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  • Question 1 - How does aspirin mediate its antiplatelet effect: ...

    Incorrect

    • How does aspirin mediate its antiplatelet effect:

      Your Answer: It is a GPIIb/IIIa inhibitor.

      Correct Answer: It irreversibly inhibits cyclo-oxygenase

      Explanation:

      Aspirin irreversibly inhibits cyclooxygenase and blocks the platelet production of thromboxane A2 (TXA2), thus inhibiting platelet aggregation.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      2698.8
      Seconds
  • Question 2 - A patient presents with an adducted eye at rest which cannot abduct past...

    Incorrect

    • A patient presents with an adducted eye at rest which cannot abduct past the midline, which of the following cranial nerves is most likely to be affected:

      Your Answer: Trochlear nerve

      Correct Answer: Abducens nerve

      Explanation:

      Abducens nerve palsies result in a convergent squint at rest (eye turned inwards) with inability to abduct the eye because of unopposed action of the rectus medialis. The patient complains of horizontal diplopia when looking towards the affected side. With complete paralysis, the eye cannot abduct past the midline.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      39.6
      Seconds
  • Question 3 - One of your patients is in resuscitation and is suffering from kidney failure....

    Incorrect

    • One of your patients is in resuscitation and is suffering from kidney failure. The intensive care outreach team arrives to assess them and determines that a dopamine infusion is necessary.

      Dopamine primarily acts on which of the following receptors at low doses?

      Your Answer: Alpha-1 receptors

      Correct Answer: Dopamine receptors

      Explanation:

      Dopamine is a catecholamine that occurs naturally and is used to treat low cardiac output, septic shock, and renal failure. It is both adrenaline and noradrenaline’s immediate precursor.

      Dopamine acts on D1 and D2 dopamine receptors in the renal, mesenteric, and coronary beds at low doses (1-5 g/kg/min). Dopamine causes a significant decrease in renal vascular resistance and an increase in renal blood flow at these doses. Within this dose range, it is also involved in central modulation of behaviour and movement.

      Dopamine stimulates beta- and alpha-adrenergic receptors directly and indirectly at higher doses. Beta-stimulation predominates at a rate of 5-10 g/kg/min, resulting in a positive inotropic effect that increases cardiac output and coronary blood flow. Alpha-stimulation predominates at infusion rates greater than 15 g/kg/min, resulting in peripheral vasoconstriction and an increase in venous return and systolic blood pressure.

      Below is a summary of the mechanisms and effects of various inotropic agents:
      Inotrope
      Mechanism
      Effects
      Adrenaline (epinephrine)
      Beta-1 and -2 agonist at increasing doses;
      Alpha-agonist at high doses
      Increased cardiac output;
      Vasoconstriction at higher doses
      Noradrenaline (norepinephrine)
      Mainly alpha-agonist;
      Beta-1 and -2 agonist at increasing doses
      Vasoconstriction;
      Some increased cardiac output
      Dopamine
      Dopamine agonist at low doses;
      Beta-1 and -2 agonist at increasing doses;
      Alpha-agonist at high doses
      Increased cardiac output;
      Vasoconstriction at higher doses
      Dobutamine
      Mainly beta-1 agonist
      Increased cardiac output

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      9448.9
      Seconds
  • Question 4 - Which of the following is considered the best source of information if a...

    Incorrect

    • Which of the following is considered the best source of information if a research on the national hospital MRSA rates is being done?

      Your Answer: Hospital Patient Feedback Questionnaires

      Correct Answer: Hospital Episode Statistics

      Explanation:

      Hospital Episode Statistics (HES) is a data warehouse containing details of all admissions, outpatient appointments and A and E attendances at NHS hospitals in England.

      Each HES record contains a wide range of information about an individual patient admitted to an NHS hospital, including:
      – clinical information about diagnoses and operations
      – patient information, such as age group, gender and ethnicity
      – administrative information, such as dates and methods of admission and discharge
      – geographical information such as where patients are treated and the area where they live

      Some benefits of HES include:
      – monitor trends and patterns in NHS hospital activity
      – assess effective delivery of care
      – support local service planning
      – reveal health trends over time
      – determine fair access to health care

    • This question is part of the following fields:

      • Evidence Based Medicine
      135.3
      Seconds
  • Question 5 - A 32-year-old woman diagnosed with hyperthyroidism has her T 4 levels grossly elevated...

    Correct

    • A 32-year-old woman diagnosed with hyperthyroidism has her T 4 levels grossly elevated and she is started on carbimazole.

      A release of which of the following from the hypothalamus is inhibited by increase in T4 levels?

      Your Answer: Thyrotropin-releasing hormone

      Explanation:

      A negative feedback mechanism involving the hypothalamic-pituitary-thyroid axis controls the release of T3 and T4 into the bloodstream.

      When metabolic rate is low or serum T3 and/or T4 levels are decrease, this triggers the secretion of thyrotropin-releasing hormone (TRH) from the hypothalamus.

      TRH goes to the anterior pituitary gland and stimulates secretion of thyroid-stimulating hormone (TSH).

      An increased serum level of T3 and T4 inhibits the release of TRH.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      24.4
      Seconds
  • Question 6 - An 11-year-old presented to a GP with a history of headache, neck stiffness...

    Incorrect

    • 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 600 mg

      Correct 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
      715
      Seconds
  • Question 7 - A 60-year-old female presents with fatigue, easy bruising and repeated chest and skin...

    Incorrect

    • A 60-year-old female presents with fatigue, easy bruising and repeated chest and skin infections for five months. She also complains about several episodes of nosebleeds over the last few days without any history of trauma.

      Her complete blood count shows the following results:
      Hb 9 g/dl
      Total leukocyte count: 2.5x10^9/L, 1100 neutrophils/ųL
      MCV 100
      platelet count of 90,000/ųL.

      Which one of the following conditions does this patient most likely have?

      Your Answer: Folic acid deficiency

      Correct Answer: Myelodysplastic syndrome

      Explanation:

      Myelodysplastic syndromes are a group of clonal haematopoietic disorders which are characterised by anaemia, leukopenia and thrombocytopenia.

      Patients will complain of fatigue, symptoms of thrombocytopenia such as nosebleeds and easy bleeding and a history of repeated infections due to low white blood cells (especially Neutrophils).

      In Chronic lymphocytic leukaemia production of hematopoietic cells goes on for a longer time.

      Folate and B12 deficiency would result in hypersegmented neutrophils and a raised MCV.

      Iron deficiency anaemia would not cause neutropenia or thrombocytopenia.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      38.9
      Seconds
  • Question 8 - An 80-year-old male has presented with chest pain characteristic of angina pectoris. Before...

    Incorrect

    • An 80-year-old male has presented with chest pain characteristic of angina pectoris. Before initiating treatment with Glyceryl nitrate, you examine the patient and find a murmur. The patient reveals that he has a heart valve disorder, and you immediately put a hold on the GTN order.

      Which of the following valve disorders is an absolute contraindication to the use of GTN?

      Your Answer: Mitral valve prolapse

      Correct Answer: Mitral stenosis

      Explanation:

      Angina pectoris is the most common symptom of ischemic heart disease and presents with chest pain relieved by rest and nitro-glycerine.

      Nitrates are the first-line treatment to relieve chest pain caused by angina. The commonly used nitrates are:
      1. Nitro-glycerine (NTG) – angina pectoris (treatment/prophylaxis), acute coronary syndrome, heart failure, hypertension
      2. Isosorbide mononitrate (ISMN) – chronic angina pectoris (treatment)
      3. Isosorbide dinitrate (ISDN) – angina pectoris (treatment/prophylaxis)

      The nitrate drugs cause vasodilation via the action of nitric oxide.

      The contraindications to the use of nitrate are the following:
      1. Allergy to nitrates
      2. Concomitant use of phosphodiesterases (PDE) inhibitors such as tadalafil and sildenafil
      3. Right ventricular infarction
      4. Hypertrophic cardiomyopathy
      5. Cardiac tamponade
      6. Constrictive pericarditis
      7. Hypotensive conditions
      8. Hypovolaemia
      9. Marked anaemia
      10. Mitral stenosis
      11. Raised intracranial pressure due to cerebral haemorrhage or head trauma
      12. Toxic pulmonary oedema

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      41.1
      Seconds
  • Question 9 - All of the following typically occurs as part of normal passive expiration except:...

    Incorrect

    • All of the following typically occurs as part of normal passive expiration except:

      Your Answer: Depression of the lateral shaft of the ribs

      Correct Answer: Contraction of the internal intercostal muscles

      Explanation:

      Passive expiration is produced primarily by relaxation of the inspiratory muscles (diaphragm and external intercostal muscles) in addition to the elastic recoil of the lungs.
      In expiration, several movements occur. There are:
      1. depression of the sternal ends of the ribs (‘pump handle’ movement),
      2. depression of the lateral shafts of the ribs (‘bucket handle’ movement) and
      3. elevation of the diaphragm.
      These result in a reduction of the thorax in an anteroposterior, transverse and vertical direction respectively. There is then a decreased intrathoracic volume and increased intrathoracic pressure and air is forced out of the lungs.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      38.3
      Seconds
  • Question 10 - Which patients are particularly susceptible to infection with herpes simplex, those with: ...

    Correct

    • Which patients are particularly susceptible to infection with herpes simplex, those with:

      Your Answer: T-cell deficiency

      Explanation:

      Cell-mediated immunity, especially the action of cytotoxic T-cells, is essential in the control of herpesvirus infections and patients with T-cell deficiency are at particular risk of reactivation and severe infection. T-cell deficiency may follow HIV infection, chemotherapy, corticosteroid therapy or organ transplantation.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      21.8
      Seconds
  • Question 11 - Regarding red blood cell group antigens and antibodies, which of the following statements...

    Incorrect

    • Regarding red blood cell group antigens and antibodies, which of the following statements is CORRECT:

      Your Answer: Anti-A and anti-B antibodies are usually IgG.

      Correct Answer: Anti-D antibodies are usually IgG.

      Explanation:

      Approximately 400 red blood cell group antigens have been described. The ABO group antigens are unusual in that naturally occurring antibodies occur in the plasma of subjects who lack the corresponding antigen, even if they have not been exposed to that antigen previously. The most important of these natural antibodies are anti-A and anti-B, which are usually IgM. Anti-D antibodies don’t occur naturally, and are therefore immune antibodies that result from previous transfusions or pregnancy. Only IgG antibodies are capable of transplacental passage and the most important immune antibody is the Rh antibody, anti-D.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      7.3
      Seconds
  • Question 12 - Which of the following immunoglobulins is most important for mast cell degranulation: ...

    Incorrect

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

      Your Answer: IgM

      Correct Answer: IgE

      Explanation:

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

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      110.5
      Seconds
  • Question 13 - A 18 year old university student develops facial swelling and dark frothy urine. Urine...

    Incorrect

    • A 18 year old university student develops facial swelling and dark frothy urine. Urine dipstick demonstrates haematuria and proteinuria. Approximately 3 weeks ago, he was treated with oral antibiotics for a sore throat. His condition is most likely to be secondary to infection with:

      Your Answer: Staphylococcus epidermidis

      Correct Answer: Streptococcus pyogenes

      Explanation:

      Post-streptococcal glomerulonephritis is a postinfectious immune-mediated reaction secondary to infection with Streptococcus pyogenes. It typically occurs 2 weeks or more after acute/initial infection, and presents with haematuria, reduced urine output, peripheral oedema, proteinuria, and hypertension. Permanent kidney damage is rare.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      20.2
      Seconds
  • Question 14 - The fracture of the medial epicondyle will cause damage to the ulnar nerve....

    Incorrect

    • The fracture of the medial epicondyle will cause damage to the ulnar nerve. Which of the following motions would be impaired by this type of injury?

      Your Answer: Abduction of the thumb

      Correct Answer: Adduction of the thumb

      Explanation:

      Fracture of the medial epicondyle is most likely to result in damage to the ulnar nerve.

      The three hypothenar muscles, two medial lumbricals, seven interossei, the adductor pollicis, and the deep head of the flexor pollicis brevis are all innervated by the deep branch of the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      86.2
      Seconds
  • Question 15 - The patient is a 66-year-old woman who has troublesome bilateral ankle swelling. This...

    Incorrect

    • The patient is a 66-year-old woman who has troublesome bilateral ankle swelling. This has been happening since she began taking a new antihypertensive medication a few weeks ago.

      Which of the following medications is most likely to be the cause of this adverse reaction?

      Your Answer: Ramipril

      Correct Answer: Amlodipine

      Explanation:

      Amlodipine is a calcium-channel blocker that is frequently used to treat hypertension. Ankle swelling is a very common side effect of calcium-channel blockers, and it occurs quite frequently.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      58.9
      Seconds
  • Question 16 - A 54-year-old man returns from a recently holiday on a cruise ship with...

    Incorrect

    • A 54-year-old man returns from a recently holiday on a cruise ship with a dry cough and a fever. Today he has also had several episodes of diarrhoea and has developed bilateral pleuritic chest pain. He states that he is short of breath, most notably on exertion. He had been prescribed amoxicillin by the cruise ship doctor a few days earlier but has not seen any improvement.
      Which of the following is the most likely causative organism? Select ONE answer only.

      Your Answer: Streptococcus pneumoniae

      Correct Answer: Legionella pneumophila

      Explanation:

      Legionella pneumophilais a Gram negative bacterium that is found in natural water supplies and in the soil, transmitted predominantly via inhalation of aerosols generated from contaminated water (direct person-to-person spread of infected patients does not occur). It is the cause of Legionnaires’ disease. Outbreaks of Legionnaires’ disease have been linked to poorly maintained air conditioning systems, whirlpool spas and hot tubs.

      The clinical features of the pneumonic form of Legionnaires’ disease include:
      Mild flu-like prodrome for 1-3 days
      Cough (usually non-productive and occurs in approximately 90%)
      Pleuritic chest pain
      Haemoptysis
      Headache
      Nausea, vomiting and diarrhoea
      Anorexia
      Legionella pneumophilainfections can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used.
      The syndrome of inappropriate antidiuretic hormone secretion (SIADH) can occur with Legionnaires’ disease and will result in hyponatraemia as is seen in this case.
      Legionella pneumophilainfections are resistant to amoxicillin but can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used. The majority of cases of Legionnaires’ disease are caused by Legionella pneumophila, however many other species of Legionella have been identified.
      Legionella longbeachae is another less commonly encountered species that has also been implicated in outbreaks. It is predominantly found in soil and potting compost, and has caused outbreaks of Pontiac fever, the non-respiratory and less severe variant of Legionnaires’ disease.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      9.2
      Seconds
  • Question 17 - The pelvic bone is formed by which of the following: ...

    Incorrect

    • The pelvic bone is formed by which of the following:

      Your Answer: Ilium, ischium and sacrum

      Correct Answer: Ilium, ischium and pubis

      Explanation:

      Each pelvic bone is formed by three elements: the ilium (superiorly), the pubis (anteroinferiorly) and the ischium (posteroinferiorly).

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      14.3
      Seconds
  • Question 18 - During her pregnancy, a 28-year-old lady was given an antibiotic. The neonate was...

    Correct

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

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

      Your Answer: Chloramphenicol

      Explanation:

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

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

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

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      18.6
      Seconds
  • Question 19 - Which of the following is the most abundant immunoglobulin in plasma: ...

    Incorrect

    • Which of the following is the most abundant immunoglobulin in plasma:

      Your Answer: IgD

      Correct Answer: IgG

      Explanation:

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

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      8.9
      Seconds
  • Question 20 - You've been summoned to the resuscitation area to assist a patient who is...

    Incorrect

    • You've been summoned to the resuscitation area to assist a patient who is having a seizure. As part of the treatment protocol, a benzodiazepine dose is given.

      Which of the following statements about the use of benzodiazepines in seizures is correct?

      Your Answer: Most patients require multiple doses to terminate their seizure

      Correct Answer: Lorazepam can be given by the rectal route

      Explanation:

      A single dose of IV benzodiazepine will terminate the seizure in 60 to 80 percent of patients who present with seizures.

      Because benzodiazepines are lipid-soluble, they cross the blood-brain barrier quickly. This explains their quick onset of action.

      As a first-line treatment, IV lorazepam should be given. If IV lorazepam is not available, IV diazepam can be used instead, and buccal midazolam can be used if intravenous access cannot be established quickly. Lorazepam can be administered via the rectal route, but it is less reliable and has a lower absorption rate and bioavailability.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      7.5
      Seconds
  • Question 21 - Which of these organisms is commonly spread by droplet transmission? ...

    Correct

    • Which of these organisms is commonly spread by droplet transmission?

      Your Answer: Neisseria meningitidis

      Explanation:

      Droplets are airborne particles greater than 5 µm in size. Droplet transmission occurs during talking, coughing and sneezing where respiratory droplets are generated.

      Examples of organisms transmitted by the droplet route include:
      Neisseria meningitidis
      Respiratory syncytial virus
      Parainfluenza virus
      Bordetella pertussis
      Influenza virus

      Poliovirus and Rotavirus are transmitted by the faeco-oral route

      Hepatitis B is transmitted by Sexual route

      Staphylococcus aureus is transmitted by direct contact

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      20.2
      Seconds
  • Question 22 - Identify the type of graph described below:

    A graph that is a useful summary...

    Incorrect

    • Identify the type of graph described below:

      A graph that is a useful summary of a set of bivariate data (two variables), usually drawn before working out a linear correlation coefficient or fitting a regression line.

      Your Answer: Pareto chart

      Correct Answer: Scatterplot

      Explanation:

      A scatterplot is a useful summary of a set of bivariate data (two variables), usually drawn before working out a linear correlation coefficient or fitting a regression line. It gives a good visual picture of the relationship between the two variables, and aids the interpretation of the correlation coefficient or regression model. Each unit contributes one point to the scatterplot, on which points are plotted but not joined. The resulting pattern indicates the type and strength of the relationship between the two variables.

    • This question is part of the following fields:

      • Evidence Based Medicine
      29.3
      Seconds
  • Question 23 - Beta cells of the endocrine pancreas produce which of the following hormones: ...

    Incorrect

    • Beta cells of the endocrine pancreas produce which of the following hormones:

      Your Answer: Glucagon

      Correct Answer: Insulin

      Explanation:

      Insulin is produced by beta cells, located centrally within the islets of Langerhans, in the endocrine tissues of the pancreas. Insulin is a polypeptide hormone consisting of two short chains (A and B) linked by disulphide bonds. Proinsulin is synthesised as a single-chain peptide. Within storage granules, a connecting peptide (C peptide) is removed by proteases to yield insulin. Insulin release is stimulated initially during eating by the parasympathetic nervous system and gut hormones such as secretin, but most output is driven by the rise in plasma glucose concentration that occurs after a meal. The effects of insulin are mediated by the receptor tyrosine kinase.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      170.5
      Seconds
  • Question 24 - A dermatological examination of a patient who has presented with a lump shows...

    Incorrect

    • A dermatological examination of a patient who has presented with a lump shows a collection of boils clustered together.

      Which one of these best describes the lump you have found on examination?

      Your Answer: Bulla

      Correct Answer: Carbuncle

      Explanation:

      A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus.

      A carbuncle is a collection of individual boils clustered together.

      A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter.

      A vesicle is a visible collection of clear fluid measuring less than 0.5 cm in diameter.

      A pustule is a small visible skin elevation containing an accumulation of pus.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      39.4
      Seconds
  • Question 25 - A 25 year old man has sustained a fracture to the surgical neck...

    Incorrect

    • A 25 year old man has sustained a fracture to the surgical neck of the humerus after falling from his bike. Examination suggests an axillary nerve injury. The clinical features expected to be seen in this patient are:

      Your Answer: Weakness of shoulder flexion

      Correct Answer: Weakness of shoulder abduction

      Explanation:

      Axillary nerve injury results in:
      1. weakness of arm abduction (paralysis of deltoid),
      2. weakness of lateral rotation of the arm (paralysis of teres minor)
      3. loss of sensation over the regimental badge area.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      20.5
      Seconds
  • Question 26 - A 12-year-old boy presents to you with a history of fever. A rash...

    Incorrect

    • A 12-year-old boy presents to you with a history of fever. A rash began as small red dots on the face, scalp, torso, upper arms and legs shortly afterwards and has now progressed to small blisters and pustules. You make a diagnosis of chickenpox.

      The following complications of chickenpox is the LEAST likely.

      Your Answer: Orchitis

      Correct Answer: Bronchospasm

      Explanation:

      Chickenpox (varicella zoster) is a highly contagious airborne disease and has an incubation period of between 7-21 days. It often has a prodromal phase when there is a fever, aches and headaches, dry cough, and sore throat before onset of rash.

      Some recognized complications of chickenpox are:
      Orchitis
      Hepatitis
      Pneumonia
      Encephalitis
      Infected spots
      Otitis media
      Myocarditis
      Glomerulonephritis
      Appendicitis
      Pancreatitis

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      27
      Seconds
  • Question 27 - A 45-old woman is on several medications and being treated for epilepsy and...

    Incorrect

    • A 45-old woman is on several medications and being treated for epilepsy and bipolar disorder. In the ward rounds, you are asked to examine her in detail and discover she has a noticeable tremor. You believe that one of her medications may be responsible for this new onset tremor.

      Which of the following medications is least likely to be responsible for this tremor?

      Your Answer: Olanzapine

      Correct Answer: Carbamazepine

      Explanation:

      The only medication that does not commonly cause tremors is carbamazepine.

      The other drugs present with the following types of tremors as a side effect to their usage:
      1. Sodium valproate – Postural tremor is most common, but a resting tremor can also occur. Approximately 25% of patients taking sodium valproate are found to develop a tremor within 12 months of starting therapy.
      2. Lithium – fine hand tremor is very commonly seen and reported in as many as 50% of patients during the first week of therapy. The tremor tends to reduce with time and is only present in around 5% of patients taking the medication two years or longer.
      3. Atypical antipsychotics, such as olanzapine and quetiapine – tremor and limb shakiness.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      124.7
      Seconds
  • Question 28 - Which of the following nerves is responsible for the symptoms of a patient...

    Incorrect

    • Which of the following nerves is responsible for the symptoms of a patient who presented with ophthalmic herpes zoster and a few vesicles on the nose?

      Your Answer:

      Correct Answer: Trigeminal nerve

      Explanation:

      Hutchinson sign relates to involvement of the tip of the nose from facial herpes zoster. It implies involvement of the external nasal branch of the nasociliary nerve which is a branch of the ophthalmic division of the trigeminal nerve.

      The nasociliary branch of the trigeminal nerve innervates the apex and lateral aspect of the nose, as well as the cornea. Therefore, lesions on the side or tip of the nose should raise suspicion of ocular involvement.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      0
      Seconds
  • Question 29 - A 79-year-old male had a humeral shaft fracture during a road traffic accident...

    Incorrect

    • A 79-year-old male had a humeral shaft fracture during a road traffic accident and is being followed up in a fracture clinic. He complains of inability to use the limb 6 months after the injury. X-rays of that arm shows non union of his fracture.

      All the following are responsible for this non-union EXCEPT?

      Your Answer:

      Correct Answer: Osteoporosis

      Explanation:

      An imbalance between bone resorption and formation is Osteoporosis. In normal bone, formation and resorption are roughly equal, and the density of bone matrix remains constant but there is more resorption in osteoporosis and the matrix density reduces and bones become weaker. Fractures are more likely to occur but healing is unaffected.

      Non-union of a fracture occurs when the two sides of a fracture fail to unite after 6 months. Causes include: infection, movement at the fracture site, avascular necrosis, tissue interposed between the fracture and gross misalignment.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds
  • Question 30 - Which of the following best describes the therapeutic effect of calcium gluconate when used...

    Incorrect

    • Which of the following best describes the therapeutic effect of calcium gluconate when used in treatment for hyperkalaemia:

      Your Answer:

      Correct Answer: Reduces cardiac cell membrane excitability

      Explanation:

      Calcium resonium is an ion-exchange resin that exchanges sodium for potassium as it passes through the intestine, leading to excretion of potassium from the body. Salbutamol and insulin act to increase intracellular uptake of K+ via Na-K ATP pump. Sodium bicarbonate acts to correct acidosis and thus promotes intracellular uptake of K+. Calcium gluconate acts to protect the cardiac membrane and has no effect on serum K+ levels.

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
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