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  • Question 1 - Herpes simplex encephalitis has a predilection for which of the following sites: ...

    Incorrect

    • Herpes simplex encephalitis has a predilection for which of the following sites:

      Your Answer: Frontal lobe

      Correct Answer: Temporal lobe

      Explanation:

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

    • This question is part of the following fields:

      • Infections
      • Microbiology
      16.3
      Seconds

  • Question 2 - A 65-year-old female presents to the Emergency Department with complaints of chest pain...

    Incorrect

    • A 65-year-old female presents to the Emergency Department with complaints of chest pain pointing to angina. A dose of glyceryl trinitrate (GTN) was administered, rapidly resolving her symptoms. Unfortunately, she develops a side-effect of the drug.

      Which one of the following is the side effect she is most likely to have developed?

      Your Answer: Syncope

      Correct Answer: Flushing

      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. Glyceryl trinitrate
      2. Isosorbide dinitrate

      Side effects to nitrate therapy are common especially
      The most common side effects are:
      1. Headaches
      2. Feeling dizzy, weak, or tired
      3. Nausea
      4. Flushing

      The serious but less likely to occur side effects are:
      1. Methemoglobinemia (rare)
      2. Syncope
      3. Prolonged bleeding time
      4. Exfoliative dermatitis
      5. Unstable angina
      6. Rebound hypertension
      7. Thrombocytopenia

      Dry eyes, bradycardia, and metabolic acidosis have not been reported.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      25
      Seconds

  • Question 3 - A 17-year-old male presenting in the department has a history of C3 deficiency.

    C3...

    Incorrect

    • A 17-year-old male presenting in the department has a history of C3 deficiency.

      C3 deficiency is associated with all of the following EXCEPT?

      Your Answer: Membranous glomerulonephritis

      Correct Answer: Hereditary angioedema

      Explanation:

      C1-inhibitor deficiency is the cause of hereditary angioedema not C3 deficiency,

      All the other statements are correct

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      33.4
      Seconds

  • Question 4 - Which of the following is where the rectovesical fascia is located: ...

    Correct

    • Which of the following is where the rectovesical fascia is located:

      Your Answer: Between the fundus of the bladder and the ampulla of the rectum

      Explanation:

      In a triangular area between the vasa deferentia, the bladder and rectum are separated only by rectovesical fascia, commonly known as Denonvillier’s fascia.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      28.7
      Seconds

  • Question 5 - External haemorrhoids may cause anal pain. When explaining to your patient why it...

    Correct

    • External haemorrhoids may cause anal pain. When explaining to your patient why it does so, which of the following nerves will you point out as being affected?

      Your Answer: Pudendal nerve

      Explanation:

      The pain associated with external haemorrhoids is carried by a branch of the pudendal nerve, specifically the somatic fibres (S2-S4).

      It innervates the external anal sphincter and most of the skin over the perineum.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      16.2
      Seconds

  • Question 6 - A 59-year-old otherwise well woman presents with a history of polydipsia and...

    Incorrect

    • A 59-year-old otherwise well woman presents with a history of polydipsia and polyuria. There is a past history of kidney stones, and blood tests done reveal the following:

      Na: 147 mmol/L (135-147 mmol/L)
      K: 4.0 mmol/L (3.5-5.5 mmol/L)
      Urea: 7.3 mmol/L (2.0-6.6 mmol/L)
      Creatinine: 126 mmol/L (75-125 mmol/L)
      Fasting blood glucose: 5.0 mmol/L (3.4-5.5 mmol/L)
      Corrected calcium: 3.21 mmol/L (2.05-2.60 mmol/L)
      Phosphate: 0.70 mmol/L (0.8-1.4 mmol/L)
      Parathyroid hormone: 189 ng/L (10-60 ng/L)

      The most likely diagnosis is?

      Your Answer: Tertiary hyperparathyroidism

      Correct Answer: Primary hyperparathyroidism

      Explanation:

      ​Primary hyperparathyroidism the commonest cause of hypercalcaemia. It is commonest in women aged 50 to 60.
      The commonest cause of primary hyperparathyroidism is a solitary adenoma of the parathyroid gland (approximately 85% of cases).

      Primary hyperparathyroidism may present with features of hypercalcaemia such as polyuria, polydipsia, renal stones, bone and joint pain, constipation, and psychiatric disorders.

      In primary Hyperparathyroidism:
      PTH is elevated
      Calcium is elevated
      Phosphate is lowered

      In secondary Hyperparathyroidism:
      PTH is elevated
      Calcium is low or low-normal
      Phosphate is raised in CRF

      In tertiary Hyperparathyroidism:
      PTH is elevated
      Calcium is elevated
      Phosphate is lowered in CRF

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      38
      Seconds

  • Question 7 - You are seeing a child with known mitochondrial disease who has presented breathlessness...

    Correct

    • You are seeing a child with known mitochondrial disease who has presented breathlessness and cough. Which of the following best describes the function of mitochondria:

      Your Answer: Energy production

      Explanation:

      Mitochondria are membrane-bound organelles that are responsible for the production of the cell’s supply of chemical energy. This is achieved by using molecular oxygen to utilise sugar and small fatty acid molecules to generate adenosine triphosphate (ATP). This process is known as oxidative phosphorylation and requires an enzyme called ATP synthase. ATP acts as an energy-carrying molecule and releases the energy in situations when it is required to fuel cellular processes. Mitochondria are also involved in other cellular processes, including Ca2+homeostasis and signalling. Mitochondria contain a small amount of maternal DNA.
      Mitochondria have two phospholipid bilayers, an outer membrane and an inner membrane. The inner membrane is intricately folded inwards to form numerous layers called cristae. The cristae contain specialised membrane proteins that enable the mitochondria to synthesise ATP. Between the two membranes lies the intermembrane space, which stores large proteins that are required for cellular respiration. Within the inner membrane is the perimitochondrial space, which contains a jelly-like matrix. This matrix contains a large quantity of ATP synthase.
      Mitochondrial disease, or mitochondrial disorder, refers to a group of disorders that affect the mitochondria. When the number or function of mitochondria in the cell are disrupted, less energy is produced and organ dysfunction results.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      18.1
      Seconds

  • Question 8 - You are reviewing a patient complaining of loss of vision. Previous images shows...

    Correct

    • You are reviewing a patient complaining of loss of vision. Previous images shows a lesion at the optic chiasm. What type of visual field defect are you most likely to see in a lesion at the optic chiasm:

      Your Answer: Bitemporal hemianopia

      Explanation:

      A lesion at the optic chiasm will result in a bitemporal hemianopia.
      A lesion of the optic nerve will result in ipsilateral monocular visual loss.
      A lesion of the optic tract will result in a contralateral homonymous hemianopia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      21.9
      Seconds

  • Question 9 - A 78-year-old man develops renal impairment and hearing loss after inpatient management...

    Correct

    • A 78-year-old man develops renal impairment and hearing loss after inpatient management for sepsis.

      Which of these antibiotics is most likely to have been used?

      Your Answer: Gentamicin

      Explanation:

      Gentamicin, an aminoglycoside antibiotic, acts by binding to the 30S subunit of the bacterial ribosome inhibiting the binding of aminoacyl-tRNA, and thus prevents initiation of protein synthesis.

      Two of its most notable side effects are reversible nephrotoxicity(caused by the inhibition of protein synthesis in renal cells, which causes acute tubular necrosis) and hearing loss (caused by damage to the vestibular apparatus of the inner ear).

      Both side effects are dose-related and occur commonly in the elderly.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      13
      Seconds

  • Question 10 - Which of the following side effects is most likely caused by erythromycin: ...

    Correct

    • Which of the following side effects is most likely caused by erythromycin:

      Your Answer: QT - prolongation

      Explanation:

      The side effects of erythromycin include abdominal pain, anaphylaxis,
      cholestatic hepatitis, confusion,
      diarrhoea, dyspepsia, fever, flatulence, hallucinations, hearing loss,
      headache, hypertrophic pyloric stenosis, hypotension, Interstitial
      nephritis, mild allergic reactions, nausea, nervous system effects,
      including seizures, pain, pruritus, pseudomembranous colitis,
      QT prolongation, rash, skin eruptions, tinnitus, urticaria,
      ventricular arrhythmias, ventricular tachycardia, vertigo, vomiting

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      57.3
      Seconds

  • Question 11 - A 1-year-old male is brought to the paediatrician by his mother due to...

    Incorrect

    • A 1-year-old male is brought to the paediatrician by his mother due to swelling of the right knee after a minor fall. On examination, the right knee is swollen, fluctuant and tender. Ultrasound-guided aspiration reveals a massive hemarthrosis. Family history shows that his older brother also has a bleeding disorder.

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

      Your Answer: Von Willebrand disease

      Correct Answer: Haemophilia A

      Explanation:

      A diagnosis of Haemophilia is supported in this patient by the family history and the presence of hemarthrosis-both characteristics of Haemophilia. Haemophilia A is caused by Factor VIII deficiency, leading to impaired coagulation. This disease typically presents after six months when the child starts crawling.

      Von Willebrand disease presents with nosebleeds and hematomas. Idiopathic thrombocytopenic purpura presents with bruises that resemble a rash.

      Glucose-6-phosphate dehydrogenase (G6PD) deficiency presents with haemolytic anaemia induced by specific drugs or foods.

      Factor V Leiden mutation causes blood clotting rather than bleeding.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      27.3
      Seconds

  • Question 12 - Which of the following is NOT an adverse effect of amitriptyline: ...

    Correct

    • Which of the following is NOT an adverse effect of amitriptyline:

      Your Answer: Hypokalaemia

      Explanation:

      Adverse effects include:
      Antimuscarinic effects: Dry mouth, Blurred vision, Constipation, Urinary retention, Sedation, Confusion
      Cardiovascular effects: Heart block, Arrhythmias, Tachycardia, Postural hypotension, QT-interval prolongation, Hepatic impairment, Narrow-angle glaucoma

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      28.9
      Seconds

  • Question 13 - A 70-year-old patient diagnosed with Cushing's syndrome and has a history of weight...

    Incorrect

    • A 70-year-old patient diagnosed with Cushing's syndrome and has a history of weight gain, hypertension, and easy bruising.

      Which of these assertions about Cushing's syndrome is correct?

      Your Answer: Cortisol levels are likely to be low at midnight

      Correct Answer: Diagnosis can be confirmed by a dexamethasone suppression test

      Explanation:

      Cushing’s syndrome is a group of symptoms and signs brought on by long-term exposure to high amounts of endogenous or exogenous glucocorticoids.

      Iatrogenic corticosteroid injection is the most prevalent cause of Cushing’s syndrome. Cushing’s illness is the second most prevalent cause of Cushing’s syndrome. Cushing’s disease is distinct from Cushing’s syndrome in that it refers to a single cause of the illness, a pituitary adenoma that secretes high quantities of ACTH, which raises cortisol levels.

      Because cortisol enhances the vasoconstrictive impact of endogenous adrenaline, patients with Cushing’s syndrome are usually hypertensive.

      Hyperglycaemia (due to insulin resistance) rather than hypoglycaemia is a common symptom.
      Cortisol levels fluctuate throughout the day, with the greatest levels occurring around 0900 hours and the lowest occurring at 2400 hrs during sleep. The diurnal swing of cortisol levels is lost in Cushing’s syndrome, and levels are greater throughout the 24-hour period. In the morning, levels may be normal, but they may be high at night-time, when they are generally repressed.

      A dexamethasone suppression test or a 24-hour urine free cortisol collection can both be used to establish the existence of Cushing’s syndrome.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      57.7
      Seconds

  • Question 14 - The lymph drainage of the anal canal above the pectinate line is initially...

    Correct

    • The lymph drainage of the anal canal above the pectinate line is initially to the:

      Your Answer: Internal iliac nodes

      Explanation:

      Above the pectinate line, the anal canal drains to the internal iliac lymph nodes which subsequently drain to the lumbar (para-aortic) nodes.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      16.7
      Seconds

  • Question 15 - How does aspirin mediate its antiplatelet effect: ...

    Correct

    • How does aspirin mediate its antiplatelet effect:

      Your 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
      19.6
      Seconds

  • Question 16 - Regarding the partial pressure of gases, which of the following statements is INCORRECT:...

    Correct

    • Regarding the partial pressure of gases, which of the following statements is INCORRECT:

      Your Answer: At high altitude, the oxygen fraction is reduced.

      Explanation:

      At altitude, the oxygen fraction is unaltered but the barometric pressure and thus partial pressure of oxygen is reduced.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      56.7
      Seconds

  • Question 17 - Regarding acute idiopathic thrombocytopaenic purpura (ITP), which of the following statements is CORRECT:...

    Incorrect

    • Regarding acute idiopathic thrombocytopaenic purpura (ITP), which of the following statements is CORRECT:

      Your Answer: It is usually idiopathic with no precipitating cause.

      Correct Answer: Over 80% of children recover without treatment.

      Explanation:

      Acute ITP is most common in children. In approximately 75% of cases, the episode follows vaccination or infection such as chicken pox or glandular fever. Most cases are caused by non-specific immune complex attachment to platelets. Acute ITP usually has a very sudden onset and the symptoms usually disappear in less than 6 months (often within a few weeks). It is usually a self-limiting condition and over 80% of children recover without treatment; in 5 – 10% of cases a chronic form of the disease develops.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      25.4
      Seconds

  • Question 18 - Among the following infectious diseases, which is typically considered to have an incubation...

    Incorrect

    • Among the following infectious diseases, which is typically considered to have an incubation period of 3 weeks and longer?

      Your Answer: Mumps

      Correct Answer: Infectious mononucleosis

      Explanation:

      Infectious mononucleosis is caused by Epstein-Barr virus (EBV). The incubation period for EBV varies from 2 weeks to 2 months.

      The usual incubation period for rubella is 14 days; with a range of 12 to 23 days.

      Gonorrhoea has a short incubation period of approximately 2 to 7 days.

      The mumps virus can be isolated from infected saliva and swabs rubbed over the Stensen’s duct from 9 days before onset of symptoms until 8 days after parotitis appears.

      Scarlet fever, which appears within 1 to 2 days after bacterial infection, is characterized by a diffuse red rash that appears on the upper chest and spreads to the trunk and extremities. The rash disappears over the next 5 to
      7 days and is followed by desquamation.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      19.1
      Seconds

  • Question 19 - A 30-year-old man presents with piriformis syndrome pain, tingling, and numbness in her...

    Incorrect

    • A 30-year-old man presents with piriformis syndrome pain, tingling, and numbness in her buttocks. He noted that the pain gets worse upon sitting down. He was seen by a physiotherapist and a diagnosis of piriformis syndrome was made.

      Which of the following nerves becomes irritated in piriformis syndrome?

      Your Answer: Obturator nerve

      Correct Answer: Sciatic nerve

      Explanation:

      Piriformis syndrome is a clinical condition of sciatic nerve entrapment at the level of the ischial tuberosity. While there are multiple factors potentially contributing to piriformis syndrome, the clinical presentation is fairly consistent, with patients often reporting pain in the gluteal/buttock region that may shoot, burn or ache down the back of the leg (i.e. sciatic-like pain). In addition, numbness in the buttocks and tingling sensations along the distribution of the sciatic nerve is not uncommon.

      The sciatic nerve runs just adjacent to the piriformis muscle, which functions as an external rotator of the hip. Hence, whenever the piriformis muscle is irritated or inflamed, it also affects the sciatic nerve, which then results in sciatica-like pain.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      32.4
      Seconds

  • Question 20 - Which of the following is NOT an effect of cytokine activity: ...

    Correct

    • Which of the following is NOT an effect of cytokine activity:

      Your Answer: Opsonisation of bacteria for phagocytosis

      Explanation:

      Cytokines are a family of chemical messengers, secreted by leucocytes, that act over short distances by binding specific receptors on target cell surfaces. They include: interleukins (act between leucocytes), interferons (inhibit replication of viruses within cells and activate macrophages and natural killer cells), growth factors, and tumour necrosis factors (kill tumour cells). Effects include: induction of fever and acute phase response, stimulation of leucocyte differentiation and maturation, leucocyte recruitment and activation and increased antibody production.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      42.6
      Seconds

  • Question 21 - Following a bee sting, a 8-year old boy was transported to resus with...

    Correct

    • Following a bee sting, a 8-year old boy was transported to resus with symptoms and signs of an anaphylactic reaction. You decide to administer adrenaline IM stat. What is the recommended dose of intramuscular adrenaline?

      Your Answer: 0.3 mL of 1:1000

      Explanation:

      Anaphylaxis is a type I hypersensitivity reaction that is severe and life-threatening. It is marked by the fast onset of life-threatening airway and/or circulatory issues, which are generally accompanied by skin and mucosal abnormalities. When an antigen attaches to specific IgE immunoglobulins on mast cells, degranulation and the release of inflammatory mediators takes place (e.g. histamine, prostaglandins, and leukotrienes).

      The most important medicine for treating anaphylactic responses is adrenaline. It decreases oedema and reverses peripheral vasodilation as an alpha-adrenergic receptor agonist. Its beta-adrenergic effects widen the bronchial airways, enhance the force of cardiac contraction, and inhibit the release of histamine and leukotriene. The first medicine to be given is adrenaline, and the IM route is optimal for most people.

      In anaphylaxis, age-related dosages of IM adrenaline are:
      150 mcg (0.15 mL of 1:1000) for a child under 6 years
      300 mcg (0.3 mL of 1:1000) for a child aged 6 to 12 years
      500 mcg (0.5 mL of 1:1000) for children aged 12 and above
      500 mcg for adults (0.5 mL of 1:1000)

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      23.6
      Seconds

  • Question 22 - In the ventricular myocyte action potential, depolarisation occurs through the opening of: ...

    Incorrect

    • In the ventricular myocyte action potential, depolarisation occurs through the opening of:

      Your Answer: Voltage-gated Ca 2+ channels

      Correct Answer: Voltage-gated Na + channels

      Explanation:

      An action potential (AP) is initiated when the myocyte is depolarised to a threshold potential of about -65 mV, as a result of transmission from an adjacent myocyte via gap junctions. Fast voltage-gated Na+channels are activated and a Na+influx depolarises the membrane rapidly to about +30 mV. This initial depolarisation is similar to that in nerve and skeletal muscle, and assists the transmission to the next myocyte.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      19.9
      Seconds

  • Question 23 - A 6 year old boy is brought into the ED by his mom...

    Incorrect

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

      Your Answer: Once mucosal involvement has resolved

      Correct Answer: 4 days from the onset of the rash

      Explanation:

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

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      28.3
      Seconds

  • Question 24 - A 40-year-old woman presents with retrosternal central chest pain that she has been...

    Incorrect

    • A 40-year-old woman presents with retrosternal central chest pain that she has been complaining about for the past two days. Upon deep inspiration and while lying flat, the pain worsens but relieved by sitting forwards. The pain radiates to both of her shoulders. The result of her ECG shows widespread concave ST-elevation and PR depression. A diagnosis of pericarditis is suspected.

      Which of the following nerves is responsible for the pattern of her pain?

      Your Answer: Vagus nerve

      Correct Answer: Phrenic nerve

      Explanation:

      Pericarditis is inflammation of the pericardial sac and is the most common pathologic process involving the pericardium. Frequently, pericardial inflammation can be accompanied by increased fluid accumulation within the pericardial sac forming a pericardial effusion, which may be serous, hemorrhagic or purulent depending on aetiology.

      The classic presentation is with chest pain that is central, severe, pleuritic (worse on deep inspiration) and positional (improved by sitting up and leaning forward). The pain may also be radiating and may involve the ridges of the trapezius muscle if the phrenic nerve is inflamed as it traverses the pericardium.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      30.2
      Seconds

  • Question 25 - A patient presents with an adducted eye at rest which cannot abduct past...

    Correct

    • 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: 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
      46.4
      Seconds

  • Question 26 - A 28-year-old female arrives after taking an unknown chemical in excess. She is tired...

    Incorrect

    • A 28-year-old female arrives after taking an unknown chemical in excess. She is tired and her speech is slurred. The following are her observations and results:HR 118,BP 92/58,SaO2 96%
      HR 118,  11/15 The following are the results  of his arterial blood gas (ABG):
      pH: 7.24pO 2 : 9.4kPa PCO2 : 3.3kPa HCO 3 -: 22 mmol/lNa + : 143 mmol/lCl – : 99 mmol/lLactate: 5 IU/l

      Which of the following statements about this patient is TRUE?

      Your Answer: She has respiratory acidosis

      Correct Answer: Her anion gap is elevated

      Explanation:

      The interpretation of arterial blood gas (ABG) aids in the measurement of a patient’s pulmonary gas exchange and acid-base balance.
      The normal values on an ABG vary a little depending on the analyser, but they are roughly as follows:
      Variable
      Range
      pH
      7.35 – 7.45
      PaO2
      10 – 14 kPa
      PaCO2
      4.5 – 6 kPa
      HCO3-
      22 – 26 mmol/l
      Base excess
      -2 – 2 mmol/l

      The patient’s history indicates that she has taken an overdose in this case. Because her GCS is 11/15 and she can communicate with slurred speech, she is clearly managing her own airway, there is no current justification for intubation.

      The following are the relevant ABG findings:

      Hypoxia (mild)
      pH has been lowered (acidaemia)
      PCO2 levels are low.
      bicarbonate in its natural state
      Lactate levels have increased

      The anion gap represents the concentration of all the unmeasured anions in the plasma. It is the difference between the primary measured cations and the primary measured anions in the serum. It can be calculated using the following formula:
      Anion gap = [Na+] – [Cl-] – [HCO3-]

      The reference range varies depending on the technique of measurement, but it is usually between 8 and 16 mmol/L.

      The following formula can be used to compute her anion gap:
      Anion gap = [143] – [99] – [22]
      Anion gap = 22

      As a result, it is clear that she has a metabolic acidosis with an increased anion gap.

      The following are some of the causes of type A and type B lactic acidosis:
      Type A lactic acidosis
      Type B lactic acidosis
      Shock (including septic shock)
      Left ventricular failure
      Severe anaemia
      Asphyxia
      Cardiac arrest
      CO poisoning
      Respiratory failure
      Severe asthma and COPD
      Regional hypoperfusion
      Renal failure
      Liver failure
      Sepsis (non-hypoxic sepsis)
      Thiamine deficiency
      Alcoholic ketoacidosis
      Diabetic ketoacidosis
      Cyanide poisoning
      Methanol poisoning
      Biguanide poisoning

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      627.6
      Seconds

  • Question 27 - A patient with diplopia is found to have eye deviation downwards and outwards....

    Correct

    • A patient with diplopia is found to have eye deviation downwards and outwards. The likely nerves that are affected are:

      Your Answer: Oculomotor nerve

      Explanation:

      The results of an oculomotor (CN III) nerve palsy are a depressed and abducted (down and out) eye, ptosis, diplopia, and a fixed and dilated pupil.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      10.6
      Seconds

  • Question 28 - A 29 year old man presents to ED followed an alleged assault whilst...

    Correct

    • A 29 year old man presents to ED followed an alleged assault whilst out drinking. He received blunt trauma to his right axilla. He is complaining of difficulty abducting his right arm above the level of his shoulder, and on inspection, the inferior angle of his right scapula protrudes more than that of his left scapula. Which of the following nerves has most likely been affected:

      Your Answer: Long thoracic nerve

      Explanation:

      Damage to the long thoracic nerve results in weakness/paralysis of the serratus anterior muscle causing difficulty abducting the upper limb above 90 degrees and giving a ‘winged ‘ scapula appearance where the medial border, particularly the inferior angle, of the scapula moves laterally and posteriorly away from the thoracic wall (this becomes more pronounced if the patient presses the upper limb against a wall).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      53.4
      Seconds

  • Question 29 - Regarding Clostridium tetani, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding Clostridium tetani, which of the following statements is CORRECT:

      Your Answer: Tetanus exotoxin results in increased release of excitatory neurotransmitter.

      Correct Answer: Germination and outgrowth of clostridial spores depends on anaerobic conditions.

      Explanation:

      Clostridium tetani is found in normal human intestinal flora, although infection is predominantly exogenous. Tetanospasmin, an exotoxin produced by C. tetani is responsible for the neurotoxic effects of tetanus, largely by preventing the release of the inhibitory neurotransmitter GABA, resulting in prolonged excitation. Clostridium tetani is an obligate anaerobe, with an incubation period of about 3 – 21 days (average 10 days).

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      34.3
      Seconds

  • Question 30 - Regarding autoregulation of local blood flow, which of the following statements is CORRECT:...

    Correct

    • Regarding autoregulation of local blood flow, which of the following statements is CORRECT:

      Your Answer: An increase in blood flow dilutes locally produced vasodilating factors causing vasoconstriction.

      Explanation:

      Autoregulation is the ability to maintain a constant blood flow despite variations in blood pressure (between 50 – 170 mmHg). It is particularly important in the brain, kidney and heart. There are two main methods contributing to autoregulation:
      The myogenic mechanism involves arterial constriction in response to stretching of the vessel wall, probably due to activation of smooth muscle stretch-activated Ca2+channels and Ca2+entry. A reduction in pressure and stretch closes these channels, causing vasodilation.
      The second mechanism of autoregulation is due to locally produced vasodilating factors; an increase in blood flow dilutes these factors causing vasoconstriction, whereas decreased blood flow has the opposite effect.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      52.9
      Seconds

  • Question 31 - A 34-year-old man arrives at the department befuddled. He has a history of...

    Correct

    • A 34-year-old man arrives at the department befuddled. He has a history of schizophrenia and is on an antipsychotic medication, but he can't recall what it's called.

      Which of the following statements about antipsychotic drug side effects is correct?

      Your Answer: Haloperidol is the most common causative antipsychotic drug

      Explanation:

      Extrapyramidal side effects are most common with piperazine phenothiazines (fluphenazine, prochlorperazine, and trifluoperazine) and butyrophenones (fluphenazine, prochlorperazine, and trifluoperazine) (benperidol and haloperidol). The most common causative antipsychotic drug is haloperidol.

      Tardive dyskinesia (rhythmic, involuntary movements of the tongue, face, and jaw) is most commonly associated with long-term or high-dose treatment. It is the most serious form of extrapyramidal symptoms because withdrawal of the causative drug may make it irreversible, and treatment is usually ineffective.

      Dystonia (abnormal facial and body movements) is more common in children and young adults, and it usually shows up after only a few doses. Procyclidine 5 mg IV or benzatropine 2 mg IV as a bolus can be used to treat acute dystonia.

      An unpleasant feeling of restlessness characterises akathisia. The inability to initiate movement is known as akinesia.

      Renal impairment causes increased cerebral sensitivity, so lower doses should be used.

      In elderly patients with dementia-related psychosis who are treated with haloperidol, there is an increased risk of death. This appears to be due to a higher risk of heart attacks and infections like pneumonia.

      The following are some of the antipsychotic drugs’ contraindications:
      Reduced level of consciousness/coma
      Depression of the central nervous system
      Phaeochromocytoma

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      149.9
      Seconds

  • Question 32 - A 32-year-old woman presents with abdominal pain and bloody diarrhoea that has been...

    Incorrect

    • A 32-year-old woman presents with abdominal pain and bloody diarrhoea that has been going on for 3 days.

      Among the following microorganisms, which is considered to be a cause of infectious bloody diarrhoea?

      Your Answer: Vibrio cholerae

      Correct Answer: Entamoeba histolytica

      Explanation:

      The following are organisms that are capable of producing acute, bloody diarrhoea:
      – Campylobacter jejuni
      – Escherichia coli O157:H7
      – Salmonella species
      – Shigella species
      – Yersinia species
      – Entamoeba histolytica

      Other E. coli strains, Giardia, Vibrio, and other parasites are associated with watery, but not bloody, diarrhoea.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      33.4
      Seconds

  • Question 33 - You review an 18-months-old child who seems to be having a reaction following...

    Incorrect

    • You review an 18-months-old child who seems to be having a reaction following an immunisation she took earlier in the day.

      Which statement concerning immunity and vaccination is true?

      Your Answer: Vaccination induces passive adaptive immunity

      Correct Answer: The strongest immunological response is seen with natural immunity

      Explanation:

      Vaccination induces ACTIVE adaptive immunity. Actively acquired immunity involves the development of an immune response either due to vaccination or natural exposure to a pathogen and leads to long-lasting resistance to infection.

      Immediate protection is achieved with injection of immunoglobulin. The protection is transient lasting only a few weeks and is useful as post-exposure prophylaxis.

      Passively acquired immunity usually leads to short-lasting resistance to infection because it does not involve a host immune response.

      With inactivated bacteria, a series of primary vaccinations is usually required to induce an adequate immune response. In most cases, boosters are required to sustain adequate immunity.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      48.4
      Seconds

  • Question 34 - Carbon dioxide is transported in the blood approximately: ...

    Incorrect

    • Carbon dioxide is transported in the blood approximately:

      Your Answer: 80% as bicarbonate ions and 20% dissolved in plasma

      Correct Answer: 60% as bicarbonate ions, 30% as carbamino compounds and 10% dissolved in plasma.

      Explanation:

      Carbon dioxide is transported in the blood from tissues to the lungs in three ways as bicarbonate ions (60%), as carbamino compounds with proteins (30%) or simply dissolved in plasma (10%).

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      16.6
      Seconds

  • Question 35 - A 61-year-old patient experiences a spontaneous rupture of his Achilles tendon following a...

    Correct

    • A 61-year-old patient experiences a spontaneous rupture of his Achilles tendon following a course of antibiotics

      Which of the antibiotics listed below is MOST likely to be the cause? 

      Your Answer: Ciprofloxacin

      Explanation:

      Tendinopathy and spontaneous tendon rupture are caused by fluoroquinolones, which are an uncommon but well-known cause. Tendon problems caused by fluoroquinolones are expected to affect 15 to 20 people per 100,000. Patients over the age of 60 are most likely to develop them.

      It usually affects the Achilles tendon, but it has also been described in cases involving the quadriceps, peroneus brevis, extensor pollicis longus, long head of biceps brachii, and rotator cuff tendons. The exact aetiology is uncertain, although the fluoroquinolone medication is thought to obstruct collagen activity and/or cut off blood supply to the tendon.

      Other factors linked to tendon rupture spontaneously include:
      Gout
      Treatment with corticosteroids
      Hypercholesterolaemia
      Long-term dialysis
      Kidney transplant
      Rheumatoid arthritis 

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      23.1
      Seconds

  • Question 36 - When a person changes from a supine to an upright position, which of...

    Correct

    • When a person changes from a supine to an upright position, which of the followingcompensatory mechanismsoccurs:

      Your Answer: Increased contractility

      Explanation:

      On standing from a prone position, gravity causes blood to pool in veins in the legs. Central venous pressure (CVP) falls, causing a fall in stroke volume and cardiac output (due to Starling’s law) and thus a fall in blood pressure. Normally this fall in BP is rapidly corrected by the baroreceptor reflex which causes venoconstriction (partially restoring CVP), and an increase in heart rate and contractility, so restoring cardiac output and blood pressure. Impaired autonomic nervous activity in the elderly accounts for the greater likelihood of postural hypotension. Any symptoms of dizziness, blurred vision or syncope is due to a transient fall in cerebral perfusion that occurs before cardiac output and mean arterial pressure (MAP) can be corrected.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      52.1
      Seconds

  • Question 37 - Which of the following is NOT a heritable risk factor for venous thrombosis:...

    Incorrect

    • Which of the following is NOT a heritable risk factor for venous thrombosis:

      Your Answer: Factor V Leiden

      Correct Answer: Von Willebrand disease

      Explanation:

      Approximately one-third of patients who suffer DVT or PE have an identifiable heritable risk factor, although additional risk factors are usually present when they develop the thrombosis. The history of a spontaneous DVT in a close relative increases an individual’s risk of DVT even if no known genetic predisposition can be identified.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      26.2
      Seconds

  • Question 38 - A 72-year-old man has a past medical history of diverticular disease. He now...

    Incorrect

    • A 72-year-old man has a past medical history of diverticular disease. He now presents in the clinic with crampy abdominal pain. The nurse at the triage suggests prescribing hyoscine butyl bromide to help relieve the abdominal pain. However, you do not agree with this medication, as you can see on his chart that the patient has several other comorbidities.

      Out of the following, what is NOT a contraindication to using hyoscine butyl bromide?

      Your Answer: Intestinal atony

      Correct Answer: Prostatic hyperplasia

      Explanation:

      Hyoscine butylbromide is an antispasmodic drug that blocks muscarinic receptors and reduces intestinal motility. It is used for gastrointestinal and genitourinary smooth muscle spasms and symptomatic relief of IBS.

      It has the following contraindications:
      1. Closed-angle glaucoma
      2. Gastrointestinal obstruction
      3. Intestinal atony
      4. Paralytic ileus
      5. Toxic megacolon
      6. Severe ulcerative colitis
      7. Significant bladder outflow obstruction
      8. Urinary retention
      9. Myasthenia gravis

      Use cautiously in the following conditions:
      1. Acute myocardial infarction (in adults)
      2. Arrhythmias (may be worsened)
      3. Autonomic neuropathy
      4. Hypertension
      5. Cardiac insufficiency (due to association with tachycardia)
      6. Congestive cardiac failure (maybe worsened)
      7. Cardiac surgery (due to association with tachycardia)
      8. Gastro-oesophageal reflux disease
      9. Ulcerative colitis
      10. Prostatic hyperplasia
      11. Use in children (increased risk of side effects)

    • This question is part of the following fields:

      • Gastrointestinal Pharmacology
      • Pharmacology
      24.3
      Seconds

  • Question 39 - The following statements concerning lung compliance is true EXCEPT?
    ...

    Incorrect

    • The following statements concerning lung compliance is true EXCEPT?

      Your Answer: Lung compliance is inversely proportional to stiffness and elastance

      Correct Answer: Lung compliance is described by the equation: C = ∆ P/ ∆V, where C = compliance, P = pressure, and V = volume

      Explanation:

      Lung compliance is the change in volume per unit change in distending pressure.

      It is calculated using the equation:
      Lung compliance = ΔV / ΔP
      Where:
      ΔV is the change in volume
      ΔP is the change in pleural pressure.

      Lung compliance is inversely proportional to stiffness and elastance.

      It comprises static (no airflow) and dynamic (during continuous breathing) components.

      It is the slope of the pressure-volume curve.

      Lung compliance describes the distensibility of the lungs and the chest wall.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      103.2
      Seconds

  • Question 40 - Loop diuretics primarily act on which Na+ transporter? ...

    Incorrect

    • Loop diuretics primarily act on which Na+ transporter?

      Your Answer: Na + /K + ATPase pump

      Correct Answer: Na + /K + /2Cl - symporter

      Explanation:

      The most potent diuretics are loop diuretics e.g. furosemide. They work by inhibiting the Na+/K+/2Cl-symporter in the thick ascending limb of the loop of Henle, which inhibits sodium, potassium, and chloride reabsorption. As a result, there is diuresis with loss of these electrolytes. There is a reduction in transcellular voltage difference, paracellular calcium and magnesium reabsorption.
      The medullary interstitium becomes more concentrated by salt reabsorption in the ascending limb. Loop diuretics block this process and reduce the ability of the kidney to concentrate urine. In the collecting duct, there is increased sodium delivery to the principal cells, which increases potassium secretion in return for sodium reabsorption.

    • This question is part of the following fields:

      • Physiology
      • Renal
      9.3
      Seconds

  • Question 41 - 1-alpha-hydroxylase is a cytochrome p450 enzyme that is involved in the production of...

    Correct

    • 1-alpha-hydroxylase is a cytochrome p450 enzyme that is involved in the production of vitamin D's hormonally active metabolite.

      Which of the following promotes the activity of 1-alpha-hydroxylase?

      Your Answer: Parathyroid hormone

      Explanation:

      1-alpha-hydroxylase converts 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol in the kidney.

      The key regulatory point in the formation of 1,25-dihydroxycholecalciferol is 1-alpha-hydroxylase, which is promoted by parathyroid hormone or hypophosphatemia.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      30.8
      Seconds

  • Question 42 - Which of the following is an action of glucagon: ...

    Incorrect

    • Which of the following is an action of glucagon:

      Your Answer: Inhibits gluconeogenesis

      Correct Answer: Stimulates glycogenolysis

      Explanation:

      Glucagon is a peptide hormone that is produced and secreted by alpha cells of the islets of Langerhans, which are located in the endocrine portion of the pancreas. The main physiological role of glucagon is to stimulate hepatic glucose output, thereby leading to increases in glycaemia. It provides the major counter-regulatory mechanism to insulin in maintaining glucose homeostasis.
      Hypoglycaemia is the principal stimulus for the secretion of glucagon but may also be used as an antidote in beta-blocker overdose and in anaphylaxis in patients on beta-blockers that fail to respond to adrenaline.
      Glucagon then causes:
      Glycogenolysis
      Gluconeogenesis
      Lipolysis in adipose tissue
      The secretion of glucagon is also stimulated by:
      Adrenaline
      Cholecystokinin
      Arginine
      Alanine
      Acetylcholine
      The secretion of glucagon is inhibited by:
      Insulin
      Somatostatin
      Increased free fatty acids
      Increased urea production

      Glycolysis is the metabolic pathway that converts glucose into pyruvate. The free energy released by this process is used to form ATP and NADH. Glycolysis is inhibited by glucagon, and glycolysis and gluconeogenesis are reciprocally regulated so that when one cell pathway is activated, the other is inactive and vice versa.

      Glucagon has a minor effect of enhancing lipolysis in adipose tissue. Lipolysis is the breakdown of lipids and involves the hydrolysis of triglycerides into glycerol and free fatty acids. It makes fatty acids available for oxidation.

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
      30.9
      Seconds

  • Question 43 - Regarding benzodiazepines, which of the following statements is INCORRECT: ...

    Correct

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

      Your Answer: Diazepam is a short-acting benzodiazepine.

      Explanation:

      Diazepam is used to produce mild sedation with amnesia. It is a long-acting drug with active metabolites and a second period of drowsiness can occur several hours after its administration. Midazolam is a water-soluble benzodiazepine that is often used in preference to intravenous diazepam; recovery is faster than from diazepam, but may be significantly longer in the elderly, in patients with a low cardiac output, or after repeated dosing. Midazolam is associated with profound sedation when high doses are given intravenously or when it is used with certain other drugs.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      41.6
      Seconds

  • Question 44 - The renin-angiotensin-aldosterone system (RAAS) controls blood pressure and fluid balance.

    Which of the following...

    Incorrect

    • The renin-angiotensin-aldosterone system (RAAS) controls blood pressure and fluid balance.

      Which of the following sites produces the most angiotensinogen?

      Your Answer: The lungs

      Correct Answer: The liver

      Explanation:

      Angiotensinogen is an alpha-2-globulin generated predominantly by the liver and released into the blood. Renin, which cleaves the peptide link between the leucine and valine residues on angiotensinogen, converts it to angiotensin I.

      Angiotensinogen levels in the blood are raised by:
      Corticosteroid levels have risen.
      Thyroid hormone levels have risen.
      Oestrogen levels have risen.
      Angiotensin II levels have risen.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      11.5
      Seconds

  • Question 45 - A dermatological examination on a patient presenting with a lump shows a small...

    Correct

    • A dermatological examination on a patient presenting with a lump shows a small visible skin elevation containing an accumulation of pus.

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

      Your Answer: Pustule

      Explanation:

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

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

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

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      17.8
      Seconds

  • Question 46 - All of the muscles of the tongue (other than the palatoglossus) are innervated...

    Correct

    • All of the muscles of the tongue (other than the palatoglossus) are innervated by which of the following nerves:

      Your Answer: Hypoglossal nerve

      Explanation:

      All of the muscles of the tongue are innervated by the hypoglossal nerve, except for the palatoglossus, which is innervated by the vagus nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      10.5
      Seconds

  • Question 47 - Which patients are particularly susceptible to infection with herpes simplex, those with: ...

    Incorrect

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

      Your Answer: Asplenia

      Correct 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
      Seconds

  • Question 48 - The sensory innervation of the oropharynx is provided by which of the following...

    Incorrect

    • The sensory innervation of the oropharynx is provided by which of the following nerves:

      Your Answer: Maxillary nerve

      Correct Answer: Glossopharyngeal nerve

      Explanation:

      Each subdivision of the pharynx has a different sensory innervation:the nasopharynx is innervated by the maxillary nervethe oropharynx is innervated by the glossopharyngeal nervethe laryngopharynx is innervated by the vagus nerve.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      19.9
      Seconds

  • Question 49 - For the treatment of his atrial fibrillation, a 67-year-old man is about to...

    Incorrect

    • For the treatment of his atrial fibrillation, a 67-year-old man is about to begin taking warfarin. He also takes a number of other medications.

      Which of the following medications will prevent warfarin from working?

      Your Answer: Isoniazid

      Correct Answer: Phenytoin

      Explanation:

      Many medications, including warfarin, require cytochrome P450 enzymes for their metabolism. When co-prescribing cytochrome p450 enzyme inducers and inhibitors with warfarin, it’s critical to be cautious.

      Inhibitors of the cytochrome p450 enzyme inhibit the effects of warfarin, resulting in a lower INR. To remember the most commonly encountered cytochrome p450 enzyme inducers, use the mnemonic PC BRASS:

      P– Phenytoin
      C– Carbamazepine
      B– Barbiturates
      R– Rifampicin
      A– Alcohol (chronic ingestion)
      S– Sulphonylureas
      S– Smoking

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      77.3
      Seconds

  • Question 50 - A 64-year-old woman with a history of chronic breathlessness is referred for lung...

    Correct

    • A 64-year-old woman with a history of chronic breathlessness is referred for lung function testing.
      Which of the following statements regarding lung function testing is FALSE? Select ONE answer only.

      Your Answer: In restrictive lung disease, the FVC is increased

      Explanation:

      In restrictive lung disorders there is a reduction in the forced vital capacity (FVC) and the forced expiratory volume in one second (FEV1). The decline in the FVC is greater than that of the FEV1, resulting in preservation of the FEV1/FVC ratio (>0.7%).
      In obstructive lung disease, FEV1is reduced to <80% of normal and FVC is usually reduced but to a lesser extent than FEV1. The FEV1/FVC ratio is reduced to <0.7.
      According to the latestNICE guidelines(link is external), airflow obstruction is defined as follows:
      Mild airflow obstruction = an FEV1 of >80% in the presence of symptoms
      Moderate airflow obstruction = FEV1 of 50-79%
      Severe airflow obstruction = FEV1 of 30-49%
      Very severe airflow obstruction = FEV1<30%.
      Spirometry is a poor predictor of durability and quality of life in COPD but can be used as part of the assessment of severity.
      COPD can only be diagnosed on spirometry if the FEV1 is <80% and FEV1/FVC ratio is < 0.7.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      60.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Infections (3/4) 75%
Microbiology (0/6) 0%
Cardiovascular Pharmacology (0/2) 0%
Pharmacology (7/11) 64%
General Pathology (1/3) 33%
Pathology (3/8) 38%
Abdomen (3/3) 100%
Anatomy (8/11) 73%
Endocrine Physiology (1/3) 33%
Physiology (6/14) 43%
Basic Cellular (1/1) 100%
Central Nervous System (2/2) 100%
Haematology (1/4) 25%
Respiratory (1/2) 50%
Specific Pathogen Groups (0/2) 0%
Lower Limb (0/1) 0%
Inflammatory Responses (1/1) 100%
Respiratory Pharmacology (1/1) 100%
Cardiovascular (2/3) 67%
Pathogens (0/3) 0%
Thorax (0/1) 0%
Cranial Nerve Lesions (2/2) 100%
Renal Physiology (0/2) 0%
Upper Limb (1/1) 100%
CNS Pharmacology (1/1) 100%
Gastrointestinal Pharmacology (0/1) 0%
Respiratory Physiology (1/2) 50%
Renal (0/1) 0%
Endocrine (0/1) 0%
Anaesthesia (1/1) 100%
Head And Neck (1/2) 50%
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