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  • Question 1 - The patient is a 61-year-old man with severe central chest pain. An acute...

    Correct

    • The patient is a 61-year-old man with severe central chest pain. An acute myocardial infarction is revealed by his ECG. Clopidogrel is one of the medications he takes as part of his treatment.

      Clopidogrel's direct mechanism of action is which of the following?

      Your Answer: Inhibition of platelet ADP receptors

      Explanation:

      Clopidogrel, a thienopyridine derivative, prevents platelet aggregation and cross-linking by the protein fibrin by inhibiting the ADP receptor on platelet cell membranes (inhibits binding of ADP to its platelet receptor (P2Y12 ADP-receptor).

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      141.9
      Seconds
  • Question 2 - Renal potassium excretion is promoted by all but which one of the following:...

    Correct

    • Renal potassium excretion is promoted by all but which one of the following:

      Your Answer: Increased intracellular magnesium

      Explanation:

      Aldosterone: A rise in [K+] in the extracellular fluid of the adrenal cortex directly stimulates aldosterone release. Aldosterone promotes the synthesis of Na+/K+ATPases and the insertion of more Na+/K+ATPases into the basolateral membrane, and also stimulates apical sodium and potassium channel activity, overall acting to increase sodium reabsorption and potassium secretion.
      pH changes: Potassium secretion is reduced in acute acidosis and increased in acute alkalosis. A higher pH increases the apical K+channel activity and the basolateral Na+/K+ATPase activity – both changes that promote K+secretion.
      Flow rates: Increased flow rates in the collecting duct reduce K+concentration in the lumen and therefore enhance K+secretion. Increased flow also activates BK potassium channels, and ENaC channels which promote potassium secretion and sodium reabsorption respectively.
      Sodium delivery: Decreased Na+delivery to the collecting ducts results in less Na+reabsorption and hence a reduced gradient for K+secretion.
      Magnesium: Intracellular magnesium can bind and block K+channels inhibiting K+secretion into the tubules. Therefore magnesium deficiency reduces this inhibitory effect and so allows more potassium to be secreted into tubules and can cause hypokalaemia.

    • This question is part of the following fields:

      • Physiology
      • Renal
      450
      Seconds
  • Question 3 - A 10-year-old girl presents with polyuria, polydipsia, and stomach pain. She has a...

    Correct

    • A 10-year-old girl presents with polyuria, polydipsia, and stomach pain. She has a history of type I diabetes mellitus. On blood gas analysis, she has metabolic acidosis. Diabetic ketoacidosis (DKA) is diagnosed, and therapy is initiated. She becomes increasingly confused when intravenous fluids and insulin are administered.

      Which electrolyte imbalance is the MOST likely reason of the increased confusion

      Your Answer: Hyponatraemia

      Explanation:

      Because of the shift of water from the intracellular to the extracellular compartment as a result of hyperglycaemia and increased plasma osmolality, dilutional hyponatraemia is common in diabetic ketoacidosis (DKA).

      If intravenous fluids are not delivered with caution, hyponatraemia might worsen, which can lead to increased degrees of disorientation. Hyponatraemia has also been linked to an increased risk of cerebral oedema, especially if blood glucose levels drop too quickly following treatment.

      Headache, recurrence of vomiting, irritability, Glasgow Coma Scale score, inappropriate heart rate slowing, and rising blood pressure are the most common causes of death in paediatric DKA, and children should be monitored for the symptoms mentioned above. To prevent this from developing,  s low osmolarity normalization, attention to glucose and salt levels, as well as hydration over 48 hours, is necessary. 

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
      18.7
      Seconds
  • Question 4 - Which among the following antibacterial regimens is considered the most appropriate to prescribe...

    Incorrect

    • Which among the following antibacterial regimens is considered the most appropriate to prescribe in a patient presenting with clinical signs and symptoms consistent with a diagnosis of pelvic inflammatory disease?

      Your Answer: Doxycylcine plus metronidazole

      Correct Answer: Ceftriaxone plus doxycycline plus metronidazole

      Explanation:

      The endocervix is the most common site of Neisseria gonorrhoeae infection in women. Symptoms of infection, when present, include dysuria, cervical discharge, and lower abdominal pain. However, 50% of cases in women may be asymptomatic leading to complications such as pelvic inflammatory disease (PID), which may cause sterility, ectopic pregnancy, or perihepatitis.

      PID is also known as Fitz-Hugh-Curtis syndrome is defined as an inflammation of the upper genital tract due to an infection in women. The disease affects the uterus, fallopian tubes, and ovaries. It is typically an ascending infection, spreading from the lower genital tract.

      The recommended intramuscular or oral regimens for PID are as follows:

      Ceftriaxone at 500 mg IM in a single dose (for persons weighing ≥150 kg, administer 1 g of ceftriaxone); plus doxycycline at 100 mg PO BID for 14 days with metronidazole at 500 mg PO BID for 14 days.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      456.3
      Seconds
  • Question 5 - Salbutamol should be used with caution in patients with which of the following:...

    Correct

    • Salbutamol should be used with caution in patients with which of the following:

      Your Answer: Susceptibility to QT-interval prolongation

      Explanation:

      Beta-2 agonists should be used with caution in people with:
      Cardiovascular disease, including arrhythmias and hypertension (beta-2 agonists may cause an increased risk of arrhythmias and significant changes to blood pressure and heart rate)
      Diabetes(risk of hyperglycaemia and ketoacidosis, especially with intravenous use)
      Hyperthyroidism(beta-2 agonists may stimulate thyroid activity)
      Hypokalaemia(potentially serious hypokalaemia may result from beta-2 agonist therapy; this effect may be potentiated in severe asthma by concomitant treatment with theophylline, corticosteroids, diuretics and by hypoxia)
      Susceptibility to QT-interval prolongation
      Convulsive disorders

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      9.5
      Seconds
  • Question 6 - A 29 year old man presents to ED followed an alleged assault whilst...

    Correct

    • A 29 year old man presents to ED followed an alleged assault whilst out drinking. He received blunt trauma to his right axilla. He is complaining of difficulty abducting his right arm above the level of his shoulder, and on inspection, the inferior angle of his right scapula protrudes more than that of his left scapula. Which of the following nerves has most likely been affected:

      Your Answer: Long thoracic nerve

      Explanation:

      Damage to the long thoracic nerve results in weakness/paralysis of the serratus anterior muscle causing difficulty abducting the upper limb above 90 degrees and giving a ‘winged ‘ scapula appearance where the medial border, particularly the inferior angle, of the scapula moves laterally and posteriorly away from the thoracic wall (this becomes more pronounced if the patient presses the upper limb against a wall).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      23.8
      Seconds
  • Question 7 - A 32 year old man is brought to ED having been thrown off...

    Correct

    • A 32 year old man is brought to ED having been thrown off his motorbike. Following initial resuscitation and ruling out life-threatening injuries, you establish the patient has weakness of hip flexion. Which of the following nerves has most likely been injured:

      Your Answer: Femoral nerve

      Explanation:

      Flexion of the hip is produced by the iliacus, the psoas major, the sartorius, rectus femoris and the pectineus muscles. The femoral nerve innervates the iliacus, pectineus, sartorius and quadriceps femoris muscles, and supplies skin on the anterior thigh, anteromedial knee and medial leg.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      19.3
      Seconds
  • Question 8 - Which of the following nerves innervates the gastrocnemius muscle? ...

    Incorrect

    • Which of the following nerves innervates the gastrocnemius muscle?

      Your Answer: Sciatic nerve

      Correct Answer: Tibial nerve

      Explanation:

      The gastrocnemius is innervated by the anterior rami of S1 and S2 spinal nerves, carried by the tibial nerve into the posterior compartment of the leg.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      12.4
      Seconds
  • Question 9 - In the emergency room, a 28-year-old woman complains of wobbly and slurred speech,...

    Correct

    • In the emergency room, a 28-year-old woman complains of wobbly and slurred speech, is unable to do the heel-shin test, and has nystagmus. The following signs are most likely related to damage to which of the following areas:

      Your Answer: Cerebellum

      Explanation:

      Cerebellar injury causes delayed and disorganized motions. When walking, people with cerebellar abnormalities sway and stagger.

      Damage to the cerebellum can cause asynergia, the inability to judge distance and when to stop, dysmetria, the inability to perform rapid alternating movements or adiadochokinesia, movement tremors, staggering, wide-based walking or ataxic gait, a proclivity to fall, weak muscles or hypotonia, slurred speech or ataxic dysarthria, and abnormal eye movements or nystagmus.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      52.3
      Seconds
  • Question 10 - Doxycycline is indicated first line for treatment of which of the following infections:...

    Incorrect

    • Doxycycline is indicated first line for treatment of which of the following infections:

      Your Answer: Gonorrhoea

      Correct Answer: Chlamydia

      Explanation:

      Doxycycline may be used first line for chlamydia, pelvic inflammatory disease (with metronidazole and ceftriaxone), acute bacterial sinusitis, exacerbation of chronic bronchitis, moderate-severity community acquired pneumonia and high-severity community acquired pneumonia (with benzylpenicillin).

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      8.5
      Seconds
  • Question 11 - During her pregnancy, a 28-year-old lady was given an antibiotic. The neonate was...

    Correct

    • During her pregnancy, a 28-year-old lady was given an antibiotic. The neonate was prematurely born with cyanosis and ashen grey coloured skin as a result of this. Other symptoms were hypotonia, low blood pressure, and poor feeding.

      From the  following antibiotics, which one is most likely to cause this side effect?

      Your Answer: Chloramphenicol

      Explanation:

      Grey baby syndrome is a rare but causes significant adverse effect caused by the build-up of chloramphenicol in neonates (particularly preterm babies).

      The following are the main characteristics of ‘grey baby syndrome’:

      Skin that is ashy grey in colour.
      Feeding problems
      Vomiting
      Cyanosis
      Hypotension
      Hypothermia
      Hypotonia
      Collapse of the cardiovascular system
      Distension of the abdomen
      trouble breathing

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      205.7
      Seconds
  • Question 12 - The renal team is currently prescribing erythropoietin to a patient with chronic kidney...

    Correct

    • The renal team is currently prescribing erythropoietin to a patient with chronic kidney disease.

      Which of the following statements about erythropoietin is correct?

      Your Answer: It protects red blood cell progenitors from apoptosis

      Explanation:

      Erythropoietin is a glycoprotein hormone that regulates the formation of red blood cells (red cell production). It is mostly produced by interstitial fibroblasts in the kidney, which are located near the PCT. It is also produced in the liver’s perisinusoidal cells, however this is more common during the foetal and perinatal periods.

      The kidneys produce and secrete erythropoietin in response to hypoxia. On red blood cells, erythropoietin has two main effects:
      – It encourages stem cells in the bone marrow to produce more red blood cells.
      – It protects red blood cell progenitors and precursors from apoptosis by targeting them in the bone marrow.
      As a result of the increased red cell mass, the oxygen-carrying capacity and oxygen delivery increase.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      39.4
      Seconds
  • Question 13 - A type II error occurs when: ...

    Incorrect

    • A type II error occurs when:

      Your Answer:

      Correct Answer: The null hypothesis is accepted when it is false.

      Explanation:

      A type II error occurs when the null hypothesis is wrongly accepted when it is actually false and we conclude that there is no evidence of a difference in effect when one really exists (a false negative result).

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      0
      Seconds
  • Question 14 - 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
      0
      Seconds
  • Question 15 - You examine an elderly man who is experiencing chest pain. He doesn't recall...

    Incorrect

    • You examine an elderly man who is experiencing chest pain. He doesn't recall all of his medications, but he does know that he takes a diuretic.

      The enzyme carbonic anhydrase is inhibited by which of the following diuretics?

      Your Answer:

      Correct Answer: Acetazolamide

      Explanation:

      Acetazolamide is a non-competitive, reversible inhibitor of carbonic anhydrase found in the cytosol of cells and on the brush border of the proximal convoluted tubule. Bicarbonate and hydrogen ions are converted to carbonic acid by carbonic anhydrase, which then converts carbonic acid to carbon dioxide and water. As a result, acetazolamide reduces the availability of hydrogen ions, causing sodium and bicarbonate ions to accumulate in the renal tubule, resulting in diuresis.
      The mechanism of action of the various types of diuretics is summarised below:

      1) Loop diuretics, e.g. furosemide, bumetanide
      Act on the Na.K.2Cl co-transporters in the ascending loop of Henlé to inhibit sodium, chloride and potassium reabsorption.

      2) Thiazide diuretics, e.g. Bendroflumethiazide, hydrochlorothiazide
      Act on the Na.Cl co-transporter in the distal convoluted tubule to inhibit sodium and chloride reabsorption.

      3) Osmotic diuretics, e.g. mannitol
      Increases the osmolality of the glomerular filtrate and tubular fluid, increasing urinary volume by an osmotic effect.

      4) Aldosterone antagonists, e.g. spironolactone
      Acts in the distal convoluted tubule as a competitive aldosterone antagonist resulting in inhibition of sodium reabsorption and increasing potassium reabsorption.

      5) Carbonic anhydrase inhibitors, e.g. acetazolamide
      Inhibit the enzyme carbonic anhydrase preventing the conversion of bicarbonate and hydrogen ions into carbonic acid.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 16 - Compression of this nerve can cause weakness in the left leg while walking...

    Incorrect

    • Compression of this nerve can cause weakness in the left leg while walking and thigh adduction weakness at the hip joint.

      Your Answer:

      Correct Answer: Obturator nerve

      Explanation:

      The obturator nerve is a sensory and motor nerve that emerges from the lumbar plexus and innervates the thigh.

      This nerve supplies motor innervation to the medial compartment of the thigh, making it necessary for thigh adduction.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 17 - Which of the following nerves is most important for eversion of the foot:...

    Incorrect

    • Which of the following nerves is most important for eversion of the foot:

      Your Answer:

      Correct Answer: Superficial fibular nerve

      Explanation:

      Eversion of the foot is primarily produced by the fibularis longus and fibularis brevis, both innervated by the superficial fibular nerve. The fibularis tertius, innervated by the deep fibular nerve, also assists in this action.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds
  • Question 18 - You're evaluating a male patient who's having a lung function test done. In...

    Incorrect

    • You're evaluating a male patient who's having a lung function test done. In calculating the patient’s functional residual capacity, what parameters should you add to derive the functional residual capacity volume?

      Your Answer:

      Correct Answer: Expiratory reserve volume + residual volume

      Explanation:

      The volume of air that remains in the lungs after a single breath is known as functional residual capacity (FRC). It is calculated by combining the expiratory reserve volume and residual volume.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      0
      Seconds
  • Question 19 - A 52-year-old man presents to the emergency room with chest pain. He was...

    Incorrect

    • A 52-year-old man presents to the emergency room with chest pain. He was recently released from the hospital after receiving abciximab during coronary angioplasty.

      Which of the following is NOT a contraindication to abciximab (ReoPro) treatment?

      Your Answer:

      Correct Answer: Major surgery within the last 6 months

      Explanation:

      Abciximab (ReoPro) is a glycoprotein IIb/IIIa receptor antagonist that is a chimeric monoclonal antibody. It is primarily used during and after coronary artery procedures such as angioplasty to inhibit platelet aggregation.

      The use of abciximab is contraindicated in the following situations:
      Internal bleeding is present.
      Within the last two months, you’ve had major surgery, intracranial surgery, or trauma.
      Stroke in the previous two years
      Intracranial tumour
      Aneurysm or arteriovenous malformation
      Haemorrhagic diathesis is a type of haemorrhagic diathesis.
      Vasculitis
      Retinopathy caused by hypertension

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 20 - A 62-year-old woman presents with cold sensitivity, tiredness, and weight gain. A series...

    Incorrect

    • A 62-year-old woman presents with cold sensitivity, tiredness, and weight gain. A series of blood tests done shows a grossly elevated TSH level and a diagnosis of hypothyroidism is made.

      What is the commonest cause of hypothyroidism worldwide?

      Your Answer:

      Correct Answer: Iodine deficiency

      Explanation:

      Hypothyroidism occurs when there is a deficiency of circulating thyroid hormones. It is commoner in women and is most frequently seen in the age over 60.

      Iodine deficiency is the commonest cause of hypothyroidism worldwide.

      In developed countries, iodine deficiency is not a problem and autoimmune thyroiditis is the commonest cause.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds
  • Question 21 - Regarding autoregulation of local blood flow, which of the following statements is CORRECT:...

    Incorrect

    • Regarding autoregulation of local blood flow, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: An increase in blood flow dilutes locally produced vasodilating factors causing vasoconstriction.

      Explanation:

      Autoregulation is the ability to maintain a constant blood flow despite variations in blood pressure (between 50 – 170 mmHg). It is particularly important in the brain, kidney and heart. There are two main methods contributing to autoregulation:
      The myogenic mechanism involves arterial constriction in response to stretching of the vessel wall, probably due to activation of smooth muscle stretch-activated Ca2+channels and Ca2+entry. A reduction in pressure and stretch closes these channels, causing vasodilation.
      The second mechanism of autoregulation is due to locally produced vasodilating factors; an increase in blood flow dilutes these factors causing vasoconstriction, whereas decreased blood flow has the opposite effect.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 22 - Which extraocular muscle is entrapped in a patient with a blowout fracture? ...

    Incorrect

    • Which extraocular muscle is entrapped in a patient with a blowout fracture?

      Your Answer:

      Correct Answer: Inferior rectus

      Explanation:

      A blowout fracture is an isolated fracture of the orbital walls without compromise of the orbital rims. The common mechanisms are falls, high-velocity ball-related sports, traffic accidents, and interpersonal violence.

      The frontal, ethmoidal, sphenoid, zygomatic, and lacrimal bones form the bony structures of the orbit. Medially, the maxillary and the lacrimal bone form the lacrimal fossa. Together with the lamina papyracea of the ethmoid bone, they form the medial wall. The sphenoid bone forms the posterior wall and houses the orbital canal. Lateral to the orbital canal lies the superior orbital fissure housing cranial nerves III, IV, V, and VI. The zygomatic bone forms the lateral wall. Superior and inferior borders are the frontal and maxillary bones. Located around the globe of the eye and attached to it are 6 extraocular muscles; the 4 rectus muscles and the superior and inferior oblique muscles. The fat and connective tissue around the globe help to reduce the pressure exerted by the extraocular muscles.

      The goal of treatment is to restore aesthetics and physiological function. The problem with orbital blowout fractures is that the volume of the orbit can be increased, resulting in enophthalmos and hypoglobus. In addition, the orbital tissue and inferior rectus muscle can become trapped by the bony fragments leading to diplopia, limitation of gaze, and tethering. Finally, the orbital injury can lead to retinal oedema, hyphema, and significant loss of vision.

      While some cases may be managed with conservative care, others may require some type of surgical intervention.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 23 - The tetanus vaccination contains inactivated tetanus toxoid, which induces the body to produce...

    Incorrect

    • The tetanus vaccination contains inactivated tetanus toxoid, which induces the body to produce protective antibodies. How do these antibodies protect the body from tetanus?

      Your Answer:

      Correct Answer: Neutralise the protein exotoxin of C. tetani

      Explanation:

      C. Tetanospasmin, an exotoxin produced by tetani, is responsible for the neurotoxic consequences of tetanus.

      The tetanus vaccination contains inactivated tetanus toxoid, which induces the body to produce protective antibodies that neutralize the tetanus toxin.

      It induces active immunization against Clostridium tetani exotoxin via toxoid-induced Ab generation.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds
  • Question 24 - Which of the following nerves supplies the abductor pollicis brevis? ...

    Incorrect

    • Which of the following nerves supplies the abductor pollicis brevis?

      Your Answer:

      Correct Answer: The recurrent branch of the median nerve

      Explanation:

      Abductor pollicis brevis is innervated by the recurrent (thenar) branch of median nerve (root value C8 and T1).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 25 - A patient who has a nerve injury has sparing of the upper half...

    Incorrect

    • A patient who has a nerve injury has sparing of the upper half of the orbicularis oculi muscle but not the lower half. Which branch of the facial nerve supplies the lower half of the orbicularis oculi?

      Your Answer:

      Correct Answer: Zygomatic branch

      Explanation:

      The facial nerve divides into five terminal branches once in the parotid gland.
      1. The temporal branch innervates muscles in the temple, forehead and supraorbital areas.
      2. The zygomatic branch innervates muscles in the infraorbital area, the lateral nasal area and the upper lip.
      3. The buccal branch innervates muscles in the cheek, the upper lip and the corner of the mouth.
      4. The marginal mandibular branch innervates muscles of the lower lip and chin.
      5. The cervical branch innervates the platysma muscle.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      0
      Seconds
  • Question 26 - Which of these structures is the smallest and deepest component of...

    Incorrect

    • Which of these structures is the smallest and deepest component of muscle connective tissue?

      Your Answer:

      Correct Answer: Endomysium

      Explanation:

      There are three types of muscle:
      Skeletal muscle
      Cardiac muscle
      Smooth muscle

      Individual muscle is enveloped in a layer of dense irregular connective tissue called the epimysium. The epimysium protects the muscles from friction against bones and other muscles.

      Skeletal muscle is composed of muscle fibres, referred to as myofibers which is ensheathed by a wispy layer of areolar connective tissue called the endomysium. The endomysium is the smallest and deepest component of muscle connective tissue.

      Myofibers grouped together in bundles form fascicles, or fasciculi. These are surrounded by a type of connective tissue called the perimysium.

      Beneath the endomysium lies the sarcolemma, an elastic sheath with infoldings that invaginate the interior of the myofibers, particularly at the motor endplate of the neuromuscular junction.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      0
      Seconds
  • Question 27 - A 76-year-old man presents with complaints of double vision. Upon physical examination, it...

    Incorrect

    • A 76-year-old man presents with complaints of double vision. Upon physical examination, it was observed that he exhibits left-sided hemiplegia and left-sided loss of joint position sense, vibratory sense and discriminatory touch. In addition, he has the inability to abduct his right eye and is holding his head towards the right side. A CT scan was ordered and showed that he has suffered a right-sided stroke.

      Branches of which of the following arteries are most likely implicated in the case?

      Your Answer:

      Correct Answer: Basilar artery

      Explanation:

      Inferior medial pontine syndrome, also known as Foville syndrome, is one of the brainstem stroke syndromes which occurs when there is infarction of the medial inferior aspect of the pons due to occlusion of the paramedian branches of the basilar artery.

      It is characterized by ipsilateral sixth nerve palsy, facial palsy, contralateral hemiparesis, contralateral loss of proprioception and vibration, ipsilateral ataxia, ipsilateral facial weakness, and lateral gaze paralysis and diplopia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 28 - All of the following statements is considered true regarding Streptococcus pneumoniae, except: ...

    Incorrect

    • All of the following statements is considered true regarding Streptococcus pneumoniae, except:

      Your Answer:

      Correct Answer: It is the commonest cause of erysipelas

      Explanation:

      Erysipelas is a rare infection of the skin and subcutaneous tissues observed frequently in elderly patients. It is characterized by an acute spreading skin lesion that is intensely erythematous with a plainly demarcated but irregular edge. It is most commonly caused by Streptococcus pyogenes or Group A Streptococcus (GAS).

      GAS are susceptible to penicillin, which remains the drug of choice for treatment. For patients allergic to penicillin, erythromycin can be used.

      S. pyogenes colonizes the throat and skin on humans, making these sites the primary sources of transmission. Infections resulting from S. pyogenes include pharyngitis, scarlet fever, skin or pyodermal infections, and other septic infections. In addition, the sequelae rheumatic fever and acute glomerulonephritis can occur as a result of infection with S. pyogenes.

      Agammaglobulinemia is mostly associated with S. pneumoniae.

      The M protein is attached to the peptidoglycan of the cell wall and extends to
      the cell surface. The M protein is essential for virulence. The polysaccharide capsule is characteristic of S. pneumoniae.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 29 - A patient presents complaining of visual loss. On examination you note a contralateral...

    Incorrect

    • A patient presents complaining of visual loss. On examination you note a contralateral homonymous hemianopia. Where is the most likely site of the lesion:

      Your Answer:

      Correct Answer: Optic tract

      Explanation:

      At the optic chiasm, fibres from the medial (nasal) half of each retina crossover, forming the right and left optic tracts.
      The left optic tract contains fibres from the left lateral (temporal) retina and the right medial retina.
      The right optic tract contains fibres from the right lateral retina and the left medial retina.
      Each optic tract travels to its corresponding cerebral hemisphere to reach its lateral geniculate nucleus (LGN) located in the thalamus where the fibres synapse.
      A lesion of the optic tract will cause a contralateral homonymous hemianopia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 30 - Which of the following is the most common cause of hyperthyroidism: ...

    Incorrect

    • Which of the following is the most common cause of hyperthyroidism:

      Your Answer:

      Correct Answer: Graves disease

      Explanation:

      Graves disease is the most common cause of hyperthyroidism. It is an autoimmune disease in which autoantibodies against TSH receptors are produced. These antibodies bind to and stimulate these TSH receptors leading to an excess production of thyroid hormones. Therefore, the signs and symptoms of Graves disease are the same as those of hyperthyroidism, reflecting the actions of increased circulating levels of thyroid hormones: increased heat production, weight loss, increased 02 consumption and cardiac output and exophthalmos (bulging eyes, not drooping eyelids). TSH levels will be decreased (not increased) as a result of the negative feedback effect of increased T3 levels on the anterior pituitary.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular Pharmacology (1/1) 100%
Pharmacology (4/5) 80%
Physiology (2/2) 100%
Renal (1/1) 100%
Musculoskeletal Pharmacology (1/1) 100%
Microbiology (0/1) 0%
Specific Pathogen Groups (0/1) 0%
Respiratory (1/1) 100%
Anatomy (3/4) 75%
Upper Limb (1/1) 100%
Lower Limb (1/2) 50%
Central Nervous System (1/1) 100%
Infections (1/2) 50%
Renal Physiology (1/1) 100%
Passmed