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Question 1
Correct
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Which of the following statements is false regarding the biceps brachii muscle?
Your Answer: It pronates the radioulnar joint in the forearm
Explanation:The biceps brachii muscle is one of the chief muscles of the arm. The origin at the scapula and the insertion into the radius of the biceps brachii means it can act on both the shoulder joint and the elbow joint, which is why this muscle participates in a few movements of the arm. It derives its name from its two heads which merge in one unique distal body, defining the unusual structure of the muscle.
The biceps brachii muscle is supplied by the musculocutaneous nerve (C5-C6), a branch of the brachial plexus.
Arterial supply to the biceps brachii muscle varies considerably, coming from up to eight vessels originating from the brachial artery in the middle third of the arm.
In the shoulder joint both muscle heads partially enforce opposite movements. The long head pulls the arm away from the trunk (abduction) and turns it inwards (inward rotation) whereas the short head pulls the arm back towards the trunk (adduction). When both heads contract simultaneously it leads to an arm bend (flexion). In the elbow joint the muscle bends the forearm (flexion) and rotates it outwards (supination). The supination is most powerful in a flexed elbow. In addition to the movement functions, the biceps has the important task to support the humeral head within the shoulder joint. Its antagonist is the triceps brachii in the posterior compartment of the arm.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 2
Correct
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What is the most common application of Nitrates?
Your Answer: Angina
Explanation:In patients with exertional stable angina, nitrates improve exercise tolerance, time to onset of angina, and ST-segment depression during exercise testing. In combination with beta-blockers or calcium channel blockers, nitrates produce greater anti-anginal and anti-ischemic effects.
While they act as vasodilators, coronary vasodilators, and modest arteriolar dilators, the primary anti ischemic effect of nitrates is to decrease myocardial oxygen demand by producing systemic vasodilation more than coronary vasodilation. This systemic vasodilation reduces left ventricular systolic wall stress. -
This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 3
Correct
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In adults, there are normally how many teeth:
Your Answer: 32
Explanation:In adults, there are 32 teeth, 16 in the upper jaw and 16 in the lower jaw. On each side in both upper and lower arches, there are two incisors, one canine, two premolars and three molar teeth.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 4
Correct
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Regarding the management of diabetic ketoacidosis (DKA), insulin should initially be given:
Your Answer: At a concentration of 1 unit/mL at a fixed rate of 0.1 units/kg/hour
Explanation:An intravenous insulin infusion should be started at a concentration of 1 unit/mL, at a fixed rate of 0.1 units/kg/hour. Established subcutaneous long-acting insulin therapy should be continued concomitantly. Blood ketone and blood glucose concentrations should be checked hourly and the insulin infusion rate adjusted accordingly. Blood ketone concentration should fall by at least 0.5 mmol/litre/hour and blood glucose concentration should fall by at least 3 mmol/litre/hour.
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This question is part of the following fields:
- Endocrine
- Pharmacology
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Question 5
Incorrect
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Question 6
Correct
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Following a bee sting, a 8-year old boy was transported to resus with symptoms and signs of an anaphylactic reaction. You decide to administer adrenaline IM stat. What is the recommended dose of intramuscular adrenaline?
Your Answer: 0.3 mL of 1:1000
Explanation:Anaphylaxis is a type I hypersensitivity reaction that is severe and life-threatening. It is marked by the fast onset of life-threatening airway and/or circulatory issues, which are generally accompanied by skin and mucosal abnormalities. When an antigen attaches to specific IgE immunoglobulins on mast cells, degranulation and the release of inflammatory mediators takes place (e.g. histamine, prostaglandins, and leukotrienes).
The most important medicine for treating anaphylactic responses is adrenaline. It decreases oedema and reverses peripheral vasodilation as an alpha-adrenergic receptor agonist. Its beta-adrenergic effects widen the bronchial airways, enhance the force of cardiac contraction, and inhibit the release of histamine and leukotriene. The first medicine to be given is adrenaline, and the IM route is optimal for most people.
In anaphylaxis, age-related dosages of IM adrenaline are:
150 mcg (0.15 mL of 1:1000) for a child under 6 years
300 mcg (0.3 mL of 1:1000) for a child aged 6 to 12 years
500 mcg (0.5 mL of 1:1000) for children aged 12 and above
500 mcg for adults (0.5 mL of 1:1000) -
This question is part of the following fields:
- Pharmacology
- Respiratory Pharmacology
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Question 7
Correct
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Which of the following clinical features is most suggestive of a lesion of the occipital lobe:
Your Answer: Homonymous hemianopia
Explanation:Homonymous hemianopia is a visual field defect involving either the two right or the two left halves of the visual fields of both eyes. It is caused by lesions of the retrochiasmal visual pathways, ie, lesions of the optic tract, the lateral geniculate nucleus, the optic radiations, and the cerebral visual (occipital) cortex
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 8
Correct
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All of the following statements are correct regarding penicillin antibiotics except:
Your Answer: Penicillins are of no use in meningitis as they are unable to penetrate into the cerebrospinal fluid.
Explanation:Penicillin penetration into the cerebrospinal fluid is generally poor. However, when the meninges are inflamed, as in meningitis, penetration of penicillin is increased. Benzylpenicillin should be given before transfer to hospital if meningococcal disease (meningitis with non-blanching rash or meningococcal septicaemia) is suspected, once this does not delay transfer.
Benzylpenicillin is no longer the drug of first choice for pneumococcal meningitis.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 9
Correct
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Which of the following statements about vitamin B12 absorption is TRUE:
Your Answer: On ingestion, vitamin B12 is bound to R protein which protects it from digestion in the stomach.
Explanation:The substance intrinsic factor,
essential for absorption of vitamin B12 in the ileum, is
secreted by the parietal cells along with the secretion of
hydrochloric acid. When the acid-producing parietal
cells of the stomach are destroyed, which frequently
occurs in chronic gastritis, the person develops not only
achlorhydria (lack of stomach acid secretion) but often
also pernicious anaemia because of failure of maturation
of the red blood cells in the absence of vitamin B12 stimulation of the bone marrow. -
This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 10
Incorrect
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Regarding Clostridium species, which of the following statements is INCORRECT:
Your Answer: They are Gram-positive.
Correct Answer: They are facultative anaerobes.
Explanation:Clostridium spp. are obligatory anaerobic spore-forming Gram-positive bacilli. Toxin production is the main pathogenicity mechanism.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 11
Correct
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Which of the following muscles is NOT involved in depression of the mandible:
Your Answer: Masseter
Explanation:Depression of the mandible is generated by the digastric, geniohyoid, mylohyoid and lateral pterygoid muscles on both side, assisted by gravity. The lateral pterygoid muscles are also involved as this movement also involves protraction of the mandible. The masseter muscle is a powerful elevator of the mandible.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 12
Correct
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You've been summoned to a young man in the resus area who is experiencing an SVT. You decide to use adenosine after trying several vagal manoeuvres without success.
Which of the following is the correct adenosine mechanism of action?Your Answer: Opens K + channels in the heart
Explanation:The purine nucleoside adenosine is used to diagnose and treat paroxysmal supraventricular tachycardia. Adenosine works by stimulating A1-adenosine receptors and opening potassium channels that are sensitive to acetylcholine. This causes the atrioventricular (AV) node’s cell membrane to become hyperpolarized, slowing conduction by inhibiting calcium channels.
Patients who have had a heart transplant are extremely sensitive to the effects of adenosine and should start with a lower dose of 3 mg, then 6 mg, and finally 12 mg.Dipyridamole potentiates the effects of adenosine, so it should be used with caution in patients who are taking it.
The use of adenosine is contraindicated in the following situations:
Asthma
COPD (chronic obstructive pulmonary disease)
Decompensated heart failure
Long QT syndrome
AV block in the second or third degree
Sinusitis is a condition in which the sinuses become (unless pacemaker fitted)
Hypotension that is severe -
This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 13
Correct
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A patient presents with a cough, productive of green sputum and fever. He was commenced on antibiotics 4 days earlier, but his condition has worsened. There is a documented history of penicillin allergy, and the GP prescribed erythromycin.
Erythromycin exert its pharmacological effect by binding to?
Your Answer: The 50S subunit of the bacterial ribosome
Explanation:Macrolides are bacteriostatic antibiotics. They act by binding to the 50S subunit of the bacterial ribosome and inhibit translocation, therefore, inhibiting protein synthesis.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 14
Correct
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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: 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
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Question 15
Incorrect
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Your consultant requests that you do a lumbar puncture on a patient who is suspected of having meningitis. This patient, a 15-year-old female, presented to the emergency department with a fever, headache, and neck stiffness. Where should you aspirate a sample of CSF?
Your Answer: Epidural space
Correct Answer: Subarachnoid space
Explanation:A lumbar puncture, also known as a spinal tap, is a procedure that involves inserting a needle into the lower back’s lumbar region.
A needle is inserted into the space between the arachnoid mater and the pia mater, also known as the subarachnoid space, to remove a sample of cerebrospinal fluid.
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This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 16
Correct
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A suicidal patient had lacerated his wrist, which resulted in an ulnar nerve injury. Which of the following will confirm the presence of an ulnar nerve injury?
Your Answer: Claw hand appearance
Explanation:An ulnar injury may result in abnormal sensations in the little finger and ring finger, usually on the palm side, weakness, and loss of coordination of the fingers.
A claw like deformity of the hand and wrist is present. Pain, numbness, decreased sensation, tingling, or burning sensation in the areas controlled by the nerve are also possible.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 17
Incorrect
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A young boy is carried by his friends to the Emergency Department in an unconscious state. He is quickly moved into the resuscitation room.
He was at a party with friends and has injected heroin. On examination, his GCS is 6/15, and he has bilateral pinpoint pupils and a very low respiratory rate of 6 breaths per minute.
Which of the following is the first-line treatment for this patient?Your Answer: Naloxone 2 mg IV
Correct Answer: Naloxone 0.8 mg IV
Explanation:Heroin is injected into the veins and is the most commonly abused drug. Acute intoxication with opioid overuse is the most common cause of death by drug overdose.
The clinical features of opioid overdose are:
1. Decreased respiratory rate
2. Reduced conscious level or coma
3. Decreased bowel sounds
4. Miotic (constricted) pupils
5. Cyanosis
6. Hypotension
7. Seizures
8. Non-cardiogenic pulmonary oedema (with IV heroin usage)The main cause of death secondary to opioid overdose is respiratory depression, which usually occurs within 1 hour of the overdose. Vomiting is also common, and aspiration can occur.
Naloxone is a short-acting, specific antagonist of mu(μ)-opioid receptors. It is used to reverse the effects of opioid toxicity.
It can be given by a continuous infusion if repeated doses are required and the infusion rate is adjusted according to the vital signs. Initially, the infusion rate can be set at 60% of the initial resuscitative IV dose per hour.
Naloxone has a shorter duration of action (6-24 hours) than most opioids, and so close monitoring according to the respiratory rate and depth of coma with repeated injections is necessary. When repeated doses are needed in opioid addicts, naloxone administration may precipitate a withdrawal syndrome with abdominal cramps, nausea and diarrhoea, but these usually settle within 2 hours.
An initial dose of 0.4 to 2 mg can be given intravenously and can be repeated at 2 to 3-minute intervals to a maximum of 10mg.
If the intravenous route is inaccessible, naloxone can be administered via an IO line, subcutaneously (SQ), IM, or via the intranasal (IN) route.
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This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
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Question 18
Incorrect
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Regarding bias, which of the following statements is CORRECT:
Your Answer: Randomisation eliminates bias from a study.
Correct Answer: Bias leads to the systematic difference between the results from a study and the true states of affair.
Explanation:Bias is the term used to describe an error at any stage of the study that was not due to chance. Bias leads to the systematic difference between the results from a study and the true states of affair. Bias may be introduced at all stages of the research process, from study design, through to analysis and publication. Bias can create a spurious association or mask a real association.Good research design can reduce the effect of bias (e.g. blinding, randomisation) but they cannot eliminate it completely. Increasing the sample size does not reduce bias.
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This question is part of the following fields:
- Evidence Based Medicine
- Study Methodology
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Question 19
Correct
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Regarding threadworms, which of the following statements is CORRECT:
Your Answer: First line treatment of threadworms is with mebendazole.
Explanation:First line treatment of threadworms is with mebendazole, with treatment of the whole family, and a repeat treatment after 2 weeks. Threadworms live in the large bowel, but direct multiplication of worms does not occur here. Threadworms most commonly infect children, and may be symptomatic or cause pruritus ani.
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This question is part of the following fields:
- Microbiology
- Pathogens
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Question 20
Incorrect
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Identify the type of graph described below:
This graph is a scatter plot of the effect estimates from individual studies against some measure of each study's size or precision.
Your Answer: Kaplan-Meier plot
Correct Answer: Funnel plot
Explanation:A funnel plot is a scatter plot of the effect estimates from individual studies against some measure of each study’s size or precision. The standard error of the effect estimate is often chosen as the measure of study size and plotted on the vertical axis with a reversed scale that places the larger, most powerful studies towards the top. The effect estimates from smaller studies should scatter more widely at the bottom, with the spread narrowing among larger studies. In the absence of bias and between study heterogeneity, the scatter will be due to sampling variation alone and the plot will resemble a symmetrical inverted funnel. A triangle centred on a fixed effect summary estimate and extending 1.96 standard errors either side will include about 95% of studies if no bias is present and the fixed effect assumption (that the true treatment effect is the same in each study) is valid.
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This question is part of the following fields:
- Evidence Based Medicine
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Question 21
Correct
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A 2nd-year medical student is solving an exam paper with questions about the immune system. She comes across a question regarding innate immunity. Innate immunity is the immunity naturally present within the body from birth.
Which ONE of the following is not a part of this type of immunity?Your Answer: Antibody production
Explanation:Innate immunity, also called non-specific immunity, refers to the components of the immune system naturally present in the body at birth.
The components of innate immunity include:
1) Natural Killer Cells
2) Neutrophils
3) Macrophages
4) Mast Cells
5) Dendritic Cells
6) Basophils.Acquired or adaptive immunity is acquired in response to infection or vaccination. Although the response takes longer to develop, it is also a more long-lasting form of immunity.
The components of this system include:
1) T lymphocytes
2) B lymphocytes
3) Antibodies -
This question is part of the following fields:
- General Pathology
- Pathology
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Question 22
Incorrect
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A newborn baby is rushed to the neonatal ICU 4 hours after birth due to sudden onset severe jaundice and generalised oedema. Family history reveals that this is the second baby, while blood testing shows that the mother has an Rh-negative blood group while the baby is Rh-positive. A diagnosis of haemolytic disease of the newborn is established.
Which one of the following hypersensitivity reactions have occurred in this case?Your Answer: Type IV hypersensitivity reaction
Correct Answer: Type II hypersensitivity reaction
Explanation:Hepatitis A usually doesn’t pose a special risk to a pregnant woman or her baby. Maternal infection doesn’t result in birth defects, and a mother typically doesn’t transmit the infection to her baby. HAV is almost always transmitted by the faecal-oral route and is usually acquired through close personal contact or via contaminated food.
When a woman has chickenpox in the first 20 weeks of pregnancy, there is a 1 in 50 chance for the baby to develop a set of birth defects. This is called the congenital varicella syndrome. It includes scars, defects of muscle and bone, malformed and paralyzed limbs, small head size, blindness, seizures, and intellectual disability.
TORCH Syndrome refers to infection of a developing foetus or newborn by any of a group of infectious agents. “TORCH” is an acronym meaning (T)oxoplasmosis, (O)ther Agents, (R)ubella (also known as German Measles), (C)ytomegalovirus, and (H)erpes Simplex.
Infection with any of these agents may cause a constellation of similar symptoms in affected newborns. These may include fever; difficulties feeding; small areas of bleeding under the skin, causing the appearance of small reddish or purplish spots; enlargement of the liver and spleen (hepatosplenomegaly); yellowish discoloration of the skin, whites of the eyes, and mucous membranes (jaundice); hearing impairment; abnormalities of the eyes; and other symptoms and findings. -
This question is part of the following fields:
- General Pathology
- Pathology
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Question 23
Incorrect
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Regarding cytotoxic T cells, which of the following statements is CORRECT:
Your Answer:
Correct Answer: They kill target cells by inducing cell apoptosis.
Explanation:CD8+ T-cells (Cytotoxic T cells)
Recognise antigen only in association with HLA Class I molecules (found on all nucleated cells; present endogenous antigens such as those found in cells infected by viruses or intracellular bacteria.)
Comprise about 25% of peripheral T-cells
Responsible for cytotoxic killing of target cells -
This question is part of the following fields:
- Immune Responses
- Pathology
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Question 24
Incorrect
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Polyuria and polydipsia develop in a patient with a history of affective disorder, who has been on long-term lithium treatment. She has a fluid deprivation test done because she is suspected of having nephrogenic diabetic insipidus. Which of the following urine osmolality findings would be the most reliable in confirming the diagnosis?
Your Answer:
Correct Answer: After fluid deprivation <300 mosmol/kg, after IM desmopressin >800 mosmol/kg
Explanation:The inability to produce concentrated urine is a symptom of diabetes insipidus. Excessive thirst, polyuria, and polydipsia are all symptoms of this condition. There are two forms of diabetes insipidus: Nephrogenic diabetes insipidus and cranial (central) diabetes insipidus.
A lack of ADH causes cranial diabetic insipidus. Patients with cranial diabetes insipidus can have a urine output of up to 10-15 litres per 24 hours, however most patients can maintain normonatraemia with proper fluid consumption. Thirty percent of cases are idiopathic, while another thirty percent are caused by head injuries. Neurosurgery, brain tumours, meningitis, granulomatous disease (e.g. sarcoidosis), and medicines like naloxone and phenytoin are among the other reasons. There is also a very rare hereditary type that is linked to diabetes, optic atrophy, nerve deafness, and bladder atonia.
Renal resistance to the action of ADH causes nephrogenic diabetes insipidus. Urine output is significantly increased, as it is in cranial diabetes insipidus. Secondary polydipsia can keep serum sodium levels stable or raise them. Chronic renal dysfunction, metabolic diseases (e.g., hypercalcaemia and hypokalaemia), and medications, such as long-term lithium use and demeclocycline, are all causes of nephrogenic diabetes insipidus.
The best test to establish if a patient has diabetes insipidus vs another cause of polydipsia is the water deprivation test, commonly known as the fluid deprivation test. It also aids in the distinction between cranial and nephrogenic diabetes insipidus. Weight, urine volume, urine osmolality, and serum osmolality are all measured after patients are denied water for up to 8 hours. At the end of the 8-hour period, 2 micrograms of IM desmopressin is given, and measures are taken again at 16 hours.
The following are the way results are interpreted:
Urine osmolality after fluid deprivation : Urine osmolality after IM desmopressin
Cranial diabetes insipidus: <300 mosmol/kg : >800 mosmol/kg
Nephrogenic diabetes insipidus: <300 mosmol/kg : <300 mosmol/kg
Primary polydipsia: >800 mosmol/kg : >800 mosmol/kg -
This question is part of the following fields:
- Physiology
- Renal Physiology
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Question 25
Incorrect
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Regarding the extensor carpi ulnaris muscle, which of the following statements is true?
Your Answer:
Correct Answer: It receives its blood supply from the ulnar artery
Explanation:Extensor carpi ulnaris is a fusiform muscle in the posterior forearm. It spans between the elbow and base of the little finger. This muscle belongs to the superficial forearm extensor group, along with anconaeus, brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum and extensor digiti minimi muscles.
Like all the muscles of this compartment, extensor carpi ulnaris works as an extensor of the wrist. Moreover, due to its specific course, this muscle also acts to adduct the hand.
Extensor carpi ulnaris is innervated by the posterior interosseous nerve (C7, C8), a branch of the deep division of the radial nerve. The radial nerve stems from the posterior cord of the brachial plexus.
Blood supply to the extensor carpi ulnaris muscle is provided by branches of the radial recurrent and posterior interosseous arteries, which stem from the radial and ulnar arteries, respectively.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 26
Incorrect
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A 78-year-old man complains of lumps in his neck. Several large, non-tender cervical lymph nodes are discovered during your examination.
You arrange for some blood tests, and the results reveal that he has lymphocytosis with a count of 16 x 10 9 /l.
In this case, what is the most likely diagnosis?Your Answer:
Correct Answer: Chronic lymphocytic leukaemia
Explanation:The most common type of adult leukaemia is chronic lymphocytic leukaemia (CLL). It develops as a result of relatively mature lymphocytes clonally proliferating. The B-cell lineage accounts for approximately 95% of cases. CLL is primarily a disease of adult men, with men over the age of 50 accounting for more than 75% of CLL patients.
It is the most indolent form of chronic leukaemia, and it is frequently discovered by chance when blood counts are taken for other reasons, such as ‘well man’ screening tests. The patient may develop lymphadenopathy, hepatosplenomegaly, anaemia, and infections as the disease progresses.
The following are examples of CLL laboratory findings:
Clonal B cell lymphocytosis (diagnosed at greater than 5 x 109/l, but can reach 300 x 109/l)
In advanced disease, normocytic, normochromic anaemia is present.Patients with autoimmune-related haemolytic anaemias have a positive direct antiglobulin test (DAT).
Although bone marrow aspiration is not always required, it can aid in the diagnosis of CLL. If there has been rapid lymph node enlargement, a lymph node biopsy is required to rule out Richter’s syndrome. This is the transition from low-grade lymphoma to high-grade lymphoma, which is characterised by fever, weight loss, and pain.
Although there is no cure for CLL, it can be managed with chemotherapy regimens that help patients live longer. Early treatment has no benefit, and the standard treatment for early disease is to watch and wait, with examinations and blood counts every 3 to 12 months. Chemotherapy is usually reserved for patients who have a disease that is active and causing symptoms.
The following is the overall prognosis for CLL:
1/3 will not require treatment and will live a long time.
1/3 will go through an indolent phase before the disease progresses.
1/3 of patients will have an aggressive disease that requires immediate treatment. -
This question is part of the following fields:
- Haematology
- Pathology
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Question 27
Incorrect
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A 28-year-old asthmatic patient is seen in the Emergency Department following an acute exacerbation. His symptoms start to improve when your consultant gives him a high dose of IV aminophylline.
Which of the following is correct mechanism of action of aminophylline ?Your Answer:
Correct Answer: Inhibition of phosphodiesterase
Explanation:Aminophylline has the following properties:
Phosphodiesterase inhibitor that increases intracellular cAMP and relaxes smooth muscle in the bronchial airways and pulmonary blood vessels.
Mast cell stabilization is achieved by using a non-selective adenosine receptor antagonist. -
This question is part of the following fields:
- Pharmacology
- Respiratory Pharmacology
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Question 28
Incorrect
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You are about to give an antimuscarinic agent to a 55 year-old male patient. Which of the following conditions will make you with stop the administration, since it is a contraindication to antimuscarinic agents?
Your Answer:
Correct Answer: Prostatic enlargement
Explanation:Antimuscarinic medications may impair the contractility of bladder smooth muscle, resulting in acute urine retention in men with BPH, and should be avoided or used with caution.
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This question is part of the following fields:
- Gastrointestinal
- Pharmacology
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Question 29
Incorrect
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Which of the following causes the first heart sound?
Your Answer:
Correct Answer: Closing of the atrioventricular valves
Explanation:The heart sounds are as a result of the various parts of the cardiac cycle.
Heart Sound – Phase of Cardiac Cycle – Mechanical Event:
1st heart sound – Systole starts – there is closure of the atrioventricular (mitral & tricuspid) valves
2nd heart sound – Systole ends – there is closure of the semilunar (aortic and pulmonary) valves
3rd heart sound – Early diastole – this is caused by rapid flow of blood from the atria into the ventricles during the ventricular filling phase
4th heart sound – Late diastole – this is caused by filling of an abnormally stiff ventricle in atrial systole -
This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 30
Incorrect
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A 53-year-old man arrives at the emergency department complaining of visual impairment in his right eye. On examination, you notice that neither his right nor left pupil constricts when you shine a light in his right eye. When you flash a light in his left eye, the pupils of both his left and right eyes constrict. Which of the following nerves is the most likely to be affected:
Your Answer:
Correct Answer: Optic nerve
Explanation:In full optic nerve palsy, the afferent pupillary light reflex is lost. Because the afferent optic nerve does not sense light flashed in the afflicted eye, the ipsilateral direct and contralateral consensual reflexes are gone. However, the contralateral direct and ipsilateral consensual reflexes are intact because the efferent oculomotor nerve is normal.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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SESSION STATS - PERFORMANCE PER SPECIALTY
