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  • Question 1 - A 18 year old student presents to ED with a headache, fever and...

    Correct

    • A 18 year old student presents to ED with a headache, fever and photophobia. You suspect meningitis and agree to observe your junior performing a lumbar puncture. What is the highest safest vertebral level to perform lumbar puncture in adults:

      Your Answer: L3/L4

      Explanation:

      In adults, the spinal cord typically ends between L1/L2 whereas the subarachnoid space extends to approximately the lower border of vertebra S2. Lumbar puncture is performed in the intervertebral space L4/L5 or L3/L4.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      90.9
      Seconds

  • Question 2 - When the breast cancer of a 60-year old patient metastasizes and compresses the...

    Incorrect

    • When the breast cancer of a 60-year old patient metastasizes and compresses the intervertebral foramina between the fourth and fifth cervical vertebrae, as well as the fourth and fifth thoracic vertebrae, this causes back pain. Which pair of nerves is most likely affected?

      Your Answer: Fourth cervical and fifth thoracic nerves

      Correct Answer: Fifth cervical and fourth thoracic nerves

      Explanation:

      The fifth cervical nerve passes between the fourth and fifth cervical vertebrae, and the fourth thoracic nerve passes between the fourth and fifth thoracic vertebrae. Therefore, when the cancer metastasizes in this area, they are most likely affected.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      118.4
      Seconds

  • Question 3 - A new chemotherapy drug is being tested. The intervention reduces the risk of...

    Incorrect

    • A new chemotherapy drug is being tested. The intervention reduces the risk of death from 10 in 1000 to 5 in 1000. What is the number needed to treat to prevent one death:

      Your Answer: 5

      Correct Answer: 200

      Explanation:

      Absolute risk reduction (ARR) of treatment
      = risk of death in control group – risk of death in treatment group
      ARR = (10/1000) – (5/1000)
      = 5/1000 = 0.005
      Number needed to treat (NNT)
      = 1/ARR
      = 1/0.005
      = 200
      Therefore 200 people would need to be treated to prevent one extra death.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      379
      Seconds

  • Question 4 - A 27-year-old female is brought to the Emergency Department by ambulance with extensive...

    Incorrect

    • A 27-year-old female is brought to the Emergency Department by ambulance with extensive bleeding from her upper arm following a fall from a bicycle onto a fence. On inspection her biceps brachii muscle has been lacerated.
      How will the muscle heal from this injury? Select ONE answer only.

      Your Answer: No healing will occur

      Correct Answer: Satellite cells will produce a small number of regenerated myocytes

      Explanation:

      Muscle heals with fibrous tissue to form a scar. Once cut, it will never regain its previous bulk or power. Within the scar a small number of myocytes (muscle cells) may be seen, which are formed from satellite cells but they contribute little to the function of the muscle overall.
      In more widespread ischaemic injury, such as critical ischaemic limb due to arterial compromise, or in compartment syndrome, damaged myocytes are replaced diffusely with fibrous tissue. This fibrous tissue contracts and reduces movement, and in extreme cases can pull the limb into abnormal positions such as in Volkmann’s ischaemic contracture of the forearm.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      19.3
      Seconds

  • Question 5 - A 50-year-old man managed by the renal team for stage 4 chronic kidney...

    Correct

    • A 50-year-old man managed by the renal team for stage 4 chronic kidney disease which appears to be deteriorating presents with a history of shortness of breath and ankle oedema. His most recent blood tests shows low calcium levels.

      Which of these increases the renal reabsorption of calcium?

      Your Answer: Parathyroid hormone

      Explanation:

      Parathyroid hormone (PTH), a polypeptide containing 84 amino acids, is the principal hormone that controls free calcium in the body.

      Its main actions are:
      Increases osteoclastic activity
      Increases plasma calcium concentration
      Decreases renal phosphate reabsorption
      Decreases plasma phosphate concentration
      Increases renal tubular reabsorption of calcium
      Increases calcium and phosphate absorption in the small intestine
      Increases renal conversion of 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      30.3
      Seconds

  • Question 6 - A 27 year old woman presents to ED having sustained a deep laceration...

    Incorrect

    • A 27 year old woman presents to ED having sustained a deep laceration to the dorsum of her ring finger whilst cooking. Her proximal interphalangeal joint is fixed in flexion and the distal interphalangeal joint is hyperextended. Which of the following structures in the digit has most likely been injured:

      Your Answer:

      Correct Answer: Insertion of the central slip of the extensor tendon

      Explanation:

      Damage to the central slip of the extensor digitorum tendon would result in loss of extension at the proximal interphalangeal joint resulting in a fixed flexion deformity of this joint, and hyperextension of the distal interphalangeal joint due to a loss of balancing forces. This is called the Boutonniere deformity.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 7 - A 71-year-old woman is treated with co-amoxiclav for a chest infection but she...

    Incorrect

    • A 71-year-old woman is treated with co-amoxiclav for a chest infection but she returns 1 week later. Her chest infection has resolved but she developed a profuse, offensive smelling diarrhoea and abdominal cramps. You suspect Clostridium difficile associated diarrhoea (CDAD).

      ONE of these statements is true concerning this diagnosis.

      Your Answer:

      Correct Answer: The gold standard for the diagnosis of Clostridium difficile colitis is cytotoxin assay

      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 associated diarrhoea (CDAD) occurs.

      Alcohol hand gel is not effective against Clostridium Difficile spores. Hand washing with soap and water is very essential for healthcare workers who come in contact with it.

      Currently, the gold standard for the diagnosis of Clostridium difficile colitis is cytotoxin assay. Stool culture to detect Clostridium difficile is not specific for pathogenic strains, is expensive and therefore not specific for a diagnosis of CDAD

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 8 - Which of the following is NOT a characteristic of megaloblastic anaemia? ...

    Incorrect

    • Which of the following is NOT a characteristic of megaloblastic anaemia?

      Your Answer:

      Correct Answer: Raised reticulocyte count

      Explanation:

      The LDH level is usually markedly increased in severe megaloblastic anaemia. Reticulocyte counts are inappropriately low, representing a lack of production of RBCs due to massive intramedullary haemolysis. These findings are characteristics of ineffective haematopoiesis that occurs in megaloblastic anaemia as well as in other disorders such as thalassemia major.
      The common feature in megaloblastosis is a defect in DNA synthesis in rapidly dividing cells. To a lesser extent, RNA and protein synthesis are impaired. Unbalanced cell growth and impaired cell division occur since nuclear maturation is arrested. More mature RBC precursors are destroyed in the bone marrow prior to entering the bloodstream (intramedullary haemolysis).

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

  • Question 9 - Regarding iron deficiency anaemia, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding iron deficiency anaemia, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Dietary insufficiency is the most common cause of iron deficiency anaemia in adult men in the UK.

      Explanation:

      Blood loss from the gastrointestinal (GI) tract is the most common cause of iron deficiency anaemia in adult men and postmenopausal women.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

  • Question 10 - What is the earliest physiological effect that causes postural hypotension: ...

    Incorrect

    • What is the earliest physiological effect that causes postural hypotension:

      Your Answer:

      Correct Answer: A fall in central venous pressure

      Explanation:

      When autonomic reflexes are impaired or intravascular volume is markedly depleted, a significant reduction in blood pressure occurs upon standing, a phenomenon termed Postural Hypotension (orthostatic hypotension). Orthostatic hypotension can cause dizziness, syncope, and even angina or stroke. When autonomic reflexes are impaired, blood pressure falls progressively after standing because the gravitational pooling of blood in the legs cannot be compensated by sympathetic vasoconstriction.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 11 - Which patient group are most commonly associated with infection with Klebsiella spp: ...

    Incorrect

    • Which patient group are most commonly associated with infection with Klebsiella spp:

      Your Answer:

      Correct Answer: Hospitalised patients

      Explanation:

      Klebsiella spp. are facultatively anaerobic Gram-negative rods, found in the normal intestinal and respiratory flora. These organisms are usually opportunistic pathogens that cause nosocomial infections, most commonly pneumonia and UTI.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

  • Question 12 - An analytical cohort study aimed to determine a relationship between intake of dietary...

    Incorrect

    • An analytical cohort study aimed to determine a relationship between intake of dietary calcium and incidence of hip fractures among post-menopausal women. The following are the data obtained from the study:

      No. of post-menopausal women who took Calcium: 500
      No. of post-menopausal women who took Calcium and suffered a hip fracture: 10

      No. of post-menopausal women who took placebo: 500
      No. of post-menopausal women who took placebo and suffered a hip fracture: 25

      Compute for the absolute risk in the placebo group.

      Your Answer:

      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 = 25/500 = 0.05

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds

  • Question 13 - Given a patient with dislocation of the patella, which muscle is the most...

    Incorrect

    • Given a patient with dislocation of the patella, which muscle is the most important to address during rehabilitation to prevent recurrent dislocation?

      Your Answer:

      Correct Answer: Vastus medialis

      Explanation:

      Patellar dislocation is a disabling musculoskeletal disorder which predominantly affects younger people who are engaged in multidirectional physically active pursuits. Conservative (non-operative) treatment is the treatment of choice for FTPD (first time patellar dislocation). Quadriceps strengthening exercises are considered one of the principal management aims for people following FTPD. A United Kingdom (UK) survey of physiotherapy practice has shown that quadriceps strengthening and specific-vastus medialis obliquus (VMO) or distal vastus medialis (VM) muscle strengthening or recruitment exercises were two of the most frequently used interventions for this population. Specific VM exercises are favoured in some quarters based on the assumption that the VM has an important role in preventing excessive lateral patellar translation.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 14 - Nitric oxide release from endothelium is stimulated by all of the following EXCEPT...

    Incorrect

    • Nitric oxide release from endothelium is stimulated by all of the following EXCEPT for:

      Your Answer:

      Correct Answer: Noradrenaline

      Explanation:

      Nitric oxide (NO) production by the endothelium is increased by factors that elevate intracellular Ca2+, including local mediators such as bradykinin, histamine and serotonin, and some neurotransmitters (e.g. substance P). Increased flow (shear stress) also stimulates NO production and additionally activates prostacyclin synthesis. The basal production of NO continuously modulates vascular resistance; increased production of nitric oxide acts to cause vasodilation. Nitric oxide also inhibits platelet activation and thrombosis.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds

  • Question 15 - Antidiuretic hormone (ADH) has which of the following effects: ...

    Incorrect

    • Antidiuretic hormone (ADH) has which of the following effects:

      Your Answer:

      Correct Answer: Increases urine osmolality

      Explanation:

      ADH binds V2 receptors on renal principal cells in the late distal tubule and collecting ducts, raising cAMP levels and causing intracellular vesicles to fuse with the apical membrane. In their membrane these vesicles have water channels called aquaporins, which increase the water permeability allowing greater water reabsorption and concentration of urine. ADH also binds to V1 receptor receptors on vascular smooth muscle, causing vasoconstriction and enhancing the effect of aldosterone on sodium reabsorption in the distal tubule. ADH release is stimulated primarily by raised plasma osmolality detected by osmoreceptors in the anterior hypothalamus. Other factors that increase ADH release include: extracellular fluid volume depletion, angiotensin II, nausea, pain, stress, exercise, emotion, hypoglycaemia. ADH release is inhibited by low plasma osmolality, alcohol, caffeine, glucocorticoids and atrial natriuretic peptide (ANP). ADH deficiency (or an inadequate response to ADH) results in diabetes insipidus. Excess levels of ADH results in syndrome of inappropriate ADH secretion (SIADH).

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds

  • Question 16 - A 7-year old boy is referred to the Paediatrics Department due to slurred...

    Incorrect

    • A 7-year old boy is referred to the Paediatrics Department due to slurred speech. Upon further examination, the attending physician noted the presence of dysdiadochokinesia, intention tremors, and nystagmus. An MRI is taken, which revealed a brain tumour.

      Which of the following options is the most probable diagnosis given the clinical features of the patient?

      Your Answer:

      Correct Answer: Astrocytoma of cerebellum

      Explanation:

      Pilocytic astrocytoma (PCA), previously known as cystic cerebellar astrocytoma or juvenile pilocytic astrocytoma, was first described in 1931 by Harvey Cushing, based on a case series of cerebellar astrocytomas; though he never used these terms but rather described a spongioblastoma. They are low-grade, and usually well-circumscribed tumours, which tend to occur in young patients. By the World Health Organization (WHO) classification of central nervous system tumours, they are considered grade I gliomas and have a good prognosis.

      PCA most commonly occurs in the cerebellum but can also occur in the optic pathway, hypothalamus, and brainstem. They can also occur in the cerebral hemispheres, although this tends to be the case in young adults. Presentation and treatment vary for PCA in other locations. Glial cells include astrocytes, oligodendrocytes, ependymal cells, and microglia. Astrocytic tumours arise from astrocytes and are the most common tumour of glial origin. The WHO 2016 categorized these tumours as either diffuse gliomas or other astrocytic tumours. Diffuse gliomas include grade II and III diffuse astrocytomas, grade IV glioblastoma, and diffuse gliomas of childhood. The other astrocytic tumours group include PCA, pleomorphic xanthoastrocytoma, subependymal giant cell astrocytoma, and anaplastic pleomorphic xanthoastrocytoma.

      PCA can present with symptoms secondary to the posterior fossa mass effect. This may include obstructive hydrocephalus, with resultant headache, nausea and vomiting, and papilledema. If hydrocephalus occurs before the fusion of the cranial sutures (<18-months-of-age), then an increase in head circumference will likely occur. Lesions of the cerebellar hemisphere result in peripheral ataxia, dysmetria, intention tremor, nystagmus, and dysarthria. In contrast, lesions of the vermis cause a broad-based gait, truncal ataxia, and titubation. Posterior fossa lesions can also cause cranial nerve palsies. Diplopia may occur due to abducens palsy from the stretching of the nerve. They may also have blurred vision due to papilledema. Seizures are rare with posterior fossa lesions.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 17 - The fracture of the medial epicondyle will cause damage to the ulnar nerve....

    Incorrect

    • The fracture of the medial epicondyle will cause damage to the ulnar nerve. Which of the following motions would be impaired by this type of injury?

      Your Answer:

      Correct Answer: Adduction of the thumb

      Explanation:

      Fracture of the medial epicondyle is most likely to result in damage to the ulnar nerve.

      The three hypothenar muscles, two medial lumbricals, seven interossei, the adductor pollicis, and the deep head of the flexor pollicis brevis are all innervated by the deep branch of the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 18 - A 6-year-old female is brought to the Ophthalmology Clinic by her mother with...

    Incorrect

    • A 6-year-old female is brought to the Ophthalmology Clinic by her mother with the complaint of itching, redness, and a watery discharge of the right eye. Past medical history revealed an upper respiratory tract infection one week ago.

      On examination of the right eye, there is mild erythema of the palpebral conjunctiva and visible follicles seen on eversion of the eyelid, lid oedema, and subconjunctival petechial haemorrhages. The discharge is watery and not purulent.

      You diagnose her with viral conjunctivitis. According to the current NICE guidelines, which ONE of the following management options would NOT be included for this patient?

      Your Answer:

      Correct Answer: The child should be excluded from school until the infection has resolved

      Explanation:

      The NICE guidelines do NOT recommend isolating a patient with viral conjunctivitis from others or skipping school or work. The disease is contagious, but the spread of the disease can be controlled by maintaining good hygiene practices such as:
      1. frequent hand washing
      2. use of separate flannels and towels
      3. Avoid close contact with others

      Antibiotic prescriptions are not part of the NICE guidelines for viral conjunctivitis as they will not affect the course of the disease. Most cases of viral conjunctivitis are self-limiting and resolve within one to two weeks.

      The NICE guidelines recommend that symptoms may be eased with self-care measures such as:
      1. Bathing/cleaning the eyelids with cotton wool soaked in sterile saline or boiled and cooled water to remove any discharge
      2. Cool compresses applied gently around the eye area
      3. Use of lubricating drops or artificial tears

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 19 - Pancreatic ductal alkaline fluid secretion is mainly stimulated by which of the following hormones:...

    Incorrect

    • Pancreatic ductal alkaline fluid secretion is mainly stimulated by which of the following hormones:

      Your Answer:

      Correct Answer: Secretin

      Explanation:

      Pancreatic exocrine secretion is controlled by:
      Parasympathetic stimulation which enhances secretion of both the enzyme and aqueous components
      Sympathetic stimulation which inhibits pancreatic secretion
      Secretin which stimulates secretion of the alkaline-rich fluid from ductal cells
      Cholecystokinin which stimulates secretion of the enzyme-rich fluid from acinar cellsSomatostatin which inhibits secretion from both acinar and ductal cells
      Gastrin which stimulates pancreatic acinar cells to secrete digestive enzymes

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      0
      Seconds

  • Question 20 - 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:

      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
      0
      Seconds

  • Question 21 - A 42-year-old male patient, presenting with polyuria and polydipsia symptoms had normal blood...

    Incorrect

    • A 42-year-old male patient, presenting with polyuria and polydipsia symptoms had normal blood test results. Upon interview, he had mentioned being in a car accident in which he had a head injury. His polyuria and polydipsia symptoms are most likely associated with which of the following conditions?

      Your Answer:

      Correct Answer: Cranial diabetes insipidus

      Explanation:

      Polydipsia is the feeling of extreme thirstiness. It is often linked to polyuria, which is a urinary condition that causes a person to urinate excessively. The cycle of these two processes makes the body feel a constant need to replace the fluids lost in urination. In healthy adults, a 3 liter urinary output per day is considered normal. A person with polyuria can urinate up to 15 liters of urine per day. Both of these conditions are classic signs of diabetes.

      The other options are also types of diabetes, except for psychogenic polydipsia (PPD), which is the excessive volitional water intake seen in patients with severe mental illness or developmental disability. However, given the patient’s previous head injury, the most likely diagnosis is cranial diabetes insipidus.

      By definition, cranial diabetes insipidus is caused by damage to the hypothalamus or pituitary gland after an infection, operation, brain tumor, or head injury. And the patient’s history confirms this diagnosis. To define the other choices, nephrogenic diabetes insipidus happens when the structures in the kidneys are damaged and results in an inability to properly respond to antidiuretic hormone.

      Kidney damage can be caused by an inherited (genetic) disorder or a chronic kidney disorder. As with cranial diabetes insipidus, nephrogenic diabetes insipidus can also cause an elevated urine output.

      Diabetes mellitus is classified into two types, and the main difference between them is that type 1 diabetes is a genetic disorder, and type 2 diabetes is diet-related and develops over time. Type 1 diabetes is also known as insulin-dependent diabetes, in which the pancreas produces little or no insulin. Type 2 diabetes is termed insulin resistance, as cells don’t respond customarily to insulin.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      0
      Seconds

  • Question 22 - Which of the following movements is controlled by the pectoralis major muscle? ...

    Incorrect

    • Which of the following movements is controlled by the pectoralis major muscle?

      Your Answer:

      Correct Answer: Flexion, adduction and medial rotation of the humerus

      Explanation:

      The pectoralis major is a muscle that runs across the top of the chest and connects to a ridge on the back of the humerus (the bone of the upper arm).

      Adduction, or lowering, of the arm (opposed to the deltoideus muscle) and rotation of the arm forward around the axis of the body are two of its main functions.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 23 - One of your patients has been infected by an obligate pathogen and presents...

    Incorrect

    • One of your patients has been infected by an obligate pathogen and presents with features of this condition.

      Which of these is an example of an obligate pathogen?

      Your Answer:

      Correct Answer: Trepenoma pallidum

      Explanation:

      Treponema pallidum is an obligate pathogen. Obligate pathogens are almost always associated with disease and usually cannot survive outside of the body for long periods of time. Examples include and HIV.

      Staphylococcus aureus and Bacteroides fragilis are conditional pathogens. These are pathogens that usually cause disease only if certain conditions are met.

      Pneumocystis jiroveci and Pseudomonas aeruginosa, are opportunistic pathogens. These are pathogens that can only cause disease in an immunocompromised host or under unusual circumstances.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
      Seconds

  • Question 24 - A 4-year-old child has been convulsing for 20 minutes. She has received two...

    Incorrect

    • A 4-year-old child has been convulsing for 20 minutes. She has received two doses of lorazepam. She takes phenytoin for maintenance therapy, and you draw up a phenobarbitone infusion.
      What dose of phenobarbitone is advised in the treatment of the convulsing child that reaches that stage of the APLS algorithm? Select ONE answer only.

      Your Answer:

      Correct Answer: 20 mg/kg over 30-60 minutes

      Explanation:

      If a convulsing child reaches step 3 of the APLS algorithm, then a phenytoin infusion should be set up at 20 mg/kg over 20 minutes. If they are already taken phenytoin as maintenance therapy, then a phenobarbitone infusion should be set up at 20 mg/kg over 30-60 minutes.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 25 - A blood test of a 7-year-old child with a 6-day history of bloody...

    Incorrect

    • A blood test of a 7-year-old child with a 6-day history of bloody diarrhoea reveals a low platelet count, anaemia, and impaired kidney function. What bacteria is suspected of causing such a condition?

      Your Answer:

      Correct Answer: Escherichia coli

      Explanation:

      Escherichia coli produces shiga toxin that causes diarrhoea, hemorrhagic colitis, and haemolytic uremic syndrome.

      Haemolytic uremic syndrome is characterized by anaemia, thrombocytopenia, and acute renal failure. Transmission of E. coli is possible after consuming contaminated, undercooked drinks and foods. E. coli enters the body via the faecal-oral pathway.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

  • Question 26 - A 40-year-old woman presents with retrosternal central chest pain that she has been...

    Incorrect

    • A 40-year-old woman presents with retrosternal central chest pain that she has been complaining about for the past two days. Upon deep inspiration and while lying flat, the pain worsens but relieved by sitting forwards. The pain radiates to both of her shoulders. The result of her ECG shows widespread concave ST-elevation and PR depression. A diagnosis of pericarditis is suspected.

      Which of the following nerves is responsible for the pattern of her pain?

      Your Answer:

      Correct Answer: Phrenic nerve

      Explanation:

      Pericarditis is inflammation of the pericardial sac and is the most common pathologic process involving the pericardium. Frequently, pericardial inflammation can be accompanied by increased fluid accumulation within the pericardial sac forming a pericardial effusion, which may be serous, hemorrhagic or purulent depending on aetiology.

      The classic presentation is with chest pain that is central, severe, pleuritic (worse on deep inspiration) and positional (improved by sitting up and leaning forward). The pain may also be radiating and may involve the ridges of the trapezius muscle if the phrenic nerve is inflamed as it traverses the pericardium.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds

  • Question 27 - What is the approximate lifespan of the mature erythrocyte: ...

    Incorrect

    • What is the approximate lifespan of the mature erythrocyte:

      Your Answer:

      Correct Answer: 120 days

      Explanation:

      Erythrocytes have a normal lifespan of about 120 days. Mature erythrocytes are biconcave discs with no nucleus, ribosomes or mitochondria but with the ability to generate energy as ATP by the anaerobic glycolytic pathway. The red cell membrane consists of a bipolar lipid layer with a membrane skeleton of penetrating and integral proteins anchoring carbohydrate surface antigens. The shape and flexibility of red cells allows them to deform easily and pass through capillaries.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds

  • Question 28 - Which family of receptors does the glucagon receptor belong?
    ...

    Incorrect

    • Which family of receptors does the glucagon receptor belong?

      Your Answer:

      Correct Answer: G-protein coupled receptors

      Explanation:

      Glucagon binds to class B G-protein coupled receptors and activates adenylate cyclase, increasing cAMP intracellularly.

      This activates protein kinase A. Protein kinase A phosphorylates and activates important enzymes in target cells.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds

  • Question 29 - Regarding Gaussian sample distribution, which of the following statements is false? ...

    Incorrect

    • Regarding Gaussian sample distribution, which of the following statements is false?

      Your Answer:

      Correct Answer: It can be skewed left or right

      Explanation:

      Gaussian distribution, also known as normal distribution, is the most important probability distribution in statistics because it fits many natural phenomena. The normal distribution is a probability function that describes how the values of a variable are distributed. Below are its characteristics:

      (1) Bell-shaped and symmetrical about the mean
      (2) The mean, median, mode are all equal
      (3) The total area under the curve and above the x-axis is equal to 1
      (4) It has long tapering tails extending infinitely but never touching the x-axis
      (5) It is determined by its parameters: its mean and standard deviation
      (6) The standard deviation becomes a more meaningful quality than merely being a measure of dispersion

      The mean is the most common measure of central tendency. It is the sum of all observed values divided by the number of observation, and is also known as the ‘average’.

      The median is the value that falls in the middle position when the observations are ranked in order from the smallest to the largest. If the number of observations is odd, the median is the middle number. If it is even, the median is the average of the two middle numbers.

      The mode is the value that occurs with the greatest frequency in a set of observations, and is commonly used in public health statistics, such as the top 10 causes of mortality.

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds

  • Question 30 - Which of the following statements about vitamin B12 absorption is TRUE: ...

    Incorrect

    • Which of the following statements about vitamin B12 absorption is TRUE:

      Your Answer:

      Correct Answer: On ingestion, vitamin B12 is bound to R protein which protects it from digestion in the stomach.

      Explanation:

      The substance intrinsic factor,
      essential for absorption of vitamin B12 in the ileum, is
      secreted by the parietal cells along with the secretion of
      hydrochloric acid. When the acid-producing parietal
      cells of the stomach are destroyed, which frequently
      occurs in chronic gastritis, the person develops not only
      achlorhydria (lack of stomach acid secretion) but often
      also pernicious anaemia because of failure of maturation
      of the red blood cells in the absence of vitamin B12 stimulation of the bone marrow.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (1/2) 50%
Head And Neck (1/2) 50%
General Pathology (0/1) 0%
Pathology (0/1) 0%
Evidence Based Medicine (1/1) 100%
Statistics (1/1) 100%
Endocrine Physiology (1/1) 100%
Physiology (1/1) 100%
Passmed
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