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  • Question 1 - A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited...

    Correct

    • A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited range of motion in the right elbow for the past two days. On examination, the right elbow is extremely tender with erythema and warmth of the overlying skin due to acute inflammation.

      Which ONE of the following statements is true with regards to acute inflammation?

      Your Answer: Neutrophils are activated and adhere to the endothelium as a result of interaction with endothelial cell adhesion molecules

      Explanation:

      Acute inflammation is defined as inflammation occurring within minutes to hours in response to an injury lasting for less than two weeks.

      Acute inflammation
      Rapid onset (minutes to hours)
      Quick resolution (usually days)

      Chronic inflammation
      May last weeks, months, or years

      There are five cardinal signs of inflammation:
      1) Pain
      2) Redness
      3) Warmth
      4) Oedema
      5) Loss of function

      During acute inflammation, neutrophils are activated and attracted to the site of inflammation in response to various interleukins and cytokines. This process takes place via the following mechanism:
      1) Margination
      Neutrophils flow nearer the vessel wall rather than in the axial stream, which is referred to as margination
      2) Rolling along the surface of vascular endothelium
      3) Adhesion to the endothelium by interaction with adhesion molecules (ICAMS and VCAMS)
      4) Diapedesis is the movement of neutrophils from the endothelial cells into the interstitial space by squeezing through the gaps between adjacent endothelial cells

      Bradykinin and histamine are both responsible for vasodilation which causes oedema and decreases intravascular osmotic pressure.

      Neutrophils dominate early (<2 days)
      – Many in the bloodstream
      – Attach firmly to adhesion molecules
      – Apoptosis after 24-48hrs
      Monocytes/macrophages dominate late (>2 days)
      – Live longer
      – Replicate in tissues

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      32
      Seconds

  • Question 2 - Which of the following is where the rectovesical fascia is located: ...

    Correct

    • Which of the following is where the rectovesical fascia is located:

      Your Answer: Between the fundus of the bladder and the ampulla of the rectum

      Explanation:

      In a triangular area between the vasa deferentia, the bladder and rectum are separated only by rectovesical fascia, commonly known as Denonvillier’s fascia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      14
      Seconds

  • Question 3 - Regarding gas exchange at the alveolar-capillary membrane, which of the following statements is...

    Correct

    • Regarding gas exchange at the alveolar-capillary membrane, which of the following statements is CORRECT:

      Your Answer: The rate of diffusion in lungs can be estimated by measuring the diffusing capacity of the lungs for carbon monoxide.

      Explanation:

      Gas exchange between alveolar air and blood in the pulmonary capillaries takes place by diffusion across the alveolar-capillary membrane. Diffusion occurs from an area of high partial pressure to an area of low partial pressure, thus the driving force for diffusion is the alveolar-capillary partial pressure gradient. Diffusion occurs across a membrane and is therefore governed by Fick’s law. Although CO2is larger than O2, it is is much more soluble and diffuses 20 times more rapidly. The diffusing capacity for oxygen (DLO2) cannot be measured directly but the rate of diffusion in the lungs can be estimated by measuring the diffusing capacity of the lungs for carbon monoxide (DLCO).

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      553.5
      Seconds

  • Question 4 - A 60-year-old man presents with marked breathlessness. He has with a history of...

    Correct

    • A 60-year-old man presents with marked breathlessness. He has with a history of ischaemic heart disease. On examination, there is coarse bibasal crackles, marked peripheral oedema and chest X-ray taken is consistent with severe pulmonary oedema. RR is 28 per minute.

      Which receptor is responsible for detecting pulmonary oedema and the subsequent increase in respiratory rate?

      Your Answer: Juxtacapillary receptors

      Explanation:

      Pulmonary oedema causes stimulation of the Juxtacapillary receptors (J receptors) leading to a reflex increase in breathing rate. These receptors are also thought to be involved in the sensation of dyspnoea. The J receptors are sensory cells and are located within the alveolar walls in juxtaposition to the pulmonary capillaries.

      Aortic baroreceptor are involved in detecting blood pressure

      Central chemoreceptors detect changes in CO2 and hydrogen ion within the brain

      Atrial volume receptors regulate plasma volume

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      548.6
      Seconds

  • Question 5 - A young farmer who is caught under farm machinery and suffering from a...

    Correct

    • A young farmer who is caught under farm machinery and suffering from a major crush injury is taken to the emergency department and requires a quick induction sequence. In this type of injury, which of the following anaesthetic medicines should be avoided?

      Your Answer: Suxamethonium

      Explanation:

      Suxamethonium is a neuromuscular blocker. It is contraindicated in patients who have experienced massive trauma, hyperkalemic, or burn injuries.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      10.2
      Seconds

  • Question 6 - You're evaluating a 37-year-old woman who is 12 weeks pregnant. She has experienced...

    Correct

    • You're evaluating a 37-year-old woman who is 12 weeks pregnant. She has experienced vaginal bleeding.

      Which of the following anti-D statements is correct?

      Your Answer: Routine antenatal prophylaxis is recommended for RhD negative women at 28 and 34 weeks

      Explanation:

      Anti-D is an IgG antibody that targets the antigen Rhesus D (RhD). Plasma from rhesus-negative donors who have been immunised against the anti-D-antigen is used to make anti-D immunoglobulin.

      Only RhD negative women are given Anti-D Ig. Women who are RhD negative do not have the RhD antigen on their RBC. If a foetus has the RhD antigen (i.e. is RhD positive) and the mother is exposed to foetal blood, she may develop antibodies to RhD that pass through the placenta and attack foetal red cells (resulting in newborn haemolytic disease). Anti-D is given to bind and neutralise foetal red cells in the maternal circulation before an immune response is triggered. In the event of a sensitising event, 500 IU Anti-D Ig should be administered intramuscularly.

      The following are examples of potentially sensitising events:
      Birth
      Haemorrhage during pregnancy
      Miscarriage
      Ectopic pregnancy
      Death within the womb
      Amniocentesis
      Chorionic villus sampling
      Trauma to the abdomen

      The sooner anti-D is given in the event of a sensitising event, the better; however, it is most effective within 72 hours, and the BNF states that it is still likely to have some benefit if given outside of this time frame.

      At 28 and 34 weeks, RhD negative women should receive routine antenatal prophylaxis. This is regardless of whether they have previously received Anti-D for a sensitising event during the same pregnancy.

      Prophylactic anti-D is not necessary before 12 weeks gestation, as confirmed by scan, in uncomplicated miscarriage (where the uterus is not instrumented), or mild, painless vaginal bleeding, as the risk of foeto-maternal haemorrhage (FMH) is negligible. In cases of therapeutic termination of pregnancy, whether by surgical or medical means, 250 IU of prophylactic anti-D immunoglobulin should be given to confirmed RhD negative women who are not known to be RhD sensitised.

    • This question is part of the following fields:

      • Immunological Products & Vaccines
      • Pharmacology
      6.3
      Seconds

  • Question 7 - Which of the following does not increase renal phosphate excretion? ...

    Correct

    • Which of the following does not increase renal phosphate excretion?

      Your Answer: Vitamin D

      Explanation:

      PO43-renal excretion is regulated several mechanisms. These include:
      -parathyroid hormone – increases excretion by inhibiting reabsorption in the proximal tubule
      -acidosis – increases excretion
      -glucocorticoids – increases excretion
      -calcitonin – increases excretion
      -activated vitamin D – decreases excretion by increasing reabsorption in the distal tubule

    • This question is part of the following fields:

      • Physiology
      • Renal
      5.4
      Seconds

  • Question 8 - A 32-year-old asthmatic patient on theophylline as part of her asthma management...

    Correct

    • A 32-year-old asthmatic patient on theophylline as part of her asthma management presents to the Emergency Department with an unrelated medical condition.

      Which of these drugs should be avoided?

      Your Answer: Clarithromycin

      Explanation:

      Macrolide antibiotics (e.g. clarithromycin and erythromycin) are cytochrome P450 enzyme inhibitors. They increase blood levels of theophylline leading to hypokalaemia, and potentially increasing the risk of Torsades de pointes when they are prescribed together.

      Co-prescription with theophylline should be avoided.

      Factors that enhance theophylline clearance include cigarette smoking, carbamazepine, phenobarbital, phenytoin, primidone, and rifampin.
      Medications that inhibit clearance include ethanol, ciprofloxacin, erythromycin, verapamil, propranolol, ticlopidine, tacrine, allopurinol, and cimetidine.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      1088.3
      Seconds

  • Question 9 - A 78-year-old male presents to the Orthopaedic clinic with lower back pain for...

    Correct

    • A 78-year-old male presents to the Orthopaedic clinic with lower back pain for the past month. His past medical history reveals a history of cancer. After examination, you diagnose Metastatic Spinal Cord Compression (MSCC).

      Which one of the following cancers is this patient most likely to have had?

      Your Answer: Prostate cancer

      Explanation:

      Compression of the thecal sac causes metastatic Spinal Cord Compression (MSCC) due to a Metastatic tumour and its components. It can cause symptoms of limb weakness, sensory disturbances and back pain depending on the extent and level of Compression.

      The most common source of a tumour causing MSCC is a prostate carcinoma that metastasized to the spinal cord via the vertebral venous plexus.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      1546.1
      Seconds

  • Question 10 - Which of the following does NOT typically cause a neutrophil leucocytosis: ...

    Correct

    • Which of the following does NOT typically cause a neutrophil leucocytosis:

      Your Answer: Glandular fever

      Explanation:

      Causes of neutrophil leucocytosis:
      Bacterial infection
      Inflammation and tissue necrosis (e.g. cardiac infarct, trauma, vasculitis, myositis)
      Metabolic disorders (e.g. uraemia, acidosis, eclampsia, gout)
      Pregnancy
      Acute haemorrhage or haemolysis
      Neoplasms of all types
      Drugs (e.g. corticosteroid therapy, lithium, tetracyclines)
      Asplenia
      Myeloproliferative disorders (e.g. CML, essential thrombocythaemia, polycythaemia vera, myelofibrosis)
      Rare inherited disorders

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      10
      Seconds

  • Question 11 - Regarding haemophilia A, which of the following statements is INCORRECT: ...

    Correct

    • Regarding haemophilia A, which of the following statements is INCORRECT:

      Your Answer: In haemophilia both the APTT and PT are prolonged.

      Explanation:

      Haemophilia A is the most common of the hereditary clotting factor deficiencies. The inheritance is sex-linked but up to one-third of patients have no family history and these cases result from recent mutation. The vast majority of cases are inherited in an X-linked recessive fashion, affecting males born to carrier mothers. Females born to affected fathers can also, rarely, be affected due to homozygosity for the gene, where there is marriage to close relatives.

      The defect is an absence or low level of plasma factor VIII. The APTT is prolonged but the PT is normal. Recurrent painful haemarthroses and muscle haematomas dominate the clinical course of severely affected patients and if inadequately treated, lead to progressive joint deformity and disability. Local pressure can cause entrapment neuropathy or ischaemic necrosis. Prolonged bleeding occurs after dental extractions or post-trauma. Spontaneous haematuria and gastrointestinal haemorrhage may occur. The clinical severity of the disease correlates inversely with the factor VIII level. Operative and post-traumatic haemorrhage are life-threatening both in severely and mildly affected patients.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      10.8
      Seconds

  • Question 12 - A blood culture was performed from a sample taken from a patient. It...

    Correct

    • A blood culture was performed from a sample taken from a patient. It was noted that a Gram-positive coccus organism was grown.

      Among the following microorganisms, which is considered an example of a Gram-positive coccus?

      Your Answer: Staphylococcus aureus

      Explanation:

      Bacillus cereus = Gram-positive bacillus
      Neisseria meningitidis = Gram-negative coccus
      Salmonella enterica & Escherichia coli = Gram-negative bacilli

      In Gram staining, crystal violet is a purple stain that is used to stain the bacteria first. The stained bacteria are decolorized and then stained with a red stain, which is safranin. Bacteria with thick cell walls keep the purple stain and are called Gram-positive. Thin-walled bacteria are easily decolorized so when safranin, the red stain, is placed on the organisms, they become red or Gram-negative.
      The Staphylococci that are associated with infections in humans are colonizers of various skin and mucosal surfaces. Because the carrier state is common among the human population, infections are frequently acquired when the colonizing strain gains entrance to a normally sterile site as a result of trauma or abrasion to the skin or mucosal surface.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      17.6
      Seconds

  • Question 13 - A patient complains of headache and visual loss. CT scan demonstrates a lesion...

    Incorrect

    • A patient complains of headache and visual loss. CT scan demonstrates a lesion of the temporal lobe. What type of visual field defect would you most expect to see in this patient:

      Your Answer: Contralateral homonymous inferior quadrantanopia

      Correct Answer: Contralateral homonymous superior quadrantanopia

      Explanation:

      Axons from the lateral geniculate nucleus (LGN) carry visual information, via the upper and lower optic radiations, to the visual cortex in the occipital lobe:
      The upper optic radiation carries fibres from the superior retinal quadrants (corresponding to the inferior visual field quadrants) and travels through the parietal lobe to reach the visual cortex.
      The lower optic radiation carries fibres from the inferior retinal quadrants (corresponding to the superior visual field quadrants) and travels through the temporal lobe to reach the visual cortex of the occipital lobe.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      16.2
      Seconds

  • Question 14 - Regarding thalassaemia, which of the following statements is CORRECT: ...

    Correct

    • Regarding thalassaemia, which of the following statements is CORRECT:

      Your Answer: Screening for thalassaemia in pregnancy is offered to all pregnant women.

      Explanation:

      Beta thalassemia is caused by mutations in one or both of the beta globin genes. Alpha thalassemia is caused by a deletion or mutation (less commonly) in one or more of the four alpha globin gene copies. β-thalassaemia is more common in the Mediterranean region while α-thalassaemia is more common in the Far East.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      1245.7
      Seconds

  • Question 15 - Which of the following nerves innervates the adductor brevis? ...

    Correct

    • Which of the following nerves innervates the adductor brevis?

      Your Answer: Obturator nerve

      Explanation:

      Like the majority of the thigh adductors, adductor brevis is innervated by the obturator nerve. Obturator nerve is derived from the lumbar plexus (anterior branches of spinal nerves L2-L4).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      20.8
      Seconds

  • Question 16 - Following the administration of a drug that was started a few months earlier,...

    Correct

    • Following the administration of a drug that was started a few months earlier, a patient presents with features of peripheral neuropathy.

      Which of the following drugs is most likely to cause peripheral neuropathy?

      Your Answer: Isoniazid

      Explanation:

      Isoniazid, a first-line agent for the treatment of tuberculosis, has the commonest side effect of peripheral neuropathy. It occurs in up to 20% of patients taking the drug at a dose > 6 mg/kg daily.

      Isoniazid combines with pyridoxine (vitamin B6) to form hydrazone, which is excreted in the urine. This causes a deficiency of biologically active pyridoxine leading to peripheral neuropathy.

      Peripheral neuropathy of isoniazid is prevented by the co-administration of pyridoxine at a dose of 10 mg for each 100 mg of isoniazid given.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      94.3
      Seconds

  • Question 17 - Regarding nitrous oxide, which of the following statements is CORRECT: ...

    Correct

    • Regarding nitrous oxide, which of the following statements is CORRECT:

      Your Answer: Nitrous oxide may be used for maintenance of anaesthesia where its use allows reduced dosage of other agents.

      Explanation:

      For anaesthesia, nitrous oxide is commonly used in a concentration of around 50 – 66% in oxygen in association with other inhalation or intravenous agents. Nitrous oxide cannot be used as the sole anaesthetic agent due to lack of potency, but is useful as part of a combination of drugs since it allows reduction in dosage of other agents. Exposure to nitrous oxide for prolonged periods, either by continuous or by intermittent administration, may result in megaloblastic anaemia as a result of interference with the action of vitamin B12. Nitrous oxide increases cerebral blood flow and should be avoided in patients with, or at risk of, raised intracranial pressure. Nitrous oxide may be administered by any trained personnel experienced in its use.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      186.9
      Seconds

  • Question 18 - Which of the following cell types in the stomach secretes histamine? ...

    Correct

    • Which of the following cell types in the stomach secretes histamine?

      Your Answer: Enterochromaffin-like cells

      Explanation:

      The parietal cells operate in close association with another type of cell called enterochromaffin-like cells (ECL cells), the primary function of which is to secrete histamine. The ECL cells lie in the deep recesses of the oxyntic glands and therefore release histamine indirect contact with the parietal cells of the glands.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      4.4
      Seconds

  • Question 19 - Red cell protein expression is induced by which of the following pathogens: ...

    Incorrect

    • Red cell protein expression is induced by which of the following pathogens:

      Your Answer: Treponema pallidum

      Correct Answer: Plasmodium falciparum

      Explanation:

      Plasmodium falciparum induces the expression of red cell protein, making cerebral malaria more severe. Bacteria may invade a host passively through micro traumata or macro traumata in the skin or mucosa. On the other hand, bacteria that invade
      through intact mucosa first, adhere to this anatomical barrier, then actively
      breach it.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      12
      Seconds

  • Question 20 - Regarding box and whisker plots, which of the following statements is true? ...

    Correct

    • Regarding box and whisker plots, which of the following statements is true?

      Your Answer: 25% of the values lie below the lower quartile

      Explanation:

      A box and whisker plot is defined as a graphical method of displaying variation in a set of data. In most cases, a histogram analysis provides a sufficient display, but a box and whisker plot can provide additional detail while allowing multiple sets of data to be displayed in the same graph.

      The procedure to develop a box and whisker plot comes from the five statistics below:

      (1) Minimum value: The smallest value in the data set

      (2) Second quartile: The value below which the lower 25% of the data are contained

      (3) Median value: The middle number in a range of numbers

      (4) Third quartile: The value above which the upper 25% of the data are contained

      (5) Maximum value: The largest value in the data set

    • This question is part of the following fields:

      • Evidence Based Medicine
      7.2
      Seconds

  • Question 21 - Adenosine is primarily indicated for which of the following: ...

    Correct

    • Adenosine is primarily indicated for which of the following:

      Your Answer: Paroxysmal supraventricular tachycardia

      Explanation:

      Adenosine is usually the treatment of choice for terminating paroxysmal supraventricular tachycardia including those associated with accessory conduction pathways e.g. Wolff-Parkinson-White syndrome.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      7.6
      Seconds

  • Question 22 - A 29-year-old woman presents with night sweats, fever, and haemoptysis. A diagnosis of...

    Correct

    • A 29-year-old woman presents with night sweats, fever, and haemoptysis. A diagnosis of tuberculosis was suspected.

      Which of the following statements regarding the diagnosis of tuberculosis is considered correct?

      Your Answer: Mycobacteria tuberculosis can be typed using a RFLP method

      Explanation:

      Although a variety of clinical specimens may be submitted to the
      laboratory to recover MTB and NTM, respiratory secretions such
      as sputum and bronchial aspirates are the most common. An
      early-morning specimen should be collected on three consecutive
      days, although recent studies have suggested that the addition of
      a third specimen does not significantly increase the sensitivity
      of detecting Mycobacteria.

      Mycobacterium tuberculosis appear red on acid-fast staining because they take up the primary stain, which is carbolfuchsin, and is not decolorized by the acid alcohol anymore.

      Culture on Lowenstein-Jensen medium should be read within 5 to 7 days after inoculation and once a week thereafter for up to 8 weeks.

      Nucleic acid amplification assays designed to detect M. tuberculosis complex
      bacilli directly from patient specimens can be performed in as little as 6 to 8 hours on processed specimens.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      44.9
      Seconds

  • Question 23 - 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
      7.2
      Seconds

  • Question 24 - Following a bee sting, a 8-year old boy was transported to resus with...

    Correct

    • Following a bee sting, a 8-year old boy was transported to resus with symptoms and signs of an anaphylactic reaction. You decide to administer adrenaline IM stat. What is the recommended dose of intramuscular adrenaline?

      Your Answer: 0.3 mL of 1:1000

      Explanation:

      Anaphylaxis is a type I hypersensitivity reaction that is severe and life-threatening. It is marked by the fast onset of life-threatening airway and/or circulatory issues, which are generally accompanied by skin and mucosal abnormalities. When an antigen attaches to specific IgE immunoglobulins on mast cells, degranulation and the release of inflammatory mediators takes place (e.g. histamine, prostaglandins, and leukotrienes).

      The most important medicine for treating anaphylactic responses is adrenaline. It decreases oedema and reverses peripheral vasodilation as an alpha-adrenergic receptor agonist. Its beta-adrenergic effects widen the bronchial airways, enhance the force of cardiac contraction, and inhibit the release of histamine and leukotriene. The first medicine to be given is adrenaline, and the IM route is optimal for most people.

      In anaphylaxis, age-related dosages of IM adrenaline are:
      150 mcg (0.15 mL of 1:1000) for a child under 6 years
      300 mcg (0.3 mL of 1:1000) for a child aged 6 to 12 years
      500 mcg (0.5 mL of 1:1000) for children aged 12 and above
      500 mcg for adults (0.5 mL of 1:1000)

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      9.1
      Seconds

  • Question 25 - A 39-year-old guy comes to the emergency room with a persistent nasal bleed....

    Incorrect

    • A 39-year-old guy comes to the emergency room with a persistent nasal bleed. You suspect the bleeding is coming from Little's area based on your examination. Which of the blood vessels listed below is most likely to be involved:

      Your Answer: Posterior superior alveolar and anterior ethmoidal arteries

      Correct Answer: Sphenopalatine and superior labial arteries

      Explanation:

      The Kiesselbach plexus is a vascular network formed by five arteries that supply oxygenated blood to the nasal septum, which refers to the wall separating the right and left sides of the nose. The five arteries that form the Kiesselbach plexus: the sphenopalatine artery, which branches from the maxillary artery originating behind the jawbone; the anterior ethmoidal artery, which branches from the ophthalmic artery behind the eye; the posterior ethmoidal artery, which also branches from the ophthalmic artery; the septal branch of the superior labial artery, which is a branch of the facial artery supplying blood to all of the superficial features of the face; and finally, the greater palatine artery, which is a terminal branch of the maxillary artery.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      877.9
      Seconds

  • Question 26 - A 65-year-old female presents to the Emergency Department with complaints of chest pain...

    Correct

    • A 65-year-old female presents to the Emergency Department with complaints of chest pain pointing to angina. A dose of glyceryl trinitrate (GTN) was administered, rapidly resolving her symptoms. Unfortunately, she develops a side-effect of the drug.

      Which one of the following is the side effect she is most likely to have developed?

      Your Answer: Flushing

      Explanation:

      Angina pectoris is the most common symptom of ischemic heart disease and presents with chest pain relieved by rest and nitro-glycerine.

      Nitrates are the first-line treatment to relieve chest pain caused by angina. The commonly used nitrates are:
      1. Glyceryl trinitrate
      2. Isosorbide dinitrate

      Side effects to nitrate therapy are common especially
      The most common side effects are:
      1. Headaches
      2. Feeling dizzy, weak, or tired
      3. Nausea
      4. Flushing

      The serious but less likely to occur side effects are:
      1. Methemoglobinemia (rare)
      2. Syncope
      3. Prolonged bleeding time
      4. Exfoliative dermatitis
      5. Unstable angina
      6. Rebound hypertension
      7. Thrombocytopenia

      Dry eyes, bradycardia, and metabolic acidosis have not been reported.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      28.8
      Seconds

  • Question 27 - Which of the following is NOT an effect of gastrin: ...

    Correct

    • Which of the following is NOT an effect of gastrin:

      Your Answer: Stimulation of insulin release

      Explanation:

      Gastrin acts to:
      Stimulate acid secretion from parietal cells (both directly and indirectly by stimulating release of histamine from ECL cells)
      Stimulate pepsinogen secretion from chief cells
      Increase gastric motility
      Stimulate growth of gastric mucosa

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      9.8
      Seconds

  • Question 28 - A patient sustains an injury to the proximal median nerve after falling through...

    Incorrect

    • A patient sustains an injury to the proximal median nerve after falling through a glass door. Which of the following muscles would you not expect to be affected:

      Your Answer: Flexor pollicis longus

      Correct Answer: Flexor carpi ulnaris

      Explanation:

      All of the muscles in the anterior forearm are innervated by the median nerve, except for the flexor carpi ulnaris and the medial half of the flexor digitorum profundus which are innervated by the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      271.2
      Seconds

  • Question 29 - A 62-year-old woman has reduced urine output, nausea, and confusion. Renal function tests...

    Correct

    • A 62-year-old woman has reduced urine output, nausea, and confusion. Renal function tests and other investigations done leads to a diagnosis of acute kidney injury (AKI). Which one of these is consistent with a diagnosis of AKI?

      Your Answer: A rise in serum creatinine of 26 μmol/L within 48 hours

      Explanation:

      AKI is diagnosed based on an acutely rising serum creatinine and/or reduction in urine output.

      • AKI can often be non-oliguric.

      AKI is present if any one or more of the following criteria is met:

      • A rise in serum creatinine of ≥26 micromol/L (≥0.3 mg/dL) within 48 hours

      • A rise in serum creatinine to ≥1.5 times baseline, which is known or presumed to have occurred within the past 7 days (in practice you can use the lowest value from the past 3 months as the baseline for the patient)

      • Urine volume <0.5 ml/kg/hour for at least 6 hours.

       

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      5.6
      Seconds

  • Question 30 - An outbreak of acute pneumonia occurs in military recruits living in one barrack...

    Incorrect

    • An outbreak of acute pneumonia occurs in military recruits living in one barrack and only in those persons located near the air conditioner. Epidemiologic surveillance results in isolation of the causal organism from the patients and from the drip pans of the air conditioner. The organism is weakly Gram-negative. The most likely organism is:

      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
      • Pathogens
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SESSION STATS - PERFORMANCE PER SPECIALTY

General Pathology (3/3) 100%
Pathology (6/6) 100%
Abdomen (1/1) 100%
Anatomy (2/5) 40%
Physiology (6/6) 100%
Respiratory (1/1) 100%
Respiratory Physiology (1/1) 100%
Anaesthesia (2/2) 100%
Pharmacology (8/8) 100%
Immunological Products & Vaccines (1/1) 100%
Renal (1/1) 100%
Respiratory Pharmacology (2/2) 100%
Immune Responses (1/1) 100%
Haematology (2/2) 100%
Microbiology (2/3) 67%
Principles Of Microbiology (1/1) 100%
Central Nervous System (0/1) 0%
Lower Limb (1/1) 100%
Infections (1/1) 100%
Gastrointestinal (2/2) 100%
Principles (0/1) 0%
Evidence Based Medicine (1/1) 100%
Cardiovascular (1/1) 100%
Specific Pathogen Groups (1/1) 100%
Basic Cellular (1/1) 100%
Head And Neck (0/1) 0%
Cardiovascular Pharmacology (1/1) 100%
Upper Limb (0/1) 0%
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