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  • Question 1 - A 24-year-old man was hit on the lateral aspect of his head by...

    Correct

    • A 24-year-old man was hit on the lateral aspect of his head by a high velocity cricket ball and lost consciousness immediately. Paramedics found him to have a Glasgow coma score of 15 but take him to the A&E for further investigation. His Glasgow coma score on examination in the A&E is 13 (M5, V4, E4) and he has anterograde and retrograde amnesia to recent events. The doctors arrange an urgent CT scan. Which clinical sign would be most concerning if present?

      Your Answer: Bradycardia

      Explanation:

      Intracranial pressure (ICP) is a complex brain modality that determines cerebral perfusion pressure (CPP), which is the difference between arterial blood pressure (ABP), and ICP. Raised ICP reduces CPP and blood delivery to the brain. This jeopardizes cerebral function and organismal survival in many species. A massive rise in ICP is also known to produce an increase in ABP, bradycardia and respiratory irregularities termed Cushing response. This mechanism is generally considered to be an agonal and terminal event occurring in extreme condition of brainstem ischaemia leading to a sympatho-adrenal response.

    • This question is part of the following fields:

      • Clinical Sciences
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      Seconds
  • Question 2 - Choose the karyotype associated with short stature: ...

    Incorrect

    • Choose the karyotype associated with short stature:

      Your Answer:

      Correct Answer: 45,XO

      Explanation:

      Turner syndrome (TS) is one of the most common genetic disorders; occurs with an incidence of I: 2,500 female live births. It results from complete or partial chromosome X monosomy. TS is associated with abnormalities of the X chromosome and characteristic clinical features of short stature, gonadal dysgenesis, sexual developmental deficiencies, cardiac and/or renal defects, webbed neck, low-set ears, skeletal deformities including cubitus valgus, a propensity to ear infections and hearing deficits.

    • This question is part of the following fields:

      • Clinical Sciences
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  • Question 3 - A 34-year-old male patient is admitted with hemisection of the spinal cord at...

    Incorrect

    • A 34-year-old male patient is admitted with hemisection of the spinal cord at the level T5, after being stabbed in the back. Which sign would you expect to see by assessing the patient's sensory function and muscle strength?

      Your Answer:

      Correct Answer: Contralateral loss of temperature, ipsilateral loss of fine touch and vibration, ipsilateral spastic paresis

      Explanation:

      Depending on the level of SCI, patients experience paraplegia or tetraplegia. Paraplegia is defined as the impairment of sensory or motor function in lower extremities. Patients with incomplete paraplegia generally have a good prognosis in regaining locomotor ability (,76% of patients) within a year. Complete paraplegic patients, however, experience limited recovery of lower limb function if their NLI is above T9. The spinothalamic tract is the one responsible for sensory information such as pain or temperature. However, it decussates at the same level the nerve root enters the spinal cord, meaning that the sensory loss will be contralateral. However, the dorsal column carries sensory fibres for fine touch and vibration and it decussates at the medulla which means that the sensory loss will be ipsilateral. The corticospinal tract is responsible for motor functions and it decussates at the medulla, meaning that the motor function loss will be ipsilateral.

    • This question is part of the following fields:

      • Clinical Sciences
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  • Question 4 - Intracellular proteins tagged with mannose-6-phosphate are destined to which of the following organelles?...

    Incorrect

    • Intracellular proteins tagged with mannose-6-phosphate are destined to which of the following organelles?

      Your Answer:

      Correct Answer: Lysosome

      Explanation:

      Lysosomal hydrolases are synthesized in the rough endoplasmic reticulum and specifically transported through the Golgi apparatus to the trans-Golgi network, from which transport vesicles bud to deliver them to the endosomal/lysosomal compartment. The explanation of how the lysosomal enzymes are accurately recognized and selected over many other proteins in the trans-Golgi network relies on them being tagged with a unique marker: the mannose-6-phosphate (M6P) group, which is added exclusively to the N-linked oligosaccharides of lysosomal soluble hydrolases, as they pass through the cis-Golgi network. Generation of the M6P recognition marker depends on a reaction involving two different enzymes: UDP-N-acetylglucosamine 1-phosphotransferase and α-N-acetylglucosamine-1-phosphodiester α-N-acetylglucosaminidase.

    • This question is part of the following fields:

      • Clinical Sciences
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  • Question 5 - A 52-year-old man presents with numbness and tingling in his left hand. On...

    Incorrect

    • A 52-year-old man presents with numbness and tingling in his left hand. On examination he has weakness of elbow extension, metacarpophalangeal joint flexion and extension and distal interphalangeal joint flexion. All other movements and reflexes are normal. Sensation is normal apart from reduced pin-prick sensation over the medial aspect of the hand. An MRI scan of the cervical spine is performed due to suspicion of a nerve lesion. Which of the following pathologies is most likely to be found on the scan based on the clinical findings?

      Your Answer:

      Correct Answer: Disc herniation between C7 and T1

      Explanation:

      The C8 nerve forms part of the radial and ulnar nerves via the brachial plexus, and therefore has motor and sensory function in the upper limb. It originates from the spinal column from below the cervical vertebra 7 (C7).
      The C8 nerve receives sensory afferents from the C8 dermatome. This consists of all the skin on the little finger, and continuing up slightly past the wrist on the palmar and dorsal aspects of the hand and forearm.
      The other options available correspond to the C6 or C7 roots and these are unaffected as evidenced by normal elbow flexion and thumb sensation (C6) and normal sensation over the middle finger (C7). Elbow extension is weak as it has roots from both C7 and C8 and so cannot be used alone to decide between the two levels clinically.
      The C8 nerve contributes to the motor innervation of many of the muscles in the trunk and upper limb. Its primary function is the flexion of the fingers, and this is used as the clinical test for C8 integrity, in conjunction with the finger jerk reflex.

      Trunk:
      – Pectoralis major – Medial and lateral pectoral nerves (C5, C6, C7, C8, T1)
      – Pectoralis minor – Medial pectoral nerve (C5, C6, C7,C8, T1)
      – Latissimus dorsi – Thoracodorsal nerve (C6, C7, C8)
      Upper arm:
      – Triceps brachii – Radial nerve (C6, C7,C8)
      Forearm
      – Flexor carpi ulnaris – Ulnar nerve (C7, C8, T1)
      – Palmaris longus – Median nerve (C7,C8)
      – Flexor digitorum superficialis – Median nerve (C8, T1)
      – Flexor digitorum profundus – Median and Ulnar nerves (C8, T1)
      – Flexor pollicis longus – Median nerve (C7,C8)
      – Pronator quadratus – Median nerve (C7,C8)
      – Extensor carpi radialis brevis – Deep branch of the radial nerve (C7,C8)
      – Extensor digitorum – Posterior interosseous nerve (C7,C8)
      – Extensor digiti minimi – Posterior interosseous nerve (C7,C8)
      – Extensor carpi ulnaris – Posterior interosseous nerve (C7,C8)
      – Anconeus – Radial nerve (C6, C7,C8)
      – Abductor pollicis longus – Posterior interosseous nerve (C7,C8)
      – Extensor pollicis brevis – Posterior interosseous nerve (C7,C8)
      – Extensor pollicis longus – Posterior interosseous nerve (C7,C8)
      – Extensor indicis – Posterior interosseous nerve (C7,C8)
      Hand
      – Palmaris brevis – Superficial branch of ulnar nerve (C8, T1)
      – Dorsal interossei – Deep branch of ulnar nerve (C8, T1)
      – Palmar interossei – Deep branch of ulnar nerve (C8, T1)
      – Adductor pollicis – Deep branch of ulnar nerve (C8, T1)
      – Lumbricals – Deep branch of ulnar, Digital branches of median nerve
      – Opponens pollicis – Recurrent branch of median nerve (C8, T1)
      – Abductor pollicis brevis – Recurrent branch of median nerve (C8, T1)
      – Flexor pollicis brevis – Recurrent branch of median nerve (C8, T1)
      – Opponens digiti minimi – Deep branch of ulnar nerve (C8, T1)
      – Abductor digiti minimi – Deep branch of ulnar nerve (C8, T1)
      – Flexor digiti minimi brevis – Deep branch of ulnar nerve (C8, T1)

    • This question is part of the following fields:

      • Clinical Sciences
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  • Question 6 - Choose the correct definition regarding the standard error of the mean: ...

    Incorrect

    • Choose the correct definition regarding the standard error of the mean:

      Your Answer:

      Correct Answer: Standard deviation / square root (number of patients)

      Explanation:

      The SEM is an indicator of how close the sample mean is to the population mean. In reality, however, only one sample is extracted from the population. Therefore, the SEM is estimated using the standard deviation (SD) and a sample size (Estimated SEM). The SEM computed by a statistical program is an estimated value calculated via this process.

      Estimated Standard Error of the Mean (SEM)=SDn√

    • This question is part of the following fields:

      • Clinical Sciences
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  • Question 7 - Which of the following is not a tumour suppressor gene? ...

    Incorrect

    • Which of the following is not a tumour suppressor gene?

      Your Answer:

      Correct Answer: myc

      Explanation:

      Myc is a family of regulator genes and proto-oncogenes that code for transcription factors.

      A tumor suppressor gene, or antioncogene, is a gene that protects a cell from one step on the path to cancer. When this gene mutates to cause a loss or reduction in its function, the cell can progress to cancer, usually in combination with other genetic changes. Tumor suppressor genes can be grouped into categories including caretaker genes, gatekeeper genes, and landscaper genes; the classification schemes are continually evolving.
      Examples include:
      Gene Associated cancers
      p53 Common to many cancers, Li-Fraumeni syndrome
      APC Colorectal cancer
      BRCA1 Breast and ovarian cancer
      BRCA2 Breast and ovarian cancer
      NF1 Neurofibromatosis
      Rb Retinoblastoma
      WT1 Wilm’s tumour

    • This question is part of the following fields:

      • Clinical Sciences
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  • Question 8 - A study is developed to compare two chemotherapy schemas for individuals with small...

    Incorrect

    • A study is developed to compare two chemotherapy schemas for individuals with small cell lung cancer. Which of the following would you choose to compare survival time with in this particular study?

      Your Answer:

      Correct Answer: Hazard ratio

      Explanation:

      The hazard ratio describes the relative risk of the complication based on comparison of event rates.

      Hazard ratios have also been used to describe the outcome of therapeutic trials where the question is to what extent treatment can shorten the duration of the illness. However, the hazard ratio, a type of relative risk, does not always accurately portray the degree of abbreviation of the illness that occurred. In these circumstances, time-based parameters available from the time-to-event curve, such as the ratio of the median times of the placebo and drug groups, should be used to describe the magnitude of the benefit to the patient. The difference between hazard-based and time-based measures is analogous to the odds of winning a race and the margin of victory. The hazard ratio is the odds of a patient’s healing faster under treatment but does not convey any information about how much faster this event may occur.

    • This question is part of the following fields:

      • Clinical Sciences
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  • Question 9 - A cohort study is developed to assess the correlation between blood pressure and...

    Incorrect

    • A cohort study is developed to assess the correlation between blood pressure and working long hours. After 10 years of follow-up and for the 1050 individuals working less than 40 hours per week, 1000 patients had normal blood pressure and 50 patients were diagnosed with hypertension. For the 660 patients working more than 40 hours per week, 600 patients had normal blood pressure and 60 patients were diagnosed with hypertension. If you work more than 40 hours per week, what is the odds ratio of developing hypertension compared to the individuals working less than 40 hours per week?

      Your Answer:

      Correct Answer: 2

      Explanation:

      An odds ratio (OR) is a measure of the association between an exposure and an outcome. The OR represents the odds that an outcome will occur given a particular exposure, compared to the odds of the outcome occurring in the absence of that exposure. Odds ratios are most commonly used in case-control studies, however they can also be used in cross-sectional and cohort study designs as well (with some modifications and/or assumptions). Where

      a = Number of exposed cases

      b = Number of exposed non-cases

      c = Number of unexposed cases

      d = Number of unexposed non-cases

      OR=(a/c) / (b/d) = ad/bc

    • This question is part of the following fields:

      • Clinical Sciences
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  • Question 10 - A 38-year-old female is referred to the dermatologist for a rash on both...

    Incorrect

    • A 38-year-old female is referred to the dermatologist for a rash on both her elbows. The rash is red, is papulovesicular in nature, and looks like it has many small blisters. The dermatologist diagnoses her with dermatitis herpetiformis. Which HLA haplotype is this associated with?

      Your Answer:

      Correct Answer: HLA-DR3

      Explanation:

      Dermatitis herpetiformis (DH), or Duhring’s disease, is a chronic blistering skin condition,characterised by blisters filled with a watery fluid. Despite its name, it is neither related to nor caused by herpes virus: the name means that it is a skin inflammation having an appearance similar to herpes.
      Dermatitis herpetiformis is characterized by intensely itchy, chronic papulovesicular eruptions, usually distributed symmetrically on extensor surfaces (buttocks, back of neck, scalp, elbows, knees, back, hairline, groin, or face)
      Dermatitis herpetiformis is an autoimmune condition associated with HLA-DR3.
      HLA-A3 is associated with haemochromatosis. HLA-B5 is most commonly associated with Behcet’s disease. HLA-DR4 is associated with both type 1 diabetes mellitus and rheumatoid arthritis. HLA-B27 is most commonly associated with several diseases, most commonly ankylosing spondylitis.

    • This question is part of the following fields:

      • Clinical Sciences
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Clinical Sciences (1/1) 100%
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