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Question 1
Correct
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External haemorrhoids may cause anal pain. When explaining to your patient why it does so, which of the following nerves will you point out as being affected?
Your Answer: Pudendal nerve
Explanation:The pain associated with external haemorrhoids is carried by a branch of the pudendal nerve, specifically the somatic fibres (S2-S4).
It innervates the external anal sphincter and most of the skin over the perineum.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 2
Incorrect
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All of the following statements are considered true regarding L'Abbe plots, except:
Your Answer:
Correct Answer: Treatment group results are plotted on the horizontal axis
Explanation:A L’Abbé plot is a scatter plot with the risk in the control group on the x-axis and the risk in the experimental group on the y-axis. It can be used to evaluate heterogeneity in meta-analysis. Furthermore, this plot can aid to choose a summary measure (odds ratio, risk ratio, risk difference) that will result in more consistent results.
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This question is part of the following fields:
- Evidence Based Medicine
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Question 3
Incorrect
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Herpes simplex virus is transmitted most commonly through which of the following routes:
Your Answer:
Correct Answer: Direct contact spread
Explanation:Herpes simplex virus is the most common cause of infective encephalitis and has a predilection for the temporal lobes. Herpes simplex is transmitted through direct contact. It invades skin locally producing skin vesicles by its cytolytic activity.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 4
Incorrect
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A 39-year-old woman is feeling unwell one week after a parathyroid surgery.
Which of the following stimulates release of parathyroid hormone (PTH)?Your Answer:
Correct Answer: Increased plasma phosphate concentration
Explanation:PTH is synthesised and released from the chief cells of the four parathyroid glands located behind the thyroid gland.
It is a polypeptide containing 84 amino acids and it controls free calcium in the body.The following stimuli causes release of PTH:
Increased plasma phosphate concentration
Decreased plasma calcium concentrationPTH release is inhibited by:
Normal or increased plasma calcium concentration
HypomagnesaemiaThe main actions of PTH are:
Increases plasma calcium concentration
Decreases plasma phosphate concentration
Increases osteoclastic activity (increasing calcium and phosphate resorption from bone)
Increases renal tubular reabsorption of calcium
Decreases renal phosphate reabsorption
Increases renal conversion of 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol (via stimulation of 1-alpha hydroxylase)
Increases calcium and phosphate absorption in the small intestine (indirectly via increased 1,25-dihydroxycholecalciferol) -
This question is part of the following fields:
- Endocrine Physiology
- Physiology
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Question 5
Incorrect
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What is the most common application of Nitrates?
Your Answer:
Correct Answer: Angina
Explanation:In patients with exertional stable angina, nitrates improve exercise tolerance, time to onset of angina, and ST-segment depression during exercise testing. In combination with beta-blockers or calcium channel blockers, nitrates produce greater anti-anginal and anti-ischemic effects.
While they act as vasodilators, coronary vasodilators, and modest arteriolar dilators, the primary anti ischemic effect of nitrates is to decrease myocardial oxygen demand by producing systemic vasodilation more than coronary vasodilation. This systemic vasodilation reduces left ventricular systolic wall stress. -
This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 6
Incorrect
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All of the following are indications for beta-blockers EXCEPT for:
Your Answer:
Correct Answer: Raynaud's disease
Explanation:Beta-blockers are contraindicated in Raynaud’s syndrome.
Beta-blockers may be indicated in:
Hypertension
Pheochromocytoma (only with an alpha-blocker)
Angina
Secondary prevention after ACS
Arrhythmias including atrial fibrillation
Heart failure
Thyrotoxicosis
Anxiety
Prophylaxis of migraine
Essential tremor
Glaucoma -
This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 7
Incorrect
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After what time period should intravenous phenytoin be used as second-line treatment of status epilepticus?
Your Answer:
Correct Answer: 25 minutes
Explanation:If seizures recur or fail to respond after initial treatment with benzodiazepines within 25 minutes of onset, phenytoin sodium, fosphenytoin sodium, or phenobarbital sodium should be used.
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 8
Incorrect
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Regarding carbohydrate, which of the following statements is INCORRECT:
Your Answer:
Correct Answer: Most dietary carbohydrate is in the form of disaccharides.
Explanation:Carbohydrates are the main energy source of most diets. They provide 17 kJ (4 kcal) of energy per gram. Most dietary carbohydrate is in the form of polysaccharides. The principal ingested polysaccharides are starch which is derived from plant sources and glycogen which is derived from animal sources. Dietary fibre consists of indigestible carbohydrate (found in plant foods) such as cellulose, lignin and pectin.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 9
Incorrect
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A 26 year old horse rider has a bad fall and sustains a neck injury which displays the following signs:
- ability to extend the wrist against gravity
- paralysis of the hands, trunk, and legs
- absent sensation in the fingers and medial upper arms
- normal sensation over the thumbs
- absent sensation in chest, abdomen, and legs
What is the neurological level of the injury?Your Answer:
Correct Answer: C6
Explanation:C1 – C4 INJURY
Most severe of the spinal cord injury levels; paralysis in arms, hands, trunk and legs; patient may not be able to breathe on his or her own, cough, or control bowel or bladder movements; ability to speak is sometimes impaired or reducedC5 INJURY
Person can raise his or her arms and bend elbows; likely to have some or total paralysis of wrists, hands, trunk and legs; can speak and use diaphragm, but breathing will be weakenedC6 INJURY
Nerves affect wrist extension; paralysis in hands, trunk and legs, typically; should be able to bend wrists back; can speak and use diaphragm, but breathing will be weakenedC7 INJURY
Nerves control elbow extension and some finger extension; most can straighten their arm and have normal movement of their shouldersC8 INJURY
Nerves control some hand movement; should be able to grasp and release objectsC5 – Elbow flexors (biceps, brachialis)
C6 – Wrist extensors (extensor carpi radialis longus and brevis)
C7 – Elbow extensors (triceps)
C8 – Finger flexors (flexor digitorum profundus) to the middle fingerC5 – Elbow flexed at 90 degrees, arm at the patient’s side and forearm supinated
C6 – Wrist in full extension
C7 – Shoulder is neutral rotation, adducted and in 90 degrees of flexion with elbow in 45 degrees of flexion
C8 –Full flexed position of the distal phalanx with the proximal finger joints stabilized in a extended position -
This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 10
Incorrect
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An analytical study is conducted to compare the risk of stroke between Ticagrelor therapy and Warfarin therapy among patients with atrial fibrillation. The following is obtained from the study:
No. of patients who took Ticagrelor: 300
No. of patients who took Ticagrelor and suffered a stroke: 30
No. of patients who took Warfarin: 500
No. of patients who took Warfarin and suffered a stroke: 20
Compute for the absolute risk in the Ticagrelor group.Your Answer:
Correct Answer: 0.1
Explanation:The absolute risk (AR) is the probability or chance of an event. It is computed as the number of events in treated or control groups, divided by the number of people in that group.
AR = 30/300 = 0.1
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This question is part of the following fields:
- Evidence Based Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY
