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  • Question 1 - Which of the following statements is true about anterior cord syndrome? ...

    Incorrect

    • Which of the following statements is true about anterior cord syndrome?

      Your Answer: It has the best prognosis of the incomplete spinal cord injuries

      Correct Answer: There is preservation of proprioception

      Explanation:

      Anterior cord syndrome is an incomplete cord syndrome that predominantly affects the anterior 2/3 of the spinal cord, characteristically resulting in motor paralysis below the level of the lesion as well as the loss of pain and temperature at and below the level of the lesion. The patient presentation typically includes these two findings; however, there is variability depending on the portion of the spinal cord affected. Other findings include back pain, or autonomic dysfunction such as hypotension, neurogenic bowel or bladder, and sexual dysfunction. The severity of motor dysfunction can vary, typically resulting in paraplegia or quadriplegia.

      Proprioception, vibratory sense, two-point discrimination, and fine touch are not affected in anterior cord syndrome. These sensations are under the control of the dorsal column of the spinal cord, which is supplied by two posterior spinal arteries running in the posterior lateral sulci.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      110.8
      Seconds
  • Question 2 - An 82 year old man taking warfarin as a maintenance medication comes in...

    Incorrect

    • An 82 year old man taking warfarin as a maintenance medication comes in to your clinic because of an infection. Which antibiotic is the safest choice for this patient?

      Your Answer: Ciprofloxacin

      Correct Answer: Cefalexin

      Explanation:

      Alterations in the international normalized ratio (INR) brought about by the concurrent use of antibiotics and warfarin may result in either excessive clotting or excessive bleeding if they are deemed to have a high risk for interaction. As such, there should be careful consideration of the class of antibiotic to be used.

      Antibiotics from the following drug classes should generally be avoided as they have a high risk for interaction with warfarin, possible enhancing the anticoagulant effects of warfarin resulting in bleeding: Fluoroquinolones (e.g. ciprofloxacin, levofloxacin), Macrolides (e.g. clarithromycin, erythromycin, azithromycin), Nitroimidazoles (e.g. metronidazole), Sulphonamides (e.g. co-trimoxazole, a combination of trimethoprim and sulfamethoxazole), Trimethoprim, Tetracyclines (e.g. doxycycline).

      Low risk antibiotics that have low risk for interaction with warfarin includes cephalexin, from the cephalosporin class, and clindamycin which is a lincomycin.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      29.6
      Seconds
  • Question 3 - A 14-year-old female is brought to the Emergency Room by her mother after...

    Incorrect

    • A 14-year-old female is brought to the Emergency Room by her mother after a fall from a tree in which she injured her elbow. An elbow fracture is suspected based on the examination findings, and she is given Entonox for analgesia as her elbow is set in a cast.

      Which one of the following statements regarding this drug is true?

      Your Answer: It continues to work for approximately 10 minutes after inhalation has ceased

      Correct Answer: It can cause inhibition of vitamin B12 synthesis

      Explanation:

      Entonox is a mixture of 50% Oxygen and 50% nitrous oxide and is given in an inhaled form as a quick form of analgesia. Entonox causes non-competitive inhibition of NMDA (N-methyl-D-aspartate) receptors, which are a subtype of the glutamate receptor.

      It is stored in blue and white cylinders and administered via a pressure regulator and demand valve. The administration of this medicine reduces pain and anxiety in paediatric and dental procedures ands during labour.

      Effects are apparent after 20 seconds, and peak action occurs after 3 to 5 minutes as it is a drug with a rapid onset and the patient will also recover rapidly from its effects. Entonox is widely used as it does not accumulate in the body and does not cause many side effects. However, a notable side effect is the inhibition of Vitamin B12 synthesis.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      51.3
      Seconds
  • Question 4 - In patients requiring oxygen, who are at risk of hypercapnic respiratory failure, oxygen...

    Incorrect

    • In patients requiring oxygen, who are at risk of hypercapnic respiratory failure, oxygen saturations should be maintained at:

      Your Answer: 92 - 94%

      Correct Answer: 88 - 92%

      Explanation:

      A lower target of 88 – 92% oxygen saturation is indicated for patients at risk of hypercapnic respiratory failure e.g. patients with COPD. Until blood gases can be measured, initial oxygen should be given using a controlled concentration of 28% or less, titrated towards the SpO2 of 88 – 92%. The aim is to provide the patient with enough oxygen to achieve an acceptable arterial oxygen tension without worsening carbon dioxide retention and respiratory acidosis.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      284.3
      Seconds
  • Question 5 - Which of the following statements is true regarding the extensor pollicis longus? ...

    Incorrect

    • Which of the following statements is true regarding the extensor pollicis longus?

      Your Answer: Its tendons form the lateral border of the anatomical snuffbox

      Correct Answer: It is innervated by the posterior interosseous nerve

      Explanation:

      Extensor pollicis longus is part of the deep extensors of the forearm together with extensor pollicis brevis, abductor pollicis longus, extensor indicis and supinator muscles. It is located on the posterior aspect of forearm, extending from the middle third of the ulna, and adjacent interosseous membrane, to the distal phalanx of the thumb.

      Extensor digitorum is innervated by posterior interosseous nerve which is a continuation of a deep branch of radial nerve (root value C7 and C8).

      Extensor pollicis brevis receives its blood supply from the posterior interosseous artery and perforating branches of the anterior interosseous artery.

      The main action of extensor pollicis longus is extension of the thumb at the metacarpophalangeal and interphalangeal joints. Extension at the metacarpophalangeal joint occurs in synergy with extensor pollicis brevis muscle. When the thumb reaches the full extension or abduction, extensor pollicis longus can also assist in adduction of the thumb.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      6.3
      Seconds
  • Question 6 - A 33-year-old female, who recently returned from a trip to Bangladesh, presents to...

    Correct

    • A 33-year-old female, who recently returned from a trip to Bangladesh, presents to the infectious diseases clinic with complaints of productive cough with blood-stained sputum, night sweats, and weight loss for the past one month. Based on the history and examination findings, you suspect pulmonary tuberculosis.

      Which ONE of the following investigations is most appropriate to make a diagnosis of active tuberculosis?

      Your Answer: Sputum for acid-fast bacilli smear

      Explanation:

      Multiple investigations may be done to establish a diagnosis of active tuberculosis. In this case, sputum for acid-fast bacilli would be the best option as it can be done immediately, give fast results, and promptly initiate treatment. Three-morning sputum samples are collected and tested for acid-fast bacilli using gram staining.

      Blood culture would yield results in tuberculous bacteraemia and would be less sensitive than sputum testing.

      A chest X-ray would not differentiate active tuberculosis from an old infection in which the Ghon complex has formed, and the body’s immune reaction contains the Mycobacterium tuberculosis bacteria.

      Mantoux test shows the presence of antibodies to tuberculosis and may be positive if the patient has had a previous infection or been vaccinated against tuberculosis.

      A CT chest would also be unable to differentiate between an active infection and the findings of old tuberculosis infection.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      22.2
      Seconds
  • Question 7 - Regarding gastric motility and emptying, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding gastric motility and emptying, which of the following statements is CORRECT:

      Your Answer: A high pH in the duodenum inhibits gastric emptying.

      Correct Answer: Gastric emptying is inhibited by the presence of the products of fat digestion in the duodenum.

      Explanation:

      Gastric emptying is decreased by the presence of fats in the duodenum (by stimulating release of cholecystokinin). Mixing of the food with gastric secretions takes place in the distal body and antrum of the stomach where the muscularis externa layer is thicker. The stomach has an additional inner oblique smooth muscle layer (in addition to the inner circular layer and outer longitudinal layer). Gastric emptying is increased by a low gastric pH and decreased by a low duodenal pH.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      98.9
      Seconds
  • Question 8 - Regarding antihistamines, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding antihistamines, which of the following statements is CORRECT:

      Your Answer: The newer antihistamines have more of a sedating effect than older antihistamines.

      Correct Answer: Elderly patients and children are more susceptible to side effects.

      Explanation:

      Elderly patients and children are more susceptible to side effects. Antihistamines are competitive inhibitors at the H1-receptor. The newer antihistamines e.g. cetirizine cause less sedation and psychomotor impairment than the older antihistamines because they are much less lipid soluble and penetrate the blood brain barrier only to a slight extent. Antihistamines are used as a second line adjunct to adrenaline in anaphylaxis.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      16.8
      Seconds
  • Question 9 - A 79-year-old male had a humeral shaft fracture during a road traffic accident...

    Incorrect

    • A 79-year-old male had a humeral shaft fracture during a road traffic accident and is being followed up in a fracture clinic. He complains of inability to use the limb 6 months after the injury. X-rays of that arm shows non union of his fracture.

      All the following are responsible for this non-union EXCEPT?

      Your Answer: Infection

      Correct Answer: Osteoporosis

      Explanation:

      An imbalance between bone resorption and formation is Osteoporosis. In normal bone, formation and resorption are roughly equal, and the density of bone matrix remains constant but there is more resorption in osteoporosis and the matrix density reduces and bones become weaker. Fractures are more likely to occur but healing is unaffected.

      Non-union of a fracture occurs when the two sides of a fracture fail to unite after 6 months. Causes include: infection, movement at the fracture site, avascular necrosis, tissue interposed between the fracture and gross misalignment.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      80.2
      Seconds
  • Question 10 - Which of the following best describes the main sites of constriction of the...

    Incorrect

    • Which of the following best describes the main sites of constriction of the ureters:

      Your Answer: Where the ureter passes posterior to the uterus and at the pelvic brim

      Correct Answer: At the ureteropelvic junction, at the pelvic brim and where the ureters enter the bladder

      Explanation:

      At three points along their course, the ureters are constricted denoting the most likely areas for renal calculi to lodge:the first point is at the ureteropelvic junction (where the renal pelvis becomes continuous with the ureter)the second point is where the ureter crosses the common iliac vessels at the pelvic brimthe third point is at the vesicoureteric junction (where the ureter enters the wall of the bladder)

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      47.8
      Seconds
  • Question 11 - A new chemotherapy drug is being tested. The intervention reduces the risk of...

    Correct

    • A new chemotherapy drug is being tested. The intervention reduces the risk of death from 10 in 1000 to 5 in 1000. What is the number needed to treat to prevent one death:

      Your Answer: 200

      Explanation:

      Absolute risk reduction (ARR) of treatment
      = risk of death in control group – risk of death in treatment group
      ARR = (10/1000) – (5/1000)
      = 5/1000 = 0.005
      Number needed to treat (NNT)
      = 1/ARR
      = 1/0.005
      = 200
      Therefore 200 people would need to be treated to prevent one extra death.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      87.7
      Seconds
  • Question 12 - You've been summoned to a young man in the resus area who has...

    Incorrect

    • You've been summoned to a young man in the resus area who has an SVT. You decide to use adenosine after trying several vagal manoeuvres without success.

      The use of adenosine is not contraindicated in which of the following situations?

      Your Answer: 2 nd -degree AV block

      Correct Answer: Concurrent use of a beta-blocker

      Explanation:

      The use of a beta-blocker at the same time increases the risk of myocardial depression, but it is not a contraindication.
      The use of adenosine is contraindicated in the following situations:
      Asthma
      COPD (chronic obstructive pulmonary disease)
      Decompensated heart failure 
      Long QT syndrome
      AV block in the second or third degree
      Sinusitis is a condition in which the sinuses become (unless pacemaker fitted)
      Hypotension that is severe

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      40.3
      Seconds
  • Question 13 - A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part...

    Incorrect

    • A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part in a powerlifting competition, he felt a painful snap at the front of his shoulder and chest. There is also the presence of bruising and swelling over the left side of his chest. A ruptured pectoralis major muscle was suspected upon examining the injured area.

      Which of the following statements regarding the surface markings of the pectoralis major muscle is considered correct?

      Your Answer: It has three heads

      Correct Answer: It inserts into the lateral lip of the bicipital groove of the humerus

      Explanation:

      The pectoralis major is the superior most and largest muscle of the anterior chest wall. It is a thick, fan-shaped muscle that lies underneath the breast tissue and forms the anterior wall of the axilla.

      Its origin lies anterior surface of the medial half of the clavicle, the anterior surface of the sternum, the first 7 costal cartilages, the sternal end of the sixth rib, and the aponeurosis of the external oblique of the anterior abdominal wall.
      The insertion of the pectoralis major is at the lateral lip of the intertubercular sulcus of the humerus. There are 2 heads of the pectoralis major, the clavicular and the sternocostal, which reference their area of origin.
      The function of the pectoralis major is 3-fold and dependent on which heads of muscles are involved:
      – Flexion, adduction and medial rotation of the arm at the glenohumeral joint
      – Clavicular head causes flexion of the extended arm
      – Sternoclavicular head causes extension of the flexed arm

      Arterial supply of the pectoralis major, the pectoral artery, arises from the second branch of the axillary artery, the thoracoacromial trunk.

      The 2 heads of the pectoralis major have different nervous supplies. The clavicular head derives its nerve supply from the lateral pectoral nerve. The medial pectoral nerve innervates the sternocostal head. The lateral pectoral nerve arises directly from the lateral cord of the brachial plexus, and the medial pectoral nerve arises from the medial cord.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      35.5
      Seconds
  • Question 14 - A 25-year old male is brought to the emergency room after a traffic...

    Incorrect

    • A 25-year old male is brought to the emergency room after a traffic accident. Upon examination, there was tenderness and erythema on the right acromioclavicular joint, with notable step deformity. On radiographic imaging, there is a superior elevation of the clavicle, a twice than normal coracoclavicular distance, and absence of fracture.

      Which of the following structure/s is/are likely to have ruptured?

      Your Answer: Acromioclavicular ligament only

      Correct Answer: Acromioclavicular ligament, coracoclavicular ligament and joint capsule

      Explanation:

      Acromioclavicular joint injuries account for more than forty percent of all shoulder injuries. Mild injuries are not associated with any significant morbidity, but severe injuries can lead to significant loss of strength and function of the shoulder. Acromioclavicular injuries may be associated with a fractured clavicle, impingement syndromes, and more rarely neurovascular insults.

      The AC joint is a diarthrodial joint defined by the lateral process of the clavicle articulating with the acromion process as it projects anteriorly off the scapula. The joint is primarily stabilized by the acromioclavicular ligament, which is composed of an anterior, posterior, inferior, and superior component. Of note, the superior portion of the AC ligament is the most important component for the stability of the AC joint. Supporting structures include two coracoclavicular ligaments (trapezoid and conoid ligaments), which provide vertical stability, as well as the coracoacromial ligament.

      Patients with an AC joint injury typically present with anterosuperior shoulder pain and will describe a mechanism of injury of blunt trauma to the abducted shoulder or landing on an outstretched arm, suggestive of this type of injury. They may describe pain radiating to the neck or shoulder, which is often worse with movement or when they try to sleep on the affected shoulder. On examination, the clinician may observe swelling, bruising, or a deformity of the AC joint, depending on the degree of injury. The patient will be tender at that location. They may have a restriction in the active and passive range of motion secondary to pain. Piano key sign may be seen, with an elevation of the clavicle that rebounds after inferior compression.

      Standard X-rays are adequate to make a diagnosis of acromioclavicular joint injury and should be used to evaluate for other causes of traumatic shoulder pain.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      59.9
      Seconds
  • Question 15 - A 55-year-old woman was complaining of headaches. On examination, the patient is found...

    Incorrect

    • A 55-year-old woman was complaining of headaches. On examination, the patient is found to have weakness on the left side of her body and her eyes are deviated towards the right hand side. These are signs of damage to which of the following areas?

      Your Answer: Occipital lobe

      Correct Answer: Frontal lobe

      Explanation:

      Some potential symptoms of frontal lobe damage can include loss of movement, either partial or complete, on the opposite side of the body.

      In the patient’s case, it is a result of motor cortex damage on the right side since her left side of the body is affected. The conjugate eye deviation symptom towards the side of the lesion is a result of damage to the frontal eye field.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      9.5
      Seconds
  • Question 16 - Regarding hepatitis A, which of the following statements is CORRECT: ...

    Correct

    • Regarding hepatitis A, which of the following statements is CORRECT:

      Your Answer: Anti-HAV IgM antibodies are diagnostic.

      Explanation:

      Anti-HAV IgM antibodies are diagnostic. Disease in children is more commonly asymptomatic, risk of symptomatic disease increases with age. Transmission is by the faecal-oral route. Faecal shedding has been demonstrated for 2 – 3 weeks before and about a week after, the onset of jaundice. Infection confers lifelong immunity.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      15.9
      Seconds
  • Question 17 - When treating diabetic ketoacidosis (DKA), glucose should be given together with insulin as...

    Incorrect

    • When treating diabetic ketoacidosis (DKA), glucose should be given together with insulin as soon as the blood glucose concentration falls below 14 mmol/L in the form of:

      Your Answer: 20% glucose intravenous infusion at a rate of 125 mL/hour

      Correct Answer: 10% glucose intravenous infusion at a rate of 125 mL/hour

      Explanation:

      In addition to the sodium chloride 0.9 percent infusion, glucose 10% should be given intravenously (into a large vein with a large-gauge needle) at a rate of 125 mL/hour once blood glucose concentration falls below 14 mmol/litre.

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
      16.2
      Seconds
  • Question 18 - How does aspirin mediate its antiplatelet effect: ...

    Correct

    • How does aspirin mediate its antiplatelet effect:

      Your Answer: It irreversibly inhibits cyclo-oxygenase

      Explanation:

      Aspirin irreversibly inhibits cyclooxygenase and blocks the platelet production of thromboxane A2 (TXA2), thus inhibiting platelet aggregation.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      32.5
      Seconds
  • Question 19 - Regarding defaecation, which of the following statements is CORRECT: ...

    Correct

    • Regarding defaecation, which of the following statements is CORRECT:

      Your Answer: Colonic mass movement occurs shortly after a meal due to distension of the stomach and duodenum.

      Explanation:

      Colonic mass movement describes the intense contraction that begins halfway along the transverse colon and pushes the intestinal contents in the proximal colon towards the rectum. It occurs shortly after a meal due to distension of the stomach and duodenum as part of the gastrocolic reflex and if faeces is present in the rectum, stimulates the urge to defecate. Distention of the rectum causes firing of afferent cholinergic parasympathetic fibres. The internal sphincter is made up of circular smooth muscle innervated by the autonomic fibres, and the more distal external sphincter is composed of striated muscle innervated by motor fibres from the pudendal nerve. During defaecation, relaxation of pelvic muscles straightens the rectum.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      173.8
      Seconds
  • Question 20 - For an action potential to occur, which of the following must be true:...

    Correct

    • For an action potential to occur, which of the following must be true:

      Your Answer: Depolarisation of the membrane must reach threshold potential

      Explanation:

      For an action potential to occur, the membrane must become more permeable to Na+and the Na+influx must be greater than the K+efflux. An action potential occurs when depolarisation of the membrane reaches threshold potential. The membrane must be out of the absolute refractory period, however an action potential can still occur in a relative refractory period but only in response to a larger than normal stimulus.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      20
      Seconds
  • Question 21 - Which of the following best characterizes the correct administration of amiodarone for a...

    Correct

    • Which of the following best characterizes the correct administration of amiodarone for a shockable rhythm in adults on advanced life support:

      Your Answer: Give 300 mg IV amiodarone after 3 shocks

      Explanation:

      After three shocks, 300 mg IV amiodarone should be administered. After five defibrillation attempts, a further dose of 150 mg IV amiodarone may be considered. If amiodarone is not available, lidocaine may be used as a substitute, but it should not be given if amiodarone has previously been administered.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      26
      Seconds
  • Question 22 - A patient is sent in to ED by her GP with hyponatraemia and...

    Incorrect

    • A patient is sent in to ED by her GP with hyponatraemia and hyperkalaemia. There is most likely to be a deficiency in which of the following hormones:

      Your Answer: Antidiuretic hormone

      Correct Answer: Aldosterone

      Explanation:

      A deficiency of aldosterone, as seen in adrenal insufficiency, can result in hyponatraemia and hyperkalaemia.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      19.7
      Seconds
  • Question 23 - The functional residual capacity (FRC) will be decreased in which of the following:...

    Incorrect

    • The functional residual capacity (FRC) will be decreased in which of the following:

      Your Answer: Emphysema

      Correct Answer: Pulmonary fibrosis

      Explanation:

      Factors decreasing FRC:
      Restrictive ventilatory defects e.g. pulmonary fibrosis
      Posture – lying supine
      Increased intra-abdominal pressure (e.g. obesity, pregnancy, ascites)
      Reduced muscle tone of diaphragm e.g. muscle relaxants in anaesthesia, neuromuscular disease

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      10.3
      Seconds
  • Question 24 - Regarding skeletal muscle contraction, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding skeletal muscle contraction, which of the following statements is CORRECT:

      Your Answer: The force of contraction of a muscle can be controlled by increasing synchronised firing of motor units.

      Correct Answer: The force of contraction of a muscle can be controlled by increasing recruitment of motor units.

      Explanation:

      Each motor unit contracts in an all or nothing fashion, i.e. if a motor unit is excited, it will stimulate all of its muscle fibres to contract. The force of contraction of a muscle is controlled by varying the motor unit recruitment (spatial summation), and by varying the firing rate of the motor units (temporal summation). During a gradual increase in contraction of a muscle, the first units start to discharge and increase their firing rate, and, as the force needs to increase, new units are recruited and, in turn, also increase their firing rate. For most motor units, the firing rate for a steady contraction is between 5 and 8 Hz. Because the unitary firing rates for each motor unit are different and not synchronised, the overall effect is a smooth force profile from the muscle. Increasing the firing rate of motor units is temporal summation where the tension developed by the first action potential has not completely decayed when the second action potential and twitch is grafted onto the first and so on. If the muscle fibres are stimulated repeatedly at a faster frequency, a sustained contraction results where it is not possible to detect individual twitches. This is called tetanus.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      7.3
      Seconds
  • Question 25 - What is the effect of a positive inotrope on the Starling curve: ...

    Incorrect

    • What is the effect of a positive inotrope on the Starling curve:

      Your Answer: Shifts the curve downwards

      Correct Answer: Shifts the curve upwards

      Explanation:

      Contractility (inotropy) is the intrinsic ability of cardiac muscle to develop force at a given muscle length. It is determined by the intracellular [Ca2+] and can be estimated by the ejection fraction. Increases in contractility cause an increase in stroke volume/cardiac output for any level of right atrial pressure or end-diastolic volume, and hence shift the Starling curve upwards. Decreases in contractility cause a decrease in stroke volume/cardiac output for any level of right atrial pressure or end-diastolic volume and hence shift the Starling curve downwards.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      19.1
      Seconds
  • Question 26 - A 27 year old woman presents to ED having sustained a deep laceration...

    Incorrect

    • A 27 year old woman presents to ED having sustained a deep laceration to the dorsum of her ring finger whilst cooking. Her proximal interphalangeal joint is fixed in flexion and the distal interphalangeal joint is hyperextended. Which of the following structures in the digit has most likely been injured:

      Your Answer:

      Correct Answer: Insertion of the central slip of the extensor tendon

      Explanation:

      Damage to the central slip of the extensor digitorum tendon would result in loss of extension at the proximal interphalangeal joint resulting in a fixed flexion deformity of this joint, and hyperextension of the distal interphalangeal joint due to a loss of balancing forces. This is called the Boutonniere deformity.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 27 - Regarding drug interactions with erythromycin, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding drug interactions with erythromycin, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Erythromycin decreases plasma levels of warfarin.

      Explanation:

      Erythromycin and clarithromycin inhibit cytochrome P450-mediated metabolism of warfarin, phenytoin and carbamazepine and may lead to accumulation of these drugs. There is an increased risk of myopathy (due to cytochrome P450 enzyme CYP3A4 inhibition) if erythromycin or clarithromycin is taken with atorvastatin or simvastatin. Erythromycin increases plasma concentrations of theophylline, and theophylline may also reduce absorption of oral erythromycin. All macrolides can prolong the QT-interval and concomitant use of drugs that prolong the QT interval is not recommended.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds
  • Question 28 - As part of his angina treatment, a 68-year-old man is prescribed a beta...

    Incorrect

    • As part of his angina treatment, a 68-year-old man is prescribed a beta blocker. He starts having nightmares and has trouble sleeping soon after starting the beta-blocker.

      Which of the beta blockers listed below is the most likely to be in his system?

      Your Answer:

      Correct Answer: Propranolol

      Explanation:

      The beta-adrenoceptors in the heart, peripheral vasculature, bronchi, pancreas, and liver are blocked by beta-adrenoceptor blocking drugs (beta blockers).

      Beta blockers come in a wide range of strengths, with the choice largely determined by the disease being treated and the patient’s unique circumstances. The intrinsic sympathomimetic activity, lipid solubility, duration of action, and cardioselectivity of beta blockers all differ.

      Some beta blockers are lipid (lipophilic) soluble, while others are water soluble (hydrophilic). Drugs that are more lipid-soluble are absorbed faster from the gut, undergo more first-pass metabolism, and are eliminated faster. They’re also more likely to get into the brain and cause central effects like insomnia and nightmares. Propranolol, pindolol, labetalol, and metoprolol are examples of lipid-soluble beta blockers. Beta blockers that are water-soluble are less likely to enter the brain and are more resistant to first-pass metabolism. They are excreted by the kidneys, and in renal impairment, dosage reduction is frequently required. Atenolol, nadolol, celiprolol, and sotalol are examples of water-soluble beta blockers.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 29 - A patient suffers an injury to the nerve that innervates gluteus medius.​
    The gluteus...

    Incorrect

    • A patient suffers an injury to the nerve that innervates gluteus medius.​
      The gluteus medius muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer:

      Correct Answer: Superior gluteal nerve

      Explanation:

      Gluteus minimus is innervated by the superior gluteal nerve.
      Gluteus medius is innervated by the superior gluteal nerve.
      Gluteus maximus is innervated by the inferior gluteal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 30 - Regarding threadworms, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding threadworms, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: First line treatment of threadworms is with mebendazole.

      Explanation:

      First line treatment of threadworms is with mebendazole, with treatment of the whole family, and a repeat treatment after 2 weeks. Threadworms live in the large bowel, but direct multiplication of worms does not occur here. Threadworms most commonly infect children, and may be symptomatic or cause pruritus ani.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
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Pharmacology (3/7) 43%
Respiratory (1/2) 50%
Anatomy (3/7) 43%
Upper Limb (1/4) 25%
Microbiology (2/3) 67%
Specific Pathogen Groups (1/1) 100%
Gastrointestinal (0/2) 0%
Physiology (2/5) 40%
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Pathology (1/2) 50%
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Evidence Based Medicine (1/1) 100%
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