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  • Question 1 - Factors influencing cardiac output include which of the following? ...

    Correct

    • Factors influencing cardiac output include which of the following?

      Your Answer: All of the above

      Explanation:

      There is a correlation between resting CO and body surface area. The output per min per square meter of body surface (the cardiac index) averages 3.2l.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      27.8
      Seconds
  • Question 2 - A 18-year-old girl is brought to A&E having ingested at least 16 tablets...

    Correct

    • A 18-year-old girl is brought to A&E having ingested at least 16 tablets of paracetamol 8 hours earlier. What should her immediate management consist of?

      Your Answer: Intravenous N-acetylcysteine

      Explanation:

      Activated charcoal is useful if given within one hour of the paracetamol overdose. Liver function tests, INR and prothrombin time will be normal, as liver damage may not manifest until 24 hours or more after ingestion.The antidote of choice is intravenous N-acetylcysteine, which provides complete protection against toxicity if given within 10 hours of the overdose.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      17.3
      Seconds
  • Question 3 - A patient has been diagnosed with multi-drug resistant tuberculosis and is currently bring...

    Correct

    • A patient has been diagnosed with multi-drug resistant tuberculosis and is currently bring treated with rifampicin, isoniazid, and pyrazinamide. He is commenced on streptomycin.Which among the following is the most likely neurological side-effect of streptomycin?

      Your Answer: Vestibular damage

      Explanation:

      Vestibular damage is a neurological side effect of streptomycin.Streptomycin is an aminoglycoside bactericidal antibiotic. It is used in the treatment of tularaemia and resistant mycobacterial infections.The most common neurological side-effect is vestibular damage leading to vertigo and vomiting. Cochlear damage is less frequent and results in deafness. Other side-effects include rashes, angioneurotic oedema, and nephrotoxicity.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      30.3
      Seconds
  • Question 4 - A 48-year-old male with a history of bipolar disorder presents with acute confusion....

    Correct

    • A 48-year-old male with a history of bipolar disorder presents with acute confusion. In-transit to hospital he had a generalized seizure which terminated spontaneously after around 30 seconds. On arrival to the emergency department, his GCS is 14/15 and he is noted to have a coarse tremor. Suspecting a diagnosis of lithium toxicity, intravenous access is obtained, a blood sample was drawn for investigations and a saline infusion is started. The blood investigations revealed:Lithium level: 4.2 mmol/lNa+: 136 mmol/lK+: 4.6 mmol/lUrea: 8.1 mmol/lCreatinine: 99 µmol/lBicarbonate: 18 mmol/lWhat is the most appropriate management for the patient?

      Your Answer: Arrange haemodialysis

      Explanation:

      The presentation of the patient is typical of chronic lithium toxicity (due to the presence of mainly neurological manifestations). Additional to the blood investigations mentioned, urine analysis, electrolyte levels, and renal function should also be performed. A low urine Anion gap and a low urine specific gravity are highly suggestive of lithium toxicity.ECG obtained in this patient is likely to show: nonspecific, diffuse ST segment depression with T wave inversion.Acute lithium toxicity presents with more GI manifestations while, the clinical features of chronic lithium toxicity are mainly neurological and can include:Coarse tremors (fine tremors are seen in therapeutic levels), hyperreflexia, acute confusion, seizures, and coma.The management of lithium toxicity is as follows:Immediate GI decontamination with gastric lavage (in case of acute intoxication)Saline Administrations: the goal of saline administration is to restore GFR, normalize urine output and enhance lithium clearance.Haemodialysis remains the mainstay treatment for lithium toxicity as lithium is readily dialyzed because of water solubility, low volume of distribution, and lack of protein binding.The Extracorporeal Treatments in Poisoning Workgroup (EXTRIP Workgroup) recommendations for dialysis (extracorporeal treatment) in lithium toxicity include:• Impaired kidney function and lithium levels > 4.0 mEq/L• Decreased consciousness, seizures, or life-threatening dysrhythmias, regardless of lithium levels• Levels are > 5.0 mEq/L, significant confusion is noted, or the expected time to reduce levels to < 1.0 mEq/L is more than 36 hoursAs post-dialysis rebound elevations in lithium levels have been documented, continuous veno-venous hemofiltration (CVVH) has been advocated.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      118.6
      Seconds
  • Question 5 - What is the mechanism of action of carbimazole? ...

    Incorrect

    • What is the mechanism of action of carbimazole?

      Your Answer: Conversion to methimazole, which blocks the TSH receptor

      Correct Answer: Inhibition of the iodination of tyrosine

      Explanation:

      Carbimazole is used to treat hyperthyroidism. Carbimazole is a pro-drug as after absorption it is converted to the active form, methimazole. Methimazole prevents thyroid peroxidase enzyme from coupling and iodinating the tyrosine residues on thyroglobulin, hence reducing the production of the thyroid hormones T3 and T4 (thyroxine).

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      18.3
      Seconds
  • Question 6 - Regarding the structure of the 3 pituitary glycoprotein hormones FSH, LH, and TSH,...

    Correct

    • Regarding the structure of the 3 pituitary glycoprotein hormones FSH, LH, and TSH, which of the following is true about the α- and β-subunits of each hormone?

      Your Answer: Maximal physiological activity occurs only on their combination

      Explanation:

      Glycoprotein hormones (GPHs) are the most complex molecules that function as hormones. They each consist of two different subunits, α and β, which are non-covalently associated. The combination of these subunits results in an increase in their activity and β structure.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      15.8
      Seconds
  • Question 7 - Which cranial nerve is responsible for the parasympathetic nerve supply of the thorax...

    Correct

    • Which cranial nerve is responsible for the parasympathetic nerve supply of the thorax and upper abdomen?

      Your Answer: CN X

      Explanation:

      Cranial nerve X supplies the structures of the thorax and abdomen. All the rest of the cranial nerves supply the structures in the head and neck

    • This question is part of the following fields:

      • Medicine
      • Neurology
      3.5
      Seconds
  • Question 8 - The axons of which neurons serve as the only output from the cerebellar...

    Incorrect

    • The axons of which neurons serve as the only output from the cerebellar cortex?

      Your Answer: Stellate

      Correct Answer: Purkinje

      Explanation:

      The cerebellar cortex consist of 3 layers. The molecular layer, the granule cell layer and the Purkinje cell layer in the middle. The Purkinje cells project into the deep cerebellar nuclei. They are the only output cells of the cerebellar cortex.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      57.4
      Seconds
  • Question 9 - All of the following are consistent with the indicator dilution method except--- ...

    Correct

    • All of the following are consistent with the indicator dilution method except---

      Your Answer: In thermodilution, the indicator used is warm saline

      Explanation:

      In thermodilution, the indicator used is cold saline.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      4.8
      Seconds
  • Question 10 - Which part of the cerebellum is primarily responsible for equilibrium and eye movements?...

    Incorrect

    • Which part of the cerebellum is primarily responsible for equilibrium and eye movements?

      Your Answer: Cerebrocerebellum

      Correct Answer: Vestibulocerebellum

      Explanation:

      The vestibulocerebellum develops at the same time as the vestibular apparatus in the inner ear. Its regulates balance between agonist and antagonist muscle contractions of the spine, hips, and shoulders during rapid movements.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      23.6
      Seconds
  • Question 11 - A study is carried out to assess the efficacy of a new anti-epileptic...

    Incorrect

    • A study is carried out to assess the efficacy of a new anti-epileptic drug for children with absence seizures. The total number of the children selected for the study was 400, from which 150 children were assigned to take the new drug and 250 children were assigned in the control group. After a period of four months, only 15 children taking the new drug had a seizure compared to 100 children from the control group who had seizure. What is the correct value regarding the relative risk reduction?

      Your Answer: 30%

      Correct Answer: 75%

      Explanation:

      Relative risk reduction (RRR) tells you by how much the treatment reduced the risk of bad outcomes relative to the control group who did not have the treatment. In the previous example, the relative risk reduction of fever and rash in the group of the children on the intervention was 40 per cent (1 – 0.6 = 0.4 or 40 per cent). RRR = (EER -CER) / CER = (0.1 – 0.4) / 0.4 = -0.75 or 75% reduction.

    • This question is part of the following fields:

      • Medicine
      • Research Skills
      81.6
      Seconds
  • Question 12 - Endotoxin will typically act on which one of the following cells, to produce...

    Incorrect

    • Endotoxin will typically act on which one of the following cells, to produce endogenous pyrogens?

      Your Answer: Neutrophils

      Correct Answer: Monocytes

      Explanation:

      Endotoxin, also known as lipopolysaccharides or lipoglycans, are molecules that consist of a lipid and a polysaccharide. They bind to many cell types, but especially to monocytes, promoting the secretion of proinflammatory cytokines, acting as a pyrogen.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      19.9
      Seconds
  • Question 13 - The process whereby DNA fragments are separated by size and charge is called:...

    Correct

    • The process whereby DNA fragments are separated by size and charge is called:

      Your Answer: Gel electrophoresis

      Explanation:

      Fragments of DNA of varying length can be separated on the basis of their charge and their size by a process called gel electrophoresis. Because DNA contains negatively charged phosphate groups, it will migrate in an electric field toward the positive electrode. Shorter chains migrate more rapidly through the pores of the gel, and thus separation depends on length. DNA bands in the gel can be visualized by various techniques including staining with dyes and autoradiography.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      5.7
      Seconds
  • Question 14 - Which of the following is least recognised as a potential complication of acromegaly?...

    Correct

    • Which of the following is least recognised as a potential complication of acromegaly?

      Your Answer: Mental retardation

      Explanation:

      Acromegaly is a condition that results from excess growth hormone (GH) after the growth plates have closed. It is typically due to the pituitary gland producing too much growth hormone. In more than 95% of people the excess production is due to a benign tumour, known as a pituitary adenoma. The condition is not inherited.Complications:Severe headacheArthritis and carpal tunnel syndromeEnlarged heartLiver fibrosis and bile duct hyperplasiaHypertensionDiabetes mellitus (excess of GH leads to insulin resistance)Heart failureKidney failureColorectal cancerCompression of the optic chiasm leading to loss of vision in the outer visual fields (typically bitemporal hemianopia.)Increased palmar sweating and sebum production over the face (seborrhoea) are clinical indicators of active GH-producing pituitary tumours.hypertensiondiabetes (>10%)cardiomyopathycolorectal cancer

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      6.5
      Seconds
  • Question 15 - Select the CORRECT statement regarding bile salts… ...

    Incorrect

    • Select the CORRECT statement regarding bile salts…

      Your Answer: Contain enzymes required for the digestion of fat.

      Correct Answer: Are necessary for any bile acid secretion by hepatocytes.

      Explanation:

      Bile salts stimulate bile secretion by the liver. Bile salts do not have an enzymatic action on digestion of fat but rather emulsify fat for the action of enzymes secreted mainly by the pancreas. Bile salts are polar cholesterol derivatives and are not derived from amino acids.

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      62.9
      Seconds
  • Question 16 - The brainstem reticular formation, consists of which important control system responsible for consciousness...

    Correct

    • The brainstem reticular formation, consists of which important control system responsible for consciousness and sleep?

      Your Answer: RAS reticular activating system

      Explanation:

      The reticular formation is a set of interconnected nuclei that are located along the brainstem. Reticular activating system (RAS) is a set of connected nuclei in the brain that is responsible for regulating wakefulness and sleep wake transitions and is the most influential component in the reticular formation.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      20.3
      Seconds
  • Question 17 - The complex twisting and folding of peptide chains describes which order of protein...

    Correct

    • The complex twisting and folding of peptide chains describes which order of protein structure?

      Your Answer: Secondary structure

      Explanation:

      Secondary Structure refers to the coiling or folding of a polypeptide chain that gives the protein its 3-D shape. There are two types of secondary structures: the alpha (α) helix and the beta (β) pleated sheet.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      3.8
      Seconds
  • Question 18 - Which enzyme is responsible for the formation of the active endopeptidases from their...

    Correct

    • Which enzyme is responsible for the formation of the active endopeptidases from their inactive precursors?

      Your Answer: Enterokinase

      Explanation:

      Enterokinase is a brush border enzyme of the duodenum that activates proteolytic enzymes for further digestion of proteins. Trypsinogen is converted to trypsin by the action of enterokinase. Trypsin and chymotrypsin are secreted by the pancreatic acinar cells and are enzymes that aid in protein digestion. Pepsin is secreted by chief cells of gastric mucosa. Procarboxydase is the inactive form of carboxypeptidase which is converted to its active form by trypsin and is secreted by pancreatic acinar cells.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      4.9
      Seconds
  • Question 19 - Around 30 patients have been admitted to the hospital following a suspected chemical...

    Correct

    • Around 30 patients have been admitted to the hospital following a suspected chemical attack in the city. The patients are extremely unwell, with symptoms of excessive salivation, lacrimation, diarrhoea, and emesis. Sarin gas was suspected as the most likely agent used in the attack. What is the mechanism of action of this chemical agent?

      Your Answer: Inhibition of acetylcholinesterase

      Explanation:

      Sarin acts by inhibiting acetylcholinesterase.Sarin gas is a highly toxic synthetic organophosphorus compound which causes inhibition of the enzyme acetylcholinesteraseSarin gas is a highly toxic synthetic organophosphorus compound which causes inhibition of the enzyme acetylcholinesterase. This results in high levels of acetylcholine (ACh).The effects of excessive ACh can be remembered by the mnemonic DUMBELLS:DiarrhoeaUrinationMiosis/muscle weaknessBronchorrhea/BradycardiaEmesisLacrimationSalivation/sweatingOrganophosphate insecticide poisoning:One of the effects of organophosphate poisoning is inhibition of acetylcholinesteraseFeatures can be predicted by the accumulation of acetylcholine (mnemonic = SLUD)SalivationLacrimationUrinationDefecation/diarrhoeacardiovascular: hypotension, bradycardiamiosis, muscle fasciculation.Organophosphate poisoning is treated with the anti-muscarinic atropine.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      15.7
      Seconds
  • Question 20 - A 22-year-old female comes to you for counselling regarding the initiation of combined...

    Correct

    • A 22-year-old female comes to you for counselling regarding the initiation of combined oral contraceptive pill. Which of the following statements is correct?

      Your Answer: She will still be protected against pregnancy if she takes amoxicillin for a lower respiratory tract infection while on the combined pill

      Explanation:

      The true statement among the given options is that she will still be protected against pregnancy if she takes amoxicillin for a lower respiratory tract infection while on the combined pill.Other than enzyme-inducing antibiotics such as rifampicin, antibiotics do not reduce the efficacy of the combined oral contraceptive pill.It was previously advised that barrier methods of contraception should be used if taking an antibiotic while using the contraceptive pill, due to concerns that antibiotics might reduce the absorption of the pill. This is now known to be untrue. However, if the absorptive ability of the gut is compromised for another reason, such as severe diarrhoea or vomiting, or bowel disease, this may affect the efficacy of the pill.The exception to the antibiotic rule is that hepatic enzyme-inducing antibiotics such as rifampicin and rifaximin do reduce the efficacy of the pill. Other enzyme-inducing drugs, such as phenytoin, phenobarbital, carbamazepine or St John’s Wort can also reduce the effectiveness of the pill.Other options:The combined pill is often prescribed for women with heavy periods as it can make them lighter and less painful. There is no evidence that women on the combined pill put on any significant weight, although they may experience bloating at certain times in the course. Women on the pill require monitoring of their blood pressure. There are multiple different types of combined pills.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      28.7
      Seconds
  • Question 21 - The principle by which the energy of contraction is proportional to the initial...

    Correct

    • The principle by which the energy of contraction is proportional to the initial length of cardiac muscle fiber is known as:

      Your Answer: Starling’s law

      Explanation:

      The Frank starling relationship describes that an increase in the venous return or the end diastolic volume will cause an increase in the stroke volume/ preload and also cardiac output. It stems from the fact that increase venous return will increase the stretch on the ventricular muscle fibers. The sarcomere will stretch a considerable length that is needed for maximum contraction and increased development of tension in the muscle fiber. The greater the venous return the greater the cardiac output. This relation is directly proportional.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      29.2
      Seconds
  • Question 22 - Select the correct statement about the microanatomy of the thyroid gland. ...

    Incorrect

    • Select the correct statement about the microanatomy of the thyroid gland.

      Your Answer: Each follicle is lined by two layers of epithelial cells.

      Correct Answer: The capillaries adjacent to thyroid cells have a fenestrated endothelium.

      Explanation:

      Fenestrated capillaries have a very thin endothelium, which is perforated by numerous fenestrations or pores. Hormones are usually released into these capillaries, reaching their target cells through the circulatory system.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      40.3
      Seconds
  • Question 23 - Which cell type functions as the critical bridge between innate and adaptive immune...

    Correct

    • Which cell type functions as the critical bridge between innate and adaptive immune systems, by activating naïve T lymphocytes?

      Your Answer: Dendritic cells

      Explanation:

      Dendritic cells are antigen presenting cells. They express class II MHC and T cell co-stimulatory molecules. They bind antigens and present them to native T cells and in the process activate the specific T cell against that antigen.

    • This question is part of the following fields:

      • Immunology
      • Medicine
      18.2
      Seconds
  • Question 24 - Lipid- lowering drugs like Lovastatin reduce cholesterol synthesis by inhibiting which enzyme? ...

    Correct

    • Lipid- lowering drugs like Lovastatin reduce cholesterol synthesis by inhibiting which enzyme?

      Your Answer: HMG-CoA reductase

      Explanation:

      Statins, also known as HMG-CoA reductase inhibitors, are a class of lipid-lowering medications. Statins have been found to reduce cardiovascular disease (CVD) and mortality in those who are at high risk.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      5.8
      Seconds
  • Question 25 - An effect of aging on the kidney includes? ...

    Correct

    • An effect of aging on the kidney includes?

      Your Answer: Decreased GFR

      Explanation:

      The normal range of GFR, adjusted for body surface area, is 100 to 130 mL/min/1.73m2 in men and 90 to 120 ml/min/1.73m2 in women younger than the age of 40. After age 40, GFR decreases progressively with age, by about 0.4 mL/min to 1.2 mL/min per year.

    • This question is part of the following fields:

      • Medicine
      • Renal
      18.5
      Seconds
  • Question 26 - Which of the following is NOT associated with the development of aortic regurgitation?...

    Correct

    • Which of the following is NOT associated with the development of aortic regurgitation?

      Your Answer: Dilated cardiomyopathy

      Explanation:

      Aortic insufficiency, is often due to the aortic root dilation, which is idiopathic in over 80% of cases, but otherwise may result from aging, syphilitic aortitis, osteogenesis imperfecta, aortic dissection, Bechet’s disease, reactive arthritis and systemic hypertension. Additionally, aortic insufficiency has been linked to the use of some medications and other potential causes that affect the valve directly including Marfan’s syndrome, Ehlers–Danlos syndrome, ankylosing spondylitis, and systemic lupus erythematosus. In acute cases of aortic insufficiency, the main causes are infective endocarditis, aortic dissection or trauma. Dilated cardiomyopathy is associated with the development of mitral regurgitation, not aortic regurgitation

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      19
      Seconds
  • Question 27 - A 24-year-old women presents following an overdose. Which one of the following would...

    Incorrect

    • A 24-year-old women presents following an overdose. Which one of the following would suggest anticholinergic syndrome?

      Your Answer: Bradycardia is common

      Correct Answer: Mydriasis occurs

      Explanation:

      Anticholinergic syndrome results from the inhibition of muscarinic cholinergic neurotransmission. Clinical manifestations can be remembered by the mnemonic, red as a beet, dry as a bone, blind as a bat, mad as a hatter, hot as a hare, and full as a flask. The mnemonic refers to the symptoms of flushing, dry skin and mucous membranes, mydriasis (dilated pupil) with loss of accommodation, altered mental status, fever, and urinary retention, respectively.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      18.5
      Seconds
  • Question 28 - Which of the following statements regarding influenza virus is correct? ...

    Correct

    • Which of the following statements regarding influenza virus is correct?

      Your Answer: Influenza is a RNA virus

      Explanation:

      The Orthomyxoviruses are a family of RNA viruses that includes six genera: Influenza virus A, Influenza virus B, Influenza virus C, Isavirus, Thogotovirus and Quaranjavirus.The mechanism of the evolutionary force of antigenic shift allows influenza viruses to exchange genes with strains that infect different species. Under this mechanism, a human influenza virus could exchange genes with an avian strain, and that is how pandemic strains arise.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      27.2
      Seconds
  • Question 29 - Which of the flowing plasma proteins has the greatest affinity for T4? ...

    Correct

    • Which of the flowing plasma proteins has the greatest affinity for T4?

      Your Answer: Thyroxin-binding globulin

      Explanation:

      There are three principal plasma thyroid hormone-binding proteins, thyroxine-binding globulin (TBG), transthyretin (TTR), and albumin. TBG is synthesized in the liver and due to its relatively high affinity for iodothyronines, binds and carries approximately 70–75% of circulating T4 and T3.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      13
      Seconds
  • Question 30 - In Restriction Fragment Length Polymorphism (RFLP), the DNA fragments are separated by length through...

    Correct

    • In Restriction Fragment Length Polymorphism (RFLP), the DNA fragments are separated by length through a process known as:

      Your Answer: Gel electrophoresis

      Explanation:

      Samples of DNA from individuals are broken into pieces by restriction enzymes and the fragments are separated according to their lengths via gel electrophoresis. Although now largely obsolete due to the rise of inexpensive DNA sequencing technologies, RFLP analysis was the first DNA profiling technique inexpensive enough to see widespread application.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      4
      Seconds
  • Question 31 - Closure of the tricuspid valve is marked by which of the following features...

    Correct

    • Closure of the tricuspid valve is marked by which of the following features of the jugular venous waveform?

      Your Answer: c wave

      Explanation:

      The jugular venous pressure (JVP) classically has three upward deflections and two downward deflections. The upward deflections are the a (atrial contraction), c (ventricular contraction and resulting bulging of tricuspid into the right atrium during isovolumetric systole) and v = venous filling. The downward deflections of the wave are the x (the atrium relaxes and the tricuspid valve moves downward) and the y descent (filling of ventricle after tricuspid opening).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.1
      Seconds
  • Question 32 - A 26 year old male presents with right sided elbow and wrist pain...

    Correct

    • A 26 year old male presents with right sided elbow and wrist pain and left sided knee and ankle pain that has persisted for about two weeks. He recently returned from a trip to Thailand that last for two weeks. The patient admits to having unprotected sex while on holiday. Examination reveals swelling and tenderness of tendons around joints but no inflammation of the joints. A vesiculopustular skin rash is also observed. What is the most likely cause?

      Your Answer: Gonococcal arthritis

      Explanation:

      Patients with disseminated gonococcal arthritis may present with dermatitis-arthritis syndrome (60%) of with localized septic arthritis. (40%). Arthritis-dermatitis syndrome includes the classic triad of dermatitis, tenosynovitis, and migratory polyarthritis. Gout usually involves a singe joint and does not cause vesicopustular skin rash. Reactive arthritis has ocular symptoms (conjunctivitis), urethritis, and arthritis. Fungal arthritis occurs rarely and it may occur after a surgical infection or fungal spread hematogenously. it presents with tender, red, hot and swollen joint with loss of range of motion.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      31.1
      Seconds
  • Question 33 - A case-control study is being designed to look at the relationship between eczema...

    Incorrect

    • A case-control study is being designed to look at the relationship between eczema and a new vaccine for yellow fever. What is the usual outcome measure in a case-control study?

      Your Answer: Relative risk

      Correct Answer: Odds ratio

      Explanation:

      A case–control study (also known as case–referent study) is a type of observational study in which two existing groups differing in outcome are identified and compared on the basis of some supposed causal attribute. Case–control studies are often used to identify factors that may contribute to a medical condition by comparing subjects who have that condition/disease (the cases) with patients who do not have the condition/disease but are otherwise similar (the controls).An odds ratio (OR) is a statistic that quantifies the strength of the association between two events, A and B. The odds ratio is defined as the ratio of the odds of A in the presence of B and the odds of A in the absence of B or vice versa.

    • This question is part of the following fields:

      • Medicine
      • Research Skills
      21
      Seconds
  • Question 34 - Which one of the following diseases is correctly matched with the animal reservoir:...

    Incorrect

    • Which one of the following diseases is correctly matched with the animal reservoir:

      Your Answer: Variant of Creutzfeldt–Jakob disease = poultry

      Correct Answer: Leptospirosis = Rats

      Explanation:

      Creutzfeldt–Jakob disease = consuming beef or beef products.Brucellosis = ingestion of unpasteurized milk or undercooked meat from infected animals.Leptospirosis is transmitted by both wild and domestic animals. The most common animals that spread the disease are rodents.Lyme disease is transmitted to humans by the bite of infected ticks of the Ixodes genus.Leishmaniasis is a disease caused by protozoan parasites of the genus Leishmania and spread by the bite of certain types of sandflies.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      48
      Seconds
  • Question 35 - The midbrain, medulla and pons, contain the following cranial nerve nuclei? ...

    Incorrect

    • The midbrain, medulla and pons, contain the following cranial nerve nuclei?

      Your Answer: CN 1 - 12

      Correct Answer: CN 3 - 12

      Explanation:

      The cranial nerves (with the exception of I and II) originate in the brainstem, which includes the midbrain, the pons, and the medulla.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      13.3
      Seconds
  • Question 36 - What does a deficiency of adenosine deaminase lead to? ...

    Incorrect

    • What does a deficiency of adenosine deaminase lead to?

      Your Answer: Lesch-Nyhan syndrome

      Correct Answer: SCID

      Explanation:

      Severe combined immunodeficiency, SCID, also known as alymphocytosis, Glanzmann–Riniker syndrome, severe mixed immunodeficiency syndrome, and thymic alymphoplasia,[1] is a rare genetic disorder characterized by the disturbed development of functional T cells and B cells. Most cases of SCID are due to mutations in the gene encoding the common gamma chain (γc), a protein that is shared by the receptors for interleukins. The second most common form of SCID after X-SCID is caused by a defective enzyme, adenosine deaminase (ADA), necessary for the breakdown of purines.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      11.8
      Seconds
  • Question 37 - Cholesterol is synthesized in all of these organs EXCEPT? ...

    Correct

    • Cholesterol is synthesized in all of these organs EXCEPT?

      Your Answer: Stomach

      Explanation:

      The liver primarily synthesizes about 20-25% of the total daily cholesterol. Cholesterol is also synthesized to smaller extents in the adrenal glands, reproductive organs (as cholesterol is the precursor of sex hormones), skin and is also produced in the intestines.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      19.6
      Seconds
  • Question 38 - A 52-year-old man has squamous-cell carcinoma of his lower lip. Which of the...

    Incorrect

    • A 52-year-old man has squamous-cell carcinoma of his lower lip. Which of the following is most likely to be a feature of this type of carcinoma?

      Your Answer: It commonly spreads to distant sites by venous channels

      Correct Answer: It is capable of metastasising via the lymphatics

      Explanation:

      Squamous-cell skin cancer usually presents as a hard lump with a scaly top but can also form an ulcer. Onset is often over months and it is more likely to spread to distant areas than basal cell cancer vie the lymphatics. The greatest risk factor is high total exposure to ultraviolet radiation from the Sun. Other risks include prior scars, chronic wounds, actinic keratosis, lighter skin, Bowen’s disease, arsenic exposure, radiation therapy, poor immune system function, previous basal cell carcinoma, and HPV infection. While prognosis is usually good, if distant spread occurs five-year survival is ,34%

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      50.9
      Seconds
  • Question 39 - The extrinsic coagulation pathway is initiated by activation of which clotting factor? ...

    Incorrect

    • The extrinsic coagulation pathway is initiated by activation of which clotting factor?

      Your Answer: Factor VIII

      Correct Answer: Factor VII

      Explanation:

      The tissue factor pathway (extrinsic) begins following damage to the blood vessel. FVII leaves the circulation and comes into contact with tissue factor (TF) expressed on tissue-factor-bearing cells (stromal fibroblasts and leukocytes), forming an activated complex (TF-FVIIa).

    • This question is part of the following fields:

      • Haematology
      • Medicine
      18.3
      Seconds
  • Question 40 - Myocardial fibers have a resting membrane potential of approximately: ...

    Correct

    • Myocardial fibers have a resting membrane potential of approximately:

      Your Answer: -90mv

      Explanation:

      The resting membrane potential of the mammalian heart is about -90 mv.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.4
      Seconds
  • Question 41 - The lamina propria contains all of the following except: ...

    Correct

    • The lamina propria contains all of the following except:

      Your Answer: Neutrophils

      Explanation:

      The connective tissue of the lamina propria is very loose, allowing it to be very cell rich. The cell population of the lamina propria is variable and can include, for example, fibroblasts, lymphocytes, plasma cells, macrophages, eosinophilic leukocytes, and mast cells. It provides support and nutrition to the epithelium, as well as the means to bind to the underlying tissue.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      2.5
      Seconds
  • Question 42 - What is found in the posterior cavity of the eye? ...

    Correct

    • What is found in the posterior cavity of the eye?

      Your Answer: Vitreous humor

      Explanation:

      The eye ball contains an anterior cavity and a posterior cavity. The anterior cavity once again is divided into the anterior chamber and posterior chamber. The anterior cavity is filled with aqueous humor whereas the posterior cavity contains vitreous humor.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      4.6
      Seconds
  • Question 43 - How does the proximal convoluted tubule excrete H+? ...

    Correct

    • How does the proximal convoluted tubule excrete H+?

      Your Answer: Via Na+/H+ antiporter.

      Explanation:

      H+ secretion from cells across the luminal membrane is mostly in exchange for Na+ ions, and to a small extent, through a proton ATPase. Secreted H+ react with filtered HC03- to form H2CO3.

    • This question is part of the following fields:

      • Medicine
      • Renal
      5.5
      Seconds
  • Question 44 - Microtubule subunits include: ...

    Correct

    • Microtubule subunits include:

      Your Answer: Alpha and beta tubulin

      Explanation:

      Microtubules are long, hollow cylinders made up of polymerised α- and β-tubulin dimers.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      7.2
      Seconds
  • Question 45 - Which of the toxin secretion pathways in the cell membrane of gram– bacteria...

    Incorrect

    • Which of the toxin secretion pathways in the cell membrane of gram– bacteria delivers the toxin extracellular in a 2 stage process to the host?

      Your Answer: IV

      Correct Answer: II

      Explanation:

      Gram negative bacteria contain two membranes and there are about six specialized secretion systems. The secreted proteins play a key role in pathogenesis. Type II secretion systems (T2SS) are conserved in most Gram-negative bacteria, where they transport proteins from the periplasm into the extracellular environment. Because the T2SS channel is only found in the outer membrane, proteins secreted through this apparatus must first be delivered to the periplasm via the Sec or Tat secretion pathways and then to the extracellular environment making it a two-stage process.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      14.1
      Seconds
  • Question 46 - Calcium needed for cardiac muscle contraction is made available during which phase of...

    Correct

    • Calcium needed for cardiac muscle contraction is made available during which phase of the action potential?

      Your Answer: 2

      Explanation:

      It is made available during the plateau phase of the action potential i.e. phase 2. During the plateau phase of the action potential, Calcium from the extracellular fluid enters through the L type of calcium channels. This entry triggers the release of more calcium from the sarcoplasmic reticulum via the ryanodine receptors.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.9
      Seconds
  • Question 47 - Which of the following would provide relief from nausea and vomiting? ...

    Correct

    • Which of the following would provide relief from nausea and vomiting?

      Your Answer: Cannabinoids

      Explanation:

      Ondansetron, chlorpromazine and haloperidol are effective antiemetic agents. Corticosteroids, cannabinoids, and benzodiazepines, alone or in combination with 5-HT3 and D2 antagonists, are also useful in the treatment of vomiting produced by chemotherapy.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      23
      Seconds
  • Question 48 - In paralytic ileus the following are true except: ...

    Correct

    • In paralytic ileus the following are true except:

      Your Answer: Opioid blocking drugs will exacerbate the symptoms

      Explanation:

      Paralytic ileus causes adynamic intestinal obstruction or decreased peristalsis and the most common reason being postoperative ileus. Opioid drugs like morphine are given for pain management and cause decreased peristalsis in the gut resulting in constipation. Theoretically opioid blocking drugs or opioid antagonists can increase peristalsis and can alleviate paralytic ileus symptoms.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      29.3
      Seconds
  • Question 49 - In which stage of mitosis are the chromosomes most obvious or prominent? ...

    Correct

    • In which stage of mitosis are the chromosomes most obvious or prominent?

      Your Answer: Metaphase

      Explanation:

      Prophase begins when the nucleus envelope disintegrates and the chromosomes start to condense. The chromosomes consist of two sister chromatids that are joined at a constriction known as centromere. When the cell reaches the metaphase the chromosomes are completely condensed and ready to align on the equatorial plate.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      26.9
      Seconds
  • Question 50 - Coronary arteries arise from? ...

    Incorrect

    • Coronary arteries arise from?

      Your Answer: Ascending aorta

      Correct Answer: None of the above

      Explanation:

      Coronary arteries arise from the sinuses behind 2 of the cusps of the aortic valve at the root of aorta.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      18.2
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (7/8) 88%
Medicine (34/50) 68%
Pharmacology (5/7) 71%
Endocrinology (3/5) 60%
Neurology (3/6) 50%
Research Skills (0/2) 0%
Genetics (3/3) 100%
Hepatobiliary (0/1) 0%
Metabolism (2/3) 67%
Gastrointestinal (5/5) 100%
Immunology (1/1) 100%
Renal (2/2) 100%
Infectious Diseases (1/3) 33%
Connective Tissue (1/1) 100%
Dermatology (0/1) 0%
Haematology (0/1) 0%
Cell Biology (1/1) 100%
Passmed