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  • Question 1 - In patients requiring oxygen, who are at risk of hypercapnic respiratory failure, oxygen...

    Incorrect

    • In patients requiring oxygen, who are at risk of hypercapnic respiratory failure, oxygen saturations should be maintained at:

      Your Answer: 92 - 94%

      Correct Answer: 88 - 92%

      Explanation:

      A lower target of 88 – 92% oxygen saturation is indicated for patients at risk of hypercapnic respiratory failure e.g. patients with COPD. Until blood gases can be measured, initial oxygen should be given using a controlled concentration of 28% or less, titrated towards the SpO2 of 88 – 92%. The aim is to provide the patient with enough oxygen to achieve an acceptable arterial oxygen tension without worsening carbon dioxide retention and respiratory acidosis.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      395.1
      Seconds
  • Question 2 - 1-alpha-hydroxylase is a cytochrome p450 enzyme that is involved in the production of...

    Correct

    • 1-alpha-hydroxylase is a cytochrome p450 enzyme that is involved in the production of vitamin D's hormonally active metabolite.

      Which of the following promotes the activity of 1-alpha-hydroxylase?

      Your Answer: Parathyroid hormone

      Explanation:

      1-alpha-hydroxylase converts 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol in the kidney.

      The key regulatory point in the formation of 1,25-dihydroxycholecalciferol is 1-alpha-hydroxylase, which is promoted by parathyroid hormone or hypophosphatemia.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      44.1
      Seconds
  • Question 3 - A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part...

    Incorrect

    • A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part in a powerlifting competition, he felt a painful snap at the front of his shoulder and chest. There is also the presence of bruising and swelling over the left side of his chest. A ruptured pectoralis major muscle was suspected upon examining the injured area.

      Which of the following statements regarding the surface markings of the pectoralis major muscle is considered correct?

      Your Answer: It has three heads

      Correct Answer: It inserts into the lateral lip of the bicipital groove of the humerus

      Explanation:

      The pectoralis major is the superior most and largest muscle of the anterior chest wall. It is a thick, fan-shaped muscle that lies underneath the breast tissue and forms the anterior wall of the axilla.

      Its origin lies anterior surface of the medial half of the clavicle, the anterior surface of the sternum, the first 7 costal cartilages, the sternal end of the sixth rib, and the aponeurosis of the external oblique of the anterior abdominal wall.
      The insertion of the pectoralis major is at the lateral lip of the intertubercular sulcus of the humerus. There are 2 heads of the pectoralis major, the clavicular and the sternocostal, which reference their area of origin.
      The function of the pectoralis major is 3-fold and dependent on which heads of muscles are involved:
      – Flexion, adduction and medial rotation of the arm at the glenohumeral joint
      – Clavicular head causes flexion of the extended arm
      – Sternoclavicular head causes extension of the flexed arm

      Arterial supply of the pectoralis major, the pectoral artery, arises from the second branch of the axillary artery, the thoracoacromial trunk.

      The 2 heads of the pectoralis major have different nervous supplies. The clavicular head derives its nerve supply from the lateral pectoral nerve. The medial pectoral nerve innervates the sternocostal head. The lateral pectoral nerve arises directly from the lateral cord of the brachial plexus, and the medial pectoral nerve arises from the medial cord.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      342.6
      Seconds
  • Question 4 - 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: It is brought about by reflex activation of parasympathetic nerves.

      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
      510.1
      Seconds
  • Question 5 - Which of the following side effects would you least associated with ciprofloxacin: ...

    Correct

    • Which of the following side effects would you least associated with ciprofloxacin:

      Your Answer: Folate deficiency

      Explanation:

      Common side effects include diarrhoea, dizziness, headache, nausea and vomiting.
      Other adverse effects include: Tendon damage (including rupture), Seizures (in patients with and without epilepsy), QT-interval prolongation, Photosensitivity and Antibiotic-associated colitis

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      15.2
      Seconds
  • Question 6 - Regarding amoxicillin, which of the following statements is INCORRECT: ...

    Correct

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

      Your Answer: It is used first line for bacterial tonsillitis.

      Explanation:

      Amoxicillin is a derivative of ampicillin and has a similar antibacterial spectrum. It is better absorbed than ampicillin when given orally, producing higher plasma and tissue concentrations; unlike ampicillin, absorption is not affected by the presence of food in the stomach.

      The adverse effects of amoxicillin are mainly gastrointestinal and mild and include nausea, vomiting and diarrhoea. Amoxicillin is used first line for low to moderate severity community acquired pneumonia, exacerbations of chronic bronchitis, for acute otitis media, for acute sinusitis, for oral infections/dental abscess, for Listeria meningitis (in combination with another antibiotic), for infective endocarditis (in combination with another antibiotic) and for H. Pylori eradication (in combination with metronidazole/clarithromycin and a PPI).

      Penicillin V is used first line for bacterial tonsillitis; amoxicillin should be avoided in blind treatment of a sore throat as there is a high risk of a rash if glandular fever is present.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      20.8
      Seconds
  • Question 7 - A 63-year-old man presents with severe abdominal pain and vomiting of blood. An...

    Incorrect

    • A 63-year-old man presents with severe abdominal pain and vomiting of blood. An endoscopy was performed and a peptic ulcer was found to have eroded into an artery nearby.

      Which of the following most likely describes the location of the ulcer?

      Your Answer: The greater curvature of the stomach

      Correct Answer: The posterior duodenum

      Explanation:

      The most common cause of upper gastrointestinal bleeding is peptic ulcer disease, particularly gastric and duodenal ulcers. Duodenal ulcers are most commonly associated with bleeding compared with gastric ulcers. Posterior duodenal ulcers are considered to be the most likely to cause severe bleeding because of its proximity to the branches of the gastroduodenal artery (GDA).

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      28.6
      Seconds
  • Question 8 - The action potential is generated by excitable tissues, which are specialized tissues that...

    Incorrect

    • The action potential is generated by excitable tissues, which are specialized tissues that can generate a meaningful electrical signal. Local currents transport action potentials down the axons of neurons.

      Which of the following claims about the action potential's conduction is correct?

      Your Answer: The action potential can travel in two directions

      Correct Answer: The areas of the membrane that have recently depolarised will not depolarise again due to the refractory period

      Explanation:

      Local currents propagate action potentials down the axons of neurons. Following depolarization, this local current flow depolarizes the next axonal membrane, and when this region crosses the threshold, more action potentials are formed, and so on. Due to the refractory period, portions of the membrane that have recently depolarized will not depolarize again, resulting in the action potential only being able to go in one direction.

      The square root of axonal diameter determines the velocity of the action potential; the axons with the biggest diameter have the quickest conduction velocities. When a neuron is myelinated, the speed of the action potential rises as well.

      The myelin sheath is an insulating coating that surrounds certain neural axons. By increasing membrane resistance and decreasing membrane capacitance, the myelin coating increases conduction. This enables faster electrical signal transmission via a neuron, making them more energy-efficient than non-myelinated neuronal axons.

      Nodes of Ranvier are periodic holes in a myelinate axon when there is no myelin and the axonal membrane is exposed. There are no gated ion channels in the portion of the axon covered by the myelin sheath, but there is a high density of ion channels in the Nodes of Ranvier. Action potentials can only arise at the nodes as a result of this.
      Electrical impulses are quickly transmitted from one node to the next, causing depolarization of the membrane above the threshold and triggering another action potential, which is then transmitted to the next node. An action potential is rapidly conducted down a neuron in this manner. Saltatory conduction is the term for this.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      33.7
      Seconds
  • Question 9 - After a work-related accident, a 33-year old male is taken to the emergency...

    Incorrect

    • 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 axillary 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.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      52.8
      Seconds
  • Question 10 - A 10-year-old girl presents with polyuria, polydipsia, and stomach pain. She has a...

    Correct

    • A 10-year-old girl presents with polyuria, polydipsia, and stomach pain. She has a history of type I diabetes mellitus. On blood gas analysis, she has metabolic acidosis. Diabetic ketoacidosis (DKA) is diagnosed, and therapy is initiated. She becomes increasingly confused when intravenous fluids and insulin are administered.

      Which electrolyte imbalance is the MOST likely reason of the increased confusion

      Your Answer: Hyponatraemia

      Explanation:

      Because of the shift of water from the intracellular to the extracellular compartment as a result of hyperglycaemia and increased plasma osmolality, dilutional hyponatraemia is common in diabetic ketoacidosis (DKA).

      If intravenous fluids are not delivered with caution, hyponatraemia might worsen, which can lead to increased degrees of disorientation. Hyponatraemia has also been linked to an increased risk of cerebral oedema, especially if blood glucose levels drop too quickly following treatment.

      Headache, recurrence of vomiting, irritability, Glasgow Coma Scale score, inappropriate heart rate slowing, and rising blood pressure are the most common causes of death in paediatric DKA, and children should be monitored for the symptoms mentioned above. To prevent this from developing,  s low osmolarity normalization, attention to glucose and salt levels, as well as hydration over 48 hours, is necessary. 

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
      32
      Seconds
  • Question 11 - A 32-year-old woman presents with abdominal pain and bloody diarrhoea that has been...

    Incorrect

    • A 32-year-old woman presents with abdominal pain and bloody diarrhoea that has been going on for 3 days.

      Among the following microorganisms, which is considered to be a cause of infectious bloody diarrhoea?

      Your Answer: Giardia lamblia

      Correct Answer: Entamoeba histolytica

      Explanation:

      The following are organisms that are capable of producing acute, bloody diarrhoea:
      – Campylobacter jejuni
      – Escherichia coli O157:H7
      – Salmonella species
      – Shigella species
      – Yersinia species
      – Entamoeba histolytica

      Other E. coli strains, Giardia, Vibrio, and other parasites are associated with watery, but not bloody, diarrhoea.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      16.8
      Seconds
  • Question 12 - Which of the following is the primary indication for loop diuretics? ...

    Correct

    • Which of the following is the primary indication for loop diuretics?

      Your Answer: Acute pulmonary oedema

      Explanation:

      Loop diuretics have long been the cornerstone of pulmonary oedema treatment, with furosemide being the most commonly used of these drugs. Premedication with drugs that decrease preload (e.g., nitro-glycerine [NTG]) and afterload (e.g., angiotensin-converting enzyme [ACE] inhibitors) before the administration of loop diuretics can prevent adverse hemodynamic changes.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      32.4
      Seconds
  • Question 13 - Insulin is produced by which of the following pancreatic cells: ...

    Correct

    • Insulin is produced by which of the following pancreatic cells:

      Your Answer: β cells

      Explanation:

      Insulin is produced by beta cells, located centrally within the islets of Langerhans, in the endocrine tissues of the pancreas. Insulin is a polypeptide hormone consisting of two short chains (A and B) linked by disulphide bonds. Proinsulin is synthesised as a single-chain peptide. Within storage granules, a connecting peptide (C peptide) is removed by proteases to yield insulin. Insulin release is stimulated initially during eating by the parasympathetic nervous system and gut hormones such as secretin, but most output is driven by the rise in plasma glucose concentration that occurs after a meal. The effects of insulin are mediated by the receptor tyrosine kinase.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      5.3
      Seconds
  • Question 14 - A 7-year-old boy is brought to the emergency room with complaints of a...

    Correct

    • A 7-year-old boy is brought to the emergency room with complaints of a red and painful left eye. Upon physical examination, it was noted that there is the presence of conjunctival erythema. A mucopurulent discharge and crusting of the lid was also evident. A diagnosis of bacterial conjunctivitis was made.

      According to the latest NICE guidelines, which of the following should NOT be a part of the management of this patient?

      Your Answer: Topical antibiotics should be prescribed routinely

      Explanation:

      The following are the NICE guidelines on the management of bacterial conjunctivitis:
      – Infective conjunctivitis is a self-limiting illness that usually settles without treatment within 1-2 weeks. If symptoms persist for longer than two weeks they should return for review.
      – Seek medical attention urgently if marked eye pain or photophobia, loss of visual acuity, or marked redness of the eye develop.
      – Remove contact lenses, if worn, until all symptoms and signs of infection have completely resolved and any treatment has been completed for 24 hours.
      – Lubricant eye drops may reduce eye discomfort; these are available over the counter, as well as on prescription.
      – Clean away infected secretions from eyelids and lashes with cotton wool soaked in water.
      – Wash hands regularly, particularly after touching the eyes.
      – Avoid sharing pillows and towels.
      – It is not necessary to exclude a child from school or childcare if they have infective conjunctivitis, as mild infectious illnesses should not interrupt school attendance. An exception would be if there is an outbreak of infective conjunctivitis, when advice should be sought from the Health Protection Agency by the school.
      – Adults who work in close contact with others, or with vulnerable patients, should avoid such contact until the discharge has settled.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      53
      Seconds
  • Question 15 - In which of the following cases is intravenous phenytoin contraindicated? ...

    Incorrect

    • In which of the following cases is intravenous phenytoin contraindicated?

      Your Answer: Hepatic impairment

      Correct Answer: Second degree heart block

      Explanation:

      Phenytoin Contraindications include:

      Hypersensitivity
      Sinus bradycardia
      Sinoatrial block
      Second and third degree A-V block
      Adams-Stokes syndrome
      Concurrent use with delavirdine
      History of prior acute hepatotoxicity attributable to phenytoin

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      21.7
      Seconds
  • Question 16 - A 42-year-old woman with a history of hyposplenism arrives at the Emergency Department...

    Incorrect

    • A 42-year-old woman with a history of hyposplenism arrives at the Emergency Department sick and feverish. A complete set of bloods, including a peripheral blood film, is organised.

      On a hyposplenic blood film, which of the following features is LEAST likely to be seen?

      Your Answer: Heinz bodies

      Correct Answer: Teardrop cells

      Explanation:

      The collection of abnormalities found in these patients is referred to as a hyposplenic film.
      The following features can be seen on hyposplenic blood films:
      Howell-Jolly bodies
      Heinz’s bodies
      Target cells
      RBCs with nuclei on occasion
      Lymphocytosis
      Macrocytosis
      Acanthocytes
      Teardrop cells, also known as dacrocytes, are named for their teardrop-shaped shape.

      Dacrocytosis is a condition in which a large number of these cells are present. Myelofibrosis and beta thalassemia major both have dacrocytes, but hyposplenism does not.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      22.8
      Seconds
  • Question 17 - A 17-year-old type I diabetic patient presents with abdominal pain and vomiting. Measurement...

    Correct

    • A 17-year-old type I diabetic patient presents with abdominal pain and vomiting. Measurement of her blood glucose level is done and found to be grossly elevated. She is diagnosed with diabetic ketoacidosis. A fixed rate insulin infusion is given as part of her treatment.

      Which of these is an action of insulin?

      Your Answer: Stimulates lipogenesis

      Explanation:

      Insulin is an anabolic hormone. Its actions can be broadly divided into:
      Lipid metabolism
      Protein metabolism and
      Carbohydrate metabolism

      For lipid metabolism, insulin:
      Stimulates lipogenesis
      Inhibits lipolysis by lipase

      For carbohydrate metabolism, insulin:
      Decreases gluconeogenesis
      Stimulates glycolysis
      Promotes glucose uptake in muscle and adipose tissue
      Promotes glycogen storage
      Increases glycogenesis
      Decreases glycogenolysis

      Protein metabolism:
      Stimulates protein synthesis
      Accelerates net formation of protein
      Stimulates amino acid uptake
      Inhibits protein degradation
      Inhibits amino acid conversion to glucose

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      36
      Seconds
  • Question 18 - A 49-year-old woman has a history of hypertension and persistent hypokalaemia and is...

    Incorrect

    • A 49-year-old woman has a history of hypertension and persistent hypokalaemia and is diagnosed with hyperaldosteronism.

      Which of these is the commonest cause of hyperaldosteronism?

      Your Answer: Diuretic usage

      Correct Answer: Adrenal adenoma

      Explanation:

      When there are excessive circulating levels of aldosterone, hyperaldosteronism occurs. There are two main types of hyperaldosteronism:

      Primary hyperaldosteronism (,95% of cases)
      Secondary hyperaldosteronism (,5% of cases)

      Primary causes of hyperaldosteronism include:
      Adrenal adenoma (Conn’s syndrome)
      Adrenal hyperplasia
      Adrenal cancer
      Familial aldosteronism
      Secondary causes of hyperaldosteronism include:
      Drugs
      Obstructive renal artery disease
      Renal vasoconstriction
      Oedematous disorders syndrome

      Adrenal adenoma is the commonest cause of hyperaldosteronism (seen in ,80% of all cases).

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      23.3
      Seconds
  • Question 19 - Regarding postural hypotension, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding postural hypotension, which of the following statements is INCORRECT:

      Your Answer: On standing, there is an initial drop in central venous pressure.

      Correct Answer: Postural hypotension usually causes a reflex bradycardia.

      Explanation:

      On standing from a prone position, gravity causes blood to pool in veins in the legs. Central venous pressure (CVP) falls, causing a fall in stroke volume and cardiac output (due to Starling’s law) and thus a fall in blood pressure. Normally this fall in BP is rapidly corrected by the baroreceptor reflex which causes venoconstriction (partially restoring CVP), and an increase in heart rate and contractility, so restoring cardiac output and blood pressure. Impaired autonomic nervous activity in the elderly accounts for the greater likelihood of postural hypotension. Any symptoms of dizziness, blurred vision or syncope is due to a transient fall in cerebral perfusion that occurs before cardiac output and mean arterial pressure (MAP) can be corrected.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      38.3
      Seconds
  • Question 20 - What is the mechanism of action of cetirizine: ...

    Incorrect

    • What is the mechanism of action of cetirizine:

      Your Answer: Leukotriene receptor antagonist

      Correct Answer: H1-receptor antagonist

      Explanation:

      Cetirizine is a competitive inhibitor at the H1-receptor (an antihistamine).

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      12.8
      Seconds
  • Question 21 - A 38-year-old man returns from an overseas business trip with a fever and...

    Correct

    • A 38-year-old man returns from an overseas business trip with a fever and a headache. Following investigations a diagnosis of Plasmodium falciparum malaria is made.
      Which of the following statements regarding Plasmodium falciparum malaria is true? Select ONE answer only.

      Your Answer: There may be a continuous fever

      Explanation:

      Plasmodium falciparum malaria is transmitted by female of the Anopheles genus of mosquito. The Aedes genus is responsible for transmitting diseases such as dengue fever and yellow fever.
      Plasmodium falciparumis found globally but is mainly found in sub-Saharan Africa.
      The incubation period of Plasmodium falciparum malaria is 7-14 days.
      Sporozoites invade hepatocytes. Within the hepatocyte asexual reproduction occurs producing merozoites, which are released into the blood stream and invade the red blood cells of the host.
      Artesunate is the drug treatment of choice for Plasmodium falciparum malaria. Quinine can still be used where artesunate is not available. Often combination therapy with drugs such as doxycycline or fansidar is also required.
      The classic symptom of malaria is the malarial paroxysm, a cyclical occurrence of a cold phase, where the patient experiences intense chills, a hot stage, where the patient feels extremely hot and finally a sweating stage, where the fever declines and the patient sweats profusely. There may also, however, be a continuous fever.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      35.4
      Seconds
  • Question 22 - Regarding meningococcal meningitis, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding meningococcal meningitis, which of the following statements is CORRECT:

      Your Answer: All healthcare workers should receive chemoprophylaxis if they have come into contact with an infected patient.

      Correct Answer: Infection occurs most commonly below the age of 5 years.

      Explanation:

      About half of meningococcal disease occurs in children aged less than five years, and babies are at the highest risk because their immune systems have not yet fully developed. There is a second, smaller increase in risk for older adolescents, mainly for social and behavioural reasons. Infection is most common in winter months. Antibiotics should be given as soon as the diagnosis is suspected (ideally cultures should be performed first but this should not delay treatment), and ceftriaxone/cefuroxime is the first line antibiotic. Only healthcare workers who have been directly exposed to large particle droplets/secretions from the respiratory tract of the index case should receive prophylaxis.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      17.2
      Seconds
  • Question 23 - The ECG of a patient presenting with a history of intermittent palpitations has...

    Incorrect

    • The ECG of a patient presenting with a history of intermittent palpitations has a prolonged QT interval.

      Which of these can cause prolongation of the QT interval on the ECG?

      Your Answer: Hypercalcaemia

      Correct Answer: Hypomagnesaemia

      Explanation:

      The causes of a prolonged QT interval include:

      Hypomagnesaemia
      Hypothermia
      Hypokalaemia
      Hypocalcaemia
      Hypothyroidism
      Jervell-Lange-Nielsen syndrome (autosomal dominant)
      Romano Ward syndrome (autosomal recessive)
      Ischaemic heart disease
      Mitral valve prolapse
      Rheumatic carditis
      Erythromycin
      Amiodarone
      Quinidine
      Tricyclic antidepressants
      Terfenadine
      Methadone
      Procainamide
      Sotalol

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      37.3
      Seconds
  • Question 24 - Which of the following is most likely to cause a homonymous hemianopia: ...

    Correct

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

      Your 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
      7.5
      Seconds
  • Question 25 - What is the maximum strength of a scar versus unwounded skin: ...

    Correct

    • What is the maximum strength of a scar versus unwounded skin:

      Your Answer: 0.8

      Explanation:

      Basic healing is complete by 5-10 days but maximal wound strength (80% of normal) may take 12 weeks.

    • This question is part of the following fields:

      • Pathology
      • Wound Healing
      9.3
      Seconds
  • Question 26 - Regarding tapeworm, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer: Mebendazole is the first line treatment for tapeworm infection.

      Correct Answer: Diagnosis is by direct visualisation of characteristic eggs in the stool.

      Explanation:

      Diagnosis of tapeworm is by direct visualisation of characteristic eggs in stool. Humans may be infected by pork or beef tapeworm. Treatment is with praziquantel or niclosamide. Specialist advice should be sought for the management of neurocysticercosis.Iron-deficiency anaemia is typically seen in hookworm infection. Threadworms migrate from the intestine at night to lay eggs on the perianal skin. Mebendazole is first line treatment for threadworms.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      17.9
      Seconds
  • Question 27 - You examine a 73-year-old patient who is experiencing a worsening of his chronic...

    Incorrect

    • You examine a 73-year-old patient who is experiencing a worsening of his chronic heart failure. Bumetanide was recently prescribed for him.

      Which of the following statements about bumetanide is correct?

      Your Answer: It acts on the Na.Cl co-transporter in the distal convoluted tubule to inhibit sodium and chloride reabsorption

      Correct Answer: It has better intestinal absorption than furosemide

      Explanation:

      Bumetanide is a loop diuretic that inhibits sodium, chloride, and potassium reabsorption by acting on the Na.K.2Cl co-transporter in the ascending loop of Henlé. This reduces the osmotic gradient that forces water out of the collecting duct system and prevents the formation of a hypertonic renal medulla. This has a strong diuretic effect on the body.

      It’s primarily used in patients with heart failure who aren’t responding to high doses of furosemide. Bumetanide and furosemide differ primarily in terms of bioavailability and pharmacodynamic potency.

      In the intestine, furosemide is only partially absorbed, with a bioavailability of 40-50 percent. Bumetanide, on the other hand, is almost completely absorbed in the intestine and has a bioavailability of about 80%. Bumetanide is 40 times more potent than furosemide, and one milligram is roughly equivalent to 40 milligrams of furosemide.

      Bumetanide also lowers the concentration of neuronal chloride, making GABA’s action more depolarizing. In the neonatal period, it is being studied as an antiepileptic.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      25.9
      Seconds
  • Question 28 - Regarding the varicella zoster virus, which of the following statements is CORRECT: ...

    Correct

    • Regarding the varicella zoster virus, which of the following statements is CORRECT:

      Your Answer: Contracting chickenpox infection while pregnant is associated with a higher risk of developing varicella pneumonitis.

      Explanation:

      Chickenpox infection in neonates, adults/adolescents and pregnant women is associated with more severe disease. Varicella zoster pneumonitis typically occurs in pregnant women or immunocompromised individuals and is associated with a high mortality. A live attenuated-virus vaccine is available and recommended for non-immune healthcare workers but is not part of the routine childhood immunisation schedule. Antiviral treatment is not typically recommended in childhood chickenpox but is indicated for shingles.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      32.3
      Seconds
  • Question 29 - Which of these is an example of ordinal data? ...

    Incorrect

    • Which of these is an example of ordinal data?

      Your Answer: Marital status

      Correct Answer: Disease staging system

      Explanation:

      Categorical data or data that is ordered is Ordinal data e.g. disease staging system, pain scoring system.

      Disease staging system is the correct answer

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      11.1
      Seconds
  • Question 30 - A 22-year-old woman is brought in by ambulance from her GP surgery with...

    Incorrect

    • A 22-year-old woman is brought in by ambulance from her GP surgery with suspected meningitis. She has been given a dose of benzylpenicillin already.
      What is the mechanism of action of benzylpenicillin? Select ONE answer only.

      Your Answer: Inhibition of nucleic acid synthesis

      Correct Answer: Inhibition of cell wall synthesis

      Explanation:

      Penicillins and the other ß-lactam antibiotics are bactericidal. They produce their antimicrobial action by preventing cross-linkage between the linear peptidoglycan polymer chains that make up the bacterial cell wall. They, therefore, inhibit cell wall synthesis.
      An overview of the different mechanisms of action of the various types of antimicrobial agents is shown below:
      Mechanism of action
      Examples
      Inhibition of cell wall synthesis
      Penicillins
      Cephalosporins
      Vancomycin
      Disruption of cell membrane function
      Polymyxins
      Nystatin
      Amphotericin B
      Inhibition of protein synthesis
      Macrolides
      Aminoglycosides
      Tetracyclines
      Chloramphenicol
      Inhibition of nucleic acid synthesis
      Quinolones
      Trimethoprim
      5-nitroimidazoles
      Rifampicin
      Anti-metabolic activity
      Sulfonamides
      Isoniazid

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      34.1
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