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  • Question 1 - A 60-year-old man comes to your department with complaints of epigastric pain. There...

    Correct

    • A 60-year-old man comes to your department with complaints of epigastric pain. There is a history of rheumatoid arthritis and he has been taking ibuprofen 200 mg TDS for the last 2 weeks.

      The following scenarios would prompt you to consider the co-prescription of a PPI for gastroprotection with NSAIDs EXCEPT?

      Your Answer: Long-term use for chronic back pain in a patient aged 30

      Explanation:

      The current recommendations by NICE suggest that gastro-protection should be considered if patients have ≥1 of the following:

      Aged 65 or older
      – Using maximum recommended dose of an NSAID
      – History of peptic ulcer or GI bleeding
      – Concomitant use of: antidepressants like SSRIs and SNRIs, Corticosteroids, anticoagulants and low dose aspirin
      – Long-term NSAID usage for: long-term back pain if older than 45 and patients with OA or RA at any age

      The maximum recommended dose of ibuprofen is 2.4 g daily and this patient is on 400 mg of ibuprofen TDS.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
      32.9
      Seconds
  • Question 2 - Which family of receptors does the glucagon receptor belong?
    ...

    Correct

    • Which family of receptors does the glucagon receptor belong?

      Your Answer: G-protein coupled receptors

      Explanation:

      Glucagon binds to class B G-protein coupled receptors and activates adenylate cyclase, increasing cAMP intracellularly.

      This activates protein kinase A. Protein kinase A phosphorylates and activates important enzymes in target cells.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      4
      Seconds
  • Question 3 - An 82 year old man taking warfarin as a maintenance medication comes in...

    Incorrect

    • An 82 year old man taking warfarin as a maintenance medication comes in to your clinic because of an infection. Which antibiotic is the safest choice for this patient?

      Your Answer: Clarithromycin

      Correct Answer: Cefalexin

      Explanation:

      Alterations in the international normalized ratio (INR) brought about by the concurrent use of antibiotics and warfarin may result in either excessive clotting or excessive bleeding if they are deemed to have a high risk for interaction. As such, there should be careful consideration of the class of antibiotic to be used.

      Antibiotics from the following drug classes should generally be avoided as they have a high risk for interaction with warfarin, possible enhancing the anticoagulant effects of warfarin resulting in bleeding: Fluoroquinolones (e.g. ciprofloxacin, levofloxacin), Macrolides (e.g. clarithromycin, erythromycin, azithromycin), Nitroimidazoles (e.g. metronidazole), Sulphonamides (e.g. co-trimoxazole, a combination of trimethoprim and sulfamethoxazole), Trimethoprim, Tetracyclines (e.g. doxycycline).

      Low risk antibiotics that have low risk for interaction with warfarin includes cephalexin, from the cephalosporin class, and clindamycin which is a lincomycin.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      18.4
      Seconds
  • Question 4 - How does aspirin mediate its antiplatelet effect: ...

    Correct

    • How does aspirin mediate its antiplatelet effect:

      Your Answer: It irreversibly inhibits cyclo-oxygenase

      Explanation:

      Aspirin irreversibly inhibits cyclooxygenase and blocks the platelet production of thromboxane A2 (TXA2), thus inhibiting platelet aggregation.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      3.4
      Seconds
  • Question 5 - A 45-year-old obese patient goes to the emergency department with a fever and...

    Incorrect

    • A 45-year-old obese patient goes to the emergency department with a fever and significant right upper quadrant pain. The pain radiates to her right shoulder tip.  Murphy's sign is positive and acute cholecystitis is diagnosed. The pain referred to the shoulder tip is caused by one of the following nerves:

      Your Answer: Lesser thoracic splanchnic nerve

      Correct Answer: Phrenic nerve

      Explanation:

      Gallbladder inflammation can cause pain in the right upper quadrant and right shoulder, which is caused by irritation of the diaphragmatic peritoneum. Pain from areas supplied by the phrenic nerve is often referred to other somatic regions served by spinal nerves C3-C5.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      24.4
      Seconds
  • Question 6 - You examine an elderly man who is experiencing chest pain. He doesn't recall...

    Correct

    • You examine an elderly man who is experiencing chest pain. He doesn't recall all of his medications, but he does know that he takes a diuretic.

      The enzyme carbonic anhydrase is inhibited by which of the following diuretics?

      Your Answer: Acetazolamide

      Explanation:

      Acetazolamide is a non-competitive, reversible inhibitor of carbonic anhydrase found in the cytosol of cells and on the brush border of the proximal convoluted tubule. Bicarbonate and hydrogen ions are converted to carbonic acid by carbonic anhydrase, which then converts carbonic acid to carbon dioxide and water. As a result, acetazolamide reduces the availability of hydrogen ions, causing sodium and bicarbonate ions to accumulate in the renal tubule, resulting in diuresis.
      The mechanism of action of the various types of diuretics is summarised below:

      1) Loop diuretics, e.g. furosemide, bumetanide
      Act on the Na.K.2Cl co-transporters in the ascending loop of Henlé to inhibit sodium, chloride and potassium reabsorption.

      2) Thiazide diuretics, e.g. Bendroflumethiazide, hydrochlorothiazide
      Act on the Na.Cl co-transporter in the distal convoluted tubule to inhibit sodium and chloride reabsorption.

      3) Osmotic diuretics, e.g. mannitol
      Increases the osmolality of the glomerular filtrate and tubular fluid, increasing urinary volume by an osmotic effect.

      4) Aldosterone antagonists, e.g. spironolactone
      Acts in the distal convoluted tubule as a competitive aldosterone antagonist resulting in inhibition of sodium reabsorption and increasing potassium reabsorption.

      5) Carbonic anhydrase inhibitors, e.g. acetazolamide
      Inhibit the enzyme carbonic anhydrase preventing the conversion of bicarbonate and hydrogen ions into carbonic acid.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      7.1
      Seconds
  • Question 7 - You're evaluating a male patient who's having a lung function test done. In...

    Correct

    • You're evaluating a male patient who's having a lung function test done. In calculating the patient’s functional residual capacity, what parameters should you add to derive the functional residual capacity volume?

      Your Answer: Expiratory reserve volume + residual volume

      Explanation:

      The volume of air that remains in the lungs after a single breath is known as functional residual capacity (FRC). It is calculated by combining the expiratory reserve volume and residual volume.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      15.8
      Seconds
  • Question 8 - A patient is sent in by her GP with suspected ectopic pregnancy. Tubal...

    Correct

    • A patient is sent in by her GP with suspected ectopic pregnancy. Tubal ectopic pregnancies occur most commonly in which part of the uterine tube:

      Your Answer: Ampulla

      Explanation:

      Ectopic pregnancy most commonly occurs in the ampulla (70% of cases).

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      4.7
      Seconds
  • Question 9 - Which of the following is NOT an advantage of a case-control study used...

    Incorrect

    • Which of the following is NOT an advantage of a case-control study used to identify past exposure to a risk factor in patients with a disease:

      Your Answer: Particularly suitable for studying association between an exposure and an outcome when the outcome is uncommon

      Correct Answer: Can directly measure absolute and relative risk of a disease

      Explanation:

      Advantages:relatively quickrelatively cheap and easy to performparticularly suitable for studying associations between an exposure and an outcome when the outcome is uncommon or if the outcome occurs decades after exposurea wide range of risk factors can be investigated in each studyDisadvantages:subject to recall biasunlike in a whole population study, absolute risk cannot be quantifiedtemporal relationship between exposure and outcome can be difficult to establishunsuitable for rare risk factorsprone to confounding

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Study Methodology
      6.3
      Seconds
  • Question 10 - A 22-year-old woman is brought in by ambulance from her GP surgery with...

    Correct

    • A 22-year-old woman is brought in by ambulance from her GP surgery with suspected meningitis. She has been given a dose of benzylpenicillin already.
      What is the mechanism of action of benzylpenicillin? Select ONE answer only.

      Your Answer: Inhibition of cell wall synthesis

      Explanation:

      Penicillins and the other ß-lactam antibiotics are bactericidal. They produce their antimicrobial action by preventing cross-linkage between the linear peptidoglycan polymer chains that make up the bacterial cell wall. They, therefore, inhibit cell wall synthesis.
      An overview of the different mechanisms of action of the various types of antimicrobial agents is shown below:
      Mechanism of action
      Examples
      Inhibition of cell wall synthesis
      Penicillins
      Cephalosporins
      Vancomycin
      Disruption of cell membrane function
      Polymyxins
      Nystatin
      Amphotericin B
      Inhibition of protein synthesis
      Macrolides
      Aminoglycosides
      Tetracyclines
      Chloramphenicol
      Inhibition of nucleic acid synthesis
      Quinolones
      Trimethoprim
      5-nitroimidazoles
      Rifampicin
      Anti-metabolic activity
      Sulfonamides
      Isoniazid

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      11.8
      Seconds
  • Question 11 - A 43-year old male is taken to the Emergency Room for a lacerated...

    Incorrect

    • A 43-year old male is taken to the Emergency Room for a lacerated wound on the abdomen, situated above the umbilicus. A short segment of the small bowel has herniated through the wound.

      Which of these anatomic structures is the most superficial structure injured in the case above?

      Your Answer: Transversalis fascia

      Correct Answer: Camper’s fascia

      Explanation:

      The following structures are the layers of the anterior abdominal wall from the most superficial to the deepest layer:

      Skin
      Fatty layer of the superficial fascia (Camper’s fascia)
      Membranous layer of the superficial fascia (Scarpa’s fascia)
      Aponeurosis of the external and internal oblique muscles
      Rectus abdominis muscle
      Aponeurosis of the internal oblique and transversus abdominis
      Fascia transversalis
      Extraperitoneal fat
      Parietal peritoneum

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      33.1
      Seconds
  • Question 12 - You examine a 50-year-old female who has a swollen, painful right big toe. She...

    Incorrect

    • You examine a 50-year-old female who has a swollen, painful right big toe. She has a history of gout, and this discomfort is identical to prior relapses, according to her. She is currently taking 200 mg of allopurinol per day and has been for the last year. This is her second round of acute gout within this time period. She has no prior medical history to speak of and does not take any other medications. She doesn't have any known drug allergies.

      Which of the following management options is the SINGLE MOST APPROPRIATE?

      Your Answer: Stop the allopurinol and commence naproxen

      Correct Answer: Continue with the allopurinol and commence naproxen

      Explanation:

      Allopurinol should not be started during an acute gout episode because it can both prolong and trigger another acute attack. Allopurinol should be continued in patients who are currently taking it, and acute attacks should be treated as usual with NSAIDs or colchicine, as needed.

      Non-steroidal anti-inflammatory medications (NSAIDs), such as naproxen, are the first-line treatment for acute gout attacks. Colchicine can be used in situations where NSAIDs are contraindicated, such as in patients with hypertension or those who have had a history of peptic ulcer disease. Because there is no reason for this patient to avoid NSAIDs, naproxen would be the medicine of choice from the list above.

      It would be reasonable to titrate up the allopurinol dose once the acute episode has subsided, targeting <6 mg/dl (<360 µmol/l) plasma urate levels .
      Febuxostat (Uloric) is a drug that can be used instead of allopurinol to treat persistent gout.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
      29
      Seconds
  • Question 13 - Which of the following statements is true about anterior cord syndrome? ...

    Incorrect

    • Which of the following statements is true about anterior cord syndrome?

      Your Answer: There is preservation of temperature sensation

      Correct Answer: There is preservation of proprioception

      Explanation:

      Anterior cord syndrome is an incomplete cord syndrome that predominantly affects the anterior 2/3 of the spinal cord, characteristically resulting in motor paralysis below the level of the lesion as well as the loss of pain and temperature at and below the level of the lesion. The patient presentation typically includes these two findings; however, there is variability depending on the portion of the spinal cord affected. Other findings include back pain, or autonomic dysfunction such as hypotension, neurogenic bowel or bladder, and sexual dysfunction. The severity of motor dysfunction can vary, typically resulting in paraplegia or quadriplegia.

      Proprioception, vibratory sense, two-point discrimination, and fine touch are not affected in anterior cord syndrome. These sensations are under the control of the dorsal column of the spinal cord, which is supplied by two posterior spinal arteries running in the posterior lateral sulci.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      12.2
      Seconds
  • Question 14 - A 43 year old lady who has a previous medical history of hyperthyroidism...

    Incorrect

    • A 43 year old lady who has a previous medical history of hyperthyroidism presents to the emergency room with sweating, palpitations and agitation. On examination, she is tachycardic, hypertensive and hyperpyrexic. She recently had a stomach bug and has not been able to take her medication regularly. The best medication to immediately treat her symptoms is which of the following?

      Your Answer: Carbimazole

      Correct Answer: Propranolol

      Explanation:

      There is a high suspicion of a thyroid crisis in this patient and emergent treatment should be initiated even before the results of TFT’s have returned. Antiadrenergic drugs like IV propranolol should be administered immediately to minimise sympathomimetic symptoms. Antithyroid medications like propylthiouracil or carbimazole should be administered to block further synthesis of thyroid hormones. After thionamide therapy has been started to prevent stimulation of new hormone synthesis, there should then be delayed administration of oral iodine solution. Hydrocortisone administration is also recommended as it treats possible relative adrenal insufficiency while also decreases peripheral conversion of T4 to T3.

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
      16.5
      Seconds
  • Question 15 - The neurotransmitter in the synaptic cleft is either eliminated or deactivated after the...

    Correct

    • The neurotransmitter in the synaptic cleft is either eliminated or deactivated after the postsynaptic cell responds to the neurotransmitter.

      Which of the following enzymes catalyses the breakdown of noradrenaline?

      Your Answer: Catechol-O-methyltransferase (COMT)

      Explanation:

      The neurotransmitter in the synaptic cleft is either eliminated or deactivated after the post-synaptic cell responds to the neurotransmitter.

      This can be accomplished in a variety of ways:
      Re-uptake
      Breakdown
      Diffusion

      Serotonin is an example of a neurotransmitter that is uptake. Serotonin is absorbed back into the presynaptic neuron via the serotonin transporter (SERT), which is found in the presynaptic membrane. Re-uptake neurotransmitters are either recycled by repackaging into vesicles or broken down by enzymes.
      Specific enzymes found in the synaptic cleft can also break down neurotransmitters. The following enzymes are examples of these enzymes:
      Acetylcholinesterase (AChE) catalyses the acetylcholine breakdown (ACh)
      The enzyme catechol-O-methyltransferase (COMT) catalyses the breakdown of catecholamines like adrenaline , dopamine and noradrenaline.

      The breakdown of catecholamines, as well as other monoamines like serotonin, tyramine, and tryptamine, is catalysed by monoamine oxidases (MOA).
      Diffusion of neurotransmitters into nearby locations can also be used to eliminate them.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      16.8
      Seconds
  • Question 16 - Regarding airway resistance, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding airway resistance, which of the following statements is INCORRECT:

      Your Answer: Flow through airways is inversely proportional to airway resistance.

      Correct Answer: In the lower respiratory tract, airway resistance is mostly determined by the smallest bronchioles.

      Explanation:

      Airway resistance is primarily determined by the airway radius according to Poiseuille’s law, and whether the flow is laminar or turbulent. The major site of airway resistance is the medium-sized bronchi. The smallest airways would seem to offer the highest resistance, but they do not because of their branching parallel arrangement.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      24.4
      Seconds
  • Question 17 - The primary mechanism of action of ketamine is: ...

    Correct

    • The primary mechanism of action of ketamine is:

      Your Answer: N-methyl-D-aspartate (NMDA)-receptor antagonist

      Explanation:

      Ketamine is a non-competitive antagonist of the calcium-ion channel in the NMDA (N-methyl-D-aspartate) receptor. It further inhibits the NMDA-receptor by binding to its phencyclidine binding site. Ketamine also acts at other receptors as an opioid receptor agonist (analgesic effects), as an muscarinic anticholinergic receptor antagonist (antimuscarinic effects) and by blocking fast sodium channels (local anaesthetic effect).

      Overdose may lead to panic attacks and aggressive behaviour; rarely seizures, increased ICP, and cardiac arrest

      Very similar in chemical makeup to PCP (phencyclidine), but it is shorter acting and less toxic

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      6.8
      Seconds
  • Question 18 - A 28-year-old known intravenous drug user has a history of persistent high-fever. On...

    Incorrect

    • A 28-year-old known intravenous drug user has a history of persistent high-fever. On examination you hear a harsh systolic murmur and the patient says a murmur has never been heard before in previous hospital visits. A diagnosis of endocarditis is suspect.

      Which of these antibacterial agents would be most appropriate to prescribe in this case?

      Your Answer: Vancomycin and metronidazole

      Correct Answer: Flucloxacillin and gentamicin

      Explanation:

      Endocarditis is infective or non infective inflammation (marantic endocarditis) of the inner layer of the heart and it often involves the heart valves.

      Risk factors include:
      Prosthetic heart valves
      Congenital heart defects
      Prior history of endocarditis
      Rheumatic fever
      Illicit intravenous drug use

      In the presentation of endocarditis, the following triad is often quoted:
      Persistent fever
      Embolic phenomena
      New or changing murmur

      Flucloxacillin and gentamicin are current recommended by NICE and the BNF for the initial ‘blind’ therapy in endocarditis.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      16.2
      Seconds
  • Question 19 - A 58-year-old woman presents with symptoms of increase in weight, proximal muscular weakening...

    Correct

    • A 58-year-old woman presents with symptoms of increase in weight, proximal muscular weakening and withering, easy bruising, and acne. You notice that she has a full, plethoric aspect to her face, as well as significant supraclavicular fat pads, when you examine her. She has previously been diagnosed with Cushing's syndrome.

      Which of the following biochemical profiles best supports this diagnosis?

      Your Answer: Hypokalaemic metabolic alkalosis

      Explanation:

      Cushing’s syndrome is a group of symptoms and signs brought on by long-term exposure to high amounts of endogenous or exogenous glucocorticoids. Cushing’s syndrome affects about 10-15 persons per million, and it is more common in those who have had a history of obesity, hypertension, or diabetes.

      A typical biochemical profile can help establish a diagnosis of Cushing’s syndrome. The following are the primary characteristics:
      Hypokalaemia
      Alkalosis metabolique

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      20.3
      Seconds
  • Question 20 - What is the recommended dosing regime for amiodarone in the treatment of a...

    Incorrect

    • What is the recommended dosing regime for amiodarone in the treatment of a stable regular broad-complex tachycardia:

      Your Answer: 150 mg IV bolus, followed by an IV infusion of 300 mg over next 20 - 60 minutes

      Correct Answer: 300 mg IV over 10 - 60 minutes, followed by an IV infusion of 900 mg over the next 24 hours

      Explanation:

      A ventricular tachycardia (or broad-complex tachycardia of uncertain origin) should be treated with amiodarone 300 mg IV over 10 – 60 min, followed by an infusion of 900 mg over the next 24 hours.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      17.2
      Seconds
  • Question 21 - A 27-year-old man was sent to the emergency department by ambulance with suspected...

    Correct

    • A 27-year-old man was sent to the emergency department by ambulance with suspected anaphylaxis. What is the best first-line treatment for this patient?

      Your Answer: 500 micrograms of adrenaline intramuscularly

      Explanation:

      Anaphylaxis is the sudden onset of systemic hypersensitivity due to IgE-mediated chemical release from mast cells and basophils.

      If anaphylaxis is suspected, 500 micrograms of adrenaline should be administered promptly (0.5 ml of 1:1000 solution).

      In anaphylaxis, the intramuscular route is the most immediate approach; the optimal site is the anterolateral aspect of the middle part of the thigh.

      Intravenous adrenaline should only be given by people who are well-versed in the use and titration of vasopressors in their routine clinical practice.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      18.2
      Seconds
  • Question 22 - While studying fluid homeostasis in the body, you encounter the term exudate. Exudate...

    Incorrect

    • While studying fluid homeostasis in the body, you encounter the term exudate. Exudate is a fluid that leaks out of the intravascular space due to changes in the permeability of the microcirculation secondary to inflammation.

      Which ONE of the following conditions would not be listed among the causes of an exudate?

      Your Answer: Breast cancer

      Correct Answer: Myxoedema

      Explanation:

      An exudate is an inflammatory fluid that leaks out of the intravascular space due to increased vascular permeability and intravascular pressure. It is mostly caused by local processes and can occur in the following conditions:
      1) Infection (e.g. pneumonia)
      2) Malignancy
      3) Pericarditis
      4) Collagen vascular diseases, e.g., Rheumatoid Arthritis

      Myxoedema is a state of severe hypothyroidism in which deposition of mucopolysaccharides occurs in the dermis. This causes a transudative effusion, typically in the pretibial region.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      17.4
      Seconds
  • Question 23 - You review a 34-year-old man with lower back pain and plan to prescribe...

    Incorrect

    • You review a 34-year-old man with lower back pain and plan to prescribe him ibuprofen and codeine phosphate. His only past medical history of note is depression, for which he takes fluoxetine.
      Which of the following scenarios would prompt you to consider the co-prescription of a PPI for gastro-protection? Select ONE answer only.

      Your Answer: Ibuprofen dose of 400 mg TDS

      Correct Answer: Co-prescription of fluoxetine

      Explanation:

      Patients at risk of gastro-intestinal ulceration (including the elderly) who need NSAID treatment should receive gastroprotective treatment. The current recommendations by NICE suggest that gastro-protection should be considered if patients have ≥1 of the following:
      Using maximum recommended dose of an NSAID
      Aged 65 or older
      History of peptic ulcer or GI bleeding
      Concomitant use of medications that increase risk:
      Low dose aspirin
      Anticoagulants
      Corticosteroids
      Anti-depressants including SSRIs and SNRIs
      Requirements for prolonged NSAID usage:
      Patients with OA or RA at any age
      Long-term back pain if older than 45
      It is suggested that if required, either omeprazole 20 mg daily or lansoprazole 15-30 mg daily should be the PPIs of choice.
      This patient is on 400 mg of ibuprofen TDS, but the maximum recommended dose of ibuprofen is 2.4 g daily. Co-prescription of codeine, raised BMI, and a family history of peptic ulceration would also not prompt gastro-protection.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
      17.7
      Seconds
  • Question 24 - All these structures make up the portal triad EXCEPT? ...

    Correct

    • All these structures make up the portal triad EXCEPT?

      Your Answer: Branches of the hepatic vein

      Explanation:

      The portal triad, is made up of a portal arteriole (a branch of the hepatic artery), a portal venule (a branch of the hepatic portal vein) and a bile duct. Also contained within the portal triad are lymphatic vessels and vagal parasympathetic nerve fibres.

      Branches of the hepatic vein is not part of the portal triad

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      14.8
      Seconds
  • Question 25 - Regarding the phases of gastric secretion, which of the following statements is INCORRECT:...

    Incorrect

    • Regarding the phases of gastric secretion, which of the following statements is INCORRECT:

      Your Answer: The cephalic phase is initiated by the sight, smell and taste of food.

      Correct Answer: A high pH in the stomach inhibits gastrin secretion.

      Explanation:

      A low pH in the stomach inhibits gastrin secretion, therefore when the stomach is empty or when acid has been secreted for some time after food has entered it, there is inhibition of acid secretion. However, when food first enters the stomach, the pH rises, and this leads to release of the inhibition and causes a maximum secretion of gastrin. Thus gastric acid secretion is self-regulating.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      22.9
      Seconds
  • Question 26 - All of the following predisposes to lithium toxicity in patients taking long-term therapy...

    Incorrect

    • All of the following predisposes to lithium toxicity in patients taking long-term therapy EXCEPT:

      Your Answer: Infections

      Correct Answer: Hypernatraemia

      Explanation:

      A common complication of long term lithium therapy results in most cases of lithium intoxication. It is caused by reduced excretion of the drug which can be due to several factors including deterioration of renal function, dehydration, hyponatraemia, infections, and co-administration of diuretics or NSAIDs or other drugs that may interact.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      10
      Seconds
  • Question 27 - The Meissner’s plexus acts as the main control for gastrointestinal secretion and local...

    Incorrect

    • The Meissner’s plexus acts as the main control for gastrointestinal secretion and local blood flow within the gut.

      The Meissner’s plexus lies in which layer of the gut wall?

      Your Answer: Muscular layer

      Correct Answer: Submucosa

      Explanation:

      The Meissner’s plexus (submucosal plexus), an enteric nervous plexus, acts as the main control for gastrointestinal secretion and local blood flow within the gut.

      It is located in the submucosal layer on the inner surface of the muscularis externa.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      20.7
      Seconds
  • Question 28 - Which of the following medications can block the effect of adrenaline? ...

    Correct

    • Which of the following medications can block the effect of adrenaline?

      Your Answer: Beta-blockers

      Explanation:

      Beta-blockers may reduce the response to adrenaline in the treatment of anaphylactic reactions.

      Noncardioselective beta-blockers in particular can antagonize the broncho dilating and cardio stimulatory effects of adrenaline by blocking beta-2 adrenergic receptors in the smooth muscles of the bronchial tree and in the heart muscles.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      3.2
      Seconds
  • Question 29 - 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: Spironolactone

      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
      4.4
      Seconds
  • Question 30 - You examine a 34-year-old lady with symptoms that are consistent with acute sinusitis. You're...

    Incorrect

    • You examine a 34-year-old lady with symptoms that are consistent with acute sinusitis. You're thinking about giving her doxycycline for treatment.

      What is doxycycline's mechanism of action?

      Your Answer: Inhibition of nucleic acid synthesis

      Correct Answer: Inhibition of protein synthesis

      Explanation:

      Doxycycline and other tetracycline antibiotics attach to the 30S subunit of the bacterial ribosome, preventing aminoacyl-tRNA binding and so protein synthesis beginning.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      6.4
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Musculoskeletal Pharmacology (1/3) 33%
Pharmacology (6/14) 43%
Endocrine Physiology (2/2) 100%
Physiology (4/7) 57%
Cardiovascular (0/2) 0%
Haematology (1/1) 100%
Pathology (1/2) 50%
Abdomen (2/3) 67%
Anatomy (2/5) 40%
Cardiovascular Pharmacology (1/2) 50%
Respiratory Physiology (1/1) 100%
Evidence Based Medicine (0/1) 0%
Study Methodology (0/1) 0%
Infections (1/2) 50%
Abdomen And Pelvis (0/1) 0%
Central Nervous System (0/2) 0%
Endocrine (0/1) 0%
Basic Cellular Physiology (1/1) 100%
Respiratory (2/3) 67%
Anaesthesia (1/1) 100%
Microbiology (0/1) 0%
Specific Pathogen Groups (0/1) 0%
General Pathology (0/1) 0%
Gastrointestinal (0/1) 0%
Gastrointestinal Physiology (0/1) 0%
Passmed