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  • Question 1 - If the afferent arteriole's diameter is smaller than the efferent arteriole's diameter in...

    Correct

    • If the afferent arteriole's diameter is smaller than the efferent arteriole's diameter in the glomerulus:

      Your Answer: The net filtration pressure will decrease

      Explanation:

      The relative resistance of the afferent and efferent arterioles substantially influences glomerular capillary hydrostatic pressure and consequently GFR. Filtration is forced through the filtration barrier due to high pressure in the glomerular capillaries. Afferent arteriolar constriction lowers this pressure while efferent arteriolar constriction raises it.

    • This question is part of the following fields:

      • Physiology
      • Renal
      15
      Seconds
  • Question 2 - Action potentials are transmitted from myocyte to myocyte via which of the following:...

    Incorrect

    • Action potentials are transmitted from myocyte to myocyte via which of the following:

      Your Answer:

      Correct Answer: Gap junctions

      Explanation:

      Action potentials are transmitted to adjacent myocytes via gap junctions.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
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      Seconds
  • Question 3 - A 29-year-old man is diagnosed with a severe case of asthma.

    In the treatment...

    Incorrect

    • A 29-year-old man is diagnosed with a severe case of asthma.

      In the treatment of acute asthma in adults, which of the following is NOT recommended?

      Your Answer:

      Correct Answer: Nebulised magnesium

      Explanation:

      There is no evidence to support the use of nebulized magnesium sulphate in the treatment of adults at this time.

      In adults with acute asthma, the following medication dosages are recommended:
      By using an oxygen-driven nebuliser, you can get 5 milligrams of salbutamol.
      500 mcg ipratropium bromide in an oxygen-driven nebuliser
      Oral prednisolone 40-50 mg
      100 mg hydrocortisone intravenous
      1.2-2 g magnesium sulphate IV over 20 minutes
      When inhaled treatment is ineffective, intravenous salbutamol (250 mcg IV slowly) may be explored (e.g. a patient receiving bag-mask ventilation).

      Following senior counsel, current ALS recommendations propose that IV aminophylline be explored in severe or life-threatening asthma. If utilized, a loading dose of 5 mg/kg should be administered over 20 minutes, then a 500-700 mcg/kg/hour infusion should be given. To avoid toxicity, serum theophylline levels should be kept below 20 mcg/ml.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      0
      Seconds
  • Question 4 - Which of the following is NOT a typical complication associated with mumps: ...

    Incorrect

    • Which of the following is NOT a typical complication associated with mumps:

      Your Answer:

      Correct Answer: Subacute sclerosing panencephalitis

      Explanation:

      Complications of mumps include meningitis, post meningitis deafness, encephalitis, pancreatitis, orchitis and oophoritis. Subacute sclerosing panencephalitis is a complication typically associated with measles infection.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds
  • Question 5 - The qSOFA score is a bedside prompt designed to identify patients with suspected...

    Incorrect

    • The qSOFA score is a bedside prompt designed to identify patients with suspected infection who are at greater risk for a poor outcome outside of the intensive care unit.
      Which of the following is one of the criteria used in the qSOFA score? Select ONE answer only.

      Your Answer:

      Correct Answer: Respiratory rate >22

      Explanation:

      In February 2016 the Society of Critical Care Medicine published a JAMA article reformatting the definitions of sepsis in an attempt to overcome the shortcomings of the old definitions.
      The main changes are a new definition of sepsis, the replacement of the SIRS criteria with the quick Sepsis-related Organ Failure Assessment (qSOFA), and the complete removal of “severe sepsis” as an entity.
      The new definition of sepsis is that it is “life-threatening organ dysfunction caused by a dysregulated host response to infection.”
      Septic shock is “a subset of sepsis in which underlying circulatory and cellular metabolism abnormalities are profound enough to increase mortality.”
      In essence this means that septic shock is sepsis plus the following, despite adequate fluid resuscitation:
      Vasopressors required to maintain a MAP > 65 mmHg
      Serum lactate > 2 mmol/l
      The qSOFA score is a bedside prompt designed to identify patients with suspected infection who are at greater risk for a poor outcome outside of the intensive care unit. It uses the following three criteria:
      Hypotension (SBP < 100 mmHg)
      Tachypnoea (RR > 22)
      Altered mental status (GCS < 15)
      The presence of 2 or more of the qSOFA criteria near the onset of infection is associated with greater risk of death or a prolonged intensive care unit stay.

    • This question is part of the following fields:

      • Pathology
      • Pathology Of Infections
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  • Question 6 - Regarding cardiac excitation-contraction coupling, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding cardiac excitation-contraction coupling, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: In relaxation, Ca 2+ is transported out of the cell using energy from a Na + gradient.

      Explanation:

      During the AP plateau, Ca2+enters the cell and activates Ca2+sensitive Ca2+release channels in the sarcoplasmic reticulum allowing stored Ca2+to flood into the cytosol; this is called Ca2+-induced Ca2+release. In relaxation, about 80% of Ca2+is rapidly pumped back into the SR (sequestered) by Ca2+ATPase pumps. The Ca2+that entered the cell during the AP is transported out of the cell primarily by the Na+/Ca2+exchanger in the membrane which pumps one Ca2+ion out in exchange for three Na+ions in, using the Na+electrochemical gradient as an energy source. Increased heart rate increases the force of contraction in a stepwise fashion as intracellular [Ca2+] increases cumulatively over several beats; this is the Treppe effect. Factors that affect intracellular [Ca2+] and hence cardiac contractility are called inotropes.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
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  • Question 7 - During bedside rounds, an 82-year old female in the Medicine Ward complains of...

    Incorrect

    • During bedside rounds, an 82-year old female in the Medicine Ward complains of pain and tingling of all fingers of the right hand. The attending physician is considering carpal tunnel syndrome.

      Which of the following is expected to undergo atrophy in carpal tunnel syndrome?

      Your Answer:

      Correct Answer: The thenar eminence

      Explanation:

      Carpal tunnel syndrome (CTS) is an entrapment neuropathy caused by compression of the median nerve as it travels through the wrist’s carpal tunnel. It is the most common nerve entrapment neuropathy, accounting for 90% of all neuropathies. Early symptoms of carpal tunnel syndrome include pain, numbness, and paraesthesia’s. These symptoms typically present, with some variability, in the thumb, index finger, middle finger, and the radial half (thumb side) of the ring finger. Pain also can radiate up the affected arm. With further progression, hand weakness, decreased fine motor coordination, clumsiness, and thenar atrophy can occur.

      The muscles innervated by the median nerve can be remembered using the mnemonic ‘LOAF’:
      L– lateral two lumbricals
      O– Opponens pollicis
      A– Abductor pollicis
      F– Flexor pollicis brevis

      In the early presentation of the disease, symptoms most often present at night when lying down and are relieved during the day. With further progression of the disease, symptoms will also be present during the day, especially with certain repetitive activities, such as when drawing, typing, or playing video games. In more advanced disease, symptoms can be constant.

      Typical occupations of patients with carpal tunnel syndrome include those who use computers for extended periods of time, those who use equipment that has vibration such as construction workers, and any other occupation requiring frequent, repetitive movement.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
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  • Question 8 - Antispasmodic drugs are primarily indicated in which of the following conditions: ...

    Incorrect

    • Antispasmodic drugs are primarily indicated in which of the following conditions:

      Your Answer:

      Correct Answer: Irritable bowel syndrome

      Explanation:

      Antispasmodics, such as antimuscarinics, may be used in the management of irritable bowel syndrome. Other antispasmodics used include direct-acting smooth muscle relaxants such as mebeverine, alverine, and peppermint oil. Antispasmodics are contraindicated in bowel obstruction and severe inflammatory bowel disease. Antispasmodics are occasionally of value in treating abdominal cramp associated with diarrhoea but they should not be used for primary treatment. Antispasmodics should be avoided in young children with gastroenteritis because they are rarely effective and have troublesome side effects. Antimuscarinics are contraindicated in urinary retention.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
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  • Question 9 - A patient presents with acute severe asthma. Her initial salbutamol nebulization produced a...

    Incorrect

    • A patient presents with acute severe asthma. Her initial salbutamol nebulization produced a poor response and you administer another nebuliser with ipratropium bromide added on.

      Which statement about ipratropium bromide is true?

      Your Answer:

      Correct Answer: It can trigger acute closed-angle glaucoma

      Explanation:

      Ipratropium bromide is an antimuscarinic drug. It is used in the management of acute asthma and COPD.

      It provides short-term relief in chronic asthma. Short-acting β2agonists are preferred and act more quickly.

      The commonest side effect of ipratropium bromide is dry mouth. Tremor is commonly seen with β2agonists.

      It can trigger acute closed-angle glaucoma in patients that are susceptible.

      First-line treatment for moderate asthma attacks is short-acting β2agonists.

      The BTS guidelines recommend that nebulised ipratropium bromide (0.5 mg 4-6 hourly) be added to β2agonist treatment in patients with a poor initial response to β2agonist therapy or with acute severe or life-threatening asthma.

      Its duration of action is 3-6 hours, maximum effect occurs 30-60 minutes after use, and bronchodilation can be maintained with three times per day dosing.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      0
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  • Question 10 - Campylobacter jejuni is primarily spread via which of the following routes: ...

    Incorrect

    • Campylobacter jejuni is primarily spread via which of the following routes:

      Your Answer:

      Correct Answer: Faecal-oral route

      Explanation:

      Campylobacter spp. are a common cause of acute infective gastroenteritis, particularly in children, with Campylobacter jejuni responsible for 90% of Campylobacter gastroenteritis. Infection typically follows ingestion of contaminated meat (most frequently undercooked poultry), unpasteurised milk or contaminated water, following which the microorganism invades and colonises the mucosa of the small intestine.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
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  • Question 11 - All of the following statements are incorrect about insulin except: ...

    Incorrect

    • All of the following statements are incorrect about insulin except:

      Your Answer:

      Correct Answer: Proinsulin is cleaved into insulin and C peptide.

      Explanation:

      Proinsulin is synthesised as a single-chain peptide. A connecting peptide (C peptide) within storage granules is removed by proteases to yield insulin.

      Insulin:
      1. is a polypeptide hormone consisting of two short chains (A and B) linked by disulphide bonds.
      2. is produced by beta cells, located centrally within the islets of Langerhans, in the endocrine tissues of the pancreas.
      3. release is stimulated initially during eating by the parasympathetic nervous system and gut hormones such as secretin. However, most output is driven by the rise in plasma glucose concentration that occurs after a meal.
      4. effects are mediated by the receptor tyrosine kinase.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
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  • Question 12 - A 21 year old student presents to the emergency room with severe acute...

    Incorrect

    • A 21 year old student presents to the emergency room with severe acute asthma. Salbutamol and ipratropium bromide nebuliser are prescribed. The most appropriate dose of salbutamol that should be prescribed initially for this patient is which of the following?

      Your Answer:

      Correct Answer: 5 mg every 15 - 30 minutes

      Explanation:

      The first line treatment for acute asthma is high-dose inhaled short-acting beta2-agonists like salbutamol or terbutaline. Oxygen use should be reserved for hypoxemic patients in order to maintain oxygen saturations of 94 – 98%. In patients with moderate to severe asthma, a pressurised metered dose inhaler with spacer device is preferred (4 puffs initially, followed by 2 puffs every 2 minutes according to response, up to 10 puffs, whole process repeated every 10 – 20 minutes if necessary). For patients with life-threatening features or poorly responsive severe asthma, the oxygen-driven nebuliser route is recommended (salbutamol 5 mg at 15 – 30 minute intervals). In patients with severe acute asthma that is poorly responsive to initial bolus dose, continuous nebulisation should be considered (salbutamol at 5 – 10 mg/hour). For those in whom inhaled therapy cannot be used reliably, the intravenous route is usually reserved.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
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  • Question 13 - A 23-year-old student presents with a fever and sore throat. Upon physical examination,...

    Incorrect

    • A 23-year-old student presents with a fever and sore throat. Upon physical examination, it was observed that he had bilaterally enlarged tonsils that are covered in large amounts of exudate. A diagnosis of tonsillitis was made.

      The lymph from the tonsils will drain to which of the following nodes?

      Your Answer:

      Correct Answer: Deep cervical lymph nodes

      Explanation:

      The tonsils are collections of lymphatic tissue located within the pharynx. They collectively form a ringed arrangement, known as Waldeyer’s ring: pharyngeal tonsil, 2 tubal tonsils, 2 palatine tonsils, and the lingual tonsil.

      Lymphatic fluid from the lingual tonsil drains into the jugulodigastric and deep cervical lymph nodes.

      Lymphatic fluid from the pharyngeal tonsil drains into the retropharyngeal nodes (which empty into the deep cervical chain), and directly into deep cervical nodes within the parapharyngeal space.

      The retropharyngeal and the deep cervical lymph nodes drain the tubal tonsils.

      The palatine tonsils drain to the jugulodigastric node, a node of the deep cervical lymph nodes, located inferior to the angle of the mandible.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
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  • Question 14 - 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
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  • Question 15 - What is the mechanism of action of captopril: ...

    Incorrect

    • What is the mechanism of action of captopril:

      Your Answer:

      Correct Answer: Inhibition of the conversion of angiotensin I to angiotensin II

      Explanation:

      Angiotensin-converting enzyme inhibitors (ACE inhibitors) e.g. captopril inhibit the conversion of angiotensin I to angiotensin II, and thus have a vasodilatory effect, lowering both arterial and venous resistance. The cardiac output increases and, because the renovascular resistance falls, there is an increase in renal blood flow. This latter effect, together with reduced aldosterone release, increases Na+ and H2O excretion, contracting the blood volume and reducing venous return to the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
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  • Question 16 - Which of the following is a physiological function that is mediated by a...

    Incorrect

    • Which of the following is a physiological function that is mediated by a hormone released by the posterior pituitary:

      Your Answer:

      Correct Answer: Water retention

      Explanation:

      Antidiuretic hormone (ADH), released by the posterior pituitary, acts on the kidneys to increase water permeability in the distal nephron allowing greater water reabsorption and concentration of urine. Prolactin, from the anterior pituitary, is responsible for milk production. The thyroid hormones, from the thyroid gland, are responsible for an increase in basal metabolic rate (stimulated by TSH from the anterior pituitary). FSH/LH, from the anterior pituitary, are responsible for maturation of egg and sperm. Calcitonin, from the thyroid gland, is responsible for decreasing calcium levels.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
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  • Question 17 - Regarding the hard palate, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding the hard palate, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Lymphatic vessels from the palate usually drain into deep cervical lymph nodes.

      Explanation:

      Lymphatic vessels from the pharynx and palate drain into the deep cervical lymph nodes.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
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  • Question 18 - Metabolic hyperaemia harmonizes local blood flow with local O2 demand. If there is...

    Incorrect

    • Metabolic hyperaemia harmonizes local blood flow with local O2 demand. If there is an increase in metabolic rate, the production of vasoactive metabolites increases. These metabolites act locally on the surrounding arterioles, causes vasodilation and an increase blood supply.

      Which of these metabolites is the most potent vasodilator in skeletal muscle?

      Your Answer:

      Correct Answer: K +

      Explanation:

      Hyperaemia is the process where the body adjusts blood flow to meet the metabolic needs of different tissues in health and disease. Vasoactive mediators that take part in this process include K+, adenosine, CO2, H+, phosphates and H2O2. Although the mechanism is not clear, all these mediators likely contribute to some extent at different points.

      Specific organs are more sensitive to specific metabolites:
      K+ and adenosine are the most potent vasodilators in skeletal muscles

      CO2 and K+ are the most potent vasodilators in cerebral circulation.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
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  • Question 19 - Which of the following is NOT one of insulin's actions: ...

    Incorrect

    • Which of the following is NOT one of insulin's actions:

      Your Answer:

      Correct Answer: Increased gluconeogenesis

      Explanation:

      Insulin has a number of effects on glucose metabolism, including:
      Inhibition of glycogenolysis and gluconeogenesis
      Increased glucose transport into fat and muscle
      Increased glycolysis in fat and muscle
      Stimulation of glycogen synthesis
      By inhibiting gluconeogenesis, insulin maintains the availability of amino acids as substrates for protein synthesis. Thus, insulin supports protein synthesis through direct and indirect mechanisms.

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
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  • Question 20 - A 63-year-old man complains of chest pain and syncope on occasion. His heart...

    Incorrect

    • A 63-year-old man complains of chest pain and syncope on occasion. His heart rate is 37 beats per minute, and he has a second-degree heart block, according to his rhythm strip.

      Which of the following would be the most appropriate next step in his management, according to the ALS bradycardia algorithm?

      Your Answer:

      Correct Answer: Give atropine 500 mcg

      Explanation:

      Atropine is used to treat bradycardia (sinus, atrial, or nodal) or AV block when the patient’s haemodynamic condition is compromised by the bradycardia.

      If any of the following adverse features are present, the ALS bradycardia algorithm recommends a dose of atropine 500 mcg IV:
      Shock
      Syncope
      Myocardial ischemia
      Insufficiency of the heart

      If this does not work, give additional 500 mcg doses at 3-5 minute intervals until a maximum dose of 3 mg is reached. The heart rate can be slowed paradoxically if the dose is higher than 3 mg.

      The ALS bradycardia algorithm also suggests the following interim measures:
      Transcutaneous pacing
      Isoprenaline infusion 5 mcg/min
      Adrenaline infusion 2-10 mcg/minutes
      Alternative drugs (aminophylline, dopamine, glucagon, glycopyrrolate)

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 21 - A 67-year-old woman arrives at the Emergency Department with chest pain. Flecainide is...

    Incorrect

    • A 67-year-old woman arrives at the Emergency Department with chest pain. Flecainide is one of the medications she is taking.

      Which of the following statements about flecainide mechanism of action is correct?

      Your Answer:

      Correct Answer: Blocks Na+ channels in the heart

      Explanation:

      Flecainide is an antiarrhythmic drug of class Ic that works by blocking the Nav1.5 sodium channel in the heart, prolonging the cardiac action potential and slowing cardiac impulse conduction. It has a significant impact on accessory pathway conduction, particularly retrograde conduction, and significantly reduces ventricular ectopic foci.

      Many different arrhythmias can be treated with flecainide, including:
      Pre-excitation syndromes (e.g. Wolff-Parkinson-White)
      Acute atrial arrhythmias
      Ventricular arrhythmias
      Chronic neuropathic pain

      The use of flecainide is contraindicated in the following situations:
      Abnormal left ventricular function
      Atrial conduction defects (unless pacing rescue available)
      Bundle branch block (unless pacing rescue available)
      Distal block (unless pacing rescue available)
      Haemodynamically significant valvular heart disease
      Heart failure
      History of myocardial infarction
      Long-standing atrial fibrillation where conversion to sinus rhythm not attempted
      Second-degree or greater AV block (unless pacing rescue available)
      Sinus node dysfunction (unless pacing rescue available)

      Flecainide should only be used in people who don’t have a structural heart problem. The CAST trial found a significant increase in sudden cardiac death and all-cause mortality in patients with an ejection fraction of less than 40% after a myocardial infarction, where it tended to be pro-arrhythmic.

      Anti-arrhythmic drugs have a limited and ineffective role in the treatment of atrial flutter. It’s important to keep in mind that flecainide shouldn’t be used by itself to treat atrial flutter. When used alone, there is a risk of inducing 1:1 atrioventricular conduction, which results in an increase in ventricular rate that is paradoxical. As a result, it should be used in conjunction with a beta-blocker or a calcium channel blocker with a rate-limiting effect.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 22 - Which of the following ligaments supports the head of the talus? ...

    Incorrect

    • Which of the following ligaments supports the head of the talus?

      Your Answer:

      Correct Answer: Spring ligament

      Explanation:

      The spring-ligament complex is a significant medial arch stabilizer.

      The two important functions of this ligament include promoting the stability of the talonavicular joint by acting as a support for the talus head and by acting as a static support to maintain the medial longitudinal arch.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 23 - Which of the following is NOT a typical side effect of digoxin: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Hypokalaemia

      Explanation:

      Digoxin does not cause hypokalaemia, but hypokalaemia does potentiate digoxin toxicity. The adverse effects of digoxin are frequently due to its narrow therapeutic window and include:
      Cardiac adverse effects – Sinoatrial and atrioventricular block, Premature ventricular contractions, PR prolongation and ST-segment depression
      Nausea, vomiting and diarrhoea
      Blurred or yellow vision
      CNS effects – weakness, dizziness, confusion, apathy, malaise, headache, depression, psychosis
      Thrombocytopenia and agranulocytosis (rare)
      Gynaecomastia in men in prolonged administration

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 24 - A 14-year-old female is brought to the Emergency Room by her mother after...

    Incorrect

    • A 14-year-old female is brought to the Emergency Room by her mother after a fall from a tree in which she injured her elbow. An elbow fracture is suspected based on the examination findings, and she is given Entonox for analgesia as her elbow is set in a cast.

      Which one of the following statements regarding this drug is true?

      Your Answer:

      Correct Answer: It can cause inhibition of vitamin B12 synthesis

      Explanation:

      Entonox is a mixture of 50% Oxygen and 50% nitrous oxide and is given in an inhaled form as a quick form of analgesia. Entonox causes non-competitive inhibition of NMDA (N-methyl-D-aspartate) receptors, which are a subtype of the glutamate receptor.

      It is stored in blue and white cylinders and administered via a pressure regulator and demand valve. The administration of this medicine reduces pain and anxiety in paediatric and dental procedures ands during labour.

      Effects are apparent after 20 seconds, and peak action occurs after 3 to 5 minutes as it is a drug with a rapid onset and the patient will also recover rapidly from its effects. Entonox is widely used as it does not accumulate in the body and does not cause many side effects. However, a notable side effect is the inhibition of Vitamin B12 synthesis.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
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  • Question 25 - Which of the following is characterised by passive carrier-mediated transport down a chemical...

    Incorrect

    • Which of the following is characterised by passive carrier-mediated transport down a chemical concentration gradient:

      Your Answer:

      Correct Answer: Facilitated diffusion

      Explanation:

      Facilitated diffusion is the process of spontaneous passive transport of molecules or ions down their concentration gradient across a cell membrane via specific transmembrane transporter (carrier) proteins. The energy required for conformational changes in the transporter protein is provided by the concentration gradient rather than by metabolic activity.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
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  • Question 26 - A patient who was put on low molecular weight heparin for suspected DVT...

    Incorrect

    • A patient who was put on low molecular weight heparin for suspected DVT and was scheduled for an ultrasound after the weekend, arrives at the emergency department with significant hematemesis. Which of the following medications can be used as a heparin reversal agent:

      Your Answer:

      Correct Answer: Protamine sulfate

      Explanation:

      The management of bleeding in a patient receiving heparin depends upon the location and severity of bleeding, the underlying thromboembolic risk, and the current aPTT (for heparin) or anti-factor Xa activity (for LMW heparin). As an example, a patient with minor skin bleeding in the setting of a mechanical heart valve (high thromboembolic risk) and a therapeutic aPTT may continue heparin therapy, whereas a patient with major intracerebral bleeding in the setting of venous thromboembolism several months prior who is receiving heparin bridging perioperatively may require immediate heparin discontinuation and reversal with protamine sulphate. If haemorrhage occurs it is usually sufficient to withdraw unfractionated or low molecular weight heparin, but if rapid reversal of the effects of the heparin is required, protamine sulphate is a specific antidote (but only partially reverses the effects of low molecular weight heparins). Clinician judgment and early involvement of the appropriate consulting specialists is advised.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 27 - Which of the following statements about lithium treatment is FALSE: ...

    Incorrect

    • Which of the following statements about lithium treatment is FALSE:

      Your Answer:

      Correct Answer: Concomitant treatment with NSAIDs decreases serum-lithium concentration.

      Explanation:

      Lithium levels are raised by NSAIDs because renal clearance is reduced. Lithium is a small ion (74 Daltons) with no protein or tissue binding and is therefore amenable to haemodialysis. Lithium is freely distributed throughout total body water with a volume of distribution between 0.6 to 0.9 L/kg, although the volume may be smaller in the elderly, who have less lean body mass and less total body water. Steady-state serum levels are typically reached within five days at the usual oral dose of 1200 to 1800 mg/day. The half-life for lithium is approximately 18 hours in adults and 36 hours in the elderly.
      Lithium is excreted almost entirely by the kidneys and is handled in a manner similar to sodium. Lithium is freely filtered but over 60 percent is then reabsorbed by the proximal tubules.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 28 - A young patient presents with the features of an easily recognisable infectious disease.
    Which...

    Incorrect

    • A young patient presents with the features of an easily recognisable infectious disease.
      Which of the following infectious diseases typically has an incubation period of less than 1 week? Select ONE answer only.

      Your Answer:

      Correct Answer: Cholera

      Explanation:

      Cholera has an incubation period of 12 hours to 6 days.
      Other infectious disease that have an incubation period of less than 1 week include:
      Staphylococcal enteritis (1-6 hours)
      Salmonella enteritis (12-24 hours)
      Botulism (18-36 hours)
      Gas gangrene (6 hours to 4 days)
      Scarlet fever (1-4 days)
      Diphtheria (2-5 days)
      Gonorrhoea (3-5 days)
      Yellow fever (3-6 days)
      Meningococcaemia (1-7 days)
      Brucellosis has an incubation period of 7-21 days.
      Measles has an incubation period of 14-18 days.
      Falciparum malaria usually has an incubation period of 7-14 days. The other forms of malaria have a longer incubation period of 12-40 days.
      Rubella has an incubation period of 14-21 days.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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  • Question 29 - All of the following cause bronchoconstriction, EXCEPT for: ...

    Incorrect

    • All of the following cause bronchoconstriction, EXCEPT for:

      Your Answer:

      Correct Answer: Adrenaline

      Explanation:

      Factors causing bronchoconstriction:

      • Via muscarinic receptors
      • Parasympathetic stimulation
      • Stimulation of irritant receptors
      • Inflammatory mediators e.g. histamine, prostaglandins, leukotrienes
      • Beta-blockers

    • This question is part of the following fields:

      • Physiology
      • Respiratory
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  • Question 30 - The last two segments of the nephrons are the distal convoluted tubule (DCT)...

    Incorrect

    • The last two segments of the nephrons are the distal convoluted tubule (DCT) and collecting duct (CD).

      Which cell reabsorbs sodium more in the late DCT and CD?

      Your Answer:

      Correct Answer: Principal cells

      Explanation:

      The main Na+ reabsorbing cells in the late distal convoluted tubule and collecting duct are the principal cells. These make up the majority of the tubular cells.

      The exchange is driven by the Na.K.ATPase pumps on the basolateral membrane.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
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Physiology (1/1) 100%
Renal (1/1) 100%
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