Haematology Study Notes for AKT and PLA Exams

123 Questions

A 40-year-old woman presents with a 2-day history of worsening dyspnea and cough. She has a history of rheumatoid arthritis and is currently taking prednisone and methotrexate. Chest X-ray shows bilateral infiltrates. What is the most likely diagnosis?

Pneumocystis jirovecii pneumonia

A 30-year-old woman presents with a 2-week history of right upper quadrant pain and jaundice. She has a history of heavy alcohol consumption and smokes 10 cigarettes daily. What is the most likely diagnosis?

Alcoholic hepatitis

A 45-year-old man presents with a 6-month history of progressive numbness and weakness in his legs. He has a history of back pain and has been taking narcotics for pain relief. What is the most likely diagnosis?

Spinal cord compression

A 25-year-old woman presents with a 2-day history of fever, headache, and confusion. She has a history of IV drug use and HIV infection. What is the most likely diagnosis?

Cryptococcal meningitis

A 60-year-old man presents with a 4-week history of worsening shortness of breath, cough, and fatigue. He has a history of smoking 20 cigarettes daily for 30 years. What is the most likely diagnosis?

Chronic obstructive pulmonary disease

A 50-year-old woman presents with a 2-year history of worsening fatigue, weight loss, and dark urine. She has a history of rheumatoid arthritis and is currently taking methotrexate. What is the most likely diagnosis?

Methotrexate-induced bone marrow suppression

What is the primary function of the spleen?

To filter the blood and remove old or damaged red blood cells

What is the term for the abnormal production of red blood cells?

Erythrocytosis

Which of the following is a characteristic of sickle cell disease?

Abnormal hemoglobin production

What is the term for the formation of blood clots?

Thrombosis

What is the primary function of platelets?

To form blood clots

What is the term for the abnormal bleeding that occurs due to a deficiency of clotting factors?

Hemophilia

What is the term for the study of blood and blood-forming tissues?

Hematology

What is the term for the abnormal increase in white blood cells?

Leukocytosis

Match the following mood/affective problems with their descriptions:

Depressive disorders = Mood/affective problem Bipolar disorders = Mood/affective problem Suicidal risk = Mood/affective problem

What is included in organic brain syndrome?

Dementia

Which of the following are urinary problems?

Renal biopsy

Which of the following are recognized major nutritional abnormalities associated with thyroid disorders?

Goitre; nodules

Hypothyroidism is a type of thyroid disorder.

True

Match the following endocrine conditions with their descriptions:

Diabetes Mellitus = Type 1 diabetes, Type 2 diabetes, Diabetic foot care, Hypoglycaemia/hyperglycaemia General = Hyperparathyroidism, Hypoparathyroidism, Multiple endocrine neoplasia Adrenal = Adrenal gland, Addisonian crisis, Addison’s disease, Hyperaldosteronism

What are some potential causes of earache?

Infection

Abnormal blood film is associated with abnormalities in peripheral blood film (red cell, white cell, and platelets), differential white cell count, and __________.

ESR

Which of the following are haematological malignancies and myeloproliferative disorders?

Amyloidosis

Immunosuppressive drugs are used to boost the immune system.

False

Match the following congenital abnormalities with their descriptions:

Ventricular septal defect = Opening in the wall that separates the heart's lower chambers Atrial septal defect = Opening in the wall that separates the heart's upper chambers Patent ductus arteriosus = Failure of a fetal blood vessel to close after birth Aortic stenosis = Narrowing of the heart's aortic valve

What is a common benign breast condition characterized by a solid lump?

fibro-adenoma

Which of the following are causes of anaemia?

Sideroblastic anaemia

Which nerve innervates the superior oblique muscle and causes diplopia on downgaze?

Trochlear nerve

In a 33-year-old man complaining of double vision when looking to the right, which nerve is the SINGLE most likely to be involved?

Right abducens

What is the SINGLE most likely structure affected in a 32-year-old patient with an inability to extend the distal phalanx of the ring finger after a cut?

Extensor digitorum

Which artery descends into the anterior interventricular groove? A. Acute marginal branch B. ______ C. Septal branches D. Circumflex artery E. Right coronary artery

Left anterior descending artery

In a 45-year-old man with herpes zoster over the dermatome of the maxillary branch of the trigeminal nerve, which mucosa is MOST likely affected along with the dermatome?

Palate

What is the SINGLE most likely cause of symptoms in a 60-year-old man who had a myocardial infarction 2 weeks ago, presents with dyspnea and pleuritic chest pain, shows widespread ST elevation on ECG, has an enlarged, globular heart on chest X-ray, and has a pericardial friction rub on examination?

Dressler’s syndrome

What is the SINGLE most likely diagnosis in a 62-year-old man with a routine ECG pre-operatively for an elective knee replacement, in sinus rhythm, with gradual prolongation of the PR interval followed by a dropped beat every 3 or 4 QRS complexes?

Mobitz type 1 block

A 60 year old man experienced a rupture at the cubital fossa while screwing his cupboard to the wall. What is the SINGLE most likely diagnosis based on the symptoms of weakness on flexion and supination, and a lump in the distal arm?

Biceps tendon rupture

What important landmark is found above the 5th intercostal space and anterior to the mid-axillary line?

Chest drain insertion

A camel rider sustains an injury to the lateral side of his right leg below the knee, resulting in bruising, tenderness, inability to dorsiflex or evert the foot, and loss of sensation in specific areas. What is the SINGLE most likely anatomical structure affected?

Common peroneal nerve

What nerve is most likely to be involved in a fracture dislocation of the right elbow resulting in loss of sensation in the little finger and ring finger?

Ulnar nerve

A 75-year-old woman experiences sudden painless loss of vision in her right eye, with a history of similar episodes. Which artery is most likely involved?

Central retinal artery

In a patient diagnosed with carcinoma of the head of the pancreas, which structure is in close proximity with the affected area?

Common bile duct

After undergoing surgery for varicose veins, a patient complains of numbness on the medial side of their foot. Which nerve is most likely involved?

Saphenous nerve

Following a mandibular fracture, a patient experiences loss of sensation over the chin and mucosal surface of the lower lip. Which nerve is most likely affected?

Inferior alveolar nerve

A patient struck above the knee experiences loss of motor control in the leg, foot drop, and loss of sensation over specific areas. What is the SINGLE most likely anatomical structure to be affected?

Common peroneal nerve

In a lateral cervical X-ray for neck injury evaluation, which is the lowest vertebra that should be visible on the X-ray?

C7/T1

Where can a calculus be lodged in the biliary tree to cause obstructive jaundice following cholecystectomy?

Common hepatic duct

What structure lies just above the midpoint of the inguinal ligament?

Deep inguinal ring

At the midpoint between the suprasternal notch and pubic symphysis, what landmark is located?

Transpyloric plane

What is the most likely structure to be damaged causing numbness and weakness on the left hand post prolonged arm hanging?

Radial nerve

What structure is most likely affected causing foot drop and sensory loss between the big toe and second toe post sitting cross-legged?

Deep peroneal nerve

What is the most likely visual defect following a temporal lobe stroke?

Upper homonymous quadrantanopias

Which lymph node is likely involved in a nonhealing ulcer on the right medial malleolus?

Inguinal lymph node

What is the lymphatic drainage of the testes?

Para-aortic nodes

Where is the single most likely location of a collection in the peritoneum in a patient with a known posterior gastric ulcer?

Lesser sac

Which vertebrae is likely to be affected in a patient experiencing back pain at the midpoint of the spine at the level of the iliac crest?

Which is the single most likely tendon to have been damaged in a patient who can only extend the interphalangeal joint of the right thumb but not the metacarpophalangeal joint?

Extensor pollicis brevis

Which is the single most likely nerve to be affected in a patient presenting with outward gaze, ptosis of the right eye, and seeing double?

Right oculomotor

What is the single most likely anatomical structure to be pierced when inserting a drain in the mid-axillary line?

Intercostal muscles

What is the single most likely associated injury in a patient with pain on the medial side of the left forearm, weakness of finger abduction and adduction, weakness upon adduction of the thumb, and muscle atrophy in the left hand?

T1 nerve root injury

In a patient with atrial fibrillation, what is the single most appropriate management based on the clinical presentation provided?

Metoprolol

Based on the ECG provided, what is the single most likely diagnosis for a patient with sudden central chest pain and shortness of breath?

Left bundle branch block

Which of the following may cause the abnormalities of the QRS axis shown on the ECG provided?

Inferior myocardial infarction

A 72 year old woman has had a stroke a month ago. Which is the SINGLE most likely anatomical site to be affected?

Internal capsule

A 35 year old man is due for surgery to remove a glioma. What is the SINGLE most likely anatomical structure to be opened during the surgery?

Dura Mater

A 69 year old woman has been diagnosed with left ovary carcinoma. What lymph nodes are likely to be removed?

Para-aortic nodes

A 68 year old woman is unable to extend the interphalangeal joint of her right thumb six weeks following a fracture of the right radius. What is the SINGLE most likely tendon to be damaged?

Extensor pollicis longus

A 12 year old boy presents with a painful swollen knee after a sudden fall on his right knee. The pain is localized below the knee cap. Which SINGLE anatomical structure is most likely to be affected?

Prepatellar bursa

A 34 year old man has a white patch on the margin of the mid-third of his tongue. Which is the SINGLE most likely lymph node involved?

Submandibular lymph node

A 45 year old man has a cancer of the posterior oropharynx. What is the SINGLE most likely lymph node to be involved?

Deep cervical nodes

A 36 year old male involved in a street fight presents with bruises and deformity of his lower right knee. The X-ray shows a fracture of the neck of the fibula. What is the SINGLE most associated nerve injury?

Common peroneal nerve

Which reflex and innervating spinal nerves are correctly paired?

Knee jerk reflex – L3 & L4

A 23 year old man is having difficulty in speaking following a stab wound to the right of his neck. On tongue protrusion test, the tip of the tongue is deviated to the right. Which nerve is the SINGLE most likely to be affected in this patient?

Hypoglossal nerve

What anatomical landmark correlates to the tip of the 9th costal cartilage?

Fundus of the gallbladder

A 63 year old woman presents with an inability to flex the proximal interphalangeal joint of her fingers of the left hand. What structure is most likely to be injured in her case?

Flexor digitorum superficialis

A 63 year old lady with a BMI of 32 has pigmentation on her legs and dilated veins on the lateral aspect of her ankles. Which structure would be involved?

Short saphenous vein

A 15 year old boy complains of double vision when climbing down the stairs and looking to the right since he was hit in the face. What is the SINGLE most likely nerve to be affected?

Left trochlear nerve

Which nerve is responsible for the contraction of the external anal sphincter muscle?

S2-S4

Which of the following nerves is involved in the knee jerk reflex?

L3 & L4

A patient presents with a stab wound to the right of the neck and has difficulty speaking. On tongue protrusion test, the tip of the tongue is deviated to the right. Which nerve is most likely damaged?

Hypoglossal nerve

Which muscle is innervated by the C6 & C7 nerve roots?

Brachioradialis

Which nerve is responsible for the contraction of the quadriceps muscle?

Femoral nerve

A patient presents with a fracture of the humerus and has lost sensation over the deltoid region. Which nerve is most likely damaged?

Axillary nerve

Which anatomical landmark is located above the 5th intercostal space and anterior to the mid-axillary line?

Nipple

A patient presents with a injury to the lateral side of the leg below the knee, resulting in bruising, tenderness, inability to dorsiflex or evert the foot, and loss of sensation in specific areas. Which nerve is most likely damaged?

Common peroneal nerve

Which cranial nerve is responsible for finger abduction and adduction?

Ulnar nerve

What is the anatomical landmark located at the level of the 9th rib?

Transpyloric plane

Which muscle is responsible for full extension of the thumb?

Extensor pollicis longus

What is the artery that descends into the anterior interventricular groove?

Left anterior descending artery

Which nerve is responsible for innervating the extensor digitorum muscle?

Posterior interosseous nerve

What is the superficial vein that travels on the lateral aspect of the ankle?

Short saphenous vein

Which anatomical structure is located about 2.5 cm above the midpoint of the inguinal ligament?

Deep inguinal ring

What is the level at which the skin at the medial malleolus drains into the inguinal lymph nodes?

Inguinal level

Which cranial nerve is responsible for the movement of the superior oblique muscle?

Trochlear nerve

What is the anatomical landmark found above the 5th intercostal space and anterior to the mid-axillary line?

Nipple

Which abdominal structure is in close proximity to the head of the pancreas?

Duodenum

Which nerve is responsible for the innervation of the extensor carpi radialis brevis muscle in the upper limb?

Radial nerve

Which muscle is responsible for the abduction of the thumb?

Abductor pollicis brevis

Which nerve is responsible for the innervation of the flexor digitorum profundus muscle in the upper limb?

Ulnar nerve

What is the anatomical structure pierced when inserting a drain in the mid-axillary line?

Intercostal muscles

Which nerve root injury is associated with movement disorders affecting the intrinsic muscles of the hand?

T1 nerve root injury

Which cranial nerve is responsible for the movement of the superior oblique muscle?

Trochlear nerve

What is the anatomical landmark located above the 5th intercostal space and anterior to the mid-axillary line?

Nipple

Which muscle is innervated by the radial nerve and is responsible for extension of the wrist?

Extensor carpi radialis brevis

What is the name of the tendinous intersection of the rectus abdominis muscle?

Tendinous intersections

Which nerve is responsible for the innervation of the intercostal muscles?

Intercostal nerve

What is the name of the muscle that is innervated by the ulnar nerve and is responsible for adduction of the thumb?

Adductor pollicis

Which artery is responsible for the blood supply to the liver?

Hepatic artery

What is the name of the nerve that is responsible for the innervation of the deltoid muscle?

Axillary nerve

Which of the following nerves is responsible for the contraction of the external anal sphincter muscle on stroking the skin around the anus?

S2&S4

Which of the following muscles is responsible for wrist extension with radial deviation?

Brachioradialis

Which of the following spinal nerves is responsible for the knee jerk reflex?

L3&L4

Which of the following nerves is responsible for the contraction of the quadriceps muscle?

Femoral nerve

A 23-year-old man is having difficulty speaking following a stab wound to the right of his neck. On tongue protrusion test, the tip of the tongue is deviated to the right. Which nerve is most likely affected?

Hypoglossal nerve

Which of the following muscles is responsible for plantar flexion of the foot?

Gastrocnemius

Which of the following spinal nerves is responsible for the innervation of the biceps brachii muscle?

C5&C6

Which of the following nerves is responsible for the innervation of the triceps brachii muscle?

C6&C7

Which nerve is responsible for finger abduction and adduction?

Ulnar nerve

What is the anatomical landmark at the level of the first lumbar vertebra?

Transpyloric plane

Which muscle is responsible for full extension of the right thumb?

Extensor pollicis longus

Which vein is the only one that travels on the lateral aspect of the ankle?

Short saphenous vein

Which artery appears to be a direct continuation of the left coronary artery?

Left anterior descending artery

What is the anatomical landmark where the fundus of the gallbladder approaches the surface?

Behind the anterior end of the ninth right costal cartilage

Which nerve is responsible for innervating the superior oblique muscle?

Trochlear nerve

What is the SINGLE most likely structure affected in a patient with an inability to extend the distal phalanx of the ring finger?

Extensor digitorum

Study Notes

Haematology Study Notes

Question Format

Questions are formatted with a unique number and topic name
The topic name is followed by an HTML format indicator
Clinical scenario question stems are provided, followed by five answer choices
Correct answers are prefixed with = and suffixed with # and an explanation
Incorrect answers are prefixed with ~ and suffixed with # and an explanation of why the answer is wrong

Exam Preparation

The questions are designed for AKT and PLAB1 preparation
The questions are intended to help doctors prepare for their exam and pass to get GMC registration
Questions are in the form of clinical scenarios and match the required level of difficulty

Question Structure

Each question block is separated by an empty line
The correct answer is explained and justified
Incorrect answers are explained and justified with reasons why they are incorrect and why the correct answer is correct

Haematology

Abnormal blood film: peripheral blood film, differential white cell count, pancytopenia, bone marrow failure, ESR, hyperviscosity syndrome
Haematological malignancies and myeloproliferative disorders: leukaemia, myeloma, paraproteinemia, amyloidosis
Bleeding disorders: intrinsic and extrinsic pathways, anticoagulants, thrombophilia, inherited bleeding disorders, anaemia of any cause
Immunodeficiency disorders: immunosuppressive drugs, anaemia of chronic disease, sideroblastic anaemia, macrocytic anaemia, haemolytic anaemia, sickle cell anaemia, thalassaemia

Cardiovascular

Chest pain: acute myocardial infarction, acute coronary syndrome, angina pectoris
Heart murmurs: any cause
Hypertension: all causes, including risk factors
Palpitations: bradycardia, narrow complex tachycardia, atrial fibrillation and flutter, broad complex tachycardia, pacemakers
Peripheral arterial disease: aneurysms, ischaemic limb, occlusions
Peripheral venous problems: VTE, DVT, risk factors, varicose veins, inflammatory conditions

Breast Lump and/or Pain

Cancer
Infection: abscess, puerperal mastitis
Benign: fibro-adenoma, fibro-adenosis, fat necrosis, cysts
Nipple discharge

Developmental Problems

Congenital abnormalities: VSD, ASD, PDA, aortic stenosis, pulmonary stenosis, coarctation of the aorta, Fallot's tetralogy
Developmental delay: endocrine problems, metabolic disorders, malabsorption, inadequate diet
Psychological and social: non-accidental injury, sexual abuse, emotional deprivation, bullying, manifestations of neglect

Digestive

Abdominal mass: organomegaly, hernias, ascites
Abdominal pain: perforation, obstruction, ischaemia, aneurysm, bleeding, dysphagia
Upper GI problems: nausea and vomiting, infections, pyloric stenosis, drug-induced, constipation
Lower GI problems: faecal incontinence, spurious diarrhoea, encopresis, cancer, ulceration, bleeding, abnormal anatomy

ENT

Earache: any cause
Hearing problems: any cause
Hoarseness and stridor: any cause
Nasal symptoms: cancer, bleeding, nasal obstruction, infections, trauma

Endocrine

Diabetes mellitus: type 1, type 2, complications, diabetic foot care, hypoglycaemia/hyperglycaemia
General: hyperparathyroidism, hypoparathyroidism, multiple endocrine neoplasia
Adrenal: Addisonian crisis, Addison's disease, hyperaldosteronism, phaeochromocytoma, virilism
Thyroid disorders: cancer, hyperthyroidism, hypothyroidism, thyroid eye disease, goitre, nodules

Eye

Eye pain: cancer, sinusitis, glaucoma, migraine
Orbital swelling: cancer, infection, thyroid disease, cysts: congenital and acquired
Red eye: infection, conjunctivitis, iritis, trauma, scleritis/episcleritis
Visual impairment: tumours, arterial and venous, lens, degenerative, hereditary, systemic conditions, infections, detached retina

Haemostatic

Acid-base imbalance and blood gas abnormalities
Electrolyte abnormalities: sodium, potassium, glucose, calcium, magnesium

Infectious Disease

Hospital-acquired infection: infection control, MRSA, C.diff
Serious infection: HIV, AIDS, Hep B, TB
Travel medicine and tropical infections: any cause### Medical Conditions and Symptoms
Urethral Discharge: causes include Infection, Cancer, Foreign body, and STI
Vaginal Discharge: causes include Pruritis vulvae, Normal physiological, Cancer, and Infection
Viral Infections: include Exanthemata, Mumps, Measles, Rubella, Herpes simplex, Herpes zoster, Viral meningitis, and Influenza
Mental Health:
- Alcohol and drug misuse and dependence
- Anxiety disorders, including Generalized anxiety disorder, Phobias, and OCD
- Deliberate self-harm and suicidal risk
- Eating Problems, including Anorexia and Bulimia nervosa
- Learning and communication problems, including Intellectual disability and Acquired brain injury
- Medically-unexplained physical symptoms, including Somatisation disorders
- Mood/affective problems, including Depressive disorders and Bipolar disorders
- Organic Brain Syndrome, including Delirium, Dementia, and Encephalopathy
- Personality and behavioural disorders, including Emotionally unstable personality disorder and Antisocial personality disorder
- Psychosis, including Schizoaffective disorder

Musculoskeletal

Back and Neck: disorders and injuries
Connective tissue Disorders: including Rheumatoid arthritis, Osteoarthrosis, Psoriatic arthritis, and Gout
Foot and Ankle: disorders and injuries
Hand and Wrist: disorders and injuries
Hip: disorders and injuries
Knee: disorders and injuries
Rheumatological problems: including Rheumatoid arthritis, Osteoarthrosis, Psoriatic arthritis, and Gout
Skeletal: disorders and injuries, including Disorders of calcium homeostasis, Infections, Tumours, and Fractures
Upper limb: disorders and injuries

Neurological

Blackouts and Faints: causes and types
Cranial Nerve Problems: including Visual field defects, Multiple sclerosis, and Bell's palsy
Falls: causes and types
Headache: causes and types
Movement Disorders: including Tremor, Chorea, Athetosis, and Parkinson's disease
Peripheral Nerve Problems: including Neuropathies, Mononeuropathies, and Polyneuropathies
Seizure: causes and types
Speech and Language: disorders and impairments
Weakness and Fatigue: causes and types

Renal

Urine Abnormalities: including Blood, Protein, pH, and Volumes
Renal Calculi: including Nephrolithiasis and Ureterolithiasis
Renal Problems: including Acute kidney injury, Chronic kidney disease, and Renal failure
Urinary Excretion: including Oliguria and Polyuria
Urinary Symptoms: including Dysuria, Frequency, and Incontinence

Reproductive

Contraception: methods and types
Fertility Problems: including Male and Female infertility
Normal Pregnancy and Care: including prenatal diagnosis and role of folic acid
Pelvic Mass: including Ectopic pregnancy and Pelvic inflammatory disease
Problems in Pregnancy: including Antepartum haemorrhage, Postpartum haemorrhage, and Miscarriage

Respiratory

Breathlessness: causes and types
Chest Pain: causes and types
Cough and Haemoptysis: causes and types
Respiratory Failure: causes and types
Wheeze and Stridor: causes and types

Seriously Ill Patient

Collapse: causes and types
Fever and Infection: causes and types
Multiple Trauma: including head injury and intra-abdominal injury
Shock: causes and types

Skin

Bites and Stings: including Insect, Fish, Scorpion, Snake, and Human bites
Bullous Disorders: including Pemphigus and Pemphigoid
Dermatological Manifestations of Systemic Disease: including Endocrine, Cancer, and Connective tissue disorders
Extreme of Temperature: including Burns, Frostbite, Hyperthermia, and Hypothermia
Hair and Nail: including Excess hair, Hair loss, and Nail changes in systemic diseases### Anatomy and Physiology

Biliary System

Hepatopancreatic ampulla (Ampulla of Vater) is formed by the pancreatic duct and common bile duct, opening into the second part of the duodenum.

Neurology

Radial nerve (C5-T1): motor functions include extension of forearm, wrist, and fingers; sensory functions include the dorsal aspect of the root of the thumb and the area between the 1st and 2nd metacarpals; damage leads to wrist drop and loss of extension of the wrist and fingers.
Common peroneal nerve: innervates the muscles in the anterior compartment of the leg, responsible for dorsiflexion of the foot at the ankle joint; sensory functions include the webbed space of skin between the great toe and the second toe; damage leads to foot drop and loss of dorsiflexion of the foot.
Ulnar nerve (C8-T1): sensory loss in the little finger and a variable area of the ring finger; injury level determines severity of claw deformity.
Trochlear nerve (IV): innervates the superior oblique muscle; diplopia on downgaze (looking downwards).

Lymphatic System

Skin at the medial malleolus drains into inguinal lymph nodes.

Orthopedics

Transpyloric plane: located halfway between the jugular notch and the upper border of the pubic symphysis, passes through the pylorus of the stomach, the tips of the ninth costal cartilages, and the lower border of the first lumbar vertebra.
Deep inguinal ring: located about 2.5 cm above the midpoint of the inguinal ligament.

Surgery

Chest drain insertion: important landmark above the 5th intercostal space and anterior to the mid-axillary line.

Ophthalmology

Central retinal artery: supplies the retina; occlusion leads to sudden painless loss of vision, often with a history of amaurosis fugax (temporary loss of vision).

Oncology

Carcinoma of the head of the pancreas: commonly presents with jaundice due to obstruction of the common bile duct.

Neurosurgery

Cervical spine injury: a lateral cervical X-ray should extend up to C7/T1 to rule out cervical fractures.

Orthopedic Injuries

Biceps tendon rupture: weakness and lump at distal arm, leading to weakness of flexion and supination.
Peroneal strike: a temporarily disabling blow to the common peroneal nerve, causing loss of motor control of the leg, accompanied by numbness and painful tingling sensation from the point of impact down to the leg.

Reflexes and Innervation

Anal reflex: Contraction of external anal sphincter muscle on stroking the skin around the anus; Innervated by S2-S4
Ankle reflex: Plantar flexion of the foot caused by striking the Achilles tendon; Innervated by S1&S2 via Sciatic nerve
Knee (patella) reflex: Contraction of the quadriceps muscle caused by striking the patellar ligament; Innervated by L3 & L4 via Femoral nerve
Biceps reflex: Flexion at the elbow caused by striking the biceps brachii tendon; Innervated by C5 & C6 via Musculocutaneous nerve
Brachioradialis (supinator reflex): Wrist extension with radial deviation caused by striking the brachioradialis; Innervated by C6 & C7 via Radial nerve
Triceps reflex: Extension caused by striking the triceps brachii tendon; Innervated by C6 & C7 via Radial nerve

Nerve Injuries

Right oculomotor nerve: Associated with difficulty in speaking and tongue protrusion test deviating to the right
T1 nerve root injury: Presents with movement disorders affecting the intrinsic muscles of the hand (e.g., adduction or abduction of the digits), paraesthesiae, and pain
C8 nerve root lesion: Presents with abnormalities of thumb movement primarily and an inability to extend the elbow against resistance
Ulnar nerve injury: Leads to the classic ‘claw hand’ deformity, originates from the C8-T1 nerve roots, and is associated with sensory loss over the little finger and a variable area of the ring finger

Anatomy

Extensor digitorum: Responsible for extending the distal phalanx of the finger
Ulnar nerve: Sensory loss is over the little finger and a variable area of the ring finger (palmar & dorsal), determines severity of claw deformity
Short saphenous vein: Travels on the lateral aspect of the ankle
Great or long saphenous vein: Travels on the medial aspect of the ankle
Left anterior descending (LAD) artery: Appears to be a direct continuation of the left coronary artery, descends into the anterior interventricular groove
Medial malleolus: Skin drains into inguinal lymph nodes
First lumbar vertebra: Level with the anterior end of the ninth rib, also known as the transpyloric plane, where the pylorus of the stomach is located
Deep inguinal ring: Located about 2.5 cm above the midpoint of the inguinal ligament
Extensor pollicis longus: Responsible for full extension of the right thumb
Fundus of the gall-bladder: Approaches the surface behind the anterior end of the ninth right costal cartilage, close to the lateral margin of the Rectus abdominis

Reflexes and Innervation

Anal reflex: Contraction of external anal sphincter muscle on stroking the skin around the anus; Innervated by S2-S4
Ankle reflex: Plantar flexion of the foot caused by striking the Achilles tendon; Innervated by S1&S2 via Sciatic nerve
Knee (patella) reflex: Contraction of the quadriceps muscle caused by striking the patellar ligament; Innervated by L3 & L4 via Femoral nerve
Biceps reflex: Flexion at the elbow caused by striking the biceps brachii tendon; Innervated by C5 & C6 via Musculocutaneous nerve
Brachioradialis (supinator reflex): Wrist extension with radial deviation caused by striking the brachioradialis; Innervated by C6 & C7 via Radial nerve
Triceps reflex: Extension caused by striking the triceps brachii tendon; Innervated by C6 & C7 via Radial nerve

Nerve Injuries

Right oculomotor nerve: Associated with difficulty in speaking and tongue protrusion test deviating to the right
T1 nerve root injury: Presents with movement disorders affecting the intrinsic muscles of the hand (e.g., adduction or abduction of the digits), paraesthesiae, and pain
C8 nerve root lesion: Presents with abnormalities of thumb movement primarily and an inability to extend the elbow against resistance
Ulnar nerve injury: Leads to the classic ‘claw hand’ deformity, originates from the C8-T1 nerve roots, and is associated with sensory loss over the little finger and a variable area of the ring finger

Anatomy

Extensor digitorum: Responsible for extending the distal phalanx of the finger
Ulnar nerve: Sensory loss is over the little finger and a variable area of the ring finger (palmar & dorsal), determines severity of claw deformity
Short saphenous vein: Travels on the lateral aspect of the ankle
Great or long saphenous vein: Travels on the medial aspect of the ankle
Left anterior descending (LAD) artery: Appears to be a direct continuation of the left coronary artery, descends into the anterior interventricular groove
Medial malleolus: Skin drains into inguinal lymph nodes
First lumbar vertebra: Level with the anterior end of the ninth rib, also known as the transpyloric plane, where the pylorus of the stomach is located
Deep inguinal ring: Located about 2.5 cm above the midpoint of the inguinal ligament
Extensor pollicis longus: Responsible for full extension of the right thumb
Fundus of the gall-bladder: Approaches the surface behind the anterior end of the ninth right costal cartilage, close to the lateral margin of the Rectus abdominis

Review and prepare for your AKT and PLA exams with these haematology study notes. Questions and answers are formatted for easy learning and retention.

Make Your Own Quizzes and Flashcards

Convert your notes into interactive study material.