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  • Question 1 - Decreased velocity of impulse conduction through the atrioventricular node (AV node) in the...

    Incorrect

    • Decreased velocity of impulse conduction through the atrioventricular node (AV node) in the heart will lead to:

      Your Answer: Decreased PR interval

      Correct Answer: Increased PR interval

      Explanation:

      AV node damage may lead to an increase in the PR interval to as high as 0.25 – 0.40 s (normal = 0.12 – 0.20 s). In the case of severe impairment, there might be a complete failure of passage of impulses leading to complete block. In this case, the atria and ventricles will beat independently of each other.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      12.2
      Seconds
  • Question 2 - Abnormal breathing is noticed in a of victim of a road traffic accident,...

    Correct

    • Abnormal breathing is noticed in a of victim of a road traffic accident, who sustained a head injury. The breathing pattern is characterised by alternate periods of waxing and waning tidal volumes with interspersed periods of apnoea. This breathing pattern is known as:

      Your Answer: Cheyne–Stokes breathing

      Explanation:

      Cheyne-Stokes breathing is an abnormal breathing pattern with breathing periods of gradually waxing and waning tidal volumes, with apnoeic periods interspersed. It is usually the first breathing pattern to be seen with a rise in intracranial pressure and is caused by failure of the respiratory centre in the brain to compensate quickly enough to changes in serum partial pressure of oxygen and carbon dioxide. The aetiology includes strokes, head injuries, brain tumours and congestive heart failure. It is also a sign of altitude sickness in normal people, a symptom of carbon monoxide poisoning or post-morphine administration. Biot’s respiration (cluster breathing) is characterized by cluster of quick, shallow inspirations followed by regular or irregular periods of apnoea. It is different from ataxic respiration, which has completely irregular breaths and pauses. It results due to damage to the medulla oblongata by any reason (stroke, uncal herniation, trauma) and is a poor prognostic indicator. Kussmaul breathing, also known as ‘air hunger’, is basically respiratory compensation for metabolic acidosis and is characterized by quick, deep and laboured breathing. It is most often seen in in diabetic ketoacidosis. Due to forced inspiratory rate, the patients will show a low p(CO2). Ondine’s curse is congenital central hypoventilation syndrome or primary alveolar hypoventilation, which can be fatal and leads to sleep apnoea. It involves an inborn failure to control breathing autonomically during sleep and in severe cases, can affect patients even while awake. It is known to occur in 1 in 200000 liveborn children. Treatment includes tracheostomies and life long mechanical ventilator support.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      1.8
      Seconds
  • Question 3 - What is the normal amount of oxygen that is carried in the blood?...

    Correct

    • What is the normal amount of oxygen that is carried in the blood?

      Your Answer: 20 ml oxygen/100 ml blood

      Explanation:

      Normally, 100 ml of blood contains 15g haemoglobin and a single gram of haemoglobin can bind to 1.34 ml oxygen when 100% saturated. Thus, 15 × 1.34 = 20 ml O2/100 ml blood. The haemoglobin in venous blood that is leaving the tissues is about 75% saturated with oxygen, and hence it carries about 15 ml O2/100 ml venous blood. This implies that for each 10 ml of blood, 5 ml oxygen is transported to the tissues. With a p(O2) > 100 mm Hg, only 3 ml of oxygen is dissolved in every one litre of plasma. By increasing the pA(O2) by breathing 100% oxygen, one can add an extra amount of oxygen in the plasma, but the amount of oxygen carried by haemoglobin will not increase significantly as it is already > 95% saturated.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      5.4
      Seconds
  • Question 4 - A 50-year-old woman goes to the doctor complaining of myalgia, muscle cramps, and...

    Correct

    • A 50-year-old woman goes to the doctor complaining of myalgia, muscle cramps, and weakness; she is diagnosed with severe hypokalaemia. Which of the following is the most common cause of hypokalaemia?

      Your Answer: Prolonged vomiting

      Explanation:

      Potassium is one of the body’s major ions. Nearly 98% of the body’s potassium is intracellular. The ratio of intracellular to extracellular potassium is important in determining the cellular membrane potential. Small changes in the extracellular potassium level can have profound effects on the function of the cardiovascular and neuromuscular systems. Hypokalaemia may result from conditions as varied as renal or gastrointestinal (GI) losses, inadequate diet, transcellular shift (movement of potassium from serum into cells) and medications. The important causes of hypokalaemia are:

      Renal losses: renal tubular acidosis, hyperaldosteronism, magnesium depletion, leukaemia (mechanism uncertain).

      GI losses: vomiting or nasogastric suctioning, diarrhoea, enemas or laxative use, ileal loop.

      Medication effects: diuretics (most common cause), β-adrenergic agonists, steroids, theophylline, aminoglycosides.

      Transcellular shift: insulin, alkalosis.

      Severe hypokalaemia, with serum potassium concentrations of 2.5–3 meq/l, may cause muscle weakness, myalgia, tremor, muscle cramps and constipation.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      18.3
      Seconds
  • Question 5 - Causes of metabolic acidosis with a normal anion gap include: ...

    Correct

    • Causes of metabolic acidosis with a normal anion gap include:

      Your Answer: Diarrhoea

      Explanation:

      Excess acid intake and excess bicarbonate loss as in diarrhoea, are causes of metabolic acidosis with a normal anion gap. The other conditions all result in an increased anion gap.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      4.5
      Seconds
  • Question 6 - A 45-year-old pregnant woman develops high blood pressure at 20 weeks. She complains...

    Correct

    • A 45-year-old pregnant woman develops high blood pressure at 20 weeks. She complains of headaches and swollen feet, and a test reveals proteinuria (350 mg/day). Which of the following is the most likely diagnosis?

      Your Answer: Pre-eclampsia

      Explanation:

      Pre-eclampsia (PE) is a disorder of pregnancy characterized by the onset of high blood pressure (two separate readings taken at least 6 h apart of 140/90 or more) and often a significant amount of protein in the urine (>300 mg of protein in a 24-h urine sample). While blood pressure elevation is the most visible sign of the disease, it involves generalised damage to the maternal endothelium of the kidneys and liver, with the release of vasopressive factors only secondary to the original damage. Pre-eclampsia may develop at varying times within pregnancy and its progress differs among patients; most cases present pre-term. It has no known cure apart from ending the pregnancy (induction of labour or abortion). It may also present up to 6 weeks post partum. Risk factors for pre-eclampsia include obesity, prior hypertension, older age, and diabetes mellitus.

    • This question is part of the following fields:

      • Physiology
      • Renal
      3.8
      Seconds
  • Question 7 - Hormones of the anterior pituitary include which of the following? ...

    Correct

    • Hormones of the anterior pituitary include which of the following?

      Your Answer: Prolactin

      Explanation:

      The anterior pituitary gland (adenohypophysis or pars distalis) synthesizes and secretes:

      1. FSH (follicle-stimulating hormone)

      2. LH (luteinizing hormone)

      3. Growth hormone

      4. Prolactin

      5. ACTH (adrenocorticotropic hormone)

      6. TSH (thyroid-stimulating hormone).

      The posterior pituitary gland (neurohypophysis) stores and secretes 2 hormones produced by the hypothalamus:

      1. ADH (antidiuretic hormone or vasopressin)

      2. Oxytocin

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      3
      Seconds
  • Question 8 - Which of the following is the cause of flattened (notched) T waves on...

    Correct

    • Which of the following is the cause of flattened (notched) T waves on electrocardiogram (ECG)?

      Your Answer: Hypokalaemia

      Explanation:

      The T-wave is formed due to ventricular repolarisation. Normally, it is seen as a positive wave. It can be normally inverted (negative) in V1 (occasionally in V2-3 in African-Americans/Afro-Caribbeans). Hyperacute T-waves are the earliest ECG change of acute myocardial infarction. ECG findings of hyperkalaemia include high, tent-shaped T-waves, a small P-wave and a wide QRS complex. Hypokalaemia results in flattened (notched) T-waves, U-waves, ST-segment depression and prolonged QT interval.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      10.1
      Seconds
  • Question 9 - A 34-year-old woman has been suffering from headaches, fever, vomiting, and confusion for...

    Correct

    • A 34-year-old woman has been suffering from headaches, fever, vomiting, and confusion for the last 5 days. A CT scan reveals an oedematous mass with ring enhancement in the left temporal region. It is biopsied, revealing glial cells, necrosis, neutrophils and lymphocytes. What is the most likely diagnosis?

      Your Answer: Cerebral abscess

      Explanation:

      A cerebral abscess can result from direct extension of cranial infections, penetrating head trauma, haematogenous spread, or for unknown causes. An abscess forms when an area of cerebral inflammation becomes necrotic and encapsulated by glial cells and fibroblasts. Oedema around the abscess can increase the intracranial pressure. Symptoms result from increased intracranial pressure and mass effects. It is most frequent in the third decade of life, and when it occurs in children, it is usually associated with congenital heart disease.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      8.8
      Seconds
  • Question 10 - After a total colectomy and ileotomy, a 50-year old diabetic man who was...

    Correct

    • After a total colectomy and ileotomy, a 50-year old diabetic man who was a known case of diabetic nephropathy had persistent metabolic acidosis. The patient appeared well perfused, with normal vital signs and normal fluid balance. Investigations revealed:

      Sodium = 132 mmol/l

      Potassium = 6.6 mmol/l

      Creatinine = 185 μmol/l (2.16 mg/dl)

      Chloride = 109 μmol/l

      8am cortisol = 500 nmol/l (18 μg/dl)

      pH = 7.29, p(CO2) = 27 mmHg

      p(O2) = 107 mmHg

      standard bicarbonate = 12 mmol/l.

      What is the likely causes of his acidosis?

      Your Answer: Renal tubular acidosis

      Explanation:

      Acidosis here is due to low bicarbonate. The low p(CO2) is seen in compensation. The anion gap is normal, ruling out intra-abdominal ischaemia (which leads to metabolic acidosis). If it was a gastrointestinal aetiology, low potassium would be seen. The history of diabetic nephropathy predisposes to renal tubular acidosis. Type 4 (hyporeninaemic hypoaldosteronism) is associated with high potassium and is found in diabetic and hypertensive renal disease.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      21.3
      Seconds
  • Question 11 - Which of the following conditions causes an elevation of the pH in the...

    Correct

    • Which of the following conditions causes an elevation of the pH in the tissues with elevated arterial CO2 content?

      Your Answer: Metabolic alkalosis

      Explanation:

      Metabolic alkalosis is a metabolic condition in which the pH of tissue is elevated beyond the normal range (7.35-7.45). This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate, or alternatively a direct result of increased bicarbonate concentrations. Normally, arterial pa(CO2) increases by 0.5–0.7 mmHg for every 1 mEq/l increase in plasma bicarbonate concentration, a compensatory response that is very quick. If the change in pa(CO2) is not within this range, then a mixed acid–base disturbance occurs.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      3.5
      Seconds
  • Question 12 - A 70-year-old man who was previously healthy develops a rapidly progressing neurological deficit....

    Incorrect

    • A 70-year-old man who was previously healthy develops a rapidly progressing neurological deficit. A MRI reveals a large, poorly defined mass with central necrosis in his left temporal lobe. What is the most likely diagnosis?

      Your Answer: Meningioma

      Correct Answer: Glioblastoma multiforme

      Explanation:

      Glioblastoma multiforme, or grade 4 astrocytoma, is the most common and aggressive primary brain tumour. They are formed by small areas of necrotising tissue surrounded by highly anaplastic cells. Most of them arise from the deep white matter of the brain and quickly infiltrate it, becoming very large before they are symptomatic. The most common symptom is progressive memory, personality or neurological deficit due to temporal and frontal lobe involvement. It is most common in men, and risk factors include: neurofibromatosis, tuberous sclerosis, Von Hippel-Lindau disease, Li-Fraumeni syndrome, and Turcot syndrome.

    • This question is part of the following fields:

      • Neurology
      • Pathology
      18.5
      Seconds
  • Question 13 - The pleural cavity is the space between the two pulmonary pleurae which cover...

    Correct

    • The pleural cavity is the space between the two pulmonary pleurae which cover the lungs. What is the normal amount of pleural fluid?

      Your Answer: 10 ml

      Explanation:

      Pleural fluid is a serous fluid produced by the serous membrane covering normal pleurae. Most fluid is produced by the parietal circulation (intercostal arteries) via bulk flow and reabsorbed by the lymphatic system. The total volume of fluid present in the intrapleural space is estimated to be only 2–10 ml. A small amount of protein is present in intrapleural fluid. Normally, the rate of reabsorption increases as a physiological response to accumulating fluid.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      6.3
      Seconds
  • Question 14 - Ventricular filling follows a delay caused by? ...

    Correct

    • Ventricular filling follows a delay caused by?

      Your Answer: AV node

      Explanation:

      The AV node is a conducting tissue found between the atria and the ventricles of the heart. It conducts electrical signal from the atria to the ventricles and acts a delaying mechanism preventing the atria and the ventricles from contracting at the same time. This decremental conduction prevents premature ventricular contraction in cases such as atrial fibrillation. A delay in the AV node is the reason for the PR segment seen on the ECG. In certain types of supraventricular tachycardia, a person could have two AV nodes; this will cause a loop in electrical current and uncontrollably rapid heart beat. When this electricity catches up with itself, it will dissipate and return to a normal heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      2
      Seconds
  • Question 15 - A 50-year old gentleman who was admitted for elective surgery was found to...

    Correct

    • A 50-year old gentleman who was admitted for elective surgery was found to have haemoglobin 9.5 g/dl, white blood cell count of 1.4 × 109/l and a mean corpuscular volume (MCV) of 134 fl. Which of the following is the likely finding on his peripheral blood smear?

      Your Answer: Hypersegmented neutrophils

      Explanation:

      The likely diagnosis is megaloblastic anaemia, which also shows the presence of hypersegmented neutrophils.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      10.7
      Seconds
  • Question 16 - Calculate the cardiac output of a patient with the following measurements: oxygen uptake...

    Correct

    • Calculate the cardiac output of a patient with the following measurements: oxygen uptake 200 ml/min, oxygen concentration in the peripheral vein 7 vol%, oxygen concentration in the pulmonary artery 10 vol% and oxygen concentration in the aorta 15 vol%.

      Your Answer: 4000 ml/min

      Explanation:

      The Fick’s principle states that the uptake of a substance by an organ equals the arteriovenous difference of the substance multiplied by the blood flowing through the organ. We can thus calculate the pulmonary blood flow with pulmonary arterial (i.e., mixed venous) oxygen content, aortic oxygen content and oxygen uptake. The pulmonary blood flow, systemic blood flow and cardiac output can be considered the same assuming there are no intracardiac shunts. Thus, we can calculate the cardiac output. Cardiac output = oxygen uptake/(aortic − mixed venous oxygen content) = 200 ml/min/(15 ml O2/100 ml − 10 ml O2/100 ml) = 200 ml/min/(5 ml O2/100 ml) = 200 ml/min/0.05 = 4000 ml/min.

      It is crucial to remember to use pulmonary arterial oxygen content and not peripheral vein oxygen content, when calculating the cardiac output by Fick’s method.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      3.6
      Seconds
  • Question 17 - During strenuous exercise, what else occurs besides tachycardia? ...

    Incorrect

    • During strenuous exercise, what else occurs besides tachycardia?

      Your Answer: Increased renal blood flow

      Correct Answer: Increased stroke volume

      Explanation:

      During strenuous exercise there is an increase in:

      – Heart rate, stroke volume and therefore cardiac output. (CO = HR x SV)

      – Respiratory rate (hyperventilation) which will lead to a reduction in Paco2.

      – Oxygen demand of skeletal muscle, therefore leading to a reduction in mixed venous blood oxygen concentration.

      Renal blood flow is autoregulated, so renal blood flow is preserved and will tend to remain the same. Mean arterial blood pressure is a function of cardiac output and total peripheral resistance and will increase with exercise, mainly as a result of the increase in cardiac output that occurs.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      7.6
      Seconds
  • Question 18 - Skin infiltration by neoplastic T lymphocytes is seen in: ...

    Incorrect

    • Skin infiltration by neoplastic T lymphocytes is seen in:

      Your Answer: Hodgkin’s disease

      Correct Answer: Mycosis fungoides

      Explanation:

      Mycosis fungoides is a chronic T-cell lymphoma that involves the skin and less commonly, the internal organs such as nodes, liver, spleen and lungs. It is usually diagnosed in patients above 50 years and the average life expectancy is 7-10 years. It is insidious in onset and presents as a chronic, itchy rash, eventually spreading to involve most of the skin. Lesions are commonly plaque-like, but can be nodular or ulcerated. Symptoms include fever, night sweats and weight loss. Skin biopsy is diagnostic. However, early cases may pose a challenge due to fewer lymphoma cells. The malignant cells are mature T cells (T4+, T11+, T12+). The epidermis shows presence of characteristic Pautrier’s micro abscesses are present in the epidermis.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      4.3
      Seconds
  • Question 19 - How much blood can the pulmonary vessels of a 45-year-old healthy man accommodate...

    Correct

    • How much blood can the pulmonary vessels of a 45-year-old healthy man accommodate when he is at rest?

      Your Answer: 500 ml

      Explanation:

      Pulmonary circulation is the portion of the cardiovascular system which carries deoxygenated blood away from the heart, to the lungs, and returns oxygenated blood back to the heart. The vessels of the pulmonary circulation are very compliant (easily distensible) and so typically accommodate about 500 ml of blood in an adult man. This large lung blood volume can serve as a reservoir for the left ventricle, particularly during periods when left ventricular output momentarily exceeds venous return.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      3.3
      Seconds
  • Question 20 - The physician suggested lifestyle modification for his patient because his present condition could...

    Correct

    • The physician suggested lifestyle modification for his patient because his present condition could increase his risk for the development of adenocarcinoma of the oesophagus. What is the most common predisposing factor for the development of adenocarcinoma of the oesophagus?

      Your Answer: Gastro-oesophageal reflux disease

      Explanation:

      Barret’s oesophagus is attributed primarily to gastro-oesophageal reflux disease. The chronic acidic environment damages the squamous epithelial lining of the oesophagus, and subsequently undifferentiated pluripotent stem cells develop into columnar epithelium, this is then known as Barret’s oesophagitis.

    • This question is part of the following fields:

      • Neoplasia
      • Pathology
      7.9
      Seconds
  • Question 21 - Which of the following variables are needed to calculate inspiratory reserve volume of...

    Correct

    • Which of the following variables are needed to calculate inspiratory reserve volume of a patient?

      Your Answer: Tidal volume, vital capacity and expiratory reserve volume

      Explanation:

      Vital capacity = inspiratory reserve volume + tidal volume + expiratory reserve volume. Thus, inspiratory reserve volume can be calculated if tidal volume, vital capacity and expiratory reserve volume are known.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      35.8
      Seconds
  • Question 22 - A 35-year-old woman in her 37th week of pregnancy complains of urinary incontinence....

    Correct

    • A 35-year-old woman in her 37th week of pregnancy complains of urinary incontinence. She is most likely to have:

      Your Answer: Stress incontinence

      Explanation:

      Urinary incontinence is the involuntary excretion of urine from one’s body. It is often temporary and it almost always results from an underlying medical condition. Several types include:

      – Stress incontinence is the voiding of urine following increased abdominal pressure e.g. laughing, coughing, pregnancy etc. It is the most common form of incontinence in women, most commonly due to pelvic floor muscle weakness, physical changes from pregnancy, childbirth and menopause. In men it is a common problem following a prostatectomy. Most lab results such as urine analysis, cystometry and postvoid residual volume are normal.

      – Urge incontinence is involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urinate. The most common cause of urge incontinence are involuntary and inappropriate detrusor muscle contractions.

      – Functional incontinence – occurs when a person does not recognise the need to go to the toilet, recognise where the toilet is or get to the toilet in time. The urine loss may be large. Causes of functional incontinence include confusion, dementia, poor eyesight, poor mobility, poor dexterity or unwillingness. t

      – Overflow incontinence – sometimes people find that they cannot stop their bladders from constantly dribbling or continuing to dribble for some time after they have passed urine.

    • This question is part of the following fields:

      • Physiology
      • Renal
      2.9
      Seconds
  • Question 23 - The proximal tubule is the portion of the ductal system of the nephron of the kidney which leads from Bowman's capsule to the loop...

    Incorrect

    • The proximal tubule is the portion of the ductal system of the nephron of the kidney which leads from Bowman's capsule to the loop of Henle. Which of the following is most likely to be seen in a sample of fluid leaving the proximal tubule?

      Your Answer: It will have more HCO3 – ions than plasma

      Correct Answer: It will have no amino acids

      Explanation:

      The proximal tubule is the portion of the duct system of the nephron leading from Bowman’s capsule to the loop of Henlé. The most distinctive characteristic of the proximal tubule is its brush border (or ‘striated border’). The luminal surface of the epithelial cells of this segment of the nephron is covered with densely packed microvilli forming a border which greatly increases the luminal surface area of the cells, presumably facilitating their reabsorptive function. Glucose, amino acids, inorganic phosphate, and some other solutes are100% reabsorbed via secondary active transport through co-transporters driven by the sodium gradient out of the nephron.

    • This question is part of the following fields:

      • Physiology
      • Renal
      5.7
      Seconds
  • Question 24 - A 43-year-old diabetic man complains of headaches, palpitations, anxiety, abdominal pain and weakness....

    Correct

    • A 43-year-old diabetic man complains of headaches, palpitations, anxiety, abdominal pain and weakness. He is administered sodium bicarbonate used to treat:

      Your Answer: Metabolic acidosis

      Explanation:

      Sodium bicarbonate is indicated in the management of metabolic acidosis, which may occur in severe renal disease, uncontrolled diabetes, circulatory insufficiency due to shock or severe dehydration, extracorporeal circulation of blood, cardiac arrest and severe primary lactic acidosis. Bicarbonate is given at 50-100 mmol at a time under scrupulous monitoring of the arterial blood gas readings. This intervention, however, has some serious complications including lactic acidosis, and in those cases, should be used with great care.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      9.7
      Seconds
  • Question 25 - Extracellular body fluid as compared with intracellular body fluid: ...

    Correct

    • Extracellular body fluid as compared with intracellular body fluid:

      Your Answer: Is relatively rich in glucose

      Explanation:

      The percentages of body water contained in various fluid compartments add up to total body water (TBW). This water makes up a significant fraction of the human body, both by weight and by volume. Ensuring the right amount of body water is part of fluid balance, an aspect of homeostasis. The extracellular fluid (ECF) includes all fluids outside the cells. This fluid can be divided into three fluid departments: interstitial (in the tissue spaces) fluid, blood plasma and lymph, and specialised compartments called transcellular fluid. The extracellular fluid surrounds all the cells in the body and is in equilibrium with the intracellular fluid. So, its composition must remain fairly constant even though substances are passing into and out of the cells. The interstitial fluid, though called a fluid, is in a reality a gel-like composition made up of: water, proteoglycan molecules and collagen. The extracellular fluid constitutes 40% of total body water, with intracellular fluid making up the remaining 60%. It is relatively rich in glucose.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      2.4
      Seconds
  • Question 26 - A suspected recreational drug user was brought to the Emergency department in an...

    Correct

    • A suspected recreational drug user was brought to the Emergency department in an unconscious state, and was found to be hypoventilating. Which of the following set of arterial blood gas analysis report is most consistent with hypoventilation as the primary cause? pH, pa(CO2) (mmHg), pa(O2) (mmHg).

      Your Answer: 7.28, 55, 81

      Explanation:

      Hypoventilation (or respiratory depression) causes an increase in carbon dioxide (hypercapnia) and respiratory acidosis. It can result due to drugs such as alcohol, benzodiazepines, barbiturates, opiates, mechanical conditions or holding ones breath. Strong opioids such as heroin and fentanyl are commonly implicated and can lead to respiratory arrest. In recreational drug overdose, acute respiratory acidosis occurs with an increase in p(CO2) over 45 mm Hg and acidaemia (pH < 7.35)

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      4.4
      Seconds
  • Question 27 - Which of the following statements is true of Colles’ fracture? ...

    Correct

    • Which of the following statements is true of Colles’ fracture?

      Your Answer: Is a cause of carpal tunnel syndrome

      Explanation:

      Colles’ fracture is a distal fracture of the radius that is a known cause of carpal tunnel syndrome (compression of the median nerve in the carpal tunnel). It rarely results in ulnar nerve compression. A Colles’ fracture is extra-articular and does not extend into the wrist joint, otherwise this would make it an intra-articular fracture (Barton’s fracture). The distal fragment in a Colles’ fracture is displaced dorsally, unlike in a Smith’s fracture where the distal fragment is displaced volarly (ventrally). Associated fracture of the ulnar styloid process may occur and is a common associated injury.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      8.8
      Seconds
  • Question 28 - A 35-year-old ultra marathon runner becomes severely dehydrated and collapses. This patient most...

    Correct

    • A 35-year-old ultra marathon runner becomes severely dehydrated and collapses. This patient most likely has:

      Your Answer: Decreased baroreceptor firing rate

      Explanation:

      Baroreceptors are sensors located in the blood vessels of all vertebrate animals. They sense the blood pressure and relay the information to the brain, so that a proper blood pressure can be maintained. Acute dehydration results in decreased plasma volume and increased plasma osmolarity, since more water than salt is lost in sweat. The decrease in plasma volume leads to an inhibition of the baroreceptors and a lower firing rate. The increase in plasma osmolarity leads to increased ADH secretion and high plasma ADH levels, which increases water permeability of collecting duct cells. Therefore more water is reabsorbed by the kidneys and renal water excretion is low.

    • This question is part of the following fields:

      • Physiology
      • Renal
      17.9
      Seconds
  • Question 29 - A 72 year old man suffered a MI. What is the approximate time...

    Incorrect

    • A 72 year old man suffered a MI. What is the approximate time needed by the scar tissue of the MI to recover and attain full strength?

      Your Answer: 3 weeks

      Correct Answer: Several months

      Explanation:

      A week following a MI attack, a little collagen starts to form and deposit. By the end of the 2nd week, neovascularisation of the scar occurs, with some collagen being laid down in a haphazard fashion. By this time the scar attains some strength. During the next 6 months, collagen is constantly being laid down and is rearranged in order to shrink the scar. Most of the blood vessels by this time have regenerated, decreasing vascularity of the scar reaching full maturity.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing; Cardiovascular
      • Pathology
      9.9
      Seconds
  • Question 30 - Which part of the nephron would have to be damaged to stop the...

    Correct

    • Which part of the nephron would have to be damaged to stop the reabsorption of the majority of salt and water?

      Your Answer: Proximal tubule

      Explanation:

      The proximal tubule is the portion of the duct system of the nephron of the kidney which leads from Bowman’s capsule to the loop of Henle. It is conventionally divided into the proximal convoluted tubule (PCT) and the proximal straight tubule (PST). The proximal tubule reabsorbs the majority (about two-thirds) of filtered salt and water. This is done in an essentially iso-osmotic manner. Both the luminal salt concentration and the luminal osmolality remain constant (and equal to plasma values) along the entire length of the proximal tubule. Water and salt are reabsorbed proportionally because the water is dependent on and coupled with the active reabsorption of Na+. The water permeability of the proximal tubule is high and therefore a significant transepithelial osmotic gradient is not possible.

    • This question is part of the following fields:

      • Physiology
      • Renal
      9.9
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (3/5) 60%
Physiology (20/23) 87%
Respiratory (7/7) 100%
Fluids & Electrolytes (5/5) 100%
Renal (4/5) 80%
Endocrine (1/1) 100%
Neurology (1/2) 50%
Pathology (4/7) 57%
Haematology (1/2) 50%
Neoplasia (1/1) 100%
Orthopaedics (1/1) 100%
Cell Injury & Wound Healing; Cardiovascular (0/1) 0%
Passmed