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  • Question 1 - A 50-year-old man from Russia presents with a history of cough with blood-stained...

    Correct

    • A 50-year-old man from Russia presents with a history of cough with blood-stained sputum, fever, night sweats, and weight loss. Suspecting tuberculosis, you begin investigations.

      All the following statements regarding tuberculosis (TB) are true EXCEPT?

      Your Answer: Corticosteroid use is not a risk factor for developing TB

      Explanation:

      Immunosuppressants like corticosteroids may be an important risk factor for developing tuberculosis.

      All of the other statements are true.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      59.1
      Seconds

  • Question 2 - Which of the following ions normally has the highest concentration in intracellular fluid: ...

    Correct

    • Which of the following ions normally has the highest concentration in intracellular fluid:

      Your Answer: K +

      Explanation:

      Potassium (K+) is the principal intracellular ion; approximately 4 mmol/L is extracellular (3%) and 140 mmol/L intracellular (97%).

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      5.7
      Seconds

  • Question 3 - The ventilation over perfusion ratio is highest at the apex of the lung....

    Incorrect

    • The ventilation over perfusion ratio is highest at the apex of the lung. What is the approximate V/Q ratio at this area?

      Your Answer: 2.1

      Correct Answer: 3.3

      Explanation:

      The ventilation/perfusion ratio (V/Q ratio) is a ratio used to assess the efficiency and adequacy of the matching ventilation and perfusion. The ideal V/Q ratio is 1.

      Any mismatch between ventilation and perfusion will be evident in the V/Q ratio. If perfusion is normal but ventilation is reduced, the V/Q ratio will be less than 1, whereas if ventilation is normal, but perfusion is reduced, the V/Q ratio will be greater than 1.

      If the alveoli were ventilated but not perfused at all, then the V/Q ratio would be infinity. The V/Q ratio is also affected by location. The various areas of the lungs have a different V/Q ratio since ventilation and perfusion increase from the apex to the base of the lungs. The apex of the lungs has a V/Q ratio of approximately 3.3.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      76.3
      Seconds

  • Question 4 - Which of the following diseases is caused by a build-up of lymphoblasts in...

    Correct

    • Which of the following diseases is caused by a build-up of lymphoblasts in the bone marrow?

      Your Answer: Acute lymphoblastic leukaemia

      Explanation:

      Acute lymphoblastic leukaemia (ALL) is a clonal (malignant) bone marrow disorder in which early lymphoid precursors multiply and replace the marrow’s normal hematopoietic cells. ALL is most common between the ages of 3 and 7, with 75 percent of cases occurring before the age of 6.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      18.4
      Seconds

  • Question 5 - A patient suffers a stab wound to the neck. The entry point of...

    Incorrect

    • A patient suffers a stab wound to the neck. The entry point of the blade is situated within the posterior triangle of the neck.
      Which of the following muscles is most likely to be involved? Select ONE answer only.

      Your Answer: Trapezius

      Correct Answer: Anterior scalene

      Explanation:

      The anterior triangle is the triangular area of the neck found anteriorly to the sternocleidomastoid muscle. It is formed by the anterior border of sternocleidomastoid laterally, the median line of the neck medially and by the inferior border of the mandible superiorly. The apex of the anterior triangle extends towards the manubrium sterni. The anterior triangle contains:
      Muscles: thyrohyoid, sternothyroid, sternohyoid muscles
      Organs: thyroid gland, parathyroid glands, larynx, trachea, esophagus, submandibular gland, caudal part of the parotid gland
      Arteries: superior and inferior thyroid, common carotid, external carotid, internal carotid artery (and sinus), facial, submental, lingual arteries
      Veins: anterior jugular veins, internal jugular, common facial, lingual, superior thyroid, middle thyroid veins, facial vein, submental vein, lingual veins
      Nerves: vagus nerve (CN X), hypoglossal nerve (CN XII), part of sympathetic trunk, mylohyoid nerve

      The posterior triangle is a triangular area found posteriorly to the sternocleidomastoid muscle. It has three borders; anterior, posterior and inferior borders. The anterior border is the posterior margin of the sternocleidomastoid muscle. The posterior border is the anterior margin of the trapezius muscle, while the inferior border is the middle one-third of the clavicle. The investing layer of deep cervical fascia and integument forms the roof of the space, while the floor is covered with the prevertebral fascia along with levator scapulae, splenius capitis and the scalene muscles. The inferior belly of omohyoid subdivides the posterior triangle into a small supraclavicular, and a large occipital, triangle.
      Contents:
      Vessels: the third part of the subclavian artery, suprascapular and transverse cervical branches of the thyrocervical trunk, external jugular vein, lymph nodes
      Nerves: accessory nerve (CN XI), the trunks of the brachial plexus, fibers of the cervical plexus
      Of the muscles listed in the options, only the anterior scalene is situated within the posterior triangle of the neck.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      30.9
      Seconds

  • Question 6 - A patient has a diagnosis of acute osteomyelitis. They have no joint prosthesis...

    Correct

    • A patient has a diagnosis of acute osteomyelitis. They have no joint prosthesis on indwelling metal work and no known drug allergies. He has had a recent skin swab that has cultured MRSA and MRSA infection is suspected.
      Which of the following antibacterial agents would be most appropriate to prescribe in this case? Select ONE answer only.

      Your Answer: Vancomycin

      Explanation:

      In the majority of patients the commonest causative organism for osteomyelitis isStaphylococcus aureus.Salmonella spp. are the commonest cause in patients with sickle cell disease.
      Other bacteria that can cause osteomyelitis include:
      Enterobacter spp.
      Group A and B streptococcus
      Haemophilus influenzae
      The current recommendations by NICE and the BNF on the treatment of osteomyelitis are:
      Flucloxacillin first-line
      Consider adding fusidic acid or rifampicin for initial 2 weeks
      If penicillin allergic use clindamycin
      If MRSA is suspected use vancomycin
      Suggested duration of treatment is 6 weeks for acute infection

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      21.4
      Seconds

  • Question 7 - A 60-year-old male presents to the genitourinary clinic with dysuria and urinary frequency...

    Correct

    • A 60-year-old male presents to the genitourinary clinic with dysuria and urinary frequency complaints. He has a past medical history of benign prostate enlargement, for which he has been taking tamsulosin. There is blood, protein, leucocytes, and nitrites on a urine dipstick. Fresh blood tests were sent, and his estimated GFR is calculated to be >60 ml/minute. A urinary tract infection (UTI) diagnosis is made, and he is prescribed antibiotics. Out of the following, which antibiotic is most appropriate to be prescribed to this patient?

      Your Answer: Ciprofloxacin

      Explanation:

      URINARY TRACT INFECTIONS IN ADULT MEN
      Symptomatic urinary tract infections are much less common in men than in women, and all UTIs
      in men are considered complicated UTIs. Men with UTIs should be evaluated for predisposing or
      causative factors.

      Uncomplicated cystitis

      • Fosfomycin, oral, 3 g as a single dose.

      If fosfomycin is unavailable:

      • Nitrofurantoin, oral, 100 mg 6 hourly for 5 days.

      Do not use nitrofurantoin or fosfomycin if there is any suspicion of early pyelonephritis as they do
      not achieve adequate renal tissue levels.
      If there are any factors precluding the use of the above agents, then a beta-lactam should be used.
      Options include:
      Cefixime 200 mg PO 12 hourly for 7 days
      OR
      Cefpodoxime 100 mg PO 12 hourly for 7 days

      Complicated cystitis
      Adults

      • Ciprofloxacin 500 mg PO 12 hourly
        OR
      • Levofloxacin 750 mg PO once daily

      Empiric antibiotic therapy should be changed based upon the bacteria isolated and its
      antimicrobial susceptibility.
      Treat for a total of 7–14 days

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      42.5
      Seconds

  • Question 8 - Which of the following is an example of discrete data: ...

    Incorrect

    • Which of the following is an example of discrete data:

      Your Answer:

      Correct Answer: Number of children

      Explanation:

      Discrete data is quantitative data that can only take whole numerical values e.g. number of children, number of days missed from work.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      0
      Seconds

  • Question 9 - A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense,...

    Incorrect

    • A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense, vibratory sense, and discriminatory touch. Upon further physical examination, it was observed that her tongue deviates to the left-hand side. An MRI and CT scan was ordered and results showed that he was suffering a left-sided stroke.

      Which of the following is considered the best diagnosis for the case presented above?

      Your Answer:

      Correct Answer: Medial medullary syndrome

      Explanation:

      Medial medullary syndrome is a form of stroke that affects the medial medulla of the brain. It is caused by a lesion in the medial part of the medulla, which is due to an infraction of vertebral arteries and/or paramedian branches of the anterior spinal artery.

      It is characterized by contralateral paralysis of the upper and lower limb of the body, a contralateral decrease in proprioception, vibration, and/or fine touch sensation, paresthesias or less commonly dysesthesias in the contralateral trunk and lower limb, and loss of position and vibration sense with proprioceptive dysfunction. Ipsilateral deviation of the tongue due to ipsilateral hypoglossal nerve damage can also be seen.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 10 - Identify the type of graph described below:

    This graph has been used to create...

    Incorrect

    • Identify the type of graph described below:

      This graph has been used to create visual representations to communicate the risks and benefits of treatments using 4 face categories.

      Your Answer:

      Correct Answer: Cates plot

      Explanation:

      Cates Plot, since 1999, has been used to create visual representations to communicate the risks and benefits of treatments. The essence of Cates Plot is the use of 4 face categories to visually indicate the following:

      People not affected by a treatment (green faces for those with a good outcome and red for those with a bad outcome)
      People for which treatment changes their category from a bad outcome to a good outcome (yellow faces)
      People for which treatment causes an adverse event and changes their category from a good outcome to a bad outcome (crossed out green faces)

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds

  • Question 11 - A 22-year-old man arrives at the emergency department with a sore throat, low-grade...

    Incorrect

    • A 22-year-old man arrives at the emergency department with a sore throat, low-grade fever, and malaise. His partner has infectious mononucleosis, which was recently diagnosed. In this situation, which of the following cells is the most proliferative:

      Your Answer:

      Correct Answer: Lymphocytes

      Explanation:

      Histologic findings in EBV infectious mononucleosis: Oropharyngeal epithelium demonstrates an intense lymphoproliferative response in the cells of the oropharynx. The lymph nodes and spleen show lymphocytic infiltration primarily in the periphery of a lymph node.
      Relative lymphocytosis (≥ 60%) plus atypical lymphocytosis (≥ 10%) are the characteristic findings of Epstein Barr virus (EBV) infectious mononucleosis.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds

  • Question 12 - You evaluate a 80-year-old man who has a history of persistent heart failure...

    Incorrect

    • You evaluate a 80-year-old man who has a history of persistent heart failure and discover that he has generalised oedema.

      Which of the following claims regarding capillary hydrostatic pressure (P c) is false?

      Your Answer:

      Correct Answer: P c increases along the length of the capillary, from arteriole to venule

      Explanation:

      The capillary hydrostatic pressure (Pc) is normally between 15 and 30 millimetres of mercury. Pc Decreases along the capillary’s length, mirroring the arteriolar and venule pressures proximally and distally.
      Pc is determined by the ratio of arteriolar resistance (RA) to venular resistance (RV).

      When the RA/RV ratio is high, the pressure drop across the capillary is modest, and Pcis is close to venule pressure.

      When the ratio of RA/RV is low, the pressure drop across the capillary is considerable, and Pcis is close to arteriolar pressure.

      Pcis closer to the venule pressure and thus more responsive to changes in venous pressure than arteriolar pressure when RA/RV is high.

      Pcis the major force behind fluid pushing out of the capillary bed and into the interstitium.
      It is also the most variable of the forces affecting fluid transport at the capillary, partly because sympathetic-mediated arteriolar vasoconstriction varies.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      0
      Seconds

  • Question 13 - What is the main mechanism of action of cyclizine: ...

    Incorrect

    • What is the main mechanism of action of cyclizine:

      Your Answer:

      Correct Answer: Histamine-H1 antagonist

      Explanation:

      Antihistamines e.g. cyclizine, are effective against nausea and vomiting caused by many different conditions, including motion sickness and vertigo. These agents act by inhibiting histamine pathways, and cholinergic pathways involved in transmission from the vestibular apparatus to the vomiting centre. There is no evidence that any one antihistamine is superior to another but their duration of action and incidence of adverse effects differ. Adverse effects include drowsiness and antimuscarinic effects such as blurred vision, dry mouth, urinary retention, constipation and confusion.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 14 - Regarding the renin-angiotensin-aldosterone system (RAAS), which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the renin-angiotensin-aldosterone system (RAAS), which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Angiotensin II has a predominant vasoconstrictor effect on the efferent arteriole.

      Explanation:

      Angiotensin II constricts both the afferent and efferent arterioles, but preferentially increases efferent resistance. The net effect of the more prominent increase in efferent tone is that the intraglomerular pressure is stable or increased, thereby tending to maintain or even raise the GFR. Renin is produced by granular cells of the juxtaglomerular apparatus. Renin cleaves plasma angiotensinogen (produced in the liver) into angiotensin I. Angiotensin I is converted by angiotensin-converting enzyme (ACE) on pulmonary endothelial cells to angiotensin II. Angiotensin II acts to potentiate sympathetic activity (positive feedback).

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds

  • Question 15 - You need to give your patient antibiotics, so you call microbiology for some advice.

    Of...

    Incorrect

    • You need to give your patient antibiotics, so you call microbiology for some advice.

      Of the following antibacterial drugs, which of them is a protein synthesis inhibitor?

      Your Answer:

      Correct Answer: Erythromycin

      Explanation:

      Bacteriostatic antibiotics include erythromycin and other macrolides. They work by attaching to the bacterial ribosome’s 50S subunit, preventing translocation and, as a result, inhibit protein synthesis. Macrolide antibiotics are actively concentrated inside leukocytes and delivered into the infection site as a result.

      Action Mechanisms- Examples:

      Cell wall production is inhibited
      Vancomycin
      Vancomycin
      Cephalosporins

      The function of the cell membrane is disrupted
      Nystatin
      Polymyxins
      Amphotericin B

      Inhibition of protein synthesis
      Chloramphenicol
      Macrolides
      Aminoglycosides
      Tetracyclines

      Nucleic acid synthesis inhibition
      Quinolones
      Trimethoprim
      Rifampicin
      5-nitroimidazoles
      Sulphonamides
      Anti-metabolic activity
      Isoniazid

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds

  • Question 16 - You examine a child who has been admitted to the paediatric emergency department...

    Incorrect

    • You examine a child who has been admitted to the paediatric emergency department with a flu-like illness. His parents tell you that he was born with an inborn defect of steroid metabolism and that he was treated for it with hormone replacement therapy.

      Which of the following is classified as a steroid hormone?

      Your Answer:

      Correct Answer: Aldosterone

      Explanation:

      Hormones can be classified into three categories depending on their chemical composition: amines, peptides (and proteins), and steroids. Amines are made up of single amino acids (for example, tyrosine), peptide hormones are made up of peptides (or proteins), and steroid hormones are made up of cholesterol.
      The table below lists some prominent instances of each of these three hormone classes:

      1. Peptide hormone:
      Adrenocorticotropic hormone (ACTH)
      Prolactin
      Vasopressin
      Oxytocin
      Glucagon
      Insulin
      Somatostatin
      Cholecystokinin

      2. Amine hormone:
      Adrenaline (epinephrine)
      Noradrenaline (norepinephrine)
      Dopamine

      3. Steroid hormone:
      Mineralocorticoids (e.g. aldosterone)
      Glucocorticoids (e.g. cortisol)
      Progestogens
      Androgens
      Oestrogens

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds

  • Question 17 - Which of the following is NOT a typical side effect of thiopental sodium:...

    Incorrect

    • Which of the following is NOT a typical side effect of thiopental sodium:

      Your Answer:

      Correct Answer: Seizures

      Explanation:

      Extravasation of thiopental during injection can lead to tissue damage. Accidental intra-arterial injection causes vasospasm and may lead to thrombosis and tissue necrosis. Other side effects include involuntary muscle movements on induction, cough and laryngospasm, arrhythmias, hypotension, headache and hypersensitivity reactions. Thiopental sodium has anticonvulsant properties and does not cause seizures.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      0
      Seconds

  • Question 18 - Which of the following is NOT a mineralocorticoid effect of corticosteroids: ...

    Incorrect

    • Which of the following is NOT a mineralocorticoid effect of corticosteroids:

      Your Answer:

      Correct Answer: Hyperglycaemia

      Explanation:

      Mineralocorticoid side effects include:hypertensionsodium retentionwater retention and oedemapotassium losscalcium loss
      Glucocorticoid side effects include:weight gainhyperglycaemia and diabetesosteoporosis and osteoporotic fracturesmuscle wasting (proximal myopathy)peptic ulceration and perforationpsychiatric reactions

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
      0
      Seconds

  • Question 19 - The monospot test for infectious mononucleosis uses which of the following types...

    Incorrect

    • The monospot test for infectious mononucleosis uses which of the following types of red blood cell?

      Your Answer:

      Correct Answer: Horse red blood cells

      Explanation:

      Infectious mononucleosis can be diagnosed using specific EBV antibodies and a variety if unrelated non-EBV heterophile antibodies. These antibodies can be detected by two main screening tests:

      The monospot test uses horse red blood cells. It agglutinates in the presence of heterophile antibodies.

      Sheep red blood cells is used in Paul-Bunnell test. The blood agglutinates in the presence of heterophile antibodies.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 20 - A 55-year-old female is urgently rushed into the Emergency Department as she complains...

    Incorrect

    • A 55-year-old female is urgently rushed into the Emergency Department as she complains of chest pain that is worse on breathing, shortness of breath, palpitations, and haemoptysis.

      She undergoes a CT pulmonary angiogram, which reveals a large pulmonary embolus. She is immediately started on heparin and shifted to the acute medical ward.

      Which of the following statements is true regarding heparin?

      Your Answer:

      Correct Answer: It activates antithrombin III

      Explanation:

      Heparin is a polymer of glycosaminoglycan. It occurs naturally and is found in mast cells. Clinically, it is used in two forms:
      1. Unfractionated: widely varying polymer chain lengths
      2. Low molecular weight: Smaller polymers only

      Heparin works by binding to and activating the enzyme inhibitor antithrombin III. Antithrombin III inactivates thrombin (factor IIa) by forming a 1:1 complex with thrombin. The heparin-antithrombin III complex also inhibits factor Xa and some other proteases involved with clotting. The heparin-ATIII complex can also inactivate IX, XI, XII, and plasmin.

      Heparin is not thrombolytic or fibrinolytic. It prevents the progression of existing clots by inhibiting further clotting. The lysis of existing clots relies on endogenous thrombolytics.

      Heparin is used for:
      1. Prevention and treatment of venous thromboembolism
      2. Treatment of disseminated intravascular coagulation
      3. Treatment of fat embolism
      4. Priming of haemodialysis and cardiopulmonary bypass machines

      There is no evidence that heparin is superior to low-molecular-weight heparins in preventing mortality from thrombosis.

      Vitamin K is used to reverse the effects of warfarin but not heparin. For heparin, protamine sulphate is used to counteract its effects.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds

  • Question 21 - A 27-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.

    In...

    Incorrect

    • A 27-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.

      In which of the following nerves is the gluteus maximus muscle innervated by?

      Your Answer:

      Correct Answer: Inferior gluteal nerve

      Explanation:

      The gluteal muscles are a group of muscles that make up the buttock area. These muscles include: gluteus maximus, gluteus medius. and gluteus minimus.
      The gluteus maximus is the most superficial as well as largest of the three muscles and makes up most of the shape and form of the buttock and hip area. It is a thick, fleshy muscle with a quadrangular shape. It is a large muscle and plays a prominent role in the maintenance of keeping the upper body erect.
      The innervation of the gluteus maximus muscle is from the inferior gluteal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 22 - Which nerve innervates the brachioradialis muscle? ...

    Incorrect

    • Which nerve innervates the brachioradialis muscle?

      Your Answer:

      Correct Answer: The radial nerve

      Explanation:

      Brachioradialis is innervated by the radial nerve (from the root values C5-C6) that stems from the posterior cord of the brachial plexus.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds

  • Question 23 - A migrant from Eastern Europe needs to have screening performed for tuberculosis (TB)...

    Incorrect

    • A migrant from Eastern Europe needs to have screening performed for tuberculosis (TB) because he is a high-risk patient.

      Which statement concerning TB screening in the UK is true?

      Your Answer:

      Correct Answer: Vaccination with the BCG can result in a false positive test

      Explanation:

      Vaccination with the BCG can result in a false positive test.

      The Mantoux test replaced the Heaf test as the TB screening test in the UK in 2005.
      The ‘Sterneedle’ gun is used to inject 100,000 units/ml of tuberculin purified protein derivative into the skin for the Heaf test

      The Mantoux test involves the injection of 5 Tuberculin units (0.1mL) intradermally and the result read 2-3 days later.

      The interferon gamma release assay (IGRA) should NOT be used for neonates

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 24 - Regarding the penis, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: The corpus spongiosum is ventral in the erect penis.

      Explanation:

      Because the anatomical position of the penis is erect, the paired corpora cavernosa are defined as dorsal in the body of the penis and the single corpus spongiosum as ventral. The nerves and vessels lie superficial to the corpus cavernosum. The urethra lies within the corpus spongiosum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      0
      Seconds

  • Question 25 - Haemophilia B results from a deficiency in: ...

    Incorrect

    • Haemophilia B results from a deficiency in:

      Your Answer:

      Correct Answer: Factor IX

      Explanation:

      Haemophilia B is a bleeding disorder caused by a deficiency of clotting factor IX. It is the second commonest form of haemophilia, and is rarer than haemophilia A. Haemophilia B tends to be similar to haemophilia A but less severe. The two disorders can only be distinguished by specific coagulation factor assays.

      The incidence is one-fifth of that of haemophilia A. Laboratory findings demonstrate prolonged APTT, normal PT and low factor IX.
      Haemophilia B inherited in an X-linked recessive fashion, affecting males born to carrier mothers.
      There is also a variation called Leyden, in which factor IX levels are below 1% until puberty, when they rise, potentially reaching as high as 40-60% of normal. This is thought to be due to the effects of testosterone at puberty.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

  • Question 26 - A 61-year-old patient experiences a spontaneous rupture of his Achilles tendon following a...

    Incorrect

    • A 61-year-old patient experiences a spontaneous rupture of his Achilles tendon following a course of antibiotics

      Which of the antibiotics listed below is MOST likely to be the cause? 

      Your Answer:

      Correct Answer: Ciprofloxacin

      Explanation:

      Tendinopathy and spontaneous tendon rupture are caused by fluoroquinolones, which are an uncommon but well-known cause. Tendon problems caused by fluoroquinolones are expected to affect 15 to 20 people per 100,000. Patients over the age of 60 are most likely to develop them.

      It usually affects the Achilles tendon, but it has also been described in cases involving the quadriceps, peroneus brevis, extensor pollicis longus, long head of biceps brachii, and rotator cuff tendons. The exact aetiology is uncertain, although the fluoroquinolone medication is thought to obstruct collagen activity and/or cut off blood supply to the tendon.

      Other factors linked to tendon rupture spontaneously include:
      Gout
      Treatment with corticosteroids
      Hypercholesterolaemia
      Long-term dialysis
      Kidney transplant
      Rheumatoid arthritis 

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds

  • Question 27 - At which opioid receptors do opioid analgesics act primarily? ...

    Incorrect

    • At which opioid receptors do opioid analgesics act primarily?

      Your Answer:

      Correct Answer: Mu

      Explanation:

      Opioid receptors are widely distributed throughout the central nervous system. Opioid analgesics mimic endogenous opioid peptides by causing prolonged activation of these receptors, mainly the mu(μ)-receptors which are the most highly concentrated in brain areas involved in nociception.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 28 - What is the pathophysiology of a phaeochromocytoma: ...

    Incorrect

    • What is the pathophysiology of a phaeochromocytoma:

      Your Answer:

      Correct Answer: Catecholamine-secreting tumour

      Explanation:

      Phaeochromocytomas are catecholamine-secreting tumours which occur in about 0.1% of patients with hypertension. In about 90% of cases they arise from the adrenal medulla. The remaining 10%, which arise from extra-adrenal chromaffin tissue, are termed paragangliomas. Common presenting symptoms include one or more of headache, sweating, pallor and palpitations. Less commonly, patients describe anxiety, panic attacks and pyrexia. Hypertension, whether sustained or episodic, is present in at least 90% of patients. Left untreated phaeochromocytoma can occasionally lead to hypertensive crisis, encephalopathy, hyperglycaemia, pulmonary oedema, cardiac arrhythmias, or even death.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds

  • Question 29 - Which of the following clotting factors is NOT vitamin K-dependent: ...

    Incorrect

    • Which of the following clotting factors is NOT vitamin K-dependent:

      Your Answer:

      Correct Answer: V

      Explanation:

      Fat-soluble vitamin K is obtained from green vegetables and bacterial synthesis in the gut. Deficiency may present in the newborn (haemorrhagic disease of the newborn) or in later life. Deficiency may be caused by an inadequate diet, malabsorption or inhibition of vitamin K by drugs such as warfarin. The activity of factors II, VII, IX and X are vitamin K dependent as well as that of protein C and protein S. Both PT and APTT are prolonged.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds

  • Question 30 - A patient is diagnosed with a Klebsiella pneumoniae infection.
    Which SINGLE statement regarding Klebsiella...

    Incorrect

    • A patient is diagnosed with a Klebsiella pneumoniae infection.
      Which SINGLE statement regarding Klebsiella pneumoniae is FALSE?

      Your Answer:

      Correct Answer: Species with ESBLs are sensitive to cefotaxime

      Explanation:

      Klebsiellais a genus of non-motile,Gram-negative, rod-shaped bacteriawith a prominent polysaccharide-based capsule. They are routinely found in the nose, mouth and gastrointestinal tract as normal flora, however, they can also behave as opportunistic pathogens.
      Infections with Klebsiella spp. areusually nosocomial. They are an important cause of ventilator-associated pneumonia (VAP), urinary tract infection, wound infection and bacteraemia. Outbreaks of infections with Klebsiellaspp. in high-dependency units have been described and are associated with septicaemia and high mortality rates. Length of hospital stay and performance of invasive procedures are risk factors forKlebsiellainfections.
      Primary pneumonia withKlebsiella pneumoniaeis a rare,severe, community-acquired infection associated with a poor outcome.
      Klebsiella rhinoscleromatis causes a progressive granulomatous infection of the nasal passages and surrounding mucous membranes. This infection is mainly seen in the tropics.
      Klebsiella ozanae is a recognised cause of chronic bronchiectasis.
      Klebsiella organisms are resistant to multiple antibiotics including penicillins. This is thought to be a plasmid-mediated property. Agents with high intrinsic activity againstKlebsiellapneumoniaeshould be selected for severely ill patients. Examples of such agents include third-generation cephalosporins (e.g cefotaxime), carbapenems (e.g. imipenem), aminoglycosides (e.g. gentamicin), and quinolones (e.g. ciprofloxacin). These agents may be used as monotherapy or combination therapy. Aztreonam may be used in patients who are allergic to beta-lactam antibiotics.
      Species with ESBLs (Extended spectrum beta-lactamase) are resistant to penicillins and also cephalosporins such as cefotaxime and ceftriaxone
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    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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SESSION STATS - PERFORMANCE PER SPECIALTY

Microbiology (2/2) 100%
Specific Pathogen Groups (2/2) 100%
Basic Cellular (1/1) 100%
Physiology (1/2) 50%
Respiratory Physiology (0/1) 0%
Haematology (1/1) 100%
Pathology (1/1) 100%
Anatomy (0/1) 0%
Head And Neck (0/1) 0%
Infections (1/1) 100%
Pharmacology (1/1) 100%
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