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Question 1
Correct
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Which of the following is a function of Vitamin C?
Your Answer: Hydroxylation of proline to hydroxyproline for collagen synthesis
Explanation:Vitamin C acts as an electron donor for eight different enzymes: Three enzymes (prolyl-3-hydroxylase, prolyl-4-hydroxylase, and lysyl hydroxylase) that are required for the hydroxylation of proline and lysine in the synthesis of collagen.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 2
Incorrect
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Regarding the formation of CSF, which of the following is true?
Your Answer: The contents of CSF are uniformly in equilibrium with ECF
Correct Answer: Its composition resembles that of brain ECF
Explanation:In normal adults CSF volume is around 125ml to 150ml. Turnover of entire volume of cerebrospinal fluid a day is about 3 to 4 times a day. Composition of CSF is similar to that of plasma except that CSF is nearly protein-free compared with plasma and has a different electrolyte level. About 80% of CSF is produced by the choroid plexus. It is also produced by a single layer of column shaped ependymal cells. The composition and rate of CSF generation depends on several factors and is influenced by hormones and the content and pressure of blood and CSF.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 3
Incorrect
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Which of the following statements is the most characteristic of primary Raynaud's phenomena?
Your Answer: Nail fold capillary scope shows dilated vessels
Correct Answer: Fingers are symmetrically involved during an attack
Explanation:A typical attack may last less than an hour but can also persist for longer. In primary Raynaud’s, attacks are more likely symmetric, episodic, and without evidence of peripheral vascular disease. Patients more commonly have a negative ANA and normal inflammatory markers. There should be no evidence of tissue gangrene, digital pitting, or tissue injury in primary Raynaud’s. In contrast, patients with secondary Raynaud’s will describe attacks that are more frequent, painful, often asymmetric and may lead to digital ulcerations.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 4
Incorrect
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Question 5
Incorrect
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The pathway responsible for the discriminative aspect of pain, is called the:
Your Answer:
Correct Answer: Neospinothalamic tract
Explanation:The spinothalamic tract is an ascending or a sensory tract, responsible for transmission of pain and temperature. The neospinothalamic tract is responsible for fast pain or discriminative pain whereas the palaeospinothalamic tract is responsible for transmission of slow pain.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 6
Incorrect
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Vagotomy leads to the following:
Your Answer:
Correct Answer: Irregular and chaotic peristalsis
Explanation:The Vagus nerve is primarily responsible for autonomic regulation involved in heart, lung and gastrointestinal function. The gastric branches supply the stomach. The right branch joins the celiac plexus and supplies the intestines. Vagotomy involves cutting of the vagus nerve or its branches which is a now-obsolete therapy that was performed for peptic ulcer disease. Vagotomy causes a decrease in peristalsis and a change in the emptying patterns of the stomach.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 7
Incorrect
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Regarding the surface anatomy of the orifices of the heart, where is the aortic valve located?
Your Answer:
Correct Answer: Opposite the left 3rd intercostal space to the left of the sternum
Explanation:The aortic valve is situated in the left 3rd intercostal space just beneath the sternum.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 8
Incorrect
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Which one of the following antibiotics is safest to use in pregnancy?
Your Answer:
Correct Answer: Erythromycin
Explanation:Antibiotics that should be avoided in pregnancy are included in the mnemonic: Countless SAFe Moms Take Really Good Care -Clarithromycin, Sulphonamides, Aminoglycosides, Fluoroquinolones, Metronidazole, Tetracyclines, Ribavirin, Griseofulvin, Chloramphenicol
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 9
Incorrect
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Select the correct statement regarding the 4th heart sound, it?
Your Answer:
Correct Answer: Can be heard in atrial systole.
Explanation:The fourth heart sound is not normally audible in a normal adult. It occurs as a consequence of ventricular hypertrophy. It is caused by filling of the ventricle by atrial systole.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 10
Incorrect
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Which lipoprotein is responsible for lowering of plasma lipids?
Your Answer:
Correct Answer: HDL
Explanation:High-density lipoproteins (HDL) are one of the five major groups of lipoproteins. Lipoproteins are complex particles composed of multiple proteins which transport all fat molecules (lipids) around the body within the water outside cells. Unlike the larger lipoprotein particles which deliver fat molecules to cells, HDL particles remove fat molecules from cells.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 11
Incorrect
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The oesophagus is lined by
Your Answer:
Correct Answer: Stratified squamous epithelium
Explanation:The wall of the oesophagus from the lumen outwards consists of mucosa, submucosa (connective tissue), layers of muscle fibers between layers of fibrous tissue, and an outer layer of connective tissue. The mucosa is a stratified squamous epithelium of around three layers of squamous cells, which contrasts to the single layer of columnar cells of the stomach. The transition between these two types of epithelium is visible as a zig-zag line. Most of the muscle is smooth muscle although striated muscle predominates in its upper two thirds.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 12
Incorrect
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Which one of the following statements regarding the normal distribution is correct?
Your Answer:
Correct Answer: Mean = mode = median
Explanation:Normal distribution, also known as the Gaussian distribution, is a probability distribution that is symmetric about the mean. The normal distribution has the following properties:- It is symmetric around the mode, the median and the mean of the distribution.- It is unimodal- The area under the curve and over the x-axis is unity (i.e. equal to one).- Its density has two inflection points.- Its density is log-concave.The standard deviation (SD) is a measure of how much dispersion exists from the mean. SD = square root (variance)
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This question is part of the following fields:
- Medicine
- Research Skills
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Question 13
Incorrect
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With regard to X-linked disorders which of the following are true:
Your Answer:
Correct Answer: X linked recessive disorders usually present in males and only very rarely present in homozygous females
Explanation:X linked disorders are more common in males as they only need one mutated copy of the X chromosome to manifest the disease with full severity while the females need two X chromosomes to manifest the disease, even with one defected X chromosome the severity is less than that seen in males.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 14
Incorrect
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A 62 year old man arrives at the clinic with a history of cough and intermittent haemoptysis for the last 3 months. He has a 50 pack year smoking history and is currently waiting for bronchoscopy to assess a left lower lobe collapse. The patient also has a marked muscle weakness and wasting of proximal muscles of his shoulders and pelvic girdle. His wife states that lately he has been unable to eat solids. Which of the following statements would be true regarding this scenario?
Your Answer:
Correct Answer: He may have a photosensitive facial rash
Explanation:The patient has presented with signs of small cell lung cancer. The associated proximal muscle weakness is most probably due to dermatomyositis which occurs as a paraneoplastic syndrome associated with lung carcinoma. In most cases, the first symptom is a distinctive skin rash on the face, eyelids, chest, nail cuticle areas, knuckles, knees or elbows. The rash is patchy and usually a bluish-purple colour. Corticosteroids are helpful in the management of the cutaneous changes and muscle weakness.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 15
Incorrect
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What is the main reason for checking the urea and electrolytes prior to commencing a patient on amiodarone?
Your Answer:
Correct Answer: To detect hypokalaemia
Explanation:All antiarrhythmic drugs have the potential to cause arrhythmias. Coexistent hypokalaemia significantly increases this risk.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 16
Incorrect
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A 42 year old female with a history of SLE presents with an exacerbation of wrist pain. Which of the following markers would be the most suitable for monitoring disease activity?
Your Answer:
Correct Answer: Anti-dsDNA titres
Explanation:A high level of anti-dsDNA in the blood is strongly associated with lupus and is often significantly increased during or just prior to a flare-up. When the anti-dsDNA is positive and the person tested has other clinical signs and symptoms associated with lupus, it means that the person tested likely has lupus. This is especially true if an anti-Sm test is also positive.In the evaluation of someone with lupus nephritis, a high level (titre) of anti-dsDNA is generally associated with ongoing inflammation and damage to the kidneys.A very low level of anti-dsDNA is considered negative but does not exclude a diagnosis of lupus. Only about 65-85% of those with lupus will have anti-dsDNA.Low to moderate levels of the autoantibody may be seen with other autoimmune disorders, such as Sjögren syndrome and mixed connective tissue disease (MCTD).
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 17
Incorrect
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The areas of extensive series of sarcoplasmic folds known as intercalated discs always occur at what portion of the muscle fiber?
Your Answer:
Correct Answer: Z lines
Explanation:The muscle fibers of the heart branch and interdigitate, but one complete unit is surrounded by a cell membrane. The place where one muscle fiber abuts the other, the cell membrane of both the fibers run parallel to each other through a series of extensive folds. These areas always occur on the Z lines and are known as intercalated discs.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 18
Incorrect
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The blood supply to the greater curvature of the stomach is via the:
Your Answer:
Correct Answer: Right and left gastro-epiploic arteries
Explanation:The blood supply to the greater curvature of the stomach is via the left and the right gastro-epiploic arteries branching from the splenic artery near the hilum.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 19
Incorrect
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An exaggerated response to a noxious stimulus is called:
Your Answer:
Correct Answer: Hyperalgesia
Explanation:Allodynia is the sensation of pain following non-painful stimulation.
Hyperalgesia is enhanced intensity of pain sensation.
Causalgia is a constant burning pain resulting from peripheral nerve injury.
Hyperesthesia is the abnormal increase in sensitivity to stimuli of sense.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 20
Incorrect
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Select the correct statement regarding terminal bronchioles:
Your Answer:
Correct Answer: Terminal bronchioles form part of the conducting zone
Explanation:Bronchioles divide into even smaller bronchioles, called terminal bronchioles, which are 0.5mm or less in diameter. Terminal bronchioles in turn divide into smaller respiratory bronchioles which divide into alveolar ducts. Terminal bronchioles mark the end of the conducting division of air flow in the respiratory system while respiratory bronchioles are the beginning of the respiratory division where actual gas exchange takes place. Terminal bronchioles are lined with simple cuboidal epithelium containing club cells. Terminal bronchioles contain a limited number of ciliated cells and no goblet cells. Club cells are non-ciliated, rounded protein secreting cells. Their secretions are a non-stick, proteinaceous compound (surfactant) to maintain the airway in the smallest bronchioles.
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This question is part of the following fields:
- Medicine
- Respiratory
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Question 21
Incorrect
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The action of progesterone on different organs/systems includes:
Your Answer:
Correct Answer: Breasts: stimulation of lobular and alveolar development
Explanation:Progesterone is a sex hormone which affects mainly the reproductive system. In the breasts, it mediates the lobuloalveolar maturation to allow for milk production; this is done in conjunction with prolactin. It acts to maintain female reproductive and sex characteristics.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 22
Incorrect
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A 25-year-old student consumed a bottle of vodka at a party, the next day he finds that he feels excessively thirsty and is passing more urine than usual. Which of the following mechanisms best explains the polyuria due to excessive alcohol consumption?
Your Answer:
Correct Answer: Ethanol inhibits ADH secretion
Explanation:Ethanol reduces the calcium-dependent secretion of anti-diuretic hormone (ADH) by blocking channels in the neurohypophyseal nerve terminal.Thus, ethanol’s inhibitory effect helps to explain the increased diuresis experienced during intoxicated states as well as increased free water loss; without appropriate ADH secretion, more water is excreted by the kidneys.Nausea associated with hangovers is mainly due to vagal stimulation to the vomiting centre. Following a particularly severe episode of alcohol excess, people may experience tremors due to increased glutamate production by neurons to compensate for the previous inhibition by ethanol.Management of alcoholism:Nutritional support: – Alcoholic patients should receive oral thiamine if their ‘diet may be deficient’.Pharmacological management:- Benzodiazepines for acute withdrawal- Disulfiram promotes abstinence – alcohol intake causes a severe reaction due to inhibition of acetaldehyde dehydrogenase. Patients should be aware that even small amounts of alcohol (e.g. In perfumes, foods, mouthwashes) can produce severe symptoms. Contraindications include ischaemic heart disease and psychosis.- Acamprosate reduces craving, known to be a weak antagonist of NMDA receptors, improves abstinence in placebo-controlled trials.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 23
Incorrect
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Which of the following structures is not part of the conducting system of the heart?
Your Answer:
Correct Answer: Ventricular wall
Explanation:The conduction system of the heart consists of the SA node, AV node, internodal pathway between these two nodes, Bundle of His and the purkinje fibers
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 24
Incorrect
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What is the correct formula to calculate the positive predictive value?(TP = true positive; FP = false positive; TN = true negative; FN = false negative)
Your Answer:
Correct Answer: TP / (TP + FP)
Explanation:Positive predictive value is the probability that subjects with a positive screening test truly have the disease.Positive predictive value = true positive / ( true positive + false positive)
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This question is part of the following fields:
- Medicine
- Research Skills
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Question 25
Incorrect
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Which is NOT a prognostic factor for patients with malignant melanoma?
Your Answer:
Correct Answer: Diameter of melanoma > 6 mm
Explanation:Features that affect prognosis are tumour thickness in millimetres (Breslow’s depth – the deeper the Breslow thickness the poorer the prognosis.), depth related to skin structures (Clark level – the level of invasion through the dermis), type of melanoma, presence of ulceration, presence of lymphatic/perineural invasion, presence of tumour-infiltrating lymphocytes (if present, prognosis is better), location of lesion, presence of satellite lesions, and presence of regional or distant metastasis. Malignant melanoma tends to grow radially before entering a vertical growth phase. The diameter it reaches has not been found to be a prognostic factor.
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 26
Incorrect
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A 56 year old woman presents to the clinic complaining of shoulder pain that she has been experiencing for the last 4 weeks. She does not remember getting injured previously. The pain worsens on movement especially when she is moving the arm quickly. At night, lying on the affected side is painful. Examination reveals no erythema or swelling. However, pain is felt on passive abduction between 60 to 120 degrees and she is unable to abduct the arm past 70-80 degrees. Flexion and extension are intact. What is the most likely diagnosis?
Your Answer:
Correct Answer: Supraspinatus tendonitis
Explanation:Supraspinatus tendinopathy is a common and disabling condition that becomes more prevalent after middle age and is a common cause of pain in the shoulder. A predisposing factor is resistive overuse. This patient has the classic painful arc that is a sign of shoulder impingement characteristic of supraspinatus tendonitis.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 27
Incorrect
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Which of the following concerning PR interval is INCORRECT?
Your Answer:
Correct Answer: Always measured from the beginning of p wave to the beginning of r wave
Explanation:The PR interval measures the time from the start of atrial depolarization to the start of ventricular depolarization. The PR interval is only measured from the beginning of P wave to beginning of R wave if the Q wave is absent.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 28
Incorrect
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Which of the following isoforms of Nitric oxide synthase (NOS) is found in endothelial cells?
Your Answer:
Correct Answer: Nos 3
Explanation:There are only 3 isoforms:NOS 1: found in nervous systemNOS 2: in macrophages and other immune cellsNOS 3: In endothelial cells
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 29
Incorrect
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Why is tissue plasminogen activator (tPa) a valuable treatment used in myocardial infarction and stroke?
Your Answer:
Correct Answer: It forms plasmin from its inactive precursor
Explanation:tPA is a serine protease involved in the breakdown of blood clots. It functions by converting plasminogen, an inactive precursor, into plasmin, an active enzyme. Plasmin then degrades fibrin, the main protein component of blood clots, leading to clot dissolution. This mechanism is particularly valuable in the treatment of myocardial infarction (heart attack) and ischemic stroke, where timely dissolution of the clot can restore blood flow to affected tissues and reduce damage.
Therefore, the correct answer is:
- It forms plasmin from its inactive precursor
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This question is part of the following fields:
- Haematology
- Medicine
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Question 30
Incorrect
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A study is carried out to assess the efficacy of a new anti-epileptic drug for children with absence seizures. The total number of the children selected for the study was 400, from which 150 children were assigned to take the new drug and 250 children were assigned in the control group. After a period of four months, only 15 children taking the new drug had a seizure compared to 100 children from the control group who had seizure. What is the correct value regarding the relative risk reduction?
Your Answer:
Correct Answer: 75%
Explanation:Relative risk reduction (RRR) tells you by how much the treatment reduced the risk of bad outcomes relative to the control group who did not have the treatment. In the previous example, the relative risk reduction of fever and rash in the group of the children on the intervention was 40 per cent (1 – 0.6 = 0.4 or 40 per cent). RRR = (EER -CER) / CER = (0.1 – 0.4) / 0.4 = -0.75 or 75% reduction.
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This question is part of the following fields:
- Medicine
- Research Skills
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SESSION STATS - PERFORMANCE PER SPECIALTY
