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  • Question 1 - You examine a 48-year-old woman's blood results and notice that her glucose level...

    Correct

    • You examine a 48-year-old woman's blood results and notice that her glucose level is elevated. When you tell her about it, she tells you that her doctor recently ran some tests and discovered that she has impaired glucose tolerance.

      Which of the following medications has not been linked to a reduction in glucose tolerance?

      Your Answer: Amlodipine

      Explanation:

      The following drugs have been linked to impaired glucose tolerance:
      Thiazide diuretics, e.g. Bendroflumethiazide
      Loop diuretics, e.g. furosemide
      Steroids, e.g. prednisolone
      Beta-blockers, e.g. atenolol

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      192.1
      Seconds
  • Question 2 - Which of the following cell types in the stomach secretes histamine? ...

    Incorrect

    • Which of the following cell types in the stomach secretes histamine?

      Your Answer: Chief cells

      Correct Answer: Enterochromaffin-like cells

      Explanation:

      The parietal cells operate in close association with another type of cell called enterochromaffin-like cells (ECL cells), the primary function of which is to secrete histamine. The ECL cells lie in the deep recesses of the oxyntic glands and therefore release histamine indirect contact with the parietal cells of the glands.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      868.8
      Seconds
  • Question 3 - You note that the prostate of a 60-year-old patient is enlarged during the...

    Correct

    • You note that the prostate of a 60-year-old patient is enlarged during the examination. You suspect BPH. Anatomically, the prostate has four main lobes. Which of the lobes is affected by benign prostatic hypertrophy?

      Your Answer: Median lobe

      Explanation:

      Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is characterized by an enlarged prostate gland.

      The prostate is divided into four major lobes. The median lobe is the most commonly affected by benign prostatic enlargement, resulting in urethral obstruction and urine symptoms.

    • This question is part of the following fields:

      • Abdomen
      • Anatomy
      15.2
      Seconds
  • Question 4 - A 29-year-old female with chronic anaemia secondary to sickle cell disease is being...

    Correct

    • A 29-year-old female with chronic anaemia secondary to sickle cell disease is being transfused. A few minutes after starting the blood transfusion, she develops widespread itching with urticarial rash, wheezing, nausea and chest pain. Her BP reduces to 60/40 mmHg.

      What is the most appropriate treatment?

      Your Answer: Stop the transfusion and administer adrenaline

      Explanation:

      Anaphylaxis transfusion reaction occurs when an individual has previously been sensitized to an allergen present in the blood and, on re-exposure, releases IgE or IgG antibodies. Patients with anaphylaxis usually develop laryngospasm, bronchospasm, abdominal pain, nausea, vomiting, hypotension, shock, and loss of consciousness. The transfusion should be stopped immediately and the patient should be treated with adrenaline, oxygen, corticosteroids, and antihistamines.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      112.2
      Seconds
  • Question 5 - Identify the type of graph described below:

    A graph that is a useful summary...

    Incorrect

    • Identify the type of graph described below:

      A graph that is a useful summary of a set of bivariate data (two variables), usually drawn before working out a linear correlation coefficient or fitting a regression line.

      Your Answer: Histogram

      Correct Answer: Scatterplot

      Explanation:

      A scatterplot is a useful summary of a set of bivariate data (two variables), usually drawn before working out a linear correlation coefficient or fitting a regression line. It gives a good visual picture of the relationship between the two variables, and aids the interpretation of the correlation coefficient or regression model. Each unit contributes one point to the scatterplot, on which points are plotted but not joined. The resulting pattern indicates the type and strength of the relationship between the two variables.

    • This question is part of the following fields:

      • Evidence Based Medicine
      223
      Seconds
  • Question 6 - 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
      317.2
      Seconds
  • Question 7 - Which of the following is a common adverse effect of glucagon: ...

    Incorrect

    • Which of the following is a common adverse effect of glucagon:

      Your Answer:

      Correct Answer: Nausea

      Explanation:

      Adverse effects include:
      Common: Nausea
      Uncommon: Vomiting
      Rare: Abdominal pain, hypertension, hypotension, tachycardia

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
      0
      Seconds
  • Question 8 - Swelling of the lips, tongue, and face is observed in a 59-year-old African-American...

    Incorrect

    • Swelling of the lips, tongue, and face is observed in a 59-year-old African-American woman. In the emergency room, she is given intramuscular adrenaline, but her symptoms do not improve. Her GP recently started her on a new medication.

      Which of the following drugs is most likely to have caused her symptoms?

      Your Answer:

      Correct Answer: Ramipril

      Explanation:

      Angiotensin-converting enzyme (ACE) inhibitors are the most common cause of drug-induced angioedema in the United Kingdom and the United States, owing to their widespread use.

      Angioedema is caused by ACE inhibitors in 0.1 to 0.7 percent of patients, with data indicating a persistent and relatively constant risk year after year. People of African descent have a five-fold higher chance of contracting the disease.

      Swelling of the lips, tongue, or face is the most common symptom, but another symptom is episodic abdominal pain due to intestinal angioedema. Itching and urticaria are noticeably absent.

      The mechanism appears to be activated complement or other pro-inflammatory cytokines like prostaglandins and histamine, which cause rapid vasodilation and oedema.

      Other medications that are less frequently linked to angioedema include:
      Angiotensin-receptor blockers (ARBs)
      Nonsteroidal anti-inflammatory drugs (NSAIDs)
      Bupropion (e.g. Zyban and Wellbutrin)
      Beta-lactam antibiotics
      Statins
      Proton pump inhibitors

      The majority of these reactions are minor and can be treated by stopping the drug and prescribing antihistamines.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 9 - The syndrome of inappropriate antidiuresis due to excessive antidiuretic hormone (ADH) secretion is...

    Incorrect

    • The syndrome of inappropriate antidiuresis due to excessive antidiuretic hormone (ADH) secretion is diagnosed in a male patient with a history of recurrent hyponatraemia.

      Which of the following produces ADH?

      Your Answer:

      Correct Answer: Hypothalamus

      Explanation:

      Antidiuretic hormone (ADH), commonly known as vasopressin, is a peptide hormone that controls how much water the body retains.

      It is produced in the magnocellular and parvocellular neurosecretory cells of the paraventricular nucleus and supraoptic nucleus in the hypothalamus from a prohormone precursor. It is subsequently carried to the posterior pituitary via axons and stored in vesicles.

      The secretion of ADH from the posterior pituitary is regulated by numerous mechanisms:
      Increased plasma osmolality: Osmoreceptors in the hypothalamus detect an increase in osmolality and trigger ADH release.

      Stretch receptors in the atrial walls and big veins detect a decrease in atrial pressure as a result of this (cardiopulmonary baroreceptors). ADH release is generally inhibited by atrial receptor firing, but when the atrial receptors are stretched, the firing reduces and ADH release is promoted.
      Hypotension causes baroreceptor firing to diminish, resulting in increased sympathetic activity and ADH release.
      An increase in angiotensin II stimulates angiotensin II receptors in the hypothalamus, causing ADH production to increase.

      The main sites of action for ADH are:
      The kidney is made up of two parts. ADH’s main job is to keep the extracellular fluid volume under control. It increases permeability to water by acting on the renal collecting ducts via V2 Receptors (via a camp-dependent mechanism). This leads to a decrease in urine production, an increase in blood volume, and an increase in arterial pressure as a result.

      Vascular system: Vasoconstriction is a secondary function of ADH. ADH causes vasoconstriction via binding to V1 Receptors on vascular smooth muscle (via the IP3 signal transduction pathway). An increase in arterial pressure occurs as a result of this.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      0
      Seconds
  • Question 10 - For the treatment of his atrial fibrillation, a 67-year-old man is about to...

    Incorrect

    • For the treatment of his atrial fibrillation, a 67-year-old man is about to begin taking warfarin. He also takes a number of other medications.

      Which of the following medications will prevent warfarin from working?

      Your Answer:

      Correct Answer: Phenytoin

      Explanation:

      Many medications, including warfarin, require cytochrome P450 enzymes for their metabolism. When co-prescribing cytochrome p450 enzyme inducers and inhibitors with warfarin, it’s critical to be cautious.

      Inhibitors of the cytochrome p450 enzyme inhibit the effects of warfarin, resulting in a lower INR. To remember the most commonly encountered cytochrome p450 enzyme inducers, use the mnemonic PC BRASS:

      P– Phenytoin
      C– Carbamazepine
      B– Barbiturates
      R– Rifampicin
      A– Alcohol (chronic ingestion)
      S– Sulphonylureas
      S– Smoking

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 11 - Which among the following antibacterial regimens is considered the most appropriate to prescribe...

    Incorrect

    • Which among the following antibacterial regimens is considered the most appropriate to prescribe in a patient presenting with clinical signs and symptoms consistent with a diagnosis of pelvic inflammatory disease?

      Your Answer:

      Correct Answer: Ceftriaxone plus doxycycline plus metronidazole

      Explanation:

      The endocervix is the most common site of Neisseria gonorrhoeae infection in women. Symptoms of infection, when present, include dysuria, cervical discharge, and lower abdominal pain. However, 50% of cases in women may be asymptomatic leading to complications such as pelvic inflammatory disease (PID), which may cause sterility, ectopic pregnancy, or perihepatitis.

      PID is also known as Fitz-Hugh-Curtis syndrome is defined as an inflammation of the upper genital tract due to an infection in women. The disease affects the uterus, fallopian tubes, and ovaries. It is typically an ascending infection, spreading from the lower genital tract.

      The recommended intramuscular or oral regimens for PID are as follows:

      Ceftriaxone at 500 mg IM in a single dose (for persons weighing ≥150 kg, administer 1 g of ceftriaxone); plus doxycycline at 100 mg PO BID for 14 days with metronidazole at 500 mg PO BID for 14 days.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 12 - Streptococcus pneumoniae is commonly implicated in all of the following infectious diseases EXCEPT...

    Incorrect

    • Streptococcus pneumoniae is commonly implicated in all of the following infectious diseases EXCEPT for:

      Your Answer:

      Correct Answer: Impetigo

      Explanation:

      Impetigo is a highly contagious infection of the superficial epidermis that most commonly affects young children but can occur in any age group. In children it is the most common bacterial skin infection and it is the third most common skin disease overall, behind dermatitis and viral warts.
      The commonest causative organism is Staphylococcus aureus. Streptococcus pyogenesis the second commonest and causes fewer cases, either alone or in combination withS. aureus.The streptococcal form tends to be commoner in warmer, more humid climates. (Hirschmann JV. Impetigo: etiology and therapy. Curr Clin Top Infect Dis. 2002;22:42–51.)
      Impetigo is most commonly spread by direct person-to-person contact, and can spread rapidly through families and school classes. It can also, less commonly, be spread by indirect contact.
      There are two main forms of impetigo:
      Non-bullous impetigo – lesions usually start as tiny pustules or vesicles that evolve rapidly into honey-crusted plaques that tend to be under 2 cm in diameter. These can be itchy but are rarely painful.
      Bullous impetigo – lesions have a thin roof and tend to rupture spontaneously. This type is more likely to be painful and may be associated with systemic upset.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds
  • Question 13 - In a ward round, you come across a patient's treatment chart prescribed an...

    Incorrect

    • In a ward round, you come across a patient's treatment chart prescribed an antibiotic to fight his infection. This antibiotic is an inhibitor of cell wall synthesis.

      Which of the following antimicrobial drugs is prescribed to this patient?

      Your Answer:

      Correct Answer: Benzylpenicillin

      Explanation:

      Penicillins and cephalosporins are the major antibiotics that inhibit bacterial cell wall synthesis. They inactivate transpeptidases that help cross-link peptidoglycans in cell walls.

      Isoniazid decreases the synthesis of mycolic acids in mycobacterium.

      Clarithromycin binds to the 50S subunit of ribosomes and inhibits protein synthesis.

      Metronidazole and the other 5-nitroimidazole agents inhibit nucleic acid synthesis by forming toxic free radical metabolites in the bacterial cell that damage DNA.

      Tetracycline bind to 30S and prevent attachment of aminoacyl-tRNA.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds
  • Question 14 - A 71-year-old woman presents with complaints of fatigue and worsening muscle weakness, and...

    Incorrect

    • A 71-year-old woman presents with complaints of fatigue and worsening muscle weakness, and blood tests done shows a potassium level of 2.4 mmol/L.

      Which is NOT a recognised cause of hypokalaemia?

      Your Answer:

      Correct Answer: Type 4 renal tubular acidosis

      Explanation:

      A plasma potassium less than 3.5 mmol/L defines hypokalaemia.

      Excessive liquorice ingestion causes hypermineralocorticoidism and leads to hypokalaemia.

      Gitelman’s syndrome causes metabolic alkalosis with hypokalaemia and hypomagnesaemia. It is an inherited defect of the distal convoluted tubules.

      Bartter’s syndrome causes hypokalaemic alkalosis. It is a rare inherited defect in the ascending limb of the loop of Henle.

      Type 1 and 2 renal tubular acidosis both cause hypokalaemia

      Type 4 renal tubular acidosis causes hyperkalaemia.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      0
      Seconds
  • Question 15 - Which of the following is NOT an effect of benzodiazepines: ...

    Incorrect

    • Which of the following is NOT an effect of benzodiazepines:

      Your Answer:

      Correct Answer: Analgesic effect

      Explanation:

      Benzodiazepines are gamma-aminobutyric acid (GABA) receptor agonists which enhance inhibitory synaptic transmission throughout the central nervous system, with sedative, hypnotic, anxiolytic, anticonvulsant, amnesic and muscle relaxant properties.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      0
      Seconds
  • Question 16 - Which of the following best describes the correct administration of adrenaline for a...

    Incorrect

    • Which of the following best describes the correct administration of adrenaline for a shockable rhythm in adult advanced life support?

      Your Answer:

      Correct Answer: Give 1 mg of adrenaline after the second shock and every 3 - 5 minutes thereafter

      Explanation:

      Give adrenaline 1 mg IV (IO) (10 mL of 1:10,000 solution) after the 2nd shock for adult patients in cardiac arrest with a shockable rhythm. Repeat adrenaline 1 mg IV (IO) every 3-5 minutes whilst ALS continues.

      Figure 3. Adult Cardiac Arrest Algorithm

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds
  • Question 17 - Which of the following statements concerning the facial nerve is INCORRECT? ...

    Incorrect

    • Which of the following statements concerning the facial nerve is INCORRECT?

      Your Answer:

      Correct Answer: Forehead sparing in facial nerve palsy is indicative of a lower motor neuron lesion.

      Explanation:

      In facial nerve palsy, LMN damage will involve the forehead and there will be an inability to close the eyes due to paralysis of the orbicularis oculi or raise the eyebrows due to paralysis of the occipitofrontalis muscle.
      UMN damage causes sparing of the forehead as the occipitofrontalis and orbicularis oculi muscles have bilateral cortical representation.

    • This question is part of the following fields:

      • Anatomy
      • Cranial Nerve Lesions
      0
      Seconds
  • Question 18 - A lesion to which part of the optic radiation will result in contralateral...

    Incorrect

    • A lesion to which part of the optic radiation will result in contralateral homonymous inferior quadrantanopia?

      Your Answer:

      Correct Answer: Right parietal lobe

      Explanation:

      A visual loss in the lower left quadrant in both visual fields is an indication of an inferior homonymous. This is due to a lesion of the superior fibres of the optic radiation in the parietal lobe on the contralateral side of the visual pathway.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds
  • Question 19 - 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:

      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
      0
      Seconds
  • Question 20 - 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:

      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
      0
      Seconds
  • Question 21 - You intend to suture a hand wound with plain 1 percent lidocaine.

    In 1...

    Incorrect

    • You intend to suture a hand wound with plain 1 percent lidocaine.

      In 1 mL of plain 1 percent lidocaine solution, how much lidocaine hydrochloride is there?

      Your Answer:

      Correct Answer: 10 mg lidocaine hydrochloride

      Explanation:

      10 mg of lidocaine hydrochloride is contained in each 1 mL of plain 1 percent lidocaine solution.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      0
      Seconds
  • Question 22 - Following a phone call from the microbiology consultant, you evaluate a patient who...

    Incorrect

    • Following a phone call from the microbiology consultant, you evaluate a patient who has been diagnosed with urinary sepsis. Following the results of the blood cultures, he recommends that you add gentamicin to the patient's antibiotic treatment.

      Gentamicin produces its pharmacological effect by binding to which of the following?

      Your Answer:

      Correct Answer: The 30S subunit of the bacterial ribosome

      Explanation:

      Antibiotics with aminoglycosides, such as gentamicin, bind to the 30S subunit of the bacterial ribosome and prevent aminoacyl-tRNA from binding, preventing protein synthesis.

      They also cause mRNA misreading, resulting in the production of non-functional proteins. This last mechanism is unique to aminoglycosides, and it may explain why they are bactericidal rather than bacteriostatic, as other protein synthesis inhibitors are.

      Patients with myasthenia gravis should avoid aminoglycosides since they can disrupt neuromuscular transmission. They cross the placenta and are linked to poisoning of the 8th cranial nerve in the foetus, as well as permanent bilateral deafness.

      It is possible that they will cause deafness, although this is not a contraindication. In individuals with renal impairment, serum aminoglycoside concentrations should be closely monitored, but this is still not considered a contraindication.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds
  • Question 23 - Which of the following is NOT a characteristic of megaloblastic anaemia? ...

    Incorrect

    • Which of the following is NOT a characteristic of megaloblastic anaemia?

      Your Answer:

      Correct Answer: Raised reticulocyte count

      Explanation:

      The LDH level is usually markedly increased in severe megaloblastic anaemia. Reticulocyte counts are inappropriately low, representing a lack of production of RBCs due to massive intramedullary haemolysis. These findings are characteristics of ineffective haematopoiesis that occurs in megaloblastic anaemia as well as in other disorders such as thalassemia major.
      The common feature in megaloblastosis is a defect in DNA synthesis in rapidly dividing cells. To a lesser extent, RNA and protein synthesis are impaired. Unbalanced cell growth and impaired cell division occur since nuclear maturation is arrested. More mature RBC precursors are destroyed in the bone marrow prior to entering the bloodstream (intramedullary haemolysis).

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 24 - A 58-year-old woman presents with symptoms of increase in weight, proximal muscular weakening...

    Incorrect

    • 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.

      Cushing's syndrome is most commonly caused by which of the following?

      Your Answer:

      Correct Answer: Iatrogenic administration of corticosteroids

      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.

      Iatrogenic corticosteroid injection is the most prevalent cause of Cushing’s syndrome. Cushing’s illness is the second most prevalent cause of Cushing’s syndrome. Cushing’s disease is distinct from Cushing’s syndrome in that it refers to a single cause of the illness, a pituitary adenoma that secretes high quantities of ACTH, which raises cortisol levels.

      Cushing’s syndrome has several endogenous sources, including:
      Cushing’s disease is caused by a pituitary adenoma.
      Adrenal adenoma Ectopic corticotropin syndrome, e.g. small cell cancer of the lung
      Adrenal carcinoma is a cancer of the adrenal gland.
      Hyperplasia of the adrenal glands

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds
  • Question 25 - A 27-year-old man has been diagnosed with testicular cancer and has spread to...

    Incorrect

    • A 27-year-old man has been diagnosed with testicular cancer and has spread to the regional lymph nodes.

      The lymph from the testes will drain to which of the following nodes?

      Your Answer:

      Correct Answer: Para-aortic lymph nodes

      Explanation:

      Testes are retroperitoneal organs and its lymphatic drainage is to the lumbar and para-aortic nodes along the lumbar vertebrae.

      The scrotum is the one which drains into the nearby superficial inguinal nodes.

      The glans penis and clitoris drains into the deep inguinal lymph nodes.

    • This question is part of the following fields:

      • Abdomen And Pelvis
      • Anatomy
      0
      Seconds
  • Question 26 - A 56-year-old man presents with pneumonia 8 days after being admitted for an...

    Incorrect

    • A 56-year-old man presents with pneumonia 8 days after being admitted for an open fracture of his tibia and fibula. Upon history taking and observation, it was established that he has no known drug allergies, has coarse left basal crackles and evidence of consolidation in the left lower lobe based on his chest X-ray.

      Which of the following antibacterial agents would be the most appropriate to prescribe according to the latest NICE guidelines?

      Your Answer:

      Correct Answer: Ciprofloxacin

      Explanation:

      The current NICE guidelines for hospital-acquired pneumonia are as follow:
      – First-choice oral antibiotic if non‑severe symptoms or signs, and not at higher risk of resistance (guided by microbiological results when available): co-amoxiclav

      – Alternative oral antibiotics if non‑severe symptoms or signs, and not at higher risk of resistance, for penicillin allergy or if co‑amoxiclav unsuitable (based on specialist microbiological advice and local resistance data): doxycycline, cefalexin, co-trimoxazole, levofloxacin

      – First-choice intravenous antibiotics if severe symptoms or signs (for example, symptoms or signs of sepsis) or at higher risk of resistance (based on specialist microbiological advice and local resistance data): piperacillin with tazobactam, ceftazidime, ceftriaxone, cefuroxime, meropenem, ceftazidime with avibactam, levofloxacin

      – Antibiotics to be added if suspected or confirmed methicillin-resistant Staphylococcus aureus infection (dual therapy with a first-choice intravenous antibiotic): vancomycin, teicoplanin, linezolid

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
      Seconds
  • Question 27 - The second generation antihistamine, cetirizine is a less-sedating antihistamine than the older antihistamine,...

    Incorrect

    • The second generation antihistamine, cetirizine is a less-sedating antihistamine than the older antihistamine, chlorphenamine because:

      Your Answer:

      Correct Answer: It is less lipid-soluble so less able to cross the blood brain barrier.

      Explanation:

      All older antihistamines such as chlorphenamine cause sedation. The newer antihistamines e.g. cetirizine cause less sedation and psychomotor impairment than the older antihistamines because they are much less lipid soluble and penetrate the blood brain barrier only to a slight extent.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      0
      Seconds
  • Question 28 - A 22-year-old woman comes in with an asthmatic flare. Salbutamol is her only regular...

    Incorrect

    • A 22-year-old woman comes in with an asthmatic flare. Salbutamol is her only regular medication.

      What is the dosage per inhalation of a standard metered dose salbutamol inhaler?

      Your Answer:

      Correct Answer: 100 micrograms

      Explanation:

      The dose of a conventional metered dose inhaler is 100 micrograms per metered inhalation.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
      0
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  • Question 29 - Regarding acute lymphoblastic leukaemia (ALL), which of the following statements is CORRECT: ...

    Incorrect

    • Regarding acute lymphoblastic leukaemia (ALL), which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: ALL is the most common malignancy of childhood.

      Explanation:

      Acute lymphoblastic leukaemia (ALL) is caused by an accumulation of lymphoblasts in the bone marrow and is the most common malignancy of childhood. The incidence of ALL is highest at 3 – 7 years, with 75% of cases occurring before the age of 6. 85% of cases are of B-cell lineage. Haematological investigations reveal a normochromic normocytic anaemia with thrombocytopenia in most cases. The total white cell count may be decreased, normal or increased. The blood film typically shows a variable number of blast cells. The bone marrow is hypercellular with >20% blast cells.

    • This question is part of the following fields:

      • Haematology
      • Pathology
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  • Question 30 - 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:

      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
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SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular Pharmacology (1/1) 100%
Pharmacology (1/2) 50%
Gastrointestinal (0/1) 0%
Physiology (0/1) 0%
Abdomen (1/1) 100%
Anatomy (1/1) 100%
Haematology (1/1) 100%
Pathology (1/1) 100%
Evidence Based Medicine (0/1) 0%
Musculoskeletal Pharmacology (0/1) 0%
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