MCQ TEST ANSWERS - PART I

I am providing the answers of questions asked in MCQ test. If you have not done the test so far, first write the test, send the answers to me and then see these correct answers

LEVEL ONE

1.Which among the following does not cause edema?

a.       Increased hydrostatic pressure

b.      Increased protein in blood

c.       Lymphatic obstruction

d.      Inflammation

Question 1:
 Hydrostatic pressure is because of the fluid component of blood. It tries to push the fluid out of the vessels.
 So increase in hydrostatic pressure will push more fluid out of the vessel. Hence more fluid will accumulate in the interstitium resulting in edema.

Osmotic pressure (Oncotic pressure) is due to the solutes like protein in the blood. Osmotic pressure tends to pull the blood back into the blood vessels.. 
If protein level increases in blood, osmotic pressure will also increase. so more blood will be pulled back into the blood vessel from interstitium. Fluid in interstitium will become less. Hence there is no edema.

Normally lymphatics remove whatever fluid is collected in interstitium. So if lymphatics are blocked, fluid cannot be removed from interstitium. Hence more fluid accumulates in interstitium resulting in edema.

Inflammation is associated with an increase in vascular permeability. Hence more fluid accumulates in the interstitium resulting in edema.

So the right answer is OPTION B.


2. Which is not a clinical manifestation of shock?

a.       Hypotension

b.      Weak pulse

c.       Bradycardia

d.      Cool skin

Direct answer. Refer to the clinical consequences of shock in your text book. Shock is associated with hypotension, weak pulse and cool skin.

To compensate for the hypotension heart rate will increase. Hence tachycardia is usually seen in shock and not bradycardia. Hence option C is the answer.

3. Which among the following leads to prolonged prothrombin time?

a.       Factor VIII deficiency

b.      Factor IX deficiency

c.       Factor VII deficiency 

Prothrombin time is an investigation used to assess the extrinsic pathway. It is prolonged if there is deficiency of a factor involved in extrinsic pathway. Of the given options, only Factor VII belongs to extrinsic pathway. Hence that is the answer.

4.Arrange the following events in the correct order of their occurrence

1) Platelet aggregation

2) Platelet adhesion

3) Clot formation

4) vasoconstriction

a.       1,2,3,4

b.      2,1,3,4

c.       4,1,2,3

d.      4,2,1,3

After injury to a vessel, an initial vasoconstriction happens so that less blood is lost. This is followed by two steps, primary hemostasis and secondary hemostasis. 

Primary hemostasis is nothing but the formation of a platelet plug which plugs the injured site in the vessel. Primary hemostasis involves two substeps.
1. Platelet adheres to the vessel wall at the site of injury (Platelet adhesion)
2. After platelet adhesion to the vessel wall, numerous platelets aggregate together so that the injured site is completely sealed (platelet aggregation)

But the platelet plug is not strong enough to last for a long time.  A clot has to be formed to seal the injured site permanently. So coagulation system is activated resulting in clot formation. This step is called secondary hemostasis.

So the order of events is vasoconstriction followed by platelet adhesion, next platelet aggregation and then clot formation. Option D is the right answer

5. Which among the following is not a hypercoagulable state?

a.       Oral contraceptive use

b.      Cancer

c.       Exercise

Obviously answer C is the right answer. you can refer the table of hypercoagulable states in your textbook