enlarged lower jaw. His blood film shows blast cells and macrophages. Which virus is responsible for this?

      Your Answer:

      Correct Answer: Epstein–Barr virus

      Explanation:

      Burkitt’s lymphoma is a type of non-Hodgkin’s lymphoma. Histologically it is characterised by a starry sky appearance due to numerous neoplastic macrophages which are required to clear the rapidly dividing tumour cells/blast cells. Burkitt’s lymphoma commonly affects the jaw bone, forming a huge tumour mass. It is associated with translocation of c-myc gene and has three types: 1) endemic/African type, 2)sporadic and 3)immunodeficiency-associated. The first type is strongly associated with EBV.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      0
      Seconds
  • Question 11 - A cell is classified on the basis of its regenerative ability. Which of...

    Incorrect

    • A cell is classified on the basis of its regenerative ability. Which of the following cells represent a permanent cell?

      Your Answer:

      Correct Answer: Erythrocyte

      Explanation:

      An erythrocyte is the last cell in the progeny of RBC cell division and is not capable of further division and regeneration. Hepatocytes, osteocytes and epithelium of kidney tubules are all stable cells. Colonic mucosa and pluripotent hematopoietic stem cells are all labile cells.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 12 - Pain in the epigastric region occurring typically 2-3 hours after meals and causing...

    Incorrect

    • Pain in the epigastric region occurring typically 2-3 hours after meals and causing the patient to wake up at night is characteristic of which of the following conditions?

      Your Answer:

      Correct Answer: Duodenal ulcer

      Explanation:

      The description is typical for duodenal ulcers. There is no pain upon waking in the morning however it appears around mid-morning and is relieved by ingestion of food. The pain also often causes the patient to wake up at night.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
      Seconds
  • Question 13 - A young man undergoes a total thyroidectomy and develops respiratory stridor and a...

    Incorrect

    • A young man undergoes a total thyroidectomy and develops respiratory stridor and a small haematoma in the neck, 5 hours after surgery. Which of the following is the most appropriate course of action?

      Your Answer:

      Correct Answer: Re-open the neck wound

      Explanation:

      Answer: Re-open the neck wound

      Thyroidectomy: complications
      Airway obstruction (compressing hematoma, tracheomalacia)

      Incidence of hematoma is 1-2%, tracheomalacia incidence is <1%. Acute airway obstruction from hematoma may occur immediately postoperatively and is the most frequent cause of airway obstruction in the first 24 hours. Definitive therapy is opening the surgical incision to evacuate the hematoma. Re-intubation may be lifesaving for persistent airway obstruction. Consider awake fibreoptic intubation.

    • This question is part of the following fields:

      • Post-operative Management And Critical Care
      • Principles Of Surgery-in-General
      0
      Seconds
  • Question 14 - A 45-year-old female is receiving chemotherapy for the treatment of metastatic breast cancer....

    Incorrect

    • A 45-year-old female is receiving chemotherapy for the treatment of metastatic breast cancer. You are called because it has become apparent that her doxorubicin infusion has extravasated. What is the most appropriate course of action?

      Your Answer:

      Correct Answer: Stop the infusion and apply a cold compress to the site

      Explanation:

      Extravasation is the process by which any liquid (fluid or drug) accidentally leaks into the surrounding tissue. In terms of cancer therapy, extravasation refers to the inadvertent infiltration of chemotherapy into the subcutaneous or subdermal tissues surrounding the intravenous or intra-arterial administration site.
      Extravasated drugs are classified according to their potential for causing damage as ‘vesicant’, ‘irritant’ and ‘non-vesicant’.
      Doxorubicin is one of the vesicant drugs.
      Regardless of the chemotherapy drug, early initiation of treatment is considered mandatory. In this context, patient education is crucial for prompt identification of the extravasation.
      Step 1: Stop the infusion and leave the needle in place
      Step 2: Identify the extravasated agent
      Step 3: Leave the cannula in place, gently aspirate the agent and avoid manual compression, then remove the cannula
      Step 4: Use a pen to outline the extravasated area
      Step 5: Start Specific measures
      Step 5A: For Anthracyclines (Doxorubicin), Apply cold compressions for 20 minutes, 4 times daily for 1-2 days.
      Step 5B: Using Specific Antidotes as Topical Dimethyl sulfoxide (DMSO) or Dexrazoxane

    • This question is part of the following fields:

      • Oncology
      • Principles Of Surgery-in-General
      0
      Seconds
  • Question 15 - A 71 year old woman is being observed at the hospital for severe...

    Incorrect

    • A 71 year old woman is being observed at the hospital for severe epigastric pain. Her abdomen is soft and non tender. However, the medical intern states that you should look at the ECG which looks abnormal. Which of the following features is an indication for urgent coronary thrombolysis or percutaneous intervention?

      Your Answer:

      Correct Answer: ST elevation of greater than 1mm in leads II, III and aVF

      Explanation:

      Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a nonsurgical technique for treating obstructive coronary artery disease, including unstable angina, acute myocardial infarction (MI), and multivessel coronary artery disease (CAD).

      Inferior STEMI is usually caused by occlusion of the right coronary artery, or less commonly the left circumflex artery, causing infarction of the inferior wall of the heart.

      The ECG findings of an acute inferior myocardial infarction include the following:
      ST segment elevation in the inferior leads (II, III and aVF)
      Reciprocal ST segment depression in the lateral and/or high lateral leads (I, aVL, V5 and V6)

    • This question is part of the following fields:

      • Emergency Medicine And Management Of Trauma
      • Principles Of Surgery-in-General
      0
      Seconds
  • Question 16 - A 30-year-old male presents to the clinic with a recurrent thyroid cyst. It...

    Incorrect

    • A 30-year-old male presents to the clinic with a recurrent thyroid cyst. It has been drained on three different occasions. Each time the cyst is aspirated and cytology is reassuring. What is the most appropriate course of action?

      Your Answer:

      Correct Answer: Resection of the ipsilateral thyroid lobe

      Explanation:

      Aspiration is the treatment of choice in thyroid cysts, but the recurrence rates are high (60%–90% of patients), particularly with repeated aspirations and large-volume cysts.
      Percutaneous ethanol injection (PEI) has been studied in several large randomized controlled studies, with reported success in 82–85% of the cases after an average of 2 sessions, with a volume reduction of more than 85% from baseline size.
      PEI may also be considered for hyperfunctioning nodules, particularly if a large fluid component is present. It has a success rate ranging from 64% to 95%, with a mean volume reduction of 66%, but recurrences are more common and the number of sessions required to achieve good response is higher (about 4 sessions per patient). PEI is a safe procedure, with the most common reported adverse effects being local pain, dysphonia, flushing, dizziness, and, rarely, recurrent laryngeal nerve damage.
      Surgery, Lobectomy is also a reasonable therapy for cystic lesions, as an alternative to the previously mentioned procedures.

    • This question is part of the following fields:

      • Breast And Endocrine Surgery
      • Generic Surgical Topics
      0
      Seconds
  • Question 17 - The gastrosplenic ligament also known as the gastrolienal ligament is the structure that...

    Incorrect

    • The gastrosplenic ligament also known as the gastrolienal ligament is the structure that connects the greater curvature of the stomach to the hilum of the spleen. Which of the following arteries would most likely be injured if a surgeon accidentally tore this ligament?

      Your Answer:

      Correct Answer: Short gastric

      Explanation:

      The short gastric arteries arise from the end of the splenic arteries and form five to seven branches. The short gastric arteries inside the gastrosplenic ligament from the left to the right, supply the greater curvature of the stomach. The hepatic artery proper runs inside the hepatoduodenal ligament. The right gastric artery and the left gastric artery are contained in the hepatogastric ligament. The caudal pancreatic artery branches off from the splenic artery and supplies the tail of the pancreas. The middle colic artery supplies the transverse colon. The splenic artery does not travel in the gastrosplenic ligament and so it would not be damaged by a tear to this ligament.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 18 - A 39 year old man with a long standing inguinal hernia inquires about...

    Incorrect

    • A 39 year old man with a long standing inguinal hernia inquires about the risk of strangulation over the next year if he decides not to have surgery done. He is seen with a small, direct inguinal hernia. Which percentage matches with the likely risk of strangulation over the year?

      Your Answer:

      Correct Answer:

      Explanation:

      Indirect inguinal hernias have a higher risk of strangulation. The risk of strangulation and obstruction is lowest for direct inguinal hernias as they have a wide neck, which can often be monitored and managed conservatively. A study conducted showed that the cumulative probability of strangulation for inguinal hernias was 2.8 per cent, rising to 4.5 per cent after 2 years.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • The Abdomen
      0
      Seconds
  • Question 19 - A 66 year old retired judge has recently undergone a wide local excision...

    Incorrect

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

      Your Answer:

      Correct Answer: Nodal status

      Explanation:

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

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

    • This question is part of the following fields:

      • Breast And Endocrine Surgery
      • Generic Surgical Topics
      0
      Seconds
  • Question 20 - The muscle which has an antagonistic action to the serratus anterior muscle and...

    Incorrect

    • The muscle which has an antagonistic action to the serratus anterior muscle and is the primary protractor of the scapula is the?

      Your Answer:

      Correct Answer: Rhomboid major

      Explanation:

      The rhomboid major arises from the second, third, fourth and fifth thoracic vertebrae. It is inserted into a narrow tendinous arch attached to the root of the spine of the scapula and the inferior angle. By its insertion in the inferior angle of the scapula, it acts on this angle and produces a slight rotation of the scapula on the side of the chest. It also retracts the scapula by working with the trapezius muscle.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 21 - A chef, whilst preparing food, cut her thumb with a knife. She transected...

    Incorrect

    • A chef, whilst preparing food, cut her thumb with a knife. She transected the arteria princeps pollicis. This artery is a branch of the?

      Your Answer:

      Correct Answer: Radial artery

      Explanation:

      The radial artery branches into the arteria princeps pollicis as it turns medially into the deep part of the hand. The arteria princeps pollicis is distributed to the skin and subcutaneous tissue of the thumb.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
      Seconds
  • Question 22 - An 8 year old boy presents with bleeding from the nose. From which...

    Incorrect

    • An 8 year old boy presents with bleeding from the nose. From which area did the bleeding most likely originate?

      Your Answer:

      Correct Answer: Kiesselbach's plexus

      Explanation:

      Answer: Kiesselbach’s plexus

      Epistaxis is defined as acute haemorrhage from the nostril, nasal cavity, or nasopharynx. The source of 90% of anterior nosebleeds within the Kiesselbach’s plexus (also known as Little’s area) on the anterior nasal septum.

      Kiesselbach’s plexus (Kiesselbach’s area or Little’s area) is a vascular region of the anteroinferior nasal septum that comprises four arterial anastomoses:
      1)anterior ethmoidal artery – a branch of the ophthalmic artery
      2)sphenopalatine artery

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Head And Neck Surgery
      0
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  • Question 23 - A 35-year-old male presents with recurrent episodes of knife-like pain within his rectum....

    Incorrect

    • A 35-year-old male presents with recurrent episodes of knife-like pain within his rectum. On examination, there is no abnormality to find on either proctoscopy or palpation. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Proctalgia fugax

      Explanation:

      Proctalgia fugax or functional recurrent anorectal pain is part of a spectrum of functional gastrointestinal disorders defined by the Rome III diagnostic criteria as episodes of sharp fleeting pain that recur over weeks, are localized to the anus or lower rectum, and last from seconds to several minutes with no pain between episodes. There is no diurnal variation. There are numerous precipitants including sexual activity, stress, constipation, defecation and menstruation, although the condition can occur without a trigger. It should be differentiated from chronic proctalgia, a functional anorectal pain disorder with a vague, dull ache or pressure sensation high in the rectum, often worse when sitting than when standing or lying down, and lasts at least 20 minutes.
      Most treatments for proctalgia fugax (e.g., oral diltiazem, topical glyceryl nitrate, nerve blocks) act by relaxing the anal sphincter spasm, but the effectiveness of these treatments are supported only by case reports or case series, with the exception of a single randomized controlled trial of salbutamol, making the value of most treatment options, including salbutamol, difficult to judge.

    • This question is part of the following fields:

      • Colorectal Surgery
      • Generic Surgical Topics
      0
      Seconds
  • Question 24 - A 56 year old man is scheduled for flexible sigmoidoscopy to investigate bright...

    Incorrect

    • A 56 year old man is scheduled for flexible sigmoidoscopy to investigate bright red rectal bleeding. Which of the following would be the most appropriate preparation for this procedure?

      Your Answer:

      Correct Answer: Single phosphate enema 30 minutes pre procedure

      Explanation:

      Bowel preparation is a significant aspect of the flexible sigmoidoscopy procedure. Clear visibility of the bowel mucosa is critical for a thorough examination. The combination of a light breakfast in the morning and the application of 1 or 2 phosphate enemas a few hours before the examination is a safe and commonly used method of preparing a patient for a flexible sigmoidoscopy procedure.

    • This question is part of the following fields:

      • Peri-operative Care
      • Principles Of Surgery-in-General
      0
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  • Question 25 - 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:

      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
      0
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  • Question 26 - A 30-year-old female presents with a painless lump in the upper outer quadrant...

    Incorrect

    • A 30-year-old female presents with a painless lump in the upper outer quadrant of her left breast. Ultrasound is indeterminate (U3). Two core biopsies show normal breast tissue (B1). What is the most appropriate course of action?

      Your Answer:

      Correct Answer: Undertake an excision biopsy of the lump

      Explanation:

      Discrete masses graded P3 or R3/M3 or U3 and above should be triple assessed using core biopsy rather than FNAC unless core biopsy is not feasible.
      When cytology or biopsy has been reported as C1 or B1 it will require a further biopsy to delineate the pathology in most instances.
      The exceptions are when the lesion is suspected to be a lipoma or hamartoma following imaging and discussion. Following triple assessment, if there is non-concordance by more than one grade then further biopsy and or investigations should be undertaken.
      In this case, Excisional biopsy is the next required biopsy to delineate the pathology.

    • This question is part of the following fields:

      • Breast And Endocrine Surgery
      • Generic Surgical Topics
      0
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  • Question 27 - A 62-year-old male patient in the intensive care unit was found to have...

    Incorrect

    • A 62-year-old male patient in the intensive care unit was found to have a low serum phosphate level. What is the serum level of phosphate which is considered as normal in adults?

      Your Answer:

      Correct Answer: 0.8–1.45 mmol/l

      Explanation:

      After calcium, phosphorus is the most plentiful mineral in the human body. It is an important and vital element which our body needs to complete many physiologic processes , such as filtering waste and repairing cells. Phosphorus helps with bone growth and approximately 85% of phosphate in the body is contained in bone. Phosphate is involved in energy storage, and nerve and muscle production. A normal range of plasma phosphate in adults teenagers generally from 0.8 mmol/l to 1.45 mmol/l. The normal range varies depending on age. Infants and children have higher phosphorus levels because more of this mineral is needed for their normal growth and bone development.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
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  • Question 28 - Skin infiltration by neoplastic T lymphocytes is seen in: ...

    Incorrect

    • Skin infiltration by neoplastic T lymphocytes is seen in:

      Your Answer:

      Correct Answer: Mycosis fungoides

      Explanation:

      Mycosis fungoides is a chronic T-cell lymphoma that involves the skin and less commonly, the internal organs such as nodes, liver, spleen and lungs. It is usually diagnosed in patients above 50 years and the average life expectancy is 7-10 years. It is insidious in onset and presents as a chronic, itchy rash, eventually spreading to involve most of the skin. Lesions are commonly plaque-like, but can be nodular or ulcerated. Symptoms include fever, night sweats and weight loss. Skin biopsy is diagnostic. However, early cases may pose a challenge due to fewer lymphoma cells. The malignant cells are mature T cells (T4+, T11+, T12+). The epidermis shows presence of characteristic Pautrier’s micro abscesses are present in the epidermis.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      0
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  • Question 29 - During a clinical rotation in the ENT clinic, you observe a flexible bronchoscopy....

    Incorrect

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

      Your Answer:

      Correct Answer: Carina

      Explanation:

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

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      0
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  • Question 30 - A 35 year old gardener presents to the clinic complaining of a lesion...

    Incorrect

    • A 35 year old gardener presents to the clinic complaining of a lesion on the dorsum of his right hand that has been present for the last 10 days. He had been pruning rose bushes before the lesion occurred. Examination shows a raised ulcerated lesion that bleeds easily on contact. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Pyogenic granuloma

      Explanation:

      Pyogenic granuloma is a vascular lesion that occurs on both mucosa and skin, and appears as an overgrowth of tissue due to irritation, physical trauma, or hormonal factors. It is often found to involve the gums, the skin and nasal septum, and has also been found far from the head such as in the thigh. Contact bleeding and ulceration are common.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Skin Lesions
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      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Basic Sciences (0/2) 0%
Pathology (0/1) 0%
Generic Surgical Topics (0/1) 0%
Upper Gastrointestinal Surgery (0/1) 0%
Anatomy (0/1) 0%
Passmed