00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Mins)
  • Question 1 - What is the main mechanism of action of flecainide: ...

    Incorrect

    • What is the main mechanism of action of flecainide:

      Your Answer: Blocks Ca2+ channels

      Correct Answer: Blocks Na+ channels

      Explanation:

      Flecainide inhibits the transmembrane influx of extracellular Na+ ions via fast channels on cardiac tissues resulting in a decrease in rate of depolarisation of the action potential, prolonging the PR and QRS intervals. At high concentrations, it exerts inhibitory effects on slow Ca2+ channels, accompanied by moderate negative inotropic effect.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      36.9
      Seconds
  • Question 2 - An 82 year old man has fever, left sided abdominal and back pain...

    Incorrect

    • An 82 year old man has fever, left sided abdominal and back pain and presents to the emergency room. Imaging reveals a large perinephric abscess. Which of the following most likely describes the fluid location:

      Your Answer: Between the renal capsule and the perinephric fat

      Correct Answer: Between the renal capsule and the renal fascia

      Explanation:

      The perinephric fat is immediately external to the renal capsule and completely surrounds the kidney. The renal fascia surrounds the perinephric fat and the paranephric fat is external to the renal fascia. The location of a perinephric abscess is in the perinephric fat between the renal capsule and the renal fascia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      2137.6
      Seconds
  • Question 3 - Cardiac muscle and skeletal muscle are alike, but there are a few key variations.
    Which...

    Correct

    • Cardiac muscle and skeletal muscle are alike, but there are a few key variations.
      Which of the following is NOT a characteristic of skeletal muscle but is a characteristic of cardiac muscle? 

      Your Answer: The presence of intercalated discs

      Explanation:

      Cardiac muscle is striated, and the sarcomere is the contractile unit, similar to skeletal muscle. Contracture is mediated by the interaction of calcium, troponins, and myofilaments, much as it occurs in skeletal muscle. Cardiac muscle, on the other hand, differs from skeletal muscle in a number of ways.

      In contrast to skeletal muscle cells, cardiac myocytes have a nucleus in the middle of the cell and sometimes two nuclei. The cells are striated because the thick and thin filaments are arranged in an orderly fashion, although the arrangement is less well-organized than in skeletal muscle.

      Intercalated discs, which work similarly to the Z band in skeletal muscle in defining where one cardiac muscle cell joins the next, are a very significant component of cardiac muscle.

      Adherens junctions and desmosomes, which are specialized structures that hold the cardiac myocytes together, are formed by the transverse sections. The lateral sections produce gap junctions, which join the cytoplasm of two cells directly, allowing for rapid action potential conduction. These critical properties allow the heart to contract in a coordinated manner, allowing for more efficient blood pumping.

      Cardiac myocytes have the ability to create their own action potentials, which is referred to as myogenic’. They can depolarize spontaneously to initiate a cardiac action potential. Pacemaker cells, as well as the sino-atrial (SA) and atrioventricular (AV) nodes, control this.

      The Purkinje cells and the cells of the bundle of His are likewise capable of spontaneous depolarization. While the bundle of His is made up of specialized myocytes, it’s vital to remember that Purkinje cells are not myocytes and have distinct characteristics. They are larger than myocytes, with fewer filaments and more gap junctions than myocytes. They conduct action potentials more quickly, allowing the ventricles to contract synchronously.
      Cardiac myocytes contract by excitation-contraction coupling, just like skeletal myocytes. Heart myocytes, on the other hand, utilise a calcium-induced calcium release mechanism that is unique to cardiac muscle (CICR). The influx of calcium ions (Ca2+) into the cell causes a ‘calcium spark,’ which causes more ions to be released into the cytoplasm.

      An influx of sodium ions induces an initial depolarisation, much as it does in skeletal muscle; however, in cardiac muscle, the inflow of Ca2+ sustains the depolarisation, allowing it to remain longer. Due to potassium ion (K+) inflow, CICR causes a plateau phase in which the cells remain depolarized for a short time before repolarizing. Skeletal muscle, on the other hand, repolarizes almost instantly.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      325.1
      Seconds
  • Question 4 - Regarding chronic idiopathic thrombocytopaenic purpura (ITP), which of the following statements is INCORRECT:...

    Incorrect

    • Regarding chronic idiopathic thrombocytopaenic purpura (ITP), which of the following statements is INCORRECT:

      Your Answer: ITP is a diagnosis of exclusion.

      Correct Answer: ITP is classically associated with massive splenomegaly.

      Explanation:

      Chronic ITP is a relatively common disorder. The highest incidence is in women aged 15 – 50 years. It is the most common cause of thrombocytopaenia without anaemia or neutropaenia. It is usually idiopathic but it may been seen in association with other conditions. Platelet autoantibodies (usually IgG) result in the premature removal of platelets from the circulation by macrophages of the reticuloendothelial system. In many causes the antibody is directed against the glycoprotein IIb/IIIa or Ib complex. The normal platelet lifespan of 10 days is reduced to a few hours. Total megakaryocyte mass and platelet turnover are increased to approximately five times normal. Despite the destruction of platelets by splenic macrophages, the spleen is normally not enlarged.  In fact, an enlarged spleen should lead to a search for other possible causes for the thrombocytopenia.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      19.3
      Seconds
  • Question 5 - Which of the following is the most common cause of megaloblastic anaemia: ...

    Incorrect

    • Which of the following is the most common cause of megaloblastic anaemia:

      Your Answer: Alcohol

      Correct Answer: Vitamin B12 deficiency

      Explanation:

      Megaloblastic anemia results from inhibition of DNA synthesis during red blood cell production. When DNA synthesis is impaired, the cell cycle cannot progress from the growth stage to the mitosis stage. This leads to continuing cell growth without division, which presents as macrocytosis, with an increase in mean corpuscular volume (MCV). The defect in red cell DNA synthesis is most often due to hypovitaminosis, specifically vitamin B12 deficiency or folate deficiency.
      Folate is an essential vitamin found in most foods, especially liver, green vegetables and yeast. The normal daily diet contains 200 – 250 μg, of which about 50% is absorbed. Daily adult requirements are about 100 μg. Absorption of folate is principally from the duodenum and jejunum. Stores of folate are normally only adequate for 4 months and so features of deficiency may be apparent after this time.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      20.4
      Seconds
  • Question 6 - The medial and lateral pterygoid muscles are innervated by which of the following...

    Correct

    • The medial and lateral pterygoid muscles are innervated by which of the following nerves:

      Your Answer: Mandibular division of the trigeminal nerve

      Explanation:

      Both the medial and lateral pterygoids are innervated by the mandibular division of the trigeminal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      98.4
      Seconds
  • Question 7 - When inserting a Seldinger chest drain for management of pneumothorax, the 'safe triangle'...

    Correct

    • When inserting a Seldinger chest drain for management of pneumothorax, the 'safe triangle' should be identified. Which of the following forms the inferior border of the 'safe triangle'?

      Your Answer: 5 th intercostal space

      Explanation:

      Care and management of the thoracostomy tubes (chest tubes) are subject to the direction and practice pattern of the responsible physician. Therefore, it is difficult to make a “one size fits all” set of instructions about the specific management recommendations for all chest tubes. It is recommended to discuss specific expectations for management with the patient’s attending physician. Facility specific Clinical Practice Guidelines (CPGs) may provide further guidance for one’s practice.

      Placement of the appropriately sized chest tube is performed on the affected side. The typical landmark for placement is the 4th or 5th intercostal space (nipple line for males, inframammary fold for females) at the anterior axillary line. The space above the 5th intercostal space and below the base of the axilla that is bordered posteriorly by the trapezius and anteriorly by the pectoralis muscle has recently been described as the safe triangle. Tubes are positioned anteriorly for pneumothoraces and posteriorly for fluid processes.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      15.9
      Seconds
  • Question 8 - A patient has a cardiac output of 4.8 L/min and a heart rate...

    Correct

    • A patient has a cardiac output of 4.8 L/min and a heart rate of 80 bpm, therefore their stroke volume is:

      Your Answer: 60 mL

      Explanation:

      Cardiac output (CO) = Stroke volume (SV) x Heart rate (HR).
      Therefore SV = CO/HR
      = 4.8/80
      = 0.06 L = 60 mL.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      131.4
      Seconds
  • Question 9 - Regarding local anaesthetics, which of the following statements is INCORRECT: ...

    Correct

    • Regarding local anaesthetics, which of the following statements is INCORRECT:

      Your Answer: Adrenaline should be used in digital nerve blocks to create a bloodless field.

      Explanation:

      It is not advisable to give adrenaline/epinephrine with a local anaesthetic injection in digits or appendages because of the risk of ischaemic necrosis.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      429.1
      Seconds
  • Question 10 - A patient suffers from an injury to his hip and thigh. As a...

    Incorrect

    • A patient suffers from an injury to his hip and thigh. As a consequence of his injury, the nerve that was damaged innervates the obturator externus muscle.

      In which of the following nerves is the obturator externus muscle innervated by?

      Your Answer: The posterior division of the femoral nerve

      Correct Answer: Posterior branch of the obturator nerve

      Explanation:

      The obturator externus is innervated by the posterior branch of the obturator nerve, L2-L4.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      39.5
      Seconds
  • Question 11 - A 5-year-old girl presents in a paediatric clinic with symptoms of viral gastroenteritis....

    Incorrect

    • A 5-year-old girl presents in a paediatric clinic with symptoms of viral gastroenteritis. You encourage the mother to treat the child at home with oral rehydration therapy (ORT), e.g. dioralyte.

      Out of the following, which statement is FALSE regarding the use of ORT in the management of gastroenteritis?

      Your Answer: To prevent dehydration, a child with diarrhoea should drink 200 ml of ORT after each loose stool

      Correct Answer: ORT is sugar-free

      Explanation:

      One of the major complications of gastroenteritis is dehydration. Choosing the correct fluid replacement therapy is essential according to a patient’s hydration status.

      Oral rehydration therapy (ORT) refers to the restitution of water and electrolyte deficits in dehydrated patients using an oral rehydration salt (ORS) solution. It is a fluid replacement strategy that is less invasive than other strategies for fluid replacement and has successfully lowered the mortality rate of diarrhoea in developing countries.

      Some characteristics of Oral rehydration solutions are:
      – slightly hypo-osmolar (about 250 mmol/litre) to prevent the possible induction of osmotic diarrhoea.
      – contain glucose (e.g. 90 mmol/L in dioralyte). The addition of glucose improves sodium and water absorption in the bowel and prevents hypoglycaemia.
      – also contains essential mineral salts

      Current NICE guidance recommends that 50 ml/kg is given over 4 hours to treat mild dehydration.
      Once rehydrated, a child should continue with their usual daily fluid intake plus 200 ml ORT after each loose stool. In an infant, give ORT at 1-1.5 x the normal feed volume and in an adult, give 200-400 ml after each loose stool.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Pharmacology
      609.2
      Seconds
  • Question 12 - Which of the following nerves provides cutaneous innervation to the posterior surface of...

    Incorrect

    • Which of the following nerves provides cutaneous innervation to the posterior surface of the scrotum?

      Your Answer: Branch of the ilioinguinal nerve

      Correct Answer: Branch of the perineal nerve

      Explanation:

      The following nerves provide cutaneous innervation to the scrotum, and other anatomic structures:

      The perineal nerve supplies the muscles in the urogenital triangle, and the skin on the posterior surface of the scrotum (or labia majora).

      The genital branch of the genitofemoral nerve supplies the cremaster muscle, the skin over the anterior surface of the thigh, and the anterolateral surface of the scrotum.

      The ilioinguinal nerve supplies the external oblique, internal oblique, transversus abdominis, skin of the upper medial aspect of thigh, the root of the penis and the anterior surface of the scrotum in the male, and the mons pubis and labia majora in the female.

      The posterior cutaneous nerve of the thigh, or posterior femoral cutaneous nerve, supplies the skin over the lower medial quadrant of the buttock, the inferior skin of the scrotum or labium majus, and the back of the thigh and the upper part of the leg.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      86
      Seconds
  • Question 13 - Glomerular filtration rate can be calculated using any substance that: ...

    Incorrect

    • Glomerular filtration rate can be calculated using any substance that:

      Your Answer: is freely filtered and completely reabsorbed by the nephron

      Correct Answer: is freely filtered and neither reabsorbed nor secreted by the nephron

      Explanation:

      Clearance of a substance can provide an accurate estimate of the glomerular filtration rate (GFR) provided that the substance is:freely filterednot reabsorbed in the nephronnot secreted in the nephronnot synthesised or metabolised by the kidney

    • This question is part of the following fields:

      • Physiology
      • Renal
      40.6
      Seconds
  • Question 14 - A patient with a history of worsening chronic breathlessness on exertion undergoes lung...

    Correct

    • A patient with a history of worsening chronic breathlessness on exertion undergoes lung function testing. The results demonstrate an FEV 1 that is 58% predicted and an FEV 1 /FVC ratio less than 0.7.
      Which of the following is the most likely diagnosis? Select ONE answer only.

      Your Answer: COPD

      Explanation:

      Obstructive lung disorders are characterised by airway obstruction. Many obstructive diseases of the lung result from narrowing of the smaller bronchi and larger bronchioles, often because of excessive contraction of the smooth muscle itself.
      In obstructive lung disease, FEV1is reduced to <80% of normal and FVC is usually reduced but to a lesser extent than FEV1. The FEV1/FVC ratio is reduced to <0.7.
      Types of obstructive lung disorders include:
      Chronic obstructive pulmonary disease (COPD)
      Asthma
      Bronchiectasis

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      24.2
      Seconds
  • Question 15 - A 6-year-old child with a few itchy honey crusted sores on her left...

    Incorrect

    • A 6-year-old child with a few itchy honey crusted sores on her left cheek is brought in by her mother. Following a thorough examination of the child, you diagnose impetigo and recommend a course of topical fusidic acid.

      Fusidic acid's mode of action is which of the following?

      Your Answer: Disrupting the DNA of microbial cells

      Correct Answer: Inhibition of protein synthesis

      Explanation:

      By binding EF-G-GDP, fusidic acid prevents both peptide translocation and ribosome disassembly, which slows protein synthesis. Because it has a novel structure and mechanism of action, it is unlikely to cause cross-resistance with existing antibiotics.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      610.6
      Seconds
  • Question 16 - 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 17 - What is the primary route of transmission of Norovirus? ...

    Incorrect

    • What is the primary route of transmission of Norovirus?

      Your Answer: Respiratory droplet spread

      Correct Answer: Oral-faecal route

      Explanation:

      Norovirus is spread primarily by faecal-oral contact, but it can also be spread through contact with an infected person, ingestion of contaminated food or water, or contact with contaminated surfaces or items.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      10.9
      Seconds
  • Question 18 - A 71-year-old man treated with antibiotics for a chest infection returns with a...

    Correct

    • 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.

      The action most effective at minimizing spread to other patients is?

      Your Answer: Hand washing

      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.

      Wearing an apron and gloves, and isolation to a side room are important contact precautions. They are, however, ineffective if hand washing is neglected.

      Although oral vancomycin is the first-line treatment for C. difficile associated diarrhoea, it will not limit patient to patient spread.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      36.6
      Seconds
  • Question 19 - The neurotransmitter in the synaptic cleft is either eliminated or deactivated after the...

    Incorrect

    • The neurotransmitter in the synaptic cleft is either eliminated or deactivated after the postsynaptic cell responds to the neurotransmitter.

      Which of the following enzymes catalyses the breakdown of noradrenaline?

      Your Answer: Phenylethanolamine N-methyltransferase (PNMT)

      Correct Answer: Catechol-O-methyltransferase (COMT)

      Explanation:

      The neurotransmitter in the synaptic cleft is either eliminated or deactivated after the post-synaptic cell responds to the neurotransmitter.

      This can be accomplished in a variety of ways:
      Re-uptake
      Breakdown
      Diffusion

      Serotonin is an example of a neurotransmitter that is uptake. Serotonin is absorbed back into the presynaptic neuron via the serotonin transporter (SERT), which is found in the presynaptic membrane. Re-uptake neurotransmitters are either recycled by repackaging into vesicles or broken down by enzymes.
      Specific enzymes found in the synaptic cleft can also break down neurotransmitters. The following enzymes are examples of these enzymes:
      Acetylcholinesterase (AChE) catalyses the acetylcholine breakdown (ACh)
      The enzyme catechol-O-methyltransferase (COMT) catalyses the breakdown of catecholamines like adrenaline , dopamine and noradrenaline.

      The breakdown of catecholamines, as well as other monoamines like serotonin, tyramine, and tryptamine, is catalysed by monoamine oxidases (MOA).
      Diffusion of neurotransmitters into nearby locations can also be used to eliminate them.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      156.1
      Seconds
  • Question 20 - Aldin is a 24-year-old male patient who arrives at the emergency department diagnosed...

    Incorrect

    • Aldin is a 24-year-old male patient who arrives at the emergency department diagnosed with psittacosis based on his symptoms and history of being a pigeon enthusiast. Which of the following is the causative bacteria of psittacosis?

      Your Answer: Mycoplasma pneumoniae

      Correct Answer: Chlamydia psittaci

      Explanation:

      Chlamydia psittaci is a microorganism that is commonly found in birds.

      These bacteria can infect people and cause psittacosis. Psittacosis is an infectious disease that may cause high fever and pneumonia associated with headaches, altered mental state, and hepatosplenomegaly.

    • This question is part of the following fields:

      • Infections
      • Microbiology
      63.6
      Seconds
  • Question 21 - A 67-year-old woman complains of general malaise, nausea, and vomiting. She is perplexed...

    Incorrect

    • A 67-year-old woman complains of general malaise, nausea, and vomiting. She is perplexed and declares that everything 'looks yellow.' Her potassium level is 6.8 mmol/l, according to a blood test.

      Which of the drugs listed below is most likely to be the cause of her symptoms?

      Your Answer: Aspirin

      Correct Answer: Digoxin

      Explanation:

      Because digoxin has a narrow therapeutic index, it can cause toxicity both during long-term therapy and after an overdose. Even when the serum digoxin concentration is within the therapeutic range, it can happen.

      Acute digoxin toxicity usually manifests itself within 2-4 hours of an overdose, with serum levels peaking around 6 hours after ingestion and life-threatening cardiovascular complications following 8-12 hours.

      Chronic digoxin toxicity is most common in the elderly or those with impaired renal function, and it is often caused by a coexisting illness. The clinical signs and symptoms usually appear gradually over days to weeks.

      The following are characteristics of digoxin toxicity:
      Nausea and vomiting
      Diarrhoea
      Abdominal pain
      Confusion
      Tachyarrhythmias or bradyarrhythmias
      Xanthopsia (yellow-green vision)
      Hyperkalaemia (early sign of significant toxicity)

      Some precipitating factors are as follows:
      Elderly patients
      Renal failure
      Myocardial ischaemia
      Hypokalaemia
      Hypomagnesaemia
      Hypercalcaemia
      Hypernatraemia
      Acidosis
      Hypothyroidism
      Spironolactone
      Amiodarone
      Quinidine
      Verapamil
      Diltiazem

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      88.5
      Seconds
  • Question 22 - You are giving a presentation on the immune system as part of your...

    Correct

    • You are giving a presentation on the immune system as part of your peer-to-peer teaching sessions. Yu are currently discussing phagocytes. Macrophages are derived from which of the following cells:

      Your Answer: Monocytes

      Explanation:

      Monocytes spend only a short time in the marrow and, after circulating for 20-40 hours, leave the blood to enter the tissues where they become macrophages. Macrophages form the reticuloendothelial system in the liver, spleen and lymph nodes. The lifespan of macrophages may be as long as several months or even years. In tissues the macrophages become self-replicating without replenishment from the blood. They assume specific functions in different tissues e.g. dendritic cells which are involved in antigen presentation to T-cells. Macrophages may be activated by cytokines such as IFN-gamma, contact with complement or direct contact with the target cell through leucocyte adhesion molecules.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      138.2
      Seconds
  • Question 23 - 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: Clostridium difficile

      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
      244.8
      Seconds
  • Question 24 - Adenosine has a half-life of approximately: ...

    Correct

    • Adenosine has a half-life of approximately:

      Your Answer: 8 - 10 seconds

      Explanation:

      Adenosine stimulates A1-adenosine receptors and opens acetylcholine sensitive K+ channels, increasing K+ efflux. This hyperpolarises the cell membrane in the atrioventricular node and, by inhibiting the calcium channels, slows conduction in the AVN. As it has a very short duration of action (half-life only about 8 – 10 seconds), most side effects are short lived.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      8.1
      Seconds
  • Question 25 - Which of the following factors does NOT decrease glucagon secretion: ...

    Correct

    • Which of the following factors does NOT decrease glucagon secretion:

      Your Answer: Catecholamines

      Explanation:

      Factors that increase glucagon secretion:
      ↓ Blood glucose
      ↑ Amino acids
      Cholecystokinin
      Catecholamines
      Acetylcholine

      Factors that decrease glucagon secretion:
      ↑ Blood glucose
      Insulin
      Somatostatin
      Fatty acids, ketoacids

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      35.9
      Seconds
  • Question 26 - A patient with diplopia is found to have eye deviation downwards and outwards....

    Incorrect

    • A patient with diplopia is found to have eye deviation downwards and outwards. The likely nerves that are affected are:

      Your Answer: Optic nerve

      Correct Answer: Oculomotor nerve

      Explanation:

      The results of an oculomotor (CN III) nerve palsy are a depressed and abducted (down and out) eye, ptosis, diplopia, and a fixed and dilated pupil.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      10.3
      Seconds
  • Question 27 - A patient in a high-dependency unit complains of severe and painful muscle cramps....

    Incorrect

    • A patient in a high-dependency unit complains of severe and painful muscle cramps. His total corrected plasma calcium level is 1.90 mmol/L.

      What is the most likely underlying cause?

      Your Answer: Addison’s disease

      Correct Answer: Rhabdomyolysis

      Explanation:

      Hypocalcaemia occurs when there is abnormally low level of serum calcium ( >2.2 mmol/l) after correction for the serum albumin concentration.

      Rhabdomyolysis causes hyperphosphatemia, and this leads to a reduction in ionised calcium levels.

      Patients with rhabdomyolysis are commonly cared for in a high dependency care setting.

      Addison’s disease, hyperthyroidism, thiazide diuretics and lithium all cause hypercalcaemia.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      287.8
      Seconds
  • Question 28 - Regarding amoxicillin, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer: It is better absorbed than ampicillin when given orally.

      Correct 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
      30
      Seconds
  • Question 29 - A newborn baby is referred by the community midwife who is concerned the...

    Incorrect

    • A newborn baby is referred by the community midwife who is concerned the baby is jaundiced because of the yellow appearance of his eyes and skin following a postnatal home visit. The jaundice is visible in the baby’s feet making her worried.

      Jaundice are visible in the extremities of neonates at what approximate threshold bilirubin level?

      Your Answer: 185 μmol/L

      Correct Answer: 255 μmol/L

      Explanation:

      Newborn babies have a higher concentration of red blood cells with shorter lifespan leading to higher bilirubin levels than in adults. This condition is short-lived and harmless but with potential serious causes that need to be assessed for if present.

      The most obvious physical sign of jaundice is a yellow discolouration of the sclera, skin and mucous membranes. At a bilirubin level of 35 μmol/L or higher, the eye is affected. The bilirubin level will need to be higher than 255 μmol/L for the feet and extremities to be affected.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      20.2
      Seconds
  • Question 30 - Dysuria and urinary frequency are symptoms of a 29-year-old woman. A urine dipstick...

    Incorrect

    • Dysuria and urinary frequency are symptoms of a 29-year-old woman. A urine dipstick is used to detect the presence of blood, protein, leucocytes, and nitrites in the urine. You diagnose a urinary tract infection and give antibiotics to the patient.

      In the United Kingdom, which of the following antibiotics has the highest percentage of E.coli resistance?

      Your Answer: Nitrofurantoin

      Correct Answer: Trimethoprim

      Explanation:

      In the United Kingdom, antibiotic resistance is becoming a significant factor in the treatment of urinary tract infections and pyelonephritis. E. coli (the main causative organism of both urinary tract infections and acute pyelonephritis) resistance to the following antibiotics in laboratory-processed urine specimens is:
      30.3 percent trimethoprim (varies by area from 27.1 to 33.4 percent )
      19.8 percent co-amoxiclav (varies by area from 10.8 to 30.7 percent )
      Ciprofloxacin (Cipro): 10.6% (varies by area from 7.8 to 13.7 percent )
      Cefalexin has a concentration of 9.9%. (varies by area from 8.1 to 11.4 percent )

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      31
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (2/3) 67%
Pharmacology (2/8) 25%
Abdomen (0/1) 0%
Anatomy (2/6) 33%
Basic Cellular Physiology (1/2) 50%
Physiology (5/8) 63%
Haematology (0/2) 0%
Pathology (1/4) 25%
Head And Neck (1/1) 100%
Thorax (1/1) 100%
Anaesthesia (1/1) 100%
Lower Limb (0/1) 0%
Fluids & Electrolytes (0/1) 0%
Abdomen And Pelvis (0/1) 0%
Renal (0/1) 0%
Respiratory Physiology (1/1) 100%
Infections (0/4) 0%
Endocrine (2/2) 100%
Microbiology (1/4) 25%
Pathogens (0/2) 0%
Specific Pathogen Groups (1/1) 100%
Cardiovascular Pharmacology (0/1) 0%
Immune Responses (1/1) 100%
Cranial Nerve Lesions (0/1) 0%
Endocrine Physiology (0/1) 0%
General Pathology (0/1) 0%
Passmed