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  • Question 1 - Normal human immunoglobulin is mostly used to protect against which of the following...

    Incorrect

    • Normal human immunoglobulin is mostly used to protect against which of the following infectious diseases?

      Your Answer: Hepatitis B

      Correct Answer: Measles and hepatitis A

      Explanation:

      Immune globulin IM is indicated for prophylaxis following exposure
      to hepatitis A, to prevent or modify measles (rubeola) in a
      susceptible person exposed fewer than 6 days previously,
      for susceptible household contacts of measles patients,
      particularly contacts <1 year and pregnant women without
      evidence of immunity, and to modify rubella in exposed pregnant
      women who will not consider a therapeutic abortion.

    • This question is part of the following fields:

      • Immunoglobulins And Vaccines
      • Pharmacology
      25.7
      Seconds
  • Question 2 - Regarding skeletal muscle, which of the following best describes the Z-line: ...

    Correct

    • Regarding skeletal muscle, which of the following best describes the Z-line:

      Your Answer: A line dividing muscle fibres into sarcomeres

      Explanation:

      Each muscle fibre is divided at regular intervals along its length into sarcomeres separated by Z-lines. The sarcomere is the functional unit of the muscle.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      22
      Seconds
  • Question 3 - You are reviewing a patient in the Emergency Department brought in by the...

    Correct

    • You are reviewing a patient in the Emergency Department brought in by the ambulance team from a burning building. After examination, you decide to intubate the patient due to laryngeal oedema. The induction agent you are planning to use is propofol.

      Which one of the following statements about this medicine is TRUE?

      Your Answer: It decreases cardiac output by approximately 20%

      Explanation:

      Propofol is a short-acting anaesthetic that is thought to work by potentiating GABA and glycine. It induces anterograde amnesia and anaesthetic effects and is used to induce anaesthesia, outpatient surgeries and preoperative sedation. The dose for induction of anaesthesia is 1.5-2.5mg/kg. The dose for maintenance of anaesthesia is 4-12 mg/kg/hour. Following intravenous injection, propofol acts within 30 seconds and its duration of action is 5-10 minutes.

      Propofol produces a 15-25% decrease in blood pressure and systemic vascular resistance without a compensatory increase in heart rate. It is negatively inotropic and decreases cardiac output by approximately 20%.

      The main side effects of propofol are:
      Pain on injection (in up to 30%)
      Hypotension
      Transient apnoea
      Hyperventilation
      Coughing and hiccough
      Headache
      Thrombosis and phlebitis

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      27
      Seconds
  • Question 4 - A 70-year-old man has severe diarrhoea one week after taking co-amoxiclav for a...

    Incorrect

    • A 70-year-old man has severe diarrhoea one week after taking co-amoxiclav for a chest infection. The diarrhoea is yellow in colour and smell is offensive.

      What is the SINGLE MOST likely causative organism?

      Your Answer: Salmonella enteritidis

      Correct Answer: Clostridium difficile

      Explanation:

      Clostridium difficile, a Gram-positive, anaerobic, spore forming bacteria is present in the gut of approximately 3% of healthy adults (2012 UK HPA estimates). Following use of broad spectrum antibiotics, which alter normal gut flora, Clostridium difficile associated diarrhoea (CDAD) occurs.

      About 80% of Clostridium difficile infections are seen in people over the age of 65 and its main clinical features are:
      Abdominal cramps, severe bloody and/or watery diarrhoea, offensive smelling diarrhoea, and fever.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      13.3
      Seconds
  • Question 5 - Which of the following tracts must be affected if a patient presents with...

    Incorrect

    • Which of the following tracts must be affected if a patient presents with decreased pain and temperature sensation in both lower extremities?

      Your Answer: The dorsal column-medial lemniscal pathway

      Correct Answer: The lateral spinothalamic tract

      Explanation:

      The main function of the spinothalamic tract is to carry pain and temperature via the lateral part of the pathway and crude touch via the anterior part. The spinothalamic tract pathway is an imperative sensory pathway in human survival because it enables one to move away from noxious stimuli by carrying pain and temperature information from the skin to the thalamus where it is processed and transmitted to the primary sensory cortex. The primary sensory cortex communicates with the primary motor cortex, which lies close to it, to generate rapid movement in response to potentially harmful stimuli. Furthermore, the spinothalamic tract has a role in responding to pruritogens, causing us to itch. Interestingly, itching suppresses the spinothalamic tract neuron response to the histamine effect.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      13.9
      Seconds
  • Question 6 - A 6-year-old child with a few itchy honey crusted sores on her left...

    Correct

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

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

      Your Answer: Inhibition of protein synthesis

      Explanation:

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

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      40.3
      Seconds
  • Question 7 - 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
      15.3
      Seconds
  • Question 8 - A 20-year-old boy took almost 25 tablets of paracetamol almost 4 hours ago....

    Incorrect

    • A 20-year-old boy took almost 25 tablets of paracetamol almost 4 hours ago. The boy is healthy and has no known comorbid or drug history.

      Out of the following metabolic pathways, which one is primarily responsible for the toxic effects of paracetamol?

      Your Answer: Glucuronidation

      Correct Answer: N-hydroxylation

      Explanation:

      Paracetamol is predominantly metabolized in the liver by three main metabolic pathways:
      1. Glucuronidation (45-55%)
      2. Sulphate conjugation (30-35%)
      3. N-hydroxylation via the hepatic cytochrome P450 enzyme system (10-15%)

      Cytochrome P450 enzymes catalyse the oxidation of acetaminophen to the reactive metabolite N-acetyl-p-benzoquinoneimine (NAPQI). NAPQI primarily contributes to the toxic effects of acetaminophen. NAPQI is an intermediate metabolite that is further metabolized by fast conjugation with glutathione. The conjugated metabolite is then excreted in the urine as mercapturic acid. High doses of acetaminophen (overdoses) can lead to hepatic necrosis due to depleting glutathione and high binding levels of reactive metabolite (NAPQI) to important parts of liver cells.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      59.1
      Seconds
  • Question 9 - A 5-year-old girl is brought into the Paediatric ER for acute seizures. She...

    Incorrect

    • A 5-year-old girl is brought into the Paediatric ER for acute seizures. She has been convulsing for the past 18 minutes now and was already two doses of lorazepam in the ambulance. Now, you prepare a phenytoin infusion to abolish the seizures.

      According to the APLS algorithm, what dose of phenytoin is advised for a convulsing child at this stage?

      Your Answer: 5 mg/kg over 20 minutes

      Correct Answer: 20 mg/kg over 20 minutes

      Explanation:

      Advanced paediatric life support (APLS) recommends phenytoin as the first choice for second-line anticonvulsant in a patient that continues to seize ten minutes after the second dose of the first-line anticonvulsant (benzodiazepine). (step 3 of the APLS algorithm)

      The recommended dose of phenytoin infusion is up at 20 mg/kg over 20 minutes. If the patient has already taken phenytoin as maintenance therapy or is allergic to phenytoin, then a phenobarbitone infusion should be set up at 20 mg/kg over 30-60 minutes.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      18.4
      Seconds
  • Question 10 - Which one of these infectious diseases typically has an incubation period of between...

    Correct

    • Which one of these infectious diseases typically has an incubation period of between 1 and 3 weeks?

      Your Answer: Chickenpox

      Explanation:

      The incubation period for Chickenpox is 7-23 days (usually around 2 weeks).

      Incubation period of botulism is 18-36 hours

      Incubation period of Meningococcaemia is 1-7 days.

      Incubation period of Gonorrhoea is 3-5 days.

      Incubation period of Hepatitis A is 3-5 weeks.
      Other infectious with an incubation period of between 1 and 3 weeks are:
      Whooping cough (7-10 days)
      Brucellosis (7-21 days)
      Leptospirosis (7-12 days)
      Malaria (7-40 days depending on strain)
      Typhoid (8-21 days)
      Measles (10-18 days)
      Mumps (14-18 days)
      Rubella (14-21 days)

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      22.2
      Seconds
  • Question 11 - Which of the following immunoglobulins is most important for mast cell degranulation: ...

    Incorrect

    • Which of the following immunoglobulins is most important for mast cell degranulation:

      Your Answer: IgG

      Correct Answer: IgE

      Explanation:

      IgA is the major Ig in secretions, particularly from the gastrointestinal tract (but also in saliva, tears, sweat and breast milk).
      IgE is important for mast cell degranulation in allergic and antiparasitic response. In the allergic response, the plasma cell produces IgE-antibodies, which, like antibodies of other immunoglobulin isotypes, are capable of binding a specific allergen via its Fab portion.
      IgG is the most abundant in plasma (comprising 80% of normal serum immunoglobulin) and the main circulatory Ig for the secondary immune response.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      8
      Seconds
  • Question 12 - An elderly female with a diagnosed psychiatric illness was prescribed prochlorperazine for her...

    Correct

    • An elderly female with a diagnosed psychiatric illness was prescribed prochlorperazine for her complaints of dizziness and nausea. Two days later, she returned to the clinic with no improvement in the symptoms.

      Which one of the following is the mechanism of action of prochlorperazine?

      Your Answer: Dopamine receptor antagonism

      Explanation:

      Prochlorperazine is a phenothiazine drug as it is categorized as a first-generation antipsychotic. It mainly blocks the D2 (dopamine 2) receptors in the brain. Along with dopamine, it also blocks histaminergic, cholinergic, and noradrenergic receptors.

      It exerts its antiemetic effect via dopamine (D2) receptor antagonist. It is used to treat nausea and vomiting of various causes, including labyrinthine disorders.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      21.7
      Seconds
  • Question 13 - A 60-year-old man diagnosed with chronic kidney disease has an elevated creatinine level...

    Incorrect

    • A 60-year-old man diagnosed with chronic kidney disease has an elevated creatinine level and a reduced glomerular filtration rate (GFR).

      Which statement concerning glomerular filtration is true?

      Your Answer: The GFR declines with age after the age of 40 at a rate of approximately 5 ml/min/year

      Correct Answer: Creatinine is freely filtered at the glomerulus

      Explanation:

      Glomerular filtration is a passive process. It depends on the net hydrostatic pressure across the glomerular capillaries, the oncotic pressure, and the intrinsic permeability of the glomerulus.

      The mean values for glomerular filtration rate (GFR) in young adults are 130 ml/min/1.73m2 in males and 120 ml/min/1.73m2in females.

      The GFR declines with age after the age of 40 at a rate of approximately 1 ml/min/year.

      The Cockcroft and Gault formula overestimates creatinine in obese patients. This is because their endogenous creatinine production is less than that predicted by overall body weight.

      Creatinine is used in the estimation of GFR because it is naturally produced by muscle breakdown, not toxic, not produced by the kidney, freely filtered at the glomerulus, not reabsorbed from the nephron, and does not alter GFR.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      24.1
      Seconds
  • Question 14 - Regarding the refractory period, which of the following statements is INCORRECT: ...

    Correct

    • Regarding the refractory period, which of the following statements is INCORRECT:

      Your Answer: Action potentials can occur in the relative refractory period but the amplitude of the action potential is smaller.

      Explanation:

      Following the action potential, Na+channels remain inactive for a time in a period known as the absolute refractory period where they cannot be opened by any amount of depolarisation. Following this there is a relative refractory period where the temporary hyperpolarisation (due to delayed closure of rectifier K+channels) makes the cell more difficult to depolarise and an action potential can be generated only in response to a larger than normal stimulus. The refractory period limits the frequency at which action potentials can be generated, and ensures that, once initiated, an action potential can travel only in one direction. An action potential is an all or nothing response so the amplitude of the action potential cannot be smaller.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      59.1
      Seconds
  • Question 15 - The most important nerves for inversion of the foot are: ...

    Incorrect

    • The most important nerves for inversion of the foot are:

      Your Answer: Deep fibular and superficial fibular nerve

      Correct Answer: Tibial and deep fibular nerve

      Explanation:

      Inversion of the foot is achieved by the tibialis anterior which is innervated by the deep fibular nerves, and the tibialis posterior muscles which is innervated by the tibial nerve respectively.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      15.2
      Seconds
  • Question 16 - Regarding Clostridium tetani, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding Clostridium tetani, which of the following statements is CORRECT:

      Your Answer: It has endotoxin-mediated effects.

      Correct Answer: Metronidazole is usually the antibiotic of choice for tetanus infection.

      Explanation:

      Clostridium tetani infection is predominantly derived from animal faeces and soil.  Clostridium tetani has exotoxin-mediated effects, predominantly by tetanospasmin which inhibits the release of GABA at the presynaptic membrane throughout the central and peripheral nervous system. Metronidazole has overtaken penicillin as the antibiotic of choice for treatment of tetanus (together with surgical debridement, tetanus toxoid immunisation, and human tetanus immunoglobulin).

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      18.3
      Seconds
  • Question 17 - A 54-year-old woman presents with polyuria and polydipsia. She is known to suffer...

    Correct

    • A 54-year-old woman presents with polyuria and polydipsia. She is known to suffer from bipolar disorder, which has been well controlled by the use of lithium for many years.
      What is the SINGLE most likely diagnosis?

      Your Answer: Nephrogenic diabetes insipidus

      Explanation:

      Diabetes insipidus is the inability to produce concentrated urine. It is characterised by the presence of excessive thirst, polyuria and polydipsia. There are two distinct types of diabetes insipidus:
      Cranial (central) diabetes insipidus and;
      Nephrogenic diabetes insipidus
      Cranial diabetes insipidus is caused by a deficiency of vasopressin (anti-diuretic hormone). Patients with cranial diabetes insipidus can have a urine output as high as 10-15 litres per 24 hours, but adequate fluid intake allows most patients to maintain normonatraemia. 30% of cases are idiopathic, and a further 30% are secondary to head injuries. Other causes include neurosurgery, brain tumours, meningitis, granulomatous disease (e.g. sarcoidosis) and drugs, such as naloxone and phenytoin. A very rare inherited form also exists that is associated with diabetes mellitus, optic atrophy, nerve deafness and bladder atonia.
      Nephrogenic diabetes insipidus is caused by renal resistance to the action of vasopressin. As with cranial diabetes insipidus, urine output is markedly elevated. Serum sodium levels can be maintained by secondary polydipsia or can be elevated. Causes of nephrogenic diabetes insipidus include chronic renal disease, metabolic disorders (e.g. hypercalcaemia and hypokalaemia) and drugs, including long-term lithium usage and demeclocycline.
      In view of the history of long-term lithium use, in this case, nephrogenic diabetes insipidus is the most likely diagnosis.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      18
      Seconds
  • Question 18 - A patient suffers a stab wound to the neck. The entry point of...

    Correct

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

      Your Answer: Sternohyoid

      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

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      14.1
      Seconds
  • Question 19 - A 34-year-old male is brought into the Emergency Department by the paramedics after...

    Incorrect

    • A 34-year-old male is brought into the Emergency Department by the paramedics after a road traffic accident. After a quick triage, you establish that he will need to be intubated, and you ask for some ketamine to be prepared.

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

      Your Answer: It works by agonism of the NDMA receptor

      Correct Answer: It is the only anaesthetic agent available that has analgesic, hypnotic, and amnesic properties

      Explanation:

      Ketamine is a dissociative anaesthetic with analgesic, amnesic, and hypnotic effects. It is the only anaesthetic agent which causes all three of these effects.

      Ketamine exerts its action by non-competitive antagonism at the NMDA (N-methyl-D-aspartate) receptor. Due to its analgesic property, Ketamine is given so that patients do not retain memories of short term procedures. Ketamine is used for the induction and maintenance of anaesthesia in general surgery and for treating burn wounds, battlefield injuries, and children who cannot tolerate other anaesthetic or analgesic agents.

      It can be given by both intravenous and intramuscular routes. Ketamine causes cardiac stimulation by increasing the sympathetic tone. The major side effect is increased intracranial pressure as an increase in the sympathetic tone causes vasoconstriction and an increase in the MAP.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      36.6
      Seconds
  • Question 20 - Which of the following best describes the process of opsonisation: ...

    Correct

    • Which of the following best describes the process of opsonisation:

      Your Answer: The coating of foreign particles with molecules which allow easier recognition of that cell by phagocytes

      Explanation:

      An opsonin is any molecule that enhances phagocytosis by marking an antigen for an immune response, for example, immunoglobulin or complement. Opsonisation is the molecular mechanism whereby molecules, microbes, or apoptotic cells are chemically modified to have a stronger attraction to the cell surface receptors on phagocytes and natural killer cells. With the antigen coated in opsonins, binding to immune cells is greatly enhanced. Opsonisation also mediates phagocytosis via signal cascades from cell surface receptors.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      18.8
      Seconds
  • Question 21 - Which of the following is most likely to cause a bitemporal hemianopia: ...

    Incorrect

    • Which of the following is most likely to cause a bitemporal hemianopia:

      Your Answer: Frontal lobe tumour

      Correct Answer: Pituitary adenoma

      Explanation:

      A bitemporal hemianopia is most likely due to compression at the optic chiasm. This may be caused by pituitary tumour, craniopharyngioma, meningioma, optic glioma or aneurysm of the internal carotid artery. A posterior cerebral stroke will most likely result in a contralateral homonymous hemianopia with macular sparing.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      16.8
      Seconds
  • Question 22 - On his stool culture, a patient with a diarrhoeal illness grows Escherichia coli.

    What...

    Correct

    • On his stool culture, a patient with a diarrhoeal illness grows Escherichia coli.

      What SINGLE statement about Escherichia coli is true?

      Your Answer: Most serotypes are harmless

      Explanation:

      Escherichia coli is a Gram-negative, non-spore forming, facultative anaerobic, rod-shaped bacterium.

      Although some can cause serious food poisoning, most serotypes are harmless.

      Escherichia coli is transmitted via the faeco-oral route.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      12.5
      Seconds
  • Question 23 - A 30-year-old rugby player suffers from an anterior cruciate ligament tear while pivoting...

    Correct

    • A 30-year-old rugby player suffers from an anterior cruciate ligament tear while pivoting to attempt to run around another player. An MRI was performed and showed that his injury caused two other structures in the knee joint to be injured.

      Which of the following structures is most likely also injured?

      Your Answer: Medial meniscus

      Explanation:

      The O’Donoghue unhappy triad or terrible triad often occurs in contact and non-contact sports, such as basketball, football, or rugby, when there is a lateral force applied to the knee while the foot is fixated on the ground. This produces an abduction-external rotation mechanism of injury.

      The O’Donoghue unhappy triad comprises three types of soft tissue injury that frequently tend to occur simultaneously in knee injuries. O’Donoghue described the injuries as: anterior cruciate ligament tear, medial collateral ligament injury, and medial meniscal tear (lateral compartment bone bruise).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      22.1
      Seconds
  • Question 24 - Streptococcus pneumoniae is commonly implicated in all of the following infectious diseases EXCEPT...

    Incorrect

    • Streptococcus pneumoniae is commonly implicated in all of the following infectious diseases EXCEPT for:

      Your Answer: Meningitis

      Correct Answer: Impetigo

      Explanation:

      Impetigo is a highly contagious infection of the superficial epidermis that most commonly affects young children but can occur in any age group. In children it is the most common bacterial skin infection and it is the third most common skin disease overall, behind dermatitis and viral warts.
      The commonest causative organism is Staphylococcus aureus. Streptococcus pyogenesis the second commonest and causes fewer cases, either alone or in combination withS. aureus.The streptococcal form tends to be commoner in warmer, more humid climates. (Hirschmann JV. Impetigo: etiology and therapy. Curr Clin Top Infect Dis. 2002;22:42–51.)
      Impetigo is most commonly spread by direct person-to-person contact, and can spread rapidly through families and school classes. It can also, less commonly, be spread by indirect contact.
      There are two main forms of impetigo:
      Non-bullous impetigo – lesions usually start as tiny pustules or vesicles that evolve rapidly into honey-crusted plaques that tend to be under 2 cm in diameter. These can be itchy but are rarely painful.
      Bullous impetigo – lesions have a thin roof and tend to rupture spontaneously. This type is more likely to be painful and may be associated with systemic upset.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      10.8
      Seconds
  • Question 25 - An increased anion gap metabolic acidosis is typically caused by which of the...

    Correct

    • An increased anion gap metabolic acidosis is typically caused by which of the following?

      Your Answer: Propylene glycol overdose

      Explanation:

      Causes of a raised anion gap acidosis can be remember using the mnemonic MUDPILES:
      -Methanol
      -Uraemia (in renal failure)
      -Diabetic ketoacidosis
      -Propylene glycol overdose
      -Infection/Iron overdose/Isoniazid/Inborn errors of metabolism
      -Lactic acidosis
      -Ethylene glycol overdose
      -Salicylate overdose

    • This question is part of the following fields:

      • Physiology
      • Renal
      14.3
      Seconds
  • Question 26 - Continuous capillaries are typically found where in the body: ...

    Incorrect

    • Continuous capillaries are typically found where in the body:

      Your Answer: Renal glomeruli

      Correct Answer: Blood-brain barrier

      Explanation:

      Continuous capillaries, found in the skin, lungs, muscles and CNS, are the most selective with low permeability, as junctions between the endothelial cells are very tight, restricting the flow of molecules with MW > 10,000.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      15.3
      Seconds
  • Question 27 - Regarding hepatitis A, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding hepatitis A, which of the following statements is CORRECT:

      Your Answer: Transmission is by the parenteral route.

      Correct Answer: Anti-HAV IgM antibodies are diagnostic.

      Explanation:

      Anti-HAV IgM antibodies are diagnostic. Disease in children is more commonly asymptomatic, risk of symptomatic disease increases with age. Transmission is by the faecal-oral route. Faecal shedding has been demonstrated for 2 – 3 weeks before and about a week after, the onset of jaundice. Infection confers lifelong immunity.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      21
      Seconds
  • Question 28 - A 73-year-old woman arrives at the emergency department 48 hours after being discharged from...

    Correct

    • A 73-year-old woman arrives at the emergency department 48 hours after being discharged from the hospital after a two-week stay for sepsis treatment. She has fever, productive cough with thick green sputum, and shortness of breath. An X-ray shows left lower lobe pneumonia. Which of the bacteria listed below is more likely to be the causative agent:

      Your Answer: Pseudomonas aeruginosa

      Explanation:

      Hospital-acquired pneumonia (HAP), or nosocomial pneumonia, is a lower respiratory infection that was not incubating at the time of hospital admission and that presents clinically 2 or more days after hospitalization. Pneumonia that presents sooner should be regarded as community­ acquired pneumonia. VAP refers to nosocomial pneumonia that develops among patients on ventilators. Ventilator-associated pneumonia (VAP) is defined as pneumonia that presents more than 48 hours after endotracheal intubation.

      Common bacteria involved in hospital-acquired pneumonia (HAP) include the following [10] :
      Pseudomonas Aeruginosa
      Staphylococcus aureus, including methicillin-susceptible S aureus (MSSA) and methicillin-resistant S aureus (MRSA)
      Klebsiella pneumoniae
      Escherichia coli

    • This question is part of the following fields:

      • Infections
      • Microbiology
      17.1
      Seconds
  • Question 29 - If the null hypothesis is wrongly rejected when it is actually true, this...

    Incorrect

    • If the null hypothesis is wrongly rejected when it is actually true, this is an example of:

      Your Answer: A test with a type II error

      Correct Answer: A test with a type I error

      Explanation:

      A type I error occurs when the null hypothesis is wrongly rejected when it is actually true and we conclude that there is a difference of effect when in reality there is none (a false positive result).

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      46.7
      Seconds
  • Question 30 - Which of the following statements is correct regarding the partial pressure of oxygen...

    Incorrect

    • Which of the following statements is correct regarding the partial pressure of oxygen during respiration?

      Your Answer: Inhaled PO 2 < Humidified inspired PO 2

      Correct Answer: Exhaled PO 2 > Alveolar PO 2

      Explanation:

      Because of humidification, inspired PO2 in the airways is less than inhaled PO2.
      Because of gas exchange, alveolar PO2 is less than inhaled or inspired PO2.
      Because of mixing with anatomical dead space (air that has not taken part in gas exchange, exhaled PO2 is greater than alveolar O2, and therefore that has relatively higher PO2 on the way out, but is less than inhaled or inspired PO2.
      Typical values for a resting young healthy male (in kPa) are shown below:
      -Inhaled air: PO221.2, PCO20.0
      -Inspired air in airways (after humidification): PO219.9, PCO20.0
      -Alveolar air (after equilibrium with pulmonary capillaries): PO213.3, PCO25.3
      -Exhaled air (after mixing with anatomical dead space air): PO215.5, PCO24.3

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      32.4
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