Free Bachelor of Medicine & Bachelor of Surgery Trivia Questions and Answers — Questions and Answers
Question 1: After an MVC, an ambulance transports a 43-year-old woman who has numerous left rib fractures and respiratory problems to the emergency department. She exhibits tachycardia, tachypnea, and hypoxia. Chest XR shows the tip of the NG tube in the left chest after an NG tube is inserted. Which statement about the issue with this patient is accurate?
- This injury occurs more commonly on the left side (Correct answer)
- Rib fractures can obscure NG location on XR and CT scan should be performed
- NG tube is in the left airway and should be removed
- NG tubes commonly puncture the esophagus if care is not taken in placement
Correct answer: This injury occurs more commonly on the left side
The presence of an NG tube in the left chest after multiple left rib fractures indicates a traumatic diaphragmatic rupture. This injury occurs more commonly on the left side because the liver on the right side provides a protective barrier to the right hemidiaphragm, making it less prone to rupture from blunt trauma. The NG tube's position confirms herniation of abdominal contents into the thoracic cavity.
Question 2: Which statement about the Renin-Angiotensin System is TRUE?
- Angiotensinogen is secreted by the kidney
- ACE converts Angiotensinogen to Angiotensin I
- Renin stimulates the conversion from Angiotensin I to Angiotensin II
- Decreased renal perfusion stimulates renin production (Correct answer)
Correct answer: Decreased renal perfusion stimulates renin production
The Renin-Angiotensin System (RAS) is a vital regulatory pathway for blood pressure and fluid balance. Renin, an enzyme produced by the juxtaglomerular cells in the kidneys, is primarily stimulated by decreased renal perfusion. This reduction in blood flow to the kidneys, often due to low blood pressure or hypovolemia, triggers the release of renin to initiate the cascade that ultimately raises blood pressure.
Question 3: Chyle leaks are frequently treated by adding extra of the following fatty acids to the patient's diet:
- Short-chain
- Medium-chain (Correct answer)
- Long-chain
- Very Long-chain
Correct answer: Medium-chain
Chyle leaks involve the leakage of lymphatic fluid, which is rich in long-chain triglycerides (LCTs) absorbed via the lymphatic system. To reduce lymphatic flow and promote healing of the leak, a diet supplemented with medium-chain fatty acids (MCFAs) is often prescribed. MCFAs are absorbed directly into the portal venous system, bypassing the lymphatic system, thereby decreasing the volume and LCT content of chyle.
Question 4: A biological mechanism for each of the following bacteria's antibiotic resistance is correctly matched, WITH THE EXCEPTION OF:
- Vancomycin Resistant Enterococcus: mutation in Penicillin Binding Protein (PBP) on the cell membrane
- Gentamycin Resistant Enterococcus: mutation in Penicillin Binding Protein (PBP) on the cell membrane (Correct answer)
- Carbapenem Resistant Klebsiella pneumonia (KPC): Carbapenemase production
- Methicillin Resistant Staph aureus: mutation in Penicillin Binding Protein (PBP) on the cell membrane
Correct answer: Gentamycin Resistant Enterococcus: mutation in Penicillin Binding Protein (PBP) on the cell membrane
Gentamicin resistance in Enterococcus is typically mediated by aminoglycoside-modifying enzymes that inactivate the antibiotic, not by mutations in Penicillin Binding Proteins (PBPs). PBP mutations are primarily associated with resistance to beta-lactam antibiotics, such as methicillin resistance in Staph aureus or vancomycin resistance in Enterococcus (though VRE often involves altered peptidoglycan precursors, not directly PBP mutation for vancomycin itself).
Question 5: A woman visits the emergency room six days after starting warfarin therapy with severe, black eschars on her arm, breast, buttocks, and foot. Your presumed illness is probably caused by a lack in one of the following:
- Vitamin K
- Vitamin C
- Platelets
- Protein C (Correct answer)
Correct answer: Protein C
The patient's severe, black eschars developing shortly after starting warfarin therapy are characteristic of warfarin-induced skin necrosis. This rare but serious complication is caused by a transient hypercoagulable state resulting from the rapid depletion of Protein C, a natural anticoagulant, before the depletion of procoagulant factors. This imbalance leads to microthrombosis and subsequent skin necrosis.
Question 6: Which of the following typically becomes severely depleted and is frequently administered after large and enormous blood transfusions:
- Calcium (Correct answer)
- Vitamin K
- Potassium
- Glucose
Correct answer: Calcium
Massive blood transfusions frequently lead to hypocalcemia due to the citrate anticoagulant present in stored blood products. Citrate binds to ionized calcium in the recipient's bloodstream, effectively chelating it and reducing its physiological availability. This can cause various symptoms, including cardiac dysfunction, necessitating careful monitoring and often calcium supplementation during large volume transfusions.
Question 7: A 56-year-old guy who underwent a heart catheterization earlier in the day is brought to your attention. He expresses pain in the femoral region (site of procedure). A painful, pulsating lump is palpable, and ultrasound results support your probable diagnosis of pseudoaneurysm. The tumor had kept growing despite fruitless attempts to treat the compression of the ultrasonography probe and thrombin injection. What should we do next?
- covered stent placement
- surgical ligation (Correct answer)
- ultrasound probe compression
- ultrasound-guided thrombin injection
Correct answer: surgical ligation
A pseudoaneurysm is a contained rupture of an artery. When less invasive methods like ultrasound-guided compression and thrombin injection fail to resolve a growing, painful, pulsating lump, it indicates a persistent and potentially worsening problem. Surgical ligation or repair becomes necessary to directly close or excise the pseudoaneurysm, preventing further expansion, rupture, or complications like distal ischemia.
Free Bachelor of Medicine & Bachelor of Surgery Trivia Questions and Answers
After an MVC, an ambulance transports a 43-year-old woman who has numerous left rib fractures and respiratory problems to the emergency department.
She exhibits tachycardia, tachypnea, and hypoxia.
Chest XR shows the tip of the NG tube in the left chest after an NG tube is inserted.
Which statement about the issue with this patient is accurate?