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Question 1
Incorrect
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A medical student is reviewing the chart of a patient who has recently been diagnosed with leukaemia. The chief resident asks him to identify ONE feature that will most support acute leukaemia diagnosis in contrast to chronic leukaemia.
Which one of the following options will he pick?Your Answer: Absence of marrow failure
Correct Answer: The patient is a child
Explanation:Acute lymphocytic leukaemia (ALL) is more common in children than chronic leukaemias, which generally occur in adults. Bone marrow failure occurs early on in the course of the disease in acute leukaemias, and there is the massive proliferation of undifferentiated cells with functioning cells being crowded out. Hepatosplenomegaly occurs in both acute and chronic forms of leukaemia and is not a differentiating feature.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 2
Incorrect
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Question 3
Correct
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The following all cause a right shift in the oxygen dissociation curve EXCEPT for:
Your Answer: Foetal haemoglobin
Explanation:A decreased affinity of haemoglobin for oxygen (and hence increased ease of dissociation), shown by a right shift in the oxygen dissociation curve, is caused by a fall in pH, a rise in PCO2(the Bohr effect) and an increase in temperature. These changes occur in metabolically active tissues such as in exercise, and encourage oxygen release. The metabolic by-product 2,3-diphosphoglycerate (2,3 -DPG) also causes a right shift; 2, 3 -DPG may also be raised in chronic anaemia, chronic lung disease, or at high altitude. Foetal haemoglobin (HbF) binds 2, 3 -DPG less strongly than does adult haemoglobin (HbA), and so the HbF dissociation curve lies to the left of that for HbA, reflecting its higher oxygen affinity. This helps transfer oxygen from mother to foetus.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 4
Incorrect
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All of the following statements regarding Helicobacter pylori is considered true, except:
Your Answer: It is a Gram-negative bacterium
Correct Answer: Serum antibody levels should be used to check for successful eradication
Explanation:Helicobacter pylori is a curved, non-spore forming, Gram-negative bacteria that is primarily linked to gastric infections. Once acquired, it colonizes the stomach for a long time and can cause a low-grade inflammatory process, producing a chronic superficial gastritis.
H. pylori can be recovered from gastric biopsy materials. Samples must be transported quickly to the laboratory.
Helicobacter infections usually are identified by nonculture methods. H. pylori can be presumptively identified in a gastric biopsy specimen by testing for the presence of a rapid urease reaction.Serologic testing is an important screening method for the diagnosis of H. pylori infection. It can also be diagnosed by faecal antigen detection, microscopic examination of stained gastric tissue, and DNA amplification tests.
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This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 5
Incorrect
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An very unwell patient is receiving treatment in your hospital's HDU and is found to have an Escherichia coli O157 infection.
Which one of these statements about Escherichia coli O157 is true?Your Answer: Infections are more common in winter
Correct Answer: Haemolytic uraemic syndrome develops in approximately 6% of patients
Explanation:Escherichia coli O157 is a serotype of Escherichia coli.
The Escherichia coliO157 strain is ‘enterohaemorrhagic’ and causes severe forms of acute haemorrhagic diarrhoea. It can also cause non-haemorrhagic diarrhoea.Incubation period of Escherichia coli O157 is usually 3-4 days and bloody diarrhoea usually begins on the 3rd or 4th day of the infection.
Infections with Escherichia coliO157 are more common during the warmer months than in winter.
Haemolytic uraemic syndrome develops in approximately 6% of patients. It is commonly seen in children and in the elderly.
Escherichia coli O157 can also cause:
Haemorrhagic colitis
Haemolytic uraemic syndrome
Thrombotic thrombocytopenic purpura but not immune thrombocytopenic purpura. -
This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 6
Incorrect
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Which of the following best describes the popliteal artery's course?
Your Answer: After exiting the popliteal fossa continues down the posterior leg terminating at the level of the lateral malleolus
Correct Answer: After exiting the popliteal fossa terminates at the lower border of the popliteus muscle
Explanation:The popliteal artery divides into the anterior and posterior tibial arteries at the lower border of the popliteus after exiting the popliteal fossa between the gastrocnemius and popliteus muscles.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 7
Correct
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A man working as a waiter cuts his arm on a glass while he was working. The palmaris longus muscle was damaged as a consequence of his injury.
Which of the following statements regarding the palmaris longus muscle is considered correct?Your Answer: It receives its blood supply from the ulnar artery
Explanation:The palmaris longus is a small, fusiform-shaped muscle located on the anterior forearm of the human upper extremity. The palmaris longus muscle is commonly present but may be absent in a small percentage of the population, ranging from 2.5% to 26% of individuals, depending on the studied population.
The palmaris longus belongs to the anterior forearm flexor group in the human upper extremity. The muscle attaches proximally to the medial humeral epicondyle and distally to the palmar aponeurosis and flexor retinaculum. The blood supply to the palmaris longus muscle is via the ulnar artery, a branch of the brachial artery in the human upper extremity.
The palmaris longus muscle receives its innervation via branches of the median nerve containing nerve roots C5-T1. Median nerve injury at or above the elbow joint (including brachial plexus and nerve root injury) can lead to deficits in the palmaris longus and other forearm flexor muscles, leading to weakened elbow flexion, wrist flexion, radial deviation, finger flexion, thumb opposition, flexion, and abduction, in addition to the loss of sensory function in the distribution of the median nerve.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 8
Incorrect
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Aside from the inability to extend the leg above the knee, which of the following clinical symptoms should you anticipate seeing in a patient who had a pelvic and right leg injury as well as femoral nerve damage?
Your Answer: Trendelenburg's sign
Correct Answer: Loss of sensation over the anterior thigh
Explanation:The femoral nerve runs down the front of the leg from the pelvis. It gives the front of the thigh and a portion of the lower leg sensation.
Extension of the leg at the knee joint, flexion of the thigh at the hip are produced by muscles that is primarily innervated by the femoral nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 9
Incorrect
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How is measles primarily transmitted:
Your Answer: Oral-faecal route
Correct Answer: Respiratory droplet route
Explanation:Measles belongs to the paramyxoviridae group of viruses. The incubation period is 7-18 days (average 10) and it is spread by airborne or droplet transmission. The classical presentation is of a high fever with coryzal symptoms and photophobia with conjunctivitis often being present. The rash that is associated is a widespread erythematous maculopapular rash. Koplik spots are pathognomonic for measles, and are the presence of white lesions on the buccal mucosa.
Differential diagnoses would include:
Rubella
Roseola infantum (exanthem subitom)
Scarlet fever
Kawasaki disease
Erythema infectiosum (5thdisease)
Enterovirus
Infectious mononucleosis
Diagnosis can be confirmed by the following means:
Salivary swab for measles specific IgM
Serum sample for measles specific IgM
Salivary swab for RNA detection
Possible complications include:
Otitis media
Febrile convulsions
Pneumonia
Bronchiectasis
Diarrhoea
Meningitis
Encephalitis
Immunosuppression
Subacute sclerosing panencephalitis
Death -
This question is part of the following fields:
- Microbiology
- Pathogens
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Question 10
Incorrect
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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 suprascapular nerve
Correct 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.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 11
Incorrect
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Metabolic hyperaemia harmonizes local blood flow with local O2 demand. If there is an increase in metabolic rate, the production of vasoactive metabolites increases. These metabolites act locally on the surrounding arterioles, causes vasodilation and an increase blood supply.
Which of these metabolites is the most potent vasodilator in skeletal muscle?Your Answer: H 2 O 2
Correct Answer: K +
Explanation:Hyperaemia is the process where the body adjusts blood flow to meet the metabolic needs of different tissues in health and disease. Vasoactive mediators that take part in this process include K+, adenosine, CO2, H+, phosphates and H2O2. Although the mechanism is not clear, all these mediators likely contribute to some extent at different points.
Specific organs are more sensitive to specific metabolites:
K+ and adenosine are the most potent vasodilators in skeletal musclesCO2 and K+ are the most potent vasodilators in cerebral circulation.
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This question is part of the following fields:
- Cardiovascular Physiology
- Physiology
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Question 12
Incorrect
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A 52-year-old woman visits her local pharmacy to get medication to help with mild dyspepsia symptoms. The pharmacist on duty suggests she uses an over-the-counter antacid. She purchases an antacid that contains magnesium carbonate, which relieves her symptoms, but she unfortunately also develops a side effect.
Out of the following, which side effect is she MOST likely to develop after using the antacid?Your Answer: Constipation
Correct Answer: Diarrhoea
Explanation:Magnesium carbonate is an over the counter antacid commonly used to relieve symptoms in ulcer dyspepsia and non-erosive gastro-oesophageal reflux.
Antacids containing magnesium also tend to work as a laxative, while the antacids with aluminium may cause constipation. There is no significant increased risk of anaphylaxis, hepatotoxicity or renal impairment.
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This question is part of the following fields:
- Gastrointestinal Pharmacology
- Pharmacology
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Question 13
Incorrect
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Streptococcus viridans has developed subacute bacterial endocarditis in your patient. Which of the following locations is most likely to be the organism's origin?
Your Answer: Colon
Correct Answer: Oral cavity
Explanation:Streptococci that are alpha-haemolytic, such as Streptococcus viridans, are major components of the flora in the oral cavity.
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This question is part of the following fields:
- Infections
- Microbiology
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Question 14
Incorrect
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A 72-year-old woman presents to your clinic with worsening oedema. She has ischaemic heart disease and heart failure. You decide to add a loop diuretic to her current drug regime to control the oedema. Which of the following is a contraindication to using a loop diuretic?
Your Answer: Hypotension
Correct Answer: Anuria
Explanation:Loop diuretics are drugs used to manage and treat fluid overload associated with CHF, liver cirrhosis, and renal disease. The drugs commonly used are:
- Furosemide
- Bumetanide
- Torsemide
- Ethacrynic Acid
Loop diuretics inhibit the Na-K-Cl pump in the ascending loop of Henle, resulting in salt-water excretion. This relieves congestion and reduces oedema.
The contra-indications to the use of loop diuretics are:
1. Anuria
2. Comatose and precomatose states associated with liver cirrhosis
3. Renal failure due to nephrotoxic or hepatotoxic drugs
4. Severe hypokalaemia
5. Severe hyponatremia
6. History of hypersensitivity to furosemide, bumetanide, or torsemide (or sulphonamides)The following conditions or states are not contraindications, but loop diuretics needs to be used cautiously in these conditions:
1. Diabetes (but hyperglycaemia less likely than with thiazides)
2. Gout
3. Hypotension (correct before initiation of treatment)
4. Hypovolaemia (Correct before initiation of treatment) -
This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 15
Incorrect
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Typically, granulomatous inflammation is associated with one of the following infections:
Your Answer: Multiple myeloma
Correct Answer: Tuberculosis
Explanation:Granulomatous inflammation is typically seen when an infective agent with a digestion-resistance capsule (e.g. Mycobacterium tuberculosis) or a piece of inert foreign material (such as suture or glass) is introduced into the tissue. A transient acute inflammatory response occurs and when this is ineffective in eradicating the stimulus, chronic inflammation occurs.
Tuberculosis is the prototype of the granulomatous diseases, but sarcoidosis, cat-scratch disease, lymphogranuloma inguinale, leprosy, brucellosis, syphilis, some mycotic infections, berylliosis, reactions of irritant lipids, and some autoimmune diseases are also included
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This question is part of the following fields:
- Inflammatory Responses
- Pathology
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Question 16
Incorrect
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A patient presents to your clinic with fever of unknown origin. His blood results shows a markedly elevated C-Reactive Protein (CRP) level.
Which of these is responsible for mediating the release of CRP?
Your Answer: IL-10
Correct Answer: IL-6
Explanation:C-reactive protein (CRP) is an acute phase protein produced by the liver hepatocytes. Its production is regulated by cytokines, particularly interleukin 6 (IL-6) and it can be measured in the serum as a nonspecific marker of inflammation.
Although a high CRP suggest an acute infection or inflammation, it does not identify the cause or location of infection.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 17
Correct
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Which of the following is NOT a typical feature of a lesion to the vestibulocochlear nerve:
Your Answer: Hyperacusis
Explanation:Hyperacusis is increased acuity of hearing with hypersensitivity to low tones resulting from paralysis of the stapedius muscle, innervated by the facial nerve. General sensation to the face and to the anterior two-thirds of the tongue is carried by the divisions of the trigeminal nerve (although taste to the anterior two-thirds of the tongue is supplied by the facial nerve). Eye movements are mediated by the oculomotor, trochlear and abducens nerve. Ptosis results from paralysis of the levator palpebrae superioris, innervated by the oculomotor nerve, or the superior tarsal muscle, innervated by the sympathetic chain.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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Question 18
Correct
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Which of the following drugs is first line treatment for a stable regular broad-complex tachycardia:
Your Answer: Amiodarone
Explanation:A regular broad-complex tachycardia is likely to be ventricular tachycardia or a regular supraventricular rhythm with bundle branch block. A ventricular tachycardia (or broad-complex tachycardia of uncertain origin) should be treated with amiodarone 300 mg IV over 10 – 60 min, followed by an infusion of 900 mg over the next 24 hours. If previously confirmed as SVT with bundle branch block, the patient should be treated as for narrow-complex tachycardia.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 19
Incorrect
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Regarding ACE inhibitors, which of the following statements is CORRECT:
Your Answer: They are contraindicated in diabetic nephropathy due to risk of worsening renal impairment.
Correct Answer: Angiotensin-II receptor blockers are a useful alternative in patients who cannot tolerate ACE-inhibitors due a persistent cough.
Explanation:ACE inhibitors should be used with caution in patients of Afro-Caribbean descent who may respond less well; calcium channel blockers are first line for hypertension in these patients. ACE inhibitors have a role in the management of diabetic nephropathy. ACE inhibitors are contraindicated in pregnant women. ACE inhibitors inhibit the breakdown of bradykinin; this is the cause of the persistent dry cough. Blocking ACE also diminishes the breakdown of the potent vasodilator bradykinin which is the cause of the persistent dry cough. Angiotensin-II receptor blockers do not have this effect, therefore they are useful alternative for patients who have to discontinue an ACE inhibitor because of persistent cough.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 20
Incorrect
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The triage nurse asks if you will prescribe a dose of codeine phosphate for a patient who is in a lot of pain. You discover that you are unable to prescribe it due to a contra-indication after evaluating the patient.
The use of codeine phosphate is contraindicated in which of the following situations?Your Answer: Irritable bowel syndrome
Correct Answer: Age under 12 years
Explanation:Codeine phosphate is a mild opiate that can be used to treat mild to moderate pain when other pain relievers like paracetamol or ibuprofen have failed. It can also be used to treat diarrhoea and coughs that are dry or painful.
The use of all opioids is contraindicated for the following reasons:
Respiratory depression (acute)
Patients who are comatose
Head injury (opioid analgesics impair pupillary responses, which are crucial for neurological evaluation)
Intracranial pressure has risen (opioid analgesics interfere with pupillary responses vital for neurological assessment)
There’s a chance you’ll get paralytic ileus.The use of codeine phosphate is contraindicated in the following situations:
Because of the significant risk of respiratory side effects in children under the age of 12, it is not recommended for children under the age of 12.Patients of any age who have been identified as ultra-rapid codeine metabolizers (CYP2D6 ultra-rapid metabolizers)
Because codeine can pass through breast milk to the baby and because mothers’ ability to metabolise codeine varies greatly, it is especially dangerous in breastfeeding mothers.
If other painkillers, such as paracetamol or ibuprofen, fail to relieve acute moderate pain in children over the age of 12, codeine should be used. In children with obstructive sleep apnoea who received codeine after tonsillectomy or adenoidectomy, a significant risk of serious and life-threatening adverse reactions has been identified.
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This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
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Question 21
Incorrect
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While on morning rounds in the medical ward, the attending physician asks a medical student about the differences between transudates and exudates and their causes. The student explains that a transudate is an excess fluid that leaks out of an intravascular compartment due to an imbalance between oncotic and hydrostatic pressures.
Which ONE of the following conditions will he mention as the cause of a transudate?Your Answer: Empyema
Correct Answer: Meig’s syndrome
Explanation:Transudative effusions are caused due to systemic causes leading to increased hydrostatic pressure or decreased oncotic pressure. These include:
1) Meig’s Syndrome (Ovarian tumour causing ascites and pleural effusion)
2) Congestive heart failure
3) Nephrotic Syndrome
4) Myxoedema
5) Cirrhosis
6) SarcoidosisAn exudate is caused by local inflammation and results from increased vascular permeability. Causes include:
1) Rheumatoid arthritis
2) Pneumonia leading to empyema
3) Malignancies
4) Pericarditis -
This question is part of the following fields:
- General Pathology
- Pathology
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Question 22
Incorrect
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You see a patient in the ED with photophobia, petechial rash, headache and neck stiffness, and suspect a diagnosis of meningococcal meningitis.
What is the most appropriate initial management?
Your Answer: Perform an LP and await results of Gram-staining
Correct Answer: Give ceftriaxone 2 g IV
Explanation:Treatment should be commenced with antibiotics immediately before laboratory confirmation due to the potentially life-threatening nature of the disease.
In a hospital setting, 2g of IV ceftriaxone (80 mg/kg for a child) or IV cefotaxime (2 g adult; 80 mg/kg child) are the drugs of choice.
In the prehospital setting, IM benzylpenicillin can be given as an alternative. -
This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 23
Incorrect
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Which of the following conditions require IV Lidocaine administration?
Your Answer: Terminating paroxysmal supraventricular tachycardia
Correct Answer: Refractory ventricular fibrillation in cardiac arrest
Explanation:IV Lidocaine is indicated in Ventricular Arrhythmias or Pulseless Ventricular Tachycardia (after defibrillation, attempted CPR, and vasopressor administration)
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 24
Incorrect
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Which of the following nerves is most important for eversion of the foot:
Your Answer: Tibial nerve
Correct 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.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 25
Correct
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Streptococcus pneumoniae is commonly implicated in all of the following infectious diseases EXCEPT for:
Your Answer: Impetigo
Explanation:Impetigo is a highly contagious infection of the superficial epidermis that most commonly affects young children but can occur in any age group. In children it is the most common bacterial skin infection and it is the third most common skin disease overall, behind dermatitis and viral warts.
The commonest causative organism is Staphylococcus aureus. Streptococcus pyogenesis the second commonest and causes fewer cases, either alone or in combination withS. aureus.The streptococcal form tends to be commoner in warmer, more humid climates. (Hirschmann JV. Impetigo: etiology and therapy. Curr Clin Top Infect Dis. 2002;22:42–51.)
Impetigo is most commonly spread by direct person-to-person contact, and can spread rapidly through families and school classes. It can also, less commonly, be spread by indirect contact.
There are two main forms of impetigo:
Non-bullous impetigo – lesions usually start as tiny pustules or vesicles that evolve rapidly into honey-crusted plaques that tend to be under 2 cm in diameter. These can be itchy but are rarely painful.
Bullous impetigo – lesions have a thin roof and tend to rupture spontaneously. This type is more likely to be painful and may be associated with systemic upset. -
This question is part of the following fields:
- Microbiology
- Pathogens
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Question 26
Correct
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You review an 18-months-old child who seems to be having a reaction following an immunisation she took earlier in the day.
Which statement concerning immunity and vaccination is true?Your Answer: The strongest immunological response is seen with natural immunity
Explanation:Vaccination induces ACTIVE adaptive immunity. Actively acquired immunity involves the development of an immune response either due to vaccination or natural exposure to a pathogen and leads to long-lasting resistance to infection.
Immediate protection is achieved with injection of immunoglobulin. The protection is transient lasting only a few weeks and is useful as post-exposure prophylaxis.
Passively acquired immunity usually leads to short-lasting resistance to infection because it does not involve a host immune response.
With inactivated bacteria, a series of primary vaccinations is usually required to induce an adequate immune response. In most cases, boosters are required to sustain adequate immunity.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 27
Incorrect
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An ambulance transports a 72-year-old woman to the Emergency Department. She is confused, has been vomiting and having stomach pains. Digoxin is one of her medications.
Which of the following claims about digoxin is correct?Your Answer: It is the first-line drug in the treatment of persistent and permanent atrial fibrillation
Correct Answer: Therapeutic plasma levels are between 1.0-1.5 nmol/l
Explanation:Digoxin is a cardiac glycoside that is used to treat atrial fibrillation and flutter, as well as congestive heart failure. In cardiac myocytes, it works by inhibiting the membrane Na/K ATPase. Through Na/Ca exchange, this raises intracellular sodium concentration and indirectly increases intracellular calcium availability. Increased intracellular calcium levels have both a positive inotropic and negative chronotropic effect.
Digoxin therapeutic plasma levels are typically between 1.0 and 1.5 nmol/l, though higher concentrations may be required, and the value varies between laboratories. At concentrations greater than 2 nmol/l, the risk of toxicity increases dramatically.
In patients with normal renal function, digoxin has a long plasma half-life of 36 to 48 hours. This can take up to 5 days in patients with impaired renal function.
Hypokalaemia, rather than hyperkalaemia, has been shown to increase the risk of digoxin toxicity.
In the treatment of persistent and permanent atrial fibrillation, digoxin is no longer widely used. Beta-blockers, also known as rate-limiting calcium channel blockers, are now the first-line treatment for this condition.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 28
Incorrect
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Identify the type of graph described below:
This graph is a scatter plot of the effect estimates from individual studies against some measure of each study's size or precision.
Your Answer: Pareto diagram
Correct Answer: Funnel plot
Explanation:A funnel plot is a scatter plot of the effect estimates from individual studies against some measure of each study’s size or precision. The standard error of the effect estimate is often chosen as the measure of study size and plotted on the vertical axis with a reversed scale that places the larger, most powerful studies towards the top. The effect estimates from smaller studies should scatter more widely at the bottom, with the spread narrowing among larger studies. In the absence of bias and between study heterogeneity, the scatter will be due to sampling variation alone and the plot will resemble a symmetrical inverted funnel. A triangle centred on a fixed effect summary estimate and extending 1.96 standard errors either side will include about 95% of studies if no bias is present and the fixed effect assumption (that the true treatment effect is the same in each study) is valid.
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This question is part of the following fields:
- Evidence Based Medicine
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Question 29
Incorrect
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Which of the following pathogens is most commonly implicated in croup:
Your Answer: Respiratory syncytial virus
Correct Answer: Parainfluenza
Explanation:Parainfluenza virus is the most commonly implicated infectious agent in croup.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 30
Incorrect
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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: Lidocaine
Correct 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.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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