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  • Question 1 - Regarding control of hospital acquired infection (HAI), which of the following statements is...

    Incorrect

    • Regarding control of hospital acquired infection (HAI), which of the following statements is CORRECT:

      Your Answer: Autoclaving is a method of disinfection.

      Correct Answer: Chlorhexidine is an anti-staphylococcal agent.

      Explanation:

      Chlorhexidine is an anti-staphylococcal agent. Cleaning is the removal of foreign material from areas or objects to a point at which they are visually free from debris.  Disinfection is the reduction in the number of infectious particles. Isopropyl alcohol is not effective against C. difficile spores. Autoclaving is a method of sterilisation.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      31.3
      Seconds

  • Question 2 - A blood transfusion is given to a 52-year-old woman. She develops chills and...

    Incorrect

    • A blood transfusion is given to a 52-year-old woman. She develops chills and rigours shortly after the transfusion begins.

      The following are her observations: Temperature 40°C, HR 116 bpm, BP 80/48, SaO 2 97 percent on air.

      Which of the following treatments is the most appropriate?

      Your Answer: Stop the transfusion and administer corticosteroids

      Correct Answer: Stop the transfusion and administer antibiotics

      Explanation:

      Bacterial infections are common in the following situations:

      Platelet transfusions are associated with a higher risk of bacterial infection (as platelets are stored at room temperature)
      Immersion in a water bath thawed previously frozen components.
      Components of red blood cells that have been stored for several weeks
      Gram-positive and Gram-negative bacteria have both been linked to transfusion-transmitted bacterial infection, but Gram-negative bacteria are linked to a higher rate of morbidity and mortality.
      Yersinia enterocolitica is the most common bacterial organism linked to transfusion-transmitted bacterial infection. This organism can multiply at low temperatures while also utilising iron as a nutrient. As a result, it’s well-suited to proliferating in blood banks.

      The following are some of the most common clinical signs and symptoms of a bacterial infection transmitted through a blood transfusion. These symptoms usually appear shortly after the transfusion begins:
      Fever is very high.
      Rigours and chills
      Vomiting and nausea
      Tachycardia
      Hypotension
      Collapse of the circulatory system

      If a bacterial infection from a transfusion is suspected, the transfusion should be stopped right away. Blood cultures and a Gram stain should be requested, as well as broad-spectrum antibiotics. In addition, the blood pack should be returned to the blood bank for an urgent culture and Gram-stain.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      30.6
      Seconds

  • Question 3 - In a 7-year-old child with chickenpox, which of the following would you advise...

    Incorrect

    • In a 7-year-old child with chickenpox, which of the following would you advise the mother NOT to do?

      Your Answer: Use topical emollients to help ease the itching

      Correct Answer: Give ibuprofen for the fever

      Explanation:

      Chickenpox (varicella zoster) is a highly contagious airborne disease and has an incubation period of between 7-21 days. It often has a prodromal phase when there is a fever, aches and headaches, dry cough, and sore throat before onset of rash.

      Some recognized complications of chickenpox are:
      Orchitis
      Hepatitis
      Pneumonia
      Encephalitis
      Infected spots
      Otitis media
      Myocarditis
      Glomerulonephritis
      Appendicitis
      Pancreatitis

      Treatment is symptomatic and includes using paracetamol to manage fever. There is a link between use of ibuprofen in patients with chicken-pox and necrotizing fasciitis so Ibuprofen should NOT be used.

      An emollient and antihistamine can be used to ease the itchy rash and oral hydration is encouraged.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      19.9
      Seconds

  • Question 4 - Platelet alpha granules release which of the following? ...

    Incorrect

    • Platelet alpha granules release which of the following?

      Your Answer: Thromboxane A2

      Correct Answer: Von Willebrand factor (VWF)

      Explanation:

      There are three types of storage granules contained in platelets. These are dense granules which contain the following:
      -ATP
      -ADP
      -serotonin and calcium alpha granules containing clotting factors
      -von Willebrand factor (VWF)
      -platelet-derived growth factor (PDGF)
      – other proteins lysosomes containing hydrolytic enzymes.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      14.2
      Seconds

  • Question 5 - What type of pump is the Na+/K+ATPase pump? ...

    Correct

    • What type of pump is the Na+/K+ATPase pump?

      Your Answer: An antiporter

      Explanation:

      In order for primary active transport to pump ions against their electrochemical gradient, chemical energy is used in the form of ATP. This is facilitated by the Na+/K+-ATPase antiporter pump, which uses metabolic energy to move 3 Na+ions out of the cell for every 2 K+ions that come in, against their respective electrochemical gradients. As a result, the cell the maintains a high intracellular concentration of K+ions and a low concentration of Na+ions.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      619.5
      Seconds

  • Question 6 - You are instructed by a senior to administer Mannitol to an RTA patient...

    Incorrect

    • You are instructed by a senior to administer Mannitol to an RTA patient with increased intracranial pressure.

      Mannitol is a low molecular weight compound that freely filters at the glomerulus and is not reabsorbed.
      Out of the following, which is a contraindication to the use of mannitol?

      Your Answer: Rhabdomyolysis

      Correct Answer: Severe pulmonary oedema

      Explanation:

      Mannitol is the most widely used osmotic diuretic that is most commonly used to reduce cerebral oedema and intracranial pressure.
      It is recommended to use mannitol for the reduction of CSF pressure/cerebral oedema in a dose of 0.25-2 g/kg as an intravenous infusion over 30-60 minutes. This can be repeated 1-2 times after 4-8 hours if needed.

      Mannitol has several contraindications and some of them are listed below:
      1. Anuria due to renal disease
      2. Acute intracranial bleeding (except during craniotomy)
      3. Severe cardiac failure
      4. Severe dehydration
      5. Severe pulmonary oedema or congestion
      6. Known hypersensitivity to mannitol

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      26.4
      Seconds

  • Question 7 - In adult basic life support, chest compressions should be performed at which of...

    Correct

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

      Your 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
      8.1
      Seconds

  • Question 8 - Swelling of the lips, tongue, and face is observed in a 59-year-old African-American...

    Correct

    • Swelling of the lips, tongue, and face is observed in a 59-year-old African-American woman. In the emergency room, she is given intramuscular adrenaline, but her symptoms do not improve. Her GP recently started her on a new medication.

      Which of the following drugs is most likely to have caused her symptoms?

      Your Answer: Ramipril

      Explanation:

      Angiotensin-converting enzyme (ACE) inhibitors are the most common cause of drug-induced angioedema in the United Kingdom and the United States, owing to their widespread use.

      Angioedema is caused by ACE inhibitors in 0.1 to 0.7 percent of patients, with data indicating a persistent and relatively constant risk year after year. People of African descent have a five-fold higher chance of contracting the disease.

      Swelling of the lips, tongue, or face is the most common symptom, but another symptom is episodic abdominal pain due to intestinal angioedema. Itching and urticaria are noticeably absent.

      The mechanism appears to be activated complement or other pro-inflammatory cytokines like prostaglandins and histamine, which cause rapid vasodilation and oedema.

      Other medications that are less frequently linked to angioedema include:
      Angiotensin-receptor blockers (ARBs)
      Nonsteroidal anti-inflammatory drugs (NSAIDs)
      Bupropion (e.g. Zyban and Wellbutrin)
      Beta-lactam antibiotics
      Statins
      Proton pump inhibitors

      The majority of these reactions are minor and can be treated by stopping the drug and prescribing antihistamines.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      21.9
      Seconds

  • Question 9 - The most important nerve for plantar flexion of the foot at the ankle...

    Incorrect

    • The most important nerve for plantar flexion of the foot at the ankle joint is:

      Your Answer: Common fibular nerve

      Correct Answer: Tibial nerve

      Explanation:

      Muscles of the posterior compartment of the leg, innervated by the tibial nerve, perform plantar flexion of the foot at the ankle joint. The fibularis longus (innervated by the superficial fibular nerve) assists in plantar flexion but is not the most important.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      19.9
      Seconds

  • Question 10 - Which of the following nerves is responsible for the symptoms of a patient...

    Correct

    • Which of the following nerves is responsible for the symptoms of a patient with history of recurrent herpes simplex outbreaks on his face and presents with ophthalmic herpes zoster and a painful vesicle on the tip of his nose?

      Your Answer: Nasociliary nerve

      Explanation:

      Hutchinson sign relates to involvement of the tip of the nose from facial herpes zoster. It implies involvement of the external nasal branch of the nasociliary nerve which is a branch of the ophthalmic division of the trigeminal nerve.

      The nasociliary branch of the trigeminal nerve innervates the apex and lateral aspect of the nose, as well as the cornea. Therefore, lesions on the side or tip of the nose should raise suspicion of ocular involvement.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      28
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Microbiology (1/3) 33%
Principles (0/1) 0%
Haematology (0/1) 0%
Pathology (0/1) 0%
Specific Pathogen Groups (1/2) 50%
Basic Cellular (1/2) 50%
Physiology (1/2) 50%
Cardiovascular Pharmacology (1/2) 50%
Pharmacology (2/3) 67%
Cardiovascular (1/1) 100%
Anatomy (0/1) 0%
Lower Limb (0/1) 0%
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