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  • Question 1 - The deep planter artery is a branch of the: ...

    Correct

    • The deep planter artery is a branch of the:

      Your Answer: Dorsalis pedis artery

      Explanation:

      The deep plantar artery is a branch of the dorsalis pedis artery.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      22.2
      Seconds
  • Question 2 - A 5-year-old child diagnosed with nephrotic syndrome developed generalised oedema. What is the...

    Correct

    • A 5-year-old child diagnosed with nephrotic syndrome developed generalised oedema. What is the mechanism for the development of oedema in patients with nephrotic syndrome?

      Your Answer: Decreased colloid osmotic pressure

      Explanation:

      The development of oedema in nephrotic syndrome has traditionally been viewed as an underfill mechanism. According to this view, urinary loss of protein results in hypoalbuminemia and decreased plasma oncotic pressure. As a result, plasma water translocates out of the intravascular space and results in a decrease in intravascular volume. In response to the underfilled circulation, effector mechanisms are then activated that signal the kidney to secondarily retain salt and water. While an underfill mechanism may be responsible for oedema formation in a minority of patients, recent clinical and experimental findings would suggest that oedema formation in most nephrotic patients is the result of primary salt retention. Direct measurements of blood and plasma volume or measurement of neurohumoral markers that indirectly reflect effective circulatory volume are mostly consistent with either euvolemia or a volume expanded state. The ability to maintain plasma volume in the setting of a decreased plasma oncotic pressure is achieved by alterations in transcapillary exchange mechanisms known to occur in the setting of hypoalbuminemia that limit excessive capillary fluid filtration.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pathology
      6
      Seconds
  • Question 3 - Which of the following is the most common germ cell tumour of the...

    Correct

    • Which of the following is the most common germ cell tumour of the testis affecting an adult male?

      Your Answer: Seminoma

      Explanation:

      Germ cell tumours represent 90% of primary tumours arising in the testis. They are broadly divided into seminomas and non-seminomas. Seminomas are the most common testicular germ cell tumour seen in 40% cases. The other non-seminomatous histological subtypes include embryonal (25%), teratocarcinoma (25%), teratoma (5%) and pure choriocarcinoma (1%).

    • This question is part of the following fields:

      • Pathology
      • Urology
      46.1
      Seconds
  • Question 4 - A 15-year-old girl was diagnosed with bacterial meningitis. Gram staining of the spinal...

    Correct

    • A 15-year-old girl was diagnosed with bacterial meningitis. Gram staining of the spinal fluid shows numerous polymorphonuclear neutrophils and Gram-positive cocci. Which is the empiric drug of choice to be given to the patient until the antibiotic sensitivity report is available?

      Your Answer: Ceftriaxone

      Explanation:

      Acute meningitis is a medical emergency. All suspects should receive their first dose of antibiotics immediately and be transferred to hospital as soon as possible. If facilities for blood culture and/or lumbar puncture (LP) are immediately available, they should be performed before administration
      of the first dose of antibiotics (see contraindications to LP below). Neither procedure should lead to a significant delay in antibiotic administration.
      Administer ceftriaxone 80-100 mg/kg (maximum 2 g, 12 hourly) intravenously. The intramuscular or intraosseous route can be used if there is no vascular access. Penicillin allergy is not a contraindication to ceftriaxone in acute meningitis (C-1). Omit ceftriaxone only if there has been documented ceftriaxone anaphylaxis. Give chloramphenicol 25 mg/kg (maximum 500 mg) intravenously instead, if available. Administer adequate analgesia and transfer the patient immediately to hospital, detailing all administered
      medication in the referral letter.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      16.3
      Seconds
  • Question 5 - A medical student is asked to calculate the net pressure difference in a...

    Incorrect

    • A medical student is asked to calculate the net pressure difference in a capillary wall, considering: Interstitial fluid hydrostatic pressure = –3 mmHg, Plasma colloid osmotic pressure = 28 mmHg, Capillary hydrostatic pressure = 17 mmHg, Interstitial fluid colloid osmotic pressure = 8 mmHg, and Filtration coefficient = 1. Which is the correct answer?

      Your Answer: +3 mmHg

      Correct Answer: 0 mmHg

      Explanation:

      The rate of filtration at any point along a capillary depends on a balance of forces sometimes called Starling’s forces after the physiologist who first described their operation in detail. The Starling principle of fluid exchange is key to understanding how plasma fluid (solvent) within the bloodstream (intravascular fluid) moves to the space outside the bloodstream (extravascular space). Fluid movement = k[(pc– pi)–(Πc– Πi)] where k = capillary filtration coefficient, pc = capillary hydrostatic pressure, pi= interstitial hydrostatic pressure, Πc = capillary colloid osmotic pressure, Πi = interstitial colloid osmotic pressure. Therefore: 1 × [capillary hydrostatic pressure (17) – interstitial fluid hydrostatic pressure (–3)] – [plasma colloid osmotic pressure (28) – interstitial fluid colloid osmotic pressure (8)] = 0 mmHg

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      36.3
      Seconds
  • Question 6 - During a surgical procedure involving the carotid artery, which nerve in the cervical...

    Incorrect

    • During a surgical procedure involving the carotid artery, which nerve in the cervical plexus of nerves that is embedded in the carotid sheath is most susceptible to injury?

      Your Answer: Phrenic nerve

      Correct Answer: Ansa cervicalis

      Explanation:

      The ansa cervicalis is a loop of nerves that are part of the cervical plexus. They lie superficial to the internal jugular vein in the carotid triangle. Branches from the ansa cervicalis innervate the sternohyoid, sternothyroid and the inferior belly of the omohyoid. The superior root of the ansa cervicalis is formed by a branch of spinal nerve C1. These nerve fibres travel in the hypoglossal nerve before leaving to form the superior root. The superior root goes around the occipital artery and then descends embedded in the carotid sheath. It sends a branch off to the superior belly of the omohyoid muscle and is then joined by the inferior root. The inferior root is formed by fibres from spinal nerves C2 and C3.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      115.2
      Seconds
  • Question 7 - A 45-year old farmer was referred to the surgical clinic with complaints of...

    Incorrect

    • A 45-year old farmer was referred to the surgical clinic with complaints of pain in his right hypochondrium. Investigations confirmed the diagnosis of hepatocellular carcinoma with malignant ascites. According to you, what is the most likely cause of HCC in this patient?

      Your Answer: Hepatitis A virus

      Correct Answer: Aflatoxin

      Explanation:

      Aflatoxins are naturally occurring toxins produced by the Aspergillus fungus (most often, A. flavus and A. parasiticus). These organisms are common and their native habitat is soil, decaying vegetation and grains. They can contaminate the grain before harvest or after storage, more likely in high-humidity (at least 7%) or high temperature environment of after stressful conditions like drought. Aflatoxins are mycotoxins and also carcinogenic. They get metabolized in the liver to an epoxide, aflatoxin M1. High exposure can lead to acute necrosis, cirrhosis or liver carcinoma. These substances can cause haemorrhage, acute liver damage, oedema, and alteration in digestion, absorption and/or metabolism of nutrients. Although humans are susceptible to these toxins like all other animals, they have a high tolerance level and hence, rarely develop acute aflatoxicosis. However, children are particularly susceptible to exposure leading to growth impairment and delayed development. Chronic exposure carries a high risk of hepatic cancer, due to intercalation of its metabolite aflatoxin M1 into the DNA and alkylation of the bases because of its epoxide moiety.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      23.1
      Seconds
  • Question 8 - A 78-year-old man who has been bedridden for a month is prescribed griseofulvin....

    Incorrect

    • A 78-year-old man who has been bedridden for a month is prescribed griseofulvin. What class of drugs does griseofulvin belong to?

      Your Answer: Autonomic nervous system drugs

      Correct Answer: Antifungal

      Explanation:

      Griseofulvin is an antifungal drug. It is administered orally, and it is used to treat ringworm infections of the skin and nails. It binds to keratin in keratin precursor cells and makes them resistant to fungal infections. Griseofulvin works by interfering with fungal mitosis.

    • This question is part of the following fields:

      • Pathology
      • Pharmacology
      70.6
      Seconds
  • Question 9 - A surgeon ligates the left superior suprarenal artery whilst preforming a left adrenalectomy....

    Incorrect

    • A surgeon ligates the left superior suprarenal artery whilst preforming a left adrenalectomy. Where does the left superior suprarenal artery originate?

      Your Answer: Abdominal aorta

      Correct Answer: Left inferior phrenic artery

      Explanation:

      The superior suprarenal arteries arises from the inferior phrenic artery on either side.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      15.7
      Seconds
  • Question 10 - A young lady visited a doctor with complaints of fever and a dull,...

    Incorrect

    • A young lady visited a doctor with complaints of fever and a dull, continuous pain in the right lumbar region for 6 days. On, enquiry, she recalled passing an increasing number of stools with occasional blood in last few months. Lower gastrointestinal endoscopic biopsy was taken 5 cm proximal to ileocaecal valve which showed transmural inflammation with several granulomas. Tissue section showed the absence of acid-fast bacillus. She denies any history of travel and her stool cultures were negative. What is the likely diagnosis?

      Your Answer: Ulcerative colitis

      Correct Answer: Crohn’s disease

      Explanation:

      Crohn’s disease is a chronic, inflammatory disease that can affect any part of the gastrointestinal tract but is usually seen in the distal ileum and colon. It is transmural and symptoms include chronic diarrhoea, abdominal pain, fever, anorexia and weight loss. On examination, there is usually abdominal tenderness with a palpable mass or fullness seen occasionally. Rectal bleeding is uncommon (except in isolated colonic involvement) which manifests like ulcerative colitis. Differential diagnosis includes acute appendicitis or intestinal obstruction. 25%-33% patients also have perianal disease in the form of fissure or fistulas.

      Extra intestinal manifestations predominate in children, and include: arthritis, pyrexia, anaemia or growth retardation. Histologically, the disease shows crypt inflammation and abscesses initially, which progress to aphthoid ulcers. These eventually develop into longitudinal and transverse ulcers with interspersed mucosal oedema, leading to the characteristic ‘cobblestoned appearance’. Transmural involvement leads to lymphoedema and thickening of bowel wall and mesentery, leading to extension of mesenteric fat on the serosal surface of bowel and enlargement of mesenteric nodes. There can also be hypertrophy of the muscularis mucosae, fibrosis and stricture formation, which can cause bowel obstruction.

      Abscesses are common and the disease can also leas to development of fistulas with various other organs, anterior abdominal wall and adjacent muscles. Pathognomonic non-caseating granulomas are seen in 50% cases and they can occur in nodes, peritoneum, liver, and in all layers of the bowel wall. The clinical course does not depend on the presence of granulomas. There is sharp demarcation between the diseased and the normal bowel (skip areas).

      35% cases show only the ileal involvement, whereas in 45% cases, both the ileum and colon are involved with a predilection for right side of colon. 20% cases show only colonic involvement, often sparing the rectum (unlike ulcerative colitis). In occasional cases, there is jejunoileitis – involvement of the entire small bowel. The stomach, duodenum and oesophagus are rarely involved, although there has been microscopic evidence of disease involving the gastric antrum in younger patients. The affected small bowel segments show increased rick of cancer. Moreover, patients with colonic disease show a long-term risk of cancer similar to that seen in ulcerative colitis.

    • This question is part of the following fields:

      • Gastrointestinal; Hepatobiliary
      • Pathology
      51.1
      Seconds
  • Question 11 - The stomach is an organ that is divided into several important anatomical parts....

    Incorrect

    • The stomach is an organ that is divided into several important anatomical parts. These parts of the stomach have varied arterial blood supply that ensure that the whole organ receive oxygenated blood. Which of the following arteries if ligated, will not render any portion of the stomach ischaemic?

      Your Answer: Hepatic

      Correct Answer: Superior mesenteric

      Explanation:

      The blood supply to the stomach is through the following arteries:

      – The superior mesenteric artery supplies blood to the lower part of the duodenum, pancreas and two-thirds of the transverse colon. Thus ligation of the superior mesenteric artery would not affect the stomach.

      – The right and the left gastroepiploic arteries supply the greater curvature of the stomach – along its edges.

      – The short gastric artery supplies blood to the upper portion of the of the greater curvature and the fundus of the stomach.

      – The gastroduodenal artery supplies blood to the distal part of the stomach (the pyloric sphincter) and the proximal end of the duodenum.

      – The left gastroepiploic and the short gastric are branches of the splenic artery and therefore ligation of the splenic artery would directly affect the stomach.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      78.3
      Seconds
  • Question 12 - A patient with this type of tumour is advised to follow up regularly...

    Correct

    • A patient with this type of tumour is advised to follow up regularly for monitoring of tumour size as there is a strong correlation with malignant potential and tumour size. Which of the following is the most likely tumour in this patient?

      Your Answer: Renal adenocarcinoma

      Explanation:

      The distinction between a benign renal adenoma and renal adenocarcinoma is commonly made on the basis of size. Tumours less than 2 cm in size rarely become malignant as opposed to those greater than 3 cm.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      8.3
      Seconds
  • Question 13 - During clinic, a medical student conducts a physical examination on a teenage boy...

    Correct

    • During clinic, a medical student conducts a physical examination on a teenage boy with a lump in the inguinal region. The lump is protruding from the superficial inguinal ring. The student correctly concluded that it was:

      Your Answer: Either a direct or an indirect inguinal hernia

      Explanation:

      It is not possible to tell if an inguinal hernia is direct or indirect just by palpating it. Despite the fact that indirect inguinal hernias commonly come out of the superficial inguinal ring to enter the scrotum, direct inguinal hernia might still do this.

      Femoral hernia goes through the femoral ring into the femoral canal (has nothing to do with the superficial inguinal ring).

      Superficial inguinal lymph nodes lie in the superficial fascia parallel to the inguinal ligament; it would therefore feel more superficial and would not be mistaken for a hernia protruding through the inguinal ring.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      43
      Seconds
  • Question 14 - A patient at the time of her second delivery opted for a bilateral...

    Incorrect

    • A patient at the time of her second delivery opted for a bilateral pudendal nerve block. In order to inject the anaesthetic agent near the pudendal nerve a anaesthetic consultant had to insert a finger into the vagina and press laterally to palpate which landmark?

      Your Answer: Lateral fornix

      Correct Answer: Ischial spine

      Explanation:

      The ischial spine is always palpated through the walls of the vagina when performing a transvaginal pudendal nerve block and can easily be palpated on the lateral wall of the vagina.

    • This question is part of the following fields:

      • Anatomy
      • Pelvis
      34.1
      Seconds
  • Question 15 - A teenager presents with pain and swelling in a limb which increases after...

    Incorrect

    • A teenager presents with pain and swelling in a limb which increases after activity. X-rays reveal an expansible, eccentric, lytic lesion in the metaphysis distally in the affected bone surrounded by new bone. What is the most likely diagnosis?

      Your Answer: Chondrosarcoma

      Correct Answer: Aneurysmal bone cyst

      Explanation:

      Aneurysmal bone cysts tend to develop in patients younger than 20 years old. They usually occur in the metaphyseal region of long bones, and are cystic lesions composed of numerous blood filled channels that grow slowly. In X-rays, they show up as circumscribed lesions, sometimes surrounded by new bone.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      16.3
      Seconds
  • Question 16 - A lad involved in a road traffic accident is rushed to casualty where...

    Incorrect

    • A lad involved in a road traffic accident is rushed to casualty where physical examination reveals that he has limited extension of his right humerus. Which of the following nerves is most likely to have been injured?

      Your Answer: Long thoracic nerve

      Correct Answer: Thoracodorsal nerve

      Explanation:

      Extension of the humerus is a function of the latissimus dorsi. This muscle is supplied by the thoracodorsal nerve which is a branch of the posterior cord of the plexus whose fibres are derived from cranial nerves V, VI and VII.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      27.6
      Seconds
  • Question 17 - A 30 year old man suffered severe blood loss, approx. 20-30% of his...

    Incorrect

    • A 30 year old man suffered severe blood loss, approx. 20-30% of his blood volume. What changes are most likely seen in the pulmonary vascular resistance (PVR) and pulmonary artery pressure (PAP) respectively following this decrease in cardiac output?

      Your Answer: Decrease Decrease

      Correct Answer: Increase Decrease

      Explanation:

      Hypovolemia will result in the activation of the sympathetic adrenal discharge resulting is a decrease pulmonary artery pressure and an elevated pulmonary vascular resistance.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      35.7
      Seconds
  • Question 18 - A 26-year-old female sought consultation due to excessive vaginal discharge. Vaginal smear showed...

    Incorrect

    • A 26-year-old female sought consultation due to excessive vaginal discharge. Vaginal smear showed numerous bacilli under the microscope. The organism was non-pathogenic. What is the most likely organism:

      Your Answer: Gardnerella vaginalis

      Correct Answer: Lactobacillus species

      Explanation:

      Lactobacillus is a Gram-positive facultative bacteria. It is commonly present in the vagina and the gastrointestinal tract. Colonization of Lactobacillus is usually benign and it makes up a small portion of the gastrointestinal flora.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      8.9
      Seconds
  • Question 19 - A retroperitoneal structure is: ...

    Correct

    • A retroperitoneal structure is:

      Your Answer: Pancreas

      Explanation:

      Retroperitoneal structures are those that are found behind the peritoneum. They include: kidneys, suprarenal glands, bladder, ureter, inferior vena cava, rectum, oesophagus (part of it), part of the pancreas, 2nd, 3rd and 4th parts of the duodenum and ascending and descending parts of the colon.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      6.2
      Seconds
  • Question 20 - Diuretics that act on the ascending limb of the loop of Henle produce:...

    Correct

    • Diuretics that act on the ascending limb of the loop of Henle produce:

      Your Answer: Reduced active transport of sodium

      Explanation:

      The loop of Henlé leads from the proximal convoluted tubule to the distal convoluted tubule. Its primary function uses a counter current multiplier mechanism in the medulla to reabsorb water and ions from the urine. It can be divided into four parts:

      1. Descending limb of loop of Henlé – low permeability to ions and urea, while being highly permeable to water

      2. Thin ascending limb of loop of Henlé – not permeable to water, but it is permeable to ions

      3. Medullary thick ascending limb of loop of Henlé – sodium (Na+), potassium (K+) and chloride (Cl–) ions are reabsorbed by active transport. K+ is passively transported along its concentration gradient through a K+ channel in the basolateral aspect of the cells, back into the lumen of the ascending limb.

      4. The cortical thick ascending limb – the site of action where loop diuretics such as furosemide block the K+/Na+/2Cl− co-transporters = reduced active transport.

    • This question is part of the following fields:

      • Physiology
      • Renal
      18.4
      Seconds
  • Question 21 - In a hypertensive patient with secondary hyperaldosteronism, aldosterone is released mainly in response...

    Correct

    • In a hypertensive patient with secondary hyperaldosteronism, aldosterone is released mainly in response to:

      Your Answer: Angiotensin II

      Explanation:

      Secondary hyperaldosteronism in hypertension is either due to primary renin overproduction by the kidneys or renin overproduction secondary to decreased renal blood flow. The main stimulus for aldosterone release are adrenocorticotrophic hormone (ACTH), angiotensin II and high plasma K+ levels. Low plasma Na+ might also stimulate the adrenal cortex. Fluid overload will reduce aldosterone secretion. Atrial natriuretic peptide is secreted under conditions of expanded extracellular volume and will not lead to aldosterone secretion.

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      12.3
      Seconds
  • Question 22 - A 55-year old patient with signs and symptoms of internal haemorrhage was brought...

    Correct

    • A 55-year old patient with signs and symptoms of internal haemorrhage was brought in for emergency surgery to control the bleeding. Angiography results revealed an advanced duodenal tumour that had perforated the blood vessel immediately behind the first part of the duodenum. Which of the following is the most likely blood vessel that was ruptured by the cancer?

      Your Answer: Gastroduodenal artery

      Explanation:

      The gastroduodenal artery is the artery that lies just behind the first portion of the duodenum. The gastroduodenal artery would be the most likely artery to be perforated by a cancer in this area. The perforation is as a result of the spillage of the acidic content of the chyme in the duodenum. All the other blood vessels in the list would less likely be affected by the gastric expellant from the duodenum. The coronary vein is located in the lesser curvature of the stomach. The inferior pancreaticoduodenal arcade is located inferiorly to the first part of the duodenum on the head of the pancreas. The hepatic artery proper is a branch of the common hepatic artery that is located superior to the first portion of the duodenum. The splenic vein arises from the spleen; it forms the portal vein by joining the superior mesenteric vein. It is laterally detached from the duodenum. Both the left gastric vein and the splenic vein are located superior to the first portion of the duodenum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      20.3
      Seconds
  • Question 23 - Abnormal breathing is noticed in a of victim of a road traffic accident,...

    Correct

    • Abnormal breathing is noticed in a of victim of a road traffic accident, who sustained a head injury. The breathing pattern is characterised by alternate periods of waxing and waning tidal volumes with interspersed periods of apnoea. This breathing pattern is known as:

      Your Answer: Cheyne–Stokes breathing

      Explanation:

      Cheyne-Stokes breathing is an abnormal breathing pattern with breathing periods of gradually waxing and waning tidal volumes, with apnoeic periods interspersed. It is usually the first breathing pattern to be seen with a rise in intracranial pressure and is caused by failure of the respiratory centre in the brain to compensate quickly enough to changes in serum partial pressure of oxygen and carbon dioxide. The aetiology includes strokes, head injuries, brain tumours and congestive heart failure. It is also a sign of altitude sickness in normal people, a symptom of carbon monoxide poisoning or post-morphine administration. Biot’s respiration (cluster breathing) is characterized by cluster of quick, shallow inspirations followed by regular or irregular periods of apnoea. It is different from ataxic respiration, which has completely irregular breaths and pauses. It results due to damage to the medulla oblongata by any reason (stroke, uncal herniation, trauma) and is a poor prognostic indicator. Kussmaul breathing, also known as ‘air hunger’, is basically respiratory compensation for metabolic acidosis and is characterized by quick, deep and laboured breathing. It is most often seen in in diabetic ketoacidosis. Due to forced inspiratory rate, the patients will show a low p(CO2). Ondine’s curse is congenital central hypoventilation syndrome or primary alveolar hypoventilation, which can be fatal and leads to sleep apnoea. It involves an inborn failure to control breathing autonomically during sleep and in severe cases, can affect patients even while awake. It is known to occur in 1 in 200000 liveborn children. Treatment includes tracheostomies and life long mechanical ventilator support.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      9.7
      Seconds
  • Question 24 - Which of the following is involved in vitamin B12 absorption? ...

    Incorrect

    • Which of the following is involved in vitamin B12 absorption?

      Your Answer: Transferrin

      Correct Answer: Intrinsic factor

      Explanation:

      Absorption of vitamin B12 is by an active transport process and occurs in the ileum. Most cobalamins are bound to proteins and are released in the stomach due to low pH and pepsin. The cobalamins then bind to R proteins, i.e. haptocorrin (HC) secreted from salivary glands and gastric juice. Another cobalamin binding protein is Intrinsic factor (IF) secreted from the gastric parietal cells. The cobalamin-HC complex is digested by pancreatic proteases in the intestinal lumen, and the free cobalamin then binds to IF. The complex then reaches a transmembrane receptor in the ileum and undergoes endocytosis. Cobalamin is then released intracellularly and binds to transcobalamin II (TC II). The newly formed complex then exits the ileal cell and enters the blood circulation.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      10.9
      Seconds
  • Question 25 - Which antibiotic acts by inhibiting protein synthesis? ...

    Incorrect

    • Which antibiotic acts by inhibiting protein synthesis?

      Your Answer: Co-trimoxazole

      Correct Answer: Erythromycin

      Explanation:

      Penicillins and cephalosporins (e.g. cefuroxime, cefotaxime, ceftriaxone) inhibit bacterial cell wall synthesis through the inhibition of peptidoglycan cross-linking.

      Macrolides (e.g. erythromycin), tetracyclines, aminoglycosides and chloramphenicol act by interfering with bacterial protein synthesis.

      Sulphonamides (e.g. trimethoprim, co-trimoxazole) work by inhibiting the synthesis of nucleic acid

    • This question is part of the following fields:

      • Pharmacology; Microbiology
      • Physiology
      16.1
      Seconds
  • Question 26 - A surgeon performing a Whipple's procedure, that involves mobilizing the head of the...

    Correct

    • A surgeon performing a Whipple's procedure, that involves mobilizing the head of the pancreases, accidentally injured a structure immediately posterior to the neck of the pancreases which bled out. Which structure is most likely to have been injured?

      Your Answer: Superior mesenteric artery

      Explanation:

      The splenic vein runs behind the pancreas, receives the inferior mesenteric vein and joins the superior mesenteric vein to form the portal vein behind the pancreatic neck.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      11
      Seconds
  • Question 27 - A 7-year old child from a rural setting complains of recurrent abdominal pain....

    Incorrect

    • A 7-year old child from a rural setting complains of recurrent abdominal pain. The child is found to have a heavy parasitic infestation and anaemia. Which type of anaemia is most likely seen in this patient?

      Your Answer: Haemolytic anaemia

      Correct Answer: Iron deficiency anaemia

      Explanation:

      The most common cause of iron deficiency anaemia in children in developing countries is parasitic infection (hookworm, amoebiasis, schistosomiasis and whipworm).

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      11.7
      Seconds
  • Question 28 - The middle meningeal artery is the largest among the arteries that supplies that...

    Incorrect

    • The middle meningeal artery is the largest among the arteries that supplies that dura mater of the brain. The middle meningeal artery is a branch of the?

      Your Answer: Internal carotid artery

      Correct Answer: Maxillary artery

      Explanation:

      The middle meningeal artery is the largest of the three (paired) arteries that supply the meninges.

      The middle meningeal artery is a large arterial branch of the maxillary artery which is a terminal branch of the external carotid artery. Upon originating, the middle meningeal artery passes through the foramen spinosum. In the skull, it courses in the middle cranial fossa where it provides several branches.

    • This question is part of the following fields:

      • Anatomy
      • Head & Neck
      246.2
      Seconds
  • Question 29 - The vascular structure found on the right side of the fifth lumbar vertebra...

    Correct

    • The vascular structure found on the right side of the fifth lumbar vertebra is?

      Your Answer: Inferior vena cava

      Explanation:

      The most likely vascular structure is the inferior vena cava. The inferior vena cava is formed by the joining of the two common iliac arteries, the right and the left iliac artery, at the level of the fifth lumbar vertebra( L5). The inferior vena cava passes along the right side of the vertebral column. It enters the thoracic cavity into the underside of the heart through the caval opening of the diaphragm at the level of the eight thoracic vertebra (T8).

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      173.3
      Seconds
  • Question 30 - Which of the following physiological changes will you see in a young man...

    Incorrect

    • Which of the following physiological changes will you see in a young man who has been trekking in the Himalayas for 3 years?

      Your Answer: Pulmonary vasodilatation

      Correct Answer: Increased renal excretion of HCO3 –

      Explanation:

      The atmospheric pressure is lower at high altitudes as compared with sea level. This leads to a decrease in the partial pressure of oxygen. Once 2100 m (7000 feet) of altitude is reached, there is a drop in saturation of oxyhaemoglobin. The oxygen saturation of haemoglobin determines the oxygen content in the blood. The body physiological tries to adapt to high altitude by acclimatization. Immediate effects include hyperventilation, fluid loss (due to a decreased thirst drive), increase in heart rate and slightly lowered stroke volume. Long term effects include lower lactate production, compensatory alkali loss in urine, decrease in plasma volume, increased erythropoietin release and red cell mass, increased haematocrit, higher concentration of capillaries in striated muscle tissue, increase in myoglobin, increase in mitochondria, increase in aerobic enzyme concentration such as 2,3-DPG and pulmonary vasoconstriction.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      30.9
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (6/12) 50%
Lower Limb (1/1) 100%
Fluids & Electrolytes (1/2) 50%
Pathology (4/10) 40%
Urology (1/1) 100%
Microbiology (1/3) 33%
Physiology (3/8) 38%
Head & Neck (0/2) 0%
Gastrointestinal; Hepatobiliary (0/2) 0%
Pharmacology (0/1) 0%
Abdomen (5/7) 71%
Neoplasia (1/1) 100%
Pelvis (0/1) 0%
Orthopaedics (0/1) 0%
Upper Limb (0/1) 0%
Cardiovascular (0/1) 0%
Renal (1/1) 100%
Endocrinology (1/1) 100%
Respiratory (1/2) 50%
Gastroenterology (0/1) 0%
Pharmacology; Microbiology (0/1) 0%
Passmed