00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - Regarding the refractory period, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding the refractory period, which of the following statements is INCORRECT:

      Your Answer: Hyperpolarisation occurs due to delayed closure of K + channels.

      Correct Answer: Action potentials can occur in the relative refractory period but the amplitude of the action potential is smaller.

      Explanation:

      Following the action potential, Na+channels remain inactive for a time in a period known as the absolute refractory period where they cannot be opened by any amount of depolarisation. Following this there is a relative refractory period where the temporary hyperpolarisation (due to delayed closure of rectifier K+channels) makes the cell more difficult to depolarise and an action potential can be generated only in response to a larger than normal stimulus. The refractory period limits the frequency at which action potentials can be generated, and ensures that, once initiated, an action potential can travel only in one direction. An action potential is an all or nothing response so the amplitude of the action potential cannot be smaller.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      17.7
      Seconds
  • Question 2 - A 73-year-old woman arrives at the emergency department 48 hours after being discharged from...

    Incorrect

    • A 73-year-old woman arrives at the emergency department 48 hours after being discharged from the hospital after a two-week stay for sepsis treatment. She has fever, productive cough with thick green sputum, and shortness of breath. An X-ray shows left lower lobe pneumonia. Which of the bacteria listed below is more likely to be the causative agent:

      Your Answer: Mycoplasma pneumoniae

      Correct Answer: Pseudomonas aeruginosa

      Explanation:

      Hospital-acquired pneumonia (HAP), or nosocomial pneumonia, is a lower respiratory infection that was not incubating at the time of hospital admission and that presents clinically 2 or more days after hospitalization. Pneumonia that presents sooner should be regarded as community­ acquired pneumonia. VAP refers to nosocomial pneumonia that develops among patients on ventilators. Ventilator-associated pneumonia (VAP) is defined as pneumonia that presents more than 48 hours after endotracheal intubation.

      Common bacteria involved in hospital-acquired pneumonia (HAP) include the following [10] :
      Pseudomonas Aeruginosa
      Staphylococcus aureus, including methicillin-susceptible S aureus (MSSA) and methicillin-resistant S aureus (MRSA)
      Klebsiella pneumoniae
      Escherichia coli

    • This question is part of the following fields:

      • Infections
      • Microbiology
      38
      Seconds
  • Question 3 - Which of the following is most true of the sinoatrial node: ...

    Incorrect

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

      Your Answer: It is located between the right atrium and ventricle near the atrial septum.

      Correct 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
      22.8
      Seconds
  • Question 4 - A 55-year-old woman with history of gastritis and reflux esophagitis tested positive for...

    Incorrect

    • A 55-year-old woman with history of gastritis and reflux esophagitis tested positive for Helicobacter pylori infection.

      Which of the following statements regarding Helicobacter pylori is considered true?

      Your Answer: It is Gram-positive

      Correct Answer: It is helix shaped

      Explanation:

      Helicobacter pylori is a curved or helix-shaped, non-spore forming, Gram-negative, microaerophilic bacteria. It is motile, having multiple flagella at one pole. It has a lipopolysaccharide component in its outer membrane.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      8.5
      Seconds
  • Question 5 - A 40-year-old man with reduced urine output, nausea, and confusion also has a...

    Incorrect

    • A 40-year-old man with reduced urine output, nausea, and confusion also has a 150% rise of creatinine from baseline over the past 7 days. A diagnosis of acute kidney injury (AKI) is made after more tests are done.

      His AKI stage is?

      Your Answer: Stage 3

      Correct Answer: Stage 2

      Explanation:

      This patient with a 150% rise of creatinine above baseline within 7 days has stage 2 Acute kidney injury (AKI).

      AKI stages are as follows:
      Stage 1
      Creatinine rise of 26 micromole/L or more within 48 hours, or
      Creatinine rise of 50-99% from baseline within 7 days (1.5-1.99 x baseline),or
      Urine output <0.5 mL/kg/hour for more than 6 hours Stage 2
      Creatinine rise of 100-199% from baseline within 7 days (2.0-2.99 x baseline),or
      Urine output <0.5 mL/kg/hour for more than 12 hours Stage 3
      Creatinine rise of 200% or more from baseline within 7 days (3.0 or more x baseline), or
      Creatinine rise to 354 micromole/L or more with acute rise of 26 micromole/L or more within 48 hours or 50% or more rise within 7 days, or
      Urine output <0.3 mL/kg/hour for 24 hours or anuria for 12 hours

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      24.1
      Seconds
  • Question 6 - Regarding cytotoxic T cells, which of the following statements is CORRECT: ...

    Correct

    • Regarding cytotoxic T cells, which of the following statements is CORRECT:

      Your Answer: They kill target cells by inducing cell apoptosis.

      Explanation:

      CD8+ T-cells (Cytotoxic T cells)
      Recognise antigen only in association with HLA Class I molecules (found on all nucleated cells; present endogenous antigens such as those found in cells infected by viruses or intracellular bacteria.)
      Comprise about 25% of peripheral T-cells
      Responsible for cytotoxic killing of target cells

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      25
      Seconds
  • Question 7 - A young boy is carried by his friends to the Emergency Department in...

    Incorrect

    • A young boy is carried by his friends to the Emergency Department in an unconscious state. He is quickly moved into the resuscitation room.

      He was at a party with friends and has injected heroin. On examination, his GCS is 6/15, and he has bilateral pinpoint pupils and a very low respiratory rate of 6 breaths per minute.

      Which of the following is the first-line treatment for this patient?

      Your Answer: Naloxone 2 mg IV

      Correct Answer: Naloxone 0.8 mg IV

      Explanation:

      Heroin is injected into the veins and is the most commonly abused drug. Acute intoxication with opioid overuse is the most common cause of death by drug overdose.

      The clinical features of opioid overdose are:
      1. Decreased respiratory rate
      2. Reduced conscious level or coma
      3. Decreased bowel sounds
      4. Miotic (constricted) pupils
      5. Cyanosis
      6. Hypotension
      7. Seizures
      8. Non-cardiogenic pulmonary oedema (with IV heroin usage)

      The main cause of death secondary to opioid overdose is respiratory depression, which usually occurs within 1 hour of the overdose. Vomiting is also common, and aspiration can occur.

      Naloxone is a short-acting, specific antagonist of mu(μ)-opioid receptors. It is used to reverse the effects of opioid toxicity.

      It can be given by a continuous infusion if repeated doses are required and the infusion rate is adjusted according to the vital signs. Initially, the infusion rate can be set at 60% of the initial resuscitative IV dose per hour.

      Naloxone has a shorter duration of action (6-24 hours) than most opioids, and so close monitoring according to the respiratory rate and depth of coma with repeated injections is necessary. When repeated doses are needed in opioid addicts, naloxone administration may precipitate a withdrawal syndrome with abdominal cramps, nausea and diarrhoea, but these usually settle within 2 hours.

      An initial dose of 0.4 to 2 mg can be given intravenously and can be repeated at 2 to 3-minute intervals to a maximum of 10mg.

      If the intravenous route is inaccessible, naloxone can be administered via an IO line, subcutaneously (SQ), IM, or via the intranasal (IN) route.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      28.5
      Seconds
  • Question 8 - A 65-year-old man presents with a red, hot, swollen great toe. A diagnosis...

    Incorrect

    • A 65-year-old man presents with a red, hot, swollen great toe. A diagnosis of acute gout is made. His past medical history includes heart failure and type 2 diabetes mellitus.
      Which of the following is the most appropriate medication to use in the treatment of his gout? Select ONE answer only.

      Your Answer: Naproxen

      Correct Answer: Colchicine

      Explanation:

      In the absence of any contra-indications, high-dose NSAIDs are the first-line treatment for acute gout. Naproxen 750 mg as a stat dose followed by 250 mg TDS is a commonly used and effective regime.
      Aspirin should not be used in gout as it reduces the urinary clearance of urate and interferes with the action of uricosuric agents. Naproxen, Diclofenac or Indomethacin are more appropriate choices.
      Allopurinol is used prophylactically, preventing future attacks by reducing serum uric acid levels. It should not be started in the acute phase as it increases the severity and duration of symptoms.
      Colchicine acts on the neutrophils, binding to tubulin to prevent neutrophil migration into the joint. It is as effective as NSAIDs in relieving acute attacks. It also has a role in prophylactic treatment if Allopurinol is not tolerated.
      NSAIDs are contra-indicated in heart failure as they can cause fluid retention and congestive cardiac failure. Colchicine is the preferred treatment in patients with heart failure or those who are intolerant of NSAIDs.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
      16.9
      Seconds
  • Question 9 - After collapsing in his nursing home, a 70-year-old man is brought into the...

    Incorrect

    • After collapsing in his nursing home, a 70-year-old man is brought into the ER. He has diabetes mellitus and is on medication for it. An RBS of 2.0 mmol/L (3.9-5.5 mmol/L) is recorded in the ER.

      Out of the following, which medication for diabetes mellitus is LEAST likely responsible for his hypoglycaemic episode?

      Your Answer: Gliclazide

      Correct Answer: Metformin

      Explanation:

      Metformin is a biguanide used as the first-line to treat type 2 diabetes mellitus. It has a good reputation as it has an extremely low risk of causing hypoglycaemia compared to the other agents for diabetes. It does not affect the insulin secreted by the pancreas or increase insulin levels. Toxicity with metformin can, however, cause lactic acidosis with associated hypoglycaemia.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
      12.7
      Seconds
  • Question 10 - Intravenous glucose solutions are typically used in the treatment of all of the...

    Incorrect

    • Intravenous glucose solutions are typically used in the treatment of all of the following situations except:

      Your Answer: Hyperkalaemia

      Correct Answer: Hypokalaemia

      Explanation:

      In hypokalaemia, initial potassium replacement therapy should not involve glucose infusions, as glucose may cause a further decrease in the plasma-potassium concentration. Glucose infusions are used for the other indications like diabetic ketoacidosis, hypoglycaemia, routine fluid maintenance in patients who are nil by mouth (very important in children), and in hyperkalaemia.

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
      10.9
      Seconds
  • Question 11 - The lymph drainage of the anal canal above the pectinate line is initially...

    Incorrect

    • The lymph drainage of the anal canal above the pectinate line is initially to the:

      Your Answer:

      Correct Answer: Internal iliac nodes

      Explanation:

      Above the pectinate line, the anal canal drains to the internal iliac lymph nodes which subsequently drain to the lumbar (para-aortic) nodes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds
  • Question 12 - Regarding dynamic compression of the airways, which of the following statements is CORRECT:...

    Incorrect

    • Regarding dynamic compression of the airways, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: It occurs during forced expiration.

      Explanation:

      Dynamic compression occurs because as the expiratory muscles contract during forced expiration, all the structures within the lungs, including the airways, are compressed by the positive intrapleural pressure. Consequently the smaller airways collapse before the alveoli empty completely and some air remains within the lungs (the residual volume). Physiologically this is important as a completely deflated lung with collapsed alveoli requires significantly more energy to inflate. Dynamic compression does not occur in normal expiration because the intrapleural pressure is negative throughout the whole cycle.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 13 - A 33 year old female patient presents to emergency room with some symptoms...

    Incorrect

    • A 33 year old female patient presents to emergency room with some symptoms that she thinks might be due to a drug that she has recently started. She was started on hyoscine butyl bromide for symptomatic relief of irritable bowel syndrome. The least likely expected side effect of this drug in this patient is:

      Your Answer:

      Correct Answer: Diarrhoea

      Explanation:

      One of the commonest antispasmodic medications that is used is hyoscine butylbromide. It is an antimuscarinic and typical side effects of this class of drugs include:
      – dilation of pupils with loss of accommodation (cycloplegia)
      -photophobia resulting in blurred vision (Blind as a bat)
      -dry mouth, eyes and skin (Dry as a bone),
      -elevated temperature (Hot as a hare)
      -skin flushing (Red as a beet)
      -confusion or agitation particularly in the elderly (Mad as a hatter)
      -reduced bronchial secretions
      -transient bradycardia followed by tachycardia, palpitation and arrhythmias
      -urinary retention and/or constipation

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      0
      Seconds
  • Question 14 - Regarding basophils, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding basophils, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: They are the second most common type of granulocyte.

      Explanation:

      Basophils are only occasionally seen in normal peripheral blood comprising < 1% of circulating white cells. However, they are the largest type of granulocyte. They have many dark cytoplasmic granules which overlie the nucleus and contain heparin and histamine. They have immunoglobulin E (IgE) attachment sites and their degranulation is associated with histamine release. Basophils are very similar in both appearance and function to mast cells.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds
  • Question 15 - Which of the following is most likely to cause a homonymous hemianopia: ...

    Incorrect

    • Which of the following is most likely to cause a homonymous hemianopia:

      Your Answer:

      Correct Answer: Posterior cerebral artery stroke

      Explanation:

      A posterior cerebral stroke will most likely result in a contralateral homonymous hemianopia with macular sparing.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 16 - In a VF arrest, a 6-year-old child is brought to your Emergency Department...

    Incorrect

    • In a VF arrest, a 6-year-old child is brought to your Emergency Department resuscitation area. He weighs 16 kilogrammes. He's had three DC shocks, but he's still in VF and doesn't have an output.

      What amiodarone dose should he get now, according to the most recent APLS guidelines?

      Your Answer:

      Correct Answer: 80 mg

      Explanation:

      In a shockable (Vf/pVT) paediatric cardiac arrest, amiodarone should be administered after the third and fifth shocks. The dose is 5 mg/kg (maximum 300 mg) and should be administered over a three-minute period. If at all possible, administration via a central line is recommended.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 17 - Regarding the lacrimal apparatus, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the lacrimal apparatus, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Lacrimal fluid is drained from the eyeball through the lacrimal punctum.

      Explanation:

      Lacrimal fluid is drained from the eyeball through the lacrimal punctum.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 18 - Which of the following is NOT a typical side effect of digoxin: ...

    Incorrect

    • Which of the following is NOT a typical side effect of digoxin:

      Your Answer:

      Correct Answer: Hypokalaemia

      Explanation:

      Digoxin does not cause hypokalaemia, but hypokalaemia does potentiate digoxin toxicity. The adverse effects of digoxin are frequently due to its narrow therapeutic window and include:
      Cardiac adverse effects – Sinoatrial and atrioventricular block, Premature ventricular contractions, PR prolongation and ST-segment depression
      Nausea, vomiting and diarrhoea
      Blurred or yellow vision
      CNS effects – weakness, dizziness, confusion, apathy, malaise, headache, depression, psychosis
      Thrombocytopenia and agranulocytosis (rare)
      Gynaecomastia in men in prolonged administration

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds
  • Question 19 - Regarding macrolide antibiotics, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding macrolide antibiotics, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Macrolides are first line for treatment of whooping cough.

      Explanation:

      A macrolide antibiotic is recommended first line for whooping cough (if onset of cough is within the previous 21 days)
      Prescribe clarithromycin for infants less than 1 month of age.
      Prescribe azithromycin or clarithromycin for children aged 1 month or older, and non-pregnant adults.
      Prescribe erythromycin for pregnant women.
      Macrolides interfere with bacterial protein synthesis and are mainly active against Gram-positive organisms. They have a similar antibacterial spectrum to penicillin and are thus a useful alternative in penicillin-allergic patients. Erythromycin is commonly associated with gastrointestinal upset.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds
  • Question 20 - Which of the following nerves provides sensory innervation to the anteromedial and anterosuperior...

    Incorrect

    • Which of the following nerves provides sensory innervation to the anteromedial and anterosuperior aspects of the external ear?

      Your Answer:

      Correct Answer: Auriculotemporal nerve

      Explanation:

      Sensory innervation to the external ear is supplied by both cranial and spinal nerves. Branches of the trigeminal, facial, and vagus nerves (CN V, VII, X) are the cranial nerve components, while the lesser occipital (C2, C3) and greater auricular (C2, C3) nerves are the spinal nerve components involved. The lateral surface of the tympanic membrane, the external auditory canal, and the external acoustic meatus are all innervated by nervus intermedius (a branch of CN VII), the auriculotemporal nerve (CN V3), and the auricular branch of the vagus nerve. The concha receives split innervation from nervus intermedius, the auricular branch of the vagus nerve, and the greater auricular (spinal) nerve. Beyond the concha, the anteromedial and anterosuperior parts of the pinna are innervated by the auriculotemporal nerve, and a portion of the lateral helix by the lesser occipital nerve. The greater auricular nerve provides innervation to the area of the pinna inferolateral to the lobule.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 21 - A 25-year-old female arrives at the emergency room with a severe case of asthma....

    Incorrect

    • A 25-year-old female arrives at the emergency room with a severe case of asthma. When she doesn't seem to be improving after initial treatment, you decide to start an aminophylline infusion.

      From the options below, which is Aminophylline's main mechanism of action?

      Your Answer:

      Correct Answer: Phosphodiesterase inhibition

      Explanation:

      Theophylline and Ethylenediamine are combined in a 2:1 ratio to form Aminophylline. Its solubility is improved by the addition of Ethylenediamine. It has a lower potency and a shorter duration of action than Theophylline.
      It is used to treat the following conditions:
      Heart failure
      It is used to treat the following conditions:
      COPD
      Bradycardias

      Aminophylline has the following properties:
      Phosphodiesterase inhibitor that increases intracellular cAMP and relaxes smooth muscle in the bronchial airways and pulmonary blood vessels.
      Mast cell stabilization is achieved by using a non-selective adenosine receptor antagonist.
      It has slight positive inotropic and chronotropic effects, increasing cardiac output and decreasing systemic vascular resistance, lowering arterial blood pressure. It has been used historically in the treatment of refractory heart failure and is indicated by the current ALS guidelines as a substitute treatment for bradycardia.

      The daily oral dose for adults is 900 mg, divided into 2-3 doses. For severe asthma or COPD, a loading dosage of 5 mg/kg over 10-20 minutes is given, followed by a continuous infusion of 0.5 mg/kg/hour. The therapeutic range is small (10-20 microgram/ml), hence assessments of aminophylline plasma concentrations are useful during long-term treatment.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      0
      Seconds
  • Question 22 - Regarding the heart sounds in the cardiac cycle, which of the following statements...

    Incorrect

    • Regarding the heart sounds in the cardiac cycle, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: The third heart sound is caused by filling of an abnormally stiff ventricle in atrial systole.

      Explanation:

      Heart Sound – Phase of Cardiac Cycle – Mechanical Event:
      First heart sound – Start of systole – Caused by closure of the atrioventricular (mitral & tricuspid) valves
      Second heart sound – End of systole – Caused by closure of the semilunar (aortic and pulmonary) valves
      Third heart sound – Early diastole – Caused by rapid flow of blood from the atria into the ventricles during the ventricular filling phase
      Fourth heart sound – Late diastole – Caused by filling of an abnormally stiff ventricle in atrial systole

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 23 - A 54-year-old man returns from a recently holiday on a cruise ship with...

    Incorrect

    • A 54-year-old man returns from a recently holiday on a cruise ship with a dry cough and a fever. Today he has also had several episodes of diarrhoea and has developed bilateral pleuritic chest pain. He states that he is short of breath, most notably on exertion. He had been prescribed amoxicillin by the cruise ship doctor a few days earlier but has not seen any improvement.
      Which of the following is the most likely causative organism? Select ONE answer only.

      Your Answer:

      Correct Answer: Legionella pneumophila

      Explanation:

      Legionella pneumophilais a Gram negative bacterium that is found in natural water supplies and in the soil, transmitted predominantly via inhalation of aerosols generated from contaminated water (direct person-to-person spread of infected patients does not occur). It is the cause of Legionnaires’ disease. Outbreaks of Legionnaires’ disease have been linked to poorly maintained air conditioning systems, whirlpool spas and hot tubs.

      The clinical features of the pneumonic form of Legionnaires’ disease include:
      Mild flu-like prodrome for 1-3 days
      Cough (usually non-productive and occurs in approximately 90%)
      Pleuritic chest pain
      Haemoptysis
      Headache
      Nausea, vomiting and diarrhoea
      Anorexia
      Legionella pneumophilainfections can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used.
      The syndrome of inappropriate antidiuretic hormone secretion (SIADH) can occur with Legionnaires’ disease and will result in hyponatraemia as is seen in this case.
      Legionella pneumophilainfections are resistant to amoxicillin but can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used. The majority of cases of Legionnaires’ disease are caused by Legionella pneumophila, however many other species of Legionella have been identified.
      Legionella longbeachae is another less commonly encountered species that has also been implicated in outbreaks. It is predominantly found in soil and potting compost, and has caused outbreaks of Pontiac fever, the non-respiratory and less severe variant of Legionnaires’ disease.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 24 - While studying fluid homeostasis in the body, you encounter the term exudate. Exudate...

    Incorrect

    • While studying fluid homeostasis in the body, you encounter the term exudate. Exudate is a fluid that leaks out of the intravascular space due to changes in the permeability of the microcirculation secondary to inflammation.

      Which ONE of the following conditions would not be listed among the causes of an exudate?

      Your Answer:

      Correct Answer: Myxoedema

      Explanation:

      An exudate is an inflammatory fluid that leaks out of the intravascular space due to increased vascular permeability and intravascular pressure. It is mostly caused by local processes and can occur in the following conditions:
      1) Infection (e.g. pneumonia)
      2) Malignancy
      3) Pericarditis
      4) Collagen vascular diseases, e.g., Rheumatoid Arthritis

      Myxoedema is a state of severe hypothyroidism in which deposition of mucopolysaccharides occurs in the dermis. This causes a transudative effusion, typically in the pretibial region.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds
  • Question 25 - A 32-old woman comes for a follow-up visit after being discharged on medications...

    Incorrect

    • A 32-old woman comes for a follow-up visit after being discharged on medications for her newly diagnosed epilepsy. She now complains of a tremor in her arm when she holds a tray in her hand. You examine the patient and notice she has developed postural tremors.

      Which of the following medications for epilepsy is most likely responsible for this tremor?

      Your Answer:

      Correct Answer: Sodium valproate

      Explanation:

      A postural tumour is observed when a person maintains a position against gravity, such as holding the arms outstretched. (The patient holding her tray against gravity)

      Sodium valproate is the most commonly prescribed medication for epilepsy. It is commonly associated with tremors as valproate-induced tremors occur in around 6-45% of patients. The tremors are commonly postural, but a resting tremor may also occur.

      Approximately 25% of patients taking sodium valproate are found to develop a tremor within 3-12 months of initiating therapy.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 26 - A 4-year-old girl is rushed to the Emergency Department by her grandparents after...

    Incorrect

    • A 4-year-old girl is rushed to the Emergency Department by her grandparents after swallowing some of her grandfather's Warfarin tablets. On further questioning, it turns out that she took 5 of his 3 mg tablets which he needs to take due to a history of atrial fibrillation. The child appears healthy well-oriented in time, place and person, and has normal vitals.

      What is the threshold dose of Warfarin that needs to be ingested for there to be a risk of anticoagulation?

      Your Answer:

      Correct Answer: 0.5 mg/kg

      Explanation:

      The clinical effects of Warfarin occur after a dose of greater than 0.5 mg/kg, and they will be observable 8-10 hours after consumption of the drug. The antidote used for Warfarin is Vitamin K.

      1. In low-risk cases with no apparent bleeding:
      an oral dose of 10 mg vitamin K

      2. If there is clinically significant bleeding
      an intravenous dose of 250-300 mcg/kg

      Activated charcoal:
      in cases of warfarin ingestion
      binds to it and reduces the absorption of warfarin
      the ingestion must have occurred within the last hour
      There is, however, rarely a need for the use of activated charcoal because vitamin K is such as safe and effective antidote.

      Clotting studies, including an INR, can be performed, but small children who have ingested warfarin do not require INRs or follow up if they have been treated with 10 mg vitamin K. This dose of vitamin will completely reverse the anticoagulative effects of warfarin.

      Perform INR if any of the following are present:
      1. Delayed presentation (>6 hours)
      2. Patients with symptoms or signs of anticoagulation
      3. Possible massive ingestion

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 27 - Which of the following ions is more abundant in extracellular fluid than in...

    Incorrect

    • Which of the following ions is more abundant in extracellular fluid than in intracellular fluid:

      Your Answer:

      Correct Answer: Cl -

      Explanation:

      Protein and phosphate are the primary intracellular anions, while chloride (Cl-) and bicarbonate are the predominant extracellular anions (HCO3-).

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds
  • Question 28 - 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:

      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
      0
      Seconds
  • Question 29 - In adult basic life support, chest compressions should be performed at which of...

    Incorrect

    • In adult basic life support, chest compressions should be performed at which of the following rates:

      Your Answer:

      Correct Answer: 100 - 120 per minute

      Explanation:

      Chest compressions should be performed at a rate of 100 – 120 per minute.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds
  • Question 30 - A 6 year old boy is brought into the ED by his mom...

    Incorrect

    • A 6 year old boy is brought into the ED by his mom with a rash that is associated with Koplik's spots and a diagnosis of measles is made. What advice should be given about returning to school?

      Your Answer:

      Correct Answer: 4 days from the onset of the rash

      Explanation:

      Prevention of spread of measles is extremely important and infected patients should be isolated. The infectious stage is from 3 days before the rash emerges and patients are advised to stay away from school/nursery/work for 4 days from onset of the rash.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Basic Cellular (0/1) 0%
Physiology (0/2) 0%
Infections (0/1) 0%
Microbiology (0/2) 0%
Cardiovascular (0/1) 0%
Specific Pathogen Groups (0/1) 0%
General Pathology (0/1) 0%
Pathology (1/2) 50%
Immune Responses (1/1) 100%
CNS Pharmacology (0/1) 0%
Pharmacology (0/4) 0%
Musculoskeletal Pharmacology (0/1) 0%
Endocrine Pharmacology (0/1) 0%
Fluids And Electrolytes (0/1) 0%
Passmed