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  • Question 1 - Herpes simplex virus is transmitted most commonly through which of the following routes:...

    Incorrect

    • Herpes simplex virus is transmitted most commonly through which of the following routes:

      Your Answer: Respiratory droplet spread

      Correct Answer: Direct contact spread

      Explanation:

      Herpes simplex virus is the most common cause of infective encephalitis and has a predilection for the temporal lobes. Herpes simplex is transmitted through direct contact. It invades skin locally producing skin vesicles by its cytolytic activity.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      165.2
      Seconds
  • Question 2 - Which of the following clinical features is most suggestive of a lesion of...

    Correct

    • Which of the following clinical features is most suggestive of a lesion of the occipital lobe:

      Your Answer: Homonymous hemianopia

      Explanation:

      Homonymous hemianopia is a visual field defect involving either the two right or the two left halves of the visual fields of both eyes. It is caused by lesions of the retrochiasmal visual pathways, ie, lesions of the optic tract, the lateral geniculate nucleus, the optic radiations, and the cerebral visual (occipital) cortex

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      12.7
      Seconds
  • Question 3 - Regarding the penis, which of the following statements is CORRECT: ...

    Correct

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

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

      Explanation:

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

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      13.4
      Seconds
  • Question 4 - Regarding the brachioradialis muscle, which of the following statements is true? ...

    Correct

    • Regarding the brachioradialis muscle, which of the following statements is true?

      Your Answer: It assists with supination of the forearm at the radioulnar joints

      Explanation:

      Brachioradialis is a fusiform muscle located in the lateral part of the posterior forearm. Along with extensor carpi radialis brevis and extensor carpi radialis longus, it comprises the radial group of forearm muscles, which belong to the superficial layer of posterior forearm muscles. Although anatomically part of the posterior forearm muscles, which are known to be forearm extensors, brachioradialis’ fibre orientation enables it to rather flex the forearm, and aids in supination of the forearm at the radioulnar joint.

      The brachioradialis muscle originates from the upper two-thirds of the lateral supracondylar ridge of humerus and the anterior surface of the lateral intermuscular septum of the arm. It slides over the lateral surface of the elbow joint, entering the anterolateral cubital area. The muscle fibres course inferiorly down the radial part of the anterior forearm, forming a thick tendon in approximately the middle of the forearm. This tendon then traverses the remainder of the forearm, inserting near the wrist, just proximal to the styloid process of radius.

      Brachioradialis is innervated by the radial nerve (from the root values C5-C6) that stems from the posterior cord of the brachial plexus. Blood supply to the brachioradialis muscle comes from branches of the radial artery, radial recurrent artery and the radial collateral branch of the deep brachial artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      41.2
      Seconds
  • Question 5 - A 4-year-old child has been convulsing for 20 minutes. She has received two...

    Correct

    • A 4-year-old child has been convulsing for 20 minutes. She has received two doses of lorazepam. She takes phenytoin for maintenance therapy, and you draw up a phenobarbitone infusion.
      What dose of phenobarbitone is advised in the treatment of the convulsing child that reaches that stage of the APLS algorithm? Select ONE answer only.

      Your Answer: 20 mg/kg over 30-60 minutes

      Explanation:

      If a convulsing child reaches step 3 of the APLS algorithm, then a phenytoin infusion should be set up at 20 mg/kg over 20 minutes. If they are already taken phenytoin as maintenance therapy, 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
      10690.2
      Seconds
  • Question 6 - A patient sustains an injury to the proximal median nerve after falling through...

    Correct

    • A patient sustains an injury to the proximal median nerve after falling through a glass door. Which of the following muscles would you not expect to be affected:

      Your Answer: Flexor carpi ulnaris

      Explanation:

      All of the muscles in the anterior forearm are innervated by the median nerve, except for the flexor carpi ulnaris and the medial half of the flexor digitorum profundus which are innervated by the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      59.4
      Seconds
  • Question 7 - A 57-year-old woman has presented with cough and shortness of breath. Her GP...

    Incorrect

    • A 57-year-old woman has presented with cough and shortness of breath. Her GP had done some blood tests recently and told her that she had a positive ANA result.

      Which of these statements is true about anti-nuclear antibodies (ANAs)? Select only ONE answer.

      Your Answer: Anti-double stranded DNA (Anti-DsDNA) is suggestive of drug-induced lupus.

      Correct Answer: The presence of ANAs in rheumatoid arthritis is suggestive of Felty’s syndrome

      Explanation:

      Anti-nuclear antibodies are auto-antibodies directed against a variety of nuclear antigens. There are different staining patterns and each pattern is suggestive of a different disorder.

      Speckled staining is suggestive of mixed connective tissue disease.

      Nucleolar staining is suggestive of scleroderma, while homogenous staining is suggestive of lupus.

      Anti-double stranded DNA is suggestive of SLE while anti-histone antibodies are suggestive of drug-induced lupus.

      ELISA testing is cheaper but not the most accurate means of testing for ANAs. Indirect immunofluorescence testing is the most accurate.

      The presence of ANAs in rheumatoid arthritis is suggestive of Felty’s syndrome. Felty’s syndrome is characterized by a combination of rheumatoid arthritis, splenomegaly and neutropenia.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      431
      Seconds
  • Question 8 - A 22 year old student has recently returned from travelling around Kenya and...

    Correct

    • A 22 year old student has recently returned from travelling around Kenya and presents to ED with a headache and persistent fever. Malaria is being considered as a potential diagnosis. Which of the following strains of malaria is most likely:

      Your Answer: Plasmodium falciparum

      Explanation:

      Malaria is an infectious disease transmitted by female of theAnophelesgenus of mosquito. It is a parasitic infection caused by the genusPlasmodium. Five species are recognized as causing disease in humans;Plasmodium falciparum,Plasmodium ovale,Plasmodium vivax,Plasmodium malariaeandPlasmodium knowlesi.
      The classic symptom of malaria is the malarial paroxysm, a cyclical occurrence of a cold phase, where the patient experiences intense chills, a hot stage, where the patient feels extremely hot and finally a sweating stage, where the fever declines and the patient sweats profusely. On examination the patient may show signs of anaemia, jaundice and have hepatosplenomegaly without evidence of lymphadenopathy.

      Plasmodium falciparum is the most serious form and is responsible for most deaths. Severe or complicated malaria is suggested by the presence of impaired consciousness, seizures, hypoglycaemia, anaemia, renal impairment, respiratory distress and spontaneous bleeding.
      Plasmodium falciparum is the most likely type in this case in view of the presentation.
      Haemoglobinuria and renal failure following treatment is suggestive of blackwater fever, which is caused byPlasmodium falciparum. An autoimmune reaction between the parasite and quinine causes haemolysis, haemoglobinuria, jaundice and renal failure. This can be fatal.
      The benign malarias: P.vivax, P. malariae and P.ovale are usually treated with chloroquine. A course of primaquine is also required in P.vivax and P.ovale infection. Artesunate is the drug treatment of choice for Plasmodium falciparum malaria. Quinine can still be used where artesunate is not available. Often combination therapy with drugs such as doxycycline or fansidar is also required.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      16.3
      Seconds
  • Question 9 - A patient suffers from an injury and as a consequence, is unable to...

    Correct

    • A patient suffers from an injury and as a consequence, is unable to externally rotate his femur when his hip is extended. You suspect a nerve injury to the obturator internus muscle. Which of the following nerves innervate the obturator internus muscle?

      Your Answer: Obturator internus nerve

      Explanation:

      The obturator internus is innervated by the obturator internus nerve (L5–S2), a branch of sacral plexus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      49
      Seconds
  • Question 10 - What is the main mechanism of action of flecainide: ...

    Incorrect

    • What is the main mechanism of action of flecainide:

      Your Answer: Closes K+ channels

      Correct Answer: Blocks Na+ channels

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      725.5
      Seconds
  • Question 11 - A 25-year-old patient requires procedural sedation for reduction of an open fracture of...

    Incorrect

    • A 25-year-old patient requires procedural sedation for reduction of an open fracture of his tibia and fibula. You plan on using ketamine as the sedative agent.
      Ketamine works as a result of action on what type of receptor? Select ONE answer only.

      Your Answer: Kainate

      Correct Answer: N-methyl-D-aspartate (NMDA)

      Explanation:

      Ketamine is the only anaesthetic agent available that has analgesic, hypnotic, and amnesic properties. When used correctly it is a very useful and versatile drug.
      Ketamine acts by non-competitive antagonism of the NMDA receptor Ca2+ channel pore and also inhibits NMDA receptor activity by interaction with the phencyclidine binding site.
      Ketamine can be used intravenously and intramuscularly. The intramuscular dose is 10 mg/kg, and when used by this route, it acts within 2-8 minutes and has a duration of action of 10-20 minutes. The intravenous dose is 1.5-2 mg/kg administered over a period of 60 seconds. When used intravenously, it acts within 30 seconds and has a duration of action of 5-10 minutes. Ketamine is also effective when administered orally, rectally, and nasally.
      Ketamine causes tachycardia, an increase in blood pressure, central venous pressure, and cardiac output, secondary to an increase in sympathetic tone. Baroreceptor function is well maintained, and arrhythmias are uncommon.
      The main disadvantage to the use of ketamine is the high incidence of hallucinations, nightmares, and other transient psychotic effects. These can be reduced by the co-administration of a benzodiazepine, such as diazepam or midazolam.
      The main side effects of ketamine are:
      Nausea and vomiting
      Hypertension
      Nystagmus
      Diplopia
      Rash

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      13.3
      Seconds
  • Question 12 - Which of the following movements does the iliacus muscle produce? ...

    Incorrect

    • Which of the following movements does the iliacus muscle produce?

      Your Answer: Extension of the thigh at the hip joint

      Correct Answer: Flexion of the thigh at the hip joint

      Explanation:

      The iliacus flexes the thigh at the hip joint when the trunk is stabilised. It flexes the trunk against gravity when the body is supine.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      48.6
      Seconds
  • Question 13 - A 34-year-old man presented to the emergency room after being involved in a...

    Incorrect

    • A 34-year-old man presented to the emergency room after being involved in a road traffic accident. Upon observation and examination, it was noted that he was hypotensive and has muffled heart sounds. It was suspected that he has pericardial effusion, so an emergency pericardiocentesis was to be performed.

      In performing pericardiocentesis for suspected pericardial effusion, which of the following anatomical sites are at risk of being punctured?

      Your Answer: 2 cm above the left xiphocostal angle

      Correct Answer: 1 cm below the left xiphocostal angle

      Explanation:

      Pericardiocentesis is a procedure done to remove fluid build-up in the sac around the heart known as the pericardium. The pericardium can be tapped from almost any reasonable location on the chest wall. However, for the usual blind pericardiocentesis, the subxiphoid approach is preferred. Ideally, 2-D echocardiography is used to guide needle insertion and the subsequent path of the needle/catheter.

      In the subxiphoid approach, the needle is inserted 1 cm inferior to the left xiphocostal angle with an angle of 30 degrees from the patient’s chest with a direction towards the left mid-clavicle.

      The fingers may sense a distinct give when the needle penetrates the parietal pericardium. Successful removal of fluid confirms the needle’s position.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      40.2
      Seconds
  • Question 14 - The least likely feature expected to be seen in a lesion of the...

    Incorrect

    • The least likely feature expected to be seen in a lesion of the frontal lobe is which of the following?

      Your Answer: Contralateral weakness of the face and arm

      Correct Answer: Loss of two-point discrimination

      Explanation:

      Lesions in different areas give rise to different symptoms.
      Lesions of the parietal lobe give rise to loss of two-point discrimination.
      Lesions to Broca’s area give rise to expressive dysphasia results from damage
      Lesions to the primary motor cortex give rise to contralateral weakness of the face and arm.
      Lesions to the prefrontal cortex give rise to personality change.
      Lesions to the frontal eye field give rise to conjugate eye deviation towards side of lesion.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      12.9
      Seconds
  • Question 15 - C3 deficiency leads to particular susceptibility of infection with which of the following:...

    Incorrect

    • C3 deficiency leads to particular susceptibility of infection with which of the following:

      Your Answer: Intracellular bacteria

      Correct Answer: Encapsulated bacteria

      Explanation:

      Macrophages and neutrophils have C3b receptors and they phagocytose C3b-coated cells. C3 deficiency thus leads to increased susceptibility of infection with encapsulated organisms (e.g. S. pneumoniae, H. influenzae).The early stages of the complement cascade leading to coating of the cells with C3b can occur by two different pathways:The classical pathway usually activated by IgG or IgM coating of cellsThe alternative pathway which is more rapid and activated by IgA, endotoxin and other factors

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      14.3
      Seconds
  • Question 16 - If the ejection fraction increases, there will be a decrease in: ...

    Incorrect

    • If the ejection fraction increases, there will be a decrease in:

      Your Answer:

      Correct Answer: End-systolic volume

      Explanation:

      An increase in ejection fraction means that a higher fraction of the end-diastolic volume is ejected in the stroke volume (e.g. because of the administration of a positive inotropic agent). When this situation occurs, the volume remaining in the ventricle after systole, the end-systolic volume, will be reduced. Cardiac output, stroke volume, and mean arterial pressure will be increased.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 17 - An 82 year old man taking warfarin as a maintenance medication comes in...

    Incorrect

    • An 82 year old man taking warfarin as a maintenance medication comes in to your clinic because of an infection. Which antibiotic is the safest choice for this patient?

      Your Answer:

      Correct Answer: Cefalexin

      Explanation:

      Alterations in the international normalized ratio (INR) brought about by the concurrent use of antibiotics and warfarin may result in either excessive clotting or excessive bleeding if they are deemed to have a high risk for interaction. As such, there should be careful consideration of the class of antibiotic to be used.

      Antibiotics from the following drug classes should generally be avoided as they have a high risk for interaction with warfarin, possible enhancing the anticoagulant effects of warfarin resulting in bleeding: Fluoroquinolones (e.g. ciprofloxacin, levofloxacin), Macrolides (e.g. clarithromycin, erythromycin, azithromycin), Nitroimidazoles (e.g. metronidazole), Sulphonamides (e.g. co-trimoxazole, a combination of trimethoprim and sulfamethoxazole), Trimethoprim, Tetracyclines (e.g. doxycycline).

      Low risk antibiotics that have low risk for interaction with warfarin includes cephalexin, from the cephalosporin class, and clindamycin which is a lincomycin.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds
  • Question 18 - The 'bucket handle' movement of the thoracic wall describes which of the following movements:...

    Incorrect

    • The 'bucket handle' movement of the thoracic wall describes which of the following movements:

      Your Answer:

      Correct Answer: The middles of the shafts of the ribs moving upwards and laterally

      Explanation:

      Because the middles of the shafts of the ribs are lower than either the anterior or posterior end, elevation of the ribs also moves the middles of the shafts laterally. This ‘bucket handle’ upwards and lateral movement increases the lateral dimensions of the thorax.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 19 - Which of the following accurately describes the extensor pollicis brevis muscle? ...

    Incorrect

    • Which of the following accurately describes the extensor pollicis brevis muscle?

      Your Answer:

      Correct Answer: It lies on the medial side of abductor pollicis longus

      Explanation:

      Extensor pollicis brevis is a short and slender muscle located in the posterior compartment of the forearm, extending from the posterior surface of radius to the proximal phalanx of thumb. It is one of the deep extensors of the forearm, together with supinator, abductor pollicis longus, extensor pollicis longus and extensor indicis muscles.

      Extensor pollicis brevis is a deep extensor of the thumb that lies deep to extensor digitorum muscle. It sits directly medial to abductor pollicis longus and posterolateral to extensor pollicis longus muscle. Just above the wrist, extensor pollicis brevis obliquely crosses the tendons of extensor carpi radialis brevis and extensor carpi radialis longus muscles.

      Extensor pollicis brevis is innervated by posterior interosseous nerve which is a continuation of a deep branch of radial nerve (root value C7 and C8).

      Extensor pollicis brevis receives its blood supply by posterior interosseous artery and perforating branches from the anterior interosseous artery, which are the branches of common interosseous artery. The common interosseous artery arises immediately below the tuberosity of radius from the ulnar artery.

      Together with extensor pollicis longus, extensor pollicis brevis is in charge of extension of the thumb in the first metacarpophalangeal joint. It also extends the thumb in the carpometacarpal joint of the thumb. This movement is important in the anatomy of the grip, as it enables letting go of an object. As it crosses the wrist, extensor pollicis brevis also participates in the extension and abduction of this joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 20 - 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:

      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
      0
      Seconds
  • Question 21 - Diabetic ketoacidosis is characterised by which of the following: ...

    Incorrect

    • Diabetic ketoacidosis is characterised by which of the following:

      Your Answer:

      Correct Answer: Hyperglycaemia, ketonaemia and acidosis

      Explanation:

      DKA is characterised by the biochemical triad:
      1. Hyperglycaemia (> 11 mmol/L)
      2. Ketonaemia (> 3 mmol/L)
      3. Acidosis (pH < 7.3 +/- HCO3 < 15 mmol/L)

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds
  • Question 22 - 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:

      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
      0
      Seconds
  • Question 23 - Which of the following immunoglobulins is predominant in saliva: ...

    Incorrect

    • Which of the following immunoglobulins is predominant in saliva:

      Your Answer:

      Correct Answer: IgA

      Explanation:

      Immunoglobulin A is predominant in saliva.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      0
      Seconds
  • Question 24 - Which of the following statements is true regarding a pleural aspiration? ...

    Incorrect

    • Which of the following statements is true regarding a pleural aspiration?

      Your Answer:

      Correct Answer: The needle should be inserted just above the upper border of the chosen rib

      Explanation:

      Pleural aspiration describes a procedure whereby pleural fluid or air may be aspirated via a system inserted temporarily into the pleural space. This may be for diagnostic purposes (usually removing 20–50 ml fluid) or therapeutic to relieve symptoms. In the literature it is varyingly called thoracocentesis, thoracentesis or pleural aspiration.

      In determining the correct patient position and site of insertion, it is important for the operator to be aware of the normal anatomy of the thorax and the pathology of the patient. Patient position is dependent on the operator preference and the site of the pathology. In the case of a posterior lying locule, this may be specific to the image-guided spot where fluid is most likely to be obtained. In most circumstances, however, the site of insertion of the needle is either in the triangle of safety or the second intercostal space in the midclavicular line. The patient may therefore either sit upright leaning forward with arms elevated but resting on a table or bed, thereby exposing the axilla, or lying on a bed in a position. The needle is inserted in the space just above the chosen rib to avoid damaging the neurovascular bundle. It is common practice to insert the needle more posteriorly for a pleural aspiration, but it should be noted that the neurovascular bundle may not be covered by the lower flange of the rib in this position and a more lateral or anterior site of insertion is considered safer.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      0
      Seconds
  • Question 25 - Regarding defaecation, which of the following statements is CORRECT: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Colonic mass movement occurs shortly after a meal due to distension of the stomach and duodenum.

      Explanation:

      Colonic mass movement describes the intense contraction that begins halfway along the transverse colon and pushes the intestinal contents in the proximal colon towards the rectum. It occurs shortly after a meal due to distension of the stomach and duodenum as part of the gastrocolic reflex and if faeces is present in the rectum, stimulates the urge to defecate. Distention of the rectum causes firing of afferent cholinergic parasympathetic fibres. The internal sphincter is made up of circular smooth muscle innervated by the autonomic fibres, and the more distal external sphincter is composed of striated muscle innervated by motor fibres from the pudendal nerve. During defaecation, relaxation of pelvic muscles straightens the rectum.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      0
      Seconds
  • Question 26 - A 44 year old woman sustains an injury to the median nerve at...

    Incorrect

    • A 44 year old woman sustains an injury to the median nerve at the elbow after falling awkwardly. Which of the following clinical features are you LEAST likely to see on examination:

      Your Answer:

      Correct Answer: Loss of flexion of the medial two digits

      Explanation:

      Flexion of the index and middle fingers at the IPJs is lost due to paralysis of the flexor digitorum superficialis and the lateral half of the flexor digitorum profundus. Flexion of the MCPJs of the index and middle fingers are lost due to paralysis of the lateral two lumbrical muscles. Flexion of the ring and little fingers are preserved as these are supported by the medial half of the flexor digitorum profundus and the medial two lumbrical muscles, innervated by the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 27 - A 20-year-old male receives a small cut over his hand while climbing a...

    Incorrect

    • A 20-year-old male receives a small cut over his hand while climbing a fence causing it to bleed. Upon applying pressure for a few minutes, the bleeding stops. Which one of the following physiological components of the blood is responsible for the primary haemostasis reaction, such as in this case?

      Your Answer:

      Correct Answer: Platelet plug formation

      Explanation:

      Haemostasis is your body’s defence against an injury that causes bleeding. It stops bleeding in three main steps:

      1) Primary haemostasis – formation of a weak platelet plug
      – The primary reaction of the body is to cause local vasoconstriction at the site of injury and decrease blood flow to the affected area
      – the release of cytokines and inflammatory markers lead to adhesion of platelets and aggregation at the site of injury forming a platelet plug
      – the injured vessel wall has exposed subendothelial collagen that releases von Willebrand factor

      Any damage to the vessel wall causes the release of the Von Willebrand factor, which is necessary for platelet adhesion. Tissue Thromboplastin is also released, which activates the coagulation pathway, a component of secondary haemostasis. The coagulation cascade ultimately results in the conversion of fibrinogen to fibrin.

      2) Secondary haemostasis
      3) Fibrinolysis

      Fibrin (factor Ia) is a long, thin protein with branches produced at the end of the coagulation cascade when fibrinogen (factor I) is converted to fibrin, which stabilizes the blood clot.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds
  • Question 28 - A 52-year-old man develops pneumonia 3 days following an admission for investigation of...

    Incorrect

    • A 52-year-old man develops pneumonia 3 days following an admission for investigation of chest pain. He has coarse left basal crackles and evidence of consolidation in the left lower lobe of chest X-ray. He has no known drug allergies.
      According to the latest NICE guidelines, which of the following antibacterial agents would be most appropriate to prescribe in this case? Select ONE answer only.

      Your Answer:

      Correct Answer: Co-amoxiclav

      Explanation:

      Nosocomial infections are defined as those occurring within 48 hours of hospital admission, 3 days of discharge or 30 days of an operation. They affect 1 in 10 patients admitted to hospital. Annually, this results in 5000 deaths with a cost to the National Health Service of a billion pounds. On average, a patient with hospital acquired infection spent 2.5-times longer in hospital, incurring additional costs of £3000 more than an uninfected patient. Intensive care units (ICU) have the highest prevalence of hospital-acquired infections in the hospital setting.
      The current recommendations by NICE and the BNF on the treatment of hospital acquired pneumonia are:
      Early onset infection(less than 5 days after admission to hospital): co-amoxiclav or cefuroxime for 7 days
      Late-onset infection(more than 5 days after admission to hospital): an antipseudomonal penicillin (e.g. piperacillin with tazobactam), a broad-spectrum cephalosporin (e.g. ceftazidime), or a quinolone (e.g. ciprofloxacin)
      If the patient developed a hospital-acquired pneumonia within 5 days of admission – co-amoxiclav would be the most appropriate choice.
      If the patient has developed a hospital-acquired pneumonia > 5 days after admission – ciprofloxacin would be the most appropriate choice from the list of options available.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
      Seconds
  • Question 29 - Epigastric pain and haematemesis present in a 67-year-old man. In the emergency room,...

    Incorrect

    • Epigastric pain and haematemesis present in a 67-year-old man. In the emergency room, he is stabilised and referred to the on-call medical team. He has been scheduled for an endoscopy in the morning due to a suspected peptic ulcer. Before transferring him to the ward, you consider giving him a proton pump inhibitor (PPI).

      Which of the following doses and routes are the best?

      Your Answer:

      Correct Answer: A PPI should not be prescribed

      Explanation:

      PPIs should not be used prior to endoscopic therapy when an early endoscopic examination is performed within 24 hours of admission, according to current recommendations.
      High-dose PPI therapy reduces the risk of rebleeding and surgery after endoscopic treatment of severe peptic ulcer bleeding. Both oral and intravenous PPIs produce similar results, and there is no discernible benefit to using the intravenous formulation in patients who can tolerate oral medication.

    • This question is part of the following fields:

      • Gastrointestinal Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 30 - You've been requested to give a discussion to a group of medical students...

    Incorrect

    • You've been requested to give a discussion to a group of medical students about cardiovascular physiology. One of them inquires about cardiac output and asks if you can explain it.

      Which of the following statements is correct?

      Your Answer:

      Correct Answer: An average resting cardiac output in a woman is 5 L/min

      Explanation:

      The terminology cardiac output refers to the amount of blood pumped by the heart in one minute. Women’s rates are around 5 L/min, whereas men’s rates are somewhat higher, around 5.5 L/min.
      Cardiac output (CO) is calculated by multiplying stroke volume (SV) by heart rate (HR):
      CO = HR x SV

      As a result, both stroke volume and heart rate are exactly proportional to cardiac output. There will be an increase in cardiac output if the stroke volume or heart rate increases, and a reduction in cardiac output if the stroke volume or heart rate lowers.

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
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Microbiology (1/2) 50%
Pathogens (1/2) 50%
Anatomy (8/8) 100%
Central Nervous System (2/2) 100%
Abdomen (2/2) 100%
Upper Limb (2/2) 100%
CNS Pharmacology (1/1) 100%
Pharmacology (1/2) 50%
General Pathology (0/1) 0%
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Lower Limb (1/1) 100%
Anaesthesia (0/1) 0%
Abdomen And Pelvis (1/1) 100%
Immune Responses (0/1) 0%
Cardiovascular (1/1) 100%
Physiology (1/1) 100%
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