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  • Question 1 - A 33-year-old woman demonstrates right-sided superior homonymous quadrantanopia upon visual field testing. A...

    Incorrect

    • A 33-year-old woman demonstrates right-sided superior homonymous quadrantanopia upon visual field testing. A diagnosis of a brain tumour has been established.

      Which of the following anatomical points in the visual pathway has the lesion occurred?

      Your Answer: Optic tract

      Correct Answer: Lower optic radiation

      Explanation:

      Homonymous quadrantanopia is not a disease; it is a clinical finding that points towards a lesion of the optic radiations coursing through the temporal lobe.
      Homonymous superior quadrantanopia is caused by damage to the contralateral inferior parts of the posterior visual pathway: the inferior optic radiation (temporal Meyer loop), or the inferior part of the occipital visual cortex below the calcarine fissure.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      7.2
      Seconds
  • Question 2 - Which of the following is NOT a common myeloma laboratory finding: ...

    Correct

    • Which of the following is NOT a common myeloma laboratory finding:

      Your Answer: Elevated serum Bence-Jones protein

      Explanation:

      Myeloma laboratory findings include:
      – The presence of a paraprotein in serum or urine (the paraprotein is IgG in 60 percent of cases, IgA in 20 percent, and light chain only in almost all the rest),
      – Increased serum immunoglobulin-free light chain proteins generated by plasma cells but not coupled with heavy chains 
      – Reduced IgG, IgA, and IgM levels in the blood (immune paresis)
      – Anaemia, whether normochromic, normocytic, or macrocytic. 
      – On a blood film, a Rouleaux formation has been marked.
      – In advanced illness, neutropenia and thrombocytopenia are common.
      – ESR is high.
      – Plasma cells in the bone marrow are overabundant, typically in aberrant forms. – Hypercalcemia
      – Creatinine levels are high.
      – Serum albumin levels are low in advanced illness.
      60 percent of patients have osteolytic lesions, osteoporosis, or pathological fractures.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      3.3
      Seconds
  • Question 3 - All of the following statements are correct regarding the management of acute asthma...

    Correct

    • All of the following statements are correct regarding the management of acute asthma in adults except:

      Your Answer: Intravenous aminophylline has been shown to result in significant additional bronchodilation compared to standard care.

      Explanation:

      There usually isn’t any additional bronchodilation with intravenous (IV) aminophylline compared to standard care with inhaled bronchodilators and steroids. IV aminophylline may cause side effects such as arrhythmias and vomiting. However, some additional benefit may be gained in patients with near-fatal asthma or life-threatening asthma with a poor response to initial therapy (5 mg/kg loading dose over 20 minutes unless on maintenance oral therapy, then continuous infusion of 0.5 – 0.7 mg/kg/hr).

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      9.1
      Seconds
  • Question 4 - Which of the following statements regarding the pituitary gland is CORRECT: ...

    Correct

    • Which of the following statements regarding the pituitary gland is CORRECT:

      Your Answer: Cortisol inhibits release of adrenocorticotropic hormone (ACTH) from the anterior pituitary.

      Explanation:

      Anterior pituitary hormones are released under the control of hypothalamic releasing or inhibiting hormones originating from small neurons with their cell bodies in the hypothalamus and released into the blood at the median eminence. These hypothalamic hormones are transported directly to the anterior pituitary via hypophyseal portal vessels. The anterior pituitary hormones (and the hormones released by their target organs) inhibit further release of hypothalamic and anterior pituitary hormones by negative feedback mechanisms e.g. cortisol inhibits the release of ACTH. Prolactin release from the anterior pituitary is inhibited by dopamine.The posterior pituitary is really a direct extension of the hypothalamus. Oxytocin and ADH are manufactured in the cell bodies of large neurons in the hypothalamus and are transported down the axons of these cells to their terminals on capillaries originating from the inferior hypophyseal artery within the posterior pituitary gland. ADH release is controlled by negative feedback mechanisms based on plasma osmolality and blood volume, oxytocin however is involved in positive feedback mechanisms.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      6.2
      Seconds
  • Question 5 - An ambulance transports a 72-year-old woman to the Emergency Department. She is confused,...

    Correct

    • An ambulance transports a 72-year-old woman to the Emergency Department. She is confused, has been vomiting and having stomach pains. Digoxin is one of her medications.

      Which of the following claims about digoxin is correct?

      Your Answer: Therapeutic plasma levels are between 1.0-1.5 nmol/l

      Explanation:

      Digoxin is a cardiac glycoside that is used to treat atrial fibrillation and flutter, as well as congestive heart failure. In cardiac myocytes, it works by inhibiting the membrane Na/K ATPase. Through Na/Ca exchange, this raises intracellular sodium concentration and indirectly increases intracellular calcium availability. Increased intracellular calcium levels have both a positive inotropic and negative chronotropic effect.

      Digoxin therapeutic plasma levels are typically between 1.0 and 1.5 nmol/l, though higher concentrations may be required, and the value varies between laboratories. At concentrations greater than 2 nmol/l, the risk of toxicity increases dramatically.

      In patients with normal renal function, digoxin has a long plasma half-life of 36 to 48 hours. This can take up to 5 days in patients with impaired renal function.

      Hypokalaemia, rather than hyperkalaemia, has been shown to increase the risk of digoxin toxicity.

      In the treatment of persistent and permanent atrial fibrillation, digoxin is no longer widely used. Beta-blockers, also known as rate-limiting calcium channel blockers, are now the first-line treatment for this condition.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      20.5
      Seconds
  • Question 6 - 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
      13.5
      Seconds
  • Question 7 - A patient with a diagnosis of HIV presents with a fever, sore throat,...

    Correct

    • A patient with a diagnosis of HIV presents with a fever, sore throat, and general malaise and you are concerned the patient may have an AIDS defining illness.

      Which one of these, according to the CDC definition, would mean a patient infected with HIV has AIDS?

      Your Answer: CD4 T-cell percentage of total lymphocytes of less than 15%

      Explanation:

      According to the CDC definition, a patient co-infected with HIV can be diagnosed with AIDS if he or she has:
      A CD4 T-cell count of less than 200 cells/mm3 or;
      A CD4 T-cell percentage of total lymphocytes of less than 15% or;
      An AIDS defining infection

      A Streptococcal throat infection is not an AIDS defining infection.

      A normal CD4 count ranges from 500-1000 cells/mm3. A CD4 (not CD8) count of less than 200 cells/mm3 is AIDS defining.

      The CD4 count can vary from day to day and depending upon the time that the blood test is taken. It can also be affected by the presence of other infections or illnesses. Treatment with anti-retroviral therapy should be considered at CD4 count of less than 350 cells/mm3.

      Serum concentrations of the p24 antigen (the viral protein that makes up most of the core of the HIV) are usually high in the first few weeks after human immunodeficiency virus (HIV) infection and testing for p24 antigen is therefore a useful way of diagnosing very early infection.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      9.9
      Seconds
  • Question 8 - Clostridium difficile primarily causes which of the following infectious diseases: ...

    Correct

    • Clostridium difficile primarily causes which of the following infectious diseases:

      Your Answer: Pseudomembranous colitis

      Explanation:

      Clostridium difficile causes pseudomembranous colitis, an acute inflammatory diarrhoeal disease and an important cause of morbidity and mortality in hospitals. Gas gangrene is primarily caused by Clostridium perfringens. Tetanus is caused by Clostridium tetani. Toxic shock syndrome may be caused by Staphylococcus aureus or Streptococcus pyogenes. Necrotising fasciitis is most commonly caused by Streptococcus pyogenes but has a multitude of causes.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      2.6
      Seconds
  • Question 9 - A 36-year-old man presented to the emergency room with a two-week history of...

    Correct

    • A 36-year-old man presented to the emergency room with a two-week history of shortness of breath, fevers, and malaise. A chest X-ray was ordered and the results confirmed the diagnosis of a right middle lobe pneumonia.

      Which of the following structures of the heart lies closest to the consolidation?

      Your Answer: Right atrium

      Explanation:

      In its typical anatomical orientation, the heart has 5 surfaces formed by different internal divisions of the heart:

      Anterior (or sternocostal) – Right ventricle
      Posterior (or base) – Left atrium
      Inferior (or diaphragmatic) – Left and right ventricles
      Right pulmonary – Right atrium
      Left pulmonary – Left ventricle

      The silhouette sign of Felson is with respect to the right middle lobe. The right heart border should have a distinct appearance due to the right atrium abutting aerated right middle lobe. The consolidation in the right middle lobe has resulted in loss of this silhouette.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      29.3
      Seconds
  • Question 10 - An ambulance transports a 23-year-old woman who has taken a witnessed overdose of...

    Correct

    • An ambulance transports a 23-year-old woman who has taken a witnessed overdose of her mother's diazepam tablets. She has no significant medical history and does not take any medications on a regular basis.

      In this case, what is the SINGLE MOST APPROPRIATE FIRST DRUG TREATMENT?

      Your Answer: Flumazenil IV 200 μg

      Explanation:

      Flumazenil is a benzodiazepine antagonist that can be helpful in some overdose situations. It works quickly (in less than a minute), but the effects are fleeting, lasting less than an hour. The dose is 200 micrograms every 1-2 minutes with a maximum dose of 3 milligrams per hour.

      Flumazenil should be avoided by patients who are addicted to benzodiazepines or who take tricyclic antidepressants because it can cause withdrawal symptoms. It can cause seizures or cardiac arrest in these situations.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
      11.3
      Seconds
  • Question 11 - Identify the type of graph described below:

    This graph has been used to create...

    Incorrect

    • Identify the type of graph described below:

      This graph has been used to create visual representations to communicate the risks and benefits of treatments using 4 face categories.

      Your Answer: Funnel plot

      Correct Answer: Cates plot

      Explanation:

      Cates Plot, since 1999, has been used to create visual representations to communicate the risks and benefits of treatments. The essence of Cates Plot is the use of 4 face categories to visually indicate the following:

      People not affected by a treatment (green faces for those with a good outcome and red for those with a bad outcome)
      People for which treatment changes their category from a bad outcome to a good outcome (yellow faces)
      People for which treatment causes an adverse event and changes their category from a good outcome to a bad outcome (crossed out green faces)

    • This question is part of the following fields:

      • Evidence Based Medicine
      144.3
      Seconds
  • Question 12 - A 33-year-old woman who is investigated for recurrent renal stones is discovered to...

    Incorrect

    • A 33-year-old woman who is investigated for recurrent renal stones is discovered to have a markedly elevated parathyroid hormone (PTH) level.
      Which of the following would stimulate PTH release under normal circumstances? Select ONE answer only.

      Your Answer: Decreased plasma phosphate concentration

      Correct Answer: Decreased plasma calcium concentration

      Explanation:

      Parathyroid hormone (PTH) is a polypeptide containing 84 amino acids. It is the principal controller of free calcium in the body.
      PTH is synthesised by and released from the chief cells of the four parathyroid glands that are located immediately behind the thyroid gland.
      PTH is released in response to the following stimuli:
      Decreased plasma calcium concentration
      Increased plasma phosphate concentration (indirectly by binding to plasma calcium and reducing the calcium concentration)
      PTH release is inhibited by the following factors:
      Normal/increased plasma calcium concentration
      Hypomagnesaemia
      The main actions of PTH are:
      Increases plasma calcium concentration
      Decreases plasma phosphate concentration
      Increases osteoclastic activity (increasing calcium and phosphate resorption from bone)
      Increases renal tubular reabsorption of calcium
      Decreases renal phosphate reabsorption
      Increases renal conversion of 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol (via stimulation of 1-alpha hydroxylase)
      Increases calcium and phosphate absorption in the small intestine (indirectly via increased 1,25-dihydroxycholecalciferol)

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      6.8
      Seconds
  • Question 13 - You are examining the lower limbs of a 54 year old man who...

    Correct

    • You are examining the lower limbs of a 54 year old man who presented after falling from a ladder at home. During your neurological assessment you note a weakness of hip flexion. Which of the following nerves is the most important for flexion of the thigh at the hip joint:

      Your Answer: Femoral nerve

      Explanation:

      Flexion of the thigh at the hip joint is produced by the sartorius, psoas major, iliacus and pectineus muscles, assisted by the rectus femoris muscle, all innervated by the femoral nerve (except for the psoas major, innervated by the anterior rami of L1 – 3).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      5.8
      Seconds
  • Question 14 - A 63 year old lady presents to ED with a persistent cough and...

    Incorrect

    • A 63 year old lady presents to ED with a persistent cough and red currant jelly sputum. She has a history of chronic alcohol abuse and has an X-ray which demonstrates a cavitating pneumonia. The most likely causative pathogen is:

      Your Answer: Staphylococcus aureus

      Correct Answer: Klebsiella pneumoniae

      Explanation:

      One of the results of Klebsiella pneumoniae is pneumonia that is usually a very severe infection. It is characterised by thick, bloody sputum (red currant jelly sputum), and is associated with complications like lung abscess, cavitation, necrosis, empyema and pleural effusions.

    • This question is part of the following fields:

      • Infections
      • Microbiology
      5
      Seconds
  • Question 15 - A 40-year-old man complains of pain and redness in his lower thigh due...

    Incorrect

    • A 40-year-old man complains of pain and redness in his lower thigh due to an insect bite. He was diagnosed with cellulitis. Select the first-line antibiotic for cellulitis.

      Your Answer: Metronidazole

      Correct Answer: Flucloxacillin

      Explanation:

      Cellulitis is most commonly caused by bacteria from the group Aß-hemolytic streptococcus.

      Cellulitis can be caused by animal bites. For uncomplicated cellulitis, flucloxacillin is the first-line antibiotic. Because it is beta-lactamase stable, it is efficient against Staphylococcus aureus.

    • This question is part of the following fields:

      • Infections
      • Microbiology
      5
      Seconds
  • Question 16 - You are prescribing ipratropium bromide for a patient who has presented with an...

    Incorrect

    • You are prescribing ipratropium bromide for a patient who has presented with an exacerbation of her COPD. What is the mechanism of action of ipratropium bromide:

      Your Answer: Beta-blocker

      Correct Answer: Muscarinic antagonist

      Explanation:

      Ipratropium bromide is an antimuscarinic drug used in the management of acute asthma and COPD. It can provide short-term relief in chronic asthma, but short-acting β2agonists act more quickly and are preferred.

      The BTS guidelines recommend that nebulised ipratropium bromide (0.5 mg 4-6 hourly) can be added to β2agonist treatment for patients with acute severe or life-threatening asthma or those with a poor initial response to β2 agonist therapy.
      The aerosol inhalation of ipratropium can be used for short-term relief in mild chronic obstructive pulmonary disease in patients who are not already using a long-acting antimuscarinic drug (e.g. tiotropium).

      Its maximum effect occurs 30-60 minutes after use; its duration of action is 3-6 hours, and bronchodilation can usually be maintained with treatment three times per day.
      The commonest side effect of ipratropium bromide is dry mouth. It can also trigger acute closed-angle glaucoma in susceptible patients. Tremor is commonly seen with β2agonists but not with antimuscarinics. Ipratropium bromide should be used with caution in: Men with prostatic hyperplasia and bladder-outflow obstruction (worsened urinary retention has been reported in elderly men), People with chronic kidney disease (CKD) stages 3 and above (because of the risk of drug toxicity), People with angle-closure glaucoma (nebulised mist of antimuscarinic drugs can precipitate or worsen acute angle-closure glaucoma)

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      4.9
      Seconds
  • Question 17 - Elevation of the mandible is produced primarily by which of the following muscles:...

    Incorrect

    • Elevation of the mandible is produced primarily by which of the following muscles:

      Your Answer: Temporalis, geniohyoid and mylohyoid

      Correct Answer: Temporalis, masseter and medial pterygoid

      Explanation:

      Elevation of the mandible is generated by the temporalis, masseter and medial pterygoid muscles.

    • This question is part of the following fields:

      • Anatomy
      • Head And Neck
      8
      Seconds
  • Question 18 - A 77 year old lady presents to ED with her left leg shortened...

    Incorrect

    • A 77 year old lady presents to ED with her left leg shortened and externally rotated following slipping and falling on a wet bathroom floor. There is an intracapsular fracture of the neck of femur seen on imaging studies. She is at risk of avascular necrosis of the head of femur.

      This is caused by lack of blood supply from which of these arteries?

      Your Answer: Obturator artery

      Correct Answer: Medial circumflex artery

      Explanation:

      The primary blood supply to the head of the femur is from branches of the medial femoral circumflex artery.

      The superior and inferior gluteal arteries supply the hip joint but not the head of femur.

      The lateral circumflex artery anastomoses with the medial femoral circumflex artery and assists in supplying the head of femur.

      The obturator artery is an important source of blood supply in children up to about 8 years. It gives rise to the artery of the head of femur which runs in the ligamentum teres and is insufficient to supply the head of femur in adults.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      5.2
      Seconds
  • Question 19 - Regarding control of hospital acquired infection (HAI), which of the following statements is...

    Incorrect

    • Regarding control of hospital acquired infection (HAI), which of the following statements is CORRECT:

      Your Answer: Autoclaving is a method of disinfection.

      Correct Answer: Chlorhexidine is an anti-staphylococcal agent.

      Explanation:

      Chlorhexidine is an anti-staphylococcal agent. Cleaning is the removal of foreign material from areas or objects to a point at which they are visually free from debris.  Disinfection is the reduction in the number of infectious particles. Isopropyl alcohol is not effective against C. difficile spores. Autoclaving is a method of sterilisation.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      7.7
      Seconds
  • Question 20 - About what percentage of patients with hepatitis A develop chronic infection: ...

    Incorrect

    • About what percentage of patients with hepatitis A develop chronic infection:

      Your Answer: 0.05

      Correct Answer: None

      Explanation:

      Chronic hepatitis and carrier state does not occur in hepatitis A infection and complete immunity is attained after infection.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      14.4
      Seconds
  • Question 21 - A 39-year-old man with a long history of depression presents after intentionally overdoing...

    Incorrect

    • A 39-year-old man with a long history of depression presents after intentionally overdoing his heart medication. Verapamil immediate-release 240 mg is the tablet he takes for this condition, he says. He took the pills about 30 minutes ago, but his wife discovered him right away and rushed him to the emergency room.

      At the moment, he is completely symptom-free. When it comes to this type of overdose, how long does it usually take for symptoms to appear?

      Your Answer: 8-12 hours

      Correct Answer: 1-2 hours

      Explanation:

      Overdosing on calcium-channel blockers should always be taken seriously and regarded as potentially fatal. Verapamil and diltiazem are the two most lethal calcium channel blockers in overdose. These work by binding the alpha-1 subunit of L-type calcium channels, preventing calcium from entering the cell. In cardiac myocytes, vascular smooth muscle cells, and islet beta-cells, these channels play an important role.

      >10 tablets of verapamil (160 mg or 240 mg immediate or sustained-release capsules) or diltiazem can cause serious toxicity (180 mg, 240 mg or 360 mg immediate or sustained-release capsules)

      In children, 1-2 tablets of verapamil or diltiazem (immediate or sustained-release)

      Symptoms usually appear within 1-2 hours of ingestion with standard preparations. However, with slow-release preparations, significant toxicity may take 12-16 hours to manifest, with peak effects occurring after 24 hours.

      The following are the main clinical features of calcium-channel blocker overdose:
      Nausea and vomiting
      Hypotension
      Bradycardia and first-degree heart block
      Myocardial ischaemia and stroke
      Renal failure
      Pulmonary oedema
      Hyperglycaemia

      The following are some of the most important bedside investigations to conduct:
      Blood glucose
      ECG
      Arterial blood gas
      Other investigations that can be helpful include
      Urea & electrolytes
      Chest X-ray (pulmonary oedema)
      Echocardiography

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      6.4
      Seconds
  • Question 22 - A 50-year-old man managed by the renal team for stage 4 chronic kidney...

    Incorrect

    • A 50-year-old man managed by the renal team for stage 4 chronic kidney disease which appears to be deteriorating presents with a history of shortness of breath and ankle oedema. His most recent blood tests shows low calcium levels.

      Which of these increases the renal reabsorption of calcium?

      Your Answer: Calcitonin

      Correct Answer: Parathyroid hormone

      Explanation:

      Parathyroid hormone (PTH), a polypeptide containing 84 amino acids, is the principal hormone that controls free calcium in the body.

      Its main actions are:
      Increases osteoclastic activity
      Increases plasma calcium concentration
      Decreases renal phosphate reabsorption
      Decreases plasma phosphate concentration
      Increases renal tubular reabsorption of calcium
      Increases calcium and phosphate absorption in the small intestine
      Increases renal conversion of 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      11.3
      Seconds
  • Question 23 - A 10-year-old girl that appears systemically well presents with a honey-crusted scab close...

    Incorrect

    • A 10-year-old girl that appears systemically well presents with a honey-crusted scab close to the corner of her mouth and states that the area is slightly itchy but not painful. The diagnosis given was impetigo.

      What is most likely the mode of transmission of the causative agent of the said diagnosis?

      Your Answer: Faeco-oral transmission

      Correct Answer: Direct contact

      Explanation:

      Impetigo is a common pyoderma that is most often seen in children. Historically, most cases were caused by group A streptococci (GAS; Streptococcus pyogenes), although S. aureus has become the predominant pathogen over the last 15 years.

      A bullous form of impetigo accounts for approximately 10% of cases. It is caused by strains of S. aureus that produce exfoliative toxins leading to the formation of bullae, which quickly rupture and form a transparent, light brown crust.

      Impetigo is spread mainly by person-to-person contact; it is rapidly spread through direct transmission. The diagnosis of impetigo can be made from a Gram stain and culture of the vesicular contents.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      5.3
      Seconds
  • Question 24 - Which of these cell types in the stomach releases pepsinogen? ...

    Incorrect

    • Which of these cell types in the stomach releases pepsinogen?

      Your Answer: G-cells

      Correct Answer: Chief cells

      Explanation:

      The gastric chief cells in the stomach wall releases pepsinogen. Pepsinogen is a proenzyme. It mixes with hydrochloric acid in the stomach and is converted to pepsin. Pepsin breaks down proteins into peptides aiding protein digestion.

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      9.2
      Seconds
  • Question 25 - A patient suffers from an injury to his hip and thigh. As a...

    Incorrect

    • A patient suffers from an injury to his hip and thigh. As a consequence of his injury, the nerve that was damaged innervates the obturator externus muscle.

      In which of the following nerves is the obturator externus muscle innervated by?

      Your Answer: Anterior branch of the obturator nerve

      Correct Answer: Posterior branch of the obturator nerve

      Explanation:

      The obturator externus is innervated by the posterior branch of the obturator nerve, L2-L4.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      6.7
      Seconds
  • Question 26 - A 42-year-old patient with worsening epigastric pain has been referred to you by...

    Incorrect

    • A 42-year-old patient with worsening epigastric pain has been referred to you by a GP. The patient has been taking omeprazole for a month, but her symptoms are getting worse.

      Which of the following is NOT a well-known side effect of proton pump inhibitor treatment?

      Your Answer: Constipation

      Correct Answer: Pelvic fracture

      Explanation:

      Proton pump inhibitors (PPIs) have a variety of side effects, including:
      Vomiting and nausea
      Pain in the abdomen
      Flatulence
      Diarrhoea
      Constipation
      Headache

      PPIs have been linked to a significant increase in the risk of focal tachyarrhythmias (link is external).
      Low serum magnesium and sodium levels have been linked to long-term use of PPIs, according to the US Food and Drug Administration (link is external).

      Long-term PPI use has also been linked to an increased risk of fracture, according to epidemiological evidence (link is external). Observational studies have discovered a slight link between hip, wrist, and spine fractures. However, there is no link between the two and an increased risk of pelvic fracture. For this reason, the MHRA recommends that patients at risk of osteoporosis who take PPIs maintain an adequate calcium and vitamin D intake.

    • This question is part of the following fields:

      • Gastrointestinal Pharmacology
      • Pharmacology
      8.6
      Seconds
  • Question 27 - A patient suffered from a chest injury while working out in the gym....

    Incorrect

    • A patient suffered from a chest injury while working out in the gym. As a consequence of his injury, his pectoralis minor muscle was damaged.

      Which of the following statements regarding the pectoralis minor muscle is considered correct?

      Your Answer: It overlies pectoralis major

      Correct Answer: It stabilises the scapula

      Explanation:

      The pectoralis minor, in comparison to the pectoralis major, is much thinner and triangular in shape and resides below the major. It originates from the margins of the third to fifth ribs adjacent to the costochondral junction. The fibres consequently pass upward and laterally to insert into the medial border and superior surface of the coracoid process. It is crucial in the stabilization of the scapula by pulling it downward and anteriorly against the thoracic wall.

      Arterial supply to the pectoralis minor also derives from the pectoral branch of the thoracoacromial trunk. Nerve supply of the pectoralis minor is a function of the lateral pectoral nerve and the medial pectoral nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      3
      Seconds
  • Question 28 - Insulin is produced by which of the following pancreatic cells: ...

    Incorrect

    • Insulin is produced by which of the following pancreatic cells:

      Your Answer: α cells

      Correct Answer: β cells

      Explanation:

      Insulin is produced by beta cells, located centrally within the islets of Langerhans, in the endocrine tissues of the pancreas. Insulin is a polypeptide hormone consisting of two short chains (A and B) linked by disulphide bonds. Proinsulin is synthesised as a single-chain peptide. Within storage granules, a connecting peptide (C peptide) is removed by proteases to yield insulin. Insulin release is stimulated initially during eating by the parasympathetic nervous system and gut hormones such as secretin, but most output is driven by the rise in plasma glucose concentration that occurs after a meal. The effects of insulin are mediated by the receptor tyrosine kinase.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      4.3
      Seconds
  • Question 29 - EMLA cream is a topical local anaesthetic containing which of the following: ...

    Incorrect

    • EMLA cream is a topical local anaesthetic containing which of the following:

      Your Answer: 50/50 mixture 2.5% lidocaine and 2.5% bupivacaine

      Correct Answer: 50/50 mixture 2.5% lidocaine and 2.5% prilocaine

      Explanation:

      EMLA cream, an effective topical local anaesthetic, is a 50/50 mixture of 2.5% prilocaine and 2.5% lidocaine.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      2.5
      Seconds
  • Question 30 - 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:

      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
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (5/7) 71%
Central Nervous System (0/1) 0%
Haematology (1/1) 100%
Pathology (1/1) 100%
Pharmacology (9/9) 100%
Respiratory (3/3) 100%
Endocrine (2/2) 100%
Physiology (3/5) 60%
Cardiovascular Pharmacology (2/2) 100%
Microbiology (6/7) 86%
Specific Pathogen Groups (1/1) 100%
Pathogens (1/2) 50%
Thorax (1/1) 100%
CNS Pharmacology (1/1) 100%
Endocrine Physiology (1/2) 50%
Lower Limb (2/3) 67%
Infections (2/2) 100%
Head And Neck (1/1) 100%
Principles (1/1) 100%
Principles Of Microbiology (1/1) 100%
Gastrointestinal Physiology (0/1) 0%
Gastrointestinal Pharmacology (1/1) 100%
Upper Limb (1/1) 100%
Anaesthesia (2/2) 100%
Passmed