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Question 1
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Which of the following is NOT a typical side effect of thiopental sodium:
Your Answer: Seizures
Explanation:Extravasation of thiopental during injection can lead to tissue damage. Accidental intra-arterial injection causes vasospasm and may lead to thrombosis and tissue necrosis. Other side effects include involuntary muscle movements on induction, cough and laryngospasm, arrhythmias, hypotension, headache and hypersensitivity reactions. Thiopental sodium has anticonvulsant properties and does not cause seizures.
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 2
Correct
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Question 3
Correct
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A 20-year-old male receives a small cut over his hand while climbing a fence causing it to bleed. Upon applying pressure for a few minutes, the bleeding stops. Which one of the following physiological components of the blood is responsible for the primary haemostasis reaction, such as in this case?
Your Answer: Platelet plug formation
Explanation:Haemostasis is your body’s defence against an injury that causes bleeding. It stops bleeding in three main steps:
1) Primary haemostasis – formation of a weak platelet plug
– The primary reaction of the body is to cause local vasoconstriction at the site of injury and decrease blood flow to the affected area
– the release of cytokines and inflammatory markers lead to adhesion of platelets and aggregation at the site of injury forming a platelet plug
– the injured vessel wall has exposed subendothelial collagen that releases von Willebrand factorAny damage to the vessel wall causes the release of the Von Willebrand factor, which is necessary for platelet adhesion. Tissue Thromboplastin is also released, which activates the coagulation pathway, a component of secondary haemostasis. The coagulation cascade ultimately results in the conversion of fibrinogen to fibrin.
2) Secondary haemostasis
3) FibrinolysisFibrin (factor Ia) is a long, thin protein with branches produced at the end of the coagulation cascade when fibrinogen (factor I) is converted to fibrin, which stabilizes the blood clot.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 4
Correct
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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.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 5
Correct
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Regarding hypertensive crises, which of the following statements is CORRECT:
Your Answer: In a hypertensive emergency, blood pressure should be reduced by 20 - 25% within 2 hours.
Explanation:A hypertensive emergency is defined as severe hypertension (blood pressure ≥ 180/110 mmHg) with acute damage to the target organs. Prompt treatment with intravenous antihypertensive therapy is generally required; over the first few minutes or within 2 hours, blood pressure should be reduced by 20 – 25%. Severe hypertension without acute target organ damage is defined as hypertensive urgency.; blood pressure should be reduced gradually over 24 – 48 hours with oral antihypertensive therapy. If blood pressure is reduced too quickly in the management of hypertensive crises, there is a risk of reduced organ perfusion leading to cerebral infarction, blindness, deterioration in renal function, and myocardial ischaemia.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 6
Correct
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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.
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 7
Incorrect
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A 67-year-old female presents with a history of morning stiffness and arthritis of her hand joints. She is being investigated for rheumatoid arthritis.
Which test is most sensitive and specific for this diagnosis?
Your Answer: Rheumatoid factor
Correct Answer: Anti-CCP
Explanation:Anti-cyclic citrullinated peptide (anti-CCP) is an antibody present in 60-80% of rheumatoid arthritis patients. It is measured by enzyme-linked immunosorbent assay (ELISA). It may be present years before the onset of the disease and is associated with a more severe disease course.
While most patients with anti-CCP antibodies are also positive for rheumatoid factor (RF), RF antibody is not specific for rheumatoid arthritis as it can occur in patients with other conditions such as infections and other autoimmune conditions.
ESR, antinuclear antibodies(ANA) and Synovial fluid examination are not specific for rheumatoid arthritis.
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This question is part of the following fields:
- General Pathology
- Pathology
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Question 8
Incorrect
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What is the interquartile range for these numbers: 11, 4, 6, 8, 3, 10, 8, 10, 4, 12, 31?
Your Answer: 10
Correct Answer: 7
Explanation:We obtain 3, 4, 4, 6, 8, 8, 10, 11, 12, and 31, and sample size (n) = 11 when we order the data. [(n+1)/2] = median 6th value = (11+1)/2 = [(n+1)/4] represents the bottom (first) quartile. (3rd value = 4th value = (11 + 1)/4 3[(n+1)/4] for the top (third) quartile 3[(11 + 1)/4] = 9th value = 11th value = 11th value = 11th value = 11th value = 11th value = 11th value = 11th value = 11th The difference between the upper and lower quartiles is the interquartile range, which is equal to 11 minus 4 = 7.
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This question is part of the following fields:
- Evidence Based Medicine
- Statistics
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Question 9
Incorrect
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A 22-year-old presents with acute severe asthma. He takes a drug prescribed by her GP but cannot recall the name and is receiving regular salbutamol nebulisers. His current potassium level is 2.8 mmol/l.
Which drug is least likely to have caused his hypokalaemia?
Your Answer: Bendroflumethiazide
Correct Answer: Spironolactone
Explanation:Serious hypokalaemia can occur in severe asthma and the effect can be potentiated by concomitant treatment with theophyllines like aminophylline, corticosteroids, thiazide and loop diuretics, and hypoxia. Plasma-potassium concentration should be monitored in severe asthma.
Spironolactone, a potassium-sparing diuretic, is not likely to have contributed to patients hypokalaemia.
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This question is part of the following fields:
- Pharmacology
- Respiratory Pharmacology
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Question 10
Correct
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Regarding transport across a membrane, which of the following statements is CORRECT:
Your Answer: Ion channels may be voltage-gated or ligand-gated.
Explanation:Diffusion is the passive movement of ions across a cell membrane down their electrochemical or concentration gradient through ion channels. Ion channels can be voltage-gated (regulated according to the potential difference across the cell membrane) or ligand-gated (regulated by the presence of a specific signal molecule). Facilitated diffusion is the process of spontaneous passive transport of molecules or ions down their concentration gradient across a cell membrane via specific transmembrane transporter (carrier) proteins. The energy required for conformational changes in the transporter protein is provided by the concentration gradient rather than by metabolic activity. In secondary active transport there is no direct coupling of ATP but the initial Na+ electrochemical gradient that drives the secondary active transport is set up by a process that requires metabolic energy. Examples include the sodium/calcium exchanger, or the sodium/glucose symporter.
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This question is part of the following fields:
- Basic Cellular
- Physiology
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