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  • Question 1 - Which of the following drug can cause galactorrhoea? ...

    Correct

    • Which of the following drug can cause galactorrhoea?

      Your Answer: Metoclopramide

      Explanation:

      Metoclopramide causes extrapyramidal effects (especially in children and young adults), hyperprolactinaemia, and occasionally tardive dyskinesia on prolonged administration. Also reported are drowsiness, restlessness, diarrhoea, depression, neuroleptic malignant syndrome, rashes, pruritus, oedema.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      3.6
      Seconds
  • Question 2 - Which of the following supplies the AV node? ...

    Correct

    • Which of the following supplies the AV node?

      Your Answer: Right coronary artery

      Explanation:

      The AV node is supplied by the right coronary artery near the origin of the posterior IV artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      5.4
      Seconds
  • Question 3 - Which of the following is a precursor to the tissue macrophage? ...

    Correct

    • Which of the following is a precursor to the tissue macrophage?

      Your Answer: Monocyte

      Explanation:

      Monocytes are a type of white blood cell, or leukocyte. They are the largest type of leukocyte and can differentiate into macrophages or dendritic cells.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      4.4
      Seconds
  • Question 4 - Majority of gastrinomas are found in the: ...

    Incorrect

    • Majority of gastrinomas are found in the:

      Your Answer: Oesophagus

      Correct Answer: Duodenum

      Explanation:

      A gastrinoma is a tumour in the pancreas or duodenum that secretes excess of gastrin leading to ulceration in the duodenum, stomach and the small intestine. It is usually found in the duodenum, although it may arise in the stomach or pancreas. Those occurring in the pancreas have a greater potential for malignancy. Most gastrinomas are found in the gastrinoma triangle; this is bound by the junction of cystic and common bile ducts, junction of the second and third parts of the duodenum, and the junction of the neck and body of the pancreas.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      1.8
      Seconds
  • Question 5 - What happens first during depolarisation of the membrane potential? ...

    Correct

    • What happens first during depolarisation of the membrane potential?

      Your Answer: Gated Na channels open allowing the influx of Na

      Explanation:

      Generation of an action potential in response to a stimulus is a result of a previously maintained resting membrane potential (RMP). Generation of resting membrane potential is mediated mainly by potassium ions. Several membrane proteins maintain RMP by transport of ions in and out of cell. Na+/K+ ATPase pump maintains a concentration gradient of Na+ and K+ ions. Na+ concentration in extracellular fluid is higher compared to intracellular fluid and K+ ion concentration is higher intracellularly. Generation of an action potential facilitates opening of Na+ ion channels which allow for Na+ to diffuse inside the cell according to the concentration gradient.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      11.3
      Seconds
  • Question 6 - The nucleus ambiguus: ...

    Correct

    • The nucleus ambiguus:

      Your Answer: Regulates swallowing, phonation and parasympathetic supply to the heart via CN IX, X and XI

      Explanation:

      Nucleus Ambiguus is a group of large motor neurons found deep in the medullary reticular formation. It contains cell bodies of nerves that are responsible for the innervation of muscles of speech and swallowing which are located in the soft palate, pharynx and larynx. Additionally, it contains cholinergic preganglionic parasympathetic neurons of the heart via CN X, IX and XI

    • This question is part of the following fields:

      • Medicine
      • Neurology
      3.8
      Seconds
  • Question 7 - The energy needed for glycogen synthesis comes from which compound? ...

    Correct

    • The energy needed for glycogen synthesis comes from which compound?

      Your Answer: UTP

      Explanation:

      Glycogen synthesis is, unlike its breakdown, endergonic—it requires the input of energy. Energy for glycogen synthesis comes from uridine triphosphate (UTP)

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      2.8
      Seconds
  • Question 8 - Which one of the following have not been shown to improve mortality in...

    Correct

    • Which one of the following have not been shown to improve mortality in patients with chronic heart failure?

      Your Answer: Furosemide

      Explanation:

      A number of drugs have been shown to improve mortality in patients with chronic heart failure:• ACE inhibitors (SAVE, SOLVD, CONSENSUS)• spironolactone (RALES)• beta-blockers (CIBIS)• hydralazine with nitrates (VHEFT-1)

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.4
      Seconds
  • Question 9 - A 50-year-old woman under treatment for manic-depressive psychosis presents in an unconscious state...

    Correct

    • A 50-year-old woman under treatment for manic-depressive psychosis presents in an unconscious state after an episode of seizure on the street. Her husband who accompanied her into the ER reported that they argued about 6-7 hours ago. On examination, she is found to be hypertonic with a GCS of 8, BP: 90/60 mmHg and a pulse of 105 bpm. Blood investigations revealed a lithium level of 3.2 mmol/L. She was intubated and ventilated. Which of the following are the TWO interventions which are most appropriate in this case?

      Your Answer: Gastric lavage should be considered

      Explanation:

      Among the above statements, gastric lavage and normal saline IV infusion are the two appropriate interventions for a patient of acute lithium toxicity.Activated charcoal is not effective after lithium overdose, although gastric lavage should be considered if patients present within 6–8 h. Where levels are above 3 mmol/l, the use of normal saline to induce diuresis should be considered, although careful monitoring of fluid balance is necessary. Where levels of lithium are above 4 mmol/l, dialysis is often required. Haemodialysis is preferred, but in a facility where haemodialysis is not possible, peritoneal dialysis may be considered.Patients should not be discharged until they are asymptomatic and have a serum lithium level less than 1.5 mEq/L.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      6.7
      Seconds
  • Question 10 - A patient with achalasia ...

    Correct

    • A patient with achalasia

      Your Answer: Has decreased production of vasoactive intestinal polypeptide (VIP)

      Explanation:

      Oesophageal achalasia is an oesophageal motility disorder involving the smooth muscle layer of the oesophagus and the lower oesophageal sphincter (LES). It is characterized by incomplete LES relaxation, increased LES tone, and lack of peristalsis of the oesophagus (inability of smooth muscle to move food down the oesophagus) in the absence of other explanations like cancer or fibrosis. In achalasia, there is loss of nitric oxide (NO) and vasoactive intestinal polypeptide (VIP) releasing inhibitory neurons.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      3.4
      Seconds
  • Question 11 - Which part of the ECG represents ventricular repolarisation? ...

    Correct

    • Which part of the ECG represents ventricular repolarisation?

      Your Answer: T wave

      Explanation:

      Ventricular repolarisation is denoted by the T wave.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3
      Seconds
  • Question 12 - The tectum as part of the Midbrain contains which structure important in visual...

    Correct

    • The tectum as part of the Midbrain contains which structure important in visual reflexes.

      Your Answer: Superior colliculus

      Explanation:

      The tectum is a part of the midbrain, specifically, the dorsal part of the midbrain. The tectum consists of the superior and inferior colliculi. The superior colliculus is involved in preliminary visual processing and control of eye movement.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      4.4
      Seconds
  • Question 13 - When looking at the JVP what does the c wave signify: ...

    Correct

    • When looking at the JVP what does the c wave signify:

      Your Answer: Isovolumetric ventricular contraction

      Explanation:

      The C wave signifies a rise in the atrial pressure during isovolumetric contraction due to the tricuspid valve bulging into the atria.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      2.9
      Seconds
  • Question 14 - The branche(s) of the left coronary artery are ...

    Correct

    • The branche(s) of the left coronary artery are

      Your Answer: A and b

      Explanation:

      Posterior descending artery comes from Right coronary artery. The anterior interventricular artery is otherwise known as the anterior descending branch.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3.3
      Seconds
  • Question 15 - Cholinergic neurons that pass into a retrograde direction activate neurons that release: ...

    Correct

    • Cholinergic neurons that pass into a retrograde direction activate neurons that release:

      Your Answer: Substance P and acetyl choline

      Explanation:

      Serotonin activates sensory neurons that activate the myenteric plexus. Cholinergic neurons passing in a retrograde direction in the myenteric plexus activate neurons that release substance P and acetylcholine, causing smooth muscle contraction.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      2
      Seconds
  • Question 16 - Growth hormone deficiency causes? ...

    Correct

    • Growth hormone deficiency causes?

      Your Answer: Decreased epiphyseal growth

      Explanation:

      Growth hormone deficiency is caused by conditions affecting the pituitary gland, such as tumours. Its effects depend on the age of the patient: in infancy and childhood, growth failure is most likely to occur. The epiphyseal plate is the area in long bones where growth occurs, and it is the area affected by growth hormone deficiency. Poor growth/shortness is the main symptom of GH deficiency in children, usually resulting in growth at about half the usual rate for age.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      2.2
      Seconds
  • Question 17 - A 38-year-old woman has a melanocytic naevi on her left forearm.Which of the...

    Correct

    • A 38-year-old woman has a melanocytic naevi on her left forearm.Which of the following features do not suggest malignant change?

      Your Answer: Decrease in size

      Explanation:

      Melanocytic nevi are benign neoplasms or hamartomas composed of melanocytes. Melanocytes are derived from the neural crest and migrate during embryogenesis to selected ectodermal sites (primarily the skin and the CNS), but also to the eyes and the ears.They tend to appear during early childhood and during the first 30 years of life. They may change slowly, becoming raised, changing color or gradually fading.. Pregnancy can increase the number of naevi as well as the degree of hyperpigmentation.They may become malignant and this should be suspected if the naevus increases in size, develops an irregular surface or becomes darker, itches or bleeds.

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      6.1
      Seconds
  • Question 18 - A 22 year old man who has recently returned from a trip to...

    Correct

    • A 22 year old man who has recently returned from a trip to Far East presents with sore eyes and symmetrical joint pain in his knees, ankles and feet. Labs reveal an elevated ESR. The synovial fluid aspirate is sterile and has a high neutrophil count. What is the most likely diagnosis?

      Your Answer: Reactive arthropathy

      Explanation:

      Reactive arthritis, (formerly known as Reiter’s syndrome), is an autoimmune condition that occurs after a bacterial infection of the gastrointestinal or urinary tract. It is categorized as a seronegative spondylarthritis because of its association with HLA-B27. Reactive arthritis primarily affects young men and usually presents with musculoskeletal or extra‑articular symptoms. The characteristic triad consists of arthritis, conjunctivitis, and urethritis. Symmetric lower limb arthropathy and a sterile joint aspirate points towards reactive arthropathy.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      37.5
      Seconds
  • Question 19 - In the urea cycle, which substance is formed in the mitochondria? ...

    Correct

    • In the urea cycle, which substance is formed in the mitochondria?

      Your Answer: Carbamoyl phosphate

      Explanation:

      Before the urea cycle begins ammonia is converted to carbamoyl phosphate in the mitochondria.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      2.8
      Seconds
  • Question 20 - Which of the following affects the magnitude of the action potential? ...

    Correct

    • Which of the following affects the magnitude of the action potential?

      Your Answer: Changes in the external Na+ concentration

      Explanation:

      The magnitude of the action potential is determined by the sodium current. Increase in external sodium will result in increased influx of sodium and hence generation of a stronger action potential.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      19
      Seconds
  • Question 21 - The parasympathetic innervation of the parotid salivary gland arrives from the salivary nuclei:...

    Correct

    • The parasympathetic innervation of the parotid salivary gland arrives from the salivary nuclei:

      Your Answer: CN IX

      Explanation:

      Parasympathetic presynaptic nerve fibers from the glossopharyngeal nerve (CN IX) synapse in the otic ganglion and the postsynaptic parasympathetic nerve fibers pass to the parotid gland via the auriculotemporal nerve.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      6.2
      Seconds
  • Question 22 - The right border of the heart corresponds to which line on the surface...

    Correct

    • The right border of the heart corresponds to which line on the surface of the chest?

      Your Answer: Line drawn from the 3rd right costal cartilage to the 6th right costal cartilage

      Explanation:

      The right border corresponds to a line drawn from the 3rd right costal cartilage to the 6th right costal cartilage; this border is slightly convex to the right.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      3
      Seconds
  • Question 23 - Which of the following skin coloration abnormalities occurs due to adrenal insufficiency due...

    Correct

    • Which of the following skin coloration abnormalities occurs due to adrenal insufficiency due to primary adrenal disease?

      Your Answer: Hyperpigmentation

      Explanation:

      Addison’s disease, also known as primary adrenal insufficiency, or hypocortisolism is an endocrine disorder. Hyperpigmentation is one of its most common signs; it occurs as a result of an increase in pro-opiomelanocortin to produce more ACTH in response to the decreased levels of cortisol. Pro-opiomelanocortin is a precursor of melanocyte stimulating hormone (MSH), which stimulates melanocytes, causing darkening of the skin.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      2.4
      Seconds
  • Question 24 - The role of the hemidesmosome is? ...

    Correct

    • The role of the hemidesmosome is?

      Your Answer: Attaches cells to underlying basal lamina

      Explanation:

      Hemidesmosomes connect the basal surface of epithelial cells via intermediate filaments to the underlying basal lamina. The transmembrane proteins of hemidesmosomes are not cadherins, but another type of protein called integrin.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      3.4
      Seconds
  • Question 25 - Bile acids will be prevented from being absorbed by resection of which part...

    Correct

    • Bile acids will be prevented from being absorbed by resection of which part of the gastrointestinal tract?

      Your Answer: Ileum

      Explanation:

      Bile acids (also called bile salts) are produced in the liver, secreted into the biliary system, stored in the gallbladder and are released after meals stimulated by cholecystokinin. They are important for the digestion and absorption of fats (lipids) in the small intestine. Usually over 95% of the bile acids are absorbed in the terminal ileum and are taken up by the liver and resecreted.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      2.1
      Seconds
  • Question 26 - An 18-year-old young lady is brought to the ER by her mother. She...

    Incorrect

    • An 18-year-old young lady is brought to the ER by her mother. She was found, lying on the floor having consumed an unidentified quantity of her mother's prescription pills with alcohol. The patient's mother is a known hypertensive under treatment. On examination, the patient was found to be lethargic, hypotensive with a BP of 70/50 mmHg, and bradycardic with a pulse rate of 38 bpm. A finger prick glucose is 3.2 mmol/L. Which TWO among the following are the most appropriate steps for the initial management of this patient?

      Your Answer: Isoprenaline and atropine

      Correct Answer: Glucagon and isoprenaline

      Explanation:

      The most appropriate steps of initial management include iv glucagon and iv isoprenaline.The most likely diagnosis in the above scenario (decreased conscious level, profound hypertension, and bradycardia) is β-blocker toxicity/overdose. Bronchospasm rarely occurs in an overdose of β-blockers, except where there is a history of asthma.Immediate management is to give iv glucagons (50–150μg/kg) followed by infusion to treat hypotension and isoprenaline or atropine to treat bradycardia. Where patients fail to respond to these measures, temporary pacing may be required. If the patient is seen within the first 4 hours of the overdose, gastric lavage may be of value.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      6.8
      Seconds
  • Question 27 - During anaerobic glycolysis, the net production of ATP is: ...

    Correct

    • During anaerobic glycolysis, the net production of ATP is:

      Your Answer: 2

      Explanation:

      Anaerobic glycolysis is the transformation of glucose to lactate when limited amounts of oxygen (O2) are available. Anaerobic glycolysis is only an effective means of energy production during short, intense exercise, providing energy for a period ranging from 10 seconds to 2 minutes. It produces 2 ATP molecules per glucose molecule.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      2.5
      Seconds
  • Question 28 - The brainstem reticular formation, consists of which important control system responsible for consciousness...

    Incorrect

    • The brainstem reticular formation, consists of which important control system responsible for consciousness and sleep?

      Your Answer: RAM reticular activated memory

      Correct Answer: RAS reticular activating system

      Explanation:

      The reticular formation is a set of interconnected nuclei that are located along the brainstem. Reticular activating system (RAS) is a set of connected nuclei in the brain that is responsible for regulating wakefulness and sleep wake transitions and is the most influential component in the reticular formation.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      9.8
      Seconds
  • Question 29 - Psoriatic arthropathy most commonly presents with which of the following types of arthritis?...

    Correct

    • Psoriatic arthropathy most commonly presents with which of the following types of arthritis?

      Your Answer: Peripheral asymmetric oligoarthropathy

      Explanation:

      Most patients with psoriatic arthritis present with monoarthritis or asymmetric oligoarthritis. The most common form of the disease is the one involving a few joints of the peripheral skeleton with a distinct asymmetry of symptoms. Involvement of the smaller joints of the hands and feet, especially distal interphalangeal joints, seems to be a characteristic feature. Arthritis mutilans is a rare and severe complication of psoriatic arthritis.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      6.6
      Seconds
  • Question 30 - The lamina propria contains all of the following except: ...

    Incorrect

    • The lamina propria contains all of the following except:

      Your Answer:

      Correct Answer: Neutrophils

      Explanation:

      The connective tissue of the lamina propria is very loose, allowing it to be very cell rich. The cell population of the lamina propria is variable and can include, for example, fibroblasts, lymphocytes, plasma cells, macrophages, eosinophilic leukocytes, and mast cells. It provides support and nutrition to the epithelium, as well as the means to bind to the underlying tissue.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Medicine (26/29) 90%
Pharmacology (2/3) 67%
Cardiovascular (7/7) 100%
Haematology (1/1) 100%
Gastrointestinal (3/4) 75%
Neurology (3/4) 75%
Metabolism (4/4) 100%
Endocrinology (2/2) 100%
Dermatology (1/1) 100%
Connective Tissue (2/2) 100%
Cell Biology (1/1) 100%
Passmed