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  • Question 1 - A 20-year-old patient had sustained a supracondylar fracture due to falling from a...

    Incorrect

    • A 20-year-old patient had sustained a supracondylar fracture due to falling from a skateboard. The frequency of acute nerve injuries accompanying supracondylar humeral fractures ranges from 10 to 20%. The most common complication is injury to which nerve?

      Your Answer: Ulnar nerve

      Correct Answer: Median nerve

      Explanation:

      According to various studies, the frequency of acute nerve damage associated with supracondylar humeral fractures in children ranges from 10% to 20%.

      Median nerve injury and anterior interosseous nerve injury are the most common consequences.

      Damage to this nerve indicated weakening or abnormal extension of the index finger’s distal interphalangeal joint and the thumb’s interphalangeal joint. The absence of sensibility is a distinguishing attribute.

      A surgical neck humerus fracture may cause injury to the axillary nerve. A midshaft humerus fracture might cause injury to the radial nerve. A medial epicondylar fracture might cause injury to the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      22.8
      Seconds
  • Question 2 - The role of the juxtaglomerular (granular) cells of the juxtaglomerular apparatus is: ...

    Correct

    • The role of the juxtaglomerular (granular) cells of the juxtaglomerular apparatus is:

      Your Answer: Production of renin

      Explanation:

      Juxtaglomerular cells synthesise renin. These cells are specialised smooth muscle cells that are located in the walls of the afferent arterioles, and there are some in the efferent arterioles.

    • This question is part of the following fields:

      • Physiology
      • Renal
      993.6
      Seconds
  • Question 3 - Regarding the flexor digitorum profundus muscle, which of the following is true? ...

    Incorrect

    • Regarding the flexor digitorum profundus muscle, which of the following is true?

      Your Answer: The entire muscle is innervated by the median nerve

      Correct Answer: The medial aspect of the muscle is innervated by the ulnar nerve

      Explanation:

      Flexor digitorum profundus is a fusiform muscle located deep within the anterior (flexor) compartment of the forearm. Along with the flexor pollicis longus and pronator quadratus muscles, it comprises the deep flexor compartment of the forearm.

      Flexor digitorum profundus has a dual innervation:

      (1) The medial part of the muscle, that inserts to the fourth and fifth digits, is innervated by the ulnar nerve (C8-T1);

      (2) The lateral part, that inserts to the second and third digits, is innervated by the median nerve, via anterior interosseous branch (C8-T1).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      524.3
      Seconds
  • Question 4 - Which of the following immunoglobulin molecules is the most abundant in secretions (such...

    Correct

    • Which of the following immunoglobulin molecules is the most abundant in secretions (such as saliva and breast milk):

      Your Answer: IgA

      Explanation:

      IgA is the predominant antibody class in secretions and tremendous quantities are secreted into various body spaces and onto mucosal surfaces (the gut lumen, the pharynx and sinuses, the larger airways, although not the alveoli).
      Because of its size, the majority of IgM is found in the circulation.

      Along with IgM, IgD is predominant among the surface receptors of mature B cells, where it plays a key role in B cells activation.

      IgE has the lowest concentration in normal human serum. It plays a prominent role in immune responses to helminth parasites, and in allergic reactions.
      IgG is the most abundant immunoglobulin and constitutes 75 percent of serum immunoglobulin in an adult human

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      5.7
      Seconds
  • Question 5 - A 28 year old man presents with abdominal pain and constipation, and bloods...

    Correct

    • A 28 year old man presents with abdominal pain and constipation, and bloods show hypocalcaemia. Which of the following hormones is increased as a result of hypocalcaemia?

      Your Answer: Parathyroid hormone

      Explanation:

      Parathyroid hormone (PTH), also called parathormone or parathyrin, is a peptide hormone that is secreted by the parathyroid glands, which lie immediately behind the thyroid gland. In particular, this hormone is made by chief cells. It regulates the serum calcium concentration through its effects on bone, kidney, and intestine. This hormone is primarily released in response to decreasing plasma Ca2+ concentration and it serves to increase plasma calcium levels and decrease plasma phosphate levels.
      PTH activates Ca2+entry channels in the apical membrane and the Ca2+ATPase pump in the basolateral membrane and as a result, increases calcium reabsorption in the distal tubule of the nephron. It inhibits reabsorption of phosphate and this increases its excretion by in the proximal tubule of the nephron.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      140.6
      Seconds
  • Question 6 - A dermatological examination of a patient presenting with a lump shows a visible...

    Correct

    • A dermatological examination of a patient presenting with a lump shows a visible collection of fluid measuring 0.3 cm in diameter.

      Which one of these best describes the lump you have found on examination?

      Your Answer: Vesicle

      Explanation:

      A vesicle is a visible collection of fluid measuring less than 0.5 cm in diameter.

      A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus.

      A carbuncle is a collection of individual boils clustered together.

      A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter.

      A pustule is a small visible skin elevation containing an accumulation of pus.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      165
      Seconds
  • Question 7 - Gastrin release from antral G-cells is inhibited by all but which one of...

    Incorrect

    • Gastrin release from antral G-cells is inhibited by all but which one of the following:

      Your Answer: Cholecystokinin

      Correct Answer: Vagal stimulation

      Explanation:

      Gastrin secretion is inhibited by:
      Low gastric pH (negative feedback mechanism)
      Somatostatin
      Secretin
      Gastric inhibitory polypeptide (GIP)
      Cholecystokinin

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      14.1
      Seconds
  • Question 8 - Beta cells of the endocrine pancreas produce which of the following hormones: ...

    Correct

    • Beta cells of the endocrine pancreas produce which of the following hormones:

      Your Answer: Insulin

      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
      26.2
      Seconds
  • Question 9 - A 71-year-old man treated with antibiotics for a chest infection returns with a...

    Incorrect

    • A 71-year-old man treated with antibiotics for a chest infection returns with a profuse, offensive smelling diarrhoea. A diagnosis of Clostridium difficile diarrhoea is made after investigations.

      Which antibiotic is associated with the greatest risk of causing Clostridium Difficile diarrhoea?

      Your Answer: Tetracycline

      Correct Answer: Ciprofloxacin

      Explanation:

      Clostridium difficile, a Gram-positive, anaerobic, spore forming bacteria is present in the gut of approximately 3% of healthy adults (2012 UK HPA estimates). Following use of broad spectrum antibiotics, which alter normal gut flora, Clostridium difficile infection (CDI) occurs. About 80% of Clostridium Difficile infections are seen in people over the age of 65 and its main clinical features are:
      Abdominal cramps, severe bloody and/or watery diarrhoea, offensive smelling diarrhoea, and fever.

      CDI is the most severe consequence of antibiotic treatment and is a major cause of morbidity and mortality.
      Risk for CDI has been found to be greatest with clindamycin followed by fluoroquinolones Tetracyclines are not associated with risk for CDI.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      30.1
      Seconds
  • Question 10 - During quiet respiration, position of the right oblique fissure can be marked by...

    Incorrect

    • During quiet respiration, position of the right oblique fissure can be marked by a line drawn on the thoracic wall that:

      Your Answer: Begins at the spinous process of T3, crosses the fifth intercostal space laterally and follows the contour of rib 5 anteriorly.

      Correct Answer: Begins at the spinous process of T4, crosses the fifth intercostal space laterally and follows the contour of rib 6 anteriorly.

      Explanation:

      During quiet respiration, the approximate position of the right oblique fissure can be marked by a line on the thoracic wall that begins at the spinous process of vertebra T4, crosses the fifth intercostal space laterally and then follows the contour of rib 6 anteriorly.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      36.9
      Seconds
  • Question 11 - A 22 year old student has recently returned from travelling around Kenya and...

    Correct

    • A 22 year old student has recently returned from travelling around Kenya and presents to ED with a headache and persistent fever. Malaria is being considered as a potential diagnosis. Which of the following strains of malaria is most likely:

      Your Answer: Plasmodium falciparum

      Explanation:

      Malaria is an infectious disease transmitted by female of theAnophelesgenus of mosquito. It is a parasitic infection caused by the genusPlasmodium. Five species are recognized as causing disease in humans;Plasmodium falciparum,Plasmodium ovale,Plasmodium vivax,Plasmodium malariaeandPlasmodium knowlesi.
      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. On examination the patient may show signs of anaemia, jaundice and have hepatosplenomegaly without evidence of lymphadenopathy.

      Plasmodium falciparum is the most serious form and is responsible for most deaths. Severe or complicated malaria is suggested by the presence of impaired consciousness, seizures, hypoglycaemia, anaemia, renal impairment, respiratory distress and spontaneous bleeding.
      Plasmodium falciparum is the most likely type in this case in view of the presentation.
      Haemoglobinuria and renal failure following treatment is suggestive of blackwater fever, which is caused byPlasmodium falciparum. An autoimmune reaction between the parasite and quinine causes haemolysis, haemoglobinuria, jaundice and renal failure. This can be fatal.
      The benign malarias: P.vivax, P. malariae and P.ovale are usually treated with chloroquine. A course of primaquine is also required in P.vivax and P.ovale infection. 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.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      109.3
      Seconds
  • Question 12 - A medical student is reviewing the chart of a patient who has recently...

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      520.1
      Seconds
  • Question 13 - A 30-year-old woman with type 1 diabetes mellitus is brought in drowsy and...

    Correct

    • A 30-year-old woman with type 1 diabetes mellitus is brought in drowsy and confused. Her BM is 2.2 mmol/l and a dose of IM glucagon is administered.

      What is the principal stimulus for the secretion of glucagon?

      Your Answer: Hypoglycaemia

      Explanation:

      Glucagon, a peptide hormone, is produced and secreted by alpha cells of the islets of Langerhans, located in the endocrine portion of the pancreas.

      Its main physiological role is stimulation of hepatic glucose output leading to increase in blood glucose. It is the major counter-regulatory hormone to insulin in maintaining glucose homeostasis.

      The principal stimulus for the secretion of glucagon is hypoglycaemia. Hypoglycaemia then stimulates:
      Glycogenolysis
      Gluconeogenesis
      Lipolysis in adipose tissue leading to increased glycaemia.

      Secretion of glucagon is also stimulated by arginine, alanine, adrenaline, acetylcholine and cholecystokinin

      Secretion of glucagon is inhibited by:
      Insulin
      Somatostatin
      Increased free fatty acids
      Increased urea production

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      49.6
      Seconds
  • Question 14 - 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
      80.7
      Seconds
  • Question 15 - In the extrinsic pathway of the coagulation cascade, the tenase complex is: ...

    Correct

    • In the extrinsic pathway of the coagulation cascade, the tenase complex is:

      Your Answer: Factor VIIa-tissue factor complex

      Explanation:

      The extrinsic pathway for initiating the formation of prothrombin activator begins with a traumatized vascular wall or traumatized extravascular tissues that come in contact with the blood. Exposed and activated by vascular injury, with plasma factor VII. The extrinsic tenase complex, factor VIIa-tissue factor complex, activates factor X to factor Xa.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      18.4
      Seconds
  • Question 16 - Which of the following is most likely affected in De Quervain's tenosynovitis? ...

    Incorrect

    • Which of the following is most likely affected in De Quervain's tenosynovitis?

      Your Answer: Abductor pollicis brevis

      Correct Answer: Extensor pollicis brevis

      Explanation:

      De Quervain tenosynovitis is named after the Swiss surgeon, Fritz de Quervain, who first described it in 1895. It is a condition which involves tendon entrapment affecting the first dorsal compartment of the wrist. With this condition thickening of the tendon sheaths around the abductor pollicis longus and extensor pollicis brevis develops where the tendons pass in through the fibro-osseous tunnel located along the radial styloid at the distal wrist. Pain is exacerbated by thumb movement and radial and ulnar deviation of the wrist.

      The estimated prevalence of de Quervain tenosynovitis is about 0.5% in men and 1.3% in women with peak prevalence among those in their forties and fifties. It may be seen more commonly in individuals with a history of medial or lateral epicondylitis. Bilateral involvement is often reported in new mothers or child care providers in whom spontaneous resolution typically occurs once lifting of the child is less frequent.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      90.9
      Seconds
  • Question 17 - You examine a 73-year-old patient who is experiencing a worsening of his chronic...

    Correct

    • 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 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
      215.5
      Seconds
  • Question 18 - A 70-year-old patient diagnosed with Cushing's syndrome, has a history of weight gain,...

    Incorrect

    • A 70-year-old patient diagnosed with Cushing's syndrome, has a history of weight gain, hypertension, and easy bruising.

      Which of the following statements about Cushing's syndrome is NOT true?

      Your Answer: The commonest cause is iatrogenic corticosteroid administration

      Correct Answer: Menorrhagia is a common feature

      Explanation:

      Cushing’s syndrome is a group of symptoms and signs brought on by long-term exposure to high amounts of endogenous or exogenous glucocorticoids.

      Iatrogenic corticosteroid injection is the most prevalent cause of Cushing’s syndrome.
      Cortisol levels fluctuate throughout the day, with the greatest levels occurring around 0900 hours and the lowest occurring at 2400 hrs during sleep. The diurnal swing of cortisol levels is lost in Cushing’s syndrome, and levels are greater throughout the 24-hour period. In the morning, levels may be normal, but they may be high at night-time, when they are generally repressed.

      Insulin resistance causes hyperglycaemia, which is a frequent symptom. Insulin resistance can produce acanthosis nigricans in the axilla and around the neck, as well as other skin abnormalities.

      In contrast to menorrhagia, elevated testosterone levels are more likely to produce amenorrhoea or oligomenorrhoea. Infertility in women of reproductive age can also be caused by high androgen levels.

      A dexamethasone suppression test or a 24-hour urine free cortisol collection can both be used to establish the existence of Cushing’s syndrome.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      26.2
      Seconds
  • Question 19 - You are seeing a child with known mitochondrial disease who has presented breathlessness...

    Correct

    • You are seeing a child with known mitochondrial disease who has presented breathlessness and cough. Which of the following best describes the function of mitochondria:

      Your Answer: Energy production

      Explanation:

      Mitochondria are membrane-bound organelles that are responsible for the production of the cell’s supply of chemical energy. This is achieved by using molecular oxygen to utilise sugar and small fatty acid molecules to generate adenosine triphosphate (ATP). This process is known as oxidative phosphorylation and requires an enzyme called ATP synthase. ATP acts as an energy-carrying molecule and releases the energy in situations when it is required to fuel cellular processes. Mitochondria are also involved in other cellular processes, including Ca2+homeostasis and signalling. Mitochondria contain a small amount of maternal DNA.
      Mitochondria have two phospholipid bilayers, an outer membrane and an inner membrane. The inner membrane is intricately folded inwards to form numerous layers called cristae. The cristae contain specialised membrane proteins that enable the mitochondria to synthesise ATP. Between the two membranes lies the intermembrane space, which stores large proteins that are required for cellular respiration. Within the inner membrane is the perimitochondrial space, which contains a jelly-like matrix. This matrix contains a large quantity of ATP synthase.
      Mitochondrial disease, or mitochondrial disorder, refers to a group of disorders that affect the mitochondria. When the number or function of mitochondria in the cell are disrupted, less energy is produced and organ dysfunction results.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      12.7
      Seconds
  • Question 20 - The first line drug for oral candidiasis is: ...

    Incorrect

    • The first line drug for oral candidiasis is:

      Your Answer: Fluconazole

      Correct Answer: Nystatin

      Explanation:

      Treatment for oral candidiasis is with nystatin mouthwash. In unresponsive cases, oral fluconazole is used

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      10.3
      Seconds
  • Question 21 - A 32-year-old female is diagnosed case of bipolar disorder and is on medication....

    Correct

    • A 32-year-old female is diagnosed case of bipolar disorder and is on medication. She presents to her psychiatric team with symptoms of severe depression. She is currently taking Lithium.

      Out of the following, which is TRUE regarding lithium?

      Your Answer: It commonly causes a tremor

      Explanation:

      Lithium is the drug of choice for bipolar disorders but is commonly associated with side effects and toxicity.

      Fine hand tremor is very commonly seen and reported in as many as 50% of patients during the first week of therapy with Lithium. The tremor tends to reduce with time and is only present in around 5% of patients taking the medication two years or longer. Lithium tremors are more common with older age, presumably due to the additive effects of age-related essential tremors.

      Option The normal therapeutic range is 2.0-2.5 mmol/l: Lithium should be carefully monitored as it has a very low therapeutic index. The normal therapeutic range is 0.4-0.8 mmol/l. Levels should be checked one week after starting therapy and one week after every change in dosage. (Option Levels should be checked one month after starting therapy)

      Option It can induce hyperthyroidism: Lithium has a known effect on thyroid function. Lithium decreases the production of T4 and T3 and commonly causes hypothyroidism. More rarely, lithium causes hyperthyroidism due to thyroiditis.

      Option It can induce diabetes mellitus: Lithium can induce nephrogenic diabetes insipidus but not diabetes mellitus.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      28.4
      Seconds
  • Question 22 - A tumour is discovered behind the pectinate line during an examination of a...

    Incorrect

    • A tumour is discovered behind the pectinate line during an examination of a 72-year-old patient with rectal bleeding. Which of the following is the lymphatic drainage of the pectinate line?

      Your Answer: External iliac nodes

      Correct Answer: Superficial inguinal nodes

      Explanation:

      The pectinate line is known as the watershed line because it divides the anal canal into two sections. Below the pectinate line, lymphatic drainage drains to the superficial inguinal lymph nodes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      185.8
      Seconds
  • Question 23 - An analytical cohort study is done to compare the relationship between omega 3...

    Incorrect

    • An analytical cohort study is done to compare the relationship between omega 3 intake and occurrence of myocardial infarction (MI) among males aged over 65 years. The following are the data from the study:

      No. of subjects taking placebo: 100 men
      No. of subjects taking placebo who suffered an MI: 15 men

      No. of subjects taking omega 3: 100 men
      No. of subjects taking omega 3 who suffered an MI: 5 men

      Compute for the absolute risk in the treatment (omega 3) group.

      Your Answer: 0.5

      Correct Answer: 0.05

      Explanation:

      The absolute risk (AR) is the probability or chance of an event. It is computed as the number of events in treated or control groups, divided by the number of people in that group.

      AR = 5/100 = 0.05

    • This question is part of the following fields:

      • Evidence Based Medicine
      3.8
      Seconds
  • Question 24 - You are about to perform an emergency pericardiocentesis on a 26-year-old male who...

    Correct

    • You are about to perform an emergency pericardiocentesis on a 26-year-old male who was involved in a car accident and is suspected of having cardiac tamponade due to signs of hypotension, muffled heart sounds, and distended neck veins. Where should you insert the needle to relieve tamponade?

      Your Answer: Inferior and to the left of the xiphochondral junction

      Explanation:

      Pericardiocentesis is a procedure that removes excess fluid from the pericardium. As a result, it’s used in cases of cardiac tamponade, which occurs when there’s too much fluid in the space around the heart.

      During the procedure, a needle and a small catheter are inserted 1 to 2 cm inferior and to the left of the xiphochondral junction into the pericardial cavity.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      24.6
      Seconds
  • Question 25 - The parasympathetic supply to the rectum is from which of the following: ...

    Correct

    • The parasympathetic supply to the rectum is from which of the following:

      Your Answer: Pelvic splanchnic nerves

      Explanation:

      Parasympathetic supply is from the pelvic splanchnic nerves (S2 – S4) and inferior hypogastric plexus.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      154
      Seconds
  • Question 26 - Which of the following statements is correct regarding gentamicin? ...

    Incorrect

    • Which of the following statements is correct regarding gentamicin?

      Your Answer: Gentamicin is effective against haemolytic streptococci.

      Correct Answer: Gentamicin is ineffective against anaerobic bacteria.

      Explanation:

      Gentamicin is the aminoglycoside of choice and is a parenterally administered, broad spectrum antibiotic typically used for moderate to severe gram negative infections. However, it is inactive against anaerobes. There is poor activity against haemolytic streptococci and pneumococci. It is usually given in conjunction with a penicillin or metronidazole (or both) when used for the blind treatment of undiagnosed serious infections. Nephrotoxicity and ototoxicity are the main toxic effects due to damage to the vestibulocochlear nerve (CN VIII).

      It is contraindicated in myasthenia gravis and should be used with great care in renal disease as it may result in accumulation and a higher risk of toxic side effects.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      30.2
      Seconds
  • Question 27 - How does abciximab mediate its antiplatelet effect: ...

    Incorrect

    • How does abciximab mediate its antiplatelet effect:

      Your Answer: It is a phosphodiesterase inhibitor.

      Correct Answer: It is a GPIIb/IIIa inhibitor.

      Explanation:

      Abciximab, eptifibatide and tirofiban are GPIIb/IIIa inhibitors, inhibiting platelet aggregation by preventing the binding of fibrinogen, von Willebrand factor and other adhesive molecules.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      7.9
      Seconds
  • Question 28 - Regarding a cohort study, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding a cohort study, which of the following statements is INCORRECT:

      Your Answer: The usual outcome measure is the relative risk.

      Correct Answer: It is useful for rare diseases.

      Explanation:

      A cohort study is a longitudinal, prospective, observational study that follows a defined group (cohort) matched to unexposed controls for a set period of time and investigates the effect of exposure to a risk factor on a particular future outcome. The usual outcome measure is the relative risk (risk ratio). A large sample size is required for a rare outcome of interest so it is not useful for rare diseases.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      20.1
      Seconds
  • Question 29 - A 70-year old male is taken to the Emergency Room after suffering a...

    Correct

    • A 70-year old male is taken to the Emergency Room after suffering a traumatic fall while showering. Upon physical examination, the attending physician noted a hyperextended neck, 1/5 muscle strength in both upper extremities, 4/5 muscle strength in both lower extremities, and variable loss in sensation. The patient is placed in the wards for monitoring. For the next 24 hours, anuria is noted.

      Which of the following spinal cord injuries is the most likely diagnosis?

      Your Answer: Central cord syndrome

      Explanation:

      Central cord syndrome is the most common type of incomplete cord injury and almost always occurs due to a traumatic injury. It results in motor deficits that are worse in the upper extremities as compared to the lower extremities. It may also cause bladder dysfunction (retention) and variable sensory deficits below the level of injury.

      The majority of these patients will be older and present with symptoms after a fall with hyperextension of their neck. On examination, patients will have more significant strength impairments in the upper extremities (especially the hands) compared to the lower extremities. Patients often complain of sensory deficits below the level of injury, but this is variable. Pain and temperature sensations are typically affected, but the sensation of light touch can also be impaired. The most common sensory deficits are in a cape-like distribution across their upper back and down their posterior upper extremities. They will often have neck pain at the site of spinal cord impingement.

      Bladder dysfunction (most commonly urinary retention) and priapism can also be signs of upper motor neuron dysfunction. The sacral sensation is usually preserved, but the clinician should assess the rectal tone to evaluate the severity of the compression.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      14.6
      Seconds
  • Question 30 - Which of the following is the most abundant peripheral blood leucocyte: ...

    Correct

    • Which of the following is the most abundant peripheral blood leucocyte:

      Your Answer: Neutrophils

      Explanation:

      Neutrophils are the most abundant peripheral blood leucocyte, comprising about 50 – 70% of circulating white cells. Neutrophils have a characteristic dense nucleus consisting of between two and five lobes, and a pale cytoplasm with an irregular outline containing many fine pink-blue or grey-blue granules. The granules are divided into primary, which appear at the promyelocyte stage, and secondary, which appear at the myelocyte stage and predominate in the mature nucleus. Both types of granule are lysosomal in origin; the primary contains myeloperoxidase and other acid hydrolases; the secondary contains lactoferrin, lysozyme and other enzymes. The lifespan of neutrophils in the blood is only 6 – 10 hours. In response to tissue damage, cytokines and complement proteins, neutrophils migrate from the bloodstream to the site of insult within minutes, where they destroy pathogens by phagocytosis.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      6.3
      Seconds

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