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  • Question 1 - Needle thoracentesis in a patient with a tension pneumothorax is performed at which...

    Correct

    • Needle thoracentesis in a patient with a tension pneumothorax is performed at which anatomical landmark?

      Your Answer: 4th or 5th intercostal space mid-axillary line

      Explanation:

      Tension pneumothorax is a fatal disease causing acute and severe compromise of patients’ ventilation and circulation, in which case immediate decompression is necessary for better prognosis [6]. A previous study has shown that the incidence of tension pneumothorax varies from 0.2% to 1.7% in patients with prehospital trauma. Several trauma guidelines recommend needle thoracostomy as a life-saving intervention, with placement in the second intercostal space at the midclavicular line (second ICS-MCL), the fourth intercostal space at the anterior axillary line (fourth ICS-AAL), or the fifth intercostal space at the midaxillary line (fifth ICS-MAL) for tension pneumothorax in a prehospital environment.

      In 2018, according to newly issued the Advanced Trauma Life Support (ATLS) guidelines, the fifth ICS-MAL was suggested as the preferred place, and an 8 cm needle rather than the common 5 cm needle was proved to increase success rate of adults’ decompression.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      4.9
      Seconds
  • Question 2 - An analytical cohort study is done to compare the relationship between omega 3...

    Correct

    • An analytical cohort study is done to compare the relationship between omega 3 intake and occurrence of myocardial infarction (MI) among males aged over 65 years. The following are the data from the study:

      No. of subjects taking placebo: 100 men
      No. of subjects taking placebo who suffered an MI: 15 men

      No. of subjects taking omega 3: 100 men
      No. of subjects taking omega 3 who suffered an MI: 5 men

      Compute for the relative risk of the study.

      Your Answer: 0.33

      Explanation:

      Relative risk (RR) is a ratio of the probability of an event occurring in the exposed group versus the probability of the event occurring in the non-exposed group.

      RR can be computed as the absolute risk of events in the treatment group (ART), divided by the absolute risk of events in the control group (ARC).

      RR = ART/ARC
      RR = (5/100) / (15/100)
      RR = 0.33

    • This question is part of the following fields:

      • Evidence Based Medicine
      24.2
      Seconds
  • Question 3 - Glomerular filtration rate can be calculated using any substance that: ...

    Correct

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

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

      Explanation:

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

    • This question is part of the following fields:

      • Physiology
      • Renal
      6.1
      Seconds
  • Question 4 - A 70-year-old woman presents with right-sided loss of pain and temperature sense on...

    Correct

    • A 70-year-old woman presents with right-sided loss of pain and temperature sense on the body as well as left-sided loss of pain and temperature sense on the face. She also has complaints of vertigo, nausea, and tinnitus. Further examination of her cranial nerves suggest the presence of Horner's Syndrome. An MRI and CT scan was ordered and results showed that she is suffering from a left-sided stroke.

      Branches of which of the following arteries are most likely implicated in the case?

      Your Answer: Posterior inferior cerebellar artery

      Explanation:

      Wallenberg syndrome is also known as lateral medullary syndrome and posterior inferior cerebellar artery syndrome. It is the most common posterior circulation ischemic stroke syndrome. The primary pathology of Wallenberg syndrome is occlusion of the posterior inferior cerebellar artery (PICA) or one of its branches.

      It is characterized by vertigo with nystagmus, nausea and vomiting, and sometimes hiccups, dysphonia, dysarthria, and dysphagia often present with ipsilateral loss of gag reflex, ipsilateral ataxia with a tendency to fall to the ipsilateral side, pain and numbness with impaired facial sensation on the face, impaired taste sensation, and impaired pain and temperature sensation in the arms and legs.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      25.2
      Seconds
  • Question 5 - A 22-year-old with a history of brittle asthma is brought to the ED...

    Correct

    • A 22-year-old with a history of brittle asthma is brought to the ED by her partner. She is wheezing and very short of breath and her condition is deteriorating rapidly. Following a series of nebulisations, hydrocortisone and IV magnesium sulphate, she is taken to resus and the intensive care team is called to review her. She is severely hypoxic and confused and a decision is made to intubate her.

      Which of these drugs is ideal as an induction agent in this patient?

      Your Answer: Ketamine

      Explanation:

      Only about 2% of asthma attacks requires intubation and most severe cases are managed with non-invasive ventilation techniques.

      Though life-saving in the crashing asthmatic, intubation in asthmatic patients is associated with significant morbidity and mortality and is risky. Indications for intubation in asthmatic patients include:
      Severe hypoxia
      Altered mental state
      Respiratory or cardiac arrest
      Failure to respond to medications

      Ketamine (1-2 mg/kg) is the preferred induction agent. It has bronchodilatory properties and does not cause hypotension.

      Propofol poses a risk of hypotension but can also be used.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      10.3
      Seconds
  • Question 6 - Aside from the inability to extend the leg above the knee, which of...

    Correct

    • Aside from the inability to extend the leg above the knee, which of the following clinical symptoms should you anticipate seeing in a patient who had a pelvic and right leg injury as well as femoral nerve damage?

      Your Answer: Loss of sensation over the anterior thigh

      Explanation:

      The femoral nerve runs down the front of the leg from the pelvis. It gives the front of the thigh and a portion of the lower leg sensation.

      Extension of the leg at the knee joint, flexion of the thigh at the hip are produced by muscles that is primarily innervated by the femoral nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      15.6
      Seconds
  • Question 7 - A 29-year-old woman with a skin infection not responding to first-line antibiotics return...

    Incorrect

    • A 29-year-old woman with a skin infection not responding to first-line antibiotics return for a review clinic appointment. The result of her culture shows growth of methicillin-resistant Staphylococcus aureus (MRSA).

      Which among the following antibiotics is methicillin-resistant Staphylococcus aureus usually sensitive to?

      Your Answer: Imipenem

      Correct Answer: Linezolid

      Explanation:

      Historically, MRSA has been treated successfully with outpatient oral sulphonamides, clindamycin, rifampin, doxycycline, or a combination of these agents. With the development of increasing drug resistance of MRSA to these traditional antimicrobials, there has been a search for more effective antibiotics. One recent study demonstrated that vancomycin, linezolid, and quinupristin-dalfopristin were the most effective antibiotics against multiple strains of MRSA.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      13.2
      Seconds
  • Question 8 - Which of the following causes increased aldosterone secretion: ...

    Correct

    • Which of the following causes increased aldosterone secretion:

      Your Answer: Decreased blood volume

      Explanation:

      Decreased blood volume stimulates the secretion of renin (because of decreased renal perfusion pressure) and initiates the renin-angiotensin-aldosterone cascade. Angiotensin-converting enzyme (ACE) inhibitors block the cascade by decreasing the production of angiotensin. Hyperosmolarity stimulates antidiuretic hormone (ADH) [not aldosterone] secretion. Hyperkalaemia, not hypokalaemia, directly stimulates aldosterone secretion by the adrenal cortex. ANP inhibits renin secretion, thereby inhibiting the production of angiotensin and aldosterone.

    • This question is part of the following fields:

      • Physiology
      • Renal
      9
      Seconds
  • Question 9 - The patients listed below have had wounds or injuries and were treated as...

    Incorrect

    • The patients listed below have had wounds or injuries and were treated as described in a local walk-in clinic.

      Which of the following patients has had adequate tetanus protection?

      Your Answer: 8-year-old cut hand on a kitchen knife, had primary course of vaccinations as a baby plus booster at 4 years - receives vaccination

      Correct Answer: 80-year-old diabetic, a rusty nail went through his shoe and into his foot when walking in the woods, uncertain of vaccination history - receives vaccination and immunoglobulin

      Explanation:

      25-year-old receives immunoglobulin and vaccination after cutting her hand on a drinking glass and not knowing her vaccination history.

      Because this is not a tetanus-prone wound, immunoglobulin is not recommended. Because you can’t be sure about her vaccination history, now is the best time to start a tetanus vaccination course to ensure coverage later in life. The first vaccination should be administered at the time of presentation; the patient’s own GP should then review the patient’s vaccination history and schedule the rest of the course as needed.

      8-year-old whose hand was cut with a kitchen knife, received her first round of vaccinations as a baby and a booster at the age of four – receives vaccination:
      The tetanus vaccinations for this child are up to date, and the next booster should not be given too soon. Immunoglobulin is not required because this is not a tetanus-prone wound.

      80-year-old diabetic, a rusty nail went through his shoe and into his foot while walking in the woods, and he was uncertain of his vaccination history – he received vaccination and immunoglobulin:
      A tetanus vaccination course may not have been completed by an 80-year-old UK resident (the vaccination was introduced in 1961). The vaccination should be given at a walk-in clinic, and the patient’s own GP should be contacted to confirm vaccination history and to schedule the rest of the course as needed. Because this is a tetanus-prone wound (puncture wound and potential soil contact), immunoglobulin would be recommended in a patient with incomplete tetanus vaccinations.

      A 28-year-old Polish man cuts his leg while working in the garden, the wound is heavily contaminated with soil, and his vaccination history is unknown – he receives vaccination:
      In a patient with an unknown vaccination history, this is a tetanus-prone wound. In this case, the best course of action would be to administer both the vaccination and immunoglobulin at the walk-in clinic, then contact the patient’s own GP to check his or her vaccination history and schedule the rest of the course as needed.

      30-year-old with a large amount of devitalized tissue in the torso from an electrical burn – has had all vaccinations, so no need for vaccination or immunoglobulin:
      Because this is a high-risk tetanus wound (with a lot of devitalized tissue), even if the patient has had a full course of vaccinations in the past, immunoglobulin is recommended. There is no need for any additional vaccinations.

    • This question is part of the following fields:

      • Immunological Products & Vaccines
      • Pharmacology
      43.8
      Seconds
  • Question 10 - A diagnosis of acute osteomyelitis was made on a patient with a known...

    Incorrect

    • A diagnosis of acute osteomyelitis was made on a patient with a known history of sickle cell disease. He has no joint prosthesis on in-dwelling metal work and no known drug allergies.

      Which of the following is most likely the causative agent of the case presented above?

      Your Answer: Staphylococcus aureus

      Correct Answer: Salmonella spp .

      Explanation:

      Patients with sickle cell disease are prone to infection of the bone and bone marrow in areas of infarction and necrosis. Although Staphylococcus aureus is the most common cause of osteomyelitis in the general population, studies have shown that in patients with sickle cell disease, the relative incidence of Salmonella osteomyelitis is twice that of staphylococcal infection.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      6.6
      Seconds
  • Question 11 - Insulin binds to the insulin receptor (IR) on cell surfaces to exert its...

    Incorrect

    • Insulin binds to the insulin receptor (IR) on cell surfaces to exert its action. The IR is a very specific transmembrane receptor belonging to the tyrosine kinase receptor class.

      One of these also activates the IR:

      Your Answer: Somatostatin

      Correct Answer: IGF-I

      Explanation:

      Insulin receptor (IR), in addition to being activated by insulin, is also activated by IGF-I and IGF-II.

      The IR is a dimer with two identical subunits spanning the cell membrane and are connected by a single disulphide bond. The two sub-units include: The alpha chain situated on the exterior of the cell membrane and the beta chain spanning the cell membrane in a single segment.

      When insulin is detected, the alpha chains move together folding around the insulin making the beta chains move together, converting them into an active tyrosine kinase. This initiates a phosphorylation cascade increasing the expression of GLUT4 and allowing uptake of glucose by cells.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      12.4
      Seconds
  • Question 12 - A type II error occurs when: ...

    Incorrect

    • A type II error occurs when:

      Your Answer: The null hypothesis is rejected when it is true.

      Correct Answer: The null hypothesis is accepted when it is false.

      Explanation:

      A type II error occurs when the null hypothesis is wrongly accepted when it is actually false and we conclude that there is no evidence of a difference in effect when one really exists (a false negative result).

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      4.1
      Seconds
  • Question 13 - Compression of this nerve can cause weakness in the left leg while walking...

    Incorrect

    • Compression of this nerve can cause weakness in the left leg while walking and thigh adduction weakness at the hip joint.

      Your Answer: Superior gluteal nerve

      Correct Answer: Obturator nerve

      Explanation:

      The obturator nerve is a sensory and motor nerve that emerges from the lumbar plexus and innervates the thigh.

      This nerve supplies motor innervation to the medial compartment of the thigh, making it necessary for thigh adduction.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      10.2
      Seconds
  • Question 14 - Which of the following is a contraindication for aspirin? ...

    Correct

    • Which of the following is a contraindication for aspirin?

      Your Answer: Children under 16 years

      Explanation:

      Aspirin contraindications include: hypersensitivity to NSAIDs; asthma, rhinitis, and nasal polyps; and usage in children or teens.
      There is little evidence of allergic cross-reactivity for salicylates. However, due to similarities in chemical structure and/or pharmacologic activities, the possibility of cross-sensitivity cannot be completely ruled out.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      6.1
      Seconds
  • Question 15 - Regarding Hodgkin lymphoma, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding Hodgkin lymphoma, which of the following statements is CORRECT:

      Your Answer: The inguinal lymph nodes are most commonly affected.

      Correct Answer: Some patients may complain alcohol-induced nodal pain and pruritus

      Explanation:

      Lymphomas are a group of diseases caused by malignant lymphocytes that accumulate in lymph nodes and other lymphoid tissue and cause the characteristic clinical feature of lymphadenopathy. The major subdivision of lymphomas is into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) and this is based on the histological presence of Reed-Sternberg cells present in HL. Hodgkin lymphoma can present at any age but is rare in children and has a peak incidence in young adults. There is an almost 2 : 1 male predominance. Most patients present with painless, asymmetrical, firm and discrete enlargement of superficial lymph nodes. Cervical nodes are involved in 60-70% of cases, axillary nodes in 10-15% and inguinal nodes in 6-12%. Modest splenomegaly occurs during the course of the disease in 50% of patients; the liver may also be enlarged. Bone marrow failure involvement is unusual in early disease. The prognosis depends on age, stage and histology, but overall approximately 85% of patients are cured. Alcohol‐induced pain and pruritus are two well‐known but rare symptoms in HL.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      23.5
      Seconds
  • Question 16 - Regarding antiemetics, which of the following statements is INCORRECT: ...

    Incorrect

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

      Your Answer: Cyclizine acts by inhibiting histamine pathways involved in transmission from the vestibular apparatus to the vomiting centre.

      Correct Answer: Of the antiemetics, cyclizine is most commonly associated with acute dystonic reactions.

      Explanation:

      Cyclizine acts by inhibiting histamine pathways and cholinergic pathways involved in transmission from the vestibular apparatus to the vomiting centre. Metoclopramide is a dopamine-receptor antagonist which acts both peripherally in the GI tract and centrally within the chemoreceptor trigger zone. Prochlorperazine is a dopamine-D2 receptor antagonist and acts centrally by blocking the chemoreceptor trigger zone. Metoclopramide and prochlorperazine are both commonly associated with extrapyramidal effects, such as acute dystonic reaction. Cyclizine may rarely cause extrapyramidal effects.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      13.3
      Seconds
  • Question 17 - All of the following statements are correct regarding penicillin antibiotics except: ...

    Correct

    • All of the following statements are correct regarding penicillin antibiotics except:

      Your Answer: Penicillins are of no use in meningitis as they are unable to penetrate into the cerebrospinal fluid.

      Explanation:

      Penicillin penetration into the cerebrospinal fluid is generally poor. However, when the meninges are inflamed, as in meningitis, penetration of penicillin is increased. Benzylpenicillin should be given before transfer to hospital if meningococcal disease (meningitis with non-blanching rash or meningococcal septicaemia) is suspected, once this does not delay transfer.

      Benzylpenicillin is no longer the drug of first choice for pneumococcal meningitis.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      19.3
      Seconds
  • Question 18 - Captopril should not be used if you have any of the following conditions:...

    Incorrect

    • Captopril should not be used if you have any of the following conditions:

      Your Answer: Heart failure

      Correct Answer: Renal artery stenosis

      Explanation:

      Contraindications indications of Captopril include:
      – Bilateral renal artery stenosis
      – Hypersensitivity to ACE inhibitors
      – Anuria
      – History of ACEI-induced angioedema
      – Hereditary or idiopathic angioedema
      – Co-administration of Neprilysin inhibitors (e.g., sacubitril) with ACE inhibitors may increase angioedema risk; do not administer ACE inhibitors within 36 hours of switching to or from sacubitril/valsartan.
      If ACE inhibitors are used, they should be initiated only under specialist supervision and renal function should be monitored regularly. ACE inhibitors should also be used with particular caution in patients who may have undiagnosed and clinically silent renovascular disease. This includes patients with peripheral vascular disease or those with severe generalised atherosclerosis.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      17.8
      Seconds
  • Question 19 - Where does carbohydrate digestion begin: ...

    Incorrect

    • Where does carbohydrate digestion begin:

      Your Answer: Duodenum

      Correct Answer: Mouth

      Explanation:

      Carbohydrate digestion begins in the mouth, by alpha-amylase produced in saliva.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      27
      Seconds
  • Question 20 - In the United Kingdom, which of the following is the most often used...

    Incorrect

    • In the United Kingdom, which of the following is the most often used intravenous aesthetic:

      Your Answer: Midazolam

      Correct Answer: Propofol

      Explanation:

      In the United Kingdom, propofol is the most widely used intravenous anaesthetic. In adults and children, it can be used to induce or maintain anaesthesia, although it is not commonly used in newborns. It can also be used to sedate individuals in intensive care and for sedation during operations.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      7.5
      Seconds
  • Question 21 - A new chemotherapy drug is being tested. The intervention reduces the risk of...

    Correct

    • A new chemotherapy drug is being tested. The intervention reduces the risk of death from 10 in 1000 to 5 in 1000. What is the number needed to treat to prevent one death:

      Your Answer: 200

      Explanation:

      Absolute risk reduction (ARR) of treatment
      = risk of death in control group – risk of death in treatment group
      ARR = (10/1000) – (5/1000)
      = 5/1000 = 0.005
      Number needed to treat (NNT)
      = 1/ARR
      = 1/0.005
      = 200
      Therefore 200 people would need to be treated to prevent one extra death.

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      21.9
      Seconds
  • Question 22 - Following the administration of a medication for a heart condition, a 69-year-old man...

    Incorrect

    • Following the administration of a medication for a heart condition, a 69-year-old man develops hypothyroidism.

      Which of the following drugs is most likely to be the cause?

      Your Answer: Digoxin

      Correct Answer: Amiodarone

      Explanation:

      Amiodarone has a chemical structure that is similar to that of thyroxine and can bind to the nuclear thyroid receptor. It can cause both hypothyroidism and hyperthyroidism, though hypothyroidism is far more common, with 5-10% of patients suffering from it.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      509.6
      Seconds
  • Question 23 - You assess a patient that has suffered a nerve injury that has paralysed...

    Incorrect

    • You assess a patient that has suffered a nerve injury that has paralysed her left latissimus dorsi muscle.
      Latissimus dorsi receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer: Long thoracic nerve

      Correct Answer: Thoracodorsal nerve

      Explanation:

      Latissimus dorsi originates from the lower part of the back, where it covers a wide area. It lies underneath the inferior fibres of trapezius superiorly, and trapezius is the most superficial back muscle.
      Superficial muscles of the back showing latissimus dorsi (from Gray’s Anatomy)
      Latissimus dorsi has a broad origin, arising from the spinous processes of T6-T12, the thoracolumbar fascia, the iliac crest and the inferior 3 or 4 ribs. The fibres converge into a tendon that inserts into the intertubercular groove of the humerus.
      Latissimus dorsi is innervated by the thoracodorsal nerve.
      Latissimus dorsi acts to extend, adduct and medially rotate the humerus. It, therefore, raises the body towards the arm during climbing.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      8.7
      Seconds
  • Question 24 - You are reviewing a patient in the Emergency Department brought in by the...

    Incorrect

    • You are reviewing a patient in the Emergency Department brought in by the ambulance team from a burning building. After examination, you decide to intubate the patient due to laryngeal oedema. The induction agent you are planning to use is propofol.

      Which one of the following statements about this medicine is TRUE?

      Your Answer: 75% of patients experience pain on injection

      Correct Answer: It decreases cardiac output by approximately 20%

      Explanation:

      Propofol is a short-acting anaesthetic that is thought to work by potentiating GABA and glycine. It induces anterograde amnesia and anaesthetic effects and is used to induce anaesthesia, outpatient surgeries and preoperative sedation. The dose for induction of anaesthesia is 1.5-2.5mg/kg. The dose for maintenance of anaesthesia is 4-12 mg/kg/hour. Following intravenous injection, propofol acts within 30 seconds and its duration of action is 5-10 minutes.

      Propofol produces a 15-25% decrease in blood pressure and systemic vascular resistance without a compensatory increase in heart rate. It is negatively inotropic and decreases cardiac output by approximately 20%.

      The main side effects of propofol are:
      Pain on injection (in up to 30%)
      Hypotension
      Transient apnoea
      Hyperventilation
      Coughing and hiccough
      Headache
      Thrombosis and phlebitis

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      10.4
      Seconds
  • Question 25 - A patient presents with a rash for a dermatological examination. A flat circumscribed...

    Correct

    • A patient presents with a rash for a dermatological examination. A flat circumscribed area of discoloured skin measuring 0.7 cm in diameter is seen on examination.

      What is the best description of this rash that you have found on examination?

      Your Answer: Macule

      Explanation:

      A macule is a flat, well circumscribed area of discoloured skin less than 1 cm in diameter with no changes in the thickness or texture of the skin.

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

      A papule is a solid, well circumscribed, skin elevation measuring less than 0.5 cm in diameter.

      A nodule is a solid, well circumscribed, raised area that lies in or under the skin and measures greater than 0.5 cm in diameter. They are usually painless.

      A plaque is a palpable skin lesion that is elevated and measures >1cm in diameter.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      12.4
      Seconds
  • Question 26 - Anatomical barriers to infection include all of the following EXCEPT: ...

    Incorrect

    • Anatomical barriers to infection include all of the following EXCEPT:

      Your Answer: Irritant receptors causing the cough reflex

      Correct Answer: Mucociliary escalator in the gastrointestinal tract

      Explanation:

      Anatomical barriers to infection include:tight junctions between cells of the skin and mucosal membranesthe flushing action of tears, saliva and urinethe mucociliary escalator in the respiratory tract (together with the actions of coughing and sneezing)the acidic pH of gastric and vaginal secretionsthe acidic pH of the skin (maintained by lactic acid and fatty acids in sebum)enzymes such as lysozyme found in saliva, sweat and tearspepsin present in the stomachbiological commensal flora formed on the skin and the respiratory, gastrointestinal and genitourinary tracts which protect the host by competing with pathogenic bacteria for nutrients and attachment sites and by producing antibacterial substances

    • This question is part of the following fields:

      • Microbiology
      • Principles
      8.4
      Seconds
  • Question 27 - You're examining a 58-year-old male who has cellulitis in his left leg. Because...

    Incorrect

    • You're examining a 58-year-old male who has cellulitis in his left leg. Because he is allergic to penicillin, you start him on erythromycin.

      Which of the following statements about erythromycin is correct?

      Your Answer: It can only be administered orally

      Correct Answer: It can be used to treat Legionnaire’s disease

      Explanation:

      Bacteriostatic antibiotics include erythromycin and other macrolide antibiotics. They work by attaching to the bacterial ribosome’s 50S subunit, preventing translocation and thereby protein synthesis. Macrolide antibiotics are actively concentrated inside leukocytes and delivered to the infection site as a result.

      Erythromycin is an orally active antibiotic that can also be given intravenously. It is metabolized in the liver and eliminated in the bile and has a biological half-life of 1.5 hours.

      It has a similar antibacterial spectrum to benzylpenicillin (i.e., a narrow spectrum, primarily against Gram-positive pathogens) and can be used as a penicillin substitute in people who are allergic to penicillin.
      Erythromycin is unsuccessful in the treatment of meningitis because it does not penetrate the central nervous system well enough. It is efficient against a variety of unusual pathogens, unlike penicillin.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      15.1
      Seconds
  • Question 28 - Clostridium tetani causes which of the following infectious diseases: ...

    Correct

    • Clostridium tetani causes which of the following infectious diseases:

      Your Answer: Tetanus

      Explanation:

      Clostridium tetani causes tetanus.
      Scarlet fever is caused by Streptococcus pyogenes.
      Toxic shock syndrome is caused by Staphylococcus aureus or Streptococcus pyogenes.
      Gas gangrene is primarily caused by Clostridium perfringens.
      Pseudomembranous colitis is commonly caused by Clostridium difficile.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      7.5
      Seconds
  • Question 29 - In a VF arrest, a 6-year-old child is brought to your Emergency Department...

    Correct

    • In a VF arrest, a 6-year-old child is brought to your Emergency Department resuscitation area. He weighs 16 kilogrammes. He's had three DC shocks, but he's still in VF and doesn't have an output.

      What amiodarone dose should he get now, according to the most recent APLS guidelines?

      Your Answer: 80 mg

      Explanation:

      In a shockable (Vf/pVT) paediatric cardiac arrest, amiodarone should be administered after the third and fifth shocks. The dose is 5 mg/kg (maximum 300 mg) and should be administered over a three-minute period. If at all possible, administration via a central line is recommended.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      78.7
      Seconds
  • Question 30 - Which of the following statements accurately describes the flexor digitorum superficialis muscle? ...

    Correct

    • Which of the following statements accurately describes the flexor digitorum superficialis muscle?

      Your Answer: It flexes the middle phalanges of the medial four fingers at the proximal interphalangeal joints

      Explanation:

      Flexor digitorum superficialis is the largest muscle of the anterior compartment of the forearm. It belongs to the superficial flexors of the forearm, together with pronator teres, flexor carpi radialis, flexor carpi ulnaris and palmaris longus. Some sources alternatively classify this muscle as an independent middle/intermediate layer of the anterior forearm, found between the superficial and deep groups.

      Flexor digitorum superficialis is innervated by muscular branches of the median nerve, derived from roots C8 and T1 that arises from the medial and lateral cords of the brachial plexus. The skin that overlies the muscle is supplied by roots C6-8 and T1.

      The primary arterial blood supply to the flexor digitorum superficialis is derived from the ulnar artery and its anterior recurrent branch. In addition to branches of the ulnar artery, the anterior and lateral surfaces of the muscle are supplied by branches of the radial artery; and its posterior surface also receives branches from the median artery.

      The main function of flexor digitorum superficialis is flexion of the digits 2-5 at the proximal interphalangeal and metacarpophalangeal joints. Unlike the flexor digitorum profundus, flexor digitorum superficialis has independent muscle slips for all four digits. This allows it to flex the digits individually at their proximal interphalangeal joints. In addition, flexor digitorum superficialis aids the aids flexion of the wrist.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      11.1
      Seconds

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