MHKICBSC Part 1 - Applied Basic Sciences MCQ (Hong Kong) Feed

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A 35-year-old female presents with paresthesia in her right ring and little fingers, along with wasting of the hypothenar eminence. A diagnosis of thoracic outlet syndrome is suspected. Compression of which of the following structures in the scalene triangle is the primary cause of these symptoms?

Surgical Anatomy

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During an open inguinal hernia repair, the surgeon identifies a hernia sac projecting directly through Hesselbach's triangle. Which of the following landmarks forms the lateral boundary of this triangle?

Surgical Anatomy

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A surgeon is performing a laparoscopic cholecystectomy and is dissecting Calot's triangle. Which of the following structures forms the superior boundary of this space?

Surgical Anatomy

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During an emergency laparotomy for a bleeding duodenal ulcer, the surgeon decides to compress the hepatic artery in the free edge of the lesser omentum (Pringle maneuver). Which of the following structures lies immediately posterior to the epiploic foramen (Foramen of Winslow)?

Surgical Anatomy

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During a total thyroidectomy, ligation of the superior thyroid artery is performed. To avoid damaging the external branch of the superior laryngeal nerve, where should the artery be ligated?

Surgical Anatomy

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A patient undergoing a left hemicolectomy for colon cancer is at risk of ischemia at the splenic flexure. Which anatomical area represents this watershed zone between the superior and inferior mesenteric artery territories?

Surgical Anatomy

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A surgeon is performing an excision of a retroperitoneal sarcoma and needs to identify the ureter. Which of the following statements correctly describes the anatomical path or blood supply of the abdominal ureter?

Surgical Anatomy

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During a Whipple procedure (pancreaticoduodenectomy), which vessel represents the key anatomical landmark running immediately posterior to the neck of the pancreas and anterior to the uncinate process?

Surgical Anatomy

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A 60-year-old male with chronic pelvic pain undergoes pudendal nerve block. The pudendal nerve is targeted as it exits the pelvis through the greater sciatic foramen and re-enters through the lesser sciatic foramen. Which ligament is used as the key bony/fibrous landmark to locate the nerve at this site?

Surgical Anatomy

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A patient undergoing an axillary lymph node dissection for breast cancer is found to have lymph nodes located between the pectoralis major and pectoralis minor muscles. These nodes are classified as which of the following?

Surgical Anatomy

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A 70-year-old female presents with a painful mass in the groin, inferior and lateral to the pubic tubercle, which is diagnosed as a femoral hernia. Which of the following structures forms the medial boundary of the femoral ring through which the hernia protrudes?

Surgical Anatomy

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A patient presents with an inability to abduct the arm beyond 15 degrees and loss of sensation over the lateral shoulder following a proximal humeral fracture. Injury to which nerve is the most likely cause?

Surgical Anatomy

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During a pelvic dissection, the surgeon identifies the muscles of the pelvic floor. Which of the following muscles is the primary component of the levator ani that forms a sling around the anorectal junction, maintaining the anorectal angle?

Surgical Anatomy

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Anatomical variations of the hepatic artery are common. In about 10-15% of individuals, a replaced left hepatic artery arises from which of the following vessels?

Surgical Anatomy

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During a superficial parotidectomy, the branches of the facial nerve (CN VII) must be carefully preserved. Which branch of the facial nerve runs inferiorly and is at risk of injury during dissection of the lower pole of the parotid gland, potentially causing weakness in drawing down the corner of the mouth?

Surgical Anatomy

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A surgeon is performing an anterior lumbar interbody fusion (ALIF) and retroperitoneal dissection. Postoperatively, the patient reports numbness in the anterior thigh and difficulty extending the knee. Which nerve of the lumbar plexus was most likely compressed or injured during the retractor placement on the psoas muscle?

Surgical Anatomy

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During a splenectomy, the surgeon must mobilize the spleen by dividing its peritoneal attachments. Which ligament contains the splenic artery and vein as well as the tail of the pancreas, and must be ligated with extreme care?

Surgical Anatomy

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A 25-year-old male presents with a lucid interval followed by rapid deterioration of consciousness after being struck on the side of the head. Head CT reveals a biconvex (lens-shaped) extradural hematoma. Through which cranial opening does the artery responsible for this hemorrhage enter the skull?

Surgical Anatomy

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During a left supraclavicular lymph node biopsy (Virchow's node evaluation), a milky fluid begins to leak into the wound. This suggests injury to the thoracic duct. At which anatomical junction does the thoracic duct typically drain into the venous system?

Surgical Anatomy

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A 45-year-old typist complains of numbness and tingling in the thumb, index, and middle fingers, especially at night. On examination, there is weakness of thumb abduction. Which of the following structures forms the anterior roof of the carpal tunnel, which is incised during surgical decompression?

Surgical Anatomy

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General anesthesia and the supine position are known to significantly alter lung volumes. Which of the following parameters is defined as the volume of air remaining in the lungs at the end of a normal tidal expiration, and is decreased under general anesthesia?

Surgical Physiology

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A 45-year-old trauma patient experiences significant hemorrhage. In response to hypovolemia, which of the following physiological cascades is activated to maintain blood pressure and renal perfusion?

Surgical Physiology

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A 65-year-old male with severe coronary artery disease is undergoing an emergency laparotomy. The anesthesiologist monitors myocardial oxygen consumption. Which of the following factors has the GREATEST impact on increasing myocardial oxygen demand?

Surgical Physiology

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An arterial blood gas (ABG) from a patient with severe bowel ischemia reveals: pH 7.15, pCO2 28 mmHg, HCO3- 10 mEq/L, Na+ 140 mEq/L, Cl- 105 mEq/L. Which of the following acid-base disturbances is present?

Surgical Physiology

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The neuroendocrine response to surgical stress is characterized by changes in hormone levels to mobilize energy substrates. Which of the following hormonal changes is typical of the acute phase of this response?

Surgical Physiology

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A 48-year-old female experiences circumoral paresthesia and muscle spasms 24 hours after undergoing a total thyroidectomy. The symptoms are relieved by calcium gluconate. Which of the following hormones is primary in restoring extracellular calcium levels when they fall?

Surgical Physiology

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A patient with a high-output small bowel fistula is at risk of electrolyte imbalance. Which of the following is the predominant intracellular cation, whose homeostasis is critical to prevent cardiac arrhythmias?

Surgical Physiology

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Gastric acid secretion is tightly regulated by neural, endocrine, and paracrine pathways. Which of the following cells in the gastric mucosa is responsible for producing hydrochloric acid (HCl), and which receptor does NOT directly stimulate its secretion?

Surgical Physiology

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A postoperative patient is found to have a prolonged activated partial thromboplastin time (aPTT) but a normal prothrombin time (PT). Which clotting factor deficiency or inhibition is most likely responsible for this laboratory profile?

Surgical Physiology

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In early hemorrhagic shock (Class I and II), how does the body compensate to maintain perfusion to vital organs like the brain and heart?

Surgical Physiology

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A patient on a mechanical ventilator develops a mucous plug in the left main bronchus. Which of the following physiological changes occurs in the left lung?

Surgical Physiology

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Which of the following metabolical adaptations occurs during prolonged starvation (simple starvation), but is absent or suppressed during the catabolic stress of sepsis or major trauma?

Surgical Physiology

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A patient undergoing a prolonged abdominal surgery under general anesthesia is at risk of hypothermia. Which of the following represents a major physiological consequence of intraoperative hypothermia (temperature < 35°C)?

Surgical Physiology

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A postoperative patient develops oliguria. The fractional excretion of sodium (FeNa) is calculated to be less than 1%, and the urine osmolality is > 500 mOsm/kg. Which of the following is the most likely diagnosis?

Surgical Physiology

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Bile salts are essential for the emulsification and absorption of dietary fats. At which anatomical site are the majority of bile salts active reabsorbed to enter the enterohepatic circulation?

Surgical Physiology

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A patient with a suspected pheochromocytoma is prepared for tumor resection. To prevent a hypertensive crisis during surgery, which of the following pharmacological strategies is physiological necessary?

Surgical Physiology

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Stored red blood cells undergo a depletion of 2,3-diphosphoglycerate (2,3-DPG) over time. What is the physiological consequence of transfusing blood with low 2,3-DPG levels?

Surgical Physiology

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What is the primary physiological drive for ventilation in a healthy individual under normal conditions, and which chemoreceptors are primarily responsible?

Surgical Physiology

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A patient with congestive heart failure is prescribed furosemide (a loop diuretic). Which of the following describes its primary site and mechanism of action in the nephron?

Surgical Physiology

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During the proliferation phase of wound healing, which of the following cell types is primary in synthesizing collagen and glycosaminoglycans to form granulation tissue, and which vitamin is cofactor for collagen cross-linking?

Surgical Physiology

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A 55-year-old male undergoes a distal pancreatectomy for chronic pancreatitis. Histological analysis of the peripancreatic tissue reveals necrotic cells with chalky-white deposits and focal calcium accumulation. Which type of necrosis is described?

Pathology Microbiology

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The TP53 gene is a crucial tumor suppressor. Which of the following best describes the physiological role of the p53 protein in response to DNA damage?

Pathology Microbiology

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During the acute inflammatory response, which of the following chemical mediators is primarily responsible for causing immediate vasoconstriction followed by prolonged vasodilation and increased vascular permeability?

Pathology Microbiology

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A 40-year-old male presents with severe pain, swelling, and crepitus in his thigh 24 hours after sustaining a contaminated deep laceration. A Gram stain of the wound exudate reveals large Gram-positive, anaerobic bacilli. Which organism is the most likely cause of this life-threatening condition?

Pathology Microbiology

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Gram-negative bacterial sepsis is initiated by the interaction of bacterial cell wall components with the host immune system. Which specific component of the Gram-negative cell wall binds to Toll-like receptor 4 (TLR4) on macrophages to trigger the release of pro-inflammatory cytokines?

Pathology Microbiology

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A 30-year-old female presents with a raised, firm, pruritic scar over her sternum that has grown beyond the boundaries of the original surgical incision made 1 year ago. Histological examination shows thick, disorganized, hyalinized collagen bundles. What is the diagnosis?

Pathology Microbiology

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Atherosclerosis is a disease of the large and medium-sized arteries. Which of the following events is considered the crucial initiating step in the pathogenesis of an atherosclerotic plaque?

Pathology Microbiology

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