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  • Question 1 - You suspect an anaphylactic reaction in a patient who is hypotensive, with trouble...

    Incorrect

    • You suspect an anaphylactic reaction in a patient who is hypotensive, with trouble breathing after eating peanuts. Which of the following diagnostic tests will confirm this?

      Your Answer: Specific IgE (RAST) test

      Correct Answer: Mast cell tryptase

      Explanation:

      The concentration of serum tryptase rises in anaphylaxis and anaphylactoid responses.

      Because tryptase is a significant component of mast cell granules, mast cell degranulation causes elevated tryptase levels in the blood.

      Although tryptase levels are not always high during anaphylaxis, it is considered a particular marker.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      20.9
      Seconds

  • Question 2 - A patient presents with acute severe asthma. Her initial salbutamol nebulization produced a...

    Incorrect

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

      Which statement about ipratropium bromide is true?

      Your Answer: It is a first-line treatment for moderate asthma attacks

      Correct Answer: It can trigger acute closed-angle glaucoma

      Explanation:

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

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

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

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

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

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

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

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      133.7
      Seconds

  • Question 3 - A 30-year-old male with a known allergy to natural latex rubber presents with...

    Correct

    • A 30-year-old male with a known allergy to natural latex rubber presents with an allergic reaction to a food he has just eaten.

      Which ONE of these foods is most likely to cause an associated hypersensitivity in him?

      Your Answer: Banana

      Explanation:

      About one third of patients with allergy to natural latex rubber (NRL) have an associated allergy to some plant-derived foods. It is known as the latex-fruit syndrome and occurs commonly with consumption of fresh fruits. Banana and avocado are the most implicated fruits but it can also be seen with tomato, kiwi and chestnut.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      34.8
      Seconds

  • Question 4 - Which of the following microbes binds strongly to CD4 antigen: ...

    Correct

    • Which of the following microbes binds strongly to CD4 antigen:

      Your Answer: HIV

      Explanation:

      HIV mainly infects CD4+ T helper cells. Viral replication results in progressive T-cell depletion and impaired cell-mediated immunity with subsequent secondary opportunistic infections and increased risk of malignancy. B-cell function is also reduced as a result of lack of T-cell stimulation.
      HIV is not a notifiable disease.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      22.6
      Seconds

  • Question 5 - A patient diagnosed with cranial nerve palsy exhibits asymmetrical movement of the palate,...

    Incorrect

    • A patient diagnosed with cranial nerve palsy exhibits asymmetrical movement of the palate, nasal regurgitation of food, and nasal quality to the voice.

      Which of the following cranial nerves is most likely responsible for the aforementioned features?

      Your Answer: Hypoglossal nerve

      Correct Answer: Vagus nerve

      Explanation:

      The vagus nerve, ‘the wanderer’, contains motor fibres (to the palate and vocal cords), sensory components (posterior and floor of external acoustic meatus) and visceral afferent and efferent fibres.

      Palatal weakness can cause nasal speech and nasal regurgitation of food. The palate moves asymmetrically when the patient says ‘ahh’. Recurrent nerve palsy results in hoarseness, loss of volume and ‘bovine cough’.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      40.3
      Seconds

  • Question 6 - You examine a 78-year-old man who has been diagnosed with chronic lymphocytic leukaemia...

    Incorrect

    • You examine a 78-year-old man who has been diagnosed with chronic lymphocytic leukaemia (CLL).

      What is the MAIN contributory factor in this condition's immunodeficiency?

      Your Answer: Lymphopenia

      Correct Answer: Hypogammaglobulinemia

      Explanation:

      Immunodeficiency is present in all patients with chronic lymphocytic leukaemia (CLL), though it is often mild and not clinically significant. Infections are the leading cause of death in 25-50 percent of CLL patients, with respiratory tract, skin, and urinary tract infections being the most common.

      Hypogammaglobulinemia is the most common cause of immunodeficiency in CLL patients, accounting for about 85 percent of all cases.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      49
      Seconds

  • Question 7 - Which of the following statements is correct regarding paracetamol? ...

    Correct

    • Which of the following statements is correct regarding paracetamol?

      Your Answer: Liver damage peaks 3 to 4 days after paracetamol ingestion.

      Explanation:

      The maximum daily dose of paracetamol in an adult is 4 grams. Doses greater than this can lead to hepatotoxicity and, less frequently, acute kidney injury. Early symptoms of paracetamol toxicity include nausea, vomiting, and abdominal pain, and usually settle within 24 hours. Symptoms of liver damage include right subcostal pain and tenderness, and this peaks 3 to 4 days after paracetamol ingestion. Other signs of hepatic toxicity include encephalopathy, bleeding, hypoglycaemia, and cerebral oedema.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      31.2
      Seconds

  • Question 8 - Regarding water and electrolyte absorption in the small intestine, which of the following statements...

    Incorrect

    • Regarding water and electrolyte absorption in the small intestine, which of the following statements is INCORRECT:

      Your Answer: K+ leaves the cell across the basolateral membrane down its concentration gradient linked to an outward movement of Cl-.

      Correct Answer: Na+ enters the cell across the apical membrane against its concentration gradient by both membrane channels and transporter protein mechanisms.

      Explanation:

      As the contents of the intestine are isotonic with body fluids and mostly have the same concentration of the major electrolytes, their absorption is active. Water cannot be moved directly, but follows osmotic gradients set up by the transport of ions, primarily mediated by the sodium pump.Na+/K+ ATPase located on the basolateral membrane of the epithelial cells pumps three Na+ ions from the cell in exchange for two K+ ions, against their respective concentration gradients. This leads to a low intracellular concentration of Na+ and a high intracellular concentration of K+. The low intracellular concentration of Na+ ensures a movement of Na+ from the intestinal contents into the cell down its concentration gradient by both membrane channels and transporter protein mechanisms. Na+ is then rapidly pumped again by the basolateral sodium pump. K+ leaves the cell across the basolateral membrane down its concentration gradient linked to an outward movement of Cl- against its concentration gradient (Cl- having entered the cell across the luminal membrane down its concentration gradient).

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      65.3
      Seconds

  • Question 9 - Damage to this nerve affects the flexor digitorum longus. ...

    Incorrect

    • Damage to this nerve affects the flexor digitorum longus.

      Your Answer: Deep peroneal nerve

      Correct Answer: Tibial nerve

      Explanation:

      Like all muscles in the deep posterior compartment of the leg, flexor digitorum longus muscle is innervated by branches of the tibial nerve (root value L5, S1 and S2) which is a branch of sciatic nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      53.8
      Seconds

  • Question 10 - Glomerular filtration rate can be calculated using any substance that: ...

    Correct

    • Glomerular filtration rate can be calculated using any substance that:

      Your Answer: is freely filtered and neither reabsorbed nor secreted by the nephron

      Explanation:

      Clearance of a substance can provide an accurate estimate of the glomerular filtration rate (GFR) provided that the substance is:freely filterednot reabsorbed in the nephronnot secreted in the nephronnot synthesised or metabolised by the kidney

    • This question is part of the following fields:

      • Physiology
      • Renal
      121.9
      Seconds

  • Question 11 - A 20-year-old female presents with painful wrist following a fall while skating. X-rays...

    Correct

    • A 20-year-old female presents with painful wrist following a fall while skating. X-rays shows fracture of the ulna.

      The initial phase of bone healing is?

      Your Answer: Haematoma at the fracture site

      Explanation:

      Haemorrhage occurs into the fracture site from the ruptured vessels in the bone marrow and those supplying the periosteum immediately after fracture. This hematoma formation is the first phase of bone healing.

      The 4 stages of bone healing are:
      Haematoma at the fracture site (provides a framework for healing)
      Callus formation
      Lamellar bone formation
      Remodelling

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      187.1
      Seconds

  • Question 12 - Regarding the trachea, which of the following statements is INCORRECT: ...

    Correct

    • Regarding the trachea, which of the following statements is INCORRECT:

      Your Answer: A cricothyrotomy involves making an opening in the neck inferior to the cricoid cartilage.

      Explanation:

      A cricothyrotomy involves making an opening in the median cricothyroid ligament (the medial part of the cricothyroid membrane), between the cricoid cartilage below and the thyroid cartilage above.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      126.8
      Seconds

  • Question 13 - A patient is diagnosed with a Klebsiella pneumoniae infection.
    Which SINGLE statement regarding Klebsiella...

    Incorrect

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

      Your Answer: It is an important cause of ventilator-associated pneumonia

      Correct Answer: Species with ESBLs are sensitive to cefotaxime

      Explanation:

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

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      99.8
      Seconds

  • Question 14 - A 6 year old boy is brought into the ED by his mom...

    Incorrect

    • A 6 year old boy is brought into the ED by his mom with a rash that is associated with Koplik's spots and a diagnosis of measles is made. What advice should be given about returning to school?

      Your Answer: Once mucosal involvement has resolved

      Correct Answer: 4 days from the onset of the rash

      Explanation:

      Prevention of spread of measles is extremely important and infected patients should be isolated. The infectious stage is from 3 days before the rash emerges and patients are advised to stay away from school/nursery/work for 4 days from onset of the rash.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      51.3
      Seconds

  • Question 15 - A 24-year-old male presents to the Emergency Department with a three-day history of...

    Incorrect

    • A 24-year-old male presents to the Emergency Department with a three-day history of high-grade fever, headache and rash along with neck stiffness. On examination, Kernig's sign is positive, and you note a petechial rash over the trunk and limbs. Her vital signs show tachycardia and hypotension. Based on these findings, you diagnose sepsis secondary to meningitis.

      Which one of the following definitions of sepsis is currently accepted?

      Your Answer: The presence of > 3 SIRS criteria in the presence of a suspected source of infection

      Correct Answer: Life-threatening organ dysfunction caused by a dysregulated host response to infection

      Explanation:

      In 2016 the SOFA guideline was introduced, also called the Sepsis-related Organ Failure Assessment, to make a sepsis diagnosis easier and prevent mortality.

      According to this guideline, sepsis was defined as a life-threatening organ dysfunction due to a dysregulated host response to infection.

      Septic shock was defined as a subset of sepsis in which the circulatory and metabolic abnormalities would lead to a greater risk of mortality than sepsis alone. Patients with septic shock would be clinically identified by a need for vasopressors to maintain MAP greater than 65 mmHg and serum lactate greater than two mmol/L.

    • This question is part of the following fields:

      • Pathology
      • Pathology Of Infections
      69.4
      Seconds

  • Question 16 - A 59-year-old man is complaining of pain in his perineal area, a recent...

    Correct

    • A 59-year-old man is complaining of pain in his perineal area, a recent onset of urinary frequency and urgency, fever, chills, and muscle aches. He has a long history of nocturia and terminal dribbling. On rectal examination you find an exquisitely tender prostate.

      Which of these antibacterial agents would be most appropriate in this case?

      Your Answer: Ciprofloxacin for 14 days

      Explanation:

      An acute focal or diffuse suppurative inflammation of the prostate gland is called acute bacterial prostatitis.

      According to the National Institute for Health and Care Excellence (NICE), acute prostatitis should be suspected in a man presenting with:
      A feverish illness of sudden onset which may be associated with rigors, arthralgia, or myalgia; Irritative urinary voiding symptoms; acute urinary retention; perineal or suprapubic pain and an exquisitely tender prostate on rectal examination.

      Treatment of acute prostatitis as recommended by NICE and the BNFare:
      Ciprofloxacin or ofloxacin for 14 days
      Alternatively, trimethoprim can be used. Duration of treatment is still 14 days

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      101.2
      Seconds

  • Question 17 - The normal range of arterial HCO3- is: ...

    Incorrect

    • The normal range of arterial HCO3- is:

      Your Answer: 20 - 28 mmol/L

      Correct Answer: 24 - 30 mmol/L

      Explanation:

      Normal ranges:
      pH = 7.35 – 7.45
      pO2(on air) = 11 -14 kPa
      pCO2= 4.5 – 6.0 kPa
      HCO3-= 24 – 30 mmol/L
      BE = +/- 2 mmol/L

    • This question is part of the following fields:

      • Physiology
      • Renal
      13.8
      Seconds

  • Question 18 - A patient presents to your clinic with fever of unknown origin. His...

    Correct

    • A patient presents to your clinic with fever of unknown origin. His blood results shows a markedly elevated C-Reactive Protein (CRP) level.

      Which of these is responsible for mediating the release of CRP?

      Your Answer: IL-6

      Explanation:

      C-reactive protein (CRP) is an acute phase protein produced by the liver hepatocytes. Its production is regulated by cytokines, particularly interleukin 6 (IL-6) and it can be measured in the serum as a nonspecific marker of inflammation.

      Although a high CRP suggest an acute infection or inflammation, it does not identify the cause or location of infection.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      20.4
      Seconds

  • Question 19 - A 35-year-old man suffers an open fracture of his forearm. The nerve that...

    Incorrect

    • A 35-year-old man suffers an open fracture of his forearm. The nerve that innervates the pronator quadratus muscle is damaged as a consequence of this injury.
      Which of the following nerves has been damaged in this case? Select ONE answer only.

      Your Answer: The musculocutaneous nerve

      Correct Answer: The anterior interosseous nerve

      Explanation:

      Pronator quadratus is a small, square-shaped muscle that lies in the anterior compartment of the forearm. It arises from the distal fourth of the anterior surface of the ulna and inserts into the distal fourth of the anterior surface of the radius.
      Pronator quadratus is innervated by the anterior interosseous nerve. It receives its blood supply from the anterior interosseous artery, which is a branch of the common interosseous artery, which in turn is a branch of the ulnar artery.
      The main action of pronator quadratus is to assist pronator teres with pronation of the forearm. The deep fibres bind the radius and ulna together.
      The pronator quadratus muscle highlighted in blue (adapted from Gray’s Anatomy)

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      44.8
      Seconds

  • Question 20 - In adults in the United Kingdom, which of the following pathogens is the...

    Incorrect

    • In adults in the United Kingdom, which of the following pathogens is the most likely cause of viral infectious gastroenteritis:

      Your Answer: Adenovirus

      Correct Answer: Norovirus

      Explanation:

      Norovirus is the most common viral cause of epidemic gastroenteritis worldwide; it is also a common cause of endemic diarrhoea in community settings. In the United Kingdom, norovirus has become the most common cause of gastroenteritis in adults and children since the introduction of rotavirus vaccination.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      11
      Seconds

  • Question 21 - Regarding shingles, which of the following statements is CORRECT: ...

    Correct

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

      Your Answer: You can catch chickenpox from a patient with shingles.

      Explanation:

      After primary infection, VZV remains latent in sensory ganglia and in about 20% of patients will reactivate resulting in shingles, a painful vesicular rash in the related dermatome. Shingles usually affects older people and the immunocompromised. Shingles lesions are infectious to non-immune individuals who are at risk of developing chickenpox. Shingles can not be contracted directly from chickenpox, or from other cases of shingles. Shingles is treated with systemic antiviral treatment to reduce the severity and duration of pain, reduce complications, and reduce viral shedding.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      184.4
      Seconds

  • Question 22 - An ambulance transports a 72-year-old woman to the Emergency Department. She is confused,...

    Incorrect

    • An ambulance transports a 72-year-old woman to the Emergency Department. She is confused, has been vomiting and having stomach pains. Digoxin is one of her medications.

      Which of the following claims about digoxin is correct?

      Your Answer: Hyperkalaemia can predispose to digoxin toxicity

      Correct Answer: Therapeutic plasma levels are between 1.0-1.5 nmol/l

      Explanation:

      Digoxin is a cardiac glycoside that is used to treat atrial fibrillation and flutter, as well as congestive heart failure. In cardiac myocytes, it works by inhibiting the membrane Na/K ATPase. Through Na/Ca exchange, this raises intracellular sodium concentration and indirectly increases intracellular calcium availability. Increased intracellular calcium levels have both a positive inotropic and negative chronotropic effect.

      Digoxin therapeutic plasma levels are typically between 1.0 and 1.5 nmol/l, though higher concentrations may be required, and the value varies between laboratories. At concentrations greater than 2 nmol/l, the risk of toxicity increases dramatically.

      In patients with normal renal function, digoxin has a long plasma half-life of 36 to 48 hours. This can take up to 5 days in patients with impaired renal function.

      Hypokalaemia, rather than hyperkalaemia, has been shown to increase the risk of digoxin toxicity.

      In the treatment of persistent and permanent atrial fibrillation, digoxin is no longer widely used. Beta-blockers, also known as rate-limiting calcium channel blockers, are now the first-line treatment for this condition.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      42.9
      Seconds

  • Question 23 - Which statement concerning aerosol transmission is true? ...

    Correct

    • Which statement concerning aerosol transmission is true?

      Your Answer: They can be spread via ventilation systems in hospitals

      Explanation:

      Aerosols are airborne particles less than 5 µm in size containing infective organisms.

      They usually cause infection of both the upper and/or lower respiratory tract.

      The organisms can remain suspended in the air for long periods and also survive outside the body.

      They can be transmitted through the ventilation systems and can spread over great distances.

      Some examples of organisms transmitted by the aerosol route include: Varicella zoster virus, Mycobacterium tuberculosis and measles virus

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      86.8
      Seconds

  • Question 24 - Which of the following laboratory findings is NOT typical of Hodgkin lymphoma: ...

    Incorrect

    • Which of the following laboratory findings is NOT typical of Hodgkin lymphoma:

      Your Answer: Eosinophilia

      Correct Answer: Basophilia

      Explanation:

      Features may include:Normochromic normocytic anaemia is most common; bone marrow failure involvement is unusual in early disease, but if it occurs bone marrow failure may develop with leucoerythroblastic anaemiaOne-third of patients have a neutrophilia; eosinophilia is frequentAdvanced disease is associated with lymphopenia and loss of cell-mediated immunityPlatelet count is normal or increased in early disease and reduced in later stagesESR and CRP are usually raised (ESR is useful in monitoring disease progress)Serum LDH is raised initially in 30-40% of casesDiagnosis is made by histological examination of an excised lymph nodeThe distinctive multinucleate polypoid RS cell is central to the diagnosis of the four classic types of HL (95% of cases)

    • This question is part of the following fields:

      • Haematology
      • Pathology
      19.6
      Seconds

  • Question 25 - You are taking care of a 55-year-old male patient who is a weightlifter....

    Correct

    • You are taking care of a 55-year-old male patient who is a weightlifter. He is suspected of having a direct inguinal hernia. Where would this hernia appear?

      Your Answer: Medial to the inferior epigastric artery

      Explanation:

      A direct inguinal hernia is a form of groin hernia that occurs when abdominal viscera protrude through a weakness in the posterior wall of the inguinal canal, notably through Hesselbach’s triangle, medial to the inferior epigastric veins.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      31.7
      Seconds

  • Question 26 - You review a 46-year-old woman who has recently been prescribed antibiotics for a...

    Incorrect

    • You review a 46-year-old woman who has recently been prescribed antibiotics for a urinary tract infection. She suffers from COPD and is currently prescribed salbutamol and Seretide inhalers, and Phyllocontin continus. Since starting the antibiotics, she has been experiencing nausea, vomiting and abdominal pain.
      Which of the following antibiotics is she MOST LIKELY to have been prescribed for her UTI? Select ONE answer only .

      Your Answer: Nitrofurantoin

      Correct Answer: Ciprofloxacin

      Explanation:

      Phyllocontin continus contains aminophylline (a mixture of theophylline and ethylenediamine), a bronchodilator used in the management of COPD and asthma.
      This patient is exhibiting symptoms of theophylline toxicity, which may have been triggered by the prescription of the antibiotic. Quinolone antibiotics, such as ciprofloxacin and levofloxacin, and macrolide antibiotics, such as erythromycin, increase the plasma concentration of theophyllines and can lead to toxicity.
      The drugs that commonly affect the half-life and the plasma concentration of theophylline are summarised in the table below:
      Drugs increasing plasma concentration of theophylline
      Drugs decreasing plasma concentration of theophylline
      Calcium channel blockers, e.g. Verapamil
      Cimetidine
      Fluconazole
      Macrolides, e.g. erythromycin
      Quinolones, e.g. ciprofloxacin
      Methotrexate
      Barbiturates
      Carbamazepine
      Phenobarbitol
      Phenytoin (and fosphenytoin)
      Rifampicin
      St. John’s wort

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      32.5
      Seconds

  • Question 27 - How is filtered K+mainly reabsorbed in the thick ascending limb of the loop...

    Correct

    • How is filtered K+mainly reabsorbed in the thick ascending limb of the loop of Henle:

      Your Answer: Secondary active transport via Na + /K + /2Cl - cotransporter

      Explanation:

      Around 30% of filtered K+is reabsorbed in the thick ascending limb of the loop of Henle, primarily via the luminal Na+/K+/2Cl-cotransporter, but there is also significant paracellular reabsorption, encouraged by the positive potential in the tubular lumen.

    • This question is part of the following fields:

      • Physiology
      • Renal
      30.3
      Seconds

  • Question 28 - 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
      23.1
      Seconds

  • Question 29 - An 11-year-old presented to a GP with a history of headache, neck stiffness...

    Correct

    • An 11-year-old presented to a GP with a history of headache, neck stiffness and photophobia. On examination, HR is 122, BP is 87/42, RR is 28, SaO 2 is 95%, temperature is 39.4 o C. There is a recent petechial rash on legs and arms. The GP administered a dose of antibiotics in the prehospital setting before transferring to the Emergency Department. Which of these would the GP have administered?

      Your Answer: IM benzylpenicillin 1.2 g

      Explanation:

      General Practitioners are advised to give a single injection of benzylpenicillin by intravenous or intramuscular injection before transferring the patient urgently to the ED when bacterial meningitis is suspected.

      The recommended doses are:
      Infants under 1 year: 300 mg
      Children ages 1 to 9 years: 600 mg
      Children aged 10 years and over: 1.2g
      Adults: 1.2g

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      30
      Seconds

  • Question 30 - A 55-year-old woman with a known history of bronchiectasis has lung function testing...

    Incorrect

    • A 55-year-old woman with a known history of bronchiectasis has lung function testing carried out and is found to have significant airways obstruction.
      Which of the following lung volumes or capacities is LEAST likely to be decreased in this case? Select ONE answer only.

      Your Answer: Expiratory reserve volume

      Correct Answer: Functional residual capacity

      Explanation:

      Obstructive lung disorders are characterised by airway obstruction. Many obstructive diseases of the lung result from narrowing of the smaller bronchi and larger bronchioles, often because of excessive contraction of the smooth muscle itself.
      In obstructive lung disease, FEV1is reduced to <80% of normal and FVC is usually reduced but to a lesser extent than FEV1. The FEV1/FVC ratio is reduced to <0.7.
      Types of obstructive lung disorders include:
      Chronic obstructive pulmonary disease (COPD)
      Asthma
      Bronchiectasis
      The following table outlines the effects of obstructive lung disease on the various lung volumes and capacities:
      Increased by obstructive lung disease
      Decreased in obstructive lung disease
      Total lung capacity (TLC)
      Residual volume (RV)
      Functional residual capacity (FRC) Residual volume/total lung capacity (RV/TLC) ratio
      Vital capacity (VC)
      Inspiratory capacity (IC)
      Inspiratory reserve volume (IRV) Expiratory reserve volume (ERV)
      According to the latestNICE guidelines(link is external), airflow obstruction is defined as follows:
      Mild airflow obstruction = an FEV1of >80% in the presence of symptoms
      Moderate airflow obstruction = FEV1of 50-79%
      Severe airflow obstruction = FEV1of 30-49%
      Very severe airflow obstruction = FEV1<30%.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      50.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Pharmacology (2/6) 33%
Respiratory (0/1) 0%
Respiratory Pharmacology (0/2) 0%
General Pathology (3/3) 100%
Pathology (3/6) 50%
Microbiology (4/8) 50%
Principles (1/1) 100%
Anatomy (2/5) 40%
Central Nervous System (1/2) 50%
Haematology (0/2) 0%
Gastrointestinal (0/1) 0%
Physiology (2/5) 40%
Lower Limb (0/1) 0%
Renal (2/3) 67%
Head And Neck (1/1) 100%
Specific Pathogen Groups (1/2) 50%
Pathogens (1/4) 25%
Pathology Of Infections (0/1) 0%
Upper Limb (0/1) 0%
Cardiovascular Pharmacology (0/1) 0%
Principles Of Microbiology (1/1) 100%
Abdomen (1/1) 100%
Infections (1/1) 100%
Respiratory Physiology (0/1) 0%
Passmed
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