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  • Question 1 - By which of the following is mean arterial pressure (MAP) primarily determined? ...

    Correct

    • By which of the following is mean arterial pressure (MAP) primarily determined?

      Your Answer: Total peripheral resistance and cardiac output

      Explanation:

      Mean arterial pressure (MAP) = Cardiac output (CO) x Total peripheral resistance (TPR).

      Cardiac output is dependent on the central venous pressure (CVP). CVP, in turn, is highly dependent on the blood volume.
      Any alterations of any of these variables will likely change MAP.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      22.1
      Seconds

  • Question 2 - Regarding antimuscarinic antispasmodics, which of the following statements is CORRECT: ...

    Correct

    • Regarding antimuscarinic antispasmodics, which of the following statements is CORRECT:

      Your Answer: They are contraindicated in paralytic ileus.

      Explanation:

      Antimuscarinics are contraindicated in paralytic ileus. Antimuscarinics reduce intestinal motility by blocking muscarinic acetylcholine receptors and relaxing smooth muscle. Hyoscine butylbromide is advocated as a gastrointestinal antispasmodic, but it is poorly absorbed and thus has limited clinical utility. Antimuscarinics cause a reduction in bronchial secretions (they can be used to this effect in palliative patients). Antispasmodics are occasionally of value in treating abdominal cramp associated with diarrhoea but they should not be used for primary treatment. Antispasmodics should be avoided in young children with gastroenteritis because they are rarely effective and have troublesome side effects.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      26.2
      Seconds

  • Question 3 - You examine a patient who is experiencing a worsening of his chronic heart...

    Correct

    • You examine a patient who is experiencing a worsening of his chronic heart failure. You discuss his care with the on-call cardiology registrar, who recommends switching him from furosemide to bumetanide at an equivalent dose. He's on 80 mg of furosemide once a day right now.

      What is the recommended dose of bumetanide?

      Your Answer: 2 mg

      Explanation:

      Bumetanide is 40 times more powerful than furosemide, and one milligram is roughly equivalent to 40 milligrams of furosemide. This patient is currently taking 80 mg of furosemide and should be switched to a 2 mg bumetanide once daily.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      14.9
      Seconds

  • Question 4 - A patient suffers a lower limb fracture that causes damage to the nerve...

    Incorrect

    • A patient suffers a lower limb fracture that causes damage to the nerve that innervates peroneus longus.
      Peroneus longus receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer: Deep peroneal nerve

      Correct Answer: Superficial peroneal nerve

      Explanation:

      Peroneus brevis is innervated by the superficial peroneal nerve.
      Peroneus longus is innervated by the superficial peroneal nerve.
      Peroneus tertius is innervated by the deep peroneal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      21.1
      Seconds

  • Question 5 - A 36-year-old man presented to the emergency room after an incident of slipping...

    Correct

    • A 36-year-old man presented to the emergency room after an incident of slipping and falling onto his back and left hip. Upon physical examination, it was noted that he has pain on hip extension, but normal hip abduction.

      Which of the following muscles was most likely injured in this case?

      Your Answer: Gluteus maximus

      Explanation:

      The primary hip extensors are the gluteus maximus and the hamstrings such as the long head of the biceps femoris, the semitendinosus, and the semimembranosus. The extensor head of the adductor magnus is also considered a primary hip extensor.

      The hip abductor muscle group is located on the lateral thigh. The primary hip abductor muscles include the gluteus medius, gluteus minimus, and tensor fasciae latae.
      The secondary hip abductors include the piriformis, sartorius, and superior fibres of the gluteus maximus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      10.5
      Seconds

  • Question 6 - The only statement that is correct regarding diffusion is which of the following?...

    Correct

    • The only statement that is correct regarding diffusion is which of the following?

      Your Answer: The permeability of a membrane is related to the membrane thickness and composition.

      Explanation:

      Passive diffusion is a process that describes the movement down a concentration gradient. This process accounts for movement across small distances like within the cytosol or across membranes. Factors that affect the diffusion of a substance across a membrane are the permeability (p) of the membrane, a difference in concentration across the membrane and the membrane area over which diffusion occurs. The membrane thickness and composition, and the diffusion coefficient of the substance also affects the permeability. Fick’s law describes the rate of diffusion of a substance within a solution, which can be modified to describe the rate of diffusion across a membrane.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      13.6
      Seconds

  • Question 7 - Which of the following is the correct sequential order of the phases of...

    Incorrect

    • Which of the following is the correct sequential order of the phases of healing:

      Your Answer: Inflammation, haemostasis, proliferation, maturation

      Correct Answer: Haemostasis, inflammation, proliferation, remodelling

      Explanation:

      Acute wound healing has four main stages: haemostasis, inflammation, proliferation and remodelling.

    • This question is part of the following fields:

      • Pathology
      • Wound Healing
      14.2
      Seconds

  • Question 8 - You examine an elderly man who is experiencing chest pain. He doesn't recall...

    Correct

    • You examine an elderly man who is experiencing chest pain. He doesn't recall all of his medications, but he does know that he takes a diuretic.

      The enzyme carbonic anhydrase is inhibited by which of the following diuretics?

      Your Answer: Acetazolamide

      Explanation:

      Acetazolamide is a non-competitive, reversible inhibitor of carbonic anhydrase found in the cytosol of cells and on the brush border of the proximal convoluted tubule. Bicarbonate and hydrogen ions are converted to carbonic acid by carbonic anhydrase, which then converts carbonic acid to carbon dioxide and water. As a result, acetazolamide reduces the availability of hydrogen ions, causing sodium and bicarbonate ions to accumulate in the renal tubule, resulting in diuresis.
      The mechanism of action of the various types of diuretics is summarised below:

      1) Loop diuretics, e.g. furosemide, bumetanide
      Act on the Na.K.2Cl co-transporters in the ascending loop of Henlé to inhibit sodium, chloride and potassium reabsorption.

      2) Thiazide diuretics, e.g. Bendroflumethiazide, hydrochlorothiazide
      Act on the Na.Cl co-transporter in the distal convoluted tubule to inhibit sodium and chloride reabsorption.

      3) Osmotic diuretics, e.g. mannitol
      Increases the osmolality of the glomerular filtrate and tubular fluid, increasing urinary volume by an osmotic effect.

      4) Aldosterone antagonists, e.g. spironolactone
      Acts in the distal convoluted tubule as a competitive aldosterone antagonist resulting in inhibition of sodium reabsorption and increasing potassium reabsorption.

      5) Carbonic anhydrase inhibitors, e.g. acetazolamide
      Inhibit the enzyme carbonic anhydrase preventing the conversion of bicarbonate and hydrogen ions into carbonic acid.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      8.2
      Seconds

  • Question 9 - A 36 year old man who is overweight with a history of gout,...

    Incorrect

    • A 36 year old man who is overweight with a history of gout, presents to emergency room with an acutely painful big toe which is red, hot and swollen. However, he is apyrexic and otherwise systemically well. He has been diagnosed with acute gout. The most appropriate first line treatment for him is which of the following?

      Your Answer: Allopurinol

      Correct Answer: NSAIDs

      Explanation:

      The first line treatment for acute gout includes NSAIDs like diclofenac, indomethacin or naproxen. In patients in whom NSAIDs are contraindicated, not tolerated or ineffective, colchicine is an alternative. In those who cannot tolerate or who are resistant to NSAIDs and colchicine, oral or parenteral corticosteroids are an effective alternative. In acute monoarticular gout, intra-articular injection of a corticosteroid can be used occasionally. In acute gout. allopurinol is not used in the actual treatment, but its use should be continued during an acute attack if the patient is already established on long term therapy.

    • This question is part of the following fields:

      • Musculoskeletal
      • Pharmacology
      11.6
      Seconds

  • Question 10 - A 45-year-old woman presents with persistent palpitations for the past two days. She...

    Correct

    • A 45-year-old woman presents with persistent palpitations for the past two days. She has a good haemodynamic balance. An ECG is performed, which reveals that she has atrial flutter. The patient is examined by a cardiology registrar, who recommends using a 'rate control' strategy while she waits for cardioversion.

      Which of the drugs listed below is the best fit for this strategy?

      Your Answer: Bisoprolol

      Explanation:

      In atrial flutter, ventricular rate control is usually used as a stopgap measure until sinus rhythm can be restored. A beta-blocker (such as bisoprolol), diltiazem, or verapamil can be used to lower the heart rate.

      Electrical cardioversion, pharmacological cardioversion, or catheter ablation can all be used to restore sinus rhythm. Cardioversion should not be attempted until the patient has been fully anticoagulated for at least three weeks if the duration of atrial flutter is unknown or has lasted for more than 48 hours. Emergency electrical cardioversion is the treatment of choice when there is an acute presentation with haemodynamic compromise. For the treatment of recurrent atrial flutter, catheter ablation is preferred.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      6.4
      Seconds

  • Question 11 - Regarding cardiac excitation-contraction coupling, which of the following statements is CORRECT: ...

    Correct

    • Regarding cardiac excitation-contraction coupling, which of the following statements is CORRECT:

      Your Answer: In relaxation, Ca 2+ is transported out of the cell using energy from a Na + gradient.

      Explanation:

      During the AP plateau, Ca2+enters the cell and activates Ca2+sensitive Ca2+release channels in the sarcoplasmic reticulum allowing stored Ca2+to flood into the cytosol; this is called Ca2+-induced Ca2+release. In relaxation, about 80% of Ca2+is rapidly pumped back into the SR (sequestered) by Ca2+ATPase pumps. The Ca2+that entered the cell during the AP is transported out of the cell primarily by the Na+/Ca2+exchanger in the membrane which pumps one Ca2+ion out in exchange for three Na+ions in, using the Na+electrochemical gradient as an energy source. Increased heart rate increases the force of contraction in a stepwise fashion as intracellular [Ca2+] increases cumulatively over several beats; this is the Treppe effect. Factors that affect intracellular [Ca2+] and hence cardiac contractility are called inotropes.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      32.5
      Seconds

  • Question 12 - Which JVP waveform correlates to atrial systole? ...

    Correct

    • Which JVP waveform correlates to atrial systole?

      Your Answer: The a wave

      Explanation:

      JVP Waveform in Cardiac Cycle Physiology: a wave Right atrial contraction causes atrial systole (end diastole). the c wave During right isovolumetric ventricular contraction, the tricuspid valve bulges into the right atrium, resulting in isovolumetric contraction (early systole). descent by x Rapid ventricular ejection (mid systole) is caused by a combination of right atrial relaxation, tricuspid valve downward movement during right ventricular contraction, and blood ejection from both ventricles. the v-wave Ventricular ejection and isovolumetric relaxation (late systole) occur as a result of venous return filling the right atrium. y lineage Ventricular filling occurs when the tricuspid valve opens, allowing blood to flow rapidly from the right atrium to the right ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      5.1
      Seconds

  • Question 13 - Captopril should not be used if you have any of the following conditions:...

    Correct

    • Captopril should not be used if you have any of the following conditions:

      Your Answer: Renal artery stenosis

      Explanation:

      Contraindications indications of Captopril include:
      – Bilateral renal artery stenosis
      – Hypersensitivity to ACE inhibitors
      – Anuria
      – History of ACEI-induced angioedema
      – Hereditary or idiopathic angioedema
      – Co-administration of Neprilysin inhibitors (e.g., sacubitril) with ACE inhibitors may increase angioedema risk; do not administer ACE inhibitors within 36 hours of switching to or from sacubitril/valsartan.
      If ACE inhibitors are used, they should be initiated only under specialist supervision and renal function should be monitored regularly. ACE inhibitors should also be used with particular caution in patients who may have undiagnosed and clinically silent renovascular disease. This includes patients with peripheral vascular disease or those with severe generalised atherosclerosis.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      21.9
      Seconds

  • Question 14 - After a work-related accident, a 33-year old male is taken to the emergency...

    Correct

    • After a work-related accident, a 33-year old male is taken to the emergency room with difficulty in adduction and flexion of his left arm at the glenohumeral joint. The attending physician is suspects involvement of the coracobrachialis muscle.

      The nerve injured in the case above is?

      Your Answer: The musculocutaneous nerve

      Explanation:

      The coracobrachialis muscle is innervated by the musculocutaneous nerve (C5-C7) a branch of the lateral cord of the brachial plexus.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      13.9
      Seconds

  • Question 15 - In a ward round, you come across a patient's treatment chart prescribed an...

    Correct

    • In a ward round, you come across a patient's treatment chart prescribed an antibiotic to fight his infection. This antibiotic is an inhibitor of cell wall synthesis.

      Which of the following antimicrobial drugs is prescribed to this patient?

      Your Answer: Benzylpenicillin

      Explanation:

      Penicillins and cephalosporins are the major antibiotics that inhibit bacterial cell wall synthesis. They inactivate transpeptidases that help cross-link peptidoglycans in cell walls.

      Isoniazid decreases the synthesis of mycolic acids in mycobacterium.

      Clarithromycin binds to the 50S subunit of ribosomes and inhibits protein synthesis.

      Metronidazole and the other 5-nitroimidazole agents inhibit nucleic acid synthesis by forming toxic free radical metabolites in the bacterial cell that damage DNA.

      Tetracycline bind to 30S and prevent attachment of aminoacyl-tRNA.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      7.1
      Seconds

  • Question 16 - Which of the following organisms can penetrate intact skin: ...

    Correct

    • Which of the following organisms can penetrate intact skin:

      Your Answer: Leptospira spp.

      Explanation:

      Leptospirosis is a bacterial disease caused byLeptospira spp. It is the most common zoonotic infection worldwide.
      It is usually contracted by exposure to water contaminated with the urine of infected animals (such as rodents, cattle, and dogs). The most important reservoirs are rodents, and rats are the most common source worldwide.
      The bacteria enter the body through the skin or mucous membranes. This is more likely if the skin is broken by leptospirosis is somewhat unusual in that it can enter the body through intact skin.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      9.8
      Seconds

  • Question 17 - A 34-year-old man presents with loss of vision in his left eye due...

    Correct

    • A 34-year-old man presents with loss of vision in his left eye due to an episode of optic neuritis. Upon history taking, it was noted that he has a history of multiple sclerosis.

      Which of the following anatomical points in the visual pathway has the lesion occurred?

      Your Answer: Optic nerve

      Explanation:

      A lesion in the optic nerve causes ipsilateral monocular visual loss.
      Optic neuritis is an inflammatory demyelination of the optic nerve that is highly associated with multiple sclerosis. The two most common symptoms of optic neuritis are vision loss and eye pain.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      10.3
      Seconds

  • Question 18 - Which of the following is a well recognised adverse effect of prochlorperazine: ...

    Correct

    • Which of the following is a well recognised adverse effect of prochlorperazine:

      Your Answer: Acute dystonic reaction

      Explanation:

      Adverse actions include anticholinergic effects such as drowsiness, dry mouth, and blurred vision, extrapyramidal effects, and postural hypotension. Phenothiazines can all induce acute dystonic reactions such as facial and skeletal muscle spasms and oculogyric crises; children (especially girls, young women, and those under 10 kg) are particularly susceptible.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      7.1
      Seconds

  • Question 19 - Which of the following nerves is most important for eversion of the foot:...

    Correct

    • Which of the following nerves is most important for eversion of the foot:

      Your Answer: Superficial fibular nerve

      Explanation:

      Eversion of the foot is primarily produced by the fibularis longus and fibularis brevis, both innervated by the superficial fibular nerve. The fibularis tertius, innervated by the deep fibular nerve, also assists in this action.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      22.6
      Seconds

  • Question 20 - Which of the following is most true of the sinoatrial node: ...

    Correct

    • Which of the following is most true of the sinoatrial node:

      Your Answer: Frequency of depolarisation is increased by sympathetic stimulation.

      Explanation:

      Cardiac myocyte contraction is not dependent on an external nerve supply but instead the heart generates its own rhythm, demonstrating inherent rhythmicity. The heartbeat is initiated by spontaneous depolarisation of the sinoatrial node (SAN), a region of specialised myocytes in the right atrium close to the coronary sinus, at a rate of 100-110 beats/min. This intrinsic rhythm is primarily influenced by autonomic nerves, with vagal influences being dominant over sympathetic influences at rest. This vagal tone reduces the resting heart rate down to 60-80 beats/min. To increase heart rate, the autonomic nervous system increases sympathetic outflow to the SAN, with concurrent inhibition of vagal tone. These changes mean the pacemaker potential more rapidly reaches the threshold for action potential generation.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      38
      Seconds

  • Question 21 - Which of the following is NOT an adverse effect associated with warfarin therapy:...

    Incorrect

    • Which of the following is NOT an adverse effect associated with warfarin therapy:

      Your Answer: Calciphylaxis

      Correct Answer: Neutropenia

      Explanation:

      Adverse effects of warfarin:
      The most common adverse effect of warfarin is bleeding

      Other common adverse effects of warfarin include nausea, vomiting, diarrhoea, jaundice, hepatic dysfunction, pancreatitis, pyrexia, alopecia, purpura, and rash

      Skin necrosis is a rare but serious adverse effect of warfarin; treatment with warfarin should be stopped if warfarin related skin necrosis is suspected

      Calciphylaxis is a rare, but a very serious condition that causes vascular calcification and cutaneous necrosis

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      8.8
      Seconds

  • Question 22 - In the foetus at 4 months gestation, where does haematopoiesis mainly occur? ...

    Correct

    • In the foetus at 4 months gestation, where does haematopoiesis mainly occur?

      Your Answer: Liver and spleen

      Explanation:

      The first place that haematopoiesis occurs in the foetus is in the yolk sac. Later on, it occurs in the liver and spleen, which are the major hematopoietic organs from about 6 weeks until 6 – 7 months gestation. At this point, the bone marrow becomes the most important site. Haemopoiesis is restricted to the bone marrow in normal childhood and adult life.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      11.6
      Seconds

  • Question 23 - A newborn baby is referred by the community midwife who is concerned the...

    Incorrect

    • A newborn baby is referred by the community midwife who is concerned the baby is jaundiced because of the yellow appearance of his eyes and skin following a postnatal home visit. The jaundice is visible in the baby’s feet making her worried.

      Jaundice are visible in the extremities of neonates at what approximate threshold bilirubin level?

      Your Answer: 65 μmol/L

      Correct Answer: 255 μmol/L

      Explanation:

      Newborn babies have a higher concentration of red blood cells with shorter lifespan leading to higher bilirubin levels than in adults. This condition is short-lived and harmless but with potential serious causes that need to be assessed for if present.

      The most obvious physical sign of jaundice is a yellow discolouration of the sclera, skin and mucous membranes. At a bilirubin level of 35 μmol/L or higher, the eye is affected. The bilirubin level will need to be higher than 255 μmol/L for the feet and extremities to be affected.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      14.2
      Seconds

  • Question 24 - A patient complains of stomach ache. You see a midline scar in the...

    Correct

    • A patient complains of stomach ache. You see a midline scar in the epigastric area when you examine the abdomen. Upon further interrogation, the patient reveals that she had a subtotal gastrectomy for recurring stomach ulcers several years ago. The stomach mucosa secretes a variety of vital compounds, and her ability to secrete some of these molecules has been harmed as a result of his surgery.

      The stomach D-cells secrete which of the following substances?

      Your Answer: Somatostatin

      Explanation:

      Somatostatin-producing cells present in the pyloric antrum, duodenum, and pancreatic islets are known as D-cells or delta-cells. Somatostatin inhibits gastric acid secretion by acting directly on acid-producing parietal cells in the stomach via a G-protein coupled receptor. By suppressing the release of other hormones such as gastrin, secretin, and histamine, somatostatin can indirectly reduce stomach acid output, slowing the digesting process.
      The table below summarizes the many cell types found in the stomach, as well as the substances secreted by each cell type and the function of the secretion:

      Cell type/ Substance secreted/ Function of secretion
      Parietal cells/ Hydrochloric acid/ Kills microbes and activates pepsinogen
      Parietal cells/ Intrinsic factor/Binds to vitamin B12 and facilitates its absorption
      Chief cells/ Pepsinogen/ Protein digestion
      Chief cells/ Gastric lipase/ Fat digestion
      G-cells/ Gastrin/ Stimulates gastric acid secretion
      Enterochromaffin-like cells (ECL cells) /Histamine/ Stimulates gastric acid secretion
      Mucous-neck cells/ Mucous and bicarbonate/ Protects stomach epithelium from acid
      D-cells/ Somatostatin/ Inhibits gastric acid secretion

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      21.2
      Seconds

  • Question 25 - Following a phone call from the microbiology consultant, you evaluate a patient who...

    Incorrect

    • Following a phone call from the microbiology consultant, you evaluate a patient who has been diagnosed with urinary sepsis. Following the results of the blood cultures, he recommends that you add gentamicin to the patient's antibiotic treatment.

      Gentamicin produces its pharmacological effect by binding to which of the following?

      Your Answer: The 50S subunit of the bacterial ribosome

      Correct Answer: The 30S subunit of the bacterial ribosome

      Explanation:

      Antibiotics with aminoglycosides, such as gentamicin, bind to the 30S subunit of the bacterial ribosome and prevent aminoacyl-tRNA from binding, preventing protein synthesis.

      They also cause mRNA misreading, resulting in the production of non-functional proteins. This last mechanism is unique to aminoglycosides, and it may explain why they are bactericidal rather than bacteriostatic, as other protein synthesis inhibitors are.

      Patients with myasthenia gravis should avoid aminoglycosides since they can disrupt neuromuscular transmission. They cross the placenta and are linked to poisoning of the 8th cranial nerve in the foetus, as well as permanent bilateral deafness.

      It is possible that they will cause deafness, although this is not a contraindication. In individuals with renal impairment, serum aminoglycoside concentrations should be closely monitored, but this is still not considered a contraindication.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      20.4
      Seconds

  • Question 26 - Which of the following is NOT a common side effect of adenosine: ...

    Correct

    • Which of the following is NOT a common side effect of adenosine:

      Your Answer: Yellow vision

      Explanation:

      Common side effects of adenosine include:
      Apprehension
      Dizziness, flushing, headache, nausea, dyspnoea
      Angina (discontinue)
      AV block, sinus pause and arrhythmia (discontinue if asystole or severe bradycardia occur)

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      7.5
      Seconds

  • Question 27 - Molecules with a molecular weight of less than which of the following are...

    Incorrect

    • Molecules with a molecular weight of less than which of the following are filtered freely at the glomerular filtration barrier:

      Your Answer: 8000 Da

      Correct Answer: 7000 Da

      Explanation:

      Molecular weight is the main factor in determining whether a substance is filtered or not – molecules < 7 kDa in molecular weight are filtered freely e.g. glucose, amino acids, urea, ions but larger molecules are increasingly restricted up to 70 kDa, above which filtration is insignificant. Negatively charged molecules are further restricted, as they are repelled by negative charges, particularly in the basement membrane. Albumin has a molecular weight of 69 kDa and is negatively charged, thus only very small amounts are filtered (and all of the filtered albumin is reabsorbed in the proximal tubule), whereas small molecules such as ions, glucose, amino acids and urea pass the filter without hindrance. This means that ultrafiltrate is virtually protein free, but otherwise has an identical composition of that of plasma. The epithelial lining of the Bowman's capsule consists of a single layer of cells called podocytes. The glomerular capillary endothelium is perforated by pores (fenestrations) which allow plasma components with a molecular weight of < 70 kDa to pass freely.

    • This question is part of the following fields:

      • Physiology
      • Renal
      6.1
      Seconds

  • Question 28 - A 63-year-old man complains of chest pain and syncope on occasion. His heart...

    Correct

    • A 63-year-old man complains of chest pain and syncope on occasion. His heart rate is 37 beats per minute, and he has a second-degree heart block, according to his rhythm strip.

      Which of the following would be the most appropriate next step in his management, according to the ALS bradycardia algorithm?

      Your Answer: Give atropine 500 mcg

      Explanation:

      Atropine is used to treat bradycardia (sinus, atrial, or nodal) or AV block when the patient’s haemodynamic condition is compromised by the bradycardia.

      If any of the following adverse features are present, the ALS bradycardia algorithm recommends a dose of atropine 500 mcg IV:
      Shock
      Syncope
      Myocardial ischemia
      Insufficiency of the heart

      If this does not work, give additional 500 mcg doses at 3-5 minute intervals until a maximum dose of 3 mg is reached. The heart rate can be slowed paradoxically if the dose is higher than 3 mg.

      The ALS bradycardia algorithm also suggests the following interim measures:
      Transcutaneous pacing
      Isoprenaline infusion 5 mcg/min
      Adrenaline infusion 2-10 mcg/minutes
      Alternative drugs (aminophylline, dopamine, glucagon, glycopyrrolate)

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      31.2
      Seconds

  • Question 29 - Stimulation of J receptors located on alveolar and bronchial walls results in all...

    Incorrect

    • Stimulation of J receptors located on alveolar and bronchial walls results in all of the following EXCEPT for:

      Your Answer: Rapid shallow breathing

      Correct Answer: Tachycardia

      Explanation:

      Juxtapulmonary or ‘J’ receptors are located on alveolar and bronchial walls close to the capillaries. Their afferents are small unmyelinated C-fibres or myelinated nerves in the vagus nerve. Activation causes depression of somatic and visceral activity by producing apnoea or rapid shallow breathing, a fall in heart rate and blood pressure, laryngeal constriction and relaxation of skeletal muscles via spinal neurones. J receptors are stimulated by increased alveolar wall fluid, pulmonary congestion and oedema, microembolism and inflammatory mediators. J receptors are thought to be involved in the sensation of dyspnoea in lung disease.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      6.9
      Seconds

  • Question 30 - Lidocaine's mechanism of action as a local aesthetic is as follows: ...

    Correct

    • Lidocaine's mechanism of action as a local aesthetic is as follows:

      Your Answer: Blocks influx of Na+ through voltage-gated Na+ channels

      Explanation:

      Local anaesthetics prevent generation/conduction of nerve impulses by reducing sodium permeability and increasing action potential threshold; inhibits depolarization, which results in blockade of conduction

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      9.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (6/7) 86%
Physiology (7/9) 78%
Gastrointestinal (1/1) 100%
Pharmacology (10/13) 77%
Cardiovascular Pharmacology (4/4) 100%
Anatomy (4/5) 80%
Lower Limb (2/3) 67%
Basic Cellular (2/2) 100%
Pathology (0/2) 0%
Wound Healing (0/1) 0%
Musculoskeletal (0/1) 0%
Upper Limb (1/1) 100%
Infections (1/2) 50%
Microbiology (1/1) 100%
Principles (1/1) 100%
Central Nervous System (2/2) 100%
General Pathology (0/1) 0%
Gastrointestinal Physiology (1/1) 100%
Renal (0/1) 0%
Respiratory (0/1) 0%
Anaesthesia (1/1) 100%
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